A Review of Atrial Fibrillation Detection Methods as a Service

Atrial Fibrillation (AF) is a common heart arrhythmia that often goes undetected, and even if it is detected, managing the condition may be challenging. In this paper, we review how the RR interval and Electrocardiogram (ECG) signals, incorporated into a monitoring system, can be useful to track AF events. Were such an automated system to be implemented, it could be used to help manage AF and thereby reduce patient morbidity and mortality. The main impetus behind the idea of developing a service is that a greater data volume analyzed can lead to better patient outcomes. Based on the literature review, which we present herein, we introduce the methods that can be used to detect AF efficiently and automatically via the RR interval and ECG signals. A cardiovascular disease monitoring service that incorporates one or multiple of these detection methods could extend event observation to all times, and could therefore become useful to establish any AF occurrence. The development of an automated and efficient method that monitors AF in real time would likely become a key component for meeting public health goals regarding the reduction of fatalities caused by the disease. Yet, at present, significant technological and regulatory obstacles remain, which prevent the development of any proposed system. Establishment of the scientific foundation for monitoring is important to provide effective service to patients and healthcare professionals

Automated Atrial Fibrillation Detection by ECG Signal Processing: A Review

Cardiovascular diseases are the main cause of death in the world, according to the World Health Organization. Among them, ischemic heart disease is at the top, followed by a stroke. Several studies have revealed that atrial fibrillation (AF), which is the most common cardiac arrhythmia, increases up to five fold the overall risk of stroke. As AF can be asymptomatic, approximately 20% of the AF cases remain undiagnosed. AF can be detected by analyzing electrocardiography records. Many studies have been conducted to develop automatic methods for AF detection. This paper reviews some of the most relevant methods, classified into three groups: analysis of heart rate variability, analysis of the atrial activity, and hybrid methods. Their benefits and limitations are analyzed and compared, and our beliefs about where AF automatic detection research could be addressed are presented to improve its effectiveness and performance. © 2021 by Begell House, Inc

Cardiac Inter Beat Interval and Atrial Fibrillation Detection using Video Plethysmography

Facial videoplethysmography provides non-contact measurement of heart activity based on blood volume pulsations detected in facial tissue. Typically, the signal is extracted using a simple webcam followed by elaborated signal processing methods, and provides limited accuracy of time-domain characteristics. In this study, we explore the possibility of providing accurate time-domain pulse and inter-beat interval measurements using a high- quality image sensor camera and various signal processing approaches, and use these measurements to diagnose atrial fibrillation. We capture synchronized signals using a high- quality camera, a simple webcam, an earlobe photoplethysmography sensor, and a body- surface electrocardiogram from a large group of subjects, including subjects diagnosed with cardiac arrhythmias. All signals are processed using both blind source separation and color conversion. We then assess accuracy of IBI detection, heart rate variability estimation, and atrial fibrillation diagnose by comparing to a body-surface electrocardiogram. We present a new heart variability indicator for blood volume pulsating signals. Our results demonstrate that the accuracy of a facial VPG system is greatly improved when using a high-quality camera. Coupling the high-quality camera with color conversion from RGB to Hue provides a level of accuracy equivalent to that of commercially available photoplethysmography sensors, and offers a non-contact alternative to current technology for heart rate variability assessment and atrial fibrillation screening

Artificial neural network for atrial fibrillation identification in portable devices

