An ECG simulator for generating maternal-foetal activity mixtures on abdominal ECG recordings

Frequency Domain Template Subtraction Approach to Attenuate Maternal Electrocardiogram in Fetal Electrocardiogram

We develop a frequency domain template subtraction approach to attenuate the maternal ECG in the abdominal ECG measured from pregnant women. The proposed approach was tested on five public fetal ECG datasets simultaneously measured with ECG from the fetal scalp. The method's performance was compared with the template subtraction approach in the time domain using the accuracy and association metrics. The accuracy was calculated by counting the number of fetal complexes in the processed data that coincided with the fetal complexes in the scalp fetal ECG. The association is quantified as the coherence between the processed data and the gold standard. The maximum coherence values calculated for each approach were compared using the paired t-test. Our results showed no difference in the accuracy between the frequency and time domain approach (p = 0.733). However, the association was higher between the frequency domain data and the gold standard compared to the template subtraction data and the gold standard (p = 0.049), indicating that the frequency domain approach yielded a signal that resembled that of the scalp ECG compared to the time domain approach.

The Development and Implementation of Innovative Blind Source Separation Techniques for Real-Time Extraction and Analysis of Fetal and Maternal Electrocardiogram Signals

This article presents an innovative approach to analyzing and extracting electrocardiogram (ECG) signals from the abdomen and thorax of pregnant women, with the primary goal of isolating fetal ECG (fECG) and maternal ECG (mECG) signals. To resolve the difficulties related to the low amplitude of the fECG, various noise sources during signal acquisition, and the overlapping of R waves, we developed a new method for extracting ECG signals using blind source separation techniques. This method is based on independent component analysis algorithms to detect and accurately extract fECG and mECG signals from abdomen and thorax data. To validate our approach, we carried out experiments using a real and reliable database for the evaluation of fECG extraction algorithms. Moreover, to demonstrate real-time applicability, we implemented our method in an embedded card linked to electronic modules that measure blood oxygen saturation (SpO2) and body temperature, as well as the transmission of data to a web server. This enables us to present all information related to the fetus and its mother in a mobile application to assist doctors in diagnosing the fetus's condition. Our results demonstrate the effectiveness of our approach in isolating fECG and mECG signals under difficult conditions and also calculating different heart rates (fBPM and mBPM), which offers promising prospects for improving fetal monitoring and maternal healthcare during pregnancy.

A Nonlinear Functional Link Multilayer Perceptron Using Volterra Series as an Adaptive Noise Canceler for the Extraction of Fetal Electrocardiogram

Uninterrupted monitoring of fetal cardiac health is essential for the timely diagnosis of congenital diseases. The maternal Electrocardiogram (mECG), which has the most significant impact, always tampers with the signals collected from the pregnant woman's abdomen. So, an efficient nonlinear filtering network based on artificial neural network (ANN) is required to eliminate the maternal part from the abdominal Electrocardiogram (aECG) that is traveled from the thoracic of the mother to the abdomen following nonlinear dynamics. In this work, we have presented an adaptive noise canceler (ANC) using 3-layer perceptron architecture where the inputs are expanded by the functional link expansion using the second-order Volterra series, and the weights are updated using backpropagation. The adaptive filter approximates the nonlinear mapping between the thoracic Electrocardiogram (tECG) and the maternal component present in the aECG. Here the thoracic signal is the reference signal, and the abdominal signal is the desired signal to the adaptive filter. The proposed methodology uses the advantages of both multilayer perceptron (MLP) as well as functional link neural network (FLNN) in mapping the nonlinearity and effectively determining the fetal Electrocardiogram (fECG) from the aECG. For the detailed analysis, we have used the real Daisy database, the Non-invasive Fetal ECG database, and the fetal ECG synthetic database from Physionet. The results show that the nonlinear functional link MLP using the Volterra series gives a high-level performance compared to other classical adaptive filtering techniques, as all the evaluation metrics are above 90%.

A Novel Approach to Fetal ECG Extraction Using Temporal Convolutional Encoder-Decoder Network (TCED-Net)

To extract weak fetal ECG signals from the mixed ECG signal on the mother's abdominal wall, providing a basis for accurately estimating fetal heart rate and analyzing fetal ECG morphology. First, based on the relationship between the maternal chest ECG signal and the maternal ECG component in the abdominal signal, the temporal convolutional encoder-decoder network (TCED-Net) model is trained to fit the nonlinear transmission of the maternal ECG signal from the chest to the abdominal wall. Then, the maternal chest ECG signal is nonlinearly transformed to estimate the maternal ECG component in the abdominal mixed signal. Finally, the estimated maternal ECG component is subtracted from the abdominal mixed signal to obtain the fetal ECG component. The simulation results on the FECGSYN dataset show that the proposed approach achieves the best performance in F1 score, mean square error (MSE), and quality signal-to-noise ratio (qSNR) (98.94%, 0.18, and 8.30, respectively). On the NI-FECG dataset, although the fetal ECG component is small in energy in the mixed signal, this method can effectively suppress the maternal ECG component and thus extract a clearer and more accurate fetal ECG signal. Compared with existing algorithms, the proposed method can extract clearer fetal ECG signals, which has significant application value for effective fetal health monitoring during pregnancy.

Body Surface Gastrointestinal Potential Mapping: A Simulation Framework to Evaluate Source Separation Algorithms. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023;2023:1-4. [PMID: 38083102 DOI: 10.1109/embc40787.2023.10340911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Gastrointestinal (GI) potential mapping could be useful for evaluating GI motility disorders. Such disorders are found in inflammatory bowel diseases, such as Crohn's disease, or GI functional disorders. GI potential mapping data originate from a mixture of several GI electrophysiological sources (termed ExG) and other noise sources, including the electrocardiogram (ECG) and respiration. Denoising and/or source separation techniques are required, however, with real measurements, no ground truth is available. In this paper we propose a framework for the simulation of body surface GI potential mapping data. The framework is an electrostatic model, based on fecgsyn toolbox, using dipoles as electrical sources for the heart, stomach, small bowel and colon, and an array of surface electrodes. It is shown to generate realistic ExG waveforms, which are then used to compare several ECG and respiration cancellation techniques, based on, fast independent component analysis (FastICA) and pseudo-periodic component analysis (PiCA). The best performance was obtained with PiCA with a median root mean squared error of 0.005.

A signal quality assessment method for fetal QRS complexes detection

OBJECTIVE

Non-invasive fetal ECG (NI-FECG) provides a non-invasive method to monitor the health of the fetus. However, the NI-FECG is easily interfered by noise, which makes the signal quality decline, leading to the fetal heart rate (FHR) monitoring becoming a challenging task.

METHODS

In this work, an algorithm for dynamic evaluation of signal quality is proposed to improve the multi-channel FHR monitoring. The innovation of the method is to assess the signal quality in the process of multi-channel fetal QRS (FQRS) complexes detection. Specifically, the detected FQRS is used as quality unit. Each quality unit can be a true R peak (TR) or a false R peak (FR). It is the basic quality information in this work. The signal quality of each channel is estimated by estimating the correctness of the detection results. Further, the TRs of all channels can be fused to obtain more reliable fetal heart rate monitoring.

MAIN RESULTS

Analysis results demonstrate that the proposed algorithm is capable of selecting the good quality signal for FQRS detection achieving 97.40% PPV, 98.33% SE and 97.86% F₁.

