Literature DB >> 28182551

Fetal QT Interval Estimation Using Sequential Hypothesis Testing.

Suhong Yu1, Barry D Van Veen2, William J Lutter3, Ronald T Wakai4.   

Abstract

Objective: Recent studies utilizing fetal magnetocardiography have demonstrated the efficacy of corrected QT interval (QTc) measurement for in utero diagnosis and prognosis of long QT syndrome, a leading cause of sudden death in early life. The objective of the study was to formulate and test a novel statistical estimation method to detect the end of the fetal T-wave and thereby improve the accuracy of fetal QT interval measurement.
Methods: To detect the end of the T-wave, we apply a sequential composite hypothesis test to decide when the T-wave has returned to baseline. The method uses the generalized likelihood ratio test in conjunction with a low-rank spatiotemporal model that exploits the repetitive nature of cardiac signals. The unknown model parameters are determined using maximum likelihood estimation.
Results: In realistic simulations, the detector was shown to be accurate to within 10 ms (95% prediction interval), even at noise-to-signal ratios as high as 6. When applied to real data from normal fetuses, the detector agreed well with measurements made by cardiologists ( 1.4 6.9 ms). Conclusions: The method was effective and practical. Detector performance was excellent despite the continual presence of strong maternal interference. Significance: This detector serves as a valuable adjunct to traditional measurement based on subjective assessment.Objective: Recent studies utilizing fetal magnetocardiography have demonstrated the efficacy of corrected QT interval (QTc) measurement for in utero diagnosis and prognosis of long QT syndrome, a leading cause of sudden death in early life. The objective of the study was to formulate and test a novel statistical estimation method to detect the end of the fetal T-wave and thereby improve the accuracy of fetal QT interval measurement.
Methods: To detect the end of the T-wave, we apply a sequential composite hypothesis test to decide when the T-wave has returned to baseline. The method uses the generalized likelihood ratio test in conjunction with a low-rank spatiotemporal model that exploits the repetitive nature of cardiac signals. The unknown model parameters are determined using maximum likelihood estimation.
Results: In realistic simulations, the detector was shown to be accurate to within 10 ms (95% prediction interval), even at noise-to-signal ratios as high as 6. When applied to real data from normal fetuses, the detector agreed well with measurements made by cardiologists ( 1.4 6.9 ms). Conclusions: The method was effective and practical. Detector performance was excellent despite the continual presence of strong maternal interference. Significance: This detector serves as a valuable adjunct to traditional measurement based on subjective assessment.

Entities:  

Keywords:  Biomedical measurement; Covariance matrices; Detectors; Interference; Maximum likelihood estimation; Testing

Mesh:

Year:  2017        PMID: 28182551      PMCID: PMC5540868          DOI: 10.1109/TBME.2017.2661248

Source DB:  PubMed          Journal:  IEEE Trans Biomed Eng        ISSN: 0018-9294            Impact factor:   4.538


  16 in total

1.  A wavelet-based ECG delineator: evaluation on standard databases.

Authors:  Juan Pablo Martínez; Rute Almeida; Salvador Olmos; Ana Paula Rocha; Pablo Laguna
Journal:  IEEE Trans Biomed Eng       Date:  2004-04       Impact factor: 4.538

2.  Maximum-likelihood estimation of low-rank signals for multiepoch MEG/EEG analysis.

Authors:  Boris V Baryshnikov; Barry D Van Veen; Ronald T Wakai
Journal:  IEEE Trans Biomed Eng       Date:  2004-11       Impact factor: 4.538

Review 3.  The thorough QT/QTc study 4 years after the implementation of the ICH E14 guidance.

Authors:  Borje Darpo
Journal:  Br J Pharmacol       Date:  2009-11-18       Impact factor: 8.739

4.  New algorithm for QT interval analysis in 24-hour Holter ECG: performance and applications.

Authors:  P Laguna; N V Thakor; P Caminal; R Jané; H R Yoon; A Bayés de Luna; V Marti; J Guindo
Journal:  Med Biol Eng Comput       Date:  1990-01       Impact factor: 2.602

5.  Prolonged QTc interval predicts mortality in patients with Type 1 diabetes mellitus.

Authors:  P Rossing; L Breum; A Major-Pedersen; A Sato; H Winding; A Pietersen; J Kastrup; H H Parving
Journal:  Diabet Med       Date:  2001-03       Impact factor: 4.359

6.  Comparison of automatic QT measurement techniques in the normal 12 lead electrocardiogram.

Authors:  N B McLaughlin; R W Campbell; A Murray
Journal:  Br Heart J       Date:  1995-07

7.  Automatic detection of wave boundaries in multilead ECG signals: validation with the CSE database.

Authors:  P Laguna; R Jané; P Caminal
Journal:  Comput Biomed Res       Date:  1994-02

8.  Inherited arrhythmias: a National Heart, Lung, and Blood Institute and Office of Rare Diseases workshop consensus report about the diagnosis, phenotyping, molecular mechanisms, and therapeutic approaches for primary cardiomyopathies of gene mutations affecting ion channel function.

Authors:  Stephan E Lehnart; Michael J Ackerman; D Woodrow Benson; Ramon Brugada; Colleen E Clancy; J Kevin Donahue; Alfred L George; Augustus O Grant; Stephen C Groft; Craig T January; David A Lathrop; W Jonathan Lederer; Jonathan C Makielski; Peter J Mohler; Arthur Moss; Jeanne M Nerbonne; Timothy M Olson; Dennis A Przywara; Jeffrey A Towbin; Lan-Hsiang Wang; Andrew R Marks
Journal:  Circulation       Date:  2007-11-13       Impact factor: 29.690

9.  In utero diagnosis of long QT syndrome by magnetocardiography.

Authors:  Bettina F Cuneo; Janette F Strasburger; Suhong Yu; Hitoshi Horigome; Takayoshi Hosono; Akihiko Kandori; Ronald T Wakai
Journal:  Circulation       Date:  2013-11-12       Impact factor: 29.690

10.  Detection of T-wave alternans in fetal magnetocardiography using the generalized likelihood ratio test.

Authors:  Suhong Yu; Barry D Van Veen; Ronald T Wakai
Journal:  IEEE Trans Biomed Eng       Date:  2013-04-04       Impact factor: 4.538

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