Automated detection of ventricular pre-excitation in pediatric 12-lead ECG.

Background: With increased interest in screening of young people for potential causes of sudden death, accurate automated detection of ventricular pre-excitation (VPE) or Wolff-Parkinson-White syndrome (WPW) in the pediatric resting ECG is important. Several recent studies have shown interobserver v...

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Publicado en:Journal of Electrocardiology Vol. 49; no. 1; pp. 37 - 42
Autores principales: Gregg, Richard E., Zhou, Sophia H., Dubin, Anne M.
Formato: research Journal Article
Publicado: W B Saunders Jan/Feb2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan/Feb2016
      vid: 49
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      pub: W B Saunders
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        atl: Automated detection of ventricular pre-excitation in pediatric 12-lead ECG.
      aug:
        au:
          Gregg, Richard E.
          Zhou, Sophia H.
          Dubin, Anne M.
        affil: Advanced Algorithm Research Center, Philips Healthcare, Andover, MA, USA
      sug:
        subj:
          Pre-Excitation Syndromes
          Algorithms Methods
          Electrocardiography
          Software Methods
          Information Science
          Diagnosis, Computer Assisted
          Information Science Methods
          Algorithms
          Reproducibility of Results
          Electrocardiography Methods
          Diagnosis, Computer Assisted Methods
          Pre-Excitation Syndromes Diagnosis
          Reproducibility of Results Methods
          Sensitivity and Specificity
          Software
          Sensitivity and Specificity Methods
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Male
          Female
          Child
          Child, Preschool
          Adolescence
          Infant
          Infant, Newborn
          Human
          Child: 6-12 years
          Child, Preschool: 2-5 years
          Adolescent: 13-18 years
          Infant: 1-23 months
          Infant, Newborn: birth-1 month
          Male
          Female
      ab: Background: With increased interest in screening of young people for potential causes of sudden death, accurate automated detection of ventricular pre-excitation (VPE) or Wolff-Parkinson-White syndrome (WPW) in the pediatric resting ECG is important. Several recent studies have shown interobserver variability when reading screening ECGs and thus an accurate automated reading for this potential cause of sudden death is critical. We designed and tested an automated algorithm to detect pediatric VPE optimized for low prevalence.Methods: Digital ECGs with 12 leads or 15 leads (12-lead plus V3R, V4R and V7) were selected from multiple hospitals and separated into a testing and training database. Inclusion criterion was age less than 16 years. The reference for algorithm detection of VPE was cardiologist annotation of VPE for each ECG. The training database (n=772) consisted of VPE ECGs (n=37), normal ECGs (n=492) and a high concentration of conduction defects, RBBB (n=232) and LBBB (n=11). The testing database was a random sample (n=763). All ECGs were analyzed with the Philips DXL ECG Analysis algorithm for basic waveform measurements. Additional ECG features specific to VPE, mainly delta wave scoring, were calculated from the basic measurements and the average beat. A classifier based on decision tree bootstrap aggregation (tree bagger) was trained in multiple steps to select the number of decision trees and the 10 best features. The classifier accuracy was measured on the test database.Results: The new algorithm detected pediatric VPE with a sensitivity of 78%, a specificity of 99.9%, a positive predictive value of 88% and negative predictive value of 99.7%.Conclusion: This new algorithm for detection of pediatric VPE performs well with a reasonable positive and negative predictive value despite the low prevalence in the general population.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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