Methods Inf Med 1990; 29(04): 393-402
DOI: 10.1055/s-0038-1634802
ECG Interpretation Systems
Schattauer GmbH

Methodology of ECG Interpretation in the Lyon Program

P. Arnaud
1   Institut National de la Santà et de la Recherche Màdicale - U. 121, Hôpital Cardiologique, Lyon, France
,
P. Rubel
1   Institut National de la Santà et de la Recherche Màdicale - U. 121, Hôpital Cardiologique, Lyon, France
,
D. Morlet
1   Institut National de la Santà et de la Recherche Màdicale - U. 121, Hôpital Cardiologique, Lyon, France
,
J. Fayn
1   Institut National de la Santà et de la Recherche Màdicale - U. 121, Hôpital Cardiologique, Lyon, France
,
M.C. Forlini
1   Institut National de la Santà et de la Recherche Màdicale - U. 121, Hôpital Cardiologique, Lyon, France
› Author Affiliations
The authors are indebted to J. Carew for editorial assistance in the preparation of the English manuscript and M. Th. Rameaux for secretarial assistance.
Further Information

Publication History

Publication Date:
06 February 2018 (online)

Abstract

To provide an in-depth interpretation of the spatial QRS-T contour, we established a set of vectorcardiographic parameters computed octant by octant. For each statement the criteria constitute a model which is closely related to pathophysiological patterns. The diagnostic strategy is of the heuristic type. For each diagnosis a table lists several criteria providing both specific and differential diagnostic information. Inter-table competition is handled by specific logic. The program classifies diagnoses according to the number of non-satisfied criteria. Three versions are available including 124,51 and 7 diagnoses, respectively. The first, intended for interpretation of complex situations, has given satisfactory results in such situations. Rhythm analysis is performed from 8-second recordings.

All functions - acquisition, quality control, choice of a dominant complex, wave recognition, parameter extraction, interpretation, editing, storage -are integrated into a mobile cart. A complementary program performs serial analysis of successive tracings. It highlights with great precision morphological changes in the spatial loops and interval variations.

