130864 20240201151019.0 doi 10.1109/TBME.2017.2711645 sideral 102363 ART-2017-102363 eng Martín-Yebra, Alba Universidad de Zaragoza (orcid)0000-0003-0226-4950 Post-ventricular premature contraction phase correction improves the predictive value of average T-wave alternans in ambulatory ECG recordings. 2017 Objective: We proposed and evaluated a method for correcting possible phase-shifts provoked by the presence of ventricular premature contractions (VPCs) for a better assessment of T wave alternans (TWA). Methods: First, we synthesized ECG signals with artificial TWA in the presence of different noise sources. Then, we assessed the prognostic value for sudden cardiac death (SCD) of the long-term average of TWA amplitude, (the index of average alternans, IAA) in ambulatory ECG signals from congestive heart failure (CHF) and evaluated whether it is sensitive to the presence of VPCs. Results: The inclusion of the phase correction after VPC in the processing always improved estimation accuracy of the IAA under different noisy conditions and regardless of the number of the VPCs included in the sequence. It presented also a positive impact in the prognostic value of IAA with increased hazard ratios (from 17% to 29%, depending of the scenario) in comparison to the non-inclusion of this step. Conclusion: the proposed methodology for IAA estimation, which corrects for the possible phase reversal on TWA after the presence of VPCs, represents a robust TWA estimation approach with a significant impact in the prognostic value of IAA for SCD stratification in CHF patients. Significance: an accurate TWA estimation has a potential direct clinical impact in non-invasive SCD stratification, allowing better identification of patients at higher risk and helping clinicians in adopting the most appropriate therapeutic strategy. Access copy available to the general public Unrestricted info:eu-repo/semantics/openAccess All rights reserved http://www.europeana.eu/rights/rr-f/ 4.288 2017 ENGINEERING, BIOMEDICAL 9 / 77 = 0.117 2017 Q1 T1 1.267 2017 Biomedical Engineering 2017 Q1 info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion Monasterio, Violeta (orcid)0000-0001-5343-5671 Iwona Cygankiewicz Bayés-de-Luna, Antonio Caiani, Enrico Laguna, Pablo Universidad de Zaragoza (orcid)0000-0003-3434-9254 Martínez, Juan Pablo Universidad de Zaragoza (orcid)0000-0002-7503-3339 5008 X Universidad de Zaragoza Dpto. Ingeniería Electrón.Com. Proy. investigación JBA 5008 800 Universidad de Zaragoza Dpto. Ingeniería Electrón.Com. Área Teoría Señal y Comunicac. 65, 3 (2017), 635-644 IEEE trans. biomed. eng. IEEE Transactions on Biomedical Engineering 0018-9294 855725 http://zaguan.unizar.es/record/130864/files/texto_completo.pdf Postprint 3503780 http://zaguan.unizar.es/record/130864/files/texto_completo.jpg?subformat=icon icon Postprint oai:zaguan.unizar.es:130864 articulos driver 2024-02-01-14:35:35 ARTICLE