Variability of ventricular repolarization dispersion quantified by time-warping the morphology of the T-Waves

Ramírez, Julia (Universidad de Zaragoza) ; Orini, Michele ; Derek Tucker, J. ; Pueyo, Esther (Universidad de Zaragoza) ; Laguna, Pablo (Universidad de Zaragoza)

Resumen: Objective: We propose two electrocardiogram (ECG)-derived markers of T-wave morphological variability in the temporal, d¿, and amplitude, da, domains. Two additional markers, d¿NL and daNL, restricted to measure the nonlinear information present within d¿ and da are also proposed. Methods: We evaluated the accuracy of the proposed markers in capturing T-wave time and amplitude variations in 3 situations: 1) In a simulated set up with presence of additive Laplacian noise, 2) when modifying the spatio-temporal distribution of electrical repolarization with an electro-physiological cardiac model, and 3) in ECG records from healthy subjects undergoing a tilt table test. Results:The metrics d¿, da, d¿NL, and daNL followed T-wave time- and amplitude-induced variations under different levels of noise, were strongly associated with changes in the spatio-temporal dispersion of repolarization, and showed to provide additional information to differences in the heart rate, QT and Tpe intervals, and in the T-wave width and amplitude. Conclusion: The proposed ECG-derived markers robustly quantify T-wave morphological variability, being strongly associated with changes in the dispersion of repolarization. Significance: The proposed ECG-derived markers can help to quantify the variability in the dispersion of ventricular repolarization, showing a great potential to be used as arrhythmic risk predictors in clinical situations.

Idioma: Inglés

DOI: 10.1109/TBME.2016.2614899

Año: 2017

Publicado en: IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING 64, 7 (2017), 1619-1630
ISSN: 0018-9294

Factor impacto JCR: 4.288 (2017)

Categ. JCR: ENGINEERING, BIOMEDICAL rank: 9 / 78 = 0.115 (2017) - Q1 - T1

Factor impacto SCIMAGO: 1.267 - Biomedical Engineering (Q1)

Tipo y forma: Artículo (PostPrint)

Área (Departamento): Área Teoría Señal y Comunicac. (Dpto. Ingeniería Electrón.Com.)