Ectopic beats and their influence on the morphology of subsequent waves in the electrocardiogram
Ectopic beats and their influence on the morphology of subsequent waves in the electrocardiogram
复制标题
异位搏动及其对心电图中后续波形态的影响
DOI：
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发表时间：
2013
期刊：
影响因子：
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通讯作者：
O. Dössel
中科院分区：
文献类型：
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作者：
G. Lenis;T. Baas;O. Dössel
摘要室性异位搏动（VEB）引起心脏的一种特征性反应，称为心率震荡（HRT）。HRT可用于预测有心肌梗死史患者的心源性猝死。在这项工作中，我们提出了一个可靠的算法来检测和分类异位搏动。每个心电图（ECG）都经过创新的滤波技术、伪影检测方法和强大的多通道分析处理，以产生准确的注释结果。对于分类任务，使用支持向量机。此外，提出了一种新的方法来分析HRT。HRT被解释为二阶系统对外部扰动的响应。对系统理论参数进行了估算。并分析了VEB对后续T波形态的影响。在研究中检测到14例患者频繁发生VEB的强烈影响。研究了T波形态随每一次新搏动的演变，可以得出结论，指数形状是这种动态过程的基础，称为形态心率湍流（MHRT）。定义参数以量化MHRT。对MHRT的分析有助于了解异位搏动对心脏复极过程的影响，并更准确地对心源性猝死的风险进行分层。
Abstract Ventricular ectopic beats (VEBs) trigger a characteristic response of the heart called heart rate turbulence (HRT). The HRT can be used to predict sudden cardiac death in patients with a history of myocardial infarction. In this work, we present a reliable algorithm to detect and classify ectopic beats. Every electrocardiogram (ECG) is processed with innovative filtering techniques, artifact detection methods, and a robust multichannel analysis to produce accurate annotation results. For the classification task, a support vector machine was used. Furthermore, a new approach to the analysis of HRT is proposed. The HRT is interpreted as the response of a second-order system to an external perturbation. The system theoretical parameters were estimated. The influence of VEB on the morphology of subsequent T waves was also analyzed. A strong influence was detected in the study with 14 patients experiencing frequent VEB. The evolution of the morphology of the T wave with every new beat was studied, and it could be concluded that an exponential shape underlies this dynamic process and was called morphological heart rate turbulence (MHRT). Parameters were defined to quantify the MHRT. The analysis of the MHRT could help to understand the influence of an ectopic beat on the repolarization processes of the heart and more accurately stratify the risk of sudden cardiac death.