Computer ST segment measurement during transesophageal atrial pacing stress

Transesophageal atrial pacing (TAP) has been proposed as a noninvasive alternate modality of cardiac stress for patients who cannot perform an adequate exercise stress test. Present computer methods for processing the exercise ECG are inadequate in analyzing the unique surface ECG recorded during a TAP stress procedure. This is due to the presence of large simulator-induced pacing artifacts which confound computer beat identification. The authors have developed hardware to suppress the large pacing artifact, and a software method to detect the R wave, determine sustained capture, and calculate beat-by-beat and average ST-segment level, St slope, R-wave amplitude, and instantaneous RR interval and heart rate. They employ five different computer methods (single-point, average, weighted-average, linear least-squares and parabolic least-squares) in ST-segment measurements. They demonstrate the deficiency of present exercise ECG computer methods in processing the ECG during stress and show the significantly enhanced performance of their own technique on real ECG data.<>