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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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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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