Implementation of vector based approach using cardiac vector theory in mobile ECG application to improve ECG Competence for Junior Medical Professionals

Title : Implementation of vector based approach using cardiac vector theory in mobile ECG application to improve ECG Competence for Junior Medical Professionals

Abstract:

Introduction: Mobile ECG applications detect the heart's electrical signals from the skin surface using the electrodes and sensors. The signals are amplified and then filtered to remove artifacts. The software identifies the various components of the ECG waves, analyze them and display the usual metrics. This can be transmitted to a healthcare professional through wireless transmission which helps in decreasing the time delay in detection of abnormal ECG findings and the earlier management of coronary artery diseases especially the myocardial infarction.

ECG is one of the most important, cost-effective, safest,  non-invasive cardiac diagnostic tests done in hospital settings which requires only few minutes to complete the test and get the results yet its interpretation remains a challenging and arduous task for junior medical staffs that often requires expert opinion. Before a century Einthoven used vectors to represent the cardiac electrical activity. The complete detailed description of the Cardiac vector theory and its clinical utility for ECG interpretation was proposed and explained in detail by Rajini Samuel (current author) in the previous research articles.

Aim: To Implement the Vector Based Approach using Cardiac Vector Theory in Mobile ECG Application to improve ECG Competence for Junior Medical Professionals

Methods: The proposed cardiac vector theory was derived using the mathematical concepts of dot product of two vectors. The projection of heart vector onto the lead vector is applied. Using their relationship the cardiac vector angle and magnitude can be easily understood and calculated. Each cardiac wave (P, QRS, T, ST Segment) represented in the form of circles can be constructed utilizing MATLAB software by the already existing equations that interrelates the bipolar and unipolar limb lead voltage recordings.

Results: Cardiac vector magnitude and angle(axis) determination was clearly depicted in each of the four quadrant using graphical vector representation citied with various abnormal ECGs. The cardiac axis calculation remains an arduous and challenging task. Therefore this detailed vector based approach will serve as an important guide to the medical students to easily observe, understand and comprehend the changes in the magnitude and direction of the cardiac vector in various common clinical conditions like ischemia, injury, infarction, hypertrophy, enlargement, bundle branch block etc.

Conclusion: The cardiac vector theory forms the basic foundation for the initial teaching of ECG tracings and guide us to analyze, correlate and comprehend the observed changes in ECG waves in various leads in different cardiac conditions. The implementation of vector based approach in Mobile ECG Application by graphical cardiac vector representation using the cardiac vector theory may help in improving the ECG competence among the junior medical professionals thereby reducing the time lag between the detection and management of cardiac emergencies. This may serve as a supporting diagnostic tool for ECG interpretation for earlier screening and quicker referral to a speciality center for further management.

Keywords: Mobile Application, Supporting Diagnostic Tool, ECG Interpretation, Cardiac Vector Theory

Biography:

T.Rajini Samuel did MBBS (2004 -2010) in Chengalpattu Government Medical College. He started doing research in Electrocardiogram (ECG) interpretation during his undergraduate studies. He worked for two years as a duty doctor in Venkateshwara Hospitals, Nandanam, Chennai to complete the ECG project. He had proposed the cardiac vector theory, developed  a Novel  ECG interpretation using Vector Based approach  and published 7 research articles related to his novel Cardiac Vector theory that helps in the understanding and interpretation of ECG report. Coronary heart disease remains the number one killer disease of the world. The proposed cardiac vector theory has immense clinical value in the teaching and interpretation of abnormal ECG findings. Currently he is involved in the process of  implementing of his novel ECG research findings collaborating with Mobile ECG device manufactures.

He did his post-graduation in Biochemistry and completed M.D in Biochemistry (2012-2015) in Sree Balaji Medical College and Hospitals, Chennai. After completing his post-graduation, he joined as an Assistant Professor of Biochemistry in May 2015 in Shri Sathya Sai Medical College and Research Institute, SBV Chennai Campus. He was promoted as an Associate Professor on 1^st September 2020 and Professor of Biochemistry on 15th November 2023 in the same institute.

He started his research on Arterial Blood Gas (ABG) interpretation during his post-graduation. He had proposed a novel pH based ABG interpretation method and also developed a novel four quadrant graphical tool for ABG interpretation. He had published 23 research articles, 3 books and one book chapter related to Arterial Blood Gas (ABG) interpretation. During COVID times, he concentrated his research on ventilator. He had derived novel equations of motion for mechanical ventilation and published 4 research articles on Ventilator Graphics Interpretation.

He had developed a Mobile Application for ABG Interpretation using the innovative interpretation and graphical methods developed by him integrating it with already existing ABG interpretation methods. The name of the Mobile App is ccareabg. Currently he is involved in the process of testing of his ccareabg Mobile APP with many hospitals for its successful launch.

He received Atmanirbhar Bharath Award 2022 and Indian Achievers Award 2021 for excellence in innovation awarded by Indian Achievers Forum, High Flyers Global Achievers Award 2022- The best Medical Science Researcher, "International Best Researcher Award" by high society ISSN International Research Awards Congress (IIRAC 2024) and International Best Scientist award awarded by Honourable Education Minister of Tamil Nadu at the conference Scopus Index Conclave 2025.