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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.
Abstract:
The objective of this study was to explore the application value of intracavitary electrocardiogram- (IEGM-) guided diagnosis of occult heart disease and conventional electrocardiogram (EGM) in the diagnosis of occult coronary heart disease (CHD) based on the classification and regression tree (CART) mining algorithm, hoping to provide a more effective basis for clinical diagnosis of the occult CHD. In this study, 100 patients with occult CHD admitted to our hospital from February 2016 to December 2020 were selected as the research objects. Based on the random number table method, 100 patients were randomly rolled into two groups, each with 50 cases. The patients diagnosed with conventional ECG were set as the control group, and patients in the experimental group were diagnosed with IEGM under the data mining algorithms. The diagnostic effects of the two groups were compared. The results showed that the processing effect of the CART algorithm (94%) was much better than that of the multiple linear regression algorithm (78%) and the random forest algorithm (69%) (P < 0.05), the agreement between the results of the experimental group and the results of coronary angiography (80%) and Kappa (0.7) was higher than those of the control group (55%, 0.45), and the difference was statistically significant (P < 0.05). In addition, the sensitivity (93%) and accuracy (80%) of the experimental group were obviously higher than those of the control group (62% and 55%), and the differences were remarkably significant (P < 0.05). In conclusion, the consistency ratio of the IEGM examination was higher, showing high accuracy; the intracavitary examination was invasive, so IEGM was not recommended when the diagnosis result of the examination may cause more harm than good.
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