• Clinical and Experimental Pediatrics
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• 제61권11호
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• pp.362-365
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• 2018

Purpose: This study aimed to analyze changes in QRS duration and cardiothoracic ratio (CTR) following pulmonary valve replacement (PVR) in patients with tetralogy of Fallot (TOF). Methods: Children and adolescents who had previously undergone total repair for TOF (n=67; median age, 16 years) who required elective PVR for pulmonary regurgitation and/or right ventricular out tract obstruction were included in this study. The QRS duration and CTR were measured pre- and postoperatively and postoperative changes were evaluated. Results: Following PVR, the CTR significantly decreased (pre-PVR $57.2%{\pm}6.2%$, post-PVR $53.8%{\pm}5.5%$, P=0.002). The postoperative QRS duration showed a tendency to decrease (pre-PVR $162.7{\pm}26.4$ msec, post-PVR $156.4{\pm}24.4$ msec, P=0.124). QRS duration was greater than 180 msec in 6 patients prior to PVR. Of these, 5 patients showed a decrease in QRS duration following PVR; QRS duration was less than 180 msec in 2 patients, and QRS duration remained greater than 180 msec in 3 patients, including 2 patients with diffuse postoperative right ventricular outflow tract hypokinesis. Six patients had coexisting arrhythmias before PVR; 2 patients, atrial tachycardia; 3 patients, premature ventricular contraction; and 1 patient, premature atrial contraction. None of the patients presented with arrhythmia following PVR. Conclusion: The CTR and QRS duration reduced following PVR. However, QRS duration may not decrease below 180 msec after PVR, particularly in patients with right ventricular outflow tract hypokinesis. The CTR and ECG may provide additional clinical information on changes in right ventricular volume and/or pressure in these patients.

• 대한전기학회논문지
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• 제35권4호
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• pp.127-135
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• 1986

This paper represents a real time algorithm which improves the some drawbacks in the past methods for detection of the QRS conplexes of ECG signals. In the conventional method we can't detect QRS complex and QRS duration more correctly in case of (1) the contaminated ECG with 60Hz noise, muscle noise. (2) the movement of the baseline for a QRS complex. (3) being abnormal QRS complex with prolonging QRS. Therefore, we have proposed a new algorithm which can detect accurate QRS complex detection in case of the contaminated ECG with 60Hz noise, muscle noise, and movement of baseline for QRS complex. Moreover, in case of prolonging QRS we accomplished to detect not only QRS complex but also a single pulse that has a width proportional to QRS duration. This algorithm which is proposed in our paper in our paper in programmed with 6502 assembly language for real time ECG signal processing.

• Journal of Cardiovascular Imaging
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• 제30권4호
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• pp.307-319
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• 2022

BACKGROUND: Current guidelines indicate electrical dyssynchrony as the major criteria for selecting patients for cardiac resynchronization therapy, and 25-35% of patients exhibit unfavorable responses to cardiac resynchronization therapy (CRT). We aimed to evaluate different cardiac mechanical dyssynchrony parameters in heart failure patients using current echo-Doppler modalities and we analyzed their association with electrical dyssynchrony. METHODS: The study included 120 heart failure with reduced ejection fraction (HFrEF) who underwent assessments for left ventricular mechanical dyssynchrony (LVMD) and interventricular mechanical dyssynchrony (IVMD). RESULTS: Patients were classified according to QRS duration: group I with QRS < 120 ms, group II with QRS 120-149 ms, and group III with QRS ≥ 150 ms. Group III had significantly higher IVMD, LVMD indices, TS-SD speckle-tracking echocardiography (STE) 12 segments (standard deviation of time to peak longitudinal strain speckle tracking echocardiography in 12 LV-segments), and LVMD score compared with group I and group II. Group II and group III were classified according to QRS morphology into left bundle branch block (LBBB) and non-LBBB subgroups. LVMD score, TS-SD 12 TDI, and TS-SD 12 STE had good correlations with QRS duration. CONCLUSIONS: HFrEF patients with wide QRS duration (> 150 ms) had more evident LVMD compared with patients with narrow or intermediate QRS. Those patients with intermediate QRS duration (120-150 ms) had substantial LVMD assessed by both TDI and 2D STE, regardless of QRS morphology. Subsequently, we suggest that LVMD indices might be employed as additive criteria to predict CRT response in that patient subgroup. Electrical and mechanical dyssynchrony were strongly correlated in HFrEF patients.

