Automated detection of paroxysmal atrial fibrillation using an information-based similarity approach

Abstract

Atrial fibrillation (AF) is an abnormal rhythm of the heart, which can increase heart-related complications. Paroxysmal AF episodes occur intermittently with varying duration. Human-based diagnosis of paroxysmal AF with a longer-term electrocardiogram recording is time-consuming. Here we present a fully automated ensemble model for AF episode detection based on RR-interval time series, applying a novel approach of information-based similarity analysis and ensemble scheme. By mapping RR-interval time series to binary symbolic sequences and comparing the rank-frequency patterns of m-bit words, the dissimilarity between AF and normal sinus rhythms (NSR) were quantified. To achieve high detection specificity and sensitivity, and low variance, a weighted variation of bagging with multiple AF and NSR templates was applied. By performing dissimilarity comparisons between unknown RR-interval time series and multiple templates, paroxysmal AF episodes were detected. Based on our results, optimal AF detection parameters are symbolic word length m = 9 and observation window n = 150, achieving 97.04% sensitivity, 97.96% specificity, and 97.78% overall accuracy. Sensitivity, specificity, and overall accuracy vary little despite changes in m and n parameters. This study provides quantitative information to enhance the categorization of AF and normal cardiac rhythms.