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Zhang Y, Liu S, He Z, Zhang Y, Wang C. A CNN Model for Cardiac Arrhythmias Classification Based on Individual ECG Signals. Cardiovasc Eng Technol 2022; 13:548-557. [PMID: 34981316 DOI: 10.1007/s13239-021-00599-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 11/18/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE Wearable devices in the scenario of connected home healthcare integrated with artificial intelligence have been an effective alternative to the conventional medical devices. Despite various benefits of wearable electrocardiogram (ECG) device, several deficiencies remain unsolved such as noise problem caused by user mobility. Therefore, an insensitive and robust classification model for cardiac arrhythmias detection system needs to be devised. METHODS A one-dimensional seven-layer convolutional neural network (CNN) classification model with dedicated design of structure and parameters is developed to perform automatic feature extraction and classification based on large volume of original noisy signals. Record-based ten-fold cross validation scheme is devised for evaluation to ensure the independence of the training set and test set, and further improve the robustness of our method. RESULTS The model can effectively detect cardiac arrhythmias, and can reduce the computational workload to a certain extent. Our experimental results outperform most recent literature on the cardiac arrhythmias classification with diagnostic accuracy of 0.9874, sensitivity of 0.9811, and specificity of 0.9905 for original signals; diagnostic accuracy of 0.9876, sensitivity of 0.9813, and specificity of 0.9907 for de-noised signals, respectively. CONCLUSION The evaluation indicates that our proposed approach, which performs well on both original signals and de-noised signals, fits well with wearable ECG monitoring and applications.
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Affiliation(s)
- Yuan Zhang
- Chongqing Key Laboratory of Nonlinear Circuits and Intelligent Information Processing, College of Electronic and Information Engineering, Southwest University, Chongqing, 400715, China.
| | - Sen Liu
- Department of Oncology, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, China
| | - Zhihui He
- Department of Pediatric Respiration, Chongqing Ninth People's Hospital, Chongqing, 400700, China
| | - Yuwei Zhang
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210096, China.
| | - Changming Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
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Scridon A, Halaţiu VB, Balan AI, Cozac DA, Moldovan V, Bănescu C, Perian M, Şerban RC. Long-Term Effects of Ivabradine on Cardiac Vagal Parasympathetic Function in Normal Rats. Front Pharmacol 2021; 12:596956. [PMID: 33897414 PMCID: PMC8061748 DOI: 10.3389/fphar.2021.596956] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/26/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The complex interactions that exist between the pacemaker current, I f, and the parasympathetic nervous system could significantly influence the course of patients undergoing chronic therapy with the I f blocker ivabradine. We thus aimed to assess the effects of chronic ivabradine therapy on autonomic modulation and on the cardiovascular response to in situ and in vitro parasympathetic stimulation. The right atrial expression of HCN genes, encoding proteins for I f, was also evaluated. Methods: Sympathetic and parasympathetic heart rate variability parameters and right atrial HCN(1-4) RNA levels were analyzed in 6 Control and 10 ivabradine-treated male Wistar rats (IVA; 3 weeks, 10 mg/kg/day). The heart rate (HR) and systolic blood pressure (SBP) responses to in situ electrical stimulation of the vagus nerve (2-20 Hz) were assessed in 6 additional Control and 10 IVA rats. The spontaneous sinus node discharge rate (SNDR) response to in vitro cholinergic receptors stimulation using carbamylcholine (10-9-10-6 mol/L) was also assessed in these later rats. Results: Ivabradine significantly increased vagal modulation and shifted the sympatho-vagal balance toward vagal dominance. In Control, in situ vagus nerve stimulation induced progressive decrease in both the SBP (p = 0.0001) and the HR (p< 0.0001). Meanwhile, in IVA, vagal stimulation had no effect on the HR (p = 0.16) and induced a significantly lower drop in SBP (p< 0.05). IVA also displayed a significantly lower SNDR drop in response to carbamylcholine (p< 0.01) and significantly higher right atrial HCN4 expression (p = 0.02). Conclusion: Chronic ivabradine administration enhanced vagal modulation in healthy rats. In addition, ivabradine reduced the HR response to direct muscarinic receptors stimulation, canceled the cardioinhibitory response and blunted the hemodynamic response to in situ vagal stimulation. These data bring new insights into the mechanisms of ivabradine-related atrial proarrhythmia and suggest that long-term I f blockade may protect against excessive bradycardia induced by acute vagal activation.
