Detection of Paroxysmal Atrial Fibrillation from Sinus Rhythm Using 96-Lead Electrocardiography and Graph Neural Networks

Qingrong Wu1, Xin Lian1, Haiying Li2, Yanhong Chen2, Hairui Li3, Yanyan Suo4, Wu Jian5
1Tsinghua Shenzhen International Graduate School, 2The University of Hong Kong - Shenzhen Hospital, 3The University of Hong Kong Shenzhen Hospital, 4The Testing and Technology Center for Industrial Products of Shenzhen Customs, 5Shenzhen International Graduate School, Tsinghua University


Abstract

Paroxysmal atrial fibrillation (PAF) is difficult to detect because patients often remain in sinus rhythm between arrhythmic episodes. This study proposes a Multi-scale Temporal-Graph Fusion Network (MTGF-Net) for PAF detection using high-density 96-lead electrocardiograms (ECGs). The framework combines multi-scale temporal feature extraction with graph-based modeling of inter-lead spatial relationships. A 96-lead ECG dataset was constructed from 65 participants, including 31 patients with PAF and 34 healthy controls. A total of 5,561 valid ECG segments were retained. Compared with the Multi-CNN and ResNet baselines, the Graph Convolutional Network (GCN)-based variant, MTGF-GCN, achieved the best overall performance, with an accuracy of 85.26%, an AUROC of 0.931, and a sensitivity of 81.79%. In addition, an approximate 12-lead configuration achieved lower performance than the full 96-lead input. These findings support the potential of high-density ECG and spatial modeling for identifying PAF-related patterns during sinus rhythm.