Atrial Electrical Activity Detection Using Linear Combination of 12-Lead ECG Signals

ECG analysis is the method for cardiac arrhythmia diagnosis. During the diagnostic process many features should be taken into consideration, such as regularity and atrial activity. Since in some arrhythmias, the atrial electrical activity (AEA) waves are hidden in other waves, and a precise classification from surface ECG is inapplicable, a confirmation diagnosis is usually performed during an invasive procedure. In this paper, we study a “semiautomatic” method for AEA-waves detection using a linear combination of 12-lead ECG signals. This method's objective is to be applicable to a variety of arrhythmias with emphasis given to detect concealed AEA waves. It includes two variations--using maximum energy ratio and a synthetic AEA signal. In the former variation, an energy ratio-based cost function is created and maximized using the gradient ascent method. The latter variation adapted the linear combiner method, when applied on a synthetic signal, combined with surface ECG leads. A study was performed evaluating the AEA-waves detection from 63 patients (nine training, 54 validation) presenting eight arrhythmia types. Averaged sensitivity of 92.21% and averaged precision of 92.08% were achieved compared to the definite diagnosis. In conclusion, the presented method may lead to early and accurate detection of arrhythmias, which will result in a better oriented treatment.

[1]  Ilya S. Molchanov,et al.  Steepest descent algorithms in a space of measures , 2002, Stat. Comput..

[2]  Pablo Laguna,et al.  The adaptive linear combiner with a periodic-impulse reference input as a linear comb filter , 1996, Signal Process..

[3]  Chao Huang,et al.  A Novel Method for Detection of the Transition Between Atrial Fibrillation and Sinus Rhythm , 2011, IEEE Transactions on Biomedical Engineering.

[4]  Sarabjeet Singh Mehta,et al.  Application of support vector machine for the detection of P- and T-waves in 12-lead electrocardiogram , 2009, Comput. Methods Programs Biomed..

[5]  Willis J. Tompkins,et al.  A Real-Time QRS Detection Algorithm , 1985, IEEE Transactions on Biomedical Engineering.

[6]  P. Zimetbaum,et al.  Electrophysiology Study: Indications and Interpretations , 2011 .

[7]  A. Antoniadis,et al.  High Accuracy of Automatic Detection of Atrial Fibrillation Using Wavelet Transform of Heart Rate Intervals , 2002, Pacing and clinical electrophysiology : PACE.

[8]  H. Huikuri,et al.  Sudden death due to cardiac arrhythmias. , 2001, The New England journal of medicine.

[9]  Rahul Wadke,et al.  Atrial fibrillation. , 2022, Disease-a-month : DM.

[10]  A. J. Camm,et al.  Atrial arrhythmias , 1993, The Lancet.

[11]  Richard P. Lewis,et al.  Guidelines for clinical intracardiac electrophysiological and catheter ablation procedures. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Clinical Intracardiac Electrophysiologic and Catheter Ablation Procedures), developed , 1995, Journal of the American College of Cardiology.

[12]  A. Katz,et al.  Cardiac arrhythmia classification in 12-lead ECG using synthetic atrial activity signal , 2012, 2012 IEEE 27th Convention of Electrical and Electronics Engineers in Israel.

[13]  Leif Sörnmo,et al.  Spatiotemporal QRST cancellation techniques for analysis of atrial fibrillation , 2001, IEEE Transactions on Biomedical Engineering.

[14]  P Caminal,et al.  Automatic detection of wave boundaries in multilead ECG signals: validation with the CSE database. , 1994, Computers and biomedical research, an international journal.

[15]  L. Ganz,et al.  Supraventricular tachycardia. , 1995, The New England journal of medicine.

[16]  P. Wolf,et al.  Epidemiologic assessment of chronic atrial fibrillation and risk of stroke , 1978, Neurology.

[17]  J. S. Barlow,et al.  EKG-artifact minimization in referential EEG recordings by computer subtraction. , 1980, Electroencephalography and clinical neurophysiology.

[18]  M. Link,et al.  Clinical practice. Evaluation and initial treatment of supraventricular tachycardia. , 2012, The New England journal of medicine.

[19]  Philip Langley,et al.  Comparison of atrial signal extraction algorithms in 12-lead ECGs with atrial fibrillation , 2006, IEEE Transactions on Biomedical Engineering.

[20]  C. Tracy,et al.  American College of Cardiology/American Heart Association 2006 update of the clinical competence statement on invasive electrophysiologystudies,catheterablation,andcardioversion: a report of the American College of Cardiology/American Heart Association/American College of Physicians Task Force on Cl , 2006, Journal of the American College of Cardiology.

[21]  Guillem Serra,et al.  A new method of filtering T waves to detect hidden P waves in electrocardiogram signals. , 2011, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[22]  John M. Darrington.  Towards real time QRS detection: A fast method using minimal pre-processing , 2006, Biomed. Signal Process. Control..

[23]  Leif Sörnmo,et al.  Chapter 3 – EEG Signal Processing , 2005 .

[24]  N.V. Thakor,et al.  Applications of adaptive filtering to ECG analysis: noise cancellation and arrhythmia detection , 1991, IEEE Transactions on Biomedical Engineering.

[25]  P. Caminal,et al.  Adaptive filter for event-related bioelectric signals using an impulse correlated reference input: comparison with signal averaging techniques , 1992, IEEE Transactions on Biomedical Engineering.

[26]  J. Han,et al.  Management of cardiac arrhythmias. , 2020, American family physician.

[27]  François Portet,et al.  P wave detector with PP rhythm tracking: evaluation in different arrhythmia contexts , 2008, Physiological measurement.

[28]  Philip Langley,et al.  Surface Atrial Frequency Analysis in Patients with Atrial Fibrillation: , 2004, Journal of cardiovascular electrophysiology.

[29]  Silvia G Priori,et al.  ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Co , 2003, Circulation.

[30]  E. C. Ifeachor,et al.  The removal of ocular artefacts from the electroencephalogram: a review , 2006, Medical and Biological Engineering and Computing.

[31]  李永军,et al.  Atrial Fibrillation , 1999 .

[32]  N Weissman,et al.  A new method for atrial electrical activity analysis from surface ECG signals using an energy ratio measure , 2009, 2009 36th Annual Computers in Cardiology Conference (CinC).

[33]  R. Vukmir.  Cardiac arrhythmia diagnosis. , 1995, The American journal of emergency medicine.

[34]  Jeffrey M. Hausdorff,et al.  Physionet: Components of a New Research Resource for Complex Physiologic Signals". Circu-lation Vol , 2000 .

[35]  Jean-Yves Tourneret,et al.  P- and T-Wave Delineation in ECG Signals Using a Bayesian Approach and a Partially Collapsed Gibbs Sampler , 2010, IEEE Transactions on Biomedical Engineering.

[36]  O. Perlman,et al.  Atrial electrical activity detection in the 12-lead ECG using synthetic atrial activity signals , 2012, 2012 Computing in Cardiology.

[37]  José Millet-Roig,et al.  Atrial activity extraction for atrial fibrillation analysis using blind source separation , 2004, IEEE Transactions on Biomedical Engineering.