ECG signal classification with binarized convolutional neural network

Recent advances in the tools and techniques for AI-aided diagnosis of atrial fibrillation

Atrial fibrillation (AF) is recognized as a developing global epidemic responsible for a significant burden of morbidity and mortality. To counter this public health crisis, the advancement of artificial intelligence (AI)-aided tools and methodologies for the effective detection and monitoring of AF is becoming increasingly apparent. A unified strategy from the international research community is essential to develop effective intelligent tools and technologies to support the health professionals for effective surveillance and defense against AF. This review delves into the practical implications of AI-aided tools and techniques for AF detection across different clinical settings including screening, diagnosis, and ambulatory monitoring by reviewing the revolutionary research works. The key finding is that the advance in AI and its use for automatic detection of AF has achieved remarkable success, but collaboration between AI and human intelligence is required for trustworthy diagnostic of this life-threatening cardiac condition. Moreover, designing efficient and robust intelligent algorithms for onboard AF detection using portable and implementable computing devices with limited computation power and energy supply is a crucial research problem. As modern wearable devices are equipped with sophisticated embedded sensors, such as optical sensors and accelerometers, hence photoplethysmography and ballistocardiography signals could be explored as an affordable alternative to electrocardiography (ECG) signals for AF detection, particularly for the development of low-cost and miniature screening and monitoring devices.

A comprehensive review on efficient artificial intelligence models for classification of abnormal cardiac rhythms using electrocardiograms

Deep learning has made many advances in data classification using electrocardiogram (ECG) waveforms. Over the past decade, data science research has focused on developing artificial intelligence (AI) based models that can analyze ECG waveforms to identify and classify abnormal cardiac rhythms accurately. However, the primary drawback of the current AI models is that most of these models are heavy, computationally intensive, and inefficient in terms of cost for real-time implementation. In this review, we first discuss the current state-of-the-art AI models utilized for ECG-based cardiac rhythm classification. Next, we present some of the upcoming modeling methodologies which have the potential to perform real-time implementation of AI-based heart rhythm diagnosis. These models hold significant promise in being lightweight and computationally efficient without compromising the accuracy. Contemporary models predominantly utilize 12-lead ECG for cardiac rhythm classification and cardiovascular status prediction, increasing the computational burden and making real-time implementation challenging. We also summarize research studies evaluating the potential of efficient data setups to reduce the number of ECG leads without affecting classification accuracy. Lastly, we present future perspectives on AI's utility in precision medicine by providing opportunities for accurate prediction and diagnostics of cardiovascular status in patients.

Reseek-Arrhythmia: Empirical Evaluation of ResNet Architecture for Detection of Arrhythmia

Arrhythmia is a cardiac condition characterized by an irregular heart rhythm that hinders the proper circulation of blood, posing a severe risk to individuals' lives. Globally, arrhythmias are recognized as a significant health concern, accounting for nearly 12 percent of all deaths. As a result, there has been a growing focus on utilizing artificial intelligence for the detection and classification of abnormal heartbeats. In recent years, self-operated heartbeat detection research has gained popularity due to its cost-effectiveness and potential for expediting therapy for individuals at risk of arrhythmias. However, building an efficient automatic heartbeat monitoring approach for arrhythmia identification and classification comes with several significant challenges. These challenges include addressing issues related to data quality, determining the range for heart rate segmentation, managing data imbalance difficulties, handling intra- and inter-patient variations, distinguishing supraventricular irregular heartbeats from regular heartbeats, and ensuring model interpretability. In this study, we propose the Reseek-Arrhythmia model, which leverages deep learning techniques to automatically detect and classify heart arrhythmia diseases. The model combines different convolutional blocks and identity blocks, along with essential components such as convolution layers, batch normalization layers, and activation layers. To train and evaluate the model, we utilized the MIT-BIH and PTB datasets. Remarkably, the proposed model achieves outstanding performance with an accuracy of 99.35% and 93.50% and an acceptable loss of 0.688 and 0.2564, respectively.

