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Analysis of QRS-T subtraction in unipolar atrial fibrillation electrograms

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An Erratum to this article was published on 25 May 2013

Abstract

This paper presents a QRS-T subtraction approach for atrial fibrillation (AF) intracardiac atrial electrograms (AEG). It also presents a comparison between the proposed method and two alternative ventricular subtraction techniques: average beat subtraction (ABS) using a fixed length window and an approach based on flat interpolation for QRS cancellation. Areas of the atrium close to the mitral valve showed stronger ventricular influence on the AEGs when compared with the remaining atrial regions. Ventricular influence affects the spectral power distribution of the AEG and can also affect the estimation of the dominant frequency unless the whole ventricular activity influence (QRS-T) is removed. The average power after QRS-T subtraction is significantly reduced for frequencies above 10 Hz (mostly associated with QRS complexes), as well as for frequencies between 3 and 5.5 Hz, (mostly related to T waves). The results indicate that the proposed approach removes ventricular influence on the AF AEGs better than the QRS cancellation method. Spectral analysis showed that both the ABS and the proposed method do well and no method should be preferred to the other. In the time domain, the proposed approach is matched to the lengths and timings of onset and offset for individual QRS-T segments while the ABS approach uses an arbitrary length around the QRS for the pattern used for QRS-T removal.

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References

  1. Ahmad A, Salinet JL Jr, Brown PD, Tuan JH, Stafford PJ, Andre Ng G, Schlindwein FS (2011) QRS subtraction for atrial electrograms: flat, linear and spline interpolation. Med Biol Eng Comp 49:1321–1328

    Article  CAS  Google Scholar 

  2. Bollmann A, Lombardi F (2006) Electrocardiology of atrial fibrillation. IEEE Eng Med Biol Mag 25:15–23

    Article  PubMed  Google Scholar 

  3. Chinitz LA, Sethi JS (2006) How to perform noncontact mapping. Heart Rhythm 3(1):120–123

    Article  PubMed  Google Scholar 

  4. Connolly SJ (2011) Atrial fibrillation in 2010: advances in treatment and management. Nat Rev Card 8:67–68

    Article  Google Scholar 

  5. Crandall MA, Bradley DJ, Packer DL, Asirvatham SJ (2009) Contemporary management of atrial fibrillation: update on anticoagulation and invasive management strategies. Mayo Clin Proc 84(7):643–662

    PubMed  Google Scholar 

  6. Earley MJ, Abrams DJR, Sporton SC, Schilling RJ (2006) Validation of the noncontact mapping system in the left atrium during permanent atrial fibrillation and sinus rhythm. J Am Coll Cardiol 48(3):485–491

    Article  PubMed  Google Scholar 

  7. Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL et al (2006) ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation. Circulation 114(7):700–752

    Article  Google Scholar 

  8. Gornick CC, Adler SW, Pederson B, Hauck J, Budd J, Schweitzer J (1999) Validation of a new noncontact catheter system for electroanatomic mapping of left ventricular endocardium. Circulation 99:829–835

    Article  PubMed  CAS  Google Scholar 

  9. Illanes-Manriquez A, Zhang Q (2008) An algorithm for robust detection of QRS onset and offset in ECG signals. In: Computers in Cardiology, Bologna, Italy, pp 857–860

  10. Jais P, Haissaguerre M, Shah DC, Chouairi S, Gencel L, Hocini M, Clémenty J (1997) A focal source of atrial fibrillation treated by discrete radiofrequency ablation. Circulation 95(3):572–576

    Article  PubMed  CAS  Google Scholar 

  11. Kadish A, Hauck J, Pederson B, Beatty G, Gornick C (1999) Mapping of atrial activation with a noncontact, multielectrode catheter in dogs. Circulation 99(14):1906–1913

    Article  PubMed  CAS  Google Scholar 

  12. Lemay M, Jacquemet V, Forclaz A, Vesin JM, Kappenberger L (2005) Spatiotemporal QRS-T cancellation method using separate QRS and T-waves templates. In: Computers in cardiology, Lyon, France, pp 611–614

  13. Madeiro JPV, Cortez PC, Marques JAL, Seisdedos CR, Sobrinho CR (2012) An innovative approach of QRS segmentation based on first-derivative, Hilbert and wavelet transforms. Med Eng Phys 4(9):1236–1246

    Article  Google Scholar 

  14. Nygards ME, Sörnmo L (1983) Delineation of the QRS complex using the envelope of the e.c.g. Med Biol Eng Comp 21(5):538–547

