Обзор методов автоматической диагностики сердечной аритмии для принятия решений о необходимости проведения дефибрилляции

Ventricular fibrillation is considered the most common cause of sudden cardiac arrest. The fibrillation, and ventricular tachycardia often preceding it, are cardiac rhythms that may respond to emergency electroshock therapy and return to normal sinus rhythm when diagnosed early after cardiac arrest with the restoration of adequate cardiac pumping function. However, manually checking ECG signals on the existence of a pattern of such arrhythmias is a risky and time-consuming task in stressful situations and practically impossible in the absence of a qualified medical specialist. Therefore, systems of the computer classification of arrhythmias with the function of making a decision on the necessity of electric cardioversion with the parameters of a high-voltage pulse calculated adaptively for each patient are widely used for the automatic diagnosis of such conditions. This paper discusses methods of analyzing the electrocardiographic signal taken from the electrodes of an external automatic or semi-automatic defibrillator in order to make a decision on the necessity for defibrillation, which are applicable in the embedded software of automatic and semiautomatic external defibrillators. The paper includes an overview of applicable filtering techniques as well as subsequent algorithms for extracting, classifying and compressing features for the ECG signal.  Lipchak D. A., Chupov A. A. Methods of Signal Analysis for Automatic Diagnosis of Shockable Cardiac Arrhythmias: A Review. Ural Radio Engineering Journal. 2021;5(4):380–409. (In Russ.) DOI: 10.15826/ urej.2021.5.4.004. Фибрилляция желудочков сердца считается наиболее часто встречающейся причиной внезапной остановки сердца. Такая фибрилляция и часто предшествующая ей желудочковая тахикардия – это ритмы сердца, которые могут реагировать на экстренную электрошоковую терапию и вернуться к нормальному синусовому ритму при ранней диагностике после остановки сердца с восстановлением адекватной насосной функции сердца. Однако ручная проверка сигналов ЭКГ на наличие паттерна такой аритмии является сложной аналитической задачей, требующей немедленного принятия решения в стрессовой ситуации, практически невыполнимой в отсутствие квалифицированного медицинского специалиста. Поэтому для автоматической диагностики острых состояний широкое применение получили системы компьютерной классификации аритмий с функцией принятия решения о необходимости проведения электрокардиотерапии с параметрами высоковольтного импульса, вычисленного адаптивно для каждого пациента. В данной работе рассмотрены методы анализа электрокардиографического сигнала, снимаемого с электродов наружного автоматического или полуавтоматического дефибриллятора, с целью принятия решения о необходимости оказания дефибрилляции, применимые во встроенном программном обеспечении автоматических и полуавтоматических внешних дефибрилляторов. Работа включает обзор применимых методов фильтрации, а также последующих алгоритмов извлечения, классификации и сжатия характерных признаков для сигнала ЭКГ.  Липчак Д. А., Чупов А. А. Обзор методов автоматической диагностики сердечной аритмии для принятия решений о необходимости проведения дефибрилляции. Ural Radio Engineering Journal. 2021;5(4):380–409. DOI: 10.15826/urej.2021.5.4.004.

Methods of Signal Analysis for Automatic Diagnosis of Shockable Cardiac Arrhythmias: A Review

Ventricular fibrillation is considered the most common cause of sudden cardiac arrest. Ventricular fibrillation, and ventricular tachycardia often preceding it, are cardiac rhythms that can respond to emergency electroshock therapy and return to normal sinus rhythm when diagnosed early after cardiac arrest with the restoration of adequate cardiac pumping function. However, manually checking ECG signals for the presence of a pattern of such arrhythmias is a risky and time- consuming task in stressful situations and practically impossible in the absence of a qualified medical specialist. Therefore, for the automatic diagnosis of such conditions, systems for the computer classification of arrhythmias to decide on the need for electric cardioversion with the parameters of a high-voltage pulse, calculated adaptively for each patient, are widely used. This paper discusses methods for analyzing the electrocardiographic signal taken from external automatic or semi-automatic defibrillator electrodes to decide the need for defibrillation, which is applicable in the embedded software of automatic, semi-automatic external defibrillators. The paper includes an overview of applicable filtering techniques and subsequent algorithms for extracting, classifying, and compressing features for the ECG signal. Both advantages and disadvantages are discussed for the studied algorithms. © 2022 IEEE.Russian Foundation for Basic Research, РФФИ, (20-37-90037)The reported study is funded by RFBR according to research project No. 20-37-90037

