Suppressing the Influence of Ectopic Beats by Applying a Physical Threshold-Based Sample Entropy

Sample entropy (SampEn) is widely used for electrocardiogram (ECG) signal analysis to quantify the inherent complexity or regularity of RR interval time series (i.e., heart rate variability (HRV)), with the hypothesis that RR interval time series in pathological conditions output lower SampEn values. However, ectopic beats can significantly influence the entropy values, resulting in difficulty in distinguishing the pathological situation from normal situations. Although a theoretical operation is to exclude the ectopic intervals during HRV analysis, it is not easy to identify all of them in practice, especially for the dynamic ECG signal. Thus, it is important to suppress the influence of ectopic beats on entropy results, i.e., to improve the robustness and stability of entropy measurement for ectopic beats-inserted RR interval time series. In this study, we introduced a physical threshold-based SampEn method, and tested its ability to suppress the influence of ectopic beats for HRV analysis. An experiment on the PhysioNet/MIT RR Interval Databases showed that the SampEn use physical meaning threshold has better performance not only for different data types (normal sinus rhythm (NSR) or congestive heart failure (CHF) recordings), but also for different types of ectopic beat (atrial beats, ventricular beats or both), indicating that using a physical meaning threshold makes SampEn become more consistent and stable.