Automatic detection of atrial fibrillation in cardiac vibration signals

Bed sensor ballistocardiogram for non-invasive detection of atrial fibrillation: a comprehensive clinical study

Objective.Atrial fibrillation (AFib) is a common cardiac arrhythmia associated with high morbidity and mortality, making early detection and continuous monitoring essential to prevent complications like stroke. This study explores the potential of using a ballistocardiogram (BCG) based bed sensor for the detection of AFib.Approach.We conducted a comprehensive clinical study with night hospital recordings from 116 patients, divided into 72 training and 44 test subjects. The study employs established methods such as autocorrelation to identify AFib from BCG signals. Spot and continuous Holter ECG were used as reference methods for AFib detection against which BCG rhythm classifications were compared.Results.Our findings demonstrate the potential of BCG-based AFib detection, achieving 94% accuracy on the training set using a rule-based method. Furthermore, the machine learning model trained with the training set achieved an AUROC score of 97% on the test set.Significance.This innovative approach shows promise for accurate, non-invasive, and continuous monitoring of AFib, contributing to improved patient care and outcomes, particularly in the context of home-based or hospital settings.

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.

Solving variability: Accurately extracting feature components from ballistocardiograms

Objective

A ballistocardiogram (BCG) is a vibration signal generated by the ejection of the blood in each cardiac cycle. The BCG has significant variability in amplitude, temporal aspects, and the deficiency of waveform components, attributed to individual differences, instantaneous heart rate, and the posture of the person being measured. This variability may make methods of extracting J-waves, the most distinct components of BCG less generalizable so that the J-waves could not be precisely localized, and further analysis is difficult. This study is dedicated to solving the variability of BCG to achieve accurate feature extraction.

Methods

Inspired by the generation mechanism of the BCG, we proposed an original method based on a profile of second-order derivative of BCG waveform (2ndD-P) to capture the nature of vibration and solve the variability, thereby accurately localizing the components especially when the J-wave is not prominent.

Results

In this study, 51 recordings of resting state and 11 recordings of high-heart-rate from 24 participants were used to validate the algorithm. Each recording lasts about 3 min. For resting state data, the sensitivity and positive predictivity of proposed method are: 98.29% and 98.64%, respectively. For high-heart-rate data, the proposed method achieved a performance comparable to those of low-heart-rate: 97.14% and 99.01% for sensitivity and positive predictivity, respectively.

Conclusion

Our proposed method can detect the peaks of the J-wave more accurately than conventional extraction methods, under the presence of different types of variability. Higher performance was achieved for BCG with non-prominent J-waves, in both low- and high-heart-rate cases.

Non-invasive monitoring of cardiac function through Ballistocardiogram: an algorithm integrating short-time Fourier transform and ensemble empirical mode decomposition

The Ballistocardiogram (BCG) is a vibration signal that is generated by the displacement of the entire body due to the injection of blood during each heartbeat. It has been extensively utilized to monitor heart rate. The morphological features of the BCG signal serve as effective indicators for the identification of atrial fibrillation and heart failure, holding great significance for BCG signal analysis. The IJK-complex identification allows for the estimation of inter-beat intervals (IBI) and enables a more detailed analysis of BCG amplitude and interval waves. This study presents a novel algorithm for identifying the IJK-complex in BCG signals, which is an improvement over most existing algorithms that only perform IBI estimation. The proposed algorithm employs a short-time Fourier transform and summation across frequencies to initially estimate the occurrence of the J wave using peak finding, followed by Ensemble Empirical Mode Decomposition and a regional search to precisely identify the J wave. The algorithm's ability to detect the morphological features of BCG signals and estimate heart rates was validated through experiments conducted on 10 healthy subjects and 2 patients with coronary heart disease. In comparison to commonly used methods, the presented scheme ensures accurate heart rate estimation and exhibits superior capability in detecting BCG morphological features. This advancement holds significant value for future applications involving BCG signals.

Machine learning-aided detection of heart failure (LVEF ≤ 49%) by using ballistocardiography and respiratory effort signals

Purpose: Under the influence of COVID-19 and the in-hospital cost, the in-home detection of cardiovascular disease with smart sensing devices is becoming more popular recently. In the presence of the qualified signals, ballistocardiography (BCG) can not only reflect the cardiac mechanical movements, but also detect the HF in a non-contact manner. However, for the potential HF patients, the additional quality assessment with ECG-aided requires more procedures and brings the inconvenience to their in-home HF diagnosis. To enable the HF detection in many real applications, we proposed a machine learning-aided scheme for the HF detection in this paper, where the BCG signals recorded from the force sensor were employed without the heartbeat location, and the respiratory effort signals separated from force sensors provided more HF features due to the connection between the heart and the lung systems. Finally, the effectiveness of the proposed HF detection scheme was verified in comparative experiments. Methods: First, a piezoelectric sensor was used to record a signal sequences of the two-dimensional vital sign, which includes the BCG and the respiratory effort. Then, the linear and the non-linear features w.r.t. BCG and respiratory effort signals were extracted to serve the HF detection. Finally, the improved HF detection performance was verified through the LOO and the LOSO cross-validation settings with different machine learning classifiers. Results: The proposed machine learning-aided scheme achieved the robust performance in the HF detection by using 4 different classifiers, and yielded an accuracy of 94.97% and 87.00% in the LOO and the LOSO experiments, respectively. In addition, experimental results demonstrated that the designed respiratory and cardiopulmonary features are beneficial to the HF detection (LVEF ≤ 49 % ). Conclusion: This study proposed a machine learning-aided HF diagnostic scheme. Experimental results demonstrated that the proposed scheme can fully exploit the relationship between the heart and the lung systems to potentially improve the in-home HF detection performance by using both the BCG, the respiratory and the cardiopulmonary-related features.