none6siAtrial fibrillation (AF) is a common cardiac disorder that can cause severe complications. AF diagnosis is typically based on the electrocardiogram (ECG) evaluation in hospitals or in clinical facilities. The aim of the present work is to propose a new artificial neural network for reliable AF identification in ECGs acquired through portable devices. A supervised fully connected artificial neural network (RSL_ANN), receiving 19 ECG features (11 morphological, 4 on F waves and 4 on heart-rate variability (HRV)) in input and discriminating between AF and non-AF classes in output, was created using the repeated structuring and learning (RSL) procedure. RSL_ANN was created and tested on 8028 (training: 4493; validation: 1125; testing: 2410) annotated ECGs belonging to the “AF Classification from a Short Single Lead ECG Recording” database and acquired with the portable KARDIA device by AliveCor. RSL_ANN performance was evaluated in terms of area under the curve (AUC) and confidence intervals (CIs) of the received operating characteristic. RSL_ANN performance was very good and very similar in training, validation and testing datasets. AUC was 91.1% (CI: 89.1%–93.0%), 90.2% (CI: 86.2%–94.3%) and 90.8% (CI: 88.1%–93.5%) for the training, validation and testing datasets, respectively. Thus, RSL_ANN is a promising tool for reliable identification of AF in ECGs acquired by portable devices.openMarinucci D.; Sbrollini A.; Marcantoni I.; Morettini M.; Swenne C.A.; Burattini L.Marinucci, D.; Sbrollini, A.; Marcantoni, I.; Morettini, M.; Swenne, C. A.; Burattini, L

Recent Advances in the Noninvasive Study of Atrial Conduction Defects Preceding Atrial Fibrillation

The P-wave represents the electrical activity in the electrocardiogram (ECG) associated with the heart\u27s atrial contraction. This wave has merited significant research efforts in recent years with the aim to characterize atrial depolarization from the ECG. Indeed, the alterations of the P-wave main time, frequency, and wavelet features have been widely studied to predict the onset of atrial fibrillation (AF), both spontaneously and after a specific treatment, such as pharmacological or electrical cardioversion, catheter ablation, as well as cardiac surgery. To this respect, the P-wave prolongation is today a clinically accepted marker of high risk of suffering AF. However, given the relatively low P-wave amplitude in the ECG, its analysis has been most widely carried out from signal-averaged ECG signals. Unfortunately, these kind of recordings are uncommon in routine clinical practice and, moreover, they obstruct the possibility of studying the information carried by each single P-wave as well as its variability over time. These limitations have motivated the recent development of the beat-to-beat P-wave analysis, which has proven to be very useful in revealing interesting information about the altered atrial conduction preceding the onset of AF. Within this context, the main goal of this chapter is to review the most recent advances reached by this kind of analysis in the noninvasive assessment of atrial conduction alterations. Thus, the chapter will introduce and discuss the existing methods of the beat-to-beat P-wave analysis and their application to predict the onset of AF as well as its advantages and disadvantages compared with the signal-averaged P-wave analysis

Feasibility of atrial fibrillation detection from a novel wearable armband device

BACKGROUND: Atrial fibrillation (AF) is the world’s most common heart rhythm disorder and even several minutes of AF episodes can contribute to risk for complications, including stroke. However, AF often goes undiagnosed owing to the fact that it can be paroxysmal, brief, and asymptomatic. OBJECTIVE: To facilitate better AF monitoring, we studied the feasibility of AF detection using a continuous electrocardiogram (ECG) signal recorded from a novel wearable armband device. METHODS: In our 2-step algorithm, we first calculate the R-R interval variability–based features to capture randomness that can indicate a segment of data possibly containing AF, and subsequently discriminate normal sinus rhythm from the possible AF episodes. Next, we use density Poincaré plot-derived image domain features along with a support vector machine to separate premature atrial/ventricular contraction episodes from any AF episodes. We trained and validated our model using the ECG data obtained from a subset of the MIMIC-III (Medical Information Mart for Intensive Care III) database containing 30 subjects. RESULTS: When we tested our model using the novel wearable armband ECG dataset containing 12 subjects, the proposed method achieved sensitivity, specificity, accuracy, and F1 score of 99.89%, 99.99%, 99.98%, and 0.9989, respectively. Moreover, when compared with several existing methods with the armband data, our proposed method outperformed the others, which shows its efficacy. CONCLUSION: Our study suggests that the novel wearable armband device and our algorithm can be used as a potential tool for continuous AF monitoring with high accuracy

Classification of De novo post-operative and persistent atrial fibrillation using multi-channel ECG recordings

