Computer Aided ECG Analysis - State of the Art and Upcoming Challenges

In this paper we present current achievements in computer aided ECG analysis and their applicability in real world medical diagnosis process. Most of the current work is covering problems of removing noise, detecting heartbeats and rhythm-based analysis. There are some advancements in particular ECG segments detection and beat classifications but with limited evaluations and without clinical approvals. This paper presents state of the art advancements in those areas till present day. Besides this short computer science and signal processing literature review, paper covers future challenges regarding the ECG signal morphology analysis deriving from the medical literature review. Paper is concluded with identified gaps in current advancements and testing, upcoming challenges for future research and a bullseye test is suggested for morphology analysis evaluation.Comment: 7 pages, 3 figures, IEEE EUROCON 2013 International conference on computer as a tool, 1-4 July 2013, Zagreb, Croati

Transfer learning in ECG classification from human to horse using a novel parallel neural network architecture

Automatic or semi-automatic analysis of the equine electrocardiogram (eECG) is currently not possible because human or small animal ECG analysis software is unreliable due to a different ECG morphology in horses resulting from a different cardiac innervation. Both filtering, beat detection to classification for eECGs are currently poorly or not described in the literature. There are also no public databases available for eECGs as is the case for human ECGs. In this paper we propose the use of wavelet transforms for both filtering and QRS detection in eECGs. In addition, we propose a novel robust deep neural network using a parallel convolutional neural network architecture for ECG beat classification. The network was trained and tested using both the MIT-BIH arrhythmia and an own made eECG dataset with 26.440 beats on 4 classes: normal, premature ventricular contraction, premature atrial contraction and noise. The network was optimized using a genetic algorithm and an accuracy of 97.7% and 92.6% was achieved for the MIT-BIH and eECG database respectively. Afterwards, transfer learning from the MIT-BIH dataset to the eECG database was applied after which the average accuracy, recall, positive predictive value and F1 score of the network increased with an accuracy of 97.1%

Extraction and Detection of Fetal Electrocardiograms from Abdominal Recordings

The non-invasive fetal ECG (NIFECG), derived from abdominal surface electrodes, offers novel diagnostic possibilities for prenatal medicine. Despite its straightforward applicability, NIFECG signals are usually corrupted by many interfering sources. Most significantly, by the maternal ECG (MECG), whose amplitude usually exceeds that of the fetal ECG (FECG) by multiple times. The presence of additional noise sources (e.g. muscular/uterine noise, electrode motion, etc.) further affects the signal-to-noise ratio (SNR) of the FECG. These interfering sources, which typically show a strong non-stationary behavior, render the FECG extraction and fetal QRS (FQRS) detection demanding signal processing tasks. In this thesis, several of the challenges regarding NIFECG signal analysis were addressed. In order to improve NIFECG extraction, the dynamic model of a Kalman filter approach was extended, thus, providing a more adequate representation of the mixture of FECG, MECG, and noise. In addition, aiming at the FECG signal quality assessment, novel metrics were proposed and evaluated. Further, these quality metrics were applied in improving FQRS detection and fetal heart rate estimation based on an innovative evolutionary algorithm and Kalman filtering signal fusion, respectively. The elaborated methods were characterized in depth using both simulated and clinical data, produced throughout this thesis. To stress-test extraction algorithms under ideal circumstances, a comprehensive benchmark protocol was created and contributed to an extensively improved NIFECG simulation toolbox. The developed toolbox and a large simulated dataset were released under an open-source license, allowing researchers to compare results in a reproducible manner. Furthermore, to validate the developed approaches under more realistic and challenging situations, a clinical trial was performed in collaboration with the University Hospital of Leipzig. Aside from serving as a test set for the developed algorithms, the clinical trial enabled an exploratory research. This enables a better understanding about the pathophysiological variables and measurement setup configurations that lead to changes in the abdominal signal's SNR. With such broad scope, this dissertation addresses many of the current aspects of NIFECG analysis and provides future suggestions to establish NIFECG in clinical settings.:Abstract Acknowledgment Contents List of Figures List of Tables List of Abbreviations List of Symbols (1)Introduction 1.1)Background and Motivation 1.2)Aim of this Work 1.3)Dissertation Outline 1.4)Collaborators and Conflicts of Interest (2)Clinical Background 2.1)Physiology 2.1.1)Changes in the maternal circulatory system 2.1.2)Intrauterine structures and feto-maternal connection 2.1.3)Fetal growth and presentation 2.1.4)Fetal circulatory system 2.1.5)Fetal autonomic nervous system 2.1.6)Fetal heart activity and underlying factors 2.2)Pathology 2.2.1)Premature rupture of membrane 2.2.2)Intrauterine growth restriction 2.2.3)Fetal anemia 2.3)Interpretation of Fetal Heart Activity 2.3.1)Summary of clinical studies on FHR/FHRV 2.3.2)Summary of studies on heart conduction 2.4)Chapter Summary (3)Technical State of the Art 3.1)Prenatal Diagnostic and Measuring Technique 3.1.1)Fetal heart monitoring 3.1.2)Related metrics 3.2)Non-Invasive Fetal ECG Acquisition 3.2.1)Overview 3.2.2)Commercial equipment 3.2.3)Electrode configurations 3.2.4)Available NIFECG databases 3.2.5)Validity and usability of the non-invasive fetal ECG 3.3)Non-Invasive Fetal ECG Extraction Methods 3.3.1)Overview on the non-invasive fetal ECG extraction methods 3.3.2)Kalman filtering basics 3.3.3)Nonlinear Kalman filtering 3.3.4)Extended Kalman filter for FECG estimation 3.4)Fetal QRS Detection 3.4.1)Merging multichannel fetal QRS detections 3.4.2)Detection performance 3.5)Fetal Heart Rate Estimation 3.5.1)Preprocessing the fetal heart rate 3.5.2)Fetal heart rate statistics 3.6)Fetal ECG Morphological Analysis 3.7)Problem Description 3.8)Chapter Summary (4)Novel Approaches for Fetal ECG Analysis 4.1)Preliminary Considerations 4.2)Fetal ECG Extraction by means of Kalman Filtering 4.2.1)Optimized Gaussian approximation 4.2.2)Time-varying covariance matrices 4.2.3)Extended Kalman filter with unknown inputs 4.2.4)Filter calibration 4.3)Accurate Fetal QRS and Heart Rate Detection 4.3.1)Multichannel evolutionary QRS correction 4.3.2)Multichannel fetal heart rate estimation using Kalman filters 4.4)Chapter Summary (5)Data Material 5.1)Simulated Data 5.1.1)The FECG Synthetic Generator (FECGSYN) 5.1.2)The FECG Synthetic Database (FECGSYNDB) 5.2)Clinical Data 5.2.1)Clinical NIFECG recording 5.2.2)Scope and limitations of this study 5.2.3)Data annotation: signal quality and fetal amplitude 5.2.4)Data annotation: fetal QRS annotation 5.3)Chapter Summary (6)Results for Data Analysis 6.1)Simulated Data 6.1.1)Fetal QRS detection 6.1.2)Morphological analysis 6.2)Own Clinical Data 6.2.1)FQRS correction using the evolutionary algorithm 6.2.2)FHR correction by means of Kalman filtering (7)Discussion and Prospective 7.1)Data Availability 7.1.1)New measurement protocol 7.2)Signal Quality 7.3)Extraction Methods 7.4)FQRS and FHR Correction Algorithms (8)Conclusion References (A)Appendix A - Signal Quality Annotation (B)Appendix B - Fetal QRS Annotation (C)Appendix C - Data Recording GU

