Biomedical subjects

L Sörnmo

Publications and source records attributed to L Sörnmo.

At least 19 recordsLinked to original sources

PubMed2003

Detection of body position changes using the surface electrocardiogram.

A method for detecting body position changes that uses the surface vectorcardiogram (VCG) is presented. Such changes are often manifested as sudden shifts in the electrical axis of the heart and can erroneously be interpreted as acute ischaemic events. Axis shifts were detected by analysing the rotation angles obtained from the alignment of successive VCG loops to a reference loop. Following the rejection of angles originating from noise events, the detection of body position changes was performed on the angle series using a Bayesian approach. On a database of ECG recordings from normal subjects performing a predefined sequence of body position changes, a detection rate of 92% and a false alarm rate of 7% was achieved.

Adult↗

PubMed2003

Estimation of the respiratory frequency using spatial information in the VCG.

A new method for extracting respiratory signals from the ECG/VCG is presented. The method is based on the alignment of an observed VCG loop to a reference loop with respect to the transformations of rotation and time synchronisation. The resulting series of estimated rotation angles reflects respiratory-induced changes in the electrical axis of the heart. The respiratory frequency is estimated by power spectral analysis of the derived respiration signal. The value of respiratory modulation of the heart rate is considered by analysing the cross power spectrum of the signals related to rotation angles and heart rate. For comparison, a respiratory signal derived from the QRS area of two different leads is implemented. The performance of the methods is validated on a database with simultaneously recorded VCG and respiratory signals acquired from 20 healthy subjects. The agreement between the respiratory frequencies obtained from the derived and the respiratory signals is presented. The angle-based respiratory signal is found to produce the best agreement with a gross median error of only 4.2%.

Algorithms↗

PubMed2001

Otoacoustic emissions and improved pass/fail separation using wavelet analysis and time windowing.

A new method is presented for the purpose of improving pass/fail separation during transient evoked otoacoustic emission (TEOAE) hearing screening. The method combines signal decomposition in scales using the discrete wavelet transform, non-linear denoising and scale-dependent time windowing. The cross-correlation coefficient between two subaveraged, processed TEOAE signals is used as a pass/fail criterion and assessed in relation to the pure-tone, mean hearing level. The performance is presented in terms of receiver operating characteristics for a database of 5,214 individuals. The results show that the specificity improves from 68% to 83% at a sensitivity of 90% when compared with the conventional wave reproducibility parameter.

Hearing Loss↗

PubMed2001

High-frequency components in ECG analysed in guinea-pig Langendorf preparations.

High-frequency components in ECG during global ischaemia were studied in isolated guinea-pig hearts perfused ad modum Langendorf. Electrocardiograph recordings were carried out from the epicardial surface both in normo- and low-flow perfusion. After bandpass filtering (5-500 Hz), signal-averaging, was undertaken. The high-frequency components either increased or decreased after low-flow perfusion was instituted. Root-mean-square voltage (RMS) of the depolarization signal correlated poorly with the signal amplitude, but highly with the first and second derivative, i.e. the velocity and the acceleration of the signal. It is concluded that high-frequency components are not pathological phenomena per se, but reflect the shape of the original electrocardiographic signal.

Animals↗

PubMed2001

Characterization of atrial fibrillation using the surface ECG: time-dependent spectral properties.

Time-frequency analysis is considered for characterizing atrial fibrillation in the surface electrocardiogram (ECG). Variations in fundamental frequency of the fibrillatory waves are tracked by using different time-frequency distributions which are appropriate to short- and long-term variations. The cross Wigner-Ville distribution is found to be particularly useful for short-term analysis due to its ability to handle poor signal-to-noise ratios. In patients with chronic atrial fibrillation, substantial short-term variations exist in fibrillation frequency and variations up to 2.5 Hz can be observed within a few seconds. Although time-frequency analysis is performed independently in each lead, short-term variations in fibrillation frequency often exhibit a similar pattern in the leads V1, V2 and V3. Using different techniques for short- and long-term analysis, it is possible to reliably detect subtle long-term changes in fibrillation frequency, e.g., related to an intervention, which otherwise would have been obscured by spontaneous variations in fibrillation frequency.

Atrial Fibrillation↗

PubMed2001

Spatiotemporal QRST cancellation techniques for analysis of atrial fibrillation.

A new method for QRST cancellation is presented for the analysis of atrial fibrillation in the surface electrocardiogram (ECG). The method is based on a spatiotemporal signal model which accounts for dynamic changes in QRS morphology caused, e.g., by variations in the electrical axis of the heart. Using simulated atrial fibrillation signals added to normal ECGs, the results show that the spatiotemporal method performs considerably better than does straightforward average beat subtraction (ABS). In comparison to the ABS method, the average QRST-related error was reduced to 58 percent. The results obtained from ECGs with atrial fibrillation agreed very well with those from simulated fibrillation signals.

