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The increasing availability of wearable electrocardiography (ECG) devicesenables the continuous monitoring of individual ECG alterations. This could bebeneficial for patients suffering from acute ischemia but with non-standard ECGfindings that do not fit to the subject-independent and absolute thresholdsdefined in clinical guidelines. In this work, we evaluate the inter-patientmagnitude of individual ECG alterations during ischemia. The freely availableSTAFF III database provides 12-lead ECG recordings of patients before, during,and after elective percutaneous coronary intervention(PCI), where a coronaryvessel is widened with a balloon inflation. We compute individual alterationsof ST-interval and T-wave amplitudes w.r.t. QRS amplitude over time for eachpatient and lead. We demonstrate that determining relative ST-interval/T-waveamplitudes and deriving individual alterations over time is feasible instandard and non-standard ECG recordings. To demonstrate clinical relevance, weuse the features for differentiating N=54 STAFF III patients withatherosclerotic plaque in either the right coronary artery (RCA) or leftascending artery (LAD). Results show significant differences in 5 leads forST-interval alterations and 3 leads for T-wave alterations, which are alsosuggested by clinical guidelines for ischemia detection. Clinical relevance-Assessing individual alterations over time could eventually close the gap inECG evaluation of patients presenting with pre-existing heart conditions andnon-standard ECGs.

Measurement of Individual Alteration in Perioperative ECGs During Elective Percutaneous Coronary Intervention