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Late Potential의 검출을 위한 고해상도 심전계의 개발

Development of a High-Resolution Electrocardiography for the Detection of Late Potentials


Most of the conventional electrocardiowaphs foil to detect signals other than P-QRS-T due to the limited SNR and bandwidth. High-resolution electrocardiography(HRECG) provides better SNR and wider bandwidth for the detection of micro-potentials with higher frequency components such as vontricular late potentials(LP). We have developed a HRECG using uncorrected XYZ lead for the detection of LPs. The overall gain of the amplifier is 4000 and the bandwidth is 0.5-300Hz without using 60Hz notch filter. Three 16-bit A/D converters sample X, Y, and Z signals simultaneously with a sampling frequency of 2000Hz. Sampled data are transmitted to a PC via a DMA-controlled, optically-coupled serial communication channel. In order to further reduce the noise, we implemented a signal averaging algorithm that averaged many instances of aligned beats. The beat alignment was carried out through the use of a template matching technique that finds a location maximizing cross-correlation with a given beat tem- plate. Beat alignment error was reduced to $\pm$0.25ms. FIR high-pass filter with cut-off frequency of 40Hz was applied to remove the low frequency components of the averaged X, Y, and Z signals. QRS onset and end point were determined from the vector magnitude of the sigrlaIL and some parameters needed to detect the existence of LP were estimated. The entire system was designed for the easy application of the future research topics including the optimal lead system, filter design, new parameter extraction, etc. In the developed HRECG, without signal averaging, the noise level was less than 5$\mu$V$_rms RTI$. With signal averaging of at least 100 beats, the noise level was reduced to 0.5$\mu$V$_rms RTI$, which is low enough to detect LPs. The developed HRECG will provide a new advanced functionality to interpretive ECG analyzers.

참고문헌 (14)

  1. Principles and signal processing techniques of the high-resolution electro-cardiogram , P. Lander;E. J. Berbari , Progress in Cardiovascular Diseases / v.XXXV,pp.169-188, 1992
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  3. Detection of patients at risk for paroxysmal atrial fibrillation during sinus rhythm by P-wave triggered signal-averaged ECG , M. Fukunami;T. Yamada;M. Ohmuri;K. Kumagai;K. Umemoto , Circulation / v.83,pp.162-169, 1991
  4. Standards for analysis of ventricular late potentials using high-resolution or signal-averaged electrocardiography , G. Breithardt;M. E. Cain;N. El-Sherif;N. C. Flowers;V. Hombach;M. Janse;M. B. Simson;G. Steinbeck , Circulation / v.83,pp.1481-1486, 1991
  5. Diagnostic implication of spectral and temporal analysis of the entire cardiac cycle in patients with ventricular tachycardia , M. E. Cain;H. D. Ambos;J. Markham;B. D. Lindsay;R. M. Arthur , Circulation / v.83,pp.1637-1648, 1991
  6. The significance of electrocardiographic late potentials:Predictors of ventricular tachycardia , E. J. Berbari;R. Lazzara , Annu. Rev. Med. / v.43,pp.157-169, 1992
  7. M. B. Simson;P. W. Macfarlane(ed.);T. D. V. Lawrie(ed.) , The Signal Averaged Electrocardiogram in Comprehensive Electrocardiology / v.,pp., 1989
  8. Relationship between late potentials on the body surface and directly recorded fragmented electrograms in patients with ventricular tachycardia , M. B. Simson;W. J. Untereker;S. R. Spielman;L. N. Horowitz;N. H. Marcus;R. A. Falcone;A. H. Harken;M. E. Josephson , Am. J. of Cardiology / v.51,pp.105-112, 1983
  9. Noninvasive beat-to-beat detection of ventricular late potentials , H. A. M. Al-Nashash;S. W. Kelly , Med. & Biol. Eng. & Comput. / v.27,pp.64-68, 1989
  10. 의공학교육연구회 , 의용계측공학 / v.,pp., 1993
  11. P. W. Macfarlane;P. W. Macfarlane(ed.);T. D. V. Lawrie(ed.) , Lead Systems in Comprehensive Electrocardiology / v.,pp., 1989
  12. Criteria for optimal averaging of cardiac signals , W. Craelius;M. Restivo;M. A. Assadi;N. El-Sherif , IEEE Trans. Biomed. Eng. / v.33,pp.957-966, 1986
  13. Alignment methods for averaging of high-resolution cardiac signals: A comparative study of performance , R. Jane;H. Rix;P. Caminal;P. Laguna , IEEE Trans. Biomed. Eng. / v.38,pp.571-579, 1991
  14. High resolution ECG , B. R. S. Reddy;D. W. Christenson;G. I. Rowlandson;C. Hammill , Med. Elec. / v.,pp.60-73, 1992

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