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A supervised neural network (NN)-based algorithm was used for automated detection of ischemic episodes resulting from ST segment elevation or depression. The performance of the method was measured using the European ST-T database. In particular, the performance was measured in terms of beat-by-beat ischemia detection and in terms of the detection of ischemic episodes. The algorithm used to train the NN was an adaptive backpropagation (BP) algorithm. This algorithm drastically reduces training time (tenfold decrease in our case) when compared to the classical BP algorithm. The recall phase of the NN is then extremely fast, a fact that makes it appropriate for real-time detection of ischemic episodes. The resulting NN is capable of detecting ischemia independent of the lead used. It was found that the average ischemia episode detection sensitivity is 88.62% while the ischemia duration sensitivity is 72.22%. The results show that NN can be used in electrocardiogram (EGG) processing in cases where fast and reliable detection of ischemic episodes is desired as in the case of critical care units (CCUs).