Development of SVM based classification techniques for the delineation of wave components in 12-lead electrocardiogram

A neural network model based on attention pooling and adaptive multi-level feature fusion for arrhythmia automatic detection

With the rising incidence of cardiovascular disease, timely detection and treatment are critical for patients with arrhythmias, and the electrocardiogram (ECG) remains a vital tool for diagnosing and monitoring heart health. In automated arrhythmia detection, researchers have made significant progress in intra-patient paradigms. However, challenges persist in the inter-patient paradigm, where existing methods often rely on manually extracted features or exhibit inadequate performance in detecting anomalous categories. Against the above challenges, this paper proposes a neural network model based on Attention Pooling (AP) and Adaptive Multilevel Feature Fusion (AMFF) to enhance the performance for automatic detection of abnormal categories in the inter-patient paradigm. Among them, the attentional pooling mechanism enables the model to focus on the features of key channels and spatial locations, effectively reducing the influence of redundant information; to address the problem of ECG signal scale differences, we designed adaptive multilevel feature fusion (AMFF), which uses weighted multilevel features to achieve adaptive feature fusion and can utilize multilevel features at the same time, thus enhancing the feature expression capability of the model. Based on following the AAMI criteria, we evaluated the proposed model using the MIT-BIH arrhythmia database. The results showed that the model achieved an overall accuracy of 99.32% in the intra-patient paradigm and 93.35% in the inter-patient paradigm. For the inter-patient paradigm, the model not only performs well in N-category classification but also achieves good results in the anomaly categories of S, V, and F. This demonstrates a relatively balanced performance.

Abnormal recognition-assisted and onset-offset aware network for pathological wearable ECG delineation

Electrocardiogram (ECG) delineation is essential to the identification of abnormal cardiac status, especially when ECG signals are remotely monitored with wearable devices. The complexity and diversity of cardiac conditions generate numerous pathological ECG patterns, not only requiring the recognition of normal ECG but also addressing an extensive range of abnormal ECG patterns, posing a challenging task. Therefore, we propose an abnormal recognition-assisted network to integrate supplementary information on diverse ECG patterns. Simultaneously, we design an onset-offset aware loss to enhance precise waveform localization. Specifically, we establish a two-branch framework where ECG delineation serves as the target task, producing the final segmentation results. Additionally, the abnormal recognition-assisted network serves as an auxiliary task, extracting multi-label pathological information from ECGs. This joint learning approach establishes crucial correlations between ECG delineation and associated ECG abnormalities. The correlations enable the model to demonstrate sufficient generalization in the presence of diverse abnormal ECG patterns. Besides, onset-offset aware loss focuses intensively on wave onsets and offsets by applying biased weights to various waveform positions. This approach ensures a focus on precise localization, facilitating seamless integration into cross-entropy loss function. A large-scale wearable 12-lead dataset containing 4,913 signals is collected, offering an extensive range of ECG data for model training. Results demonstrate that our method achieves outstanding performance on two test datasets, attaining sensitivity of 94.97% and 94.27% and an error tolerance lower than 20 ms. Furthermore, our method is effective for various aberrant ECG signals, including ST-segment changes, atrial premature beats, and right and left bundle branch blocks.

Improved delineation model of a standard 12-lead electrocardiogram based on a deep learning algorithm

BACKGROUND

Signal delineation of a standard 12-lead electrocardiogram (ECG) is a decisive step for retrieving complete information and extracting signal characteristics for each lead in cardiology clinical practice. However, it is arduous to manually assess the leads, as a variety of signal morphological variations in each lead have potential defects in recording, noise, or irregular heart rhythm/beat.

METHOD

A computer-aided deep-learning algorithm is considered a state-of-the-art delineation model to classify ECG waveform and boundary in terms of the P-wave, QRS-complex, and T-wave and indicated the satisfactory result. This study implemented convolution layers as a part of convolutional neural networks for automated feature extraction and bidirectional long short-term memory as a classifier. For beat segmentation, we have experimented beat-based and patient-based approach.

RESULTS

The empirical results using both beat segmentation approaches, with a total of 14,588 beats were showed that our proposed model performed excellently well. All performance metrics above 95% and 93%, for beat-based and patient-based segmentation, respectively.

CONCLUSIONS

This is a significant step towards the clinical pertinency of automated 12-lead ECG delineation using deep learning.

