[Beat-by-beat validation of the Oxford Medilog 4500, a 24-hour long-term ECG system with real-time analysis].
We compared the annotation of the AHA and MIT databases beat-to-beat with the classification preformed by the microprocessor of a 24-hour ambulatory electrocardiographic device, based on real-time analysis. Sensitivity and positive predictive accuracy for QRS detection were 99.9% (99.9%) and 99.9% (99.8%) for the AHA database (MIT database respectively). Sensitivity and positive predictive accuracy were 99.1% (96.6%) and 98.3% (94.9%) for ventricular ectopic beats, 98.3% (91.8%) and 96.0% (63.0%) for couplets and 96.4% (74.2%) and 99.2% (41.1%) for salvoes. On 90% of the AHA tapes (MIT tapes) sensitivity and positive predictive accuracy were at least 93.8% (76.6%) and 92.7% (65.5%) for ventricular ectopic beats, at least 98.0% (96.3%) and 54.5% (0%) for couplets and at least 100% (66.6%) and 100% (0%) for salvoes. A sensitivity of 100% was achieved for ventricular ectopic beats on 56% (45%), for couplets on 90% (82%) and for salvoes on 95% (84%) of the AHA tapes (MIT tapes). A positive predictive accuracy of 100% was achieved for ventricular ectopic beats on 49% (52%), for couplets on 76% (61%) and for salvoes on 97% (75%) of the AHA tapes (MIT tapes). Real-time analysis of the Oxford Medilog 4500 proved sufficient for QRS detection and classification of ventricular ectopic beats. The quantification of frequent couplets and salvoes was sufficient, too. Sporadic false-positive detections of complex ventricular ectopic beats produced the false Lown grade IVA/IVB on 10% of the tapes as a consequence. The final computer report must hence be edited by a physician.
D000572:American Heart Association; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D005117:Cardiac Complexes, Premature / Q000175:diagnosis; D003201:Computers; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000295:instrumentation*; D006339:Heart Rate; D006801:Humans; D007256:Information Systems / Q000295:instrumentation; D008838:Microcomputers; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D012815:Signal Processing, Computer-Assisted; D012984:Software; D014481:United States
Schlaggenaue Validierung des Oxford Medilog 4500, eines 24-Stunden-Langzeit-EKG-Systems mit Echtzeitanalyse.