Multi-label correlation guided feature fusion network for abnormal ECG diagnosis

Semi-Supervised Learning for Multi-Label Cardiovascular Diseases Prediction: A Multi-Dataset Study

Electrocardiography (ECG) is a non-invasive tool for predicting cardiovascular diseases (CVDs). Current ECG-based diagnosis systems show promising performance owing to the rapid development of deep learning techniques. However, the label scarcity problem, the co-occurrence of multiple CVDs and the poor performance on unseen datasets greatly hinder the widespread application of deep learning-based models. Addressing them in a unified framework remains a significant challenge. To this end, we propose a multi-label semi-supervised model (ECGMatch) to recognize multiple CVDs simultaneously with limited supervision. In the ECGMatch, an ECGAugment module is developed for weak and strong ECG data augmentation, which generates diverse samples for model training. Subsequently, a hyperparameter-efficient framework with neighbor agreement modeling and knowledge distillation is designed for pseudo-label generation and refinement, which mitigates the label scarcity problem. Finally, a label correlation alignment module is proposed to capture the co-occurrence information of different CVDs within labeled samples and propagate this information to unlabeled samples. Extensive experiments on four datasets and three protocols demonstrate the effectiveness and stability of the proposed model, especially on unseen datasets. As such, this model can pave the way for diagnostic systems that achieve robust performance on multi-label CVDs prediction with limited supervision.

ECG-based data-driven solutions for diagnosis and prognosis of cardiovascular diseases: A systematic review

Cardiovascular diseases (CVD) are a leading cause of death globally, and result in significant morbidity and reduced quality of life. The electrocardiogram (ECG) plays a crucial role in CVD diagnosis, prognosis, and prevention; however, different challenges still remain, such as an increasing unmet demand for skilled cardiologists capable of accurately interpreting ECG. This leads to higher workload and potential diagnostic inaccuracies. Data-driven approaches, such as machine learning (ML) and deep learning (DL) have emerged to improve existing computer-assisted solutions and enhance physicians' ECG interpretation of the complex mechanisms underlying CVD. However, many ML and DL models used to detect ECG-based CVD suffer from a lack of explainability, bias, as well as ethical, legal, and societal implications (ELSI). Despite the critical importance of these Trustworthy Artificial Intelligence (AI) aspects, there is a lack of comprehensive literature reviews that examine the current trends in ECG-based solutions for CVD diagnosis or prognosis that use ML and DL models and address the Trustworthy AI requirements. This review aims to bridge this knowledge gap by providing a systematic review to undertake a holistic analysis across multiple dimensions of these data-driven models such as type of CVD addressed, dataset characteristics, data input modalities, ML and DL algorithms (with a focus on DL), and aspects of Trustworthy AI like explainability, bias and ethical considerations. Additionally, within the analyzed dimensions, various challenges are identified. To these, we provide concrete recommendations, equipping other researchers with valuable insights to understand the current state of the field comprehensively.

Pre-Processing techniques and artificial intelligence algorithms for electrocardiogram (ECG) signals analysis: A comprehensive review

Electrocardiogram (ECG) are the physiological signals and a standard test to measure the heart's electrical activity that depicts the movement of cardiac muscles. A review study has been conducted on ECG signals analysis with the help of artificial intelligence (AI) methods over the last ten years i.e., 2012-22. Primarily, the method of ECG analysis by software systems was divided into classical signal processing (e.g. spectrograms or filters), machine learning (ML) and deep learning (DL), including recursive models, transformers and hybrid. Secondly, the data sources and benchmark datasets were depicted. Authors grouped resources by ECG acquisition methods into hospital-based portable machines and wearable devices. Authors also included new trends like advanced pre-processing, data augmentation, simulations and agent-based modeling. The study found improvement in ECG examination perfection made each year through ML, DL, hybrid models, and transformers. Convolutional neural networks and hybrid models were more targeted and proved efficient. The transformer model extended the accuracy from 90% to 98%. The Physio-Net library helps acquire ECG signals, including the popular benchmark databases such as MIT-BIH, PTB, and challenging datasets. Similarly, wearable devices have been established as a appropriate option for monitoring patient health without the time and place limitations and are also helpful for AI model calibration with so far accuracy of 82%-83% on Samsung smartwatch. In the pre-processing signals, spectrogram generation through Fourier and wavelet transformations are erected leading approaches promoting on average accuracy of 90%-95%. Likewise, data enhancement using geometrical techniques is well-considered; however, extraction and concatenation-based methods need attention. As the what-if analysis in healthcare or cardiac issues can be performed using a complex simulation, the study reviews agent-based modeling and simulation approaches for cardiovascular risk event assessment.

DAMS-Net: Dual attention and multi-scale information fusion network for 12-lead ECG classification

Automated 12-lead electrocardiographic (ECG) classification algorithms play an important role in the diagnosis of clinical arrhythmias. Current methods that perform well in the field of automatic ECG classification are usually based on Convolutional Neural Networks (CNN) or Transformer. However, due to the intrinsic locality of convolution operations, CNN can't extract long-dependence between series. On the other side, the Transformer design includes a built-in global self-attention mechanism, but it doesn't pay enough attention to local features. In this paper, we propose DAMS-Net, which combines the advantages of Transformer and CNN, introducing a spatial attention module and a channel attention module using a CNN-Transformer hybrid encoder to adaptively focus on the significant features of global and local parts between space and channels. In addition, our proposal fuses multi-scale information to capture high and low-level semantic information by skip-connections. We evaluate our method on the 2018 Physiological Electrical Signaling Challenge dataset, and our proposal achieves a precision rate of 83.6%, a recall rate of 84.7%, and an F1-score of 0.839. The classification performance is superior to all current single-model methods evaluated in this dataset. The experimental results demonstrate the promising application of our proposed method in 12-lead ECG automatic classification tasks.

