Improving reliability of ‘Total-Cosine-R-to-T’ (TCRT) in patients with acute myocardial Infarction

The parameter TCRT (total cosine R-to-T) calculated from ECG recording has been shown to have a remarkable prognostic value as a predictor of the outcomes of the coronary artery disease and the acute myocardial infarction (AMI) patients. The TCRT is conventionally calculated using an algorithm produced by Acar et al. (1999). In this study, the reliability of the healthy group (n=25) and the AMI group (n=45). Typical problems occurred in the detection of the maximum of the T vector (9% of patients), the bounding of the R wave (18%), a comprehensive segmentation (11%), and a decreased congruence between TCRT and the spatial QRS-T angle (33%). The results show that small improvements to the basic algorithm can decrease the number of failures up to 82% in AMI data. It is concluded that segmentation properties should be improved in the basic TCRT algorithm in order to maintain the diagnostic value of TCRT in different patient data.