Human-assisted vs. deep learning feature extraction: an evaluation of ECG features extraction methods for arrhythmia classification using machine learning

The success of arrhythmia classification tasks with Machine Learning (ML) algorithms is based on the handcrafting extraction of features from Electrocardiography (ECG) signals. However, feature extraction is a time-consuming trial-and-error approach. Deep Neural Network (DNN) algorithms bypass the process of handcrafting feature extraction since the algorithm extracts the features automatically in their hidden layers. However, it is important to have access to a balanced dataset for algorithm training. In this exploratory research study, we will compare the evaluation metrics among Convolutional Neural Networks (1D-CNN) and Support Vector Machines (SVM) using a dataset based on the merged public ECG signals database TNMG and CINC17 databases. Results: Both algorithms showed good performance using the new, merged ECG database. For evaluation metrics, the 1D-CNN algorithm has a precision of 93.04%, an accuracy of 93.07%, a recall of 93.20%, and an F1-score of 93.05%. The SVM classifier (λ = 10, C = 10 × 109) achieved the best classification metrics with two combined, handcrafted feature extraction methods: Wavelet transforms and R-peak Interval features, which achieved an overall precision of 89.04%, accuracy of 92.00%, recall of 94.20%, and F1-score of 91.54%. As an unique input feature and SVM (λ=10,C=100), wavelet transforms achieved precision, accuracy, recall, and F1-score metrics of 86.15%, 85.33%, 81.16%, and 83.58%. Conclusion: Researchers face a challenge in finding a broad dataset to evaluate ML models. One way to solve this problem, especially for deep learning models, is to combine several public datasets to increase the amount of data. The SVM and 1D-CNN algorithms showed positive results with the merge of databases, showing similar F1-score, precision, and recall during arrhythmia classification. Despite the favorable results for both of them, it should be considered that in the SVM, feature selection is a time-consuming trial-and-error process; meanwhile, CNN algorithms can reduce the workload significantly. The disadvantage of CNN algorithms is that it has a higher computational processing cost; moreover, in the absence of access to powerful computational processing, the SVM can be a reliable solution.“FCT–Fundação para a Ciência e Tecnologia” within the R&D Units Project Scope: UIDB/00319/2020

Photoplethysmography based atrial fibrillation detection: an updated review from July 2019

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia associated with significant health ramifications, including an elevated susceptibility to ischemic stroke, heart disease, and heightened mortality. Photoplethysmography (PPG) has emerged as a promising technology for continuous AF monitoring for its cost-effectiveness and widespread integration into wearable devices. Our team previously conducted an exhaustive review on PPG-based AF detection before June 2019. However, since then, more advanced technologies have emerged in this field. This paper offers a comprehensive review of the latest advancements in PPG-based AF detection, utilizing digital health and artificial intelligence (AI) solutions, within the timeframe spanning from July 2019 to December 2022. Through extensive exploration of scientific databases, we have identified 59 pertinent studies. Our comprehensive review encompasses an in-depth assessment of the statistical methodologies, traditional machine learning techniques, and deep learning approaches employed in these studies. In addition, we address the challenges encountered in the domain of PPG-based AF detection. Furthermore, we maintain a dedicated website to curate the latest research in this area, with regular updates on a regular basis

