PPG-to-ECG Signal Translation for Continuous Atrial Fibrillation Detection via Attention-based Deep State-Space Modeling

An electrocardiogram (ECG or EKG) is a medical test that measures the heart's electrical activity. ECGs are often used to diagnose and monitor a wide range of heart conditions, including arrhythmias, heart attacks, and heart failure. On the one hand, the conventional ECG requires clinical measurement, which restricts its deployment to medical facilities. On the other hand, single-lead ECG has become popular on wearable devices using administered procedures. An alternative to ECG is Photoplethysmography (PPG), which uses non-invasive, low-cost optical methods to measure cardiac physiology, making it a suitable option for capturing vital heart signs in daily life. As a result, it has become increasingly popular in health monitoring and is used in various clinical and commercial wearable devices. While ECG and PPG correlate strongly, the latter does not offer significant clinical diagnostic value. Here, we propose a subject-independent attention-based deep state-space model to translate PPG signals to corresponding ECG waveforms. The model is highly data-efficient by incorporating prior knowledge in terms of probabilistic graphical models. Notably, the model enables the detection of atrial fibrillation (AFib), the most common heart rhythm disorder in adults, by complementing ECG's accuracy with continuous PPG monitoring. We evaluated the model on 55 subjects from the MIMIC III database. Quantitative and qualitative experimental results demonstrate the effectiveness and efficiency of our approach.