Automated ECG Analysis for Localizing Thrombus in Culprit Artery Using Rule Based Information Fuzzy Network

Cardio-vascular diseases are one of the foremost causes of mortality in today’s world. The prognosis for cardiovascular diseases is usually done by ECG signal, which is a simple 12-lead Electrocardiogram (ECG) that gives complete information about the function of the heart including the amplitude and time interval of P-QRST-U segment. This article recommends a novel approach to identify the location of thrombus in culprit artery using the Information Fuzzy Network (IFN). Information Fuzzy Network, being a supervised machine learning technique, takes known evidences based on rules to create a predicted classification model with thrombus location obtained from the vast input ECG data. These rules are well-defined procedures for selecting hypothesis that best fits a set of observations. Results illustrate that the recommended approach yields an accurateness of 92.30%. This novel approach is shown to be a viable ECG analysis approach for identifying the culprit artery and thus localizing the thrombus

Abnormality Detection in ECG Signal applying Poincare and Entropy-based Approaches

Detection of abnormality in heart is of major importance for early and appropriate clinical medication. In this work, we have proposed two models for detection of abnormality in ECG signals. The normal ECG signals are closely repetitive in nature to a large extent, whereas ECG signals with abnormalities tend to differ from cycle to cycle. Hence, repetitive plot like the Poincare is efficient to detect such non-repetitiveness of the signal; thereby, indicating abnormalities. Hence, we have used Poincare plot to develop the two proposed models. One of the models uses direct analysis of the binary image of the plot to detect the difference in retracing, between the healthy and unhealthy samples. The other model uses entropy of the Poincare plot to detect the difference in randomness of plots between the two classes. Most importantly, we have used only lead II ECG signal for analysis. This ensures ease of computation as it uses signal of only a single lead instead of the 12 leads of the complete ECG signal. We have validated the proposed models using ECG signals from the ‘ptb database’. We have observed that the entropy analysis of the Poincare plots gives the best results with 90% accuracy of abnormality detection. This high accuracy of classification, combined with less computational burden enables its practical implementation for the development of a real life abnormality detection schem

Three-Heartbeat Multilead ECG Recognition Method for Arrhythmia Classification

Electrocardiogram (ECG) is the primary basis for the diagnosis of cardiovascular diseases. However, the amount of ECG data of patients makes manual interpretation time-consuming and onerous. Therefore, the intelligent ECG recognition technology is an important means to decrease the shortage of medical resources. This study proposes a novel classification method for arrhythmia that uses for the very first time a three-heartbeat multi-lead (THML) ECG data in which each fragment contains three complete heartbeat processes of multiple ECG leads. The THML ECG data pre-processing method is formulated which makes use of the MIT-BIH arrhythmia database as training samples. Four arrhythmia classification models are constructed based on one-dimensional convolutional neural network (1D-CNN) combined with a priority model integrated voting method to optimize the integrated classification effect. The experiments followed the recommended inter-patient scheme of the Association for the Advancement of Medical Instrumentation (AAMI) recommendations, and the practicability and effectiveness of THML ECG data are proved with ablation experiments. Results show that the average accuracy of the N, V, S, F, and Q classes is 94.82%, 98.10%, 97.28%, 98.70%, and 99.97%, respectively, with the positive predictive value of the N, V, S, and F classes being 97.0%, 90.5%, 71.9%, and 80.4%, respectively. Compared with current studies, the THML ECG data can effectively improve the morphological integrity and time continuity of ECG information and the 1D-CNN model of ECG sequence has a higher accuracy for arrhythmia classification. The proposed method alleviates the problem of insufficient samples, meets the needs of medical ECG interpretation and contributes to the intelligent dynamic research of cardiac disease

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

Techniques for ventricular repolarization instability assessment from the ECG

Instabilities in ventricular repolarization have been documented to be tightly linked to arrhythmia vulnera- bility. Translation of the information contained in the repolar- ization phase of the electrocardiogram (ECG) into valuable clinical decision-making tools remains challenging. This work aims at providing an overview of the last advances in the pro- posal and quantification of ECG-derived indices that describe repolarization properties and whose alterations are related with threatening arrhythmogenic conditions. A review of the state of the art is provided, spanning from the electrophysio- logical basis of ventricular repolarization to its characteriza- tion on the surface ECG through a set of temporal and spatial risk markers

