Department of Cardiology, Rabin Medical Center, Petah Tikva, Israel.
The Heart Institute, Shaare Zedek Medical Center, Jerusalem, Israel.
J Cardiovasc Electrophysiol. 2022 Aug;33(8):1647-1654. doi: 10.1111/jce.15595. Epub 2022 Jun 21.
Early detection of atrial fibrillation (AF) is desirable but challenging due to the often-asymptomatic nature of AF. Known screening methods are limited and most of them depend of electrocardiography or other techniques with direct contact with the skin. Analysis of voice signals from natural speech has been reported for several applications in medicine. The study goal was to evaluate the usefulness of vocal features analysis for the detection of AF.
This prospective study was performed in two medical centers. Patients with persistent AF admitted for cardioversion were enrolled. The patients pronounced the vowels "Ahh" and "Ohh" were recorded synchronously with an ECG tracing. An algorithm was developed to provide an "AF indicator" for detection of AF from the speech signal.
A total of 158 patients were recruited. The final analysis of "Ahh" and "Ohh" syllables was performed on 143 and 142 patients, respectively. The mean age was 71.4 ± 9.3 and 43% of patients were females. The developed AF indicator was reliable. Its numerical value decreased significantly in sinus rhythm (SR) after the cardioversion ("Ahh": from 13.98 ± 3.10 to 7.49 ± 1.58; "Ohh": from 11.39 ± 2.99 to 2.99 ± 1.61). The values at SR were significantly more homogenous compared to AF as indicated by a lower standard deviation. The area under the receiver operating characteristic curve was >0.98 and >0.89 ("Ahh" and "Ohh," respectively, p < .001). The AF indicator sensitivity is 95% with 82% specificity.
This study is the first report to demonstrate feasibility and reliability of the identification of AF episodes using voice analysis with acceptable accuracy, within the identified limitations of our study methods. The developed AF indicator has higher accuracy using the "Ahh" syllable versus "Ohh."
由于房颤 (AF) 常常无症状,因此早期发现房颤是可取的,但具有挑战性。已知的筛查方法有限,其中大多数方法都依赖于心电图或其他与皮肤直接接触的技术。从自然语音中分析声音信号已在医学的多个应用中得到了报道。本研究旨在评估基于语音特征分析用于检测 AF 的效用。
这是一项在两家医疗中心进行的前瞻性研究。招募了因需要进行心脏复律而住院的持续性房颤患者。在记录心电图的同时,让患者发出元音“啊”和“哦”的音。开发了一种算法,以从语音信号中提供用于检测 AF 的“AF 指示符”。
共纳入了 158 名患者。最终对 143 名和 142 名患者分别进行了“啊”和“哦”音节的分析。患者的平均年龄为 71.4 ± 9.3 岁,43%的患者为女性。所开发的 AF 指示符是可靠的。在心脏复律后窦性心律 (SR) 时,其数值明显下降(“啊”:从 13.98 ± 3.10 降至 7.49 ± 1.58;“哦”:从 11.39 ± 2.99 降至 2.99 ± 1.61)。SR 时的数值更加均匀,标准差也较低,表明这一数值更能代表 SR。接收者操作特征曲线下的面积大于 0.98 和 0.89(“啊”和“哦”,分别为 p<0.001)。AF 指示符的灵敏度为 95%,特异性为 82%。
这项研究首次报告了使用语音分析识别 AF 发作的可行性和可靠性,在我们研究方法的确定限制内,其准确性可接受。与“哦”相比,开发的 AF 指示符使用“啊”音节具有更高的准确性。