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Rudnicka Z, Pręgowska A, Glądys K, Perkins M, Proniewska K. Advancements in artificial intelligence-driven techniques for interventional cardiology. Cardiol J 2024; 31:321-341. [PMID: 38247435 PMCID: PMC11076027 DOI: 10.5603/cj.98650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 12/31/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024] Open
Abstract
This paper aims to thoroughly discuss the impact of artificial intelligence (AI) on clinical practice in interventional cardiology (IC) with special recognition of its most recent advancements. Thus, recent years have been exceptionally abundant in advancements in computational tools, including the development of AI. The application of AI development is currently in its early stages, nevertheless new technologies have proven to be a promising concept, particularly considering IC showing great impact on patient safety, risk stratification and outcomes during the whole therapeutic process. The primary goal is to achieve the integration of multiple cardiac imaging modalities, establish online decision support systems and platforms based on augmented and/or virtual realities, and finally to create automatic medical systems, providing electronic health data on patients. In a simplified way, two main areas of AI utilization in IC may be distinguished, namely, virtual and physical. Consequently, numerous studies have provided data regarding AI utilization in terms of automated interpretation and analysis from various cardiac modalities, including electrocardiogram, echocardiography, angiography, cardiac magnetic resonance imaging, and computed tomography as well as data collected during robotic-assisted percutaneous coronary intervention procedures. Thus, this paper aims to thoroughly discuss the impact of AI on clinical practice in IC with special recognition of its most recent advancements.
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Affiliation(s)
- Zofia Rudnicka
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Agnieszka Pręgowska
- Institute of Fundamental Technological Research, Polish Academy of Sciences, Warsaw, Poland
| | - Kinga Glądys
- Jagiellonian University Medical College, Krakow, Poland
| | - Mark Perkins
- Collegium Prometricum, the Business School for Healthcare, Sopot, Poland
- Royal Society of Arts, London, United Kingdom
| | - Klaudia Proniewska
- Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Krakow, Poland.
- Center for Digital Medicine and Robotics, Jagiellonian University Medical College, Krakow, Poland.
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Yoon T, Kang D. Multi-Modal Stacking Ensemble for the Diagnosis of Cardiovascular Diseases. J Pers Med 2023; 13:jpm13020373. [PMID: 36836607 PMCID: PMC9967487 DOI: 10.3390/jpm13020373] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/18/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
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.
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Huang JD, Wang J, Ramsey E, Leavey G, Chico TJA, Condell J. Applying Artificial Intelligence to Wearable Sensor Data to Diagnose and Predict Cardiovascular Disease: A Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:8002. [PMID: 36298352 PMCID: PMC9610988 DOI: 10.3390/s22208002] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 06/06/2023]
Abstract
Cardiovascular disease (CVD) is the world's leading cause of mortality. There is significant interest in using Artificial Intelligence (AI) to analyse data from novel sensors such as wearables to provide an earlier and more accurate prediction and diagnosis of heart disease. Digital health technologies that fuse AI and sensing devices may help disease prevention and reduce the substantial morbidity and mortality caused by CVD worldwide. In this review, we identify and describe recent developments in the application of digital health for CVD, focusing on AI approaches for CVD detection, diagnosis, and prediction through AI models driven by data collected from wearables. We summarise the literature on the use of wearables and AI in cardiovascular disease diagnosis, followed by a detailed description of the dominant AI approaches applied for modelling and prediction using data acquired from sensors such as wearables. We discuss the AI algorithms and models and clinical applications and find that AI and machine-learning-based approaches are superior to traditional or conventional statistical methods for predicting cardiovascular events. However, further studies evaluating the applicability of such algorithms in the real world are needed. In addition, improvements in wearable device data accuracy and better management of their application are required. Lastly, we discuss the challenges that the introduction of such technologies into routine healthcare may face.
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Affiliation(s)
- Jian-Dong Huang
- School of Computing, Engineering and Intelligent Systems, Ulster University at Magee, Londonderry BT48 7JL, UK
| | - Jinling Wang
- School of Computing, Engineering and Intelligent Systems, Ulster University at Magee, Londonderry BT48 7JL, UK
| | - Elaine Ramsey
- Department of Global Business & Enterprise, Ulster University at Magee, Londonderry BT48 7JL, UK
| | - Gerard Leavey
- School of Psychology, Ulster University at Coleraine, Londonderry BT52 1SA, UK
| | - Timothy J. A. Chico
- Department of Infection, Immunity and Cardiovascular Disease, The Medical School, The University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK
| | - Joan Condell
- School of Computing, Engineering and Intelligent Systems, Ulster University at Magee, Londonderry BT48 7JL, UK
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A New 12-Lead ECG Signals Fusion Method Using Evolutionary CNN Trees for Arrhythmia Detection. MATHEMATICS 2022. [DOI: 10.3390/math10111911] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
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.
