Reference database and performance evaluation of methods for extraction of atrial fibrillatory waves in the ECG

[EN] Objective: This study proposes a reference database, composed of a large number of simulated ECG signals in atrial fibrillation (AF), for investigating the performance of methods for extraction of atrial fibrillatory waves (f -waves). Approach: The simulated signals are produced using a recently published and validated model of 12-lead ECGs in AF. The database is composed of eight signal sets together accounting for a wide range of characteristics known to represent major challenges in f -wave extraction, including high heart rates, high morphological QRST variability, and the presence of ventricular premature beats. Each set contains 30 5 min signals with different f -wave amplitudes. The database is used for the purpose of investigating the statistical association between different indices, designed for use with either real or simulated signals. Main results: Using the database, available at the PhysioNet repository of physiological signals, the performance indices unnormalized ventricular residue (uVR), designed for real signals, and the root mean square error, designed for simulated signals, were found to exhibit the strongest association, leading to the recommendation that uVR should be used when characterizing performance in real signals. Significance: The proposed database facilitates comparison of the performance of different f -wave extraction methods and makes it possible to express performance in terms of the error between simulated and extracted f -wave signals.This work was supported by project DPI2017-83952-C3 of the Spanish Ministry of Economy, Industry and Competitiveness, project SBPLY/17/180501/000411 of the Junta de Comunidades de Castilla-La Mancha, Grant 'Jose Castillejo' (CAS17/00436) from the Spanish Ministry of Education, Culture and Sport, Grant No. BEST/2017/028 from the Education, Research, Culture and Sports Department of Generalitat Valenciana, European Regional Development Fund, and Grant No. 03382/2016 from the Swedish Research Council.Alcaraz, R.; Sornmo, L.; Rieta, JJ. (2019). Reference database and performance evaluation of methods for extraction of atrial fibrillatory waves in the ECG. Physiological Measurement. 40(7):1-11. https://doi.org/10.1088/1361-6579/ab2b17S111407Chugh, S. 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Event synchronous adaptive filter based atrial activity estimation in single-lead atrial fibrillation electrocardiograms. Medical & Biological Engineering & Computing, 50(8), 801-811. doi:10.1007/s11517-012-0931-7Lemay, M., Vesin, J.-M., van Oosterom, A., Jacquemet, V., & Kappenberger, L. (2007). Cancellation of Ventricular Activity in the ECG: Evaluation of Novel and Existing Methods. IEEE Transactions on Biomedical Engineering, 54(3), 542-546. doi:10.1109/tbme.2006.888835Llinares, R., Igual, J., & Miró-Borrás, J. (2010). A fixed point algorithm for extracting the atrial activity in the frequency domain. Computers in Biology and Medicine, 40(11-12), 943-949. doi:10.1016/j.compbiomed.2010.10.006Malik, J., Reed, N., Wang, C.-L., & Wu, H. (2017). Single-lead f-wave extraction using diffusion geometry. Physiological Measurement, 38(7), 1310-1334. doi:10.1088/1361-6579/aa707cMateo, J., & Joaquín Rieta, J. (2013). Radial basis function neural networks applied to efficient QRST cancellation in atrial fibrillation. Computers in Biology and Medicine, 43(2), 154-163. doi:10.1016/j.compbiomed.2012.11.007McSharry, P. E., Clifford, G. D., Tarassenko, L., & Smith, L. A. (2003). A dynamical model for generating synthetic electrocardiogram signals. IEEE Transactions on Biomedical Engineering, 50(3), 289-294. doi:10.1109/tbme.2003.808805Nault, I., Lellouche, N., Matsuo, S., Knecht, S., Wright, M., Lim, K.-T., … Haïssaguerre, M. (2009). Clinical value of fibrillatory wave amplitude on surface ECG in patients with persistent atrial fibrillation. Journal of Interventional Cardiac Electrophysiology, 26(1), 11-19. doi:10.1007/s10840-009-9398-3Petrenas, A., Marozas, V., Sološenko, A., Kubilius, R., Skibarkiene, J., Oster, J., & Sörnmo, L. (2017). Electrocardiogram modeling during paroxysmal atrial fibrillation: application to the detection of brief episodes. Physiological Measurement, 38(11), 2058-2080. doi:10.1088/1361-6579/aa9153Petrenas, A., Marozas, V., Sornmo, L., & Lukosevicius, A. (2012). An Echo State Neural Network for QRST Cancellation During Atrial Fibrillation. IEEE Transactions on Biomedical Engineering, 59(10), 2950-2957. doi:10.1109/tbme.2012.2212895Platonov, P. G., Corino, V. D. A., Seifert, M., Holmqvist, F., & Sornmo, L. (2014). Atrial fibrillatory rate in the clinical context: natural course and prediction of intervention outcome. Europace, 16(suppl 4), iv110-iv119. doi:10.1093/europace/euu249Sassi, R., Corino, V. D. A., & Mainardi, L. T. (2009). Analysis of Surface Atrial Signals: Time Series with Missing Data? Annals of Biomedical Engineering, 37(10), 2082-2092. doi:10.1007/s10439-009-9757-3Schotten, U., Dobrev, D., Platonov, P. G., Kottkamp, H., & Hindricks, G. (2016). Current controversies in determining the main mechanisms of atrial fibrillation. 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Combined Nonlinear Analysis of Atrial and Ventricular Series for Automated Screening of Atrial Fibrillation

