Automatic identification of a stable QRST complex for non-invasive evaluation of human cardiac electrophysiology

Background A vectorcardiography approach to electrocardiology contributes to the non-invasive assessment of electrical heterogeneity in the ventricles of the heart and to risk stratification for cardiac events including sudden cardiac death. The aim of this study was to develop an automatic method t...

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Main Authors: Gunilla Lundahl, Lennart Gransberg, Gabriel Bergqvist, Göran Bergström, Lennart Bergfeldt, Elena G. Tolkacheva
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498068/?tool=EBI
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author Gunilla Lundahl
Lennart Gransberg
Gabriel Bergqvist
Göran Bergström
Lennart Bergfeldt
Elena G. Tolkacheva
author_facet Gunilla Lundahl
Lennart Gransberg
Gabriel Bergqvist
Göran Bergström
Lennart Bergfeldt
Elena G. Tolkacheva
author_sort Gunilla Lundahl
collection DOAJ
description Background A vectorcardiography approach to electrocardiology contributes to the non-invasive assessment of electrical heterogeneity in the ventricles of the heart and to risk stratification for cardiac events including sudden cardiac death. The aim of this study was to develop an automatic method that identifies a representative QRST complex (QRSonset to Tend) from a Frank vectorcardiogram (VCG). This method should provide reliable measurements of morphological VCG parameters and signal when such measurements required manual scrutiny. Methods Frank VCG was recorded in a population-based sample of 1094 participants (550 women) 50–65 years old as part of the Swedish CArdioPulmonary bioImage Study (SCAPIS) pilot. Standardized supine rest allowing heart rate stabilization and adaptation of ventricular repolarization preceded a recording period lasting ≥5 minutes. In the Frank VCG a recording segment during steady-state conditions and with good signal quality was selected based on QRST variability. In this segment a representative signal-averaged QRST complex from cardiac cycles during 10s was selected. Twenty-eight morphological parameters were calculated including both conventional conduction intervals and VCG-derived parameters. The reliability and reproducibility of these parameters were evaluated when using completely automatic and automatic but manually edited annotation points. Results In 1080 participants (98.7%) our automatic method reliably selected a representative QRST complex where its instability measure effectively identified signal variability due to both external disturbances (”noise”) and physiologic and pathophysiologic variability, such as e.g. sinus arrhythmia and atrial fibrillation. There were significant sex-related differences in 24 of 28 VCG parameters. Some VCG parameters were insensitive to the instability value, while others were moderately sensitive. Conclusion We developed an automatic process for identification of a signal-averaged QRST complex suitable for morphologic measurements which worked reliably in 99% of participants. This process is applicable for all non-invasive analyses of cardiac electrophysiology including risk stratification for cardiac death based on such measurements.
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spelling doaj.art-d786d40fe0a8432798bdb2538ce7d88c2022-12-21T19:03:24ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01159Automatic identification of a stable QRST complex for non-invasive evaluation of human cardiac electrophysiologyGunilla LundahlLennart GransbergGabriel BergqvistGöran BergströmLennart BergfeldtElena G. TolkachevaBackground A vectorcardiography approach to electrocardiology contributes to the non-invasive assessment of electrical heterogeneity in the ventricles of the heart and to risk stratification for cardiac events including sudden cardiac death. The aim of this study was to develop an automatic method that identifies a representative QRST complex (QRSonset to Tend) from a Frank vectorcardiogram (VCG). This method should provide reliable measurements of morphological VCG parameters and signal when such measurements required manual scrutiny. Methods Frank VCG was recorded in a population-based sample of 1094 participants (550 women) 50–65 years old as part of the Swedish CArdioPulmonary bioImage Study (SCAPIS) pilot. Standardized supine rest allowing heart rate stabilization and adaptation of ventricular repolarization preceded a recording period lasting ≥5 minutes. In the Frank VCG a recording segment during steady-state conditions and with good signal quality was selected based on QRST variability. In this segment a representative signal-averaged QRST complex from cardiac cycles during 10s was selected. Twenty-eight morphological parameters were calculated including both conventional conduction intervals and VCG-derived parameters. The reliability and reproducibility of these parameters were evaluated when using completely automatic and automatic but manually edited annotation points. Results In 1080 participants (98.7%) our automatic method reliably selected a representative QRST complex where its instability measure effectively identified signal variability due to both external disturbances (”noise”) and physiologic and pathophysiologic variability, such as e.g. sinus arrhythmia and atrial fibrillation. There were significant sex-related differences in 24 of 28 VCG parameters. Some VCG parameters were insensitive to the instability value, while others were moderately sensitive. Conclusion We developed an automatic process for identification of a signal-averaged QRST complex suitable for morphologic measurements which worked reliably in 99% of participants. This process is applicable for all non-invasive analyses of cardiac electrophysiology including risk stratification for cardiac death based on such measurements.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498068/?tool=EBI
spellingShingle Gunilla Lundahl
Lennart Gransberg
Gabriel Bergqvist
Göran Bergström
Lennart Bergfeldt
Elena G. Tolkacheva
Automatic identification of a stable QRST complex for non-invasive evaluation of human cardiac electrophysiology
PLoS ONE
title Automatic identification of a stable QRST complex for non-invasive evaluation of human cardiac electrophysiology
title_full Automatic identification of a stable QRST complex for non-invasive evaluation of human cardiac electrophysiology
title_fullStr Automatic identification of a stable QRST complex for non-invasive evaluation of human cardiac electrophysiology
title_full_unstemmed Automatic identification of a stable QRST complex for non-invasive evaluation of human cardiac electrophysiology
title_short Automatic identification of a stable QRST complex for non-invasive evaluation of human cardiac electrophysiology
title_sort automatic identification of a stable qrst complex for non invasive evaluation of human cardiac electrophysiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498068/?tool=EBI
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