Real-time classification technique for early detection and prevention of myocardial infarction on wearable devices

Continuous monitoring of patients suffering from cardiovascular diseases and, in particular, myocardial infarction (MI) places a considerable burden on health-care systems and government budgets. The rise of wearable devices alleviates this burden, allowing for long-term patient monitoring in ambulatory settings. One of the major challenges in this area is to design ultra-low energy wearable devices for long-term monitoring of patients’ vital signs. In this work, we present a real-time event-driven classification technique, based on support vector machines (SVM) and statistical outlier detection. The main goal of this technique is to maintain a high classification accuracy while reducing the complexity of the classification algorithm. This technique leads to a reduction in energy consumption and thus battery lifetime extension. We validate our approach on a well-established and complete myocardial infarction (MI) database (Physiobank, PTB Diagnostic ECG database [1]). Our experimental evaluation demonstrates that our real-time classification scheme outperforms the existing approaches in terms of energy consumption and battery lifetime by a factor of 3, while maintaining the classification accuracy at a medically-acceptable level of 90%

Multidimensional embedded MEMS motion detectors for wearable mechanocardiography and 4D medical imaging

Background: Cardiovascular diseases are the number one cause of death. Of these deaths, almost 80% are due to coronary artery disease (CAD) and cerebrovascular disease. Multidimensional microelectromechanical systems (MEMS) sensors allow measuring the mechanical movement of the heart muscle offering an entirely new and innovative solution to evaluate cardiac rhythm and function. Recent advances in miniaturized motion sensors present an exciting opportunity to study novel device-driven and functional motion detection systems in the areas of both cardiac monitoring and biomedical imaging, for example, in computed tomography (CT) and positron emission tomography (PET). Methods: This Ph.D. work describes a new cardiac motion detection paradigm and measurement technology based on multimodal measuring tools — by tracking the heart’s kinetic activity using micro-sized MEMS sensors — and novel computational approaches — by deploying signal processing and machine learning techniques—for detecting cardiac pathological disorders. In particular, this study focuses on the capability of joint gyrocardiography (GCG) and seismocardiography (SCG) techniques that constitute the mechanocardiography (MCG) concept representing the mechanical characteristics of the cardiac precordial surface vibrations. Results: Experimental analyses showed that integrating multisource sensory data resulted in precise estimation of heart rate with an accuracy of 99% (healthy, n=29), detection of heart arrhythmia (n=435) with an accuracy of 95-97%, ischemic disease indication with approximately 75% accuracy (n=22), as well as significantly improved quality of four-dimensional (4D) cardiac PET images by eliminating motion related inaccuracies using MEMS dual gating approach. Tissue Doppler imaging (TDI) analysis of GCG (healthy, n=9) showed promising results for measuring the cardiac timing intervals and myocardial deformation changes. Conclusion: The findings of this study demonstrate clinical potential of MEMS motion sensors in cardiology that may facilitate in time diagnosis of cardiac abnormalities. Multidimensional MCG can effectively contribute to detecting atrial fibrillation (AFib), myocardial infarction (MI), and CAD. Additionally, MEMS motion sensing improves the reliability and quality of cardiac PET imaging.Moniulotteisten sulautettujen MEMS-liiketunnistimien käyttö sydänkardiografiassa sekä lääketieteellisessä 4D-kuvantamisessa Tausta: Sydän- ja verisuonitaudit ovat yleisin kuolinsyy. Näistä kuolemantapauksista lähes 80% johtuu sepelvaltimotaudista (CAD) ja aivoverenkierron häiriöistä. Moniulotteiset mikroelektromekaaniset järjestelmät (MEMS) mahdollistavat sydänlihaksen mekaanisen liikkeen mittaamisen, mikä puolestaan tarjoaa täysin uudenlaisen ja innovatiivisen ratkaisun sydämen rytmin ja toiminnan arvioimiseksi. Viimeaikaiset teknologiset edistysaskeleet mahdollistavat uusien pienikokoisten liiketunnistusjärjestelmien käyttämisen sydämen toiminnan tutkimuksessa sekä lääketieteellisen kuvantamisen, kuten esimerkiksi tietokonetomografian (CT) ja positroniemissiotomografian (PET), tarkkuuden parantamisessa. Menetelmät: Tämä väitöskirjatyö esittelee uuden sydämen kineettisen toiminnan mittaustekniikan, joka pohjautuu MEMS-anturien käyttöön. Uudet laskennalliset lähestymistavat, jotka perustuvat signaalinkäsittelyyn ja koneoppimiseen, mahdollistavat sydämen patologisten häiriöiden havaitsemisen MEMS-antureista saatavista signaaleista. Tässä tutkimuksessa keskitytään erityisesti mekanokardiografiaan (MCG), joihin kuuluvat gyrokardiografia (GCG) ja seismokardiografia (SCG). Näiden tekniikoiden avulla voidaan mitata kardiorespiratorisen järjestelmän mekaanisia ominaisuuksia. Tulokset: Kokeelliset analyysit osoittivat, että integroimalla usean sensorin dataa voidaan mitata syketiheyttä 99% (terveillä n=29) tarkkuudella, havaita sydämen rytmihäiriöt (n=435) 95-97%, tarkkuudella, sekä havaita iskeeminen sairaus noin 75% tarkkuudella (n=22). Lisäksi MEMS-kaksoistahdistuksen avulla voidaan parantaa sydämen 4D PET-kuvan laatua, kun liikeepätarkkuudet voidaan eliminoida paremmin. Doppler-kuvantamisessa (TDI, Tissue Doppler Imaging) GCG-analyysi (terveillä, n=9) osoitti lupaavia tuloksia sydänsykkeen ajoituksen ja intervallien sekä sydänlihasmuutosten mittaamisessa. Päätelmä: Tämän tutkimuksen tulokset osoittavat, että kardiologisilla MEMS-liikeantureilla on kliinistä potentiaalia sydämen toiminnallisten poikkeavuuksien diagnostisoinnissa. Moniuloitteinen MCG voi edistää eteisvärinän (AFib), sydäninfarktin (MI) ja CAD:n havaitsemista. Lisäksi MEMS-liiketunnistus parantaa sydämen PET-kuvantamisen luotettavuutta ja laatua

