Arrhythmia Diagnosis Using Morphology and Timing from Atrial and Ventricular Leads

Reliable computer arrhythmia diagnosis is mostly restricted to ventricular arrhythmias because information about atrial activation cannot be reliably obtained from surface lead electrocardiograms (ECGs) [1,2,3]. A two channel computer arrhythmia detection system has been designed and successfully tested on a data base of a simultaneous esophageal electrograms and surface lead ECGs. The system has the unique feature of examining the morphology of atrial depolarizations on the esophageal electrogram as well as QRS morphology on the surface EGG. This allows recognition of both ectopic and retrograde atrial activation. The system measures the interval between two consecutive atrial depolarizations (AA interval), the interval between two consecutive ventricular depolarizations (VV interval), and the interval between the atrial and ventricular depolarizations (AV interval). The system has been tested on twenty-nine passages from twenty-one patients. Test results yielded 99.2% accuracy for single beat diagnosis and 99.5% accuracy for underlying arrhythmia diagnosis. There were no false positives or false negatives.