Automatic P-wave analysis of patients prone to atrial fibrillation

Abstract

A method is presented for automatic analysis of the P-wave, based on lead II of a 12-lead standard ECG, in resting conditions during a routine examination for the detection of patients prone to atrial fibrillation (AF), one of the most prevalent arrhythmias. First, the P-wave was delineated, and this was achieved in two steps: the detection of the QRS complexes for ECG segmentation, using a wavelet analysis method, and a hidden Markov model to represent one beat of the signal for P-wave isolation. Then, a set of parameters to detect patients prone to AF was calculated from the P-wave. The detection efficiency was validated on an ECG database of 145 patients, including a control group of 63 people and a study group of 82 patients with documented AF. A discriminant analysis was applied, and the results obtained showed a specificity and a sensitivity between 65% and 70%.

Improvement of the Diagnostic Accuracy in Computer-Assisted Differential Diagnosis for Wide QRS Premature Complexes

“…Sippensgroenewegen et al have reported the usefulness of spatial analysis using 62-lead QRST subtraction system, 10 and Clavier et al have applied a wavelet analysis on it. 11 Both emphasized the high diagnostic accuracy, but their systems were fairly complicated to apply to routine ECG analysis. There have not been any reported studies that used second derivatives to detect ectopic P waves.…”

Proposición de un método basado en cadenas de Markov para el pronóstico de fibrilaciones auriculares paroxísticas

“…La Fibrilación Auricular Paroxística (PAF, del inglés Paroxysmal Atrial Fibrillation) es una de las arritmias cardiacas más comunes en la práctica clínica, y aunque no se encuentra asociada a una elevada tasa de mortalidad, son las complicaciones secundarias (por ejemplo tromboembolismos) las que conllevan a un mayor riesgo para el paciente [1][2]. En este contexto, si bien hay muchas formas de estabilizar un ritmo cardiaco afectado por una fibrilación auricular, una posibilidad fiable de pronóstico podría tener un alto interés clínico [3].…”

“…Patrones de este tipo poseen una gran relevancia para el pronóstico de esta patología [1,[13][14]. Sin embargo, la detección de la onda P no es una tarea sencilla y ha sido objeto de diversos trabajos [5].…”

Quantification of not-dipolar components of atrial depolarization by principal component analysis of the P-wave

“…When a patient continues with AF as the dominant cardiac rhythm without reversion to the normal rhythm, the condition is known as chronic AF. Two main electrophysiological conditions are indicated for AF initiation and perpetuation [1]: slower conduction velocity in some atrial areas and heterogeneity of cell refractory periods. This heterogeneity of structural and electrophysiological properties leads to a longer and more fragmented P-wave [2][3][4].…”