Atrial Fibrillation↗

PubMed2001

Non-invasive assessment of atrial fibrillation (AF) cycle length in man: potential application for studying AF.

Non-invasive assessment of the fibrillatory frequency of atrial fibrillation (AF) can be performed by frequency domain analysis. The peak frequency in the derived spectrum can be converted to a dominant atrial cycle length (DACL). The DACL can be altered through autonomic modulation or pharmacologic manipulation, but the change in DACL is less marked in those with a short DACL value. In patients with AF, those with a short duration of the arrhythmia have longer DACL values. Finally, patients with paroxysmal AF generally exhibit longer DACL values than patients with permanent AF. Thus non-invasive assessment of the atrial fibrillatory cycle length provides a useful index of atrial refractoriness and has the potential of clinical utility in patient assessment and treatment planning.

Anti-Arrhythmia Agents↗

PubMed2000

Changes in high-frequency QRS components are more sensitive than ST-segment deviation for detecting acute coronary artery occlusion.

OBJECTIVES: This study describes changes in high-frequency QRS components (HF-QRS) during percutaneous transluminal coronary angioplasty (PTCA) and compares the ability of these changes in HF-QRS and ST-segment deviation in the standard 12-lead electrocardiogram (ECG) to detect acute coronary artery occlusion. BACKGROUND: Previous studies have shown decreased HF-QRS in the frequency range of 150-250 Hz during acute myocardial ischemia. It would be important to know whether the high-frequency analysis could add information to that available from the ST segments in the standard ECG. METHODS: The study population consisted of 52 patients undergoing prolonged balloon occlusion during PTCA. Signal-averaged electrocardiograms (SAECG) were recorded prior to and during the balloon inflation. The HF-QRS were determined within a bandwidth of 150-250 Hz in the preinflation and inflation SAECGs. The ST-segment deviation during inflation was determined in the standard frequency range. RESULTS: The sensitivity for detecting acute coronary artery occlusion was 88% using the high-frequency method. In 71% of the patients there was ST elevation during inflation. If both ST elevation and depression were considered, the sensitivity was 79%. The sensitivity was significantly higher using the high-frequency method, p<0.002, compared with the assessment of ST elevation. CONCLUSIONS: Acute coronary artery occlusion is detected with higher sensitivity using high-frequency QRS analysis compared with conventional assessment of ST segments. This result suggests that analysis of HF-QRS could provide an adjunctive tool with high sensitivity for detecting acute myocardial ischemia.

Adult↗

PubMed2000

Sampling rate and the estimation of ensemble variability for repetitive signals.

The measurement of ensemble variability in time-aligned event signals is studied in relation to sampling rate requirements. The theoretical analysis is based on statistical modelling of time misalignment in which the time resolution is limited by the length of the sampling interval. For different signal-to-noise ratios (SNRs), the sampling rate is derived which limits the misalignment effect to less than 10% of the noise effect. Each signal is assumed to be corrupted by additive noise. Using a normal QRS complex with a high SNR (approximately equal to 30 dB), a sampling rate of approximately 3 kHz is needed for accurate ensemble variability measurements. This result is surprising since it implies that the Nyquist rate is far too low for accurate variability measurements. The theoretical results are supplemented with results obtained from an ECG database of 94 subjects for which the ensemble variability is computed at different sampling rates using signal interpolation. The ensemble variability is substantially reduced (40%) when increasing the rate from 1 to 3 kHz, thus corroborating the results suggested by the theoretical analysis.

Electrocardiography↗

PubMed2000

Temporal evolution of traditional versus transformed ECG-based indexes in patients with induced myocardial ischemia.

The time course of changes in the electrocardiogram as a result of myocardial ischemia induced during prolonged coronary angioplasty has been studied. We have analyzed the electrocardiogram evolution during the occlusion in terms of the Ischemic Changes Sensor, which is a parameter that describes the capacity of different indexes to detect induced changes. Traditional indexes at specific time locations (ST level, T wave amplitude and position, and durations of QT interval and QRS complex) and global indexes (based on the Karhunen-Loève transform as applied to the QRS complex, ST-T complex, ST segment and T wave) have been considered. The global indexes better detected ischemic changes than the traditional indexes. The most sensitive were the index for the ST-T complex (89%) in the Karhunen-Loève transform-derived group and for the ST level (61%) in the traditional group. Changes in the ventricular repolarization period usually appeared earlier (77% of patients) than changes in the depolarization period (23% of patients). A similar percentage of patients exhibited the earliest ischemic changes in the T wave (41%) and in the ST segment (36%). The evolution of the Ischemic Changes Sensor parameters showed that the majority (60%) of the total changes occurred during the first minute of occlusion. The results suggest that the use of global electrocardiogram indexes better reflect ischemic changes than do traditional indexes, such as the ST segment deviation.

