Biomedical Engineering Reference
In-Depth Information
LBBB and RBBB early in the interpretive sequences as delineated previously in re-
finement 2 and refinement 3. This refinement introduces two new variables
S_Depth
and
R_S_Ratio
in form of total functions mapping leads (LEADS) to
. These func-
tions are used to calculate the S-wave depth and ratio of R-wave and S-wave from
the 12-leads ECG signal.
Invariants (
inv
3-
inv
4) are used to verify an abnormal state (
KO
) of the heart in
case of detecting any disease. Two new events (
LVH_Assessment
and
RVH_Assess-
ment
) are introduced to assess the LVH and RVH from the 12-leads ECG. Detailed
textual representation of assessment of the LVH and RVH is given in [
16
].
N
inv
1
:
S
_
Depth
∈
LEADS
→ N
inv
2
:
R
_
S
_
Ratio
∈
LEADS
→ N
inv
3
:
Sinus
=
Ye s
∧
Disease
_
step
6
=
RVH
⇒
Heart
_
State
=
KO
inv
4
:
Sinus
=
Ye s
∧
Disease
_
step
6
=
LVH
_
cause
⇒
Heart
_
State
=
KO
The event
LVH_Assessment
refines
P_Wave_assessment_Broad_Yes_Check_
LAE
. This event is used to assess the Left Ventricular Hypertrophy (LVH) causes.
A set of guards is used to satisfy the required condition for the symptoms of LVH.
The guards of this event state that the broad of P-wave is greater than or equal to
110 ms in leads II and V1, or the diphasic is TRUE in lead II or V1, through the
previous assessment of the disease indicates that the symptoms of LAE, sex is 0 or
1, where 0 denotes for man and 1 denotes for woman, an addition of the depth of
S-wave in lead V1 and R-wave in lead V5 is greater than 35000 µm or an addition
of depth of S-wave in lead V1 and R-wave in lead V6 is greater than 35000 µm, an
addition of the depth of S-wave in lead aVL and R-wave in lead V1 is greater than
or equal to 24000 µm for a man or 18000 µm for woman, LVH specificity is equal to
90 and sensitivity is less than 40, if the previous assessment of the disease indicates
the symptoms of LAE then LVH specificity should be less than 98, and heart state
is in abnormal state.
EVENT
LVH_Assessment
Refines P
_
Wave
_
assessment
_
Broad
_
Ye s
_
Check
_
LAE
ANY
LVH
_
specificity, sensitivity, sex
WHERE
grd1
:
(P
_
Wa v e
_
Broad(II)
≥
110
∧
P
_
Wa v e
_
Broad(V
1
)
≥
110
)
∨
Diphasic(II)
=
TRUE
∨
Diphasic(V
1
)
=
TRUE
grd2
:
Disease
_
step
6
=
LAE
grd5
:
sex
∈{
0
,
1
}
grd3
:
((S
_
Depth(V
1
)
+
R
_
Depth(V
5
)) >
35000
(S
_
Depth(V
1
)
+
R
_
Depth(V
6
)) >
35000
)
grd4
:
((R
_
Depth(aVL)
+
S
_
Depth(V
1
)
≥
24000
)
∧
sex
=
0
)
((R
_
Depth(aVL)
+
S
_
Depth(V
1
)
≥
18000
)
∧
sex
=
1
)
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