Precision medicine and artificial intelligence : a pilot study on deep learning for hypoglycemic events detection based on ECG

Tracking the fluctuations in blood glucose levels is important for healthy subjects and crucial diabetic patients. Tight glucose monitoring reduces the risk of hypoglycemia, which can result in a series of complications, especially in diabetic patients, such as confusion, irritability, seizure and can even be fatal in specific conditions. Hypoglycemia affects the electrophysiology of the heart. However, due to strong inter-subject heterogeneity, previous studies based on a cohort of subjects failed to deploy electrocardiogram (ECG)-based hypoglycemic detection systems reliably. The current study used personalised medicine approach and Artificial Intelligence (AI) to automatically detect nocturnal hypoglycemia using a few heartbeats of raw ECG signal recorded with non-invasive, wearable devices, in healthy individuals, monitored 24 hours for 14 consecutive days. Additionally, we present a visualisation method enabling clinicians to visualise which part of the ECG signal (e.g., T-wave, ST-interval) is significantly associated with the hypoglycemic event in each subject, overcoming the intelligibility problem of deep-learning methods. These results advance the feasibility of a real-time, non-invasive hypoglycemia alarming system using short excerpts of ECG signal

Precision medicine and artificial intelligence : a pilot study on deep learning for hypoglycemic events detection based on ECG

Tracking the fluctuations in blood glucose levels is important for healthy subjects and crucial diabetic patients. Tight glucose monitoring reduces the risk of hypoglycemia, which can result in a series of complications, especially in diabetic patients, such as confusion, irritability, seizure and can even be fatal in specific conditions. Hypoglycemia affects the electrophysiology of the heart. However, due to strong inter-subject heterogeneity, previous studies based on a cohort of subjects failed to deploy electrocardiogram (ECG)-based hypoglycemic detection systems reliably. The current study used personalised medicine approach and Artificial Intelligence (AI) to automatically detect nocturnal hypoglycemia using a few heartbeats of raw ECG signal recorded with non-invasive, wearable devices, in healthy individuals, monitored 24 hours for 14 consecutive days. Additionally, we present a visualisation method enabling clinicians to visualise which part of the ECG signal (e.g., T-wave, ST-interval) is significantly associated with the hypoglycemic event in each subject, overcoming the intelligibility problem of deep-learning methods. These results advance the feasibility of a real-time, non-invasive hypoglycemia alarming system using short excerpts of ECG signal

An Ensemble of Deep Learning-Based Multi-Model for ECG Heartbeats Arrhythmia Classification

An automatic system for heart arrhythmia classification can perform a substantial role inmanaging and treating cardiovascular diseases. In this paper, a deep learning-based multi-model system is proposed for the classification of electrocardiogram (ECG) signals. Two different deep learning bagging models are introduced to classify heartbeats into different arrhythmias types. The first model (CNN-LSTM) is based on a combination of a convolutional neural network (CNN) and long short-term memory (LSTM) network to capture local features and temporal dynamics in the ECG data. The second model (RRHOS-LSTM) integrates some classical features, i.e. RR intervals and higher-order statistics (HOS), with LSTM model to effectively highlight abnormality heartbeats classes. We create a bagging model from the CNN-LSTM and RRHOS-LSTM networks by training each model on a different sub-sampling dataset to handle the high imbalance distribution of arrhythmias classes in the ECG data. Each model is also trained using a weighted loss function to provide high weight for not sufficiently represented classes. These models are then combined using a meta-classifier to form a strong coherent model. The meta-classifier is a feedforward fully connected neural network that takes the different predictions of bagging models as an input and combines them into a final prediction. The result of the meta-classifier is then verified by another CNN-LSTM model to decrease the false positive of the overall system. The experimental results are acquired by evaluating the proposed method on ECG data from the MIT-BIH arrhythmia database. The proposedmethod achieves an overall accuracy of 95.81% in the ‘‘subject-oriented’’ patient independent evaluation scheme. The averages of F1 score and positive predictive value are higher than all other methods by more than 3% and 8% respectively. The experimental results show the superiority of the proposed method for ECG heartbeats classification compared to many state-of-the-art methods

Heartbeat classification and arrhythmia detection using a multi-model deep-learning technique

Cardiac arrhythmias pose a significant danger to human life; therefore, it is of utmost importance to be able to efficiently diagnose these arrhythmias promptly. There exist many techniques for the detection of arrhythmias; however, the most widely adopted method is the use of an Electrocardiogram (ECG). The manual analysis of ECGs by medical experts is often inefficient. Therefore, the detection and recognition of ECG characteristics via machine-learning techniques have become prevalent. There are two major drawbacks of existing machine-learning approaches: (a) they require extensive training time; and (b) they require manual feature selection. To address these issues, this paper presents a novel deep-learning framework that integrates various networks by stacking similar layers in each network to produce a single robust model. The proposed framework has been tested on two publicly available datasets for the recognition of five micro-classes of arrhythmias. The overall classification sensitivity, specificity, positive predictive value, and accuracy of the proposed approach are 98.37%, 99.59%, 98.41%, and 99.35%, respectively. The results are compared with state-of-the-art approaches. The proposed approach outperformed the existing approaches in terms of sensitivity, specificity, positive predictive value, accuracy and computational cost

Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table