Background: Accurate detection of QRS complexes during mobile, ultra-long-term ECG monitoring is challenged by instances of high heart rate, dramatic and persistent changes in signal amplitude, and intermittent deformations in signal quality that arise due to subject motion, background noise, and misplacement of the ECG electrodes. Purpose: We propose a revised QRS detection algorithm which addresses the above-mentioned challenges. Methods and Results: Our proposed algorithm is based on a state-of-the-art algorithm after applying two key modifications. The first modification is implementing local estimates for the amplitude of the signal. The second modification is a mechanism by which the algorithm becomes adaptive to changes in heart rate. We validated our proposed algorithm against the state-of-the-art algorithm using short-term ECG recordings from eleven annotated databases available at Physionet, as well as four ultra-long-term (14-day) ECG recordings which were visually annotated at a central ECG core laboratory. On the database of ultra-long-term ECG recordings, our proposed algorithm showed a sensitivity of 99.90% and a positive predictive value of 99.73%. Meanwhile, the state-of-the-art QRS detection algorithm achieved a sensitivity of 99.30% and a positive predictive value of 99.68% on the same database. The numerical efficiency of our new algorithm was evident, as a 14-day recording sampled at 200 Hz was analyzed in approximately 157 seconds. Conclusions: We developed a new QRS detection algorithm. The efficiency and accuracy of our algorithm makes it a good fit for mobile health applications, ultra-long-term and pathological ECG recordings, and the batch processing of large ECG databases.
This paper presents a multi-lead fusion method for the accurate and automated detection of the QRS complex location in 12 lead ECG (Electrocardiogram) signals. The proposed multi-lead fusion method accurately delineates the QRS complex by the fusion of detected QRS complexes of the individual 12 leads. The proposed algorithm consists of two major stages. Firstly, the QRS complex location of each lead is detected by the single lead QRS detection algorithm. Secondly, the multi-lead fusion algorithm combines the information of the QRS complex locations obtained in each of the 12 leads. The perfor…
Cardiovascular disease is associated with high rates of morbidity and mortality, and can be reflected by 19 abnormal features of electrocardiogram (ECG). Detecting changes in the QRS complexes in ECG 20 signals is regarded as a straightforward, noninvasive, inexpensive, and preliminary diagnosis approach 21 for evaluating the cardiac health of patients. Therefore, detecting QRS complexes in ECG signals must 22 be accurate over short times. However, the reliability of automatic QRS detection is restricted by all 23 kinds of noise and complex signal morphologies. In this study, we proposed a new…
Automated QRS detection methods depend on the ECG data which is sampled at a certain frequency, irrespective of filter-based traditional methods or convolutional network (CNN) based deep learning methods. These methods require a selection of the sampling frequency at which they operate in the very first place. While working with data from two different datasets, which are sampled at different frequencies, often, data from both the datasets may need to resample at a common target frequency, which may be the frequency of either of the datasets or could be a different one. However, choosing data …
The electrocardiogram (ECG) signal is the most widely used non-invasive tool for the investigation of cardiovascular diseases. Automatic delineation of ECG fiducial points, in particular the R-peak, serves as the basis for ECG processing and analysis. This study proposes a new method of ECG signal analysis by introducing a new class of graphical models based on optimal changepoint detection models, named the graph-constrained changepoint detection (GCCD) model. The GCCD model treats fiducial points delineation in the non-stationary ECG signal as a changepoint detection problem. The proposed mo…
Lobachevsky University of Nizhni Novgorod（下诺夫哥罗德罗巴切夫斯基大学）
We propose an algorithm for electrocardiogram (ECG) segmentation using a UNet-like full-convolutional neural network. The algorithm receives an arbitrary sampling rate ECG signal as an input, and gives a list of onsets and offsets of P and T waves and QRS complexes as output. Our method of segmentation differs from others in speed, a small number of parameters and a good generalization: it is adaptive to different sampling rates and it is generalized to various types of ECG monitors. The proposed approach is superior to other state-of-the-art segmentation methods in terms of quality. In partic…
