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ECG-Based Detection of Early Myocardial Ischemia in a Computational Model: Impact of Additional Electrodes, Optimal Placement, and a New Feature for ST Deviation

Loewe, A. ORCID iD icon 1; Schulze, W. H. W. 1; Jiang, Y. 1; Wilhelms, M. 1; Luik, A.; Dössel, O. 1; Seemann, G. 1
1 Institut für Biomedizinische Technik (IBT), Karlsruher Institut für Technologie (KIT)

Abstract:

In case of chest pain, immediate diagnosis of myocardial ischemia is required to respond with an appropriate treatment. The diagnostic capability of the electrocardiogram (ECG), however, is strongly limited for ischemic events that do not lead to ST elevation. This computational study investigates the potential of different electrode setups in detecting early ischemia at 10 minutes after onset: standard 3-channel and 12-lead ECG as well as body surface potential maps (BSPMs). Further, it was assessed if an additional ECG electrode with optimized position or the right-sided Wilson leads can improve sensitivity of the standard 12-lead ECG. To this end, a simulation study was performed for 765 different locations and sizes of ischemia in the left ventricle. Improvements by adding a single, subject specifically optimized electrode were similar to those of the BSPM: 2-11% increased detection rate depending on the desired specificity. Adding right-sided Wilson leads had negligible effect. Absence of ST deviation could not be related to specific locations of the ischemic region or its transmurality. As alternative to the ST time integral as a feature of ST deviation, the K point deviation was introduced: the baseline deviation at the minimum of the ST-segment envelope signal, which increased 12-lead detection rate by 7% for a reasonable threshold. ... mehr


Volltext §
DOI: 10.5445/IR/1000052173
Originalveröffentlichung
DOI: 10.1155/2015/530352
Scopus
Zitationen: 15
Web of Science
Zitationen: 13
Dimensions
Zitationen: 17
Cover der Publikation
Zugehörige Institution(en) am KIT Institut für Biomedizinische Technik (IBT)
Publikationstyp Zeitschriftenaufsatz
Publikationsjahr 2015
Sprache Englisch
Identifikator ISSN: 2314-6133
urn:nbn:de:swb:90-521735
KITopen-ID: 1000052173
Erschienen in BioMed Research International
Verlag Hindawi
Band 2015
Seiten 530352/1-11
Bemerkung zur Veröffentlichung Gefördert durch den KIT-Publikationsfonds
Nachgewiesen in Web of Science
Scopus
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