Model-based Assessment of f-Wave Signal Quality in Patients with Atrial Fibrillation

Objective: The detection and analysis of atrial fibrillation (AF) in the ECG is greatly influenced by signal quality. The present study proposes and evaluates a model-based f-wave signal quality index (SQI), denoted S, for use in the QRST-cancelled ECG signal. Methods: S is computed using a harmonic f-wave model, allowing for variation in frequency and amplitude. The properties of S are evaluated on both f-waves and P-waves using 378 12-lead ECGs, 1875 single-lead ECGs, and simulated signals. Results: S decreases monotonically when noise is added to f-wave signals, even for noise which overlaps spectrally with f-waves. Moreover, S is shown to be closely associated with the accuracy of AF frequency estimation, where S>0.3 implies accurate estimation. When S is used as a measure of f-wave presence, AF detection performance improves: the sensitivity increases from 97.0% to 98.1% and the specificity increases from 97.4% to 97.8% when compared to the reference detector. Conclusion: The proposed SQI represents a novel approach to assessing f-wave signal quality, as well as to determining whether f-waves are present. Significance: The use of S improves the detection of AF and benefits the analysis of noisy ECGs