Classification of Alzheimer's disease using robust TabNet neural networks on genetic data

Alzheimer's disease (AD) is one of the most common neurodegenerative diseases and its onset is significantly associated with genetic factors. Being the capabilities of high specificity and accuracy, genetic testing has been considered as an important technique for AD diagnosis. In this paper, we presented an improved deep learning (DL) algorithm, namely differential genes screening TabNet (DGS-TabNet) for AD binary and multi-class classifications. For performance evaluation, our proposed approach was compared with three novel DLs of multi-layer perceptron (MLP), neural oblivious decision ensembles (NODE), TabNet as well as five classical machine learnings (MLs) including decision tree (DT), random forests (RF), gradient boosting decision tree (GBDT), light gradient boosting machine (LGBM) and support vector machine (SVM) on the public data set of gene expression omnibus (GEO). Moreover, the biological interpretability of global important genetic features implemented for AD classification was revealed by the Kyoto encyclopedia of genes and genomes (KEGG) and gene ontology (GO). The results demonstrated that our proposed DGS-TabNet achieved the best performance with an accuracy of 93.80% for binary classification, and with an accuracy of 88.27% for multi-class classification. Meanwhile, the gene pathway analyses demonstrated that there existed two most important global genetic features of AVIL and NDUFS4 and those obtained 22 feature genes were partially correlated with AD pathogenesis. It was concluded that the proposed DGS-TabNet could be used to detect AD-susceptible genes and the biological interpretability of susceptible genes also revealed the potential possibility of being AD biomarkers.

A Deep Learning Architecture Using 3D Vectorcardiogram to Detect R-Peaks in ECG with Enhanced Precision

Providing reliable detection of QRS complexes is key in automated analyses of electrocardiograms (ECG). Accurate and timely R-peak detections provide a basis for ECG-based diagnoses and to synchronize radiologic, electrophysiologic, or other medical devices. Compared with classical algorithms, deep learning (DL) architectures have demonstrated superior accuracy and high generalization capacity. Furthermore, they can be embedded on edge devices for real-time inference. 3D vectorcardiograms (VCG) provide a unifying framework for detecting R-peaks regardless of the acquisition strategy or number of ECG leads. In this article, a DL architecture was demonstrated to provide enhanced precision when trained and applied on 3D VCG, with no pre-processing nor post-processing steps. Experiments were conducted on four different public databases. Using the proposed approach, high F1-scores of 99.80% and 99.64% were achieved in leave-one-out cross-validation and cross-database validation protocols, respectively. False detections, measured by a precision of 99.88% or more, were significantly reduced compared with recent state-of-the-art methods tested on the same databases, without penalty in the number of missed peaks, measured by a recall of 99.39% or more. This approach can provide new applications for devices where precision, or positive predictive value, is essential, for instance cardiac magnetic resonance imaging.

Reliable P wave detection in pathological ECG signals

Accurate automated detection of P waves in ECG allows to provide fast correct diagnosis of various cardiac arrhythmias and select suitable strategy for patients’ treatment. However, P waves detection is a still challenging task, especially in long-term ECGs with manifested cardiac pathologies. Software tools used in medical practice usually fail to detect P waves under pathological conditions. Most of recently published approaches have not been tested on such the signals at all. Here we introduce a novel method for accurate and reliable P wave detection, which is success in both normal and pathological cases. Our method uses phasor transform of ECG and innovative decision rules in order to improve P waves detection in pathological signals. The rules are based on a deep knowledge of heart manifestation during various arrhythmias, such as atrial fibrillation, premature ventricular contraction, etc. By involving the rules into the decision process, we are able to find the P wave in the correct location or, alternatively, not to search for it at all. In contrast to another studies, we use three, highly variable annotated ECG databases, which contain both normal and pathological records, to objectively validate our algorithm. The results for physiological records are Se = 98.56% and PP = 99.82% for MIT-BIH Arrhythmia Database (MITDP, with MITDB P-Wave Annotations) and Se = 99.23% and PP = 99.12% for QT database. These results are comparable with other published methods. For pathological signals, the proposed method reaches Se = 96.40% and PP = 91.56% for MITDB and Se = 93.07% and PP = 88.60% for Brno University of Technology ECG Signal Database with Annotations of P wave (BUT PDB). In these signals, the proposed detector greatly outperforms other methods and, thus, represents a huge step towards effective use of fully automated ECG analysis in a real medical practice.

Advanced P Wave Detection in Ecg Signals During Pathology: Evaluation in Different Arrhythmia Contexts

Reliable P wave detection is necessary for accurate and automatic electrocardiogram (ECG) analysis. Currently, methods for P wave detection in physiological conditions are well-described and efficient. However, methods for P wave detection during pathology are not generally found in the literature, or their performance is insufficient. This work introduces a novel method, based on a phasor transform, as well as innovative rules that improve P wave detection during pathology. These rules are based on the extraction of a heartbeats' morphological features and knowledge of heart manifestation during both physiological and pathological conditions. To properly evaluate the performance of the proposed algorithm in pathological conditions, a standard database with a sufficient number of reference P wave positions is needed. However, such a database did not exist. Thus, ECG experts annotated 12 chosen pathological records from the MIT-BIH Arrhythmia Database. These annotations are publicly available via Physionet. The algorithm performance was also validated using physiological records from the MIT-BIH Arrhythmia and QT databases. The results for physiological signals were Se = 98.42% and PP = 99.98%, which is comparable to other methods. For pathological signals, the proposed method reached Se = 96.40% and PP = 85.84%, which greatly outperforms other methods. This improvement represents a huge step towards fully automated analysis systems being respected by ECG experts. These systems are necessary, particularly in the area of long-term monitoring.

