Journal article
Multidimensional rhythm disturbances as a precursor of sustained ventricular tachyarrhythmias
Circulation research, Vol.88(7), pp.705-712
2001
DOI: 10.1161/hh0701.088770
PMID: 11304493
Abstract
Cardiac cycle dynamics reflect underlying physiological changes that could predict imminent arrhythmias but are obscured by high complexity, nonstationarity, and large interindividual differences. To overcome these problems, we developed an adaptive technique, referred to as the modified Karhunen-Loeve transform (MKLT), that identifies an individual characteristic (“core”) pattern of cardiac cycles and then tracks the changes in the pattern by projecting the signal onto characteristic eigenvectors. We hypothesized that disturbances in the core pattern, indicating progressive destabilization of cardiac rhythm, would predict the onset of spontaneous sustained ventricular tachyarrhythmias (VTAs) better than previously reported methods. We analyzed serial ambulatory ECGs recorded in 57 patients at the time of VTA and non-VTA 24-hour periods. The disturbances in the pattern were found in 82% of the recordings before the onset of impending VTA, and their dimensionality, defined as the number of unstable orthogonal projections, increased gradually several hours before the onset. MKLT provided greater sensitivity and specificity (70% and 93%) compared with the best traditional method (68% and 67%, respectively). We present a theoretical analysis of MKLT and describe the effects of ectopy and slow changes in cardiac cycles on the disturbances in the pattern. We conclude that MKLT provides greater predictive accuracy than previously reported methods. The improvement is due to the use of individual patterns as a reference for tracking the changes. Because this approach is independent of the group reference values or the underlying clinical context, it should have substantial potential for predicting other forms of arrhythmic events in other populations.
Details
- Title: Subtitle
- Multidimensional rhythm disturbances as a precursor of sustained ventricular tachyarrhythmias
- Creators
- Vladimir SHUSTERMAN - University of Pittsburgh, Pa, United StatesBenhur AYSIN - University of Pittsburgh, Pa, United StatesKelley P ANDERSON - Marshfield Clinic, Marshfield, Wis, United StatesAnna BEIGEL - Biosonix, Ltd, Hod-Hasharon, Israel
- Resource Type
- Journal article
- Publication Details
- Circulation research, Vol.88(7), pp.705-712
- Publisher
- Lippincott
- DOI
- 10.1161/hh0701.088770
- PMID
- 11304493
- ISSN
- 0009-7330
- eISSN
- 1524-4571
- Language
- English
- Date published
- 2001
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094748202771
Metrics
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