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Nguyen MT, Nguyen THT, Le HC. A review of progress and an advanced method for shock advice algorithms in automated external defibrillators. Biomed Eng Online 2022; 21:22. [PMID: 35366906 PMCID: PMC8976411 DOI: 10.1186/s12938-022-00993-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 03/23/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractShock advice algorithm plays a vital role in the detection of sudden cardiac arrests on electrocardiogram signals and hence, brings about survival improvement by delivering prompt defibrillation. The last decade has witnessed a surge of research efforts in racing for efficient shock advice algorithms, in this context. On one hand, it has been reported that the classification performance of traditional threshold-based methods has not complied with the American Heart Association recommendations. On the other hand, the rise of machine learning and deep learning-based counterparts is paving the new ways for the development of intelligent shock advice algorithms. In this paper, we firstly provide a comprehensive survey on the development of shock advice algorithms for rhythm analysis in automated external defibrillators. Shock advice algorithms are categorized into three groups based on the classification methods in which the detection performance is significantly improved by the use of machine learning and/or deep learning techniques instead of threshold-based approaches. Indeed, in threshold-based shock advice algorithms, a parameter is calculated as a threshold to distinguish shockable rhythms from non-shockable ones. In contrast, machine learning-based methods combine multiple parameters of conventional threshold-based approaches as a set of features to recognize sudden cardiac arrest. Noticeably, those features are possibly extracted from stand-alone ECGs, alternative signals using various decomposition techniques, or fully augmented ECG segments. Moreover, these signals can be also used directly as the input channels of deep learning-based shock advice algorithm designs. Then, we propose an advanced shock advice algorithm using a support vector machine classifier and a feature set extracted from a fully augmented ECG segment with its shockable and non-shockable signals. The relatively high detection performance of the proposed shock advice algorithm implies a potential application for the automated external defibrillator in the practical clinic environment. Finally, we outline several interesting yet challenging research problems for further investigation.
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Automatic cardiac arrhythmia classification based on hybrid 1-D CNN and Bi-LSTM model. Biocybern Biomed Eng 2022. [DOI: 10.1016/j.bbe.2022.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Radhakrishnan T, Karhade J, Ghosh SK, Muduli PR, Tripathy RK, Acharya UR. AFCNNet: Automated detection of AF using chirplet transform and deep convolutional bidirectional long short term memory network with ECG signals. Comput Biol Med 2021; 137:104783. [PMID: 34481184 DOI: 10.1016/j.compbiomed.2021.104783] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Abstract
Atrial fibrillation (AF) is the most common type of cardiac arrhythmia and is characterized by the heart's beating in an uncoordinated manner. In clinical studies, patients often do not have visible symptoms during AF, and hence it is harder to detect this cardiac ailment. Therefore, automated detection of AF using the electrocardiogram (ECG) signals can reduce the risk of stroke, coronary artery disease, and other cardiovascular complications. In this paper, a novel time-frequency domain deep learning-based approach is proposed to detect AF and classify terminating and non-terminating AF episodes using ECG signals. This approach involves evaluating the time-frequency representation (TFR) of ECG signals using the chirplet transform. The two-dimensional (2D) deep convolutional bidirectional long short-term memory (BLSTM) neural network model is used to detect and classify AF episodes using the time-frequency images of ECG signals. The proposed TFR based 2D deep learning approach is evaluated using the ECG signals from three public databases. Our developed approach has obtained an accuracy, sensitivity, and specificity of 99.18% (Confidence interval (CI) as [98.86, 99.49]), 99.17% (CI as [98.85 99.49]), and 99.18% (CI as [98.86 99.49]), respectively, with 10-fold cross-validation (CV) technique to detect AF automatically. The proposed approach also classified terminating and non-terminating AF episodes with an average accuracy of 75.86%. The average accuracy value obtained using the proposed approach is higher than the short-time Fourier transform (STFT), discrete-time continuous wavelet transform (DT-CWT), and Stockwell transform (ST) based time-frequency analysis methods with deep convolutional BLSTM models to detect AF. The proposed approach has better AF detection performance than the existing deep learning-based techniques using ECG signals from the MIT-BIH database.
