Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table

Mathematical Modeling and Simulation of Ventricular Activation Sequences: Implications for Cardiac Resynchronization Therapy

Next to clinical and experimental research, mathematical modeling plays a crucial role in medicine. Biomedical research takes place on many different levels, from molecules to the whole organism. Due to the complexity of biological systems, the interactions between components are often difficult or impossible to understand without the help of mathematical models. Mathematical models of cardiac electrophysiology have made a tremendous progress since the first numerical ECG simulations in the 1960s. This paper briefly reviews the development of this field and discusses some example cases where models have helped us forward, emphasizing applications that are relevant for the study of heart failure and cardiac resynchronization therapy

Computer modeling and signal analysis of cardiovascular physiology

This dissertation aims to study cardiovascular physiology from the cellular level to the whole heart level to the body level using numerical approaches. A mathematical model was developed to describe electromechanical interaction in the heart. The model integrates cardio-electrophysiology and cardiac mechanics through excitation-induced contraction and deformation-induced currents. A finite element based parallel simulation scheme was developed to investigate coupled electrical and mechanical functions. The developed model and numerical scheme were utilized to study cardiovascular dynamics at cellular, tissue and organ levels. The influence of ion channel blockade on cardiac alternans was investigated. It was found that the channel blocker may significantly change the critical pacing period corresponding to the onset of alternans as well as the alternans’ amplitude. The influence of electro-mechanical coupling on cardiac alternans was also investigated. The study supported the earlier assumptions that discordant alternans is induced by the interaction of conduction velocity and action potential duration restitution at high pacing rates. However, mechanical contraction may influence the spatial pattern and onset of discordant alternans. Computer algorithms were developed for analysis of human physiology. The 12-lead electrocardiography (ECG) is the gold standard for diagnosis of various cardiac abnormalities. However, disturbances and mistakes may modify physiological waves in ECG and lead to wrong diagnoses. This dissertation developed advanced signal analysis techniques and computer software to detect and suppress artifacts and errors in ECG. These algorithms can help to improve the quality of health care when integrated into medical devices or services. Moreover, computer algorithms were developed to predict patient mortality in intensive care units using various physiological measures. Models and analysis techniques developed here may help to improve the quality of health care

Three-dimensional Multiscale Modelling and Simulation of Atria and Torso Electrophysiology

A better understanding of the electrical activity of the heart under physiological and pathological conditions has always been key for clinicians and researchers. Over the last years, the information in the P-wave signals has been extensively analysed to un-cover the mechanisms underlying atrial arrhythmias by localizing ectopic foci or high-frequency rotors. However, the relationship between the activation of the different areas of the atria and the characteristics of the P-wave signals or body surface poten-tial maps are still far from being completely understood. Multiscale anatomical and functional models of the heart are a new technological framework that can enable the investigation of the heart as a complex system. This thesis is centred in the construction of a multiscale framework that allows the realistic simulation of atrial and torso electrophysiology and integrates all the anatom-ical and functional descriptions described in the literature. The construction of such model involves the development of heterogeneous cellular and tissue electrophysiolo-gy models fitted to empirical data. It also requires an accurate 3D representation of the atrial anatomy, including tissue fibre arrangement, and preferential conduction axes. This multiscale model aims to reproduce faithfully the activation of the atria under physiological and pathological conditions. We use the model for two main applica-tions. First, to study the relationship between atrial activation and surface signals in sinus rhythm. This study should reveal the best places for recording P-waves signals in the torso, and which are the regions of the atria that make the most significant contri-bution to the body surface potential maps and determine the main P-wave characteris-tics. Second, to spatially cluster and classify ectopic atrial foci into clearly differenti-ated atrial regions by using the body surface P-wave integral map (BSPiM) as a bi-omarker. We develop a machine-learning pipeline trained from simulations obtained from the atria-torso model aiming to validate whether ectopic foci with similar BSPiM naturally cluster into differentiated non-intersected atrial regions, and whether new BSPiM could be correctly classified with high accuracy.En la actualidad, una mejor compresión de la actividad eléctrica del corazón en condi-ciones fisiológicas y patológicas es clave para médicos e investigadores. A lo largo de los últimos años, la información derivada de la onda P se ha utilizado para intentar descubrir los mecanismos subyacentes a las arritmias auriculares mediante la localiza-ción de focos ectópicos y rotores de alta frecuencia. Sin embargo, la relación entre la activación de distintas regiones auriculares y las características tanto de las ondas P como de la distribución de potencial en la superficie del torso está lejos de entenderse completamente. Los modelos cardíacos funcionales y anatómicos son una nueva he-rramienta que puede facilitar la investigación relativa al corazón entendido como sis-tema complejo. La presente tesis se centra en la construcción de un modelo multiescala para la simula-ción realista de la electrofisiología cardíaca tanto a nivel auricular como de torso, integrando toda la información anatómica y funcional disponible en la literatura. La construcción de este modelo implica el desarrollo, en base a datos experimentales, de modelos electrofisiológicos heterogéneos tanto celulares como tisulares. Así mismo, es imprescindible una representación tridimensional precisa de la anatomía auricular, incluyendo la dirección de fibras y los haces de conducción preferentes. Este modelo multiescala busca reproducir fielmente la activación auricular en condiciones fisiológi-cas y patológicas. Su uso se ha centrado fundamentalmente en dos aplicaciones. En primer lugar, estudiar la relación entre la activación auricular en ritmo sinusal y las señales en la superficie del torso. Este estudio busca definir la mejor ubicación para el registro de las ondas P en el torso así como determinar aquellas regiones auriculares que contribuyen fundamentalmente a la formación y distribución de potenciales super-ficiales así como a las características de las ondas P. En segundo lugar, agrupar y cla-sificar espacialmente los focos ectópicos en regiones auriculares claramente diferen-ciables empleando como biomarcador los mapas superficiales de integral de la onda P (BSPiM). Se ha desarrollado para ello una metodología de aprendizaje automático en la que las simulaciones obtenidas con el modelo multiescala aurícula-torso sirven de entrenamiento, permitiendo validar si los focos ectópicos cuyos BSPiMs son similares se agrupan de forma natural en regiones auriculares no intersectadas y si BSPiMs nue-vos podrían ser clasificados prospectivamente con gran precisión.Avui en dia, una millor comprenssió de l'activitat elèctrica del cor en condicions fisio-lògiques i patològiques és clau per a metges i investigadors. Al llarg dels últims anys, la informació derivada de l'ona P s'ha utilitzat per intentar descobrir els mecanismes subjacents a les arítmies auriculars mitjançant la localització de focus ectòpics i rotors d'alta freqüència. No obstant això, la relació entre l'activació de diferents regions auri-culars i les característiques tant de les ones P com de la distribució de potencial en la superfície del tors està lluny d'entendre's completament. Els models cardíacs funcionals i anatòmics són una nova eina que pot facilitar la recerca relativa al cor entès com a sistema complex. La present tesi es centra en la construcció d'un model multiescala per a la simulació realista de la electrofisiologia cardíaca tant a nivell auricular com de tors, integrant tota la informació anatòmica i funcional disponible en la literatura. La construcció d'aquest model implica el desenvolupament, sobre la base de dades experimentals, de models electrofisiològics heterogenis, tant cel·lulars com tissulars. Així mateix, és imprescindible una representació tridimensional precisa de l'anatomia auricular, in-cloent la direcció de fibres i els feixos de conducció preferents. Aquest model multies-cala busca reproduir fidelment l'activació auricular en condicions fisiològiques i pa-tològiques. El seu ús s'ha centrat fonamentalment en dues aplicacions. En primer lloc, estudiar la relació entre l'activació auricular en ritme sinusal i els senyals en la superfí-cie del tors. A més a més, amb aquest estudi també es busca definir la millor ubicació per al registre de les ones P en el tors, així com, determinar aquelles regions auriculars que contribueixen fonamentalment a la formació i distribució de potencials superfi-cials a l'hora que es caracteritzen les ones P. En segon lloc, agrupar i classificar espa-cialment els focus ectòpics en regions auriculars clarament diferenciables emprant com a biomarcador els mapes superficials d'integral de l'ona P (BSPiM). És per això que s'ha desenvolupat una metodologia d'aprenentatge automàtic en la qual les simulacions obtingudes amb el model multiescala aurícula-tors serveixen d'entrenament, la qual cosa permet validar si els focus ectòpics, llurs BSPiMs són similars, s'agrupen de for-ma natural en regions auriculars no intersectades i si BSPiMs nous podrien ser classifi-cats de manera prospectiva amb precisió.Ferrer Albero, A. (2017). Three-dimensional Multiscale Modelling and Simulation of Atria and Torso Electrophysiology [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/88402TESI