SIGNIFICANCE

This work sheds light on the quality assessment of fetal monitoring signal.

Morphology extraction of fetal ECG using temporal CNN-based nonlinear adaptive noise cancelling

OBJECTIVES

Noninvasive fetal electrocardiography (FECG) offers many advantages over alternative fetal monitoring techniques in evaluating fetal health conditions. However, it is difficult to extract a clean FECG signal with morphological features from an abdominal ECG recorded at the maternal abdomen; the signal is usually contaminated by the maternal ECG and various noises. The aim of the work is to extract an FECG signal that preserves the morphological features from the mother's abdominal ECG recording, which allows for accurately estimating the fetal heart rate (FHR) and analyzing the waveforms of the fetal ECG.

METHODS

We propose a novel nonlinear adaptive noise cancelling framework (ANC) based on a temporal convolutional neural network (CNN) to effectively extract fetal ECG signals from mothers' abdominal ECG recordings. The proposed framework consists of a two-stage network, using the ANC architecture; one network is for the maternal ECG component elimination and the other is for the residual noise component removal of the extracted fetal ECG signal. Then, JADE (one of the blind source separation algorithms) is applied as a postprocessing step to produce a clean fetal ECG signal.

RESULTS

Synthetic ECG data (FECGSYNDB) and clinical ECG data (NIFECGDB, PCDB) are used to evaluate the extraction performance of the proposed framework. The statistical and visual results demonstrate that our method outperforms the other state-of-the-art algorithms in the literature. Specifically, on the FECGSYNDB, the mean squared error (MSE), signal-to-noise ratio (SNR), correlation coefficient (R) and F1-score of our method are 0.16, 7.94, 0.95 and 98.89%, respectively. The F1-score on the NIFECGDB reaches 98.62%. The value of the F1-score on the PCDB is 98.62%.

CONCLUSION

As opposed to the existing algorithms being restricted to fetal QRS complex detection, the proposed framework can preserve the morphological features of the extracted fetal ECG signal well, which could support medical diagnoses based on the morphology of the fetal ECG signal.

A comparative study of the performance of methods for f-wave extraction

Objective.This study proposes a novel technique for atrial fibrillatory waves (f-waves) extraction and investigates the performance of the proposed method comparing with different f-wave extraction methods.Approach.We propose a novel technique combining a periodic component analysis (PiCA) and echo state network (ESN) for f-waves extraction, denoted PiCA-ESN. PiCA-ESN benefits from the advantages of using both source separation and nonlinear adaptive filtering. PiCA-ESN is evaluated by comparing with other state-of-the-art approaches, which include template subtraction technique based on principal component analysis, spatiotemporal cancellation, nonlinear adaptive filtering using an echo state neural network, and a source separation technique based on PiCA. Quality assessment is performed on a recently published reference database including a large number of simulated ECG signals in atrial fibrillation (AF). The performance of the f-wave extraction methods is evaluated in terms of signal quality metrics (SNR, ΔSNR) and robustness of f-wave features.Main results.The proposed method offers the best signal quality performance, with a ΔSNR of approximately 22 dB across all 8 sets of the reference database, as well as the most robust extraction of f-wave features, with 75% of all estimates of dominant atrial frequency well below 1 Hz.

Wearable Fetal ECG Monitoring System from Abdominal Electrocardiography Recording

Fetal electrocardiography (ECG) monitoring during pregnancy can provide crucial information for assessing the fetus’s health status and making timely decisions. This paper proposes a portable ECG monitoring system to record the abdominal ECG (AECG) of the pregnant woman, comprising both maternal ECG (MECG) and fetal ECG (FECG), which could be applied to fetal heart rate (FHR) monitoring at the home setting. The ECG monitoring system is based on data acquisition circuits, data transmission module, and signal analysis platform, which consists of low input-referred noise, high input impedance, and high resolution. The combination of the adaptive dual threshold (ADT) and the independent component analysis (ICA) algorithm is employed to extract the FECG from the AECG signals. To validate the performance of the proposed system, AECG is recorded and analyzed of pregnant women in three different postures (supine, seated, and standing). The result shows that the proposed system can record the AECG in different postures with good signal quality and high accuracy in fetal ECG and heart rate information. Sensitivity (Se), positive predictive accuracy (PPV), accuracy (ACC), and their harmonic mean (F1) are utilized as the metrics to evaluate the performance of the fetal QRS (fQRS) complexes extraction. The average Se, PPV, ACC, and F1 score are 99.62%, 97.90%, 97.40%, and 98.66% for the fQRS complexes extraction,, respectively. This paper shows the proposed system has a promising application in fetal health monitoring.

A Deep Learning Approach for the Assessment of Signal Quality of Non-Invasive Foetal Electrocardiography

Non-invasive foetal electrocardiography (NI-FECG) has become an important prenatal monitoring method in the hospital. However, due to its susceptibility to non-stationary noise sources and lack of robust extraction methods, the capture of high-quality NI-FECG remains a challenge. Recording waveforms of sufficient quality for clinical use typically requires human visual inspection of each recording. A Signal Quality Index (SQI) can help to automate this task but, contrary to adult ECG, work on SQIs for NI-FECG is sparse. In this paper, a multi-channel signal quality classifier for NI-FECG waveforms is presented. The model can be used during the capture of NI-FECG to assist technicians to record high-quality waveforms, which is currently a labour-intensive task. A Convolutional Neural Network (CNN) is trained to distinguish between NI-FECG segments of high and low quality. NI-FECG recordings with one maternal channel and three abdominal channels were collected from 100 subjects during a routine hospital screening (102.6 min of data). The model achieves an average 10-fold cross-validated AUC of 0.95 ± 0.02. The results show that the model can reliably assess the FECG signal quality on our dataset. The proposed model can improve the automated capture and analysis of NI-FECG as well as reduce technician labour time.

Frequency-Based Maternal Electrocardiogram Attenuation for Fetal Electrocardiogram Analysis

Fetal electrocardiogram (ECG) waveform analysis along with cardiac time intervals (CTIs) measurements are critical for the management of high-risk pregnancies. Currently, there is no system that can consistently and accurately measure fetal ECG. In this work, we present a new automatic approach to attenuate the maternal ECG in the frequency domain and enhance it with measurable CTIs. First, the coherent components between the maternal ECG and abdominal ECG were identified and subtracted from the latter in the frequency domain. The residual was then converted into the time domain using the inverse Fourier transform to yield the fetal ECG. This process was improved by averaging multiple beats. Two fetal cardiologists, blinded to the method, assessed the quality of fetal ECG based on a grading system and measured the CTIs. We evaluated the fetal ECG quality of our method and time-based methods using one synthetic dataset, one human dataset available in the public domain, and 37 clinical datasets. Among the 37 datasets analyzed, the mean average (± standard deviation) grade was 3.49 ± 1.22 for our method vs. 2.64 ± 1.26 for adaptive interference cancellation (p-value < 0.001), thus showing the frequency-based fetal ECG extraction was the superior method, as assessed from our clinicians' perspectives. This method has the potential for use in clinical settings.