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Affiliation(s)
- Tejas Radhakrishnan
- Department of Electrical and Electronics Engineering, BITS-Pilani, Hyderabad Campus, Hyderabad, 500078, India
| | - Jay Karhade
- Department of Electrical and Electronics Engineering, BITS-Pilani, Hyderabad Campus, Hyderabad, 500078, India
| | - S K Ghosh
- Department of Electrical and Electronics Engineering, BITS-Pilani, Hyderabad Campus, Hyderabad, 500078, India
| | - P R Muduli
- Department of Electronics Engineering, Indian Institute of Technology (BHU), Varanasi, Uttar Pradesh, 221005, India
| | - R K Tripathy
- Department of Electrical and Electronics Engineering, BITS-Pilani, Hyderabad Campus, Hyderabad, 500078, India.
| | - U Rajendra Acharya
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan; Department of Biomedical Engineering, School of Science and Technology, SUSS University, Singapore
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Idrobo-Ávila E, Loaiza-Correa H, Muñoz-Bolaños F, van Noorden L, Vargas-Cañas R. A Proposal for a Data-Driven Approach to the Influence of Music on Heart Dynamics. Front Cardiovasc Med 2021; 8:699145. [PMID: 34490368 PMCID: PMC8417899 DOI: 10.3389/fcvm.2021.699145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/20/2021] [Indexed: 11/13/2022] Open
Abstract
Electrocardiographic signals (ECG) and heart rate viability measurements (HRV) provide information in a range of specialist fields, extending to musical perception. The ECG signal records heart electrical activity, while HRV reflects the state or condition of the autonomic nervous system. HRV has been studied as a marker of diverse psychological and physical diseases including coronary heart disease, myocardial infarction, and stroke. HRV has also been used to observe the effects of medicines, the impact of exercise and the analysis of emotional responses and evaluation of effects of various quantifiable elements of sound and music on the human body. Variations in blood pressure, levels of stress or anxiety, subjective sensations and even changes in emotions constitute multiple aspects that may well-react or respond to musical stimuli. Although both ECG and HRV continue to feature extensively in research in health and perception, methodologies vary substantially. This makes it difficult to compare studies, with researchers making recommendations to improve experiment planning and the analysis and reporting of data. The present work provides a methodological framework to examine the effect of sound on ECG and HRV with the aim of associating musical structures and noise to the signals by means of artificial intelligence (AI); it first presents a way to select experimental study subjects in light of the research aims and then offers possibilities for selecting and producing suitable sound stimuli; once sounds have been selected, a guide is proposed for optimal experimental design. Finally, a framework is introduced for analysis of data and signals, based on both conventional as well as data-driven AI tools. AI is able to study big data at a single stroke, can be applied to different types of data, and is capable of generalisation and so is considered the main tool in the analysis.
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Affiliation(s)
- Ennio Idrobo-Ávila
- Escuela de Ingeniería Eléctrica y Electrónica, PSI - Percepción y Sistemas Inteligentes, Universidad del Valle, Cali, Colombia
| | - Humberto Loaiza-Correa
- Escuela de Ingeniería Eléctrica y Electrónica, PSI - Percepción y Sistemas Inteligentes, Universidad del Valle, Cali, Colombia
| | - Flavio Muñoz-Bolaños
- Departamento de Ciencias Fisiológicas, CIFIEX - Ciencias Fisiológicas Experimentales, Universidad del Cauca, Popayán, Colombia
| | - Leon van Noorden
- Department of Art, Music, and Theatre Sciences, IPEM—Institute for Systematic Musicology, Ghent University, Ghent, Belgium
| | - Rubiel Vargas-Cañas
- Departamento de Física, SIDICO - Sistemas Dinámicos, Instrumentación y Control, Universidad del Cauca, Popayán, Colombia
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Mandal S, Roy AH, Mondal P. Automated detection of fibrillations and flutters based on fused feature set and ANFIS classifier. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Han D, Bashar SK, Mohagheghian F, Ding E, Whitcomb C, McManus DD, Chon KH. Premature Atrial and Ventricular Contraction Detection using Photoplethysmographic Data from a Smartwatch. SENSORS (BASEL, SWITZERLAND) 2020; 20:E5683. [PMID: 33028000 PMCID: PMC7582300 DOI: 10.3390/s20195683] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/19/2020] [Accepted: 09/30/2020] [Indexed: 12/12/2022]
Abstract