A novel transformer-based ECG dimensionality reduction stacked auto-encoders for arrhythmia beat detection

BACKGROUND

Electrocardiogram (ECG) is a powerful tool for studying cardiac activity and diagnosing various cardiovascular diseases, including arrhythmia. While machine learning and deep learning algorithms have been applied to ECG interpretation, there is still room for improvement. For instance, the commonly used Recurrent Neural Networks (RNNs), reply on its previous state to update and is therefore ineffective for parallel computing. RNN also struggles to efficiently address the issue of long-distance reliance.

PURPOSE

To reduce computational complexity by dimensionality reduction of ECG signals we constructed a Stacked Auto-encoders model using Transformer for ECG-based arrhythmia detection. And overcome the challenges of long-term dependencies and limited parallelizability in traditional RNNs when applied to ECG signal processing.

METHODS

In this paper, a Transformer-Based ECG Dimensionality Reduction Stacked Auto-encoders model is proposed for ECG-based arrhythmia detection. The transformer is used to encode ECG signals into a feature matrix, which is then dimensionally reduced using unsupervised greedy training through the four linear layers. This resulted in a low-dimensional representation of ECG features, which are subsequently classified using support vector machines (SVM) to minimize overfitting.

RESULTS

The proposed method is benchmarked on the MIT-BIH Arrhythmia database. In the 10-fold cross validation of beat-based arrhythmia detection, the average accuracy, sensitivity, specificity and F1 score of the proposed method are 99.83%, 98.84%, 99.84% and 99.13%, respectively, for the record-based arrhythmia detection which refers to the approach where the training and testing sets use ECG data from independent recorded patients are 88.10%, 49.79%, 91.56% and 39.95%, respectively.

CONCLUSIONS

Compared to other existing ECG-based arrhythmia detection methods, our proposed approach exhibits improved detection accuracy and stronger generalization for arrhythmia beats. Additionally, the use of the record-based data division method makes our approach more suitable for clinical practice.

An Efficient and Private ECG Classification System Using Split and Semi-Supervised Learning

Electrocardiography (ECG) is a standard diagnostic tool for evaluating the overall heart's electrical activity and is vital for detecting many cardiovascular diseases. Classifying ECG recordings using deep neural networks has been investigated in literature and has shown very good performance. However, this performance assumes that the training data is centralized, which is often not the case in real-life scenarios, where data resides in multiple places and only a small portion of it is labeled. Therefore, in this work, we propose an ECG classification system that focuses on preserving data privacy and enhancing overall system efficiency. We analyzed the complexity of previously proposed deep learning-based models and showed that the temporal convolutional network-based models (TCN) were the most efficient. Then, we built on the TCN models a modified split-learning (SL) system that achieves the same classification performance as the basic SL but reduces the communication overhead between the server and the client by 71.7% as well as reducing the computations at the client by 46.5% compared to the original SL system based on the TCN network. Finally, we implement semi-supervised learning in our system to enhance its classification performance by 9.1%-15.7%, when the training data consists only of 10% labeled data. We have tested our proposed system on a test IoT setup and it achieved satisfactory classification accuracy while being private and energy efficient for green-AI applications.

ECG Heartbeat Classification Using Machine Learning and Metaheuristic Optimization for Smart Healthcare Systems

