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

A study on stability analysis of atrial repolarization variability using ARX model in sinus rhythm and atrial tachycardia ECGs

© 2016 Elsevier Ireland Ltd Background The interaction between the PTa and PP interval dynamics from the surface ECG is seldom explained. Mathematical modeling of these intervals is of interest in finding the relationship between the heart rate and repolarization variability. Objective The goal of this paper is to assess the bounded input bounded output (BIBO) stability in PTa interval (PTaI) dynamics using autoregressive exogenous (ARX) model and to investigate the reason for causing instability in the atrial repolarization process. Methods Twenty-five male subjects in normal sinus rhythm (NSR) and ten male subjects experiencing atrial tachycardia (AT) were included in this study. Five minute long, modified limb lead (MLL) ECGs were recorded with an EDAN SE-1010 PC ECG system. The number of minute ECGs with unstable segments (N us ) and the frequency of premature activation (PA) (i.e. atrial activation) were counted for each ECG recording and compared between AT and NSR subjects. Results The instability in PTaI dynamics was quantified by measuring the numbers of unstable segments in ECG data for each subject. The unstable segments in the PTaI dynamics were associated with the frequency of PA. The presence of PA is not the only factor causing the instability in PTaI dynamics in NSR subjects, and it is found that the cause of instability is mainly due to the heart rate variability (HRV). C onclusion The ARX model showed better prediction of PTa interval dynamics in both groups. The frequency of PA is significantly higher in AT patients than NSR subjects. A more complex model is needed to better identify and characterize healthy heart dynamics

Detection of atrial fibrillation episodes in long-term heart rhythm signals using a support vector machine

Atrial fibrillation (AF) is a serious heart arrhythmia leading to a significant increase of the risk for occurrence of ischemic stroke. Clinically, the AF episode is recognized in an electrocardiogram. However, detection of asymptomatic AF, which requires a long-term monitoring, is more efficient when based on irregularity of beat-to-beat intervals estimated by the heart rate (HR) features. Automated classification of heartbeats into AF and non-AF by means of the Lagrangian Support Vector Machine has been proposed. The classifier input vector consisted of sixteen features, including four coefficients very sensitive to beat-to-beat heart changes, taken from the fetal heart rate analysis in perinatal medicine. Effectiveness of the proposed classifier has been verified on the MIT-BIH Atrial Fibrillation Database. Designing of the LSVM classifier using very large number of feature vectors requires extreme computational efforts. Therefore, an original approach has been proposed to determine a training set of the smallest possible size that still would guarantee a high quality of AF detection. It enables to obtain satisfactory results using only 1.39% of all heartbeats as the training data. Post-processing stage based on aggregation of classified heartbeats into AF episodes has been applied to provide more reliable information on patient risk. Results obtained during the testing phase showed the sensitivity of 98.94%, positive predictive value of 98.39%, and classification accuracy of 98.86%.Web of Science203art. no. 76

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

Nonlinear trend removal should be carefully performed in heart rate variability analysis

$\bullet$ Background : In Heart rate variability analysis, the rate-rate time series suffer often from aperiodic non-stationarity, presence of ectopic beats etc. It would be hard to extract helpful information from the original signals. 10 $\bullet$ Problem : Trend removal methods are commonly practiced to reduce the influence of the low frequency and aperiodic non-stationary in RR data. This can unfortunately affect the signal and make the analysis on detrended data less appropriate. $\bullet$ Objective : Investigate the detrending effect (linear \& nonlinear) in temporal / nonliear analysis of heart rate variability of long-term RR data (in normal sinus rhythm, atrial fibrillation, 15 congestive heart failure and ventricular premature arrhythmia conditions). $\bullet$ Methods : Temporal method : standard measure SDNN; Nonlinear methods : multi-scale Fractal Dimension (FD), Detrended Fluctuation Analysis (DFA) \& Sample Entropy (Sam-pEn) analysis. $\bullet$ Results : The linear detrending affects little the global characteristics of the RR data, either 20 in temporal analysis or in nonlinear complexity analysis. After linear detrending, the SDNNs are just slightly shifted and all distributions are well preserved. The cross-scale complexity remained almost the same as the ones for original RR data or correlated. Nonlinear detrending changed not only the SDNNs distribution, but also the order among different types of RR data. After this processing, the SDNN became indistinguishable be-25 tween SDNN for normal sinus rhythm and ventricular premature beats. Different RR data has different complexity signature. Nonlinear detrending made the all RR data to be similar , in terms of complexity. It is thus impossible to distinguish them. The FD showed that nonlinearly detrended RR data has a dimension close to 2, the exponent from DFA is close to zero and SampEn is larger than 1.5 -- these complexity values are very close to those for 30 random signal. $\bullet$ Conclusions : Pre-processing by linear detrending can be performed on RR data, which has little influence on the corresponding analysis. Nonlinear detrending could be harmful and it is not advisable to use this type of pre-processing. Exceptions do exist, but only combined with other appropriate techniques to avoid complete change of the signal's intrinsic dynamics. 35 Keywords $\bullet$ heart rate variability $\bullet$ linear / nonlinear detrending $\bullet$ complexity analysis $\bullet$ mul-tiscale analysis $\bullet$ detrended fluctuation analysis $\bullet$ fractal dimension $\bullet$ sample entropy

HEART RHYTHM CLASSIFICATION FROM STATIC AND ECG TIME-SERIES DATA USING HYBRID MULTIMODAL DEEP LEARNING

Cardiovascular arrhythmia diseases are considered as the most common diseases that cause death around the world. Abnormal arrhythmia diseases can be identified by analyzing heart rhythm using an electrocardiogram (ECG). However, this analysis is done manually by cardiologists, which may be subjective and susceptible to different cardiologist observations and experiences, as well as to noise and irregularities in those signals. This can lead to misdiagnosis. Motivated by this challenge, an automated heart rhythm diagnosis approach from ECG signals using Deep Learning has been proposed. In order to achieve this goal, three research problems have been addressed. First, recognize the role of each single-lead of a 12-lead ECG to classify heart rhythms. Second, understanding the importance of static data (e.g., demographics and clinical profile) in classifying heart rhythms. Third, realizing whether the static data can be combined with the ECG time series data for better classification performance. In this thesis, different deep learning models have been proposed to address these problems and satisfactory results are achieved. Therefore, using this knowledge, an effective hybrid deep learning model to classify heart rhythms has been proposed. As per knowledge obtained from relevant literature, this is the first work to identify the importance of individual lead and combined lead as well as the importance of combining static data with ECG time series data in classifying heart rhythms. Extensive experiments have been performed to evaluate this algorithm on a 12-lead ECG database that contains data from more than 10,000 individual subjects and obtained a high average of accuracy (up to 98.7%) and F1-measure (up to 98.7%). Moreover, in this thesis, the distribution of heart rhythms from the database based on heart rhythm type, gender, and age group have been analyzed, which will be valuable for further improvement of classification performance. This study will provide valuable insights and will prove to be an effective tool in automated heart rhythm classification and will assist cardiologists in effectively and accurately diagnosing heart disease

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/