Robust 3-way tensor decomposition and extended state Kalman filtering to extract fetal ECG

International audienceThis paper addresses the problem of fetal electrocardiogram (ECG) extraction from multichannel recordings. The proposed two-step method, which is applicable to as few as two channels, relies on (i) a deterministic tensor decomposition approach, (ii) a Kalman filtering. Tensor decomposition criteria that are robust to outliers are proposed and used to better track weak traces of the fetal ECG. Then, the state parameters used within an extended realistic nonlinear dynamic model for extraction of N ECGs from M mixtures of several ECGs and noise are estimated from the loading matrices provided by the first step. Application of the proposed method on actual data shows its significantly superior performance in comparison to the classic methods

Robust 3-way tensor decomposition and extended state Kalman filtering to extract fetal ECG

International audienceThis paper addresses the problem of fetal electrocardiogram (ECG) extraction from multichannel recordings. The proposed two-step method, which is applicable to as few as two channels, relies on (i) a deterministic tensor decomposition approach, (ii) a Kalman filtering. Tensor decomposition criteria that are robust to outliers are proposed and used to better track weak traces of the fetal ECG. Then, the state parameters used within an extended realistic nonlinear dynamic model for extraction of N ECGs from M mixtures of several ECGs and noise are estimated from the loading matrices provided by the first step. Application of the proposed method on actual data shows its significantly superior performance in comparison to the classic methods

Blind source separation of underdetermined mixtures of event-related sources

International audienceThis paper addresses the problem of blind source separation for underdetermined mixtures (i.e., more sources than sensors) of event-related sources that include quasi-periodic sources (e.g., electrocardiogram (ECG)), sources with synchronized trials (e.g., event-related potentials (ERP)), and amplitude-variant sources. The proposed method is based on two steps: (i) tensor decomposition for underdetermined source separation and (ii) signal extraction by Kalman filtering to recover the source dynamics. A tensor is constructed for each source by synchronizing on the ''event'' period of the corresponding signal and stacking different periods along the second dimension of the tensor. To cope with the interference from other sources that impede on the extraction of weak signals, two robust tensor decomposition methods are proposed and compared. Then, the state parameters used within a nonlinear dynamic model for the extraction of event-related sources from noisy mixtures are estimated from the loading matrices provided by the first step. The influence of different parameters on the robustness to outliers of the proposed method is examined by numerical simulations. Applied to clinical electroencephalogram (EEG), ECG and magnetocardiogram (MCG), the proposed method exhibits a significantly higher performance in terms of expected signal shape than classical source separation methods such as piCA and FastICA

Extraction et débruitage de signaux ECG du foetus.

