title: Extraction and analysis of T waves in electrocardiograms during atrial flutter.
abstract: Analysis of T waves in the ECG is an essential clinical tool for diagnosis, monitoring, and follow-up of patients with heart dysfunction. During atrial flutter, this analysis has been so far limited by the perturbation of flutter waves superimposed over the T wave. This paper presents a method based on missing data interpolation for eliminating flutter waves from the ECG during atrial flutter. To cope with the correlation between atrial and ventricular electrical activations, the CLEAN deconvolution algorithm was applied to reconstruct the spectrum of the atrial component of the ECG from signal segments corresponding to TQ intervals. The locations of these TQ intervals, where the atrial contribution is presumably dominant, were identified iteratively. The algorithm yields the extracted atrial and ventricular contributions to the ECG. Standard T-wave morphology parameters (T-wave amplitude, T peak-T end duration, QT interval) were measured. This technique was validated using synthetic signals, compared to average beat subtraction in a patient with a pacemaker, and tested on pseudo-orthogonal ECGs from patients in atrial flutter. Results demonstrated improvements in accuracy and robustness of T-wave analysis as compared to current clinical practice.
authors.affiliation: Centre de Recherche, Hôpital du Sacré-Coeur de Montréal, Montréal, QC H4J 1C5, Canada. vincent.jacquemet@umontreal.ca
authors.forename: Vincent
authors.initials: V
authors.lastname: Jacquemet
authors.forename: Bruno
authors.initials: B
authors.lastname: Dubé
authors.forename: Réginald
authors.initials: R
authors.lastname: Nadeau
authors.forename: A Robert
authors.initials: AR
authors.lastname: LeBlanc
authors.forename: Marcio
authors.initials: M
authors.lastname: Sturmer
authors.forename: Giuliano
authors.initials: G
authors.lastname: Becker
authors.forename: Teresa
authors.initials: T
authors.lastname: Kus
authors.forename: Alain
authors.initials: A
authors.lastname: Vinet
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001282:Atrial Flutter / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010363:Pattern Recognition, Automated / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity