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

Electrocardiogram Monitoring Wearable Devices and Artificial-Intelligence-Enabled Diagnostic Capabilities: A Review

Worldwide, population aging and unhealthy lifestyles have increased the incidence of high-risk health conditions such as cardiovascular diseases, sleep apnea, and other conditions. Recently, to facilitate early identification and diagnosis, efforts have been made in the research and development of new wearable devices to make them smaller, more comfortable, more accurate, and increasingly compatible with artificial intelligence technologies. These efforts can pave the way to the longer and continuous health monitoring of different biosignals, including the real-time detection of diseases, thus providing more timely and accurate predictions of health events that can drastically improve the healthcare management of patients. Most recent reviews focus on a specific category of disease, the use of artificial intelligence in 12-lead electrocardiograms, or on wearable technology. However, we present recent advances in the use of electrocardiogram signals acquired with wearable devices or from publicly available databases and the analysis of such signals with artificial intelligence methods to detect and predict diseases. As expected, most of the available research focuses on heart diseases, sleep apnea, and other emerging areas, such as mental stress. From a methodological point of view, although traditional statistical methods and machine learning are still widely used, we observe an increasing use of more advanced deep learning methods, specifically architectures that can handle the complexity of biosignal data. These deep learning methods typically include convolutional and recurrent neural networks. Moreover, when proposing new artificial intelligence methods, we observe that the prevalent choice is to use publicly available databases rather than collecting new data

A Review of Atrial Fibrillation Detection Methods as a Service

Atrial Fibrillation (AF) is a common heart arrhythmia that often goes undetected, and even if it is detected, managing the condition may be challenging. In this paper, we review how the RR interval and Electrocardiogram (ECG) signals, incorporated into a monitoring system, can be useful to track AF events. Were such an automated system to be implemented, it could be used to help manage AF and thereby reduce patient morbidity and mortality. The main impetus behind the idea of developing a service is that a greater data volume analyzed can lead to better patient outcomes. Based on the literature review, which we present herein, we introduce the methods that can be used to detect AF efficiently and automatically via the RR interval and ECG signals. A cardiovascular disease monitoring service that incorporates one or multiple of these detection methods could extend event observation to all times, and could therefore become useful to establish any AF occurrence. The development of an automated and efficient method that monitors AF in real time would likely become a key component for meeting public health goals regarding the reduction of fatalities caused by the disease. Yet, at present, significant technological and regulatory obstacles remain, which prevent the development of any proposed system. Establishment of the scientific foundation for monitoring is important to provide effective service to patients and healthcare professionals

ECG-Based Arrhythmia Classification using Recurrent Neural Networks in Embedded Systems

Cardiac arrhythmia is one of the most important cardiovascular diseases (CVDs), causing million deaths every year. Moreover it is difficult to diagnose because it occurs intermittently and as such requires the analysis of large amount of data, collected during the daily life of patients. An important tool for CVD diagnosis is the analysis of electrocardiogram (ECG), because of its non-invasive nature and simplicity of acquisition. In this work we propose a classification algorithm for arrhythmia based on recurrent neural networks (RNNs) that operate directly on ECG data, exploring the effectiveness and efficiency of several variations of the general RNN, in particular using different types of layers implementing the network memory. We use the MIT-BIH arrhythmia database and the evaluation protocol recommended by the Association for the Advancement of Medical Instrumentation (AAMI). After designing and testing the effectiveness of the different networks, we then test its porting to an embedded platform, namely the STM32 microcontroller architecture from ST, using a specific framework to port a pre-built RNN to the embedded hardware, convert it to optimized code for the platform and evaluate its performance in terms of resource usage. Both in binary and multiclass classification, the basic RNN model outperforms the other architectures in terms of memory storage (∼117 KB), number of parameters (∼5 k) and inference time (∼150 ms), while the RNN LSTM-based achieved the best accuracy (∼90%)

Algorithms for automated diagnosis of cardiovascular diseases based on ECG data: A comprehensive systematic review

