Abstract
The fetal electrocardiogram (FECG) is the recording of the electrical activity of the fetal heart. Morphologically, FECG shows the standard P-QRS-TU electrocardiographic pattern and a heart rate (HR) of 120–160 bpm. There are two techniques to acquire FECG: the direct one (DI-FECG), with a spiral wire electrode located on the fetal scalp; and the indirect one (IN-FECG), with electrodes located on the mother’s abdomen. Fetal T-wave alternans (TWA) represents a possible cause of unexplained fetal deaths; its investigation, however, is challenging. This chapter discusses about this scientific and clinical problem, and proposes a procedure to identify TWA from both DI-FECG and IN-FECG. The procedure includes the following 3 steps: (1) automatic identification of fetal R peaks, performed through the improved fetal Pan-Tompkins Algorithm; (2) FECG filtering, performed through linear filtering and the segmented-beat modulation method; and (3) automatic TWA identification, performed through the heart-rate adaptive match filter. Application of this procedure to 5 DI-FECG and 20 IN-FECG from 5 fetuses confirmed its goodness for fetal applications and suggested that fetuses show TWA even when healthy. Moreover, TWA detected in DI-FECG was comparable to that in IN-FECG, suggesting that TWA identification was reliable also in IN-FECG, which is much more affected by artifacts and interferences than DI-FECG.
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Burattini, L., Marcantoni, I., Nasim, A., Burattini, L., Morettini, M., Sbrollini, A. (2021). T-Wave Alternans Identification in Direct and Indirect Fetal Electrocardiography. In: Pani, D., Rabotti, C., Signorini, M.G., Burattini, L. (eds) Innovative Technologies and Signal Processing in Perinatal Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-54403-4_7
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