This study presents a new viewpoint on ECG signal analysis by applying a graph-based changepoint detection model to locate R-peak positions. This model is based on a new graph learning algorithm to learn the constraint graph given the labeled ECG data. The proposed learning algorithm starts with a simple initial graph and iteratively edits the graph so that the final graph has the maximum accuracy in R-peak detection. We evaluate the performance of the algorithm on the MIT-BIH Arrhythmia Database. The evaluation results demonstrate that the proposed method can obtain comparable results to othe…
Objectives: With the technological advancements in the field of tele-health monitoring, it is now possible to gather huge amounts of electro-physiological signals such as electrocardiogram (ECG). It is therefore necessary to develop models/algorithms that are capable of analysing these massive amounts of data in real-time. This paper proposes a deep learning model for real-time segmentation of heartbeats. Methods: The proposed algorithm, named as the DENS-ECG algorithm, combines convolutional neural network (CNN) and long short-term memory (LSTM) model to detect onset, peak, and offset of diff…
Deep learning based ECG segmentation for delineation of diverse arrhythmias
Seoul National University（首尔大学）；Asan Medical Center, University of Ulsan College of Medicine（蔚山大学医学院附属峨山医院）；Pusan National University Hospital, Pusan National University School of Medicine（釜山大学医学院附属釜山国立大学医院）；AI Institute, Seoul National University（首尔大学人工智能研究院）；Seoul National University Hospital（首尔大学医院）；Medifarmsoft Co., Ltd.（Medifarmsoft有限公司）
本文提出一种类 U-Net 的心电图分割模型及后处理算法，用于在多种心律失常条件下准确 delineation P、QRS 和 T 波，并针对标准基准中代表性不足的心律失常提出改进策略。
ECGs objectively reflects the working conditions of the hearts as these signals contain vast physiological and pathological information. In this work, in order to improve the efficiency and accuracy of "best so far" time series analysis-based ECG anomaly detection methods, a novel method, comprising a modified dynamic time warping (MDTW) and an innovative average non-self match distance (ANSD) measure, is proposed for ECG anomaly detection. To evaluate the performance of the proposed method, the proposed method is applied to real ECG data selected from the MIT-BIH heartbeat database. To provid…
Method: In this study, a new method is introduced for distinguishing noise-free segments of ECG from noisy segments that use sample amplitude dispersion with an adoptive threshold for variance of samples amplitude and a method which uses compatibility of detected beats in ECG and some of the other signals which are related to the heart activity such as BP, arterial pressure (ART) and pulmonary artery pressure (PAP). A prioritization is applied in other pulsatile signals based on the amplitude and clarity of the peaks on them, and a fusion strategy is employed for segments on which ECG is noisy…
Interpretable machine learning for identifying individual-specific cardiogram signatures
University of Belgrade – School of Electrical Engineering（贝尔格莱德大学电气工程学院）；Institute for Artificial Intelligence Research and Development of Serbia（塞尔维亚人工智能研究与开发研究所）；Institute of Psychology and LIRA lab, Faculty of Philosophy, University of Belgrade（贝尔格莱德大学哲学院心理学研究所及LIRA实验室）；Department of Psychology and LIRA lab, Faculty of Philosophy, University of Belgrade（贝尔格莱德大学哲学院心理学系及LIRA实验室）；University of Belgrade – Faculty of Special Education and Rehabilitation（贝尔格莱德大学特殊教育与康复学院）；Institute for Biological Research ”Siniša Stanković”, National Institute of the Republic of Serbia, University of Belgrade（塞尔维亚共和国国家研究所西尼沙·斯坦科维奇生物学研究所，贝尔格莱德大学）；Trinity College Dublin - School of Psychology（都柏林三一学院心理学院）；Faculty of Electrical Engineering, University of Ljubljana（卢布尔雅那大学电气工程学院）
International Institute of Information Technology（国际信息技术研究所）
Early detection of cardiovascular diseases is crucial for effective treatment and an electrocardiogram (ECG) is pivotal for diagnosis. The accuracy of Deep Learning based methods for ECG signal classification has progressed in recent years to reach cardiologist-level performance. In clinical settings, a cardiologist makes a diagnosis based on the standard 12-channel ECG recording. Automatic analysis of ECG recordings from a multiple-channel perspective has not been given enough attention, so it is essential to analyze an ECG recording from a multiple-channel perspective. We propose a model tha…
Opportunistic Screening of Wolff-Parkinson-White Syndrome using Single-Lead AI-ECG Mobile System: A Real-World Study of over 3.5 million ECG Recordings in China