Quantitative Analysis Using Consecutive Time Window for Unobtrusive Atrial Fibrillation Detection Based on Ballistocardiogram Signal

Atrial fibrillation (AF) is the most common clinically significant arrhythmia; therefore, AF detection is crucial. Here, we propose a novel feature extraction method to improve AF detection performance using a ballistocardiogram (BCG), which is a weak vibration signal on the body surface transmitted by the cardiogenic force. In this paper, continuous time windows (CTWs) are added to each BCG segment and recurrence quantification analysis (RQA) features are extracted from each time window. Then, the number of CTWs is discussed and the combined features from multiple time windows are ranked, which finally constitute the CTW-RQA features. As validation, the CTW-RQA features are extracted from 4000 BCG segments of 59 subjects, which are compared with classical time and time-frequency features and up-to-date energy features. The accuracy of the proposed feature is superior, and three types of features are fused to obtain the highest accuracy of 95.63%. To evaluate the importance of the proposed feature, the fusion features are ranked using a chi-square test. CTW-RQA features account for 60% of the first 10 fusion features and 65% of the first 17 fusion features. It follows that the proposed CTW-RQA features effectively supplement the existing BCG features for AF detection.

Non-Contact Atrial Fibrillation Detection From Face Videos by Learning Systolic Peaks

OBJECTIVE

We propose a non-contact approach for atrial fibrillation (AF) detection from face videos.

METHODS

Face videos, electrocardiography (ECG), and contact photoplethysmography (PPG) from 100 healthy subjects and 100 AF patients are recorded. Data recordings from healthy subjects are all labeled as healthy. Two cardiologists evaluated ECG recordings of patients and labeled each recording as AF, sinus rhythm (SR), or atrial flutter (AFL). We use the 3D convolutional neural network for remote PPG monitoring and propose a novel loss function (Wasserstein distance) to use the timing of systolic peaks from contact PPG as the label for our model training. Then a set of heart rate variability (HRV) features are calculated from the inter-beat intervals, and a support vector machine (SVM) classifier is trained with HRV features.

RESULTS

Our proposed method can accurately extract systolic peaks from face videos for AF detection. The proposed method is trained with subject-independent 10-fold cross-validation with 30s video clips and tested on two tasks. 1) Classification of healthy versus AF: the accuracy, sensitivity, and specificity are 96.00%, 95.36%, and 96.12%. 2) Classification of SR versus AF: the accuracy, sensitivity, and specificity are 95.23%, 98.53%, and 91.12%. In addition, we also demonstrate the feasibility of non-contact AFL detection.

CONCLUSION

We achieve good performance of non-contact AF detection by learning systolic peaks.

SIGNIFICANCE

non-contact AF detection can be used for self-screening of AF symptoms for suspectable populations at home or self-monitoring of AF recurrence after treatment for chronic patients.

MGNN: A multiscale grouped convolutional neural network for efficient atrial fibrillation detection

The reliable detection of atrial fibrillation (AF) is of great significance for monitoring disease progression and developing tailored care paths. In this work, we proposed a novel and robust method based on deep learning for the accurate detection of AF. Using RR interval sequences, a multiscale grouped convolutional neural network (MGNN) combined with self-attention was designed for automatic feature extraction, and AF and non-AF classification. An average accuracy of 97.07% was obtained in the 5-fold cross-validation. The generalization ability of the proposed MGNN was further independently tested on four other unseen datasets, and the accuracy was 92.23%, 96.86%, 94.23% and 95.91%. Moreover, comparison of the network structures indicated that the MGNN had not only better detection performance but also lower computational complexity. In conclusion, the proposed model is shown to be an efficient AF detector that has great potential for use in clinical auxiliary diagnosis and long-term home monitoring based on wearable devices.

End-to-end sensor fusion and classification of atrial fibrillation using deep neural networks and smartphone mechanocardiography

OBJECTIVE

The purpose of this research is to develop a new deep learning framework for detecting atrial fibrillation (AFib), one of the most common heart arrhythmias, by analyzing the heart's mechanical functioning as reflected in seismocardiography (SCG) and gyrocardiography (GCG) signals. Jointly, SCG and GCG constitute the concept of mechanocardiography (MCG), a method used to measure precordial vibrations with the built-in inertial sensors of smartphones.

