An Effective LSTM Recurrent Network to Detect Arrhythmia on Imbalanced ECG Dataset

An intelligent garment for long COVID-19 real-time monitoring

As monitoring and diagnostic tools for long COVID-19 cases, wearable systems and supervised learning-based medical image analysis have proven to be useful. Current research on these two technical roadmaps has various drawbacks, despite their respective benefits. Wearable systems allow only the real-time monitoring of physiological parameters (heart rate, temperature, blood oxygen saturation, or SpO2). Therefore, they are unable to conduct in-depth investigations or differentiate COVID-19 from other illnesses that share similar symptoms. Medical image analysis using supervised learning-based models can be used to conduct in-depth analyses and provide precise diagnostic decision support. However, these methods are rarely used for real-time monitoring. In this regard, we present an intelligent garment combining the precision of supervised learning-based models with real-time monitoring capabilities of wearable systems. Given the relevance of electrocardiogram (ECG) signals to long COVID-19 symptom severity, an explainable data fusion strategy based on multiple machine learning models uses heart rate, temperature, SpO2, and ECG signal analysis to accurately assess the patient's health status. Experiments show that the proposed intelligent garment achieves an accuracy of 97.5 %, outperforming most of the existing wearable systems. Furthermore, it was confirmed that the two physiological indicators most significantly affected by the presence of long COVID-19 were SpO2 and the ST intervals of ECG signals.

Arrhythmia detection by the graph convolution network and a proposed structure for communication between cardiac leads

One of the most common causes of death worldwide is heart disease, including arrhythmia. Today, sciences such as artificial intelligence and medical statistics are looking for methods and models for correct and automatic diagnosis of cardiac arrhythmia. In pursuit of increasing the accuracy of automated methods, many studies have been conducted. However, in none of the previous articles, the relationship and structure between the heart leads have not been included in the model. It seems that the structure of ECG data can help develop the accuracy of arrhythmia detection. Therefore, in this study, a new structure of Electrocardiogram (ECG) data was introduced, and the Graph Convolution Network (GCN), which has the possibility of learning the structure, was used to develop the accuracy of cardiac arrhythmia diagnosis. Considering the relationship between the heart leads and clusters based on different ECG poles, a new structure was introduced. In this structure, the Mutual Information(MI) index was used to evaluate the relationship between the leads, and weight was given based on the poles of the leads. Weighted Mutual Information (WMI) matrices (new structure) were formed by R software. Finally, the 15-layer GCN network was adjusted by this structure and the arrhythmia of people was detected and classified by it. To evaluate the performance of the proposed new network, sensitivity, precision, specificity, accuracy, and confusion matrix indices were used. Also, the accuracy of GCN networks was compared by three different structures, including WMI, MI, and Identity. Chapman's 12-lead ECG Dataset was used in this study. The results showed that the values of sensitivity, precision, specificity, and accuracy of the GCN-WMI network with 15 intermediate layers were equal to 98.74%, 99.08%, 99.97% & 99.82%, respectively. This new proposed network was more accurate than the Graph Convolution Network-Mutual Information (GCN-MI) with an accuracy equal to 99.71% and GCN-Id with an accuracy equal to 92.68%. Therefore, utilizing this network, the types of arrhythmia were recognized and classified. Also, the new network proposed by the Graph Convolution Network-Weighted Mutual Information (GCN-WMI) was more accurate than those conducted in other studies on the same data set (Chapman). Based on the obtained results, the structure proposed in this study increased the accuracy of cardiac arrhythmia diagnosis and classification on the Chapman data set. Achieving such accuracy for arrhythmia diagnosis is a great achievement in clinical sciences.

Automated identification of atrial fibrillation from single-lead ECGs using multi-branching ResNet

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia, which is clinically identified with irregular and rapid heartbeat rhythm. AF puts a patient at risk of forming blood clots, which can eventually lead to heart failure, stroke, or even sudden death. Electrocardiography (ECG), which involves acquiring bioelectrical signals from the body surface to reflect heart activity, is a standard procedure for detecting AF. However, the occurrence of AF is often intermittent, costing a significant amount of time and effort from medical doctors to identify AF episodes. Moreover, human error is inevitable, as even experienced medical professionals can overlook or misinterpret subtle signs of AF. As such, it is of critical importance to develop an advanced analytical model that can automatically interpret ECG signals and provide decision support for AF diagnostics. Methods: In this paper, we propose an innovative deep-learning method for automated AF identification using single-lead ECGs. We first extract time-frequency features from ECG signals using continuous wavelet transform (CWT). Second, the convolutional neural networks enhanced with residual learning (ReNet) are employed as the functional approximator to interpret the time-frequency features extracted by CWT. Third, we propose to incorporate a multi-branching structure into the ResNet to address the issue of class imbalance, where normal ECGs significantly outnumber instances of AF in ECG datasets. Results and Discussion: We evaluate the proposed Multi-branching Resnet with CWT (CWT-MB-Resnet) with two ECG datasets, i.e., PhysioNet/CinC challenge 2017 and ECGs obtained from the University of Oklahoma Health Sciences Center (OUHSC). The proposed CWT-MB-Resnet demonstrates robust prediction performance, achieving an F1 score of 0.8865 for the PhysioNet dataset and 0.7369 for the OUHSC dataset. The experimental results signify the model's superior capability in balancing precision and recall, which is a desired attribute for ensuring reliable medical diagnoses.

