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Extraction of buried P waves from printed electrocardiograms
Bryant Lin1, Paul J Wang, Srijoy Mahapatra
1New England Cardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, Tufts-New England Medical Center, USA.
Summary
This study presents a computer-based method to digitally subtract T-waves from surface electrocardiograms (ECGs), enabling accurate identification of buried ectopic P-waves for improved cardiac diagnostics.
Area of Science:
- Cardiology
- Medical Imaging
- Signal Processing
Background:
- Identifying ectopic P-waves on surface ECGs is difficult when they are obscured by the QRST complex.
- Paper-based ECGs pose challenges for digital analysis and P-wave isolation.
Purpose of the Study:
- To develop and validate a PC-based system for digitally subtracting T-waves from paper ECGs.
- To accurately extract obscured ectopic P-waves from surface electrocardiograms.
Main Methods:
- ECGs with buried P-waves were scanned and digitized.
- A computer algorithm performed digital subtraction of QRST complexes.
- Extracted P-waves were compared to non-buried P-waves using correlation coefficients and visual grading.
Main Results:
- Visual grading showed 94% accuracy in comparing buried and exposed P-waves.
- The median correlation coefficient between extracted and non-buried P-waves was 85%.
Conclusions:
- A PC-based system can accurately derive ectopic atrial P-waves obscured by QRST complexes from printed ECGs.
- This technique may assist in localizing and ablating ectopic atrial foci.