Task force III: Computers in diagnostic electrocardiography

Rautaharju, Pentti M.; Ariet, Mario; Pryor, T. Allan; Arzbaecher, Robert; Bailey, John R.; Bonner, Raymond; Goetowski, Charles R.; Hooper, James K.; Klein, Virginia; Millar, Caroline; Milliken, John A.; Mortara, David; Pipberger, Hubert V.; Pordy, L; Sandberg, Russell L.; Simmons, Roger L.; Wolf, H. K.

doi:10.1016/0002-9149(78)90150-9

Cited by 45 publications

(24 citation statements)

References 10 publications

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“…Thus in each individual the vectorcardiographic diagnosis generated by both the statistical and the deterministic classifiers was assessed with reference not to the electrocardiographer's opinion but to objective, ECG-independent reference derived from clinical evidence and catheterization data. 17 Figure 1 shows typical data from a patient with BVH whose VCG was analyzed by both methods.…”

Section: Methodsmentioning

confidence: 99%

Computer interpretation of pediatric orthogonal electrocardiograms: statistical and deterministic classification methods.

Brohet¹,

Robert²,

Derwael³

et al. 1984

Circulation

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Statistical multivariate and conventional deterministic methods of computerized interpretation of the electrocardiogram (ECG) were compared in the analysis of 1711 pediatric orthogonal ECGs validated by nonelectrocardiographic criteria on the basis of clinical and anatomic diagnoses. Among 642 children catheterized for the evaluation of congenital heart disease, there were 140 patients with left ventricular hypertrophy, 299 with right ventricular hypertrophy, and 203 with biventricular hypertrophy. A group of 1069 obviously healthy school children was studied as a control. The overall accuracy of multigroup ECG diagnosis was 85% and 79% for the statistical and deterministic methods, respectively. The diagnostic performances of both methods expressed in terms of sensitivity and predictive value were the highest for normal children and those with right ventricular hypertrophy and lowest for children with biventricular hypertrophy. The statistical method was more sensitive in the diagnosis of left ventricular hypertrophy (74% vs 64%), right ventricular hypertrophy (86% vs 83%), and biventricular hypertrophy (62% vs 50%). Mutual agreement for a correct diagnosis by the two methods was 83% for normal children and 82% for those with right ventricular hypertrophy but only 61% for children with left ventricular hypertrophy and 39% for those with biventricular hypertrophy.

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Section: Methodsmentioning

confidence: 99%

Computer interpretation of pediatric orthogonal electrocardiograms: statistical and deterministic classification methods.

Brohet¹,

Robert²,

Derwael³

et al. 1984

Circulation

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“…The most recent comprehensive AHA recommendations for the standardization of leads and general technical requirements of ECG instruments were published in 1975. 5 In 1978, task forces of the American College of Cardiology produced a collection of reports on optimal electrocardiography, 7 which addressed standardization of terminology and interpretation, 13 the development of databases, 6 the quality of ECG records, 12 computers in diagnostic cardiology, 9 the use of ECGs in practice, 10 cost-effectiveness of the ECG, 11 and a discussion of future directions. 14 In Europe, international common standards for quantitative electrocardiography (CSE) evolved from the work of Willems and colleagues.…”

Section: The Ecg and Its Technologymentioning

confidence: 99%

“…As discussed in prior sections of this statement, the fidelity of measurements used in diagnostic algorithms is determined by the technical issues that affect signal processing. 9,23,28,42,146 These signalprocessing methods include signal preparation (sampling, filtering, and template formation), feature extraction, and measurement. [147][148][149][150][151] Time-coherent simultaneous lead data and the construction of representative template complexes are critical to the reliability of feature extraction and measurement; global measurements of duration may be systematically smaller when time-coherent data are not used.…”

Section: Technologymentioning

confidence: 99%

“…The database must contain sufficient cases with varying degrees of abnormality, ranging from mild to severe cases, and a representative distribution of common confounding conditions. 6,9,17,161 The statistics of well-documented populations have been used to develop diagnostic algorithms that no longer simply mimic the human reader. 162 Similarly, it has also been shown that the addition of vector loop criteria (or the equivalent information deduced from simultaneous leads) improves 12-lead ECG diagnoses.…”

