VFPred: A fusion of signal processing and machine learning techniques in detecting ventricular fibrillation from ECG signals

An artificial intelligence-enabled Holter algorithm to identify patients with ventricular tachycardia by analysing their electrocardiogram during sinus rhythm

Aims

Ventricular tachycardia (VT) is a dangerous cardiac arrhythmia that can lead to sudden cardiac death. Early detection and management of VT is thus of high clinical importance. We hypothesize that it is possible to identify patients with VT during sinus rhythm by leveraging a continuous 24 h Holter electrocardiogram and artificial intelligence.

Methods and results

We analysed a retrospective Holter data set from the Rambam Health Care Campus, Haifa, Israel, which included 1773 Holter recordings from 1570 non-VT patients and 52 recordings from 49 VT patients. Morphological and heart rate variability features were engineered from the raw electrocardiogram signal and fed, together with demographical features, to a data-driven model for the task of classifying a patient as either VT or non-VT. The model obtained an area under the receiving operative curve of 0.76 ± 0.07. Feature importance suggested that the proportion of premature ventricular beats and beat-to-beat interval variability was discriminative of VT, while demographic features were not.

Conclusion

This original study demonstrates the feasibility of VT identification from sinus rhythm in Holter.

Efficient Extraction of Deep Image Features Using a Convolutional Neural Network (CNN) for Detecting Ventricular Fibrillation and Tachycardia

To safely select the proper therapy for ventricular fibrillation (VF), it is essential to distinguish it correctly from ventricular tachycardia (VT) and other rhythms. Provided that the required therapy is not the same, an erroneous detection might lead to serious injuries to the patient or even cause ventricular fibrillation (VF). The primary innovation of this study lies in employing a CNN to create new features. These features exhibit the capacity and precision to detect and classify cardiac arrhythmias, including VF and VT. The electrocardiographic (ECG) signals utilized for this assessment were sourced from the established MIT-BIH and AHA databases. The input data to be classified are time-frequency (tf) representation images, specifically, Pseudo Wigner-Ville (PWV). Previous to Pseudo Wigner-Ville (PWV) calculation, preprocessing for denoising, signal alignment, and segmentation is necessary. In order to check the validity of the method independently of the classifier, four different CNNs are used: InceptionV3, MobilNet, VGGNet and AlexNet. The classification results reveal the following values: for VF detection, there is a sensitivity (Sens) of 98.16%, a specificity (Spe) of 99.07%, and an accuracy (Acc) of 98.91%; for ventricular tachycardia (VT), the sensitivity is 90.45%, the specificity is 99.73%, and the accuracy is 99.09%; for normal sinus rhythms, sensitivity stands at 99.34%, specificity is 98.35%, and accuracy is 98.89%; finally, for other rhythms, the sensitivity is 96.98%, the specificity is 99.68%, and the accuracy is 99.11%. Furthermore, distinguishing between shockable (VF/VT) and non-shockable rhythms yielded a sensitivity of 99.23%, a specificity of 99.74%, and an accuracy of 99.61%. The results show that using tf representations as a form of image, combined in this case with a CNN classifier, raises the classification performance above the results in previous works. Considering that these results were achieved without the preselection of ECG episodes, it can be concluded that these features may be successfully introduced in Automated External Defibrillation (AED) and Implantable Cardioverter Defibrillation (ICD) therapies, also opening the door to their use in other ECG rhythm detection applications.

Ventricular Fibrillation and Tachycardia Detection Using Features Derived from Topological Data Analysis

A rapid and accurate detection of ventricular arrhythmias is essential to take appropriate therapeutic actions when cardiac arrhythmias occur. Furthermore, the accurate discrimination between arrhythmias is also important, provided that the required shocking therapy would not be the same. In this work, the main novelty is the use of the mathematical method known as Topological Data Analysis (TDA) to generate new types of features which can contribute to the improvement of the detection and classification performance of cardiac arrhythmias such as Ventricular Fibrillation (VF) and Ventricular Tachycardia (VT). The electrocardiographic (ECG) signals used for this evaluation were obtained from the standard MIT-BIH and AHA databases. Two input data to the classify are evaluated: TDA features, and Persistence Diagram Image (PDI). Using the reduced TDA-obtained features, a high average accuracy near 99% was observed when discriminating four types of rhythms (98.68% to VF; 99.05% to VT; 98.76% to normal sinus; and 99.09% to Other rhythms) with specificity values higher than 97.16% in all cases. In addition, a higher accuracy of 99.51% was obtained when discriminating between shockable (VT/VF) and non-shockable rhythms (99.03% sensitivity and 99.67% specificity). These results show that the use of TDA-derived geometric features, combined in this case this the k-Nearest Neighbor (kNN) classifier, raises the classification performance above results in previous works. Considering that these results have been achieved without preselection of ECG episodes, it can be concluded that these features may be successfully introduced in Automated External Defibrillation (AED) and Implantable Cardioverter Defibrillation (ICD) therapies.

