Cited by 61Non-Invasive Vital Sign MonitoringECG Monitoring and AnalysisHeart Rate Variability and Autonomic Control

Comparison between electrocardiogram- and photoplethysmogram-derived features for atrial fibrillation detection in free-living conditions

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Eerikäinen, Linda M, Bonomi, Alberto G, Schipper, Fons, Dekker, Lukas R C, Vullings, Rik, de Morree, Helma M, Aarts, Ronald M·2018·Physiological Measurement

Abstract

OBJECTIVE: Atrial fibrillation (AF) is the most commonly experienced arrhythmia and it increases the risk of stroke and heart failure. The challenge in detecting the presence of AF is the occasional and asymptomatic manifestation of the condition. Long-term monitoring can increase the sensitivity of detecting intermittent AF episodes, however it is either cumbersome or invasive and costly with electrocardiography (ECG). Photoplethysmography (PPG) is an unobtrusive measuring modality enabling heart rate monitoring, and promising results have been presented in detecting AF. However, there is still limited knowledge about the applicability of the PPG solutions in free-living conditions. The aim of this study was to compare the inter-beat interval derived features for AF detection between ECG and wrist-worn PPG in daily life. APPROACH: The data consisted of 24 h ECG, PPG, and accelerometer measurements from 27 patients (eight AF, 19 non-AF). In total, seven features (Shannon entropy, root mean square of successive differences (RMSSD), normalized RMSSD, pNN40, pNN70, sample entropy, and coefficient of sample entropy (CosEn)) were compared. Body movement was measured with the accelerometer and used with three different thresholds to exclude PPG segments affected by movement. MAIN RESULTS: CosEn resulted as the best performing feature from ECG with Cohens kappa 0.95. When the strictest movement threshold was applied, the same performance was obtained with PPG (kappa = 0.96). In addition, pNN40 and pNN70 reached similar results with the same threshold (kappa = 0.95 and 0.94), but were more robust with respect to movement artefacts. The coverage of PPG was 24.0%-57.6% depending on the movement threshold compared to 92.1% of ECG. SIGNIFICANCE: The inter-beat interval features derived from PPG are equivalent to the ones from ECG for AF detection. Movement artefacts substantially worsen PPG-based AF monitoring in free-living conditions, therefore monitoring coverage needs to be carefully selected. Wrist-worn PPG still provides a promising technology for long-term AF monitoring.

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Authors
Eerikäinen, L. M., Bonomi, A. G., Schipper, F., Dekker, L. R. C., Vullings, R., de Morree, H. M., & Aarts, R. M.
Affiliations
  • Philips (Netherlands) (NL)
  • Catharina Ziekenhuis (NL)
  • Eindhoven University of Technology (NL)
  • Philips Research
Corresponding author
  • Eerikäinen, Linda M
  • Vullings, Rik
Venue
Physiological Measurement
Published
2018-08-01
Volume
39
Issue
8
Pages
084001
ISSN
  • 0967-3334 (ISSN-L)
  • 1361-6579
OpenAlex
W2847349893
Cited by
61
References
30
Citations by year
2026: 1 · 2025: 4 · 2024: 5 · 2023: 7 · 2022: 13 · 2021: 12 · 2020: 10 · 2019: 9
FWCI
3.10
Type
journal article
Language
en
Open access
Locations
  • Physiological Measurement (publishedVersion)
  • PubMed (publishedVersion)
  • TU/e Research Portal (submittedVersion, other-oa)
  • TU/e Research Portal (submittedVersion)
Funders
Technische Universiteit Eindhoven
Topics
  • Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Keywords
atrial fibrillation detection, photoplethysmography, electrocardiogram, sample entropy, RMSSD, motion artifacts, wearable sensors, free-living conditions
MeSH terms
Activities of Daily Living, Adult, Aged, Atrial Fibrillation, Electrocardiography, Female, Heart Rate, Humans, Male, Middle Aged, Movement, ROC Curve, Signal Processing, Computer-Assisted, Photoplethysmography

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