Comparative study of algorithms for Atrial Fibrillation detection

Automatic detection of Atrial Fibrillation (AF) is necessary for the long-term monitoring of patients who are suspected to have AF. Several methods for AF detection exist in the literature. These methods are mainly based on two different characteristics of AF ECGs: the irregularity of RR intervals (RRI) and the fibrillatory electrical Atrial Activity (AA). The electrical AA is characterized by the absence of the P-wave (PWA) and special frequency properties (FSA). Nine AF detection algorithms were selected from literature and evaluated with the same protocol in order to study their performance under different conditions. Results showed that the highest sensitivity (Se=97.64%) and specificity (Sp=96.08%) was achieved with methods based on analysis of irregularity of RR interval, while combining RR and atrial activity analysis gave the highest positive predictive value (PPV=92.75%). Algorithms based on RR irregularity were also the most robust against noise (Se=85.79% and Sp=81.90% for SNR=0dB; and Se=82.52% and Sp=40.47% for SNR=-5dB).