BeatProfiler: Multimodal In Vitro Analysis of Cardiac Function Enables Machine Learning Classification of Diseases and Drugs

Goal: Contractile response and calcium handling are central to understanding cardiac function and physiology, yet existing methods of analysis to quantify these metrics are often time-consuming, prone to mistakes, or require specialized equipment/license. We developed BeatProfiler, a suite of cardiac analysis tools designed to quantify contractile function, calcium handling, and force generation for multiple in vitro cardiac models and apply downstream machine learning methods for deep phenotyping and classification. Methods: We first validate BeatProfiler's accuracy, robustness, and speed by benchmarking against existing tools with a fixed dataset. We further confirm its ability to robustly characterize disease and dose-dependent drug response. We then demonstrate that the data acquired by our automatic acquisition pipeline can be further harnessed for machine learning (ML) analysis to phenotype a disease model of restrictive cardiomyopathy and profile cardioactive drug functional response. To accurately classify between these biological signals, we apply feature-based ML and deep learning models (temporal convolutional-bidirectional long short-term memory model or TCN-BiLSTM). Results: Benchmarking against existing tools revealed that BeatProfiler detected and analyzed contraction and calcium signals better than existing tools through improved sensitivity in low signal data, reduction in false positives, and analysis speed increase by 7 to 50-fold. Of signals accurately detected by published methods (PMs), BeatProfiler's extracted features showed high correlations to PMs, confirming that it is reliable and consistent with PMs. The features extracted by BeatProfiler classified restrictive cardiomyopathy cardiomyocytes from isogenic healthy controls with 98% accuracy and identified relax90 as a top distinguishing feature in congruence with previous findings. We also show that our TCN-BiLSTM model was able to classify drug-free control and 4 cardiac drugs with different mechanisms of action at 96% accuracy. We further apply Grad-CAM on our convolution-based models to identify signature regions of perturbations by these drugs in calcium signals. Conclusions: We anticipate that the capabilities of BeatProfiler will help advance in vitro studies in cardiac biology through rapid phenotyping, revealing mechanisms underlying cardiac health and disease, and enabling objective classification of cardiac disease and responses to drugs.

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.

Application of bidirectional long short-term memory network for prediction of cognitive age

Electroencephalography (EEG) measures changes in neuronal activity and can reveal significant changes from infancy to adulthood concomitant with brain maturation, making it a potential physiological marker of brain maturation and cognition. To investigate a promising deep learning tool for EEG classification, we applied the bidirectional long short-term memory (BLSTM) algorithm to analyze EEG data from the pediatric EEG laboratory of Taipei Tzu Chi Hospital. The trained BLSTM model was 86% accurate when identifying EEGs from young children (8 months-6 years) and adolescents (12-20 years). However, there was only a modest classification accuracy (69.3%) when categorizing EEG samples into three age groups (8 months-6 years, 6-12 years, and 12-20 years). For EEG samples from patients with intellectual disability, the prediction accuracy of the trained BLSTM model was 46.4%, which was significantly lower than its accuracy for EEGs from neurotypical patients, indicating that the individual's intelligence plays a major role in the age prediction. This study confirmed that scalp EEG can reflect brain maturation and the BLSTM algorithm is a feasible deep learning tool for the identification of cognitive age. The trained model can potentially be applied to clinical services as a supportive measurement of neurodevelopmental status.

Identifying Electrocardiogram Abnormalities Using a Handcrafted-Rule-Enhanced Neural Network

A large number of people suffer from life-threatening cardiac abnormalities, and electrocardiogram (ECG) analysis is beneficial to determining whether an individual is at risk of such abnormalities. Automatic ECG classification methods, especially the deep learning based ones, have been proposed to detect cardiac abnormalities using ECG records, showing good potential to improve clinical diagnosis and help early prevention of cardiovascular diseases. However, the predictions of the known neural networks still do not satisfactorily meet the needs of clinicians, and this phenomenon suggests that some information used in clinical diagnosis may not be well captured and utilized by these methods. In this paper, we introduce some rules into convolutional neural networks, which help present clinical knowledge to deep learning based ECG analysis, in order to improve automated ECG diagnosis performance. Specifically, we propose a Handcrafted-Rule-enhanced Neural Network (called HRNN) for ECG classification with standard 12-lead ECG input, which consists of a rule inference module and a deep learning module. Experiments on two large-scale public ECG datasets show that our new approach considerably outperforms existing state-of-the-art methods. Further, our proposed approach not only can improve the diagnosis performance, but also can assist in detecting mislabelled ECG samples.

Practical intelligent diagnostic algorithm for wearable 12-lead ECG via self-supervised learning on large-scale dataset

Cardiovascular disease is a major global public health problem, and intelligent diagnostic approaches play an increasingly important role in the analysis of electrocardiograms (ECGs). Convenient wearable ECG devices enable the detection of transient arrhythmias and improve patient health by making it possible to seek intervention during continuous monitoring. We collected 658,486 wearable 12-lead ECGs, among which 164,538 were annotated, and the remaining 493,948 were without diagnostic. We present four data augmentation operations and a self-supervised learning classification framework that can recognize 60 ECG diagnostic terms. Our model achieves an average area under the receiver-operating characteristic curve (AUROC) and average F1 score on the offline test of 0.975 and 0.575. The average sensitivity, specificity and F1-score during the 2-month online test are 0.736, 0.954 and 0.468, respectively. This approach offers real-time intelligent diagnosis, and detects abnormal segments in long-term ECG monitoring in the clinical setting for further diagnosis by cardiologists.

Bimodal CNN for cardiovascular disease classification by co-training ECG grayscale images and scalograms

This study aimed to develop a bimodal convolutional neural network (CNN) by co-training grayscale images and scalograms of ECG for cardiovascular disease classification. The bimodal CNN model was developed using a 12-lead ECG database collected from Chapman University and Shaoxing People's Hospital. The preprocessed database contains 10,588 ECG data and 11 heart rhythms labeled by a specialist physician. The preprocessed one-dimensional ECG signals were converted into two-dimensional grayscale images and scalograms, which are fed simultaneously to the bimodal CNN model as dual input images. The proposed model aims to improve the performance of CVDs classification by making use of ECG grayscale images and scalograms. The bimodal CNN model consists of two identical Inception-v3 backbone models, which were pre-trained on the ImageNet database. The proposed model was fine-tuned with 6780 dual-input images, validated with 1694 dual-input images, and tested on 2114 dual-input images. The bimodal CNN model using two identical Inception-v3 backbones achieved best AUC (0.992), accuracy (95.08%), sensitivity (0.942), precision (0.946) and F1-score (0.944) in lead II. Ensemble model of all leads obtained AUC (0.994), accuracy (95.74%), sensitivity (0.950), precision (0.953), and F1-score (0.952). The bimodal CNN model showed better diagnostic performance than logistic regression, XGBoost, LSTM, single CNN model training with grayscale images alone or with scalograms alone. The proposed bimodal CNN model would be of great help in diagnosing cardiovascular diseases.

