A Classification and Prediction Hybrid Model Construction with the IQPSO-SVM Algorithm for Atrial Fibrillation Arrhythmia

Atrial fibrillation (AF) is the most common cardiovascular disease (CVD); and most existing algorithms are usually designed for the diagnosis (i.e.; feature classification) or prediction of AF. Artificial intelligence (AI) algorithms integrate the diagnosis of AF electrocardiogram (ECG) and predict the possibility that AF will occur in the future. In this paper; we utilized the MIT-BIH AF Database (AFDB); which is composed of data from normal people and patients with AF and onset characteristics; and the AFPDB database (i.e.; PAF Prediction Challenge Database); which consists of data from patients with Paroxysmal AF (PAF; the records contain the ECG preceding an episode of PAF); and subjects who do not have documented AF. We extracted the respective characteristics of the databases and used them in modeling diagnosis and prediction. In the aspect of model construction; we regarded diagnosis and prediction as two classification problems; adopted the traditional support vector machine (SVM) algorithm; and combined them. The improved quantum particle swarm optimization support vector machine (IQPSO-SVM) algorithm was used to speed the training time. During the verification process; the clinical FZU-FPH database created by Fuzhou University and Fujian Provincial Hospital was used for hybrid model testing. The data were obtained from the Holter monitor of the hospital and encrypted. We proposed an algorithm for transforming the PDF ECG waveform images of hospital examination reports into digital data. For the diagnosis model and prediction model trained using the training set of the AFDB and AFPDB databases; the sensitivity; specificity; and accuracy measures were 99.2% and 99.2%; 99.2% and 93.3%; and 91.7% and 92.5% for the test set of the AFDB and AFPDB databases; respectively. Moreover; the sensitivity; specificity; and accuracy were 94.2%; 79.7%; and 87.0%; respectively; when tested using the FZU-FPH database with 138 samples of the ECG composed of two labels. The composite classification and prediction model using a new water-fall ensemble method had a total accuracy of approximately 91% for the test set of the FZU-FPH database with 80 samples with 120 segments of ECG with three labels

A real-time data mining technique applied for critical ECG rhythm on handheld device

Sudden cardiac arrest is often caused by ventricular arrhythmias and these episodes can lead to death for patients with chronic heart disease. Hence, detection of such arrhythmia is crucial in mobile ECG monitoring. In this research, a systematic study is carried out to investigate the possible limitations that are preventing the realisation of a real-time ECG arrhythmia data-mining algorithm suitable for application on mobile devices. Based on the findings, a computationally lightweight algorithm is devised and tested. Ventricular tachycardia (VT) is the most common type of ventricular arrhythmias and is also the deadliest.. A ventricular tachycardia (VT) episode is due to a disorder ofthe regular contractions ofthe heart. It occurs when the human heart ventricles generate a rapid heartbeat which disrupts the regular physiology cycle. The normal sinus rhythm (NSR) of a regular human heart beat signal has its signature PQRST waveform and in regular pattern. Whereas, the characteristics of a ventricular tachycardia (VT) signal waveforms are short R-R intervals, widen QRS duration and the absence of P-waves. Each type of ECG arrhythmia previously mentioned has a unique waveform signature that can be exploited as features to be used for the realization of an automated ECG analysis application. In order to extract this known ECG waveform feature, a time-domain analysis is proposed for feature extraction. Cross-correlation allows the computation of a co-efficient that quantifies the similarity between two times-series. Hence, by cross-correlating known ECG waveform templates with an unknown ECG signal, the coefficient can indicate the similarities. In previous published work, a preliminary study was carried out. The cross-correlation coefficient wave (CCW) technique was introduced for feature extraction. The outcome ofthis work presents CCW as a promising feature to differentiate between NSR, VT and Vfib signals. Moreover, cross-correlation computation does not require high computational overhead. Next, an automated detection algorithm requires a classification mechanism to make sense of the feature extracted. A further study is conducted and published, a fuzzy set k-NN classifier was introduced for the classification of CCW feature extracted from ECG signal segments. A training set of size 180 is used. The outcome of the study indicates that the computationally light-weight fuzzy k-NN classifier can reliably classify between NSR and VT signals, the class detection rate is low for classifying Vfib signal using the fuzzy k-NN classifier. Hence, a modified algorithm known as fuzzy hybrid classifier is proposed. By implementing an expert knowledge based fuzzy inference system for classification of ECG signal; the Vfib signal detection rate was improved. The comparison outcome was that the hybrid fuzzy classifier is able to achieve 91.1% correct rate, 100% sensitivity and 100% specificity. The previously mentioned result outperforms the compared classifiers. The proposed detection and classification algorithm is able to achieve high accuracy in analysing ECG signal feature of NSR, VT and Vfib nature. Moreover, the proposed classifier is successfully implemented on a smart mobile device and it is able to perform data-mining of the ECG signal with satisfiable results

