title: Amplitude of Dominant T-Wave Alternans assessment on ECGs obtained from a biophysical model.
abstract: The Amplitude of Dominant T-Wave Alternans (ADTWA) is a recently introduced index which quantifies the presence of microvolt T Wave Alternans (TWA) on surface ECG recordings. In this paper we investigate the reliability of ADTWA and its robustness against broadband noise. At this regard, we generated synthetic 12-leads ECG recordings through a forward electrophysiological model and we added TWA, at different extent, by modulating the variation of the repolarization times of transmembrane action potentials across even and odd beats. Using a stochastic model, we derived an analytical relationship between the repolarization variation injected into the model and TWA at the surface, thus offering a strategy to evaluate lead sensitivity. In terms of robustness, the results of the simulations show that ADTWA correctly measured the amplitude of synthetic TWA with an average error of 3.3% ± 5.8% in absence of noise. When a 100 μV peak-to-peak broadband noise is present, its effects on estimation errors were kept limited by singular value decomposition on which ADTWA builds.
authors.affiliation: Dipartimento di Tecnologie dell’Informazione, Università degli Studi di Milano, Via Bramante 65, 26013 Crema, Italy. roberto.sassi@unimi.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Sassi
authors.forename: Luca T
authors.initials: LT
authors.lastname: Mainardi
authors.forename: Sergio
authors.initials: S
authors.lastname: Cerutti
mesh_terms: D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology*; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008955:Models, Cardiovascular; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity