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

Classification of Arrhythmia by Using Deep Learning with 2-D ECG Spectral Image Representation

The electrocardiogram (ECG) is one of the most extensively employed signals used in the diagnosis and prediction of cardiovascular diseases (CVDs). The ECG signals can capture the heart's rhythmic irregularities, commonly known as arrhythmias. A careful study of ECG signals is crucial for precise diagnoses of patients' acute and chronic heart conditions. In this study, we propose a two-dimensional (2-D) convolutional neural network (CNN) model for the classification of ECG signals into eight classes; namely, normal beat, premature ventricular contraction beat, paced beat, right bundle branch block beat, left bundle branch block beat, atrial premature contraction beat, ventricular flutter wave beat, and ventricular escape beat. The one-dimensional ECG time series signals are transformed into 2-D spectrograms through short-time Fourier transform. The 2-D CNN model consisting of four convolutional layers and four pooling layers is designed for extracting robust features from the input spectrograms. Our proposed methodology is evaluated on a publicly available MIT-BIH arrhythmia dataset. We achieved a state-of-the-art average classification accuracy of 99.11\%, which is better than those of recently reported results in classifying similar types of arrhythmias. The performance is significant in other indices as well, including sensitivity and specificity, which indicates the success of the proposed method.Comment: 14 pages, 5 figures, accepted for future publication in Remote Sensing MDPI Journa

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

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

Novel hybrid extraction systems for fetal heart rate variability monitoring based on non-invasive fetal electrocardiogram

This study focuses on the design, implementation and subsequent verification of a new type of hybrid extraction system for noninvasive fetal electrocardiogram (NI-fECG) processing. The system designed combines the advantages of individual adaptive and non-adaptive algorithms. The pilot study reviews two innovative hybrid systems called ICA-ANFIS-WT and ICA-RLS-WT. This is a combination of independent component analysis (ICA), adaptive neuro-fuzzy inference system (ANFIS) algorithm or recursive least squares (RLS) algorithm and wavelet transform (WT) algorithm. The study was conducted on clinical practice data (extended ADFECGDB database and Physionet Challenge 2013 database) from the perspective of non-invasive fetal heart rate variability monitoring based on the determination of the overall probability of correct detection (ACC), sensitivity (SE), positive predictive value (PPV) and harmonic mean between SE and PPV (F1). System functionality was verified against a relevant reference obtained by an invasive way using a scalp electrode (ADFECGDB database), or relevant reference obtained by annotations (Physionet Challenge 2013 database). The study showed that ICA-RLS-WT hybrid system achieve better results than ICA-ANFIS-WT. During experiment on ADFECGDB database, the ICA-RLS-WT hybrid system reached ACC > 80 % on 9 recordings out of 12 and the ICA-ANFIS-WT hybrid system reached ACC > 80 % only on 6 recordings out of 12. During experiment on Physionet Challenge 2013 database the ICA-RLS-WT hybrid system reached ACC > 80 % on 13 recordings out of 25 and the ICA-ANFIS-WT hybrid system reached ACC > 80 % only on 7 recordings out of 25. Both hybrid systems achieve provably better results than the individual algorithms tested in previous studies.Web of Science713178413175

A Review of Atrial Fibrillation Detection Methods as a Service

Atrial Fibrillation (AF) is a common heart arrhythmia that often goes undetected, and even if it is detected, managing the condition may be challenging. In this paper, we review how the RR interval and Electrocardiogram (ECG) signals, incorporated into a monitoring system, can be useful to track AF events. Were such an automated system to be implemented, it could be used to help manage AF and thereby reduce patient morbidity and mortality. The main impetus behind the idea of developing a service is that a greater data volume analyzed can lead to better patient outcomes. Based on the literature review, which we present herein, we introduce the methods that can be used to detect AF efficiently and automatically via the RR interval and ECG signals. A cardiovascular disease monitoring service that incorporates one or multiple of these detection methods could extend event observation to all times, and could therefore become useful to establish any AF occurrence. The development of an automated and efficient method that monitors AF in real time would likely become a key component for meeting public health goals regarding the reduction of fatalities caused by the disease. Yet, at present, significant technological and regulatory obstacles remain, which prevent the development of any proposed system. Establishment of the scientific foundation for monitoring is important to provide effective service to patients and healthcare professionals