Peter R Rijnbeek

Erasmus MC, Rotterdam, South Holland, Netherlands

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Publications (15)51.62 Total impact

  • Peter R Rijnbeek
    Drug safety : an international journal of medical toxicology and drug experience. 10/2014;
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    ABSTRACT: Although sudden cardiac death (SCD) is relatively common, contemporary data on its incidence are lacking.
    Heart rhythm: the official journal of the Heart Rhythm Society 09/2014; · 4.56 Impact Factor
  • Peter R Rijnbeek
    Drug safety : an international journal of medical toxicology and drug experience. 09/2014;
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    ABSTRACT: Sudden cardiac death (SCD) is a major health burden and is primarily caused by ventricular arrhythmias. Currently, the most well-known marker for the risk of ventricular arrhythmias is QT/QTc prolongation. Animal studies indicate that QT variability might be a better indicator. Our objective was to give an overview of the literature on QT variability in humans, therefore we performed a free-text search in PubMed and Embase from inception through February 2013. We identified nine QT variability markers in 109 studies reporting on QT variability markers, measured on the surface ECG. QT variability can be distinguished using two characteristics: heart rate normalisation and whether QT interval is measured on consecutive beats. Most study populations were small (median 48 subjects, range 1-805) and different methods, time intervals and leads for measurement were used. QT variability markers were determinants for the risk of ventricular arrhythmias, (sudden) cardiac death and total mortality. Few studies compared the predictive value of QT variability with that of QT/QTc prolongation. A study comparing all different QT variability markers is lacking. In conclusion, QT variability markers are potential determinants of ventricular arrhythmias and cardiac mortality. However, it is unclear which marker and methodology are clinically most useful as well as what reference values are reliable. More studies on larger datasets are needed to find the most accurate marker for the prediction of arrhythmias and SCD to assess its value in addition to QT/QTc duration and its role in drug-induced arrhythmia and sudden death.
    Heart (British Cardiac Society) 08/2014; · 5.01 Impact Factor
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    ABSTRACT: To establish an up-to-date and comprehensive set of normal values for the clinically current measurements in the adult ECG, covering all ages for both sexes.
    Journal of electrocardiology. 08/2014;
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    ABSTRACT: In this study we compare a variety of ECG criteria for predicting the culprit artery in cases with ST-segment elevation myocardial infarction (STEMI). We also assess the performance of these criteria for patients who did not meet the STEMI criteria although having an acute myocardial infarction (AMI).
    Computing in Cardiology, 2010; 10/2010
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    Peter R. Rijnbeek, Jan A. Kors
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    ABSTRACT: Greedy approaches suffer from a restricted search space which could lead to suboptimal classifiers in terms of performance and classifier size. This study discusses exhaustive search as an alternative to greedy search for learning short and accurate decision rules. The Exhaustive Procedure for LOgic-Rule Extraction (EXPLORE) algorithm is presented, to induce decision rules in disjunctive normal form (DNF) in a systematic and efficient manner. We propose a method based on subsumption to reduce the number of values considered for instantiation in the literals, by taking into account the relational operator without loss of performance. Furthermore, we describe a branch-and-bound approach that makes optimal use of user-defined performance constraints. To improve the generalizability we use a validation set to determine the optimal length of the DNF rule. The performance and size of the DNF rules induced by EXPLORE are compared to those of eight well-known rule learners. Our results show that an exhaustive approach to rule learning in DNF results in significantly smaller classifiers than those of the other rule learners, while securing comparable or even better performance. Clearly, exhaustive search is computer-intensive and may not always be feasible. Nevertheless, based on this study, we believe that exhaustive search should be considered an alternative for greedy search in many problems.
    Machine Learning 01/2010; 80:33-62. · 1.47 Impact Factor
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    ABSTRACT: Previous studies to determine the sensitivity of the electrocardiogram (ECG) for left ventricular hypertrophy (LVH) in children had their imperfections: they were not done on an unselected hospital population, several criteria used in adults were not applied to children, and obsolete limits of normal for the ECG parameters were used. Furthermore, left ventricular mass (LVM) was taken as the reference standard for LVH, with no regard for other clinical evidence. The study population consisted of 832 children from whom a 12-lead ECG and an M-mode echocardiogram were taken on the same day. The validity of the ECG criteria was judged on the basis of an abnormal LVM index, either alone or in combination with other clinical evidence. The ECG criteria were based on recently established age-dependent normal limits. At 95% specificity, the ECG criteria have low sensitivities (<25%) when an elevated LVM index is taken as the reference for LVH. When clinical evidence is also taken into account, the sensitivity improved considerably (<43%). Sensitivities could be further improved when ECG parameters were combined. The sensitivity of the pediatric ECG in detecting LVH is low but depends strongly on the definition of the reference used for validation.
    Pediatric Cardiology 04/2008; 29(5):923-8. · 1.20 Impact Factor
