Abstract
The TELAVIV system for computerised arrhythmia detection and identification in ambulatory ECGs has been extended to include a reliable and rapid computerised method for ST-segment analysis. It now incorporates self-learning analysis and classification of ST-segment changes. Some advantages for ST-segment analysis present in this algorithm are: (a) it analyses three channels simultaneously instead of one or two in other systems; (b) it includes a larger number of parameters describing the ST-segment changes; (c) the measurements are detected from a noise-free template, averaged over 20 beats; (d) isoelectric and J-points are detected by a self-learning process; (e) a scoring system has been added; and (f) it now has the capability to detect and classify arrhythmias and ST-segment changes simultaneously. The system was tested on three types of recordings: 30 1 h recordings in which ST-changes were observed in the quick summary plot produced by the TELAVIV system; 12 recordings taken during submaximal effort; and 13 recordings made during conventional ergometry. The results indicated a high level of sensitivity and specificity of the program.
Similar content being viewed by others
References
Akselrod, S., Norymberg, M., Karabelnik, E., Peled, I., Rosenberg, N. andGreen, M. (1986) Computerized analysis of ST-segment changes detected on ambulatory electrocardiograms. 2nd Int. Symp. Holter Monitoring Israel, Abst. no. 1.
Allen, R. D., Gettes, L. S., Phalan, C. andAvington, M. D. (1976) Painless ST-segment depression in patients with angina pectoris: correlation with daily activities and cigarette smoking.Chest,69, 467–473.
Armstrong, W. F. andMorris, S. N. (1983) The ST segment during ambulatory electrocardiographic monitoring.Ann. Int. Med.,98, 249–250.
Balasubramanian, V., Lahiri, A., Green, H. L., Stott, F. D. andRaftery, E. B. (1980) Ambulatory ST segment monitoring. Problems, pitfalls, solutions, and clinical application.Br. Heart J.,44, 419–425.
Bragg-Remschel, D. A., Anderson, C. M. andWinkle, R. A. (1982) Frequency response characteristics of ambulatory ECG monitoring systems and their implications for ST-segment analysis.Am. Heart. J.,103, 20–31.
Gallino, A., Smith, G., Chierchia, S., Croom, M., Morgan, M., Marchesi, C. andMaseri, A. (1983) Computerised detection of ST segment changes on 24 hour Holter tapes: comparison with commerical systems. Computers in Cardiology, 1983, IEEE Computer Society, 487–490.
Holmes, J., Kubo, S. H., Cody, R. J. andKligfield, P. (1985) Arrhythmias in ischemic and nonischemic dilated cardiomyopathy: prediction of mortality by ambulatory electrocardiography.Am. J. Cardiol.,55, 146–151.
Holter, N. J. (1961) New method for heart studies.Science,134, 1214–1220.
Ishimaru, Y., Yanaga, T., Sato, Y., Ichimaru, M., Ueno, T. andOtsuka, K. (1983) Rapid digital analysis of the ST-T segment of the 24-hour ambulatory electrocardiographic monitoring. Computers in Cardiology, 1983, IEEE Computer Society, 479–482.
Nygards, M. E., Ringqvist, I., Ahren, T., Johansson, K., Jonason, T., Lundin, L., Nilsson, G. andWalker, A. (1983) Automated analysis of ST segment changes in ambulatory ECG recordings. Computers in Cardiology, 1983, IEEE Computer Society, 89–92.
Pahlm, O. andSörnmo, L. (1984) Software QRS detection in ambulatory monitoring—a review.Med. & Biol. Eng. & Comput.,22, 289–297.
Pipberger, H. V., Arzbaecher, R. C., Berson, A. S., Briller, S. A., Brody, D. A., Flowers, N. C., Geselowitz, D. B., Lepeschkin, E., Oliver, G. C., Schmitt, O. H. andSpach, M. (1975) Recommendations for standardization of leads and specifications for instruments in electrocardiography and vectorcardiography: Report of the Committee on Electrocardiography, American Heart Association.Circulation,52, 11.
Rosenberg, N., Tartakovsky, M. B., Elkin, S. andRon, S. (1977) Automated analysis of three-channel Holter records taken in a factory environment. Computers in Cardiology, 1977, IEEE Computer Society, 177–180.
Rosenberg, N., Ron, S., Cocos, M. andGreen, M. (1985) Arrhythmia detection in Holter records—reliability of multilead vs. single-lead analysis. Computers in Cardiology, 1985, IEEE Computer Society, 415–418.
Schang, S. J. andPepine, C. J. (1977) Transient asymptomatic S-T segment depression during daily activity.Am. J. Cardiol.,39, 396–402.
Selwyn, A. P., Shea, M., Deanseld, V. E., Wilson, R., Horlock, P. andO'Brien, H. A. (1986) Character of transient ischemia in angina pectoris. ——Ibid.,58, 21b-25b.
Stern, S. andTzivoni, D. (1974) Early detection of silent ischaemic heart disease by 24-hour electrocardiographic monitoring of active subjects.Br. Heart J.,36, 481–486.
Stern, S., Tzivoni, D. andStern, Z. (1975) Diagnostic accuracy of ambulatory ECG monitoring in ischemic heart disease.Circulation,52, 1045–1049.
Tzivoni, D., Benhorin, J., Gavish, A. andStern, S. (1985) Holter recording during treadmill testing in assessing myocardial ischemic changes.Am. J. Cardiol.,55, 1200–1203.
Tzivoni, D., Gavish, A., Benhorin, J., Keren, A. andStern, S. (1986) Myocardial ischemia during daily activities and stress. ——Ibid.,58, 47b-50b.
Wolf, E., Tzivoni, D. andStern, S. (1974) Comparison of exercise tests and 24-hour ambulatory monitoring in detection of ST-T changes.Br. Heart J.,36, 90–95.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Akselrod, S., Norymberg, M., Peled, I. et al. Computerised analysis of ST segment changes in ambulatory electrocardiograms. Med. Biol. Eng. Comput. 25, 513–519 (1987). https://doi.org/10.1007/BF02441743
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02441743