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Affiliation(s)
- Alina Scridon
- University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Târgu Mureş, Târgu Mureş, Romania.,Center for Advanced Medical and Pharmaceutical Research, Târgu Mureş, Romania
| | - Vasile Bogdan Halaţiu
- University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Târgu Mureş, Târgu Mureş, Romania
| | - Alkora Ioana Balan
- University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Târgu Mureş, Târgu Mureş, Romania
| | - Dan Alexandru Cozac
- University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Târgu Mureş, Târgu Mureş, Romania.,Emergency Institute for Cardiovascular Diseases and Transplantation Târgu Mureş, Târgu Mureş, Romania
| | - Valeriu Moldovan
- University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Târgu Mureş, Târgu Mureş, Romania.,Center for Advanced Medical and Pharmaceutical Research, Târgu Mureş, Romania
| | - Claudia Bănescu
- University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Târgu Mureş, Târgu Mureş, Romania.,Center for Advanced Medical and Pharmaceutical Research, Târgu Mureş, Romania
| | - Marcel Perian
- University of Medicine, Pharmacy, Science and Technology "George Emil Palade" of Târgu Mureş, Târgu Mureş, Romania.,Center for Advanced Medical and Pharmaceutical Research, Târgu Mureş, Romania
| | - Răzvan Constantin Şerban
- Emergency Institute for Cardiovascular Diseases and Transplantation Târgu Mureş, Târgu Mureş, Romania
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Doñate Puertas R, Meugnier E, Romestaing C, Rey C, Morel E, Lachuer J, Gadot N, Scridon A, Julien C, Tronc F, Chapuis B, Valla C, Janin A, Pirola L, Méjat A, Rome S, Chevalier P. Atrial fibrillation is associated with hypermethylation in human left atrium, and treatment with decitabine reduces atrial tachyarrhythmias in spontaneously hypertensive rats. Transl Res 2017; 184:57-67.e5. [PMID: 28427903 DOI: 10.1016/j.trsl.2017.03.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 03/13/2017] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia. As the molecular mechanisms underlying the pathology are largely unknown, this cardiac arrhythmia remains difficult to treat. To identify specific molecular actors involved in AF, we have performed a transcriptomic analysis on left atrium (LA) from patients with valvular heart disease with or without AF. We showed that 1627 genes had altered basal expression level in LA tissue of AF patients compared with the control group. The significantly enriched gene ontology biological process "anatomical structure morphogenesis" contained the highest number of genes in line with changes in structure that occur when the human heart remodels following AF development (ie, LA dilatation and interstitial fibrosis). We then focused the study on Pitx2 (paired-like homeodomain 2), being the most altered transcription factor in LA from AF patients and from which compelling evidence have indicated that its reduced expression can be considered as a marker for the disease. In addition, its expression was inversely correlated with LA size. We demonstrated that AF is associated with Pitx2 promoter hypermethylation both in humans and arrhythmic aging spontaneously hypertensive rats. Chronic administration of a DNA methylation inhibitor (ie, 5-Aza-2'-deoxycitidine) improved ECG arrhythmic profiles and superoxide dismutase activities and reduced fibrosis in the left ventricle of spontaneously hypertensive rats. Taken together, these data support the notion that AF is associated with epigenetic changes in LA and provide a proof-of-concept that hypomethylating agents have to be considered in the treatment of atrial arrhythmias.
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Affiliation(s)
| | - E Meugnier
- CarMeN Laboratory (UMR INSERM 1060-INRA 1397, INSA), Lyon-Sud Faculty of Medicine, University of Lyon, Pierre-Bénite, France
| | - C Romestaing
- LEHNA Laboratory, CNRS, UMR 5023, University of Lyon, Villeurbanne, France
| | - C Rey
- ProfilXpert, UNIV-US7 INSERM-UMS 3453 CNRS, Lyon, France
| | - E Morel
- Rhythmology Unit, Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Bron, France
| | - J Lachuer
- ProfilXpert, UNIV-US7 INSERM-UMS 3453 CNRS, Lyon, France
| | - N Gadot
- Plateform Anipath, Laënnec Faculty of Medecine, University of Lyon, Lyon, France
| | - A Scridon
- Physiology Department, University of Medicine and Pharmacy of Tîrgu Mures, Tîrgu Mures, Romania
| | - C Julien
- EA 4612 Neurocardiology unit, University of Lyon, Lyon, France
| | - F Tronc
- Pneumology Unit, Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Bron, France
| | - B Chapuis
- EA 4612 Neurocardiology unit, University of Lyon, Lyon, France
| | - C Valla
- Institut NeuroMyoGene (INMG), UMR CNRS 5310-INSERM U1217 / University of Lyon, Lyon, France
| | - A Janin
- Institut NeuroMyoGene (INMG), UMR CNRS 5310-INSERM U1217 / University of Lyon, Lyon, France
| | - L Pirola
- CarMeN Laboratory (UMR INSERM 1060-INRA 1397, INSA), Lyon-Sud Faculty of Medicine, University of Lyon, Pierre-Bénite, France
| | - A Méjat
- Institut NeuroMyoGene (INMG), UMR CNRS 5310-INSERM U1217 / University of Lyon, Lyon, France
| | - S Rome
- CarMeN Laboratory (UMR INSERM 1060-INRA 1397, INSA), Lyon-Sud Faculty of Medicine, University of Lyon, Pierre-Bénite, France
| | - Philippe Chevalier
- EA 4612 Neurocardiology unit, University of Lyon, Lyon, France; Rhythmology Unit, Louis Pradel Cardiology Hospital, Hospices Civils de Lyon, Bron, France.
