RESUMEN
Lorenz plot (LP) method which gives a global view of long-time electrocardiogram signals, is an efficient simple visualization tool to analyze cardiac arrhythmias, and the morphologies and positions of the extracted attractors may reveal the underlying mechanisms of the onset and termination of arrhythmias. But automatic diagnosis is still impossible because it is lack of the method of extracting attractors by now. We presented here a methodology of attractor extraction and recognition based upon homogeneously statistical properties of the location parameters of scatter points in three dimensional LP (3DLP), which was constructed by three successive RR intervals as , and axis in Cartesian coordinate system. Validation experiments were tested in a group of RR-interval time series and tags data with frequent unifocal premature complexes exported from a 24-hour Holter system. The results showed that this method had excellent effective not only on extraction of attractors, but also on automatic recognition of attractors by the location parameters such as the azimuth of the points peak frequency ( ) of eccentric attractors once stereographic projection of 3DLP along the space diagonal. Besides, was still a powerful index of differential diagnosis of atrial and ventricular extrasystole. Additional experiments proved that this method was also available on several other arrhythmias. Moreover, there were extremely relevant relationships between 3DLP and two dimensional LPs which indicate any conventional achievement of LPs could be implanted into 3DLP. It would have a broad application prospect to integrate this method into conventional long-time electrocardiogram monitoring and analysis system.
RESUMEN
Uninterrupted monitoring of multiple subjects is required for mass causality events, in hospital environment or for sports by medical technicians or physicians. Movement of subjects under monitoring requires such system to be wireless, sometimes demands multiple transmitters and a receiver as a base station and monitored parameter must not be corrupted by any noise before further diagnosis. A Bluetooth Piconet network is visualized, where each subject carries a Bluetooth transmitter module that acquires vital sign continuously and relays to Bluetooth enabled device where, further signal processing is done. In this paper, a wireless network is realized to capture ECG of two subjects performing different activities like cycling, jogging, staircase climbing at 100 Hz frequency using prototyped Bluetooth module. The paper demonstrates removal of baseline drift using Fast Fourier Transform and Inverse Fast Fourier Transform and removal of high frequency noise using moving average and S-Golay algorithm. Experimental results highlight the efficacy of the proposed work to monitor any vital sign parameters of multiple subjects simultaneously. The importance of removing baseline drift before high frequency noise removal is shown using experimental results. It is possible to use Bluetooth Piconet frame work to capture ECG simultaneously for more than two subjects. For the applications where there will be larger body movement, baseline drift removal is a major concern and hence along with wireless transmission issues, baseline drift removal before high frequency noise removal is necessary for further feature extraction.
Asunto(s)
Diagnóstico , Electrocardiografía , Análisis de Fourier , Trote , Ruido , Deportes , Signos VitalesRESUMEN
Objective: To investigate the clinical value of ambulatory electrocardiogram and the neutrophils to lymphocytes ratio (NLR) in the diagnosis on Kawasaki disease combined with changes of coronary artery for children. Methods: 80 children with Kawasaki disease were enrolled in the research. According to the combined situation of coronary artery disease, all of children with combined coronary artery disease were divided in observation group (48 cases) and the children without combined coronary artery disease were divided in control group (32 cases). All of children received the examinations of dynamic electrocardiogram, routine electrocardiogram, ultrasound cardiogram scan and blood routine detection within 15d of occurring disease. And the amounts of neutrophil and lymphocyte, and change of dynamic electrocardiogram of all of children were recorded and analyzed. And then the amounts of neutrophil and lymphocyte and the NLR of the two groups were further compared. Results: The sinus tachycardia, atrioventricular block, abnormal average heart rate and the proportions of total abnormal number of observation group were significantly higher than that of control group, and the difference of total number of ambulatory electrocardiographic abnormality between the two groups were significant (x2=20.112, P<0.05). The results of ambulatory electrocardiogram for Kawasaki disease combined with abnormal coronary artery were significantly higher than that of control group (x2=17.778, P<0.05). Compared with control group, the coronary artery ectasia was more larger, the amount of neutrophils would be more greater in observation group, and the difference between the two groups was significant (t=-3.464, P<0.05). Besides, the difference of NLR between patients with mild ectasia of observation group and patients of control group was significantly (t=2.976, P<0.05). Conclusion: Dynamic electrocardiogram and the NLR have important significance in the diagnosis for children with Kawasaki disease combined with the change of coronary artery.
RESUMEN
Objective: To explore the advantage of RR-Lorenz plot (RR-LP) in analyzing the patients of sinus rhythm with long RR interval. Methods: A total of 308 RR-LP patients with long RR interval were retrospectively studied. The patients were divided into 7 groups according to the type of long RR intervals. ① Sinus bradycardia with arrhythmia group, n=63,②Repeated transient sinus arrest group, n=16, ③Ⅱ° sino-atrial block group, n=14, ④Ⅱ° atrial ventricular block (Ⅱ° AVB) group, n=47, ⑤ Un-passed atrial premature beats (APB) group, n=28, ⑥ Atrial premature beats group, n=72 and ⑦ Premature ventricular beats group, n=68. We analyzed the patients of RR interval greater than 1500 ms with ambulatory electrocardiogram record. Results: ①RR-LP of sinus bradycardia with arrhythmia group showed a single distributing area with 1500 ms for the origin of transverse and longitudinal axis with B line slope at 1, tilt angle of 45°.②RR-LP of repeated transient sinus arrest,Ⅱ° sino-atrial block,Ⅱ° AVB and APB groups showed special four distributing areas with B line slope at (0.51 ± 0.01), tilt angle of (23.04 ± 0.50) °, B line slope at 0.6, tilt angle of (27°), B line slope at (0.57 ± 0.21), tilt angle of (25.69 ± 9.59)° and B line slope at (0.50 ± 0.01), tilt angle of (22.59 ± 0.54) ° respectively.③RR-LP of premature beats groups showed special four regional distributing areas, B line slope for atrial premature beats was at (0.38 ± 0.12), tilt angle of (17.06 ± 5.22) ° and B line slope for ventricular premature beats was at (0.07 ± 0.05), tilt angle of (3.02 ± 2.39) °. Conclusion: RR-LP in patients of sinus rhythm with long RR interval had speciifc morphology and distribution features, the local abnormality could be found in a plane via all RR intervals which provided a differential diagnosis for repeated occurrence of short RR interval.