Multi-Modal Stacking Ensemble for the Diagnosis of Cardiovascular Diseases

BACKGROUND

Cardiovascular diseases (CVDs) are a leading cause of death worldwide. Deep learning methods have been widely used in the field of medical image analysis and have shown promising results in the diagnosis of CVDs.

METHODS

Experiments were performed on 12-lead electrocardiogram (ECG) databases collected by Chapman University and Shaoxing People's Hospital. The ECG signal of each lead was converted into a scalogram image and an ECG grayscale image and used to fine-tune the pretrained ResNet-50 model of each lead. The ResNet-50 model was used as a base learner for the stacking ensemble method. Logistic regression, support vector machine, random forest, and XGBoost were used as a meta learner by combining the predictions of the base learner. The study introduced a method called multi-modal stacking ensemble, which involves training a meta learner through a stacking ensemble that combines predictions from two modalities: scalogram images and ECG grayscale images.

RESULTS

The multi-modal stacking ensemble with a combination of ResNet-50 and logistic regression achieved an AUC of 0.995, an accuracy of 93.97%, a sensitivity of 0.940, a precision of 0.937, and an F1-score of 0.936, which are higher than those of LSTM, BiLSTM, individual base learners, simple averaging ensemble, and single-modal stacking ensemble methods.

CONCLUSION

The proposed multi-modal stacking ensemble approach showed effectiveness for diagnosing CVDs.

A Literature Review: ECG-Based Models for Arrhythmia Diagnosis Using Artificial Intelligence Techniques

In the health care and medical domain, it has been proven challenging to diagnose correctly many diseases with complicated and interferential symptoms, including arrhythmia. However, with the evolution of artificial intelligence (AI) techniques, the diagnosis and prognosis of arrhythmia became easier for the physicians and practitioners using only an electrocardiogram (ECG) examination. This review presents a synthesis of the studies conducted in the last 12 years to predict arrhythmia's occurrence by classifying automatically different heartbeat rhythms. From a variety of research academic databases, 40 studies were selected to analyze, among which 29 of them applied deep learning methods (72.5%), 9 of them addressed the problem with machine learning methods (22.5%), and 2 of them combined both deep learning and machine learning to predict arrhythmia (5%). Indeed, the use of AI for arrhythmia diagnosis is emerging in literature, although there are some challenging issues, such as the explicability of the Deep Learning methods and the computational resources needed to achieve high performance. However, with the continuous development of cloud platforms and quantum calculation for AI, we can achieve a breakthrough in arrhythmia diagnosis.

Method for Solving Difficulties in Rhythm Classification Caused by Few Samples and Similar Characteristics in Electrocardiograms

A method for accurately analyzing electrocardiograms (ECGs), which are obtained from electrical signals generated by cardiac activity, is essential in heart disease diagnosis. However, rhythms are typically obtained with relatively few data samples and similar characteristics, making them difficult to classify. To solve these issues, we proposed a novel method that distinguishes a given ECG rhythm using a beat score map (BSM) image. Through the proposed method, the associations between beats and previously used features, such as the R-R interval, were considered. Rhythm classification was implemented by training a convolutional neural network model and using transfer learning with the created BSM image. As a result, the proposed method for ECG rhythms with small data samples showed significant results. It also showed good performance in differentiating atrial fibrillation (AFIB) and atrial flutter (AFL) rhythms, which are difficult to distinguish due to their similar characteristics. The performance for rhythms with a small number of samples of the proposed method is 20% better than an existing method. In addition, the performance based on the F-1 score for classifying AFIB and AFL of the proposed method is 30% better than the existing method. This study solved the previous limitations caused by small sample numbers and similar rhythms.

Interpretable Machine Learning Techniques in ECG-Based Heart Disease Classification: A Systematic Review

Heart disease is one of the leading causes of mortality throughout the world. Among the different heart diagnosis techniques, an electrocardiogram (ECG) is the least expensive non-invasive procedure. However, the following are challenges: the scarcity of medical experts, the complexity of ECG interpretations, the manifestation similarities of heart disease in ECG signals, and heart disease comorbidity. Machine learning algorithms are viable alternatives to the traditional diagnoses of heart disease from ECG signals. However, the black box nature of complex machine learning algorithms and the difficulty in explaining a model's outcomes are obstacles for medical practitioners in having confidence in machine learning models. This observation paves the way for interpretable machine learning (IML) models as diagnostic tools that can build a physician's trust and provide evidence-based diagnoses. Therefore, in this systematic literature review, we studied and analyzed the research landscape in interpretable machine learning techniques by focusing on heart disease diagnosis from an ECG signal. In this regard, the contribution of our work is manifold; first, we present an elaborate discussion on interpretable machine learning techniques. In addition, we identify and characterize ECG signal recording datasets that are readily available for machine learning-based tasks. Furthermore, we identify the progress that has been achieved in ECG signal interpretation using IML techniques. Finally, we discuss the limitations and challenges of IML techniques in interpreting ECG signals.

The prediction of cardiac abnormality and enhancement in minority class accuracy from imbalanced ECG signals using modified deep neural network models

Cardiovascular disease (CVD) is the most fatal disease in the world, so its accurate and automated detection in the early stages will certainly support the medical expert in timely diagnosis and treatment, which can save many lives. Many types of research have been carried out in this regard, but due to the problem of data imbalance in the medical and health care sector, it may not provide the desired results in all aspects. To overcome this problem, a sequential ensemble technique has been proposed that detects 6 types of cardiac arrhythmias on large ECG imbalanced datasets, and the data imbalanced issue of the ECG dataset has been addressed by using a hybrid data resampling technique called "Synthetically Minority Oversampling Technique and Tomek Link (SMOTE + Tomek)". The sequential ensemble technique employs two distinct deep learning models: Convolutional Neural Network (CNN) and a hybrid model, CNN with Long Short-Term Memory Network (CNN-LSTM). The two standard datasets "MIT-BIH arrhythmias database" (MITDB) and "PTB diagnostic database" (PTBDB) are combined and extracted 23, 998 ECG beats for the model validation. In this work, the three models CNN, CNN-LSTM, and ensemble approach were tested on four kinds of ECG datasets: the original data (imbalanced), the data sampled using a random oversampled technique, data sampled using SMOTE, and the dataset resampled using SMOTE + Tomek algorithm. The overall highest accuracy was obtained of 99.02% on the SMOTE + Tomek sampled dataset by ensemble technique and the minority class accuracy result (Recall) is improved by 20% as compared to the imbalanced data.

