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Shu S, Ren J, Song J. Clinical Application of Machine Learning-Based Artificial Intelligence in the Diagnosis, Prediction, and Classification of Cardiovascular Diseases. Circ J 2021; 85:1416-1425. [PMID: 33883384 DOI: 10.1253/circj.cj-20-1121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
With the rapid development of artificial intelligence (AI) and machine learning (ML), as well as the arrival of the big data era, technological innovations have occurred in the field of cardiovascular medicine. First, the diagnosis of cardiovascular diseases (CVDs) is highly dependent on assistive examinations, the interpretation of which is time consuming and often limited by the knowledge level and clinical experience of doctors; however, AI could be used to automatically interpret the images obtained in auxiliary examinations. Second, some of the predictions of the incidence and prognosis of CVDs are limited in clinical practice by the use of traditional prediction models, but there may be occasions when AI-based prediction models perform well by using ML algorithms. Third, AI has been used to assist precise classification of CVDs by integrating a variety of medical data from patients, which helps better characterize the subgroups of heterogeneous diseases. To help clinicians better understand the applications of AI in CVDs, this review summarizes studies relating to AI-based diagnosis, prediction, and classification of CVDs. Finally, we discuss the challenges of applying AI to cardiovascular medicine.
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Affiliation(s)
- Songren Shu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Jie Ren
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Jiangping Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College
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Bayram N, Akoğlu H, Sanri E, Karacabey S, Efeoğlu M, Onur O, Denizbasi A. Diagnostic Accuracy of the Electrocardiography Criteria for Left Ventricular Hypertrophy (Cornell Voltage Criteria, Sokolow-Lyon Index, Romhilt-Estes, and Peguero-Lo Presti Criteria) Compared to Transthoracic Echocardiography. Cureus 2021; 13:e13883. [PMID: 33868847 PMCID: PMC8043050 DOI: 10.7759/cureus.13883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective/Aim: We aimed to evaluate the diagnostic utility of the widely used left ventricular hypertrophy (LVH) electrocardiography (ECG) criteria (Cornell Voltage Criteria [CVC], Sokolow-Lyon Index [SLI], Romhilt-Estes [REC], and Peguero-Lo Presti [PLP] Criteria) compared with the left ventricular mass measured by echocardiography. Methods: In this prospective diagnostic accuracy study, we screened all consecutive adults (18 to 65 years) who presented to our academic emergency department (ED) with increased blood pressure (≥130/85 mmHg) between January 2016 and January 2017, and we enrolled a convenience sample of 165 patients in our study. The attending emergency physician managed all patients as per their primary complaint. The consulting cardiologist performed a transthoracic echocardiogram (TTE) of the patient and calculated the left ventricular mass (LVM) according to the American Society of Echocardiography (ASE) formula. After completing the patient recruitment phase, researchers evaluated all ECGs and calculated scores for SLI, CVC, REC, and PLP. We used contingency tables to calculate the diagnostic utility metrics of all ECG criteria. Results: The prevalence of LVH by TTE was 31.5%. CVC, SLI, REC, and PLP criteria correctly identified (true positive rate) abnormal LVM in only 3.9%, 1.9%, 9.6%, and 19.2% of the patients, respectively. CVC, SLI, REC score and PLP criteria performed poorly with extremely low sensitivities (3.9%, 1.9%, 10%, 19.2%) and poor accuracies (67.3%, 64.9%, 57.7%, 69.7%). Conclusion: ECG voltage criteria's clinical utility in estimating LVM and LVH is low, and it should not be used for this purpose.
