000118887 001__ 118887
000118887 005__ 20240319080950.0
000118887 0247_ $$2doi$$a10.1109/TBME.2022.3161725
000118887 0248_ $$2sideral$$a128829
000118887 037__ $$aART-2022-128829
000118887 041__ $$aeng
000118887 100__ $$0(orcid)0000-0003-0226-4950$$aMartin-Yebra, A.
000118887 245__ $$aQT interval Adaptation to Heart Rate Changes in Atrial Fibrillation as a Predictor of Sudden Cardiac Death
000118887 260__ $$c2022
000118887 5060_ $$aAccess copy available to the general public$$fUnrestricted
000118887 5203_ $$aObjective: The clinical significance of QT interval adaptation to heart rate changes has been poorly investigated in atrial fibrillation (AF), since QT delineation in the presence of f-waves is challenging. Therefore, the objective of the present study is to investigate new techniques for QT adaptation estimation in permanent AF. Methods: A multilead strategy based on generalized periodic component analysis is proposed for QT delineation, involving a spatial, linear transformation which emphasizes Twave periodicity and attenuates f-waves. QT adaptation is modeled by a linear, time-invariant filter, whose impulse response describes the dependence between the current QT interval and the preceding RR intervals, followed by a memoryless, possibly nonlinear, function. The QT adaptation time lag is determined from the estimated impulse response. Results: Using simulated ECGs in permanent AF, the transformed lead was found to offer more accurate QT delineation and time lag estimation than did the original ECG leads for a wide range of f-wave amplitudes (the time lag estimation error was found to be -0.2+/-0.6 s for SNR = 12 dB). In a population with chronic heart failure and permanent AF, the time lag estimated from the transformed lead was found to have the strongest, statistically significant association with sudden cardiac death (SCD) (hazard ratio = 3.49), whereas none of the original, orthogonal leads had any such association. Conclusions: Periodic component analysis provides more accurate QT delineation and improves time lag estimation in AF. A prolonged adaptation time of the QT interval to heart rate changes is associated with a high risk for SCD. Significance: This study demonstrates that SCD risk markers, originally developed for sinus rhythm, can also be used in AF, provided that Twave periodicity is emphasized. The time lag is a potentially useful marker for identifying patients at high risk for SCD, guiding clinicians in adopting effective therapeutic decisions. IEEE
000118887 536__ $$9info:eu-repo/grantAgreement/ES/DGA-FSE/T39-20R-BSICoS group$$9info:eu-repo/grantAgreement/ES/MICINN-FEDER/PID2019-104881RB-I00$$9info:eu-repo/grantAgreement/ES/MICINN-FEDER/PID2019-105674RB-I00
000118887 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000118887 590__ $$a4.6$$b2022
000118887 592__ $$a1.167$$b2022
000118887 591__ $$aENGINEERING, BIOMEDICAL$$b34 / 96 = 0.354$$c2022$$dQ2$$eT2
000118887 593__ $$aBiomedical Engineering$$c2022$$dQ1
000118887 594__ $$a9.5$$b2022
000118887 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000118887 700__ $$aSornmo, L.
000118887 700__ $$0(orcid)0000-0003-3434-9254$$aLaguna, P.$$uUniversidad de Zaragoza
000118887 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000118887 773__ $$g69, 10 (2022), 3109-3118$$pIEEE trans. biomed. eng.$$tIEEE Transactions on Biomedical Engineering$$x0018-9294
000118887 8564_ $$s852941$$uhttps://zaguan.unizar.es/record/118887/files/texto_completo.pdf$$yPostprint
000118887 8564_ $$s3633539$$uhttps://zaguan.unizar.es/record/118887/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000118887 909CO $$ooai:zaguan.unizar.es:118887$$particulos$$pdriver
000118887 951__ $$a2024-03-18-12:56:11
000118887 980__ $$aARTICLE