An End-to-End Cardiac Arrhythmia Recognition Method with an Effective DenseNet Model on Imbalanced Datasets Using ECG Signal

Electrocardiography (ECG) is a well-known noninvasive technique in medical science that provides information about the heart's rhythm and current conditions. Automatic ECG arrhythmia diagnosis relieves doctors' workload and improves diagnosis effectiveness and efficiency. This study proposes an automatic end-to-end 2D CNN (two-dimensional convolution neural networks) deep learning method with an effective DenseNet model for addressing arrhythmias recognition. To begin, the proposed model is trained and evaluated on the 97720 and 141404 beat images extracted from the Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH) arrhythmia and St. Petersburg Institute of Cardiological Technics (INCART) datasets (both are imbalanced class datasets) using a stratified 5-fold evaluation strategy. The data is classified into four groups: N (normal), V (ventricular ectopic), S (supraventricular ectopic), and F (fusion), based on the Association for the Advancement of Medical Instrumentation® (AAMI). The experimental results show that the proposed model outperforms state-of-the-art models for recognizing arrhythmias, with the accuracy of 99.80% and 99.63%, precision of 98.34% and 98.94%, and F_1-score of 98.91% and 98.91% on the MIT-BIH arrhythmia and INCART datasets, respectively. Using a transfer learning mechanism, the proposed model is also evaluated with only five individuals of supraventricular MIT-BIH arrhythmia and five individuals of European ST-T datasets (both of which are also class imbalanced) and achieved satisfactory results. So, the proposed model is more generalized and could be a prosperous solution for arrhythmias recognition from class imbalance datasets in real-life applications.

A multiclass CNN cascade model for the clinical detection support of cardiac arrhythmia based on subject-exclusive ECG dataset

The accurate analysis of Electrocardiogram waveform plays a crucial role for supporting cardiologist in detecting and diagnosing the heartbeat disorders. To improve their detection accuracy, this work is devoted to the design of a novel classification algorithm which is composed of a cascade of two convolutional neural network (CNN), i.e a Binary CNN allowing the detection of the arrhythmic heartbeat and a Multiclass CNN able to recognize the specific disorder. Moreover, by combining the cascade architecture solution with a rule-based data splitting, which leverages the subject-exclusive and balances among the classes criteria, it is possible predicting the health status of unseen patients. Numerical results, carried out considering Massachusetts Institute of Technology-Beth Israel Hospital arrhythmia database, disclose a classification accuracy of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$96.2\%$$\end{document}96.2%. Finally, a cross-database performance evaluation and a comparison analysis w.r.t. the current state-of-art further disclose the effectiveness and the efficiency of the proposed solution, as well as its benefits in terms of patient health status prediction.

Developing Graph Convolutional Networks and Mutual Information for Arrhythmic Diagnosis Based on Multichannel ECG Signals

Cardiovascular diseases, like arrhythmia, as the leading causes of death in the world, can be automatically diagnosed using an electrocardiogram (ECG). The ECG-based diagnostic has notably resulted in reducing human errors. The main aim of this study is to increase the accuracy of arrhythmia diagnosis and classify various types of arrhythmias in individuals (suffering from cardiovascular diseases) using a novel graph convolutional network (GCN) benefitting from mutual information (MI) indices extracted from the ECG leads. In this research, for the first time, the relationships of 12 ECG leads measured using MI as an adjacency matrix were illustrated by the developed GCN and included in the ECG-based diagnostic method. Cross-validation methods were applied to select both training and testing groups. The proposed methodology was validated in practice by applying it to the large ECG database, recently published by Chapman University. The GCN-MI structure with 15 layers was selected as the best model for the selected database, which illustrates a very high accuracy in classifying different types of rhythms. The classification indicators of sensitivity, precision, specificity, and accuracy for classifying heart rhythm type, using GCN-MI, were computed as 98.45%, 97.89%, 99.85%, and 99.71%, respectively. The results of the present study and its comparison with other studies showed that considering the MI index to measure the relationship between cardiac leads has led to the improvement of GCN performance for detecting and classifying the type of arrhythmias, in comparison to the existing methods. For example, the above classification indicators for the GCN with the identity adjacency matrix (or GCN-Id) were reported to be 68.24%, 72.83%, 95.24%, and 92.68%, respectively.

Heartbeat Classification and Arrhythmia Detection Using a Multi-Model Deep-Learning Technique

Cardiac arrhythmias pose a significant danger to human life; therefore, it is of utmost importance to be able to efficiently diagnose these arrhythmias promptly. There exist many techniques for the detection of arrhythmias; however, the most widely adopted method is the use of an Electrocardiogram (ECG). The manual analysis of ECGs by medical experts is often inefficient. Therefore, the detection and recognition of ECG characteristics via machine-learning techniques have become prevalent. There are two major drawbacks of existing machine-learning approaches: (a) they require extensive training time; and (b) they require manual feature selection. To address these issues, this paper presents a novel deep-learning framework that integrates various networks by stacking similar layers in each network to produce a single robust model. The proposed framework has been tested on two publicly available datasets for the recognition of five micro-classes of arrhythmias. The overall classification sensitivity, specificity, positive predictive value, and accuracy of the proposed approach are 98.37%, 99.59%, 98.41%, and 99.35%, respectively. The results are compared with state-of-the-art approaches. The proposed approach outperformed the existing approaches in terms of sensitivity, specificity, positive predictive value, accuracy and computational cost.