SAR model for accurate detection of multi-label arrhythmias from electrocardiograms

Objective

Arrhythmias are prevalent symptoms of cardiovascular disease, necessitating accurate and timely detection to mitigate associated risks. Detecting arrhythmias from ECGs quickly and accurately holds great significance in preventing heart disease and reducing mortality. This research endeavors to outperform previous studies by developing a scientific neural network model capable of training and predicting ECG signals for 11 categories of arrhythmias, accounting for up to 5 co-existing labels.

Methods

In this study, we initially address the issue of imbalanced datasets by employing Borderline SMOTE and Cluster Centroids techniques during preprocessing. Subsequently, we propose a novel SAR model that combines attention and resnet mechanisms. The dataset is subjected to a 10-fold validation process to train and evaluate the model. Finally, several metrics such as HammingLoss, RankingLoss, F1-score, AUC and Coverage are used to evaluate the model.

Results

By evaluating the results of the tests, the average Hamming Loss is 1.12 %, the average Ranking Loss is 1.17 %, the average Micro F1-score is 98.46 %, the average Micro AUC is 98.76 %, and the average Coverage is 3.2762. The results show that the SAR model outperforms previous related studies on the task of classifying arrhythmia signals with multiple categories and labels.

Conclusion

The SAR model demonstrated excellent performance in accurately classifying multi-category and multi-label arrhythmia signals, affirming its scientific validity. Compared with previous studies, the model achieves a certain improvement in performance, which can help cardiologists to achieve scientific and accurate diagnosis of arrhythmia diseases.

Ensembled Feature based Multi-Label ECG Arrhythmia Classification

Arrhythmia is one of the major contributors to sudden cardiac death. Compared to single-label arrhythmia classification, multi-label classification provides the advantage of simultaneous detection of different cardiac ailments. Existing multi-label approaches employ deep learning models, which have several limitations, e.g., data dependency, overfitting, complexity, and lack of interpretability. In this work, we propose a multi-label classification framework with ensembled hand-crafted features added with label powerset, which better preserves the correlation between classes. Experimentation with CPSC 2018 database shows that the proposed model provides accuracy and F1-score of 88.52% and 88.45% for single-label data and 88.11% and 86.32% for multi-label data, respectively. The proposed method improves individual class performance for some important diseases compared to the existing multi-label state-of-the-art methods.Clinical relevance- Early detection of life-threatening multi-label ECG patterns consisting of atrial fibrillation, atrioventricular block, and right bundle branch block with high accuracy can reduce the sudden cardiac death rate.

A New 12-Lead ECG Signals Fusion Method Using Evolutionary CNN Trees for Arrhythmia Detection

The 12 leads of electrocardiogram (ECG) signals show the heart activities from different angles of coronal and axial planes; hence, the signals of these 12 leads have functional dependence on each other. This paper proposes a novel method for fusing the data of 12-lead ECG signals to diagnose heart problems. In the first phase of the proposed method, the time-frequency transform is employed to fuse the functional data of leads and extract the frequency data of ECG signals in 12 leads. After that, their dependence is evaluated through the correlation analysis. In the second phase, a structural learning method is adopted to extract the structural data from these 12 leads. Moreover, deep convolutional neural network (CNN) models are coded in this phase through genetic programming. These trees are responsible for learning deep structural features from functional data extracted from 12 leads. These trees are upgraded through the execution of the genetic programming (GP) algorithm to extract the optimal features. These two phases are used together to fuse the leads of ECG signals to diagnose various heart problems. According to the test results on ChapmanECG, including the signals of 10,646 patients, the proposed method enjoys the mean accuracy of 97.60% in the diagnosis of various types of arrhythmias in the Chapman dataset. It also outperformed the state-of-the-art methods.

ECG_SegNet: An ECG delineation model based on the encoder-decoder structure

With the increasing usage of wearable electrocardiogram (ECG) monitoring devices, it is necessary to develop models and algorithms that can analyze the large amounts of ECG data obtained in real-time. Accurate ECG delineation is key to assisting cardiologists in diagnosing cardiac diseases. The main objective of this study is to design a delineation model based on the encoder-decoder structure to detect different heartbeat waveforms, including P-waves, QRS complexes, T-waves, and No waves (NW), as well as the onset and offset of these waveforms. First, the introduction of a standard dilated convolution module (SDCM) into the encoder path enabled the model to extract more useful ECG signal-informative features. Subsequently, bidirectional long short-term memory (BiLSTM) was added to the encoding structure to obtain numerous temporal features. Moreover, the feature sets of the ECG signals at each level in the encoder path were connected to the decoder part for multi-scale decoding to mitigate the information loss caused by the pooling operation in the encoding process. Finally, the proposed model was trained and tested on both QT and LU databases, and it achieved accurate results compared to other state-of-the-art methods. Regarding the QT database, the average accuracy of ECG waveform classification was 96.90%, and an average classification accuracy of 95.40% was obtained on the LU database. In addition, average F1 values of 99.58% and 97.05% were achieved in the ECG delineation task of the QT and LU databases, respectively. The results show that the proposed ECG_SegNet model has good flexibility and reliability when applied to ECG delineation, and it is a reliable method for analyzing ECG signals in real-time.