Evaluation of Mesh and Sensor Resolution for Finite Element Modeling of Non-Invasive Fetal ECG Signals

Non-invasive fetal electrocardiography (NI-FECG) is an emerging tool with novel diagnostic potential for monitoring fetal wellbeing using electrical signals acquired from the maternal abdomen. However, variations in the geometric structure and conductivity of maternal-fetal tissues have been shown to affect the reliability of NI-FECG signals. Previous studies have utilized detailed finite element models to simulate these impacts, however this approach is computationally expensive. In this study, we investigate a range of mesh and sensor resolutions to determine an optimal trade-off between computational cost and modeling accuracy for simulating NI-FECG signals. Our results demonstrate that an optimal refinement of mesh resolution provides comparable accuracy to a detailed reference solution while requiring approximately 12 times less computation time and one-third of the memory usage. Furthermore, positioning simulated sensors at a 20 mm grid spacing provides a sufficient representation of abdominal surface potentials. These findings represent default parameters to be used in future simulations of NI-FECG signals. Code for the model utilized in this work is available under an open-source GPL license as part of the fecgsyn toolbox.Clinical Relevance- Simulating NI-FECG signals provides the opportunity to study the effects of sensor placement and maternal-fetal anatomic variations in a controlled setting. This work has relevance in determining default parameters for efficiently performing these simulations.

Fetal ECG Extraction from Maternal ECG using Attention-based CycleGAN

A non-invasive fetal electrocardiogram (FECG) is used to monitor the electrical pulse of the fetal heart. Decomposing the FECG signal from the maternal ECG (MECG) is a blind source separation problem, which is hard due to the low amplitude of the FECG, the overlap of R waves, and the potential exposure to noise from different sources. Traditional decomposition techniques, such as adaptive filters, require tuning, alignment, or pre-configuration, such as modeling the noise or desired signal to map the MECG to the FECG. The high correlation between maternal and fetal ECG fragments decreases the performance of convolution layers. Therefore, the masking region of interest based on the attention mechanism was performed to improve the signal generators' precision. The sine activation function was also used to retain more details when converting two signal domains. Three available datasets from the Physionet, including the A&D FECG, NI-FECG, and NI-FECG challenge, and one synthetic dataset using FECGSYN toolbox, were used to evaluate the performance. The proposed method could map an abdominal MECG to a scalp FECG with an average of 98% R-Square [CI 95%: 97%, 99%] as the goodness of fit on the A&D FECG dataset. Moreover, it achieved 99.7 % F1-score [CI 95%: 97.8-99.9], 99.6% F1-score [CI 95%: 98.2%, 99.9%] and 99.3% F1-score [CI 95%: 95.3%, 99.9%] for fetal QRS detection on the A&D FECG, NI-FECG and NI-FECG challenge datasets, respectively. Also, the distortion was in the very good and good ranges. These results are comparable to the state-of-the-art results; thus, the proposed algorithm has the potential to be used for high-performance signal-to-signal conversion.

A novel algorithm based on ensemble empirical mode decomposition for non-invasive fetal ECG extraction

Non-invasive fetal electrocardiography appears to be one of the most promising fetal monitoring techniques during pregnancy and delivery nowadays. This method is based on recording electrical potentials produced by the fetal heart from the surface of the maternal abdomen. Unfortunately, in addition to the useful fetal electrocardiographic signal, there are other interference signals in the abdominal recording that need to be filtered. The biggest challenge in designing filtration methods is the suppression of the maternal electrocardiographic signal. This study focuses on the extraction of fetal electrocardiographic signal from abdominal recordings using a combination of independent component analysis, recursive least squares, and ensemble empirical mode decomposition. The method was tested on two databases, the Fetal Electrocardiograms, Direct and Abdominal with Reference Heartbeats Annotations and the PhysioNet Challenge 2013 database. The evaluation was performed by the assessment of the accuracy of fetal QRS complexes detection and the quality of fetal heart rate determination. The effectiveness of the method was measured by means of the statistical parameters as accuracy, sensitivity, positive predictive value, and F1-score. Using the proposed method, when testing on the Fetal Electrocardiograms, Direct and Abdominal with Reference Heartbeats Annotations database, accuracy higher than 80% was achieved for 11 out of 12 recordings with an average value of accuracy 92.75% [95% confidence interval: 91.19-93.88%], sensitivity 95.09% [95% confidence interval: 93.68-96.03%], positive predictive value 96.36% [95% confidence interval: 95.05-97.17%] and F1-score 95.69% [95% confidence interval: 94.83-96.35%]. When testing on the Physionet Challenge 2013 database, accuracy higher than 80% was achieved for 17 out of 25 recordings with an average value of accuracy 78.24% [95% confidence interval: 73.44-81.85%], sensitivity 81.79% [95% confidence interval: 76.59-85.43%], positive predictive value 87.16% [95% confidence interval: 81.95-90.35%] and F1-score 84.08% [95% confidence interval: 80.75-86.64%]. Moreover, the non-invasive ST segment analysis was carried out on the records from the Fetal Electrocardiograms, Direct and Abdominal with Reference Heartbeats Annotations database and achieved high accuracy in 7 from in total of 12 records (mean values μ < 0.1 and values of ±1.96σ < 0.1).

Modeling and Reproducing Textile Sensor Noise: Implications for Textile-Compatible Signal Processing Algorithms

Smart textiles provide an opportunity to simultaneously record various electrophysiological signals from the human body, such as ECG, in a non-invasive and continuous manner. Accurate processing of ECG signals recorded using textile sensors is challenging due to the very low signal-to-noise ratio (SNR). Signal processing algorithms that can extract ECG signal out of textile-based electrode recordings, despite low SNR are needed. Presently, there are no textile ECG datasets available to develop, test and validate these algorithms. In this paper we attempted to model textile ECG signals by adding the textile sensor noise to open access ECG signals. We employed the linear predictive coding method to model different features of this noise. By approximating the linear predictive coding residual signals using Kernel Density Estimation, an artificial textile ECG noise signal was generated by filtering the residual signal with the linear predictive coding coefficients. The obtained textile sensor noise was added to the MIT-BIH Arrhythmia Database (MITDB), thus creating Textile-like ECG dataset consisting of 108 channels (30 min each). Furthermore, a Python code for generating textile-like ECG signals with variable SNR was also made available online. Finally, to provide a benchmark for the performance of R-peak detection algorithms on textile ECG, the five common R-peak detection algorithms: Pan & Tompkins, improved Pan & Tompkins (in Biosppy), Hamilton, Engelse, and Khamis, were tested on textile-like MITDB. This work provides an approach to generating noisy textile ECG signals, and facilitating the development, testing, and evaluation of signal processing algorithms for textile ECGs.

AECG-DecompNet: abdominal ECG signal decomposition through deep-learning model

Objective.The accurate decomposition of a mother's abdominal electrocardiogram (AECG) to extract the fetal ECG (FECG) is a primary step in evaluating the fetus's health. However, the AECG is often affected by different noises and interferences, such as the maternal ECG (MECG), making it hard to evaluate the FECG signal. In this paper, we propose a deep-learning-based framework, namely 'AECG-DecompNet', to efficiently extract both MECG and FECG from a single-channel abdominal electrode recording.Approach.AECG-DecompNet is based on two series networks to decompose AECG, one for MECG estimation and the other to eliminate interference and noise. Both networks are based on an encoder-decoder architecture with internal and external skip connections to reconstruct the signals better.Main results.Experimental results show that the proposed framework performs much better than utilizing one network for direct FECG extraction. In addition, the comparison of the proposed framework with popular single-channel extraction techniques shows superior results in terms of QRS detection while indicating its ability to preserve morphological information. AECG-DecompNet achieves exceptional accuracy in theprecisionmetric (97.4%), higher accuracy inrecallandF₁metrics (93.52% and 95.42% respectively), and outperforms other state-of-the-art approaches.Significance.The proposed method shows a notable performance in preserving the morphological information when the FECG within the AECG signal is weak.

