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. 2023 Oct;27(5):1753-1757.
doi: 10.1007/s11325-023-02779-3. Epub 2023 Jan 21.

Detecting atrial fibrillation in the polysomnography-derived electrocardiogram: a software validation study

Julia van Kempen  1 , Christian Glatz  1 , Julian Wolfes  2 , Gerrit Frommeyer #  2 , Matthias Boentert #  3   4
Affiliations

Detecting atrial fibrillation in the polysomnography-derived electrocardiogram: a software validation study

Julia van Kempen et al. Sleep Breath. 2023 Oct.

Abstract

Purpose: The present study validated a software-based electrocardiogram (ECG) analysis tool for detection of atrial fibrillation (AF) and risk for AF using polysomnography (PSG)-derived ECG recordings.

Methods: The Stroke Risk Analysis® (SRA®) software was applied to 3-channel ECG tracings from diagnostic PSG performed in enrolled subjects including a subgroup of subjects with previously documented AF. No subjects used positive airway pressure therapy. All ECG recordings were visually analyzed by a blinded cardiologist.

Results: Of subjects enrolled in the study, 93 had previously documented AF and 178 of 186 had an ECG that could be analyzed by either method. In subjects with known history of AF, automated analysis using SRA® classified 47 out of 87 ECG as either manifest AF or showing increased risk for paroxysmal AF (PAF) by SRA® (sensitivity 0.54, specificity 0.86). On visual analysis, 36/87 ECG showed manifest AF and 51/87 showed sinus rhythm. Among the latter subgroup, an increased risk for PAF was ascribed by SRA® in 11 cases (sensitivity 0.22, specificity 0.78) and by expert visual analysis in 5 cases (sensitivity 0.1, specificity 0.90). Among 36/178 ECG with manifest AF on visual analysis, 33 were correctly identified by the SRA® software (sensitivity and specificity 0.92).

Conclusion: Sleep studies provide a valuable source of ECG recordings that can be easily subjected to software-based analysis in order to identify manifest AF and automatically assess the risk of PAF. For optimal evaluability of data, multiple channel ECG tracings are desirable. For assessment of PAF risk, the SRA® analysis probably excels visual analysis, but sensitivity of both methods is low, reflecting that repeated ECG recording remains essential.

Keywords: Atrial fibrillation; Automated ECG analysis; Electrocardiogram; Polysomnography.

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Conflict of interest statement

The authors declare no cometing interests.

Figures

Fig. 1
Fig. 1
Example of Lorenz plots derived from SRA® analysis. a, Patient with sinus rhythm and regular R-R intervals, b, patient with sinus rhythm and irregular R-R intervals classified as “increased risk of AF”, c, patient with manifest AF. SRA®, stroke risk analysis, AF, atrial fibrillation
Fig. 2
Fig. 2
Software-based and visual ECG analysis in patients with previously documented AF
See this image and copyright information in PMC

References

    1. Lin H-J, Wolf PA, Benjamin EJ, Belanger AJ, D’Agostino RB. Newly diagnosed atrial fibrillation and acute stroke: the Framingham study. Stroke. 1995;26:1527–1530. doi: 10.1161/01.STR.26.9.1527. - DOI - PubMed
    1. Lippi G, Sanchis-Gomar F, Cervellin G. Global epidemiology of atrial fibrillation: an increasing epidemic and public health challenge. Int J Stroke. 2021;16:217–221. doi: 10.1177/1747493019897870. - DOI - PubMed
    1. Zulkifly H, Lip GYH, Lane DA. Epidemiology of atrial fibrillation. Int J Clin Pract. 2018;72:e13070. doi: 10.1111/ijcp.13070. - DOI - PubMed
    1. Hu H, Zhang X, Zhao J, Li Y, Zhao Y. Transient ischemic attack and carotid web. Am J Neuroradiol. 2019;40:313–318. doi: 10.3174/ajnr.A5946. - DOI - PMC - PubMed
    1. Humphries KH, Kerr CR, Connolly SJ, Klein G, Boone JA, Green M, Sheldon R, Talajic M, Dorian P, Newman D. New-onset atrial fibrillation: sex differences in presentation, treatment, and outcome. Circulation. 2001;103:2365–2370. doi: 10.1161/01.CIR.103.19.2365. - DOI - PubMed