Early diagnosis and classification of arrhythmia from an electrocardiogram (ECG) plays a significant role in smart healthcare systems for the health monitoring of individuals with cardiovascular diseases. Unfortunately, the nonlinearity and low amplitude of ECG recordings make the classification process difficult. Thus, the performance of most traditional machine learning (ML) classifiers is questionable, as the interrelationship between the learning parameters is not well modeled, especially for data features with high dimensions. To address the limitations of ML classifiers, this paper introduces an automatic arrhythmia classification approach based on the integration of a recent metaheuristic optimization (MHO) algorithm and ML classifiers. The role of the MHO is to optimize the search parameters of the classifiers. The approach consists of three steps: the preprocessing of the ECG signal, the extraction of the features, and the classification. The learning parameters of four supervised ML classifiers were utilized for the classification task; support vector machine (SVM), k-nearest neighbors (kNNs), gradient boosting decision tree (GBDT), and random forest (RF) were optimized using the MHO algorithm. To validate the advantage of the proposed approach, several experiments were conducted on three common databases, including the Massachusetts Institute of Technology (MIT-BIH), the European Society of Cardiology ST-T (EDB), and the St. Petersburg Institute of Cardiological Techniques 12-lead Arrhythmia (INCART). The obtained results showed that the performance of all the tested classifiers were significantly improved after integrating the MHO algorithm, with the average ECG arrhythmia classification accuracy reaching 99.92% and a sensitivity of 99.81%, outperforming the state-of the-art methods.

Method for Solving Difficulties in Rhythm Classification Caused by Few Samples and Similar Characteristics in Electrocardiograms

A method for accurately analyzing electrocardiograms (ECGs), which are obtained from electrical signals generated by cardiac activity, is essential in heart disease diagnosis. However, rhythms are typically obtained with relatively few data samples and similar characteristics, making them difficult to classify. To solve these issues, we proposed a novel method that distinguishes a given ECG rhythm using a beat score map (BSM) image. Through the proposed method, the associations between beats and previously used features, such as the R-R interval, were considered. Rhythm classification was implemented by training a convolutional neural network model and using transfer learning with the created BSM image. As a result, the proposed method for ECG rhythms with small data samples showed significant results. It also showed good performance in differentiating atrial fibrillation (AFIB) and atrial flutter (AFL) rhythms, which are difficult to distinguish due to their similar characteristics. The performance for rhythms with a small number of samples of the proposed method is 20% better than an existing method. In addition, the performance based on the F-1 score for classifying AFIB and AFL of the proposed method is 30% better than the existing method. This study solved the previous limitations caused by small sample numbers and similar rhythms.

A lightweight U-net for ECG denoising using knowledge distillation

Objective.Electrocardiogram (ECG) signals are easily polluted by various noises which are likely to have adverse effects on subsequent interpretations. Research on model lightweighting can promote the practical application of deep learning-based ECG denoising methods in real-time processing.Approach.Firstly, grouped convolution and conventional convolution are combined to replace the continuous conventional convolution in the model, and the depthwise convolution with stride is used to compress the feature map in the encoder modules. Secondly, additional identity connections and a local maximum and minimum enhancement module are designed, which can retain the detailed information and characteristic waveform in the ECG waveform while effectively denoising. Finally, we develop knowledge distillation in the experiments, which further improves the ECG denoising performance without increasing the model complexity. The ground-truth ECG is from The China Physiological Signal Challenge (CPSC) 2018, and the noise signal is from the MIT-BIH Noise Stress Test Database (NSTDB). We evaluate denoising performance using the signal-to-noise ratio (SNR), the root mean square error (RMSE) and the Pearson correlation coefficient (P). We use the floating point of operations (FLOPs) and parameters to calculate computational complexity.Main Results.Different data generation processes are used to conduct experiments: group 1, group 2 and group 3. The results show that the proposed model (U_Lde-net) can improve SNRs by 10.30 dB, 12.16 dB and 12.61 dB; reduce RMSEs by 9.88 × 10^-2, 20.63 × 10^-2and 15.25 × 10^-2; and increasePs by 14.77 × 10^-2, 27.74 × 10^-2and 21.32 × 10^-2. Moreover, the denoising performance after knowledge distillation is further improved. The U_Lde-net has parameters of 6.9 K and FLOPs of 6.6 M, which are much smaller than the compared models.Significance.We designed a lightweight model, but also retain adequate ECG denoising performance. We believe that this method can be successfully applied to practical applications under time or memory limits.

