title: Automatic QRS Selvester scoring system in patients with left bundle branch block.
abstract: OBJECTIVE
  The Selvester QRS scoring system uses quantitative criteria from the standard 12-lead electrocardiogram (ECG) to estimate the myocardial scar size of patients, including those with left bundle branch block (LBBB). Automation of the scoring system could facilitate the clinical use of this technique which requires a set of multiple QRS patterns to be identified and measured.
  
  
  RESULTS
  We developed a series of algorithms to automatically detect and measure the QRS parameters required for Selvester scoring. The 'QUantitative and Automatic REport of Selvester Score' was designed specifically for the analysis of ECGs from patients meeting new strict criteria for complete LBBB. The algorithms were designed using a training (n = 36) and a validation (n = 180) set of ECGs, consisting of signal-averaged 12-lead ECGs (1000 Hz sampling) recorded from 216 LBBB patients from the MADIT-CRT. We assessed the performance of the methods using expert manually adjudicated ECGs. The average of absolute differences between automatic and adjudicated Selvester scoring was 1.2 ± 1.5 points. The range of average differences for continuous measurements of wave locations and interval durations varied between 0 and 6 ms. Erroneous detection of Q, R, S, R', and S' waves (oversensed or missed) were 3, 1, 1, 16, and 6%, respectively. Seven percent of notches detected in the first 40 ms were misdetected.
  
  
  CONCLUSIONS
  We propose an efficient computerized method for the automatic measurement of the Selvester score in patients with the strict LBBB.
authors: Heart Research Follow-Up Program, Cardiology Division, University of Rochester Medical Center, 265 Crittenden Boulevard, PO Box 653, Rochester, NY 14642, USA heartjxx@heart.rochester.edu.
authors: Xiaojuan
authors: X
authors: Xia
authors: Clinical Physiology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden.
authors: Björn
authors: B
authors: Wieslander
authors: Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD, USA.
authors: David G
authors: DG
authors: Strauss
authors: Duke Clinical Research Institute, Duke University, Durham, NC, USA.
authors: Galen S
authors: GS
authors: Wagner
authors: Heart Research Follow-Up Program, Cardiology Division, University of Rochester Medical Center, 265 Crittenden Boulevard, PO Box 653, Rochester, NY 14642, USA.
authors: Wojciech
authors: W
authors: Zareba
authors: Heart Research Follow-Up Program, Cardiology Division, University of Rochester Medical Center, 265 Crittenden Boulevard, PO Box 653, Rochester, NY 14642, USA.
authors: Arthur J
authors: AJ
authors: Moss
authors: Heart Research Follow-Up Program, Cardiology Division, University of Rochester Medical Center, 265 Crittenden Boulevard, PO Box 653, Rochester, NY 14642, USA.
authors: Jean-Philippe
authors: JP
authors: Couderc
mesh_terms: D000200:Action Potentials; D000465:Algorithms; D001331:Automation; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D003951:Diagnostic Errors / Q000517:prevention & control; D004562:Electrocardiography / Q000379:methods*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted
keywords: Electrocardiography; Left bundle branch block; Selvester QRS scoring system