 
  • REFERENCES

  • 1 Rubel P, Morlet D, Arnaud P. et al. The Lyon microprocessor-based VCG analysis system. In: Willems JL, van Bemmel JH, Zywietz C. eds. Computer ECG Analysis: Towards Standardization. Amsterdam: North-Holland Publ Comp; 1986: 43-8.
  • 2 Morlet D. Contribution è I’ Analyse Auto-matique des Electrocardiogrammes: Algo-rithmes de Localisation, Classification et Delimitation Precise des Ondes dans le Systeme de Lyon (Thàse de Doctorat: N° 86 ISAL 0005 INSA). Lyon, 1986
  • 3 Morlet D, Rubel P, Arnaud P, Forlini MC. Classification des complexes QRS pour l’analyse du rythme cardiaque sur une courte duràe. Màthodes et evaluation, Inn Techn Biol Màd 1983; 04: 255-66.
  • 4 Talmon JL, Kors JA, van Bemmel JH. Adaptative Gaussian filtering in routine ECG/VCG analysis. IEEE Trans ASSP 1986; 34: 527-34.
  • 5 Morlet D, Rubel P, Arnaud P, Willems JL. An improved method to evaluate the precision of computer ECG measurement programs. Int J Biomed Comput 1988; 22: 199-216.
  • 6 Willems JL, Arnaud P, van Bemmel JH. et al. Establishment of a reference library for evaluating computer ECG measurement programs. Comp Biomed Res 1985; 18: 439-57.
  • 7 Willems JL, Arnaud P, van Bemmel JH. et al. Assessment of the performance of electrocardiographic computer programs with the use of a reference database. Circulation 1985; 71: 523-34.
  • 8 Rubel P, Ayad B. The true boundary recognition power of multidimensional detection functions. An optimal comparison. In: Willems JL, van Bemmel JH, Zywietz C. eds. Computer ECG Analysis: Towards Standardization. Amsterdam: North-Holland Publ Comp; 1986: 97-103.
  • 9 Bockmann RD, Dudeck J, Weber G, Kluss D. Parametrisation of the templates for the detection of QRS-onset and -offset. Comp in Cardiology 1977; 601-4.
  • 10 Arnaud P. Information contained in vectorcardiograms. Procedures of analysis and characterization of the QRS loop. Cardiologia 1966; 48: 9-20.
  • 11 Arnaud P. Quantitative vectorcardiography. A spatial approach as the basis of a new diagnostic logic. In: van Dam RT, van Oosterom A. eds. Electrocardiographic Body Surface Mapping. Dordrecht: Marti-nus Nijhoff; 1986: 225-32.
  • 12 Arnaud P, Rubel P. The Lyon ECG Program. In: van Bemmel JH, Willems JL. eds. Trends in Computer-Processed Electrocardiograms. Amsterdam: North-Holland Publ Comp; 1977: 175-81.
  • 13 Rubel P, Arnaud P, Prevot D. Systeme d’aide è la dàcision. Application è I’inter-pretation automatique des vectocardio-grammes. Int J BioMed Comp 1975; 06: 193-211.
  • 14 Arnaud P, Fayn J, Tadary B, Frachon M, Rubel P. Evaluation of QRS interpretation by the Lyon VCG program in cases having 2 or 3 associated diagnoses. In: Willems JL, van Bemmel JH, Zywietz C. eds. Computer ECG Analysis: Towards Standardization. Amsterdam: North-Holland Publ Comp; 1986: 195-201.
  • 15 Willems JL, Abreu-Lima C, Arnaud P. et al. Evaluation of ECG interpretation results obtained by computer and cardiologists. Meth Inform Med 1990; 29: 308-16.
  • 16 Willems JL, Abreu-Lima C, Arnaud P. et al. Effect of combining electrocardiographic interpretation results on diagnostic accuracy. Europ Heart J 1988; 09: 1348-55.
  • 17 Willems JL. A review of computer ECG analysis: time to evaluate and standardize. CRC Crit Rev Med Inform 1987; 01: 165-207.
  • 18 Fayn J. L’Analyse Sàquentielle des Electrocardiogrammes. Une Approche par Comparaison Optimale dTmages Filaires Spatio-Temporelles (These de Doctorat. N° 90 ISAL 0007 INSA). Lyon, 1990
  • 19 Fayn J, Rubel P. CAVIAR, a serial ECG processing system for the Comparative Analysis of VCGs and their Interpretation with Auto-Reference to the patient. J Electrocardiol 1988; 21 (Suppl): 173-6.
  • 20 Fayn J, Rubel P, Arnaud P. A new methodology for optimal comparison of serial vectorcardiograms. In: Ripley KL. ed. Computers in Cardiology. Long Beach Calif: IEEE Computer Society; 1984: 467-70.
  • 21 Rubel P, Fayn J, Arnaud P. et al. New strategies in serial VCG comparison and trend analysis. In: Willems JL, van Bemmel JH, Zywietz C. eds. Computer ECG Analysis: Towards Standardization. Amsterdam: North-Holland Publ Comp; 1986: 323-8.
  • 22 Fayn J, Rubel P, Arnaud P. et al. New serial VCG comparison techniques, application to the detection of myocardial infarction after bypass surgery. In: Ripley KL. ed. Computers in Cardiology. Long Beach Calif: IEEE Computer Society; 1987: 533-6.
  • 23 Rubel P, Fayn J, Forlini MC, Arnaud P. Stability of serial VCG parameters among a normal male population recorded before and after physical training. In: Ripley KL. ed. Computers in Cardiology. Long Beach Calif: IEEE Computer Society; 1988: 239-42.
  • 24 Rubel P, Fayn J, Mohsen N, Girard P. New methods of quantitative assessment of the extent and significance of serial ECG changes of the repolarization phase. J Electrocardiol 1988; 21 (Suppl): 177-82.