Current and Future Use of Artificial Intelligence in Electrocardiography.

Artificial intelligence (AI) is increasingly used in electrocardiography (ECG) to assist in diagnosis, stratification, and management. AI algorithms can help clinicians in the following areas: (1) interpretation and detection of arrhythmias, ST-segment changes, QT prolongation, and other ECG abnormalities; (2) risk prediction integrated with or without clinical variables (to predict arrhythmias, sudden cardiac death, stroke, and other cardiovascular events); (3) monitoring ECG signals from cardiac implantable electronic devices and wearable devices in real time and alerting clinicians or patients when significant changes occur according to timing, duration, and situation; (4) signal processing, improving ECG quality and accuracy by removing noise/artifacts/interference, and extracting features not visible to the human eye (heart rate variability, beat-to-beat intervals, wavelet transforms, sample-level resolution, etc.); (5) therapy guidance, assisting in patient selection, optimizing treatments, improving symptom-to-treatment times, and cost effectiveness (earlier activation of code infarction in patients with ST-segment elevation, predicting the response to antiarrhythmic drugs or cardiac implantable devices therapies, reducing the risk of cardiac toxicity, etc.); (6) facilitating the integration of ECG data with other modalities (imaging, genomics, proteomics, biomarkers, etc.). In the future, AI is expected to play an increasingly important role in ECG diagnosis and management, as more data become available and more sophisticated algorithms are developed.Manuel Marina-Breysse has received funding from European Union’s Horizon 2020 research and innovation program under the grant agreement number 965286; Machine Learning and Artificial Intelligence for Early Detection of Stroke and Atrial Fibrillation, MAESTRIA Consortium; and EIT Health, a body of the European Union.S

Real-Time Event-Driven Classification Technique for Early Detection and Prevention of Myocardial Infarction on Wearable Systems

