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  • 1
    Electronic Resource
    Electronic Resource
    Inter- and Intraobserver Variability in LVH and RVH Reporting in Pediatric ECGs (2005)
    350 Main Street , Malden , MA 02148 , USA , and 9600 Garsington Road , Oxford OX4 2XG , UK . : Blackwell Publishing, Inc.
    Annals of noninvasive electrocardiology 10 (2005), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Physicians' diagnoses are often used as the gold standard for evaluating computer electrocardiogram (ECG) interpretation programs. As part of a larger study to evaluate the Glasgow pediatric ECG analysis program, inter- and intraobserver variability in the ECG reporting of two pediatric cardiologists was examined. Methods: The ECGs of 984 children were sent for reporting independently by two cardiologists with all identifying information except age and sex removed. Three hundred twenty ECGs had no clinical indication available, and they were thus reported “blind.” For 664 ECGs, the clinical indication was known and included with the ECG trace. All ECGs reported as right ventricular hypertrophy (RVH) or left ventricular hypertrophy (LVH) were returned to the cardiologists without their knowledge for reporting a second time “blind” as to the clinical indication. Results: When the cardiologists' reports were compared with each other, the provision of clinical information led to greater agreement between them for the diagnosis of LVH (kappa increased from 0.44 to 0.52) but did not substantially affect their agreement in diagnosing RVH (kappa fell from 0.66 to 0.63). Intraindividual comparisons in 166 ECGs revealed that one cardiologist was more consistent in diagnosing RVH and the other more consistent in diagnosing LVH. Conclusions: This study has demonstrated the difficulties in using cardiologists' diagnoses as the gold standard with which to evaluate pediatric ECGs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.2005.00642.x
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  • 2
    Electronic Resource
    Electronic Resource
    Vectorcardiograms synthesized from 12-lead ECGs: A new method applied in 1792 healthy children (1994)
    Springer
    Pediatric cardiology 15 (1994), S. 21-26 
    Details
    ISSN: 1432-1971
    Keywords: Electrocardiography ; Vectorcardiography ; Normal limits ; Computer-assisted ECG diagnosis ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The conventional 12-lead electrocardiogram (ECG) is the completely dominating recording technique in electrocardiography despite the superiority of the Frank vectorcardiogram (VCG) in certain situations. In adult cardiology, methods for synthesizing the VCG from the 12-lead ECG have been introduced to improve the interpretation of the 12-lead ECG by permitting VCG analysis in addition. A new method for synthesizing VCGs from 12-lead ECGs is presented and the resulting “12-lead VCGs” compared to Frank VCGs in a group of 21 children. There was good agreement between the two VCG methods. In addition, the “12-lead VCG” was studied in a group of 1792 apparently healthy children. A clockwise inscription of the loop in the horizontal plane was found in less than 1% of children above 1 month of age. The maximal QRS vector in the frontal plane was directed inferiorly and to the left in children older than 1 month of age, while its direction was superior and to the left in only seven children (0.4%). The usefulness of the 12-lead VCG as a tool in ECG interpretation still has to be assessed, but the normal limits presented here represent an important base for further study.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00797001
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  • 3
    Electronic Resource
    Electronic Resource
    Normal standards of ORS duration in 12-lead ECG in healthy volunteers (2000)
    Springer
    Herzschrittmachertherapie & Elektrophysiologie 11 (2000), S. 47-51 
    Details
    ISSN: 1435-1544
    Keywords: Key words Localised right precordial QRS prolongation –¶healthy volunteers – arrhythmogenic right ventricular dysplasia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Aims: The ECG phenomenon called ‘localised right precordial QRS prolongation’ in the diagnosis of arrhythmogenic right ventricular dysplasia-cardiomyopathy defined as a QRS duration in V1, V2 or V3≥110ms has raised much interest in QRS duration in healthy volunteers. The purpose of the present study was to analyse QRS durations and special ratios in a large ECG database of healthy volunteers in order to obtain more information about the distribution of QRS duration in different leads. Methods and results: In a database of standard 12-lead ECGs of 1560 healthy volunteers (888 males and 672 females) mean, standard deviation and the 96% range of QRS duration for each lead were determined by computer using the well-established Glasgow Program. The values of a ratio of QRS duration in leads (V2+V3)/(V4+V5), of a ratio of QRS duration in leads V1/I and the presence of QRS duration in right precordial leads V1, V2 or V3≥110ms were derived. Only in 3.5% of males, but in no females, the QRS duration in V1, V2 or V3 was ≥110ms. If 1.2 was used as the critical ‘normal’ value of QRS duration ratio in (V2+V3)/(V4+V5) specificity was 90.8% for males and only 79.5% for females. Conclusion: QRS duration ≥110ms in the right precordial lead V1, V2 or V3 seems to be the best marker for discriminating healthy volunteers from patients with the phenomenon of localised right precordial QRS prolongation. The comparison of QRS duration in right and left precordial leads lacks specificity predominantly in females if a cut-off value of 1.2 is used.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003990050079