Les malformations cardiaques congénitales sont la première cause de décès liés à une anomalie congénitale. L electrocardiogramme du fœtus (ECGf), qui est censé contenir beaucoup plus d informations par rapport aux méthodes échographiques conventionnelles, peut être mesuré e par des électrodes sur l abdomen de la mère. Cependant, il est tres faible et mélangé avec plusieurs sources de bruit et interférence y compris l ECG de la mère (ECGm) dont le niveau est très fort. Dans les études précédentes, plusieurs méthodes ont été proposées pour l extraction de l ECGf à partir des signaux enregistrés par des électrodes placées à la surface du corps de la mère. Cependant, ces méthodes nécessitent un nombre de capteurs important, et s avèrent inefficaces avec un ou deux capteurs. Dans cette étude trois approches innovantes reposant sur une paramétrisation algébrique, statistique ou par variables d état sont proposées. Ces trois méthodes mettent en œuvre des modélisations différentes de la quasi-périodicité du signal cardiaque. Dans la première approche, le signal cardiaque et sa variabilité sont modélisés par un filtre de Kalman. Dans la seconde approche, le signal est découpé en fenêtres selon les battements, et l empilage constitue un tenseur dont on cherchera la décomposition. Dans la troisième approche, le signal n est pas modélisé directement, mais il est considéré comme un processus Gaussien, caractérisé par ses statistiques à l ordre deux. Dans les différentes modèles, contrairement aux études précédentes, l ECGm et le (ou les) ECGf sont modélisés explicitement. Les performances des méthodes proposées, qui utilisent un nombre minimum de capteurs, sont évaluées sur des données synthétiques et des enregistrements réels, y compris les signaux cardiaques des fœtus jumeaux.Congenital heart defects are the leading cause of birth defect-related deaths. The fetal electrocardiogram (fECG), which is believed to contain much more information as compared with conventional sonographic methods, can be measured by placing electrodes on the mother s abdomen. However, it has very low power and is mixed with several sources of noise and interference, including the strong maternal ECG (mECG). In previous studies, several methods have been proposed for the extraction of fECG signals recorded from the maternal body surface. However, these methods require a large number of sensors, and are ineffective with only one or two sensors. In this study, state modeling, statistical and deterministic approaches are proposed for capturing weak traces of fetal cardiac signals. These three methods implement different models of the quasi-periodicity of the cardiac signal. In the first approach, the heart rate and its variability are modeled by a Kalman filter. In the second approach, the signal is divided into windows according to the beats. Stacking the windows constructs a tensor that is then decomposed. In a third approach, the signal is not directly modeled, but it is considered as a Gaussian process characterized by its second order statistics. In all the different proposed methods, unlike previous studies, mECG and fECG(s) are explicitly modeled. The performances of the proposed methods, which utilize a minimal number of electrodes, are assessed on synthetic data and actual recordings including twin fetal cardiac signals.SAVOIE-SCD - Bib.électronique (730659901) / SudocGRENOBLE1/INP-Bib.électronique (384210012) / SudocGRENOBLE2/3-Bib.électronique (384219901) / SudocSudocFranceF

Extracting fetal heart beats from maternal abdominal recordings: Selection of the optimal principal components

This study presents a systematic comparison of different approaches to the automated selection of the principal components (PC) which optimise the detection of maternal and fetal heart beats from non-invasive maternal abdominal recordings. A public database of 75 4-channel non-invasive maternal abdominal recordings was used for training the algorithm. Four methods were developed and assessed to determine the optimal PC: (1) power spectral distribution, (2) root mean square, (3) sample entropy, and (4) QRS template. The sensitivity of the performance of the algorithm to large-amplitude noise removal (by wavelet de-noising) and maternal beat cancellation methods were also assessed. The accuracy of maternal and fetal beat detection was assessed against reference annotations and quantified using the detection accuracy score F1 [2*PPV*Se / (PPV + Se)], sensitivity (Se), and positive predictive value (PPV). The best performing implementation was assessed on a test dataset of 100 recordings and the agreement between the computed and the reference fetal heart rate (fHR) and fetal RR (fRR) time series quantified. The best performance for detecting maternal beats (F1 99.3%, Se 99.0%, PPV 99.7%) was obtained when using the QRS template method to select the optimal maternal PC and applying wavelet de-noising. The best performance for detecting fetal beats (F1 89.8%, Se 89.3%, PPV 90.5%) was obtained when the optimal fetal PC was selected using the sample entropy method and utilising a fixed-length time window for the cancellation of the maternal beats. The performance on the test dataset was 142.7 beats2/min2 for fHR and 19.9 ms for fRR, ranking respectively 14 and 17 (out of 29) when compared to the other algorithms presented at the Physionet Challenge 2013

Efficient fetal-maternal ECG signal separation from two channel maternal abdominal ECG via diffusion-based channel selection

There is a need for affordable, widely deployable maternal-fetal ECG monitors to improve maternal and fetal health during pregnancy and delivery. Based on the diffusion-based channel selection, here we present the mathematical formalism and clinical validation of an algorithm capable of accurate separation of maternal and fetal ECG from a two channel signal acquired over maternal abdomen

