Systematic analysis of single- and multi-reference adaptive filters for non-invasive fetal electrocardiography (Q2045685)

A major challenge in fetal electrocardiography (ECG) is separating the fetal ECG signal from the maternal signal. Adaptive filters enable satisfactory extraction when there is only a limited number of signal channels available, but the extraction quality is strongly dependent on the electrode placement. In this work, the authors systematically analyze this issue by comparing single- and multi-reference implementations of one particular adaptive filtering method (QRD-RLS), and evaluating the performance on real and simulated data. In particular, they analyze the effectiveness of this technique with different lead orientations. The results demonstrate the expected superior performance of the multi-reference version (\(p < 0.05\)) with respect to all metrics, except the QRS detection accuracy on synthetic data. Results also reveal that the single-reference approach cannot produce a signal with acceptable fetal QRS detection accuracy, regardless of the reference lead selection.