Factors Influencing Automated Limited Lead Detection of Atrial Fibrillation

Abstract

There has been interest relating to automated analysis of a lead I ECG to detect cardiac arrhythmias. Little interest has been shown in the accuracy of using lead I as opposed to 6 limb leads or the full 12 lead ECG. The aim of this small study was to assess the efficacy of using only lead I but also to look at the effect of analysing a single 30s recording as a continuous recording versus five 10s overlapping recordings constituting a 30s record.One hundred 10s digital 12 lead ECGs with atrial fibrillation (AF) were used. Chest leads were removed and the 6 limb leads then used for analysis of rhythm. Similarly, lead I alone was used. Separately 100 single lead I ECGs classified as AF in the PhysioNet 2017 database were analysed, both as single 30s recordings and as five 10s ECGs commencing at 0, 5, 10, 15 and 20s from the start of the recording. An algorithm made the diagnosis from 5 reports. All analyses were made with the Glasgow Program. For the 10s 12 lead ECGs, 96% were reported as AF using 6 limb leads and 93% using lead I. For the 30s recordings, 92% were reported as AF using a single 30s analysis and 91% as AF using the five ECGs.In conclusion, one lead and 6 leads are not as sensitive as 12 leads in detecting AF, while five 10s reports combined are no more sensitive than a single 30s report though more specific.