The emergence of deep learning has significantly enhanced the analysis of electrocardiograms (ECGs), a non-invasive method that is essential for assessing heart health. Despite the complexity of ECG interpretation, advanced deep learning models outperform traditional methods. However, the increasing complexity of ECG data and the need for real-time and accurate diagnosis necessitate exploring more robust architectures, such as transformers. Here, we present an in-depth review of transformer architectures that are applied to ECG classification. Originally developed for natural language processing, these models capture complex temporal relationships in ECG signals that other models might overlook. We conducted an extensive search of the latest transformer-based models and summarize them to discuss the advances and challenges in their application and suggest potential future improvements. This review serves as a valuable resource for researchers and practitioners and aims to shed light on this innovative application in ECG interpretation.
ECGMamba: Towards Efficient ECG Classification with BiSSM
School of Automation Science and Engineering, South China University of Technology（华南理工大学自动化科学与工程学院）；Key Laboratory of Digital Medical Engineering of Hebei Province, College of Electronic and Information Engineering, Hebei University（河北大学电子与信息工程学院）；Zhujiang Hospital of Southern Medical University（南方医科大学珠江医院）；General Hospital of Southern Command（南部战区总医院）
Arrhythmia is a cardiovascular disease that manifests irregular heartbeats. In arrhythmia detection, the electrocardiogram (ECG) signal is an important diagnostic technique. However, manually evaluating ECG signals is a complicated and time-consuming task. With the application of convolutional neural networks (CNNs), the evaluation process has been accelerated and the performance is improved. It is noteworthy that the performance of CNNs heavily depends on their architecture design, which is a complex process grounded on expert experience and trial-and-error. In this paper, we propose a novel …
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 …
PPGFlowECG: Latent Rectified Flow with Cross-Modal Encoding for PPG-Guided ECG Generation and Cardiovascular Disease Detection
National Institute of Health Data Science, Peking University, China（北京大学国家健康数据科学研究院）；School of Intelligence Science and Technology, Peking University, China（北京大学智能科学与技术学院）；Data Science Institute, Imperial College London, UK（伦敦帝国理工学院数据科学研究院）；University of Chinese Academy of Sciences, China（中国科学院大学）
Patients who suffer an acute coronary syndrome are at elevated risk for adverse cardiovascular events such as myocardial infarction and cardiovascular death. Accurate assessment of this risk is crucial to their course of care. We focus on estimating a patient's risk of cardiovascular death after an acute coronary syndrome based on a patient's raw electrocardiogram (ECG) signal. Learning from this signal is challenging for two reasons: 1) positive examples signifying a downstream cardiovascular event are scarce, causing drastic class imbalance, and 2) each patient's ECG signal consists of thous…
Ping An Technology（平安科技）；Saw Swee Hock School of Public Health, National University Health System, National University of Singapore（新加坡国立大学国立大学卫生系统苏瑞福公共卫生学院）；Yong Loo Lin School of Medicine, National University Health System, National University of Singapore（新加坡国立大学国立大学卫生系统杨潞龄医学院）；NUS Graduate School for Integrative Sciences & Engineering（新加坡国立大学综合科学与工程研究生院）；Institute of Data Science, National University of Singapore（新加坡国立大学数据科学研究所）
Cardiovascular disease is a major threat to health and one of the primary causes of death globally. The 12-lead ECG is a cheap and commonly accessible tool to identify cardiac abnormalities. Early and accurate diagnosis will allow early treatment and intervention to prevent severe complications of cardiovascular disease. In the PhysioNet/Computing in Cardiology Challenge 2020, our objective is to develop an algorithm that automatically identifies 27 ECG abnormalities from 12-lead ECG recordings.
