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Diagnostic value of synchronized phonocardiogram-electrocardiogram monitoring in children with ventricular septal
Yan Zhang1,2, Jinyong Pan1,2, Yan Guo1,2
1The First Affiliated Hospital of Shihezi University, Shihezi, Xinjiang, China.
Insights
Synchronous phonocardiogram-electrocardiogram (PCG-ECG) monitoring aids in differentiating pediatric ventricular septal defect (VSD) subtypes. This non-invasive method, using wavelet analysis to determine electromechanical activation time (EMAT), complements echocardiography in diagnosing VSD in children.
Area of Science:
- Pediatric Cardiology
- Biomedical Engineering
- Diagnostic Technology
Background:
- Ventricular septal defect (VSD) is a common congenital heart defect (CHD) in children, comprising 20-25% of all CHDs.
- Current diagnostic methods include ECG, echocardiography, and chest X-ray, with echocardiography considered the gold standard.
- Distinguishing between membranous and muscular VSD subtypes is crucial for determining appropriate clinical intervention.
Purpose of the Study:
- To evaluate the diagnostic value of synchronous phonocardiogram-electrocardiogram (PCG-ECG) monitoring for pediatric VSD subtypes.
- To compare PCG-ECG characteristics between membranous and muscular VSD in children.
- To provide evidence for the clinical application of PCG-ECG monitoring in VSD diagnosis.
Main Methods:
- A prospective cohort study enrolled 59 children with suspected VSD.
- Synchronous PCG-ECG monitoring and transthoracic color Doppler echocardiography were performed on all participants.
- Electromechanical activation time (EMAT) was analyzed using wavelet analysis to differentiate between membranous and muscular VSD subtypes, with echocardiography serving as the gold standard.
Main Results:
- Synchronous PCG-ECG monitoring, utilizing wavelet analysis, effectively determines EMAT for differential diagnosis of pediatric VSD subtypes.
- This non-invasive technique provides key clues for distinguishing between membranous and muscular VSD.
- The method is a valuable supplement to echocardiography, particularly in primary care or initial screening settings.
Conclusions:
- Synchronous PCG-ECG monitoring is a simple, non-invasive tool for diagnosing pediatric VSD subtypes.
- Wavelet analysis of PCG-ECG signals aids in differentiating VSD based on EMAT.
- This technology offers significant potential as an adjunct to echocardiography in pediatric VSD diagnosis and management.
Background:
Ventricular septal defect (VSD) is one of the most common congenital heart diseases in children, accounting for 20%-25% of all congenital heart defects (CHDs). Current clinical diagnostic methods for VSD mainly include electrocardiography (ECG), echocardiography, and chest x-ray, among which echocardiography is the "gold standard" for evaluating the clinical significance of defects and determining the need for intervention. This study aims to explore the application value of synchronous monitoring technology in the differential diagnosis of pediatric VSD (especially subtype distinction) by comparing the phonocardiogram-electrocardiogram characteristics between membranous and muscular VSD in children.
Objective:
To investigate the diagnostic value of synchronous phonocardiogram-electrocardiogram (PCG-ECG) monitoring in pediatric ventricular septal defect (membranous vs. muscular subtypes) and provide evidence for its clinical application.
Methods:
A total of 59 children with suspected VSD who visited the Pediatric Cardiovascular Department of our hospital from January 2023 to June 2025 were enrolled (a single-center prospective cohort with consecutive sampling). All children underwent synchronous PCG-ECG monitoring (simultaneous recording of ECG and phonocardiogram) and transthoracic color Doppler echocardiography (hereinafter referred to as "echocardiography"). Using echocardiography as the "gold standard", the differences in electromechanical activation time (EMAT) between the two groups were compared, and the diagnostic efficacy of synchronous monitoring for VSD subtypes (membranous/muscular) was analyzed. VSD subtypes were classified based on anatomical location: membranous defects (perimembranous type, subcristal type) and muscular defects (single, multiple).
Results:
Synchronous analysis of heart sounds and ECG using wearable devices is a simple and non-invasive method. Wavelet analysis technology is employed to automatically detect heart sound and ECG signals, thereby determining EMAT, which provides key clues for the differential diagnosis of pediatric VSD (especially membranous and muscular subtypes). It serves as an important supplement to echocardiography-especially valuable in primary medical care or preliminary screening, where echocardiography may be limited by equipment and operator experience.
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