ECG Classification Using Orthogonal Matching Pursuit and Machine Learning

Health monitoring and related technologies are a rapidly growing area of research. To date, the electrocardiogram (ECG) remains a popular measurement tool in the evaluation and diagnosis of heart disease. The number of solutions involving ECG signal monitoring systems is growing exponentially in the literature. In this article, underestimated Orthogonal Matching Pursuit (OMP) algorithms are used, demonstrating the significant effect of concise representation parameters on improving the performance of the classification process. Cardiovascular disease classification models based on classical Machine Learning classifiers were defined and investigated. The study was undertaken on the recently published PTB-XL database, whose ECG signals were previously subjected to detailed analysis. The classification was realized for class 2, class 5, and class 15 cardiac diseases. A new method of detecting R-waves and, based on them, determining the location of QRS complexes was presented. Novel aggregation methods of ECG signal fragments containing QRS segments, necessary for tests for classical classifiers, were developed. As a result, it was proved that ECG signal subjected to algorithms of R wave detection, QRS complexes extraction, and resampling performs very well in classification using Decision Trees. The reason can be found in structuring the signal due to the actions mentioned above. The implementation of classification issues achieved the highest Accuracy of 90.4% in recognition of 2 classes, as compared to less than 78% for 5 classes and 71% for 15 classes.

Environmental Affection-Driven English Tense Analysis: A Healthcare Exercise-Based Corpus Case Study over Public English Environment

Most international academic papers are written in English, and the use of tenses in English academic papers often follows some conventional rules. Automatically extracting and analyzing English tenses in scientific papers have begun to attract researchers' attention for the global environment. In the analysis of the English tense of scientific papers, consider that the neural network model that combines attention mechanism and sequential input network such as Long Short-Term Memory (LSTM) network has a long training time, low extraction accuracy, and cannot parallelize text input. We propose an environmental affection-driven English tense analysis model, which includes an attention mechanism and LSTM model and conducts a temporal analysis of English texts based on an affective computing model. In this paper, our proposed method is verified based on the self-built healthcare exercise-based corpus over public English environment. By comparison, the experimental results show that the method proposed in this paper has better performance than ordinary Convolutional Neural Network (CNN), Support Vector Machine (SVM), and LSTM based on attention mechanism.

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.

State-of-the-art Deep Learning Methods on Electrocardiogram Data: A Systematic Review (Preprint)

Background

Electrocardiogram (ECG) is one of the most common noninvasive diagnostic tools that can provide useful information regarding a patient’s health status. Deep learning (DL) is an area of intense exploration that leads the way in most attempts to create powerful diagnostic models based on physiological signals.

Objective

This study aimed to provide a systematic review of DL methods applied to ECG data for various clinical applications.

Methods

The PubMed search engine was systematically searched by combining “deep learning” and keywords such as “ecg,” “ekg,” “electrocardiogram,” “electrocardiography,” and “electrocardiology.” Irrelevant articles were excluded from the study after screening titles and abstracts, and the remaining articles were further reviewed. The reasons for article exclusion were manuscripts written in any language other than English, absence of ECG data or DL methods involved in the study, and absence of a quantitative evaluation of the proposed approaches.

Results

We identified 230 relevant articles published between January 2020 and December 2021 and grouped them into 6 distinct medical applications, namely, blood pressure estimation, cardiovascular disease diagnosis, ECG analysis, biometric recognition, sleep analysis, and other clinical analyses. We provide a complete account of the state-of-the-art DL strategies per the field of application, as well as major ECG data sources. We also present open research problems, such as the lack of attempts to address the issue of blood pressure variability in training data sets, and point out potential gaps in the design and implementation of DL models.

Conclusions

We expect that this review will provide insights into state-of-the-art DL methods applied to ECG data and point to future directions for research on DL to create robust models that can assist medical experts in clinical decision-making.

Machine learning techniques for arrhythmic risk stratification: a review of the literature

Ventricular arrhythmias (VAs) and sudden cardiac death (SCD) are significant adverse events that affect the morbidity and mortality of both the general population and patients with predisposing cardiovascular risk factors. Currently, conventional disease-specific scores are used for risk stratification purposes. However, these risk scores have several limitations, including variations among validation cohorts, the inclusion of a limited number of predictors while omitting important variables, as well as hidden relationships between predictors. Machine learning (ML) techniques are based on algorithms that describe intervariable relationships. Recent studies have implemented ML techniques to construct models for the prediction of fatal VAs. However, the application of ML study findings is limited by the absence of established frameworks for its implementation, in addition to clinicians’ unfamiliarity with ML techniques. This review, therefore, aims to provide an accessible and easy-to-understand summary of the existing evidence about the use of ML techniques in the prediction of VAs. Our findings suggest that ML algorithms improve arrhythmic prediction performance in different clinical settings. However, it should be emphasized that prospective studies comparing ML algorithms to conventional risk models are needed while a regulatory framework is required prior to their implementation in clinical practice.

Artificial intelligence opportunities in cardio-oncology: Overview with spotlight on electrocardiography

Cardiovascular disease is a leading cause of death among cancer survivors, second only to cancer recurrence or development of new tumors. Cardio-oncology has therefore emerged as a relatively new specialty focused on prevention and management of cardiovascular consequences of cancer therapies. Yet challenges remain regarding precision and accuracy with predicting individuals at highest risk for cardiotoxicity. Barriers such as access to care also limit screening and early diagnosis to improve prognosis. Thus, developing innovative approaches for prediction and early detection of cardiovascular illness in this population is critical. In this review, we provide an overview of the present state of machine learning applications in cardio-oncology. We begin by outlining some factors that should be considered while utilizing machine learning algorithms. We then examine research in which machine learning has been applied to improve prediction of cardiac dysfunction in cancer survivors. We also highlight the use of artificial intelligence (AI) in conjunction with electrocardiogram (ECG) to predict cardiac malfunction and also atrial fibrillation (AF), and we discuss the potential role of wearables. Additionally, the article summarizes future prospects and critical takeaways for the application of machine learning in cardio-oncology. This study is the first in a series on artificial intelligence in cardio-oncology, and complements our manuscript on echocardiography and other forms of imaging relevant to cancer survivors cared for in cardiology clinical practice.

