A vectorcardiographic evaluation of the consensus criteria for early repolarization

Peter L. Sorensen; Kasper Sørensen; Jacob Melgaard; Johannes J. Struijk; Steen M. Hansen; Jorgen K. Kanters; Jonas B. Nielsen; Jesper H. Svendsen; Stig Haunsoe; Lars Koeber; Anders G. Holst; Adrian Pietersen; Christian Torp-Pedersen; Freddy K. Lippert; Claus Graff

A vectorcardiographic evaluation of the consensus criteria for early repolarization

Peter L. Sorensen^*, Kasper Sørensen, Jacob Melgaard, Johannes J. Struijk, Steen M. Hansen, Jorgen K. Kanters, Jonas B. Nielsen, Jesper H. Svendsen, Stig Haunsoe, Lars Koeber, Anders G. Holst, Adrian Pietersen, Christian Torp-Pedersen, Freddy K. Lippert, Claus Graff

^*Corresponding author for this work

Abstract

A 2015 consensus paper proposed a unified definition of the early repolarization (ER) pattern based upon quantification of end-QRS notches and slurs in the ECG. In this study we investigated the relationship between end-QRS concave 'bite' segments in the vectorcardiogram (VCG) and the consensus ER pattern. We reviewed digital 12-lead ECG recordings from 1561 subjects in whom out-of-hospital cardiac arrest was later witnessed. ECGs were made available by the Copenhagen General Practitioners' Laboratory. The consensus criteria were used to quantify notches and slurs. ER manifestations were divided into 3 types: A) notches only B) notch and slur C) slurs only. An automatic algorithm developed by the authors were used to quantify bites in 3D. 85 of the 1561 subjects (5.4%) fulfilled the ECG consensus criteria for ER. End-QRS bites were present in 100 % of cases for types A and B and in 92 % of the cases for type C. Subjects with ER type A had the highest median bite amplitude with 79 μV, followed by 60 μV for type B and 36 μV for type C. Our investigation of end-QRS morphology in ER suggest the existence of a continuous transition from slurring to notching governed by the size of 3D VCG bites.

Original language	English
Title of host publication	Computing in Cardiology
Number of pages	4
Volume	43
Publisher	IEEE Computer Society Press
Publication date	2016
Pages	201-204
Article number	7868714
ISBN (Electronic)	9781509008964
Publication status	Published - 2016
Event	43rd Computing in Cardiology Conference, CinC 2016 - Vancouver, Canada Duration: 11 Sept 2016 → 14 Sept 2016

Conference

Conference	43rd Computing in Cardiology Conference, CinC 2016
Country/Territory	Canada
City	Vancouver
Period	11/09/2016 → 14/09/2016

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Cite this

Sorensen, P. L., Sørensen, K., Melgaard, J., Struijk, J. J., Hansen, S. M., Kanters, J. K., Nielsen, J. B., Svendsen, J. H., Haunsoe, S., Koeber, L., Holst, A. G., Pietersen, A., Torp-Pedersen, C., Lippert, F. K., & Graff, C. (2016). A vectorcardiographic evaluation of the consensus criteria for early repolarization. In Computing in Cardiology (Vol. 43, pp. 201-204). Article 7868714 IEEE Computer Society Press. http://www.cinc.org/archives/2016/pdf/061-436.pdf

Sorensen, PL, Sørensen, K, Melgaard, J, Struijk, JJ, Hansen, SM, Kanters, JK, Nielsen, JB, Svendsen, JH, Haunsoe, S, Koeber, L, Holst, AG, Pietersen, A, Torp-Pedersen, C, Lippert, FK & Graff, C 2016, A vectorcardiographic evaluation of the consensus criteria for early repolarization. in Computing in Cardiology. vol. 43, 7868714, IEEE Computer Society Press, pp. 201-204, 43rd Computing in Cardiology Conference, CinC 2016, Vancouver, Canada, 11/09/2016. <http://www.cinc.org/archives/2016/pdf/061-436.pdf>

