Comprehensive Analysis of Cardiogenic Vibrations for Automated Detection of Atrial Fibrillation Using Smartphone Mechanocardiograms

摘要

Atrial fibrillation (AFib) is the most common sustained heart arrhythmia and is characterized by irregular and excessively frequent ventricular contractions. Early diagnosis of AFib is a key step in the prevention of stroke and heart failure. In this paper, we present a comprehensive time-frequency pattern analysis approach for automated detection of AFib from smartphone-derived seismocardiography (SCG) and gyrocardiography (GCG) signals. We sought to assess the diagnostic performance of a smartphone mechanocardiogram (MCG) by considering joint SCG-GCG recordings from 435 subjects including 190 AFib and 245 sinus rhythm cases. A fully automated AFib detection algorithm consisting of various signal processing and multidisciplinary feature engineering techniques was developed and evaluated through a large set of cross-validation (CV) data including 300 (AFib = 150) cardiac patients. The trained model was further tested on an unseen set of recordings including 135 (AFib = 40) subjects considered as cross-database (CD). The experimental results showed accuracy, sensitivity, and specificity of approximately 97%, 99%, and 95% for the CV study and up to 95%, 93%, and 97% for the CD test, respectively. The F-1 scores were 97% and 96% for the CV and CD, respectively. A positive predictive value of approximately 95% and 92% was obtained, respectively, for the validation and test sets suggesting high reproducibility and repeatability for mobile AFib detection. Moreover, the kappa coefficient of the method was 0.94 indicating a near-perfect agreement in rhythm classification between the smartphone algorithm and visual interpretation of telemetry recordings. The results support the feasibility of self-monitoring via easy-to-use and accessible MCGs.