A considerable portion of government health-care spending is allocated to the continuous monitoring of patients suffering from cardiovascular diseases, particularly myocardial infarction (MI). Wearable devices present a cost-effective means of monitoring patients’ vital signs in ambulatory settings. A major challenge is to design such ultra-low energy devices for long-term patient monitoring. In this paper, we present a real-time event-driven classification technique based on the random forest classification scheme, which uses a confidence-related decision-making process. The main goal of this technique is to maintain a high classification accuracy while reducing the complexity of the classification algorithm. We validate our approach on a well-established and complete MI database (Physiobank, PTB Diagnostic ECG database [1]). Our experimental evaluation demonstrates that our real-time classification scheme outperforms the existing approaches in terms of energy consumption and battery lifetime by a factor of 2.60, with no classification quality loss

Wearable Technologies and AI at the Far Edge for Chronic Heart Failure Prevention and Management: A Systematic Review and Prospects

Smart wearable devices enable personalized at-home healthcare by unobtrusively collecting patient health data and facilitating the development of intelligent platforms to support patient care and management. The accurate analysis of data obtained from wearable devices is crucial for interpreting and contextualizing health data and facilitating the reliable diagnosis and management of critical and chronic diseases. The combination of edge computing and artificial intelligence has provided real-time, time-critical, and privacy-preserving data analysis solutions. However, based on the envisioned service, evaluating the additive value of edge intelligence to the overall architecture is essential before implementation. This article aims to comprehensively analyze the current state of the art on smart health infrastructures implementing wearable and AI technologies at the far edge to support patients with chronic heart failure (CHF). In particular, we highlight the contribution of edge intelligence in supporting the integration of wearable devices into IoT-aware technology infrastructures that provide services for patient diagnosis and management. We also offer an in-depth analysis of open challenges and provide potential solutions to facilitate the integration of wearable devices with edge AI solutions to provide innovative technological infrastructures and interactive services for patients and doctors

Design of the phonocardiography appliance for coronary artery disease diagnosing and monitoring : business perspectives analysis of innovative medical technologies for cardiovascular diseases in Finland

The topic of this study is the application of modern medical technology to cardiovascular conditions. The main purpose of that research is to evaluate myocardium disorders from the versatile perspectives and propose the design of a socially-demanding and financially-efficient technological solution targeted to coronary artery disease (CAD) diagnosing and monitoring. Phonocardiography and audial CAD detection are discussed as innovative methods for personalized healthcare applications and based on that, digital product design is developed in the form of functional specification, wearable device model, iOS and WatchOS applications interface architecture. In addition to the diseases study, myocardium signals acquisition discussion and to device design itself, market research is conducted. It is focused on medical technologies segment in general and cardiological systems in particular. Finland and Nordic Europe are the major covered regions, while global trends are outlined to collect the vision on the general market tendency. Core assessment topics are medical technology product distribution models, investment potential and development barriers. The final result could be used as a foundation for further product development and as an overview or guidelines for businesses interested in healthcare Internet-of-Things and cardiological systems

Development of a Real-Time Single-Lead Single-Beat Frequency-Independent Myocardial Infarction Detector

The central aim of this research is the development and deployment of a novel multilayer machine learning design with unique application for the diagnosis of myocardial infarctions (MIs) from individual heartbeats of single-lead electrocardiograms (EKGs) irrespective of their sampling frequencies over a given range. To the best of our knowledge, this design is the first to attempt inter-patient myocardial infarction detection from individual heartbeats of single-lead (lead II) electrocardiograms that achieves high accuracy and near real-time diagnosis. The processing time of 300 milliseconds to a diagnosis is just at the time range in between extremely fast heartbeats of around 300 milliseconds, or 200 beats per minute. The design achieves stable performance metrics over the frequency range of 202Hz to 2.8kHz with an accuracy of 77.12%, positive predictive value (PPV) of 75.85%, and a negative predictive value (NPV) of 83.02% over the entire PTB database; 85.07%, 81.54%, 87.31% over the PTB-XL (the largest EKG database available for research) validation set, and 84.17%, 78.37%, 87.55% over the PTB-XL test set. Major design contributions and findings of this work reveal (1) a method for the realtime detection of ventricular depolarization events in the PQRST complex from 12-lead electrocardiograms using Independent Component Analysis (ICA), with a slightly different use of ICA proposed for electrocardiogram analysis and R-peak detection/localization; (2) a multilayer Long-Short Term Memory (LSTM) neural network design that identifies infarcted patients from a single heartbeat of a single-lead (lead II) electrocardiogram; (3) and integrated LSTM neural network with an algorithm that detects the R-peaks in real time for instantaneous detection of myocardial infarctions and for effective monitoring of patients under cardiac stress and/or at risk of myocardial infarction; (4) a fully integrated 12-lead real-time classifier with even higher detection metrics and a deeper neural architecture, which could serve as a near real-time monitoring tool that could gauge disease progression and evaluate benefits gained from early intervention and treatment planning; (5) a real-time frequency-independent design based on a single-lead single-beat MI detector, which is of pivotal importance to deployment as there is no standard sampling frequency for EKGs, making them span a wider frequency spectrum. vi

