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Int. J. Environ. Res. Public Health 2018, 15(3), 428; https://doi.org/10.3390/ijerph15030428

An Interoperable System toward Cardiac Risk Stratification from ECG Monitoring

1
Department of Signal Theory and Communications and Telematics Systems and Computing, Rey Juan Carlos University, 28942 Madrid, Spain
2
Department of Signal Theory and Communications, Carlos III University, 28912 Madrid, Spain
3
Niño Jesús Hospital, 28009 Madrid, Spain
4
Doce de Octubre Hospital, 28041 Madrid, Spain
5
Unit of Arrhythmias, University Hospital Virgen de la Arrixaca, 30120 Murcia, Spain
6
Center for Computational Simulation, Universidad Politécnica de Madrid, Boadilla, 28223 Madrid, Spain
*
Author to whom correspondence should be addressed.
Received: 25 January 2018 / Revised: 25 February 2018 / Accepted: 26 February 2018 / Published: 1 March 2018
(This article belongs to the Section Health Services and Health Economics Research)
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Abstract

Many indices have been proposed for cardiovascular risk stratification from electrocardiogram signal processing, still with limited use in clinical practice. We created a system integrating the clinical definition of cardiac risk subdomains from ECGs and the use of diverse signal processing techniques. Three subdomains were defined from the joint analysis of the technical and clinical viewpoints. One subdomain was devoted to demographic and clinical data. The other two subdomains were intended to obtain widely defined risk indices from ECG monitoring: a simple-domain (heart rate turbulence (HRT)), and a complex-domain (heart rate variability (HRV)). Data provided by the three subdomains allowed for the generation of alerts with different intensity and nature, as well as for the grouping and scrutinization of patients according to the established processing and risk-thresholding criteria. The implemented system was tested by connecting data from real-world in-hospital electronic health records and ECG monitoring by considering standards for syntactic (HL7 messages) and semantic interoperability (archetypes based on CEN/ISO EN13606 and SNOMED-CT). The system was able to provide risk indices and to generate alerts in the health records to support decision-making. Overall, the system allows for the agile interaction of research and clinical practice in the Holter-ECG-based cardiac risk domain. View Full-Text
Keywords: electronic health records; archetypes; semantic interoperability; heart rate turbulence; heart rate variability; cardiovascular risk stratification; web system electronic health records; archetypes; semantic interoperability; heart rate turbulence; heart rate variability; cardiovascular risk stratification; web system
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Soguero-Ruiz, C.; Mora-Jiménez, I.; Ramos-López, J.; Quintanilla Fernández, T.; García-García, A.; Díez-Mazuela, D.; García-Alberola, A.; Rojo-Álvarez, J.L. An Interoperable System toward Cardiac Risk Stratification from ECG Monitoring. Int. J. Environ. Res. Public Health 2018, 15, 428.

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