BACKGROUND: Morphologic identification of ectopic P-waves from surface ECGs can be challenging, particularly when the P-wave is buried in the QRST wave complex. Because ECGs are often available on paper and not digitally, we developed a method of subtracting the T-wave from the buried P-wave complex on paper ECGs. METHODS: To validate our system, an atrial extrastimulus was introduced during and following the T-wave. The ECGs were scanned and then transformed from an image format to a digital format. A computer algorithm digitally subtracted a QRST with no buried P-wave from one with a buried P-wave, thus resulting in an extracted P-wave. The extracted P-waves were compared to the nonburied P-wave by determining correlation coefficients and by visual grading by two independent reviewers. RESULTS: Visual grading comparing the buried P-wave with the exposed paced P-wave was 94%. The median correlation coefficient was 85%. CONCLUSIONS: An ectopic atrial P-wave obscured by a coincident QRST wave complex can be accurately derived from printed ECG using this PC-based system. Addition of this technique to the existing methods may aid in the localization and ablation of ectopic atrial foci.
BACKGROUND: Morphologic identification of ectopic P-waves from surface ECGs can be challenging, particularly when the P-wave is buried in the QRST wave complex. Because ECGs are often available on paper and not digitally, we developed a method of subtracting the T-wave from the buried P-wave complex on paper ECGs. METHODS: To validate our system, an atrial extrastimulus was introduced during and following the T-wave. The ECGs were scanned and then transformed from an image format to a digital format. A computer algorithm digitally subtracted a QRST with no buried P-wave from one with a buried P-wave, thus resulting in an extracted P-wave. The extracted P-waves were compared to the nonburied P-wave by determining correlation coefficients and by visual grading by two independent reviewers. RESULTS: Visual grading comparing the buried P-wave with the exposed paced P-wave was 94%. The median correlation coefficient was 85%. CONCLUSIONS: An ectopic atrial P-wave obscured by a coincident QRST wave complex can be accurately derived from printed ECG using this PC-based system. Addition of this technique to the existing methods may aid in the localization and ablation of ectopic atrial foci.
Authors: A SippensGroenewegen; H A Peeters; E R Jessurun; A C Linnenbank; E O Robles de Medina; M D Lesh; N M van Hemel Journal: Circulation Date: 1998-02-03 Impact factor: 29.690
Authors: S A Chen; M H Hsieh; C T Tai; C F Tsai; V S Prakash; W C Yu; T L Hsu; Y A Ding; M S Chang Journal: Circulation Date: 1999-11-02 Impact factor: 29.690
Authors: T Yamane; D C Shah; J T Peng; P Jaïs; M Hocini; I Deisenhofer; K J Choi; L Macle; J Clémenty; M Haïssaguerre Journal: J Am Coll Cardiol Date: 2001-11-01 Impact factor: 24.094
Authors: C F Tsai; C T Tai; M H Hsieh; W S Lin; W C Yu; K C Ueng; Y A Ding; M S Chang; S A Chen Journal: Circulation Date: 2000-07-04 Impact factor: 29.690
Authors: M Haïssaguerre; P Jaïs; D C Shah; A Takahashi; M Hocini; G Quiniou; S Garrigue; A Le Mouroux; P Le Métayer; J Clémenty Journal: N Engl J Med Date: 1998-09-03 Impact factor: 91.245
Authors: C W Tang; M M Scheinman; G F Van Hare; L M Epstein; A P Fitzpatrick; R J Lee; M D Lesh Journal: J Am Coll Cardiol Date: 1995-11-01 Impact factor: 24.094