Objective: The aim of this study is to investigate the potential of arterial blood pressure (ABP) signal for the detection of the subjects with life-threatening extreme bradycardia (EBr). Approach: The steps of the proposed method include ABP signal preprocessing, ABP wave segmentation, model parameters estimation, and EBr subject detection. Firstly, the noise, interference, and abnormal segments are eliminated in pre-processing. Then, the ABP signal is segmented into a series of ABP waves by cardiac cycles. The pulse decomposition analysis (PDA) approach is presented to quantitively describe the changes in ABP waves. The back-propagation neural network (BPNN), probabilistic neural network (PNN), and decision tree (DT) are engaged to design the classifiers to discriminate the EBr subjects from healthy subjects by the parameters of PDA models. The international physiological signal databases of Fantasia for healthy subjects and 2015 PhysioNet/CinC Challenge for EBr subjects are exploited to validate the proposed method, and 79310 ABP waves of healthy subjects and 4595 ABP waves of EBr subject are extracted. Main results: We obtain the average PDA models of healthy subjects and EBr subjects and derive their changes. The two-sample Kolmogorov-Smirnov test result shows that all model parameters are markedly different (H = 1, P < 0.05) between the healthy and EBr subjects. The classification results show that the DT has the best performance with the specificity of 99.74 ± 0.07%, the sensitivity of 93.12 ± 1.24%, the accuracy of 99.37 ± 0.10%, and kappa coefficient of 93.92 ± 0.92%. Significance: The proposed method has the potential to detect EBr subjects by the ABP signal.
