scholarly journals Deep Learning for Cardiologist-Level Myocardial Infarction Detection in Electrocardiograms

Author(s):  
Arjun Gupta ◽  
Eliu Huerta ◽  
Zhizhen Zhao ◽  
Issam Moussa
2021 ◽  
Vol 11 (12) ◽  
pp. 3044-3053
Author(s):  
Rakesh Kumar Mahendran ◽  
V. Prabhu ◽  
V. Parthasarathy ◽  
A. Mary Judith

Myocardial infarction (MI) may precipitate severe health damage and lead to irreversible death of the heart muscle, the result of prolonged lack of oxygen if it is not treated in a timely manner. Lack of accurate and early detection techniques for this heart disease has reduced the efficiency of MI diagnosis. In this paper, the design, and implementation of an efficient deep learning algorithm called Adaptive Recurrent neural network (ARNN) is proposed for the MI detection. The main objective of the proposed work is the accurate identification of MI disease using ECG signals. ECG signal denoising has been performed using the Multi-Notch filter, which removes the specified noise frequency range. Discrete wavelet transform (DWT) is utilized for performing the feature extraction that decomposes the ECG signal into varied scales with waveletfiltering bank. After the extraction of specific QRS features, classification of the defected and normal ECG arrhythmic beat has been performed using the deep learning-based ARNN classifier. The MIT-BIH database has been used for testing and training data. The performance of the proposed algorithm is evaluated based on classification accuracy. Results that are attained include the classification accuracy of about 99.21%, 99% of sensitivity and 99.4% of specificity with PPV and NPV of about 99.4 and 99.01 values indicate the enhanced performance of our proposed work compared with the conventional LSTM-CAE and LSTM-CNN techniques.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Masato Shimizu ◽  
shummo cho ◽  
Yoshiki Misu ◽  
Mari Ohmori ◽  
Ryo Tateishi ◽  
...  

Introduction: Takotsubo syndrome (TTS) and acute anterior myocardial infarction (ant-AMI) show very similar 12-lead electrocardiography (ECG) featured at onset, and it is often difficult to distinguish them without cardiac catheterization. The difference of ECG between them was studied, but the diagnostic performance of machine learning (deep learning) for them had not been investigated. Hypothesis: Deep learning on 12-leads ECG has high diagnostic performance to diagnose TTS and ant-AMI at onset. Methods: Consecutive 50 patients of TTS were one-to-one matched to ant-AMI randomly by their age and gender, and total 100 patients were enrolled. No sinus rhythm patients were excluded. All ECGs were divided into each 12-lead, and 5 heart beats from one lead were extracted. For each lead, 250 ECG waves of TTS/AMI were sampled as 24bit bitmap image, and prediction model construction by convolutional neural network (CNN: transfer learning, using VGG16 architecture) underwent to distinguish the two diseases in each lead. Next, gradient weighted class activation color mapping (GradCam) was performed to detect the degree and position of convolutional importance in the leads. Results: Lead aVR (mean accuracy 0.748), I (0.733), and V1 (0.678) were the top 3 leads with high accuracy. In aVR lead, GradCam showed strong convolution of negative T wave in TTS, and sharp R wave in ant-AMI. In I lead, it spotlighted several parts of ECG wave in ant-AMI. However in TTS, whole shape of the wave, P wave onset, and negative T were invertedly convoluted in TTS. Conclusions: Deep learning was a powerful tool to distinguish TTS and ant-AMI at onset, and GradCam method gave us new insight of the difference on ECG between the two diseases.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L E Juarez-Orozco ◽  
J W Benjamins ◽  
T Maaniitty ◽  
A Saraste ◽  
P Van Der Harst ◽  
...  

