The algorithmic performance of J-Tpeak for drug safety clinical trial.
Introduction: The interval from J-point to T-wave peak (JTp) in ECG is a new biomarker able to identify drugs that prolong the QT interval but have different ion channel effects. If JTp is not prolonged, the prolonged QT may be associated with multi ion channel block that may have low torsade de poi...
| Publicado en: | Journal of Electrocardiology Vol. 50; no. 6; pp. 762 - 769 |
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| Autores principales: | , |
| Formato: | research Journal Article |
| Publicado: |
W B Saunders
Nov2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=126251984&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 126251984 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00220736 1276 jtl: Journal of Electrocardiology issn: 00220736 maglogo: N pubinfo: dt: Nov2017 vid: 50 iid: 6 pid: 1351 pub: W B Saunders place: Philadelphia, Pennsylvania artinfo: ui: 126251984 126251984 NLM28942951 126251984 10.1016/j.jelectrocard.2017.08.018 NLM28942951 126251984 ppf: 762 ppct: 7 formats: tig: atl: The algorithmic performance of J-Tpeak for drug safety clinical trial. aug: au: Chien, Simon C. Gregg, Richard E. affil: Advanced Algorithm Research Center, Philips Healthcare, Andover, MA, USA sug: subj: Algorithms Sodium Channel Blockers Pharmacodynamics Heart Conduction System Drug Effects Membrane Proteins Drug Effects Potassium Channel Blockers Pharmacodynamics Electrocardiography Methods Phenethylamines Pharmacodynamics Sulfonamides Pharmacodynamics Verapamil Pharmacodynamics Quinidine Pharmacodynamics Female Male Human Female Male ab: Introduction: The interval from J-point to T-wave peak (JTp) in ECG is a new biomarker able to identify drugs that prolong the QT interval but have different ion channel effects. If JTp is not prolonged, the prolonged QT may be associated with multi ion channel block that may have low torsade de pointes risk. From the automatic ECG measurement perspective, accurate and repeatable measurement of JTp involves different challenges than QT. We evaluated algorithm performance and JTp challenges using the Philips DXL diagnostic 12/16/18-lead algorithm. Measurement of JTp represents a different use model. Standard use of corrected QT interval is clinical risk assessment on patients with cardiac disease or suspicion of heart disease. Drug safety trials involve a very different population - young healthy subjects - who commonly have J-waves, notches and slurs. Drug effects include difficult and unusual morphology such as flat T-waves, gentle notches, and multiple T-wave peaks.Methods: The JTp initiative study provided ECGs collected from 22 young subjects (11 males and females) in randomized testing of dofetilide, quinidine, ranolazine, verapamil and placebo. We compare the JTp intervals between DXL algorithm and the FDA published measurements. The lead wise, vector-magnitude (VM), root-mean-square (RMS) and principal-component-analysis (PCA) representative beats were used to measure JTp and QT intervals. We also implemented four different methods for T peak detection for comparison.Results: We found that JTp measurements were closer to the reference for combined leads RMS and PCA than individual leads. Differences in J-point location led to part of the JTp measurement difference because of the high prevalence of J-waves, notches and slurs. Larger differences were noted for drug effect causing multiple distinct T-wave peaks (Tp). The automated algorithm chooses the later peak while the reference was the earlier peak. Choosing among different algorithmic strategies in T peak measurement results in the tradeoff between stability and the accurate detection of calcium or sodium channel block.Conclusion: Measurement of JTp has different challenges than QT measurement. JTp measurement accuracy improved with combined leads RMS and PCA over lead II or V5. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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