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Kim YJ, Heo J, Park KS, Kim S. Proposition of novel classification approach and features for improved real-time arrhythmia monitoring. Comput Biol Med 2016; 75:190-202. [PMID: 27318329 DOI: 10.1016/j.compbiomed.2016.06.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 06/03/2016] [Accepted: 06/07/2016] [Indexed: 12/13/2022]
Abstract
Arrhythmia refers to a group of conditions in which the heartbeat is irregular, fast, or slow due to abnormal electrical activity in the heart. Some types of arrhythmia such as ventricular fibrillation may result in cardiac arrest or death. Thus, arrhythmia detection becomes an important issue, and various studies have been conducted. Additionally, an arrhythmia detection algorithm for portable devices such as mobile phones has recently been developed because of increasing interest in e-health care. This paper proposes a novel classification approach and features, which are validated for improved real-time arrhythmia monitoring. The classification approach that was employed for arrhythmia detection is based on the concept of ensemble learning and the Taguchi method and has the advantage of being accurate and computationally efficient. The electrocardiography (ECG) data for arrhythmia detection was obtained from the MIT-BIH Arrhythmia Database (n=48). A novel feature, namely the heart rate variability calculated from 5s segments of ECG, which was not considered previously, was used. The novel classification approach and feature demonstrated arrhythmia detection accuracy of 89.13%. When the same data was classified using the conventional support vector machine (SVM), the obtained accuracy was 91.69%, 88.14%, and 88.74% for Gaussian, linear, and polynomial kernels, respectively. In terms of computation time, the proposed classifier was 5821.7 times faster than conventional SVM. In conclusion, the proposed classifier and feature showed performance comparable to those of previous studies, while the computational complexity and update interval were highly reduced.
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Affiliation(s)
- Yoon Jae Kim
- Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul 08826, Republic of Korea.
| | - Jeong Heo
- Interdisciplinary Program for Bioengineering, Graduate School, Seoul National University, Seoul 08826, Republic of Korea.
| | - Kwang Suk Park
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea.
| | - Sungwan Kim
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea.
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Assessment of cardiac autonomic tone in conscious rats. Auton Neurosci 2016; 194:26-31. [PMID: 26769133 DOI: 10.1016/j.autneu.2015.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/17/2015] [Accepted: 12/25/2015] [Indexed: 01/08/2023]
Abstract
Cardiac autonomic tone can be assessed either by estimating separately vagal and sympathetic tones or by evaluating the net effect of their interaction, the so-called sympathovagal balance (SVB). To compare the most commonly used methods in rats, telemetric recordings of the electrocardiogram were performed in normotensive WKY rats, and in groups of spontaneously hypertensive (SHR) rats that were either untreated or chronically treated with the cholinesterase inhibitor, pyridostigmine, to enhance vagal tone. Cardiac autonomic blockers were administered alone and in combination, so that heart rate (HR) could be measured (1) under resting conditions, (2) with either autonomic branch blocked, and (3) with both branches blocked (which provided intrinsic HR, iHR). SVB was assessed as the ratio of resting HR to iHR. This calculation pointed to a sympathetic predominance in untreated SHRs and even more so in WKY rats, and to a marked vagal predominance in pyridostigmine-treated SHRs. By contrast, the ratio between low and high frequency components (LF/HF) of RR interval spectra did not significantly differ between the groups. Each autonomic tone was quantified as the HR change induced by its selective blocker or as the difference between iHR and HR after blockade of its counterpart. Both pharmacological methods indicated vagal enhancement in treated SHRs, but provided opposite results in terms of vagal vs. sympathetic predominance. These data seriously question the use of the LF/HF ratio as an index of SVB, and the possibility to reliably estimate vagal and sympathetic tones separately through current pharmacological approaches in conscious rats.
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Sayin H, Scridon A, Oréa V, Chapuis B, Chevalier P, Barrès C, Julien C. Pyridostigmine enhances atrial tachyarrhythmias in aging spontaneously hypertensive rats. Clin Exp Pharmacol Physiol 2015; 42:1084-91. [DOI: 10.1111/1440-1681.12458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/06/2015] [Accepted: 07/07/2015] [Indexed: 02/01/2023]
Affiliation(s)
- Halil Sayin
- Neurocardiology Unit; Medical School Lyon East; University Claude Bernard Lyon 1; Lyon France
| | - Alina Scridon
- Physiology Department; University of Medicine and Pharmacy of Tîrgu Mureș; Tîrgu Mureș Romania
| | - Valérie Oréa
- Laboratory of Tissue Biology and Therapeutic Engineering; National Center for Scientific Research UMR 5305 and Technical Platform ANIPHY; University Claude Bernard Lyon 1; Lyon France
| | - Bruno Chapuis
- Neurocardiology Unit; Medical School Lyon East; University Claude Bernard Lyon 1; Lyon France
| | - Philippe Chevalier
- Neurocardiology Unit; Medical School Lyon East; University Claude Bernard Lyon 1; Lyon France
- Rhythmology Department; Louis Pradel Cardiology Hospital; Hospices Civils de Lyon; Bron France
| | - Christian Barrès
- Neurocardiology Unit; Medical School Lyon East; University Claude Bernard Lyon 1; Lyon France
| | - Claude Julien
- Neurocardiology Unit; Medical School Lyon East; University Claude Bernard Lyon 1; Lyon France
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