A new method of filtering T waves to detect hidden P waves in electrocardiogram signals

Aims A correct identification of the P wave is crucial for the diagnosis of narrow QRS tachycardias. This is sometimes difficult because atrial activity is hidden in the T wave. The aim of this study is to evaluate the usefulness of a T wave filtering technique based on wavelet transformation to ide...

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Detalles Bibliográficos
Autores: Goldwasser, D, de Luna, AB, Serra, G, Elosua, R, Rodriguez, E, Guerra, JM, Alonso, C, Prat, XV
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2011
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p11874
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11874
Access Level:acceso abierto
Palabra clave:Electrocardiography
Supraventricular arrhythmias
Wavelet technology
Atrial activity
Descripción
Sumario:Aims A correct identification of the P wave is crucial for the diagnosis of narrow QRS tachycardias. This is sometimes difficult because atrial activity is hidden in the T wave. The aim of this study is to evaluate the usefulness of a T wave filtering technique based on wavelet transformation to identify atrial activity. Methods and results Forty-two patients with narrow QRS tachycardias and regular atrial activity were studied. A surface electrocardiogram (ECG), intra-atrial recording, and the T wave filtering ECG were compared simultaneously to check the accuracy of the filtering system in detecting atrial activity. The sensitivity of the T wave filtering and P wave detection algorithm was 85.8% [95% confidence interval (CI): 81.2-89.4%] and the specificity was 89.4% (95% CI: 87.1-91.4%), with a global accuracy of 88.5% (95% CI: 86.5-90.3%). The expert cardiologist's accuracy in distinguishing between atrioventricular nodal reentry tachycardia and atrioventricular reentry tachycardia was 75% in the surface ECG vs. 100% in the ECG with the T wave filtering process (P < 0.01). Conclusions T wave filtering based on wavelet transformation improves the capacity of the surface ECG to identify atrial activity in cases of regular narrow QRS supraventricular tachycardias.