An Algorithm to Distinguish Ischaemic and Non-ischaemic ST Changes in the Holter ECG

P Langley, EJ Bowers, J Wild, MJ Drinnan, John Allen, AJ Sims, N Brown, A Murray

Research output: Chapter in Book/Report/Conference proceedingConference proceedingpeer-review

24 Citations (Scopus)


Changes in the ECG ST segment are often observed in patients with myocardial ischaemia. However, non-ischaemic changes in ST level are also common thereby limiting ischaemia detection accuracy. The aim of this study was to devise an algorithm and determine its accuracy in distinguishing between ischaemic and non-ischaemic changes in the ECG ST-segment, using expertly annotated ECG data sets as a gold standard reference. The algorithm considered only the change in ST relative to a baseline ST level (/spl Delta/ST) provided by the PhysioNet database, and based on simple level thresholding within specified time windows. An initial score of 82.3% (accuracy 91.1%, with sensitivity 99.0% and specificity 88.8%) was achieved for the learning set. By making slight modifications to the algorithm and introducing principal components of ST it was not possible to improve the original algorithm. The original algorithm was therefore left as our challenge entry achieving an accuracy of 90.7% for the test data set (score of 81.4%, entry 1, 1 May 2003).
Original languageEnglish
Title of host publicationComputers in Cardiology
Number of pages4
ISBN (Print)0-7803-8170-X
Publication statusPublished - 1 Dec 2003
Externally publishedYes
EventComputers in Cardiology 2003 - Thessaloniki Chalkidiki, Greece
Duration: 21 Sep 200324 Sep 2003


ConferenceComputers in Cardiology 2003
City Thessaloniki Chalkidiki


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