A New 12-Lead ECG Signals Fusion Method Using Evolutionary CNN Trees for Arrhythmia Detection

The 12 leads of electrocardiogram (ECG) signals show the heart activities from different angles of coronal and axial planes; hence, the signals of these 12 leads have functional dependence on each other. This paper proposes a novel method for fusing the data of 12-lead ECG signals to diagnose heart problems. In the first phase of the proposed method, the time-frequency transform is employed to fuse the functional data of leads and extract the frequency data of ECG signals in 12 leads. After that, their dependence is evaluated through the correlation analysis. In the second phase, a structural learning method is adopted to extract the structural data from these 12 leads. Moreover, deep convolutional neural network (CNN) models are coded in this phase through genetic programming. These trees are responsible for learning deep structural features from functional data extracted from 12 leads. These trees are upgraded through the execution of the genetic programming (GP) algorithm to extract the optimal features. These two phases are used together to fuse the leads of ECG signals to diagnose various heart problems. According to the test results on ChapmanECG, including the signals of 10,646 patients, the proposed method enjoys the mean accuracy of 97.60% in the diagnosis of various types of arrhythmias in the Chapman dataset. It also outperformed the state-of-the-art methods.

Application of Internet of Things on the Healthcare Field Using Convolutional Neural Network Processing

Population at risk can benefit greatly from remote health monitoring because it allows for early detection and treatment. Because of recent advances in Internet-of-Things (IoT) paradigms, such monitoring systems are now available everywhere. Due to the essential nature of the patients being monitored, these systems demand a high level of quality in aspects such as availability and accuracy. In health applications, where a lot of data are accessible, deep learning algorithms have the potential to perform well. In this paper, we develop a deep learning architecture called the convolutional neural network (CNN), which we examine in this study to see if it can be implemented. The study uses the IoT system with a centralised cloud server, where it is considered as an ideal input data acquisition module. The study uses cloud computing resources by distributing CNN operations to the servers with outsourced fitness functions to be performed at the edge. The results of the simulation show that the proposed method achieves a higher rate of classifying the input instances from the data acquisition tools than other methods. From the results, it is seen that the proposed CNN achieves an average accurate rate of 99.6% on training datasets and 86.3% on testing datasets.

Multi-classification of arrhythmias using a HCRNet on imbalanced ECG datasets

BACKGROUND AND OBJECTIVE

Cardiac arrhythmia, which is an abnormal heart rhythm, is a common clinical problem in cardiology. Arrhythmias can be divided into many Categories, and accurate detection of arrhythmias can effectively prevent heart disease and reduce mortality. However, existing screening methods require long time monitoring and are low cost and low yield. Our goal is to develop a mixed depth model for processing time series to predict multi-classification electrocardiograph (ECG).

METHODS

In this study, we developed a new, more robust network model named Hybrid Convolutional Recurrent Neural Network (HCRNet) for the time-series signal of ECG. This model utilized a nine-class ECG dataset containing tens of thousands of data to automatically detect cardiac arrhythmias. At the same time, a large imbalance arose because some of the cases in our selected MIT-BIH atrial fibrillation database had less than 100 records, but some had more than 10,000 records. Therefore, during data preprocessing, we adopted a scientific and efficient method to solve the ECG data imbalance problem. In the experimental studies, 10-fold cross validation technique is employed to evaluate performance of the model.

RESULTS

In order to fully validate our proposed model, we conducted a comprehensive experiment to investigate the performance of the proposed method. Our proposed HCRNet achieved the average accuracy of 99.01% performance and the average sensitivity of 99.58% performance on this dataset. Results suggest that the proposed model outperformed some state-of-the-art studies in ECG classification with a high overall performance value.