Deep learning-based electrocardiogram rhythm and beat features for heart abnormality classification

BACKGROUND

Electrocardiogram (ECG) signal classification plays a critical role in the automatic diagnosis of heart abnormalities. While most ECG signal patterns cannot be recognized by a human interpreter, they can be detected with precision using artificial intelligence approaches, making the ECG a powerful non-invasive biomarker. However, performing rapid and accurate ECG signal classification is difficult due to the low amplitude, complexity, and non-linearity. The widely-available deep learning (DL) method we propose has presented an opportunity to substantially improve the accuracy of automated ECG classification analysis using rhythm or beat features. Unfortunately, a comprehensive and general evaluation of the specific DL architecture for ECG analysis across a wide variety of rhythm and beat features has not been previously reported. Some previous studies have been concerned with detecting ECG class abnormalities only through rhythm or beat features separately.

METHODS

This study proposes a single architecture based on the DL method with one-dimensional convolutional neural network (1D-CNN) architecture, to automatically classify 24 patterns of ECG signals through both rhythm and beat. To validate the proposed model, five databases which consisted of nine-class of ECG-base rhythm and 15-class of ECG-based beat were used in this study. The proposed DL network was applied and studied with varying datasets with different frequency samplings in intra and inter-patient scheme.

RESULTS

Using a 10-fold cross-validation scheme, the performance results had an accuracy of 99.98%, a sensitivity of 99.90%, a specificity of 99.89%, a precision of 99.90%, and an F1-score of 99.99% for ECG rhythm classification. Additionally, for ECG beat classification, the model obtained an accuracy of 99.87%, a sensitivity of 96.97%, a specificity of 99.89%, a precision of 92.23%, and an F1-score of 94.39%. In conclusion, this study provides clinicians with an advanced methodology for detecting and discriminating heart abnormalities between different ECG rhythm and beat assessments by using one outstanding proposed DL architecture.

Cardiac Arrhythmia Classification Based on One-Dimensional Morphological Features

The electrocardiogram (ECG) is the most commonly used tool for diagnosing cardiovascular diseases. Recently, there have been a number of attempts to classify cardiac arrhythmias using machine learning and deep learning techniques. In this study, we propose a novel method to generate the gray-level co-occurrence matrix (GLCM) and gray-level run-length matrix (GLRLM) from one-dimensional signals. From the GLCM and GLRLM, we extracted morphological features for automatic ECG signal classification. The extracted features were combined with six machine learning algorithms (decision tree, k-nearest neighbor, naïve Bayes, logistic regression, random forest, and XGBoost) to classify cardiac arrhythmias. Experiments were conducted on a 12-lead ECG database collected from Chapman University and Shaoxing People’s Hospital. Of the six machine learning algorithms, combining XGBoost with the proposed features yielded an accuracy of 90.46%, an AUC of 0.982, a sensitivity of 0.892, a precision of 0.900, and an F1 score of 0.895 and presented better results than wavelet features with XGBoost. The experimental results show the effectiveness of the proposed feature extraction algorithm.

Robust deep learning pipeline for PVC beats localization

BACKGROUND:

Premature ventricular contraction (PVC) is among the most frequently occurring types of arrhythmias. Existing approaches for automated PVC identification suffer from a range of disadvantages related to hand-crafted features and benchmarking on datasets with a tiny sample of PVC beats.

OBJECTIVE:

The main objective is to address the drawbacks described above in the proposed framework, which takes a raw ECG signal as an input and localizes R peaks of the PVC beats.

METHODS:

Our method consists of two neural networks. First, an encoder-decoder architecture trained on PVC-rich dataset localizes the R peak of both Normal and anomalous heartbeats. Provided R peaks positions, our CardioIncNet model does the delineation of healthy versus PVC beats.

RESULTS:

We have performed an extensive evaluation of our pipeline with both single- and cross-dataset paradigms on three public datasets. Our approach results in over 0.99 and 0.979 F1-measure on both single- and cross-dataset paradigms for R peaks localization task and above 0.96 and 0.85 F1 score for the PVC beats classification task.

CONCLUSIONS:

We have shown a method that provides robust performance beyond the beats of Normal nature and clearly outperforms classical algorithms both in the case of a single and cross-dataset evaluation. We provide a Github1 repository for the reproduction of the results.

Learning Explainable Time-Morphology Patterns for Automatic Arrhythmia Classification from Short Single-Lead ECGs

Automatic detection of abnormal heart rhythms, including atrial fibrillation (AF), using signals obtained from a single-lead wearable electrocardiogram (ECG) device, is useful for daily cardiac health monitoring. In this study, we propose a novel image-based deep learning framework to classify single-lead ECG recordings of short variable length into several different rhythms associated with arrhythmias. By transforming variable-length 1D ECG signals into fixed-size 2D time-morphology representations and feeding them to the beat-interval-texture convolutional neural network (BIT-CNN) model, we aimed to learn the comprehensible characteristics of beat shape and inter-beat patterns over time for arrhythmia classification. The proposed approach allows feature embedding vectors to provide interpretable time-morphology patterns focused at each step of the learning process. In addition, this method reduces the number of model parameters needed to be trained and aids visual interpretation, while maintaining similar performance to other CNN-based approaches to arrhythmia classification. For experiments, we used the PhysioNet/CinC Challenge 2017 dataset and achieved an overall F_{1_NAO} of 81.75% and F_{1_NAOP} of 76.87%, which are comparable to those of the state-of-the-art methods for variable-length ECGs.

Usefulness of multi-labelling artificial intelligence in detecting rhythm disorders and acute ST-elevation myocardial infarction on 12-lead electrocardiogram

Aims

To develop an artificial intelligence-based approach with multi-labelling capability to identify both ST-elevation myocardial infarction (STEMI) and 12 heart rhythms based on 12-lead electrocardiograms (ECGs).