Clifford wavelets for fetal ECG extraction

Analysis of the fetal heart rate during pregnancy is essential for monitoring the proper development of the fetus. Current fetal heart monitoring techniques lack the accuracy in fetal heart rate monitoring and features acquisition, resulting in diagnostic medical issues. The challenge lies in the extraction of the fetal ECG from the mother's ECG during pregnancy. This approach has the advantage of being a reliable and non-invasive technique. For this aim, we propose in this paper a wavelet/multi-wavelet method allowing to extract perfectly the feta ECG parameters from the abdominal mother ECG. The method is essentially due to the exploitation of Clifford wavelets as recent variants in the field. We prove that these wavelets are more efficient and performing against classical ones. The experimental results are therefore due to two basic classes of wavelets and multi-wavelets. A first-class is the classical Haar Schauder, and a second one is due to Clifford valued wavelets and multi-wavelets. These results showed that wavelets/multiwavelets are already good bases for the FECG processing, provided that Clifford ones are the best.Comment: 21 pages, 8 figures, 1 tabl

Improving Maternal and Fetal Cardiac Monitoring Using Artificial Intelligence

Early diagnosis of possible risks in the physiological status of fetus and mother during pregnancy and delivery is critical and can reduce mortality and morbidity. For example, early detection of life-threatening congenital heart disease may increase survival rate and reduce morbidity while allowing parents to make informed decisions. To study cardiac function, a variety of signals are required to be collected. In practice, several heart monitoring methods, such as electrocardiogram (ECG) and photoplethysmography (PPG), are commonly performed. Although there are several methods for monitoring fetal and maternal health, research is currently underway to enhance the mobility, accuracy, automation, and noise resistance of these methods to be used extensively, even at home. Artificial Intelligence (AI) can help to design a precise and convenient monitoring system. To achieve the goals, the following objectives are defined in this research: The first step for a signal acquisition system is to obtain high-quality signals. As the first objective, a signal processing scheme is explored to improve the signal-to-noise ratio (SNR) of signals and extract the desired signal from a noisy one with negative SNR (i.e., power of noise is greater than signal). It is worth mentioning that ECG and PPG signals are sensitive to noise from a variety of sources, increasing the risk of misunderstanding and interfering with the diagnostic process. The noises typically arise from power line interference, white noise, electrode contact noise, muscle contraction, baseline wandering, instrument noise, motion artifacts, electrosurgical noise. Even a slight variation in the obtained ECG waveform can impair the understanding of the patient's heart condition and affect the treatment procedure. Recent solutions, such as adaptive and blind source separation (BSS) algorithms, still have drawbacks, such as the need for noise or desired signal model, tuning and calibration, and inefficiency when dealing with excessively noisy signals. Therefore, the final goal of this step is to develop a robust algorithm that can estimate noise, even when SNR is negative, using the BSS method and remove it based on an adaptive filter. The second objective is defined for monitoring maternal and fetal ECG. Previous methods that were non-invasive used maternal abdominal ECG (MECG) for extracting fetal ECG (FECG). These methods need to be calibrated to generalize well. In other words, for each