[EN] Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice. It often starts with asymptomatic and short episodes, which are difficult to detect without the assistance of automatic monitoring tools. The vast majority of methods proposed for this purpose are based on quantifying the irregular ventricular response (i.e., RR series) during the arrhythmia. However, although AF totally alters the atrial activity (AA) reflected on the electrocardiogram(ECG), replacing stable P-waves by chaotic and time-variant fibrillatory waves, this information has still not been explored for automated screening of AF. Hence, a pioneering AF detector based on quantifying the variability over time of the AA morphological pattern is here proposed. Results from two public reference databases have proven that the proposed method outperforms current state-of-the-art algorithms, reporting accuracy higher than 90%. A less false positive rate in the presence of other arrhythmias different from AF was also noticed. Finally, the combination of this algorithm with the classical analysis of RR series variability also yielded a promising trade-off between AF accuracy and detection delay. Indeed, this combination provided similar accuracy than RR-based methods, but with a significantly shorter delay of 10 beats.This work was supported by the Spanish Ministry of Economy and Competitiveness (Project TEC2014-52250-R).Rodenas, J.; Garcia, M.; Alcaraz, R.; Rieta, JJ. (2017). Combined Nonlinear Analysis of Atrial and Ventricular Series for Automated Screening of Atrial Fibrillation. Complexity. (2163610):1-13. doi:10.1155/2017/2163610S113216361

Modeling and Simulation of Task Allocation with Colored Petri Nets

The task allocation problem is a key element in the solution of several applications from different engineering fields. With the explosion of the amount of information produced by the today Internet-connected solutions, scheduling techniques for the allocation of tasks relying on grids, clusters of computers, or in the cloud computing, is at the core of efficient solutions. The task allocation is an important problem within some branch of the computer sciences and operations research, where it is usually modeled as an optimization of a combinatorial problem with the inconvenience of a state explosion problem. This chapter proposes the modeling of the task allocation problem by the use of Colored Petri nets. The proposed methodology allows the construction of compact models for task scheduling problems. Moreover, a simulation process is possible within the constructed model, which allows the study of some performance aspects of the task allocation problem before any implementation stage

Simulation of Discrete‐Event Systems in MATLAB

The discrete‐event systems (DES) are systems guided by asynchronous events rather than by the passage of the time as in traditional systems. There exists a wide set of systems that could be considered within this class, such as communication protocols, computer and microcontroller operating systems, flexible manufacturing systems, communication drivers for embedded applications and logistic systems, among others. Their proper study is a requirement for a suitable implementation of embedded hardware and software, for example. The aim of this chapter is to approach the simulation of this class of systems within the MATLAB/SIMULINK framework. A suitable simulation process, allowing the injection of input signals to the system and observing its output response, is a first step in the analysis of this class of systems, which may lead to more elaborated analysis such as reachability and deadlock avoidance. The advantage of the approach and techniques proposed in this chapter is the application of the set of tools, algorithms and visualization instruments present in the MATLAB/SIMULINK to the simulation of Discrete‐Event Systems, which allows a simple integration of various DES by utilizing the matrices that define them. The concluding section of the chapter provides a link for downloading all the code for the examples developed here

