Peculiarities of multivariate analysis based methods for detection and evaluation of ECG T-wave alternans

Two multivariate analysis methods based on Principal Component Analysis and Periodic Component Analysis designed for detection and evaluation of ECG T-wave alternans were tested on synthetic and clinical recordings in the aim to reveal their diagnostic features. Advanced data pre-processing including normalization of S-T,T segment duration by means of bicubic interpolation was used to increase methods reliability. Non-visible variations in shape of S-T,T segment were revealed by means of the methods in the recordings registered in severe cardiac situations. Results lead to the idea, that analysis of T-wave alternans could be used not only for prevention of critical cardiac situations, but give valuable additional diagnostic information about status of cardiologic patients during ordinary examination

Detection and evaluation of ventricular repolarization alternans: An approach to combined ECG, thoracic impedance, and beat-to-beat heart rate variability analysis

Background and objective: Beat-to-beat alteration in ventricles repolarization reflected by alternans of amplitude and/or shape of ECG S-T,T segment (TWA) is known as phenomena related with risk of severe arrhythmias leading to sudden cardiac death. Technical difficulties have caused limited its usage in clinical diagnostics. Possibilities to register and analyze multimodal signals reflecting heart activity inspired search for new technical solutions. First objective of this study was to test whether thoracic impedance signal and beat-to-beat heart rate reflect repolarization alternans detected as TWA. The second objective was revelation of multimodal signal features more comprehensively representing the phenomena and increasing its prognostic usefulness. Materials and methods: ECG, and thoracic impedance signal recordings made during 24 h follow-up of the patients hospitalized in acute phase of myocardial infarction were used for investigation. Signal morphology variations reflecting estimates were obtained by the principal component analysis-based method. Clinical outcomes of patients (survival and/or rehospitalization in 6 and 12 months) were compared to repolarization alternans and heart rate variability estimates. Results: Repolarization alternans detected as TWA was also reflected in estimates of thoracic impedance signal shape and variation in beat-to-beat heart rate. All these parameters showed correlation with clinical outcomes of patients. The strongest significant correlation showed magnitude of alternans in estimates of thoracic impedance signal shape. Conclusions: The features of ECG, thoracic impedance signal and beat-to-beat variability of heart rate, give comprehensive estimates of repolarization alternans, which correlate, with clinical outcomes of the patients and we recommend using them to improve diagnostic reliability