Clasification Of Arrhythmic ECG Data Using Machine Learning Techniques

In this paper we proposed a automated Artificial Neural Network (ANN) based classification system for cardiac arrhythmia using multi-channel ECG recordings. In this study, we are mainly interested in producing high confident arrhythmia classification results to be applicable in diagnostic decision support systems. Neural network model with back propagation algorithm is used to classify arrhythmia cases into normal and abnormal classes. Networks models are trained and tested for MIT-BIH arrhythmia. The differen structures of ANN have been trained by mixture of arrhythmic and non arrhythmic data patient. The classification performance is evaluated using measures; sensitivity, specificity, classification accuracy, mean squared error (MSE), receiver operating characteristics (ROC) and area under curve (AUC). Our experimental results gives 96.77% accuracy on MIT-BIH database and 96.21% on database prepared by including NSR database also

Aerospace medicine and biology: A continuing bibliography with indexes, supplement 197, September 1979

This bibliography lists 193 reports, articles, and other documents introduced into the NASA scientific and technical information system in August 1979

A rule-based method for predicting the electrical activation of the heart with cardiac resynchronization therapy from non-invasive clinical data

Item does not contain fulltex

Methods of visualization and analysis of cardiac depolarization in the three dimensional space

The master thesis presents methods for intellectual analysis and visualization 3D EKG in order to increase the efficiency of ECG analysis by extracting additional data. Visualization is presented as part of the signal analysis tasks considered imaging techniques and their mathematical description. Have been developed algorithms for calculating and visualizing the signal attributes are described using mathematical methods and tools for mining signal. The model of patterns searching for comparison purposes of accuracy of methods was constructed, problems of a clustering and classification of data are solved, the program of visualization of data is also developed. This approach gives the largest accuracy in a task of the intellectual analysis that is confirmed in this work. Considered visualization and analysis techniques are also applicable to the multi-dimensional signals of a different kind

Usefulness of Artificial Neural Networks in the Diagnosis and Treatment of Sleep Apnea-Hypopnea Syndrome

Sleep apnea-hypopnea syndrome (SAHS) is a chronic and highly prevalent disease considered a major health problem in industrialized countries. The gold standard diagnostic methodology is in-laboratory nocturnal polysomnography (PSG), which is complex, costly, and time consuming. In order to overcome these limitations, novel and simplified diagnostic alternatives are demanded. Sleep scientists carried out an exhaustive research during the last decades focused on the design of automated expert systems derived from artificial intelligence able to help sleep specialists in their daily practice. Among automated pattern recognition techniques, artificial neural networks (ANNs) have demonstrated to be efficient and accurate algorithms in order to implement computer-aided diagnosis systems aimed at assisting physicians in the management of SAHS. In this regard, several applications of ANNs have been developed, such as classification of patients suspected of suffering from SAHS, apnea-hypopnea index (AHI) prediction, detection and quantification of respiratory events, apneic events classification, automated sleep staging and arousal detection, alertness monitoring systems, and airflow pressure optimization in positive airway pressure (PAP) devices to fit patients’ needs. In the present research, current applications of ANNs in the framework of SAHS management are thoroughly reviewed

Personalized Health Monitoring Using Evolvable Block-based Neural Networks

This dissertation presents personalized health monitoring using evolvable block-based neural networks. Personalized health monitoring plays an increasingly important role in modern society as the population enjoys longer life. Personalization in health monitoring considers physiological variations brought by temporal, personal or environmental differences, and demands solutions capable to reconfigure and adapt to specific requirements. Block-based neural networks (BbNNs) consist of 2-D arrays of modular basic blocks that can be easily implemented using reconfigurable digital hardware such as field programmable gate arrays (FPGAs) that allow on-line partial reorganization. The modular structure of BbNNs enables easy expansion in size by adding more blocks. A computationally efficient evolutionary algorithm is developed that simultaneously optimizes structure and weights of BbNNs. This evolutionary algorithm increases optimization speed by integrating a local search operator. An adaptive rate update scheme removing manual tuning of operator rates enhances the fitness trend compared to pre-determined fixed rates. A fitness scaling with generalized disruptive pressure reduces the possibility of premature convergence. The BbNN platform promises an evolvable solution that changes structures and parameters for personalized health monitoring. A BbNN evolved with the proposed evolutionary algorithm using the Hermite transform coefficients and a time interval between two neighboring R peaks of ECG signal, provides a patient-specific ECG heartbeat classification system. Experimental results using the MIT-BIH Arrhythmia database demonstrate a potential for significant performance enhancements over other major techniques