Revisiting QRS detection methodologies for portable, wearable, battery-operated, and wireless ECG systems

Cardiovascular diseases are the number one cause of death worldwide. Currently, portable battery-operated systems such as mobile phones with wireless ECG sensors have the potential to be used in continuous cardiac function assessment that can be easily integrated into daily life. These portable point-of-care diagnostic systems can therefore help unveil and treat cardiovascular diseases. The basis for ECG analysis is a robust detection of the prominent QRS complex, as well as other ECG signal characteristics. However, it is not clear from the literature which ECG analysis algorithms are suited for an implementation on a mobile device. We investigate current QRS detection algorithms based on three assessment criteria: 1) robustness to noise, 2) parameter choice, and 3) numerical efficiency, in order to target a universal fast-robust detector. Furthermore, existing QRS detection algorithms may provide an acceptable solution only on small segments of ECG signals, within a certain amplitude range, or amid particular types of arrhythmia and/or noise. These issues are discussed in the context of a comparison with the most conventional algorithms, followed by future recommendations for developing reliable QRS detection schemes suitable for implementation on battery-operated mobile devices.Mohamed Elgendi, Björn Eskofier, Socrates Dokos, Derek Abbot

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

Automated Cardiac Rhythm Diagnosis for Electrophysiological Studies, an Enhanced Classifier Approach

INTRODUCTION Heart function can be impaired by rhythm disturbances (cardiac arrhythmia), illustrated by electrocardiogram (ECG) recordings. Computerised arrhythmia diagnosis is well established for ECG’s but less for intracardiac electrophysiological (EP) testing. Accurate diagnosis is pre-requisite for delivering appropriate treatment to patients however existing algorithms misdiagnose a proportion of arrhythmias. Studies suggested artificial intelligence (AI) classifiers are accurate using ECG and intracardiac electrogram features and reviews suggested new features might augment diagnosis. This study aimed to develop an accurate cardiac rhythm diagnostic algorithm for electrophysiological (EP) studies with potential application as a generic rhythm classifier. METHOD An ethically approved prospective clinical study collected clinical history, right atrial and right ventricular intracardiac electrograms, beat-to-beat cardiac stroke volume, body motion and body temperature data during EP studies. An iterative system development life-cycle was used, including knowledge management and classifier development sub-processes. Domain expert knowledge and clinical arrhythmia diagnosis were modelled, synthesised as AI classifiers and used to classify cardiac rhythms. RESULTS Data collected from 65 patients was pre-processed into instances for classifier inputs. Decision tree, naïve Bayes, neural network, support vector machine and inference engine classifiers developed using Matlab showed good performance and were combined as a production system in a mixture-of-experts multi-classifier system. 18 different rhythms were classified, with the naïve Bayes classifier used to classify 11 rhythms, decision tree 4 rhythms, neural network and support vector machine one each, unclassified instances by the inference engine classifier and final class allocation using decision rule. Production system showed overall correct clasification rate 0.960; error 0.040; mean sensitivity 0.855; mean specificity 0.977; mean κ 0.767; mean positive predictive value 0.792; mean negative predictive value 0.975; mean Pearson’s phi 0.787, with P 0.9 for sinus node dysfunction and atrio-ventricular nodal/ junctional tachycardias. Temperature, accelerometry and QT interval were assessed as features by a comparison of algorithm performances with each feature removed and found not to affect classification performance. An evaluation showed 10 beat analysis performed better than 5 beat analysis. CONCLUSIONS Modelling of the clinical diagnosis process produced an AI based mixture-of-experts multi-classifier system, which accurately diagnosed different 18 cardiac rhythms. The naïve Bayes classifier performed best and classified 11 rhythms. Features for clinical symptoms and predisposing factors, atrial electrogram morphology and changes in stroke volume were found to influence rhythm classification. High performances encourage further development and potential future improvements include: a larger sample dataset; inclusion of His and coronary sinus electrograms; data mining for unknown features with significant influence on diagnosis; binary classification. The aim to classify rhythm using artificial intelligence suitable for use during EP studies was satisfied and the research hypothesis that it outperformed current algorithms was accepted. The system was likely to be able to accept updates but needs conversion as a precursor to use in a live clinical environment

Bottom-up design of artificial neural network for single-lead electrocardiogram beat and rhythm classification

Performance improvement in computerized Electrocardiogram (ECG) classification is vital to improve reliability in this life-saving technology. The non-linearly overlapping nature of the ECG classification task prevents the statistical and the syntactic procedures from reaching the maximum performance. A new approach, a neural network-based classification scheme, has been implemented in clinical ECG problems with much success. The focus, however, has been on narrow clinical problem domains and the implementations lacked engineering precision. An optimal utilization of frequency information was missing. This dissertation attempts to improve the accuracy of neural network-based single-lead (lead-II) ECG beat and rhythm classification. A bottom-up approach defined in terms of perfecting individual sub-systems to improve the over all system performance is used. Sub-systems include pre-processing, QRS detection and fiducial point estimations, feature calculations, and pattern classification. Inaccuracies in time-domain fiducial point estimations are overcome with the derivation of features in the frequency domain. Feature extraction in frequency domain is based on a spectral estimation technique (combination of simulation and subtraction of a normal beat). Auto-regressive spectral estimation methods yield a highly sensitive spectrum, providing several local features with information on beat classes like flutter, fibrillation, and noise. A total of 27 features, including 16 in time domain and 11 in frequency domain are calculated. The entire data and problem are divided into four major groups, each group with inter-related beat classes. Classification of each group into related sub-classes is performed using smaller feed-forward neural networks. Input feature sub-set and the structure of each network are optimized using an iterative process. Optimal implementations of feed-forward neural networks provide high accuracy in beat classification. Associated neural networks are used for the more deterministic rhythm-classification task. An accuracy of more than 85% is achieved for all 13 classes included in this study. The system shows a graceful degradation in performance with increasing noise, as a result of the noise consideration in the design of every sub-system. Results indicate a neural network-based bottom-up design of single-lead ECG classification is able to provide very high accuracy, even in the presence of noise, flutter, and fibrillation

