Automated Arrhythmia Detection Based on RR Intervals

Compressed Deep Learning Models for Wearable Atrial Fibrillation Detection through Attention

Deep learning (DL) models have shown promise for the accurate detection of atrial fibrillation (AF) from electrocardiogram/photoplethysmography (ECG/PPG) data, yet deploying these on resource-constrained wearable devices remains challenging. This study proposes integrating a customized channel attention mechanism to compress DL neural networks for AF detection, allowing the model to focus only on the most salient time-series features. The results demonstrate that applying compression through channel attention significantly reduces the total number of model parameters and file size while minimizing loss in detection accuracy. Notably, after compression, performance increases for certain model variants in key AF databases (ADB and C2017DB). Moreover, analyzing the learned channel attention distributions after training enhances the explainability of the AF detection models by highlighting the salient temporal ECG/PPG features most important for its diagnosis. Overall, this research establishes that integrating attention mechanisms is an effective strategy for compressing large DL models, making them deployable on low-power wearable devices. We show that this approach yields compressed, accurate, and explainable AF detectors ideal for wearables. Incorporating channel attention enables simpler yet more accurate algorithms that have the potential to provide clinicians with valuable insights into the salient temporal biomarkers of AF. Our findings highlight that the use of attention is an important direction for the future development of efficient, high-performing, and interpretable AF screening tools for wearable technology.

Noise Reduction in Photoplethysmography Signals Using a Convolutional Denoising Autoencoder With Unconventional Training Scheme

OBJECTIVE

We propose an efficient approach based on a convolutional denoising autoencoder (CDA) network to reduce motion and noise artifacts (MNA) from corrupted atrial fibrillation (AF) and non-AF photoplethysmography (PPG) data segments so that an accurate PPG-signal-derived heart rate can be obtained. Our method's main innovation is the optimization of the CDA performance for both rhythms using more AF than non-AF data for training the AF-specific CDA model and vice versa for the non-AF CDA network.

METHODS

To evaluate this unconventional training scheme, our proposed network was trained and tested on 25-sec PPG data segments from 48 subjects from two different databases-the Pulsewatch dataset and Stanford University's publicly available PPG dataset. In total, our dataset contains 10,773 data segments: 7,001 segments for training and 3,772 independent segments from out-of-sample subjects for testing.

RESULTS

Using real-life corrupted PPG segments, our approach significantly reduced the average heart rate root mean square error (RMSE) of the reconstructed PPG segments by 45.74% and 23% compared to the corrupted non-AF and AF data, respectively. Further, our approach exhibited lower RMSE, and higher sensitivity and PPV for detected peaks compared to the reconstructed data produced by the alternative methods.

CONCLUSION

These results show the promise of our approach as a reliable denoising method, which should be used prior to AF detection algorithms for an accurate cardiac health monitoring involving wearable devices.

SIGNIFICANCE

PPG signals collected from wearables are vulnerable to MNA, which limits their use as a reliable measurement, particularly in uncontrolled real-life environments.

Arrhythmia classification detection based on multiple electrocardiograms databases

According to the World Health Organization, cardiovascular diseases are the leading cause of deaths globally. Electrocardiogram (ECG) is a non-invasive approach for detecting heart diseases and reducing the risk of heart disease-related death. However, there are limited numbers of ECG samples and imbalance distribution for existing ECG databases. It is difficult to train practical and efficient neural networks. Based on the analysis and research of many existing ECG databases, this paper conduct an in-depth study on three fine-labeled ECG databases, to extract heartbeats, unify the sampling frequency, and propose a self-processing method of heartbeats, and finally form a unified ECG arrhythmia classification database, noted as Hercules-3. It is separated into training sets (80%) and testing sets (the remaining 20%). In order to verify its capabilities, we have trained a 16-classification fully connected neural network based on Hercules-3 and it achieves an accuracy rate of up to 98.67%. Compared with other data processing, our proposed method improves classification recall by at least 6%, classification accuracy by at least 4%, and F1-score by at least 7%.

Performance Evaluation of Quantum-Based Machine Learning Algorithms for Cardiac Arrhythmia Classification

The electrocardiogram (ECG) is the most common technique used to diagnose heart diseases. The electrical signals produced by the heart are recorded by chest electrodes and by the extremity electrodes placed on the limbs. Many diseases, such as arrhythmia, cardiomyopathy, coronary heart disease, and heart failure, can be diagnosed by examining ECG signals. The interpretation of these signals by experts may take a long time, and there may be differences between expert interpretations. Since technological developments are intertwined with the medical sciences, computer-assisted diagnostic methods have recently come forward. In computer science, machine learning techniques are often preferred for automatic detection. Quantum-based structures have emerged to increase the machine learning algorithm's speed and classification performance. In this study, a quantum-based machine learning algorithm is applied to classify heart rhythms. The ECG properties were converted to qubit structure using principal component analysis (PCA). The resulting qubits are classified using the quantum support vector machine (QSVM) algorithm. Quantum computer simulation over Qiskit was used for classification studies. Within the scope of experimental studies, comparisons between classical SVM and QSVM were made using different data amounts and qubit numbers. In the results of the analysis, classical SVM achieved 86.96% accuracy, and QSVM achieved 84.64% accuracy. Despite the fact that the entire dataset was not used due to various limitations, these successful performances were achieved. Classification of medical data such as that from ECG has shown that quantum-based machine learning frameworks perform well despite current resource constraints. In this respect, the study includes essential contributions to the use of quantum-based machine learning methods on signal data in medicine.

