Improved robust T-wave alternans detectors

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• 作者：O. Meste (1)
  D. Janusek (2)
  S. Karczmarewicz (3)
  A. Przybylski (4)
  M. Kania (2)
  A. Maciag (4)
  R. Maniewski (2)
  
  1. Laboratoire I3S UNS-CNRS UMR7172 ; Universit茅 de Nice-Sophia Antipolis ; 2000 route des lucioles Les Algorithmes - bt. Euclide B ; CS 40121 ; 06903 ; Sophia Antipolis Cedex ; France
  2. Nalecz Institute of Biocybernetics and Biomedical Engineering PAS ; Ks Trojdena 4 St. ; 02-109 ; Warsaw ; Poland
  3. Warsaw Education Center CVG Medtronic Poland ; Warsaw ; Poland
  4. Cardiac Arrhythmias Department ; National Institute of Cardiology ; Warsaw ; Poland
  
• 关键词：T ; wave alternans ; Detector ; Electrocardiography ; Ventricular arrhythmia
• 刊名：Medical and Biological Engineering and Computing
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：53
• 期：4
• 页码：361-370
• 全文大小：360 KB
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• 刊物类别：Engineering
• 刊物主题：Biomedical Engineering
  Human Physiology
  Imaging and Radiology
  Computer Applications
  Neurosciences
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1741-0444

文摘

New statistical and spectral detectors, the modified matched pairs t test, the extended spectral method and the modified spectral method, were proposed for T-wave alternans (TWA) detection gaining robustness according to trend and single-frequency interferences. They were compared to classic detectors such as matched pairs t test, unpaired t test, spectral method, generalized likelihood ratio test and estimated TWA amplitude within a simulation framework and applied to real data. The optimal detection threshold was selected by using a full Monte-Carlo simulation where signals, with and without alternans episodes, were corrupted by Gaussian noise with different power and single-frequency interferences with different tones. All the combinations of noise and frequency were selected and repeated 500 times in order to compute probability of detection ( \(P_{\mathrm{d}}\) ) and the false alarm probability ( \(P_{\mathrm{fa}}\) ), providing ROC curves. The study group consisted of 50 patients with implantable cardioverter-defibrillator (age: \(55.3 \pm 16.4\) ; LVEF: \(42.8 \pm 15.5\) ), who were paced (ventricular pacing) at 100 bpm. Two-minute recordings were analyzed. The XYZ orthogonal lead system was used. The best performance was reached by using the modified matched pairs t test (in comparison with the spectral method and other reference methods).