Automatic diagnosis of strict left bundle branch block using a wavelet-based approach

PloS One
Alba Martín-Yebra, Juan Pablo Martínez

Abstract

Patients with left bundle branch block (LBBB) are known to have a good clinical response to cardiac resynchronization therapy. However, the high number of false positive diagnosis obtained with the conventional LBBB criteria limits the effectiveness of this therapy, which has yielded to the definition of new stricter criteria. They require prolonged QRS duration, a QS or rS pattern in the QRS complexes at leads V1 and V2 and the presence of mid-QRS notch/slurs in 2 leads within V1, V2, V5, V6, I and aVL. The aim of this work was to develop and assess a fully-automatic algorithm for strict LBBB diagnosis based on the wavelet transform. Twelve-lead, high-resolution, 10-second ECGs from 602 patients enrolled in the MADIT-CRT trial were available. Data were labelled for strict LBBB by 2 independent experts and divided into training (n = 300) and validation sets (n = 302) for assessing algorithm performance. After QRS detection, a wavelet-based delineator was used to detect individual QRS waves (Q, R, S), QRS onsets and ends, and to identify the morphological QRS pattern on each standard lead. Then, multilead QRS boundaries were defined in order to compute the global QRS duration. Finally, an automatic algorithm for notch/slur detec...Continue Reading

References

Jun 1, 1956·The American Journal of Medicine·R P GRANT, H T DODGE
Apr 10, 2004·IEEE Transactions on Bio-medical Engineering·Juan Pablo MartínezPablo Laguna
Sep 3, 2009·The New England Journal of Medicine·Arthur J MossUNKNOWN MADIT-CRT Trial Investigators
Mar 8, 2011·The American Journal of Cardiology·David G StraussGalen S Wagner
Jun 2, 2012·Pacing and Clinical Electrophysiology : PACE·Giosuè MascioliGianfranco Sinagra
Aug 31, 2016·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Xiaojuan XiaJean-Philippe Couderc
Jul 20, 2018·Journal of Electrocardiology·Radovan SmisekFilip Plesinger
Jul 22, 2018·International Journal of Cardiology·Maria Luce CaputoAngelo Auricchio

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