APPROACH

We present a modified deep residual neural network model for the classification of sinus rhythm (SR), AFib, and Noise categories from tri-axial SCG and GCG data derived from smartphones. In the model presented, pre-processing including automated early sensor fusion and spatial feature extraction are carried out using attention-based convolutional and residual blocks. Additionally, we use bidirectional long short-term memory layers on top of fully-connected layers to extract both spatial and spatiotemporal features of the multidimensional SCG and GCG signals. The dataset consisted of 728 short measurements recorded from 300 patients. Further, the measurements were divided into disjoint training, validation, and test sets, respectively, of 481 measurements, 140 measurements, and 107 measurements. Prior to ingestion by the model, measurements were split into 10-second segments with 75 percent overlap, pre-processed, and augmented.

MAIN RESULTS

On the unseen test set, the model delivered average micro- and macro-F1-score of 0.88 (0.87-0.89; 95% CI) and 0.83 (0.83-0.84; 95% CI) for the segment-wise classification as well as 0.95 (0.94-0.96; 95% CI) and 0.95 (0.94-0.96; 95% CI) for the measurement-wise classification, respectively.

SIGNIFICANCE

Our method not only can effectively fuse SCG and GCG signals but also can identify heart rhythms and abnormalities in the MCG signals with remarkable accuracy.

A Comprehensive Review on Seismocardiogram: Current Advancements on Acquisition, Annotation, and Applications

In recent years, cardiovascular diseases are on the rise, and they entail enormous health burdens on global economies. Cardiac vibrations yield a wide and rich spectrum of essential information regarding the functioning of the heart, and thus it is necessary to take advantage of this data to better monitor cardiac health by way of prevention in early stages. Specifically, seismocardiography (SCG) is a noninvasive technique that can record cardiac vibrations by using new cutting-edge devices as accelerometers. Therefore, providing new and reliable data regarding advancements in the field of SCG, i.e., new devices and tools, is necessary to outperform the current understanding of the State-of-the-Art (SoTA). This paper reviews the SoTA on SCG and concentrates on three critical aspects of the SCG approach, i.e., on the acquisition, annotation, and its current applications. Moreover, this comprehensive overview also presents a detailed summary of recent advancements in SCG, such as the adoption of new techniques based on the artificial intelligence field, e.g., machine learning, deep learning, artificial neural networks, and fuzzy logic. Finally, a discussion on the open issues and future investigations regarding the topic is included.

Recent Research for Unobtrusive Atrial Fibrillation Detection Methods Based on Cardiac Dynamics Signals: A Survey

Atrial fibrillation (AF) is the most common cardiac arrhythmia. It tends to cause multiple cardiac conditions, such as cerebral artery blockage, stroke, and heart failure. The morbidity and mortality of AF have been progressively increasing over the past few decades, which has raised widespread concern about unobtrusive AF detection in routine life. The up-to-date non-invasive AF detection methods include electrocardiogram (ECG) signals and cardiac dynamics signals, such as the ballistocardiogram (BCG) signal, the seismocardiogram (SCG) signal and the photoplethysmogram (PPG) signal. Cardiac dynamics signals can be collected by cushions, mattresses, fabrics, or even cameras, which is more suitable for long-term monitoring. Therefore, methods for AF detection by cardiac dynamics signals bring about extensive attention for recent research. This paper reviews the current unobtrusive AF detection methods based on the three cardiac dynamics signals, summarized as data acquisition and preprocessing, feature extraction and selection, classification and diagnosis. In addition, the drawbacks and limitations of the existing methods are analyzed, and the challenges in future work are discussed.

Detection of Ventricular Fibrillation Based on Ballistocardiography by Constructing an Effective Feature Set

Ventricular fibrillation (VF) is a type of fatal arrhythmia that can cause sudden death within minutes. The study of a VF detection algorithm has important clinical significance. This study aimed to develop an algorithm for the automatic detection of VF based on the acquisition of cardiac mechanical activity-related signals, namely ballistocardiography (BCG), by non-contact sensors. BCG signals, including VF, sinus rhythm, and motion artifacts, were collected through electric defibrillation experiments in pigs. Through autocorrelation and S transform, the time-frequency graph with obvious information of cardiac rhythmic activity was obtained, and a feature set of 13 elements was constructed for each 7 s segment after statistical analysis and hierarchical clustering. Then, the random forest classifier was used to classify VF and non-VF, and two paradigms of intra-patient and inter-patient were used to evaluate the performance. The results showed that the sensitivity and specificity were 0.965 and 0.958 under 10-fold cross-validation, and they were 0.947 and 0.946 under leave-one-subject-out cross-validation. In conclusion, the proposed algorithm combining feature extraction and machine learning can effectively detect VF in BCG, laying a foundation for the development of long-term self-cardiac monitoring at home and a VF real-time detection and alarm system.

Attention-based multi-scale features fusion for unobtrusive atrial fibrillation detection using ballistocardiogram signal

BACKGROUND

Atrial fibrillation (AF) represents the most common arrhythmia worldwide, related to increased risk of ischemic stroke or systemic embolism. It is critical to screen and diagnose AF for the benefits of better cardiovascular health in lifetime. The ECG-based AF detection, the gold standard in clinical care, has been restricted by the need to attach electrodes on the body surface. Recently, ballistocardiogram (BCG) has been investigated for AF diagnosis, which is an unobstructive and convenient technique to monitor heart activity in daily life. However, here is a lack of high-dimension representation and deep learning analysis of BCG.