Atrial fibrillation classification based on MLP networks by extracting Jitter and Shimmer parameters

Atrial fibrillation (AF) is the most common cardiac anomaly and one that potentially threatens human life. Due to its relation to a variation in cardiac rhythm during indeterminate periods, long-term observations are necessary for its diagnosis. With the increase in data volume, fatigue and the complexity of long-term features make analysis an increasingly impractical process. Most medical diagnostic aid systems based on machine learning, are designed to automatically detect, classify or predict certain behaviors. In this work, using the PhysioNet MIT-BIH Atrial Fibrillation database, a system based on MLP artificial neural network is proposed to differentiate, between AF and non-AF, segments and ECG’s features, obtaining average accuracy of 80.67% in test set, for the 10-fold cross-validation method. As a highlight, the extraction of jitter and shimmer parameters from ECG windows is presented to compose the network input sets, indicating a slight improvement in the model's performance. Added to these, Shannon's and logarithmic energy entropies are determined, also indicating an improvement in performance related to the use of fewer features.This work has been supported by FCT – Fundação para a Ciência e Tecnologia within the Project Scope: UIDB/05757/2020.info:eu-repo/semantics/publishedVersio

Methods of Signal Analysis for Automatic Diagnosis of Shockable Cardiac Arrhythmias: A Review

Поступила: 19.12.2021. Принята в печать: 18.01.2022.Received: 19.12.2021. Accepted: 18.01.2022.Фибрилляция желудочков сердца считается наиболее часто встречающейся причиной внезапной остановки сердца. Такая фибрилляция и часто предшествующая ей желудочковая тахикардия – это ритмы сердца, которые могут реагировать на экстренную электрошоковую терапию и вернуться к нормальному синусовому ритму при ранней диагностике после остановки сердца с восстановлением адекватной насосной функции сердца. Однако ручная проверка сигналов ЭКГ на наличие паттерна такой аритмии является сложной аналитической задачей, требующей немедленного принятия решения в стрессовой ситуации, практически невыполнимой в отсутствие квалифицированного медицинского специалиста. Поэтому для автоматической диагностики острых состояний широкое применение получили системы компьютерной классификации аритмий с функцией принятия решения о необходимости проведения электрокардиотерапии с параметрами высоковольтного импульса, вычисленного адаптивно для каждого пациента. В данной работе рассмотрены методы анализа электрокардиографического сигнала, снимаемого с электродов наружного автоматического или полуавтоматического дефибриллятора, с целью принятия решения о необходимости оказания дефибрилляции, применимые во встроенном программном обеспечении автоматических и полуавтоматических внешних дефибрилляторов. Работа включает обзор применимых методов фильтрации, а также последующих алгоритмов извлечения, классификации и сжатия характерных признаков для сигнала ЭКГ.Ventricular fibrillation is considered the most common cause of sudden cardiac arrest. The fibrillation, and ventricular tachycardia often preceding it, are cardiac rhythms that may respond to emergency electroshock therapy and return to normal sinus rhythm when diagnosed early after cardiac arrest with the restoration of adequate cardiac pumping function. However, manually checking ECG signals on the existence of a pattern of such arrhythmias is a risky and time-consuming task in stressful situations and practically impossible in the absence of a qualified medical specialist. Therefore, systems of the computer classification of arrhythmias with the function of making a decision on the necessity of electric cardioversion with the parameters of a high-voltage pulse calculated adaptively for each patient are widely used for the automatic diagnosis of such conditions. This paper discusses methods of analyzing the electrocardiographic signal taken from the electrodes of an external automatic or semi-automatic defibrillator in order to make a decision on the necessity for defibrillation, which are applicable in the embedded software of automatic and semiautomatic external defibrillators. The paper includes an overview of applicable filtering techniques as well as subsequent algorithms for extracting, classifying and compressing features for the ECG signal