Automatic analysis and classification of cardiac acoustic signals for long term monitoring

Objective: Cardiovascular diseases are the leading cause of death worldwide resulting in over 17.9 million deaths each year. Most of these diseases are preventable and treatable, but their progression and outcomes are significantly more positive with early-stage diagnosis and proper disease management. Among the approaches available to assist with the task of early-stage diagnosis and management of cardiac conditions, automatic analysis of auscultatory recordings is one of the most promising ones, since it could be particularly suitable for ambulatory/wearable monitoring. Thus, proper investigation of abnormalities present in cardiac acoustic signals can provide vital clinical information to assist long term monitoring. Cardiac acoustic signals, however, are very susceptible to noise and artifacts, and their characteristics vary largely with the recording conditions which makes the analysis challenging. Additionally, there are challenges in the steps used for automatic analysis and classification of cardiac acoustic signals. Broadly, these steps are the segmentation, feature extraction and subsequent classification of recorded signals using selected features. This thesis presents approaches using novel features with the aim to assist the automatic early-stage detection of cardiovascular diseases with improved performance, using cardiac acoustic signals collected in real-world conditions. Methods: Cardiac auscultatory recordings were studied to identify potential features to help in the classification of recordings from subjects with and without cardiac diseases. The diseases considered in this study for the identification of the symptoms and characteristics are the valvular heart diseases due to stenosis and regurgitation, atrial fibrillation, and splitting of fundamental heart sounds leading to additional lub/dub sounds in the systole or diastole interval of a cardiac cycle. The localisation of cardiac sounds of interest was performed using an adaptive wavelet-based filtering in combination with the Shannon energy envelope and prior information of fundamental heart sounds. This is a prerequisite step for the feature extraction and subsequent classification of recordings, leading to a more precise diagnosis. Localised segments of S1 and S2 sounds, and artifacts, were used to extract a set of perceptual and statistical features using wavelet transform, homomorphic filtering, Hilbert transform and mel-scale filtering, which were then fed to train an ensemble classifier to interpret S1 and S2 sounds. Once sound peaks of interest were identified, features extracted from these peaks, together with the features used for the identification of S1 and S2 sounds, were used to develop an algorithm to classify recorded signals. Overall, 99 features were extracted and statistically analysed using neighborhood component analysis (NCA) to identify the features which showed the greatest ability in classifying recordings. Selected features were then fed to train an ensemble classifier to classify abnormal recordings, and hyperparameters were optimized to evaluate the performance of the trained classifier. Thus, a machine learning-based approach for the automatic identification and classification of S1 and S2, and normal and abnormal recordings, in real-world noisy recordings using a novel feature set is presented. The validity of the proposed algorithm was tested using acoustic signals recorded in real-world, non-controlled environments at four auscultation sites (aortic valve, tricuspid valve, mitral valve, and pulmonary valve), from the subjects with and without cardiac diseases; together with recordings from the three large public databases. The performance metrics of the methodology in relation to classification accuracy (CA), sensitivity (SE), precision (P+), and F1 score, were evaluated. Results: This thesis proposes four different algorithms to automatically classify fundamental heart sounds – S1 and S2; normal fundamental sounds and abnormal additional lub/dub sounds recordings; normal and abnormal recordings; and recordings with heart valve disorders, namely the mitral stenosis (MS), mitral regurgitation (MR), mitral valve prolapse (MVP), aortic stenosis (AS) and murmurs, using cardiac acoustic signals. The results obtained from these algorithms were as follows: • The algorithm to classify S1 and S2 sounds achieved an average SE of 91.59% and 89.78%, and F1 score of 90.65% and 89.42%, in classifying S1 and S2, respectively. 87 features were extracted and statistically studied to identify the top 14 features which showed the best capabilities in classifying S1 and S2, and artifacts. The analysis showed that the most relevant features were those extracted using Maximum Overlap Discrete Wavelet Transform (MODWT) and Hilbert transform. • The algorithm to classify normal fundamental heart sounds and abnormal additional lub/dub sounds in the systole or diastole intervals of a cardiac cycle, achieved an average SE of 89.15%, P+ of 89.71%, F1 of 89.41%, and CA of 95.11% using the test dataset from the PASCAL database. The top 10 features that achieved the highest weights in classifying these recordings were also identified. • Normal and abnormal classification of recordings using the proposed algorithm achieved a mean CA of 94.172%, and SE of 92.38%, in classifying recordings from the different databases. Among the top 10 acoustic features identified, the deterministic energy of the sound peaks of interest and the instantaneous frequency extracted using the Hilbert Huang-transform, achieved the highest weights. • The machine learning-based approach proposed to classify recordings of heart valve disorders (AS, MS, MR, and MVP) achieved an average CA of 98.26% and SE of 95.83%. 99 acoustic features were extracted and their abilities to differentiate these abnormalities were examined using weights obtained from the neighborhood component analysis (NCA). The top 10 features which showed the greatest abilities in classifying these abnormalities using recordings from the different databases were also identified. The achieved results demonstrate the ability of the algorithms to automatically identify and classify cardiac sounds. This work provides the basis for measurements of many useful clinical attributes of cardiac acoustic signals and can potentially help in monitoring the overall cardiac health for longer duration. The work presented in this thesis is the first-of-its-kind to validate the results using both, normal and pathological cardiac acoustic signals, recorded for a long continuous duration of 5 minutes at four different auscultation sites in non-controlled real-world conditions.Open Acces

