Time- And Frequency-Based Independent Evaluation Of QRST Cancellation Techniques For Single-Lead Electrocardiograms During Atrial Fibrillation

With the increased prevalence of atrial fibrillation (AF) –rhythm disturbances in heart’s top chambers– there is growing interest in accurate non-invasive diagnosis of atrial activity to improve its therapy. A key component in non-invasive analysis of atrial activity is a successful removal of the ventricular QRST complexes from electrocardiograms (ECGs). In this study, we have developed a new approach for an objective and physiologically-based evaluation of QRST cancellation methods based on the power spectra of the AF. Three commonly used QRST cancellation methods were evaluated; namely, average beat subtraction, singular value cancellation, and principal component analysis. These methods were evaluated in time and frequency domains using a set of synthesized ECGs preserving the atrial-specific temporal and spectral properties. It was observed that the ABS method provided the best estimation when QRST morphological variability is low, while PCA produces an overall best estimate when a large QRST morphological variability is present.