Response to the article by Sungnoon et al. "Atrial electrophysiological property analysis by sample entropy and atrial fibrillatory rate with cardiac autonomic derangements in acute ischemic stroke with atrial fibrillation"

Alcaraz, R.; Rieta, JJ. (2014). Response to the article by Sungnoon et al. "Atrial electrophysiological property analysis by sample entropy and atrial fibrillatory rate with cardiac autonomic derangements in acute ischemic stroke with atrial fibrillation". Neurology Asia. 19(3):335-336. http://hdl.handle.net/10251/62850S33533619

Reliability of Local Activation Waves Features to Characterize Paroxysmal Atrial Fibrillation Substrate During Sinus Rhythm

[EN] Analysis of coronary sinus (CS) electrograms (EGMs) is vastly used for the assessment of the atrial fibrillation (AF) substrate. As a catheter consists of five dipoles (distal, mid-distal, medial, mid-proximal, proximal), results may vary upon the employed channel: myocardial contraction and bad contact are unavoidable factors affecting the recording. This work aims to specify the most reliable channels in catching AF dynamics, using 44 multichannel bipolar CS recordings in sinus rhythm (SR) of paroxysmal AF with 1-5 minutes duration. Local activation waves (LAWs) were detected and main features obtained: duration, amplitude, area and correlation between dominant morphologies of each channel. Analysis was performed with Kruskal-Wallis test for multichannel comparison and Mann-Whitney U-test for pairs of channels and comparison between one and the remaining channels, using Bonferroni correction. Median values were calculated. Distal channel presented the highest alteration in LAWs features, being the least correlated channel (82.84 - 88.31%) with the lowest amplitude and area (p(max) < 0.01). Contrastly, medial and mid-proximal channels showed the most robust LAW characteristics, with very high correlation (94.53%) and high area and amplitude values (p(max) < 0.02 and p(max) < 0.07, respectively) and their analysis is recommended for AF substrate characterization during SRResearch supported by grants DPI2017-83952-C3 from MINECO/AEI/FEDER UE, SBPLY/17/180501/000411 from JCCLM and AICO/2019/036 from GVA.Vraka, A.; Hornero, F.; Quesada, A.; Faes, L.; Alcaraz, R.; Rieta, JJ. (2020). Reliability of Local Activation Waves Features to Characterize Paroxysmal Atrial Fibrillation Substrate During Sinus Rhythm. IEEE. 1-4. https://doi.org/10.22489/CinC.2020.166S1

On the Generalization of Sleep Apnea Detection Methods Based on Heart Rate Variability and Machine Learning

[EN] Obstructive sleep apnea (OSA) is a respiratory disorder highly correlated with severe cardiovascular diseases that has unleashed the interest of hundreds of experts aiming to overcome the elevated requirements of polysomnography, the gold standard for its detection. In this regard, a variety of algorithms based on heart rate variability (HRV) features and machine learning (ML) classifiers have been recently proposed for epoch-wise OSA detection from the surface electrocardiogram signal. Many researchers have employed freely available databases to assess their methods in a reproducible way, but most were purely tested with cross-validation approaches and even some using solely a single database for training and testing procedures. Hence, although promising values of diagnostic accuracy have been reported by some of these methods, they are suspected to be overestimated and the present work aims to analyze the actual generalization ability of several epoch-wise OSA detectors obtained through a common ML pipeline and typical HRV features. Precisely, the performance of the generated OSA detectors has been compared on two validation approaches, i.e., the widely used epoch-wise, k-fold cross-validation and the highly recommended external validation, both considering different combinations of well-known public databases. Regardless of the used ML classifiers and the selected HRV-based features, the external validation results have been 20 to 40% lower than those obtained with cross-validation in terms of accuracy, sensitivity, and specificity. Consequently, these results suggest that ML-based OSA detectors trained with public databases are still not sufficiently general to be employed in clinical practice, as well as that larger, more representative public datasets and the use of external validation are mandatory to improve the generalization ability and to obtain reliable assessment of the true predictive power of these algorithms, respectively.This research has received financial support from public grants PID2021-00X128525-IV0 and PID2021-123804OB-I00 of the Spanish Government 10.13039/501100011033 jointly with the European Regional Development Fund, SBPLY/17/180501/000411 and SBPLY/21/180501/000186 from Junta de Comunidades de Castilla-La Mancha, and AICO/2021/286 from Generalitat Valenciana. Moreover, Daniele Padovano holds a predoctoral scholarship 2022-PRED-20642, which is cofinanced by the operating program of European Social Fund (ESF) 2014-2020 of Castilla-La Mancha.Padovano, D.; Martínez-Rodrigo, A.; Pastor, JM.; Rieta, JJ.; Alcaraz, R. (2022). On the Generalization of Sleep Apnea Detection Methods Based on Heart Rate Variability and Machine Learning. IEEE Access. 10:92710-92725. https://doi.org/10.1109/ACCESS.2022.320191192710927251

