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

A Smart Service Platform for Cost Efficient Cardiac Health Monitoring

Aim: In this study we have investigated the problem of cost effective wireless heart health monitoring from a service design perspective. Subject and Methods: There is a great medical and economic need to support the diagnosis of a wide range of debilitating and indeed fatal non-communicable diseases, like Cardiovascular Disease (CVD), Atrial Fibrillation (AF), diabetes, and sleep disorders. To address this need, we put forward the idea that the combination of Heart Rate (HR) measurements, Internet of Things (IoT), and advanced Artificial Intelligence (AI), forms a Heart Health Monitoring Service Platform (HHMSP). This service platform can be used for multi-disease monitoring, where a distinct service meets the needs of patients having a specific disease. The service functionality is realized by combining common and distinct modules. This forms the technological basis which facilitates a hybrid diagnosis process where machines and practitioners work cooperatively to improve outcomes for patients. Results: Human checks and balances on independent machine decisions maintain safety and reliability of the diagnosis. Cost efficiency comes from efficient signal processing and replacing manual analysis with AI based machine classification. To show the practicality of the proposed service platform, we have implemented an AF monitoring service. Conclusion: Having common modules allows us to harvest the economies of scale. That is an advantage, because the fixed cost for the infrastructure is shared among a large group of customers. Distinct modules define which AI models are used and how the communication with practitioners, caregivers and patients is handled. That makes the proposed HHMSP agile enough to address safety, reliability and functionality needs from healthcare providers

Cost-Effective and Non-Invasive Automated Benign & Malignant Thyroid Lesion Classification in 3D Contrast-Enhanced Ultrasound Using Combination of Wavelets and Textures: A Class of ThyroScan™ Algorithms

Ultrasound has great potential to aid in the differential diagnosis of malignant and benign thyroid lesions, but interpretative pitfalls exist and the accuracy is still poor. To overcome these difficulties, we developed and analyzed a range of knowledge representation techniques, which are a class of ThyroScan™ algorithms from Global Biomedical Technologies Inc., California, USA, for automatic classification of benign and malignant thyroid lesions. The analysis is based on data obtained from twenty nodules (ten benign and ten malignant) taken from 3D contrast-enhanced ultrasound images. Fine needle aspiration biopsy and histology confirmed malignancy. Discrete Wavelet Transform (DWT) and texture algorithms are used to extract relevant features from the thyroid images. The resulting feature vectors are fed to three different classifiers: K-Nearest Neighbor (K-NN), Probabilistic Neural Network (PNN), and Decision Tree (DeTr). The performance of these classifiers is compared using Receiver Operating Characteristic (ROC) curves. Our results show that combination of DWT and texture features coupled with K-NN resulted in good performance measures with the area of under the ROC curve of 0.987, a classification accuracy of 98.9%, a sensitivity of 98%, and a specificity of 99.8%. Finally, we have proposed a novel integrated index called Thyroid Malignancy Index (TMI), which is made up of texture features, to diagnose benign or malignant nodules using just one index. We hope that this TMI will help clinicians in a more objective detection of benign and malignant thyroid lesions

Improving the safety of atrial fibrillation monitoring systems through human verification

In this paper we propose a hybrid decision-making process for medical diagnosis. The hypothesis tested is that a deep learning system can provide real-time monitoring of Atrial Fibrillation (AF), a prevalent heart arrhythmia, and a human cardiologist will then verify the results and reach a diagnosis. The verification step adds the necessary checks and balances to increase the safety of the computer-based diagnostic process. In order to test hybrid-decision making, we created a prototype AF monitoring service. The service is based on Heart Rate (HR) sensors for signal acquisition as well as Internet of Things (IoT) technology for data communication and storage. These technologies enable transfer of HR data from patient to central cloud server. A deep learning system is used to analyze the data, which is then presented to a cardiologist when a dangerous condition is detected. This human specialist then works to verify the deep learning results based on the HR data and additional knowledge obtained through patient records or by personal interaction with the patient. A prerequisite for safety in any computer expert system is the clarity of purpose for the decision-making process. Health-care providers are considered customers who register patients with the AF monitoring service. The service delivers real-time diagnostic support by providing timely alarm messages and HR analysis. The safety critical decision then lies with the human practitioner