Real time QRS complex detection using DFA and regular grammar

Background

The sequence of Q, R, and S peaks (QRS) complex detection is a crucial procedure in electrocardiogram (ECG) processing and analysis. We propose a novel approach for QRS complex detection based on the deterministic finite automata with the addition of some constraints. This paper confirms that regular grammar is useful for extracting QRS complexes and interpreting normalized ECG signals. A QRS is assimilated to a pair of adjacent peaks which meet certain criteria of standard deviation and duration.

Results

The proposed method was applied on several kinds of ECG signals issued from the standard MIT-BIH arrhythmia database. A total of 48 signals were used. For an input signal, several parameters were determined, such as QRS durations, RR distances, and the peaks’ amplitudes. σRR and σQRS parameters were added to quantify the regularity of RR distances and QRS durations, respectively. The sensitivity rate of the suggested method was 99.74% and the specificity rate was 99.86%. Moreover, the sensitivity and the specificity rates variations according to the Signal-to-Noise Ratio were performed.

Conclusions

Regular grammar with the addition of some constraints and deterministic automata proved functional for ECG signals diagnosis. Compared to statistical methods, the use of grammar provides satisfactory and competitive results and indices that are comparable to or even better than those cited in the literature.

Multi-window detection for P-wave in electrocardiograms based on bilateral accumulative area

BACKGROUND AND OBJECTIVE

P-wave detection is one of the most challenging aspects in electrocardiograms (ECGs) due to its low amplitude, low frequency, and variable waveforms. This work introduces a novel multi-window detection method for P-wave delineation based on the bilateral accumulative area.

METHOD

The bilateral accumulative area is calculated by summing the areas covered by the P-wave curve with left and right sliding windows. The onset and offset of a positive P-wave correspond to the local maxima of the area detector. The position drift and difference in area variation of local extreme points with different windows are used to systematically combine multi-window and 12-lead synchronous detection methods, which are used to screen the optimization boundary points from all extreme points of different window widths and adaptively match the P-wave location.

RESULTS

The proposed method was validated with ECG signals from various databases, including the Standard CSE Database, T-Wave Alternans Challenge Database, PTB Diagnostic ECG Database, and the St. Petersburg Institute of Cardiological Technics 12-Lead Arrhythmia Database. The average sensitivity Se was 99.44% with a positive predictivity P+ of 99.37% for P-wave detection. Standard deviations of 3.7 and 4.3ms were achieved for the onset and offset of P-waves, respectively, which is in agreement with the accepted tolerances required by the CSE committee.

CONCLUSION

Compared with well-known delineation methods, this method can achieve high sensitivity and positive predictability using a simple calculation process. The experiment results suggest that the bilateral accumulative area could be an effective detection tool for ECG signal analysis.

QRS detection using K-Nearest Neighbor algorithm (KNN) and evaluation on standard ECG databases

The performance of computer aided ECG analysis depends on the precise and accurate delineation of QRS-complexes. This paper presents an application of K-Nearest Neighbor (KNN) algorithm as a classifier for detection of QRS-complex in ECG. The proposed algorithm is evaluated on two manually annotated standard databases such as CSE and MIT-BIH Arrhythmia database. In this work, a digital band-pass filter is used to reduce false detection caused by interference present in ECG signal and further gradient of the signal is used as a feature for QRS-detection. In addition the accuracy of KNN based classifier is largely dependent on the value of K and type of distance metric. The value of K = 3 and Euclidean distance metric has been proposed for the KNN classifier, using fivefold cross-validation. The detection rates of 99.89% and 99.81% are achieved for CSE and MIT-BIH databases respectively. The QRS detector obtained a sensitivity Se = 99.86% and specificity Sp = 99.86% for CSE database, and Se = 99.81% and Sp = 99.86% for MIT-BIH Arrhythmia database. A comparison is also made between proposed algorithm and other published work using CSE and MIT-BIH Arrhythmia databases. These results clearly establishes KNN algorithm for reliable and accurate QRS-detection.

Field programmable gate array based fuzzy neural signal processing system for differential diagnosis of QRS complex tachycardia and tachyarrhythmia in noisy ECG signals

The paper reports of a Field Programmable Gate Array (FPGA) based embedded system for detection of QRS complex in a noisy electrocardiogram (ECG) signal and thereafter differential diagnosis of tachycardia and tachyarrhythmia. The QRS complex has been detected after application of entropy measure of fuzziness to build a detection function of ECG signal, which has been previously filtered to remove power line interference and base line wander. Using the detected QRS complexes, differential diagnosis of tachycardia and tachyarrhythmia has been performed. The entire algorithm has been realized in hardware on an FPGA. Using the standard CSE ECG database, the algorithm performed highly effectively. The performance of the algorithm in respect of QRS detection with sensitivity (Se) of 99.74% and accuracy of 99.5% is achieved when tested using single channel ECG with entropy criteria. The performance of the QRS detection system has been compared and found to be better than most of the QRS detection systems available in literature. Using the system, 200 patients have been diagnosed with an accuracy of 98.5%.