Enhancing P-wave localization for accurate detection of second-degree and third-degree atrioventricular conduction blocks.

OBJECTIVE This paper tackles the challenge of accurately detecting second-degree and third-degree atrioventricular block AVB) in electrocardiogram (ECG) signals through automated algorithms. The inaccurate detection of P-waves poses a difficulty in this process. To address this limitation, we propose a reliable method that significantly improves the performances of AVB detection by precisely localizing P-waves. APPROACH Our proposed P-WaveNet utilized an attention mechanism to extract spatial and temporal features, and employs a BiLSTM module to capture inter-temporal dependencies within the ECG signal. To overcome the scarcity of data for second-degree and third-degree AVB (2AVB,3AVB), a mathematical approach was employed to synthesize pseudo-data. By combining P-wave positions identified by the P-WaveNet with key medical features such as RR interval rhythm and PR intervals, we established a classification rule enabling automatic AVB detection. MAIN RESULTS The P-WaveNet achieved an F1 score of 93.62% and 91.42% for P-wave localization on the QTDB and LUDB datasets, respectively. In the BUTPDB dataset, the F1 scores for P-wave localization in ECG signals with 2AVB and 3AVB were 98.29% and 62.65%, respectively. Across two independent datasets, the AVB detection algorithm achieved F1 scores of 83.33% and 84.15% for 2AVB and 3AVB, respectively. SIGNIFICANCE Our proposed P-WaveNet demonstrates accurate identification of P-waves in complex ECGs, significantly enhancing AVB detection efficacy. This paper's contributions stem from the fusion of medical expertise with data augmentation techniques and ECG classification. The proposed P-WaveNet demonstrates potential clinical applicability.