Low Power Circuits for Smart Flexible ECG Sensors

Cardiovascular diseases (CVDs) are the world leading cause of death. In-home heart condition monitoring effectively reduced the CVD patient hospitalization rate. Flexible electrocardiogram (ECG) sensor provides an affordable, convenient and comfortable in-home monitoring solution. The three critical building blocks of the ECG sensor i.e., analog frontend (AFE), QRS detector, and cardiac arrhythmia classifier (CAC), are studied in this research. A fully differential difference amplifier (FDDA) based AFE that employs DC-coupled input stage increases the input impedance and improves CMRR. A parasitic capacitor reuse technique is proposed to improve the noise/area efficiency and CMRR. An on-body DC bias scheme is introduced to deal with the input DC offset. Implemented in 0.35m CMOS process with an area of 0.405mm2, the proposed AFE consumes 0.9W at 1.8V and shows excellent noise effective factor of 2.55, and CMRR of 76dB. Experiment shows the proposed AFE not only picks up clean ECG signal with electrodes placed as close as 2cm under both resting and walking conditions, but also obtains the distinct -wave after eye blink from EEG recording. A personalized QRS detection algorithm is proposed to achieve an average positive prediction rate of 99.39% and sensitivity rate of 99.21%. The user-specific template avoids the complicate models and parameters used in existing algorithms while covers most situations for practical applications. The detection is based on the comparison of the correlation coefficient of the user-specific template with the ECG segment under detection. The proposed one-target clustering reduced the required loops. A continuous-in-time discrete-in-amplitude (CTDA) artificial neural network (ANN) based CAC is proposed for the smart ECG sensor. The proposed CAC achieves over 98% classification accuracy for 4 types of beats defined by AAMI (Association for the Advancement of Medical Instrumentation). The CTDA scheme significantly reduces the input sample numbers and simplifies the sample representation to one bit. Thus, the number of arithmetic operations and the ANN structure are greatly simplified. The proposed CAC is verified by FPGA and implemented in 0.18m CMOS process. Simulation results show it can operate at clock frequencies from 10KHz to 50MHz. Average power for the patient with 75bpm heart rate is 13.34W

