Automated electrocardiogram analysis: the state of the art

The overwhelming number of electrocardiograms (ECGs) now recorded routinely has prompted the development of computer analysis which in turn has benefited electrocardiography with important technological advances. All automated ECG analysis systems adopt a similar approach: a measurement program and a program that interprets the clinical significance of these measurements along with a rhythm analysis algorithm. Measurement, selection and classification of parameters vary according to the program used. Data compression is applied to the signal to reduce processing time and allow long-term storage. Diagnostic accuracy, however, is not greatly improved over that of experienced cardiologists. Programs studied using a validated data bank provided by an international group of cardiologists show a variability not only in parameter measurement but also in diagnostic statement and in the way in which such statements are expressed. Recommendations for measurement standards have been made to fulfil the need for exchange of diagnostic criteria. No recommendations concerning the selection of parameters have been proposed, and so new parameters or combinations of parameters can be introduced with the ultimate aim of increased diagnostic performance.