Angioplasty, Balloon, Coronary↗

PubMed2000

Spatial, individual, and temporal variation of the high-frequency QRS amplitudes in the 12 standard electrocardiographic leads.

BACKGROUND: Analysis of high-frequency QRS amplitudes (HF-QRS) may provide an additional diagnostic tool in patients with heart disease, but the basic properties of these waveforms have not been sufficiently investigated. This study describes the spatial, individual, and temporal variation at rest of HF-QRS recorded with the 12 standard electrocardiographic leads in patients with ischemic heart disease. METHODS AND RESULTS: Two consecutive electrocardiographic recordings from 67 patients were signal averaged and analyzed within a bandwidth of 150 to 250 Hz. The HF-QRS values were expressed as root mean square values. There was a spatial variation in HF-QRS among the 12 leads, with higher amplitudes in V(2) through V(4), II, aVF, and III. The individual variation among the patients was large for all leads. The sum of the HF-QRS for all 12 leads in each patient ranged from 20 to 75 microV (mean 36 +/- 11 microV). The mean of the temporal variation in HF-QRS for all 12 leads between the 2 recordings was only 0.10 +/- 0. 09 microV. CONCLUSIONS: Because of the large individual variation, analysis of HF-QRS is probably most applicable in monitoring situations when it is possible to track changes in a patient over time. The temporal variation in HF-QRS at rest is small, both in patients with and those without prior myocardial infarction.

Adult↗

PubMed2000

Vectorcardiographic loop alignment and the measurement of morphologic beat-to-beat variability in noisy signals.

The measurement of subtle morphologic beat-to-beat variability in the electrocardiogram (ECG)/vectorcardiogram (VCG) is complicated by the presence of noise which is caused by, e.g., respiration and muscular activity. A method was recently presented which reduces the influence of such noise by performing spatial and temporal alignment of VCG loops. The alignment is performed in terms of scaling, rotation and time synchronization of the loops. Using an ECG simulation model based on propagation of action potentials in cardiac tissue, the ability of the method to separate morphologic variability of physiological origin from respiratory activity was studied. Morphologic variability was created by introducing a random variation in action potential propagation between different compartments. The results indicate that the separation of these two activities can be done accurately at low to moderate noise levels (less than 10 microV). At high noise levels, the estimation of the rotation angles was found to break down in an abrupt manner. It was also shown that the breakdown noise level is strongly dependent on loop morphology; a planar loop corresponds to a lower breakdown noise level than does a nonplanar loop.

Action Potentials↗

PubMed2000

Clustering ECG complexes using hermite functions and self-organizing maps.

An integrated method for clustering of QRS complexes is presented which includes basis function representation and self-organizing neural networks (NN's). Each QRS complex is decomposed into Hermite basis functions and the resulting coefficients and width parameter are used to represent the complex. By means of this representation, unsupervised self-organizing NN's are employed to cluster the data into 25 groups. Using the MIT-BIH arrhythmia database, the resulting clusters are found to exhibit a very low degree of misclassification (1.5%). The integrated method outperforms, on the MIT-BIH database, both a published supervised learning method as well as a conventional template cross-correlation clustering method.

Algorithms↗

PubMed2000

Automatic detection of ST-T complex changes on the ECG using filtered RMS difference series: application to ambulatory ischemia monitoring.

A new detector is presented which finds changes in the repolarization phase (ST-T complex) of the cardiac cycle. It operates by applying a detection algorithm to the filtered root mean square (rms) series of differences between the beat segment (ST segment or ST-T complex) and an average pattern segment. The detector has been validated using the European ST-T database, which contains ST-T complex episodes manually annotated by cardiologists, resulting in sensitivity/positive predictivity of 85/86%, and 85/76%, for ST segment deviations and ST-T complex changes, respectively. The proposed detector has a performance similar to those which have a more complicated structure. The detector has the advantage of finding both ST segment deviations and entire ST-T complex changes thereby providing a wider characterization of the potential ischemic events. A post-processing stage, based on a cross-correlation analysis for the episodes in the rms series, is presented. With this stage subclinical events with repetitive pattern were found in around 20% of the recordings and improved the performance to 90/85%, and 89/76%, for ST segment and ST-T complex changes, respectively.

Algorithms↗

PubMed1998

Serial VCG/ECG analysis using neural networks.