Uncertainty-Aware PPG-2-ECG for Enhanced Cardiovascular Diagnosis using Diffusion Models
Verily Life Sciences, AI Team（Verily生命科学公司，人工智能团队）；Technion - Israel Institute of Technology, Computer Science Department（技术学院-以色列理工学院，计算机科学系）；Verily Life Sciences（Verily生命科学公司）
National Yang Ming Chiao Tung University（国立阳明交通大学）；Oklahoma State University（俄克拉荷马州立大学）
Arrhythmia detection from ECG is an important research subject in the prevention and diagnosis of cardiovascular diseases. The prevailing studies formulate arrhythmia detection from ECG as a time series classification problem. Meanwhile, early detection of arrhythmia presents a real-world demand for early prevention and diagnosis. In this paper, we address a problem of cardiovascular disease early classification, which is a varied-length and long-length time series early classification problem as well. For solving this problem, we propose a deep reinforcement learning-based framework, namely S…
Electrocardiography (ECG), an electrical measurement which captures cardiac activities, is the gold standard for diagnosing cardiovascular disease (CVD). However, ECG is infeasible for continuous cardiac monitoring due to its requirement for user participation. By contrast, photoplethysmography (PPG) provides easy-to-collect data, but its limited accuracy constrains its clinical usage. To combine the advantages of both signals, recent studies incorporate various deep learning techniques for the reconstruction of PPG signals to ECG; however, the lack of contextual information as well as the lim…
University of Alberta（阿尔伯塔大学）；Canadian VIGOUR Centre（加拿大VIGOUR中心）；Alberta Machine Intelligence Institute（阿尔伯塔机器智能研究所）
Electrocardiogram (ECG) abnormalities are linked to cardiovascular diseases, but may also occur in other non-cardiovascular conditions such as mental, neurological, metabolic and infectious conditions. However, most of the recent success of deep learning (DL) based diagnostic predictions in selected patient cohorts have been limited to a small set of cardiac diseases. In this study, we use a population-based dataset of >250,000 patients with >1000 medical conditions and >2 million ECGs to identify a wide range of diseases that could be accurately diagnosed from the patient's first in-hospital …
DUET（达卡工程技术大学）；EUB（欧洲孟加拉大学）；JNU（贾汉吉尔纳加尔大学）；Daffodil International University（达福迪尔国际大学）；BUP（孟加拉国国父和平大学）
Nearly 30% of the people in the rural areas of Bangladesh are below the poverty level. Moreover, due to the unavailability of modernized healthcare-related technology, nursing and diagnosis facilities are limited for rural people. Therefore, rural people are deprived of proper healthcare. In this perspective, modern technology can be facilitated to mitigate their health problems. ECG sensing tools are interfaced with the human chest, and requisite cardiovascular data is collected through an IoT device. These data are stored in the cloud incorporates with the MQTT and HTTP servers. An innovativ…
Few-Label Multimodal Modeling of SNP Variants and ECG Phenotypes Using Large Language Models for Cardiovascular Risk Stratification
University of New South Wales, Australia（新南威尔士大学，澳大利亚）；University of Surrey, United Kingdom（萨里大学，英国）；Mohamed bin Zayed University of Artificial Intelligence, UAE（穆罕默德·本·扎耶德人工智能大学，阿联酋）
Stanford Online High School（斯坦福在线高中）；AliveCor, Inc.（AliveCor公司）
Mobile electrocardiogram (ECG) recording technologies represent a promising tool to fight the ongoing epidemic of cardiovascular diseases, which are responsible for more deaths globally than any other cause. While the ability to monitor one's heart activity at any time in any place is a crucial advantage of such technologies, it is also the cause of a drawback: signal noise due to environmental factors can render the ECGs illegible. In this work, we develop convolutional neural networks (CNNs) to automatically label ECGs for noise, training them on a novel noise-annotated dataset. By reducing …
A Signal-Language Foundation Model for Broad-Spectrum Cardiovascular Assessment from Routine Electrocardiography