The prevalence of cardiovascular diseases is increasing around the world. However, the technology is evolving and can be monitored with low-cost sensors anywhere at any time. This subject is being researched, and different methods can automatically identify these diseases, helping patients and healthcare professionals with the treatments. This paper presents a systematic review of disease identification, classification, and recognition with ECG sensors. The review was focused on studies published between 2017 and 2022 in different scientific databases, including PubMed Central, Springer, Elsevier, Multidisciplinary Digital Publishing Institute (MDPI), IEEE Xplore, and Frontiers. It results in the quantitative and qualitative analysis of 103 scientific papers. The study demonstrated that different datasets are available online with data related to various diseases. Several ML/DP-based models were identified in the research, where Convolutional Neural Network and Support Vector Machine were the most applied algorithms. This review can allow us to identify the techniques that can be used in a system that promotes the patient’s autonomy.N/

Técnicas de Adquisición y Procesamiento de Señales Electrocardiográficas en la Detección de Arritmias Cardíacas

The development of ambulatory monitoring systems and its electrocardiographic (ECG) signal processing techniques has become an important field of investigation, due to its relevance in the early detection of cardiovascular diseases such as the arrhythmias. The current trend of this technology is oriented to the use of portable equipment and mobile devices such as Smartphones, which have been widely accepted due to the technical characteristics and common integration in daily life. A fundamental characteristic of these systems is their ability to reduce the most common types of noise by means of digital signal processing techniques.  Among the most used techniques are the adaptive filters and the Discrete Wavelet Transform (DWT) which have been successfully implemented in several studies. There are systems that integrate classification stages based on artificial intelligence, which increases the performance in the process of arrhythmias detection. These techniques are not only evaluated for their functionality but for their computational cost, since they will be used in real-time applications, and implemented in embedded systems. This paper shows a review of each of the stages in the construction of a standard ambulatory monitoring system, for the contextualization of the reader in this type of technology.El desarrollo de sistemas de  monitoreo  ambulatorio  y  sus  técnicas  de  procesamiento  de  la  señal  electrocardiográfica (ECG) se han convertido en un importante campo de investigación, debido a su relevancia en la detección temprana de enfermedades cardiovasculares, tales como arritmias. La tendencia actual de esta tecnología está orientada al uso de equipos portátiles y dispositivos móviles como los Smartphones, que han sido ampliamente aceptados debido a sus características técnicas y a su integración, cada vez más común, en la vida diaria. Una característica fundamental de estos sistemas es su capacidad de reducir los tipos más comunes de ruido mediante técnicas de procesamiento de señales digitales. Entre las técnicas más utilizadas se encuentran los filtros adaptativos y la Transformada Discreta Wavelet (DWT, por sus siglas en inglés), los cuales han sido implementados exitosamente en diversos estudios. Así mismo, se reportan sistemas que integran etapas de clasificación basadas en inteligencia artificial, con lo cual se aumenta el rendimiento en el proceso de detección de arritmias. En este sentido, estas técnicas no solo son evaluadas por su funcionalidad, sino por su costo computacional, debido a que deben ser utilizadas en aplicaciones en tiempo real, e implementadas en sistemas embebidos. Este documento presenta una revisión del estado del arte de cada una de las etapas en la construcción de un sistema de monitoreo ambulatorio estándar, para la contextualización del lector en este tipo de tecnologías

Classification techniques for arrhythmia patterns using convolutional neural networks and Internet of Things (IoT) devices

The rise of Telemedicine has revolutionized how patients are being treated, leading to several advantages such as enhanced health analysis tools, accessible remote healthcare, basic diagnostic of health parameters, etc. The advent of the Internet of Things (IoT), Artificial Intelligence (AI) and their incorporation into Telemedicine extends the potential of health benefits of Telemedicine even further. Therefore, the synergy between AI, IoT, and Telemedicine creates diverse innovative scenarios for integrating cyber-physical systems into medical health to provide remote monitoring and interactive assistance to patients. Data from World Health Organization reports that 7.4 million people died because of Atrial Fibrillation (AF), recognizing the most common arrhythmia associated with human heart rate. Causes like unhealthy diet, smoking, poor resources to go to the doctor and based on research studies, about 12 and 17.9 million of people will be suffering the AF in the USA and Europe, in 2050 and 2060, respectively. The AF as a cardiovascular disease is becoming an important public health issue to tackle. By using a systematic approach, this paper reviews recent contributions related to the acquisition of heart beats, arrhythmia detection, IoT, and visualization. In particular, by analysing the most closely related papers on Convolutional Neural Network (CNN) and IoT devices in heart disease diagnostics, we present a summary of the main research gaps with suggested directions for future research