Next Generation Biological Information Technology, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan.
Advanced Interdisciplinary Biomedical Engineering, Tohoku University Graduate School of Medicine, Sendai, Japan.
PLoS One. 2020 May 11;15(5):e0232769. doi: 10.1371/journal.pone.0232769. eCollection 2020.
The end timing of T waves in fetal electrocardiogram (fECG) is important for the evaluation of ST and QT intervals which are vital markers to assess cardiac repolarization patterns. Monitoring malignant fetal arrhythmias in utero is fundamental to care in congenital heart anomalies preventing perinatal death. Currently, reliable detection of end of T waves is possible only by using fetal scalp ECG (fsECG) and fetal magnetocardiography (fMCG). fMCG is expensive and less accessible and fsECG is an invasive technique available only during intrapartum period. Another safer and affordable alternative is the non-invasive fECG (nfECG) which can provide similar assessment provided by fsECG and fMECG but with less accuracy (not beat by beat). Detection of T waves using nfECG is challenging because of their low amplitudes and high noise. In this study, a novel model-based method that estimates the end of T waves in nfECG signals is proposed. The repolarization phase has been modeled as the discharging phase of a capacitor. To test the model, fECG signals were collected from 58 pregnant women (age: (34 ± 6) years old) bearing normal and abnormal fetuses with gestational age (GA) 20-41 weeks. QT and QTc intervals have been calculated to test the level of agreement between the model-based and reference values (fsECG and Doppler Ultrasound (DUS) signals) in normal subjects. The results of the test showed high agreement between model-based and reference values (difference < 5%), which implies that the proposed model could be an alternative method to detect the end of T waves in nfECG signals.
胎儿心电图(fECG)中 T 波的终点时间对于评估 ST 和 QT 间期非常重要,这些间期是评估心脏复极模式的重要标志物。监测胎儿心律失常对于预防先天性心脏畸形围产期死亡至关重要。目前,只有使用胎儿头皮心电图(fsECG)和胎儿磁心电图(fMCG)才能可靠地检测 T 波终点。fMCG 昂贵且不易获得,fsECG 是一种仅在分娩期间可用的有创技术。另一种更安全且更经济实惠的替代方法是非侵入性的 fECG(nfECG),它可以提供与 fsECG 和 fMECG 相似的评估,但准确性较低(不是逐拍)。由于 T 波幅度低且噪声高,使用 nfECG 检测 T 波具有挑战性。在这项研究中,提出了一种新的基于模型的方法,用于估计 nfECG 信号中的 T 波终点。复极阶段被建模为电容器的放电阶段。为了测试该模型,从 58 名孕妇(年龄:(34±6)岁)中采集了 fECG 信号,这些孕妇怀有正常和异常胎儿,胎龄(GA)为 20-41 周。计算 QT 和 QTc 间期以测试模型在正常受试者中与参考值(fsECG 和多普勒超声(DUS)信号)之间的一致性水平。测试结果表明模型与参考值之间具有高度一致性(差异<5%),这意味着所提出的模型可以作为检测 nfECG 信号中 T 波终点的替代方法。