Electrocardiographic and signal monitoring in ischaemic heart disease: state of the art and perspective

Automated ischemic beat classification using genetic algorithms and multicriteria decision analysis

Cardiac beat classification is a key process in the detection of myocardial ischemic episodes in the electrocardiographic signal. In the present study, we propose a multicriteria sorting method for classifying the cardiac beats as ischemic or not. Through a supervised learning procedure, each beat is compared to preclassified category prototypes under five criteria. These criteria refer to ST segment changes, T wave alterations, and the patient's age. The difficulty in applying the above criteria is the determination of the required method parameters, namely the thresholds and weight values. To overcome this problem, we employed a genetic algorithm, which, after proper training, automatically calculates the optimum values for the above parameters. A task-specific cardiac beat database was developed for training and testing the proposed method using data from the European Society of Cardiology ST-T database. Various experimental tests were carried out in order to adjust each module of the classification system. The obtained performance was 91% in terms of both sensitivity and specificity and compares favorably to other beat classification approaches proposed in the literature.

Long-term ST database: a reference for the development and evaluation of automated ischaemia detectors and for the study of the dynamics of myocardial ischaemia

The long-term ST database is the result of a multinational research effort. The goal was to develop a challenging and realistic research resource for development and evaluation of automated systems to detect transient ST segment changes in electrocardiograms and for supporting basic research into the mechanisms and dynamics of transient myocardial ischaemia. Twenty-four hour ambulatory ECG records were selected from routine clinical practice settings in the USA and Europe, between 1994 and 2000, on the basis of occurrence of ischaemic and non-ischaemic ST segment changes. Human expert annotators used newly developed annotation protocols and a specially developed interactive graphic editor tool (SEMIA) that supported paperless editing of annotations and facilitated international co-operation via the Internet. The database contains 86 two- and three-channel 24 h annotated ambulatory records from 80 patients and is stored on DVD-ROMs. The database annotation files contain ST segment annotations of transient ischaemic (1155) and heart-rate related ST episodes and annotations of non-ischaemic ST segment events related to postural changes and conduction abnormalities. The database is intended to complement the European Society of Cardiology ST-T database and the MIT-BIH and AHA arrhythmia databases. It provides a comprehensive representation of 'real-world' data, with numerous examples of transient ischaemic and non-ischaemic ST segment changes, arrhythmias, conduction abnormalities, axis shifts, noise and artifacts.

An ischemia detection method based on artificial neural networks

An automated technique was developed for the detection of ischemic episodes in long duration electrocardiographic (ECG) recordings that employs an artificial neural network. In order to train the network for beat classification, a cardiac beat dataset was constructed based on recordings from the European Society of Cardiology (ESC) ST-T database. The network was trained using a Bayesian regularisation method. The raw ECG signal containing the ST segment and the T wave of each beat were the inputs to the beat classification system and the output was the classification of the beat. The input to the network was produced through a principal component analysis (PCA) to achieve dimensionality reduction. The network performance in beat classification was tested on the cardiac beat database providing 90% sensitivity (Se) and 90% specificity (Sp). The neural beat classifier is integrated in a four-stage procedure for ischemic episode detection. The whole system was evaluated on the ESC ST-T database. When aggregate gross statistics was used the Se was 90% and the positive predictive accuracy (PPA) 89%. When aggregate average statistics was used the Se became 86% and the PPA 87%. These results are better than other reported.