Diagnosis of Arrhythmia for Patients with Occult Coronary Heart Disease Guided by Intracavitary Electrocardiogram

Gang Wang1, Li Luo2, Xia Zhao3

  • 1Department of Geriatrics, Lianshui County People's Hospital, Lianshui 223400, China.

Insights

Intracavitary electrocardiogram (IEGM) guided by the CART algorithm offers superior accuracy for diagnosing occult coronary heart disease (CHD) compared to conventional ECG. However, due to its invasive nature, IEGM is not recommended if risks outweigh benefits.

Area of Science:

  • Cardiology
  • Medical Technology
  • Data Mining

Background:

  • Occult coronary heart disease (CHD) presents diagnostic challenges.
  • Conventional electrocardiogram (ECG) has limitations in detecting subtle CHD.
  • Data mining algorithms offer potential for improved diagnostic accuracy.

Purpose of the Study:

  • To evaluate the diagnostic value of intracavitary electrocardiogram (IEGM) versus conventional ECG for occult CHD.
  • To compare the effectiveness of the Classification and Regression Tree (CART) algorithm against other data mining methods.

Main Methods:

  • A study involving 100 patients with occult CHD, randomly assigned to conventional ECG or IEGM groups.
  • Application of the CART data mining algorithm for IEGM analysis.
  • Comparison of diagnostic accuracy, sensitivity, and agreement with coronary angiography.

Main Results:

  • The CART algorithm demonstrated significantly higher processing effectiveness (94%) compared to multiple linear regression (78%) and random forest (69%).
  • IEGM showed improved agreement with coronary angiography (80% vs. 55%) and higher Kappa values (0.7 vs. 0.45) than conventional ECG.
  • IEGM exhibited significantly higher sensitivity (93% vs. 62%) and accuracy (80% vs. 55%) than conventional ECG.

Conclusions:

  • IEGM, particularly when guided by the CART algorithm, provides a more accurate diagnosis of occult CHD.
  • IEGM demonstrates superior consistency and accuracy compared to conventional ECG.
  • The invasive nature of IEGM necessitates careful consideration of risk-benefit balance in clinical application.

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