    Google Scholar 

  15. Qinghua Z, Manriquez AI, Medigue C, Papelier Y, Sorine M (2006) An algorithm for robust and efficient location of t-wave ends in electrocardiograms. IEEE Trans Bio Eng 53:2544–2552

    Article  Google Scholar 

  16. Sanders P, Berenfeld O, Hocini M, Jaïs P, Vaidyanathan R, Hsu LF, Garrigue S, Takahashi Y, Rotter M, Sacher F, Scavée C, Ploutz-Snyder R, Jalife J, Haïssaguerre M (2005) Spectral analysis identifies sites of high-frequency activity maintaining atrial fibrillation in humans. Circulation 112:789–797

    Article  PubMed  Google Scholar 

  17. Schilling RJ, Peters NS, Davies W (1998) Simultaneous endocardial mapping in the human left ventricle using a noncontact catheter—comparison of contact and reconstructed electrograms during sinus rhythm. Circulation 98(9):887–898

    Article  PubMed  CAS  Google Scholar 

  18. Shkurovich S, Sahakian AV, Swiryn S (1998) Detection of atrial activity from high-voltage leads of implantable ventricular defibrillators using a cancellation technique. IEEE Trans Bio Eng 45:229–234

    Article  CAS  Google Scholar 

  19. Slocum J, Byrom E, McCarthy L, Sahakian A, Swiryn S (1985) Computer detection of atrioventricular dissociation from surface electrocardiograms during wide QRS complex tachycardias. Circulation 72:1028–1036

    Article  PubMed  CAS  Google Scholar 

  20. Sörnmo L, Laguna P (2005) Bioelectrical signal processing in cardiac and neurological applications. Elsevier, Amsterdam, pp 485–510

  21. Tai C, Chen S (2009) Noncontact mapping of the heart: how and when to use. J Cardiovasc Electrophysiol 20:123–126

    Article  PubMed  Google Scholar 

  22. Xi Q, Sahakian AV, Swiryn S (2002) The influence of QRS cancellation on signal characteristics of atrial fibrillation in the surface electrocardiogram. In: Computers in cardiology, Memphis, Tennesee, pp 13–16

  23. Xi Q, Sahakian AV, Swiryn S (2003) The effect of QRS cancellation on atrial fibrillatory wave signal characteristics in the surface electrocardiogram. J Electrocardiol 36(3):243–249

    Article  PubMed  Google Scholar 

  24. Zipes DP, Jalife J (2004) Cardiac electrophysiology from cell to bedside, edn 4, Saunders, Philadelphia 512–522

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Acknowledgments

This study is part of the research portfolio supported by the Leicester NIHR Biomedical Research Unit. JLSJ and JPVM are supported by The National Council for Scientific and Technological Development (CNPq) of Brazil, Proc. Nos. 200598/2009-0 and 202395/2011-1. The authors would like to thank Frederique Vanheusden for Fig. 4 and Maria de la Salud Guillem for her critique of the QRS-only approach and the importance of removing the T-wave influence.

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Authors and Affiliations

  1. Department of Engineering, Bioengineering Group, University of Leicester, Leicester, UK

    J. L. Salinet Jr., J. P. V. Madeiro & F. S. Schlindwein

  2. Department of Engineering of Teleinformatics, Federal University of Ceará, Fortaleza, Brazil

    J. P. V. Madeiro & P. C. Cortez

  3. Dept. of Cardiovascular Sciences, Cardiology Group, University of Leicester, Glenfield Hospital, Leicester, UK

    P. J. Stafford & G. André Ng

  4. Leicester NIHR Biomedical Research Unit in Cardiovascular Disease, Glenfield Hospital, Leicester, UK

    P. J. Stafford, G. André Ng & F. S. Schlindwein

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  1. J. L. Salinet Jr.
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  2. J. P. V. Madeiro
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  3. P. C. Cortez
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  4. P. J. Stafford
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  5. G. André Ng
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  6. F. S. Schlindwein
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Correspondence to J. L. Salinet Jr..

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Salinet Jr., J.L., Madeiro, J.P.V., Cortez, P.C. et al. Analysis of QRS-T subtraction in unipolar atrial fibrillation electrograms. Med Biol Eng Comput 51, 1381–1391 (2013). https://doi.org/10.1007/s11517-013-1071-4

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  • DOI: https://doi.org/10.1007/s11517-013-1071-4

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