METHOD

Therefore, this paper proposes an attention-based multi-scale features fusion method by using BCG signal. The 1-D morphology feature extracted from Bi-LSTM network and 2-D rhythm feature extracted from reconstructed phase space are integrated by means of CNN network to improve the robustness of AF detection. To the best of our knowledge, this is the first study where the phase space trajectory of BCG is conducted.

RESULTS

2000 segments (AF and NAF) of BCG signals were collected from 59 volunteers suffering from paroxysmal AF in this survey. Compared to the classical time and frequency features and the state-of-the-art energy features with the popular machine learning classifiers, AF detection performance of the proposed method is superior, which has 0.947 accuracy, 0.935 specificity, 0.959 sensitivity, and 0.937 precision, for the same BCG dataset. The experimental results show that combined feature could excavate more potential characteristics, and the attention mechanism could enhance the pertinence for AF recognition.

CONCLUSIONS

The proposed method can provide an innovative solution to capture the diverse scale descriptions of BCG and explore ways to involve the deep learning method to accurately screen AF in routine life.

Over-fitting suppression training strategies for deep learning-based atrial fibrillation detection

Nowadays, deep learning-based models have been widely developed for atrial fibrillation (AF) detection in electrocardiogram (ECG) signals. However, owing to the inevitable over-fitting problem, classification accuracy of the developed models severely differed when applying on the independent test datasets. This situation is more significant for AF detection from dynamic ECGs. In this study, we explored two potential training strategies to address the over-fitting problem in AF detection. The first one is to use the Fast Fourier transform (FFT) and Hanning-window-based filter to suppress the influence from individual difference. Another is to train the model on the wearable ECG data to improve the robustness of model. Wearable ECG data from 29 patients with arrhythmia were collected for at least 24 h. To verify the effectiveness of the training strategies, a Long Short-Term Memory (LSTM) and Convolution Neural Network (CNN)-based model was proposed and tested. We tested the model on the independent wearable ECG data set, as well as the MIT-BIH Atrial Fibrillation database and PhysioNet/Computing in Cardiology Challenge 2017 database. The model achieved 96.23%, 95.44%, and 95.28% accuracy rates on the three databases, respectively. Pertaining to the comparison of the accuracy rates on each training set, the accuracy of the model trained in conjunction with the proposed training strategies only reduced by 2%, while the accuracy of the model trained without the training strategies decreased by approximately 15%. Therefore, the proposed training strategies serve as effective mechanisms for devising a robust AF detector and significantly enhanced the detection accuracy rates of the resulting deep networks.

Contact-free sensor signals as a new digital biomarker for cardiovascular disease: chances and challenges

Multiple sensor systems are used to monitor physiological parameters, activities of daily living and behaviour. Digital biomarkers can be extracted and used as indicators for health and disease. Signal acquisition is either by object sensors, wearable sensors, or contact-free sensors including cameras, pressure sensors, non-contact capacitively coupled electrocardiogram (cECG), radar, and passive infrared motion sensors. This review summarizes contemporary knowledge of the use of contact-free sensors for patients with cardiovascular disease and healthy subjects following the PRISMA declaration. Chances and challenges are discussed. Thirty-six publications were rated to be of medium (31) or high (5) relevance. Results are best for monitoring of heart rate and heart rate variability using cardiac vibration, facial camera, or cECG; for respiration using cardiac vibration, cECG, or camera; and for sleep using ballistocardiography. Early results from radar sensors to monitor vital signs are promising. Contact-free sensors are little invasive, well accepted and suitable for long-term monitoring in particular in patient's homes. A major problem are motion artefacts. Results from long-term use in larger patient cohorts are still lacking, but the technology is about to emerge the market and we can expect to see more clinical results in the near future.

Detection of Atrial Fibrillation Using a Machine Learning Approach

The atrial fibrillation (AF) is one of the most well-known cardiac arrhythmias in clinical practice, with a prevalence of 1–2% in the community, which can increase the risk of stroke and myocardial infarction. The detection of AF electrocardiogram (ECG) can improve the early detection of diagnosis. In this paper, we have further developed a framework for processing the ECG signal in order to determine the AF episodes. We have implemented machine learning and deep learning algorithms to detect AF. Moreover, the experimental results show that better performance can be achieved with long short-term memory (LSTM) as compared to other algorithms. The initial experimental results illustrate that the deep learning algorithms, such as LSTM and convolutional neural network (CNN), achieved better performance (10%) as compared to machine learning classifiers, such as support vectors, logistic regression, etc. This preliminary work can help clinicians in AF detection with high accuracy and less probability of errors, which can ultimately result in reduction in fatality rate.