Section: Technologymentioning

confidence: 99%

“…Beyond the technical issues of measurement fidelity, evaluation of the performance of ECG programs is difficult. 9,15,17,163 Programs may be compared with diagnoses of an expert cardiologist or consensus of expert cardiologists or with diagnoses ascertained by independent data. The CSE group evaluated 15 ECG and vectorcardiographic analysis programs against a reference database that included documented cases of ventricular hypertrophy and myocardial infarction, 15 diagnoses that are strongly dependent on accurate measurement of amplitudes and durations and should favor computer analysis.…”

Section: Technologymentioning

confidence: 99%

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Recommendations for the Standardization and Interpretation of the Electrocardiogram

Kligfield¹,

Gettes²,

Bailey³

et al. 2007

Circulation

Self Cite

495

152

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Abstract-This statement examines the relation of the resting ECG to its technology. Its purpose is to foster understanding of how the modern ECG is derived and displayed and to establish standards that will improve the accuracy and usefulness of the ECG in practice. Derivation of representative waveforms and measurements based on global intervals are described. Special emphasis is placed on digital signal acquisition and computer-based signal processing, which provide automated measurements that lead to computer-generated diagnostic statements. Lead placement, recording methods, and waveform presentation are reviewed. Key Words: AHA Scientific Statements Ⅲ electrocardiography Ⅲ computers Ⅲ diagnosis Ⅲ electrophysiology Ⅲ intervals Ⅲ potentials Ⅲ tests I n the century since the introduction of the string galvanometer by Willem Einthoven, 1 the electrocardiogram (ECG) has become the most commonly conducted cardiovascular diagnostic procedure and a fundamental tool of clinical practice. 2,3 It is indispensable for the diagnosis and prompt initiation of therapy in patients with acute coronary syndromes and is the most accurate means of diagnosing intraventricular conduction disturbances and arrhythmias. Its interpretation may lead to the recognition of electrolyte abnormalities, particularly of serum potassium and calcium, and permit the detection of some forms of genetically mediated electrical or structural cardiac abnormalities. The ECG is routinely used to monitor patients treated with antiarrhythmic and other drugs, in the preoperative assessment of patients undergoing noncardiac surgery, and in screening individuals in high-risk occupations and, in some The American Heart Association, the American College of Cardiology, and the Heart Rhythm Society make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest. Copies: This document is available on the World Wide Web sites of the American Heart Association (www.americanheart.org) and the American College of Cardiology (www.acc.org). A single reprint is available by calling 800-242-8721 (US only) or writing the American Heart Association, Public Information, 7272 Greenville Ave, Dallas, TX 75231-4596. Ask for reprint No. 71-0389. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.americanheart.org/presenter.jhtml? Identifierϭ4431. A link to the "Permission Request Form" appears on the right side of the page.© 2007 American...

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A new microcomputer‐based ecg analysis system

Kyle

Klingeman

Conrad

et al. 1983

Clinical Cardiology

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Summary:A new automated ECG system using advances in microprocessor technology and computerized electrocardiography is described. This microcomputer-based system is self-contained and mobile. It acquires both the 12-lead and orthogonal lead (Frank) electrocardiograms and analyzes the latter within minutes. Software includes the program developed in the Veterans Administration which uses advanced statistical classification techniques and a large well-documented patient data base. Diagnostic probabilities are computed using a Bayesian approach. Diagnostic performance has been tested using independent clinical criteria and found to be quite accurate. This system enables the clinician to immediately review the computer's identifications, measurements, and diagnostic classifications and quickly * The ECG system was conceived by Jack Klingeman, who since 1965, has specialized in diagnostic techniques for noninvasive evaluation of cardiovascular disease. In cooperation with the other authors he implemented the system and began demonstrating its usefulness to the medical community. He completed the initial manuscript describing the system shortly before his death on July 27, 1982. use these results in clinical decision making. Serial comparisons are readily made since all previous recordings are stored on floppy diskettes. The use of microprocessors in this system makes it economically feasible for practicing physicians.

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Task force III: Computers in diagnostic electrocardiography

Cited by 45 publications

References 10 publications

Computer interpretation of pediatric orthogonal electrocardiograms: statistical and deterministic classification methods.

Computer interpretation of pediatric orthogonal electrocardiograms: statistical and deterministic classification methods.

Recommendations for the Standardization and Interpretation of the Electrocardiogram

A new microcomputer‐based ecg analysis system

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