Computer Diagnosis of Supraventricular and Ventricular Arrhythmias: A New Esophageal Technique

Computerized arrhythmia monitors recognize only a few of the significant arrhythmias and generally fail to detect arrhythmias of supraventricular origin. This is because conventional surface leads, which are sufficient for QRS recognition, are highly inadequate for automated P-wave detection. A new twolead system, which includes a swallowable capsule-electrode for esophageal monitoring of atrial activity, is used in an on-line arrhythmia monitor. Three interval measurements (AA, AR and RR) and a QRS shape measurement provide the foundation for a detailed interpretation of each beat. Building on the single-beat analysis, a contextual diagnostic algorithm then recognizes and reports on-line the following arrhythmias: couplets, bigeminy, trigeminy, ventricular tachycardia, supraventricular tachycardia, atrial flutter, atrial fibrillation, ventricular tachycardia with retrograde conduction to the atria, first-degree block, second-degree block, Wenckebach periodicity, advanced block, third-degree block and sinus bradycardia.

[1]  C. D. Enselberg.  The esophageal electrocardiogram in the study of atrial activity and cardiac arrhythmias. , 1951, American heart journal.

[2]  A R LeBlanc,et al.  Canadian Colloquium on Computer-Assisted Interpretation of electrocardiograms. 3. Present state of arrhythmia analysis by computer. , 1973, Canadian Medical Association journal.

[3]  I. Rubin,et al.  The esophageal lead in the diagnosis of tachycardias with aberrant ventricular conduction. , 1959, American heart journal.

[4]  R E Bonner,et al.  A new computer program for analysis of scalar electrocardiograms. , 1972, Computers and biomedical research, an international journal.

[5]  J Wartak,et al.  Computer program for diagnostic evaluation of electrocardiograms. , 1971, Computers and biomedical research, an international journal.

[6]  A. Kistin,et al.  Simultaneous esophageal and standard electrocardiographic leads for the study of cardiac arrhythmias. , 1957, American heart journal.

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

[8]  J L Willems,et al.  Arrhythmia detection by digital computer. , 1972, Computers and biomedical research, an international journal.

[9]  R. K. Helppi,et al.  Computer analysis of rest and exercise electrocardiograms. , 1972, Computers and biomedical research, an international journal.

[10]  R Arzbaecher,et al.  A pill electrode for the study of cardiac arrhythmia. , 1978, Medical instrumentation.

[11]  J M Jenkins,et al.  Computer diagnosis of abnormal cardiac rhythms employing a new P-wave detector for interval measurement. , 1978, Computers and biomedical research, an international journal.

[12]  Z. Sherif,et al.  Oesophageal electrocardiography in the stdy of cardiac arrhythmias. , 1969, British heart journal.

[13]  V. K. Murthy,et al.  On-line real time computer algorithm for monitoring the ECG waveform. , 1970, Computers and biomedical research, an international journal.

[14]  Y Watanabe.  Automated diagnosis of arrhythmias by small scale digital computer. , 1970, Japanese heart journal.

[15]  D. Brody,et al.  The principles of esophageal electrocardiography. , 1959, American heart journal.

[16]  W. Brown,et al.  A study of the esophageal lead in clinical electrocardiography , 1936 .

[17]  R Arzbaecher,et al.  Feasibility of long-term esophageal electrocardiography in the study of transient arrhythmias. , 1978, Biomedical sciences instrumentation.

[18]  J D Laird,et al.  P-wave detection by digital computer. , 1971, Computers and biomedical research, an international journal.

[19]  H Miyahara,et al.  Cardiac arrhythmia diagnosis by digital computer. Considerations related to the temporal distribution of P and R waves. , 1968, Computers and biomedical research, an international journal.