Computer diagnosis of cardiac rhythm

The present systems for computer analysis of cardiac rhythm both for routine clinical electrocardiography and for monitoring of cardiac arrhythmias have been presented. The earlier approaches have been supplanted by more complex techniques which rival the competence of the human observer. Obviously the accuracy of such methods will vary with the type of clinical application; that is, the greater accuracy in screening of normal subjects stands in sharp contrast to the results obtained in hospital application, especially in the coronary or other intensive care units where the incidence of complex cardiac arrhythmias will be high. The basic factors upon which computer rhythm diagnoses depend include the accuracy of measurements, the degree of sophistication of the program, and the quality of the electrocardiographic recordings. Poor original tracings with high noise levels and artifacts will play havoc with any system. Various filtering methods for noise level reduction may be found to be unsatisfactory solutions because of resultant distortion of the electrocardiographic signals. The Mount Sinai Hospital Cro Med Bionics system for routine computer analysis of electrocardiograms in New York City and satellite locations has been presented and illustrated. Whereas ongoing studies reveal the computer accuracy rate for cardiac rhythm diagnosis to be over 80 per cent in hospital environments, the accuracy in screening normals is well over 99 per cent. The computer diagnostic accuracy for electrocardiographic contour may be well over 90 per cent. Considering the variability among and within human observers, these figures are exceptionally high. The recent improvement in programs for computer diagnosis in electrocardiographic monitoring is likewise dramatic. Constant upgrading of recording and computer equipment, better methods for data transmission, and continual updating of programs are receiving the emphasis necessary for greater success in this field. Moreover, these changes have been associated with a marked reduction in cost so that computer diagnosis of cardiac rhythm has become an economically feasible technique. The final aim is for analysis of cardiac arrhythmias by computer to attain an important, valuable, routine clinical role in the coronary and intensive care units and in the automated hospital heart station.