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Computer analysis of intraoperative cardiac rhythms using esophageal and surface leads

  • Andrew F. Marks
  • Dwayne R. Westenskow
  • Theodore H. Stanley
Article

Abstract

Esophageal ECG lead and computer as arrhythmia monitor were evaluated in 6 dogs and 23 patients. In dogs arrhythmias were induced by an epinephrine infusion during halothane anesthesia. The computer identified 1858 irregular beats, a cardiologist 2130. Bigeminy was correctly identified 82% of the time, trigeminy 72%, couplets 29%, and ventricular tachycardia 45%. The false positive rate was .03%. In the operating room the monitor identified an average of 44 abnormal beats per patient. In 5 patients junctional rhythm was correctly identified. This study shows the feasibility of using an esophageal ECG lead for computerized ventricular and supraventricular arrhythmia monitoring in the operating room.

Keywords

arrhythmia monitor esophageal ECG intraoperative cardiac arrhythmia computer monitoring esophageal ECG electrodes 

References

  1. 1.
    Kates RA, Zaidan JR, Kaplan JA: Esophageal lead for intraoperative electrocardiographic monitoring. Anesth Analg 61: 781–785, 1982.PubMedCrossRefGoogle Scholar
  2. 2.
    Sherif NE, EL-Ramly Z, Sorour AH: Oesophageal electrocardiography in the study of cardiac arrhythmias. Brit Heart J 31: 414–424, 1969.PubMedCrossRefGoogle Scholar
  3. 3.
    Kistin AD, Bruce JC: Simultaneous esophageal and standard electrocardiographic leads for the study of cardiac arrhythmias. Am Heart J 53: 65–73, 1957.PubMedCrossRefGoogle Scholar
  4. 4.
    Miyahara H, Whipple GH, Teager HM, Webb TW, Theophilis CA, Dohi Y: Cardiac arrhythmia diagnosis by digital computer. Comput Biomed Res 1: 277, 1968.PubMedCrossRefGoogle Scholar
  5. 5.
    Wilems JL, Pipberger HV: Arrhythmia detection by digital computer. Comput Biomed Res 5: 263, 1972.CrossRefGoogle Scholar
  6. 6.
    Haywood JL, Murthy VK, Harvey GA, Saltzberg S: On-line real-time computer algorithm for monitoring the ECG waveform. Comput Biomed Res 3: 15, 1970.PubMedCrossRefGoogle Scholar
  7. 7.
    LeBlanc AR, Roberge FA: Present state of arrhythmia analysis by computer. Can Med Assoc J 108: 1239, 1973.PubMedGoogle Scholar
  8. 8.
    Fozzard H, Kinias P: Computers for recognition and management of arrhythmias. Med Clinics North Amer 60: 291–298, 1976.Google Scholar
  9. 9.
    Jenkins JM, Uw D, Arzbaecher RC: Computer diagnosis of abnormal cardiac rhythms employing a new P-wave detector for interval measurement. Comput Biomed Res 11: 17–33, 1978.PubMedCrossRefGoogle Scholar
  10. 10.
    Jenkins JM, Kao T: Parallel processing in a two-channel arrhythmia monitor. IEEE Frontiers of Eng in Health Care: 222–225, 1982.Google Scholar
  11. 11.
    Jenkins J, Wu D, and Arzbaecher R: Extension of a single-beat algorithm into classification of arrhythmias in context. Comp in Card: 305–309, 1977.Google Scholar
  12. 12.
    Rey W, Laird J, Hugenholtz P: P-wave detection by digital computer. Comput Biomed Res 4: 509–522, 1971.PubMedCrossRefGoogle Scholar
  13. 13.
    Jenkins JM, Wu D, Arzbaecher RC: Computer diagnosis of supraventricular and ventricular arrhythmias: A new esophageal technique. circulation 60 (5): 977–985, 1979.PubMedGoogle Scholar
  14. 14.
    Goldreyer BNL: Intracardiac electrocardiography in the analysis and understanding of cardiac arrhythmias. Ann Intern Med 77: 117–136, 1972.PubMedGoogle Scholar
  15. 15.
    Kistin AD, Bruce JC: Simultaneous esophageal and standard electrocardiographic leads for the study of cardiac arrhythmias. Am Heart J 53: 65–73, 1957.PubMedCrossRefGoogle Scholar
  16. 16.
    Copeland GD, Tullis IF, Brody DA: Clinical evaluation of a new esophageal electrode, with particular reference to the bipolar esophageal electrocardiogram. Am Heart J 53: 862–873, 1959.Google Scholar
  17. 17.
    Marks AF: A microcomputer based ventricular and supraventricular arrhythmia monitor, MS thesis, University of Utah, Salt Lake City, 1982.Google Scholar
  18. 18.
    Hulting J: Detection of asystole, ventricular fibrillation and ventricular tachycardia with automated ecg monitoring. Acta Med Scand 205: 17–23, 1979.PubMedGoogle Scholar
  19. 19.
    Kuo S, Dillman R: Computer detection of ventricular fibrillation. Computers in Cardiology: 347–349, 1978.Google Scholar
  20. 20.
    Severinghaus JW: An esophageal probe monitoring device. Anesth 18: 145–149, 1957.Google Scholar
  21. 21.
    Becker CM, Malhotra IV, and Hedley-Whyte J: The distribution of radiofrequency current and burns. Anesth 38: 106–122, 1973.CrossRefGoogle Scholar
  22. 22.
    Leeming MN, Roy C, Howland WS: Low voltage direct current burns. J Amer Med Ass 214: 1681–1684, 1970.CrossRefGoogle Scholar
  23. 23.
    Newbower RS, Cooper JB: Comments on an esophageal multiprobe for temperature, electrocardiogram, and heart and lung sound measurements. IEEE Tran Biomed Eng 26: 309, 1979.CrossRefGoogle Scholar
  24. 24.
    Demer JL, Mylrea KC, Adler L, Jewett WR. An esophageal multiprobe for temperature, electrocardiogram, and heart and lung sounds measurements. IEEE Trans Biomed Eng 25: 377–380, 1978.PubMedCrossRefGoogle Scholar

Copyright information

© Martinus Nijhoff Publishers 1984

Authors and Affiliations

  • Andrew F. Marks
    • 1
  • Dwayne R. Westenskow
    • 1
  • Theodore H. Stanley
    • 1
  1. 1.Department of AnesthesiologyUniversity of UtahSalt Lake CityUSA

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