• 한국정보통신학회논문지
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• 제20권2호
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• pp.427-436
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• 2016

일반적으로 QRS간격은 시작점을 기준으로 끝점까지의 간격을 말하지만 그 기준이 모호하고 Q와 S의 검출이 정확하지 않아 부정맥 분류 성능을 저하시키는 경우가 발생한다. 본 연구에서는 심전도신호 중 가장 큰 피크인 R파를 정확히 검출한 후 이를 기준으로 위상 변이 추적 기법을 적용하여 Q와 S의 시작점과 끝점을 추출하는 방법을 제안한다. 먼저 전처리 과정을 통해 잡음이 제거된 정확한 R파를 검출한다. 이후 심전도신호의 미분값을 통해 QRS패턴을 분류하고, R파를 기준으로 위상이 변화되는 방향과 횟수를 추적함으로써 Q, S의 시작점과 끝점을 추출하는 방법이다. 제안한 방법의 우수성을 입증하기 위해 MIT-BIH 부정맥 데이터베이스 48개의 레코드를 대상으로 R파 검출율은 99.60%의 성능을 나타내었고, 위상 변이 추적 기법의 경우 조기심실수축(PVC)이 30개 이상 포함된 MIT-BIH 10개의 레코드를 대상으로 조기심실수축 분류율을 각각 비교 분석한 결과 94.12%로 우수하게 나타났다.

• 센서학회지
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• 제20권6호
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• pp.382-387
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• 2011

Whether a person is feeling sleepy or reasonably awake is important safety information in many areas, such as humans operating in traffic or in heavy industry. The changes of body signals have been mostly researched by looking at electroencephalogram(EEG) signals but more and more other medical signals are being examined. In our study, an electrocardiogram(ECG) signal is measured at a sampling rate of 100 Hz and used to try to distinguish the possible differences in signal between the two states: awake and drowsy. Practical tests are conducted using a wireless sensor node connected to a wearable ECG sensor, and an ECG signal is transmitted wirelessly to a base station connected to a server PC. Through the QRS complex in the ECG analysis it is possible to obtain much information that is helpful for diagnosing different types of cardiovascular disease. A program is made with MATLAB for digital signal filtering and graphing as well as recognizing the parts of the QRS complex within the signal. Drowsiness detection is performed by evaluating the R peaks, R-R interval, interval between R and S peaks and the duration of the QRS complex..

• Journal of Biosystems Engineering
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• 제33권5호
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• pp.317-325
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• 2008

The electrocardiogram (ECG) measurement system consists of I/O interface to input the ECG signals from two electrodes, FPGA (Field programmable gate arrays) module to process the signal conditioning, and real time module to control the system. The algorithms based on wavelet transform were developed to remove the noise of the ECG signals and to determine the QRS-waves. Triangular wave tests were conducted to determine the optimal factors of the wavelet filter by analyzing the SNRs (signal to noise ratios) and RMSEs (root mean square errors). The hybrid rule, soft method, and symlets of order 5 were selected as thresholding rule, thresholding method, and mother wavelet, respectively. The developed wavelet filter showed good performance to remove the noise of the triangular waves with 10.98 dB of SNR and 0.140 mV of RMSE. The ECG signals from a total of 6 subjects were measured at different measuring postures such as lying, sitting, and standing. The durations of QRS-waves, the amplitudes of R-waves, the intervals of RR-waves were analyzed by using the finite impulse response (FIR) filter and the developed wavelet filter. The wavelet filter showed good performance to determine the features of QRS-waves, but the FIR filter had some problems to detect the peaks of Q and S waves. The measuring postures affected accuracy and precision of the ECG signals. The noises of the ECG signals were increased due to the movement of the subject during measurement. The results showed that the wavelet filter was a useful tool to remove the noise of the ECG signals and to determine the features of the QRS-waves.

