Gabor frames for classification of paroxysmal and persistent atrial fibrillation episodes

[EN] In this study, we propose a new classification method for early differentiation of paroxysmal and persistent atrial fibrillation episodes, i.e. those which spontaneously or with external intervention will return to sinus rhythm within 7 days of onset from the ones where the arrhythmia is sustained for more than 7 days. Today, clinicians provide patients classification once the course of the arrhythmia has been disclosed. This classification problem is dealt with in this study. We study a sparse representation of surface electrocardiogram signals by means of Gabor frames and afterwards we apply a linear discriminant analysis. Thus, we provide an early discrimination, obtaining promising performances on a heterogeneous cohort of patients in terms of pharmacological treatment and state of progression of the arrhythmia: 95% sensitivity, 82% specificity, 89% accuracy. In this manner, the proposed method can help clinicians to choose the most appropriate treatment using the electrocardiogram, which is a widely available and non-invasive technique. This early differentiation is clinically highly significant in order to choose optimal patients who may undergo catheter ablation with higher success rates. (C) 2016 IPEM. Published by Elsevier Ltd. All rights reserved.This work was supported by Generalitat Valenciana under Grant PrometeoII/2013/013, and by MINECO under Grants MTM2013-43540-P and MTM2016-76647-P.Ortigosa, N.; Galbis Verdu, A.; Fernández, C.; Cano-Pérez, Ó. (2017). Gabor frames for classification of paroxysmal and persistent atrial fibrillation episodes. Medical Engineering & Physics. 39:31-37. https://doi.org/10.1016/j.medengphy.2016.10.013S31373

Statistical and Graph-Based Signal Processing: Fundamental Results and Application to Cardiac Electrophysiology

The goal of cardiac electrophysiology is to obtain information about the mechanism, function, and performance of the electrical activities of the heart, the identification of deviation from normal pattern and the design of treatments. Offering a better insight into cardiac arrhythmias comprehension and management, signal processing can help the physician to enhance the treatment strategies, in particular in case of atrial fibrillation (AF), a very common atrial arrhythmia which is associated to significant morbidities, such as increased risk of mortality, heart failure, and thromboembolic events. Catheter ablation of AF is a therapeutic technique which uses radiofrequency energy to destroy atrial tissue involved in the arrhythmia sustenance, typically aiming at the electrical disconnection of the of the pulmonary veins triggers. However, recurrence rate is still very high, showing that the very complex and heterogeneous nature of AF still represents a challenging problem. Leveraging the tools of non-stationary and statistical signal processing, the first part of our work has a twofold focus: firstly, we compare the performance of two different ablation technologies, based on contact force sensing or remote magnetic controlled, using signal-based criteria as surrogates for lesion assessment. Furthermore, we investigate the role of ablation parameters in lesion formation using the late-gadolinium enhanced magnetic resonance imaging. Secondly, we hypothesized that in human atria the frequency content of the bipolar signal is directly related to the local conduction velocity (CV), a key parameter characterizing the substrate abnormality and influencing atrial arrhythmias. Comparing the degree of spectral compression among signals recorded at different points of the endocardial surface in response to decreasing pacing rate, our experimental data demonstrate a significant correlation between CV and the corresponding spectral centroids. However, complex spatio-temporal propagation pattern characterizing AF spurred the need for new signals acquisition and processing methods. Multi-electrode catheters allow whole-chamber panoramic mapping of electrical activity but produce an amount of data which need to be preprocessed and analyzed to provide clinically relevant support to the physician. Graph signal processing has shown its potential on a variety of applications involving high-dimensional data on irregular domains and complex network. Nevertheless, though state-of-the-art graph-based methods have been successful for many tasks, so far they predominantly ignore the time-dimension of data. To address this shortcoming, in the second part of this dissertation, we put forth a Time-Vertex Signal Processing Framework, as a particular case of the multi-dimensional graph signal processing. Linking together the time-domain signal processing techniques with the tools of GSP, the Time-Vertex Signal Processing facilitates the analysis of graph structured data which also evolve in time. We motivate our framework leveraging the notion of partial differential equations on graphs. We introduce joint operators, such as time-vertex localization and we present a novel approach to significantly improve the accuracy of fast joint filtering. We also illustrate how to build time-vertex dictionaries, providing conditions for efficient invertibility and examples of constructions. The experimental results on a variety of datasets suggest that the proposed tools can bring significant benefits in various signal processing and learning tasks involving time-series on graphs. We close the gap between the two parts illustrating the application of graph and time-vertex signal processing to the challenging case of multi-channels intracardiac signals

Sparse Decompositions for Ventricular and Atrial Activity Separation

Atrial Fibrillation (AF) is the most common type of human arrhythmia. Beside its clinical description as absolute arrhythmia, its diagnosis has been assessed for years by visual inspection of the surface electrocardiogram (ECG). Due to the much higher amplitude of the electrical ventricular activity, the analysis of atrial fibrillation requires the previous isolation of the atrial activity component. In this work, an approach to separate atrial and ventricular signal components, decomposing the signal over a redundant multi-component dictionary, is explored. This idea requires a careful dictionary design, taking into account the signal structures and characteristics. Being the dictionary overcomplete, more than one decomposition of a given signal is possible. However, we are interested in sparse solutions. A key point in this work is also, jointly with the dictionary design, to determine the appropriate analysis technique for the best performance of the ECG components separation. Greedy Algorithms, such as Matching Pursuit, or optimization methods, such as Basis Pursuit are studied. To improve our signal separation, the a priori knowledge we have from the ECG signals is also used. Finally, the solution proposed is tested over an ECG database

Computer-Assisted Electroanatomical Guidance for Cardiac Electrophysiology Procedures

Cardiac arrhythmias are serious life-threatening episodes affecting both the aging population and younger patients with pre-existing heart conditions. One of the most effective therapeutic procedures is the minimally-invasive catheter-driven endovascular electrophysiology study, whereby electrical potentials and activation patterns in the affected cardiac chambers are measured and subsequent ablation of arrhythmogenic tissue is performed. Despite emerging technologies such as electroanatomical mapping and remote intraoperative navigation systems for improved catheter manipulation and stability, successful ablation of arrhythmias is still highly-dependent on the operator’s skills and experience. This thesis proposes a framework towards standardisation in the electroanatomical mapping and ablation planning by merging knowledge transfer from previous cases and patient-specific data. In particular, contributions towards four different procedural aspects were made: optimal electroanatomical mapping, arrhythmia path computation, catheter tip stability analysis, and ablation simulation and optimisation. In order to improve the intraoperative electroanatomical map, anatomical areas of high mapping interest were proposed, as learned from previous electrophysiology studies. Subsequently, the arrhythmic wave propagation on the endocardial surface and potential ablation points were computed. The ablation planning is further enhanced, firstly by the analysis of the catheter tip stability and the probability of slippage at sparse locations on the endocardium and, secondly, by the simulation of the ablation result from the computation of convolutional matrices which model mathematically the ablation process. The methods proposed by this thesis were validated on data from patients with complex congenital heart disease, who present unusual cardiac anatomy and consequently atypical arrhythmias. The proposed methods also build a generic framework for computer guidance of electrophysiology, with results showing complementary information that can be easily integrated into the clinical workflow.Open Acces

Algorithms design for improving homecare using Electrocardiogram (ECG) signals and Internet of Things (IoT)

