Comparative study of local and Karhunen-Loève-based ST-T indexes in recordings from human subjects with induced myocardial ischemia.
In this work we studied ST-T complex changes in the ECG as result of induced ischemia. The principal aim was to determine whether global changes in the ST-T complex were more sensitive markers of ischemic alterations than those based on measurements of changes at specific locations on ST segment or T wave. High-resolution ECGs from patients undergoing percutaneous transluminal coronary angioplasty in one of the major coronary arteries were analyzed to give a description of the period from the end of active depolarization (QRS complex) to the end of active repolarization (T wave). During artery occlusion traditional local measurements of the ST-T complex were compared to global measurements based on the Karhunen-Loève transform. An ischemic change sensor parameter was estimated for each of the studied indexes showing that global measurements detected changes better in the repolarization period in a larger number of leads and with higher sensitivity (more than 85%) than was done using local measurements (sensitivity of 64% with ST level, 33% with T-wave maximum position, and 37% with T-wave maximum amplitude). Using these global indexes it was found that most cases of ST-segment changes were accompanied by T-wave changes (72% of patients). With the use of traditional indexes 23% of patients showed no changes in the repolarization period, whereas with global indexes this percentage decreased to 8%. Thus a global representation of the entire ST-T complex appears to be more suitable than local measurements when studying the initial stages of myocardial ischemia.
García
J
J
Departamento de Ingeniería Electrónica y Comunicaciones, Universidad de Zaragoza, Spain. jogarmo@posta.unizar.es
Lander
P
P
Sörnmo
L
L
Olmos
S
S
Wagner
G
G
Laguna
P
P
D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary; D003198:Computer Simulation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008433:Mathematics; D009203:Myocardial Infarction / Q000503:physiopathology*; D012680:Sensitivity and Specificity