ECG Classification Using an Optimal Temporal Convolutional Network for Remote Health Monitoring

Increased life expectancy in most countries is a result of continuous improvements at all levels, starting from medicine and public health services, environmental and personal hygiene to the use of the most advanced technologies by healthcare providers. Despite these significant improvements, especially at the technological level in the last few decades, the overall access to healthcare services and medical facilities worldwide is not equally distributed. Indeed, the end beneficiary of these most advanced healthcare services and technologies on a daily basis are mostly residents of big cities, whereas the residents of rural areas, even in developed countries, have major difficulties accessing even basic medical services. This may lead to huge deficiencies in timely medical advice and assistance and may even cause death in some cases. Remote healthcare is considered a serious candidate for facilitating access to health services for all; thus, by using the most advanced technologies, providing at the same time high quality diagnosis and ease of implementation and use. ECG analysis and related cardiac diagnosis techniques are the basic healthcare methods providing rapid insights in potential health issues through simple visualization and interpretation by clinicians or by automatic detection of potential cardiac anomalies. In this paper, we propose a novel machine learning (ML) architecture for the ECG classification regarding five heart diseases based on temporal convolution networks (TCN). The proposed design, which implements a dilated causal one-dimensional convolution on the input heartbeat signals, seems to be outperforming all existing ML methods with an accuracy of 96.12% and an F1 score of 84.13%, using a reduced number of parameters (10.2 K). Such results make the proposed TCN architecture a good candidate for low power consumption hardware platforms, and thus its potential use in low cost embedded devices for remote health monitoring.

Wearable Devices for Remote Monitoring of Heart Rate and Heart Rate Variability-What We Know and What Is Coming

Heart rate at rest and exercise may predict cardiovascular risk. Heart rate variability is a measure of variation in time between each heartbeat, representing the balance between the parasympathetic and sympathetic nervous system and may predict adverse cardiovascular events. With advances in technology and increasing commercial interest, the scope of remote monitoring health systems has expanded. In this review, we discuss the concepts behind cardiac signal generation and recording, wearable devices, pros and cons focusing on accuracy, ease of application of commercial and medical grade diagnostic devices, which showed promising results in terms of reliability and value. Incorporation of artificial intelligence and cloud based remote monitoring have been evolving to facilitate timely data processing, improve patient convenience and ensure data security.

Wearable Devices Combined with Artificial Intelligence-A Future Technology for Atrial Fibrillation Detection?

Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. The arrhythmia and methods developed to cure it have been studied for several decades. However, professionals worldwide are still working to improve treatment quality. One novel technology that can be useful is a wearable device. The two most used recordings from these devices are photoplethysmogram (PPG) and electrocardiogram (ECG) signals. As the price lowers, these devices will become significant technology to increase sensitivity, for monitoring and for treatment quality support. This is important as AF can be challenging to detect in advance, especially during home monitoring. Modern artificial intelligence (AI) has the potential to respond to this challenge. AI has already achieved state of the art results in many applications, including bioengineering. In this perspective, we discuss wearable devices combined with AI for AF detection, an approach that enables a new era of possibilities for the future.

Deepaware: A hybrid deep learning and context-aware heuristics-based model for atrial fibrillation detection

BACKGROUND

State-of-the-art automatic atrial fibrillation (AF) detection models trained on RR-interval (RRI) features generally produce high performance on standard benchmark electrocardiogram (ECG) AF datasets. These models, however, result in a significantly high false positive rates (FPRs) when applied on ECG data collected under free-living ambulatory conditions and in the presence of non-AF arrhythmias.

METHOD

This paper proposes DeepAware, a novel hybrid model combining deep learning (DL) and context-aware heuristics (CAH), which reduces the FPR effectively and improves the AF detection performance on participant-operated ambulatory ECG from free-living conditions. It exploits the RRI and P-wave features, as well as the contextual features from the ambulatory ECG.

RESULTS

DeepAware is shown to be very generalizable and superior to the state-of-the-art models when applied on unseen benchmark ECG AF datasets. Most importantly, the model is able to detect AF efficiently when applied on participant-operated ambulatory ECG recordings from free-living conditions and has achieved a sensitivity (Se), specificity (Sp), and accuracy (Acc) of 97.94%, 98.39%, 98.06%, respectively. Results also demonstrate the effect of atrial activity analysis (via P-waves detection) and CAH in reducing the FPR over the RRI features-based AF detection model.

CONCLUSIONS

The proposed DeepAware model can substantially reduce the physician's workload of manually reviewing the false positives (FPs) and facilitate long-term ambulatory monitoring for early detection of AF.