CONCLUSION

The HCRNet model can effectively classify arrhythmia signals in nine categories and obtain high efficiency, accuracy and F1 values. These improvements in efficiency and accuracy explain the rationality and science of setting up the modules in the HCRNet. By using this model, it can help cardiologists to correctly identify heartbeat types and perform arrhythmia diagnosis quickly.

HADLN: Hybrid Attention-Based Deep Learning Network for Automated Arrhythmia Classification

In recent years, with the development of artificial intelligence, deep learning model has achieved initial success in ECG data analysis, especially the detection of atrial fibrillation. In order to solve the problems of ignoring the correlation between contexts and gradient dispersion in traditional deep convolution neural network model, the hybrid attention-based deep learning network (HADLN) method is proposed to implement arrhythmia classification. The HADLN can make full use of the advantages of residual network (ResNet) and bidirectional long–short-term memory (Bi-LSTM) architecture to obtain fusion features containing local and global information and improve the interpretability of the model through the attention mechanism. The method is trained and verified by using the PhysioNet 2017 challenge dataset. Without loss of generality, the ECG signal is classified into four categories, including atrial fibrillation, noise, other, and normal signals. By combining the fusion features and the attention mechanism, the learned model has a great improvement in classification performance and certain interpretability. The experimental results show that the proposed HADLN method can achieve precision of 0.866, recall of 0.859, accuracy of 0.867, and F1-score of 0.880 on 10-fold cross-validation.

Diabetic retinopathy detection through convolutional neural networks with synaptic metaplasticity

BACKGROUND AND OBJECTIVES

Diabetic retinopathy is a type of diabetes that causes vascular changes that can lead to blindness. The ravages of this disease cannot be reversed, so early detection is essential. This work presents an automated method for early detection of this disease using fundus colored images.

METHODS

A bio-inspired approach is proposed on synaptic metaplasticity in convolutional neural networks. This biological phenomenon is known to directly interfere in both learning and memory by reinforcing less common occurrences during the learning process. Synaptic metaplasticity has been included in the backpropagation stage of a convolution operation for every convolutional layer.

RESULTS

The proposed method has been evaluated by using a public small diabetic retinopathy dataset from Kaggle with four award-winning convolutional neural network architectures. Results show that convolutional neural network architectures including synaptic metaplasticity improve both learning rate and accuracy. Furthermore, obtained results outperform other methods in current literature, even using smaller datasets for training. Best results have been obtained for the InceptionV3 architecture with synaptic metaplasticity with a 95.56% accuracy, 94.24% F1-score, 98.9% precision and 90% recall, using 3662 images for training.

CONCLUSIONS

Convolutional neural networks with synaptic metaplasticity are suitable for early detection of diabetic retinopathy due to their fast convergence rate, training simplicity and high performance.

Digital biomarkers and algorithms for detection of atrial fibrillation using surface electrocardiograms: A systematic review

AIMS

Automated detection of atrial fibrillation (AF) in continuous rhythm registrations is essential in order to prevent complications and optimize treatment of AF. Many algorithms have been developed to detect AF in surface electrocardiograms (ECGs) during the past few years. The aim of this systematic review is to gain more insight into these available classification methods by discussing previously used digital biomarkers and algorithms and make recommendations for future research.

METHODS

On the 14^th of September 2020, the PubMed database was searched for articles focusing on algorithms for AF detection in ECGs using the MeSH terms Atrial Fibrillation, Electrocardiography and Algorithms. Articles which solely focused on differentiation of types of rhythm disorders or prediction of AF termination were excluded.

RESULTS

The search resulted in 451 articles, of which 130 remained after full-text screening. Not only did the amount of research on methods for AF detection increase over the past years, but a trend towards more complex classification methods is observed. Furthermore, three different types of features can be distinguished: atrial features, ventricular features, and signal features. Although AF is an atrial disease, only 22% of the described methods use atrial features.