Machine Learning Techniques for the Detection of Shockable Rhythms in Automated External Defibrillators

Early recognition of ventricular fibrillation (VF) and electrical therapy are key for the survivalof out-of-hospital cardiac arrest (OHCA) patients treated with automated external defibrilla-tors (AED). AED algorithms for VF-detection are customarily assessed using Holter record-ings from public electrocardiogram (ECG) databases, which may be different from the ECGseen during OHCA events. This study evaluates VF-detection using data from both OHCApatients and public Holter recordings. ECG-segments of 4-s and 8-s duration were ana-lyzed. For each segment 30 features were computed and fed to state of the art machinelearning (ML) algorithms. ML-algorithms with built-in feature selection capabilities wereused to determine the optimal feature subsets for both databases. Patient-wise bootstraptechniques were used to evaluate algorithm performance in terms of sensitivity (Se), speci-ficity (Sp) and balanced error rate (BER). Performance was significantly better for publicdata with a mean Se of 96.6%, Sp of 98.8% and BER 2.2% compared to a mean Se of94.7%, Sp of 96.5% and BER 4.4% for OHCA data. OHCA data required two times morefeatures than the data from public databases for an accurate detection (6 vs 3). No signifi-cant differences in performance were found for different segment lengths, the BER differ-ences were below 0.5-points in all cases. Our results show that VF-detection is morechallenging for OHCA data than for data from public databases, and that accurate VF-detection is possible with segments as short as 4-s

P Wave Detection in Pathological ECG Signals

Důležitou součástí hodnocení elektrokardiogramu (EKG) a následné detekce srdečních patologií, zejména v dlouhodobém monitorování, je detekce vln P. Výsledky detekce vln P umožňují získat ze záznamu EKG více informací o srdeční činnosti. Podle správně detekovaných pozic vln P je možné detekovat a odlišit patologie, které současné programy používané v medicínské praxi identifikovat neumožňují (např. atrioventrikulární blok 1., 2. a 3. stupně, cestující pacemaker, Wolffův-Parkinsonův-Whiteův syndrom). Tato dizertační práce představuje novou metodu detekce vln P v záznamech EKG během fyziologické a zejména patologické srdeční činnosti. Metoda je založena na fázorové transformaci, inovativních pravidlech detekce a identifikaci možných patologií zpřesňující detekci vln P. Dalším důležitým výsledkem práce je vytvoření dvou veřejně dostupných databází záznamů EKG s obsahem patologií a anotovanými vlnami P. Dizertační práce je rozdělena na teoretickou část a soubor publikací představující příspěvek autora v oblasti detekce vlny P.Accurate software for the P wave detection, mainly in long-term monitoring, is an important part of electrocardiogram (ECG) evaluation and subsequent cardiac pathological events detection. The results of P wave detection allow us to obtain more information from the ECG records. According to the correct P wave detection, it is possible to detect and distinguish cardiac pathologies which are nowadays automatically undetectable by commonly used software in medical practice (events e.g. atrioventricular block 1st, 2nd and 3rd degree, WPW syndrome, wandering pacemaker, etc.). This thesis introduces a new method for P wave detection in ECG signals during both physiological and pathological heart function. This novel method is based on a phasor transform, innovative rules, and identification of possible pathologies that improve P wave detection. An equally important part of the work is the creation of two publicly available databases of physiological and pathological ECG records with annotated P waves. The dissertation is divided into theoretical analysis and a set of publications representing the contribution of the author in the area of P wave detection.

Electrocardiogram pattern recognition and analysis based on artificial neural networks and support vector machines: a review.

