Classification of atrial fibrillation and normal sinus rhythm based on convolutional neural network

In this paper, we present our research which confirms the suitability of the convolutional neural network usage for the classification of single-lead ECG recordings. The proposed method was designed for classifying normal sinus rhythm, atrial fibrillation (AF), non-AF related other abnormal heart rhythms and noisy signals. The method combines manually selected features with the features learned by the deep neural network. The Physionet Challenge 2017 dataset of over 8500 ECG recordings was used for the model training and validation. The trained model reaches an average F1-score 0.71 in classifying normal sinus rhythm, AF and other rhythms respectively.

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Detection of Brief Episodes of Atrial Fibrillation Based on Electrocardiomatrix and Convolutional Neural Network

Frontiers in Physiology ◽

10.3389/fphys.2021.673819 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ricardo Salinas-Martínez ◽

Johannes de Bie ◽

Nicoletta Marzocchi ◽

Frida Sandberg

Keyword(s):

Neural Network ◽

Atrial Fibrillation ◽

Deep Learning ◽

Convolutional Neural Network ◽

Thrombus Formation ◽

Normal Sinus Rhythm ◽

Morphological Characteristics ◽

P Wave ◽

Learning Approaches ◽

Normal Sinus

Background: Brief episodes of atrial fibrillation (AF) may evolve into longer AF episodes increasing the chances of thrombus formation, stroke, and death. Classical methods for AF detection investigate rhythm irregularity or P-wave absence in the ECG, while deep learning approaches profit from the availability of annotated ECG databases to learn discriminatory features linked to different diagnosis. However, some deep learning approaches do not provide analysis of the features used for classification. This paper introduces a convolutional neural network (CNN) approach for automatic detection of brief AF episodes based on electrocardiomatrix-images (ECM-images) aiming to link deep learning to features with clinical meaning.Materials and Methods: The CNN is trained using two databases: the Long-Term Atrial Fibrillation and the MIT-BIH Normal Sinus Rhythm, and tested on three databases: the MIT-BIH Atrial Fibrillation, the MIT-BIH Arrhythmia, and the Monzino-AF. Detection of AF is done using a sliding window of 10 beats plus 3 s. Performance is quantified using both standard classification metrics and the EC57 standard for arrhythmia detection. Layer-wise relevance propagation analysis was applied to link the decisions made by the CNN to clinical characteristics in the ECG.Results: For all three testing databases, episode sensitivity was greater than 80.22, 89.66, and 97.45% for AF episodes shorter than 15, 30 s, and for all episodes, respectively.Conclusions: Rhythm and morphological characteristics of the electrocardiogram can be learned by a CNN from ECM-images for the detection of brief episodes of AF.

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Prediction of atrial fibrillation from normal ECG using artificial intelligence in patients with unexplained stroke

European Heart Journal ◽

10.1093/ehjci/ehaa946.0348 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

Y.S Baek ◽

S.C Lee ◽

W.I Choi ◽

D.H Kim

Keyword(s):

Neural Network ◽

Artificial Intelligence ◽

Atrial Fibrillation ◽

Sinus Rhythm ◽

Normal Sinus Rhythm ◽

Statistical Significance ◽

Validation Dataset ◽

Internal Validation ◽

Normal Sinus ◽

Group 2

Abstract Background Stroke related to embolic and of undetermined source constitute 20 to 30% of ischemic strokes. Many of these strokes are related to atrial fibrillation (AF), which might be underdetected due to its paroxysmal and silent nature. Purpose The aim of our study was to predict AF during normal sinus rhythm in a standard 12-lead ECG to train an artificial intelligence to train deep neural network in patients with unexplained stroke (embolic stroke of undetermined source; ESUS). Methods We analyzed digital raw data of 12-lead ECGs using artificial intelligence (AI) recurrent neural network (RNN) to detect the electrocardiographic signature of atrial fibrillation present during normal sinus rhythm using standard 12-lead ECGs. We included 2,585 cases aged 18 years or older with multiple ECGs at our university hospital between 2005 and 2017 validated by crossover analysis of two electrophysiologists. We defined the first recorded AF ECG as the index ECG and the first day of the window of interest as 14 days before the date of the index ECG. We allocated ECGs to the training, internal validation, and testing datasets in a 7:1:2 ratio. We calculated recall, F1 score, and the area under the curve (AUC) of the receiver operatoring characteristic curve (ROC) for the internal validation dataset to select a probability threshold. We applied this developed AI program to 169 ESUS patients who has been diagnosed and had standard 12-lead ECGs in our hospital. Results We acquired 1,266 NSR ECSs from real normal subjects and 1,319 NSR ECGs form paroxysmal AF patients. RNN AI-enabled ECG identified atrial fibrillation with an AUC of 0.79, recall of 82%, specificity of 78%, F1 score of 75% and overall accuracy of 72.8% (Figure). ESUS patients were divided into three groups according to calculated probabilities of AF using AI guided RNN program: group 1 (35 patients with probability of 0–25% of paroxysmal AF), group 2 (86 patients with probability of 25–75% of paroxysmal AF) and group 3 (48 patients with probability of 75–100% of paroxysmal AF). In Kaplan-Meier estimates, Group 2 and 3 (more than 25% of PAF probabilities) tended to have higher AF incidence although it did not reach statistical significance (log-rank p 0.678) (Figure). Conclusion AI may discriminate subtle changes between real and paroxysmal NSR and can also be helpful in patients with ESUS to identify if AF is the underlying cause of the stroke. Further studies are needed in order to evaluate their possible use in future prognostic models. Funding Acknowledgement Type of funding source: None