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Affiliation(s)
- Nurseli Bayram
- Department of Emergency Medicine, Marmara University Pendik Education and Research Hospital, Istanbul, TUR
| | - Haldun Akoğlu
- Department of Emergency Medicine, Marmara University School of Medicine, Istanbul, TUR
| | - Erkman Sanri
- Department of Emergency Medicine, Marmara University Pendik Education and Research Hospital, Istanbul, TUR
| | - Sinan Karacabey
- Department of Emergency Medicine, Marmara University School of Medicine, Istanbul, TUR
| | - Melis Efeoğlu
- Department of Emergency Medicine, Marmara University Pendik Education and Research Hospital, Istanbul, TUR
| | - Ozge Onur
- Department of Emergency Medicine, Marmara University School of Medicine, Istanbul, TUR
| | - Arzu Denizbasi
- Department of Emergency Medicine, Marmara University School of Medicine, Istanbul, TUR
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Somani S, Russak AJ, Richter F, Zhao S, Vaid A, Chaudhry F, De Freitas JK, Naik N, Miotto R, Nadkarni GN, Narula J, Argulian E, Glicksberg BS. Deep learning and the electrocardiogram: review of the current state-of-the-art. Europace 2021; 23:1179-1191. [PMID: 33564873 PMCID: PMC8350862 DOI: 10.1093/europace/euaa377] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/25/2020] [Indexed: 12/22/2022] Open
Abstract
In the recent decade, deep learning, a subset of artificial intelligence and machine learning, has been used to identify patterns in big healthcare datasets for disease phenotyping, event predictions, and complex decision making. Public datasets for electrocardiograms (ECGs) have existed since the 1980s and have been used for very specific tasks in cardiology, such as arrhythmia, ischemia, and cardiomyopathy detection. Recently, private institutions have begun curating large ECG databases that are orders of magnitude larger than the public databases for ingestion by deep learning models. These efforts have demonstrated not only improved performance and generalizability in these aforementioned tasks but also application to novel clinical scenarios. This review focuses on orienting the clinician towards fundamental tenets of deep learning, state-of-the-art prior to its use for ECG analysis, and current applications of deep learning on ECGs, as well as their limitations and future areas of improvement.
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Affiliation(s)
- Sulaiman Somani
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA
| | - Adam J Russak
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA.,Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Felix Richter
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA
| | - Shan Zhao
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA.,Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Akhil Vaid
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA
| | - Fayzan Chaudhry
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jessica K De Freitas
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nidhi Naik
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA
| | - Riccardio Miotto
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Girish N Nadkarni
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA.,Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jagat Narula
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Edgar Argulian
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Benjamin S Glicksberg
- The Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl., New York, NY 10029, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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54
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Angelaki E, Marketou ME, Barmparis GD, Patrianakos A, Vardas PE, Parthenakis F, Tsironis GP. Detection of abnormal left ventricular geometry in patients without cardiovascular disease through machine learning: An ECG-based approach. J Clin Hypertens (Greenwich) 2021; 23:935-945. [PMID: 33507615 PMCID: PMC8678829 DOI: 10.1111/jch.14200] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 01/19/2023]
Abstract
Cardiac remodeling is recognized as an important aspect of cardiovascular disease (CVD) progression. Machine learning (ML) techniques were applied to basic clinical parameters and electrocardiographic features, in order to detect abnormal left ventricular geometry (LVG) even before the onset of left ventricular hypertrophy (LVH), in a population without established CVD. The authors enrolled 528 patients with and without essential hypertension, but no other indications of CVD. All patients underwent a full echocardiographic evaluation and were classified into 3 groups; normal geometry (NG), concentric remodeling without LVH (CR), and LVH. Abnormal LVG was identified as increased relative wall thickness (RWT) and/or left ventricular mass index (LVMi). The authors trained supervised ML models to classify patients with abnormal LVG and calculated SHAP values to perform feature importance and interaction analysis. Hypertension, age, body mass index over the Sokolow‐Lyon voltage, QRS‐T angle, and QTc duration were some of the most important features. Our model was able to distinguish NG from CR+LVH combined, with 87% accuracy on an unseen test set, 75% specificity, 97% sensitivity, and area under the receiver operating curve (AUC/ROC) equal to 0.91. The authors also trained our model to classify NG and CR (NG + CR) against those with LVH, with 89% test set accuracy, 93% specificity, 67% sensitivity, and an AUC/ROC value of 0.89, for a 0.4 decision threshold. Our ML algorithm effectively detects abnormal LVG even at early stages. Innovative solutions are needed to improve risk stratification of patients without established CVD, and ML may enable progress in this direction.