An improved parallel sub-filter adaptive noise canceler for the extraction of fetal ECG

Non-invasive extraction of fetal electrocardiogram (FECG) by processing the abdominal signals is emerging as a promising approach in the areas of obstetrics and gynecology. This paper presents a two-stage improved non-linear adaptive filter for FECG extraction. The reference input to the adaptive noise canceler (ANC) is first processed using an adaptive neuro-fuzzy inference system (ANFIS) to estimate the non-linear maternal component in abdominal signals. A parallel sub-filter (PSF) ANC is proposed to assess the fetal ECG from the abdominal signal. The PSF-ANC decomposes a single adaptive filter into multiple sub-filters to improve the convergence performance. The filter coefficients of PSF-ANC adaptively obtained using normalised least mean square algorithm by minimizing the mean square error. Different error and common error algorithms are proposed based on the computation of the error signal. A synthetic data from the FECG synthetic database is used to evaluate the convergence performance. Two real-time data from the Daisy database and the Non-invasive FECG database from Physionet are used to evaluate the proposed ANFIS-PSF's performance qualitative and quantitatively. The results justify the performance improvement of proposed ANFIS-PSF ANC compared to the state of art techniques. The proposed scheme achieves a sensitivity of 97.92%, 94.52% accuracy, a positive predictive value of 94.66%, and an F1 score of 96.12%.

Efficient implementation of LMS adaptive filter-based FECG extraction on an FPGA

In this Letter, the field programmable gate array (FPGA) implementation of a foetal heart rate (FHR) monitoring system is presented. The system comprises a preprocessing unit to remove various types of noise, followed by a foetal electrocardiogram (FECG) extraction unit and an FHR detection unit. To improve the precision and accuracy of the arithmetic operations, a floating-point unit is developed. A least mean squares algorithm-based adaptive filter (LMS-AF) is used for FECG extraction. Two different architectures, namely series and parallel, are proposed for the LMS-AF, with the series architecture targeting lower utilisation of hardware resources, and the parallel architecture enabling less convergence time and lower power consumption. The results show that it effectively detects the R peaks in the extracted FECG with a sensitivity of 95.74–100% and a specificity of 100%. The parallel architecture shows up to an 85.88% reduction in the convergence time for non-invasive FECG databases while the series architecture shows a 27.41% reduction in the number of flip flops used when compared with the existing FPGA implementations of various FECG extraction methods. It also shows an increase of 2–7.51% in accuracy when compared to previous works.

Annotated real and synthetic datasets for non-invasive foetal electrocardiography post-processing benchmarking

Non-invasive foetal electrocardiography (fECG) can be obtained at different gestational ages by means of surface electrodes applied on the maternal abdomen. The signal-to-noise ratio (SNR) of the fECG is usually low, due to the small size of the foetal heart, the foetal-maternal compartment, the maternal physiological interferences and the instrumental noise. Even after powerful fECG extraction algorithms, a post-processing step could be required to improve the SNR of the fECG signal. In order to support the researchers in the field, this work presents an annotated dataset of real and synthetic signals, which was used for the study “Wavelet Denoising as a Post-Processing Enhancement Method for Non-Invasive Foetal Electrocardiography” [1]. Specifically, 21 15 s-long fECG, dual-channel signals obtained by multi-reference adaptive filtering from real electrophysiological recordings were included. The annotation of the foetal R peaks by an expert cardiologist was also provided. Recordings were performed on 17 voluntary pregnant women between the 21st and the 27th week of gestation. The raw recordings were also included for the researchers interested in applying a different fECG extraction algorithm. Moreover, 40 10 s-long synthetic non-invasive fECG were provided, simulating the electrode placement of one of the abdominal leads used for the real dataset. The annotation of the foetal R peaks was also provided, as generated by the FECGSYN tool used for the signals’ creation. Clean fECG signals were also included for the computation of indexes of signal morphology preservation. All the signals are sampled at 2048 Hz. The data provided in this work can be used as a benchmark for fECG post-processing techniques but can also be used as raw signals for researchers interested in foetal QRS detection algorithms and fECG extraction methods.

Wavelet denoising as a post-processing enhancement method for non-invasive foetal electrocardiography

BACKGROUND AND OBJECTIVE

The detection of a clean and undistorted foetal electrocardiogram (fECG) from non-invasive abdominal recordings is an open research issue. Several physiological and instrumental noise sources hamper this process, even after that powerful fECG extraction algorithms have been used. Wavelet denoising is widely used for the improvement of the SNR in biomedical signal processing. This work aims to systematically assess conventional and unconventional wavelet denoising approaches for the post-processing of fECG signals by providing evidence of their effectiveness in improving fECG SNR while preserving the morphology of the signal of interest.

METHODS

The stationary wavelet transform (SWT) and the stationary wavelet packet transform (SWPT) were considered, due to their different granularity in the sub-band decomposition of the signal. Three thresholds from the literature, either conventional (Minimax and Universal) and unconventional, were selected. To this aim, the unconventional one was adapted for the first time to SWPT by trying different approaches. The decomposition depth was studied in relation to the characteristics of the fECG signal. Synthetic and real datasets, publicly available for benchmarking and research, were used for quantitative analysis in terms of noise reduction, foetal QRS detection performance and preservation of fECG morphology.

RESULTS

The adoption of wavelet denoising approaches generally improved the SNR. Interestingly, the SWT methods outperformed the SWPT ones in morphology preservation (p<0.04) and SNR (p<0.0003), despite their coarser granularity in the sub-band analysis. Remarkably, the Han et al. threshold, adopted for the first time for fECG processing, provided the best quality improvement (p<0.003).

CONCLUSIONS

The findings of our systematic analysis suggest that particular care must be taken when selecting and using wavelet denoising for non-invasive fECG signal post-processing. In particular, despite the general noise reduction capability, signal morphology can be significantly altered on the basis of the parameterization of the wavelet methods. Remarkably, the adoption of a finer sub-band decomposition provided by the wavelet packet was not able to improve the quality of the processing.

Unsupervised hidden semi-Markov model for automatic beat onset detection in 1D Doppler ultrasound

OBJECTIVE

One dimensional (1D) Doppler ultrasound (DUS) is commonly used for fetal health assessment, during both regular prenatal visits and labor. It is used in preference to ECG and other modalities because of its simplicity and cost. To date, all analysis of such data has been confined to a smoothed, windowed heart rate estimation derived from the 1D DUS signal, reducing the potential of short-term variability information. A first step in improving the assessment of short-term variability of the fetal heart rate (FHR) is through implementing an accurate beat detector for 1D DUS signals.

APPROACH

This work presents an unsupervised probabilistic segmentation method enabled by a hidden semi-Markov model (HSMM). The proposed method employs envelope and spectral features for an online segmentation of fetal 1D DUS signal. The beat onsets and fetal cardiac beat-to-beat intervals are then estimated from the segmentations. For this work, two data sets were used, including 1D DUS recordings from five fetuses recorded in Germany, comprising 6521 beats and 45.06 minutes of data (dataset 1). Simultaneous fetal ECG (fECG) was used as the reference for beat timing. Dataset 2, comprising 4044 beats captured from 17 subjects in the UK was hand scored for beat location and was used as an independent held-out test set. Leave-one-out subject cross-validation was used for parameter tuning on dataset 1. No retraining was performed for dataset 2. To assess the performance of the beat onset detection, the root mean square error (RMSE), F1 score, sensitivity, positive predictivity (PPV) and the error in several standard common heart rate variability metrics were used. These metrics were evaluated on three fiducial points: (1) beat onset, (2) beat offset, and (3) middle of beat interval.

