Artificial neural network for atrial fibrillation identification in portable devices

none6siAtrial fibrillation (AF) is a common cardiac disorder that can cause severe complications. AF diagnosis is typically based on the electrocardiogram (ECG) evaluation in hospitals or in clinical facilities. The aim of the present work is to propose a new artificial neural network for reliable AF identification in ECGs acquired through portable devices. A supervised fully connected artificial neural network (RSL_ANN), receiving 19 ECG features (11 morphological, 4 on F waves and 4 on heart-rate variability (HRV)) in input and discriminating between AF and non-AF classes in output, was created using the repeated structuring and learning (RSL) procedure. RSL_ANN was created and tested on 8028 (training: 4493; validation: 1125; testing: 2410) annotated ECGs belonging to the “AF Classification from a Short Single Lead ECG Recording” database and acquired with the portable KARDIA device by AliveCor. RSL_ANN performance was evaluated in terms of area under the curve (AUC) and confidence intervals (CIs) of the received operating characteristic. RSL_ANN performance was very good and very similar in training, validation and testing datasets. AUC was 91.1% (CI: 89.1%–93.0%), 90.2% (CI: 86.2%–94.3%) and 90.8% (CI: 88.1%–93.5%) for the training, validation and testing datasets, respectively. Thus, RSL_ANN is a promising tool for reliable identification of AF in ECGs acquired by portable devices.openMarinucci D.; Sbrollini A.; Marcantoni I.; Morettini M.; Swenne C.A.; Burattini L.Marinucci, D.; Sbrollini, A.; Marcantoni, I.; Morettini, M.; Swenne, C. A.; Burattini, L

Towards Personalized Healthcare in Cardiac Population: The Development of a Wearable ECG Monitoring System, an ECG Lossy Compression Schema, and a ResNet-Based AF Detector

Cardiovascular diseases (CVDs) are the number one cause of death worldwide. While there is growing evidence that the atrial fibrillation (AF) has strong associations with various CVDs, this heart arrhythmia is usually diagnosed using electrocardiography (ECG) which is a risk-free, non-intrusive, and cost-efficient tool. Continuously and remotely monitoring the subjects' ECG information unlocks the potentials of prompt pre-diagnosis and timely pre-treatment of AF before the development of any life-threatening conditions/diseases. Ultimately, the CVDs associated mortality could be reduced. In this manuscript, the design and implementation of a personalized healthcare system embodying a wearable ECG device, a mobile application, and a back-end server are presented. This system continuously monitors the users' ECG information to provide personalized health warnings/feedbacks. The users are able to communicate with their paired health advisors through this system for remote diagnoses, interventions, etc. The implemented wearable ECG devices have been evaluated and showed excellent intra-consistency (CVRMS=5.5%), acceptable inter-consistency (CVRMS=12.1%), and negligible RR-interval errors (ARE<1.4%). To boost the battery life of the wearable devices, a lossy compression schema utilizing the quasi-periodic feature of ECG signals to achieve compression was proposed. Compared to the recognized schemata, it outperformed the others in terms of compression efficiency and distortion, and achieved at least 2x of CR at a certain PRD or RMSE for ECG signals from the MIT-BIH database. To enable automated AF diagnosis/screening in the proposed system, a ResNet-based AF detector was developed. For the ECG records from the 2017 PhysioNet CinC challenge, this AF detector obtained an average testing F1=85.10% and a best testing F1=87.31%, outperforming the state-of-the-art