Experience in screening for atrial fibrillation and monitoring arrhythmia using a single-lead ECG stick

Atrial fibrillation (AF) is the most common arrhythmia and is highly associated with increased morbidity and mortality. Since many AF episodes remain subclinical, screening for AF is considered a desirable approach for timely diagnosis, prevention of sequelae and effective treatment. Recently, devices for AF detection-stand-alone or integrated in mobile health technology-have become available and show promising preliminary results in the detection and monitoring of arrhythmia. This review describes the technical aspects of a single-lead ECG stick and summarizes the current literature, experience in large-scale screening for AF in pharmacies and potential fields of application.

A Unified Methodology for Heartbeats Detection in Seismocardiogram and Ballistocardiogram Signals

This work presents a methodology to analyze and segment both seismocardiogram (SCG) and ballistocardiogram (BCG) signals in a unified fashion. An unsupervised approach is followed to extract a template of SCG/BCG heartbeats, which is then used to fine-tune temporal waveform annotation. Rigorous performance assessment is conducted in terms of sensitivity, precision, Root Mean Square Error (RMSE) and Mean Absolute Error (MAE) of annotation. The methodology is tested on four independent datasets, covering different measurement setups and time resolutions. A wide application range is therefore explored, which better characterizes the robustness and generality of the method with respect to a single dataset. Overall, sensitivity and precision scores are uniform across all datasets ( p > 0.05 from the Kruskal–Wallis test): the average sensitivity among datasets is 98.7%, with 98.2% precision. On the other hand, a slight yet significant difference in RMSE and MAE scores was found ( p < 0.01 ) in favor of datasets with higher sampling frequency. The best RMSE scores for SCG and BCG are 4.5 and 4.8 ms, respectively; similarly, the best MAE scores are 3.3 and 3.6 ms. The results were compared to relevant recent literature and are found to improve both detection performance and temporal annotation errors.

Cardiovascular Function and Ballistocardiogram: A Relationship Interpreted via Mathematical Modeling

OBJECTIVE

To develop quantitative methods for the clinical interpretation of the ballistocardiogram (BCG).

METHODS

A closed-loop mathematical model of the cardiovascular system is proposed to theoretically simulate the mechanisms generating the BCG signal, which is then compared with the signal acquired via accelerometry on a suspended bed.

RESULTS

Simulated arterial pressure waveforms and ventricular functions are in good qualitative and quantitative agreement with those reported in the clinical literature. Simulated BCG signals exhibit the typical I, J, K, L, M, and N peaks and show good qualitative and quantitative agreement with experimental measurements. Simulated BCG signals associated with reduced contractility and increased stiffness of the left ventricle exhibit different changes that are characteristic of the specific pathological condition.

CONCLUSION

The proposed closed-loop model captures the predominant features of BCG signals and can predict pathological changes on the basis of fundamental mechanisms in cardiovascular physiology.

SIGNIFICANCE

This paper provides a quantitative framework for the clinical interpretation of BCG signals and the optimization of BCG sensing devices. The present paper considers an average human body and can potentially be extended to include variability among individuals.

Core/Shell Piezoelectric Nanofibers with Spatial Self-Orientated β-Phase Nanocrystals for Real-Time Micropressure Monitoring of Cardiovascular Walls

Implantable pressure biosensors show great potential for assessment and diagnostics of pressure-related diseases. Here, we present a structural design strategy to fabricate core/shell polyvinylidene difluoride (PVDF)/hydroxylamine hydrochloride (HHE) organic piezoelectric nanofibers (OPNs) with well-controlled and self-orientated nanocrystals in the spatial uniaxial orientation (SUO) of β-phase-rich fibers, which significantly enhance piezoelectric performance, fatigue resistance, stability, and biocompatibility. Then PVDF/HHE OPNs soft sensors are developed and used to monitor subtle pressure changes in vivo. Upon implanting into pig, PVDF/HHE OPNs sensors demonstrate their ultrahigh detecting sensitivity and accuracy to capture micropressure changes at the outside of cardiovascular walls, and output piezoelectric signals can real-time and synchronously reflect and distinguish changes of cardiovascular elasticity and occurrence of atrioventricular heart-block and formation of thrombus. Such biological information can provide a diagnostic basis for early assessment and diagnosis of thrombosis and atherosclerosis, especially for postoperative recrudescence of thrombus deep within the human body.

Classification of Decompensated Heart Failure From Clinical and Home Ballistocardiography

OBJECTIVE

To improve home monitoring of heart failure patients so as to reduce emergency room visits and hospital readmissions. We aim to do this by analyzing the ballistocardiogram (BCG) to evaluate the clinical state of the patient.

METHODS

1) High quality BCG signals were collected at home from HF patients after discharge. 2) The BCG recordings were preprocessed to exclude outliers and artifacts. 3) Parameters of the BCG that contain information about the cardiovascular system were extracted. These features were used for the task of classification of the BCG recording based on the status of HF.

RESULTS

The best AUC score for the task of classification obtained was 0.78 using slight variant of the leave one subject out validation method.

CONCLUSION

This work demonstrates that high quality BCG signals can be collected in a home environment and used to detect the clinical state of HF patients.

SIGNIFICANCE

In future work, a clinician/caregiver can be introduced into the system so that appropriate interventions can be performed based on the clinical state monitored at home.