Department of Cardiology, Zhongshan Hospital of Fudan University（复旦大学中山医院心内科）；Shanghai Institute of Cardiovascular Diseases, National Clinical Research Centre for Interventional Medicine（上海心血管病研究所，国家介入医学临床研究中心）；Digital Medical Research Center, School of Basic Medical Sciences, Fudan University（复旦大学基础医学研究院数字医疗研究中心）；Shanghai Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention（上海医学影像计算与计算机辅助手术重点实验室）；National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, Du Cane Road（伦敦帝国学院国家心肺研究所，哈马舍姆医院，杜肯路）；Department of Cardiology, Shanghai Geriatric Medical Center（上海老年医学中心心内科）；Cardiac Rhythm Management, Medtronic Technology Center, Medtronic (Shanghai) Ltd.（美敦力技术中心，美敦力（上海）有限公司，心律管理部）；Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School（哈佛医学院比尔·德·阿克谢心脏结局研究中心，贝斯以色列·德aconess医疗中心）；Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School（哈佛-托尔恩迪克电生理研究所，贝斯以色列·德aconess医疗中心，哈佛医学院）；Department of Cardiology, Imperial College Healthcare NHS Trust（伦敦帝国学院医疗信托心内科部）；Department of Cardiology, Chelsea and Westminster NHS Foundation Trust（切尔西和温斯洛医院 NHS 基础信托心内科部）；Department of Computer Science and Technology, University of Cambridge（剑桥大学计算机科学与技术系）
Electrocardiogram (ECG) signals are beneficial in diagnosing cardiovascular diseases, which are one of the leading causes of death. However, they are often contaminated by noise artifacts and affect the automatic and manual diagnosis process. Automatic deep learning-based examination of ECG signals can lead to inaccurate diagnosis, and manual analysis involves rejection of noisy ECG samples by clinicians, which might cost extra time. To address this limitation, we present a two-stage deep learning-based framework to automatically detect the noisy ECG samples. Through extensive experiments and …
Biosignal Fingerprinting: A Cross-Modal PPG-ECG Foundation Model
Department of Engineering Science, University of Oxford（牛津大学工程科学系）；Oxford Suzhou Centre for Advanced Research（牛津苏浙先进研究中心）；School of Public Health, Shanghai Jiao Tong University（上海交通大学公共卫生学院）
MEETI: A Multimodal ECG Dataset from MIMIC-IV-ECG with Signals, Images, Features and Interpretations
HeartVoice Medical Technology（HeartVoice医疗科技）；Saw Swee Hock School of Public Health and Institute of Data Science（Saw Swee Hock公共卫生学院和数据科学研究所）；National University of Singapore（新加坡国立大学）；Department of Cardiology, Peking University People’s Hospital（北京大学人民医院心内科）；College of Integrative Chinese and Western Medicine, Anhui University of Chinese Medicine（安徽中医药大学整合中西医学学院）；National Institute of Health Data Science, Peking University（北京大学国家健康数据科学研究院）；Institute for Artificial Intelligence, Peking University（北京大学人工智能研究院）
CE-SSL: Computation-Efficient Semi-Supervised Learning for ECG-based Cardiovascular Diseases Detection
City University of Hong Kong（香港城市大学）；Hong Kong Center for Cerebro-Cardiovascular Health Engineering (COCHE)（香港心脑血管健康工程中心）；The Johns Hopkins University School of Medicine（约翰霍普金斯大学医学院）；Shenzhen Research Institute, City University of Hong Kong（香港城市大学深圳研究院）；University of Oxford（牛津大学）；Oxford-Suzhou Institute of Advanced Research (OSCAR)（牛津苏州高等研究院）；Chinese University of Hong Kong（香港中文大学）；Hong Kong Institutes of Medical Engineering（香港医学工程研究院）
The Ohio State University（俄亥俄州立大学）；Wuhan University of Technology（武汉理工大学）
Electrocardiogram (ECG) is a widely used reliable, non-invasive approach for cardiovascular disease diagnosis. With the rapid growth of ECG examinations and the insufficiency of cardiologists, accurate and automatic diagnosis of ECG signals has become a hot research topic. Deep learning methods have demonstrated promising results in predictive healthcare tasks. In this paper, we developed a deep neural network for multi-label classification of cardiac arrhythmias in 12-lead ECG recordings. Experiments on a public 12-lead ECG dataset showed the effectiveness of our method. The proposed model ac…
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）
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…
IBM Research - Africa（IBM非洲研究院）；University of Oxford（牛津大学）；Guangdong Cardiovascular Institute（广东省心血管病研究所）
Myocardial Infarction (MI) has the highest mortality of all cardiovascular diseases (CVDs). Detection of MI and information regarding its occurrence-time in particular, would enable timely interventions that may improve patient outcomes, thereby reducing the global rise in CVD deaths. Electrocardiogram (ECG) recordings are currently used to screen MI patients. However, manual inspection of ECGs is time-consuming and prone to subjective bias. Machine learning methods have been adopted for automated ECG diagnosis, but most approaches require extraction of ECG beats or consider leads independentl…
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 …
