Automated and Interpretable Patient ECG Profiles for Disease Detection, Tracking, and Discovery

The electrocardiogram or ECG has been in use for over 100 years and remains the most widely performed diagnostic test to characterize cardiac structure and electrical activity. We hypothesized that parallel advances in computing power, innovations in machine learning algorithms, and availability of large-scale digitized ECG data would enable extending the utility of the ECG beyond its current limitations, while at the same time preserving interpretability, which is fundamental to medical decision-making. We identified 36,186 ECGs from the UCSF database that were 1) in normal sinus rhythm and 2) would enable training of specific models for estimation of cardiac structure or function or detection of disease. We derived a novel model for ECG segmentation using convolutional neural networks (CNN) and Hidden Markov Models (HMM) and evaluated its output by comparing electrical interval estimates to 141,864 measurements from the clinical workflow. We built a 725-element patient-level ECG profile using downsampled segmentation data and trained machine learning models to estimate left ventricular mass, left atrial volume, mitral annulus e' and to detect and track four diseases: pulmonary arterial hypertension (PAH), hypertrophic cardiomyopathy (HCM), cardiac amyloid (CA), and mitral valve prolapse (MVP). CNN-HMM derived ECG segmentation agreed with clinical estimates, with median absolute deviations (MAD) as a fraction of observed value of 0.6% for heart rate and 4% for QT interval. Patient-level ECG profiles enabled quantitative estimates of left ventricular and mitral annulus e' velocity with good discrimination in binary classification models of left ventricular hypertrophy and diastolic function. Models for disease detection ranged from AUROC of 0.94 to 0.77 for MVP. Top-ranked variables for all models included known ECG characteristics along with novel predictors of these traits/diseases.Comment: 13 pages, 6 figures, 1 Table + Supplemen

Exploiting Prior Knowledge in Compressed Sensing Wireless ECG Systems

Recent results in telecardiology show that compressed sensing (CS) is a promising tool to lower energy consumption in wireless body area networks for electrocardiogram (ECG) monitoring. However, the performance of current CS-based algorithms, in terms of compression rate and reconstruction quality of the ECG, still falls short of the performance attained by state-of-the-art wavelet based algorithms. In this paper, we propose to exploit the structure of the wavelet representation of the ECG signal to boost the performance of CS-based methods for compression and reconstruction of ECG signals. More precisely, we incorporate prior information about the wavelet dependencies across scales into the reconstruction algorithms and exploit the high fraction of common support of the wavelet coefficients of consecutive ECG segments. Experimental results utilizing the MIT-BIH Arrhythmia Database show that significant performance gains, in terms of compression rate and reconstruction quality, can be obtained by the proposed algorithms compared to current CS-based methods.Comment: Accepted for publication at IEEE Journal of Biomedical and Health Informatic

A Deep Learning Approach to Examine Ischemic ST Changes in Ambulatory ECG Recordings.

Patients with suspected acute coronary syndrome (ACS) are at risk of transient myocardial ischemia (TMI), which could lead to serious morbidity or even mortality. Early detection of myocardial ischemia can reduce damage to heart tissues and improve patient condition. Significant ST change in the electrocardiogram (ECG) is an important marker for detecting myocardial ischemia during the rule-out phase of potential ACS. However, current ECG monitoring software is vastly underused due to excessive false alarms. The present study aims to tackle this problem by combining a novel image-based approach with deep learning techniques to improve the detection accuracy of significant ST depression change. The obtained convolutional neural network (CNN) model yields an average area under the curve (AUC) at 89.6% from an independent testing set. At selected optimal cutoff thresholds, the proposed model yields a mean sensitivity at 84.4% while maintaining specificity at 84.9%

Biosignal Generation and Latent Variable Analysis with Recurrent Generative Adversarial Networks

The effectiveness of biosignal generation and data augmentation with biosignal generative models based on generative adversarial networks (GANs), which are a type of deep learning technique, was demonstrated in our previous paper. GAN-based generative models only learn the projection between a random distribution as input data and the distribution of training data.Therefore, the relationship between input and generated data is unclear, and the characteristics of the data generated from this model cannot be controlled. This study proposes a method for generating time-series data based on GANs and explores their ability to generate biosignals with certain classes and characteristics. Moreover, in the proposed method, latent variables are analyzed using canonical correlation analysis (CCA) to represent the relationship between input and generated data as canonical loadings. Using these loadings, we can control the characteristics of the data generated by the proposed method. The influence of class labels on generated data is analyzed by feeding the data interpolated between two class labels into the generator of the proposed GANs. The CCA of the latent variables is shown to be an effective method of controlling the generated data characteristics. We are able to model the distribution of the time-series data without requiring domain-dependent knowledge using the proposed method. Furthermore, it is possible to control the characteristics of these data by analyzing the model trained using the proposed method. To the best of our knowledge, this work is the first to generate biosignals using GANs while controlling the characteristics of the generated data

ESC core curriculum for the general cardiologist (2013)

[No abstract available

Theoretical Interpretations and Applications of Radial Basis Function Networks

Medical applications usually used Radial Basis Function Networks just as Artificial Neural Networks. However, RBFNs are Knowledge-Based Networks that can be interpreted in several way: Artificial Neural Networks, Regularization Networks, Support Vector Machines, Wavelet Networks, Fuzzy Controllers, Kernel Estimators, Instanced-Based Learners. A survey of their interpretations and of their corresponding learning algorithms is provided as well as a brief survey on dynamic learning algorithms. RBFNs' interpretations can suggest applications that are particularly interesting in medical domains