The impact of the MIT-BIH arrhythmia database

MEAs-Filter: a novel filter framework utilizing evolutionary algorithms for cardiovascular diseases diagnosis

Cardiovascular disease management often involves adjusting medication dosage based on changes in electrocardiogram (ECG) signals' waveform and rhythm. However, the diagnostic utility of ECG signals is often hindered by various types of noise interference. In this work, we propose a novel filter based on a multi-engine evolution framework named MEAs-Filter to address this issue. Our approach eliminates the need for predefined dimensions and allows adaptation to diverse ECG morphologies. By leveraging state-of-the-art optimization algorithms as evolution engine and incorporating prior information inputs from classical filters, MEAs-Filter achieves superior performance while minimizing order. We evaluate the effectiveness of MEAs-Filter on a real ECG database and compare it against commonly used filters such as the Butterworth, Chebyshev filters, and evolution algorithm-based (EA-based) filters. The experimental results indicate that MEAs-Filter outperforms other filters by achieving a reduction of approximately 30% to 60% in terms of the loss function compared to the other algorithms. In denoising experiments conducted on ECG waveforms across various scenarios, MEAs-Filter demonstrates an improvement of approximately 20% in signal-to-noise (SNR) ratio and a 9% improvement in correlation. Moreover, it does not exhibit higher losses of the R-wave compared to other filters. These findings highlight the potential of MEAs-Filter as a valuable tool for high-fidelity extraction of ECG signals, enabling accurate diagnosis in the field of cardiovascular diseases.

An innovative 12-lead resting electrocardiogram dataset in professional football

This paper aims to provide a comprehensive and innovative 12-lead electrocardiogram (ECG) dataset tailored to understand the unique needs of professional football players. Other ECG datasets are available but collected from common people, normally with diseases confirmed, while it is well known that ECG characteristics change in athletes and elite players as a result of their intense long-term physical training. This initiative is part of a broader research project employing machine learning (ML) to analyse ECG data in this athlete population and explore them according to the International criteria for ECG interpretation in athletes. The dataset is generated through the establishment of a prospective observational cohort consisting of 54 male football players from La Liga, representing a UEFA Pro-level team. Named the Pro-Football 12-lead Resting Electrocardiogram Database (PF12RED), it comprises 163 10-s ECG recordings, offering a detailed examination of the at-rest heart activity of professional football athletes. Data collection spans five phases over multiple seasons, including the 2018-2019 postseason, the 2019-20 preseason, the 2020-21 preseason, and the 2021-22 preseason. Athletes undergo medical evaluations that include a 10-s resting 12-lead ECG performed with General Electric's USB-CAM 14 module (https://co.services.gehealthcare.com/gehcstorefront/p/900995-002), with data saved using General Electric's CardioSoft V6.73 12SL V21 ECG Software. (https://www.gehealthcare.es/products/cardiosoft-v7) The data collection adheres to ethical principles, with clearance granted by the Autonomous Community of Andalusia Ethics Committee (Spain) under protocol number 1573-N-19 in December 2019. Participants provide informed consent, and data sharing is permitted following anonymization. The study aligns with the Declaration of Helsinki and adheres to the recommendations of the International Committee of Medical Journal Editors (ICMJE). The generated dataset serves as a valuable resource for research in sports cardiology and cardiac health. Its potential for reuse encompasses:1.International Comparison: Enabling cross-regional comparisons of cardiac characteristics among elite football players, enriching international studies.2.ML Model Development: Facilitating the development and refinement of machine learning models for arrhythmia detection, serving as a benchmark dataset.3.Validation of Diagnostic Methods: Allowing the validation of automatic diagnostic methods, contributing to enhanced accuracy in detecting cardiac conditions.4.Research in Sports Cardiology: Supporting future investigations into specific cardiac adaptations in elite athletes and their relation to cardiovascular health.5.Reference for Athlete Protection Policies: Influencing athlete protection policies by providing data on cardiac health and suggesting guidelines for medical assessments.6.Health Professionals Training: Serving as a training resource for health professionals interested in interpreting ECGs in sports contexts.7.Tool and Application Development: Facilitating the development of tools and applications related to the visualization, simulation and analysis of ECG signals in athletes.

Recent advancements and applications of deep learning in heart failure: Α systematic review

BACKGROUND

Heart failure (HF), a global health challenge, requires innovative diagnostic and management approaches. The rapid evolution of deep learning (DL) in healthcare necessitates a comprehensive review to evaluate these developments and their potential to enhance HF evaluation, aligning clinical practices with technological advancements.

OBJECTIVE

This review aims to systematically explore the contributions of DL technologies in the assessment of HF, focusing on their potential to improve diagnostic accuracy, personalize treatment strategies, and address the impact of comorbidities.

METHODS

A thorough literature search was conducted across four major electronic databases: PubMed, Scopus, Web of Science and IEEE Xplore, yielding 137 articles that were subsequently categorized into five primary application areas: cardiovascular disease (CVD) classification, HF detection, image analysis, risk assessment, and other clinical analyses. The selection criteria focused on studies utilizing DL algorithms for HF assessment, not limited to HF detection but extending to any attempt in analyzing and interpreting HF-related data.

RESULTS

The analysis revealed a notable emphasis on CVD classification and HF detection, with DL algorithms showing significant promise in distinguishing between affected individuals and healthy subjects. Furthermore, the review highlights DL's capacity to identify underlying cardiomyopathies and other comorbidities, underscoring its utility in refining diagnostic processes and tailoring treatment plans to individual patient needs.

CONCLUSIONS

This review establishes DL as a key innovation in HF management, highlighting its role in advancing diagnostic accuracy and personalized care. The insights provided advocate for the integration of DL in clinical settings and suggest directions for future research to enhance patient outcomes in HF care.

MA-MIL: Sampling point-level abnormal ECG location method via weakly supervised learning

BACKGROUND AND OBJECTIVE

Current automatic electrocardiogram (ECG) diagnostic systems could provide classification outcomes but often lack explanations for these results. This limitation hampers their application in clinical diagnoses. Previous supervised learning could not highlight abnormal segmentation output accurately enough for clinical application without manual labeling of large ECG datasets.

METHOD

In this study, we present a multi-instance learning framework called MA-MIL, which has designed a multi-layer and multi-instance structure that is aggregated step by step at different scales. We evaluated our method using the public MIT-BIH dataset and our private dataset.

RESULTS

The results show that our model performed well in both ECG classification output and heartbeat level, sub-heartbeat level abnormal segment detection, with accuracy and F1 scores of 0.987 and 0.986 for ECG classification and 0.968 and 0.949 for heartbeat level abnormal detection, respectively. Compared to visualization methods, the IoU values of MA-MIL improved by at least 17 % and at most 31 % across all categories.

CONCLUSIONS

MA-MIL could accurately locate the abnormal ECG segment, offering more trustworthy results for clinical application.

Machine learning based detection of T-wave alternans in real ambulatory conditions

BACKGROUND AND OBJECTIVE

T-wave alternans (TWA) is a fluctuation in the repolarization morphology of the ECG. It is associated with cardiac instability and sudden cardiac death risk. Diverse methods have been proposed for TWA analysis. However, TWA detection in ambulatory settings remains a challenge due to the absence of standardized evaluation metrics and detection thresholds.

METHODS

In this work we use traditional TWA analysis signal processing-based methods for feature extraction, and two machine learning (ML) methods, namely, K-nearest-neighbor (KNN) and random forest (RF), for TWA detection, addressing hyper-parameter tuning and feature selection. The final goal is the detection in ambulatory recordings of short, non-sustained and sparse TWA events.

RESULTS

We train ML methods to detect a wide variety of alternant voltage from 20 to 100 μV, i.e., ranging from non-visible micro-alternans to TWA of higher amplitudes, to recognize a wide range in concordance to risk stratification. In classification, RF outperforms significantly the recall in comparison with the signal processing methods, at the expense of a small lost in precision. Despite ambulatory detection stands for an imbalanced category context, the trained ML systems always outperform signal processing methods.

CONCLUSIONS

We propose a comprehensive integration of multiple variables inspired by TWA signal processing methods to fed learning-based methods. ML models consistently outperform the best signal processing methods, yielding superior recall scores.

