Skip to main content
Log in

An approach to intelligent ischaemia monitoring

  • Intelligent Instrumentation
  • Published:
Medical and Biological Engineering and Computing Aims and scope Submit manuscript

Abstract

The paper describes an approach to intelligent ischaemia event detection based on ECG ST-T segment analysis. ST-T trends are processed by means of a Bayesian forecasting approach using the multistate Kalman filter. A complete procedure, intended for use in CCU/ICU monitoring areas, is proposed, in order to give the clinician an intelligent monitoring tool. The approach serves to describe trends and their changes in a symbolic way. A novel aspect is its ability to observe certain features of ST-T elevation/depression not detected by other means, and to reject artefacts and erroneous events. A sensivity of 89.58% and a predictivity of 84.31% are obtained on selected records of the European ST-T database. Using a restriction on event amplitude, the predictivity is raised to 95.55%. An ischaemia sensitivity index of 1·2 was determined. The method has been shown to be a robust and practical trend analysis tool, and seems to be appropriate for numeric/symbolic transformations in next-generation intelligent monitoring systems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Avent, R. K., andCharlton, J. D. (1990): ‘A critical review of trend-detection methodologies for biomedical monitoring systems,’Crit. Rev. Biomed. Eng.,17, pp. 621–659

    Google Scholar 

  • Clark, K., McLear, P., Kortas, R., Mead, C., andThomas, Jr., L. (1981): ‘ARGUS/2H detection of ST-segment changes in ambulatory ECG recordings,’Comput. Cardiol., pp. 27–31

  • De Lucia, F., Pasaariello, G., Villegas, G., andMora, F. (1990): ‘Microcomputer based cornary care unit central station,’J. Clin. Eng.,15, pp. 381–389

    Google Scholar 

  • Elliot, C. D. (1991): ‘A high resolution electrocardiogram ST segment trend generator.’ MSc thesis, The University of Oklahoma, Graduate College, Norman-Oklahoma, USA

    Google Scholar 

  • Factor, M., Gelernter, D. H., Kolb, C. E., Miller, P. L., andSittig, D. F. (1991): ‘Real-time data fusion in the intensive care unit,’Comput.,24, (12), pp. 45–54

    Article  Google Scholar 

  • Gordon, K. (1986): ‘The multi-state Kalman filter in medical monitoring,’Comput. Method Prog. Biomed.,23, pp. 147–154

    Article  Google Scholar 

  • Gritzali, F. (1988): ‘Towards a generalised scheme for QRS detection in ECG waveforms,’Signal Process.,15, pp. 183–192

    Article  Google Scholar 

  • Harrison, P. J., andStevens, C. F. (1971): ‘A Bayesian approach to short-term forecasting,’Oper. Res. Q.,22, pp. 341–362

    Article  MATH  MathSciNet  Google Scholar 

  • Harrison, P. J., andStevens, C. F. (1976): ‘Bayesian forecasting’, with discussion,R. Stat. Soc., B,38, pp. 205–247

    MATH  MathSciNet  Google Scholar 

  • Jager, F., Moody, G. B., Taddei, A., andMark, R. G. (1992a): ‘Performance measures for algorithms to detect transientichaemic ST segment changes,’Comput Cardiol. (1991), pp. 369–372

    Google Scholar 

  • Jager, F., Mark, R. G. andMoody, G. B. (1992b): ‘Analysis of transient ischaemic ST segment changes during ambulatory monitoring,’Comput. Cardiol. (1991), pp. 453–456

    Google Scholar 

  • Kalman, R. E. (1960): ‘A new approach to linear filtering and prediction problems,’J. Basic Eng.,82, p. 35

    Google Scholar 

  • Krucoff, M. W. (1989): ‘Electrocardiographic monitoring and coronary occlusion,’J. Electrocardiol.,22, supplement, pp. 232–237

    Google Scholar 

  • Krucoff, M. W. (1990): ‘Comprehensive ischemia monitoring in unstable coronary syndromes,’Coronary Acute Care,1, (2), pp. 2–10

    Google Scholar 

  • Mora, F., Passariello, G., Carrault, G., andLe Pichon, J. P. (1993): ‘Intelligent patient monitoring and management systems: a review,’IEEE Eng. Med. Biol. Mag.,12, (4), pp. 23–33

    Article  Google Scholar 

  • Oates, J., Cellar, B., Bernstein, B. P., andFreeman, S. B. (1989): ‘Real-time detection of ischaemic ECG changes using quasiorthogonal leads and artificial intelligence,’Comput. Cardiol. (1988), pp. 89–92

    Google Scholar 

  • Presedo, J., Barro, S., Palacios, F., Ruiz, R., Vila, J., andBugarin, A. (1992): ‘Detection of significant variations of the ST segment for the determination of ischaemic episodes: Proc. IEEE-EMBS Ann. Conf., Paris, France, pp. 540–541

  • Shook, T. L., Valvo, V., Hubelbank, M., Feldman, C. L., andStone, P. H. (1988): ‘Varidation of a new algorithm for detection and quantification of ischaemic ST segment changes during ambulatory electrocardiography,’Comput. Cardiol. (1987), pp. 57–62

    Google Scholar 

  • Sittig, D., andFactor, M. (1990): ‘Physiologic trend detection and artifact rejection: a parallel implementation of multi-state Kalman filtering algorithm,’Comput. Method Prog. Biomed.,31, pp. 1–10

    Article  Google Scholar 

  • Smith, A. F. M. andWest, M. (1983): ‘Monitoring renal transplants: an application of the multi-process Kalman filter,’Biometrics,39, pp. 867–878

    Article  MATH  Google Scholar 

  • Stamkopoulos, T., Strinzis, M., Pappas, C., andMaglaveras, N. (1992): ‘One-lead ischemia detection using a new back-propagation algorithm and the European ST-T Database,’Comput. Cardiol. (1992), pp. 663–666

    Google Scholar 

  • Suzuki, Y., andOno, K. (1992): ‘Personal computer system for ECG ST-segment recognition based on neural networks,’Med. Biol. Eng. Comput.,30, (1), pp. 2–8

    Article  Google Scholar 

  • Taddei, A., Biagini, A., Distante, G., Marchesi, C., Mazzei, M. G., Pisani, P., Roggero, N., andZeelenberg, C. (1990): ‘An annotated database aimed at performance evaluation of algorithms for ST-T change analysis,’Comput. Cardiol. (1989), pp. 117–120

    Google Scholar 

  • Weisner, S., Tompkins, W., andTompkins, B. (1982): ‘A compact, microprocessor based ECG ST-segment analyzer for the operating room,’IEEE Trans. BME-29, pp. 642–649

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bosnjak, A., Bevilacqua, G., Passariello, G. et al. An approach to intelligent ischaemia monitoring. Med. Biol. Eng. Comput. 33, 749–756 (1995). https://doi.org/10.1007/BF02523005

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02523005

Keywords

Navigation