Document Detail


Automated Analysis of the 12 -Lead Electrocardiogram to Identify the Exit Site of Post-Infarction Ventricular Tachycardia.
MedLine Citation:
PMID:  22001707     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The value of the 12-lead ECG to identify the exit site of post-infarction ventricular tachycardia (VT) has been questioned. The purpose of this study was to assess the accuracy of a computerized algorithm for identifying a VT exit site based on the 12-lead ECG. METHODS AND RESULTS: In 34 post-infarction patients, pace-mapping was performed from within scar tissue. A computerized algorithm that used a supervised learning method (support vector machine) received the digitized pace-map morphologies combined with the pacing sites as training data. No other information (i.e. infarct localization, bundle branch block morphology, axis or R wave pattern) was used in the algorithm. The training data were validated in 58 VTs in 33 patients. Only the pace-map and/or VT morphologies were used in this algorithm. The sizes of 10 different anatomic sections within the heart were determined using the pace-maps as the determining factor. Accuracy was found to be 69% for pace-maps and when 2 adjacent regions were combined, accuracy improved to 88%. Validation of the data in 33 patients showed an accuracy of 71% for localizing a VT exit site to one of the 10 regions within the left ventricle. If combined with the best adjacent region, accuracy improved to 88%. The median anatomic size of each section was 21 cm(2). The median spatial resolution of the 12-lead ECG pattern of the pace-maps for a particular region was 15 cm(2). CONCLUSION: The 12 lead ECG of post-infarction VT contains localizing information that enables determination of a region of interest in the 10-20 cm(2) range for more than 70% of VT exit sites in a given sector.
Authors:
Miki Yokokawa; Tzu-Yu Liu; Kentaro Yoshida; Clayton Scott; Alfred Hero; Eric Good; Fred Morady; Frank Bogun
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-11
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Affiliation:
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI.
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