Computer systems for Electrocardiogram (ECG) analysis support the clinician in tedious tasks (e.g., Holter ECG monitored in Intensive Care Units) or in prompt detection of dangerous events (e.g., ventricular fibrillation). Together with clinical applications (arrhythmia detection and heart rate variability analysis), ECG is currently being investigated in biometrics (human identification), an emerging area receiving increasing attention. Methodologies for clinical applications can have both differences and similarities with respect to biometrics. This paper reviews methods of ECG processing from a pattern recognition perspective. In particular, we focus on features commonly used for heartbeat classification. Considering the vast literature in the field and the limited space of this review, we dedicated a detailed discussion only to a few classifiers (Artificial Neural Networks and Support Vector Machines) because of their popularity; however, other techniques such as Hidden Markov Models and Kalman Filtering will be also mentioned

Patient-adapted and inter-patient ecg classification using neural network and gradient boosting

Heart disease diagnosis is an important non-invasive technique. Therefore, there exists an effort to increase the accuracy of arrhythmia classification based on ECG signals. In this work, we present a novel approach of heart arrhythmia detection. The model consists of two parts. The first part extracts important features from raw ECG signal using Auto-Encoder Neural Network. Extracted features obtained by Auto-Encoder represent an input for the second part of the model, the Gradient Boosting and Feedforward Neural Network classifiers. For comparison purposes, we evaluated our approach by using MIT-BIH ECG database and also following recommendations of the Association for the Advancement of Medical Instrumentation (AAMI) for ECG class labeling. We divided our experiment into two scenarios. The first scenario represents the classification task for the patient-adapted paradigm and the second one was dedicated to the inter-patient paradigm. We compared the measured results to the state-of-the-art methods and it shows that our method outperforms the state-of-the art methods in the Ventricular Ectopic (VEB) class for both paradigms and Supraventricular Ectopic (SVEB) class in the inter-patient paradigm.Web of Science28325424

Synergy of Physics-based Reasoning and Machine Learning in Biomedical Applications: Towards Unlimited Deep Learning with Limited Data

Technological advancements enable collecting vast data, i.e., Big Data, in science and industry including biomedical field. Increased computational power allows expedient analysis of collected data using statistical and machine-learning approaches. Historical data incompleteness problem and curse of dimensionality diminish practical value of pure data-driven approaches, especially in biomedicine. Advancements in deep learning (DL) frameworks based on deep neural networks (DNN) improved accuracy in image recognition, natural language processing, and other applications yet severe data limitations and/or absence of transfer-learning-relevant problems drastically reduce advantages of DNN-based DL. Our earlier works demonstrate that hierarchical data representation can be alternatively implemented without NN, using boosting-like algorithms for utilization of existing domain knowledge, tolerating significant data incompleteness, and boosting accuracy of low-complexity models within the classifier ensemble, as illustrated in physiological-data analysis. Beyond obvious use in initial-factor selection, existing simplified models are effectively employed for generation of realistic synthetic data for later DNN pre-training. We review existing machine learning approaches, focusing on limitations caused by training-data incompleteness. We outline our hybrid framework that leverages existing domain-expert models/knowledge, boosting-like model combination, DNN-based DL and other machine learning algorithms for drastic reduction of training-data requirements. Applying this framework is illustrated in context of analyzing physiological data

Recognition and Evaluation of Heart Arrhythmias via a General Sparse Neural Network

In clinical use, an electrocardiogram (ECG) is an essential medical tool for assessing heart arrhythmias. Thousands of human beings worldwide are affected by different cardiac problems nowadays. As a consequence, studying the features of the ECG pattern is critical for detecting a wide range of cardiac diseases. The ECG is a test which assesses the intensity of the electrical impulses in the circulatory system. In the present investigation, detection and examination of arrhythmias in the heart on the  system using GSNNs (General sparsed neural network classifier) can be carried out[1]. In this paper, the methodologies of support vector regression(SVR), neural mode decomposition(NMD), Artificial Neural Network (ANN), Support Vector Machine(SVM) and are examined. To assess the suggested structure, three distinct ECG waveform situations are chosen from the MIT-BIH arrhythmia collection. The main objective of this assignment is to create a simple, accurate, and simply adaptable approach for classifying the three distinct heart diseases chosen. The wavelet transform Db4 is used in the present paper to obtain several features from an ECG signal. The suggested setup was created using the MATLAB programme. The algorithms suggested are 98% accurate for forecasting cardiac arrhythmias, which is greater than prior techniques