Detection of complex atrial arrhythmias in resting ECG

Existing computerized methods of rhythm analysis are far from satisfactory for detecting complex atrial arrhythmias (CAAs) in surface ECG. Previously the authors reported a method to detect P waves. Now they describe a contextual analysis to exclude spurious waves and to improve detection of CCAs. ECGs (n=567) with sinus rhythm and CAAs (fibrillation, flutter, AV block & dissociation and junctional rhythms) were analyzed. Median QRST was subtracted from the raw data and atrial waves were detected and measured (duration, PR and PP intervals). The context of the blocked atrial waves was examined using their measurements and the spurious waves were excluded. Rhythm analysis was performed using the overall context of the P waves and QRS complexes. The resulting accuracies for detecting CAAs were better than those obtained without the contextual analysis