Estimation of PQ distance dispersion for atrial fibrillation detection

• Published in: Computer methods and programs in biomedicine 2021-09, Vol.208, p.106167-106167, Article 106167
• Main Authors: Giraldo-Guzmán, Jader, Kotas, Marian, Castells, Francisco, Contreras-Ortiz, Sonia H., Urina-Triana, Miguel
• Format: Article
• Language: English
• Subjects: Atrial fibrillation; ECG processing; PQ dispersion; Spatio–temporal filtering; Spatio–temporal patterns
• ISSN: 0169-2607; 1872-7565
• DOI: 10.1016/j.cmpb.2021.106167

•A method based on spatio-temporal filtering aimed to enhance and magnify P-waves while suppressing other ECG components is proposed.•An idea of PQ dispersion estimation for atrial fibrillation (AF) detection is introduced.•An automated approach to improve the accuracy in early detection of AF has been developed. This can be included in hybrid methods in combination with analysis of RR series.•It can be applied to reduce the number of false warnings in massive AF screening strategies for stroke prevention. Background and objective: Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. It is associated with significantly increased morbidity and mortality. Diagnosis of the disease can be based on the analysis of the electrical atrial activity, on quantification of the heart rate irregularity or on a mixture of the both approaches. Since the amplitude of the atrial waves is small, their analysis can lead to false results. On the other hand, the heart rate based analysis usually leads to many unnecessary warnings. Therefore, our goal is to develop a new method for effective AF detection based on the analysis of the electrical atrial waves. Methods: The proposed method employs the fact that there is a lack of repeatable P waves preceding QRS complexes during AF. We apply the operation of spatio-temporal filtering (STF) to magnify and detect the prominent spatio-temporal patterns (STP) within the P waves in multi-channel ECG recordings. Later we measure their distances (PQ) to the succeeding QRS complexes, and we estimate dispersion of the obtained PQ series. For signals with normal sinus rhythm, this dispersion is usually very low, and contrary, for AF it is much raised. This allows for effective discrimination of this cardiologic disorder. Results: Tested on an ECG database consisting of AF cases, normal rhythm cases and cases with normal rhythm restored by the use of cardioversion, the method proposed allowed for AF detection with the accuracy of 98.75% on the basis of both 8–channel and 2–channel signals of 12 s length. When the signals length was decreased to 6 s, the accuracy varied in the range of 95%−97.5% depending on the number of channels and the dispersion measure applied. Conclusions: Our approach allows for high accuracy of atrial fibrillation detection using the analysis of electrical atrial activity. The method can be applied to an early detection of the desease and can advantageously be used to decrease the number of false