Methods and results

We trained, validated, and tested a long short-term memory (LSTM) model for the multi-label diagnosis of 13 ECG patterns (STEMI + 12 rhythm classes) using 60 537 clinical ECGs from 35 981 patients recorded between 15 January 2009 and 31 December 2018. In addition to the internal test above, we conducted a real-world external test, comparing the LSTM model with board-certified physicians of different specialties using a separate dataset of 308 ECGs covering all 13 ECG diagnoses. In the internal test, the area under the curves (AUCs) of the LSTM model in classifying the 13 ECG patterns ranged between 0.939 and 0.999. For the external test, the LSTM model for multi-labelling of the 13 ECG patterns evaluated by AUC was 0.987 ± 0.021, which was superior to those of cardiologists (0.898 ± 0.113, P < 0.001), emergency physicians (0.820 ± 0.134, P < 0.001), internists (0.765 ± 0.155, P < 0.001), and a commercial algorithm (0.845 ± 0.121, P < 0.001). Of note, the LSTM model achieved an accuracy of 0.987, AUC of 0.997, and precision, recall, and F 1 score of 0.952, 0.870, and 0.909, respectively, in detecting STEMI.

Conclusions

We demonstrated the usefulness of an LSTM model in the multi-labelling detection of both rhythm classes and STEMI in competitive testing against board-certified physicians. This AI tool exceeding the cardiologist-level performance in detecting STEMI and rhythm classes on 12-lead ECG may be useful in prioritizing chest pain triage and expediting clinical decision-making in healthcare.

Identification of Arrhythmia by Using a Decision Tree and Gated Network Fusion Model

In recent years, deep learning (DNN) based methods have made leapfrogging level breakthroughs in detecting cardiac arrhythmias as the cost effectiveness of arithmetic power, and data size has broken through the tipping point. However, the inability of these methods to provide a basis for modeling decisions limits clinicians' confidence on such methods. In this paper, a Gate Recurrent Unit (GRU) and decision tree fusion model, referred to as (T-GRU), was designed to explore the problem of arrhythmia recognition and to improve the credibility of deep learning methods. The fusion model multipathway processing time-frequency domain featured the introduction of decision tree probability analysis of frequency domain features, the regularization of GRU model parameters and weight control to improve the decision tree model output weights. The MIT-BIH arrhythmia database was used for validation. Results showed that the low-frequency band features dominated the model prediction. The fusion model had an accuracy of 98.31%, sensitivity of 96.85%, specificity of 98.81%, and precision of 96.73%, indicating its high reliability and clinical significance.

Handling of uncertainty in medical data using machine learning and probability theory techniques: a review of 30 years (1991-2020)

Understanding the data and reaching accurate conclusions are of paramount importance in the present era of big data. Machine learning and probability theory methods have been widely used for this purpose in various fields. One critically important yet less explored aspect is capturing and analyzing uncertainties in the data and model. Proper quantification of uncertainty helps to provide valuable information to obtain accurate diagnosis. This paper reviewed related studies conducted in the last 30 years (from 1991 to 2020) in handling uncertainties in medical data using probability theory and machine learning techniques. Medical data is more prone to uncertainty due to the presence of noise in the data. So, it is very important to have clean medical data without any noise to get accurate diagnosis. The sources of noise in the medical data need to be known to address this issue. Based on the medical data obtained by the physician, diagnosis of disease, and treatment plan are prescribed. Hence, the uncertainty is growing in healthcare and there is limited knowledge to address these problems. Our findings indicate that there are few challenges to be addressed in handling the uncertainty in medical raw data and new models. In this work, we have summarized various methods employed to overcome this problem. Nowadays, various novel deep learning techniques have been proposed to deal with such uncertainties and improve the performance in decision making.

A Study on Arrhythmia via ECG Signal Classification Using the Convolutional Neural Network

Cardiovascular diseases (CVDs) are the leading cause of death today. The current identification method of the diseases is analyzing the Electrocardiogram (ECG), which is a medical monitoring technology recording cardiac activity. Unfortunately, looking for experts to analyze a large amount of ECG data consumes too many medical resources. Therefore, the method of identifying ECG characteristics based on machine learning has gradually become prevalent. However, there are some drawbacks to these typical methods, requiring manual feature recognition, complex models, and long training time. This paper proposes a robust and efficient 12-layer deep one-dimensional convolutional neural network on classifying the five micro-classes of heartbeat types in the MIT- BIH Arrhythmia database. The five types of heartbeat features are classified, and wavelet self-adaptive threshold denoising method is used in the experiments. Compared with BP neural network, random forest, and other CNN networks, the results show that the model proposed in this paper has better performance in accuracy, sensitivity, robustness, and anti-noise capability. Its accurate classification effectively saves medical resources, which has a positive effect on clinical practice.

Accurate deep neural network model to detect cardiac arrhythmia on more than 10,000 individual subject ECG records

BACKGROUND AND OBJECTIVE

Cardiac arrhythmia, which is an abnormal heart rhythm, is a common clinical problem in cardiology. Detection of arrhythmia on an extended duration electrocardiogram (ECG) is done based on initial algorithmic software screening, with final visual validation by cardiologists. It is a time consuming and subjective process. Therefore, fully automated computer-assisted detection systems with a high degree of accuracy have an essential role in this task. In this study, we proposed an effective deep neural network (DNN) model to detect different rhythm classes from a new ECG database.

METHODS

Our DNN model was designed for high performance on all ECG leads. The proposed model, which included both representation learning and sequence learning tasks, showed promising results on all 12-lead inputs. Convolutional layers and sub-sampling layers were used in the representation learning phase. The sequence learning part involved a long short-term memory (LSTM) unit after representation of learning layers.

RESULTS

We performed two different class scenarios, including reduced rhythms (seven rhythm types) and merged rhythms (four rhythm types) according to the records from the database. Our trained DNN model achieved 92.24% and 96.13% accuracies for the reduced and merged rhythm classes, respectively.

CONCLUSION

Recently, deep learning algorithms have been found to be useful because of their high performance. The main challenge is the scarcity of appropriate training and testing resources because model performance is dependent on the quality and quantity of case samples. In this study, we used a new public arrhythmia database comprising more than 10,000 records. We constructed an efficient DNN model for automated detection of arrhythmia using these records.