Flexible Time Series Matching for Clinical and Behavioral Data

Time Series data became broadly applied by the research community in the last decades after a massive explosion of its availability. Nonetheless, this rise required an improvement in the existing analysis techniques which, in the medical domain, would help specialists to evaluate their patients condition. One of the key tasks in time series analysis is pattern recognition (segmentation and classification). Traditional methods typically perform subsequence matching, making use of a pattern template and a similarity metric to search for similar sequences throughout time series. However, real-world data is noisy and variable (morphological distortions), making a template-based exact matching an elementary approach. Intending to increase flexibility and generalize the pattern searching tasks across domains, this dissertation proposes two Deep Learning-based frameworks to solve pattern segmentation and anomaly detection problems. Regarding pattern segmentation, a Convolution/Deconvolution Neural Network is proposed, learning to distinguish, point-by-point, desired sub-patterns from background content within a time series. The proposed framework was validated in two use-cases: electrocardiogram (ECG) and inertial sensor-based human activity (IMU) signals. It outperformed two conventional matching techniques, being capable of notably detecting the targeted cycles even in noise-corrupted or extremely distorted signals, without using any reference template nor hand-coded similarity scores. Concerning anomaly detection, the proposed unsupervised framework uses the reconstruction ability of Variational Autoencoders and a local similarity score to identify non-labeled abnormalities. The proposal was validated in two public ECG datasets (MITBIH Arrhythmia and ECG5000), performing cardiac arrhythmia identification. Results indicated competitiveness relative to recent techniques, achieving detection AUC scores of 98.84% (ECG5000) and 93.32% (MIT-BIH Arrhythmia).Dados de séries temporais tornaram-se largamente aplicados pela comunidade científica nas últimas decadas após um aumento massivo da sua disponibilidade. Contudo, este aumento exigiu uma melhoria das atuais técnicas de análise que, no domínio clínico, auxiliaria os especialistas na avaliação da condição dos seus pacientes. Um dos principais tipos de análise em séries temporais é o reconhecimento de padrões (segmentação e classificação). Métodos tradicionais assentam, tipicamente, em técnicas de correspondência em subsequências, fazendo uso de um padrão de referência e uma métrica de similaridade para procurar por subsequências similares ao longo de séries temporais. Todavia, dados do mundo real são ruidosos e variáveis (morfologicamente), tornando uma correspondência exata baseada num padrão de referência uma abordagem rudimentar. Pretendendo aumentar a flexibilidade da análise de séries temporais e generalizar tarefas de procura de padrões entre domínios, esta dissertação propõe duas abordagens baseadas em Deep Learning para solucionar problemas de segmentação de padrões e deteção de anomalias. Acerca da segmentação de padrões, a rede neuronal de Convolução/Deconvolução proposta aprende a distinguir, ponto a ponto, sub-padrões pretendidos de conteúdo de fundo numa série temporal. O modelo proposto foi validado em dois casos de uso: sinais eletrocardiográficos (ECG) e de sensores inerciais em atividade humana (IMU). Este superou duas técnicas convencionais, sendo capaz de detetar os ciclos-alvo notavelmente, mesmo em sinais corrompidos por ruído ou extremamente distorcidos, sem o uso de nenhum padrão de referência nem métricas de similaridade codificadas manualmente. A respeito da deteção de anomalias, a técnica não supervisionada proposta usa a capacidade de reconstrução dos Variational Autoencoders e uma métrica de similaridade local para identificar anomalias desconhecidas. A proposta foi validada na identificação de arritmias cardíacas em duas bases de dados públicas de ECG (MIT-BIH Arrhythmia e ECG5000). Os resultados revelam competitividade face a técnicas recentes, alcançando métricas AUC de deteção de 93.32% (MIT-BIH Arrhythmia) e 98.84% (ECG5000)

Wavelet Signal Processing of Physiologic Waveforms

The prime objective of this piece of work is to devise novel techniques for computer based classification of Electrocardiogram (ECG) arrhythmias with a focus on less computational time and better accuracy. As an initial stride in this direction, ECG beat classification is achieved by using feature extracting techniques to make a neural network (NN) system more effective. The feature extraction technique used is Wavelet Signal Processing. Coefficients from the discrete wavelet transform were used to represent the ECG diagnostic information and features were extracted using the coefficients and were normalised. These feature sets were then used in the classifier i.e. a simple feed forward back propagation neural network (FFBNN). This paper presents a detail study of the classification accuracy of ECG signal by using these four structures for computationally efficient early diagnosis. Neural network used in this study is a well-known neural network architecture named as multi-Layered perceptron (MLP) with back propagation training algorithm. The ECG signals have been taken from MIT-BIH ECG database, and are used in training to classify 3 different Arrhythmias out of ten arrhythmias. These are normal sinus rhythm, paced beat, left bundle branch block. Before testing, the proposed structures are trained by back propagation algorithm. The results show that the wavelet decomposition method is very effective and efficient for fast computation of ECG signal analysis in conjunction with the classifier

Classification techniques for arrhythmia patterns using convolutional neural networks and Internet of Things (IoT) devices

The rise of Telemedicine has revolutionized how patients are being treated, leading to several advantages such as enhanced health analysis tools, accessible remote healthcare, basic diagnostic of health parameters, etc. The advent of the Internet of Things (IoT), Artificial Intelligence (AI) and their incorporation into Telemedicine extends the potential of health benefits of Telemedicine even further. Therefore, the synergy between AI, IoT, and Telemedicine creates diverse innovative scenarios for integrating cyber-physical systems into medical health to provide remote monitoring and interactive assistance to patients. Data from World Health Organization reports that 7.4 million people died because of Atrial Fibrillation (AF), recognizing the most common arrhythmia associated with human heart rate. Causes like unhealthy diet, smoking, poor resources to go to the doctor and based on research studies, about 12 and 17.9 million of people will be suffering the AF in the USA and Europe, in 2050 and 2060, respectively. The AF as a cardiovascular disease is becoming an important public health issue to tackle. By using a systematic approach, this paper reviews recent contributions related to the acquisition of heart beats, arrhythmia detection, IoT, and visualization. In particular, by analysing the most closely related papers on Convolutional Neural Network (CNN) and IoT devices in heart disease diagnostics, we present a summary of the main research gaps with suggested directions for future research

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