CONCLUSION

More and more studies focus on improving accuracy of classification methods for AF in ECGs. As a result, algorithms become increasingly complex and less well interpretable. Only a few studies focus on detecting atrial activity in the ECG. Developing innovative methods focusing on detection of atrial activity might provide accurate classifiers without compromising on transparency.

An ECG Signal Classification Method Based on Dilated Causal Convolution

The incidence of cardiovascular disease is increasing year by year and is showing a younger trend. At the same time, existing medical resources are tight. The automatic detection of ECG signals becomes increasingly necessary. This paper proposes an automatic classification of ECG signals based on a dilated causal convolutional neural network. To solve the problem that the recurrent neural network framework network cannot be accelerated by hardware equipment, the dilated causal convolutional neural network is adopted. Given the features of the same input and output time steps of the recurrent neural network and the nondisclosure of future information, the network is constructed with fully convolutional networks and causal convolution. To reduce the network depth and prevent gradient explosion or gradient disappearance, the dilated factor is introduced into the model, and the residual blocks are introduced into the model according to the shortcut connection idea. The effectiveness of the algorithm is verified in the MIT-BIH Atrial Fibrillation Database (MIT-BIH AFDB). In the experiment of the MIT-BIH AFDB database, the classification accuracy rate is 98.65%.

Heartbeat Classification Based on Multifeature Combination and Stacking-DWKNN Algorithm

Arrhythmia is one of the most common abnormal symptoms that can threaten human life. In order to distinguish arrhythmia more accurately, the classification strategy of the multifeature combination and Stacking-DWKNN algorithm is proposed in this paper. The method consists of four modules. In the preprocessing module, the signal is denoised and segmented. Then, multiple different features are extracted based on single heartbeat morphology, P length, QRS length, T length, PR interval, ST segment, QT interval, RR interval, R amplitude, and T amplitude. Subsequently, the features are combined and normalized, and the effect of different feature combinations on heartbeat classification is analyzed to select the optimal feature combination. Finally, the four types of normal and abnormal heartbeats were identified using the Stacking-DWKNN algorithm. This method is performed on the MIT-BIH arrhythmia database. The result shows a sensitivity of 89.42% and a positive predictive value of 94.90% of S-type beats and a sensitivity of 97.21% and a positive predictive value of 97.07% of V-type beats. The obtained average accuracy is 99.01%. Compared to other models with the same features, this method can improve accuracy and has a higher positive predictive value and sensitivity, which is important for clinical decision-making.

Accurate deep neural network model to detect cardiac arrhythmia on more than 10,000 individual subject ECG records

BACKGROUND AND OBJECTIVE

Cardiac arrhythmia, which is an abnormal heart rhythm, is a common clinical problem in cardiology. Detection of arrhythmia on an extended duration electrocardiogram (ECG) is done based on initial algorithmic software screening, with final visual validation by cardiologists. It is a time consuming and subjective process. Therefore, fully automated computer-assisted detection systems with a high degree of accuracy have an essential role in this task. In this study, we proposed an effective deep neural network (DNN) model to detect different rhythm classes from a new ECG database.

METHODS

Our DNN model was designed for high performance on all ECG leads. The proposed model, which included both representation learning and sequence learning tasks, showed promising results on all 12-lead inputs. Convolutional layers and sub-sampling layers were used in the representation learning phase. The sequence learning part involved a long short-term memory (LSTM) unit after representation of learning layers.

RESULTS

We performed two different class scenarios, including reduced rhythms (seven rhythm types) and merged rhythms (four rhythm types) according to the records from the database. Our trained DNN model achieved 92.24% and 96.13% accuracies for the reduced and merged rhythm classes, respectively.

CONCLUSION

Recently, deep learning algorithms have been found to be useful because of their high performance. The main challenge is the scarcity of appropriate training and testing resources because model performance is dependent on the quality and quantity of case samples. In this study, we used a new public arrhythmia database comprising more than 10,000 records. We constructed an efficient DNN model for automated detection of arrhythmia using these records.