A combined algorithm for T-wave alternans qualitative detection and quantitative measurement

BackgroundT-wave alternans (TWA) provides a noninvasive and clinically useful marker for the risk of sudden cardiac death (SCD). Current most widely used TWA detection algorithms work in two different domains: time and frequency. The disadvantage of the spectral analytical techniques is that they treat the alternans signal as a stationary wave with a constant amplitude and a phase. They cannot detect non-stationary characteristics of the signal. The temporal domain methods are sensitive to the alignment of the T-waves. In this study, we sought to develop a robust combined algorithm (CA) to assess T-wave alternans, which can qualitatively detect and quantitatively measure TWA in time domain.MethodsThe T wave sequences were extracted and the total energy of each T wave within the specified time-frequency region was calculated. The rank-sum test was applied to the ranked energy sequences of T waves to detect TWA qualitatively. The ECG containing TWA was quantitatively analyzed with correlation method.ResultsSimulation test result proved a mean sensitivity of 91.2% in detecting TWA, and for the SNR not less than 30 dB, the accuracy rate of detection achieved 100%. The clinical data experiment showed that the results from this method vs. spectral method had the correlation coefficients of 0.96.ConclusionsA novel TWA analysis algorithm utilizing the wavelet transform and correlation technique is presented in this paper. TWAs are not only correctly detected qualitatively in frequency domain by energy value of T waves, but the alternans frequency and amplitude in temporal domain are measured quantitatively.

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