MAIN RESULTS

In dataset 1, the proposed method provided an RMSE of 20 ms, F1 score of 97.5 %, a Se of 97.6%, and a PPV of 97.3%. In dataset 2, the proposed method achieved an RMSE of 26 ms, an F1 score of 98.5 %, a Se of 98.0 % and a PPV of 98.9 %. It was also determined that the best beat-to-beat interval was derived from the onset of each beat. For the dataset 2, significant correlations were found in all short term heart rate variability metrics tested, both in the time and frequency domain. Only the proportion of successive normal-to-normal interval differences greater than 20 ms (pNN20) exhibited a significant absolute difference.

SIGNIFICANCE

This work presents the first-ever description of an algorithm to identify cardiac beats with 1D DUS, closely matching the fetal ECG-derived beats, to enable short-term heart rate variability analysis. The novel algorithm proposed requires no human labeling of data, and could have applicability beyond 1D DUS to other similar highly variable time series.

Simulating Motion Artifact Using an Autoregressive Model for Research in Biomedical Signal Quality Analysis

Motion artifact contamination may adversely affect the interpretation of biological signals. The development of algorithms to detect, identify, quantify, and mitigate motion artifact is typically performed using a ground truth signal contaminated with previously recorded motion artifact, or simulated motion artifact. The diversity of available motion artifact recordings is limited, and the rationales for existing models of motion artifact are poorly described. In this paper we developed an autoregressive (AR) model of motion artifact based on data collected from 6 subjects walking at slow, medium, and fast paces. The AR model was evaluated for its ability to generate diverse data that replicated the properties of the experimental data. The simulated motion artifact data was successful at learning key time domain and frequency domain properties, including the mean, variance, and power spectrum of the data, but was ineffective for imitating the morphology and probability distribution of the motion artifact data (kurtosis % error of 100.9-103.6%). More sophisticated models of motion artifact may be necessary to develop simulations of motion artifact.

Fetal electrocardiograms, direct and abdominal with reference heartbeat annotations

Monitoring fetal heart rate (FHR) variability plays a fundamental role in fetal state assessment. Reliable FHR signal can be obtained from an invasive direct fetal electrocardiogram (FECG), but this is limited to labour. Alternative abdominal (indirect) FECG signals can be recorded during pregnancy and labour. Quality, however, is much lower and the maternal heart and uterine contractions provide sources of interference. Here, we present ten twenty-minute pregnancy signals and 12 five-minute labour signals. Abdominal FECG and reference direct FECG were recorded simultaneously during labour. Reference pregnancy signal data came from an automated detector and were corrected by clinical experts. The resulting dataset exhibits a large variety of interferences and clinically significant FHR patterns. We thus provide the scientific community with access to bioelectrical fetal heart activity signals that may enable the development of new methods for FECG signals analysis, and may ultimately advance the use and accuracy of abdominal electrocardiography methods.

A Null Space-Based Blind Source Separation for Fetal Electrocardiogram Signals

This paper presents a new non-invasive deterministic algorithm of extracting the fetal Electrocardiogram (FECG) signal based on a new null space idempotent transformation matrix (NSITM). The mixture matrix is used to compute the ITM. Then, the fetal ECG (FECG) and maternal ECG (MECG) signals are extracted from the null space of the ITM. Next, MECG and FECG peaks detection, control logic, and adaptive comb filter are used to remove the unwanted MECG component from the raw FECG signal, thus extracting a clean FECG signal. The visual results from Daisy and Physionet real databases indicate that the proposed algorithm is effective in extracting the FECG signal, which can be compared with principal component analysis (PCA), fast independent component analysis (FastICA), and parallel linear predictor (PLP) filter algorithms. Results from Physionet synthesized ECG data show considerable improvement in extraction performances over other algorithms used in this work, considering different additive signal-to-noise ratio (SNR) increasing from 0 dB to 12 dB, and considering different fetal-to-maternal SNR increasing from -30 dB to 0 dB. The FECG detection of the NSITM is evaluated using statistical measures and results show considerable improvement in the sensitivity (SE), the accuracy (ACC), and the positive predictive value (PPV), as compared with other algorithms. The study demonstrated that the NSITM is a feasible algorithm for FECG extraction.

Spatial-dependent regularization to solve the inverse problem in electromyometrial imaging

Recently, electromyometrial imaging (EMMI) was developed to non-invasively image uterine contractions in three dimensions. EMMI collects body surface electromyography (EMG) measurements and uses patient-specific body-uterus geometry generated from magnetic resonance images to reconstruct uterine electrical activity. Currently, EMMI uses the zero-order Tikhonov method with mean composite residual and smoothing operator (CRESO) to stabilize the underlying ill-posed inverse computation. However, this method is empirical and implements a global regularization parameter over all uterine sites, which is sub-optimal for EMMI given the severe eccentricity of body-uterus geometry. To address this limitation, we developed a spatial-dependent (SP) regularization method that considers both body-uterus eccentricity and EMG noise. We used electrical signals simulated with spherical and realistic geometry models to compare the reconstruction accuracy of the SP method to those of the CRESO and the L-Curve methods. The SP method reconstructed electrograms and potential maps more accurately than the other methods, especially in cases of high eccentricity and noise contamination. Thus, the SP method should facilitate clinical use of EMMI and can be used to improve the accuracy of other electrical imaging modalities, such as Electrocardiographic Imaging. Graphical abstract The spatial-dependent regularization (SP) technique was designed to improve the accuracy of Electromyometrial Imaging (EMMI). The top panel shows the eccentricity of body-uterus geometry and four representative body surface electrograms. The bottom panel shows boxplots of correlation coefficients and relative errors for the electrograms reconstructed with SP and two conventional methods, the L-Curve and mean CRESO methods.

The Influence of Vectorcardiogram Orientation on the T/QRS Ratio Obtained Via Non-Invasive Fetal ECG

Non-invasive fetal electrocardiography (NI-FECG) is an emerging technology that demonstrates potential for providing novel physiological information compared to traditional ultrasound-based cardiotocography (CTG). However, few studies have investigated the reliability of signal features derived via this technique for diagnostic use. One feature of NI-FECG recordings proposed for the purpose of identifying fetal distress is the T/QRS ratio, which has been indicated to change in response to fetal hypoxia. As the T/QRS ratio measures characteristics of the heart's electrical activity in 3D space (represented as the vectorcardiogram), it is critical to understand how changes in the vectorcardiogram orientation may influence the reliability of this feature. To study this influence, this work simulates NI-FECG recordings using eight finite element models of the maternal-fetal anatomy and calculates the T/QRS ratio for a range of vector-cardiogram orientations and sensor positions. To quantify the potential for T/QRS ratio estimation error in real world data, these results are compared to those observed in a homogeneous volume conductor model, as assumed by many existing signal processing techniques. Our results demonstrate that the fetal vectorcardiogram orientation has a significant influence on the reliability of the T/QRS ratio obtained via NI-FECG. Varying the vectorcardiogram orientation through a range of -30 to +30 degrees along each coordinate axis results in the potential for the T/QRS ratio to be underestimated by up to 94% and overestimated by up to 240% if a homogeneous volume conductor model is assumed. Furthermore, we find that the sensor positioning on the maternal abdomen strongly affects the range of the T/QRS ratio estimation error. These results confirm that further study must be undertaken to determine the relationship between the physiological and signal processing domains before utilizing the T/QRS ratio obtained via NI-FECG for diagnostic purposes.