Acceleration of machine learning research in healthcare is challenged by lack of large annotated and balanced datasets. Furthermore, dealing with measurement inaccuracies and exploiting unsupervised data are considered to be central to improving existing solutions. In particular, a primary objective in predictive modeling is to generalize well to both unseen variations within the observed classes, and unseen classes. In this work, we consider such a challenging problem in machine learning driven diagnosis: detecting a gamut of cardiovascular conditions (e.g. infarction, dysrhythmia etc.) from …
Zhejiang University（浙江大学）；RealDoctor AI Research Centre（RealDoctor人工智能研究中心）；Shanghai Polytechnic University（上海第二工业大学）；University of Notre Dame（圣母大学）
A large number of people suffer from life-threatening cardiac abnormalities, and electrocardiogram (ECG) analysis is beneficial to determining whether an individual is at risk of such abnormalities. Automatic ECG classification methods, especially the deep learning based ones, have been proposed to detect cardiac abnormalities using ECG records, showing good potential to improve clinical diagnosis and help early prevention of cardiovascular diseases. However, the predictions of the known neural networks still do not satisfactorily meet the needs of clinicians, and this phenomenon suggests that…
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…
Many people are currently suffering from heart diseases that can lead to untimely death. The most common heart abnormality is arrhythmia, which is simply irregular beating of the heart. A prediction system for the early intervention and prevention of heart diseases, including cardiovascular diseases (CDVs) and arrhythmia, is important. This paper introduces the classification of electrocardiogram (ECG) heartbeats into normal or abnormal. The approach is based on the combination of swarm optimization algorithms with a modified PannTompkins algorithm (MPTA) and support vector machines (SVMs). Th…
University of Engineering and Technology Taxila（塔克西拉工程技术大学）；University of Central Florida（中佛罗里达大学）；Hankuk University of Foreign Studies（韩国外国语大学）；Xiamen University Malaysia（厦门大学马来西亚分校）
The electrocardiogram (ECG) is one of the most extensively employed signals used in the diagnosis and prediction of cardiovascular diseases (CVDs). The ECG signals can capture the heart's rhythmic irregularities, commonly known as arrhythmias. A careful study of ECG signals is crucial for precise diagnoses of patients' acute and chronic heart conditions. In this study, we propose a two-dimensional (2-D) convolutional neural network (CNN) model for the classification of ECG signals into eight classes; namely, normal beat, premature ventricular contraction beat, paced beat, right bundle branch b…
Fraunhofer Institute for Integrated Circuits IIS（弗劳恩霍夫集成电路研究所）；Friedrich-Alexander University Erlangen-Nürnberg（埃尔朗根-纽伦堡弗里德里希-亚历山大大学）；University of Leeds（利兹大学）
Cardiovascular diseases are the most common cause of mortality worldwide. Detection of atrial fibrillation (AF) in the asymptomatic stage can help prevent strokes. It also improves clinical decision making through the delivery of suitable treatment such as, anticoagulant therapy, in a timely manner. The clinical significance of such early detection of AF in electrocardiogram (ECG) signals has inspired numerous studies in recent years, of which many aim to solve this task by leveraging machine learning algorithms. ECG datasets containing AF samples, however, usually suffer from severe class imb…
Electrocardiogram (ECG) can be reliably used as a measure to monitor the functionality of the cardiovascular system. Recently, there has been a great attention towards accurate categorization of heartbeats. While there are many commonalities between different ECG conditions, the focus of most studies has been classifying a set of conditions on a dataset annotated for that task rather than learning and employing a transferable knowledge between different tasks. In this paper, we propose a method based on deep convolutional neural networks for the classification of heartbeats which is able to ac…
Aristotle University of Thessaloniki（塞萨洛尼基亚里士多德大学）；AHEPA University Hospital（阿希帕大学医院）
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited heart muscle disease that appears between the second and forth decade of a patient's life, being responsible for 20% of sudden cardiac deaths before the age of 35. The effective and punctual diagnosis of this disease based on Electrocardiograms (ECGs) could have a vital role in reducing premature cardiovascular mortality. In our analysis, we firstly outline the digitalization process of paper - based ECG signals enhanced by a spatial filter aiming to eliminate dark regions in the dataset's images that do not correspond to E…
