Novel set of vectorcardiographic parameters for the identification of ischemic patients

Abstract

New signal processing techniques have enabled the use of the vectorcardiogram (VCG) for the detection of cardiac ischemia. Thus, we studied this signal during ventricular depolarization in 80 ischemic patients, before undergoing angioplasty, and 52 healthy subjects with the objective of evaluating the vectorcardiographic difference between both groups so leading to their subsequent classification. For that matter, seven QRS-loop parameters were analyzed, i.e.: (a) Maximum Vector Magnitude; (b) Volume; (c) Planar Area; (d) Maximum Distance between Centroid and Loop; (e) Angle between XY and Optimum Plane; (f) Perimeter and, (g) Area-Perimeter Ratio. For comparison, the conventional ST-Vector Magnitude (STVM) was also calculated. Results indicate that several vectorcardiographic parameters show significant differences between healthy and ischemic subjects. The identification of ischemic patients via discriminant analysis using STVM produced 73.2% Sensitivity (Sens) and 73.9% Specificity (Spec). In our study, the QRS-loop parameter with the best global performance was Volume, which achieved Sens=64.5% and Spec=74.6%. However, when all QRS-loop parameters and STVM were combined, we obtained Sens=88.5% and Spec=92.1%. In conclusion, QRS loop parameters can be accepted as a complement to conventional STVM analysis in the identification of ischemic patients.