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Monachino G, Zanchi B, Fiorillo L, Conte G, Auricchio A, Tzovara A, Faraci FD. Deep Generative Models: The winning key for large and easily accessible ECG datasets? Comput Biol Med 2023; 167:107655. [PMID: 37976830 DOI: 10.1016/j.compbiomed.2023.107655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/04/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
Large high-quality datasets are essential for building powerful artificial intelligence (AI) algorithms capable of supporting advancement in cardiac clinical research. However, researchers working with electrocardiogram (ECG) signals struggle to get access and/or to build one. The aim of the present work is to shed light on a potential solution to address the lack of large and easily accessible ECG datasets. Firstly, the main causes of such a lack are identified and examined. Afterward, the potentials and limitations of cardiac data generation via deep generative models (DGMs) are deeply analyzed. These very promising algorithms have been found capable not only of generating large quantities of ECG signals but also of supporting data anonymization processes, to simplify data sharing while respecting patients' privacy. Their application could help research progress and cooperation in the name of open science. However several aspects, such as a standardized synthetic data quality evaluation and algorithm stability, need to be further explored.
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Affiliation(s)
- Giuliana Monachino
- Institute of Digital Technologies for Personalized Healthcare - MeDiTech, Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Via la Santa 1, Lugano 6900, Switzerland; Institute of Informatics, University of Bern, Neubrückstrasse 10, Bern 3012, Switzerland.
| | - Beatrice Zanchi
- Institute of Digital Technologies for Personalized Healthcare - MeDiTech, Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Via la Santa 1, Lugano 6900, Switzerland; Department of Quantitative Biomedicine, University of Zurich, Schmelzbergstrasse 26, Zurich 8091, Switzerland
| | - Luigi Fiorillo
- Institute of Digital Technologies for Personalized Healthcare - MeDiTech, Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Via la Santa 1, Lugano 6900, Switzerland
| | - Giulio Conte
- Division of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48, Lugano 6900, Switzerland; Centre for Computational Medicine in Cardiology, Faculty of Informatics, Università della Svizzera Italiana, Via la Santa 1, Lugano 6900, Switzerland
| | - Angelo Auricchio
- Division of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48, Lugano 6900, Switzerland; Centre for Computational Medicine in Cardiology, Faculty of Informatics, Università della Svizzera Italiana, Via la Santa 1, Lugano 6900, Switzerland
| | - Athina Tzovara
- Institute of Informatics, University of Bern, Neubrückstrasse 10, Bern 3012, Switzerland; Sleep Wake Epilepsy Center | NeuroTec, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 16, Bern 3010, Switzerland
| | - Francesca Dalia Faraci
- Institute of Digital Technologies for Personalized Healthcare - MeDiTech, Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Via la Santa 1, Lugano 6900, Switzerland
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Zanchi B, Faraci FD, Gharaviri A, Bergonti M, Monga T, Auricchio A, Conte G. Identification of Brugada syndrome based on P-wave features: an artificial intelligence-based approach. Europace 2023; 25:euad334. [PMID: 37944131 PMCID: PMC10683037 DOI: 10.1093/europace/euad334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/27/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023] Open
Abstract
AIMS Brugada syndrome (BrS) is an inherited disease associated with an increased risk of ventricular arrhythmias. Recent studies have reported the presence of an altered atrial phenotype characterized by abnormal P-wave parameters. The aim of this study was to identify BrS based exclusively on P-wave features through an artificial intelligence (AI)-based model. METHODS AND RESULTS Continuous 5 min 12-lead ECG recordings were obtained in sinus rhythm from (i) patients with spontaneous or ajmaline-induced BrS and no history of AF and (ii) subjects with suspected BrS and negative ajmaline challenge. The recorded ECG signals were processed and divided into epochs of 15 s each. Within these epochs, P-waves were first identified and then averaged. From the averaged P-waves, a total of 67 different features considered relevant to the classification task were extracted. These features were then used to train nine different AI-based supervised classifiers. A total of 2228 averaged P-wave observations, resulting from the analysis of 33 420 P-waves, were obtained from 123 patients (79 BrS+ and 44 BrS-). Averaged P-waves were divided using a patient-wise split, allocating 80% for training and 20% for testing, ensuring data integrity and reducing biases in AI-based model training. The BrS+ patients presented with longer P-wave duration (136 ms vs. 124 ms, P < 0.001) and higher terminal force in lead V1 (2.5 au vs. 1.7 au, P < 0.01) compared with BrS- subjects. Among classifiers, AdaBoost model had the highest values of performance for all the considered metrics, reaching an accuracy of over 81% (sensitivity 86%, specificity 73%). CONCLUSION An AI machine-learning model is able to identify patients with BrS based only on P-wave characteristics. These findings confirm the presence of an atrial hallmark and open new horizons for AI-guided BrS diagnosis.
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Affiliation(s)
- Beatrice Zanchi
- Department of Innovative Technologies, Institute of Digital Technologies for Personalized Healthcare of SUPSI, Lugano, Switzerland
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Francesca Dalia Faraci
- Department of Innovative Technologies, Institute of Digital Technologies for Personalized Healthcare of SUPSI, Lugano, Switzerland
| | - Ali Gharaviri
- Center for Computational Medicine in Cardiology, USI, via La Santa 1, 6900, Lugano, Switzerland
- Centre of Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland
| | - Marco Bergonti
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, via Tesserete 64, 6900, Lugano, Switzerland
| | - Tomas Monga
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Angelo Auricchio
- Center for Computational Medicine in Cardiology, USI, via La Santa 1, 6900, Lugano, Switzerland
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, via Tesserete 64, 6900, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Giulio Conte
- Center for Computational Medicine in Cardiology, USI, via La Santa 1, 6900, Lugano, Switzerland
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, via Tesserete 64, 6900, Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
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