Modeling the Electrical Activity of the Heart via Transfer Functions and Genetic Algorithms

Although healthcare and medical technology have advanced significantly over the past few decades, heart disease continues to be a major cause of mortality globally. Electrocardiography (ECG) is one of the most widely used tools for the detection of heart diseases. This study presents a mathematical model based on transfer functions that allows for the exploration and optimization of heart dynamics in Laplace space using a genetic algorithm (GA). The transfer function parameters were fine-tuned using the GA, with clinical ECG records serving as reference signals. The proposed model, which is based on polynomials and delays, approximates a real ECG with a root-mean-square error of 4.7% and an R2 value of 0.72. The model achieves the periodic nature of an ECG signal by using a single periodic impulse input. Its simplicity makes it possible to adjust waveform parameters with a predetermined understanding of their effects, which can be used to generate both arrhythmic patterns and healthy signals. This is a notable advantage over other models that are burdened by a large number of differential equations and many parameters.

Securing Internet-of-Medical-Things networks using cancellable ECG recognition

Reinforcement of the Internet of Medical Things (IoMT) network security has become extremely significant as these networks enable both patients and healthcare providers to communicate with each other by exchanging medical signals, data, and vital reports in a safe way. To ensure the safe transmission of sensitive information, robust and secure access mechanisms are paramount. Vulnerabilities in these networks, particularly at the access points, could expose patients to significant risks. Among the possible security measures, biometric authentication is becoming a more feasible choice, with a focus on leveraging regularly-monitored biomedical signals like Electrocardiogram (ECG) signals due to their unique characteristics. A notable challenge within all biometric authentication systems is the risk of losing original biometric traits, if hackers successfully compromise the biometric template storage space. Current research endorses replacement of the original biometrics used in access control with cancellable templates. These are produced using encryption or non-invertible transformation, which improves security by enabling the biometric templates to be changed in case an unwanted access is detected. This study presents a comprehensive framework for ECG-based recognition with cancellable templates. This framework may be used for accessing IoMT networks. An innovative methodology is introduced through non-invertible modification of ECG signals using blind signal separation and lightweight encryption. The basic idea here depends on the assumption that if the ECG signal and an auxiliary audio signal for the same person are subjected to a separation algorithm, the algorithm will yield two uncorrelated components through the minimization of a correlation cost function. Hence, the obtained outputs from the separation algorithm will be distorted versions of the ECG as well as the audio signals. The distorted versions of the ECG signals can be treated with a lightweight encryption stage and used as cancellable templates. Security enhancement is achieved through the utilization of the lightweight encryption stage based on a user-specific pattern and XOR operation, thereby reducing the processing burden associated with conventional encryption methods. The proposed framework efficacy is demonstrated through its application on the ECG-ID and MIT-BIH datasets, yielding promising results. The experimental evaluation reveals an Equal Error Rate (EER) of 0.134 on the ECG-ID dataset and 0.4 on the MIT-BIH dataset, alongside an exceptionally large Area under the Receiver Operating Characteristic curve (AROC) of 99.96% for both datasets. These results underscore the framework potential in securing IoMT networks through cancellable biometrics, offering a hybrid security model that combines the strengths of non-invertible transformations and lightweight encryption.

Demonstration of In-Memory Biosignal Analysis: Novel High-Density and Low-Power 3D Flash Memory Array for Arrhythmia Detection

Smart healthcare systems integrated with advanced deep neural networks enable real-time health monitoring, early disease detection, and personalized treatment. In this work, a novel 3D AND-type flash memory array with a rounded double channel for computing-in-memory (CIM) architecture to overcome the limitations of conventional smart healthcare systems: the necessity of high area and energy efficiency while maintaining high classification accuracy is proposed. The fabricated array, characterized by low-power operations and high scalability with double independent channels per floor, exhibits enhanced cell density and energy efficiency while effectively emulating the features of biological synapses. The CIM architecture leveraging the fabricated array achieves high classification accuracy (93.5%) for electrocardiogram signals, ensuring timely detection of potentially life-threatening arrhythmias. Incorporated with a simplified spike-timing-dependent plasticity learning rule, the CIM architecture is suitable for robust, area- and energy-efficient in-memory arrhythmia detection systems. This work effectively addresses the challenges of conventional smart healthcare systems, paving the way for a more refined healthcare paradigm.

Semi-Supervised Learning for Multi-Label Cardiovascular Diseases Prediction: A Multi-Dataset Study

Electrocardiography (ECG) is a non-invasive tool for predicting cardiovascular diseases (CVDs). Current ECG-based diagnosis systems show promising performance owing to the rapid development of deep learning techniques. However, the label scarcity problem, the co-occurrence of multiple CVDs and the poor performance on unseen datasets greatly hinder the widespread application of deep learning-based models. Addressing them in a unified framework remains a significant challenge. To this end, we propose a multi-label semi-supervised model (ECGMatch) to recognize multiple CVDs simultaneously with limited supervision. In the ECGMatch, an ECGAugment module is developed for weak and strong ECG data augmentation, which generates diverse samples for model training. Subsequently, a hyperparameter-efficient framework with neighbor agreement modeling and knowledge distillation is designed for pseudo-label generation and refinement, which mitigates the label scarcity problem. Finally, a label correlation alignment module is proposed to capture the co-occurrence information of different CVDs within labeled samples and propagate this information to unlabeled samples. Extensive experiments on four datasets and three protocols demonstrate the effectiveness and stability of the proposed model, especially on unseen datasets. As such, this model can pave the way for diagnostic systems that achieve robust performance on multi-label CVDs prediction with limited supervision.

Deep Representation Learning With Sample Generation and Augmented Attention Module for Imbalanced ECG Classification

Developing an efficient heartbeat monitoring system has become a focal point in numerous healthcare applications. Specifically, in the last few years, heartbeat classification for arrhythmia detection has gained considerable interest from researchers. This paper presents a novel deep representation learning method for the efficient detection of arrhythmic beats. To mitigate the issues associated with the imbalanced data distribution, a novel re-sampling strategy is introduced. Unlike the existing oversampling methods, the proposed technique transforms majority-class samples into minority-class samples with a novel translation loss function. This approach assists the model in learning a more generalized representation of crucially important minority class samples. Moreover, by exploiting an auxiliary feature, an augmented attention module is designed that focuses on the most relevant and target-specific information. We adopted an inter-patient classification paradigm to evaluate the proposed method. The experimental results of this study on the MIT-BIH arrhythmia database clearly indicate that the proposed model with augmented attention mechanism and over-sampling strategy significantly learns a balanced deep representation and improves the classification performance of vital heartbeats.

DenRAM: neuromorphic dendritic architecture with RRAM for efficient temporal processing with delays

An increasing number of studies are highlighting the importance of spatial dendritic branching in pyramidal neurons in the neocortex for supporting non-linear computation through localized synaptic integration. In particular, dendritic branches play a key role in temporal signal processing and feature detection. This is accomplished thanks to coincidence detection (CD) mechanisms enabled by the presence of synaptic delays that align temporally disparate inputs for effective integration. Computational studies on spiking neural networks further highlight the significance of delays for achieving spatio-temporal pattern recognition with pure feed-forward neural networks, without the need of resorting to recurrent architectures. In this work, we present "DenRAM", the first realization of a feed-forward spiking neural network with dendritic compartments, implemented using analog electronic circuits integrated into a 130 nm technology node and coupled with Resistive Random Access Memory (RRAM) technology. DenRAM's dendritic circuits use RRAM devices to implement both delays and synaptic weights in the network. By configuring the RRAM devices to reproduce bio-realistic timescales, and by exploiting their heterogeneity we experimentally demonstrate DenRAM's ability to replicate synaptic delay profiles, and to efficiently implement CD for spatio-temporal pattern recognition. To validate the architecture, we conduct comprehensive system-level simulations on two representative temporal benchmarks, demonstrating DenRAM's resilience to analog hardware noise, and its superior accuracy compared to recurrent architectures with an equivalent number of parameters. DenRAM not only brings rich temporal processing capabilities to neuromorphic architectures, but also reduces the memory footprint of edge devices, warrants high accuracy on temporal benchmarks, and represents a significant step-forward in low-power real-time signal processing technologies.

