Predicting the spontaneous termination of atrial fibrillation based on Poincare section in the electrocardiogram phase space

Abstract

Atrial fibrillation (AF) is a commonly encountered cardiac arrhythmia. Predicting the conditions under which AF terminates spontaneously is an important task that would bring great benefit to both patients and clinicians. In this study, a new method was proposed to predict spontaneous AF termination by employing the points of section (POS) coordinates along a Poincare section in the electrocardiogram (ECG) phase space. The AF Termination Database provided by PhysioNet for the Computers in Cardiology Challenge 2004 was applied in the present study. It includes one training dataset and two testing datasets, A and B. The present investigation was initiated by producing a two-dimensional reconstructed phase space (RPS) of the ECG. Then, a Poincare line was drawn in a direction that included the maximum point distribution in the RPS and also passed through the origin of the RPS coordinate system. Afterward, the coordinates of the RPS trajectory intersections with this Poincare line were extracted to capture the local behavior related to the arrhythmia under investigation. The POS corresponding to atrial activity were selected with regard to the fact that similar ECG morphologies such as P waves, which are corresponding to atrial activity, distribute in a specific region of the RPS. Thirteen features were extracted from the selected intersection points to quantify their distributions. To select the best feature subset, a genetic algorithm (GA), in combination with a support vector machine (SVM), was applied to the training dataset. Based on the selected features and trained SVM, the performance of the proposed method was evaluated using the testing datasets. The results showed that 86.67% of dataset A and 80% of dataset B were correctly classified. This classification accuracy is in the same range as or higher than that of recent studies in this area. These results show that the proposed method, in which no complicated QRST cancelation algorithm was used, has the potential to predict AF termination.