The fetal electrocardiogram (FECG) is the recording of the electrical activity of the fetal heart. Morphologically, FECG shows the standard P-QRS-TU electrocardiographic pattern and a heart rate (HR) of 120-160 bpm. There are two techniques to acquire FECG: the direct one (DI-FECG), with a spiral wire electrode located on the fetal scalp; and the indirect one (IN-FECG), with electrodes located on the mother's abdomen. Fetal T-wave alternans (TWA) represents a possible cause of unexplained fetal deaths; its investigation, however, is challenging. This chapter discusses about this scientific and clinical problem, and proposes a procedure to identify TWA from both DI-FECG and IN-FECG. The procedure includes the following 3 steps: (1) automatic identification of fetal R peaks, performed through the improved fetal Pan-Tompkins Algorithm; (2) FECG filtering, performed through linear filtering and the segmented-beat modulation method; and (3) automatic TWA identification, performed through the heart-rate adaptive match filter. Application of this procedure to 5 DI-FECG and 20 IN-FECG from 5 fetuses confirmed its goodness for fetal applications and suggested that fetuses show TWA even when healthy. Moreover, TWA detected in DI-FECG was comparable to that in IN-FECG, suggesting that TWA identification was reliable also in IN-FECG, which is much more affected by artifacts and interferences than DI-FECG.
T-wave alternans identification in direct and indirect fetal electrocardiography / Burattini, L.; Marcantoni, I.; Nasim, A.; Burattini, L.; Morettini, M.; Sbrollini, A.. - ELETTRONICO. - 1:(2020), pp. 169-185. [10.1007/978-3-030-54403-4_7]
T-wave alternans identification in direct and indirect fetal electrocardiography
Burattini L.
;Marcantoni I.;Nasim A.;Morettini M.;Sbrollini A.
2020-01-01
Abstract
The fetal electrocardiogram (FECG) is the recording of the electrical activity of the fetal heart. Morphologically, FECG shows the standard P-QRS-TU electrocardiographic pattern and a heart rate (HR) of 120-160 bpm. There are two techniques to acquire FECG: the direct one (DI-FECG), with a spiral wire electrode located on the fetal scalp; and the indirect one (IN-FECG), with electrodes located on the mother's abdomen. Fetal T-wave alternans (TWA) represents a possible cause of unexplained fetal deaths; its investigation, however, is challenging. This chapter discusses about this scientific and clinical problem, and proposes a procedure to identify TWA from both DI-FECG and IN-FECG. The procedure includes the following 3 steps: (1) automatic identification of fetal R peaks, performed through the improved fetal Pan-Tompkins Algorithm; (2) FECG filtering, performed through linear filtering and the segmented-beat modulation method; and (3) automatic TWA identification, performed through the heart-rate adaptive match filter. Application of this procedure to 5 DI-FECG and 20 IN-FECG from 5 fetuses confirmed its goodness for fetal applications and suggested that fetuses show TWA even when healthy. Moreover, TWA detected in DI-FECG was comparable to that in IN-FECG, suggesting that TWA identification was reliable also in IN-FECG, which is much more affected by artifacts and interferences than DI-FECG.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