Cardiac Arrhythmia Classification Using Advanced Deep Learning Techniques on Digitized ECG Datasets

ECG classification or heartbeat classification is an extremely valuable tool in cardiology. Deep learning-based techniques for the analysis of ECG signals assist human experts in the timely diagnosis of cardiac diseases and help save precious lives. This research aims at digitizing a dataset of images of ECG records into time series signals and then applying deep learning (DL) techniques on the digitized dataset. State-of-the-art DL techniques are proposed for the classification of the ECG signals into different cardiac classes. Multiple DL models, including a convolutional neural network (CNN), a long short-term memory (LSTM) network, and a self-supervised learning (SSL)-based model using autoencoders are explored and compared in this study. The models are trained on the dataset generated from ECG plots of patients from various healthcare institutes in Pakistan. First, the ECG images are digitized, segmenting the lead II heartbeats, and then the digitized signals are passed to the proposed deep learning models for classification. Among the different DL models used in this study, the proposed CNN model achieves the highest accuracy of ∼92%. The proposed model is highly accurate and provides fast inference for real-time and direct monitoring of ECG signals that are captured from the electrodes (sensors) placed on different parts of the body. Using the digitized form of ECG signals instead of images for the classification of cardiac arrhythmia allows cardiologists to utilize DL models directly on ECG signals from an ECG machine for the real-time and accurate monitoring of ECGs.

An improved method to detect arrhythmia using ensemble learning-based model in multi lead electrocardiogram (ECG)

Arrhythmia is a life-threatening cardiac condition characterized by irregular heart rhythm. Early and accurate detection is crucial for effective treatment. However, single-lead electrocardiogram (ECG) methods have limited sensitivity and specificity. This study propose an improved ensemble learning approach for arrhythmia detection using multi-lead ECG data. Proposed method, based on a boosting algorithm, namely Fine Tuned Boosting (FTBO) model detects multiple arrhythmia classes. For the feature extraction, introduce a new technique that utilizes a sliding window with a window size of 5 R-peaks. This study compared it with other models, including bagging and stacking, and assessed the impact of parameter tuning. Rigorous experiments on the MIT-BIH arrhythmia database focused on Premature Ventricular Contraction (PVC), Atrial Premature Contraction (PAC), and Atrial Fibrillation (AF) have been performed. The results showed that the proposed method achieved high sensitivity, specificity, and accuracy for all three classes of arrhythmia. It accurately detected Atrial Fibrillation (AF) with 100% sensitivity and specificity. For Premature Ventricular Contraction (PVC) detection, it achieved 99% sensitivity and specificity in both leads. Similarly, for Atrial Premature Contraction (PAC) detection, proposed method achieved almost 96% sensitivity and specificity in both leads. The proposed method shows great potential for early arrhythmia detection using multi-lead ECG data.

Non-Invasive Biosensing for Healthcare Using Artificial Intelligence: A Semi-Systematic Review

The rapid development of biosensing technologies together with the advent of deep learning has marked an era in healthcare and biomedical research where widespread devices like smartphones, smartwatches, and health-specific technologies have the potential to facilitate remote and accessible diagnosis, monitoring, and adaptive therapy in a naturalistic environment. This systematic review focuses on the impact of combining multiple biosensing techniques with deep learning algorithms and the application of these models to healthcare. We explore the key areas that researchers and engineers must consider when developing a deep learning model for biosensing: the data modality, the model architecture, and the real-world use case for the model. We also discuss key ongoing challenges and potential future directions for research in this field. We aim to provide useful insights for researchers who seek to use intelligent biosensing to advance precision healthcare.

Automated cardiac arrhythmia detection techniques: a comprehensive review for prospective approach

Abnormal cardiac functionality produces irregular heart rhythms which are commonly known as arrhythmias. In some conditions, arrhythmias are treated as very dangerous which may lead to sudden cardiac arrest. The incidence and prevalence of cardiac anomalies seeks early detection of arrhythmias using automated classification techniques. In the past, numerous automated arrhythmia detection techniques have been developed that are based on electrocardiogram (ECG) signal analysis. Focusing on the prospective research in this field, this article reports a comprehensive review of existing techniques that are obtained using search engines such as IEEE explore, Google scholar and science direct. Based on the review, the existing techniques are broadly categorized into two types: machine-learning and deep-learning-based techniques. In this study, it is noticed that the performance of the machine-learning-based arrhythmia detection techniques depend on pre-processing of ECG signal, R-peaks detection, features extraction and classification tools while the deep-learning-based techniques do not require the features extraction step. Generally, the existing techniques utilize Massachusetts Institute of Technology-Beth Israel Hospital arrhythmia database to evaluate the classification performance. The classification performance of automated techniques also depends on ECG data used for training and testing of the classifier. It is expected that the performance should be evaluated using a variety of ECG signals including the cases of inter-patient and intra-patient paradigm. The existing techniques also require to deal with the class-imbalance problem. In addition to this, a specific partition-ratio between training and testing datasets should be maintained for fair comparison of performance of different techniques.

ECG-based cardiac arrhythmias detection through ensemble learning and fusion of deep spatial-temporal and long-range dependency features

Cardiac arrhythmia is one of the prime reasons for death globally. Early diagnosis of heart arrhythmia is crucial to provide timely medical treatment. Heart arrhythmias are diagnosed by analyzing the electrocardiogram (ECG) of patients. Manual analysis of ECG is time-consuming and challenging. Hence, effective automated detection of heart arrhythmias is important to produce reliable results. Different deep-learning techniques to detect heart arrhythmias such as Convolutional Neural Network (CNN), Long Short-Term Memory (LSTM), Transformer, and Hybrid CNN-LSTM were proposed. However, these techniques, when used individually, are not sufficient to effectively learn multiple features from the ECG signal. The fusion of CNN and LSTM overcomes the limitations of CNN in the existing studies as CNN-LSTM hybrids can extract spatiotemporal features. However, LSTMs suffer from long-range dependency issues due to which certain features may be ignored. Hence, to compensate for the drawbacks of the existing models, this paper proposes a more comprehensive feature fusion technique by merging CNN, LSTM, and Transformer models. The fusion of these models facilitates learning spatial, temporal, and long-range dependency features, hence, helping to capture different attributes of the ECG signal. These features are subsequently passed to a majority voting classifier equipped with three traditional base learners. The traditional learners are enriched with deep features instead of handcrafted features. Experiments are performed on the MIT-BIH arrhythmias database and the model performance is compared with that of the state-of-art models. Results reveal that the proposed model performs better than the existing models yielding an accuracy of 99.56%.

Multimodal automatic assessment of acute pain through facial videos and heart rate signals utilizing transformer-based architectures

Accurate and objective pain evaluation is crucial in developing effective pain management protocols, aiming to alleviate distress and prevent patients from experiencing decreased functionality. A multimodal automatic assessment framework for acute pain utilizing video and heart rate signals is introduced in this study. The proposed framework comprises four pivotal modules: the Spatial Module, responsible for extracting embeddings from videos; the Heart Rate Encoder, tasked with mapping heart rate signals into a higher dimensional space; the AugmNet, designed to create learning-based augmentations in the latent space; and the Temporal Module, which utilizes the extracted video and heart rate embeddings for the final assessment. The Spatial-Module undergoes pre-training on a two-stage strategy: first, with a face recognition objective learning universal facial features, and second, with an emotion recognition objective in a multitask learning approach, enabling the extraction of high-quality embeddings for the automatic pain assessment. Experiments with the facial videos and heart rate extracted from electrocardiograms of the BioVid database, along with a direct comparison to 29 studies, demonstrate state-of-the-art performances in unimodal and multimodal settings, maintaining high efficiency. Within the multimodal context, 82.74% and 39.77% accuracy were achieved for the binary and multi-level pain classification task, respectively, utilizing 9.62 million parameters for the entire framework.

