A real-time quality monitoring system for optimal recording of 12-lead resting ECG

TY - JOUR

T1 - A real-time quality monitoring system for optimal recording of 12-lead resting ECG

AU - Jekova, Irena

AU - Krasteva, Vessela

AU - Leber, Remo

AU - Schmid, Ramun

AU - Twerenbold, Raphael

AU - Reichlin, Tobias

AU - Müller, Christian

AU - Abächerli, Roger

N1 - Publisher Copyright: © 2017 Elsevier Ltd

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Minimizing the impact of artifacts prior to the start of the ECG recording is an approach for providing a diagnostically reliable data. A solution to this problem is a continuous feedback of the ECG quality and prompt start of the recording at potentially the best quality. The real-time lead quality monitoring library (LQMLib) is introduced to trigger the recording of 10 s resting 12-lead ECG at the optimal snapshot moment (the earliest in time, the best in quality). The triggering condition considers the Snapshot quality (signal-to-noise ratio of the most noisy 4 s segment within 10 s) exceeding an adaptive quality threshold (AQT). The optimal AQT (descending from 85% down to 60% over 1 min) is validated on two independent clinical datasets from an emergency department, including 267/385 standard 12-lead ECGs. The test-validation LQMLib performance is: (84.7–87.2)% of ECGs would be triggered at their maximal Snapshot quality; (31.2–33.1)% at the optimal snapshot time (±2.5 s); (25.7–29.3)% would be started earlier, typical for high quality ECGs with progressively increasing supra-threshold Snapshot quality; (37.2–43.1)% would be recorded with a delay >2.5 s, typical for low quality ECGs with sub-threshold maximal Snapshot quality that is not validated as potentially the best quality until AQT criterion declines later within 1 min.

AB - Minimizing the impact of artifacts prior to the start of the ECG recording is an approach for providing a diagnostically reliable data. A solution to this problem is a continuous feedback of the ECG quality and prompt start of the recording at potentially the best quality. The real-time lead quality monitoring library (LQMLib) is introduced to trigger the recording of 10 s resting 12-lead ECG at the optimal snapshot moment (the earliest in time, the best in quality). The triggering condition considers the Snapshot quality (signal-to-noise ratio of the most noisy 4 s segment within 10 s) exceeding an adaptive quality threshold (AQT). The optimal AQT (descending from 85% down to 60% over 1 min) is validated on two independent clinical datasets from an emergency department, including 267/385 standard 12-lead ECGs. The test-validation LQMLib performance is: (84.7–87.2)% of ECGs would be triggered at their maximal Snapshot quality; (31.2–33.1)% at the optimal snapshot time (±2.5 s); (25.7–29.3)% would be started earlier, typical for high quality ECGs with progressively increasing supra-threshold Snapshot quality; (37.2–43.1)% would be recorded with a delay >2.5 s, typical for low quality ECGs with sub-threshold maximal Snapshot quality that is not validated as potentially the best quality until AQT criterion declines later within 1 min.

KW - Adaptive quality threshold

KW - ECG signal quality index

KW - Optimal snapshot time

KW - Signal-to-noise ratio

UR - http://www.scopus.com/inward/record.url?scp=85012299342&partnerID=8YFLogxK

U2 - 10.1016/j.bspc.2017.01.009

DO - 10.1016/j.bspc.2017.01.009

M3 - SCORING: Journal article

AN - SCOPUS:85012299342

VL - 34

SP - 126

EP - 133

JO - BIOMED SIGNAL PROCES

JF - BIOMED SIGNAL PROCES

SN - 1746-8094

ER -