Multi-Channel Fetal ECG Denoising With Deep Convolutional Neural Networks

Non-invasive fetal electrocardiography represents a valuable alternative continuous fetal monitoring method that has recently received considerable attention in assessing fetal health. However, the non-invasive fetal electrocardiogram (ECG) is typically severely contaminated by a considerable amount of various noise sources, rendering fetal ECG denoising a very challenging task. This work employs a deep learning approach for removing the residual noise from multi-channel fetal ECG after the maternal ECG has been suppressed. We propose a deep convolutional encoder-decoder network with symmetric skip-layer connections, learning end-to-end mappings from noise-corrupted fetal ECG signals to clean ones. Experiments on simulated data show an average signal-to-noise ratio (SNR) improvement of 9.5 dB for fetal ECG signals with input SNR ranging between -20 and 20 dB. The method is additionally evaluated on a large set of real signals, demonstrating that it can provide significant quality improvement of the noisy fetal ECG signals. We further show that employment of multi-channel signal information by the network provides superior and more reliable performance as opposed to its single-channel network counterpart. The presented method is able to preserve beat-to-beat morphological variations and does not require any prior information on the power spectra of the noise or the pulse location.

Single-lead noninvasive fetal ECG extraction by means of combining clustering and principal components analysis

Early detection of potential hazards in the fetal physiological state during pregnancy and childbirth is very important. Noninvasive fetal electrocardiogram (FECG) can be extracted from the maternal abdominal signal. However, due to the interference of maternal electrocardiogram and other noises, the task of extraction is challenging. This paper introduces a novel single-lead noninvasive fetal electrocardiogram extraction method based on the technique of clustering and PCA. The method is divided into four steps: (1) pre-preprocessing; (2) fetal QRS complexes and maternal QRS complexes detection based on k-means clustering algorithm with the feature of max-min pairs; (3) FQRS correction step is to improve the performance of step two; (4) template subtraction based on PCA is introduced to extract FECG waveform. To verify the performance of the proposed algorithm, two clinical open-access databases are used to check the performance of FQRS detection. As a result, the method proposed shows the average PPV of 95.35%, Se of 96.23%, and F1-measure of 95.78%. Furthermore, the robustness test is carried out on an artificial database which proves that the algorithm has certain robustness in various noise environments. Therefore, this method is feasible and reliable to detect fetal heart rate and extract FECG. Graphical abstract Early detection of potential hazards in the fetal physiological state during pregnancy and childbirth is very important. Noninvasive fetal electrocardiogram (FECG) can be extracted from maternal abdominal signal. However, due to the interference of maternal electrocardiogram and other noises, the task of extraction is challenging. This paper introduces a novel single-lead noninvasive fetal electrocardiogram extraction method based on the technique of clustering and PCA. The method is divided into four steps: (1) pre-preprocessing; (2) fetal QRS complexes and maternal QRS complexes detection based on k-means clustering algorithm with the feature of max-min pairs; (3) FQRS correction step is to improve the performance of step two; (4) template subtraction based on PCA is introduced to extract FECG waveform. To verify the performance of algorithm, two clinical open-access databases are used to check the performance of FQRS detection. As a result, the method proposed shows the average PPV of 95.35%, Se of 96.23%, and F1-measure of 95.78%. Furthermore, the robustness test is carried out on an artificial database which proves that the algorithm has certain robustness in various noise environments. Therefore, this method is feasible and reliable to detect fetal heart rate and extract FECG.

A Review of Signal Processing Techniques for Non-Invasive Fetal Electrocardiography

Fetal electrocardiography (fECG) is a promising alternative to cardiotocography continuous fetal monitoring. Robust extraction of the fetal signal from the abdominal mixture of maternal and fetal electrocardiograms presents the greatest challenge to effective fECG monitoring. This is mainly due to the low amplitude of the fetal versus maternal electrocardiogram and to the non-stationarity of the recorded signals. In this review, we highlight key developments in advanced signal processing algorithms for non-invasive fECG extraction and the available open access resources (databases and source code). In particular, we highlight the advantages and limitations of these algorithms as well as key parameters that must be set to ensure their optimal performance. Improving or combining the current or developing new advanced signal processing methods may enable morphological analysis of the fetal electrocardiogram, which today is only possible using the invasive scalp electrocardiography method.

An open source autocorrelation-based method for fetal heart rate estimation from one-dimensional Doppler ultrasound

OBJECTIVE

Open research on fetal heart rate (FHR) estimation is relatively rare, and evidence for the utility of metrics derived from Doppler ultrasound devices has historically remained hidden in the proprietary documentation of commercial entities, thereby inhibiting its assessment and improvement. Nevertheless, recent studies have attempted to improve FHR estimation; however, these methods were developed and tested using datasets composed of few subjects and are therefore unlikely to be generalizable on a population level. The work presented here introduces a reproducible and generalizable autocorrelation (AC)-based method for FHR estimation from one-dimensional Doppler ultrasound (1D-DUS) signals.

APPROACH

Simultaneous fetal electrocardiogram (fECG) and 1D-DUS signals generated by a hand-held Doppler transducer in a fixed position were captured by trained healthcare workers in a European hospital. The fECG QRS complexes were identified using a previously published fECG extraction algorithm and were then over-read to ensure accuracy. An AC-based method to estimate FHR was then developed on this data, using a total of 721 1D-DUS segments, each 3.75 s long, and parameters were tuned with Bayesian optimization. The trained FHR estimator was tested on two additional (independent) hand-annotated Doppler-only datasets recorded with the same device but on different populations: one composed of 3938 segments (from 99 fetuses) acquired in rural Guatemala, and another composed of 894 segments (from 17 fetuses) recorded in a hospital in the UK.

MAIN RESULTS

The proposed AC-based method was able to estimate FHR within 10% of the reference FHR values 96% of the time, with an accuracy of 97% for manually identified good quality segments in both of the independent test sets.

SIGNIFICANCE

This is the first work to publish open source code for FHR estimation from 1D-DUS data. The method was shown to satisfy estimations within 10% of the reference FHR values and it therefore defines a minimum accuracy for the field to match or surpass. Our work establishes a basis from which future methods can be developed to more accurately estimate FHR variability for assessing fetal wellbeing from 1D-DUS signals.

The effects of asymmetric volume conductor modeling on non-invasive fetal ECG extraction

OBJECTIVE

Non-invasive fetal electrocardiography (NI-FECG) shows promise for capturing novel physiological information that may indicate signs of fetal distress. However, significant deterioration in NI-FECG signal quality occurs during the presence of a highly non-conductive layer known as vernix caseosa which forms on the fetal body surface beginning in approximately the 28th week of gestation. This work investigates asymmetric modeling of vernix caseosa and other maternal-fetal tissues in accordance with clinical observations and assesses their impacts for NI-FECG signal processing.