Due to the fast growing of population, a lot of hospitals get crowded from the huge amount of patients visits. Moreover, during COVID-19 a lot of patients prefer staying at home to minimize the spread of the virus. The need for providing care to patients at home is essential. Internet of Things (IoT) is widely known and used by different fields. IoT based homecare will help in reducing the burden upon hospitals. IoT with homecare bring up several benefits such as minimizing human exertions, economical savings and improved efficiency and effectiveness. One of the important requirement on homecare system is the accuracy because those systems are dealing with human health which is sensitive and need high amount of accuracy. Moreover, those systems deal with huge amount of data due to the continues sensing that need to be processed well to provide fast response regarding the diagnosis with minimum cost requirements. Heart is one of the most important organ in the human body that requires high level of caring. Monitoring heart status can diagnose disease from the early stage and find the best medication plan by health experts. Continues monitoring and diagnosis of heart could exhaust caregivers efforts. Having an IoT heart monitoring model at home is the solution to this problem. Electrocardiogram (ECG) signals are used to track heart condition using waves and peaks. Accurate and efficient IoT ECG monitoring at home can detect heart diseases and save human lives. As a consequence, an IoT ECG homecare monitoring model is designed in this thesis for detecting Cardiac Arrhythmia and diagnosing heart diseases. Two databases of ECG signals are used; one online which is old and limited, and another huge, unique and special from real patients in hospital. The raw ECG signal for each patient is passed through the implemented Low Pass filter and Savitzky Golay filter signal processing techniques to remove the noise and any external interference. The clear signal in this model is passed through feature extraction stage to extract number of features based on some metrics and medical information along with feature extraction algorithm to find peaks and waves. Those features are saved in the local database to apply classification on them. For the diagnosis purpose a classification stage is made using three classification ways; threshold values, machine learning and deep learning to increase the accuracy. Threshold values classification technique worked based on medical values and boarder lines. In case any feature goes above or beyond these ranges, a warning message appeared with expected heart disease. The second type of classification is by using machine learning to minimize the human efforts. A Support Vector Machine (SVM) algorithm is proposed by running the algorithm on the features extracted from both databases. The classification accuracy for online and hospital databases was 91.67% and 94% respectively. Due to the non-linearity of the decision boundary, a third way of classification using deep learning is presented. A full Multilayer Perceptron (MLP) Neural Network is implemented to improve the accuracy and reduce the errors. The number of errors reduced to 0.019 and 0.006 using online and hospital databases. While using hospital database which is huge, there is a need for a technique to reduce the amount of data. Furthermore, a novel adaptive amplitude threshold compression algorithm is proposed. This algorithm is able to make diagnosis of heart disease from the reduced size using compressed ECG signals with high level of accuracy and low cost. The extracted features from compressed and original are similar with only slight differences of 1%, 2% and 3% with no effects on machine learning and deep learning classification accuracy without the need for any reconstructions. The throughput is improved by 43% with reduced storage space of 57% when using data compression. Moreover, to achieve fast response, the amount of data should be reduced further to provide fast data transmission. A compressive sensing based cardiac homecare system is presented. It gives the channel between sender and receiver the ability to carry small amount of data. Experiment results reveal that the proposed models are more accurate in the classification of Cardiac Arrhythmia and in the diagnosis of heart diseases. The proposed models ensure fast diagnosis and minimum cost requirements. Based on the experiments on classification accuracy, number of errors and false alarms, the dictionary of the compressive sensing selected to be 900. As a result, this thesis provided three different scenarios that achieved IoT homecare Cardiac monitoring to assist in further research for designing homecare Cardiac monitoring systems. The experiment results reveal that those scenarios produced better results with high level of accuracy in addition to minimizing data and cost requirements

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

The hidden waves in the ECG uncovered: a sound automated interpretation method

A novel approach for analysing cardiac rhythm data is presented in this paper. Heartbeats are decomposed into the five fundamental $P$, $Q$, $R$, $S$ and $T$ waves plus an error term to account for artefacts in the data which provides a meaningful, physical interpretation of the heart's electric system. The morphology of each wave is concisely described using four parameters that allow to all the different patterns in heartbeats be characterized and thus differentiated This multi-purpose approach solves such questions as the extraction of interpretable features, the detection of the fiducial marks of the fundamental waves, or the generation of synthetic data and the denoising of signals. Yet, the greatest benefit from this new discovery will be the automatic diagnosis of heart anomalies as well as other clinical uses with great advantages compared to the rigid, vulnerable and black box machine learning procedures, widely used in medical devices. The paper shows the enormous potential of the method in practice; specifically, the capability to discriminate subjects, characterize morphologies and detect the fiducial marks (reference points) are validated numerically using simulated and real data, thus proving that it outperforms its competitors

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