Automated Arrhythmia Detection Based on RR Intervals

Abnormal heart rhythms, also known as arrhythmias, can be life-threatening. AFIB and AFL are examples of arrhythmia that affect a growing number of patients. This paper describes a method that can support clinicians during arrhythmia diagnosis. We propose a deep learning algorithm to discriminate AFIB, AFL, and NSR RR interval signals. The algorithm was designed with data from 4051 subjects. With 10-fold cross-validation, the algorithm achieved the following results: ACC = 99.98%, SEN = 100.00%, and SPE = 99.94%. These results are significant because they show that it is possible to automate arrhythmia detection in RR interval signals. Such a detection method makes economic sense because RR interval signals are cost-effective to measure, communicate, and process. Having such a cost-effective solution might lead to widespread long-term monitoring, which can help detecting arrhythmia earlier. Detection can lead to treatment, which improves outcomes for patients

Accurate detection of sleep apnea with long short-term memory network based on RR interval signals

Sleep apnea is a common condition that is characterized by sleep-disordered breathing. Worldwide the number of apnea cases has increased and there has been a growing number of patients suffering from apnea complications. Unfortunately, many cases remain undetected, because expensive and inconvenient examination methods are formidable barriers with regard to the diagnostics. Furthermore, treatment monitoring depends on the same methods which also underpin the initial diagnosis; hence issues related to the examination methods cause difficulties with managing sleep apnea as well. Computer-Aided Diagnosis (CAD) systems could be a tool to increase the efficiency and efficacy of diagnosis. To investigate this hypothesis, we designed a deep learning model that classifies beat-to-beat interval traces, medically known as RR intervals, into apnea versus non-apnea. The RR intervals were extracted from Electrocardiogram (ECG) signals contained in the Apnea-ECG benchmark Database. Before feeding the RR intervals to the classification algorithm, the signal was band-pass filtered with an Ornstein–Uhlenbeck third-order Gaussian process. 10-fold cross-validation indicated that the Long Short-Term Memory (LSTM) network has 99.80% accuracy, 99.85% sensitivity, and 99.73% specificity. With hold-out validation, the same network achieved 81.30% accuracy, 59.90% sensitivity, and 91.75% specificity. During the design, we learned that the band-pass filter improved classification accuracy by over 20%. The increased performance resulted from the fact that neural activation functions can process a DC free signal more efficiently. The result is likely transferable to the design of other RR interval based CAD systems, where the filter can help to improve classification performance

Evidence for strong relations between the upper Tagus loess formation (central Iberia) and the marine atmosphere off the Iberian margin during the last glacial period

During glacial times, the North Atlantic region was affected by serious climate changes corresponding to Dansgaard-Oeschger cycles that were linked to dramatic shifts in sea temperature and moisture transfer to the continents. However, considerable efforts are still needed to understand the effects of these shifts on terrestrial environments. In this context, the Iberian Peninsula is particularly interesting because of its close proximity to the North Atlantic, although the Iberian interior lacks paleoenvironmental information so far because suitable archives are rare. Here we provide an accurate impression of the last glacial environmental developments in central Iberia based on comprehensive investigations using the upper Tagus loess record. A multi-proxy approach revealed that phases of loess formation during Marine Isotope Stage (MIS) 2 (and upper MIS 3) were linked to utmost aridity, coldness, and highest wind strengths in line with the most intense Greenland stadials also including Heinrich Events 3–1. Lack of loess deposition during the global last glacial maximum (LGM) suggests milder conditions, which agrees with less-cold sea surface temperatures (SST) off the Iberian margin. Our results demonstrate that geomorphological system behavior in central Iberia is highly sensitive to North Atlantic SST fluctuations, thus enabling us to reconstruct a detailed hydrological model in relation to marine–atmospheric circulation patterns

Hybrid Decision Support to Monitor Atrial Fibrillation for Stroke Prevention

In this paper, we discuss hybrid decision support to monitor atrial fibrillation for stroke prevention. Hybrid decision support takes the form of human experts and machine algorithms working cooperatively on a diagnosis. The link to stroke prevention comes from the fact that patients with Atrial Fibrillation (AF) have a fivefold increased stroke risk. Early diagnosis, which leads to adequate AF treatment, can decrease the stroke risk by 66% and thereby prevent stroke. The monitoring service is based on Heart Rate (HR) measurements. The resulting signals are communicated and stored with Internet of Things (IoT) technology. A Deep Learning (DL) algorithm automatically estimates the AF probability. Based on this technology, we can offer four distinct services to healthcare providers: (1) universal access to patient data; (2) automated AF detection and alarm; (3) physician support; and (4) feedback channels. These four services create an environment where physicians can work symbiotically with machine algorithms to establish and communicate a high quality AF diagnosis