COMPUTER AIDED DIAGNOSIS OF VENTRICULAR ARRHYTHMIAS FROM ELECTROCARDIOGRAM LEAD II SIGNALS

In this work, we use computer aided diagnosis (CADx) to extract features from ECG signals and detect different types of cardiac ventricular arrhythmias including Ventricular Tachycardia (VT),Ventricular Fibrillation (VF), Ventricular Couplet (VC), and Ventricular Bigeminy (VB).Our methodology is unique in computing features of lower and higher order statistical parameters from six different data domains: time domain, Fourier domain, and four Wavelet domains (Daubechies, Coiflet, Symlet, and Meyer). These features proved to give superior classification performance, in general, regardless of the type of classifier used as compared with previous studies. However, Support Vector Machine (SVM) and Artificial Neural Network (ANN) classifiers got better performance than other classifiers tried including KNN and Naïve Bayes classifiers. Our unique features enabled classifiers to perform better in comparison with previous studies: for VT, 100% accuracy while best previous work got 95.8%, for VF, 100% accuracy while best previous work got 97.5%, for VC, 100% sensitivity while best previous work got 71.8%, and for VB, 100% sensitivity while best previous work got 84.6%

Rolling Element Bearing Performance Degradation Assessment Using Variational Mode Decomposition and Gath-Geva Clustering Time Series Segmentation

By focusing on the issue of rolling element bearing (REB) performance degradation assessment (PDA), a solution based on variational mode decomposition (VMD) and Gath-Geva clustering time series segmentation (GGCTSS) has been proposed. VMD is a new decomposition method. Since it is different from the recursive decomposition method, for example, empirical mode decomposition (EMD), local mean decomposition (LMD), and local characteristic-scale decomposition (LCD), VMD needs a priori parameters. In this paper, we will propose a method to optimize the parameters in VMD, namely, the number of decomposition modes and moderate bandwidth constraint, based on genetic algorithm. Executing VMD with the acquired parameters, the BLIMFs are obtained. By taking the envelope of the BLIMFs, the sensitive BLIMFs are selected. And then we take the amplitude of the defect frequency (ADF) as a degradative feature. To get the performance degradation assessment, we are going to use the method called Gath-Geva clustering time series segmentation. Afterwards, the method is carried out by two pieces of run-to-failure data. The results indicate that the extracted feature could depict the process of degradation precisely

Ventricular Fibrillation and Tachycardia Detection Using Features Derived from Topological Data Analysis

A rapid and accurate detection of ventricular arrhythmias is essential to take appropriate therapeutic actions when cardiac arrhythmias occur. Furthermore, the accurate discrimination between arrhythmias is also important, provided that the required shocking therapy would not be the same. In this work, the main novelty is the use of the mathematical method known as Topological Data Analysis (TDA) to generate new types of features which can contribute to the improvement of the detection and classification performance of cardiac arrhythmias such as Ventricular Fibrillation (VF) and Ventricular Tachycardia (VT). The electrocardiographic (ECG) signals used for this evaluation were obtained from the standard MIT-BIH and AHA databases. Two input data to the classify are evaluated: TDA features, and Persistence Diagram Image (PDI). Using the reduced TDA-obtained features, a high average accuracy near 99% was observed when discriminating four types of rhythms (98.68% to VF; 99.05% to VT; 98.76% to normal sinus; and 99.09% to Other rhythms) with specificity values higher than 97.16% in all cases. In addition, a higher accuracy of 99.51% was obtained when discriminating between shockable (VT/VF) and non-shockable rhythms (99.03% sensitivity and 99.67% specificity). These results show that the use of TDA-derived geometric features, combined in this case this the k-Nearest Neighbor (kNN) classifier, raises the classification performance above results in previous works. Considering that these results have been achieved without preselection of ECG episodes, it can be concluded that these features may be successfully introduced in Automated External Defibrillation (AED) and Implantable Cardioverter Defibrillation (ICD) therapie