We developed an algorithm to detect premature atrial contraction (PAC) and premature ventricular contraction (PVC) using photoplethysmographic (PPG) data acquired from a smartwatch. Our PAC/PVC detection algorithm is composed of a sequence of algorithms that are combined to discriminate various arrhythmias. A novel vector resemblance method is used to enhance the PAC/PVC detection results of the Poincaré plot method. The new PAC/PVC detection algorithm with our automated motion and noise artifact detection approach yielded a sensitivity of 86% for atrial fibrillation (AF) subjects while the overall sensitivity was 67% when normal sinus rhythm (NSR) subjects were also included. The specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy values for the combined data consisting of both NSR and AF subjects were 97%, 81%, 94% and 92%, respectively, for PAC/PVC detection combined with our automated motion and noise artifact detection approach. Moreover, when AF detection was compared with and without PAC/PVC, the sensitivity and specificity increased from 94.55% to 98.18% and from 95.75% to 97.90%, respectively. For additional independent testing data, we used two datasets: a smartwatch PPG dataset that was collected in our ongoing clinical study, and a pulse oximetry PPG dataset from the Medical Information Mart for Intensive Care III database. The PAC/PVC classification results of the independent testing on these two other datasets are all above 92% for sensitivity, specificity, PPV, NPV, and accuracy. The proposed combined approach to detect PAC and PVC can ultimately lead to better accuracy in AF detection. This is one of the first studies involving detection of PAC and PVC using PPG recordings from a smartwatch. The proposed method can potentially be of clinical importance as this enhanced capability can lead to fewer false positive detections of AF, especially for those NSR subjects with frequent episodes of PAC/PVC.
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Affiliation(s)
- Dong Han
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA; (D.H.); (S.K.B.); (F.M.)
| | - Syed Khairul Bashar
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA; (D.H.); (S.K.B.); (F.M.)
| | - Fahimeh Mohagheghian
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA; (D.H.); (S.K.B.); (F.M.)
| | - Eric Ding
- Division of Cardiology, University of Massachusetts Medical School, Worcester, MA 01655, USA; (E.D.); (C.W.); (D.D.M.)
| | - Cody Whitcomb
- Division of Cardiology, University of Massachusetts Medical School, Worcester, MA 01655, USA; (E.D.); (C.W.); (D.D.M.)
| | - David D. McManus
- Division of Cardiology, University of Massachusetts Medical School, Worcester, MA 01655, USA; (E.D.); (C.W.); (D.D.M.)
| | - Ki H. Chon
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA; (D.H.); (S.K.B.); (F.M.)
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Ghosh SK, Tripathy RK, Paternina MRA, Arrieta JJ, Zamora-Mendez A, Naik GR. Detection of Atrial Fibrillation from Single Lead ECG Signal Using Multirate Cosine Filter Bank and Deep Neural Network. J Med Syst 2020; 44:114. [PMID: 32388733 DOI: 10.1007/s10916-020-01565-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/31/2020] [Indexed: 12/14/2022]
Abstract
Atrial fibrillation (AF) is a cardiac arrhythmia which is characterized based on the irregsular beating of atria, resulting in, the abnormal atrial patterns that are observed in the electrocardiogram (ECG) signal. The early detection of this pathology is very helpful for minimizing the chances of stroke, other heart-related disorders, and coronary artery diseases. This paper proposes a novel method for the detection of AF pathology based on the analysis of the ECG signal. The method adopts a multi-rate cosine filter bank architecture for the evaluation of coefficients from the ECG signal at different subbands, in turn, the Fractional norm (FN) feature is evaluated from the extracted coefficients at each subband. Then, the AF detection is carried out using a deep learning approach known as the Hierarchical Extreme Learning Machine (H-ELM) from the FN features. The proposed method is evaluated by considering normal and AF pathological ECG signals from public databases. The experimental results reveal that the proposed multi-rate cosine filter bank based on FN features is effective for the detection of AF pathology with an accuracy, sensitivity and specificity values of 99.40%, 98.77%, and 100%, respectively. The performance of the proposed diagnostic features of the ECG signal is compared with other existing features for the detection of AF. The low-frequency subband FN features found to be more significant with a difference of the mean values as 0.69 between normal and AF classes.
