Abstract 17189: Explaining the Deep Learning Black Box by Identifying Segments of the Single-Lead ECG Signal Used for Detection of Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Praharsh Ivaturi ◽  
Matteo Gadaleta ◽  
Amitabh C Pandey ◽  
Michael Pazzani ◽  
Steven R Steinhubl ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Decision Making ◽  
Deep Learning ◽  
Network Architecture ◽  
Normal Sinus Rhythm ◽  
Black Box ◽  
P Wave ◽  
Ecg Signal ◽  
Rr Intervals ◽  
Post Hoc

Introduction: Deep learning (DL) has proved effective for automatic identification of atrial fibrillation (AF) using single-lead ECG. Adoption and trust of DL by clinicians is limited by its black box nature. Hypothesis: Post hoc explanations can elucidate what part of ECG signal is used by the black box DL algorithm, quantifying the importance of clinically relevant features in the classification decision. Making DL decision process transparent will help its integration into clinical practice. Methods: 8,528 single-lead ECG recordings collected using AliveCor devices (PhysioNet) were used. Each signal was labeled as normal sinus rhythm, AF, other arrhythmia or noise. DL automatic classification involves a lightweight convolutional neural network architecture - MobileNet - whose performance is analyzed with an explanation method for DL. Results: Each RR interval is divided into 8 equal segments, where segment 1 follows each R peak, 4 and 5 correspond to the isoelectric baseline, and 7 to the P wave. The explanation method substitutes one of these segments with a straight line, and the corresponding change in sensitivity highlights its importance for the DL algorithm decision. MobileNet achieved a sensitivity of 92.5% to identify AF (9.4% of ECGs were in AF). Sensitivity increases by 2.5% when Segment 7 is removed, indicating that the absence of P wave leads the network to classify more frequently samples as AF.(Figure) When Segments 4 and 5 are removed, the sensitivity decreases by 2.5% and 5.0%, and by 26.7% when removed together. When all RR intervals are normalized to the same value (RR in the Figure), sensitivity for AF drops by 78.3%, showing that RR intervals are key for AF detection by DL algorithm. Conclusions: Post hoc explanations for AF detection by DL from single-lead ECG show the importance of common morphological features used for classifying AF. These methods can be used to understand the decision-making process of DL and motivate its clinical adoption.

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

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.

scholarly journals An Atrial Fibrillation with Normal Limits using Signal Processing- A Review

2018 ◽  
Vol 7 (2.24) ◽  
pp. 453
Author(s):  
S. Sathish ◽  
K Mohanasundaram
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
P Wave ◽  
Wave Duration ◽  
Normal Limits ◽  
Normal Sinus ◽  
P Wave Duration ◽  
Standard Lead ◽  
Wave Morphology

Atrial fibrillation is an irregular heartbeat (arrhythmia) that can lead to the stroke, blood clots, heart failure and other heart related complications. This causes the symptoms like rapid and irregular heartbeat, fluttering, shortness of breath etc. In India for every around 4000 people eight of them are suffering from Atrial Fibrillation. P-wave Morphology.  Abnormality of P-wave (Atrial ECG components) seen during sinus rhythm are associated with Atrial fibrillation. P-wave duration is the best predictor of preoperative atrial fibrillation. but the small amplitudes of atrial ECG and its gradual increase from isometric line create difficulties in defining the onset of P wave in the Standard Lead Limb system (SLL).Studies shows that prolonged P-wave have duration in patients (PAF) In this Study, a Modified Lead Limb (MLL) which solves the practical difficulties in analyzing the P-ta interval for both in healthy subjects and Atrial Fibrillation patients. P-Ta wave interval and P-wave duration can be estimated with following proposed steps which is applicable for both filtered and unfiltered atrial ECG components which follows as the clinical database trials. For the same the p-wave fibrillated signals that escalates the diagnosis follows by providing minimal energy to recurrent into a normal sinus rhythm.  

