TY - JOUR
T1 - Statistical evaluation of reproducibility of automated ECG measurements
T2 - An example from arrhythmogenic right ventricular dysplasia/cardiomyopathy clinic
AU - Huang, Timothy
AU - James, Cynthia A.
AU - Tichnell, Crystal
AU - Murray, Brittney
AU - Xue, Joel
AU - Calkins, Hugh
AU - Tereshchenko, Larisa G.
N1 - Funding Information:
Study was partially supported by Dr. Francis P. Chiaramonte Private Foundation , the St. Jude Medical Foundation and Medtronic Inc. The Johns Hopkins ARVD/C Program is supported by the Bogle Foundation , the Healing Hearts Foundation , the Campanella family , and the Wilmerding Endowments . This work was partially supported by the National Institutes of Health (R01 HL118277) to Tereshchenko. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Funding Information:
The authors wish to acknowledge funding from the Dr. Francis P. Chiaramonte Private Foundation, the St. Jude Medical Foundation and Medtronic Inc. The Johns Hopkins ARVD/C Program is supported by the Bogle Foundation, the Healing Hearts Foundation, the Campanella family, and the Wilmerding Endowments. We are grateful to the ARVD/C patients and families who have made this work possible.
PY - 2014/9
Y1 - 2014/9
N2 - Background Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is characterized by delay in depolarization of the right ventricle, detected by prolonged terminal activation duration (TAD) in V1-V3. However, manual ECG measurements have shown moderate-to-low intra- and inter-reader agreement. The goal of this study was to assess reproducibility of automated ECG measurements in the right precordial leads. Methods Pairs of ECGs recorded in the same day from Johns Hopkins ARVD/C Registry participants [n = 247, mean age 35.2 ± 15.6 years, 58% men, 92% whites, 11(4.5%) with definite ARVD/C] were retrospectively analyzed. QRS duration, intrinsicoid deflection, TAD, and T-wave amplitude in the right precordial leads, as well as averaged across all leads QRS duration, QRS axis, T axis, QTc interval, and heart rate was measured automatically, using 12SL TM algorithm (GE Healthcare, Wauwatosa, WI, USA). Intrinsicoid deflection was measured as the time from QRS complex onset to the alignment point of the QRS complex. TAD was calculated as the difference between QRS duration and intrinsicoid in V1-V3. Reproducibility was quantified by Bland-Altman analysis (bias with 95% limits of agreement), Lin's concordance coefficient, and Bradley-Blackwood procedure. Results Bland-Altman analysis revealed satisfactory reproducibility of tested parameters. V1 QRS duration bias was -0.10 ms [95% limits of agreement -12.77 to 12.56 ms], V2 QRS duration bias -0.09 ms [-11.13 to 10.96 ms]; V1 TAD bias 0.14 ms [-13.23 to 13.51 ms], V2 TAD bias 0.008 ms [-12.42 to 12.44 ms]. Conclusion Comprehensive statistical evaluation of reproducibility of automated ECG measurements is important for appropriate interpretation of ECG. Automated ECG measurements are reproducible to within 25%.
AB - Background Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is characterized by delay in depolarization of the right ventricle, detected by prolonged terminal activation duration (TAD) in V1-V3. However, manual ECG measurements have shown moderate-to-low intra- and inter-reader agreement. The goal of this study was to assess reproducibility of automated ECG measurements in the right precordial leads. Methods Pairs of ECGs recorded in the same day from Johns Hopkins ARVD/C Registry participants [n = 247, mean age 35.2 ± 15.6 years, 58% men, 92% whites, 11(4.5%) with definite ARVD/C] were retrospectively analyzed. QRS duration, intrinsicoid deflection, TAD, and T-wave amplitude in the right precordial leads, as well as averaged across all leads QRS duration, QRS axis, T axis, QTc interval, and heart rate was measured automatically, using 12SL TM algorithm (GE Healthcare, Wauwatosa, WI, USA). Intrinsicoid deflection was measured as the time from QRS complex onset to the alignment point of the QRS complex. TAD was calculated as the difference between QRS duration and intrinsicoid in V1-V3. Reproducibility was quantified by Bland-Altman analysis (bias with 95% limits of agreement), Lin's concordance coefficient, and Bradley-Blackwood procedure. Results Bland-Altman analysis revealed satisfactory reproducibility of tested parameters. V1 QRS duration bias was -0.10 ms [95% limits of agreement -12.77 to 12.56 ms], V2 QRS duration bias -0.09 ms [-11.13 to 10.96 ms]; V1 TAD bias 0.14 ms [-13.23 to 13.51 ms], V2 TAD bias 0.008 ms [-12.42 to 12.44 ms]. Conclusion Comprehensive statistical evaluation of reproducibility of automated ECG measurements is important for appropriate interpretation of ECG. Automated ECG measurements are reproducible to within 25%.
KW - ARVD/C
KW - Automated measurement
KW - Electrocardiogram
KW - QRS duration
KW - Reproducibility
KW - Terminal activation duration
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U2 - 10.1016/j.bspc.2014.03.009
DO - 10.1016/j.bspc.2014.03.009
M3 - Article
AN - SCOPUS:84926631815
SN - 1746-8094
VL - 13
SP - 23
EP - 30
JO - Biomedical Signal Processing and Control
JF - Biomedical Signal Processing and Control
IS - 1
ER -