A Morphology-Preserving Algorithm for Denoising of EMG-Contaminated ECG Signals

Goal: Clinical interpretation of an electrocardiogram (ECG) can be detrimentally affected by noise. Removal of the electromyographic (EMG) noise is particularly challenging due to its spectral overlap with the QRS complex. The existing EMG-denoising algorithms often distort signal morphology, thus obscuring diagnostically relevant information. Methods: Here, a new iterative regeneration method (IRM) for efficient EMG-noise suppression is proposed. The main hypothesis is that the temporary removal of the dominant ECG components enables extraction of the noise with the minimum alteration to the signal. The method is validated on SimEMG database of simultaneously recorded reference and noisy signals, MIT-BIH arrhythmia database and synthesized ECG signals, both with the noise from MIT Noise Stress Test Database. Results: IRM denoising and morphology-preserving performance is superior to the wavelet- and FIR-based benchmark methods. Conclusions: IRM is reliable, computationally non-intensive, fast and applicable to any number of ECG channels recorded by mobile or standard ECG devices.

BioDiffusion: A Versatile Diffusion Model for Biomedical Signal Synthesis

Machine learning tasks involving biomedical signals frequently grapple with issues such as limited data availability, imbalanced datasets, labeling complexities, and the interference of measurement noise. These challenges often hinder the optimal training of machine learning algorithms. Addressing these concerns, we introduce BioDiffusion, a diffusion-based probabilistic model optimized for the synthesis of multivariate biomedical signals. BioDiffusion demonstrates excellence in producing high-fidelity, non-stationary, multivariate signals for a range of tasks including unconditional, label-conditional, and signal-conditional generation. Leveraging these synthesized signals offers a notable solution to the aforementioned challenges. Our research encompasses both qualitative and quantitative assessments of the synthesized data quality, underscoring its capacity to bolster accuracy in machine learning tasks tied to biomedical signals. Furthermore, when juxtaposed with current leading time-series generative models, empirical evidence suggests that BioDiffusion outperforms them in biomedical signal generation quality.

Quantifying the Suitability of Biosignals Acquired During Surgery for Multimodal Analysis

Goal: Recently, large datasets of biosignals acquired during surgery became available. As they offer multiple physiological signals measured in parallel, multimodal analysis - which involves their joint analysis - can be conducted and could provide deeper insights than unimodal analysis based on a single signal. However, it is unclear what percentage of intraoperatively acquired data is suitable for multimodal analysis. Due to the large amount of data, manual inspection and labelling into suitable and unsuitable segments are not feasible. Nevertheless, multimodal analysis is performed successfully in sleep studies since many years as their signals have proven suitable. Hence, this study evaluates the suitability to perform multimodal analysis on a surgery dataset (VitalDB) using a multi-center sleep dataset (SIESTA) as reference. Methods: We applied widely known algorithms entitled "signal quality indicators" to the common biosignals in both datasets, namely electrocardiography, electroencephalography, and respiratory signals split in segments of 10 s duration. As there are no multimodal methods available, we used only unimodal signal quality indicators. In case, all three signals were determined as being adequate by the indicators, we assumed that the whole signal segment was suitable for multimodal analysis. Results: 82% of SIESTA and 72% of VitalDB are suitable for multimodal analysis. Unsuitable signal segments exhibit constant or physiologically unreasonable values. Histogram examination indicated similar signal quality distributions between the datasets, albeit with potential statistical biases due to different measurement setups. Conclusions: The majority of data within VitalDB is suitable for multimodal analysis.

Enhancing ECG classification with continuous wavelet transform and multi-branch transformer

Background

Accurate classification of electrocardiogram (ECG) signals is crucial for automatic diagnosis of heart diseases. However, existing ECG classification methods often require complex preprocessing and denoising operations, and traditional convolutional neural network (CNN)-based methods struggle to capture complex relationships and high-level time-series features.

Method

In this study, we propose an ECG classification method based on continuous wavelet transform and multi-branch transformer. The method utilizes continuous wavelet transform (CWT) to convert the ECG signal into time-series feature map, eliminating the need for complicated preprocessing. Additionally, the multi-branch transformer is introduced to enhance feature extraction during model training and improve classification performance by removing redundant information while preserving important features.

Results

The proposed method was evaluated on the CPSC 2018 (6877 cases) and MIT-BIH (47 cases) ECG public datasets, achieving an accuracy of 98.53% and 99.38%, respectively, with F1 scores of 97.57% and 98.65%. These results outperformed most existing methods, demonstrating the excellent performance of the proposed method.

Conclusion

The proposed method accurately classifies the ECG time-series feature map, which holds promise for the diagnosis of cardiac arrhythmias. The findings of this study are valuable for advancing the field of automatic ECG diagnosis.

Analyzing ECG signals in professional football players using machine learning techniques

Background

Football player's health is important, and preventing sudden cardiac arrest may be a critical issue. Professional football players have different ECG signals than the average population, yet there are considerable gaps in study whereas the general population has been extensively studied.

Objectives

(a) Generate a reference and innovative resting 12-lead ECG database from 54 UEFA PRO level male football players from La Liga. This is a novel approach to cope the ECG and possible arrythmias in athletes. (b) Manage each XML athlete ECG data and develop a free-use program to visualize, denoise and filter the signal with the capacity to automate the labelling of the waves and save the reports. (c) Study the ECG wave shape and generate models through ML to analyse its utility to automate basic diagnosis.

Methods

The dataset collection is based on a prospective observational cohort and includes 10 s, 12-lead ECGs and rhythm and condition labels for each athlete. Physiological sport arrhythmias, T-Wave shape and other findings were studied and labelled. ECG Visualizer was developed and used for 3 machine learning (ML) methods to automate sinus bradycardia arrhythmia diagnosis.

Results

A dataset with 163 ECGs in XML format was collected comprising the Pro Football 12-lead Resting Electrocardiogram Database (PF12RED). "ECG Visualizer" software was developed, and ML was shown to be useful in detecting sinus bradycardia.

Conclusions

The study demonstrates that AI and machine learning can detect simple arrhythmias with accuracy, also it provides a valuable dataset and a free software application.

A new approach for heart disease detection using Motif transform-based CWT's time-frequency images with DenseNet deep transfer learning methods

OBJECTIVES

Electrocardiogram (ECG) signals are extensively utilized in the identification and assessment of diverse cardiac conditions, including congestive heart failure (CHF) and cardiac arrhythmias (ARR), which present potential hazards to human health. With the aim of facilitating disease diagnosis and assessment, advanced computer-aided systems are being developed to analyze ECG signals.

METHODS

This study proposes a state-of-the-art ECG data pattern recognition algorithm based on Continuous Wavelet Transform (CWT) as a novel signal preprocessing model. The Motif Transformation (MT) method was devised to diminish the drawbacks and limitations inherent in the CWT, such as the issue of boundary effects, limited localization in time and frequency, and overfitting conditions. This transformation technique facilitates the formation of diverse patterns (motifs) within the signals. The patterns (motifs) are constructed by comparing the amplitudes of each individual sample value in the ECG signals in terms of their largeness and smallness. In the subsequent stage, the obtained one-dimensional signals from the MT transformation were subjected to CWT to obtain scalogram images. In the last stage, the obtained scalogram images were subjected to classification using DenseNET deep transfer learning techniques.

RESULTS AND CONCLUSIONS

The combined approach of MT + CWT + DenseNET yielded an impressive success rate of 99.31 %.

Towards federated transfer learning in electrocardiogram signal analysis

Modern methods in artificial intelligence perform very well on many healthcare datasets, at times outperforming trained doctors. However, many assumptions made in model training are not justifiable in clinical settings. In this work, we propose a method to train classifiers for electrocardiograms, able to deal with data of disparate input dimensions, distributed across different institutions, and able to protect patient privacy. In addition, we propose a simple method for creating federated datasets from any centralized dataset. We use autoencoders in conjunction with federated learning to model a highly heterogeneous modeling problem using the Massachusetts Institute of Technology Beth Israel Hospital Arrhythmia dataset, the Computing in Cardiology 2017 challenge dataset, and the PTB-XL dataset. For an encoding dimension of 1000, our federated classifier achieves an accuracy, precision, recall, and F1 score of 73.0%, 66.6%, 73.0%, and 69.7%, respectively. Our results suggest that dropping commonly made assumptions significantly complicate training and that as a result, estimates of performance of many machine learning models may overestimate performance when adopted for clinical settings.

