Key result
The enhanced adaptive matched filter accurately identified and measured all kinds of electrocardiographic alternans, discriminating T-wave alternans as the prevalent type.
Why the study?
Electrocardiographic alternans indicates cardiac risk, but only automated methods for measuring T-wave alternans had been proposed.
The enhanced adaptive matched filter (EAMF) method accurately identifies and measures P-wave, QRS-complex, and T-wave alternans, potentially supporting their incremental clinical utility.
Answers are grounded in this paper and cite their sources.
Accurately detects simulated ECG alternans; leaves open clinical validation and utility.
Electrocardiographic alternans, consisting of P-wave alternans (PWA), QRS-complex alternans (QRSA) and T-wave alternans (TWA), is an index of cardiac risk. However, only automated TWA measurement methods have been proposed so far. Here, we presented the enhanced adaptive matched filter (EAMF) method and tested its reliability in both simulated and experimental conditions. Our methodological novelty consists in the introduction of a signal enhancement procedure according to which all sections of the electrocardiogram (ECG) but the wave of interest are set to baseline, and in the extraction of the alternans area (AAr) in addition to the standard alternans amplitude (AAm). Simulated data consisted of 27 simulated ECGs representing all combinations of PWA, QRSA and TWA of low (10 μV) and high (100 μV) amplitude. Experimental data consisted of exercise 12-lead ECGs from 266 heart failure patients with an implanted cardioverter defibrillator for primary prevention. EAMF was able to accurately identify and measure all kinds of simulated alternans (absolute maximum error equal to 2%). Moreover, different alternans kinds were simultaneously present in the experimental data and EAMF was able to identify and measure all of them (AAr: 545 μV × ms, 762 μV × ms and 1382 μV × ms; AAm: 5 μV, 9 μV and 7 μV; for PWA, QRSA and TWA, respectively) and to discriminate TWA as the prevalent one (with the highest AAr). EAMF accurately identifies and measures all kinds of electrocardiographic alternans. EAMF may support determination of incremental clinical utility of PWA and QRSA with respect to TWA only.
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Marcantoni et al. (2021) studied Heart failure (n=266). Enhanced adaptive matched filter (EAMF) was evaluated on Identification and measurement of electrocardiographic alternans (PWA, QRSA, and TWA). The enhanced adaptive matched filter accurately identified and measured all kinds of electrocardiographic alternans, discriminating T-wave alternans as the prevalent type.
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