Hardware Implementation of Deep Network Accelerators Towards Healthcare and Biomedical Applications

The advent of dedicated Deep Learning (DL) accelerators and neuromorphic processors has brought on new opportunities for applying both Deep and Spiking Neural Network (SNN) algorithms to healthcare and biomedical applications at the edge. This can facilitate the advancement of medical Internet of Things (IoT) systems and Point of Care (PoC) devices. In this paper, we provide a tutorial describing how various technologies including emerging memristive devices, Field Programmable Gate Arrays (FPGAs), and Complementary Metal Oxide Semiconductor (CMOS) can be used to develop efficient DL accelerators to solve a wide variety of diagnostic, pattern recognition, and signal processing problems in healthcare. Furthermore, we explore how spiking neuromorphic processors can complement their DL counterparts for processing biomedical signals. The tutorial is augmented with case studies of the vast literature on neural network and neuromorphic hardware as applied to the healthcare domain. We benchmark various hardware platforms by performing a sensor fusion signal processing task combining electromyography (EMG) signals with computer vision. Comparisons are made between dedicated neuromorphic processors and embedded AI accelerators in terms of inference latency and energy. Finally, we provide our analysis of the field and share a perspective on the advantages, disadvantages, challenges, and opportunities that various accelerators and neuromorphic processors introduce to healthcare and biomedical domains.

HAN-ECG: An interpretable atrial fibrillation detection model using hierarchical attention networks

Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias that affects the lives of many people around the world and is associated with a five-fold increased risk of stroke and mortality. Like other problems in the healthcare domain, artificial intelligence (AI)-based models have been used to detect AF from patients' ECG signals. The cardiologist level performance in detecting this arrhythmia is often achieved by deep learning-based methods, however, they suffer from the lack of interpretability. In other words, these approaches are unable to explain the reasons behind their decisions. The lack of interpretability is a common challenge toward a wide application of machine learning (ML)-based approaches in the healthcare which limits the trust of clinicians in such methods. To address this challenge, we propose HAN-ECG, an interpretable bidirectional-recurrent-neural-network-based approach for the AF detection task. The HAN-ECG employs three attention mechanism levels to provide a multi-resolution analysis of the patterns in ECG leading to AF. The detected patterns by this hierarchical attention model facilitate the interpretation of the neural network decision process in identifying the patterns in the signal which contributed the most to the final detection. Experimental results on two AF databases demonstrate that our proposed model performs better than the existing algorithms. Visualization of these attention layers illustrates that our proposed model decides upon the important waves and heartbeats which are clinically meaningful in the detection task (e.g., absence of P-waves, and irregular R-R intervals for the AF detection task).

The Use of Time-Frequency Moments as Inputs of LSTM Network for ECG Signal Classification

This paper refers to the method of using the deep neural long-short-term memory (LSTM) network for the problem of electrocardiogram (ECG) signal classification. ECG signals contain a lot of subtle information analyzed by doctors to determine the type of heart dysfunction. Due to the large number of signal features that are difficult to identify, raw ECG data is usually not suitable for use in machine learning. The article presents how to transform individual ECG time series into spectral images for which two characteristics are determined, which are instantaneous frequency and spectral entropy. Feature extraction consists of converting the ECG signal into a series of spectral images using short-term Fourier transformation. Then the images were converted using Fourier transform again to two signals, which includes instantaneous frequency and spectral entropy. The data set transformed in this way was used to train the LSTM network. During the experiments, the LSTM networks were trained for both raw and spectrally transformed data. Then, the LSTM networks trained in this way were compared with each other. The obtained results prove that the transformation of input signals into images can be an effective method of improving the quality of classifiers based on deep learning.

A Metaheuristic Optimization Approach for Parameter Estimation in Arrhythmia Classification from Unbalanced Data

The electrocardiogram records the heart's electrical activity and generates a significant amount of data. The analysis of these data helps us to detect diseases and disorders via heart bio-signal abnormality classification. In unbalanced-data contexts, where the classes are not equally represented, the optimization and configuration of the classification models are highly complex, reflecting on the use of computational resources. Moreover, the performance of electrocardiogram classification depends on the approach and parameter estimation to generate the model with high accuracy, sensitivity, and precision. Previous works have proposed hybrid approaches and only a few implemented parameter optimization. Instead, they generally applied an empirical tuning of parameters at a data level or an algorithm level. Hence, a scheme, including metrics of sensitivity in a higher precision and accuracy scale, deserves special attention. In this article, a metaheuristic optimization approach for parameter estimations in arrhythmia classification from unbalanced data is presented. We selected an unbalanced subset of those databases to classify eight types of arrhythmia. It is important to highlight that we combined undersampling based on the clustering method (data level) and feature selection method (algorithmic level) to tackle the unbalanced class problem. To explore parameter estimation and improve the classification for our model, we compared two metaheuristic approaches based on differential evolution and particle swarm optimization. The final results showed an accuracy of 99.95%, a F1 score of 99.88%, a sensitivity of 99.87%, a precision of 99.89%, and a specificity of 99.99%, which are high, even in the presence of unbalanced data.

Automated detection of cardiovascular disease by electrocardiogram signal analysis: a deep learning system

Automated electrocardiogram (ECG) diagnosis could be a useful aid for clinical use. We applied a deep learning method to build a system for automated detection and classification of ECG signals. We first trained a convolutional neural network (CNN) to detect cardiovascular disease in ECG signals using a training data set of 259,789 ECG signals collected from the cardiac function rooms of a tertiary care hospital. The CNN classification was validated using an independent test data set of 18,018 ECG signals. The labels used covered >90% of clinical diagnoses. The system grouped ECGs into 18 classifications-17 different types of abnormalities and normal ECG. The overall accuracy of the model was tested and found to be close to 95%; the accuracy for diagnosis of normal rhythm/atrial fibrillation was 99.15%. The proposed CNN model could help reduce misdiagnosis and missed diagnosis in primary care settings and also improve efficiency and save manpower cost for large general hospitals.