CLINet: A novel deep learning network for ECG signal classification

Machine learning is poised to revolutionize medicine with algorithms that spot cardiac arrhythmia. An automated diagnostic approach can boost the efficacy of diagnosing life-threatening arrhythmia disorders in routine medical procedures. In this paper, we propose a deep learning network CLINet for ECG signal classification. Our network uses convolution, LSTM and involution layers to bring their unique advantages together. For both convolution and involution layers, we use multiple, large size kernels for multi-scale representation learning. CLINet does not require complicated pre-processing and can handle electrocardiograms of any length. Our network achieves 99.90% accuracy on the ICCAD dataset and 99.94% accuracy on the MIT-BIH dataset. With only 297 K parameters, our model can be easily embedded in smart wearable devices. The source code of CLINet is available at https://github.com/CandleLabAI/CLINet-ECG-Classification-2024.

Improving deep-learning electrocardiogram classification with an effective coloring method

Cardiovascular diseases, particularly arrhythmias, remain a leading cause of mortality worldwide. Electrocardiogram (ECG) analysis plays a pivotal role in cardiovascular disease diagnosis. Although previous studies have focused on waveform analysis and model training, integrating additional clinical information, especially demographic data, remains challenging. In this study, we present an innovative approach to ECG classification by incorporating demographic information from patients' medical histories through a colorization technique. Our proposed method maps demographic features onto the (R, G, B) color space through normalized scaling. Each demographic feature corresponds to a distinct color, allowing for different ECG leads to be colored. This approach preserves the relationships between data by maintaining the color correlations in the statistical features, enhancing ECG analytics and supporting precision medicine. We conducted experiments with PTB-XL dataset and achieved 1%-6% improvements in the area under the receiving operator characteristic curve performance compared with other methods for various classification problems. Notably, our method excelled in multiclass and challenging classification tasks. The combined use of color features and the original waveform shape features enhanced prediction accuracy for various deep learning models. Our findings suggest that colorization is a promising avenue for advancing ECG classification and diagnosis, contributing to improved prediction and diagnosis of cardiovascular diseases and ultimately enhancing clinical outcomes.

Cardiologist-level interpretable knowledge-fused deep neural network for automatic arrhythmia diagnosis

BACKGROUND

Long-term monitoring of Electrocardiogram (ECG) recordings is crucial to diagnose arrhythmias. Clinicians can find it challenging to diagnose arrhythmias, and this is a particular issue in more remote and underdeveloped areas. The development of digital ECG and AI methods could assist clinicians who need to diagnose arrhythmias outside of the hospital setting.

METHODS

We constructed a large-scale Chinese ECG benchmark dataset using data from 272,753 patients collected from January 2017 to December 2021. The dataset contains ECG recordings from all common arrhythmias present in the Chinese population. Several experienced cardiologists from Shanghai First People's Hospital labeled the dataset. We then developed a deep learning-based multi-label interpretable diagnostic model from the ECG recordings. We utilized Accuracy, F1 score and AUC-ROC to compare the performance of our model with that of the cardiologists, as well as with six comparison models, using testing and hidden data sets.

RESULTS

The results show that our approach achieves an F1 score of 83.51%, an average AUC ROC score of 0.977, and 93.74% mean accuracy for 6 common arrhythmias. Results from the hidden dataset demonstrate the performance of our approach exceeds that of cardiologists. Our approach also highlights the diagnostic process.

CONCLUSIONS

Our diagnosis system has superior diagnostic performance over that of clinicians. It also has the potential to help clinicians rapidly identify abnormal regions on ECG recordings, thus improving efficiency and accuracy of clinical ECG diagnosis in China. This approach could therefore potentially improve the productivity of out-of-hospital ECG diagnosis and provides a promising prospect for telemedicine.

Convolutional transformer-driven robust electrocardiogram signal denoising framework with adaptive parametric ReLU

The electrocardiogram (ECG) is a widely used diagnostic tool for cardiovascular diseases. However, ECG recording is often subject to various noises, which can limit its clinical evaluation. To address this issue, we propose a novel Transformer-based convolutional neural network framework with adaptively parametric ReLU (APtrans-CNN) for ECG signal denoising. The proposed APtrans-CNN architecture combines the strengths of transformers in global feature learning and CNNs in local feature learning to address the inadequacy of learning with long sequence time-series features. By fully exploiting the global features of ECG signals, our framework can effectively extract critical information that is necessary for signal denoising. We also introduce an adaptively parametric ReLU that can assign a value to the negative information contained in the ECG signal, thereby overcoming the limitation of ReLU to retain negative information. Additionally, we introduce a dynamic feature aggregation module that enables automatic learning and retention of valuable features while discarding useless noise information. Results obtained from two datasets demonstrate that our proposed APtrans-CNN can accurately extract pure ECG signals from noisy datasets and is adaptable to various applications. Specifically, when the input consists of ECG signals with a signal-to-noise ratio (SNR) of -4 dB, APtrans-CNN successfully increases the SNR to more than 6 dB, resulting in the diagnostic model's accuracy exceeding 96%.

Person identification with arrhythmic ECG signals using deep convolution neural network

Over the past decade, the use of biometrics in security systems and other applications has grown in popularity. ECG signals in particular are attracting increased attention due to their characteristics, which are required for a trustworthy identification system. The majority of ECG-based person identification systems are evaluated without considering the health-state of the individuals. Few person identification systems consider person-by-person health-state annotation. This paper proposes a person identification system considering the health-state annotated ECG signals where each person's beats overlap among variant arrhythmia classes. This overlapping between the normal class and other arrhythmia classes grants the ability to isolate normal beats in the train set from the Arrhythmic beats in the test set. Therefore, this paper investigates the effect of arrhythmic heartbeats on biometric recognition. An effective lightweight CNN based on depth-wise separable convolution (DWSC) is proposed to enhance the performance of person identification for several common arrhythmia types using the MITBIH dataset. The proposed methodology has been tested on nine arrhythmia types and presents how different types of arrhythmia affect ECG-based biometric systems differently. The experimental results show excellent recognition performance (99.28%) on normal heartbeats and (93.81%) on arrhythmic heartbeats, outperforming other models in terms of mean accuracy.

Enhanced multimodal biometric recognition systems based on deep learning and traditional methods in smart environments

In the field of data security, biometric security is a significant emerging concern. The multimodal biometrics system with enhanced accuracy and detection rate for smart environments is still a significant challenge. The fusion of an electrocardiogram (ECG) signal with a fingerprint is an effective multimodal recognition system. In this work, unimodal and multimodal biometric systems using Convolutional Neural Network (CNN) are conducted and compared with traditional methods using different levels of fusion of fingerprint and ECG signal. This study is concerned with the evaluation of the effectiveness of proposed parallel and sequential multimodal biometric systems with various feature extraction and classification methods. Additionally, the performance of unimodal biometrics of ECG and fingerprint utilizing deep learning and traditional classification technique is examined. The suggested biometric systems were evaluated utilizing ECG (MIT-BIH) and fingerprint (FVC2004) databases. Additional tests are conducted to examine the suggested models with:1) virtual dataset without augmentation (ODB) and 2) virtual dataset with augmentation (VDB). The findings show that the optimum performance of the parallel multimodal achieved 0.96 Area Under the ROC Curve (AUC) and sequential multimodal achieved 0.99 AUC, in comparison to unimodal biometrics which achieved 0.87 and 0.99 AUCs, for the fingerprint and ECG biometrics, respectively. The overall performance of the proposed multimodal biometrics outperformed unimodal biometrics using CNN. Moreover, the performance of the suggested CNN model for ECG signal and sequential multimodal system based on neural network outperformed other systems. Lastly, the performance of the proposed systems is compared with previously existing works.