Obstructive Sleep Apnea Detection Methods Based on Heart Rate Variability Analysis: Opportunities for a Future Cinc Challenge

[EN] The effects of sleep-related disorders, such as obstructive sleep apnea (OSA), can be devastating either in children or adults. Misdiagnosis may lead to severe cardiovascular diseases. Besides, OSA consequences are often related to bad job performance, and road accidents. Nowadays, polysomnography (PSG) is still considered the gold standard for OSA diagnosis, but the required facilities are extremely high, thus reducing availability worldwide. For this reason, simpler and cost-effective diagnosing methods have been proposed in the late years. In this regard, the heart rate variability (HRV) has been demonstrated to strongly reflect apnea episodes during sleep. Hence, this work reviews the latest advances in the evaluation of OSA from the HRV perspective to consider its potentialities for a future revisited CinC Challenge.This research has been supported by grants DPI201783952-C3 from MINECO/AEI/FEDER EU, SBPLY/17/180501/000411 from Junta de Comunidades de Castilla-la Mancha and AICO/2019/036 from Generalitat Valenciana. Moreover, Daniele Padovano has held graduate research scholarships from Escuela Polit ' ecnica de Cuenca and Instituto de Tecnolog ' ias Audiovisuales, University of CastillaLa ManchaPadovano, D.; Martinez-Rodrigo, A.; Pastor, JM.; Rieta, JJ.; Alcaraz, R. (2020). Obstructive Sleep Apnea Detection Methods Based on Heart Rate Variability Analysis: Opportunities for a Future Cinc Challenge. IEEE. 1-4. https://doi.org/10.22489/CinC.2020.400S1

Evaluation of brain functional connectivity from electroencephalographic signals under different emotional states

The identification of the emotional states corresponding to the four quadrants of the valence/arousal space has been widely analyzed in the scientific literature by means of multiple techniques. Nevertheless, most of these methods were based on the assessment of each brain region separately, without considering the possible interactions among different areas. In order to study these interconnections, this study computes for the first time the functional connectivity metric called cross-sample entropy for the analysis of the brain synchronization in four groups of emotions from electroencephalographic signals. Outcomes reported a strong synchronization in the interconnections among central, parietal and occipital areas, while the interactions between left frontal and temporal structures with the rest of brain regions presented the lowest coordination. These differences were statistically significant for the four groups of emotions. All emotions were simultaneously classified with a 95.43% of accuracy, overcoming the results reported in previous studies. Moreover, the differences between high and low levels of valence and arousal, taking into account the state of the counterpart dimension, also provided notable findings about the degree of synchronization in the brain within different emotional conditions and the possible implications of these outcomes from a psychophysiological point of view.- This publication is part of the R&D Projects Nos. PID2020-115220RB-C21, EQC2019-006063P, funded by MCIN/AEI/10.13039/501100011033/, and 2018/11744, funded by "ERDF A way to make Europe". This work was partially supported by Biomedical Research Networking Centre in Mental Health (CIBERSAM) of the Instituto de Salud Carlos III. Beatriz Garcia-Martinez holds FPU16/03740 scholarship from Spanish Ministerio de Educacion y Formacion Profesional