Validation of chest-belt ECG evaluation using artificial intelligence

Abstract Background Simple, cheap wearables for long-term ECG monitoring with automatic analysis of all measurements using a bespoke artificial intelligence (AI) are scarce. Annotated single-lead ECG data from a chest-belt are missing. Methods We have developed a complex software environment to acquire raw ECG data from the Polar H10 chest-belt, and a bespoke, original AI to detect artifacts, QRS complexes and the presence of atrial fibrillation (AF) from chest-belt recordings. Original manually annotated ECG recordings from real patients from cardiology departments using the chest-belt and a public MIT-BIH database as reference were used for validation. Results QRS determination by AI (version Q4/23) in evaluating MIT-BIH database of ECG samples had a 97.67 % sensitivity and a 97.73 % positive predictive value. AF in MIT-BIH database was detected by AI with 90.31 % sensitivity and 92.09 % positive predictive value. To assess AI accuracy in ECG from a chest-belt, 150 consecutive measurements using Polar H10 chest-belt (215 hours of ECG recordings in total) from individual patients were included in the analysis. Patients were not limited in any physical activity during measurements. 7.15 % of the length of all recordings (15.4 hours) was assessed as noise by AI and excluded from the analysis. AF lasting longer than 30 seconds was present in 14 of 150 (9.3 %) manually evaluated recordings. QRS determination by AI in evaluating manually annotated chest-belt data had 99.76 % sensitivity and 99.74 % positive predictive value. AF in manually annotated chest-belt data was detected by AI with 92.86 % sensitivity and 100 % positive predictive value. Conclusion A chest-belt can be used to reliably detect QRS complexes and the presence of atrial fibrillation with high accuracy when using a bespoke artificial intelligence for the evaluation. Commonly available devices capable of long ECG measurements could be used for patient-empowered screening for important arrhythmias.Atrial fibrillation on chest-belt ECG