APPROACH

We develop a process for simulating dynamic maternal-fetal abdominal ECG mixtures using a synthetic cardiac source model embedded in a finite element volume conductor. Using this process, changes in NI-FECG signal morphology are assessed in an extensive set of finite element models including spatially variable distributions of vernix caseosa.

MAIN RESULTS

Our simulations show that volume conductor asymmetry can result in over 70% error in the observed T/QRS ratio and significant changes to signal morphology compared to a homogeneous volume conductor model. Volume conductor effects must be considered when analyzing T/QRS ratios obtained via NI-FECG and should be considered in future algorithm benchmarks using simulated data.

SIGNIFICANCE

This work shows that without knowledge of the influence of volume conductor effects, clinical evaluation of the T/QRS ratio derived via NI-FECG should be avoided.

Non-Adaptive Methods for Fetal ECG Signal Processing: A Review and Appraisal

Fetal electrocardiography is among the most promising methods of modern electronic fetal monitoring. However, before they can be fully deployed in the clinical practice as a gold standard, the challenges associated with the signal quality must be solved. During the last two decades, a great amount of articles dealing with improving the quality of the fetal electrocardiogram signal acquired from the abdominal recordings have been introduced. This article aims to present an extensive literature survey of different non-adaptive signal processing methods applied for fetal electrocardiogram extraction and enhancement. It is limiting that a different non-adaptive method works well for each type of signal, but independent component analysis, principal component analysis and wavelet transforms are the most commonly published methods of signal processing and have good accuracy and speed of algorithms.

SEPARATION OF TWIN FETAL ECG FROM MATERNAL ECG USING EMPIRICAL MODE DECOMPOSITION TECHNIQUES

In this study, by using a combination of standard Empirical Mode Decomposition (EMD), Ensembling Empirical Mode Decomposition (EEMD), Completing Empirical Mode Decomposition (CEMD) and Principal Component Analysis (PCA), a new method was introduced to separate twin fetal heart rate (FHR) from maternal ECG. The data which were the results of modeling fetal and maternal ECG which be longed to 10 mothers with a sampling frequency of 250[Formula: see text]Hz. In this method, first R-wave of maternal ECG was determined, and then maternal QRS is removed. Further, to clarify these changes and increase resistance to environmental noises, PCA was used. In the next step, all FHRs related to twin fetuses were extracted from signals. Ensemble Empirical Mode Decomposition with Adaptive Noise (CEEMDAN) was used for denoising. By using the proposed method for noise with an amplitude of over 10 dB, the FHR of the first and second (if any) fetuses were separated from maternal ECG with an accuracy of 93.3% and 91.1% respectively. The goal was to improve signal processing dimensions of fetal ECG and provides deeper insight about this issue using EEMD technique. It was tested on a twin fetus with the results suggesting its effectiveness even with increased number of fetuses with slight modifications.

Electrocardiogram modeling during paroxysmal atrial fibrillation: application to the detection of brief episodes

OBJECTIVE

A model for simulating multi-lead ECG signals during paroxysmal atrial fibrillation (AF) is proposed.

SIGNIFICANCE

The model is of particular significance when evaluating detection performance in the presence of brief AF episodes, especially since annotated databases with such episodes are lacking.

APPROACH

The proposed model accounts for important characteristics such as switching between sinus rhythm and AF, varying P-wave morphology, repetition rate of f-waves, presence of atrial premature beats, and various types of noise.

MAIN RESULTS

Two expert cardiologists assessed the realism of simulated signals relative to real ECG signals, both in sinus rhythm and AF. The cardiologists identified the correct rhythm in all cases, and considered two-thirds of the simulated signals as realistic. The proposed model was also investigated by evaluating the performance of two AF detectors which explored either rhythm only or both rhythm and morphology. The results show that detection performance is strongly dependent on AF episode duration, and, consequently, demonstrate that the model can play a significant role in the investigation of detector properties.

Single-Lead Fetal ECG Extraction Based on a Parallel Marginalized Particle Filter

This paper presents a novel method for extracting the fetal ECG (FECG) from a single-lead abdominal signal. A dynamical model for a modified abdominal signal is proposed, in which both the maternal ECG (MECG) and the FECG are modeled, and then a parallel marginalized particle filter (par-MPF) is used for tracking the abdominal signal. Finally, the FECG and MECG are simultaneously separated. Several experiments are conducted using both simulated and clinical signals. The results indicate that the method proposed in this paper effectively extracts the FECG and outperforms other Bayesian filtering algorithms.

A Combined Independent Source Separation and Quality Index Optimization Method for Fetal ECG Extraction from Abdominal Maternal Leads

The non-invasive fetal electrocardiogram (fECG) technique has recently received considerable interest in monitoring fetal health. The aim of our paper is to propose a novel fECG algorithm based on the combination of the criteria of independent source separation and of a quality index optimization (ICAQIO-based). The algorithm was compared with two methods applying the two different criteria independently—the ICA-based and the QIO-based methods—which were previously developed by our group. All three methods were tested on the recently implemented Fetal ECG Synthetic Database (FECGSYNDB). Moreover, the performance of the algorithm was tested on real data from the PhysioNet fetal ECG Challenge 2013 Database. The proposed combined method outperformed the other two algorithms on the FECGSYNDB (ICAQIO-based: 98.78%, QIO-based: 97.77%, ICA-based: 97.61%). Significant differences were obtained in particular in the conditions when uterine contractions and maternal and fetal ectopic beats occurred. On the real data, all three methods obtained very high performances, with the QIO-based method proving slightly better than the other two (ICAQIO-based: 99.38%, QIO-based: 99.76%, ICA-based: 99.37%). The findings from this study suggest that the proposed method could potentially be applied as a novel algorithm for accurate extraction of fECG, especially in critical recording conditions.

Fetal ECG extraction via Type-2 adaptive neuro-fuzzy inference systems

BACKGROUND AND OBJECTIVE

We proposed a noninvasive method for separating the fetal ECG (FECG) from maternal ECG (MECG) by using Type-2 adaptive neuro-fuzzy inference systems.

METHODS

The method can extract FECG components from abdominal signal by using one abdominal channel, including maternal and fetal cardiac signals and other environmental noise signals, and one chest channel. The proposed algorithm detects the nonlinear dynamics of the mother's body. So, the components of the MECG are estimated from the abdominal signal. By subtracting estimated mother cardiac signal from abdominal signal, fetal cardiac signal can be extracted. This algorithm was applied on synthetic ECG signals generated based on the models developed by McSharry et al. and Behar et al. and also on DaISy real database.

RESULTS

In environments with high uncertainty, our method performs better than the Type-1 fuzzy method. Specifically, in evaluation of the algorithm with the synthetic data based on McSharry model, for input signals with SNR of -5dB, the SNR of the extracted FECG was improved by 38.38% in comparison with the Type-1 fuzzy method. Also, the results show that increasing the uncertainty or decreasing the input SNR leads to increasing the percentage of the improvement in SNR of the extracted FECG. For instance, when the SNR of the input signal decreases to -30dB, our proposed algorithm improves the SNR of the extracted FECG by 71.06% with respect to the Type-1 fuzzy method. The same results were obtained on synthetic data based on Behar model. Our results on real database reflect the success of the proposed method to separate the maternal and fetal heart signals even if their waves overlap in time. Moreover, the proposed algorithm was applied to the simulated fetal ECG with ectopic beats and achieved good results in separating FECG from MECG.

