Multiclass classification of myocardial infarction with convolutional and recurrent neural networks for portable ECG devices

Abstract Myocardial infarction (MI) is a medical emergency for which the early detection of symptoms is desirable. The prevalence of portable electrocardiogram (ECG) devices makes frequent screening for MI possible. In this study, we develop an MI classifier that combines both convolutional and recurrent neural networks, and is suitable for wearable ECG devices with only a single lead recording. It performs multiclass classification to discriminate the ECG records of MI from those of healthy individuals and patients with existing chronic heart conditions, as well as ECG records contaminated with noise. The method was tested on a dataset with MI ECG records and compared with a pure convolutional neural network and classifier with hand-crafted features. It was found that the addition of a recurrent layer improved the classification sensitivity by 28.0% compared to the convolutional neural network alone. Overall, it achieved 92.4% sensitivity, 97.7% specificity, a 97.2% positive predictive value, and a 94.6% F1 score.

[1]  K. P. Indiradevi,et al.  Classification of Myocardial Infarction Using Multi Resolution Wavelet Analysis of ECG , 2016 .

[2]  Jürgen Schmidhuber,et al.  Long Short-Term Memory , 1997, Neural Computation.

[3]  M. Botvinick,et al.  Neural representations of events arise from temporal community structure , 2013, Nature Neuroscience.

[4]  T. Lai Stochastic approximation: invited paper , 2003 .

[5]  Ralf Bousseljot,et al.  Nutzung der EKG-Signaldatenbank CARDIODAT der PTB über das Internet , 2009 .

[6]  Geoffrey E. Hinton,et al.  Deep Learning , 2015, Nature.

[7]  S. Maxwell Emergency management of acute myocardial infarction. , 1999, British journal of clinical pharmacology.

[8]  David H. Wolpert,et al.  Stacked generalization , 1992, Neural Networks.

[9]  U. Rajendra Acharya,et al.  A deep convolutional neural network model to classify heartbeats , 2017, Comput. Biol. Medicine.

[10]  Mark E Josephson,et al.  Use of the electrocardiogram in acute myocardial infarction. , 2003, The New England journal of medicine.

[11]  Ronald W. Schafer,et al.  On the frequency-domain properties of Savitzky-Golay filters , 2011, 2011 Digital Signal Processing and Signal Processing Education Meeting (DSP/SPE).

[12]  K. P. Soman,et al.  An Efficient R-peak Detection Based on New Nonlinear Transformation and First-Order Gaussian Differentiator , 2011 .

[13]  D. Opitz,et al.  Popular Ensemble Methods: An Empirical Study , 1999, J. Artif. Intell. Res..

[14]  U. Rajendra Acharya,et al.  Automated Diagnosis of Myocardial Infarction ECG Signals Using Sample Entropy in Flexible Analytic Wavelet Transform Framework , 2017, Entropy.

[15]  S. Hargittai Savitzky-Golay least-squares polynomial filters in ECG signal processing , 2005, Computers in Cardiology, 2005.

[16]  Mirza Mansoor Baig,et al.  A comprehensive survey of wearable and wireless ECG monitoring systems for older adults , 2013, Medical & Biological Engineering & Computing.

[17]  U. Rajendra Acharya,et al.  Automated detection of coronary artery disease using different durations of ECG segments with convolutional neural network , 2017, Knowl. Based Syst..

[18]  U. Rajendra Acharya,et al.  Application of deep convolutional neural network for automated detection of myocardial infarction using ECG signals , 2017, Inf. Sci..

[19]  Mark H Johnson,et al.  The development of spatial frequency biases in face recognition. , 2010, Journal of experimental child psychology.

[20]  Martin J. Wainwright,et al.  Noisy matrix decomposition via convex relaxation: Optimal rates in high dimensions , 2011, ICML.

[21]  David Atienza,et al.  Real-time classification technique for early detection and prevention of myocardial infarction on wearable devices , 2017, 2017 IEEE Biomedical Circuits and Systems Conference (BioCAS).

[22]  Madhuchhanda Mitra,et al.  A classification approach for myocardial infarction using voltage features extracted from four standard ECG leads , 2011, 2011 International Conference on Recent Trends in Information Systems.