Automatic Detection of Atrial Fibrillation from Ballistocardiogram (BCG) Using Wavelet Features and Machine Learning

This paper presents an unobtrusive method for automatic detection of atrial fibrillation (AF) from single-channel ballistocardiogram (BCG) recordings during sleep. We developed a remote data acquisition system that measures BCG signals through an electromechanical-film sensor embedded into a bed's mattress and transmits the BCG data to a remote database on the cloud server. In the feasibility study, 12 AF patients' data were recorded during entire night of sleep. Each BCG recording was split into nonoverlapping 30s epochs labeled either AF or normal. Using the features extracted from stationary wavelet transform of these epochs, three popular machine learning classifiers (support vector machine, K-nearest neighbor, and ensembles) have been trained and evaluated on the set of 7816 epochs employing 30% hold-out validation. The results showed that all the trained classifiers could achieve an accuracy rate above 91.5%. The optimized ensembles model (Bagged Trees) could achieve accuracy, sensitivity, and specificity of 0.944, 0.970 and 0.891, respectively. These results suggest that the proposed BCG-based AF detection can be a potential initial screening and detection tool of AF in home-monitoring applications.

Evaluation of a Commercial Ballistocardiography Sensor for Sleep Apnea Screening and Sleep Monitoring

There exists a technological momentum towards the development of unobtrusive, simple, and reliable systems for long-term sleep monitoring. An off-the-shelf commercial pressure sensor meeting these requirements is the Emfit QS. First, the potential for sleep apnea screening was investigated by revealing clusters of contaminated and clean segments. A relationship between the irregularity of the data and the sleep apnea severity class was observed, which was valuable for screening (sensitivity 0.72, specificity 0.70), although the linear relation was limited ( R 2 of 0.16). Secondly, the study explored the suitability of this commercial sensor to be merged with gold standard polysomnography data for future sleep monitoring. As polysomnography (PSG) and Emfit signals originate from different types of sensor modalities, they cannot be regarded as strictly coupled. Therefore, an automated synchronization procedure based on artefact patterns was developed. Additionally, the optimal position of the Emfit for capturing respiratory and cardiac information similar to the PSG was identified, resulting in a position as close as possible to the thorax. The proposed approach demonstrated the potential for unobtrusive screening of sleep apnea patients at home. Furthermore, the synchronization framework enabled supervised analysis of the commercial Emfit sensor for future sleep monitoring, which can be extended to other multi-modal systems that record movements during sleep.

Atrial Fibrillation Detection by the Combination of Recurrence Complex Network and Convolution Neural Network

In this paper, R wave peak interval independent atrial fibrillation detection algorithm is proposed based on the analysis of the synchronization feature of the electrocardiogram signal by a deep neural network. Firstly, the synchronization feature of each heartbeat of the electrocardiogram signal is constructed by a Recurrence Complex Network. Then, a convolution neural network is used to detect atrial fibrillation by analyzing the eigenvalues of the Recurrence Complex Network. Finally, a voting algorithm is developed to improve the performance of the beat-wise atrial fibrillation detection. The MIT-BIH atrial fibrillation database is used to evaluate the performance of the proposed method. Experimental results show that the sensitivity, specificity, and accuracy of the algorithm can achieve 94.28%, 94.91%, and 94.59%, respectively. Remarkably, the proposed method was more effective than the traditional algorithms to the problem of individual variation in the atrial fibrillation detection.

Atrial Fibrillation Beat Identification Using the Combination of Modified Frequency Slice Wavelet Transform and Convolutional Neural Networks

Atrial fibrillation (AF) is a serious cardiovascular disease with the phenomenon of beating irregularly. It is the major cause of variety of heart diseases, such as myocardial infarction. Automatic AF beat detection is still a challenging task which needs further exploration. A new framework, which combines modified frequency slice wavelet transform (MFSWT) and convolutional neural networks (CNNs), was proposed for automatic AF beat identification. MFSWT was used to transform 1 s electrocardiogram (ECG) segments to time-frequency images, and then, the images were fed into a 12-layer CNN for feature extraction and AF/non-AF beat classification. The results on the MIT-BIH Atrial Fibrillation Database showed that a mean accuracy (Acc) of 81.07% from 5-fold cross validation is achieved for the test data. The corresponding sensitivity (Se), specificity (Sp), and the area under the ROC curve (AUC) results are 74.96%, 86.41%, and 0.88, respectively. When excluding an extremely poor signal quality ECG recording in the test data, a mean Acc of 84.85% is achieved, with the corresponding Se, Sp, and AUC values of 79.05%, 89.99%, and 0.92. This study indicates that it is possible to accurately identify AF or non-AF ECGs from a short-term signal episode.

