Efficient on-site confirmatory testing for atrial fibrillation with derived 12-lead ECG in a wireless body area network

Abstract

Smartphones that can support and assist the screening of various cardiovascular diseases are gaining popularity in recent years. The timely detection, diagnosis, and treatment of atrial fibrillation (AF) are critical, especially for those who are at risk of stroke. AF detection via screening with wearable devices should always be confirmed by a standard 12-lead electrocardiogram (ECG). However, the inability to perform on-site AF confirmatory testing results in increased patient anxiety, followed by unnecessary diagnostic procedures and treatments. Also, the delay in confirmation procedure may conclude the condition as non-AF while it was indeed present at the time of screening. To overcome these challenges, we propose an efficient on-site confirmatory testing for AF with 12-lead ECG derived from the reduced lead set (RLS) in a wireless body area network (WBAN) environment. The reduction in the number of leads enhances the comfort level of patients as well as minimizes the hurdles associated with continuous telemonitoring applications such as data transmission, storage, and bandwidth of the overall system. The proposed method is characterized by segment-wise regression and a lead selection algorithm, facilitating improved P-wave reconstruction. Further, an efficient AF detection algorithm is proposed by incorporating a novel three-level P-wave evidence score with an RR irregularity evidence score. The proposed on-site AF confirmation test reduces false positives and false negatives by 88% and 53% respectively, compared to single lead screening. In addition, the proposed lead derivation method improves accuracy, F1-score, and Matthews correlation coefficient (MCC) for the on-site AF detection compared to existing related methods.