[23]  Casey J Kohen,et al.  7. Electrocardiogram Interpretation , 2014 .

[24]  Madhuchhanda Mitra,et al.  ECG feature extraction and classification of anteroseptal myocardial infarction and normal subjects using discrete wavelet transform , 2010, 2010 International Conference on Systems in Medicine and Biology.

[25]  Janez Demsar,et al.  Statistical Comparisons of Classifiers over Multiple Data Sets , 2006, J. Mach. Learn. Res..

[26]  Muhammad Arif,et al.  Detection and Localization of Myocardial Infarction using K-nearest Neighbor Classifier , 2012, Journal of Medical Systems.

[27]  Shu-Fen Wung,et al.  A quantitative evaluation of ST-segment changes on the 18-lead electrocardiogram during acute coronary occlusions. , 2006, Journal of electrocardiology.

[28]  Momiao Xiong,et al.  Wearable computing for fully automated myocardial infarction classification , 2016, BICoB 2016.

[29]  Hubert Cardot,et al.  Combining Multiple Pairwise Neural Networks Classifiers: A Comparative Study , 2005, ANNIIP.

[30]  Yingchun Zhou,et al.  Disease Classification and Biomarker Discovery Using ECG Data , 2015, BioMed research international.

[31]  Shing-Chow Chan,et al.  Myocardial infarction detection and classification — A new multi-scale deep feature learning approach , 2016, 2016 IEEE International Conference on Digital Signal Processing (DSP).

[32]  Tze Leung Lai,et al.  Stochastic approximation , 2018 .

[33]  Roderick Tung,et al.  CHAPTER 11 – Use of the Electrocardiogram in Acute Myocardial Infarction , 2010 .

[34]  Sergey Ioffe,et al.  Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift , 2015, ICML.

[35]  Qiao Li,et al.  AF classification from a short single lead ECG recording: The PhysioNet/computing in cardiology challenge 2017 , 2017, 2017 Computing in Cardiology (CinC).

[36]  S Dandapat,et al.  A new way of quantifying diagnostic information from multilead electrocardiogram for cardiac disease classification. , 2014, Healthcare technology letters.

[37]  N. Moorjani,et al.  Mechanical complications of acute myocardial infarction. , 2013, Cardiology clinics.

[38]  Li Sun,et al.  ECG Analysis Using Multiple Instance Learning for Myocardial Infarction Detection , 2012, IEEE Transactions on Biomedical Engineering.

[39]  Nitish Srivastava,et al.  Dropout: a simple way to prevent neural networks from overfitting , 2014, J. Mach. Learn. Res..

[40]  Yuan Yu,et al.  TensorFlow: A system for large-scale machine learning , 2016, OSDI.

[41]  Jeffrey M. Hausdorff,et al.  Physionet: Components of a New Research Resource for Complex Physiologic Signals". Circu-lation Vol , 2000 .

[42]  U. Rajendra Acharya,et al.  Automated detection of arrhythmias using different intervals of tachycardia ECG segments with convolutional neural network , 2017, Inf. Sci..

[43]  F. Basile,et al.  Heart rate variability and myocardial infarction: systematic literature review and metanalysis. , 2009, European review for medical and pharmacological sciences.

[44]  J. F. Waller Davidson's Principles and Practice of Medicine , 1978 .

[45]  Padmavathi Kora,et al.  Improved Bat algorithm for the detection of myocardial infarction , 2015, SpringerPlus.

[46]  I. Menown,et al.  Optimizing the initial 12-lead electrocardiographic diagnosis of acute myocardial infarction. , 2000, European heart journal.

[47]  Michael S. Lew,et al.  Deep learning for visual understanding: A review , 2016, Neurocomputing.

[48]  Geoffrey E. Hinton,et al.  Rectified Linear Units Improve Restricted Boltzmann Machines , 2010, ICML.

[49]  Fred S Apple,et al.  Third universal definition of myocardial infarction , 2012 .

[50]  H. E. Cohen Myocardial infarction classification. , 1984, The American journal of cardiology.

[51]  Yves Cottin,et al.  Prevalence, incidence, predictive factors and prognosis of silent myocardial infarction: a review of the literature. , 2011, Archives of cardiovascular diseases.

[52]  Savitzky—Golay Filters , 2000 .