Key result
The optimized three-stage system for detecting atrial fibrillation in compressively sensed ECG achieved an average precision of 0.72 and an AUC of 0.63 at both 50% and 75% compression ratios.
Why the study?
Long-term remote AF monitoring is limited by short monitor battery life and high false alarm rates caused by artifacts.
A novel three-stage machine learning system can detect atrial fibrillation in compressively sensed ECGs, potentially extending battery life for remote monitoring devices while managing false alarms.
Supports feasibility of AF detection in compressed ECGs for remote monitoring; leaves open prospective clinical validation before practice adoption.
The objective of this paper is to develop an optimized system to detect Atrial Fibrillation (AF) in compressively sensed electrocardiogram (ECG) for long-term remote patient monitoring. A three-stage system was developed to 1) reject ECG of poor signal quality, 2) detect AF in compressively sensed ECG, and 3) detect AF in selectively reconstructed ECG. The Long-Term AF Database (LTAFDB), sampled at 128 Hz using a 12-bit ADC with a range of 20 mV, was used to validate the system. The LTAFDB had 83,315 normal and 82,435 AF rhythm 30 s ECG segments. Clean ECG from the LTAFDB was artificially contaminated with motion artifact to achieve −12 to 12 dB Signal-to-Noise Ratio (SNR) in steps of 3 dB. The contaminated ECG was compressively sensed at 50% and 75% compression ratio (CR). The system was evaluated using average precision (AP), the area under the curve (AUC) of the receiver operator characteristic curve, and the F1 score. The system was optimized to maximize the AP and minimize ECG rejection and reconstruction ratios. The optimized system for 50% CR had 0.72 AP, 0.63 AUC, and 0.58 F1 score, 0.38 rejection ratio, and 0.38 reconstruction ratio. The optimized system for 75% CR had 0.72 AP, 0.63 AUC, and 0.59 F1 score, 0.40 rejection ratio, and 0.35 reconstruction ratio. Challenges for long-term AF monitoring are the short battery life of monitors and the high false alarm rate due to artifacts. The proposed system improves the short battery life through compressive sensing while reducing false alarms (high AP) and ECG reconstruction (low reconstruction ratio).
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Abdelazez et al. (2022) studied Atrial Fibrillation (n=84). Three-stage AF detection system in compressively sensed ECG was evaluated on Average precision (AP) for AF detection. The optimized three-stage system for detecting atrial fibrillation in compressively sensed ECG achieved an average precision of 0.72 and an AUC of 0.63 at both 50% and 75% compression ratios.
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