Measurement of Individual Alteration in Perioperative ECGs During Elective Percutaneous Coronary Intervention

TL;DR

This study evaluates individual ECG alterations during elective PCI using the STAFF III database, demonstrating the feasibility of personalized monitoring and its potential to improve ischemia detection in patients with non-standard ECGs.

Contribution

It introduces a method to assess individual ECG alterations over time, highlighting their clinical relevance for personalized ischemia detection.

Findings

Significant differences in ST-interval alterations in 5 leads

Significant differences in T-wave alterations in 3 leads

Feasibility of using relative amplitudes for individual ECG monitoring

Abstract

The increasing availability of wearable electrocardiography (ECG) devices enables the continuous monitoring of individual ECG alterations. This could be beneficial for patients suffering from acute ischemia but with non-standard ECG findings that do not fit to the subject-independent and absolute thresholds defined in clinical guidelines. In this work, we evaluate the inter-patient magnitude of individual ECG alterations during ischemia. The freely available STAFF III database provides 12-lead ECG recordings of patients before, during, and after elective percutaneous coronary intervention(PCI), where a coronary vessel is widened with a balloon inflation. We compute individual alterations of ST-interval and T-wave amplitudes w.r.t. QRS amplitude over time for each patient and lead. We demonstrate that determining relative ST-interval/T-wave amplitudes and deriving individual alterations over time is feasible in standard and non-standard ECG recordings. To demonstrate clinical relevance, we use the features for differentiating N=54 STAFF III patients with atherosclerotic plaque in either the right coronary artery (RCA) or left ascending artery (LAD). Results show significant differences in 5 leads for ST-interval alterations and 3 leads for T-wave alterations, which are also suggested by clinical guidelines for ischemia detection. Clinical relevance- Assessing individual alterations over time could eventually close the gap in ECG evaluation of patients presenting with pre-existing heart conditions and non-standard ECGs.