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Importance of the heart vector origin point definition for an ECG analysis: The Atherosclerosis Risk in Communities (ARIC) study.

TitleImportance of the heart vector origin point definition for an ECG analysis: The Atherosclerosis Risk in Communities (ARIC) study.
Publication TypeJournal Article
Year of Publication2019
AuthorsPerez-Alday EAndres, Li-Pershing Y, Bender A, Hamilton C, Thomas JA, Johnson K, Lee TL, Gonzales R, Li A, Newton K
Secondary AuthorsTereshchenko LG
JournalComput Biol Med
Volume104
Pagination127-138
Date Published2019 01
ISSN1879-0534
KeywordsAlgorithms, Atherosclerosis, Death, Sudden, Cardiac, Female, Follow-Up Studies, Humans, Male, Middle Aged, Signal Processing, Computer-Assisted, Vectorcardiography
Abstract

AIM: Our goal was to investigate the effect of a global XYZ median beat construction and the heart vector origin point definition on predictive accuracy of ECG biomarkers of sudden cardiac death (SCD).

METHODS: Atherosclerosis Risk In Community study participants with analyzable digital ECGs were included (n = 15,768; 55% female, 73% white, mean age 54.2 ± 5.8 y). We developed an algorithm to automatically detect the heart vector origin point on a median beat. Three different approaches to construct a global XYZ beat and two methods to locate origin point were compared. Global electrical heterogeneity was measured by sum absolute QRST integral (SAI QRST), spatial QRS-T angle, and spatial ventricular gradient (SVG) magnitude, azimuth, and elevation. Adjudicated SCD served as the primary outcome.

RESULTS: There was high intra-observer (kappa 0.972) and inter-observer (kappa 0.984) agreement in a heart vector origin definition between an automated algorithm and a human. QRS was wider in a median beat that was constructed using R-peak alignment than in time-coherent beat (88.1 ± 16.7 vs. 83.7 ± 15.9 ms; P 

CONCLUSION: Time-coherent global XYZ median beat with physiologically meaningful definition of the heart vector's origin point improved predictive accuracy of SCD biomarkers.

DOI10.1016/j.compbiomed.2018.11.013
Alternate JournalComput Biol Med
PubMed ID30472495
PubMed Central IDPMC6400224
Grant ListR56 HL118277 / HL / NHLBI NIH HHS / United States
R01 HL118277 / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States