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Risk evaluation of ventricular
tachycardia using wavelet transform
irregularity of the high-resolution
elect rocard iog ram
P. Lewandowski I O. Meste 2 R. Maniewski I T. Mroczka 1"3
K. Steinbach 3 H. Rix 2
1Institute of Biocybernetics & Biomedical Engineering PAS,
Department of Biomeasurements & Biocontrol, Warsaw, Poland
2Universit6 de Nice, Sophia Antipolis, France
3Ludwig Boltzmann Arrhythmia Research Institute, Vienna, Austria
Abstract--A new method for analysis of high-resolution ECG signals using a wavelet
transform based on a modified Morlet function is presented. A polynomial filter is
used to reduce low-frequency, high-amplitude noise components in the analysed
signals. The method is tested on test ECG signals with simulated late potentials and
finally verified on two post-infarction patient (PP) groups: 62 PPs with ventricular
tachycardia and 44 PPs without arrhythmia. A new quantitative parameter, the
irregularity factor, is proposed for discrimination between the study groups. The
results show a significant difference in the parameter values for tachycardia patients
compared with those for patients without arrhythmia. The sensitivity of the proposed
method is 85 %, and the specificity is 93 %.
Keywords--High-resolution ECG, Late potentials, Spectro-temporal analysis, Wavelet
transform, Ventricular tachycardia
Med. Biol. Eng. Comput., 2000, 38, 666-673
J
1 Introduction
HIGH-RESOLUTIONELECTROCARDIOGRAPHY(HR ECG) is an
approved and widely used non-invasive method for detecting
ventricular late potentials. These low-amplitude signals of
higher frequency in the terminal portion of the QRS complex
are proven to be markers of risk for ventricular tachycardia,
particularly in patients after myocardial infarction (BREITHARDT
et al., 1983; ZIMMERMANN et al., 1985; KUCHAR et al., 1986;
GOMES et al., 1989).
The HR ECG signals, usually recorded in the X, Y and Z leads,
are first pre-processed by filtering, averaged and then analysed
using various time-amplitude, frequency-domain, or spectro-
temporal methods. Finally, the results are evaluated by the
calculation of quantitative parameter(s) for arrhythmia risk
evaluation.
Various methods of analysis have been developed for the
detection of micropotentials. Time-domain analysis, proposed
by SIMSON (1981), is based on the bidirectional high-pass
filtering of averaged ECG signals recorded in three X, Y, Z
orthogonal leads. From these filtered signals, the so-called
modulus of the Simson vector is calculated as the root mean
square of all the leads x/X 2 + y2 + Z 2. Despite some limita-
tions, this method is widely used and is recognised as a standard
Correspondence should be addressed to Prof. R. Maniewski;
emaih roman@hrabia.ibib.waw.pl
First received 28 January 2000 and in final form 16August 2000
MBEC online number: 20003518
© IFMBE:2000
in HR ECG analysis (BREITHARDT et al., 1991). Time-ampli-
tude parameters obtained from the Simson vector are, in many
cases, effective criteria for late-potential (LP) detection.
Besides time-domain methods, classical frequency analysis
using a fast Fourier transform (CAIN et al., 1984, 1985; PIERCE
et al., 1989; HABERL et al., 1989), as well as methods based on
autoregressive modelling (SCHELS et al., 1991; LEWANDOWSKI
et al., 1994) has been proposed. Analysis is usually carried out
on the terminal part of the QRS complex and ST segment of the
ECG signal. For the evaluation of obtained spectra, various
quantification parameters, based mainly on the spectral area
ratio, have been proposed. These parameters allow for detection
of high-frequency components representing late potentials at the
end of the QRS complex and ST segment.
However, time-domain methods, as well as frequency-
domain analysis, do not allow for the effective detection of
LPs because of the presence of excessive noise and the time-
varying frequency spectrum of the ECG signal. Combined
time-frequency analysis, e.g. the analysis of short data
segments shifted with a constant time step, often called short
time Fourier transform or spectro-temporal mapping (LANDER
et al., 1992), is more reliable for analysis ofHR ECG. in this
case, the results of analysis are presented in the form of a three-
dimensional map of time, frequency and power spectral density
(PSD). To evaluate the results, various methods of quantifica-
tion of spectro-temporal distributions have been proposed, such
as: the normality factor introduced by HABERL et al. (1989),
the spectral factor proposed by LEWANDOWSKI et al. (1994)
and spectral turbulence analysis proposed by KELEN et al.
(1991).
666 Medical & Biological Engineering & Computing 2000, Vol. 38