Improving reliability for measuring ST deviation in suspected acute coronary syndrome

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Diagnostics

Background:

• Standard 12-lead ECG is crucial for diagnosing acute coronary syndrome (ACS).
• ECG signal artifacts significantly impact diagnostic quality and decision-making.
• A novel approach using signal quality indicators (SQI) was explored to mitigate artifact impact.

Purpose of the Study:

• To evaluate the effectiveness of SQI in identifying artifact-reduced ECG segments.
• To determine if using these cleaner segments improves the consistency of ST measurements.
• To compare ST measurement reliability between artifact-reduced segments and standard initial ECG recordings.

Main Methods:

• Utilized the Staff III 12-lead ECG database (n=185).
• Calculated SQI scores to identify 10-second ECG segments with minimal noise (Clean10).
• Compared ST measurements from Clean10 segments against initial 10-second recordings (First10) using the Philips DXL™ algorithm.

Main Results:

• Clean10 segments exhibited lower standard deviations (SDs) in ST measurements compared to First10.
• ST measurements at J+20 ms and J+40 ms showed the greatest consistency improvement.
• While improvements were noted for J+60 ms and J+80 ms, the J-point showed less significant enhancement.

Conclusions:

• SQI is an effective tool for selecting ECG segments with reduced artifacts.
• This selection leads to more consistent and reliable ST measurements.
• Measurements at J+20 ms demonstrated the highest consistency among the evaluated ST measurement points.