Classificação de episódios de fibrilação atrial por análise do ECG com redes neuronais artificiais MLP e LSTM

Mestrado de dupla diplomação com a UTFPR - Universidade Tecnológica Federal do ParanáA fibrilação atrial (AF) é uma doença cardíaca que afeta aproximadamente 1% da população mundial, sendo a anomalia cardíaca mais comum. Apesar de não ser uma causa direta de morte, frequentemente está associada ou gera outros problemas que ameaçam a vida humana, como o derrame e a doença da artéria coronária. As principais características da AF são: a alta variação do ritmo cardíaco, o enfraquecimento ou desaparecimento da contração atrial e a ocorrência de irregularidades nas atividades dos ventrículos. O diagnóstico da AF é realizado por um médico especialista, principalmente através da inspeção visual de gravações de eletrocardiograma (ECG) de longo termo. Tais gravações podem chegar a várias horas, e são necessárias pois a AF pode ocorrer a qualquer momento do dia. Dessa forma surgem os problemas quanto ao grande volume de dados e as dependências de longo termo. Além disso, as particularidades e as variabilidades dos padrões de deformação de cada sujeito fazem com que o problema esteja também relacionado com a experiência do cardiologista. Assim, a proposta de um sistema computacional de auxílio ao diagnóstico médico baseado em inteligência artificial se torna muito interessante, uma vez que não sofre com a fadiga e é fortemente indicado para lidar com dados em grande quantidade e com alta variabilidade. Portanto, neste trabalho foi proposta a exploração de modelos de aprendizagem de máquina para análise e classificação de sinais ECG de longo termo, para auxiliar no diagnóstico da AF. Os modelos foram baseados em redes neuronais artificiais do tipo Multi-Layer Perceptron (MLP) e Long Short-Term Memory (LSTM). Utilizam-se os sinais da base de dados MIT-BIH Atrial Fibrillation, sem remoção de ruído, tendências ou artefatos, numa etapa de extração de características temporais, morfológicas, estatísticas e em tempo-frequência sobre segmentos de contexto variável (duração em segundos ou contagem de intervalos entre picos R). As características do sinal ECG utilizadas, foram: duração dos intervalos R-R (RRi) consecutivos, perturbação Jitter, perturbação Shimmer, entropias de Shannon e energia logarítmica, frequências instantâneas, entropia espectral e transformada Scattering. Sobre estes atributos foram aplicadas diferentes estratégias de normalização por Z-score e valor máximo absoluto, de forma a normalizar os indicadores de acordo com o contexto do sujeito ou local do segmento. Após a exploração de várias combinações destas características e dos parâmetros das redes MLP, obteve-se uma acurácia de classificação para a metodologia 10-fold cross-validation de 80,67%. Entretanto, notou-se que as marcações do pico das ondas R advindas da base de dados eram imprecisas. Dessa forma, desenvolveu-se um algoritmo de detecção do pico das ondas R baseado na combinação entre a derivada do sinal, a energia de Shannon e a transformada de Hilbert, resultado em uma acurácia de marcação dos picos R de 98,95%. A partir das novas marcações, determinou-se todas as características e em seguida foram exploradas diversas estruturas de redes neuronais MLP e LSTM, sendo que os melhores resultados em acurácia/exatidão para estas arquiteturas foram, respectivamente, 91,96% e 98,17%. Em todos os testes, a MLP demonstrou melhora de desempenho à medida que mais características foram sendo agregadas nos conjuntos de dados. A LSTM por outro lado, obteve os melhores resultados quando foram combinados 60 RRi e as respectivas entropias das ondas P, T e U.Atrial fibrillation (AF) is a heart disease that affects approximately 1% of the world population, being the most common cardiac anomaly. Although it is not a direct cause of death, it is often associated with or generates other problems that threaten human life, such as stroke and coronary artery disease. The main characteristics of AF are the high variation in heart rate, the weakening or disappearance of atrial contraction and the occurrence of irregularities in the activities of the ventricles. The diagnosis of AF is performed by a specialist doctor, mainly through visual inspection of long-term electrocardiogram (ECG) recordings. Such recordings can take several hours and are necessary because AF can occur at any time of the day. Thus, problems arise regarding the large amount of data and long-term dependencies. In addition, the particularities and variability of the deformation patterns of each subject make the problem also related to the cardiologist's experience. Thus, the proposal for a computational system to aid medical diagnosis based on artificial intelligence becomes very interesting, since it does not suffer from fatigue and is strongly indicated to deal with data in large quantities and with high variability. Therefore, in this work it was proposed to explore machine learning models for the analysis and classification of long-term ECG signals, to assist in the diagnosis of AF. The models were based on artificial neural networks Multi-Layer Perceptron (MLP) and Long Short-Term Memory (LSTM). The signals from the MIT-BIH Atrial Fibrillation database are used, without removing noise, trends or artifacts, in a stage of extracting temporal, morphological, statistical and time-frequency features over segments of variable context (duration in seconds or counting intervals between peaks R). The features of the ECG signal used were: duration of consecutive R-R (RRi) intervals, Jitter disturbance, Shimmer disturbance, Shannon entropies and logarithmic energy, instantaneous frequencies, spectral entropy and Scattering transform. On these attributes, different normalization strategies were applied by Z-score and absolute maximum value, to normalize the indicators according to the context of the subject or location of the segment. After exploring various combinations of these features and the parameters of the MLP networks, the accuracy of classification for the 10-fold cross-validation methodology was 80.67%. However, it was noted that the annotations of the peak of R waves from the database were inaccurate. Thus, an algorithm for detecting the peak of R waves was developed based on the combination of the derivative of the signal, the Shannon energy, and the Hilbert transform, resulting in an accuracy of marking the R peaks of 98.95%. From the new markings, all features were determined and then several structures of neural networks MLP and LSTM were explored, and the best results in accuracy for these architectures were, respectively, 91.96% and 98.17%. In all tests, MLP showed improvement in performance as more features were added to the data sets. LSTM, on the other hand, obtained the best result when 60 RRi and the respective entropies of the P, T and U waves were combined