ECG data enhancement method using generate adversarial networks based on Bi-LSTM and CBAM

Objective.The classification performance of electrocardiogram (ECG) classification algorithms is easily affected by data imbalance, which often leads to poor model prediction performance for a few classes and a consequent decrease in the overall performance of the model.Approach.To address this problem, this paper proposed an ECG data augmentation method based on a generative adversarial network (GAN) that combines bidirectional long short-term memory (Bi-LSTM) networks and convolutional block attention mechanism (CBAM) to improve the overall performance of ECG classification models. In this paper, we used two ECG databases, namely the MIT-BIH arrhythmia (MIT-BIH-AR) database and the Chinese cardiovascular disease database (CCDD). The quality of the ECG signals produced by the generated models was assessed using the percent relative difference, root mean square error, Frechet distance, dynamic time warping (DTW), and Pearson correlation metrics. In addition, we also validated the impact of our proposed data augmentation method on ECG classification performance on MIT-BIH-AR database and CCDD.Main results.On the MIT-BIH-AR database, the overall accuracy of the data-enhanced balanced dataset was improved to 99.46% for 15 types of heartbeat classification task. On the CCDD, which focuses on the detection of ventricular precession (PVC), the overall accuracy of PVC detection improved to 99.15% after performing data enhancement.Significance.The experimental results indicate that the data augmentation method proposed in this paper can further improve the ECG classification performance.

Towards Flexible and Low-Power Wireless Smart Sensors: Reconfigurable Analog-to-Feature Conversion for Healthcare Applications

Analog-to-feature (A2F) conversion based on non-uniform wavelet sampling (NUWS) has demonstrated the ability to reduce energy consumption in wireless sensors while employed for electrocardiogram (ECG) anomaly detection. The technique involves extracting only relevant features for a given task directly from analog signals and conducting classification in the digital domain. Building on this approach, we extended the application of the proposed generic A2F converter to address a human activity recognition (HAR) task. The performed simulations include the training and evaluation of neural network (NN) classifiers built for each application. The corresponding results enabled the definition of valuable features and the hardware specifications for the ongoing complete circuit design. One of the principal elements constituting the developed converter, the integrator brought from the state-of-the-art design, was modified and simulated at the circuit level to meet our requirements. The revised value of its power consumption served to estimate the energy spent by the communication chain with the A2F converter. It consumes at least 20 and 5 times less than the chain employing the Nyquist approach in arrhythmia detection and HAR tasks, respectively. This fact highlights the potential of A2F conversion with NUWS in achieving flexible and energy-efficient sensor systems for diverse applications.

ECG arrhythmia detection in an inter-patient setting using Fourier decomposition and machine learning

ECG beat classification or arrhythmia detection through artificial intelligence (AI) is an active topic of research. It is vital to recognize and detect the type of arrhythmia for monitoring cardiac abnormalities. The AI-based ECG beat classification algorithms proposed in the literature suffer from two main drawbacks. Firstly, some of the works have not considered any unseen test data to validate the performance of their algorithms. Secondly, the accuracy of detecting superventricular ectopic beats (SVEB) needs to be improved. In this work, we address these issues by considering an inter-patient paradigm where the test dataset is collected from a different set of subjects than the training data. Also, the proposed methodology detects SVEB with an F1 score of 89.35%, which is better than existing algorithms. We have used the Fourier decomposition method (FDM) for multi-scale analysis of ECG signals and extracted time-domain and statistical features from the narrow-band signal components obtained using FDM. Feature selection techniques, including the Kruskal-Wallis test and minimum redundancy maximum relevance (mRMR) have been used to select only the relevant features and rank these features to remove any redundancy. Since the dataset used is highly imbalanced, Mathew's correlation coefficient (MCC) has also been used to analyze the performance of the proposed method. Support vector machine classifier with linear kernel achieves an overall 98.03% accuracy and 91.84% MCC for the MIT-BIH arrhythmia dataset.

ECG Signal Denoising Using an Improved Hybrid DWT-ADTF Approach

PURPOSE

The electrocardiogram signal (ECG) presents a fundamental source of information to consider for the diagnosis of a heart condition. Given its low-frequency features, this signal is quite susceptible to various noise and interference sources. This paper presents an improved hybrid approach to ECG signal denoising based on the DWT and the ADTF methods.

METHODS

The proposed improvements consist of integrating an adaptive [Formula: see text] parameter into the ADTF approach, combining a soft thresholding ADTF-based process with the DWT details, along with employing the mean filter to handle the baseline wandering noise. Furthermore, the proposed approach incorporates several denoising measures based on various proposed noise features, which have also been introduced in this approach. Several real noises collected from the Noise Stress Test Database (NSTDB), as well as several synthetic noises at different SNR levels, are proposed to ensure a thorough assessment of the proposed method's performance.

RESULTS

The evaluation focuses on the SN Rimp, PRD, and MSE parameters, as well as the SINAD parameter as a diagnostic distortion measurement. Furthermore, a time complexity evaluation is proposed. The proposed approach demonstrated promising results compared to a recent hybridization of the DWT and ADTF methods, as well as recently published ECG signal denoising-based approaches in various real and synthetic noise cases using different statistical evaluation metrics.

CONCLUSION

In the vast majority of the study cases, the proposed approach outperforms the compared methods in terms of statistical results for real and synthetic noises. Furthermore, compared to these methods, it provides a fairly low time complexity. This is consistent with the ambition of embedding this approach in low-cost hardware architectures.

Accurate wavelet thresholding method for ECG signals

Current wavelet thresholding methods for cardiogram signals captured by flexible wearable sensors face a challenge in achieving both accurate thresholding and real-time signal denoising. This paper proposes a real-time accurate thresholding method based on signal estimation, specifically the normalized ACF, as an alternative to traditional noise estimation without the need for parameter fine-tuning and extensive data training. This method is experimentally validated using a variety of electrocardiogram (ECG) signals from different databases, each containing specific types of noise such as additive white Gaussian (AWG) noise, baseline wander noise, electrode motion noise, and muscle artifact noise. Although this method only slightly outperforms other methods in removing AWG noise in ECG signals, it far outperforms conventional methods in removing other real noise. This is attributed to the method's ability to accurately distinguish not only AWG noise that is significantly different spectrum of the ECG signal, but also real noise with similar spectra. In contrast, the conventional methods are effective only for AWG noise. In additional, this method improves the denoising visualization of the measured ECG signals and can be used to optimize other parameters of other wavelet methods to enhancing the denoised periodic signals, thereby improving diagnostic accuracy.

ECG Forecasting System Based on Long Short-Term Memory

Worldwide, cardiovascular diseases are some of the primary causes of death; yet the early detection and diagnosis of such diseases have the potential to save many lives. Technological means of detection are becoming increasingly essential and numerous techniques have been created for this purpose, such as forecasting. Of these techniques, the time series forecasting technique seeks to predict future events. The long-term time series forecasting of physiological data could assist medical professionals in predicting and treating patients based on very early diagnosis. This article presents a model that utilizes a deep learning technique to predict long-term ECG signals. The forecasting model can learn signals' nonlinearity, nonstationarity, and complexity based on a long short-term memory architecture. However, this is not a trivial task as the correct forecasting of a signal that closely resembles the original complex signal's structure and behavior while minimizing any differences in amplitude continues to pose challenges. To achieve this goal, we used a dataset available on the Physio net database, called MIT-BIH, with 48 ECG recordings of 30 min each. The developed model starts with pre-processing to reduce interference in the original signals, then applies a deep learning algorithm, based on a long short-term memory (LTSM) neural network with two hidden layers. Next, we applied the root mean square error (RMSE) and mean absolute error (MAE) metrics to evaluate the performance of the model and obtained an average RMSE of 0.0070±0.0028 and an average MAE of 0.0522±0.0098 across all simulations. The results indicate that the proposed LSTM model is a promising technique for ECG forecasting, considering the trends of the changes in the original data series, most notably in R-peak amplitude. Given the model's accuracy and the features of the physiological signals, the system could be used to improve existing predictive healthcare systems for cardiovascular monitoring.

Continual Learning with Deep Neural Networks in Physiological Signal Data: A Survey

Deep-learning algorithms hold promise in processing physiological signal data, including electrocardiograms (ECGs) and electroencephalograms (EEGs). However, healthcare often requires long-term monitoring, posing a challenge to traditional deep-learning models. These models are generally trained once and then deployed, which limits their ability to adapt to the dynamic and evolving nature of healthcare scenarios. Continual learning-known for its adaptive learning capabilities over time-offers a promising solution to these challenges. However, there remains an absence of consolidated literature, which reviews the techniques, applications, and challenges of continual learning specific to physiological signal analysis, as well as its future directions. Bridging this gap, our review seeks to provide an overview of the prevailing techniques and their implications for smart healthcare. We delineate the evolution from traditional approaches to the paradigms of continual learning. We aim to offer insights into the challenges faced and outline potential paths forward. Our discussion emphasizes the need for benchmarks, adaptability, computational efficiency, and user-centric design in the development of future healthcare systems.