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Affiliation(s)
- S K Ghosh
- MLR Institute of Technology, Hyderabad, India
| | - R K Tripathy
- Birla Institute of Technology and Science Pilani, Hyderabad, India.
| | - Mario R A Paternina
- National Autonomous University of Mexico (UNAM), Mexico City, Mex. 04510, Mexico
| | | | | | - Ganesh R Naik
- Biomedical Engineering and Neuromorphic Systems (BENS) Research Group, MARCS Institute, Western Sydney University, Penrith, New South Wales, Australia
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Shi H, Wang H, Qin C, Zhao L, Liu C. An incremental learning system for atrial fibrillation detection based on transfer learning and active learning. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 187:105219. [PMID: 31786450 DOI: 10.1016/j.cmpb.2019.105219] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/05/2019] [Accepted: 11/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Atrial fibrillation (AF) is a type of arrhythmia with high incidence. Automatic AF detection methods have been studied in previous works. However, a model cannot be used all the time without any improvement. And updating model requires adequate data and cost. Therefore, this study aims at finding a low-cost way to choose learning samples and developing an incremental learning system for AF detection. METHODS Based on transfer learning and active learning, this paper proposed a loop-locked framework integrating AF diagnose, label query, and model fine-tuning. In the pre-training stage, a novel multiple-input deep neural network (MIDNN) is pre-trained using labeled samples from an original training set. In practical application, the model can be used for AF detection. Meanwhile, continuous data is collected to form the candidate set. In the incremental learning stage, the model was fine-tuned continuously by the most informative samples in the candidate set. These samples are selected from the candidate set based on the pre-trained model and a new active learning strategy. The strategy combines the features and the uncertainty of the predicted results. RESULTS In order to evaluate the method, the MIT-BIH atrial fibrillation database was used for pre-training and samples of the MIT-BIH arrhythmia database were taken as candidate set. The initial values of Acc, Sen, and PPV were 87.40%, 97.46%, and 81.11%. These indexes reached to the top values of 97.53%, 100.00%, and 95.29% after 14 iterations. Hence, the number of queries was saved by 90.67%. CONCLUSIONS The proposed system is able to update the model continuously and reduce the labeling cost over 90%. The comparisons demonstrated the effectiveness of MIDNN model and the suitability of novel learning strategy for AF. Moreover, this framework can be extended to other biomedical applications.
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Affiliation(s)
- Haotian Shi
- School of Mechanical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, PR China
| | - Haoren Wang
- School of Mechanical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, PR China
| | - Chengjin Qin
- School of Mechanical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, PR China
| | - Liqun Zhao
- Department of Cardiology, Shanghai First People's Hospital Affiliated to Shanghai Jiao Tong University, 100, Haining Road, Shanghai 200080, PR China
| | - Chengliang Liu
- School of Mechanical Engineering, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, PR China.
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TRIPATHY RK, PATERNINA MARIORARRIETA, ARRIETA JUANG, PATTANAIK P. AUTOMATED DETECTION OF ATRIAL FIBRILLATION ECG SIGNALS USING TWO STAGE VMD AND ATRIAL FIBRILLATION DIAGNOSIS INDEX. J MECH MED BIOL 2017. [DOI: 10.1142/s0219519417400449] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Atrial fibrillation (AF) is a common atrial arrhythmia occurring in clinical practice and can be diagnosed using electrocardiogram (ECG) signal. The conventional diagnostic features of ECG signal are not enough to quantify the pathological variations during AF. Therefore, an automated detection of AF pathology using the new diagnostic features of ECG signal is required. This paper proposes a novel method for the detection of AF using ECG signals. In this work, we are using a novel nonlinear method namely, the two-stage variational mode decomposition (VMD) to analyze ECG and deep belief network (DBN) for automated AF detection. First, the ECG signals of both normal sinus rhythm (NSR) and AF classes are decomposed into different modes using VMD. The first mode of VMD is decomposed in the second stage as this mode captures the atrial activity (AA) information during AF. The remaining modes of ECG captures the ventricular activity information. The sample entropy (SE) and the VMD estimated center frequency features are extracted from the sub-modes of AA mode and ventricular activity modes. These extracted features coupled with DBN classifier is able to classify normal and AF ECG signals with an accuracy, sensitivity and specificity values of 98.27%, 97.77% and 98.67%, respectively. We have developed an atrial fibrillation diagnosis index (AFDI) using selected SE and center frequency features to detect AF with a single number. The system is ready to be tested on huge database and can be used in main hospitals to detect AF ECG classes.
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Affiliation(s)
- R. K. TRIPATHY
- Faculty of Engineering and Technology (ITER), S‘O’A University, Bhubaneswar 751030, India
| | - MARIO R. ARRIETA PATERNINA
- Department of Electrical Engineering, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | | | - P. PATTANAIK
- Faculty of Engineering and Technology (ITER), S‘O’A University, Bhubaneswar 751030, India
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