High Frequency QRS for Detection of Myocardial Ischemia

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Ischemic Heart Disease (n=183). Intervention: Ischemic Heart Disease (IHD) vs. Healthy subjects. Primary outcome: Maximal amplitude (Amax) of QRS envelope in the HF passband (150-250Hz) in µV (p=<0.0001).

Pavel Leinveber; Josef Halámek; Pavel Jurák; Filip Plešinger; Jolana Lipoldová; Juraj Jurco; Miroslav Novák

doi:10.22489/cinc.2016.087-361

September 14, 2016Computing in cardiologyOpen Access

High Frequency QRS for Detection of Myocardial Ischemia

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Why the study?

Does high frequency QRS analysis of resting ECG differentiate patients with ischemic heart disease from healthy subjects?

Study Design

Type

Observational (n=183)

Structured PICO

Does high frequency QRS analysis of resting ECG differentiate patients with ischemic heart disease from healthy subjects?

P

Population

183 subjects, comprising 103 healthy individuals and 80 patients with angiographically confirmed ischemic heart disease, underwent 5-minute resting high-frequency ECG recordings.

E

Exposure

High frequency QRS (HF-QRS) ECG signal analysis in three frequency ranges (HFQRS 150-250Hz, VHFQRS 250-500Hz, and UHFQRS 500-1000Hz) derived from a 5-minute resting supine ECG.

C

Comparator

Healthy subjects (control group).

O

Outcome

Differences in five QRS signal parameters (Amax, RMS±80ms, RMS0.1Am, Kurtosis, and RAZ) between healthy subjects and IHD patients.surrogate

Main Result

Absolute Event Rate: 8.7% vs 14.7%

p-value: p=<0.0001

Limitations

Very large inter-individual variation limits the clinical usefulness of the parameters to discriminate between normal subjects and IHD patients.
Diagnosis based on measurement only in rest has low sensitivity and specificity.
Decreased signal-to-noise ratio in the UHF passband slightly limits the differences in selected parameters.
Large inter-individual variation limits clinical usefulness to discriminate between healthy subjects and IHD patients
Diagnostics based on ECG measurement only under resting conditions has low specificity and sensitivity
Decreased signal-to-noise ratio in the UHF passband
Binary classification of the RAZ parameter strongly depends on its exact definition

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Implication

While high frequency QRS parameters differ significantly between healthy individuals and those with ischemic heart disease, high inter-individual variability limits their standalone diagnostic utility at rest.

Abstract

Several studies investigating the high frequency QRS (HF-QRS) behavior have reported the superiority of the HF-QRS method compared to the standard ST-segment changes in acute coronary syndrome and ischemic heart disease (IHD).

Discussion

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Cite This Study

Leinveber et al. (2016) conducted an observational in Ischemic Heart Disease (n=183). Ischemic Heart Disease (IHD) vs. Healthy subjects was evaluated on Maximal amplitude (Amax) of QRS envelope in the HF passband (150-250Hz) in µV (p=<0.0001).

synapsesocial.com/papers/6a230c276873956e4bd2704c https://doi.org/10.22489/cinc.2016.087-361

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High Frequency QRS for Detection of Myocardial Ischemia

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

High Frequency QRS for Detection of Myocardial Ischemia

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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