INSTRUCTIONS ON USING SEMIA, Version 3.0.1 Semia, version 3.0.1, is a tool to view time series of diagnostic and morphology parameters of long-term ambulatory recordings, and ST segment annotations with their corresponding ECG waveforms of the Long-Term ST Database. To run Semia type following command: semia & To successfully run Semia following files are needed in the current working directory: sXYYYZ.hea - Header file, where X is the number of ECG leads, YYY is the patient number, and Z is the record number of this patient. This file also contains comments of human annotators, diagnostic data of the patient, and technical data of the record. sXYYYZ.dat - Signal file (ECG data) of the record sXYYYZ_fin.dmy - File with time series of "fine" diagnostic and morphology parameters obtained on average heart beats sXYYYZ_raw.dmy - File with time series of "raw" (resampled - 0.5 samples/sec - and smoothed - 7 point - time series) diagnostic and morphology parameters sXYYYZ_1.sta - ST annotation markers according to annotation protocol A sXYYYZ.cnt - File containing numbers of annotated ST events and their durations according to annotation protocols A, B, and C and numbers of normal and abnormal heart beats semia.opt - File containing Semia's options semia.hlp - File containing this text MAIN WINDOW: After running Semia, main window appears with following buttons: - Open record (dialog to open a record appears) - Exit Semia (dialog to exit Semia) - Open "Lead0" window - Open "Lead1" window - Open "Lead2" window - Open "Data" window - Open "KL" window - Open window with annotators' comments, diagnostic data of the patient and technical data of the record - Open window with numbers of annotated ST events and their durations according to annotation protocol A, and with numbers of normal and abnormal heart beats - Apply semia's options (reads the semia.opt file) - Open window with this text The "Lead" windows display ST annotations and time series of diagnostic parameters (raw and fine ST level functions, raw and fine ST slope functions, raw linearly interpolated ST reference function, raw ST deviation functions, raw and fine heart rate functions, and annotated ST episodes). The "Data" window displays ECG signals corresponding to time instance of active reference annotation (upper) and ECG signals corresponding to time instance of marker (lower). The "KL" window displays time series of ST segment and QRS complex Karhunen-Loeve Transform morphology coefficients. DIALOG TO OPEN AND LOAD A RECORD: When typing the record name in the dialog to open a record, end it with . It is necessary to end the record name with . HINT: A useful hint on how to examine and view ST segment episode annotations with their corresponding ECG waveforms is at the bottom of this help text. OPTIONS: If modifying Semia's options, edit semia.opt file. Rows in the file have following meaning: LineWidth:1 Set the width of the functions Color1:green Color of global and local reference Color2:blue Color of active annotation Color3:red Color of marker and overlays within windows Color4:red Color of overlay from the lead 0 Color5:red Color of overlay from the lead 1 Color6:red Color of overlay from the lead 2 Line width could be 1,2,3,4, while colors could be colors "by name". No white spaces. "LEAD0", "LEAD1", AND "LEAD2" WINDOWS: What are fine and raw time series or functions? Fine functions are those obtained on average heart beats after noise detection during preprocessing phase. Raw functions are those after resampling and smoothing of fine functions. Sampling frequency is 0.5 samples/sec. Semia works in three different modes. You change modes using buttons "Subtr" ("UnSubtr"), and "ConsLR" ("ConsGR"): - Subtracted mode ("Subtr"), active reference is global reference ("ConsGR"): Upper part of a "Lead" window displays ST deviation (subtracted ST level) function - Unsubtracted mode ("UnSubtr"), active reference is global reference ("ConsGR"): Upper part of a "Lead" window displays ST level (unsubtracted ST level) function - Unsubtracted mode ("UnSubtr"), active reference is local reference ("ConsLR"): Upper part of a "Lead" window displays ST level (unsubtracted ST level) function In the bottom part of the "Lead" windows, raw and fine time indexes are indicated by short vertical lines (upper - raw indexes, lower - fine indexes). Description of buttons and menus in the "Lead" windows: < < > - Move backward for one half of screen < << > - Move backward for one screen < > > - Move forward for one half of screen < >> > - Move forward for one screen. Moves are made synchronous for all three (or two) leads. - Set marker. After clicking "Marker" button, click into the "Lead" window. Vertical marker appears in the "Lead" and "KL" windows. /() - Entering subtracted (or unsubtracted) mode. As a result, subtracted ST level function, i.e., ST deviation function (or unsubtracted ST level function, i.e., ST level function) is displayed in the upper part of "Lead" window. /() - Overlay (unoverlay) linearly interpolated ST reference function onto ST level function in the upper part of "Lead" window Menu - Overlay ST level functions from other leads. Options: - Overlay ST level function from lead 0 - Overlay ST level function from lead 1 - Overlay ST level function from lead 2 - Unoverlay overlaied functions. Menu - Displays raw and fine ST level functions, raw and fine ST slope functions, raw ST deviation functions, raw and fine heart rate functions, and annotated ST episodes. Options: - Raw ST level (deviation) function (above), fine heart rate (below)
- Raw ST level (deviation) function (above), raw heart rate (below) - Raw ST level (deviation) function (above), fine ST level function (below) - Raw ST level (deviation) function (above), fine ST slope (below) - Raw ST level (deviation) function (above), raw ST slope (below) - Raw ST level (deviation) function (above), annotated ST episodes (below) - Raw ST level (deviation) function (above), none (below). Menu <12 min> - Time scale (from 1 minute to 96 hours). Options: <1 min>, <2 min>, <3 min>, <6 min>, <9 min>, <12 min>, <24 min>, <30 min>, <1 h>, <2 h>, <4 h>, <6 h>, <12 h>, <24 h>, <48 h>, <96 h>. Chosen scale corresponds to one screen. Menu <100 uV> - Amplitude scale (from 20uV to 5 mV). Options: <20 uV>, <25 uV>, <50 uV>, <75 uV>, <100 uV>, <125 uV>, <150 uV>, <200 uV>, <250 uV>, <500 uV>, <750 uV>, <1 mV>, <2 mV>, <5 mV>. Chosen scale corresponds to one unit (0 - 1). - Examine annotation. After clicking "Exm" button, click as close as possible to an annotation to be examined. Examined annotation becomes current active annotation. /() - Currently examined local reference becomes active reference (global reference becomes active reference). In the case that a local references is active, examining any other local reference makes this last local reference as active reference. Description of annotation markers: M (Marker) - This is not an annotation GR - Global reference LR - Local reference BI - Beginning of ischemic ST episode XI - Extrema of ischemic ST episode EI - End of ischemic ST episode BR - Beginning of heart-rate related ST episode XR - Extrema of heart-rate related ST episode ER - End of heart-rate related ST episode NO - Noise UB - Beginning of unreadable interval UE - End of unreadable interval Description of the left side of the "Lead" window. From top to bottom: [units][uV] R: - Description of units, record number and lead Mode - MANUAL MODE Mode - UNSUBTRACTED/SUBTRACTED ACTIVE: - Active reference (global or local reference) RAW: - Raw time of marker [hh:mm:ss.tht] HRate: - Raw heart rate [bpm] ST80: - Value of raw ST level function [uV] at marker / value of raw ST level function [uV] at current active annotation STSb: - Value of raw ST deviation function [uV] at marker / value of raw ST deviation function [uV] at current active annotation FINE: - Fine time of marker [hh:mm:ss.ttt] HRate: - Fine heart rate [bpm] ST80: - Value of fine ST level function [uV] at marker / value of fine ST level function [uV] at current active annotation Description of the function shown in the lower part of the window [time] There exists a "fast mode" for setting marker and examining annotations: - Any click into a "Lead" window (upper two thirds) using left mouse button inserts a marker. Vertical marker appears in the "Lead" and "KL" windows. - Any click in a "Lead" window close to an annotation using middle mouse button examines this annotation. Examined annotation becomes current active annotation. Any click into lower third of a "Lead" window displays values of the functions at this time instance in the left side of the "Lead" window. Left column of this area displays the values of the functions at the position of the last click, while the right column in this area displays the differences