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Identification of post-myocardial infarction patients with ventricular tachycardia by time-domain intra-QRS analysis of signal-averaged electrocardiogram and magnetocardiogram

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Abstract

A new time-domain analysis method, which quantifies ECG/MCG intra-ORS fragmentation, is applied to parts of the QRS complex to identify postmyocardial infarction patients with ventricular tachycardia. Three leads of signalaveraged electrocardiograms and nine leads of magnetocardiograms were band-pass filtered (74Hz to 180Hz). The filtered signals showed fragmentation in the QRS region, which was quantified by the number of peaks M and a score S, that is the product of M and the sum of the peak amplitudes. Both parameters were determined for the first 80 ms of the QRS complex and the total QRS complex in each channel. For classification, the mean-values of the parameters M and S of the three electrical leads and the nine magnetic leads were calculated. Late potential and late field analyses were performed for the same signals. 31 myocardial infarction patients were included, 20 of them with a history of documented ventricular tachycardia (VT). Identification of VT patients using the SAECG led to better results (sensitivity 95%, specificity 91%) considering the entire QRS complex than with the standard late potential analysis suggested by Simson (sensitivity 90%, specificity 73%). For the SAMCG and the entire QRS complex results using the parameters S and M are also better (sensitivity 95%, specificity 100%) than for the late field analysis (sensitivity 90% and specificity 100%). For the first 80 ms, the performance of the parameters M and S is only slightly decreased.

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References

  • Brockmeier, K., Schmidt, S., Kreiseler, D., Trahms, L., Schmitz, L., Oeff, M. andHahlbohm, H. D. (1994): ‘Fragmented yenticular depolarization in the QRS complex of the magnetocardiogram after filtering with binomial non-recursive filters' in Computers in Cardiology’ (IEEE Computer Society Press), pp. 685–687

  • Brcckmeier, K., Schmitz, L., Bobadilla Chavez, J., Burghoff, M., Koch, H., Zimmermann, R. andTrahms, L. (1997): Magnetocardiography and 32-lead potential mapping: repolarization in normal subjects during pharmacologically induced stress’,J. Caranovasc. Electrophysiol.,8, pp. 615–626

    Google Scholar 

  • Cain, M. E., Ambos, H. D. andLindsay, B. D. (1987): ‘Fast Fourier transform analysis of the signal averaged electrocardiogram in the management of patients with or prone to ventricular tachycardia or fibrillation’ inBrugada, P. andWellems, H. (Eds), J. Cardiac arrhythmia: “Where to go from here?” (Futura Publishing Company, Mount Kisko, NY), pp. 311–328

    Google Scholar 

  • Chan, K. Y. (1996). ‘Acceleration spectrum analysis: a novel quantitative method for frequency-domain analysis of the signal-averaged electrocardiogram’,A.N.E.,1(3), pp. 306–315

    Google Scholar 

  • Endt, P., Hahlbohm, H.-D., Kreiseler, D., Oeff, M., Steinhoff, U. andTrahms, L. (1998): ‘Fragmentation of the band-pass filtered QRS complex of patients prone to malignant arrhythmia’,Med. Bual. Eng. Comput.,36, pp. 723–728

    Google Scholar 

  • Endt, P., Montonen, J., Mäkijärvi, M., Nenonen, J., Steinhoff, U., Trahms, L. andKatila, T. (1997): ‘Time domain analysis of the main QRS complex can identify myocardial infarction patients with ventricular tachycardia’. Proc. World Congress on Medical Physics and Bromedical Engineering’, p. 438

  • Gomis, P., Jones, D. L., Caminal, P., Berbari, E. J. andLander, P. (1997): ‘Analysis of abnormal signals within QRS complex of the high-resolution electrocardiogram’,IEEE Trans. BME,44, pp. 681–693

    Google Scholar 

  • Haas, J., Leder, U., Heinke, M., Nowak, H., Kuhnert, H. andFigulla, H. (1999): ‘Late fields in magnetocardiography and late potentials in electrocardiography after acute myocardial infarction’,Z. Nardiol.,88, pp. 566–573

    Google Scholar 

  • Haberl, R., Jilge, G., Pulter, R. andSteinbeck, G. (1988): ‘Comparison of frequency- and time-domain analysis of the signal-averaged electrocardiograms in patients ventricular tachycardia’,J. Am. Coll. Cardiol.,12, pp. 150–158

    Google Scholar 

  • Hood, M. A., Pogwiszd, S. M., Peirick, J. andCain, M. E. (1992): ‘Contribution of myocardium responsible for ventricular tachycardia to abnormalities detected by analysis of signal-averaged ECGs’,Circulation,86, pp. 1888–1901

    Google Scholar 

  • Hren, R., Steinhoff, U., Gessner, C., Endt, P., Goedde, P., Agrawal, R., Oeff, M., Lux, R. andTrahms, L. (1999): ‘Value or magnetocardiographic QRST integral maps in the identification of patients at risk of ventricular arrhythmias’,Pacing Clin. Electrophysiol.,22, pp. 1292–1304

    Google Scholar 

  • Kelhä, V., Pukki, J., Peltonen, R., Penttinen, A., Ilmoniemi, R. andHeino, J. (1982): ‘Design, construction, and performance of a large-volume magnetic shield’,IEEE Trans. Magn.,18, pp. 260–270

    Google Scholar 

  • Kelen, G. J., Henkin, R., Starr, A.-M., Caref, E., Bloomfield, D. A. andEl-Sherif, N. (1991): ‘Spectral-turbulence analysis of the signal-averaged electrocardiogram and its predictive accuracy for inducible sustained monomorphic ventricular tachycardia’,Am. J. Cardiol.,67, pp. 965–975

