Biomedical Engineering Reference
In-Depth Information
inv
1
:
PR
_
Int
∈
120
..
250
inv
2
:
Disease
_
step
2
∈
Disease
_
Codes
_
Step
2
inv
3
:
QRS
_
Int
∈
50
..
150
inv
4
:
M
_
Shape
_
Complex
∈
LEADS
→
BOOL
inv
5
:
Slurred
_
S
∈
LEADS
→
BOOL
inv
6
:
Notched
_
R
∈
LEADS
→
BOOL
inv
7
:
Small
_
R
_
QS
∈
LEADS
→
BOOL
inv
8
:
Slurred
_
S
_
duration
∈
LEADS
→ N
1
inv
9
:
Sinus
=
Ye s
∧
PR
_
Int >
200
∧
Disease
_
step
2
=
First
_
degree
_
AV
_
Block
Heart
_
State
=
KO
inv
10
:
Sinus
=
Ye s
∧
QRS
_
Int
≥
120
∧
Disease
_
step
2
∈{
LBBB, RBBB
}
Heart
_
State
=
KO
:
Sinus
=
Ye s
∧
Disease
_
step
2
=
First
_
degree
_
AV
_
Block
inv
11
Heart
_
State
=
KO
inv
12
:
Sinus
=
Ye s
∧
Disease
_
step
2
=
LBBB
Heart
_
State
=
KO
inv
13
:
Sinus
=
Ye s
∧
Disease
_
step
2
=
RBBB
Heart
_
State
=
KO
inv
14
:
Heart
_
Rate
∈
60
..
100
∧
Sinus
=
Ye s
∧
PR
_
Int
≤
200
∧
QRS
_
Int <
120
Heart
_
State
=
OK
To express formal logic for a new set of diagnoses for the ECG signal, we in-
troduce three events
PR_Test
,
QRS_Test_LBBB
and
QRS_Test_RBBB
.The
PR_Test
interval represents, if the PR intervals are abnormal (
>
200 ms), then consider the
first-degree atrioventricular (AV) block. The next two events
QRS_Test_LBBB
and
QRS_Test_RBBB
are used to assess the QRS duration for the bundle branch block
and states that, if the QRS interval is
120 ms, the bundle branch block is present.
Understanding the genesis of the QRS complex is an essential step and clarifies the
ECG manifestations of bundle branch blocks [
16
]. We formalise the basic criteria to
distinguish between RBBB and LBBB in the diagnosis process.
≥
Left Bundle Branch Block (LBBB)
•
QRS duration
≥
120 ms.
•
A small R- or QS-wave in V1 and V2.
•
A notched R-wave in leads I, V5, and V6.
Right Bundle Branch Block (RBBB)
•
QRS duration
≥
120 ms.
•
M-shaped complex in V1 and V2.
•
Slurred S-wave in leads 1, V5, V6; and an S-wave that is of greater amplitude
(length) than the preceding R-wave.
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