Enhanced adaptive matched filter for automated identification and measurement of electrocardiographic alternans

Electrocardiographic alternans, consisting of P-wave alternans (PWA), QRS-complex (QRSA) and T-wave (TWA), is an index cardiac risk. However, only automated TWA measurement methods have been proposed so far. Here, we presented the enhanced adaptive matched filter (EAMF) method tested its reliability in both simulated experimental conditions. Our methodological novelty consists introduction a signal enhancement procedure according to which all sections electrocardiogram (ECG) but wave interest are set baseline, extraction area (AAr) addition standard amplitude (AAm). Simulated data consisted 27 ECGs representing combinations PWA, QRSA low (10 μV) high (100 amplitude. Experimental exercise 12-lead from 266 heart failure patients with implanted cardioverter defibrillator for primary prevention. EAMF was able accurately identify measure kinds (absolute maximum error equal 2%). Moreover, different were simultaneously present them (AAr: 545 μV × ms, 762 ms 1382 ms; AAm: 5 μV, 9 7 μV; TWA, respectively) discriminate as prevalent one (with highest AAr). identifies measures electrocardiographic alternans. may support determination incremental clinical utility PWA respect only.