A real-time ST-segment monitoring algorithm based on a multi-channel waveform-length-transform method for Q-onset and J-point detection

In the paper, we present a fully automated real-time multi-lead ST-segment monitoring algorithm. For a representative normal beat in each ST measurement interval, the ECG leads with low signal quality are excluded and the remaining leads are used in a multi-lead waveform-length transformation to form a length signal for Q-onset (Q) and J-point (J) determination. From Q, the isoelectric point is determined and used with the J to measure the ST-segment at J or J plus an offset for all available leads. A development set of 158 records and a test set of 60 records with cardiologists´ beat-by-beat Q and J annotations were used to develop and evaluate the Q and J detection. The ESC ST-T Database and a 60-patient annotated 12-lead PTCA dataset were used to evaluate the algorithm´s ST performance. Detailed statistical results are given in the paper. The test results demonstrate that the described ST-segment monitoring algorithm is effective and reliable.