title: Identification of Atrial Fibrillation by Quantitative Analyses of Fingertip Photoplethysmogram.
abstract: Atrial fibrillation (AF) detection is crucial for stroke prevention. We investigated the potential of quantitative analyses of photoplethysmogram (PPG) waveforms to identify AF. Continuous electrocardiogram (EKG) and fingertip PPG were recorded simultaneously in acute stroke patients (n = 666) admitted to an intensive care unit. Each EKG was visually labeled as AF (n = 150, 22.5%) or non-AF. Linear and nonlinear features from the pulse interval (PIN) and peak amplitude (AMP) of PPG waveforms were extracted from the first 1, 2, and 10 min of data. Logistic regression analysis revealed six independent PPG features feasibly identifying AF rhythm, including three PIN-related (mean, mean of standard deviation, and sample entropy), and three AMP-related features (mean of the root mean square of the successive differences, sample entropy, and turning point ratio) (all p < 0.01). The performance of the PPG analytic program comprising all 6 features that were extracted from the 2-min data was better than that from the 1-min data (area under the receiver operating characteristic curve was 0.972 (95% confidence interval 0.951-0.989) vs. 0.949 (0.929-0.970), p < 0.001 and was comparable to that from the 10-min data [0.973 (0.953-0.993)] for AF identification. In summary, our study established the optimal PPG analytic program in reliably identifying AF rhythm.
authors.affiliation: Stroke center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.|NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan.
authors.forename: Sung-Chun
authors.initials: SC
authors.lastname: Tang
authors.affiliation: NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan.|Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan.
authors.forename: Pei-Wen
authors.initials: PW
authors.lastname: Huang
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chi-Sheng
authors.initials: CS
authors.lastname: Hung
authors.affiliation: NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan.|Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan.
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Shan
authors.affiliation: NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan.|Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yen-Hung
authors.initials: YH
authors.lastname: Lin
authors.affiliation: Department of Mechanical Engineering, Yuan Ze University, Tao-Yuan, Taiwan.
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Shieh
authors.affiliation: Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan.|Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Dar-Ming
authors.initials: DM
authors.lastname: Lai
authors.affiliation: NTU-NTUH-MediaTek Innovative Medical Electronics Research Center, Taipei, Taiwan.|Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan.
authors.forename: An-Yeu
authors.initials: AY
authors.lastname: Wu
authors.affiliation: Stroke center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D017156:Photoplethysmography / Q000379:methods*; D012372:ROC Curve; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control