We report Lobachevsky University Database (LUDB) of ECG signals, an open tool for validating ECG delineation algorithms, that is superior to the existing publicly available data bases in several aspects. LUDB contains 200 recordings of 10-second 12-lead electrocardiograms (ECG) from different subjects, representative of a variety of signal morphologies. The boundaries and peaks of QRS complexes and P and T waves are manually annotated by cardiologists for all recordings and independently for each lead, and all records received an expert classification by abnormalities. We present a case study …
Traditional DL models are complex and resource hungry and thus, care needs to be taken in designing Internet of (medical) things (IoT, or IoMT) applications balancing efficiency-complexity trade-off. Recent IoT solutions tend to avoid using deep-learning methods due to such complexities, and rather classical filter-based methods are commonly used. We hypothesize that a shallow CNN model can offer satisfactory level of performance in combination by leveraging other essential solution-components, such as post-processing that is suitable for resource constrained environment. In an IoMT applicatio…
Philips Research North America（飞利浦北美研究院）；Advanced Algorithm Research Center, Philips Healthcare（飞利浦医疗先进算法研究中心）
The development of new technology such as wearables that record high-quality single channel ECG, provides an opportunity for ECG screening in a larger population, especially for atrial fibrillation screening. The main goal of this study is to develop an automatic classification algorithm for normal sinus rhythm (NSR), atrial fibrillation (AF), other rhythms (O), and noise from a single channel short ECG segment (9-60 seconds). For this purpose, signal quality index (SQI) along with dense convolutional neural networks was used. Two convolutional neural network (CNN) models (main model that acce…
Sberbank AI Lab（俄罗斯联邦储蓄银行人工智能实验室）；New York University（纽约大学）
Holter monitoring, a long-term ECG recording (24-hours and more), contains a large amount of valuable diagnostic information about the patient. Its interpretation becomes a difficult and time-consuming task for the doctor who analyzes them because every heartbeat needs to be classified, thus requiring highly accurate methods for automatic interpretation. In this paper, we present a three-stage process for analysing Holter recordings with robustness to noisy signal. First stage is a segmentation neural network (NN) with encoderdecoder architecture which detects positions of heartbeats. Second s…
Philips Research North America（飞利浦北美研究院）；University of Arizona Banner Health（亚利桑那大学班纳健康）
We present our entry to the 2021 PhysioNet/CinC challenge - a waveform transformer model to detect cardiac abnormalities from ECG recordings. We compare the performance of the waveform transformer model on different ECG-lead subsets using approximately 88,000 ECG recordings from six datasets. In the official rankings, team prna ranked between 9 and 15 on 12, 6, 4, 3 and 2-lead sets respectively. Our waveform transformer model achieved an average challenge metric of 0.47 on the held-out test set across all ECG-lead subsets. Our combined performance across all leads placed us at rank 11 out of 3…
There have been several attempts to quantify the diagnostic distortion caused by algorithms that perform low-dimensional electrocardiogram (ECG) representation. However, there is no universally accepted quantitative measure that allows the diagnostic distortion arising from denoising, compression, and ECG beat representation algorithms to be determined. Hence, the main objective of this work was to develop a framework to enable biomedical engineers to efficiently and reliably assess diagnostic distortion resulting from ECG processing algorithms. We propose a semiautomatic framework for quantif…
Electrocardiogram (ECG) signal is the most commonly used non-invasive tool in the assessment of cardiovascular diseases. Segmentation of the ECG signal to locate its constitutive waves, in particular the R-peaks, is a key step in ECG processing and analysis. Over the years, several segmentation and QRS complex detection algorithms have been proposed with different features; however, their performance highly depends on applying preprocessing steps which makes them unreliable in real-time data analysis of ambulatory care settings and remote monitoring systems, where the collected data is highly …
Zhejiang University（浙江大学）；The First Affiliated Hospital of University of Science and Technology of China（中国科学技术大学附属第一医院）；HeartVoice Medical Technology（心声医疗科技）；University of Science and Technology of China（中国科学技术大学）；Peking University（北京大学）