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title = "A vectorcardiographic evaluation of the consensus criteria for early repolarization",

abstract = "A 2015 consensus paper proposed a unified definition of the early repolarization (ER) pattern based upon quantification of end-QRS notches and slurs in the ECG. In this study we investigated the relationship between end-QRS concave 'bite' segments in the vectorcardiogram (VCG) and the consensus ER pattern. We reviewed digital 12-lead ECG recordings from 1561 subjects in whom out-of-hospital cardiac arrest was later witnessed. ECGs were made available by the Copenhagen General Practitioners' Laboratory. The consensus criteria were used to quantify notches and slurs. ER manifestations were divided into 3 types: A) notches only B) notch and slur C) slurs only. An automatic algorithm developed by the authors were used to quantify bites in 3D. 85 of the 1561 subjects (5.4%) fulfilled the ECG consensus criteria for ER. End-QRS bites were present in 100 % of cases for types A and B and in 92 % of the cases for type C. Subjects with ER type A had the highest median bite amplitude with 79 μV, followed by 60 μV for type B and 36 μV for type C. Our investigation of end-QRS morphology in ER suggest the existence of a continuous transition from slurring to notching governed by the size of 3D VCG bites.",

author = "Sorensen, {Peter L.} and Kasper S{\o}rensen and Jacob Melgaard and Struijk, {Johannes J.} and Hansen, {Steen M.} and Kanters, {Jorgen K.} and Nielsen, {Jonas B.} and Svendsen, {Jesper H.} and Stig Haunsoe and Lars Koeber and Holst, {Anders G.} and Adrian Pietersen and Christian Torp-Pedersen and Lippert, {Freddy K.} and Claus Graff",

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AU - Sorensen, Peter L.

AU - Sørensen, Kasper

AU - Melgaard, Jacob

AU - Struijk, Johannes J.

AU - Hansen, Steen M.

AU - Kanters, Jorgen K.

AU - Nielsen, Jonas B.

AU - Svendsen, Jesper H.

AU - Haunsoe, Stig

AU - Koeber, Lars

AU - Holst, Anders G.

AU - Pietersen, Adrian

AU - Torp-Pedersen, Christian

AU - Lippert, Freddy K.

AU - Graff, Claus

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N2 - A 2015 consensus paper proposed a unified definition of the early repolarization (ER) pattern based upon quantification of end-QRS notches and slurs in the ECG. In this study we investigated the relationship between end-QRS concave 'bite' segments in the vectorcardiogram (VCG) and the consensus ER pattern. We reviewed digital 12-lead ECG recordings from 1561 subjects in whom out-of-hospital cardiac arrest was later witnessed. ECGs were made available by the Copenhagen General Practitioners' Laboratory. The consensus criteria were used to quantify notches and slurs. ER manifestations were divided into 3 types: A) notches only B) notch and slur C) slurs only. An automatic algorithm developed by the authors were used to quantify bites in 3D. 85 of the 1561 subjects (5.4%) fulfilled the ECG consensus criteria for ER. End-QRS bites were present in 100 % of cases for types A and B and in 92 % of the cases for type C. Subjects with ER type A had the highest median bite amplitude with 79 μV, followed by 60 μV for type B and 36 μV for type C. Our investigation of end-QRS morphology in ER suggest the existence of a continuous transition from slurring to notching governed by the size of 3D VCG bites.

AB - A 2015 consensus paper proposed a unified definition of the early repolarization (ER) pattern based upon quantification of end-QRS notches and slurs in the ECG. In this study we investigated the relationship between end-QRS concave 'bite' segments in the vectorcardiogram (VCG) and the consensus ER pattern. We reviewed digital 12-lead ECG recordings from 1561 subjects in whom out-of-hospital cardiac arrest was later witnessed. ECGs were made available by the Copenhagen General Practitioners' Laboratory. The consensus criteria were used to quantify notches and slurs. ER manifestations were divided into 3 types: A) notches only B) notch and slur C) slurs only. An automatic algorithm developed by the authors were used to quantify bites in 3D. 85 of the 1561 subjects (5.4%) fulfilled the ECG consensus criteria for ER. End-QRS bites were present in 100 % of cases for types A and B and in 92 % of the cases for type C. Subjects with ER type A had the highest median bite amplitude with 79 μV, followed by 60 μV for type B and 36 μV for type C. Our investigation of end-QRS morphology in ER suggest the existence of a continuous transition from slurring to notching governed by the size of 3D VCG bites.

M3 - Article in proceedings

AN - SCOPUS:85016119562

VL - 43

SP - 201

EP - 204

BT - Computing in Cardiology

PB - IEEE Computer Society Press

T2 - 43rd Computing in Cardiology Conference, CinC 2016

Y2 - 11 September 2016 through 14 September 2016

ER -

A vectorcardiographic evaluation of the consensus criteria for early repolarization

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