Algorithm for real-time analysis of intracoronary electrocardiogram.
Marius Reto Bigler1, Andrea Kieninger-Gräfitsch1, Frédéric Waldmann2
1Department of Cardiology, University Hospital Bern (Inselspital), University of Bern, Bern, Switzerland.
Frontiers in Cardiovascular Medicine
|September 29, 2022
Summary
A new algorithm for analyzing intracoronary electrocardiograms (icECG) accurately detects myocardial ischemia in real-time. This autonomous system matches expert analysis, paving the way for routine clinical use of icECG.
Area of Science:
- Cardiology
- Medical Technology
- Diagnostic Imaging
Background:
- Intracoronary electrocardiogram (icECG) offers higher sensitivity for myocardial ischemia detection than surface ECG.
- Routine use of icECG is limited by the absence of real-time quantitative analysis systems.
Purpose of the Study:
- To develop and validate an autonomous algorithm for real-time quantitative analysis of icECG.
- To assess the algorithm's accuracy in detecting myocardial ischemia compared to manual analysis.
Main Methods:
- Retrospective observational study involving 100 patients with chronic coronary syndrome.
- Collected ischemic and non-ischemic icECG tracings during coronary balloon occlusion.
- Compared ST-segment shift measurements between a novel autonomous algorithm and an expert manual analysis.
Main Results:
- The algorithm demonstrated high agreement with expert analysis (ICC = 0.968).
- Both manual and algorithmic analyses showed high accuracy in ischemia detection (AUCs ≈ 0.967-0.968).
- Autonomous analysis time was under 1,000 ms, significantly faster than manual analysis (>5 min).
Conclusions:
- A newly developed autonomous icECG analysis algorithm accurately detects myocardial ischemia.
- The algorithm provides the foundation for real-time quantitative icECG analysis systems.
- This technology can facilitate the routine clinical application of icECG.
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