ST-segment analysis using hidden Markov model beat segmentation: Application to ischemia detection

In this work, we propose an ECG analysis system to ischemia detection. This system is based on an original markovian approach for online beat detection and segmentation, providing a precise localization of all beat waves and particularly of the PQ and ST segments. Our approach addresses a large panel of topics never studied before in others HMM related works: multi-channel beat detection and segmentation, waveform models and unsupervised patient adaptation. Thanks to the use of some heuristic rules defined by cardiologists, our system performs a reliable ischemic episode detection, showing to be a helpful tool to ambulatory ECG analysis. The performance was evaluated on the two-channel European ST-T database, following its ST episode definitions. The experimentation was performed over 48 files extracted from 90. Our best average statistic results are 83% sensitivity and 85% positive predictivity. Performance compares favorably to others reported in the literature.