RESUMEN
Objective To investigate relation between atrial enlargement and pathogenesis of atrial tach yarrhythmia.Methods 786 patients were observed with atrial tachyarrhythmia through 24-hour electrocardiographic monitoring,echocardiographic was used to analysis atrial enlargement.Results The patient with left atrial enlargement in atrial tachyarrhythmia was more than those with right atrial enlargement(73.82%vs 21.25%,P＜0,01).Conclusions Atrial enlargement,especially left atrial enlargement,was the one of most important pathogeny in atrial tachyarrhythmia.The enhancement of pressure and muscle tension in atrial were the major factors of electronicphysiobgy disorganization,and the left atrial was the leading position in patients with electronicphysiology abnormity.
RESUMEN
Objective To develop a real-time QRS complex detection algorithm of dynamic ECG signals for the GPRS mobile telemonitoring system. Methods Before the first and second derivatives of ambulatory ECG signals were processed by moving average method, the signals sampled from CM5 monitoring lead were filtered with the average of continuous four ECG sample signal points. The R waves could be detected precisely by local minima of second derivatives and Q & S waves were located correctly by cross-zero points of first derivatives of ambulatory ECG signals in a short-time searching windows. The QRS recognition thresholds, which could revise themselves according to the detected values and vary with the analyzing signals, were designed in this paper. Results With a polynomial computation complexity, the novel algorithm insensitive to baseline draft and noise caused by mobile communication filtered power-line interference and most of muscle noise and reduced the search time below 0.02 s during detecting each Q wave, R wave and S wave. For the normal and clinical patients, this algorithm correctly detected up to 99.8% of the QRS complex of ambulatory ECG signals. Conclusion The algorithm can meet the need of real-time QRS complex detection and analysis for the GRRS mobile ECG telemonitoring system.
RESUMEN
This paper introduces the basic principle,structure of Holter analysis system as well as its introduction,clinical application and development in China.In addition,it also lists some common errors which occurred in the use of the equipment in the past few years and their solutions.
RESUMEN
Objetivo Avaliar correlação entre alterações do segmento ST indicativas de isquemia miocárdica, detectadas pela monitorização eletrocardiográfica ambulatorial, e os achados da cinecoronariografia. Métodos Cinqüenta pacientes, 48 homens, com idades entre 20 e 73 (média 49 ± 13) anos, divididos em três grupos: I) assintomático (16 pacientes, 32%); II) precordialgia atípica (15 pacientes, 30%); e III) angina (19 pacientes, 38%). Procedeu-se à monitorização eletrocardiográfica ambulatorial por período de 24 horas, utilizando-se o sistema Cardiac Care Units (Compass TM). Os pacientes que apresentaram alterações do segmento ST, compatíveis com isquemia miocárdica transitória foram submetidos à cinecoronariografia. Quando esta foi considerada normal, o estudo foi complementado pela ecocardiografia e pelo teste de esforço. Resultados A presença de doença coronária ateroesclerótica (lesões obstrutivas ou fluxo lento) foi constatada em 24 (48%) pacientes. Em 26 (52%) pacientes, as artérias coronárias se apresentaram normais. Dentre esses, em 18 (36%) a ecocardiografia mostrou alqum tipo de afecção ou alteração anatômica (hipertrofia ventricular esquerda, prolapso da valva mitral, hipertrofia septal não obstrutiva, miocardiopatia dilatada). O ecocardiograma foi normal em 8 (16%) pacientes, dos quais em 5 (10%), o teste de esforço foi negativo, entre os quais 1 paciente (2% ) apresentava ponte miocárdica para a artéria descendente anterior, 2 (4%) alterações sintomáticas do segmento ST, e outros 2 paci entes (4%) eram assintomáticos...
Purpose To determine the usefulness of an ambulatory electrocardiographic monitoring system, in identifying atherosclerotic coronary artery disease among symptomatic and asymptomatic patients, through a comparison of ST-segment depression with angiographic findings. Methods Fifty patients, 48 men, with the mean age 49 ± 13 years (range 20 to 73), presenting ST-segment depression, were submitted to coronary angiography, complemented by echocardiogram and exercise testing, when the angiography was considered normal. According to the symptoms patients were divided into three groups: Iasymptomatic (16-32%); II¾ atypical chest pain (15-30%); and IIIangina (19-38%). The Cardiac Care Units(Compass TM) system was used for the ambulatory electrocardiographic monitoring.Results Twenty-four patients (48%) had significant atherosclerotic coronary artery disease documented angiographically. Twenty-six patients (52%) had normal coronary arteries by angiography: 18 (36%), presented some pathology demonstrated by echocardiographic studies (left ventricle hypertrophy, mitral valve prolapse, non-obstructive septal hypertrophy, dilated cardiomyopathy). Eight patients (16%) had normal echocardiograms, and in (6%) the exercise test was positive and in the other 5 (6%) negative. One of those patients (2%), with negative exercise test, had a myocardial bridge over the anterior descending branch of the left coronary artery, 2 patients (4%) presented symptomatic episodes of ST depression, and 2 other patients (4%) were assymptomatic...