Biomedical Engineering Reference
In-Depth Information
The event QRS_Test_RBBB refines QRS_Test that is used to diagnose right bun-
dle branch block through the testing of QRS-wave. The guards of this event state that
the current QRS interval is within the range of 50 ms to 150 ms, and it is greater
than or equal to 120 ms, sinus rhythm is
Ye s
, the heart is in abnormal state, M-shaped
complex is TRUE in leads (V1 and V2), slurred S-wave is TRUE in leads I, V5 and
V6, and slurred S-wave duration is greater than 40 ms in leads I, V5, and V6.
EVENT
QRS_Test_RBBB
Refines QRS
_
Te s t
ANY
qrs
WHERE
grd1
:
qrs
∈
50
..
150
grd2
:
qrs
≥
120
grd3
:
Sinus
=
Ye s
grd4
:
Heart
_
State
=
KO
grd5
:
M
_
Shape
_
Complex(V
1
)
=
TRUE
∧
M
_
Shape
_
Complex(V
2
)
=
TRUE
grd6
:
Slurred
_
S(I)
=
TRUE
∧
Slurred
_
S(V
5
)
=
TRUE
∧
Slurred
_
S(V
6
)
=
TRUE
∧
grd7
:
Slurred
_
S
_
duration(I ) >
40
∧
Slurred
_
S
_
duration(V
5
)>
40
∧
Slurred
_
S
_
duration(V
6
)>
40
THEN
act1
:
QRS
_
Int
:=
qrs
act2
:
Disvease
_
step
2
:=
RBBB
END
10.5.3 Second Refinement: Assess for Nonspecific Intraventricular
Conduction Delay and Wolff-Parkinson-White Syndrome
This level of refinement of the ECG interpretation assesses for nonspecific intraven-
tricular conduction delay (IVCD) and Wolff-Parkinson-White (WPW) syndrome.
The WPW syndrome may mimic an inferior MI (see in further refinements). If
the WPW syndrome, RBBB, or LBBB is not present, interpret as nonspecific in-
traventricular conduction delay (IVCD) and assess for the presence of electronic
pacing [
16
]. Some new variables (
Delta_Wave
and
Disease_step3
) are introduced
in this refinement to assess atypical right bundle branch block using ECG signal.
Two invariants (
inv
3-
inv
4) are used to declare new variables in form of the total
functions mapping leads (LEADS) to
BOOL
. These functions are used to calculate
the ST-segment elevation and epsilon wave, respectively. Invariants (
inv
5-
inv
8) rep-
resent an abnormal state of the heart (
KO
) when the sinus rhythm is
Ye s
and any
new particular disease is found in this refinement. All these properties are derived
from the original protocol to verify the correctness and consistency of the system
according to the cardiologist.
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