The Black Box Myth

2019 ◽  
Vol 1 (1) ◽  
pp. 1-3
Author(s):  
Abraham Rudnick
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Decision Making ◽  
Deep Learning ◽  
Black Box ◽  
Dynamic Decision Making ◽  
Empirical Knowledge ◽  
Negative Consequences ◽  
Extreme Caution ◽  
Scientific Facts

Artificial intelligence (AI) and its correlates, such as machine and deep learning, are changing health care, where complex matters such as comoribidity call for dynamic decision-making. Yet, some people argue for extreme caution, referring to AI and its correlates as a black box. This brief article uses philosophy and science to address the black box argument about knowledge as a myth, concluding that this argument is misleading as it ignores a fundamental tenet of science, i.e., that no empirical knowledge is certain, and that scientific facts – as well as methods – often change. Instead, control of the technology of AI and its correlates has to be addressed to mitigate such unexpected negative consequences.

scholarly journals Local Post-hoc Explainable Methods for Adversarial Text Attacks

2021 ◽  
Author(s):  
Yidong Chai ◽  
Ruicheng Liang ◽  
Hongyi Zhu ◽  
Sagar Samtani ◽  
Meng Wang ◽  
...  
Keyword(s):  
Deep Learning ◽  
Natural Language Processing ◽  
Language Processing ◽  
Black Box ◽  
Learning Models ◽  
Two Phase ◽  
Sensitivity Estimation ◽  
Execution Phase ◽  
Adversarial Examples ◽  
Post Hoc

Deep learning models have significantly advanced various natural language processing tasks. However, they are strikingly vulnerable to adversarial text attacks, even in the black-box setting where no model knowledge is accessible to hackers. Such attacks are conducted with a two-phase framework: 1) a sensitivity estimation phase to evaluate each element’s sensitivity to the target model’s prediction, and 2) a perturbation execution phase to craft the adversarial examples based on estimated element sensitivity. This study explored the connections between the local post-hoc explainable methods for deep learning and black-box adversarial text attacks and proposed a novel eXplanation-based method for crafting Adversarial Text Attacks (XATA). XATA leverages local post-hoc explainable methods (e.g., LIME or SHAP) to measure input elements’ sensitivity and adopts the word replacement perturbation strategy to craft adversarial examples. We evaluated the attack performance of the proposed XATA on three commonly used text-based datasets: IMDB Movie Review, Yelp Reviews-Polarity, and Amazon Reviews-Polarity. The proposed XATA outperformed existing baselines in various target models, including LSTM, GRU, CNN, and BERT. Moreover, we found that improved local post-hoc explainable methods (e.g., SHAP) lead to more effective adversarial attacks. These findings showed that when researchers constantly advance the explainability of deep learning models with local post-hoc methods, they also provide hackers with weapons to craft more targeted and dangerous adversarial attacks.

scholarly journals Atrial Fibrillation Detection Using Feedforward Neural Network

2021 ◽  
Author(s):  
Yunfan Chen ◽  
Chong Zhang ◽  
Chengyu Liu ◽  
Yiming Wang ◽  
Xiangkui Wan
Keyword(s):  
Neural Network ◽  
Atrial Fibrillation ◽  
Deep Learning ◽  
Detection System ◽  
Recognition Rate ◽  
Feedforward Neural Network ◽  
Classification Model ◽  
Detection Sensitivity ◽  
Ecg Signal ◽  
Atrial Fibrillation Detection