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Classification of Atrial Fibrillation and Congestive Heart Failure using Convolutional Neural Network with Electrocardiogram

10.21203/rs.3.rs-521179/v1 ◽

2021 ◽

Author(s):

Yunendah Nur Fu’adah ◽

Ki Moo Lim

Keyword(s):

Neural Network ◽

Heart Failure ◽

Atrial Fibrillation ◽

Congestive Heart Failure ◽

Convolutional Neural Network ◽

Classification System ◽

Normal Sinus Rhythm ◽

Delayed Diagnosis ◽

Ecg Signals

Abstract Delayed diagnosis of atrial fibrillation (AF) and congestive heart failure (CHF) can lead to death. Early diagnosis of these cardiac conditions is possible by manually analyzing electrocardiogram (ECG) signals. However, manual diagnosis is complex, owing to the various characteristics of ECG signals. Several studies have reported promising results using the automatic classification of ECG signals. The performance accuracy needs to be improved considering that an accurate classification system of AF and CHF has the potential to save a patient’s life. An optimal ECG signal classification system for AF and CHF has been proposed in this study using a one-dimensional convolutional neural network (1-D CNN) to improve the performance. A total of 150 datasets of ECG signals were modeled using the1-D CNN. The proposed 1-D CNN algorithm, provided precision values, recall, f1-score, accuracy of 100%, and successfully classified raw data of ECG signals into three conditions, which are normal sinus rhythm (NSR), AF, and CHF. The results showed that the proposed method outperformed the previous methods. This approach can be considered as an adjunct for medical personnel to diagnose AF, CHF, and NSR.

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5105A deep neural network predicts atrial fibrillation from normal ECGs recorded on a smartphone-enabled device

European Heart Journal ◽

10.1093/eurheartj/ehz746.0041 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Cited By ~ 1

Author(s):

C Galloway ◽

D Treiman ◽

J Shreibati ◽

M Schram ◽

Z Karbaschi ◽

...

Keyword(s):

Neural Network ◽

Atrial Fibrillation ◽

Deep Learning ◽

Sinus Rhythm ◽

Sensitivity And Specificity ◽

Normal Sinus Rhythm ◽

Learning Model ◽

Normal Sinus ◽

Normal Ecgs ◽

Deep Learning Model

Abstract Background Electrocardiographic predictors of atrial fibrillation (AF) from a non-AF ECG–such as p wave abnormalities and supraventricular ectopy–have been extensively documented. However, risk prediction tools for AF utilize little if any of the wealth of information available from the ECG. Better AF prediction from the ECG may improve efficiency of screening and performance of AF risk tools. Deep learning methods have the potential to extract an unlimited number of features from the ECG to improve prediction of AF. Purpose We hypothesize that a deep learning model can identify patterns predictive of AF during normal sinus rhythm. To test the hypothesis, we trained and tested a neural network to predict AF from normal sinus rhythm ambulatory ECG data. Methods We trained a deep convolutional neural network to detect features of AF that are present in single-lead ECGs with normal sinus rhythm, recorded using a Food and Drug Administration (FDA)-cleared, smartphone-enabled device. A cohort of 27,526 patients with at least 50 ECGs recorded between January 7, 2013, and September, 19, 2018, and the FDA-cleared automated findings of Normal and Atrial Fibrillation associated with those ECGs, were used for model development. Specifically, we trained the deep learning model on 1,984,581 Normal ECGs from 19,267 patients with 1) only Normal ECG recordings, or 2) at least 30% ECGs with AF. Of the 27,526 patients, an internal set of 8,259 patients with 841,776 Normal ECGs was saved for testing (validation). Results Among 8,259 patients in the test set, 3,467 patients had at least 30% of their ECGs with an automated finding of AF. When the deep learning model was run on 841,776 Normal ECGs, it was able to predict whether the ECG was from a patient with no AF or with 30% or more AF, with an area under the curve (AUC) of 0.80. Using an operating point with equal sensitivity and specificity, the model's sensitivity and specificity were 73.1%. Using an operating point with high specificity (90.0%), the model's sensitivity was 48.0%. When the model was applied to a randomly-selected, broader cohort of 15,000 patients (at least 50 ECGs recorded, any amount of AF), a positive, non-linear relationship between neural network output and AF burden per patient was observed (Figure). Model Output vs AF Burden Per Patient Conclusions A deep learning model was able to predict AF from ECGs in normal sinus rhythm that were recorded on a smartphone-enabled device. The use of deep learning, if prospectively validated, may facilitate AF screening in patients with paroxysmal disease or warn patients who are at high risk for developing AF. Acknowledgement/Funding AliveCor