Serial ECG analysis is an important diagnostic tool in which two or more successive ECG recordings from the same patient are compared in order to find changes due to, e.g. myocardial infarction. The present study investigates a new approach to serial analysis which is based on artificial neural networks. Interrecording changes are sometimes falsely detected due to electrode misplacement or positional changes of the heart. In order to compensate for such problems, a new technique for VCG loop alignment was employed. A study population of 1000 patients with two recordings was used and manually scrutinized by three experienced ECG interpreters. Pathological changes indicating newly developed infarcts were found in 256 patients. Different combinations of VCG/ECG measurements served as input data to the neural network. The best performance of the neural network was obtained when ECG and VCG measurements were combined and the resulting sensitivity was 69% at a specificity of 90%. The use of only ECG or VCG measurements reduced the sensitivity to 63% and 60%, respectively. The results indicated that serial analysis based on neural networks did not improve significantly when VCG loop alignment was included.

Case-Control Studies↗

PubMed1998

Comparative study of local and Karhunen-Loève-based ST-T indexes in recordings from human subjects with induced myocardial ischemia.

In this work we studied ST-T complex changes in the ECG as result of induced ischemia. The principal aim was to determine whether global changes in the ST-T complex were more sensitive markers of ischemic alterations than those based on measurements of changes at specific locations on ST segment or T wave. High-resolution ECGs from patients undergoing percutaneous transluminal coronary angioplasty in one of the major coronary arteries were analyzed to give a description of the period from the end of active depolarization (QRS complex) to the end of active repolarization (T wave). During artery occlusion traditional local measurements of the ST-T complex were compared to global measurements based on the Karhunen-Loève transform. An ischemic change sensor parameter was estimated for each of the studied indexes showing that global measurements detected changes better in the repolarization period in a larger number of leads and with higher sensitivity (more than 85%) than was done using local measurements (sensitivity of 64% with ST level, 33% with T-wave maximum position, and 37% with T-wave maximum amplitude). Using these global indexes it was found that most cases of ST-segment changes were accompanied by T-wave changes (72% of patients). With the use of traditional indexes 23% of patients showed no changes in the repolarization period, whereas with global indexes this percentage decreased to 8%. Thus a global representation of the entire ST-T complex appears to be more suitable than local measurements when studying the initial stages of myocardial ischemia.

Algorithms↗

PubMed1998

Non-invasive assessment of the atrial cycle length during atrial fibrillation in man: introducing, validating and illustrating a new ECG method.

OBJECTIVES: Atrial fibrillation (AF) in man has previously been shown to include a wide variety of atrial activity. Assessment of the characteristics of this arrhythmia with a commonly applicable tool may therefore be important in the choice and evaluation of different therapeutic strategies. As the AF cycle length has been shown to correlate locally with atrial refractoriness and globally with the degree of atrial organization, with, in general, shorter cycle length during apparently random AF compared to more organized AF, we have developed a new method for non-invasive assessment of the AF cycle length using the surface and the esophagus (ESO) ECG. METHODS AND RESULTS: From the frequency spectrum of the residual ECG, created by suppression of the QRST complexes, the dominant atrial cycle length (DACL) was derived. By comparison with multiple intracardiac simultaneously acquired right and left AF cycle lengths in patients with paroxysmal AF, we found that the DACL in lead V1, ranging from 130 to 185 ms, well represented a spatial average of the right AF cycle lengths, whereas the DACL in the ESO ECG, ranging from 140 to 185 ms, reflected both the right and the left AF cycle length, where the influence from each structure depended on the atrial anatomy of the individual, as determined by MRI. In patients with chronic AF, the method was capable of following changes in the AF cycle length due to administration of D,L-sotalol and 5 min of ECG recording was sufficient for the DACL to be reproducible. CONCLUSIONS: We conclude that this new non-invasive method, named 'Frequency Analysis of Fibrillatory ECG' (FAF-ECG), is capable of assessing both the magnitude and the dynamics of the atrial fibrillation cycle length in man.

Adult↗

PubMed1998

Beat-to-beat QRS variability in the 12-lead ECG and the detection of coronary artery disease.

The aim of this article was to study beat-to-beat QRS variability in patients with ischemia and old myocardial infarction using the 12-lead resting electrocardiogram (ECG). The variability analysis was based on beats that have been synchronized in time with an iterative alignment technique. The QRS variability was measured in patients submitted for myocardial scintigraphy. Those with a normal myocardial scintigraphy (called NO, n = 34, mean age 57 years, 23 women) were compared with a group with both myocardial infarction and exercise-induced ischemia (called ISCINF, n = 27, mean age 57 years, 5 women). The mean QRS variability was somewhat smaller in lead I in ISCINF than in NO, and there was no statistically significant difference in QRS variability among the groups in leads II, III, and V1-V6. Using a multivariate approach, the joint variability in leads I, II, II, and V1-V6 was used for calculating receiver operating characteristics based on a leave-one-out procedure. The sensitivity for detecting coronary artery disease was 75% at a specificity of 50%. It is concluded that beat-to-beat QRS variability in the 12-lead ECG does not discriminate between the presence and absence of coronary artery disease sufficiently well for clinical purposes.

Coronary Disease↗