Abstract
An automatic accurate T-wave end (T-end) annotation for the electrocardiogram (ECG) has several important clinical applications. While there have been several algorithms proposed, their performance is usually deteriorated when the signal is noisy. Therefore, we need new techniques to support the noise robustness in T-end detection. We propose a new algorithm based on the signal quality index (SQI) for T-end, coined as tSQI, and the optimal shrinkage (OS). For segments with low tSQI, the OS is applied to enhance the signal-to-noise ratio (SNR). We validated the proposed method using eleven short-term ECG recordings from QT database available at Physionet, as well as four 14-day ECG recordings which were visually annotated at a central ECG core laboratory. We evaluated the correlation between the real-world signal quality for T-end and tSQI, and the robustness of proposed algorithm to various additive noises of different types and SNR’s. The performance of proposed algorithm on arrhythmic signals was also illustrated on MITDB arrhythmic database. The labeled signal quality is well captured by tSQI, and the proposed OS denoising help stabilize existing T-end detection algorithms under noisy situations by making the mean of detection errors decrease. Even when applied to ECGs with arrhythmia, the proposed algorithm still performed well if proper metric is applied. We proposed a new T-end annotation algorithm. The efficiency and accuracy of our algorithm makes it a good fit for clinical applications and large ECG databases. This study is limited by the small size of annotated datasets.
Highlights
The electrocardiogram (ECG) is a ubiquitous diagnostic tool for cardiovascular diseases.One important clinical application is information about the QT interval, a measure of ventricular repolarization
We evaluated our proposed T-wave end (T-end) annotation algorithm, which is an enhancement of Zhang, Carlos, or Martinez, on the above-mentioned databases
The comparison of the signal quality provided in the 14-day ECG database and the proposed tSQI
Summary
One important clinical application is information about the QT interval, a measure of ventricular repolarization. The accuracy of QT measurement directly depends on the ability to accurately determine the Q onset and T offset. Various techniques have been proposed for automatic T-end detection. This includes threshold on the first derivative [3,4], threshold on an area connected by points around the T-wave [5,6,7], wavelet transform [8,9], mathematical model [10], support vector machine [11], artificial neural network (ANN) [12,13,14], hidden Markov model (HMM) [15,16], partially collapsed Gibbs sample
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