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Affiliation(s)
- Eleni Angelaki
- Institute of Theoretical and Computational Physics and Department of Physics, University of Crete, Heraklion, Greece.,Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Maria E Marketou
- Department of Cardiology, Heraklion University Hospital, Heraklion, Greece
| | - Georgios D Barmparis
- Institute of Theoretical and Computational Physics and Department of Physics, University of Crete, Heraklion, Greece
| | | | - Panos E Vardas
- Department of Cardiology, Heraklion University Hospital, Heraklion, Greece.,Heart Sector, Hygeia Hospitals Group, Athens, Greece
| | | | - Giorgos P Tsironis
- Institute of Theoretical and Computational Physics and Department of Physics, University of Crete, Heraklion, Greece.,Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
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55
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Cho Y, Kwon JM, Kim KH, Medina-Inojosa JR, Jeon KH, Cho S, Lee SY, Park J, Oh BH. Artificial intelligence algorithm for detecting myocardial infarction using six-lead electrocardiography. Sci Rep 2020; 10:20495. [PMID: 33235279 PMCID: PMC7686480 DOI: 10.1038/s41598-020-77599-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/29/2020] [Indexed: 02/03/2023] Open
Abstract
Rapid diagnosis of myocardial infarction (MI) using electrocardiography (ECG) is the cornerstone of effective treatment and prevention of mortality; however, conventional interpretation methods has low reliability for detecting MI and is difficulty to apply to limb 6-lead ECG based life type or wearable devices. We developed and validated a deep learning-based artificial intelligence algorithm (DLA) for detecting MI using 6-lead ECG. A total of 412,461 ECGs were used to develop a variational autoencoder (VAE) that reconstructed precordial 6-lead ECG using limb 6-lead ECG. Data from 9536, 1301, and 1768 ECGs of adult patients who underwent coronary angiography within 24 h from each ECG were used for development, internal and external validation, respectively. During internal and external validation, the area under the receiver operating characteristic curves of the DLA with VAE using a 6-lead ECG were 0.880 and 0.854, respectively, and the performances were preserved by the territory of the coronary lesion. Our DLA successfully detected MI using a 12-lead ECG or a 6-lead ECG. The results indicate that MI could be detected not only with a conventional 12 lead ECG but also with a life type 6-lead ECG device that employs our DLA.
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Affiliation(s)
- Younghoon Cho
- Medical Research and Development Center, Bodyfriend, Seoul, South Korea.,Medical Technology Laboratory, Bodyfriend, Seoul, South Korea
| | - Joon-Myoung Kwon
- Department of Emergency Medicine, Mediplex Sejong Hospital, 20, Gyeyangmunhwa-ro, Gyeyang-gu, Incheon, South Korea. .,Artificial Intelligence and Big Data Research Center, Sejong Medical Research Institute, Bucheon, South Korea. .,Medical Research Team, Medical AI, Seoul, South Korea.
| | - Kyung-Hee Kim
- Artificial Intelligence and Big Data Research Center, Sejong Medical Research Institute, Bucheon, South Korea. .,Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Mediplex Sejong Hospital, 20, Gyeyangmunhwa-ro, Gyeyang-gu, Incheon, South Korea.
| | - Jose R Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ki-Hyun Jeon
- Artificial Intelligence and Big Data Research Center, Sejong Medical Research Institute, Bucheon, South Korea. .,Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Mediplex Sejong Hospital, 20, Gyeyangmunhwa-ro, Gyeyang-gu, Incheon, South Korea.