A machine-learning approach for long-term prediction of experimental cardiac action potential time series using an autoencoder and echo state networks

Computational modeling and experimental/clinical prediction of the complex signals during cardiac arrhythmias have the potential to lead to new approaches for prevention and treatment. Machine-learning (ML) and deep-learning approaches can be used for time-series forecasting and have recently been applied to cardiac electrophysiology. While the high spatiotemporal nonlinearity of cardiac electrical dynamics has hindered application of these approaches, the fact that cardiac voltage time series are not random suggests that reliable and efficient ML methods have the potential to predict future action potentials. This work introduces and evaluates an integrated architecture in which a long short-term memory autoencoder (AE) is integrated into the echo state network (ESN) framework. In this approach, the AE learns a compressed representation of the input nonlinear time series. Then, the trained encoder serves as a feature-extraction component, feeding the learned features into the recurrent ESN reservoir. The proposed AE-ESN approach is evaluated using synthetic and experimental voltage time series from cardiac cells, which exhibit nonlinear and chaotic behavior. Compared to the baseline and physics-informed ESN approaches, the AE-ESN yields mean absolute errors in predicted voltage 6-14 times smaller when forecasting approximately 20 future action potentials for the datasets considered. The AE-ESN also demonstrates less sensitivity to algorithmic parameter settings. Furthermore, the representation provided by the feature-extraction component removes the requirement in previous work for explicitly introducing external stimulus currents, which may not be easily extracted from real-world datasets, as additional time series, thereby making the AE-ESN easier to apply to clinical data.

A Lightweight CNN Model for Detecting Respiratory Diseases From Lung Auscultation Sounds Using EMD-CWT-Based Hybrid Scalogram

Listening to lung sounds through auscultation is vital in examining the respiratory system for abnormalities. Automated analysis of lung auscultation sounds can be beneficial to the health systems in low-resource settings where there is a lack of skilled physicians. In this work, we propose a lightweight convolutional neural network (CNN) architecture to classify respiratory diseases from individual breath cycles using hybrid scalogram-based features of lung sounds. The proposed feature-set utilizes the empirical mode decomposition (EMD) and the continuous wavelet transform (CWT). The performance of the proposed scheme is studied using a patient independent train-validation-test set from the publicly available ICBHI 2017 lung sound dataset. Employing the proposed framework, weighted accuracy scores of 98.92% for three-class chronic classification and 98.70% for six-class pathological classification are achieved, which outperform well-known and much larger VGG16 in terms of accuracy by absolute margins of 1.10% and 1.11%, respectively. The proposed CNN model also outperforms other contemporary lightweight models while being computationally comparable.

SSG-LUGIA: Single Sequence based Genome Level Unsupervised Genomic Island Prediction Algorithm

BACKGROUND

Genomic Islands (GIs) are clusters of genes that are mobilized through horizontal gene transfer. GIs play a pivotal role in bacterial evolution as a mechanism of diversification and adaptation to different niches. Therefore, identification and characterization of GIs in bacterial genomes is important for understanding bacterial evolution. However, quantifying GIs is inherently difficult, and the existing methods suffer from low prediction accuracy and precision-recall trade-off. Moreover, several of them are supervised in nature, and thus, their applications to newly sequenced genomes are riddled with their dependency on the functional annotation of existing genomes.

RESULTS

We present SSG-LUGIA, a completely automated and unsupervised approach for identifying GIs and horizontally transferred genes. SSG-LUGIA is a novel method based on unsupervised anomaly detection technique, accompanied by further refinement using cues from signal processing literature. SSG-LUGIA leverages the atypical compositional biases of the alien genes to localize GIs in prokaryotic genomes. SSG-LUGIA was assessed on a large benchmark dataset `IslandPick' and on a set of 15 well-studied genomes in the literature and followed by a thorough analysis on the well-understood Salmonella typhi CT18 genome. Furthermore, the efficacy of SSG-LUGIA in identifying horizontally transferred genes was evaluated on two additional bacterial genomes, namely, those of Corynebacterium diphtheria NCTC13129 and Pseudomonas aeruginosa LESB58. SSG-LUGIA was examined on draft genomes and was demonstrated to be efficient as an ensemble method.

CONCLUSIONS

Our results indicate that SSG-LUGIA achieved superior performance in comparison to frequently used existing methods. Importantly, it yielded a better trade-off between precision and recall than the existing methods. Its nondependency on the functional annotation of genomes makes it suitable for analyzing newly sequenced, yet uncharacterized genomes. Thus, our study is a significant advance in identification of GIs and horizontally transferred genes. SSG-LUGIA is available as an open source software at https://nibtehaz.github.io/SSG-LUGIA/.

From ECG signals to images: a transformation based approach for deep learning

Provocative heart disease is related to ventricular arrhythmias (VA). Ventricular tachyarrhythmia is an irregular and fast heart rhythm that emerges from inappropriate electrical impulses in the ventricles of the heart. Different types of arrhythmias are associated with different patterns, which can be identified. An electrocardiogram (ECG) is the major analytical tool used to interpret and record ECG signals. ECG signals are nonlinear and difficult to interpret and analyze. We propose a new deep learning approach for the detection of VA. Initially, the ECG signals are transformed into images that have not been done before. Later, these images are normalized and utilized to train the AlexNet, VGG-16 and Inception-v3 deep learning models. Transfer learning is performed to train a model and extract the deep features from different output layers. After that, the features are fused by a concatenation approach, and the best features are selected using a heuristic entropy calculation approach. Finally, supervised learning classifiers are utilized for final feature classification. The results are evaluated on the MIT-BIH dataset and achieved an accuracy of 97.6% (using Cubic Support Vector Machine as a final stage classifier).