Comprehensive electrocardiographic diagnosis based on deep learning

Cardiovascular disease (CVD) is the leading cause of death worldwide, and coronary artery disease (CAD) is a major contributor. Early-stage CAD can progress if undiagnosed and left untreated, leading to myocardial infarction (MI) that may induce irreversible heart muscle damage, resulting in heart chamber remodeling and eventual congestive heart failure (CHF). Electrocardiography (ECG) signals can be useful to detect established MI, and may also be helpful for early diagnosis of CAD. For the latter especially, the ECG perturbations can be subtle and potentially misclassified on manual interpretation and/or when analyzed by traditional algorithms found in ECG instrumentation. For automated diagnostic systems (ADS), deep learning techniques are favored over conventional machine learning techniques, due to the automatic feature extraction and selection processes involved. This paper highlights various deep learning algorithms exploited for the classification of ECG signals into CAD, MI, and CHF conditions. The Convolutional Neural Network (CNN), followed by combined CNN and Long Short-Term Memory (LSTM) models, appear to be the most useful architectures for classification. A 16-layer LSTM model was developed in our study and validated using 10-fold cross validation. A classification accuracy of 98.5% was achieved. Our proposed model has the potential to be a useful diagnostic tool in hospitals for the classification of abnormal ECG signals

Application of artificial intelligence techniques for automated detection of myocardial infarction: A review

Myocardial infarction (MI) results in heart muscle injury due to receiving insufficient blood flow. MI is the most common cause of mortality in middle-aged and elderly individuals around the world. To diagnose MI, clinicians need to interpret electrocardiography (ECG) signals, which requires expertise and is subject to observer bias. Artificial intelligence-based methods can be utilized to screen for or diagnose MI automatically using ECG signals. In this work, we conducted a comprehensive assessment of artificial intelligence-based approaches for MI detection based on ECG as well as other biophysical signals, including machine learning (ML) and deep learning (DL) models. The performance of traditional ML methods relies on handcrafted features and manual selection of ECG signals, whereas DL models can automate these tasks. The review observed that deep convolutional neural networks (DCNNs) yielded excellent classification performance for MI diagnosis, which explains why they have become prevalent in recent years. To our knowledge, this is the first comprehensive survey of artificial intelligence techniques employed for MI diagnosis using ECG and other biophysical signals.Comment: 16 pages, 8 figure

Unidirectional-bidirectional recurrent networks for cardiac disorders classification

The deep learning approach of supervised recurrent network classifiers model, i.e., recurrent neural networks (RNNs), long short-term memory (LSTM), and gated recurrent units (GRUs) are used in this study. The unidirectional and bidirectional for each cardiac disorder (CDs) class is also compared. Comparing both phases is needed to figure out the optimum phase and the best model performance for ECG using the Physionet dataset to classify five classes of CDs with 15 leads ECG signals. The result shows that the bidirectional RNNs method produces better results than the unidirectional method. In contrast to RNNs, the unidirectional LSTM and GRU outperformed the bidirectional phase. The best recurrent network classifier performance is unidirectional GRU with average accuracy, sensitivity, specificity, precision, and F1-score of 98.50%, 95.54%, 98.42%, 89.93% 92.31%, respectively. Overall, deep learning is a promising improved method for ECG classification

A novel automated tower graph based ECG signal classification method with hexadecimal local adaptive binary pattern and deep learning

Electrocardiography (ECG) signal recognition is one of the popular research topics for machine learning. In this paper, a novel transformation called tower graph transformation is proposed to classify ECG signals with high accuracy rates. It employs a tower graph, which uses minimum, maximum and average pooling methods altogether to generate novel signals for the feature extraction. In order to extract meaningful features, we presented a novel one-dimensional hexadecimal pattern. To select distinctive and informative features, an iterative ReliefF and Neighborhood Component Analysis (NCA) based feature selection is utilized. By using these methods, a novel ECG signal classification approach is presented. In the preprocessing phase, tower graph-based pooling transformation is applied to each signal. The proposed one-dimensional hexadecimal adaptive pattern extracts 1536 features from each node of the tower graph. The extracted features are fused and 15,360 features are obtained and the most discriminative 142 features are selected by the ReliefF and iterative NCA (RFINCA) feature selection approach. These selected features are used as an input to the artificial neural network and deep neural network and 95.70% and 97.10% classification accuracy was obtained respectively. These results demonstrated the success of the proposed tower graph-based method.</p

Development of a Real-Time Single-Lead Single-Beat Frequency-Independent Myocardial Infarction Detector

