RESEARCH ARTICLE
Noninvasive Fetal Electrocardiography Part I: Pan-Tompkins' Algorithm Adaptation to Fetal R-peak Identification
Angela Agostinelli, Ilaria Marcantoni, Elisa Moretti, Agnese Sbrollini, Sandro Fioretti, Francesco Di Nardo, Laura Burattini*
Article Information
Identifiers and Pagination:
Year: 2017Volume: 11
First Page: 17
Last Page: 24
Publisher ID: TOBEJ-11-17
DOI: 10.2174/1874120701711010017
Article History:
Received Date: 30/09/2016Revision Received Date: 13/02/2017
Acceptance Date: 21/02/2017
Electronic publication date: 31/03/2017
Collection year: 2017
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
Indirect fetal electrocardiography is preferable to direct fetal electrocardiography because of being noninvasive and is applicable also during the end of pregnancy, besides labor. Still, the former is strongly affected by noise so that even R-peak detection (which is essential for fetal heart-rate evaluations and subsequent processing procedures) is challenging. Some fetal studies have applied the Pan-Tompkins’ algorithm that, however, was originally designed for adult applications. Thus, this work evaluated the Pan-Tompkins’ algorithm suitability for fetal applications, and proposed fetal adjustments and optimizations to improve it.
Method:
Both Pan-Tompkins’ algorithm and its improved version were applied to the “Abdominal and Direct Fetal Electrocardiogram Database” and to the “Noninvasive Fetal Electrocardiography Database” of Physionet. R-peak detection accuracy was quantified by computation of positive-predictive value, sensitivity and F1 score.
Results:
When applied to “Abdominal and Direct Fetal Electrocardiogram Database”, the accuracy of the improved fetal Pan-Tompkins’ algorithm was significantly higher than the standard (positive-predictive value: 0.94 vs. 0.79; sensitivity: 0.95 vs. 0.80; F1 score: 0.94 vs. 0.79; P<0.05 in all cases) on indirect fetal electrocardiograms, whereas both methods performed similarly on direct fetal electrocardiograms (positive-predictive value, sensitivity and F1 score all close to 1). Improved fetal Pan-Tompkins’ algorithm was found to be superior to the standard also when applied to “Noninvasive Fetal Electrocardiography Database” (positive-predictive value: 0.68 vs. 0.55, P<0.05; sensitivity: 0.56 vs. 0.46, P=0.23; F1 score: 0.60 vs. 0.47, P=0.11).
Conclusion:
In indirect fetal electrocardiographic applications, improved fetal Pan-Tompkins’ algorithm is to be preferred over the standard, since it provides higher R-peak detection accuracy for heart-rate evaluations and subsequent processing.