Electrocardiogram modeling during paroxysmal atrial fibrillation: application to the detection of brief episodes

OBJECTIVE A model for simulating multi-lead ECG signals during paroxysmal atrial fibrillation (AF) is proposed. SIGNIFICANCE The model is of particular significance when evaluating detection performance in the presence of brief AF episodes, especially since annotated databases with such episodes are lacking. APPROACH The proposed model accounts for important characteristics such as switching between sinus rhythm and AF, varying P-wave morphology, repetition rate of f-waves, presence of atrial premature beats, and various types of noise. MAIN RESULTS Two expert cardiologists assessed the realism of simulated signals relative to real ECG signals, both in sinus rhythm and AF. The cardiologists identified the correct rhythm in all cases, and considered two-thirds of the simulated signals as realistic. The proposed model was also investigated by evaluating the performance of two AF detectors which explored either rhythm only or both rhythm and morphology. The results show that detection performance is strongly dependent on AF episode duration, and, consequently, demonstrate that the model can play a significant role in the investigation of detector properties.