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Classification of human electrocardiograms by multi-layer convolutional neural network and hyperparameter optimization

Journal of Intelligent & Fuzzy Systems ◽

10.3233/jifs-189610 ◽

2021 ◽

pp. 1-9

Author(s):

Yao-Mei Chen ◽

Yenming J. Chen ◽

Yun-Kai Tsai ◽

Wen-Hsien Ho ◽

Jinn-Tsong Tsai

Keyword(s):

Neural Network ◽

Heart Failure ◽

Congestive Heart Failure ◽

Sinus Rhythm ◽

Convolutional Neural Network ◽

Large Scale ◽

Normal Sinus Rhythm ◽

Performance Tests ◽

Hyperparameter Optimization ◽

Normal Sinus

A multi-layer convolutional neural network (MCNN) with hyperparameter optimization (HyperMCNN) is proposed for classifying human electrocardiograms (ECGs). For performance tests of the HyperMCNN, ECG recordings for patients with cardiac arrhythmia (ARR), congestive heart failure (CHF), and normal sinus rhythm (NSR) were obtained from three PhysioNet databases: MIT-BIH Arrhythmia Database, BIDMC Congestive Heart Failure Database, and MIT-BIH Normal Sinus Rhythm Database, respectively. The MCNN hyperparameters in convolutional layers included number of filters, filter size, padding, and filter stride. The hyperparameters in max-pooling layers were pooling size and pooling stride. Gradient method was also a hyperparameter used to train the MCNN model. Uniform experimental design approach was used to optimize the hyperparameter combination for the MCNN. In performance tests, the resulting 16-layer CNN with an appropriate hyperparameter combination (16-layer HyperMCNN) was used to distinguish among ARR, CHF, and NSR. The experimental results showed that the average correct rate and standard deviation obtained by the 16-layer HyperMCNN were superior to those obtained by a 16-layer CNN with a hyperparameter combination given by Matlab examples. Furthermore, in terms of performance in distinguishing among ARR, CHF, and NSR, the 16-layer HyperMCNN was superior to the 25-layer AlexNet, which was the neural network that had the best image identification performance in the ImageNet Large Scale Visual Recognition Challenge in 2012.

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AFibNet: an implementation of atrial fibrillation detection with convolutional neural network

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01571-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bambang Tutuko ◽

Siti Nurmaini ◽

Alexander Edo Tondas ◽

Muhammad Naufal Rachmatullah ◽

Annisa Darmawahyuni ◽

...

Keyword(s):

Neural Network ◽

Atrial Fibrillation ◽

Convolutional Neural Network ◽

Learning System ◽

Single Frequency ◽

Feature Maps ◽

Normal Sinus ◽

Unseen Data ◽

Specific Device ◽

Model Formation

Abstract Background Generalization model capacity of deep learning (DL) approach for atrial fibrillation (AF) detection remains lacking. It can be seen from previous researches, the DL model formation used only a single frequency sampling of the specific device. Besides, each electrocardiogram (ECG) acquisition dataset produces a different length and sampling frequency to ensure sufficient precision of the R–R intervals to determine the heart rate variability (HRV). An accurate HRV is the gold standard for predicting the AF condition; therefore, a current challenge is to determine whether a DL approach can be used to analyze raw ECG data in a broad range of devices. This paper demonstrates powerful results for end-to-end implementation of AF detection based on a convolutional neural network (AFibNet). The method used a single learning system without considering the variety of signal lengths and frequency samplings. For implementation, the AFibNet is processed with a computational cloud-based DL approach. This study utilized a one-dimension convolutional neural networks (1D-CNNs) model for 11,842 subjects. It was trained and validated with 8232 records based on three datasets and tested with 3610 records based on eight datasets. The predicted results, when compared with the diagnosis results indicated by human practitioners, showed a 99.80% accuracy, sensitivity, and specificity. Result Meanwhile, when tested using unseen data, the AF detection reaches 98.94% accuracy, 98.97% sensitivity, and 98.97% specificity at a sample period of 0.02 seconds using the DL Cloud System. To improve the confidence of the AFibNet model, it also validated with 18 arrhythmias condition defined as Non-AF-class. Thus, the data is increased from 11,842 to 26,349 instances for three-class, i.e., Normal sinus (N), AF and Non-AF. The result found 96.36% accuracy, 93.65% sensitivity, and 96.92% specificity. Conclusion These findings demonstrate that the proposed approach can use unknown data to derive feature maps and reliably detect the AF periods. We have found that our cloud-DL system is suitable for practical deployment

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