Adaptive Match-Filtering: A Biomedical Application to Identify T-Wave Alternans

T-wave alternans (TWA), consisting in an alternation of the electrocardiographic (ECG) repolari- zation segment (T-wave), is a promising index of the risk of sudden cardiac death. By definition, it is characterized by a frequency component, termed fTWA, that matches half heart rate. The heart- rate adaptive match filter (AMF) based method is a technique for automatic TWA identification from the digital ECG. Aim of the present study was to provide a complete technical description of the filter able to explain its methodological principles. The AMF is usually realized as a 6th order Butterworth filter with a narrow (0.12 Hz) passing band centered in fTWA. It is applied in a bidirec- tional fashion, so that final filtering order is 12. While extracting the TWA component, the AMF simultaneously filters out every ECG component including noise and artefacts, and thus results are very robust. Goodness of the technique was tested using 8 synthetic ECG tracings corrupted by typical noisy factors, such as white random noise, baseline wanderings, heart-rate variability, and others. Six ECG tracings were affected by 100 µV TWA, whereas two were not. Results indicate that the AMF-based method is able to prevent false-positive and false-negative detections and, thus, represents a useful tool for a reliable TWA identification.