Unobtrusive Nocturnal Heartbeat Monitoring by a Ballistocardiographic Sensor in Patients with Sleep Disordered Breathing

Sleep disordered breathing (SDB) is known for fluctuating heart rates and an increased risk of developing arrhythmias. The current reference for heartbeat analysis is an electrocardiogram (ECG). As an unobtrusive alternative, we tested a sensor foil for mechanical vibrations to perform a ballistocardiography (BCG) and applied a novel algorithm for beat-to-beat cycle length detection. The aim of this study was to assess the correlation between beat-to-beat cycle length detection by the BCG algorithm and simultaneously recorded ECG. In 21 patients suspected for SDB undergoing polysomnography, we compared ECG to simultaneously recorded BCG data analysed by our algorithm. We analysed 362.040 heartbeats during a total of 93 hours of recording. The baseline beat-to-beat cycle length correlation between BCG and ECG was r_s = 0.77 (n = 362040) with a mean absolute difference of 15 ± 162 ms (mean cycle length: ECG 923 ± 220 ms; BCG 908 ± 203 ms). After filtering artefacts and improving signal quality by our algorithm, the correlation increased to r_s = 0.95 (n = 235367) with a mean absolute difference in cycle length of 4 ± 72 ms (ECG 920 ± 196 ms; BCG 916 ± 194 ms). We conclude that our algorithm, coupled with a BCG sensor foil provides good correlation of beat-to-beat cycle length detection with simultaneously recorded ECG.

Gyrocardiography: A New Non-invasive Monitoring Method for the Assessment of Cardiac Mechanics and the Estimation of Hemodynamic Variables

Gyrocardiography (GCG) is a new non-invasive technique for assessing heart motions by using a sensor of angular motion – gyroscope – attached to the skin of the chest. In this study, we conducted simultaneous recordings of electrocardiography (ECG), GCG, and echocardiography in a group of subjects consisting of nine healthy volunteer men. Annotation of underlying fiducial points in GCG is presented and compared to opening and closing points of heart valves measured by a pulse wave Doppler. Comparison between GCG and synchronized tissue Doppler imaging (TDI) data shows that the GCG signal is also capable of providing temporal information on the systolic and early diastolic peak velocities of the myocardium. Furthermore, time intervals from the ECG Q-wave to the maximum of the integrated GCG (angular displacement) signal and maximal myocardial strain curves obtained by 3D speckle tracking are correlated. We see GCG as a promising mechanical cardiac monitoring tool that enables quantification of beat-by-beat dynamics of systolic time intervals (STI) related to hemodynamic variables and myocardial contractility.

Multimodal chest surface motion data for respiratory and cardiovascular monitoring applications

Chest surface motion is of significant importance as it contains information of respiratory and cardiac systems together with the complex coupling between these two systems. Chest surface motion is not only critical in radiotherapy, but also useful in personalized systems for continuous cardiorespiratory monitoring. In this dataset, a multimodal setup is employed to simultaneously acquire cardiorespiratory signals. These signals include high-density trunk surface motion (from 16 distinct locations) with VICON motion capture system, nasal breathing from a thermal sensor, respiratory effort from a strain belt and electrocardiogram in lead-II configuration. This dataset contains 72 trials recorded from 11 participants with a cumulative duration of approximately 215 min under various conditions such as normal breathing, breath-hold, irregular breathing and post-exercise recovery. The presented dataset is not only useful for evaluating prediction algorithms for radiotherapy applications, but can also be employed for the development of techniques to evaluate the cardio-mechanics and hemodynamic parameters of chest surface motion.

SensInDenT-Noncontact Sensors Integrated Into Dental Treatment Units

This paper presents the first system design (SensInDenT) for noncontact cardiorespiratory monitoring during dental treatment. The system is integrated into a dental treatment unit, and combines sensors based on electromagnetic, optical, and mechanical coupling at different sensor locations. The measurement principles and circuits are described and a system overview is presented. Furthermore, a first proof of concept is provided by taking measurements in healthy volunteers under laboratory conditions.

J peak extraction from non-standard ballistocardiography data: a preliminary study

In recent years, several advanced algorithms based on clustering, multi-method or data fusion approaches have been proposed to estimate heartbeat intervals from non-standard ballistocardiography (BCG) data. These advanced algorithms generally have higher computational complexity than J-peak based algorithms. This fact motivated us to study the problem of extracting J peaks from non-standard BCG data, because if this extraction can be realized, then a low-complexity J-peak based algorithm can be used to fast estimate heartbeat intervals from non-standard BCG data. We found that most of the energy in J peaks is contained in a relatively narrow frequency band, called J-peak band, and that the heartbeat harmonics outside the J-peak band can cause the non-standard BCG waveform. According to these findings, a FIR linear phase filter with the J-peak band as its pass-band is proposed. The experimental result demonstrates the ability of the proposed filter to extract J peaks from non-standard BCG data.

Towards numerical temporal-frequency system modelling of associations between electrocardiogram and ballistocardiogram

Ballistocardiogram (BCG) is a vital sign of ballistic forces generated by each heartbeat. With the advancements in related sensor and computing technologies in recent years, BCG has become far more accessible and thus regained its interest in both research and industry fields. Here we would like to promote the system modelling approach to BCG computing that allows to explore the underlying association between BCG and other physiological signals such as electrocardiogram (ECG). This is in contrast to most of the existing works in the related signal processing domain, which focus on detecting heart rate only. The system modelling approach may eventually improve the clinical significance of the BCG by extracting deeply embedded information. Towards this goal, here we present our preliminary study where we design a Wavelet-based temporal-frequency system model for associating BCG and ECG. To validate the model, we also collect simultaneous BCG and ECG recordings from 4 healthy subjects. We use the system model to build a BCG to ECG predicting algorithm. We demonstrate that this temporal-frequency model and algorithm is far superior, in terms of accuracy, to the naïve method of linear modelling.