Atrial fibrillation (AF) is the most sustained arrhythmia in the heart and also the most common complication developed after cardiac surgery. Due to its progressive nature, timely detection of AF is important. Currently, physicians use a surface electrocardiogram (ECG) for AF diagnosis. However, when the patient develops AF, its various development stages are not distinguishable for cardiologists based on visual inspection of the surface ECG signals. Therefore, severity detection of AF could start from differentiating between short-lasting AF and long-lasting AF. Here, de novo post-operative AF (POAF) is a good model for short-lasting AF while long-lasting AF can be represented by persistent AF. Therefore, we address in this paper a binary severity detection of AF for two specific types of AF. We focus on the differentiation of these two types as de novo POAF is the first time that a patient develops AF. Hence, comparing its development to a more severe stage of AF (e.g., persistent AF) could be beneficial in unveiling the electrical changes in the atrium. To the best of our knowledge, this is the first paper that aims to differentiate these different AF stages. We propose a method that consists of three sets of discriminative features based on fundamentally different aspects of the multi-channel ECG data, namely based on the analysis of RR intervals, a greyscale image representation of the vectorcardiogram, and the frequency domain representation of the ECG. Due to the nature of AF, these features are able to capture both morphological and rhythmic changes in the ECGs. Our classification system consists of a random forest classifier, after a feature selection stage using the ReliefF method. The detection efficiency is tested on 151 patients using 5-fold cross-validation. We achieved 89.07% accuracy in the classification of de novo POAF and persistent AF. The results show that the features are discriminative to reveal the severity of AF. Moreover, inspection of the most important features sheds light on the different characteristics of de novo post-operative and persistent AF.</p

Classification of Arrhythmia by Using Deep Learning with 2-D ECG Spectral Image Representation

The electrocardiogram (ECG) is one of the most extensively employed signals used in the diagnosis and prediction of cardiovascular diseases (CVDs). The ECG signals can capture the heart's rhythmic irregularities, commonly known as arrhythmias. A careful study of ECG signals is crucial for precise diagnoses of patients' acute and chronic heart conditions. In this study, we propose a two-dimensional (2-D) convolutional neural network (CNN) model for the classification of ECG signals into eight classes; namely, normal beat, premature ventricular contraction beat, paced beat, right bundle branch block beat, left bundle branch block beat, atrial premature contraction beat, ventricular flutter wave beat, and ventricular escape beat. The one-dimensional ECG time series signals are transformed into 2-D spectrograms through short-time Fourier transform. The 2-D CNN model consisting of four convolutional layers and four pooling layers is designed for extracting robust features from the input spectrograms. Our proposed methodology is evaluated on a publicly available MIT-BIH arrhythmia dataset. We achieved a state-of-the-art average classification accuracy of 99.11\%, which is better than those of recently reported results in classifying similar types of arrhythmias. The performance is significant in other indices as well, including sensitivity and specificity, which indicates the success of the proposed method.Comment: 14 pages, 5 figures, accepted for future publication in Remote Sensing MDPI Journa

Methodology for detection of paroxysmal atrial fibrillation based on P-Wave, HRV and QR electrical alternans features

The detection of Paroxysmal Atrial Fibrillation (PAF) is a fairly complex process performed manually by cardiologists or electrophysiologists by reading an electrocardiogram (ECG). Currently, computational techniques for automatic detection based on fast Fourier transform (FFT), Bayes optimal classifier (BOC), k-nearest neighbors (K-NNs), and artificial neural network (ANN) have been proposed. In this study, six features were obtained based on the morphology of the P-Wave, the QRS complex and the heart rate variability (HRV) of the ECG. The performance of this methodology was validated using clinical ECG signals from the Physionet arrhythmia database MIT-BIH. A feedforward neural network was used to detect the presence of PAF reaching a general accuracy of 97.4%. The results obtained show that the inclusion of the information of the P-Wave, HRV and QR Electrical alternans increases the accuracy to identify the PAF event compared to other works that use the information of only one or at most two of them