Computerised electrocardiogram classification

Advances in computing have resulted in many engineering processes being automated. Electrocardiogram (ECG) classification is one such process. The analysis of ECGs can benefit from the wide availability and power of modern computers. This study presents the usage of computer technology in the field of computerised ECG classification. Computerised electrocardiogram classification can help to reduce healthcare costs by enabling suitably equipped general practitioners to refer to hospital only those people with serious heart problems. Computerised ECG classification can also be very useful in shortening hospital waiting lists and saving life by discovering heart diseases early. The thesis investigates the automatic classification of ECGs into different disease categories using Artificial Intelligence (AI) techniques. A comparison of the use of different feature sets and AI classifiers is presented. The feature sets include conventional cardiological features, as well as features taken directly from time domain samples of an ECG. The benchmark AI classifiers tested include those based on neural network, k-Nearest Neighbour and inductive learning techniques. The research proposes two modifications to the learning vector quantisation (LVQ) neural network, namely the All Weights Updating-LVQ (AWU-LVQ) algorithm and the Neighbouring Weights Updating-LVQ (NWU-LVQ) algorithm, yielding an "intelligent" diagnostic heart system with higher accuracy and reduced training time compared to existing AI techniques.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Computerised electrocardiogram classification

Advances in computing have resulted in many engineering processes being automated. Electrocardiogram (ECG) classification is one such process. The analysis of ECGs can benefit from the wide availability and power of modern computers. This study presents the usage of computer technology in the field of computerised ECG classification. Computerised electrocardiogram classification can help to reduce healthcare costs by enabling suitably equipped general practitioners to refer to hospital only those people with serious heart problems. Computerised ECG classification can also be very useful in shortening hospital waiting lists and saving life by discovering heart diseases early. The thesis investigates the automatic classification of ECGs into different disease categories using Artificial Intelligence (AI) techniques. A comparison of the use of different feature sets and AI classifiers is presented. The feature sets include conventional cardiological features, as well as features taken directly from time domain samples of an ECG. The benchmark AI classifiers tested include those based on neural network, k-Nearest Neighbour and inductive learning techniques. The research proposes two modifications to the learning vector quantisation (LVQ) neural network, namely the All Weights Updating-LVQ (AWU-LVQ) algorithm and the Neighbouring Weights Updating-LVQ (NWU-LVQ) algorithm, yielding an "intelligent" diagnostic heart system with higher accuracy and reduced training time compared to existing AI techniques

Progress Report No. 12

Progress report of the Biomedical Computer Laboratory, covering period 1 July 1975 to 30 June 1976

Progress Report No. 24

Progress report of the Biomedical Computer Laboratory, covering period 1 July 1987 to 30 June 1988

Pattern recognition beyond classification: An abductive framework for time series interpretation

Time series interpretation aims to provide an explanation of what is observed in terms of its underlying processes. The present work is based on the assumption that the common classification-based approaches to time series interpretation suffer from a set of inherent weaknesses, whose ultimate cause lies in the monotonic nature of the deductive reasoning paradigm. In this thesis we propose a new approach to this problem, based on the initial hypothesis that abductive reasoning properly accounts for the human ability to identify and characterize the patterns appearing in a time series. The result of this interpretation is a set of conjectures in the form of observations, organized into an abstraction hierarchy and explaining what has been observed. A knowledge-based framework and a set of algorithms for the interpretation task are provided, implementing a hypothesize-and-test cycle guided by an attentional mechanism. As a representative application domain, interpretation of the electrocardiogram allows us to highlight the strengths of the present approach in comparison with traditional classification-based approaches

Seamless Multimodal Biometrics for Continuous Personalised Wellbeing Monitoring

Artificially intelligent perception is increasingly present in the lives of every one of us. Vehicles are no exception, (...) In the near future, pattern recognition will have an even stronger role in vehicles, as self-driving cars will require automated ways to understand what is happening around (and within) them and act accordingly. (...) This doctoral work focused on advancing in-vehicle sensing through the research of novel computer vision and pattern recognition methodologies for both biometrics and wellbeing monitoring. The main focus has been on electrocardiogram (ECG) biometrics, a trait well-known for its potential for seamless driver monitoring. Major efforts were devoted to achieving improved performance in identification and identity verification in off-the-person scenarios, well-known for increased noise and variability. Here, end-to-end deep learning ECG biometric solutions were proposed and important topics were addressed such as cross-database and long-term performance, waveform relevance through explainability, and interlead conversion. Face biometrics, a natural complement to the ECG in seamless unconstrained scenarios, was also studied in this work. The open challenges of masked face recognition and interpretability in biometrics were tackled in an effort to evolve towards algorithms that are more transparent, trustworthy, and robust to significant occlusions. Within the topic of wellbeing monitoring, improved solutions to multimodal emotion recognition in groups of people and activity/violence recognition in in-vehicle scenarios were proposed. At last, we also proposed a novel way to learn template security within end-to-end models, dismissing additional separate encryption processes, and a self-supervised learning approach tailored to sequential data, in order to ensure data security and optimal performance. (...)Comment: Doctoral thesis presented and approved on the 21st of December 2022 to the University of Port