Seinale prozesaketan eta ikasketa automatikoan oinarritutako ekarpenak bihotz-erritmoen analisirako bihotz-biriketako berpiztean

Tesis inglés 218 p. -- Tesis euskera 220 p.Out-of-hospital cardiac arrest (OHCA ) is characterized by the sudden loss of the cardiac function, andcauses around 10% of the total mortality in developed countries. Survival from OHCA depends largelyon two factors: early defibrillation and early cardiopulmonary resuscitation (CPR). The electrical shock isdelivered using a shock advice algorithm (SAA) implemented in defibrillators. Unfortunately, CPR mustbe stopped for a reliable SAA analysis because chest compressions introduce artefacts in the ECG. Theseinterruptions in CPR have an adverse effect on OHCA survival. Since the early 1990s, many efforts havebeen made to reliably analyze the rhythm during CPR. Strategies have mainly focused on adaptive filtersto suppress the CPR artefact followed by SAAs of commercial defibrillators. However, these solutionsdid not meet the American Heart Association¿s (AHA) accuracy requirements for shock/no-shockdecisions. A recent approach, which replaces the commercial SAA by machine learning classifiers, hasdemonstrated that a reliable rhythm analysis during CPR is possible. However, defibrillation is not theonly treatment needed during OHCA, and depending on the clinical context a finer rhythm classificationis needed. Indeed, an optimal OHCA scenario would allow the classification of the five cardiac arrestrhythm types that may be present during resuscitation. Unfortunately, multiclass classifiers that allow areliable rhythm analysis during CPR have not yet been demonstrated. On all of these studies artefactsoriginate from manual compressions delivered by rescuers. Mechanical compression devices, such as theLUCAS or the AutoPulse, are increasingly used in resuscitation. Thus, a reliable rhythm analysis duringmechanical CPR is becoming critical. Unfortunately, no AHA compliant algorithms have yet beendemonstrated during mechanical CPR. The focus of this thesis work is to provide new or improvedsolutions for rhythm analysis during CPR, including shock/no-shock decision during manual andmechanical CPR and multiclass classification during manual CPR