    Article  Google Scholar 

  • Kienzle, M. G., Falcone, R. A. andSimson, M. S. (1988): ‘Alterations in the initial portion of the signal averaged QRS complex in acute myocardial infarction with ventricular tachycardia’,Am. J. Cardiol.,61, pp. 99–103

    Google Scholar 

  • Korhonen, P., Montonen, J., Paavola, M., Mäkijärvi, M. andKatila, T. (1996): ‘Criteria for magnetocardiographic post-infarction arrhythmia risk assessment’,Eur. Heart J. (Proc. ESC 1996), p. 502

  • Lander, P., Gomis, P., Goyal, R., Berbari, E. J., Caminal, P., Lazzara, R. andSteinberg, J. S. (1997): ‘Analysis of abnormal intra-QRS potentials’,Circulation,95, pp. 1386–1393

    Google Scholar 

  • Leder, U., Haueisen, J., Huck, M. andNowak, H. (1998): ‘Noninvasive imaging of arrhythmogenic left-ventricular myocardium after infarction’,Lancet,352, p. 1825

    Article  Google Scholar 

  • Link, A., Trahms, L., Zimmermann, R. andOeff, M. (1994): ‘Complex-binomial band-pass filters for analysing phase and envelope of high-frequency components in cardiac signals’, in ‘Computers in Cardiology’ (IEEE Computer Society Press), pp. 617–629

  • Montonen, J., Mäkijärvi, M., Paavola, M., Leiniö, M., Siltanen, P. andKatila, T. (1995): Comparison of time domain and spectrotemporal domain analysis of high resolution magneto- and electrocardiographic recordings of myocardial infarction patients with and without ventricular tachycardia’ inBaumgartner, C., Deecke, L., Stroink, G., Willamson, S. J. (Eds) ‘Biomagnetism: fundamental research and clinical applications’ (Elsevier Science/IOS Press), pp. 624–627

  • Müller, H., Goedde, P., Czerski, K., Oeff, M., Agrawal, R., Endt, P., Kruse, W., Steinhoff, U. andTrahms, L. (1999): ‘Magnetocardiographic analysis of the two-dimensional distribution of intra-QRS fractionated activation’,Phys. Med. Biol.,44, pp. 105–120

    Article  Google Scholar 

  • Oeff, M., Leder, U., Endt, P., Brockmeier, K., Hennig, L. andTrahms, L. (1995): ‘Abnormal intraventricular activation in patients with malignant tachyarrhythmias detected by magnetocardiography’,PACE,18 (Part II), p 925

    Google Scholar 

  • Paavola, M. (1995): ‘Feature analysis of magnetocardiographic mappings’, Master's thesis, Helsinki University of Technology (in Finnish

  • Saarinen, M., Siltanen, P., Karp, P. andKatila, T. (1978): ‘The normal magnetocardiogram: I morphology’,Ann. Clin. Res.,10, pp. 1–43

    Google Scholar 

  • Schramm, J., Frumento, C., Dickhaus, H., Schmitt, C. andBrachmann, J. (1991): ‘Ventricular late potentials in patients with and without inducible sustained ventricular tachycardia: a combined analysis in the time and frequency domain’,Eur. Heart J., 12, pp. 563–572

    Google Scholar 

  • Simson, M. B. (1981): ‘Use of signals in the terminal QRS complex to identify patients with ventricular tachycardia after myocardial infarction’,Circulation,64, pp. 235–242

    Google Scholar 

  • Simson, M. B. (1983): ‘Electrocardiographic means and method for detecting potential ventricular tachycardia’ U.S. Patent 4,, 27 Dec. 1983

  • Weissmüller, P., Richter, P. Abraham-Fuchs, K., Härer, W., Schneider, S., Höher, M., Koch, M., Edrich, J. andHombach, V. (1993): ‘Spatial-differences of the duration if ventricular late fields in the signal-averaged magnetocardiogram in patients with ventricular late potentials’,PACE,16, pp. 70–79

    Google Scholar 

  • Winklmaier, M., Achenbach S., Kaltenhäuser, M., Moshage, W. andDaniel, W. G (1998): ‘Einfluß der Gewebsimpedanz auf das EKG und MKG Signal: eine Phantomstudie' in Biomdezinische Technik, Band 43, Ergänzungsband 1, pp. 354–355

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Authors and Affiliations

  1. Laboratory of Biomedical Engineering, Helsinki University of Technology, Finland

    P. Endt, J. Montonen, J. Nenonen & T. Katila

  2. Division of Cardiology, Helsinki University Central Hospital, Finland

    M. Mäkijärvi

  3. BioMag Laboratory, Helsinki University Central Hospital, Finland

    J. Montonen, M. Mäkijärvi & J. Nenonen

  4. Physikalisch Technische Bundesanstalt, Berlin, Germany

    P. Endt, U. Steinhoff & L. Trahms

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  1. P. Endt
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  2. J. Montonen
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  3. M. Mäkijärvi
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  4. J. Nenonen
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  5. U. Steinhoff
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  6. L. Trahms
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  7. T. Katila
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Correspondence to P. Endt.

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Endt, P., Montonen, J., Mäkijärvi, M. et al. Identification of post-myocardial infarction patients with ventricular tachycardia by time-domain intra-QRS analysis of signal-averaged electrocardiogram and magnetocardiogram. Med. Biol. Eng. Comput. 38, 659–665 (2000). https://doi.org/10.1007/BF02344872

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  • DOI: https://doi.org/10.1007/BF02344872

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