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Terzi MB, Arikan O. Machine learning based hybrid anomaly detection technique for automatic diagnosis of cardiovascular diseases using cardiac sympathetic nerve activity and electrocardiogram. BIOMED ENG-BIOMED TE 2024; 69:79-109. [PMID: 37823386 DOI: 10.1515/bmt-2022-0406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 08/25/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVES Coronary artery diseases (CADs) are the leading cause of death worldwide and early diagnosis is crucial for timely treatment. To address this, our study presents a novel automated Artificial Intelligence (AI)-based Hybrid Anomaly Detection (AIHAD) technique that combines various signal processing, feature extraction, supervised, and unsupervised machine learning methods. By jointly and simultaneously analyzing 12-lead cardiac sympathetic nerve activity (CSNA) and electrocardiogram (ECG) data, the automated AIHAD technique performs fast, early, and accurate diagnosis of CADs. METHODS In order to develop and evaluate the proposed automated AIHAD technique, we utilized the fully labeled STAFF III and PTBD databases, which contain the 12-lead wideband raw recordings non-invasively acquired from 260 subjects. Using these wideband raw recordings, we developed a signal processing technique that simultaneously detects the 12-lead CSNA and ECG signals of all subjects. Using the pre-processed 12-lead CSNA and ECG signals, we developed a time-domain feature extraction technique that extracts the statistical CSNA and ECG features critical for the reliable diagnosis of CADs. Using the extracted discriminative features, we developed a supervised classification technique based on Artificial Neural Networks (ANNs) that simultaneously detects anomalies in the 12-lead CSNA and ECG data. Furthermore, we developed an unsupervised clustering technique based on Gaussian mixture models (GMMs) and Neyman-Pearson criterion, which robustly detects outliers corresponding to CADs. RESULTS Using the automated AIHAD technique, we have, for the first time, demonstrated a significant association between the increase in CSNA signals and anomalies in ECG signals during CADs. The AIHAD technique achieved highly reliable detection of CADs with a sensitivity of 98.48 %, specificity of 97.73 %, accuracy of 98.11 %, positive predictive value of 97.74 %, negative predictive value of 98.47 %, and F1-score of 98.11 %. Hence, the automated AIHAD technique demonstrates superior performance compared to the gold standard diagnostic test ECG in the diagnosis of CADs. Additionally, it outperforms other techniques developed in this study that separately utilize either only CSNA data or only ECG data. Therefore, it significantly increases the detection performance of CADs by taking advantage of the diversity in different data types and leveraging their strengths. Furthermore, its performance is comparatively better than that of most previously proposed machine and deep learning methods that exclusively used ECG data to diagnose or classify CADs. Additionally, it has a very low implementation time, which is highly desirable for real-time detection of CADs. CONCLUSIONS The proposed automated AIHAD technique may serve as an efficient decision-support system to increase physicians' success in fast, early, and accurate diagnosis of CADs. It may be highly beneficial and valuable, particularly for asymptomatic patients, for whom the diagnostic information provided by ECG alone is not sufficient to reliably diagnose the disease. Hence, it may significantly improve patient outcomes by enabling timely treatments and considerably reducing the mortality of cardiovascular diseases (CVDs).
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Affiliation(s)
- Merve Begum Terzi
- Faculty of Engineering, Electrical and Electronics Engineering Department, Bilkent University, Ankara, Türkiye
| | - Orhan Arikan
- Faculty of Engineering, Electrical and Electronics Engineering Department, Bilkent University, Ankara, Türkiye
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Prusty MR, Pandey TN, Lekha PS, Lellapalli G, Gupta A. Scalar invariant transform based deep learning framework for detecting heart failures using ECG signals. Sci Rep 2024; 14:2633. [PMID: 38302520 PMCID: PMC10834984 DOI: 10.1038/s41598-024-53107-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/27/2024] [Indexed: 02/03/2024] Open
Abstract
Heart diseases are leading to death across the globe. Exact detection and treatment for heart disease in its early stages could potentially save lives. Electrocardiogram (ECG) is one of the tests that take measures of heartbeat fluctuations. The deviation in the signals from the normal sinus rhythm and different variations can help detect various heart conditions. This paper presents a novel approach to cardiac disease detection using an automated Convolutional Neural Network (CNN) system. Leveraging the Scale-Invariant Feature Transform (SIFT) for unique ECG signal image feature extraction, our model classifies signals into three categories: Arrhythmia (ARR), Congestive Heart Failure (CHF), and Normal Sinus Rhythm (NSR). The proposed model has been evaluated using 96 Arrhythmia, 30 CHF, and 36 NSR ECG signals, resulting in a total of 162 images for classification. Our proposed model achieved 99.78% accuracy and an F1 score of 99.78%, which is among one of the highest in the models which were recorded to date with this dataset. Along with the SIFT, we also used HOG and SURF techniques individually and applied the CNN model which achieved 99.45% and 78% accuracy respectively which proved that the SIFT-CNN model is a well-trained and performed model. Notably, our approach introduces significant novelty by combining SIFT with a custom CNN model, enhancing classification accuracy and offering a fresh perspective on cardiac arrhythmia detection. This SIFT-CNN model performed exceptionally well and better than all existing models which are used to classify heart diseases.