Abstract Atrial fibrillation is one of the most common arrhythmias in clinics, which has a great impact on people's physical and mental health. Electrocardiogram (ECG) based arrhythmia detection is widely used in early atrial fibrillation detection. However, ECG needs to be manually checked in clinical practice, which is time-consuming and labor-consuming. It is necessary to develop an automatic atrial fibrillation detection system. Recent research has demonstrated that deep learning technology can help to improve the performance of the automatic classification model of ECG signals. To this end, this work proposes effective deep learning based technology to automatically detect atrial fibrillation. First, novel preprocessing algorithms of wavelet transform and sliding window filtering (SWF) are introduced to reduce the noise of the ECG signal and to filter high-frequency components in the ECG signal, respectively. Then, a robust R-wave detection algorithm is developed, which achieves 99.22% detection sensitivity, 98.55% positive recognition rate, and 2.25% deviance on the MIT-BIH arrhythmia database. In addition, we propose a feedforward neural network (FNN) to detect atrial fibrillation based on ECG records. Experiments verified by a 10-fold cross-validation strategy show that the proposed model achieves competitive detection performance and can be applied to wearable detection devices. The proposed atrial fibrillation detection model achieves an accuracy of 84.00%, the detection sensitivity of 84.26%, the specificity of 93.23%, and the area under the receiver working curve of 89.40% on the mixed dataset composed of Challenge2017 database and MIT-BIH arrhythmia database.

scholarly journals P-Wave Detection Using a Fully Convolutional Neural Network in Electrocardiogram Images

2020 ◽  
Vol 10 (3) ◽  
pp. 976
Author(s):  
Rana N. Costandy ◽  
Safa M. Gasser ◽  
Mohamed S. El-Mahallawy ◽  
Mohamed W. Fakhr ◽  
Samir Y. Marzouk
Keyword(s):  
Neural Network ◽  
Atrial Fibrillation ◽  
Convolutional Neural Network ◽  
P Wave ◽  
Ecg Signal ◽  
P Waves ◽  
Ecg Signals ◽  
Wave Detection ◽  
Automated Algorithm ◽  
Electrocardiogram Ecg

Electrocardiogram (ECG) signal analysis is a critical task in diagnosing the presence of any cardiac disorder. There are limited studies on detecting P-waves in various atrial arrhythmias, such as atrial fibrillation (AFIB), atrial flutter, junctional rhythm, and other arrhythmias due to P-wave variability and absence in various cases. Thus, there is a growing need to develop an efficient automated algorithm that annotates a 2D printed version of P-waves in the well-known ECG signal databases for validation purposes. To our knowledge, no one has annotated P-waves in the MIT-BIH atrial fibrillation database. Therefore, it is a challenge to manually annotate P-waves in the MIT-BIH AF database and to develop an automated algorithm to detect the absence and presence of different shapes of P-waves. In this paper, we present the manual annotation of P-waves in the well-known MIT-BIH AF database with the aid of a cardiologist. In addition, we provide an automatic P-wave segmentation for the same database using a fully convolutional neural network model (U-Net). This algorithm works on 2D imagery of printed ECG signals, as this type of imagery is the most commonly used in developing countries. The proposed automatic P-wave detection method obtained an accuracy and sensitivity of 98.56% and 98.78%, respectively, over the first 5 min of the second lead of the MIT-BIH AF database (a total of 8280 beats). Moreover, the proposed method is validated using the well-known automatically and manually annotated QT database (a total of 11,201 and 3194 automatically and manually annotated beats, respectively). This results in accuracies of 98.98 and 98.9%, and sensitivities of 98.97 and 97.24% for the automatically and manually annotated QT databases, respectively. Thus, these results indicate that the proposed automatic method can be used for analyzing long-printed ECG signals on mobile battery-driven devices using only images of the ECG signals, without the need for a cardiologist.

scholarly journals A new deep learning algorithm of 12-lead electrocardiogram for identifying atrial fibrillation during sinus rhythm

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong-Soo Baek ◽  
Sang-Chul Lee ◽  
Wonik Choi ◽  
Dae-Hyeok Kim
Keyword(s):  
Atrial Fibrillation ◽  
Deep Learning ◽  
Sinus Rhythm ◽  
Learning Algorithm ◽  
Normal Sinus Rhythm ◽  
Characteristic Curve ◽  
External Validation ◽  
Digital Data ◽  
Internal Validation ◽  
Optimal Interval