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  • 4
    Electronic Resource
    Electronic Resource
    3-lead electrocardiogram transmission over Post Office telephone lines (1977)
    Springer
    Medical & biological engineering & computing 15 (1977), S. 311-318 
    Details
    ISSN: 1741-0444
    Keywords: Analogue ; telephone data links ; E.C.G. interpretation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Description / Table of Contents: Sommaire Un dispositif analogique à trois voies f.d.m/f.m. pour transmission d' e.c.g. à trois dérivations par l'intermédiaire de lignes téléphoniques normales a été mis au point après examen au point de vue technique et économique de techniques de transmission analogiques et également digitales. Ce dispositif est utilisé en liaison avec une ligne téléphonique digitale à vitesse lente pour permettre la transmission d'e.c.g. d'un hôpital éloigné à un ordinateur central où ils sont analysés. Le système complet est utilisé couramment depuis plus de 17 mois et, à l'exception de quelques interférences dues à des bruits sur la ligne, il s'est révélé être un moyen efficace de transmission d' e.c.g. à partir d'hôpitaux éloignés.
    Abstract: Zusammenfassung Es wurde ein analoges Frequenz-Multiplex-/Frequenzmodulations-system für die Übermittlung von 3-Leiter-EKGs über die Telefonleitungen der Post nach technischer und wirtschaftlicher Berücksichtigung von Analog- und Digitaltechnik entwickelt. Dieses System wird in Verbindung mit einer langsamen Digital-Telefonverbindung verwendet, damit EKGs von einem enternt liegenden Krankenhaus an einen Zentralcomputer gesandt werden und dort analysiert werden können. Das Gesamtsystem befindet sich seit über 17 Monaten im routinemäßigen Einsatz und hat sich, mit Ausnahme von gelegentlicher Störung durch Leitungsimpulsrauschen als ein wirksames Verfahren für die Übermittlung von EKGs von entfernt gelegenen Krankenhäusen aus erwiesen.
    Notes: Abstract A 3-channel analogue f.d.m./f.m. system for the transmission of 3-lead e.c.g.s over Post Office telephone lines has been developed following technical and economic considerations of both analogue and digital techniques. This system is used in conjunction with a low-speed digital telephone link to enable e.c.g.s from an outlying hospital to be transmitted to a central computer and analysed. The overall system has been in routine operation for over 17 months and has, with the exception of occasional interference from line-impulse noise, proved an effective method of reporting e.c.g.s from outlying hospitals.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02441053
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  • 5
    Electronic Resource
    Electronic Resource
    Detection of electrocardiographic ‘left ventricular strain’ using neural nets (1993)
    Springer
    Medical & biological engineering & computing 31 (1993), S. 343-348 
    Details
    ISSN: 1741-0444
    Keywords: Artificial intelligence ; Computer-assisted diagnosis ; Electrocardiography ; Neural networks
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: Abstract The use of artificial neural networks for classification of ST-T abnormalities of the electrocardiogram (ECG) was investigated. A training set of 356 lateral leads selected from 105 ECGs was visually classified as exhibiting one particular ST-T morphology (left ventricular (LV) strain) or not. Selected measurements, together with the classification, were fed as input to a three-layer software-based network during the learning process. The performance of the network was evaluated by comparing the results obtained from the network with conventional criteria, using two test sets. Set 1 comprised 63 lateral leads from 32 ECGs with ST-T changes showing atypical forms of LV strain. Set 2 consisted of 80 lateral leads from 20 ECGs containing normal and abnormal T-waves. For set 1, the network outperformed conventional criteria, having a higher sensitivity (96 per cent against 85 per cent) and specificity (67 per cent against 50 per cent). With test set 2, both network and conventional criteria were 100 per cent sensitive and 100 per cent specific. For sets 1 and 2 combined, the network had a higher overall sensitivity (97 per cent agaisst 89 per cent) and specificity (88 per cent against 82 per cent). The results suggest that neural networks may be useful in selected areas of electrocardiography, but care is required when selecting patterns for use in the training process.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02446686
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