Abstract Background Deep Learning (DL) is revolutionizing cardiovascular medicine through complex data-pattern recognition. In spite of its success in the diagnosis of coronary artery disease (CAD), DL implementation for prognostic evaluation of cardiovascular events is still limited. Traditional survival models (e.g.Cox) notably incorporate the effect of time-to-event but are unable to exploit complex non-liner dependencies between large numbers of predictors. On the other hand, DL hasn't systematically incorporated time-to-event for prognostic evaluations. Long-term registries of hybrid PET/CT imaging represent a suitable substrate for DL-based survival analysis due the large amount of time-dependent structured variables that they convey. Therefore, we sought to evaluate the feasibility and performance of DL Survival Analysis in predicting the occurrence of myocardial infarction (MI) and death in a long-term registry of cardiac hybrid PET/CT. Methods Data from our PET/CT registry of symptomatic patients with intermediate CAD risk who underwent sequential CT angiography and 15O-water PET for suspected ischemia, was analyzed. The sample has been followed for a 6-year average for MI or death. Ten clinical variables were extracted from electronic records including cardiovascular risk factors, dyspnea and early revascularization. CT angiography images were evaluated segmentally for: presence of plaque, % of luminal stenosis and calcification (58 variables). Absolute stress PET myocardial perfusion data was evaluated globally and regionally across vascular territories (4 variables). Cox-Nnet (a deep survival neural network) was implemented in a 5-fold cross-validated 80:20 split for training and testing. Resulting DL-hazard ratios were operationalized and compared to the observed events developed during follow-up. The performance of Cox-Nnet evaluating structured CT, PET/CT, and PET/CT+clinical variables was compared to expert interpretation (operationalized as: normal coronaries, non-obstructive CAD, obstructive CAD) and to Calcium Score (CaSc), through the concordance (c)-index. Results There were 426 men and 525 women with a mean age of 61±9 years-old. Twenty-four MI and 49 deaths occurred during follow-up (1 month–9.6 years), while 11.5% patients underwent early revascularization. Cox-Nnet evaluation of PET/CT data (c-index=0.75) outperformed categorical expert interpretation (c-index=0.54) and CaSc (c-index=0.65), while hybrid PET/CT and PET/CT+clinical (c-index=0.75) variables demonstrated incremental performance overall independent from early revascularization. Conclusion Deep Learning Survival Analysis is feasible in the evaluation of cardiovascular prognostic data. It might enhance the value of cardiac hybrid PET/CT imaging data for predicting the long-term development of myocardial infarction and death. Further research into the implementation of Deep Learning for prognostic analyses in CAD is warranted.


PLoS ONE ◽  
2019 ◽  
Vol 14 (10) ◽  
pp. e0224502 ◽  
Author(s):  
Joon-myoung Kwon ◽  
Ki-Hyun Jeon ◽  
Hyue Mee Kim ◽  
Min Jeong Kim ◽  
Sungmin Lim ◽  
...  

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiehui Chen ◽  
Wenqin Guo ◽  
Lingyue Zhao ◽  
Weichao Huang ◽  
Lili Wang ◽  
...  

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K H Li ◽  
J Ho ◽  
Z Xu ◽  
I Lakhani ◽  
G Bazoukis ◽  
...  

Abstract Background Risk stratification in acute myocardial infarction (AMI) is important for guiding clinical management. Current risk scores are mostly derived from clinical trials with stringent patient selection. We aimed to establish and evaluate a composite scoring system to predict short-term mortality after index episodes of AMI, independent of electrocardiography (ECG) pattern, in a large real-world cohort. Methods Using electronic health records, patients admitted to our regional teaching hospital (derivation cohort, n=2127) and an independent tertiary care center (validation cohort, n=1276) with index acute myocardial infarction between January 2013 and December 2017 as confirmed by principal diagnosis and laboratory findings, were identified retrospectively. Results Univariate logistic regression was used as the primary model to identify potential contributors to mortality. Stepwise forward likelihood ratio logistic regression revealed that neutrophil-to-lymphocyte ratio, peripheral vascular disease, age, and serum creatinine (NPAC) were significant predictors for 90-day mortality (Hosmer-Lemeshow test, P=0.21). Each component of the NPAC score was weighted by beta-coefficients in multivariate analysis. The C-statistic of the NPAC score was 0.75, which was higher than the conventional Charlson's score (C-statistic=0.63). Application of a deep learning model to our dataset improved the accuracy of classification with a C-statistic of 0.81. Multivariate binary logistic regression Variable β Adjusted Odds ratio (95% CI) P-value Points Age ≥65 years 1.304 3.68 (2.63–5.17) <0.001 2 Peripheral vascular disease 1.109 3.03 (1.52–6.04) 0.002 2 NLRt ≥9.51 1.100 2.73 (2.12–3.51) <0.001 1 Creatinine≥109 μmol/L 1.003 3.00 (2.35–3.85) <0.001 2 NPAC deep learning model Conclusions The NPAC score comprised of four items from routine laboratory parameters and basic clinical information and can facilitate early identification of cases at risk of short-term mortality following index myocardial infarction. Deep learning model can serve as a gate-keeper to provide more accurate prediction to facilitate clinical decision making.


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