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Affiliation(s)
- Manas Ranjan Prusty
- Centre for Cyber Physical Systems, Vellore Institute of Technology, Chennai, 600127, Tamil Nadu, India
| | - Trilok Nath Pandey
- School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, 600127, Tamil Nadu, India.
| | - Pujala Shree Lekha
- School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, 600127, Tamil Nadu, India
| | - Gayatri Lellapalli
- School of Computer Science and Engineering, Vellore Institute of Technology, Chennai, 600127, Tamil Nadu, India
| | - Annika Gupta
- School of Electrical Engineering, Vellore Institute of Technology, Chennai, 600127, Tamil Nadu, India
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Mitchell H, Rosario N, Hernandez C, Lipsitz SR, Levine DM. Single-lead arrhythmia detection through machine learning: cross-sectional evaluation of a novel algorithm using real-world data. Open Heart 2023; 10:e002228. [PMID: 37734747 PMCID: PMC10514635 DOI: 10.1136/openhrt-2022-002228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 08/03/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Computer-assisted interpretation of single-lead ECG is the preliminary method for clinicians to flag and further evaluate an arrhythmia of clinical importance for acutely ill patients. Critical scrutiny of novel detection algorithms is lacking, particularly in external real-world data sets. This study's objective was to evaluate a hybrid machine learning model's ability to classify eight arrhythmias from a single-lead ECG signal from acutely ill patients. METHODS This cross-sectional external retrospective evaluation of a previously trained hybrid machine learning model against an ECG reading team in the setting of home hospital care (acute care delivered at home substituting for traditional hospital care) draws from patients admitted at two hospitals in Boston, Massachusetts, USA between 12 June 2017 and 23 November 2019. We calculated classifier statistics for each arrhythmia, all arrhythmias and strips where the model identified normal sinus rhythm. RESULTS The model analysed 2 680 162 min of single-lead ECG data from 423 patients and identified 691 478 arrhythmias. Patients had a mean age of 70 years (SD, 18), 60% were female and 45% were white. For any arrhythmia, the model had a sensitivity of 98%, a specificity of 100%, an accuracy of 98%, a positive predictive value of 100%, a negative predictive value of 93% and an F1 Score of 99%. Performance was best for pause (F1 Score, 99%) and worst for paroxysmal supraventricular tachycardia (F1 Score, 92%). The model's false positive rate for any arrhythmia was 0.2%, ranging from 0.4% for pause to 7.2% for paroxysmal supraventricular tachycardia. The false negative rate for any arrhythmia was 1.9%. CONCLUSIONS A hybrid machine learning model was effective at classifying common cardiac arrhythmias from a single-lead ECG in real-world data.