AbstractAtrial fibrillation (AF) is the most prevalent arrhythmia and is associated with increased morbidity and mortality. Its early detection is challenging because of the low detection yield of conventional methods. We aimed to develop a deep learning-based algorithm to identify AF during normal sinus rhythm (NSR) using 12-lead electrocardiogram (ECG) findings. We developed a new deep neural network to detect subtle differences in paroxysmal AF (PAF) during NSR using digital data from standard 12-lead ECGs. Raw digital data of 2,412 12-lead ECGs were analyzed. The artificial intelligence (AI) model showed that the optimal interval to detect subtle changes in PAF was within 0.24 s before the QRS complex in the 12-lead ECG. We allocated the enrolled ECGs to the training, internal validation, and testing datasets in a 7:1:2 ratio. Regarding AF identification, the AI-based algorithm showed the following values in the internal and external validation datasets: area under the receiver operating characteristic curve, 0.79 and 0.75; recall, 82% and 77%; specificity, 78% and 72%; F1 score, 75% and 74%; and overall accuracy, 72.8% and 71.2%, respectively. The deep learning-based algorithm using 12-lead ECG demonstrated high accuracy for detecting AF during NSR.

scholarly journals A Deep Convolutional Neural Network Architecture for Cancer Diagnosis using Histopathological Images

2021 ◽  
Vol 10 (12) ◽  
pp. 7-12
Author(s):  
Karthika Gidijala ◽  
◽  
Mansa Devi Pappu ◽  
Manasa Vavilapalli ◽  
Mahesh Kothuru ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neural Network ◽  
Neural Networks ◽  
Decision Making ◽  
Deep Learning ◽  
Cancer Diagnosis ◽  
Network Architecture ◽  
Neural Network Architecture ◽  
Proposed Model ◽  
Histopathological Images

Many different models of Convolution Neural Networks exist in the Deep Learning studies. The application and prudence of the algorithms is known only when they are implemented with strong datasets. The histopathological images of breast cancer are considered as to have much number of haphazard structures and textures. Dealing with such images is a challenging issue in deep learning. Working on wet labs and in coherence to the results many research have blogged with novel annotations in the research. In this paper, we are presenting a model that can work efficiently on the raw images with different resolutions and alleviating with the problems of the presence of the structures and textures. The proposed model achieves considerably good results useful for decision making in cancer diagnosis.

The Sensitivity of The Heart Rate Detection for Atrial Electrograms Signal

2021 ◽  
Vol 20 (2) ◽  
pp. 33-41
Author(s):  
Pang Seng Kong ◽  
Nasarudin Ahmad ◽  
Fazilah Hassan ◽  
Anita Ahmad
Keyword(s):  
Atrial Fibrillation ◽  
Heart Rate ◽  
Wavelet Transform ◽  
Discrete Wavelet Transform ◽  
Screening Tool ◽  
Discrete Wavelet ◽  
Ecg Signal ◽  
Large Area ◽  
Rr Intervals ◽  
Rr Interval

Atrial Fibrillation (AF) is the most familiar example of arrhythmia that will occur health problems such as stroke, heart failure and other complications. Globally, the number of AF patients will more than triple by 2050 worldwide. Current methods involve performing large-area ablation without knowing the exact location of key parts. The reliability of the technology can be used as a target for atrial fibrillation’s catheter ablation. The factors that leading to the onset of atrial fibrillation include the triggering factors that induce arrhythmia and the substrate that maintains the arrhythmia. The project’s aim is to create a method for identifying AF that can be used as screening tool in medical practice. The primary goals for the detection method’s design are to develop a MATLAB software program that can compare the complexity of a normal ECG signal and an AF ECG signal. Currently, this can be achieved by the ECG Signal’s R peaks and RR Interval. For AF detection, there are more R peaks and RR Intervals and it is irregular. In this research, the detection of AF is based on the heart rate (RR Intervals). For the ECG preprocessing, Pan-Tompkins Algorithm and Discrete Wavelet Transform is used to detect the sensitivity on the R peaks and RR Intervals. As a result, Discrete Wavelet Transform algorithm gives 100% sensitivity for the dataset obtained from MIT-BIH Atrial Fibrillation and MIT-BIH Arrhythmia Database.  

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