With the development of deep learning-based methods, automated classification of electrocardiograms (ECGs) has recently gained much attention. Although the effectiveness of deep neural networks has been encouraging, the lack of information given by the outputs restricts clinicians' reexamination. If the uncertainty estimation comes along with the classification results, cardiologists can pay more attention to "uncertain" cases. Our study aims to classify ECGs with rejection based on data uncertainty and model uncertainty. We perform experiments on a real-world 12-lead ECG dataset. First, we es…
An Electrocardiogram Foundation Model Built on over 10 Million Recordings with External Evaluation across Multiple Domains
National Institute of Health Data Science, Peking University（北京大学国家健康数据科学研究院）；Department of Cardiology, Massachusetts General Hospital（麻省总医院心内科）；Department of Biomedical Informatics, School of Medicine, Emory University（埃默里大学医学院生物医学信息学系）；Department of Biomedical Engineering, Georgia Institute of Technology（佐治亚理工学院生物医学工程系）；Harvard Medical School（哈佛医学院）；Department of Neurology, Beth Israel Deaconess Medical Center（贝斯以色列医疗中心神经科）；Department of Computing, Data Science Institute, Imperial College London（伦敦帝国学院计算系、数据科学研究所）；Zhongshan School of Medicine, Sun Yat-sen University（中山医学院，孙逸仙大学）；Institute of Medical Technology, Peking University Health Science Center（北京大学医学技术研究所，北京大学医学部）；Institute for Artificial Intelligence, Peking University（北京大学人工智能研究院）
AnyPPG: An ECG-Guided PPG Foundation Model Trained on Over 100,000 Hours of Recordings for Holistic Health Profiling
School of Intelligence Science and Technology, Peking University（北京大学智能科学与技术学院）；State Key Laboratory of General Artificial Intelligence, Peking University（北京大学通用人工智能全国重点实验室）；National Institute of Health Data Science, Peking University（北京大学健康医疗大数据国家研究院）
School of Computer Science and Technology, Harbin Institute of Technology (HIT)（哈尔滨工业大学计算机科学与技术学院）；School of Physics and Astronomy, The University of Manchester（曼彻斯特大学物理与天文学院）；SPACEnter Space Science and Technology Institute（SPACEnter空间科学与技术研究院）；Northeastern University（东北大学）；Beijing Electric Power Hospital（北京电力医院）
Heart disease is one of the most common diseases causing morbidity and mortality. Electrocardiogram (ECG) has been widely used for diagnosing heart diseases for its simplicity and non-invasive property. Automatic ECG analyzing technologies are expected to reduce human working load and increase diagnostic efficacy. However, there are still some challenges to be addressed for achieving this goal. In this study, we develop an algorithm to identify multiple abnormalities from 12-lead ECG recordings. In the algorithm pipeline, several preprocessing methods are firstly applied on the ECG data for de…
Wearable electrocardiograph (ECG) recording and processing systems have been developed to detect cardiac arrhythmia to help prevent heart attacks. Conventional wearable systems, however, suffer from high energy consumption at both circuit and system levels. To overcome the design challenges, this paper proposes an event-driven compressive ECG recording and neuromorphic processing system for cardiac arrhythmia detection. The proposed system achieves low power consumption and high arrhythmia detection accuracy via system level co-design with spike-based information representation. Event-driven l…
Universitat Pompeu Fabra（庞培法布拉大学）；Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN)（生物工程、生物材料与纳米医学生物医学研究网络中心（CIBER-BBN））；Aragón Institute of Engineering Research（阿拉贡工程研究所）；University of Zaragoza（萨拉戈萨大学）
Electrocardiogram (ECG) detection and delineation are key steps for numerous tasks in clinical practice, as ECG is the most performed non-invasive test for assessing cardiac condition. State-of-the-art algorithms employ digital signal processing (DSP), which require laborious rule adaptation to new morphologies. In contrast, deep learning (DL) algorithms, especially for classification, are gaining weight in academic and industrial settings. However, the lack of model explainability and small databases hinder their applicability. We demonstrate DL can be successfully applied to low interpretati…
Atrial fibrillation (AF) is the most prevalent heart arrhythmia. AF manifests on the electrocardiogram (ECG) though irregular beat-to-beat time interval variation, the absence of P-wave and the presence of fibrillatory waves (f-wave). We hypothesize that a deep learning (DL) approach trained on the raw ECG will enable robust detection of AF events and the estimation of the AF burden (AFB). We further hypothesize that the performance reached leveraging the raw ECG will be superior to previously developed methods using the beat-to-beat interval variation time series. Consequently, we develop a n…
