Prompt and accurate diagnosis of ventricular arrhythmias with a novel index based on phase space reconstruction of ECG

Abstract Aim To develop a statistical index based on the phase space reconstruction (PSR) of the electrocardiogram (ECG) for the accurate and timely diagnosis of ventricular tachycardia (VT) and ventricular fibrillation (VF). Methods Thirty-two ECGs with sinus rhythm (SR) and 32 ECGs with VT/VF were analyzed using the PSR technique. Firstly, the method of time delay embedding were employed with the insertion of delay "τ" in the original time-series X ( t ), which produces the Y ( t )= X ( t − τ ). Afterwards, a PSR diagram was reconstructed by plotting Y (t) against X (t). The method of box counting was applied to analyze the behavior of the PSR trajectories. Measures as mean ( μ ), standard deviation ( σ ) and coefficient of variation ( CV = σ / μ ), kurtosis ( β ) for the box counting of PSR diagrams were reported. Results During SR, CV was always CV increased >0.05. A similar pattern was observed with β , where CV th =0.05 and β th J ) was proposed: J = w C V C V t h + 1 − w β β t h . During SR the upper limit of J was the value of 1. Furthermore CV , β and J crossed the cut-off point timely before the onset of arrhythmia (average time: 4min 31s; SD: 2min 30s); allowing sufficient time for preventive therapy. Conclusion The J index improved ECG utility for arrhythmia monitoring and detection utility, allowing the prompt and accurate diagnosis of ventricular arrhythmias.