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Affiliation(s)
- Henry Mitchell
- Divison of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Nicole Rosario
- Divison of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Carme Hernandez
- Divison of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- University of Barcelona, Barcelona, Catalunya, Spain
- Hospital Clinic, Barcelona, Spain
| | - Stuart R Lipsitz
- Divison of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - David M Levine
- Divison of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Kim N, Seo W, Kim JH, Choi SY, Park SM. WavelNet: A novel convolutional neural network architecture for arrhythmia classification from electrocardiograms. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 231:107375. [PMID: 36724593 DOI: 10.1016/j.cmpb.2023.107375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Automated detection of arrhythmias from electrocardiograms (ECGs) can be of considerable assistance to medical professionals in providing efficient treatment for patients with cardiovascular diseases. In recent times, convolutional neural network (CNN)-based arrhythmia classification models have been introduced, but their decision-making processes remain unclear and their performances are not reproducible. This paper proposes an accurate, interpretable, and reproducible end-to-end arrhythmia classification model based on a novel CNN architecture named WavelNet, which is interpretable and optimal for dealing with ECGs. METHODS Inspired by SincNet, which is capable of band-pass filtering-based spectral analysis, WavelNet was devised to achieve wavelet transform-based spectral analysis. WavelNet was trained using a subject-oriented five-class ECG arrhythmia dataset generated from the MIT-BIH Arrhythmia Database while following a benchmark scheme. By adopting various mother wavelets, multiple WavelNet-based arrhythmia classification models were implemented. To investigate whether our wavelet transform-based approach outperforms original end-to-end and band-pass filtering-based approaches, our proposed models were compared with vanilla CNN- and SincNet-based models. Model implementation and evaluation processes were repeated ten times in a Google Colab Pro+ environment. Furthermore, our most successful model was compared with state-of-the-art arrhythmia classification models for performance evaluation. RESULTS The proposed WavelNet-based models showed excellent performance on classifying non-ectopic, supraventricular ectopic, and ventricular ectopic beats because of their ability to perform adaptive spectral analysis while preserving temporal ECG information compared with vanilla CNN- and SincNet-based models. In particular, a Symlet 4 wavelet-adopting WavelNet-based model achieved the best performance with nearly 90% overall accuracy as well as the highest levels of sensitivity in classifying each arrhythmia class: 91.4%, 49.3%, and 91.4% for non-ectopic, supraventricular ectopic, and ventricular ectopic beat classifications, respectively. These results were comparable to those of state-of-the-art models. In addition, the results are reproducible, which differentiates our study from previous studies. CONCLUSIONS Our proposed WavelNet-based arrhythmia classification model achieved remarkable performance based on a reasonable decision-making process, in comparison with other models. As its noteworthy performance is clinically reasonable and reproducible, our proposed model can contribute toward implementing a real-world precision healthcare system for patients with cardiovascular diseases.
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Affiliation(s)
- Namho Kim
- Department of Convergence IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea
| | - Wonju Seo
- Department of Convergence IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea
| | - Ju-Ho Kim
- School of Computer Science, University of Seoul, Seoul, Republic of Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Republic of Korea.
| | - Sung-Min Park
- Department of Convergence IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea; Department of Electrical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea; Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea; Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea.
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Ramkumar M, Sarath Kumar R, Manjunathan A, Mathankumar M, Pauliah J. Auto-encoder and bidirectional long short-term memory based automated arrhythmia classification for ECG signal. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Ojha MK, Wadhwani S, Wadhwani AK, Shukla A. Automatic detection of arrhythmias from an ECG signal using an auto-encoder and SVM classifier. Phys Eng Sci Med 2022; 45:665-674. [PMID: 35304901 DOI: 10.1007/s13246-022-01119-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 03/09/2022] [Indexed: 12/29/2022]
Abstract
Millions of people around the world are affected by arrhythmias, which are abnormal activities of the functioning of the heart. Most arrhythmias are harmful to the heart and can suddenly become life-threatening. The electrocardiogram (ECG) is an important non-invasive tool in cardiology for the diagnosis of arrhythmias. This work proposes a computer-aided diagnosis (CAD) system to automatically classify different types of arrhythmias from ECG signals. First, the auto-encoder convolutional network (ACN) model is used, which is based on a one-dimensional convolutional neural network (1D-CNN) that automatically learns the best features from the raw ECG signals. After that, the support vector machine (SVM) classifier is applied to the features learned by the ACN model to improve the detection of arrhythmic beats. This classifier detects four different types of arrhythmias, namely the left bundle branch block (LBBB), right bundle branch block (RBBB), paced beat (PB), and premature ventricular contractions (PVC), along with the normal sinus rhythms (NSR). Among these arrhythmias, PVC is particularly a dangerous type of heartbeat in ECG signals. The performance of the model is measured in terms of accuracy, sensitivity, and precision using a tenfold cross-validation strategy on the MIT-BIH arrhythmia database. The obtained overall accuracy of the SVM classifier was 98.84%. The result of this model is portrayed as a better performance than in other literary works. Thus, this approach may also help in further clinical studies of cardiac cases.
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Affiliation(s)
- Manoj Kumar Ojha
- Madhav Institute of Technology and Science, Gwalior, Madhya Pradesh, India.
| | - Sulochna Wadhwani
- Madhav Institute of Technology and Science, Gwalior, Madhya Pradesh, India
| | | | - Anupam Shukla
- Indian Institute of Information Technology, Pune, Maharashtra, India
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Baygin M, Tuncer T, Dogan S, Tan RS, Acharya UR. Automated arrhythmia detection with homeomorphically irreducible tree technique using more than 10,000 individual subject ECG records. Inf Sci (N Y) 2021. [DOI: 10.1016/j.ins.2021.06.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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