Journal of Biomedical Engineering Research (대한의용생체공학회:의공학회지)

The Korean Society of Medical and Biological Engineering (대한의용생체공학회)
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Signal-Averaged P Wave Analysis in Patients with Paroxysmal Atrial Fibrillation

발작성 심방세동 환자의 신호평균 P파 분석

  • 김인영 (한양대학교 의과대학 의공학교실) ;
  • 이종연 (한양대학교 의과대학 의공학교실) ;
  • 이병채 (용인송담대학 의료정보시스템과) ;
  • 이용희 (한라대학교 정보통신공학부) ;
  • 이종민 (한양대학교 의과대학 의공학교실) ;
  • 김선일 (한양대학교 의과대학 의공학교실) ;
  • 김준수 (성균관의과대학 내과학교실 삼성서울병원)
  • Published : 2002.02.01
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Abstract

Atrial fibrillation(AF). chronic or paroxysmal is the most frequent arrhythmia in human subjects Duration of P wave in signal-averaged electrocardiography(SAECG) reflects intra-atrial conduction time and therefore. could be used as an electrophysiological marker for atrial conduction chance at the earthy stave. So we apply the analysis method using SAECG to diagnose Paroxysmal atrial fibrillation(PAF) . Subjects Participated for the study consisted of two groups: a control group(n=34) of normal healthy volunteers and a group of AF Patients(n=38) with a documented history of PAF but no other history of cardiac disease. We evaluated the effect of several filtering and determination methods to find the starting and ending feints of the P wavy on its duration. To increase the measurement reliability of P wave duration. the automatic detection method was proposed. Also. to increase the detection rate for PAF risk, the decision threshold value was optimized using receiver operation characteristics(ROC) curve. Results showed that the highest statistical difference (p〈0.001) of the P wane duration between controls and subjects was obtained at the Processing condition, using absolute threshold vague(8.75 $\mu N$) , a least mean square(LMS) high pass filter and 30 Hz cutoff frequency. The most outstanding difference(sensitivity 88 % specificity 64.4 %) between controls and subjects was obtained at the decision threshold value of 112 ms.

심방세동은 가장 많이 나타나는 부정맥으로. 뇌졸중 등 심각한 합병증을 초래하는 질환이다 심방세동이 발작성으로 발생하는 경우 단시간내 불규칙적으로 발생하기 때문에 그 진단이 어렵다 본 연구에서는 발작성 심방세동 환자의 조기진단을 위하여 심실세동 등의 진단에 이용되는 신호평균 심전도를 이용한 분석방법을 사용하였다 심방세동의 징후가 있는 환자는 초기에 심방에서 심근의 전기전도가 지연된다는 이론을 근거로 심전도 P파의 길이를 진단의 기준으로 하였다. p파 길이를 정확히 측정하기 위하여 다양한 종류의 필터와 차단주파수에 대하여 분석하였으며. p파의 시작과 끝점을 판단하는 여러 방법을 시도하였다. 분석 방법의 신뢰성을 높이기 위하여 자동으로 P파 길이를 측정하는 알고리즘을 구현하였다. 구현된 알고리즘의 검증을 위해서 발작성 심방세동 이외의 병력이 없는 환자 38명과 정상인 32명을 대상으로 임상 데이터를 수집하였다. 분석 결과 30 Hz 차주파수를 가지는 LMS 필터를 사용하고. 절대치 8.75 $\mu N$를 기준으로 P파의 시작과 끝점을 측정하여 P파 길이를 계산할 때가 가장 높은 발작성 심방세동의 예측도를 가졌다. 또한 발작성 심방세동의 진단을 위한 가장 적합한 판별 값을 구하기 위하여 수신 동작 특성 곡선을 이용한 결과. 의사결정의 판별 값을 112 ms로 하는 경우 진단의 민감도 88 %. 특이도 64.4 %의 결과를 얻을 수 있었다

Keywords

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