University of Oulu

Holkeri Arttu, Eranti Antti, Kenttä Tuomas V., Noponen Kai, Haukilahti M. Anette E., Seppänen Tapio, Junttila M. Juhani, Kerola Tuomas, Rissanen Harri, Heliövaara Markku, Knekt Paul, Aro Aapo L., Huikuri Heikki V., Experiences in digitizing and digitally measuring a paper-based ECG archive, Journal of Electrocardiology (2017), doi: 10.1016/j.jelectrocard.2017.09.007

Experiences in digitizing and digitally measuring a paper-based ECG archive

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Author: Holkeri, Arttu1; Eranti, Antti2; Kenttä, Tuomas V.3;
Organizations: 1Division of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Meilahti Tower Hospital, PL 340, Helsinki, HUS, Finland
2Department of Internal Medicine, Päijät-Häme Central Hospital, Keskussairaalankatu 7, Lahti, Finland
3Research Unit of Internal Medicine, Medical Research Center, Faculty of Medicine, Oulu University Hospital and University of Oulu, P.O. Box 5000, Oulu, Finland
4Center for Machine Vision and Signal Analysis, University of Oulu, P.O. Box 4500, Oulu, Finland
5National Institute for Health and Welfare, P.O. Box 30, Helsinki, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Elsevier, 2018
Publish Date: 2019-04-17


Background: No established method for digitizing and digital measuring of paper electrocardiograms (ECG) exists. We describe a paper ECG digitizing and digital measuring process, and report comparability to manual measurements.

Methods: A paper ECG was recorded from 7203 health survey participants in 1978–1980. With specific software, the ECGs were digitized (ECG Trace Tool), and measured digitally (EASE). A sub-sample of 100 ECGs was selected for manual measurements.

Results: The measurement methods showed good agreement. The mean global (EASE)-(manual) differences were 1.4 ms (95% CI 0.5–2.2) for PR interval, −1.0 ms (95% CI −1.5–[−0.5]) for QRS duration, and 11.6 ms (95% CI 10.5–12.7) for QT interval. The mean inter-method amplitude differences of RampV5, RampV6, SampV1, TampII and TampV5 ranged from −0.03 mV to 0.01 mV.

Conclusions: The presented paper-to-digital conversion and digital measurement process is an accurate and reliable method, enabling efficient storing and analysis of paper ECGs.

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Series: Journal of electrocardiology
ISSN: 0022-0736
ISSN-E: 1532-8430
ISSN-L: 0022-0736
Volume: 51
Issue: 1
Pages: 74 - 81
DOI: 10.1016/j.jelectrocard.2017.09.007
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
113 Computer and information sciences
Copyright information: © 2017 Elsevier Inc. All rights reserved.