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/

Computer modeling and signal analysis of cardiovascular physiology

This dissertation aims to study cardiovascular physiology from the cellular level to the whole heart level to the body level using numerical approaches. A mathematical model was developed to describe electromechanical interaction in the heart. The model integrates cardio-electrophysiology and cardiac mechanics through excitation-induced contraction and deformation-induced currents. A finite element based parallel simulation scheme was developed to investigate coupled electrical and mechanical functions. The developed model and numerical scheme were utilized to study cardiovascular dynamics at cellular, tissue and organ levels. The influence of ion channel blockade on cardiac alternans was investigated. It was found that the channel blocker may significantly change the critical pacing period corresponding to the onset of alternans as well as the alternans’ amplitude. The influence of electro-mechanical coupling on cardiac alternans was also investigated. The study supported the earlier assumptions that discordant alternans is induced by the interaction of conduction velocity and action potential duration restitution at high pacing rates. However, mechanical contraction may influence the spatial pattern and onset of discordant alternans. Computer algorithms were developed for analysis of human physiology. The 12-lead electrocardiography (ECG) is the gold standard for diagnosis of various cardiac abnormalities. However, disturbances and mistakes may modify physiological waves in ECG and lead to wrong diagnoses. This dissertation developed advanced signal analysis techniques and computer software to detect and suppress artifacts and errors in ECG. These algorithms can help to improve the quality of health care when integrated into medical devices or services. Moreover, computer algorithms were developed to predict patient mortality in intensive care units using various physiological measures. Models and analysis techniques developed here may help to improve the quality of health care

The Application of Computer Techniques to ECG Interpretation

This book presents some of the latest available information on automated ECG analysis written by many of the leading researchers in the field. It contains a historical introduction, an outline of the latest international standards for signal processing and communications and then an exciting variety of studies on electrophysiological modelling, ECG Imaging, artificial intelligence applied to resting and ambulatory ECGs, body surface mapping, big data in ECG based prediction, enhanced reliability of patient monitoring, and atrial abnormalities on the ECG. It provides an extremely valuable contribution to the field

Analysis of Ventricular Depolarisation and Repolarisation Using Registration and Machine Learning

Our understanding of cardiac diseases has greatly advanced since the advent of electrocardiography (ECG). With the increasing influx of available data in recent times, significant research efforts have been put forth to automate the study and detection of cardiac conditions. Naturally, the focus has progressed toward studying dynamic changes in ventricular depolarisation and repolarisation across serial recordings - as complex beat-to-beat changes in morphology manifest over time. Manual extraction of diagnostic and prognostic markers is a laborious task. Hence, automated and accurate methods are required to extract markers for the study of ventricular lability and detection of common diseases, such as myocardial ischemia and myocardial infarction. The aim of this thesis is to improve automated marker extraction and detection of diseases for the study of ventricular depolarisation and repolarisation lability in ECG. As such, two novel template adaptation methods capable of capturing complex beat-to-beat morphological changes are proposed for three-dimensional and two-dimensional data, respectively. The proposed three-dimensional template adaptation method provides an inhomogeneous method for transforming template vectorcardiogram (VCG) by exploiting registrationinspired parametrisation and an efficient kernel ridge regression formulation. Analysis across simulated data and clinical myocardial infarction data demonstrates state-of-the-art results. The two-dimensional template adaptation method draws from traditional registrationbased techniques and treats the ECG as a two-dimensional point set problem. Validation against previously employed simulated data and a gold-standard annotated clinical database demonstrate the highest level of performance. Subsequently, frameworks employing the proposed template adaptation techniques are developed for the automated detection of ischemic beats and myocardial infarction. Furthermore, a small study analysing ventricular repolarisation variability (VRV) in non-ischemic cardiomyopathy (CM) is considered, utilising markers of cardiac lability proposed in the development of the three-dimensional template adaptation system. In summary, this thesis highlights the necessity for custom template adaptation methods for the accurate measurement of beat-to-beat variability in cardiac data. Two novel stateof- the-art methods are proposed and extended to study myocardial ischemia, myocardial infarction and non-ischemic CM.Thesis (Ph.D.) -- University of Adelaide, School of Electrical and Electronic Engineering, 202

Solving the inverse problem of electrocardiography in a realistic environment

Heart disease is a leading cause of death worldwide. Straightforward information about the cardiac electrophysiology can help to improve the quality of diagnosis of heart diseases. The inverse problem of electrocardiography and the intracardiac catheter measurement are two ways to get access to the electrophysiology in the heart. In this thesis six research topics related to these two techniques are included