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Petmezas G, Stefanopoulos L, Kilintzis V, Tzavelis A, Rogers JA, Katsaggelos AK, Maglaveras N. State-of-the-art Deep Learning Methods on Electrocardiogram Data: A Systematic Review (Preprint). JMIR Med Inform 2022; 10:e38454. [PMID: 35969441 PMCID: PMC9425174 DOI: 10.2196/38454] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/03/2022] [Accepted: 07/03/2022] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Georgios Petmezas
- Lab of Computing, Medical Informatics and Biomedical-Imaging Technologies, The Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Leandros Stefanopoulos
- Lab of Computing, Medical Informatics and Biomedical-Imaging Technologies, The Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilis Kilintzis
- Lab of Computing, Medical Informatics and Biomedical-Imaging Technologies, The Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Tzavelis
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, United States
| | - John A Rogers
- Department of Material Science, Northwestern University, Evanston, IL, United States
| | - Aggelos K Katsaggelos
- Department of Electrical and Computer Engineering, Northwestern University, Evanston, IL, United States
| | - Nicos Maglaveras
- Lab of Computing, Medical Informatics and Biomedical-Imaging Technologies, The Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Zhou Y, Zhao G, Li J, Sun G, Qian X, Moody B, Mark RG, Lehman LWH. A contrastive learning approach for ICU false arrhythmia alarm reduction. Sci Rep 2022; 12:4689. [PMID: 35304473 PMCID: PMC8933571 DOI: 10.1038/s41598-022-07761-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 02/07/2022] [Indexed: 11/16/2022] Open
Abstract
The high rate of false arrhythmia alarms in Intensive Care Units (ICUs) can lead to disruption of care, negatively impacting patients’ health through noise disturbances, and slow staff response time due to alarm fatigue. Prior false-alarm reduction approaches are often rule-based and require hand-crafted features from physiological waveforms as inputs to machine learning classifiers. Despite considerable prior efforts to address the problem, false alarms are a continuing problem in the ICUs. In this work, we present a deep learning framework to automatically learn feature representations of physiological waveforms using convolutional neural networks (CNNs) to discriminate between true vs. false arrhythmia alarms. We use Contrastive Learning to simultaneously minimize a binary cross entropy classification loss and a proposed similarity loss from pair-wise comparisons of waveform segments over time as a discriminative constraint. Furthermore, we augment our deep models with learned embeddings from a rule-based method to leverage prior domain knowledge for each alarm type. We evaluate our method using the dataset from the 2015 PhysioNet Computing in Cardiology Challenge. Ablation analysis demonstrates that Contrastive Learning significantly improves the performance of a combined deep learning and rule-based-embedding approach. Our results indicate that the final proposed deep learning framework achieves superior performance in comparison to the winning entries of the Challenge.
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Affiliation(s)
| | | | - Jun Li
- Nanjing University of Science and Technology, Nanjing, China
| | - Gan Sun
- Chinese Academy of Sciences, Shenyang, China
| | | | - Benjamin Moody
- Institute for Medical Engineering & Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Roger G Mark
- Institute for Medical Engineering & Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Li-Wei H Lehman
- Institute for Medical Engineering & Science, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
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Computer Assisted Patient Monitoring: Associated Patient, Clinical and ECG Characteristics and Strategy to Minimize False Alarms. HEARTS 2021. [DOI: 10.3390/hearts2040036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
This chapter is a review of studies that have examined false arrhythmia alarms during in-hospital electrocardiographic (ECG) monitoring in the intensive care unit. In addition, we describe an annotation effort being conducted at the UCSF School of Nursing, Center for Physiologic Research designed to improve algorithms for lethal arrhythmias (i.e., asystole, ventricular fibrillation, and ventricular tachycardia). Background: Alarm fatigue is a serious patient safety hazard among hospitalized patients. Data from the past five years, showed that alarm fatigue was responsible for over 650 deaths, which is likely lower than the actual number due to under-reporting. Arrhythmia alarms are a common source of false alarms and 90% are false. While clinical scientists have implemented a number of interventions to reduce these types of alarms (e.g., customized alarm settings; daily skin electrode changes; disposable vs. non-disposable lead wires; and education), only minor improvements have been made. This is likely as these interventions do not address the primary problem of false arrhythmia alarms, namely deficient and outdated arrhythmia algorithms. In this chapter we will describe a number of ECG features associated with false arrhythmia alarms. In addition, we briefly discuss an annotation effort our group has undertaken to improve lethal arrhythmia algorithms.