new subject, a calibration with a trustable device is required, which makes it difficult and time-consuming. The calibration is also susceptible to errors. We explore deep learning (DL) models for domain mapping, such as Cycle-Consistent Adversarial Networks, to map MECG to fetal ECG (FECG) and vice versa. The advantages of the proposed DL method over state-of-the-art approaches, such as adaptive filters or blind source separation, are that the proposed method is generalized well on unseen subjects. Moreover, it does not need calibration and is not sensitive to the heart rate variability of mother and fetal; it can also handle low signal-to-noise ratio (SNR) conditions. Thirdly, AI-based system that can measure continuous systolic blood pressure (SBP) and diastolic blood pressure (DBP) with minimum electrode requirements is explored. The most common method of measuring blood pressure is using cuff-based equipment, which cannot monitor blood pressure continuously, requires calibration, and is difficult to use. Other solutions use a synchronized ECG and PPG combination, which is still inconvenient and challenging to synchronize. The proposed method overcomes those issues and only uses PPG signal, comparing to other solutions. Using only PPG for blood pressure is more convenient since it is only one electrode on the finger where its acquisition is more resilient against error due to movement. The fourth objective is to detect anomalies on FECG data. The requirement of thousands of manually annotated samples is a concern for state-of-the-art detection systems, especially for fetal ECG (FECG), where there are few publicly available FECG datasets annotated for each FECG beat. Therefore, we will utilize active learning and transfer-learning concept to train a FECG anomaly detection system with the least training samples and high accuracy. In this part, a model is trained for detecting ECG anomalies in adults. Later this model is trained to detect anomalies on FECG. We only select more influential samples from the training set for training, which leads to training with the least effort. Because of physician shortages and rural geography, pregnant women's ability to get prenatal care might be improved through remote monitoring, especially when access to prenatal care is limited. Increased compliance with prenatal treatment and linked care amongst various providers are two possible benefits of remote monitoring. If recorded signals are transmitted correctly, maternal and fetal remote monitoring can be effective. Therefore, the last objective is to design a compression algorithm that can compress signals (like ECG) with a higher ratio than state-of-the-art and perform decompression fast without distortion. The proposed compression is fast thanks to the time domain B-Spline approach, and compressed data can be used for visualization and monitoring without decompression owing to the B-spline properties. Moreover, the stochastic optimization is designed to retain the signal quality and does not distort signal for diagnosis purposes while having a high compression ratio. In summary, components for creating an end-to-end system for day-to-day maternal and fetal cardiac monitoring can be envisioned as a mix of all tasks listed above. PPG and ECG recorded from the mother can be denoised using deconvolution strategy. Then, compression can be employed for transmitting signal. The trained CycleGAN model can be used for extracting FECG from MECG. Then, trained model using active transfer learning can detect anomaly on both MECG and FECG. Simultaneously, maternal BP is retrieved from the PPG signal. This information can be used for monitoring the cardiac status of mother and fetus, and also can be used for filling reports such as partogram

