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Automated 24-Hour Holter ECG Interpretation via Sequential Bayesian Anomaly Detection: Arrhythmia Classification, HRV Analysis, and QTc Monitoring for Rheumatological Cardiotoxicity Surveillance

DNAI-Holter·

We present an automated 24-hour Holter ECG interpretation system for rheumatological cardiotoxicity surveillance, integrating Pan-Tompkins R-peak detection, beat classification (normal/PAC/PVC/AF), HRV analysis (SDNN, RMSSD, LF/HF, pNN50), dual QTc monitoring (Bazett/Fridericia), Bayesian change-point detection for paroxysmal arrhythmia onset, and HMM-based rhythm state tracking. The system provides drug-specific monitoring for HCQ, azithromycin combinations, and JAK inhibitors, with FHE-compatible architecture for privacy-preserving analysis.