The study in this paper presents a one-dimensional convolutional neural network (1DCNN) model, designed for the automated detection of obstructive Sleep Apnoea (OSA) captured from single-channel electrocardiogram (ECG) signals. The system provides mechanisms in clinical practice that help diagnose patients suffering with OSA. Using the state-of-the-art in 1DCNNs, a model is constructed using convolutional, max pooling layers and a fully connected Multilayer Perceptron (MLP) consisting of a hidden layer and SoftMax output for classification. The 1DCNN extracts prominent features, which are used…
Objectives: Atrial fibrillation (AF) is a common heart rhythm disorder associated with deadly and debilitating consequences including heart failure, stroke, poor mental health, reduced quality of life and death. Having an automatic system that diagnoses various types of cardiac arrhythmias would assist cardiologists to initiate appropriate preventive measures and to improve the analysis of cardiac disease. To this end, this paper introduces a new approach to detect and classify automatically cardiac arrhythmias in electrocardiograms (ECG) recordings. Methods: The proposed approach used a combi…
A Novel end-to-end Digital Health System Using Deep Learning-based ECG Analysis
KIOS Research and Innovation Center of Excellence (KIOS CoE)（KIOS研究与创新中心（KIOS CoE））；University of Cyprus（塞浦路斯大学）；MEDTL Medical Technologies Ltd.（MEDTL医疗技术有限公司）；Department of Computer Science, University of Cyprus（塞浦路斯大学计算机科学系）
A Complex UNet Approach for Non-Invasive Fetal ECG Extraction Using Single-Channel Dry Textile Electrodes
SIGMA Laboratory, CAMPUS Institute, National University of Science and Technology Politehnica Bucharest（SIGMA实验室，CAMPUS研究所，波兰学院科学技术大学布加勒斯特分校）；Department of Information Engineering and Computer Science, University of Trento（信息工程与计算机科学系，特伦特大学）；Department of Electrical Engineering, Eindhoven University of Technology（电气工程系，埃因霍温理工大学）
uPVC-Net: A Universal Premature Ventricular Contraction Detection Deep Learning Algorithm
Faculty of Biomedical Engineering, Technion-IIT（生物医学工程学院，技术ion-IIT）；Ruth and Bruce Rappaport Faculty of Medicine, Technion-IIT（鲁思和布鲁斯·拉帕波特医学学院，技术ion-IIT）
HSE University（高等经济大学）；Sber AI Lab（俄联邦储蓄银行人工智能实验室）；Artificial Intelligence Research Institute (AIRI)（人工智能研究院（AIRI））
Cardiovascular disease remains a significant problem in modern society. Among non-invasive techniques, the electrocardiogram (ECG) is one of the most reliable methods for detecting abnormalities in cardiac activities. However, ECG interpretation requires expert knowledge and it is time-consuming. Developing a novel method to detect the disease early could prevent death and complication. The paper presents novel various approaches for classifying cardiac diseases from ECG recordings. The first approach suggests the Poincare representation of ECG signal and deep-learning-based image classifiers …
HeartVoice Medical Technology（心音医疗科技）；University of Science and Technology of China（中国科学技术大学）
Electrocardiogram (ECG) is one of the most convenient and non-invasive tools for monitoring peoples' heart condition, which can use for diagnosing a wide range of heart diseases, including Cardiac Arrhythmia, Acute Coronary Syndrome, et al. However, traditional ECG disease detection models show substantial rates of misdiagnosis due to the limitations of the abilities of extracted features. Recent deep learning methods have shown significant advantages, but they do not provide publicly available services for those who have no training data or computational resources. In this paper, we demonstra…
University of Isfahan（伊斯法罕大学）；Amirkabir University of Technology（阿米尔卡比尔理工大学）；New Jersey Institute of Technology（新泽西理工学院）；Rutgers University（罗格斯大学）
Electrocardiogram (ECG) is the most frequent and routine diagnostic tool used for monitoring heart electrical signals and evaluating its functionality. The human heart can suffer from a variety of diseases, including cardiac arrhythmias. Arrhythmia is an irregular heart rhythm that in severe cases can lead to heart stroke and can be diagnosed via ECG recordings. Since early detection of cardiac arrhythmias is of great importance, computerized and automated classification and identification of these abnormal heart signals have received much attention for the past decades. Methods: This paper in…
Swiss Center for Electronics and Microtechnology (CSEM SA)（瑞士电子与微技术中心）
ECG heartbeat classification plays a vital role in diagnosis of cardiac arrhythmia. The goal of the Physionet/CinC 2021 challenge was to accurately classify clinical diagnosis based on 12, 6, 4, 3 or 2-lead ECG recordings in order to aid doctors in the diagnoses of different heart conditions. Transformers have had great success in the field of natural language processing in the past years. Our team, CinCSEM, proposes to draw the parallel between text and periodic time series signals by viewing the repeated period as words and the whole signal as a sequence of such words. In this way, the atten…
