Document Detail

A statistically based acute ischemia detection algorithm suitable for an implantable device.
MedLine Citation:
PMID:  22739698     Owner:  NLM     Status:  MEDLINE    
This study investigates the performance of a new statistically driven acute ischemia detection algorithm that can process data from two bipolar cutaneous or subcutaneous leads. During a start-up phase, the algorithm processes electrocardiogram signals to determine a normal range of ST-segment deviation as a function of heart rate. The algorithm then generates upper and lower ST-deviation thresholds based on the dispersion of the baseline ST-deviation data. After the start-up phase, persistent ST-deviation that is beyond either the upper or lower thresholds results in detection of acute ischemia. To test the algorithm, we performed long-term (10 day) Holter monitoring in a control group of 14 subjects. We also performed Holter monitoring during balloon angioplasty, and for 2 days after surgery, in 30 subjects who underwent elective percutaneous coronary interventions ("PCI"). We determined the percentage of balloon inflations the algorithm detected without producing false positive detections within the control group 10-day daily life data. The algorithm detected 17/17 LAD occlusions, 7/8 LCX occlusions, and 8/9 RCA occlusions. Our results suggest that automatically generated, subject-specific, heart-rate dependent ST-deviation thresholds can detect PCI induced myocardial ischemia without resulting in false positive detections in a small control group.
Bruce Hopenfeld; M Sasha John; Tim A Fischell; Steven R Johnson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2012-06-28
Journal Detail:
Title:  Annals of biomedical engineering     Volume:  40     ISSN:  1573-9686     ISO Abbreviation:  Ann Biomed Eng     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-28     Completed Date:  2013-05-23     Revised Date:  2013-12-05    
Medline Journal Info:
Nlm Unique ID:  0361512     Medline TA:  Ann Biomed Eng     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2627-38     Citation Subset:  IM    
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MeSH Terms
Acute Disease
Angioplasty, Balloon, Coronary / adverse effects*
Electrocardiography / methods*
Heart Rate
Myocardial Ischemia / diagnosis*,  etiology,  physiopathology
Postoperative Complications / diagnosis*,  etiology,  physiopathology
Postoperative Period
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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