The central aim of this research is the development and deployment of a novel multilayer machine learning design with unique application for the diagnosis of myocardial infarctions (MIs) from individual heartbeats of single-lead electrocardiograms (EKGs) irrespective of their sampling frequencies over a given range. To the best of our knowledge, this design is the first to attempt inter-patient myocardial infarction detection from individual heartbeats of single-lead (lead II) electrocardiograms that achieves high accuracy and near real-time diagnosis. The processing time of 300 milliseconds to a diagnosis is just at the time range in between extremely fast heartbeats of around 300 milliseconds, or 200 beats per minute. The design achieves stable performance metrics over the frequency range of 202Hz to 2.8kHz with an accuracy of 77.12%, positive predictive value (PPV) of 75.85%, and a negative predictive value (NPV) of 83.02% over the entire PTB database; 85.07%, 81.54%, 87.31% over the PTB-XL (the largest EKG database available for research) validation set, and 84.17%, 78.37%, 87.55% over the PTB-XL test set. Major design contributions and findings of this work reveal (1) a method for the realtime detection of ventricular depolarization events in the PQRST complex from 12-lead electrocardiograms using Independent Component Analysis (ICA), with a slightly different use of ICA proposed for electrocardiogram analysis and R-peak detection/localization; (2) a multilayer Long-Short Term Memory (LSTM) neural network design that identifies infarcted patients from a single heartbeat of a single-lead (lead II) electrocardiogram; (3) and integrated LSTM neural network with an algorithm that detects the R-peaks in real time for instantaneous detection of myocardial infarctions and for effective monitoring of patients under cardiac stress and/or at risk of myocardial infarction; (4) a fully integrated 12-lead real-time classifier with even higher detection metrics and a deeper neural architecture, which could serve as a near real-time monitoring tool that could gauge disease progression and evaluate benefits gained from early intervention and treatment planning; (5) a real-time frequency-independent design based on a single-lead single-beat MI detector, which is of pivotal importance to deployment as there is no standard sampling frequency for EKGs, making them span a wider frequency spectrum. vi

Implementing decision tree-based algorithms in medical diagnostic decision support systems

As a branch of healthcare, medical diagnosis can be defined as finding the disease based on the signs and symptoms of the patient. To this end, the required information is gathered from different sources like physical examination, medical history and general information of the patient. Development of smart classification models for medical diagnosis is of great interest amongst the researchers. This is mainly owing to the fact that the machine learning and data mining algorithms are capable of detecting the hidden trends between features of a database. Hence, classifying the medical datasets using smart techniques paves the way to design more efficient medical diagnostic decision support systems. Several databases have been provided in the literature to investigate different aspects of diseases. As an alternative to the available diagnosis tools/methods, this research involves machine learning algorithms called Classification and Regression Tree (CART), Random Forest (RF) and Extremely Randomized Trees or Extra Trees (ET) for the development of classification models that can be implemented in computer-aided diagnosis systems. As a decision tree (DT), CART is fast to create, and it applies to both the quantitative and qualitative data. For classification problems, RF and ET employ a number of weak learners like CART to develop models for classification tasks. We employed Wisconsin Breast Cancer Database (WBCD), Z-Alizadeh Sani dataset for coronary artery disease (CAD) and the databanks gathered in Ghaem Hospital’s dermatology clinic for the response of patients having common and/or plantar warts to the cryotherapy and/or immunotherapy methods. To classify the breast cancer type based on the WBCD, the RF and ET methods were employed. It was found that the developed RF and ET models forecast the WBCD type with 100% accuracy in all cases. To choose the proper treatment approach for warts as well as the CAD diagnosis, the CART methodology was employed. The findings of the error analysis revealed that the proposed CART models for the applications of interest attain the highest precision and no literature model can rival it. The outcome of this study supports the idea that methods like CART, RF and ET not only improve the diagnosis precision, but also reduce the time and expense needed to reach a diagnosis. However, since these strategies are highly sensitive to the quality and quantity of the introduced data, more extensive databases with a greater number of independent parameters might be required for further practical implications of the developed models

Automated characterization of coronary artery disease, myocardial infarction, and congestive heart failure using contourlet and shearlet transforms of electrocardiogram signal

Undiagnosed coronary artery disease (CAD) progresses rapidly and leads to myocardial infarction (MI) by reducing the blood flow to the cardiac muscles. Timely diagnosis of MI and its location is significant, else, it expands and may impair the left ventricular (LV) function. Thus, if CAD and MI are not picked up by electrocardiogram (ECG) during diagnostic test, it can lead to congestive heart failure (CHF). Therefore, in this paper, the characterization of three cardiac abnormalities namely, CAD, MI and CHF are compared. Performance of novel algorithms is based on contourlet and shearlet transformations of the ECG signals. Continuous wavelet transform (CWT) is performed on normal, CAD, MI and CHF ECG beat to obtain scalograms. Subsequently, contourlet and shearlet transformations are applied on the scalograms to obtain the respective coefficients. Entropies, first and second order statistical features namely, mean (Mn i), min (Min i), max (Mx i), standard deviation (Dst i), average power (Pavg i), inter-quartile range (IQRi), Shannon entropy (Esh i), mean Tsallis entropy (Emts i), kurtosis (Kur i), mean absolute deviation (MAD i), and mean energy (Ωm i), are extracted from each contourlet and shearlet coefficients. Only significant features are selected using improved binary particle swarm optimization (IBPSO) feature selection method. Selected features are ranked using analysis of variance (ANOVA) and relieff techniques. The highly ranked features are subjected to decision tree (DT) and K-nearest neighbor (KNN) classifiers. Proposed method has achieved accuracy, sensitivity and specificity of (i) 99.55%, 99.93% and 99.24% using contourlet transform, and (ii) 99.01%, 99.82% and 98.75% using shearlet transform. Among the two proposed techniques, contourlet transform method performed marginally better than shearlet transform technique in classifying the four classes. The proposed CWT combined with contourlet-based technique can be implemented in hospitals to speed up the diagnosis of three different cardiac abnormalities using a single ECG test. This technique, minimizes the unnecessary diagnostic tests required to confirm the diagnosis