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Complexity
Volume 2017, Article ID 2163610, 13 pages
https://doi.org/10.1155/2017/2163610
Research Article

Combined Nonlinear Analysis of Atrial and Ventricular Series for Automated Screening of Atrial Fibrillation

1Research Group in Electronic, Biomedical and Telecommunication Engineering, University of Castilla-La Mancha, Ciudad Real, Spain
2BioMIT.org, Electronic Engineering Department, Universitat Politecnica de Valencia, Valencia, Spain

Correspondence should be addressed to Raúl Alcaraz; se.mlcu@zaracla.luar

Received 6 June 2017; Accepted 24 September 2017; Published 26 October 2017

Academic Editor: Enzo Pasquale Scilingo

Copyright © 2017 Juan Ródenas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice. It often starts with asymptomatic and short episodes, which are difficult to detect without the assistance of automatic monitoring tools. The vast majority of methods proposed for this purpose are based on quantifying the irregular ventricular response (i.e., RR series) during the arrhythmia. However, although AF totally alters the atrial activity (AA) reflected on the electrocardiogram (ECG), replacing stable P-waves by chaotic and time-variant fibrillatory waves, this information has still not been explored for automated screening of AF. Hence, a pioneering AF detector based on quantifying the variability over time of the AA morphological pattern is here proposed. Results from two public reference databases have proven that the proposed method outperforms current state-of-the-art algorithms, reporting accuracy higher than 90%. A less false positive rate in the presence of other arrhythmias different from AF was also noticed. Finally, the combination of this algorithm with the classical analysis of RR series variability also yielded a promising trade-off between AF accuracy and detection delay. Indeed, this combination provided similar accuracy than RR-based methods, but with a significantly shorter delay of 10 beats.