CONCLUSIONS

The results show the superiority of the proposed Type-2 neuro-fuzzy inference method over the Type-1 neuro-fuzzy inference and the polynomial networks methods, which is due to its capability to capture the nonlinearities of the model better.

Non-invasive Fetal ECG Signal Quality Assessment for Multichannel Heart Rate Estimation

OBJECTIVE

The noninvasive fetal ECG (NI-FECG) from abdominal recordings offers novel prospects for prenatal monitoring. However, NI-FECG signals are corrupted by various nonstationary noise sources, making the processing of abdominal recordings a challenging task. In this paper, we present an online approach that dynamically assess the quality of NI-FECG to improve fetal heart rate (FHR) estimation.

METHODS

Using a naive Bayes classifier, state-of-the-art and novel signal quality indices (SQIs), and an existing adaptive Kalman filter, FHR estimation was improved. For the purpose of training and validating the proposed methods, a large annotated private clinical dataset was used.

RESULTS

The suggested classification scheme demonstrated an accuracy of Krippendorff's alpha in determining the overall quality of NI-FECG signals. The proposed Kalman filter outperformed alternative methods for FHR estimation achieving accuracy.

CONCLUSION

The proposed algorithm was able to reliably reflect changes of signal quality and can be used in improving FHR estimation.

SIGNIFICANCE

NI-ECG signal quality estimation and multichannel information fusion are largely unexplored topics. Based on previous works, multichannel FHR estimation is a field that could strongly benefit from such methods. The developed SQI algorithms as well as resulting classifier were made available under a GNU GPL open-source license and contributed to the FECGSYN toolbox.

Energy and Quality Evaluation for Compressive Sensing of Fetal Electrocardiogram Signals

This manuscript addresses the problem of non-invasive fetal Electrocardiogram (ECG) signal acquisition with low power/low complexity sensors. A sensor architecture using the Compressive Sensing (CS) paradigm is compared to a standard compression scheme using wavelets in terms of energy consumption vs. reconstruction quality, and, more importantly, vs. performance of fetal heart beat detection in the reconstructed signals. We show in this paper that a CS scheme based on reconstruction with an over-complete dictionary has similar reconstruction quality to one based on wavelet compression. We also consider, as a more important figure of merit, the accuracy of fetal beat detection after reconstruction as a function of the sensor power consumption. Experimental results with an actual implementation in a commercial device show that CS allows significant reduction of energy consumption in the sensor node, and that the detection performance is comparable to that obtained from original signals for compression ratios up to about 75%.

Sequential Total Variation Denoising for the Extraction of Fetal ECG from Single-Channel Maternal Abdominal ECG

Fetal heart rate (FHR) is an important determinant of fetal health. Cardiotocography (CTG) is widely used for measuring the FHR in the clinical field. However, fetal movement and blood flow through the maternal blood vessels can critically influence Doppler ultrasound signals. Moreover, CTG is not suitable for long-term monitoring. Therefore, researchers have been developing algorithms to estimate the FHR using electrocardiograms (ECGs) from the abdomen of pregnant women. However, separating the weak fetal ECG signal from the abdominal ECG signal is a challenging problem. In this paper, we propose a method for estimating the FHR using sequential total variation denoising and compare its performance with that of other single-channel fetal ECG extraction methods via simulation using the Fetal ECG Synthetic Database (FECGSYNDB). Moreover, we used real data from PhysioNet fetal ECG databases for the evaluation of the algorithm performance. The R-peak detection rate is calculated to evaluate the performance of our algorithm. Our approach could not only separate the fetal ECG signals from the abdominal ECG signals but also accurately estimate the FHR.

A novel LabVIEW-based multi-channel non-invasive abdominal maternal-fetal electrocardiogram signal generator

This paper describes the design, construction, and testing of a multi-channel fetal electrocardiogram (fECG) signal generator based on LabVIEW. Special attention is paid to the fetal heart development in relation to the fetus' anatomy, physiology, and pathology. The non-invasive signal generator enables many parameters to be set, including fetal heart rate (FHR), maternal heart rate (MHR), gestational age (GA), fECG interferences (biological and technical artifacts), as well as other fECG signal characteristics. Furthermore, based on the change in the FHR and in the T wave-to-QRS complex ratio (T/QRS), the generator enables manifestations of hypoxic states (hypoxemia, hypoxia, and asphyxia) to be monitored while complying with clinical recommendations for classifications in cardiotocography (CTG) and fECG ST segment analysis (STAN). The generator can also produce synthetic signals with defined properties for 6 input leads (4 abdominal and 2 thoracic). Such signals are well suited to the testing of new and existing methods of fECG processing and are effective in suppressing maternal ECG while non-invasively monitoring abdominal fECG. They may also contribute to the development of a new diagnostic method, which may be referred to as non-invasive trans-abdominal CTG +  STAN. The functional prototype is based on virtual instrumentation using the LabVIEW developmental environment and its associated data acquisition measurement cards (DAQmx). The generator also makes it possible to create synthetic signals and measure actual fetal and maternal ECGs by means of bioelectrodes.

An adaptive integrated algorithm for noninvasive fetal ECG separation and noise reduction based on ICA-EEMD-WS

High-resolution fetal electrocardiogram (FECG) plays an important role in assisting physicians to detect fetal changes in the womb and to make clinical decisions. However, in real situations, clear FECG is difficult to extract because it is usually overwhelmed by the dominant maternal ECG and other contaminated noise such as baseline wander, high-frequency noise. In this paper, we proposed a novel integrated adaptive algorithm based on independent component analysis (ICA), ensemble empirical mode decomposition (EEMD), and wavelet shrinkage (WS) denoising, denoted as ICA-EEMD-WS, for FECG separation and noise reduction. First, ICA algorithm was used to separate the mixed abdominal ECG signal and to obtain the noisy FECG. Second, the noise in FECG was reduced by a three-step integrated algorithm comprised of EEMD, useful subcomponents statistical inference and WS processing, and partial reconstruction for baseline wander reduction. Finally, we evaluate the proposed algorithm using simulated data sets. The results indicated that the proposed ICA-EEMD-WS outperformed the conventional algorithms in signal denoising.

Impact of the presence of noise on RR interval-based atrial fibrillation detection

Atrial fibrillation (AF) is the most common cardiac arrhythmia, but is currently under-diagnosed since it can be asymptomatic. Early detection of AF could be highly beneficial for the prevention of stroke, which is one major risk associated with AF, with a five fold increase. mHealth applications have been recently proposed for early screening of paroxysmal AF. Several automatic AF detections have been suggested, and they are mostly based on features extracted from the RR interval time-series, since this is more robust to ambulatory noise than p-wave based algorithms. The RR interval features highlight the irregularity and unpredictability of the rhythm due to the chaotic electrical conduction through the AV node. Such approach has proved to be accurate on openly available databases. However, current techniques are limited by their assumption of almost perfect R peak detection, and RR time-series features are usually estimated from manual annotations. Analysis of the huge amount of data an mHealth application may create has to be automated, robust to noise, and should incorporate a confidence index based on an estimation of the signal quality. In this study, we present an in depth analysis of the performance of AF detection algorithms as a function of noise and QRS detection performance. We show a linear decrease of AF detection accuracy with respect to the SNR. Finally, we will demonstrate how the use of an automatic signal quality index can ensure a given level of performance in AF detection, more than 95% AF detection accuracy by analyzing segments with a median SQI over 0.8.