A pooling convolution model for multi-classification of ECG and PCG signals

Electrocardiogram (ECG) and phonocardiogram (PCG) signals are physiological signals generated throughout the cardiac cycle. The application of deep learning techniques to recognize ECG and PCG signals can greatly enhance the efficiency of cardiovascular disease detection. Therefore, we propose a series of straightforward and effective pooling convolutional models for the multi-classification of ECG and PCG signals. Initially, these signals undergo preprocessing. Subsequently, we design various structural blocks, including a stacked block (MCM) comprising convolutional layer and max-pooling layers, along with its variations, as well as a residual block (REC). By adjusting the number of structural blocks, these models can handle ECG and PCG data with different sampling rates. In the final tests, the models utilizing the MCM structural block achieved accuracies of 98.70 and 92.58% on the ECG and PCG fusion datasets, respectively. These accuracies surpass those of all networks utilizing its variations. Moreover, compared to the models employing the REC structural block, the accuracies are improved by 0.02 and 4.30%, respectively. Furthermore, this research has been validated through tests conducted on multiple ECG and PCG datasets, along with comparisons to other published literature. To further validate the generalizability of the model, an additional experiment involving the classification of a synchronized ECG-PCG dataset was conducted. This dataset is divided into seven different levels of fatigue based on the amount of exercise performed by each healthy subject during the testing process. The results indicate that the model using the MCM block also achieved the highest accuracy.

Mosaic: in-memory computing and routing for small-world spike-based neuromorphic systems

The brain's connectivity is locally dense and globally sparse, forming a small-world graph-a principle prevalent in the evolution of various species, suggesting a universal solution for efficient information routing. However, current artificial neural network circuit architectures do not fully embrace small-world neural network models. Here, we present the neuromorphic Mosaic: a non-von Neumann systolic architecture employing distributed memristors for in-memory computing and in-memory routing, efficiently implementing small-world graph topologies for Spiking Neural Networks (SNNs). We've designed, fabricated, and experimentally demonstrated the Mosaic's building blocks, using integrated memristors with 130 nm CMOS technology. We show that thanks to enforcing locality in the connectivity, routing efficiency of Mosaic is at least one order of magnitude higher than other SNN hardware platforms. This is while Mosaic achieves a competitive accuracy in a variety of edge benchmarks. Mosaic offers a scalable approach for edge systems based on distributed spike-based computing and in-memory routing.

AttentionCovidNet: Efficient ECG-based diagnosis of COVID-19

The novel coronavirus caused a worldwide pandemic. Rapid detection of COVID-19 can help reduce the spread of the novel coronavirus as well as the burden on healthcare systems worldwide. The current method of detecting COVID-19 suffers from low sensitivity, with estimates of 50%-70% in clinical settings. Therefore, in this study, we propose AttentionCovidNet, an efficient model for the detection of COVID-19 based on a channel attention convolutional neural network for electrocardiograms. The electrocardiogram is a non-invasive test, and so can be more easily obtained from a patient. We show that the proposed model achieves state-of-the-art results compared to recent models in the field, achieving metrics of 0.993, 0.997, 0.993, and 0.995 for accuracy, precision, recall, and F1 score, respectively. These results indicate both the promise of the proposed model as an alternative test for COVID-19, as well as the potential of ECG data as a diagnostic tool for COVID-19.

Variable Projection Support Vector Machines and Some Applications Using Adaptive Hermite Expansions

In this paper, we develop the so-called variable projection support vector machine (VP-SVM) algorithm that is a generalization of the classical SVM. In fact, the VP block serves as an automatic feature extractor to the SVM, which are trained simultaneously. We consider the primal form of the arising optimization task and investigate the use of nonlinear kernels. We show that by choosing the so-called adaptive Hermite function system as the basis of the orthogonal projections in our classification scheme, several real-world signal processing problems can be successfully solved. In particular, we test the effectiveness of our method in two case studies corresponding to anomaly detection. First, we consider the detection of abnormal peaks in accelerometer data caused by sensor malfunction. Then, we show that the proposed classification algorithm can be used to detect abnormalities in ECG data. Our experiments show that the proposed method produces comparable results to the state-of-the-art while retaining desired properties of SVM classification such as light weight architecture and interpretability. We implement the proposed method on a microcontroller and demonstrate its ability to be used for real-time applications. To further minimize computational cost, discrete orthogonal adaptive Hermite functions are introduced for the first time.

Automatic segmentation of atrial fibrillation and flutter in single-lead electrocardiograms by self-supervised learning and Transformer architecture

OBJECTIVES

Automatic detection of atrial fibrillation and flutter (AF/AFL) is a significant concern in preventing stroke and mitigating hemodynamic instability. Herein, we developed a Transformer-based deep learning model for AF/AFL segmentation in single-lead electrocardiograms (ECGs) by self-supervised learning with masked signal modeling (MSM).

MATERIALS AND METHODS

We retrieved data from 11 open-source databases on PhysioNet; 7 of these databases included labeled ECGs, while the other 4 were without labels. Each database contained ECG recordings with durations of ≥30 s. A total of 24 intradialytic ECGs with paroxysmal AF/AFL during 4 h of hemodialysis sessions at Seoul National University Hospital were used for external validation. The model was pretrained by predicting masked areas of ECG signals and fine-tuned by predicting AF/AFL areas. Cross-database validation was used for evaluation, and the intersection over union (IOU) was used as a main performance metric in external database validation.

RESULTS

In the 7 labeled databases, the areas marked as AF/AFL constituted 41.1% of the total ECG signals, ranging from 0.19% to 51.31%. In the evaluation per ECG segment, the model achieved IOU values of 0.9254 and 0.9477 for AF/AFL segmentation and other segmentation tasks, respectively. When applied to intradialytic ECGs with paroxysmal AF/AFL, the IOUs for the segmentation of AF/AFL and non-AF/AFL were 0.9896 and 0.9650, respectively. Model performance by different training procedure indicated that pretraining with MSM and the application of an appropriate masking ratio both contributed to the model performance. It also showed higher IOUs of AF/AFL labels than in previous studies when training and test databases were matched.

CONCLUSION

The present model with self-supervised learning by MSM performs robustly in segmenting AF/AFL.

AutoMLP: A Framework for the Acceleration of Multi-Layer Perceptron Models on FPGAs for Real-Time Atrial Fibrillation Disease Detection

Cardiovascular diseases are a leading cause of death globally, and atrial fibrillation (AF) is a common arrhythmia that affects many people. Detecting AF in real-time using hardware acceleration can prompt timely medical intervention. Multi-layer perceptron (MLP) has demonstrated the ability to detect AF accurately. However, implementing MLP on Field-Programmable Gate Array (FPGA) for real-time detection poses challenges due to the complex hardware design requirements. This study presents a novel framework for generating hardware accelerators to detect AF in real-time using MLP on FPGA. The framework automates evaluating MLP model topology, data type, and bit-widths to generate parallel acceleration. The generated solutions are evaluated using two AF datasets, PhysioNet MIT-BIH atrial fibrillation (AFDB) and China Physiological Signal Challenge 2018 (CPSC2018), regarding execution time, resource utilization, and accuracy. The evaluation results demonstrate that the hardware MLP can achieve a speedup higher than 1500× and around 25000× lower energy consumption than an embedded CPU. These satisfactory results prove the framework's suitability and convenience for the online detection of AF in an accelerated and automatic way through FPGA hardware implementation.

Deep Generative Models: The winning key for large and easily accessible ECG datasets?

