Biomedical subjects

Juan Pablo Martínez

Publications and source records attributed to Juan Pablo Martínez.

6 recordsLinked to original sources

PubMed2006

Assessment of QT-measurement accuracy using the 12-lead electrocardiogram derived from EASI leads.

The purpose of the present study is to assess QT-interval measurements from the EASI 12-lead electrocardiogram (ECG) as compared with the standard 12-lead ECG. The QT interval was automatically determined in simultaneously recorded standard and EASI 12-lead ECGs, using a validated wavelet-based delineator. The agreement between the 2 sets of measurements was quantified both on a lead-by-lead basis and a multilead basis with global definitions of QRS onset and T-wave end. The results show that the agreement between QT-interval measurements from the 2 lead systems is acceptable, with negligible mean differences and with correlation coefficients ranging from 0.91 to 0.98 depending on the lead studied. Although the SD shows a clear dependence on the selected lead (ranging from 9.2 to 26.4 milliseconds), differences are within the accepted tolerances for automatic delineation. In a few patients, large differences were found, mainly because of changes in morphology present in both lead systems. QT intervals measured by the multilead approach were considerably more stable than single-lead measurements and resulted in a much better agreement between the 2 lead systems (correlation coefficient, 0.98; QT difference, 1.1 +/- 9.8 milliseconds). Thus, the EASI 12-lead ECG may be used for reliable QT monitoring when the multilead delineation approach is adopted.

Diagnosis, Computer-Assisted↗

PubMed2006

Characterization of repolarization alternans during ischemia: time-course and spatial analysis.

T-wave alternans (TWA) has been linked to increased vulnerability to ventricular fibrillation in different settings including myocardial ischemia. In this study, we propose a methodology for the characterization of TWA induced by transient, regional ischemia. We studied the prevalence, magnitude and spatio-temporal relationship between TWA and ischemia in 95 patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Two electrocardiogram records of each patient, a control recording before PTCA and the PTCA record, were analyzed using a robust, recently proposed method for TWA analysis. The detected episodes were characterized in terms of their time-course, lead distribution and alternans waveform. One third of the patients (33.7%) showed TWA episodes during PTCA. The highest prevalence (51.7%) and amplitude were found in patients with left anterior descendent artery occlusion. The onset of TWA was detected after the first 1-2 min of occlusion, suggesting that some level of ischemia must be attained before TWA arises, while disappearance of TWA following reperfusion was much more rapid. The TWA lead distributions and waveforms showed distinct distributions according to the occluded artery reflecting the regional nature of the TWA phenomenon.

Adult↗

PubMed2006

QT variability and HRV interactions in ECG: quantification and reliability.

In this paper, a dynamic linear approach was used over QT and RR series measured by an automatic delineator, to explore the interactions between QT interval variability (QTV) and heart rate variability (HRV). A low-order linear autoregressive model allowed to separate and quantify the QTV fractions correlated and not correlated with HRV, estimating their power spectral density measures. Simulated series and artificial ECG signals were used to assess the performance of the methods, considering a respiratory-like electrical axis rotation effect and noise contamination with a signal-to-noise ratio (SNR) from 30 to 10 dB. The errors found in the estimation of the QTV fraction related to HRV showed a nonrelevant performance decrease from automatic delineation. The joint performance of delineation plus variability analysis achieved less than 20% error in over 75% of cases for records presenting SNRs higher than 15 dB and QT standard deviation higher than 10 ms. The methods were also applied to real ECG records from healthy subjects where it was found a relevant QTV fraction not correlated with HRV (over 40% in 19 out of 23 segments analyzed), indicating that an important part of QTV is not linearly driven by HRV and may contain complementary information.

Algorithms↗

PubMed2005

Climatic factors and lower respiratory tract infection due to respiratory syncytial virus in hospitalised infants in northern Spain.

OBJECTIVE: To analyse the influence of climatic factors on the number of hospitalised infants with respiratory syncytial virus (RSV) per week. METHODS: A retrospective observational case-control study was designed enrolling infants under 2 years of age, admitted to hospital between October 1995 and June 2000 with lower respiratory tract infection due to RSV. Climatic and seasonal data were included. The week variable was used as the study unit: weeks with more than one admission for the case group and weeks without admissions for the control group. The total number of weeks excluding summer months, from June to September, was 174. RESULTS: A total of 167 infants were admitted to hospital with lower respiratory tract infection due to RSV with a peak in January and February. There was 82 weeks with one or more admissions (case group) and 92 without admissions (control group). The case group demonstrated lower levels of humidity (absolute: 5.6 +/- 1.5 vs. 6.5 +/- 1.5; p < 0.001) and lower temperature (ground level: 0.4 +/- 3.2 vs. 2.2 +/- 3.5; p < 0.001). When climatic factors were analysed in a logistic regression model, absolute humidity (p < 0.001) was an independent variable associated with a higher risk of infection. CONCLUSIONS: Low absolute humidity was independently associated with hospital admission of infants with lower respiratory tract infection due to RSV.

Case-Control Studies↗

PubMed2005

Methodological principles of T wave alternans analysis: a unified framework.

Visible T wave alternans (TWA) in the electrocardiogram (ECG) had been regarded as an infrequent phenomenon during the first 80 years of electrocardiography. Nevertheless, computerized analysis changed this perception. In the last two decades, a variety of techniques for automatic TWA analysis have been proposed. These techniques have allowed researchers to detect nonvisible TWA in a wide variety of clinical and experimental conditions. Such studies have recently shown that TWA is related to cardiac instability and increased arrhythmogenicity. Comparison of TWA analysis methods is a difficult task due to the diversity of approaches. In this paper, we propose a unified framework which holds the existing methods. In the light of this framework, the methodological principles of the published TWA analysis schemes are compared and discussed. This framework may have an important role to develop new approaches to this problem.

Algorithms↗

PubMed2004

A wavelet-based ECG delineator: evaluation on standard databases.

In this paper, we developed and evaluated a robust single-lead electrocardiogram (ECG) delineation system based on the wavelet transform (WT). In a first step, QRS complexes are detected. Then, each QRS is delineated by detecting and identifying the peaks of the individual waves, as well as the complex onset and end. Finally, the determination of P and T wave peaks, onsets and ends is performed. We evaluated the algorithm on several manually annotated databases, such as MIT-BIH Arrhythmia, QT, European ST-T and CSE databases, developed for validation purposes. The QRS detector obtained a sensitivity of Se = 99.66% and a positive predictivity of P+ = 99.56% over the first lead of the validation databases (more than 980,000 beats), while for the well-known MIT-BIH Arrhythmia Database, Se and P+ over 99.8% were attained. As for the delineation of the ECG waves, the mean and standard deviation of the differences between the automatic and manual annotations were computed. The mean error obtained with the WT approach was found not to exceed one sampling interval, while the standard deviations were around the accepted tolerances between expert physicians, outperforming the results of other well known algorithms, especially in determining the end of T wave.

Algorithms↗