بهره‌گیری از نقشه‌ی بازگشتی متقاطع لیدهای سینه‌ای، برای تشخیص محل مسیرهای فرعی در بیماران دارای نشانگان ولف-پارکینسون-وایت
محورهای موضوعی : مهندسی پزشکی
سکینه یحیی زاده ساروی
1
(گروه مهندسی پزشکی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران)
نادر جعفرنیا دابانلو
2
(گروه مهندسی پزشکی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران)
علی مطیع نصرآبادی
3
(گروه مهندسی پزشکی، دانشگاه شاهد، تهران، ایران)
علیرضا قربانی شریف
4
(کلینیک آریتمی دکتر قربانی شریف، تهران، ایران)
کلید واژه: تعیین محل, راه فرعی, سندروم ولف-پارکینسون-وایت, نقشه‌ی بازگشتی متقاطع,
چکیده مقاله :
تعیین محل غیرتهاجمی راه فرعی (AP) در بیماران با سندروم ولف-پارکینسون-وایت (WPW) اغلب با تشخیص پزشک از طریق مشاهده سیگنال الکتروکاردیوگرام(ECG) انجام می‌شود و گاهی تشخیص پزشکان در این خصوص با هم متفاوت است. بنابراین یک روش خودکار با صحت بالا می‌تواند این تفاوت را کاهش دهد. هدف این مطالعه، تعیین محل نیمه‌خودکار AP در بیماران WPW با استفاده از ویژگی‌های استخراج شده از نقشه‌ی بازگشتی متقاطع (CRP) لیدهای سینه‌ای متوالی ECG است. شرکت‌کنندگان شامل 31 بیمار WPWی آشکار (69-8 سال، با میانگین سنی 31.19±14.69سال، 32.3%خانم) هستند که در اولین جلسه، از طریق ابلیشن درمان شدند. ویژگی‌های استخراج شده از CRP لیدهای سینه‌ای متوالی، شامل لامیناریتی(LAM) ، ترپ‌تایم (TT)، دترمینیسم (DET) و میانگین طول خطوط قطری(L) محاسبه شدند. برای کاهش ویژگی، روش جستجوی مستقیم ترتیبی (SFS)، برای طبقه‌بندی روش K– نزدیک‌ترین همسایه(KNN) و برای اعتبارسنجی متقابل (CV) روش LOO استفاده شد. روش ارائه شده توانست APهای راست و چپ را در بیماران WPW با صحت 87% (حساسیت: 93.33%، اختصاصیت: 81.25%) تمایز دهد. این نتیجه با استفاده از ویژگی‌های LAM و L استخراج شده به ترتیب از CRP لیدهای V1 و V2 و CRP لیدهای V3 و V4 به دست آمد.
The non-invasive localization of accessory pathway (AP) in patients with Wolff-Parkinson-White (WPW) syndrome is typically performed upon physicians’ diagnoses based on observing their electrocardiogram (ECG) signals, which are not always the same. Therefore, a high-accuracy automatic method can help minimize this gap regarding AP localization. This study was to develop a novel semi-automatic localization of AP in patients with WPW syndrome, using features selected from the cross-recurrence plot (CRP) of consecutive precordial leads on ECG. The study participants comprised of 31 patients with WPW syndrome (aged 8-69, with the mean age of 31.19±14.69, 32.3% female), receiving successful ablation therapy during the first session. The features extracted from the CRP, including laminarity (LAM), trapping time (TT), determinism (DET), and mean length of diagonal line (L) were then analyzed. The feature reduction, The classification and the cross-validation (CV) methods were sequential forward selection (SFS), the k-nearest neighbors (KNN) and the leave-one-out (LOO) respectively. The proposed method could differentiate the right and left APs in the patients with WPW syndrome with the accuracy value of 87% (sensitivity: 93.33%, specificity: 81.25%). These results were achieved by the LAM and L features from the CRP of (V1, V2) and (V3, V4), respectively.
تعیین محل راه فرعی بصورت غیر تهاجمی و نیمه خودکار با استفاده از سیگنال ECG انجام شد.
ویژگیLAM حاصل از CRPی لیدهای V1 و V2 ویژگی موثری در تعیین محل راه فرعی بود.
ویژگی L حاصل از CRPی لیدهای V3 و V4 ویژگی موثری در تعیین محل راه فرعی بود.
تعیین محل راه‌های فرعی راست و چپ با صحت 87% حاصل شد.
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