An approach to cardiac arrhythmia analysis using hidden Markov models

This paper describes a new approach to ECG arrhythmia analysis based on "hidden Markov modeling" (HMM), a technique successfully used since the mid-1970's to model speech waveforms for automatic speech recognition. Many ventricular arrhythmias can be classified by detecting and analyzing QRS complexes and determining R-R intervals. Classification of supraventricular arrhythmias, however, often requires detection of the P wave in addition to the QRS complex. The hidden Markov modeling approach combines structural and statistical knowledge of the ECG signal in a single parametric model. Model parameters are estimated from training data using an iterative, maximum likelihood reestimation algorithm. Initial results suggest that this approach may provide improved supraventricular arrhythmia analysis through accurate representation of the entire beat including the P wave.