Key result
Attention-based CycleGAN maps maternal abdominal ECG to fetal scalp ECG with ~98% accuracy.
Why the study?
Extracting FECG from maternal ECG is challenging due to low FECG amplitude, overlapping R waves, and noise, while traditional decomposition techniques require tuning, alignment, or pre-configuration.
An attention-based CycleGAN algorithm successfully extracts fetal ECG from maternal abdominal ECG with high fidelity and accurate QRS detection, offering a robust non-invasive monitoring tool.
May advance non-invasive fetal ECG monitoring; leaves open prospective clinical validation before adoption.
A non-invasive fetal electrocardiogram (FECG) is used to monitor the electrical pulse of the fetal heart. Decomposing the FECG signal from the maternal ECG (MECG) is a blind source separation problem, which is hard due to the low amplitude of the FECG, the overlap of R waves, and the potential exposure to noise from different sources. Traditional decomposition techniques, such as adaptive filters, require tuning, alignment, or pre-configuration, such as modeling the noise or desired signal to map the MECG to the FECG. The high correlation between maternal and fetal ECG fragments decreases the performance of convolution layers. Therefore, the masking region of interest based on the attention mechanism was performed to improve the signal generators' precision. The sine activation function was also used to retain more details when converting two signal domains. Three available datasets from the Physionet, including the A&D FECG, NI-FECG, and NI-FECG challenge, and one synthetic dataset using FECGSYN toolbox, were used to evaluate the performance. The proposed method could map an abdominal MECG to a scalp FECG with an average of 98% R-Square [CI 95%: 97%, 99%] as the goodness of fit on the A&D FECG dataset. Moreover, it achieved 99.7% F1-score [CI 95%: 97.8-99.9], 99.6% F1-score [CI 95%: 98.2%, 99.9%] and 99.3% F1-score [CI 95%: 95.3%, 99.9%] for fetal QRS detection on the A&D FECG, NI-FECG and NI-FECG challenge datasets, respectively. Also, the distortion was in the "very good" and "good" ranges. These results are comparable to the state-of-the-art results; thus, the proposed algorithm has the potential to be used for high-performance signal-to-signal conversion.
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Mohebbian et al. (2021) studied Fetal Electrocardiogram (FECG) Extraction (n=88). Attention-Based CycleGAN vs. State-of-the-art methods (e.g., Encoder-Decoder, SVD-SW) was evaluated on R-Square goodness of fit for mapping abdominal maternal ECG to scalp fetal ECG on the A&D FECG dataset (95% CI 97%-99%). The proposed attention-based CycleGAN method mapped abdominal maternal ECG to scalp fetal ECG with an average 98% R-Square and achieved a 99.7% F1-score for fetal QRS detection on the A&D FECG dataset.
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