P and T wave analysis in ECG signals using Bayesian methods

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1.3 - Electrocardiography 21 Figure 1.12: Sinus arrhythmia. Image adapted from [CAM06]. Figure 1.13: Atrial premature contractions (indicated by arrowheads). Image adapted from [CAM06]. Figure 1.14: Ventricular premature contractions (indicated by arrowheads). Image adapted from [CAM06].
22 Chapter 1 - Introduction to Cardiac Electrophysiology these disorganized atrial wavefronts, maintaining organized ventricular depolarization distal to the A-V node with normal QRS complexes. In contrast to atrial fibrillation, the ventricular fibrillation (see Fig. 1.16) is fatal in seconds to minutes: the appearance of fibrillating ventricles has been likened to a “bag of worms” and this causes circulatory arrest, the termination of blood flow through the cardiovascular circuit. Note that as pointed out by P. Laguna et al. in [LJC94], during fibrillation, it is meaningless to measure P, QRS and T wave boundaries and to analyze the waveforms. This kind of ECG pattern is out of the scope of this thesis work. Figure 1.15: Atrial fibrillation. Image adapted from [CAM06]. Figure 1.16: Ventricular fibrillation. Image adapted from [CAM06]. Escape Rhythms The other category of arrhythmias is related to excessively slow rhythms, and abnormal blockages of wavefront propagation. As an extreme case of the heart blockages, an escape beat (see Fig. 1.17) is similar to an ectopic beat, in that it is the initiation of a depolarization wavefront outside of the SA node. However, the difference is that the escape beat is a normal, compensatory response, a normal fail-safe functionality of the heart: there is a network of cardiac cells able to initiate heart beats, so that a key life-sustaining function (e.g., pacing the heart) is not exclusively relegated to a microscopic collection cells in the SA node. Clinical ECG interpretation procedure In analyzing the clinical electrocardiogram, it is important to use a systematic approach. Meanwhile, it may also provide a relevant framework in which to apply numerical analysis techniques to the ECG. The following clinical approach, which is extracted from [CAM06], should not be considered completely thorough, but simply as a guide to understanding how clinicians identify abnormalities in the ECG. 1. Identify the QRS complexes. The following observations should be made:
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Bibliography [AAC81] [AAC + 04] [Al
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BIBLIOGRAPHY 185 [CM08] [CPD09] [CR
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BIBLIOGRAPHY 187 [Har78] [HB97] [he
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P and T wave analysis in ECG signals using Bayesian methods

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