| | - Soohyun Cho
- Medical Research and Development Center, Bodyfriend, Seoul, South Korea.,Medical Technology Laboratory, Bodyfriend, Seoul, South Korea
| | - Soo Youn Lee
- Artificial Intelligence and Big Data Research Center, Sejong Medical Research Institute, Bucheon, South Korea.,Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Mediplex Sejong Hospital, 20, Gyeyangmunhwa-ro, Gyeyang-gu, Incheon, South Korea
| | - Jinsik Park
- Medical Research Team, Medical AI, Seoul, South Korea.,Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Mediplex Sejong Hospital, 20, Gyeyangmunhwa-ro, Gyeyang-gu, Incheon, South Korea
| | - Byung-Hee Oh
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Mediplex Sejong Hospital, 20, Gyeyangmunhwa-ro, Gyeyang-gu, Incheon, South Korea
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56
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Machine Learning in Electrocardiography and Echocardiography: Technological Advances in Clinical Cardiology. Curr Cardiol Rep 2020; 22:161. [PMID: 33037949 DOI: 10.1007/s11886-020-01416-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Electrocardiography (ECG) and echocardiography are the most widely used diagnostic tools in clinical cardiology. This review focuses on recent advancements in applying machine learning (ML) in ECG and echocardiography and potential synergistic ML integration of ECG and echocardiography. RECENT FINDINGS ML algorithms have been used in ECG for technical quality assurance, arrhythmia identification, and prognostic predictions, and in echocardiography to recognize image views, quantify measurements, and identify pathologic patterns. Synergistic application of ML in ECG and echocardiograph has demonstrated the potential to optimize therapeutic response, improve risk stratification, and generate new disease classification. There is mounting evidence that ML potentially outperforms in disease diagnoses and outcome prediction with ECG and echocardiography when compared with trained healthcare professionals. The applications of ML in ECG and echocardiography are playing increasingly greater roles in medical research and clinical practice, particularly for their contributions to developing novel diagnostic/prognostic prediction models. The automation in data acquisition, processing, and interpretation help streamline the workflows of ECG and echocardiography in contemporary cardiology practice.
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57
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Artificial intelligence algorithm for predicting cardiac arrest using electrocardiography. Scand J Trauma Resusc Emerg Med 2020; 28:98. [PMID: 33023615 PMCID: PMC7541213 DOI: 10.1186/s13049-020-00791-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 09/22/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND In-hospital cardiac arrest is a major burden in health care. Although several track-and-trigger systems are used to predict cardiac arrest, they often have unsatisfactory performances. We hypothesized that a deep-learning-based artificial intelligence algorithm (DLA) could effectively predict cardiac arrest using electrocardiography (ECG). We developed and validated a DLA for predicting cardiac arrest using ECG. METHODS We conducted a retrospective study that included 47,505 ECGs of 25,672 adult patients admitted to two hospitals, who underwent at least one ECG from October 2016 to September 2019. The endpoint was occurrence of cardiac arrest within 24 h from ECG. Using subgroup analyses in patients who were initially classified as non-event, we confirmed the delayed occurrence of cardiac arrest and unexpected intensive care unit transfer over 14 days. RESULTS We used 32,294 ECGs of 10,461 patients and 4483 ECGs of 4483 patients from a hospital were used as development and internal validation data, respectively. Additionally, 10,728 ECGs of 10,728 patients from another hospital were used as external validation data, which confirmed the robustness of the developed DLA. During internal and external validation, the areas under the receiver operating characteristic curves of the DLA in predicting cardiac arrest within 24 h were 0.913 and 0.948, respectively. The high risk group of the DLA showed a significantly higher hazard for delayed cardiac arrest (5.74% vs. 0.33%, P < 0.001) and unexpected intensive care unit transfer (4.23% vs. 0.82%, P < 0.001). A sensitivity map of the DLA displayed the ECG regions used to predict cardiac arrest, with the DLA focused most on the QRS complex. CONCLUSIONS Our DLA successfully predicted cardiac arrest using diverse formats of ECG. The results indicate that cardiac arrest could be screened and predicted not only with a conventional 12-lead ECG, but also with a single-lead ECG using a wearable device that employs our DLA.
