Abstract
Timely evaluation and reperfusion have improved the myocardial salvage and the subsequent recovery rate of the patients hospitalized with acute myocardial infarction (MI). Long waiting time and time-consuming procedures of in-hospital diagnostic testing severely affect the timeliness. We present a Poincare pattern ensemble-based method with the consideration of multi-correlated non-stationary stochastic system dynamics to localize the infarct-related artery (IRA) in acute MI by fully harnessing information from paper-based Electrocardiogram (ECG). The vectorcardiogram (VCG) diagnostic features extracted from only 2.5-s long paper ECG recordings were used to hierarchically localize the IRA—not mere localization of the infarcted cardiac tissues—in acute MI. Paper ECG records and angiograms of 106 acute MI patients collected at the Heart Artery and Vein Center at Fresno California and the 12-lead ECG signals from the Physionet PTB online database were employed to validate the proposed approach. We reported the overall accuracies of 97.41% for healthy control (HC) vs. MI, 89.41 ± 9.89 for left and right culprit arteries vs. others, 88.2 ± 11.6 for left main arteries vs. right-coronary-ascending (RCA) and 93.67 ± 4.89 for left-anterior-descending (LAD) vs. left-circumflex (LCX). The IRA localization from paper ECG can be used to timely triage the patients with acute coronary syndromes to the percutaneous coronary intervention facilities.
Highlights
Rapid assessment and timely reperfusion therapy have shown to improve the recovery rate in patients with acute myocardial infarction (MI) [1]
The KL eigenfunctions estimated from the covariance matrix of the Poincare ensembles were utilized as the basis functions to estimate the missing heartbeats and subsequent full 10-s length of the missing leads
Based on the classification accuracy, we proposed the use of the classification regression tree (CART) hierarchical classification as the optimal model for the detection of MI vs. healthy control (HC) and support vector machine (SVM) for the localization of different infarct-related artery (IRA)
Summary
Rapid assessment and timely reperfusion therapy have shown to improve the recovery rate in patients with acute myocardial infarction (MI) [1]. Guidelines recommend fibrinolysis and intervention within 30 and 90 min of an acute MI onset to maximize the restoration of the jeopardized myocardium [2]. According to Heart Disease and Stroke Statistics (2017) [3], only 50% of acute MI patients are treated with thrombolytic agents and. The guidelines are often not followed in over-crowded hospitals due to the significant amount of delay between para-clinical first response to conclusive intervention [4]. Such a delay is incurred due to waiting and queuing at the overloaded emergency and the time consumed during various stages of elaborate lab diagnostic tests [5,6]. Many efforts have been devoted to reduce the door-to-device’s
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