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

Electrocardiogram pattern recognition and analysis based on artificial neural networks and support vector machines: a review.

Computer systems for Electrocardiogram (ECG) analysis support the clinician in tedious tasks (e.g., Holter ECG monitored in Intensive Care Units) or in prompt detection of dangerous events (e.g., ventricular fibrillation). Together with clinical applications (arrhythmia detection and heart rate variability analysis), ECG is currently being investigated in biometrics (human identification), an emerging area receiving increasing attention. Methodologies for clinical applications can have both differences and similarities with respect to biometrics. This paper reviews methods of ECG processing from a pattern recognition perspective. In particular, we focus on features commonly used for heartbeat classification. Considering the vast literature in the field and the limited space of this review, we dedicated a detailed discussion only to a few classifiers (Artificial Neural Networks and Support Vector Machines) because of their popularity; however, other techniques such as Hidden Markov Models and Kalman Filtering will be also mentioned

Self-adjustable domain adaptation in personalized ECG monitoring integrated with IR-UWB radar

To enhance electrocardiogram (ECG) monitoring systems in personalized detections, deep neural networks (DNNs) are applied to overcome individual differences by periodical retraining. As introduced previously [4], DNNs relieve individual differences by fusing ECG with impulse radio ultra-wide band (IR-UWB) radar. However, such DNN-based ECG monitoring system tends to overfit into personal small datasets and is difficult to generalize to newly collected unlabeled data. This paper proposes a self-adjustable domain adaptation (SADA) strategy to prevent from overfitting and exploit unlabeled data. Firstly, this paper enlarges the database of ECG and radar data with actual records acquired from 28 testers and expanded by the data augmentation. Secondly, to utilize unlabeled data, SADA combines self organizing maps with the transfer learning in predicting labels. Thirdly, SADA integrates the one-class classification with domain adaptation algorithms to reduce overfitting. Based on our enlarged database and standard databases, a large dataset of 73200 records and a small one of 1849 records are built up to verify our proposal. Results show SADA\u27s effectiveness in predicting labels and increments in the sensitivity of DNNs by 14.4% compared with existing domain adaptation algorithms

Classification of Arrhythmia by Using Deep Learning with 2-D ECG Spectral Image Representation

The electrocardiogram (ECG) is one of the most extensively employed signals used in the diagnosis and prediction of cardiovascular diseases (CVDs). The ECG signals can capture the heart's rhythmic irregularities, commonly known as arrhythmias. A careful study of ECG signals is crucial for precise diagnoses of patients' acute and chronic heart conditions. In this study, we propose a two-dimensional (2-D) convolutional neural network (CNN) model for the classification of ECG signals into eight classes; namely, normal beat, premature ventricular contraction beat, paced beat, right bundle branch block beat, left bundle branch block beat, atrial premature contraction beat, ventricular flutter wave beat, and ventricular escape beat. The one-dimensional ECG time series signals are transformed into 2-D spectrograms through short-time Fourier transform. The 2-D CNN model consisting of four convolutional layers and four pooling layers is designed for extracting robust features from the input spectrograms. Our proposed methodology is evaluated on a publicly available MIT-BIH arrhythmia dataset. We achieved a state-of-the-art average classification accuracy of 99.11\%, which is better than those of recently reported results in classifying similar types of arrhythmias. The performance is significant in other indices as well, including sensitivity and specificity, which indicates the success of the proposed method.Comment: 14 pages, 5 figures, accepted for future publication in Remote Sensing MDPI Journa

Identification of myocardial infarction by high-frequency serial ECG measurement

The purpose of this study is to attempt to identify acute myocardial infarction with high frequency serial electrocardiogram. High-frequency ECG and serial ECG are both unique ECG analysing techniques. The idea in this study is to combine these two and see if changes between different ECGs from the same person can provide us some information, whether it being in the high-frequency or normal frequency range of the ECG. To answer the questions, an existing database which contained multiple ECGs for each person with high sampling frequency was used. 5 different machine learning models were trained and tested with this database. The results of the machine learning methods were good, producing the mean accuracy of 91.9%, while the best model was the Extra Trees machine learning model. It produced the accuracy of 97.9% when applying cross-validation to the database. After these results, high-frequency serial ECG could be stated to be relevant. However, having ECG measured regularly can be expensive and time consuming. Therefore, the possibility of using a wearable ECG device was also studied. With a device called SAFE, developed by the University of Turku, a new high-frequency serial ECG database was gathered. The already existing machine learning model trained with the previous data was applied to this database and produced a mean accuracy of 90%. The quality of the ECGs gathered with the device were also deemed to be viable. Both high-frequency ECG and serial ECG were found to be relevant methods. A wearable device could be used for AMI detection if the ECG is sufficient enough. Future studies could include increasing the dataset size of the wearable device, investigate other myocardial diseases and exploring the possibilities of high-frequency ECG further

Predicting left ventricular hypertrophy from the 12-lead electrocardiogram in the UK Biobank imaging study using machine learning

Aims: Left ventricular hypertrophy (LVH) is an established, independent predictor of cardiovascular disease. Indices derived from the electrocardiogram (ECG) have been used to infer the presence of LVH with limited sensitivity. This study aimed to classify LVH defined by cardiovascular magnetic resonance (CMR) imaging using the 12-lead ECG for cost-effective patient stratification. Methods and results: We extracted ECG biomarkers with a known physiological association with LVH from the 12-lead ECG of 37 534 participants in the UK Biobank imaging study. Classification models integrating ECG biomarkers and clinical variables were built using logistic regression, support vector machine (SVM) and random forest (RF). The dataset was split into 80% training and 20% test sets for performance evaluation. Ten-fold cross validation was applied with further validation testing performed by separating data based on UK Biobank imaging centres. QRS amplitude and blood pressure (P < 0.001) were the features most strongly associated with LVH. Classification with logistic regression had an accuracy of 81% [sensitivity 70%, specificity 81%, Area under the receiver operator curve (AUC) 0.86], SVM 81% accuracy (sensitivity 72%, specificity 81%, AUC 0.85) and RF 72% accuracy (sensitivity 74%, specificity 72%, AUC 0.83). ECG biomarkers enhanced model performance of all classifiers, compared to using clinical variables alone. Validation testing by UK Biobank imaging centres demonstrated robustness of our models. Conclusion: A combination of ECG biomarkers and clinical variables were able to predict LVH defined by CMR. Our findings provide support for the ECG as an inexpensive screening tool to risk stratify patients with LVH as a prelude to advanced imaging

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