of values of the functions for the last two clicks. "DATA" WINDOW: Lower edge of the "Data" window is resizable. Menu - Signals of lead to display at time instances of active reference and marker. Options: - Display lead 0 - Display lead 1 - Display lead 2. Menu - Signals of lead to overlay. Options: - Overlay lead 0 - Overlay lead 1 - Overlay lead 2 - Unoverlay overlaied leads. Menu <16 sec> - Time interval surrounding raw index of active reference, or marker, from which individual heart beats are taken to compute average heart beat (from single to 5 min). Options: , <2 s>, <4 s>, <6 s>, <10 s>, <16 s>, <20 s>, <30 s>, <1 min>, <2 min>, <3 min>, <4 min>, <5 min>. Menu <520 ms> - Width of the average heart beat (from 200 ms to 1000 ms) Menu - How overlays are plotted. Options: - If overlays are used in menu , this option yields in overlays - If overlays are used in menu , this option yields in overlays with shifts. Menu <6s> - Time scale (from 1 sec to 60 sec). Options: <1 s>, <2 s>, <4 s>, <5 s>, <6 s>, <8 s>, <10 s>, <12 s>, <15 s>, <20 s>, <25 s>, <30 s>, <45 s>, <60 s>. Chosen scale corresponds to one screen. Menu <1 mV> - Amplitude scale (from 50 uV to 5 mV). Options: <50 uV>, <75 uV>, <100 uV>, <125 uV>, <150 uV>, <200 uV>, <250 uV>, <500 uV>, <750 uV>, <1 mV>, <2 mV>, <5 mV>. Chosen scale corresponds to one unit (0 - 1). - Overlay reference waveform over the marker's waveform Description of the left side of the "Data" window. From top to bottom: [units][uV] R: - Description of units and record number Mode - FINE MODE HRate: - Fine heart rate [bpm] Mean: - Samples used to compute amplitudes in ECG signals [smp] ABeat: - Window to compute average beat [sec] Refer. - Time (fine) of the active reference Marker - Time (fine) of the marker Time tick: [msec] "KL" WINDOW: Menu - Display ST segment or QRS complex Karhunen-Loeve Transform coefficients. Options: - Display ST segment KLT coefficients - Display ST segment KLT coefficients. () - Overlay ST segment or QRS complex distance function, i.e., Mahalanobis distance function, (unoverlay ST segment or QRS distance function). The distance function is computed using the first five ST segment or QRS complex KLT coefficients. Menu <1 std> - Amplitude scale (from 0.1 std to 20 std). Options: <0.1 std>, <0.125 std>, <0.2 std>, <0.25 std>, <0.5 std>, <1 std>, <2 std>, <4 std>, <5 std>, <8 std>, <10 std>, <20 std>. Chosen scale corresponds to one unit (0 - 1). Any click into the "KL" window displays values of KL coefficients (and value of distance function, if option "Ovrly" is used). HINT: A useful hint on how to examine and view ST segment episode annotations with their corresponding ECG waveforms: 1. Open and load a record. 2. Open a "Lead0", "Lead1", or "Lead2" window in which you wish to examine the ST segment episode annotations. - Click the "OvrApp" button to get ST reference function. - Choose proper time scale in the "12 min" menu. - Display annotated ST segment episodes by choosing the "Episodes" option in the "HRate" menu. - Find an ST segment episode of interest by moving forward/backward. 3. Open the "Data" window. - Choose the ECG lead (that to be displayed) in the "Lead 0" menu. - Choose the "1 s" option in the "6 s" (Display:) menu. - Choose, say, the "100 uV" or "200 uV" option in the "1m V" (Display:) menu. 4. In previously chosen "Lead" window, examine closest local reference (LR) at the left side of the ST segment episode of interest. For examining, you can use "Exm" button, or, simply move the cursor in the close neighborhod of the local reference of interest and click using middle mouse button. Average heart beat (from 16 second window) corresponding to the local reference annotation will appear in the lower part of the "Data" window. 5. Click the "ConsLR" button in the "Lead" window to make currently examined local reference active. The average heart beat corresponding to examined local refe- rence annotation will be copied to the upper part of the "Data" window. 6. Examine the extrema (XI: ischemic ST episode, XR: heart-rate related ST episo- de) of the ST segment episode of interest. The corresponding average heart beat will be displayed in the lower part of the "Data" window. 7. Click the "OvrRef" button in the "Data" window to overlay the average waveform of the local reference down and over the average waveform of the episode extre- ma in the lower part of the "Data" window.