Improvement of force-sensor-based heart rate estimation using multichannel data fusion

The aim of this paper is to present and evaluate algorithms for heartbeat interval estimation from multiple spatially distributed force sensors integrated into a bed. Moreover, the benefit of using multichannel systems as opposed to a single sensor is investigated. While it might seem intuitive that multiple channels are superior to a single channel, the main challenge lies in finding suitable methods to actually leverage this potential. To this end, two algorithms for heart rate estimation from multichannel vibration signals are presented and compared against a single-channel sensing solution. The first method operates by analyzing the cepstrum computed from the average spectra of the individual channels, while the second method applies Bayesian fusion to three interval estimators, such as the autocorrelation, which are applied to each channel. This evaluation is based on 28 night-long sleep lab recordings during which an eight-channel polyvinylidene fluoride-based sensor array was used to acquire cardiac vibration signals. The recruited patients suffered from different sleep disorders of varying severity. From the sensor array data, a virtual single-channel signal was also derived for comparison by averaging the channels. The single-channel results achieved a beat-to-beat interval error of 2.2% with a coverage (i.e., percentage of the recording which could be analyzed) of 68.7%. In comparison, the best multichannel results attained a mean error and coverage of 1.0% and 81.0%, respectively. These results present statistically significant improvements of both metrics over the single-channel results (p < 0.05).

Study of atrial activities for abnormality detection by phase rectified signal averaging technique

Non-invasive detection of Atrial Fibrillation (AF) and Atrial Flutter (AFL) from ECG at the time of their onset can prevent forthcoming dangers for patients. In most of the previous detection algorithms, one of the steps includes filtering of the signal to remove noise and artefacts present in the signal. In this paper, a method of AF and AFL detection is proposed from ECG without the conventional filtering stage. Here Phase Rectified Signal Average (PRSA) technique is used with a novel optimized windowing method to achieve an averaged signal without quasi-periodicities. Both time domain and statistical features are extracted from a novel SQ concatenated section of the signal for non-linear Support Vector Machine (SVM) based classification. The performance of the proposed algorithm is tested with the MIT-BIH Arrhythmia database and good performance parameters are obtained, as indicated in the result section.

Monte-Carlo Simulation and Automated Test Bench for Developing a Multichannel NIR-Based Vital-Signs Monitor

Unobtrusive, long-term monitoring of cardiac (and respiratory) rhythms using only non-invasive vibration sensors mounted in beds promises to unlock new applications in home and low acuity monitoring. This paper presents a novel concept for such a system based on an array of near infrared (NIR) sensors placed underneath a regular bed mattress. We focus on modeling and analyzing the underlying technical measurement principle with the help of a 2D model of a polyurethane foam mattress and Monte-Carlo simulations of the opto-mechanical interaction responsible for signal genesis. Furthermore, a test rig to automatically and repeatably impress mechanical vibrations onto a mattress is introduced and used to identify the properties of a prototype implementation of the proposed measurement principle. Results show that NIR-based sensing is capable of registering miniscule deformations of the mattress with a high spatial specificity. As a final outlook, proof-of-concept measurements with the sensor array are presented which demonstrate that cardiorespiratory movements of the body can be detected and that automatic heart rate estimation at competitive error levels is feasible with the proposed approach.

Ambient and Unobtrusive Cardiorespiratory Monitoring Techniques

Monitoring vital signs through unobtrusive means is a goal which has attracted a lot of attention in the past decade. This review provides a systematic and comprehensive review over the current state of the field of ambient and unobtrusive cardiorespiratory monitoring. To this end, nine different sensing modalities which have been in the focus of current research activities are covered: capacitive electrocardiography, seismo- and ballistocardiography, reflective photoplethysmography (PPG) and PPG imaging, thermography, methods relying on laser or radar for distance-based measurements, video motion analysis, as well as methods using high-frequency electromagnetic fields. Current trends in these subfields are reviewed. Moreover, we systematically analyze similarities and differences between these methods with respect to the physiological and physical effects they sense as well as the resulting implications. Finally, future research trends for the field as a whole are identified.

Individualized biomonitoring in heart failure--Biomon-HF "Keep an eye on heart failure--especially at night"

In the project "Individualized Biomonitoring in Heart Failure (Biomon-HF)," innovative sensors and algorithms for measuring vital signs, i.e., during the nocturnal sleep period, have been developed and successfully tested in five clinical feasibility studies involving 115 patients. The Biomon-HF sensor concepts are an important step toward future patient-customized telemonitoring and sensor-guided therapy management in chronic heart failure, including early detection of upcoming HF exacerbation and comorbidities at home. The resulting preventable disease complications and emergencies and reduction of consequences of disease are very important advantages for the patients, causing relief for medical staff and, thus, offer an enormous potential for improvements and cost savings in healthcare systems.