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Kabutoya T, Hoshide S, Kario K. Advances and Challenges in the Electrocardiographic Diagnosis of Left Ventricular Hypertrophy in Hypertensive Individuals. Am J Hypertens 2020; 33:819-821. [PMID: 32506126 DOI: 10.1093/ajh/hpaa092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Tomoyuki Kabutoya
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
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59
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Kwon JM, Cho Y, Jeon KH, Cho S, Kim KH, Baek SD, Jeung S, Park J, Oh BH. A deep learning algorithm to detect anaemia with ECGs: a retrospective, multicentre study. LANCET DIGITAL HEALTH 2020; 2:e358-e367. [DOI: 10.1016/s2589-7500(20)30108-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/18/2020] [Accepted: 04/27/2020] [Indexed: 12/13/2022]
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Affiliation(s)
- Patrick A Gladding
- Cardiology Department Waitemata District Health Board Auckland New Zealand.,Auckland Bioengineering Institute Auckland New Zealand
| | - Will Hewitt
- Auckland Bioengineering Institute Auckland New Zealand
| | - Todd T Schlegel
- Department of Clinical Physiology Karolinska Institutet Stockholm Sweden.,Nicollier-Schlegel Sàrl Trélex Switzerland
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61
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Serhani MA, T. El Kassabi H, Ismail H, Nujum Navaz A. ECG Monitoring Systems: Review, Architecture, Processes, and Key Challenges. SENSORS (BASEL, SWITZERLAND) 2020; 20:E1796. [PMID: 32213969 PMCID: PMC7147367 DOI: 10.3390/s20061796] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 02/01/2023]
Abstract
Health monitoring and its related technologies is an attractive research area. The electrocardiogram (ECG) has always been a popular measurement scheme to assess and diagnose cardiovascular diseases (CVDs). The number of ECG monitoring systems in the literature is expanding exponentially. Hence, it is very hard for researchers and healthcare experts to choose, compare, and evaluate systems that serve their needs and fulfill the monitoring requirements. This accentuates the need for a verified reference guiding the design, classification, and analysis of ECG monitoring systems, serving both researchers and professionals in the field. In this paper, we propose a comprehensive, expert-verified taxonomy of ECG monitoring systems and conduct an extensive, systematic review of the literature. This provides evidence-based support for critically understanding ECG monitoring systems' components, contexts, features, and challenges. Hence, a generic architectural model for ECG monitoring systems is proposed, an extensive analysis of ECG monitoring systems' value chain is conducted, and a thorough review of the relevant literature, classified against the experts' taxonomy, is presented, highlighting challenges and current trends. Finally, we identify key challenges and emphasize the importance of smart monitoring systems that leverage new technologies, including deep learning, artificial intelligence (AI), Big Data and Internet of Things (IoT), to provide efficient, cost-aware, and fully connected monitoring systems.
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Affiliation(s)
- Mohamed Adel Serhani
- Department of Information Systems and Security, College of Information Technology, UAE University, Al Ain 15551, United Arab Emirates;
| | - Hadeel T. El Kassabi
- Department of Computer Science and Software Engineering, College of Information Technology, UAE University, Al Ain 15551, United Arab Emirates; (H.T.E.K.)
| | - Heba Ismail
- Department of Computer Science and Software Engineering, College of Information Technology, UAE University, Al Ain 15551, United Arab Emirates; (H.T.E.K.)
| | - Alramzana Nujum Navaz
- Department of Information Systems and Security, College of Information Technology, UAE University, Al Ain 15551, United Arab Emirates;
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Kashou AH, Noseworthy PA. Artificial intelligence capable of detecting left ventricular hypertrophy: pushing the limits of the electrocardiogram? Europace 2020; 22:338-339. [PMID: 31898741 DOI: 10.1093/europace/euz349] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anthony H Kashou
- Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Peter A Noseworthy
- Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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