Extraction and Detection of Fetal Electrocardiograms from Abdominal Recordings

The non-invasive fetal ECG (NIFECG), derived from abdominal surface electrodes, offers novel diagnostic possibilities for prenatal medicine. Despite its straightforward applicability, NIFECG signals are usually corrupted by many interfering sources. Most significantly, by the maternal ECG (MECG), whose amplitude usually exceeds that of the fetal ECG (FECG) by multiple times. The presence of additional noise sources (e.g. muscular/uterine noise, electrode motion, etc.) further affects the signal-to-noise ratio (SNR) of the FECG. These interfering sources, which typically show a strong non-stationary behavior, render the FECG extraction and fetal QRS (FQRS) detection demanding signal processing tasks. In this thesis, several of the challenges regarding NIFECG signal analysis were addressed. In order to improve NIFECG extraction, the dynamic model of a Kalman filter approach was extended, thus, providing a more adequate representation of the mixture of FECG, MECG, and noise. In addition, aiming at the FECG signal quality assessment, novel metrics were proposed and evaluated. Further, these quality metrics were applied in improving FQRS detection and fetal heart rate estimation based on an innovative evolutionary algorithm and Kalman filtering signal fusion, respectively. The elaborated methods were characterized in depth using both simulated and clinical data, produced throughout this thesis. To stress-test extraction algorithms under ideal circumstances, a comprehensive benchmark protocol was created and contributed to an extensively improved NIFECG simulation toolbox. The developed toolbox and a large simulated dataset were released under an open-source license, allowing researchers to compare results in a reproducible manner. Furthermore, to validate the developed approaches under more realistic and challenging situations, a clinical trial was performed in collaboration with the University Hospital of Leipzig. Aside from serving as a test set for the developed algorithms, the clinical trial enabled an exploratory research. This enables a better understanding about the pathophysiological variables and measurement setup configurations that lead to changes in the abdominal signal's SNR. With such broad scope, this dissertation addresses many of the current aspects of NIFECG analysis and provides future suggestions to establish NIFECG in clinical settings.:Abstract Acknowledgment Contents List of Figures List of Tables List of Abbreviations List of Symbols (1)Introduction 1.1)Background and Motivation 1.2)Aim of this Work 1.3)Dissertation Outline 1.4)Collaborators and Conflicts of Interest (2)Clinical Background 2.1)Physiology 2.1.1)Changes in the maternal circulatory system 2.1.2)Intrauterine structures and feto-maternal connection 2.1.3)Fetal growth and presentation 2.1.4)Fetal circulatory system 2.1.5)Fetal autonomic nervous system 2.1.6)Fetal heart activity and underlying factors 2.2)Pathology 2.2.1)Premature rupture of membrane 2.2.2)Intrauterine growth restriction 2.2.3)Fetal anemia 2.3)Interpretation of Fetal Heart Activity 2.3.1)Summary of clinical studies on FHR/FHRV 2.3.2)Summary of studies on heart conduction 2.4)Chapter Summary (3)Technical State of the Art 3.1)Prenatal Diagnostic and Measuring Technique 3.1.1)Fetal heart monitoring 3.1.2)Related metrics 3.2)Non-Invasive Fetal ECG Acquisition 3.2.1)Overview 3.2.2)Commercial equipment 3.2.3)Electrode configurations 3.2.4)Available NIFECG databases 3.2.5)Validity and usability of the non-invasive fetal ECG 3.3)Non-Invasive Fetal ECG Extraction Methods 3.3.1)Overview on the non-invasive fetal ECG extraction methods 3.3.2)Kalman filtering basics 3.3.3)Nonlinear Kalman filtering 3.3.4)Extended Kalman filter for FECG estimation 3.4)Fetal QRS Detection 3.4.1)Merging multichannel fetal QRS detections 3.4.2)Detection performance 3.5)Fetal Heart Rate Estimation 3.5.1)Preprocessing the fetal heart rate 3.5.2)Fetal heart rate statistics 3.6)Fetal ECG Morphological Analysis 3.7)Problem Description 3.8)Chapter Summary (4)Novel Approaches for Fetal ECG Analysis 4.1)Preliminary Considerations 4.2)Fetal ECG Extraction by means of Kalman Filtering 4.2.1)Optimized Gaussian approximation 4.2.2)Time-varying covariance matrices 4.2.3)Extended Kalman filter with unknown inputs 4.2.4)Filter calibration 4.3)Accurate Fetal QRS and Heart Rate Detection 4.3.1)Multichannel evolutionary QRS correction 4.3.2)Multichannel fetal heart rate estimation using Kalman filters 4.4)Chapter Summary (5)Data Material 5.1)Simulated Data 5.1.1)The FECG Synthetic Generator (FECGSYN) 5.1.2)The FECG Synthetic Database (FECGSYNDB) 5.2)Clinical Data 5.2.1)Clinical NIFECG recording 5.2.2)Scope and limitations of this study 5.2.3)Data annotation: signal quality and fetal amplitude 5.2.4)Data annotation: fetal QRS annotation 5.3)Chapter Summary (6)Results for Data Analysis 6.1)Simulated Data 6.1.1)Fetal QRS detection 6.1.2)Morphological analysis 6.2)Own Clinical Data 6.2.1)FQRS correction using the evolutionary algorithm 6.2.2)FHR correction by means of Kalman filtering (7)Discussion and Prospective 7.1)Data Availability 7.1.1)New measurement protocol 7.2)Signal Quality 7.3)Extraction Methods 7.4)FQRS and FHR Correction Algorithms (8)Conclusion References (A)Appendix A - Signal Quality Annotation (B)Appendix B - Fetal QRS Annotation (C)Appendix C - Data Recording GU