Detection of atrial fibrillation episodes in long-term heart rhythm signals using a support vector machine

Atrial fibrillation (AF) is a serious heart arrhythmia leading to a significant increase of the risk for occurrence of ischemic stroke. Clinically, the AF episode is recognized in an electrocardiogram. However, detection of asymptomatic AF, which requires a long-term monitoring, is more efficient when based on irregularity of beat-to-beat intervals estimated by the heart rate (HR) features. Automated classification of heartbeats into AF and non-AF by means of the Lagrangian Support Vector Machine has been proposed. The classifier input vector consisted of sixteen features, including four coefficients very sensitive to beat-to-beat heart changes, taken from the fetal heart rate analysis in perinatal medicine. Effectiveness of the proposed classifier has been verified on the MIT-BIH Atrial Fibrillation Database. Designing of the LSVM classifier using very large number of feature vectors requires extreme computational efforts. Therefore, an original approach has been proposed to determine a training set of the smallest possible size that still would guarantee a high quality of AF detection. It enables to obtain satisfactory results using only 1.39% of all heartbeats as the training data. Post-processing stage based on aggregation of classified heartbeats into AF episodes has been applied to provide more reliable information on patient risk. Results obtained during the testing phase showed the sensitivity of 98.94%, positive predictive value of 98.39%, and classification accuracy of 98.86%.Web of Science203art. no. 76

Fetal electrocardiograms, direct and abdominal with reference heartbeat annotations

Monitoring fetal heart rate (FHR) variability plays a fundamental role in fetal state assessment. Reliable FHR signal can be obtained from an invasive direct fetal electrocardiogram (FECG), but this is limited to labour. Alternative abdominal (indirect) FECG signals can be recorded during pregnancy and labour. Quality, however, is much lower and the maternal heart and uterine contractions provide sources of interference. Here, we present ten twenty-minute pregnancy signals and 12 five-minute labour signals. Abdominal FECG and reference direct FECG were recorded simultaneously during labour. Reference pregnancy signal data came from an automated detector and were corrected by clinical experts. The resulting dataset exhibits a large variety of interferences and clinically significant FHR patterns. We thus provide the scientific community with access to bioelectrical fetal heart activity signals that may enable the development of new methods for FECG signals analysis, and may ultimately advance the use and accuracy of abdominal electrocardiography methods.Web of Science71art. no. 20

A novel algorithm based on ensemble empirical mode decomposition for non-invasive fetal ECG extraction

Non-invasive fetal electrocardiography appears to be one of the most promising fetal monitoring techniques during pregnancy and delivery nowadays. This method is based on recording electrical potentials produced by the fetal heart from the surface of the maternal abdomen. Unfortunately, in addition to the useful fetal electrocardiographic signal, there are other interference signals in the abdominal recording that need to be filtered. The biggest challenge in designing filtration methods is the suppression of the maternal electrocardiographic signal. This study focuses on the extraction of fetal electrocardiographic signal from abdominal recordings using a combination of independent component analysis, recursive least squares, and ensemble empirical mode decomposition. The method was tested on two databases, the Fetal Electrocardiograms, Direct and Abdominal with Reference Heartbeats Annotations and the PhysioNet Challenge 2013 database. The evaluation was performed by the assessment of the accuracy of fetal QRS complexes detection and the quality of fetal heart rate determination. The effectiveness of the method was measured by means of the statistical parameters as accuracy, sensitivity, positive predictive value, and F1-score. Using the proposed method, when testing on the Fetal Electrocardiograms, Direct and Abdominal with Reference Heartbeats Annotations database, accuracy higher than 80% was achieved for 11 out of 12 recordings with an average value of accuracy 92.75% [95% confidence interval: 91.19-93.88%], sensitivity 95.09% [95% confidence interval: 93.68-96.03%], positive predictive value 96.36% [95% confidence interval: 95.05-97.17%] and F1-score 95.69% [95% confidence interval: 94.83-96.35%]. When testing on the Physionet Challenge 2013 database, accuracy higher than 80% was achieved for 17 out of 25 recordings with an average value of accuracy 78.24% [95% confidence interval: 73.44-81.85%], sensitivity 81.79% [95% confidence interval: 76.59-85.43%], positive predictive value 87.16% [95% confidence interval: 81.95-90.35%] and F1-score 84.08% [95% confidence interval: 80.75-86.64%]. Moreover, the non-invasive ST segment analysis was carried out on the records from the Fetal Electrocardiograms, Direct and Abdominal with Reference Heartbeats Annotations database and achieved high accuracy in 7 from in total of 12 records (mean values mu < 0.1 and values of +/- 1.96 sigma < 0.1).Web of Science168art. no. e025615

