Evaluation of a novel portable capacitive ECG system in the clinical practice for a fast and simple ECG assessment in patients presenting with chest pain: FIDET (Fast Infarction Diagnosis ECG Trial)

Two-stage ECG signal denoising based on deep convolutional network

Background.An electrocardiogram (ECG) is an effective and non-invasive indicator for the detection and prevention of arrhythmia. ECG signals are susceptible to noise contamination, which can lead to errors in ECG interpretation. Therefore, ECG pretreatment is important for accurate analysis.Methods.The ECG data used are from CPSC2018, and the noise signal is from MIT-BIH Noise Stress Test Database. In the experiment, the signal-to-noise ratio (SNR), the root mean square error (RMSE), and the correlation coefficientPare used to evaluate the performance of the network. The method proposed is divided into two stages. In the first stage, a U_de-net model is designed for ECG signal denoising to eliminate noise. The DR-net model in the second stage is used to reconstruct the ECG signal and to correct the waveform distortion caused by noise removal in the first stage. In this paper, the U_de-net and the DR-net are constructed by the convolution method to achieve end-to-end mapping from noisy ECG signals to clean ECG signals.Result.In SNR, RMSE andPindicators, U_de-net + DR-net proposed in this paper can achieve the best performance compared with the other five schemes (FCN, U-net etc). In the three data sets, SNR can be increased by 11.61 dB, 13.71 dB and 14.40 dB and RMSE can be reduced by 10.46 × 10^-2, 21.55 × 10^-2and 15.98 × 10^-2.Conclusions.Despite the contradictory results, the proposed two-stages method can achieve both the elimination of noise and the preservation of effective details to a large extent of the signals. The proposed method has good application prospects in clinical practice.

Safety of percutaneous coronary intervention in patients with acute ischemic stroke/transient ischemic attack and acute coronary syndrome

BACKGROUND

Cardiac events in patients with acute stroke are frequent. Urgent PCI in myocardial infarction is crucial to improve outcome. However, the situation is complex as intracranial hemorrhage is a frequent complication of stroke but antithrombotic medication is indispensable during and after PCI. Therefore in this study, we aimed to investigate the safety of percutaneous coronary intervention (PCI) in patients hospitalized with acute ischemic stroke and concomitant acute coronary syndrome (ACS).

METHODS AND RESULTS

In a single-center, case-series study we investigated 80 patients hospitalized with acute stroke/transient ischemic attack (TIA) and concomitant ACS undergoing coronary angiography. Patients with subsequent PCI were compared to patients with medical treatment alone. The primary end point was the composite of death, recurrent MI, coronary re-intervention, recurrent stroke or bleeding during 1-year follow-up. The secondary end point consisted of the components of the primary end point. Age, gender and cardiovascular risk factors did not differ between groups. However, severity of initial stroke and coronary artery disease was higher in the PCI group. Accordingly, antiplatelet medication with aspirin and clopidogrel was prescribed more frequently in the PCI group. Nevertheless, during 1-year follow-up, the primary end point did not differ between groups [38 vs. 50 %, odds ratio (OR) 1.7, CI 0.69-4.07, P = 0.23]. Intracranial hemorrhage was even numerically lower in patients undergoing PCI (5 vs. 3 %, OR 0.4, CI 0.04-5.6, P = 0.46).

CONCLUSIONS

The primary and secondary end points were not enhanced in patients undergoing PCI. Therefore PCI is safe in patients with stroke/TIA and concomitant ACS.