title: Improved robust T-wave alternans detectors.
abstract: New statistical and spectral detectors, the modified matched pairs t test, the extended spectral method and the modified spectral method, were proposed for T-wave alternans (TWA) detection gaining robustness according to trend and single-frequency interferences. They were compared to classic detectors such as matched pairs t test, unpaired t test, spectral method, generalized likelihood ratio test and estimated TWA amplitude within a simulation framework and applied to real data. The optimal detection threshold was selected by using a full Monte-Carlo simulation where signals, with and without alternans episodes, were corrupted by Gaussian noise with different power and single-frequency interferences with different tones. All the combinations of noise and frequency were selected and repeated 500 times in order to compute probability of detection ([Formula: see text]) and the false alarm probability ([Formula: see text]), providing ROC curves. The study group consisted of 50 patients with implantable cardioverter-defibrillator (age: [Formula: see text]; LVEF: [Formula: see text]), who were paced (ventricular pacing) at 100 bpm. Two-minute recordings were analyzed. The XYZ orthogonal lead system was used. The best performance was reached by using the modified matched pairs t test (in comparison with the spectral method and other reference methods).
authors: Laboratoire I3S UNS-CNRS UMR7172, Université de Nice-Sophia Antipolis, 2000 route des lucioles Les Algorithmes - bt. Euclide B, CS 40121, 06903, Sophia Antipolis Cedex, France, meste@i3s.unice.fr.
authors: O
authors: O
authors: Meste
authors: D
authors: D
authors: Janusek
authors: S
authors: S
authors: Karczmarewicz
authors: A
authors: A
authors: Przybylski
authors: M
authors: M
authors: Kania
authors: A
authors: A
authors: Maciag
authors: R
authors: R
authors: Maniewski
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D017147:Defibrillators, Implantable; D004562:Electrocardiography / Q000379:methods*; D004566:Electrodes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012815:Signal Processing, Computer-Assisted
references: J Am Coll Cardiol. 2007 Jan 23;49(3):338-46
references: 17239715
references: Heart Rhythm. 2005 Mar;2(3):234-41
references: 15851310
references: J Appl Physiol (1985). 2002 Feb;92(2):541-9
references: 11796662
references: Heart Rhythm. 2010 Jun;7(6):763-8
references: 20156592
references: Science. 1991 Apr 19;252(5004):437-40
references: 2017682
references: Comput Methods Programs Biomed. 2014 Apr;114(1):102-8
references: 24573128
references: Med Biol Eng Comput. 2013 Sep;51(9):1031-42
references: 23695363
references: Med Biol Eng Comput. 2014 Apr;52(4):375-91
references: 24474594
references: J Electrocardiol. 1998;31 Suppl:114-20
references: 9988014
references: Circulation. 1999 Mar 16;99(10):1385-94
references: 10077525
references: Heart Vessels. 2011 Mar;26(2):160-7
references: 21052691
references: IEEE Trans Biomed Eng. 2005 Apr;52(4):599-613
references: 15825862
references: J Am Coll Cardiol. 2011 Sep 20;58(13):1309-24
references: 21920259
references: Cardiol J. 2010;17(1):4-10
references: 20104451
references: J Cardiovasc Electrophysiol. 2009 Apr;20(4):408-15
references: 19175840
references: Med Biol Eng Comput. 2012 Aug;50(8):813-25
references: 22729348
references: Biometrics. 1988 Sep;44(3):837-45
references: 3203132
references: Anadolu Kardiyol Derg. 2007 Jul;7 Suppl 1:116-9
references: 17584701
references: Europace. 2010 Mar;12(3):313-21
references: 20118111
references: N Engl J Med. 1994 Jan 27;330(4):235-41
references: 8272084
references: IEEE Trans Biomed Eng. 1985 Mar;32(3):230-6
references: 3997178
references: Heart Rhythm. 2009 Mar;6(3):332-7
references: 19251207
references: Cardiovasc Diabetol. 2012 Sep 06;11:104
references: 22950360
references: Comput Biomed Res. 1977 Oct;10(5):459-70
references: 923219
references: Front Physiol. 2010 Nov 29;1:154
references: 21286254
references: Pacing Clin Electrophysiol. 2011 Sep;34(9):1054-62
references: 21501180