Departmental Bulletin Paper 長時間心電図に対する効率的 T 波解析手法の開発と 心臓突然死リスク評価への応用

相原, 光希

This paper proposes a method of efficient assessment of the cardiac risk based on the long term Holter ECG recordings. In order to process a vast amount of clinical data a simplified yet effective method to characterize T-wave morphology changes has been proposed. To eliminate artifact,the beat to beat adaptive artifact detection and rectification methods have been introduced. The method is highly efficient and accurate to be able to substitute the manual artifact detection. Twave alternans, T-wave variability and related indices are suggested to be utilized for the integrated cardiac risk assessment. Automatically derived percentile ordered TWA and TAV values TWAP and TAVP are used for the risk assessment. The method has been applied to the Holter ECG data taken from the 351 outpatients visited Fujita Health University Hospital. It has been shown that TAVP could differentiate patients with ejection fraction < 40. The result agreed with data analysis made by manual artifact rectification by medical doctor. The method will be utilized for the future ubiquitous health care to analyze ECG data on the cloud realized by the life-long ECG data logging by IoT technology.Keywords: T-wave alternans, T-wave amplitude variability, Automatic artifact rectification,Holter ECG, Cardiac risk assessment

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