Large high-quality datasets are essential for building powerful artificial intelligence (AI) algorithms capable of supporting advancement in cardiac clinical research. However, researchers working with electrocardiogram (ECG) signals struggle to get access and/or to build one. The aim of the present work is to shed light on a potential solution to address the lack of large and easily accessible ECG datasets. Firstly, the main causes of such a lack are identified and examined. Afterward, the potentials and limitations of cardiac data generation via deep generative models (DGMs) are deeply analyzed. These very promising algorithms have been found capable not only of generating large quantities of ECG signals but also of supporting data anonymization processes, to simplify data sharing while respecting patients' privacy. Their application could help research progress and cooperation in the name of open science. However several aspects, such as a standardized synthetic data quality evaluation and algorithm stability, need to be further explored.

Patient Confidential Data Hiding and Transmission System Using Amplitude Quantization in the Frequency Domain of ECG Signals

The transform domain provides a useful tool in the field of confidential data hiding and protection. In order to protect and transmit patients' information and competence, this study develops an amplitude quantization system in a transform domain by hiding patients' information in an electrocardiogram (ECG). In this system, we first consider a non-linear model with a hiding state switch to enhance the quality of the hidden ECG signals. Next, we utilize particle swarm optimization (PSO) to solve the non-linear model so as to have a good signal-to-noise ratio (SNR), root mean square error (RMSE), and relative root mean square error (rRMSE). Accordingly, the distortion of the shape in each ECG signal is tiny, while the hidden information can fulfill the needs of physiological diagnostics. The extraction of hidden information is reversely similar to a hiding procedure without primary ECG signals. Preliminary outcomes confirm the effectiveness of our proposed method, especially an Amplitude Similarity of almost 1, an Interval RMSE of almost 0, and SNRs all above 30.

ECG-CL: A Comprehensive Electrocardiogram Interpretation Method Based on Continual Learning

The value of Electrocardiogram (ECG) monitoring in early cardiovascular disease (CVD) detection is undeniable, especially with the aid of intelligent wearable devices. Despite this, the requirement for expert interpretation significantly limits public accessibility, underscoring the need for advanced diagnosis algorithms. Deep learning-based methods represent a leap beyond traditional rule-based algorithms, but they are not without challenges such as small databases, inefficient use of local and global ECG information, high memory requirements for deploying multiple models, and the absence of task-to-task knowledge transfer. In response to these challenges, we propose a multi-resolution model adept at integrating local morphological characteristics and global rhythm patterns seamlessly. We also introduce an innovative ECG continual learning (ECG-CL) approach based on parameter isolation, designed to enhance data usage effectiveness and facilitate inter-task knowledge transfer. Our experiments, conducted on four publicly available databases, provide evidence of our proposed continual learning method's ability to perform incremental learning across domains, classes, and tasks. The outcome showcases our method's capability in extracting pertinent morphological and rhythmic features from ECG segmentation, resulting in a substantial enhancement of classification accuracy. This research not only confirms the potential for developing comprehensive ECG interpretation algorithms based on single-lead ECGs but also fosters progress in intelligent wearable applications. By leveraging advanced diagnosis algorithms, we aspire to increase the accessibility of ECG monitoring, thereby contributing to early CVD detection and ultimately improving healthcare outcomes.

The asymptotic distribution of the permutation entropy

Ordinal patterns serve as a robust symbolic transformation technique, enabling the unveiling of latent dynamics within time series data. This methodology involves constructing histograms of patterns, followed by the calculation of both entropy and statistical complexity-an avenue yet to be fully understood in terms of its statistical properties. While asymptotic results can be derived by assuming a multinomial distribution for histogram proportions, the challenge emerges from the non-independence present in the sequence of ordinal patterns. Consequently, the direct application of the multinomial assumption is questionable. This study focuses on the computation of the asymptotic distribution of permutation entropy, considering the inherent patterns' correlation structure. Furthermore, the research delves into a comparative analysis, pitting this distribution against the entropy derived from a multinomial law. We present simulation algorithms for sampling time series with prescribed histograms of patterns and transition probabilities between them. Through this analysis, we better understand the intricacies of ordinal patterns and their statistical attributes.

Enhancing the performance of premature ventricular contraction detection in unseen datasets through deep learning with denoise and contrast attention module

Premature ventricular contraction (PVC) is a common and harmless cardiac arrhythmia that can be asymptomatic or cause palpitations and chest pain in rare instances. However, frequent PVCs can lead to more serious arrhythmias, such as atrial fibrillation. Several PVC detection models have been proposed to enable early diagnosis of arrhythmias; however, they lack reliability and generalizability due to the variability of electrocardiograms across different settings and noise levels. Such weaknesses are known to aggravate with new data. Therefore, we present a deep learning model with a novel attention mechanism that can detect PVC accurately, even on unseen electrocardiograms with various noise levels. Our method, called the Denoise and Contrast Attention Module (DCAM), is a two-step process that denoises signals with a convolutional neural network (CNN) in the frequency domain and attends to differences. It focuses on differences in the morphologies and intervals of the remaining beats, mimicking how trained clinicians identify PVCs. Using three different encoder types, we evaluated 1D U-Net with DCAM on six external test datasets. The results showed that DCAM significantly improved the F1-score of PVC detection performance on all six external datasets and enhanced the performance of balancing both the sensitivity and precision of the models, demonstrating its robustness and generalization ability regardless of the encoder type. This demonstrates the need for a trainable denoising process before applying the attention mechanism. Our DCAM could contribute to the development of a reliable algorithm for cardiac arrhythmia detection under real clinical electrocardiograms.

Quantum conditional generative adversarial network based on patch method for abnormal electrocardiogram generation

To address the scarcity and class imbalance of abnormal electrocardiogram (ECG) databases, which are crucial in AI-driven diagnostic tools for potential cardiovascular disease detection, this study proposes a novel quantum conditional generative adversarial algorithm (QCGAN-ECG) for generating abnormal ECG signals. The QCGAN-ECG constructs a quantum generator based on patch method. In this method, each sub-generator generates distinct features of abnormal heartbeats in different segments. This patch-based generative algorithm conserves quantum resources and makes QCGAN-ECG practical for near-term quantum devices. Additionally, QCGAN-ECG introduces quantum registers as control conditions. It encodes information about the types and probability distributions of abnormal heartbeats into quantum registers, rendering the entire generative process controllable. Simulation experiments on Pennylane demonstrated that the QCGAN-ECG could generate completely abnormal heartbeats with an average accuracy of 88.8%. Moreover, the QCGAN-ECG can accurately fit the probability distribution of various abnormal ECG data. In the anti-noise experiments, the QCGAN-ECG showcased outstanding robustness across various levels of quantum noise interference. These results demonstrate the effectiveness and potential applicability of the QCGAN-ECG for generating abnormal ECG signals, which will further promote the development of AI-driven cardiac disease diagnosis systems. The source code is available at github.com/VanSWK/QCGAN_ECG.

Electrocardiogram signal compression using adaptive tunable-Q wavelet transform and modified dead-zone quantizer

The electrocardiogram (ECG) signals are commonly used to identify heart complications. These recordings generate large data that needed to be stored or transferred in telemedicine applications, which require more storage space and bandwidth. Therefore, a strong motivation is present to develop efficient compression algorithms for ECG signals. In the above context, this work proposes a novel compression algorithm using adaptive tunable-Q wavelet transform (TQWT) and modified dead-zone quantizer (DZQ). The parameters of TQWT and threshold values of DZQ are selected using the proposed Sparse-grey wolf optimization (Sparse-GWO) algorithm. The Sparse-GWO is proposed in this work to reduce the computation time of the original GWO. Moreover, it is also compared with some popular algorithms such as original GWO, particle swarm optimization (PSO), Hybrid PSOGWO, and Sparse-PSO. The DZQ has been utilized to perform thresholding and quantization. Then, run-length encoding (RLE) has been used to encode the quantized coefficients. The proposed work has been performed on the MIT-BIH arrhythmia database. Quality assessment performed on reconstructed signals ensure the minimal impact of compression on the morphology of reconstructed ECG signals. The compression performance of proposed algorithm is measured in terms of the following evaluation matrices: percent root-mean-square difference (PRD1), compression ratio (CR), signal-to-noise ratio (SNR), and quality score (QS1). The obtained average values are 3.21%, 20.56, 30.62 dB, and 7.79, respectively.