• 한국임상수의학회지
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• 제19권2호
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• pp.132-138
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• 2002

Non-human primates are widely used for experimental animal and raised as companion animal in Korea. To establish the electrocadiogram (ECG) of non-human primates that are domestically raised, the author measured bipolar limb leads and augmented unipolar limb leads, after tiletamine/zolazepam (TZ) injection as sedative agents. The amplitudes of P,Q, R,S and T wave and duration time of P wave, QRS complex, PR and QT interval in each lead of ECG were evaluated in 7 non-human primates at 15 minutes after TZ injection, respectively. The amplitude of P wave in I, II,III, aVR, aVL and aVF leads revealed 0.06$\pm$ 0.05,0.14$\pm$ 0.05, 0.1 $\pm$ 0.05,-0.11 $\pm$ 0.06,-0.04$\pm$ 0.04 and 0.12$\pm$ 0.05 mV respectively. The amplitude of Q wave revealed -0.16$\pm$ 0.15, -0.23$\pm$ 0.18, -0.17$\pm$ 0.13, 0.16$\pm$0.13, 0.04$\pm$ 0.09 and -0.2$\pm$0.13 mV, respectively. The amplitude of R wave revealed 0.56$\pm$0.56, 1.24$\pm$ 0.67, 0.92$\pm$0.33, -0.37$\pm$ 1.14, -0.22$\pm$ 0.47 and 1.12 $\pm$ 0.47 mV, respectively. The amplitude of S wave revealed -0.02$\pm$ 0.08, -0.04$\pm$0.06, -0.06$\pm$0.04, 0.02$\pm$0.04, 0.04$\pm$0.09 and -0.04 $\pm$ 0.06 mV, respectively. The amplitude of T wave revealed -0.01 $\pm$ 0.15,-0.02$\pm$ 0.13, 0.01 $\pm$ 0.08, 0.02$\pm$ 0.12, 0.01 $\pm$ 0.11 and -0.03$\pm$ 0.09 mV, respectively. The duration time of P wave revealed 0.05 $\pm$ 0.01, 0.04$\pm$ 0.01, 0.05$\pm$ 0.02, 0.05 $\pm$ 0.02, 0.04$\pm$ 0.01 and 0.04$\pm$ 0.01 sec, respectively. The duration time of QRS complex revealed 0.05 $\pm$ 0.02,0.05$\pm$ 0.01, 0.05 $\pm$ 0.01, 0.04$\pm$ 0.01, 0.05$\pm$ 0.01 and 0.05 $\pm$ 0.01 sec, respectively. The duration time of PR interval revealed 0.08$\pm$ 0.01, 0.07$\pm$0.01,0.08$\pm$ 0.03, 0.08$\pm$0.01, 0.08$\pm$ 0.01 and 0.08$\pm$0.01 sec, respectively. The duration time of QT interval revealed 0.23$\pm$ 0.06, 0.22$\pm$ 0.05, 0.23 $\pm$ 0.06, 0.23$\pm$ 0.06, 0.24$\pm$ 0.05 and 0.22$\pm$ 0.02 sec, respectively. No significant changes were observed in e amplitude of P and T waves. The amplitude of QRS complex in ketamine group was higher than that of TZ group. However, no significant changes were observed in both intra-group and inter-group. There were no significant changes in the duration time of P wave, QRS complex and PR interval obtained from both groups. Also, the duration time of QT interval in TZ group was significantly longer at 30 min.(P< 0.05) an that of 10 minutes after injection. However, significant difference was not found between two groups. The mean cardiac electric axis in ketamine group tended to decrease until 30 min. after injection and then gradually increase. However, mean cardiac electric axis of TZ group was increased until 30 min. after injection and then decreased. But significant differences were not observed between groups. These results suggest that the ECG pattern after TZ injection to non-human primates reared in korea was established. It was also considered that the injection of ketamine and TZ didn't significantly affect on ECG pattern of the non-human primates.

