S Lobodzinski | PubMed Health

PubMed1987

A technique to evaluate the performance of computerized ECG analysis systems.

No objective method to test computerized ECG systems has been available. Until now, tests have been conducted separately for instrumentation and algorithms. Hence, to facilitate objective verification and testing of modern computerized ECG equipment, a dedicated high resolution, low noise instrument (an "electronic test patient") has been developed. The purpose of this communication is to describe this new instrument and its electrocardiographic database. The instrument is designed not to cause any disturbances to the original ECG signals in the frequency range from 0 to 1 kHz. The input channels accommodating standard 12-lead and 3-lead Frank systems are sampled simultaneously at 10 kHz each with 90 dB dynamic range. The overall RMS noise figure of the instrument is 1 microV. The integral part of the instrument is a high resolution, high bandwidth minidatabase consisting of selected A-type and B-type verified electrocardiograms such as infarctions, ventricular hypertrophies, atrial fibrillations, etc. The minidatabase was collected with the aid of a computerized ECG system, which has a program for searching for specific electrocardiographic diagnosis. Each database record consists of simultaneous electrocardiographic signals of all standard leads and Frank leads, and a validated diagnostic report. A system under test is typically connected via its patient cable to the analog output of the instrument. The testing is performed with reference to the validated ECG from the database. In that way, our minidatabase is compatible with any electrocardiographic system. The only similar database assembled for testing purposes is that of the CSE group.(ABSTRACT TRUNCATED AT 250 WORDS)

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Echocardiographic design of a multicenter investigation of free-living elderly subjects: the Cardiovascular Health Study.

The Framingham study has shown by M-mode echocardiography that left ventricular hypertrophy is a powerful, independent predictor for the development of coronary heart disease and that increased left atrial dimension has been associated with an increased risk of stroke. No previous population-based study has evaluated the risk factor correlates and predictive value for coronary heart disease and stroke of two-dimensional and Doppler, as well as M-mode, echocardiography. The Cardiovascular Health Study is a multi-year prospective epidemiologic study of 5201 men and women older than 65 recruited from four geographic sites in the United States. The main objectives of incorporating echocardiography were to determine whether echocardiographic indices, or changes in these indices, are (1) correlated with traditional risk factors for coronary heart disease and stroke; and (2) independent predictors of morbidity and mortality for coronary heart disease and stroke. Echocardiographic measurements of interest include those related to global and segmental left ventricular systolic and diastolic structure and function and left atrial size. For each subject, a baseline echocardiogram was recorded in super-VHS tape using a standard protocol and equipment. All studies were sent to a reading center where images were digitized and measurements were made using customized computer algorithms. Calculated data and images were stored on optical disks to facilitate retrieval and future comparisons in longitudinal studies. A second echocardiogram is scheduled in year 7, with a goal of determining whether changes in cardiac anatomy or function over a 5-year period are important predictors of morbidity or mortality from coronary heart disease and stroke. Quality control measures included standardized training of echocardiography technicians and readers, technician observation by a trained echocardiographer, periodic blind duplicate readings with reader review sessions, phantom studies, and quality control adults.

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