scholarly journals B-PO03-094 DEEP LEARNING-BASED CLASSIFICATION OF UNIPOLAR ELECTROGRAMS IN HUMAN ATRIAL FIBRILLATION: APPLICATION IN FOCAL SOURCE AND TRIGGER (FAST) MAPPING AND ABLATION

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S226-S227
Author(s):  
Vijay S. Chauhan ◽  
Shun Liao ◽  
Don Ragot ◽  
Sachin Nayyar ◽  
Adrian Suszko ◽  
...  
2021 ◽  
Vol 12 ◽  
Author(s):  
Shun Liao ◽  
Don Ragot ◽  
Sachin Nayyar ◽  
Adrian Suszko ◽  
Zhaolei Zhang ◽  
...  

Focal sources are potential targets for atrial fibrillation (AF) catheter ablation, but they can be time-consuming and challenging to identify when unipolar electrograms (EGM) are numerous and complex. Our aim was to apply deep learning (DL) to raw unipolar EGMs in order to automate putative focal sources detection. We included 78 patients from the Focal Source and Trigger (FaST) randomized controlled trial that evaluated the efficacy of adjunctive FaST ablation compared to pulmonary vein isolation alone in reducing AF recurrence. FaST sites were identified based on manual classification of sustained periodic unipolar QS EGMs over 5-s. All periodic unipolar EGMs were divided into training (n = 10,004) and testing cohorts (n = 3,180). DL was developed using residual convolutional neural network to discriminate between FaST and non-FaST. A gradient-based method was applied to interpret the DL model. DL classified FaST with a receiver operator characteristic area under curve of 0.904 ± 0.010 (cross-validation) and 0.923 ± 0.003 (testing). At a prespecified sensitivity of 90%, the specificity and accuracy were 81.9 and 82.5%, respectively, in detecting FaST. DL had similar performance (sensitivity 78%, specificity 89%) to that of FaST re-classification by cardiologists (sensitivity 78%, specificity 79%). The gradient-based interpretation demonstrated accurate tracking of unipolar QS complexes by select DL convolutional layers. In conclusion, our novel DL model trained on raw unipolar EGMs allowed automated and accurate classification of FaST sites. Performance was similar to FaST re-classification by cardiologists. Future application of DL to classify FaST may improve the efficiency of real-time focal source detection for targeted AF ablation therapy.


2008 ◽  
Vol 55 (9) ◽  
pp. 2275-2285 ◽  
Author(s):  
Giandomenico Nollo ◽  
Mattia Marconcini ◽  
Luca Faes ◽  
Francesca Bovolo ◽  
Flavia Ravelli ◽  
...  

2000 ◽  
Vol 23 (2) ◽  
pp. 192-202 ◽  
Author(s):  
VINCENZO BARBARO ◽  
PIETRO BARTOLINI ◽  
GIOVANNI CALCAGNINI ◽  
SANDRA MORELLI ◽  
ANTONIO MICHELUCCI ◽  
...  

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Jessica Torres-Soto ◽  
Euan A. Ashley

Abstract Wearable devices enable theoretically continuous, longitudinal monitoring of physiological measurements such as step count, energy expenditure, and heart rate. Although the classification of abnormal cardiac rhythms such as atrial fibrillation from wearable devices has great potential, commercial algorithms remain proprietary and tend to focus on heart rate variability derived from green spectrum LED sensors placed on the wrist, where noise remains an unsolved problem. Here we develop DeepBeat, a multitask deep learning method to jointly assess signal quality and arrhythmia event detection in wearable photoplethysmography devices for real-time detection of atrial fibrillation. The model is trained on approximately one million simulated unlabeled physiological signals and fine-tuned on a curated dataset of over 500 K labeled signals from over 100 individuals from 3 different wearable devices. We demonstrate that, in comparison with a single-task model, our architecture using unsupervised transfer learning through convolutional denoising autoencoders dramatically improves the performance of atrial fibrillation detection from a F1 score of 0.54 to 0.96. We also include in our evaluation a prospectively derived replication cohort of ambulatory participants where the algorithm performed with high sensitivity (0.98), specificity (0.99), and F1 score (0.93). We show that two-stage training can help address the unbalanced data problem common to biomedical applications, where large-scale well-annotated datasets are hard to generate due to the expense of manual annotation, data acquisition, and participant privacy.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Miguel Rodrigo ◽  
Albert J Rogers ◽  
Prasanth Ganesan ◽  
Mahmood Alhusseini ◽  
JUSTIN XU ◽  
...  

Introduction: It is unclear whether atrial fibrillation (AF) is best identified on intracardiac recordings by varying shape, rapid rate or extent of irregularity. Prioritizing these features may improve device diagnosis of AF. Hypothesis: AF can be separated from organized atrial flutter (AFL) by electrogram shape, independent of the contributions of rate or regularity. Methods: In 86 patients (25 female, age 65±11 years) we trained a convolutional neural network (CNN) to classify AF or AFL from 64 unipolar electrograms of persistent AF recorded for 60 seconds. In cases labelled as AF, we modified inputs by progressively regularizing (a) electrogram shape; (b) rate or (c) regularity in timing, to define which switched the classification to AFL. Results: The CNN provided a c-statistic of 0.95 ± 0.05 to identify AF or AFL in independent test cohorts not used for training, using 10-fold cross validation. Fig A shows AF in which progressive regularization of shape and timing from #1 to #4 flipped CNN classification into AFL in 45%. EGMs with 100% consistent shape and timing were classified by their cycle length (CL=1/rate): ~90% AF for CL < 175 ms, ~80% AFL for CL from 200-280 ms. Fig. B shows sequences simulated from patient-specific EGMs of AF that were classified as AF in 91 ± 12% of cases even if regular with CL of 200-280 ms, showing AF classification based on EGM shape alone. Figure B illustrates some ‘AF pathognomic’ electrogram shapes in red. Conclusions: AF may be identified by specific EGM shape patterns independent of regularity or rate. Regularity in shape and timing contribute ~45% to AFL classification, and adding CL explains up to 80%. Studies are required to study the mechanistic basis and clinical implications of specific AF-electrogram shapes.


2004 ◽  
Vol 52 (S 1) ◽  
Author(s):  
S Dhein ◽  
A Boldt ◽  
J Garbade ◽  
L Polontchouk ◽  
U Wetzel ◽  
...  

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