Electrocardiogram Monitoring Wearable Devices and Artificial-Intelligence-Enabled Diagnostic Capabilities: A Review

Worldwide, population aging and unhealthy lifestyles have increased the incidence of high-risk health conditions such as cardiovascular diseases, sleep apnea, and other conditions. Recently, to facilitate early identification and diagnosis, efforts have been made in the research and development of new wearable devices to make them smaller, more comfortable, more accurate, and increasingly compatible with artificial intelligence technologies. These efforts can pave the way to the longer and continuous health monitoring of different biosignals, including the real-time detection of diseases, thus providing more timely and accurate predictions of health events that can drastically improve the healthcare management of patients. Most recent reviews focus on a specific category of disease, the use of artificial intelligence in 12-lead electrocardiograms, or on wearable technology. However, we present recent advances in the use of electrocardiogram signals acquired with wearable devices or from publicly available databases and the analysis of such signals with artificial intelligence methods to detect and predict diseases. As expected, most of the available research focuses on heart diseases, sleep apnea, and other emerging areas, such as mental stress. From a methodological point of view, although traditional statistical methods and machine learning are still widely used, we observe an increasing use of more advanced deep learning methods, specifically architectures that can handle the complexity of biosignal data. These deep learning methods typically include convolutional and recurrent neural networks. Moreover, when proposing new artificial intelligence methods, we observe that the prevalent choice is to use publicly available databases rather than collecting new data

Applying Artificial Intelligence to wearable sensor data to diagnose and predict cardiovascular disease: a review

Cardiovascular disease (CVD) is the world’s leading cause of mortality. There is significant interest in using Artificial Intelligence (AI) to analyse data from novel sensors such as wearables to provide an earlier and more accurate prediction and diagnosis of heart disease. Digital health technologies that fuse AI and sensing devices may help disease prevention and reduce the substantial morbidity and mortality caused by CVD worldwide. In this review, we identify and describe recent developments in the application of digital health for CVD, focusing on AI approaches for CVD detection, diagnosis, and prediction through AI models driven by data collected from wearables. We summarise the literature on the use of wearables and AI in cardiovascular disease diagnosis, followed by a detailed description of the dominant AI approaches applied for modelling and prediction using data acquired from sensors such as wearables. We discuss the AI algorithms and models and clinical applications and find that AI and machine-learning-based approaches are superior to traditional or conventional statistical methods for predicting cardiovascular events. However, further studies evaluating the applicability of such algorithms in the real world are needed. In addition, improvements in wearable device data accuracy and better management of their application are required. Lastly, we discuss the challenges that the introduction of such technologies into routine healthcare may fac

Algorithms for automated diagnosis of cardiovascular diseases based on ECG data: A comprehensive systematic review

The prevalence of cardiovascular diseases is increasing around the world. However, the technology is evolving and can be monitored with low-cost sensors anywhere at any time. This subject is being researched, and different methods can automatically identify these diseases, helping patients and healthcare professionals with the treatments. This paper presents a systematic review of disease identification, classification, and recognition with ECG sensors. The review was focused on studies published between 2017 and 2022 in different scientific databases, including PubMed Central, Springer, Elsevier, Multidisciplinary Digital Publishing Institute (MDPI), IEEE Xplore, and Frontiers. It results in the quantitative and qualitative analysis of 103 scientific papers. The study demonstrated that different datasets are available online with data related to various diseases. Several ML/DP-based models were identified in the research, where Convolutional Neural Network and Support Vector Machine were the most applied algorithms. This review can allow us to identify the techniques that can be used in a system that promotes the patient’s autonomy.N/