Methods Inf Med - Robust detection of sleep apnea from Holter ECGs. Joint assessment of modulations in QRS amplitude and respiratory myogram interference.

Tópicos

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Resumo

TRODUCTION: This article is part of the Focus Theme of Methods of Information in Medicine on "Biosignal Interpretation: Advanced Methods for Studying Cardiovascular and Respiratory Systems".OBJECTIVES: Detect presence of sleep-related breathing disorders (SRBD) in epochs of 1 min by signal analysis of Holter ECG recordings.METHODS: In 121 patients, 140 synchronized polysomnograms (PSGs) and 8-channel Holter ECGs were recorded. The only excluded condition was persistent arrhythmias. Respiratory events as scored from the PSGs were mapped to a 1 min grid and served as reference for ECG-based detection. Moreover, 69/70 recordings of the Physionet Sleep Apnea ECG Database (PADB) were included. We performed receiver operating characteristics analysis of a single, novel time-domain feature, the joint local similarity index (jLSI). Based on cross-correlation, the jLSI quantifies the time-locked occurrence of characteristic low-frequency (LF) modulations in ECG respiratory myogram interference (RMI), QRS amplitude (QRSA) and heart rate.RESULTS: Joint oscillations in QRSA, RMI and the envelope of RMI identified positive epochs with a sensitivity of 0.855 (PADB: 0.873) and a specificity of 0.86 (PADB: 0.88). Inclusion of heart rate did not improve detection accuracy.CONCLUSIONS: Joint occurrence of LF-modulations in QRSA and RMI is a characteristic feature of SRBD that is robustly quantified by the jLSI and permits reliable and reproducible detection of sleep apnea in very heterogeneous settings.

Resumo Limpo

troduct articl part focus theme method inform medicin biosign interpret advanc method studi cardiovascular respiratori systemsobject detect presenc sleeprel breath disord srbd epoch min signal analysi holter ecg recordingsmethod patient synchron polysomnogram psgs channel holter ecg record exclud condit persist arrhythmia respiratori event score psgs map min grid serv refer ecgbas detect moreov record physionet sleep apnea ecg databas padb includ perform receiv oper characterist analysi singl novel timedomain featur joint local similar index jlsi base crosscorrel jlsi quantifi timelock occurr characterist lowfrequ lf modul ecg respiratori myogram interfer rmi qrs amplitud qrsa heart rateresult joint oscil qrsa rmi envelop rmi identifi posit epoch sensit padb specif padb inclus heart rate improv detect accuracyconclus joint occurr lfmodul qrsa rmi characterist featur srbd robust quantifi jlsi permit reliabl reproduc detect sleep apnea heterogen set

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