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 and Interpretable Patient ECG Profiles for Disease Detection, Tracking, and Discovery

The electrocardiogram or ECG has been in use for over 100 years and remains the most widely performed diagnostic test to characterize cardiac structure and electrical activity. We hypothesized that parallel advances in computing power, innovations in machine learning algorithms, and availability of large-scale digitized ECG data would enable extending the utility of the ECG beyond its current limitations, while at the same time preserving interpretability, which is fundamental to medical decision-making. We identified 36,186 ECGs from the UCSF database that were 1) in normal sinus rhythm and 2) would enable training of specific models for estimation of cardiac structure or function or detection of disease. We derived a novel model for ECG segmentation using convolutional neural networks (CNN) and Hidden Markov Models (HMM) and evaluated its output by comparing electrical interval estimates to 141,864 measurements from the clinical workflow. We built a 725-element patient-level ECG profile using downsampled segmentation data and trained machine learning models to estimate left ventricular mass, left atrial volume, mitral annulus e' and to detect and track four diseases: pulmonary arterial hypertension (PAH), hypertrophic cardiomyopathy (HCM), cardiac amyloid (CA), and mitral valve prolapse (MVP). CNN-HMM derived ECG segmentation agreed with clinical estimates, with median absolute deviations (MAD) as a fraction of observed value of 0.6% for heart rate and 4% for QT interval. Patient-level ECG profiles enabled quantitative estimates of left ventricular and mitral annulus e' velocity with good discrimination in binary classification models of left ventricular hypertrophy and diastolic function. Models for disease detection ranged from AUROC of 0.94 to 0.77 for MVP. Top-ranked variables for all models included known ECG characteristics along with novel predictors of these traits/diseases.Comment: 13 pages, 6 figures, 1 Table + Supplemen

Atrial fibrillation detection using support vector machine and electrocardiographic descriptive statistics

Copyright © 2017 Inderscience Enterprises Ltd. This paper proposes a new technique for detecting atrial fibrillation (AF). The method employs electrocardiographic features and support vector machine (SVM). The features include descriptive statistics of electrocardiographic RR interval. The RR interval is the distance in time between two consecutive R-peaks of electrocardiogram. AF detections using SVM with different electrocardiographic features and different SVM free parameters are explored. Employing SVM with the optimal free parameters and all the proposed electrocardiographic features, we find an AF detection technique with a comparable performance. The best performance obtained by the technique is 98.47% and 97.84%, in terms of sensitivity and specificity

Classification of Arrhythmia from ECG Signals using MATLAB

An Electrocardiogram (ECG) is defined as a test that is performed on the heart to detect any abnormalities in the cardiac cycle. Automatic classification of ECG has evolved as an emerging tool in medical diagnosis for effective treatments. The work proposed in this paper has been implemented using MATLAB. In this paper, we have proposed an efficient method to classify the ECG into normal and abnormal as well as classify the various abnormalities. To brief it, after the collection and filtering the ECG signal, morphological and dynamic features from the signal were obtained which was followed by two step classification method based on the traits and characteristic evaluation. ECG signals in this work are collected from MIT-BIH, AHA, ESC, UCI databases. In addition to this, this paper also provides a comparative study of various methods proposed via different techniques. The proposed technique used helped us process, analyze and classify the ECG signals with an accuracy of 97% and with good convenience

Exponential distribution of long heart beat intervals during atrial fibrillation and their relevance for white noise behaviour in power spectrum

The statistical properties of heart beat intervals of 130 long-term surface electrocardiogram recordings during atrial fibrillation (AF) are investigated. We find that the distribution of interbeat intervals exhibits a characteristic exponential tail, which is absent during sinus rhythm, as tested in a corresponding control study with 72 healthy persons. The rate of the exponential decay lies in the range 3-12 Hz and shows diurnal variations. It equals, up to statistical uncertainties, the level of the previously uncovered white noise part in the power spectrum, which is also characteristic for AF. The overall statistical features can be described by decomposing the intervals into two statistically independent times, where the first one is associated with a correlated process with 1/f noise characteristics, while the second one belongs to an uncorrelated process and is responsible for the exponential tail. It is suggested to use the rate of the exponential decay as a further parameter for a better classification of AF and for the medical diagnosis. The relevance of the findings with respect to a general understanding of AF is pointed out

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