Influence of noise on wave boundary recognition by ECG measurement programs. Recommendations for preprocessing.

In the international cooperative project entitled "Common Standards for Quantitative Electrocardiography" (CSE) systematic noise tests have been performed in order to compare measurement results of electrocardiographic computer programs under degraded operational conditions and to develop recommendations for preprocessing and measurement strategies. The influence of seven different high- and low-frequency noise types on the recognition of P, QRS, and T wave onsets and offsets was investigated. The analysis was performed on 160 electrocardiograms derived from two sets of 10 cases each, by eight electrocardiographic and six vectorcardiographic computer programs. The stability and precision of these programs were tested with respect to the results obtained (1) in the noise-free recordings and (2) by a group of five cardiologists who have analyzed the recordings previously in a Delphi reviewing process. Increasing levels of high-frequency noise shifted the onsets and offsets of most programs outward. Programs analyzing an averaged beat showed significantly less variability than programs which measure every complex or a selected beat. On the basis of the findings of the present study, a measurement strategy based on selective averaging is recommended for diagnostic ECG computer programs. However, averaging should be performed only if proper alignment and precise waveform comparison have been performed beforehand in order to exclude dissimilar complexes.

[1]  C Brohet.  Computer-assisted interpretation of electro- and vectorcardiograms. , 1980, Revue de l'Institut d'hygiene des mines.

[2]  W. J. Walker,et al.  Measurement in Exercise Electrocardiography. , 1971 .

[3]  J L Willems,et al.  Common standards for quantitative electrocardiography. , 1985, Journal of medical engineering & technology.

[4]  P. W. MacFarlane.  Computer application on ECG and VCG analysis , 1976 .

[5]  H V PIPBERGER,et al.  Automatic Recognition of Electrocardiographic Waves by Digital Computer , 1961, Circulation research.

[6]  Jan H. van Bemmel,et al.  23 Recognition of electrocardiographic patterns , 1982, Classification, Pattern Recognition and Reduction of Dimensionality.

[7]  John Rawles,et al.  Computer ECG analysis: Towards standardization , 1987 .

[8]  J L Willems,et al.  A plea for common standards in computer aided ECG analysis. , 1980, Computers and biomedical research, an international journal.

[9]  M Demeester,et al.  Assessment of the performance of electrocardiographic computer programs with the use of a reference data base. , 1985, Circulation.

[10]  Dominique Morlet.  Contribution à l'analyse automatique des électrocardiogrammes : algorithmes de localisation, classification et délimitation précise des ondes dans le système de Lyon , 1986 .

[11]  Chr. Zywietz,et al.  Common Standards for Quantitative Electrocardiography : The CSE Pilot Study , 1981 .

[12]  M. Simson.  Use of Signals in the Terminal QRS Complex to Identify Patients with Ventricular Tachycardia After Myocardial Infarction , 1981, Circulation.

[13]  J L Talmon,et al.  Template waveform recognition applied to ECG-VCG analysis. , 1973, Computers and biomedical research, an international journal.

[14]  P W Macfarlane,et al.  Establishment of a reference library for evaluating computer ECG measurement programs. , 1985, Computers and biomedical research, an international journal.

[15]  M L Simoons,et al.  Quantitation of exercise electrocardiography. , 1981, Circulation.

[16]  V. Froelicher,et al.  Computer analysis of the exercise ECG: a review. , 1980, Progress in cardiovascular diseases.