Expert system-based application for fatal ventricular arrhythmia risk level estimation based on QT-Interval prolongation

Abstract

There is an overwhelming number of medications that can affect the morphology of the beating heart by delaying the ventricular depolarization and repolarization processes, resulting in an elongated QT interval. This circumstance, in turn, can lead to ventricular arrhythmias, which can result in the patient’s death, as was overwhelmingly the case at the beginning of the coronavirus pandemic. In this regard, this document presents an innovative expert system-based application devoted to estimating the level of risk of fatal ventricular arrhythmia as a consequence of QT prolonging treatments. For this purpose, the use of a fuzzy rule-based system has been considered for the decision-making process, establishing three different risk levels regarding the QT interval obtained from an electrocardiogram, its evolution from a basal electrocardiogram, and other significant clinical information of the patient such as age, sex, among others. This novel expert system-based application has been designed by considering the criteria of several specialist physicians from four different Spanish private and public hospitals. The proposed application can be especially important in primary health care centers, where the absence of specialists is remarkable because it provides clinical staff with a powerful tool for estimating the level of risk of fatal ventricular arrhythmia with 96.5% accuracy when comparing its decisions to those of specialist physicians, which could imply a significant reduction in the risk of death due to fatal ventricular arrhythmias in patients with QT prolonging treatment. In this respect, the developed application is currently used in some primary health care centers in Spain.