Biomedical Engineering Reference
In-Depth Information
ECG signal using ST-segment elevation or depression features [
16
]. To assess the
ST-segments elevation or depression; we have formalised the following the textual
criteria:
•
Focus on the ST-segment for elevation or depression. ST-elevation
1000 µm
(0.1 mV) in two or more contiguous ECG leads in a patient with chest pain indi-
cates ST elevation MI (STEMI). The diagnosis is strengthened if there is recipro-
cal depression.
≥
•
ST-elevation in leads II, III, and aVF, with marked reciprocal depression in leads
I and aVL, diagnostic of acute inferior MI.
•
ST-segment elevation in V1 through V5, caused by extensive acute anterior
MI.
•
The ECG of a patient with a subtotal occlusion of the left main coronary artery.
Note the ST elevation in aVR is greater than the ST elevation in V1, a recently
identified marker of left main coronary disease.
•
Features of non-ST-elevation MI (non-Q-wave MI).
•
Elevation of the ST-segment may occur as a normal variant and ST-segment ab-
normalities and MI.
These textual sentences are formulated in the incremental development of our
ECG protocol. This refinement advises scrutiny of the ST-segment before assess-
ment of the T-waves, electrical axis, QT interval, and hypertrophy because the diag-
nosis of acute MI or ischemia is vital and depends on careful assessment of the
ST-segment. Above given criteria are more complex and too ambiguous to rep-
resent. Therefore, we have formalised this part through careful cross reading of
many reliable sources such as literature and encounter suggestions of the medical
experts.
The event
ST_seg_elevation_YES
presents a diagnoses process for the ST Ele-
vation Myocardial Infarction (STMEI). A set of guard predicates characterised the
heart state and shows that the sinus rhythm is
Ye s
, the ST elevation is TRUE and
the length of ST segment elevation is greater than or equal to 1000 µm in two or
more leads (II, III, aVF), or the ST elevation is TRUE and the length of ST seg-
ment elevation is greater than or equal to 1000 µm in two or more contiguous pre-
cordial leads V1 to V6, and disease must be Acute anterior MI or Acute inferior
MI.
EVENT ST
_
seg
_
elevation
_
YES
WHEN
grd1
:
Sinus
=
Ye s
grd2
:
(
∃
l,k
·
l
∈{
II, III, aVF
}∧
k
∈{
II, III, aVF
}∧
(ST
_
elevation(l)
=
TRUE
∧
ST
_
elevation(k)
=
TRUE)
(ST
_
seg
_
ele(l)
≥
1000
∧
ST
_
seg
_
ele(k)
≥
1000
)
∧
l
=
k)
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