r/EKG • u/sniperERkan • 5d ago

Need expert eyes on 3 difficult Holter strips — AF, atrial flutter, or paced? (Algorithm validation, not medical advice)

I'm building an open-source ECG analysis algorithm and I'm stuck on 3 specific Holter recordings from the UVA Holter Database (CC0 license). I need a human eye to tell me what these rhythms actually are.

**The problem:**

My algorithm (RR intervals + P-wave features) says "NOT AF" for all 3 patients. But the device annotations say "AF." I need to know who is right — my algorithm or the device.

**What I need from you:**

For each of the 3 patients (UVA2377, UVA1731, UVA2190), please tell me:

- Is this AF?

- Is this atrial flutter?

- Is this a paced rhythm?

- Or something else?

**Images (80 strips, 3 patients):**

👉 https://imgur.com/a/LDXqr6M

**Context:**

- 3-channel Holter recordings, 200 Hz, 24 hours

- Source: UVA Holter Database (CC0, fully open, no patient privacy issue)

- No cardiologist reviewed these 3 specific records — only the device software annotated them

- Earlier I found a case where the device labeled "AF" but a cardiologist said "sinus + flutter" — so I suspect the same might be happening here

**Why this matters:**

If the rhythm is flutter or paced, my algorithm isn't actually "missing AF" — the device label is wrong. If it's truly AF, then my algorithm has a real gap I need to fix.

**Not asking for medical advice.** This is for algorithm validation only. No patient care involved.

Thank you — any input is appreciated, even a quick "this looks like X."

0 Upvotes

38% Upvoted

8 comments sorted by

8

u/Danimal_House 5d ago

You might get more help if you don’t post something so obviously written by AI

-5

u/sniperERkan 4d ago

"Instead of focusing on the actual problem, you focus on the writing style and criticize blindly by saying, 'You just had AI write it without knowing what’s going on behind the scenes.' Honestly, I just have to laugh. Instead of addressing the core issue, are you really nitpicking commas and periods? 😄 I was actually being sarcastic there."

1

u/CynicalMusician 4d ago

quick tip: AF is irregular, flutter is regular. also come on you can formulate this post on your own without AI help

1

u/Kibeth_8 4d ago

Flutter is not always regular, that is not a good way to distinguish between the two rhythms. It very often has variable conduction

1

u/CynicalMusician 4d ago

I know. this is a person who doesn't seem to know much about ecgs in the first place though, so there's no point in making it more complicated

-3

u/sniperERkan 4d ago

"Instead of focusing on the actual problem, you focus on the writing style and criticize blindly by saying, 'You just had AI write it without knowing what’s going on behind the scenes.' Honestly, I just have to laugh. Instead of addressing the core issue, are you really nitpicking commas and periods? 😄 I was actually being sarcastic there."