journal article·2026-02-28Open access

Comparative Analysis of Machine Learning and Deep Learning Models for Atrial Fibrillation Detection from Long-Term ECG

Lerina Aversano, Ilaria Mancino, Agostino Marengo, Chiara Verdone

Applied Sciences· Volume 16· Issue 5

Abstract

Atrial fibrillation is the most prevalent sustained cardiac arrhythmia and a major risk factor for stroke, heart failure, and premature mortality. Automatic detection remains challenging due to the variability of electrocardiogram (ECG) morphology, noise, and the paroxysmal nature of atrial fibrillation events. This study proposes a comprehensive framework that integrates optimised segmentation, feature extraction, and advanced deep learning architectures to improve detection accuracy. A coalescence window is introduced to dynamically cluster arrhythmic episodes, aligning computational analysis with clinical event distributions. Multiple classifiers are investigated, ranging from traditional machine learning models to state-of-the-art deep neural networks, including Temporal Convolutional Networks (TCNs), Convolutional Neural Networks (CNNs), and Bidirectional Long Short-Term Memory (BiLSTM). Experimental evaluation on a balanced dataset of ECG signals demonstrates the superior performance of deep learning models, with the best architecture achieving high accuracy and F1-score, significantly outperforming traditional approaches. Furthermore, the proposed pipeline is designed to be modular and resource-aware, supporting potential deployment in real-time and edge computing environments. These results highlight the feasibility of scalable atrial fibrillation monitoring systems that bridge algorithmic innovation with clinical applicability, ultimately contributing to earlier diagnosis and improved patient management.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: ECG Monitoring and Analysis · Atrial Fibrillation Management and Outcomes · Imbalanced Data Classification Techniques

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Agricultural Science, Food, Natural Resources and Engineering, University of Foggia, 71100 Foggia, Italy

Department of Engineering, University of Sannio, 82100 Benevento, Italy

Funding

DARE - DigitAl lifelong pRevEntion

References (25)

Show source-provided references
1. Atrial fibrillation detection using convolutional neural networks on 2-dimensional representation of ECG signal10.1016/j.bspc.2021.103470 ↗
2. Artificial intelligence-based approach for atrial fibrillation detection using normalised and short-duration time-frequency ECG10.1016/j.bspc.2021.103270 ↗
3. A novel deep neural network for detection of Atrial Fibrillation using spatial and frequency features
4. Automated diagnosis of arrhythmia using combination of CNN and LSTM techniques with variable length heart beats10.1016/j.compbiomed.2018.06.002 ↗
5. Detecting atrial fibrillation by deep convolutional neural networks10.1016/j.compbiomed.2017.12.007 ↗
6. Deep learning for ECG analysis: Benchmarks and insights from PTB-XL
7. Opportunities and challenges of deep learning methods for electrocardiogram data: A systematic review10.1016/j.compbiomed.2020.103801 ↗
8. Kachuee, M., Fazeli, S., and Sarrafzadeh, M. (2018, January 4–7). Ecg heartbeat classification: A deep transferable representation. Proceedings of the 2018 IEEE International Conference on Healthcare Informatics (ICHI), New York, NY, USA.10.1109/ICHI.2018.00092 ↗
9. Passive detection of atrial fibrillation using a commercially available smartwatch10.1001/jamacardio.2018.0136 ↗
10. Edge2Analysis: A Novel AIoT Platform for Atrial Fibrillation Recognition and Detection10.1109/JBHI.2022.3171918 ↗
11. Rahman, M., and Morshed, B.I. (2024, January 15–17). A Smart Wearable for Real-Time Cardiac Disease Detection Using Beat-by-Beat ECG Signal Analysis with an Edge Computing AI Classifier. Proceedings of the 2024 IEEE 20th International Conference on Body Sensor Networks (BSN), Chicago, IL, USA.10.1109/BSN63547.2024.10780696 ↗
12. Liu, X., Liu, H., Li, J., Yang, Z., Huang, Y., and Zhang, J. (2024, January 5–9). AcousAF: Acoustic Sensing-Based Atrial Fibrillation Detection System for Mobile Phones. Proceedings of the Companion of the 2024 on ACM International Joint Conference on Pervasive and Ubiquitous Computing, Melbourne, Australia.10.1145/3675094.3678488 ↗
13. Detection of atrial fibrillation from PPG sensor data using variational mode decomposition10.1109/LSENS.2024.3358589 ↗
14. mmArrhythmia: Contactless arrhythmia detection via mmwave sensing
15. An Intelligent Telecardiology System Using a Wearable and Wireless ECG to Detect Atrial Fibrillation10.1109/TITB.2010.2047401 ↗
16. Sabbadini, R., Riccio, M., Maresca, L., Irace, A., and Breglio, G. (2022, January 22–24). Atrial Fibrillation Detection by Means of Edge Computing on Wearable Device: A Feasibility Assessment. Proceedings of the 2022 IEEE International Symposium on Medical Measurements and Applications (MeMeA), Messina, Italy.10.1109/MeMeA54994.2022.9856438 ↗
17. Real-Time Personalized Atrial Fibrillation Prediction on Multi-Core Wearable Sensors
18. Multimodal spatio-temporal-spectral fusion for deep learning applications in physiological time series processing: A Case Study in Monitoring the Depth of Anesthesia10.1016/j.inffus.2021.03.001 ↗
19. Petroni, A., Cuomo, F., Scarano, G., Francia, P., and Colonnese, S. (2021, January 7–11). Atrial Fibrillation Detection by Multi-Lead ECG Processing at the Edge. Proceedings of the 2021 IEEE Globecom Workshops (GC Wkshps), Madrid, Spain.10.1109/GCWkshps52748.2021.9682133 ↗
20. Spontaneous Brain Activity and EEG Microstates: A Novel EEG-fMRI Analysis Approach to explore resting-state networks10.1016/j.neuroimage.2010.01.093 ↗
21. A Comprehensive Survey on ECG Signals as New Biometric Modality for Human Authentication: Recent Advances and Future Challenges10.1109/ACCESS.2021.3095248 ↗
22. Xiong, Z., Stiles, M., and Zhao, J. (2017, January 24–27). Robust ECG signal classification for detection of atrial fibrillation using a novel neural network. Proceedings of the 2017 Computing in Cardiology (CinC), Rennes, France.10.22489/CinC.2017.066-138 ↗
23. Randomized Attention and Dual-Path System for Electrocardiogram Identity Recognition10.1016/j.engappai.2024.107883 ↗
24. Bouhenguel, R., and Mahgoub, I. (2012, January 21–24). A Risk and Incidence Based Atrial Fibrillation Detection Scheme for Wearable Healthcare Computing Devices. Proceedings of the 2012 6th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth) and Workshops, San Diego, CA, USA.10.4108/icst.pervasivehealth.2012.248670 ↗
25. IRIDIA-AF, a large paroxysmal atrial fibrillation long-term electrocardiogram monitoring database10.1038/s41597-023-02621-1 ↗