Cardiac arrhythmia diagnosis by digital computer: Considerations related to the temporal distribution of P and R waves

A digital computer program has been described for automatic interpretation of cardiac arrhythmias. Emphasis has been placed on determining the diagnostic information which can be obtained by considering only the temporal location of the P and R waves, without regard to their shape. Mechanisms are included which permit progressive reclassification of beats and consequent refinement of the diagnosis in successive parts of the program. Primary attention has been given in this paper to separating out and distinguishing among those sustained (“dominant”) cardiac rhythms which are controlled by the sinus pacemaker (“sinus rhythm group”). Only one of the 21 cases belonging to the abnormal dominant rhythm group was incorrectly diagnosed or could not be assigned a dominant rhythm on the basis of temporal beat distribution input information alone. It is anticipated that the addition of information concerning the shape of the P and R waves will materially reduce the errors further.