Non-invasive fetal electrocardiogram extraction based on novel hybrid method for intrapartum ST segment analysis

This study focuses on non-invasive fetal electrocardiogram extraction based on a novel hybrid method, which combines the advantages of non-adaptive and adaptive approaches for non-invasive fetal electrocardiogram morphological analysis. Besides estimating fetal heart rate, which is the main parameter used in the clinical practice, this study provides non-invasive ST segment analysis on data from Abdominal and Direct Fetal Electrocardiogram Database consisting of simultaneous traditional - gold standard invasive fetal scalp electrode and non-invasive fetal electrocardiogram recorded during delivery. This innovative approach utilizing the combination of independent component analysis and recursive least squares algorithms has the potential to extract valuable information from non-invasive fetal electrocardiogram in order to identify eventual sign of fetal distress. This was a prospective observational study of non-invasive fetal electrocardiogram, using 4 abdominally sited electrodes, against the traditional fetal scalp electrode on 8 patients. In terms of fetal heart rate estimation, the accuracy was high for all 8 tested patients with average value equaled 0.20 beats per minute and average value of 1.96 standard deviation equaled 5.80 beats per minute. In 7 patients, it was possible to perform the ST segment analysis with high accuracy in determining T/QRS in comparison with the reference fetal scalp electrode signal with average values and 1.96 standard deviation equaled 0.008 and 0.031 respectively. This study thus demonstrates that ST segment analysis is feasible using non-invasive fECG using the proposed hybrid method.Web of Science9286312860

Passive fetal monitoring by advanced signal processing methods in fetal phonocardiography

Fetal phonocardiography (fPCG) is a non-invasive technique for detection of fetal heart sounds (fHSs), murmurs and vibrations. This acoustic recording is passive and provides an alternative low-cost method to ultrasonographic cardiotocography (CTG). Unfortunately, the fPCG signal is often disturbed by the wide range of artifacts that make it difficult to obtain significant diagnostic information from this signal. The study focuses on the filtering of an fPCG signal containing three types of noise (ambient noise, Gaussian noise, and movement artifacts of the mother and the fetus) having different amplitudes. Three advanced signal processing methods: empirical mode decomposition (EMD), ensemble empirical mode decomposition (EEMD), and adaptive wavelet transform (AWT) were tested and compared. The evaluation of the extraction was performed by determining the accuracy of S1 sounds detection and by determining the fetal heart rate (fHR). The evaluation of the effectiveness of the method was performed using signal-to-noise ratio (SNR), mean error of heart interval measurement ((vertical bar Delta T-i vertical bar) over bar), and the statistical parameters of accuracy (ACC), sensitivity (SE), positive predictive value (PPV), and harmonic mean between SE and PPV (F1). Using the EMD method, ACC > 95% was achieved in 7 out of 12 types and levels of interference with average values of ACC D 88 :73%, SE D 91 :57%, PPV D 94 :80% and F1 D 93 :12%. Using the EEMD method, ACC > 95% was achieved in 9 out of 12 types and levels of interference with average values of ACC D 97 :49%, SE D 97 :89%, PPV D 99 :53% and F1 D 98 :69%. In this study, the best results were achieved using the AWT method, which provided ACC > 95% in all 12 types and levels of interference with average values of ACC D 99 :34%, SE D 99 :49%, PPV D 99 :85% a F1 D 99 :67%.Web of Science822196222194