The influence of atrial flutter in automated detection of atrial arrhythmias - are we ready to go into clinical practice?"

OBJECTIVE

To investigate the impact of atrial flutter (A_fl) in the atrial arrhythmias classification task. We additionally advocate the use of a subject-based split for future studies in the field in order to avoid within-subject correlation which may lead to over-optimistic inferences. Finally, we demonstrate the effectiveness of the classifiers outside of the initially studied circumstances, by performing an inter-dataset model evaluation of the classifiers in data from different sources.

METHODS

ECG signals of two private and three public (two MIT-BIH and Chapman ecgdb) databases were preprocessed and divided into 10s segments which were then subject to feature extraction. The created datasets were divided into a training and test set in two ways, based on a random split and a patient split. Classification was performed using the XGBoost classifier, as well as two benchmark classification models using both data splits. The trained models were then used to make predictions on the test data of the remaining datasets.

RESULTS

The XGBoost model yielded the best performance across all datasets compared to the remaining benchmark models, however variability in model performance was seen across datasets, with accuracy ranging from 70.6% to 89.4%, sensitivity ranging from 61.4% to 76.8%, and specificity ranging from 87.3% to 95.5%. When comparing the results between the patient and the random split, no significant difference was seen in the two private datasets and the Chapman dataset, where the number of samples per patient is low. Nonetheless, in the MIT-BIH dataset, where the average number of samples per patient is approximately 1300, a noticeable disparity was identified. The accuracy, sensitivity, and specificity of the random split in this dataset of 93.6%, 86.4%, and 95.9% respectively, were decreased to 88%, 61.4%, and 89.8% in the patient split, with the largest drop being in A_fl sensitivity, from 71% to 5.4%. The inter-dataset scores were also significantly lower than their intra-dataset counterparts across all datasets.

CONCLUSIONS

CAD systems have great potential in the assistance of physicians in reliable, precise and efficient detection of arrhythmias. However, although compelling research has been done in the field, yielding models with excellent performances on their datasets, we show that these results may be over-optimistic. In our study, we give insight into the difficulty of detection of A_fl on several datasets and show the need for a higher representation of A_fl in public datasets. Furthermore, we show the necessity of a more structured evaluation of model performance through the use of a patient-based split and inter-dataset testing scheme to avoid the problem of within-subject correlation which may lead to misleadingly high scores. Finally, we stress the need for the creation and use of datasets with a higher number of patients and a more balanced representation of classes if we are to progress in this mission.

A Novel Deep-Learning-Based Framework for the Classification of Cardiac Arrhythmia

Cardiovascular diseases (CVDs) are the primary cause of death. Every year, many people die due to heart attacks. The electrocardiogram (ECG) signal plays a vital role in diagnosing CVDs. ECG signals provide us with information about the heartbeat. ECGs can detect cardiac arrhythmia. In this article, a novel deep-learning-based approach is proposed to classify ECG signals as normal and into sixteen arrhythmia classes. The ECG signal is preprocessed and converted into a 2D signal using continuous wavelet transform (CWT). The time–frequency domain representation of the CWT is given to the deep convolutional neural network (D-CNN) with an attention block to extract the spatial features vector (SFV). The attention block is proposed to capture global features. For dimensionality reduction in SFV, a novel clump of features (CoF) framework is proposed. The k-fold cross-validation is applied to obtain the reduced feature vector (RFV), and the RFV is given to the classifier to classify the arrhythmia class. The proposed framework achieves 99.84% accuracy with 100% sensitivity and 99.6% specificity. The proposed algorithm outperforms the state-of-the-art accuracy, F1-score, and sensitivity techniques.

PrismatoidPatNet54: An Accurate ECG Signal Classification Model Using Prismatoid Pattern-Based Learning Architecture

Background and objective: Arrhythmia is a widely seen cardiologic ailment worldwide, and is diagnosed using electrocardiogram (ECG) signals. The ECG signals can be translated manually by human experts, but can also be scheduled to be carried out automatically by some agents. To easily diagnose arrhythmia, an intelligent assistant can be used. Machine learning-based automatic arrhythmia detection models have been proposed to create an intelligent assistant. Materials and Methods: In this work, we have used an ECG dataset. This dataset contains 1000 ECG signals with 17 categories. A new hand-modeled learning network is developed on this dataset, and this model uses a 3D shape (prismatoid) to create textural features. Moreover, a tunable Q wavelet transform with low oscillatory parameters and a statistical feature extractor has been applied to extract features at both low and high levels. The suggested prismatoid pattern and statistical feature extractor create features from 53 sub-bands. A neighborhood component analysis has been used to choose the most discriminative features. Two classifiers, k nearest neighbor (kNN) and support vector machine (SVM), were used to classify the selected top features with 10-fold cross-validation. Results: The calculated best accuracy rate of the proposed model is equal to 97.30% using the SVM classifier. Conclusion: The computed results clearly indicate the success of the proposed prismatoid pattern-based model.