P wave detection and delineation in the ECG based on the phase free stationary wavelet transform and using intracardiac atrial electrograms as reference

P wave detection and delineation in the ECG based on the phase free stationary wavelet transform... AbstractRobust and exact automatic P wave detection and delineation in the electrocardiogram (ECG) is still an interesting but challenging research topic. The early prognosis of cardiac afflictions such as atrial fibrillation and the response of a patient to a given treatment is believed to improve if the P wave is carefully analyzed during sinus rhythm. Manual annotation of the signals is a tedious and subjective task. Its correctness depends on the experience of the annotator, quality of the signal, and ECG lead. In this work, we present a wavelet-based algorithm to detect and delineate P waves in individual ECG leads. We evaluated a large group of commonly used wavelets and frequency bands (wavelet levels) and introduced a special phase free wavelet transformation. The local extrema of the transformed signals are directly related to the delineating points of the P wave. First, the algorithm was studied using synthetic signals. Then, the optimal parameter configuration was found using intracardiac electrograms and surface ECGs measured simultaneously. The reverse biorthogonal wavelet 3.3 was found to be optimal for this application. In the end, the method was validated using the QT database from PhysioNet. We showed that the algorithm works more accurately and more robustly than other methods presented in literature. The validation study delivered an average delineation error of the P wave onset of -0.32±12.41 ms when compared to manual annotations. In conclusion, the algorithm is suitable for handling varying P wave shapes and low signal-to-noise ratios. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Biomedical Engineering / Biomedizinische Technik de Gruyter

P wave detection and delineation in the ECG based on the phase free stationary wavelet transform and using intracardiac atrial electrograms as reference

P wave detection and delineation in the ECG based on the phase free stationary wavelet transform and using intracardiac atrial electrograms as reference

IntroductionDetection and delineation of the P wave in the electrocardiogram (ECG) in an automatic and reliable manner has gained interest among cardiologists and researchers in recent years because of its important role in a variety of applications. For instance, supraventricular arrhythmias such as ectopic beats, atrial flutter, and fibrillation are the most frequent cardiac arrhythmias [8] and a major cause of stroke [12]. Thus, it is of highest priority to diagnose them at an early stage. The cause of these type of afflictions is often a structural remodeling of the heart tissue and the electrophysiological properties of the atria [10]. Therefore, modifications of the normal P wave morphology in the ECG could be evaluated over the course of time and subjects with higher risk could be identified and treated even before symptoms appear [3, 5, 34].Minimally invasive radiofrequency ablation is commonly used as first-line therapy of supraventricular arrhythmia if pharmacological treatment fails. An exact characterization of the P wave morphology during sinus rhythm can be used to reconstruct local activation times (LAT) in the atria. Since ectopic beats have a different LAT map from the ones observed in sinus rhythm, this technique could be used to reconstruct its origin [7, 18, 26]. With this information, the physician can create an optimal ablation strategy to spend less time during an intracardiac mapping procedure. Even though ablation therapy is very successful for the majority of the patients, in some cases, the symptoms can reappear and the patient has to be treated repeatedly. Analyzing the evolution of the normal P wave morphology in the ECG after ablation can help forecast the final outcome of the chosen therapy [13, 22].Considering atrial fibrillation, the analysis of the P wave during sinus rhythm is suggested as an approach for risk stratification [1]. The early diagnosis of the subjects prone to atrial fibrillation would also have a strong impact on...
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Publisher
de Gruyter
Copyright
©2016 by De Gruyter
ISSN
1862-278X
eISSN
1862-278X
D.O.I.
10.1515/bmt-2014-0161
Publisher site
See Article on Publisher Site

Abstract

AbstractRobust and exact automatic P wave detection and delineation in the electrocardiogram (ECG) is still an interesting but challenging research topic. The early prognosis of cardiac afflictions such as atrial fibrillation and the response of a patient to a given treatment is believed to improve if the P wave is carefully analyzed during sinus rhythm. Manual annotation of the signals is a tedious and subjective task. Its correctness depends on the experience of the annotator, quality of the signal, and ECG lead. In this work, we present a wavelet-based algorithm to detect and delineate P waves in individual ECG leads. We evaluated a large group of commonly used wavelets and frequency bands (wavelet levels) and introduced a special phase free wavelet transformation. The local extrema of the transformed signals are directly related to the delineating points of the P wave. First, the algorithm was studied using synthetic signals. Then, the optimal parameter configuration was found using intracardiac electrograms and surface ECGs measured simultaneously. The reverse biorthogonal wavelet 3.3 was found to be optimal for this application. In the end, the method was validated using the QT database from PhysioNet. We showed that the algorithm works more accurately and more robustly than other methods presented in literature. The validation study delivered an average delineation error of the P wave onset of -0.32±12.41 ms when compared to manual annotations. In conclusion, the algorithm is suitable for handling varying P wave shapes and low signal-to-noise ratios.

Journal

Biomedical Engineering / Biomedizinische Technikde Gruyter

Published: Feb 1, 2016

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