PMID- 29461965
OWN - NLM
STAT- MEDLINE
DCOM- 20190115
LR  - 20190115
IS  - 1558-2531 (Electronic)
IS  - 0018-9294 (Linking)
VI  - 65
IP  - 3
DP  - 2018 Mar
TI  - Post-Ventricular Premature Contraction Phase Correction Improves the Predictive 
      Value of Average T-Wave Alternans in Ambulatory ECG Recordings.
PG  - 635-644
LID - 10.1109/TBME.2017.2711645 [doi]
AB  - OBJECTIVE: We proposed and evaluated a method for correcting possible phase 
      shifts provoked by the presence of ventricular premature contractions (VPCs) for 
      a better assessment of T-wave alternans (TWA).  Methods: First, we synthesized 
      ECG signals with artificial TWA in the presence of different noise sources. Then, 
      we assessed the prognostic value for sudden cardiac death (SCD) of the long-term 
      average of TWA amplitude (the index of average alternans, ) in ambulatory ECG 
      signals from congestive heart failure (CHF) and evaluated whether it is sensitive 
      to the presence of VPCs. RESULTS: The inclusion of the phase correction after VPC 
      in the processing always improved estimation accuracy of the under different 
      noisy conditions and regardless of the number of the VPCs included in the 
      sequence. It also presented a positive impact on the prognostic value of with 
      increased hazard ratios (from 17% to 29%, depending of the scenario) in 
      comparison to the noninclusion of this step. CONCLUSION: The proposed methodology 
      for estimation, which corrects for the possible phase reversal on TWA after the 
      presence of VPCs, represents a robust TWA estimation approach with a significant 
      impact on the prognostic value of for SCD stratification in CHF patients. 
      SIGNIFICANCE: An accurate TWA estimation has a potential direct clinical impact 
      on noninvasive SCD stratification, allowing better identification of patients at 
      higher risk and helping clinicians in adopting the most appropriate therapeutic 
      strategy.
FAU - Martin-Yebra, Alba
AU  - Martin-Yebra A
FAU - Monasterio, Violeta
AU  - Monasterio V
FAU - Cygankiewicz, Iwona
AU  - Cygankiewicz I
FAU - Bayes-de-Luna, Antoni
AU  - Bayes-de-Luna A
FAU - Caiani, Enrico G
AU  - Caiani EG
FAU - Laguna, Pablo
AU  - Laguna P
FAU - Martinez, Juan Pablo
AU  - Martinez JP
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - IEEE Trans Biomed Eng
JT  - IEEE transactions on bio-medical engineering
JID - 0012737
SB  - IM
MH  - Aged
MH  - *Death, Sudden, Cardiac
MH  - Electrocardiography, Ambulatory/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Signal Processing, Computer-Assisted
MH  - Ventricular Premature Complexes/*physiopathology
EDAT- 2018/02/21 06:00
MHDA- 2019/01/16 06:00
CRDT- 2018/02/21 06:00
PHST- 2018/02/21 06:00 [entrez]
PHST- 2018/02/21 06:00 [pubmed]
PHST- 2019/01/16 06:00 [medline]
AID - 10.1109/TBME.2017.2711645 [doi]
PST - ppublish
SO  - IEEE Trans Biomed Eng. 2018 Mar;65(3):635-644. doi: 10.1109/TBME.2017.2711645.