Diagnosis of shockable rhythms for automated external defibrillators using a reliable support vector machine classifier

Artificial intelligence and machine learning in prehospital emergency care: A scoping review

Our scoping review provides a comprehensive analysis of the landscape of artificial intelligence (AI) applications in prehospital emergency care (PEC). It contributes to the field by highlighting the most studied AI applications and identifying the most common methodological approaches across 106 included studies. The findings indicate a promising future for AI in PEC, with many unique use cases, such as prognostication, demand prediction, resource optimization, and the Internet of Things continuous monitoring systems. Comparisons with other approaches showed AI outperforming clinicians and non-AI algorithms in most cases. However, most studies were internally validated and retrospective, highlighting the need for rigorous prospective validation of AI applications before implementation in clinical settings. We identified knowledge and methodological gaps using an evidence map, offering a roadmap for future investigators. We also discussed the significance of explainable AI for establishing trust in AI systems among clinicians and facilitating real-world validation of AI models.

Diagnosis of sudden cardiac arrest using principal component analysis in automated external defibrillators

Sudden cardiac arrest (SCA) consisting of ventricular fibrillation and ventricular tachycardia considered as shockable rhythms is a life-threatening heart disease, which is treated efficiently by the automated external defibrillator (AED). This work proposes a novel design of the SAA, which includes a k-nearest neighbors model and a subset of 8 features extracted from the ECG segments, for the SCA diagnosis on the electrocardiogram (ECG) signal. These features are addressed as the most productive subset among 31 input features based on the evaluation of the feature correlation. The recursive feature elimination algorithm combined with the Boosting model and wise-patient fivefold cross-validation method is adopted for the calculation of the average feature importance, which shows the degree of feature correlation, to construct various input feature subsets. Moreover, component feature combinations known as the representatives of the input feature subsets with an enormous level of correlation and independence are transformed from the input subsets by the principal component analysis method. The wise-patient fivefold cross-validation procedure is used for the evaluation of these component feature combinations on the validation set. The proposed SAA is certainly efficient for SCA detection with a small number of the extracted feature and relatively high diagnosis performance such as accuracy of 99.52%, sensitivity of 97.69%, and specificity of 99.91%.

E-Cardiac Care: A Comprehensive Systematic Literature Review

The Internet of Things (IoT) is a complete ecosystem encompassing various communication technologies, sensors, hardware, and software. IoT cutting-edge technologies and Artificial Intelligence (AI) have enhanced the traditional healthcare system considerably. The conventional healthcare system faces many challenges, including avoidable long wait times, high costs, a conventional method of payment, unnecessary long travel to medical centers, and mandatory periodic doctor visits. A Smart healthcare system, Internet of Things (IoT), and AI are arguably the best-suited tailor-made solutions for all the flaws related to traditional healthcare systems. The primary goal of this study is to determine the impact of IoT, AI, various communication technologies, sensor networks, and disease detection/diagnosis in Cardiac healthcare through a systematic analysis of scholarly articles. Hence, a total of 104 fundamental studies are analyzed for the research questions purposefully defined for this systematic study. The review results show that deep learning emerges as a promising technology along with the combination of IoT in the domain of E-Cardiac care with enhanced accuracy and real-time clinical monitoring. This study also pins down the key benefits and significant challenges for E-Cardiology in the domains of IoT and AI. It further identifies the gaps and future research directions related to E-Cardiology, monitoring various Cardiac parameters, and diagnosis patterns.

A review of progress and an advanced method for shock advice algorithms in automated external defibrillators

Shock 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.

LDIAED: A lightweight deep learning algorithm implementable on automated external defibrillators

Differentiating between shockable and non-shockable Electrocardiogram (ECG) signals would increase the success of resuscitation by the Automated External Defibrillators (AED). In this study, a Deep Neural Network (DNN) algorithm is used to distinguish 1.4-second segment shockable signals from non-shockable signals promptly. The proposed technique is frequency-independent and is trained with signals from diverse patients extracted from MIT-BIH, MIT-BIH Malignant Ventricular Ectopy Database (VFDB), and a database for ventricular tachyarrhythmia signals from Creighton University (CUDB) resulting, in an accuracy of 99.1%. Finally, the raspberry pi minicomputer is used to load the optimized version of the model on it. Testing the implemented model on the processor by unseen ECG signals resulted in an average latency of 0.845 seconds meeting the IEC 60601-2-4 requirements. According to the evaluated results, the proposed technique could be used by AED’s.

Deep Feature Learning for Sudden Cardiac Arrest Detection in Automated External Defibrillators

Ventricular fibrillation and ventricular tachycardia (VF/VT), known as shockable (SH) rhythms, are the mainly cause of sudden cardiac arrests (SCA), which is cured efficiently by the automated external defibrillator (AED). The performance of the shock advice algorithm (SAA) applied in the AED has been improved by using machine learning technique and variously conventional features, recently. In this paper, we propose a novel algorithm with relatively high performance for the SCA detection on electrocardiogram (ECG) signal. The algorithm consists of a convolutional neural network as a feature extractor (CNNE) and a Boosting (BS) classifier. A grid search with nested 5-folds cross validation (CV) is used to select the CNNE trained with preprocessed ECG, SH, and NSH signals using the modified variational mode decomposition technique. The deep feature vector learned by this CNNE is extracted at the first fully connected layer and then fed into BS classifier to validate its performance using 5-folds CV procedure. The secondary learning of the BS classifier and the use of three input channels for the CNNE improve certainly the detection performance of the proposed SAA with the validated accuracy of 99.26%, sensitivity of 97.07%, and specificity of 99.44%.