  • Peter R. Rijnbeek, Gerard van Herpen, Jan A. Kors
    Journal of Electrocardiology - J ELECTROCARDIOL. 01/2006; 39(4).
  • Journal of Electrocardiology 02/2004; 37 Suppl:198-200. · 1.09 Impact Factor
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    ABSTRACT: Accurate normal limits of the electrocardiogram (ECG) are the basis on which diagnostic criteria are developed. The ECG, however, is subject to age- and sex-variations and may also be racially determined. Studies into normal ECG limits for the Chinese, comprising one fifth of the world population, are few and have their limitations. We have undertaken to establish normal limits of the ECG from a large sample of healthy Chinese subjects. Standard simultaneous 12-lead ECGs from 5360 apparently healthy Chinese subjects (3614 men and 1746 women, ages ranging from 18 to 84 years) were collected with a modern digital recorder and processed with a well-validated ECG computer program. The medians, lower limits (2nd percentile) and upper limits (98th percentile) of various ECG measurements were calculated and age and sex differences examined. Significant age trends were present in, for example, P-wave duration, QTc interval, and frontal QRS axis, with concomitant changes of R amplitudes in the extremity leads. Sex differences existed for heart rate, interval durations, the Sokolow and Cornell indices, and QRS and ST-T amplitudes in different leads. Notably, left-precordial R-wave amplitudes in women increased with age; the Sokolow index showed a clearer age trend for men than for women, the reverse being true for the Cornell index. Some of these findings are at odds with established diagnostic ECG criteria. Normal ECG limits of Chinese subjects show marked age and sex differences. This merits the definition and use of age- and sex-specific ECG criteria for a Chinese population.
    International Journal of Cardiology 02/2003; 87(1):37-51. · 6.18 Impact Factor
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    P R Rijnbeek, J A Kors, M Witsenburg
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    ABSTRACT: Previous studies that determined the frequency content of the pediatric ECG had their limitations: the study population was small or the sampling frequency used by the recording system was low. Therefore, current bandwidth recommendations for recording pediatric ECGs are not well founded. We wanted to establish minimum bandwidth requirements using a large set of pediatric ECGs recorded at a high sampling rate. For 2169 children aged 1 day to 16 years, a 12-lead ECG was recorded at a sampling rate of 1200 Hz. The averaged beats of each ECG were passed through digital filters with different cut off points (50 to 300 Hz in 25-Hz steps). We measured the absolute errors in maximum QRS amplitude for each simulated bandwidth and determined the percentage of records with an error >25 microV. We found that in any lead, a bandwidth of 250 Hz yields amplitude errors <25 microV in >95% of the children <1 year. For older children, a gradual decrease in ECG frequency content was demonstrated. We recommend a minimum bandwidth of 250 Hz to record pediatric ECGs. This bandwidth is considerably higher than the previous recommendation of 150 Hz from the American Heart Association.
    Circulation 01/2002; 104(25):3087-90. · 15.20 Impact Factor
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    ABSTRACT: Previous studies that determined the normal limits for the paediatric ECG had their imperfections: ECGs were recorded at a relatively low sampling rate, ECG measurements were conducted manually, or normal limits were presented for only a limited set of parameters. The aim of this study was to establish an up-to-date and complete set of clinically relevant normal limits for the paediatric ECG. ECGs from 1912 healthy Dutch children (age 11 days to 16 years) were recorded at a sampling rate of 1200 Hz. The digitally stored ECGs were analysed using a well-validated ECG computer program. The normal limits of all clinically relevant ECG measurements were determined for nine age groups. Clinically significant differences were shown to exist, compared with previously established normal limits. Sex differences could be demonstrated for QRS duration and several amplitude measurements. These new normal limits differ substantially from those commonly used and suggest that diagnostic criteria for the paediatric ECG should be adjusted.
    European Heart Journal 05/2001; 22(8):702-11. · 14.72 Impact Factor
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    ABSTRACT: The interpretation pediatric electrocardiograms (ECGs) is complicated because of the strong age-dependency of the diagnostic criteria. We wanted to develop and evaluate a computer program for the interpretation of pediatric 12-lead ECGs. Continuous age-dependent normal limits were established based on ECGs from 1,912 healthy Dutch children. Additionally, a reference interpretation was obtained for 1,718 ECGs recorded at the Sophia Children's Hospital. The total set of ECGs was divided in a training set of 1076 ECGs and a test set of 642 ECGs. All ECGs were recorded at a sampling rate of 1,200 Hz. Based on the normal limits and the training set, diagnostic rules were formalized in an iterative process by using expert interviews and automatic rule induction. The resultant rules were evaluated on the test set. The performance of the program, on our study population, appears to justify its use in a clinical setting. Preferably, the program should also be evaluated in other clinical centers.
    Journal of Electrocardiology 02/2001; 34 Suppl:85-91. · 1.09 Impact Factor
  • P R Rijnbeek, M Witsenburg, J Hess, J A Kors
    Journal of Electrocardiology 02/2000; 33 Suppl:199-201. · 1.09 Impact Factor

Publication Stats

154 Citations
51.62 Total Impact Points

Institutions

  • 2014
    • Erasmus MC
      • Department of Medical Informatics
      Rotterdam, South Holland, Netherlands
  • 2000–2014
    • Erasmus Universiteit Rotterdam
      • Department of Medical Informatics
      Rotterdam, South Holland, Netherlands