ECG analysis and classification using CSVM, MSVM and SIMCA classifiers

Reliable ECG classification can potentially lead to better detection methods and increase accurate diagnosis of arrhythmia, thus improving quality of care. This thesis investigated the use of two novel classification algorithms: CSVM and SIMCA, and assessed their performance in classifying ECG beats. The project aimed to introduce a new way to interactively support patient care in and out of the hospital and develop new classification algorithms for arrhythmia detection and diagnosis. Wave (P-QRS-T) detection was performed using the WFDB Software Package and multiresolution wavelets. Fourier and PCs were selected as time-frequency features in the ECG signal; these provided the input to the classifiers in the form of DFT and PCA coefficients. ECG beat classification was performed using binary SVM. MSVM, CSVM, and SIMCA; these were subsequently used for simultaneously classifying either four or six types of cardiac conditions. Binary SVM classification with 100% accuracy was achieved when applied on feature-reduced ECG signals from well-established databases using PCA. The CSVM algorithm and MSVM were used to classify four ECG beat types: NORMAL, PVC, APC, and FUSION or PFUS; these were from the MIT-BIH arrhythmia database (precordial lead group and limb lead II). Different numbers of Fourier coefficients were considered in order to identify the optimal number of features to be presented to the classifier. SMO was used to compute hyper-plane parameters and threshold values for both MSVM and CSVM during the classifier training phase. The best classification accuracy was achieved using fifty Fourier coefficients. With the new CSVM classifier framework, accuracies of 99%, 100%, 98%, and 99% were obtained using datasets from one, two, three, and four precordial leads, respectively. In addition, using CSVM it was possible to successfully classify four types of ECG beat signals extracted from limb lead simultaneously with 97% accuracy, a significant improvement on the 83% accuracy achieved using the MSVM classification model. In addition, further analysis of the following four beat types was made: NORMAL, PVC, SVPB, and FUSION. These signals were obtained from the European ST-T Database. Accuracies between 86% and 94% were obtained for MSVM and CSVM classification, respectively, using 100 Fourier coefficients for reconstructing individual ECG beats. Further analysis presented an effective ECG arrhythmia classification scheme consisting of PCA as a feature reduction method and a SIMCA classifier to differentiate between either four or six different types of arrhythmia. In separate studies, six and four types of beats (including NORMAL, PVC, APC, RBBB, LBBB, and FUSION beats) with time domain features were extracted from the MIT-BIH arrhythmia database and the St Petersburg INCART 12-lead Arrhythmia Database (incartdb) respectively. Between 10 and 30 PCs, coefficients were selected for reconstructing individual ECG beats in the feature selection phase. The average classification accuracy of the proposed scheme was 98.61% and 97.78 % using the limb lead and precordial lead datasets, respectively. In addition, using MSVM and SIMCA classifiers with four ECG beat types achieved an average classification accuracy of 76.83% and 98.33% respectively. The effectiveness of the proposed algorithms was finally confirmed by successfully classifying both the six beat and four beat types of signal respectively with a high accuracy ratio

The Impact of Digital Technologies on Public Health in Developed and Developing Countries

This open access book constitutes the refereed proceedings of the 18th International Conference on String Processing and Information Retrieval, ICOST 2020, held in Hammamet, Tunisia, in June 2020.* The 17 full papers and 23 short papers presented in this volume were carefully reviewed and selected from 49 submissions. They cover topics such as: IoT and AI solutions for e-health; biomedical and health informatics; behavior and activity monitoring; behavior and activity monitoring; and wellbeing technology. *This conference was held virtually due to the COVID-19 pandemic

Improving Access and Mental Health for Youth Through Virtual Models of Care

The overall objective of this research is to evaluate the use of a mobile health smartphone application (app) to improve the mental health of youth between the ages of 14–25 years, with symptoms of anxiety/depression. This project includes 115 youth who are accessing outpatient mental health services at one of three hospitals and two community agencies. The youth and care providers are using eHealth technology to enhance care. The technology uses mobile questionnaires to help promote self-assessment and track changes to support the plan of care. The technology also allows secure virtual treatment visits that youth can participate in through mobile devices. This longitudinal study uses participatory action research with mixed methods. The majority of participants identified themselves as Caucasian (66.9%). Expectedly, the demographics revealed that Anxiety Disorders and Mood Disorders were highly prevalent within the sample (71.9% and 67.5% respectively). Findings from the qualitative summary established that both staff and youth found the software and platform beneficial

The Impact of Digital Technologies on Public Health in Developed and Developing Countries

This open access book constitutes the refereed proceedings of the 18th International Conference on String Processing and Information Retrieval, ICOST 2020, held in Hammamet, Tunisia, in June 2020.* The 17 full papers and 23 short papers presented in this volume were carefully reviewed and selected from 49 submissions. They cover topics such as: IoT and AI solutions for e-health; biomedical and health informatics; behavior and activity monitoring; behavior and activity monitoring; and wellbeing technology. *This conference was held virtually due to the COVID-19 pandemic

Design and Implementation of Complexity Reduced Digital Signal Processors for Low Power Biomedical Applications