• 한국축산식품학회지
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• 제21권3호
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• pp.272-277
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• 2001

Electrocardiograms in rats fed diets with boiled eggs for 30 days was investigated. Amplitudes of P,Q and R waves were not significant differences among treatment groups. Amplitude of S wave in rats fed the diet with 95% boiled eggs was significantly tended to be increased compared with other groups(P<0.05). Amplitude of T wave in the rats fed the diet with 0% boiled eggs showed the highest values, and there were significant difference among treatment groups fed diets with 0% boiled eggs, 25% and 95% boiled eggs (P<0.05). Durations of P and PQ(PR) waves were high in the rats fed diets with 25% and 50% boiled eggs (P<0.05). Duration of QRS complex showed low in the rats fed diet 0% boiled eggs but not significant difference among treatment groups. Duration of QT was high in the rats fed diet with 0% boiled eggs(P<0.05). This result is assumed that electrocardiograms in the rats is not changed to intake the boiled eggs.

• Clinical and Experimental Pediatrics
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• 제50권5호
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• pp.462-468
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• 2007

목 적 : 활로씨 4징 교정 수술을 받은 환자들에서 추적관찰 기간 동안 신호 평준화 심전도, 표준 12 유도 심전도 검사를 반복적으로 시행하고, 신호 평준화 심전도 상의 후전위, 심전도상의 QRS 기간, QT 간격 및 JT 간격, QRS 기간 분산, QT 간격 분산 및 JT 간격 분산을 측정하여 우심실 용적 부하 기간에 따른 변화를 알아보고자 하였다. 방 법 : 1985년 이후 경북대학교병원에서 활로씨 4징 교정 수술을 받고 1999년과 2005년에 표준 12 유도 심전도와 신호 평준화 심전도를 추적 관찰할 수 있었던 환자 9명을 대상으로 하였다. 대상 환자에서 1999년을 시점 1로, 2005년을 시점 2로 하여 각 시점별로 시행된 12 유도 심전도와 신호 평준화 심전도를 검토하여 표준 12 유도 심전도에서는 QRS 기간, QT 간격 및 JT 간격, QRS 기간 분산, QT 간격 분산 및 JT 간격 분산, SAECG에서는 f-QRS, HFLA, RMS, MV를 측정하였다. 결 과 : 시점 1과 시점 2 사이에서 JT 간격 분산은 통계학적으로 의미 있는 감소가 있었고($101.11{\pm}50.11$ vs $71.11{\pm}22.61ms$, P<0.05), HFLA는 통계학적으로 의미 있는 증가가 있었다($24.67{\pm}13.19$ vs $32.89{\pm}14.21ms$, P<0.05). 그러나 다른 계측치들은 유의한 차이가 없었다. 결 론 : 활로씨 4징 환자의 교정 수술 후 발생할 수 있는 폐동맥 역류증, 우심실 확장, 심실성 부정맥, 급사 등의 후기 부작용을 발견하기 위해 추적 관찰 기간 동안 심전도 및 신호 평준화 심전도를 시행 하였고,일부 계측치에서 유의한 변화를 발견할 수 있었다(JT dispersion, HFLA). 그러나 이러한 계측치의 유의한 변화와 활로씨 4징 환자의 수술 후 예후간의 관계를 규명하기 위해 더 많은 환자에서 더욱 장기적인 추적 관찰이 필요하다.

• 대한의용생체공학회:의공학회지
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• 제35권3호
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• pp.42-49
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• 2014

We propose an individual identification method using a single-lead electrocardiogram signal. In this paper, lead I ECG is measured from subjects in various physical and psychological states. We performed a noise reduction for lead I signal as a preprocessing stage and this signal is used to acquire the representative beat waveform for individuals by utilizing the ensemble average. From the P-QRS-T waves, features are extracted to identify individuals, 19 using the duration and amplitude information, and 16 from the QRS complex acquired by applying Pan-Tompkins algorithm to the ensemble averaged waveform. To analyze the effect of each feature and to improve efficiency while maintaining the performance, Relief-F algorithm is used to select features from the 35 features extracted. Some or all of these 35 features were used in the support vector machine (SVM) learning and tests. The classification accuracy using the entire feature set was 98.34%. Experimental results show that it is possible to identify a person by features extracted from limb lead I signal only.