Heart-Rate Adapting Match Filter Detection of T-Wave Alternans in Experimental Holter ECG Recordings

L. Burattini (Italy), W. Zareba (USA), and R. Burattini (Italy)


ECG baseline removal; Repolarization; T-wave alternans.


T-wave alternans (TWA) is an electrophysiological phenomenon associated with cardiac electrical instability. Recently we proposed a new heart-rate adapting match filter (AMF) to detect TWA in ECG tracings affected by baseline wanders. AMF performance was tested against the third-order spline (TOS) interpolation baseline removal technique, the only other baseline-removal method proposed in literature for TWA-detection purposes. Using simulated data, we proved that our AMF method increased correct TWA identification by significantly reducing the number of TWA false-negative detections. The aim of the present study was to test AMF performance in Holter ECG recordings from 15 patients with acute myocardial infarction (AMI) and 15 healthy (H) subjects. Comparison with TOS was also made. Four AMI patients and two H subjects were identified as TWA-positive after application of AMF. By contrast, eight AMI patients (p<0.05) and nine H subjects (p<0.05) were identified as TWA-positive after application of TOS-method. According to clinical observations TWA is infrequent, especially in H-subjects. Thus, our results suggest that TOS-based technique may introduce false positive TWA detections. In conclusion, compared to TOS-method, our AMF-based method reduces both false positive (experimental study) and false-negative (simulation study) TWA detections, thus yielding an improvement over the TOS in the effectiveness of automatic TWA detection.

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