Wearable health monitoring systems can provide remote care with supervised, inde-pendent living which are capable of signal sensing, acquisition, local processing and transmission. A generic biopotential signal (such as Electrocardiogram (ECG), and Electroencephalogram (EEG)) processing platform consists of four main functional components. The signals acquired by the electrodes are amplified and preconditioned by the (1) Analog-Front-End (AFE) which are then digitized via the (2) Analog-to-Digital Converter (ADC) for further processing. The local digital signal processing is usually handled by a custom designed (3) Digital Signal Processor (DSP) which is responsible for either anyone or combination of signal processing algorithms such as noise detection, noise/artefact removal, feature extraction, classification and compres-sion. The digitally processed data is then transmitted via the (4) transmitter which is renown as the most power hungry block in the complete platform. All the afore-mentioned components of the wearable systems are required to be designed and fitted into an integrated system where the area and the power requirements are stringent. Therefore, hardware complexity and power dissipation of each functional component are crucial aspects while designing and implementing a wearable monitoring platform. The work undertaken focuses on reducing the hardware complexity of a biosignal DSP and presents low hardware complexity solutions that can be employed in the aforemen-tioned wearable platforms. A typical state-of-the-art system utilizes Sigma Delta (Σ∆) ADCs incorporating a Σ∆ modulator and a decimation filter whereas the state-of-the-art decimation filters employ linear phase Finite-Impulse-Response (FIR) filters with high orders that in-crease the hardware complexity [1–5]. In this thesis, the novel use of minimum phase Infinite-Impulse-Response (IIR) decimators is proposed where the hardware complexity is massively reduced compared to the conventional FIR decimators. In addition, the non-linear phase effects of these filters are also investigated since phase non-linearity may distort the time domain representation of the signal being filtered which is un-desirable effect for biopotential signals especially when the fiducial characteristics carry diagnostic importance. In the case of ECG monitoring systems the effect of the IIR filter phase non-linearity is minimal which does not affect the diagnostic accuracy of the signals. The work undertaken also proposes two methods for reducing the hardware complexity of the popular biosignal processing tool, Discrete Wavelet Transform (DWT). General purpose multipliers are known to be hardware and power hungry in terms of the number of addition operations or their underlying building blocks like full adders or half adders required. Higher number of adders leads to an increase in the power consumption which is directly proportional to the clock frequency, supply voltage, switching activity and the resources utilized. A typical Field-Programmable-Gate-Array’s (FPGA) resources are Look-up Tables (LUTs) whereas a custom Digital Signal Processor’s (DSP) are gate-level cells of standard cell libraries that are used to build adders [6]. One of the proposed methods is the replacement of the hardware and power hungry general pur-pose multipliers and the coefficient memories with reconfigurable multiplier blocks that are composed of simple shift-add networks and multiplexers. This method substantially reduces the resource utilization as well as the power consumption of the system. The second proposed method is the design and implementation of the DWT filter banks using IIR filters which employ less number of arithmetic operations compared to the state-of-the-art FIR wavelets. This reduces the hardware complexity of the analysis filter bank of the DWT and can be employed in applications where the reconstruction is not required. However, the synthesis filter bank for the IIR wavelet transform has a higher computational complexity compared to the conventional FIR wavelet synthesis filter banks since re-indexing of the filtered data sequence is required that can only be achieved via the use of extra registers. Therefore, this led to the proposal of a novel design which replaces the complex IIR based synthesis filter banks with FIR fil-ters which are the approximations of the associated IIR filters. Finally, a comparative study is presented where the hybrid IIR/FIR and FIR/FIR wavelet filter banks are de-ployed in a typical noise reduction scenario using the wavelet thresholding techniques. It is concluded that the proposed hybrid IIR/FIR wavelet filter banks provide better denoising performance, reduced computational complexity and power consumption in comparison to their IIR/IIR and FIR/FIR counterparts

Sensor Signal and Information Processing II

In the current age of information explosion, newly invented technological sensors and software are now tightly integrated with our everyday lives. Many sensor processing algorithms have incorporated some forms of computational intelligence as part of their core framework in problem solving. These algorithms have the capacity to generalize and discover knowledge for themselves and learn new information whenever unseen data are captured. The primary aim of sensor processing is to develop techniques to interpret, understand, and act on information contained in the data. The interest of this book is in developing intelligent signal processing in order to pave the way for smart sensors. This involves mathematical advancement of nonlinear signal processing theory and its applications that extend far beyond traditional techniques. It bridges the boundary between theory and application, developing novel theoretically inspired methodologies targeting both longstanding and emergent signal processing applications. The topic ranges from phishing detection to integration of terrestrial laser scanning, and from fault diagnosis to bio-inspiring filtering. The book will appeal to established practitioners, along with researchers and students in the emerging field of smart sensors processing

Detection of atrial fibrillation from single lead ECG signal using multirate cosine filter bank and deep neural network

Atrial fibrillation (AF) is a cardiac arrhythmia which is characterized based on the irregsular beating of atria, resulting in, the abnormal atrial patterns that are observed in the electrocardiogram (ECG) signal. The early detection of this pathology is very helpful for minimizing the chances of stroke, other heart-related disorders, and coronary artery diseases. This paper proposes a novel method for the detection of AF pathology based on the analysis of the ECG signal. The method adopts a multi-rate cosine filter bank architecture for the evaluation of coefficients from the ECG signal at different subbands, in turn, the Fractional norm (FN) feature is evaluated from the extracted coefficients at each subband. Then, the AF detection is carried out using a deep learning approach known as the Hierarchical Extreme Learning Machine (H-ELM) from the FN features. The proposed method is evaluated by considering normal and AF pathological ECG signals from public databases. The experimental results reveal that the proposed multi-rate cosine filter bank based on FN features is effective for the detection of AF pathology with an accuracy, sensitivity and specificity values of 99.40%, 98.77%, and 100%, respectively. The performance of the proposed diagnostic features of the ECG signal is compared with other existing features for the detection of AF. The low-frequency subband FN features found to be more significant with a difference of the mean values as 0.69 between normal and AF classes