Detection of Bundle Branch Blocks using Machine Learning Techniques

The most effective method used for the diagnosis of heart diseases is the Electrocardiogram (ECG). The shape of the ECG signal and the time interval between its various components gives useful details about any underlying heart disease. Any dysfunction of the heart is called as cardiac arrhythmia. The electrical impulses of the heart are blocked due to the cardiac arrhythmia called Bundle Branch Block (BBB) which can be observed as an irregular ECG wave. The BBB beats can indicate serious heart disease. The precise and quick detection of cardiac arrhythmias from the ECG signal can save lives and can also reduce the diagnostics cost. This study presents a machine learning technique for the automatic detection of BBB. In this method both morphological and statistical features were calculated from the ECG signals available in the standard MIT BIH database to classify them as normal, Left Bundle Branch Block (LBBB) and Right Bundle Branch Block (RBBB). ECG records in the MIT- BIH arrhythmia database containing Normal sinus rhythm, RBBB, and LBBB were used in the study. The suitability of the features extracted was evaluated using three classifiers, support vector machine, k-nearest neighbours and linear discriminant analysis. The accuracy of the technique is highly promising for all the three classifiers with k-nearest neighbours giving the highest accuracy of 98.2%. Since the ECG waveforms of patients with the same cardiac disorder is similar in shape, the proposed method is subject independent. The proposed technique is thus a reliable and simple method involving less computational complexity for the automatic detection of bundle branch block. This system can reduce the effort of cardiologists thereby enabling them to concentrate more on treatment of the patients

An Empiric Analysis of Wavelet-Based Feature Extraction on Deep Learning and Machine Learning Algorithms for Arrhythmia Classification

The aberration in human electrocardiogram (ECG) affects cardiovascular events that may lead to arrhythmias. Many automation systems for ECG classification exist, but the ambiguity to wisely employ the in-built feature extraction or expert based manual feature extraction before classification still needs recognition. The proposed work compares and presents the enactment of using machine learning and deep learning classification on time series sequences. The two classifiers, namely the Support Vector Machine (SVM) and the Bi-directional Long Short-Term Memory (BiLSTM) network, are separately trained by direct ECG samples and extracted feature vectors using multiresolution analysis of Maximal Overlap Discrete Wavelet Transform (MODWT). Single beat segmentation with R-peaks and QRS detection is also involved with 6 morphological and 12 statistical feature extraction. The two benchmark datasets, multi-class, and binary class, are acquired from the PhysioNet database. For the binary dataset, BiLSTM with direct samples and with feature extraction gives 58.1% and 80.7% testing accuracy, respectively, whereas SVM outperforms with 99.88% accuracy. For the multi-class dataset, BiLSTM classification accuracy with the direct sample and the extracted feature is 49.6% and 95.4%, whereas SVM shows 99.44%. The efficient statistical workout depicts that the extracted feature-based selection of data can deliver distinguished outcomes compared with raw ECG data or in-built automatic feature extraction. The machine learning classifiers like SVM with knowledge-based feature extraction can equally or better perform than Bi-LSTM network for certain datasets