An artificial neural network to safely reduce the number of ambulance ECGs transmitted for physician assessment in a system with prehospital detection of ST elevation myocardial infarction

<p>Abstract</p> <p>Background</p> <p>Pre-hospital electrocardiogram (ECG) transmission to an expert for interpretation and triage reduces time to acute percutaneous coronary intervention (PCI) in patients with ST elevation Myocardial Infarction (STEMI). In order to detect all STEMI patients, the ECG should be transmitted in all cases of suspected acute cardiac ischemia. The aim of this study was to examine the ability of an artificial neural network (ANN) to safely reduce the number of ECGs transmitted by identifying patients without STEMI and patients not needing acute PCI.</p> <p>Methods</p> <p>Five hundred and sixty ambulance ECGs transmitted to the coronary care unit (CCU) in routine care were prospectively collected. The ECG interpretation by the ANN was compared with the diagnosis (STEMI or not) and the need for an acute PCI (or not) as determined from the Swedish coronary angiography and angioplasty register. The CCU physician's real time ECG interpretation (STEMI or not) and triage decision (acute PCI or not) were registered for comparison.</p> <p>Results</p> <p>The ANN sensitivity, specificity, positive and negative predictive values for STEMI was 95%, 68%, 18% and 99%, respectively, and for a need of acute PCI it was 97%, 68%, 17% and 100%. The area under the ANN's receiver operating characteristics curve for STEMI detection was 0.93 (95% CI 0.89-0.96) and for predicting the need of acute PCI 0.94 (95% CI 0.90-0.97). If ECGs where the ANN did not identify a STEMI or a need of acute PCI were theoretically to be withheld from transmission, the number of ECGs sent to the CCU could have been reduced by 64% without missing any case with STEMI or a need of immediate PCI.</p> <p>Conclusions</p> <p>Our ANN had an excellent ability to predict STEMI and the need of acute PCI in ambulance ECGs, and has a potential to safely reduce the number of ECG transmitted to the CCU by almost two thirds.</p

Automated myocardial infarction diagnosis from ECG

In the present dissertation, an automated neural network-based ECG diagnosing system was designed to detect the presence of myocardial infarction based on the hypothesis that an artificial neural network-based ECG interpretation system may improve the clinical myocardial infarction. 137 patients were included. Among them 122 had myocardial infarction, but the remaining 15 were normal. The sensitivity and the specificity of present system were 92.2% and 50.7% respectively. The sensitivity was consistent with relevant research. The relatively low specificity results from the rippling of the low pass filtering. We can conclude that neural network-based system is a promising aid for the myocardial infarction diagnosis

Personal Heart Health Monitoring Based on 1D Convolutional Neural Network

The automated detection of suspicious anomalies in electrocardiogram (ECG) recordings allows frequent personal heart health monitoring and can drastically reduce the number of ECGs that need to be manually examined by the cardiologists, excluding those classified as normal, facilitating healthcare decision-making and reducing a considerable amount of time and money. In this paper, we present a system able to automatically detect the suspect of cardiac pathologies in ECG signals from personal monitoring devices, with the aim to alert the patient to send the ECG to the medical specialist for a correct diagnosis and a proper therapy. The main contributes of this work are: (a) the implementation of a binary classifier based on a 1D-CNN architecture for detecting the suspect of anomalies in ECGs, regardless of the kind of cardiac pathology; (b) the analysis was carried out on 21 classes of different cardiac pathologies classified as anomalous; and (c) the possibility to classify anomalies even in ECG segments containing, at the same time, more than one class of cardiac pathologies. Moreover, 1D-CNN based architectures can allow an implementation of the system on cheap smart devices with low computational complexity. The system was tested on the ECG signals from the MIT-BIH ECG Arrhythmia Database for the MLII derivation. Two different experiments were carried out, showing remarkable performance compared to other similar systems. The best result showed high accuracy and recall, computed in terms of ECG segments and even higher accuracy and recall in terms of patients alerted, therefore considering the detection of anomalies with respect to entire ECG recordings