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Mousavi S, Afghah F, Khadem F, Acharya UR. ECG Language processing (ELP): A new technique to analyze ECG signals. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 202:105959. [PMID: 33607552 PMCID: PMC8009849 DOI: 10.1016/j.cmpb.2021.105959] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/27/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND A language is constructed of a finite/infinite set of sentences composing of words. Similar to natural languages, the Electrocardiogram (ECG) signal, the most common noninvasive tool to study the functionality of the heart and diagnose several abnormal arrhythmias, is made up of sequences of three or four distinct waves, including the P-wave, QRS complex, T-wave, and U-wave. An ECG signal may contain several different varieties of each wave (e.g., the QRS complex can have various appearances). For this reason, the ECG signal is a sequence of heartbeats similar to sentences in natural languages) and each heartbeat is composed of a set of waves (similar to words in a sentence) of different morphologies. METHODS Analogous to natural language processing (NLP), which is used to help computers understand and interpret the human's natural language, it is possible to develop methods inspired by NLP to aid computers to gain a deeper understanding of Electrocardiogram signals. In this work, our goal is to propose a novel ECG analysis technique, ECG language processing (ELP), focusing on empowering computers to understand ECG signals in a way physicians do. RESULTS We evaluated the proposed approach on two tasks, including the classification of heartbeats and the detection of atrial fibrillation in the ECG signals. Overall, our technique resulted in better performance or comparable performance with smaller neural networks compared to other deep neural networks and existing algorithms. CONCLUSION Experimental results on three databases (i.e., PhysioNet's MIT-BIH, MIT-BIH AFIB, and PhysioNet Challenge 2017 AFIB Dataset databases) reveal that the proposed approach as a general idea can be applied to a variety of biomedical applications and can achieve remarkable performance.
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Affiliation(s)
- Sajad Mousavi
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ 86011, USA.
| | - Fatemeh Afghah
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ 86011, USA.
| | - Fatemeh Khadem
- School of Informatics, Computing, and Cyber Systems, Northern Arizona University, Flagstaff, AZ 86011, USA.
| | - U Rajendra Acharya
- School of Engineering, Ngee Ann Polytechnic, Singapore; School of Science and Technology, Singapore University of Social Sciences, 463 Clementi Road, 599494, Singapore; Department Bioinformatics and Medical Engineering, Asia University, Taiwan.
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Fotoohinasab A, Hocking T, Afghah F. A greedy graph search algorithm based on changepoint analysis for automatic QRS complex detection. Comput Biol Med 2021; 130:104208. [PMID: 33484946 PMCID: PMC8026760 DOI: 10.1016/j.compbiomed.2021.104208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/31/2020] [Accepted: 01/01/2021] [Indexed: 11/19/2022]
Abstract
The electrocardiogram (ECG) signal is the most widely used non-invasive tool for the investigation of cardiovascular diseases. Automatic delineation of ECG fiducial points, in particular the R-peak, serves as the basis for ECG processing and analysis. This study proposes a new method of ECG signal analysis by introducing a new class of graphical models based on optimal changepoint detection models, named the graph-constrained changepoint detection (GCCD) model. The GCCD model treats fiducial points delineation in the non-stationary ECG signal as a changepoint detection problem. The proposed model exploits the sparsity of changepoints to detect abrupt changes within the ECG signal; thereby, the R-peak detection task can be relaxed from any preprocessing step. In this novel approach, prior biological knowledge about the expected sequence of changes is incorporated into the model using the constraint graph, which can be defined manually or automatically. First, we define the constraint graph manually; then, we present a graph learning algorithm that can search for an optimal graph in a greedy scheme. Finally, we compare the manually defined graphs and learned graphs in terms of graph structure and detection accuracy. We evaluate the performance of the algorithm using the MIT-BIH Arrhythmia Database. The proposed model achieves an overall sensitivity of 99.64%, positive predictivity of 99.71%, and detection error rate of 0.19 for the manually defined constraint graph and overall sensitivity of 99.76%, positive predictivity of 99.68%, and detection error rate of 0.55 for the automatic learning constraint graph.
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Affiliation(s)
- Atiyeh Fotoohinasab
- School of Informatics, Computing and Cyber Systems at Northern Arizona University, United States.
| | - Toby Hocking
- School of Informatics, Computing and Cyber Systems at Northern Arizona University, United States
| | - Fatemeh Afghah
- School of Informatics, Computing and Cyber Systems at Northern Arizona University, United States
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Yildirim O, Talo M, Ciaccio EJ, Tan RS, Acharya UR. Accurate deep neural network model to detect cardiac arrhythmia on more than 10,000 individual subject ECG records. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 197:105740. [PMID: 32932129 PMCID: PMC7477611 DOI: 10.1016/j.cmpb.2020.105740] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 08/31/2020] [Indexed: 05/04/2023]
Abstract
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.
