A Stochastic Resonance Electrocardiogram Enhancement Algorithm for Robust QRS Detection

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.

Second-Order Level-Crossing Sampling Analog to Digital Converter for Electrocardiogram Delineation and Premature Ventricular Contraction Detection

This article presents an electrocardiogram (ECG) delineation and arrhythmia heartbeat detection system using a novel second-order level-crossing sampling analog to digital converter (ADC) for real-time data compression and feature extraction. The proposed system consists of the front-end integrated circuit of the data converter, the delineation algorithm, and the arrhythmia detection algorithm. Compared with conventional level-sampling ADCs, the proposed circuit updates tracking thresholds using linear extrapolation, which forms a second-order level-crossing sampling ADC that has sloped sampling levels. The computing is done digitally and is implemented by modifying the digital control logic of a conventional Successive-approximation-register (SAR) ADC. The system separates the sampling and quantization processes and only selects the turning points in the input waveform for quantization. The output of the proposed data converter consists of both the digital value of the selected sampling points and the timestamp between the selected sampling points. The main advantages are data savings for the data converter and the following digital signal processing or communication circuits, which are ideal for low-power sensors. The test chip was fabricated using a 180 nm CMOS process. When sensing sparse signals such as ECG signals the proposed ADC achieves a compression factor of 8.33. The delineation algorithm uses a triangle filter method to locate the fiducial points and measures the intervals, slopes, and morphology of the QRS complex and the P/T waves. Those extracted features are then used in the arrhythmia heartbeat detection algorithm to identify Premature Ventricular Contraction (PVC). The overall performance of the system is evaluated using the MIT-BIH database and the QT database, which is also compared with the recently reported systems. The accuracy, sensitivity, specificity, PPV, and F1 score are 97.3%, 89.6%, 97.8%, 73.3%, and 0.81 for detecting PVC.

ECG-CL: A Comprehensive Electrocardiogram Interpretation Method Based on Continual Learning

The value of Electrocardiogram (ECG) monitoring in early cardiovascular disease (CVD) detection is undeniable, especially with the aid of intelligent wearable devices. Despite this, the requirement for expert interpretation significantly limits public accessibility, underscoring the need for advanced diagnosis algorithms. Deep learning-based methods represent a leap beyond traditional rule-based algorithms, but they are not without challenges such as small databases, inefficient use of local and global ECG information, high memory requirements for deploying multiple models, and the absence of task-to-task knowledge transfer. In response to these challenges, we propose a multi-resolution model adept at integrating local morphological characteristics and global rhythm patterns seamlessly. We also introduce an innovative ECG continual learning (ECG-CL) approach based on parameter isolation, designed to enhance data usage effectiveness and facilitate inter-task knowledge transfer. Our experiments, conducted on four publicly available databases, provide evidence of our proposed continual learning method's ability to perform incremental learning across domains, classes, and tasks. The outcome showcases our method's capability in extracting pertinent morphological and rhythmic features from ECG segmentation, resulting in a substantial enhancement of classification accuracy. This research not only confirms the potential for developing comprehensive ECG interpretation algorithms based on single-lead ECGs but also fosters progress in intelligent wearable applications. By leveraging advanced diagnosis algorithms, we aspire to increase the accessibility of ECG monitoring, thereby contributing to early CVD detection and ultimately improving healthcare outcomes.

Enhancing Performance of Convolutional Neural Network-Based Epileptic Electroencephalogram Diagnosis by Asymmetric Stochastic Resonance

Epilepsy is a chronic disorder that leads to transient neurological dysfunction and is clinically diagnosed primarily by electroencephalography. Several intelligent systems have been proposed to automatically detect seizures, among which deep convolutional neural networks (CNNs) have shown better performance than traditional machine-learning algorithms. Owing to artifacts and noise, the raw electroencephalogram (EEG) must be preprocessed to improve the signal-to-noise ratio prior to being fed into the CNN classifier. However, because of the spectrum overlapping of uncontrollable noise with EEG, traditional filters cause information loss in EEG; thus, the potential of classifiers cannot be fully exploited. In this study, we propose a stochastic resonance-effect-based EEG preprocessing module composed of three asymmetrical overdamped bistable systems in parallel. By setting different asymmetries for the three parallel units, the inherent noise can be transferred to the different spectral components of the EEG through the asymmetric stochastic resonance effect. In this process, the proposed preprocessing module not only avoids the loss of information of EEG but also provides a CNN with high-quality EEG of diversified frequency information to enhance its performance. By combining the proposed preprocessing module with a residual neural network, we developed an intelligent diagnostic system for predicting seizure onset. The developed system achieved an average sensitivity of 98.96% on the CHB-MIT dataset and 95.45% on the Siena dataset, with a false prediction rate of 0.048/h and 0.033/h, respectively. In addition, a comparative analysis demonstrated the superiority of the developed diagnostic system with the proposed preprocessing module over other existing methods.

Heartbeat detector from ECG and PPG signals based on wavelet transform and upper envelopes

The analysis of cardiac activity is one of the most common elements for evaluating the state of a subject, either to control possible health risks, sports performance, stress levels, etc. This activity can be recorded using different techniques, with electrocardiogram and photoplethysmogram being the most common. Both techniques make significantly different waveforms, however the first derivative of the photoplethysmographic data produces a signal structurally similar to the electrocardiogram, so any technique focusing on detecting QRS complexes, and thus heartbeats in electrocardiogram, is potentially applicable to photoplethysmogram. In this paper, we develop a technique based on the wavelet transform and envelopes to detect heartbeats in both electrocardiogram and photoplethysmogram. The wavelet transform is used to enhance QRS complexes with respect to other signal elements, while the envelopes are used as an adaptive threshold to determine their temporal location. We compared our approach with three other techniques using electrocardiogram signals from the Physionet database and photoplethysmographic signals from the DEAP database. Our proposal showed better performances when compared to others. When the electrocardiographic signal was considered, the method had an accuracy greater than 99.94%, a true positive rate of 99.96%, and positive prediction value of 99.76%. When photoplethysmographic signals were investigated, an accuracy greater than 99.27%, a true positive rate of 99.98% and positive prediction value of 99.50% were obtained. These results indicate that our proposal can be adapted better to the recording technology.

A 2.2 nW Analog Electrocardiogram Processor based on Stochastic Resonance Achieving a 99.94% QRS Complex Detection Sensitivity

This paper presents an ultra-low power electrocardiogram (ECG) processor that can detect QRS-waves in real time as the data streams in. The processor performs out-of-band noise suppression via a linear filter, and in-band noise suppression via a nonlinear filter. The nonlinear filter also enhances the QRS-waves by facilitating stochastic resonance. The processor identifies the QRS-waves on noise-suppressed and enhanced recordings using a constant threshold detector. For energy-efficiency and compactness, the processor exploits current-mode analog signal processing techniques, which significantly reduces the design complexity when implementing the second-order dynamics of the nonlinear filter. The processor is designed and implemented in TSMC 65 nm CMOS technology. In terms of detection performance, the processor achieves an average F1 = 99.88% over the MIT-BIH Arrhythmia database and outperforms all previous ultra-low power ECG processors. The processor is the first that is validated against noisy ECG recordings of MIT-BIH NST and TELE databases, where it achieves better detection performances than most digital algorithms run on digital platforms. The design has a footprint of 0.08 mm² and dissipates 2.2 nW when supplied by a single 1V supply, making it the first ultra-low power and real-time processor that facilitates stochastic resonance.