Detection of atrial fibrillation episodes using a wristband device

Objective: Undiagnosed atrial fibrillation (AF) patients are at high risk of cardioembolic stroke or other complications. The aim of this study was to analyze the blood volume pulse (BVP) signals obtained from a wristband device and develop an algorithm for discriminating AF from normal sinus rhythm (NSR) or from other arrhythmias (ARR). Approach: Thirty patients with AF, 9 with ARR and 31 in NSR were included in the study. The recordings were obtained at rest from Empatica E4 wristband device and lasted 10 min. The analysis, on a 2 min segment, included spectral, variability and irregularity analysis performed on the inter-diastolic interval series, and similarity analysis performed on the BVP signal. Main results and Significance: Variability parameters were the highest in AF, the lowest in NSR and intermediate for ARR, as an example pNN50 values were, respectively 81 ± 8, 20 ± 5, 55 ± (p < 0.05). The similarity parameters were the highest in NSR, the lowest in AF and intermediate for ARR, as an example using a threshold for assessing similarity of : π/4: 0.90 ± 0.09, 0.40 ± 0.20, 0.58 ± 0.23 all p < 0.05. The rhythm classification was preceded by over-sampling (using synthetic minority over-sampling technique) the class of ARR, being it the smallest class. Then, the features selection was performed (using the sequential forward floating search algorithm) which identified two variability parameters (pNN70 and pNN40) as the best selection. The classification by the k-nearest neighbor classifier reached an accuracy of about 0.9 for NSR and AF, and 0.8 for ARR. Using pNN70 and pNN40, the specificity for the three rhythms was Spnsr = 0.928, Spaf = 0.963, Sparr = 0.768, while the sensitivity was Spnsr = 0.773, Spaf = 0.754, Sparr = 0.758.