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Affiliation(s)
- Ozal Yildirim
- Department of Computer Engineering, Munzur University, Tunceli,62000, Turkey
| | - Muhammed Talo
- Department of Software Engineering, Firat University, Elazig, Turkey
| | - Edward J Ciaccio
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, New York, NY 10032, USA
| | - Ru San Tan
- National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
| | - U Rajendra Acharya
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore; Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan; School of Management and Enterprise University of Southern Queensland, Springfield, Australia.
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HAN-ECG: An interpretable atrial fibrillation detection model using hierarchical attention networks. Comput Biol Med 2020; 127:104057. [PMID: 33126126 DOI: 10.1016/j.compbiomed.2020.104057] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/10/2020] [Accepted: 10/11/2020] [Indexed: 11/22/2022]
Abstract
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).
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Fotoohinasab A, Hocking T, Afghah F. A Graph-constrained Changepoint Detection Approach for ECG Segmentation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:332-336. [PMID: 33017996 DOI: 10.1109/embc44109.2020.9175333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Electrocardiogram (ECG) signal is the most commonly used non-invasive tool in the assessment of cardiovascular diseases. Segmentation of the ECG signal to locate its constitutive waves, in particular the R-peaks, is a key step in ECG processing and analysis. Over the years, several segmentation and QRS complex detection algorithms have been proposed with different features; however, their performance highly depends on applying preprocessing steps which makes them unreliable in realtime data analysis of ambulatory care settings and remote monitoring systems, where the collected data is highly noisy. Moreover, some issues still remain with the current algorithms in regard to the diverse morphological categories for the ECG signal and their high computation cost. In this paper, we introduce a novel graph-based optimal changepoint detection (GCCD) method for reliable detection of Rpeak positions without employing any preprocessing step. The proposed model guarantees to compute the globally optimal changepoint detection solution. It is also generic in nature and can be applied to other time-series biomedical signals. Based on the MIT-BIH arrhythmia (MIT-BIH-AR) database, the proposed method achieves overall sensitivity Sen = 99.76, positive predictivity PPR = 99.68, and detection error rate DER = 0.55 which are comparable to other state-of-the-art approaches.1 2.
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Hong S, Zhou Y, Shang J, Xiao C, Sun J. Opportunities and challenges of deep learning methods for electrocardiogram data: A systematic review. Comput Biol Med 2020; 122:103801. [PMID: 32658725 DOI: 10.1016/j.compbiomed.2020.103801] [Citation(s) in RCA: 108] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND The electrocardiogram (ECG) is one of the most commonly used diagnostic tools in medicine and healthcare. Deep learning methods have achieved promising results on predictive healthcare tasks using ECG signals. OBJECTIVE This paper presents a systematic review of deep learning methods for ECG data from both modeling and application perspectives. METHODS We extracted papers that applied deep learning (deep neural network) models to ECG data that were published between January 1st of 2010 and February 29th of 2020 from Google Scholar, PubMed, and the Digital Bibliography & Library Project. We then analyzed each article according to three factors: tasks, models, and data. Finally, we discuss open challenges and unsolved problems in this area. RESULTS The total number of papers extracted was 191. Among these papers, 108 were published after 2019. Different deep learning architectures have been used in various ECG analytics tasks, such as disease detection/classification, annotation/localization, sleep staging, biometric human identification, and denoising. CONCLUSION The number of works on deep learning for ECG data has grown explosively in recent years. Such works have achieved accuracy comparable to that of traditional feature-based approaches and ensembles of multiple approaches can achieve even better results. Specifically, we found that a hybrid architecture of a convolutional neural network and recurrent neural network ensemble using expert features yields the best results. However, there are some new challenges and problems related to interpretability, scalability, and efficiency that must be addressed. Furthermore, it is also worth investigating new applications from the perspectives of datasets and methods. SIGNIFICANCE This paper summarizes existing deep learning research using ECG data from multiple perspectives and highlights existing challenges and problems to identify potential future research directions.
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Affiliation(s)
- Shenda Hong
- Department of Computational Science and Engineering, Georgia Institute of Technology, Atlanta, USA.
| | - Yuxi Zhou
- School of Electronics Engineering and Computer Science, Peking University, Beijing, China; Key Laboratory of Machine Perception (Ministry of Education), Peking University, Beijing, China.
| | - Junyuan Shang
- School of Electronics Engineering and Computer Science, Peking University, Beijing, China; Key Laboratory of Machine Perception (Ministry of Education), Peking University, Beijing, China.
| | - Cao Xiao
- Analytics Center of Excellence, IQVIA, Cambridge, USA.
| | - Jimeng Sun
- Department of Computer Science, University of Illinois at Urbana-Champaign, Urbana, USA.
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