Comparative evaluation of methodologies for T-wave alternans mapping in electrograms. Orini, M., Hanson, B., Monasterio, V., Martínez, J., P., Hayward, M., Taggart, P., & Lambiase, P. IEEE Transactions on Biomedical Engineering, 61(2):308-316, 2014. ![Comparative evaluation of methodologies for T-wave alternans mapping in electrograms [pdf]](https://bibbase.org/img/filetypes/pdf.svg "pdf")
Paper abstract bibtex Electrograms (EGM) recorded from the surface of the myocardium are becoming more and more accessible. T-wave alternans (TWA) is associated with increased vulnerability to ventricular tachycardia/fibrillation and it occurs before the onset of ventricular arrhythmias. Thus, accurate methodologies for time-varying alternans estimation/detection in EGM are needed. In this paper, we perform a simulation study based on epicardial EGM recorded in vivo in humans to compare the accuracy of four methodologies: the spectral method (SM), modified moving average method (MMA), laplacian likelihood ratio method (LLR) and a novel method based on time-frequency distributions (TFD). A variety of effects are considered, which include the presence of wide band noise, respiration and impulse artifacts. We found that (a) EGM-TWA can be detected accurately when the standard deviation of wide band noise is equal or smaller than 10 times the magnitude of EGM-TWA. (b) Respiration can be critical for EGM-TWA analysis, even at typical respiratory rates. (c) Impulse noise strongly reduces the accuracy of all methods, except LLR. (d) If depolarization time is used as a fiducial point, the localization of the T-wave is not critical for the accuracy of EGMTWA detection. (e) According to this study, all methodologies provided accurate EGM-TWA detection/quantification in ideal conditions, while LLR was the most robust, providing better detection-rates in noisy conditions. Application on epicardial mapping of the in-vivo human heart shows that EGM-TWA has heterogeneous spatio-temporal distribution.
@article{
title = {Comparative evaluation of methodologies for T-wave alternans mapping in electrograms},
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year = {2014},
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keywords = {Electrograms (EGM),T-wave alternans,intracardiac ECG,repolarization,ventricular arrhythmia},
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abstract = {Electrograms (EGM) recorded from the surface of the myocardium are becoming more and more accessible. T-wave alternans (TWA) is associated with increased vulnerability to ventricular tachycardia/fibrillation and it occurs before the onset of ventricular arrhythmias. Thus, accurate methodologies for time-varying alternans estimation/detection in EGM are needed. In this paper, we perform a simulation study based on epicardial EGM recorded in vivo in humans to compare the accuracy of four methodologies: the spectral method (SM), modified moving average method (MMA), laplacian likelihood ratio method (LLR) and a novel method based on time-frequency distributions (TFD). A variety of effects are considered, which include the presence of wide band noise, respiration and impulse artifacts. We found that (a) EGM-TWA can be detected accurately when the standard deviation of wide band noise is equal or smaller than 10 times the magnitude of EGM-TWA. (b) Respiration can be critical for EGM-TWA analysis, even at typical respiratory rates. (c) Impulse noise strongly reduces the accuracy of all methods, except LLR. (d) If depolarization time is used as a fiducial point, the localization of the T-wave is not critical for the accuracy of EGMTWA detection. (e) According to this study, all methodologies provided accurate EGM-TWA detection/quantification in ideal conditions, while LLR was the most robust, providing better detection-rates in noisy conditions. Application on epicardial mapping of the in-vivo human heart shows that EGM-TWA has heterogeneous spatio-temporal distribution.},
bibtype = {article},
author = {Orini, Michele and Hanson, Ben and Monasterio, Violeta and Martínez, Juan Pablo and Hayward, Martin and Taggart, Peter and Lambiase, Pier},
journal = {IEEE Transactions on Biomedical Engineering},
number = {2}
}
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(c) Impulse noise strongly reduces the accuracy of all methods, except LLR. (d) If depolarization time is used as a fiducial point, the localization of the T-wave is not critical for the accuracy of EGMTWA detection. (e) According to this study, all methodologies provided accurate EGM-TWA detection/quantification in ideal conditions, while LLR was the most robust, providing better detection-rates in noisy conditions. 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