how analyze ecg report

I have an image of ecg report in png file format. i want to calculate hart rate using this ecg report image. this ecg picture in binary image. any one know how to do this.

[Star Strider]

Post the .png file.

[Image Analyst]

Can't you get the actual digital data from the patient's file as saved by the instrument? I would think that would be easier and more accurate than trying to rebuild it from a printout.

[Anupa]

http://imageshack.com/a/img843/5461/bl12.png this is my png file

[Image Analyst]

Can you answer my question too? Why don't you have the electronic file???? Why only a scan of a printout???

[Anupa]

i want to calculate hart rate,qtc interval only analyzing printed reports.

Answer 1

[Star Strider]

You would have to identify both the EKG tracing and the grid that all EKGs are printed on. The minor gridlines 40 ms apart. You could not simply isolate the EKG trace and calculate the rate without also determining the time base from the gridlines.

[Star Strider]

Without the gridlines, measurements are difficult. Assumming a normal PR interval of 200 ms, the rate appears to be 75, the QRS axis is about 70° (the electrocardiography reference is upside-down from the normal mathematical reference, with 0° is to the patient’s left, +90° to the patient’s feet). The normal axis is 60°, so this is slight right-axis deviation. This could be consistent with chronic obstructive pulmonary disease, but without knowing more, it’s impossible to say for sure.

[Star Strider]

The QTc is calculated from the measured QT interval over the square root of the previous R-R interval in seconds. A rate of 75 corresponds to an R-R interval of 800 ms, and with a measured QT of 400 ms (based on an assumed normal PR interval of 200 ms), the QTc = 447 ms meeting the general criteria of ‘borderline’ QT prolongation. (The measured QT should not be longer than half the previous RR interval.) There could also be ‘p-pulmonale’, indicative of right atrial enlargement that would support right heart overload in the context of the right axis deviation. This tracing is noisy, difficult to read, and impossible time or interpret correctly without the reference time- and voltage gridlines.