CRT-Net: A Generalized and Scalable Framework for the Computer-Aided Diagnosis of Electrocardiogram Signals

Electrocardiogram (ECG) signals play critical roles in the clinical screening and diagnosis of many types of cardiovascular diseases. Despite deep neural networks that have been greatly facilitated computer-aided diagnosis (CAD) in many clinical tasks, the variability and complexity of ECG in the clinic still pose significant challenges in both diagnostic performance and clinical applications. In this paper, we develop a robust and scalable framework for the clinical recognition of ECG. Considering the fact that hospitals generally record ECG signals in the form of graphic waves of 2-D images, we first extract the graphic waves of 12-lead images into numerical 1-D ECG signals by a proposed bi-directional connectivity method. Subsequently, a novel deep neural network, namely CRT-Net, is designed for the fine-grained and comprehensive representation and recognition of 1-D ECG signals. The CRT-Net can well explore waveform features, morphological characteristics and time domain features of ECG by embedding convolution neural network(CNN), recurrent neural network(RNN), and transformer module in a scalable deep model, which is especially suitable in clinical scenarios with different lengths of ECG signals captured from different devices. The proposed framework is first evaluated on two widely investigated public repositories, demonstrating the superior performance of ECG recognition in comparison with state-of-the-art. Moreover, we validate the effectiveness of our proposed bi-directional connectivity and CRT-Net on clinical ECG images collected from the local hospital, including 258 patients with chronic kidney disease (CKD), 351 patients with Type-2 Diabetes (T2DM), and around 300 patients in the control group. In the experiments, our methods can achieve excellent performance in the recognition of these two types of disease, i.e., more than 90.1% accuracy, precision, sensitivity, and F1 score. 1 ar X iv :2 10 5. 13 61 9v 1 [ cs .L G ] 2 8 M ay 2 02 1

[1]  Ruxin Wang,et al.  Multi-class Arrhythmia detection from 12-lead varied-length ECG using Attention-based Time-Incremental Convolutional Neural Network , 2020, Inf. Fusion.

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

[3]  Yun-Chi Yeh,et al.  Feature Selection Algorithm for ECG Signals and Its Application on Heartbeat Case Determining , 2014 .

[4]  Sonali Agarwal,et al.  Cardiac Arrhythmia Detection from Single-lead ECG using CNN and LSTM assisted by Oversampling , 2018, 2018 International Conference on Advances in Computing, Communications and Informatics (ICACCI).

[5]  Ahmed Mostayed,et al.  Classification of 12-Lead ECG Signals with Bi-directional LSTM Network , 2018, ArXiv.

[6]  Özal Yildirim,et al.  A novel wavelet sequence based on deep bidirectional LSTM network model for ECG signal classification , 2018, Comput. Biol. Medicine.

[7]  Willis J. Tompkins,et al.  A Real-Time QRS Detection Algorithm , 1985, IEEE Transactions on Biomedical Engineering.

[8]  Organización Mundial de la Salud World health statistics 2017: monitoring health for the SDGs, Sustainable Development Goals , 2018 .

[9]  LuoXiaoqing,et al.  Heartbeat classification using disease-specific feature selection , 2014 .

[10]  U. Rajendra Acharya,et al.  ECG beat classification using PCA, LDA, ICA and Discrete Wavelet Transform , 2013, Biomed. Signal Process. Control..

[11]  Juan Pablo Martínez,et al.  Heartbeat Classification Using Feature Selection Driven by Database Generalization Criteria , 2011, IEEE Transactions on Biomedical Engineering.

[12]  Yu Tian,et al.  High-Performance Personalized Heartbeat Classification Model for Long-Term ECG Signal , 2017, IEEE Transactions on Biomedical Engineering.

[13]  Yanchun Zhang,et al.  An Attention-based Hybrid LSTM-CNN Model for Arrhythmias Classification , 2019, 2019 International Joint Conference on Neural Networks (IJCNN).

[14]  C. Li,et al.  Detection of ECG characteristic points using wavelet transforms. , 1995, IEEE transactions on bio-medical engineering.

[15]  Yang Liu,et al.  Automatic Cardiac Arrhythmia Classification Using Combination of Deep Residual Network and Bidirectional LSTM , 2019, IEEE Access.

[16]  J. Coresh,et al.  Prevalence of chronic kidney disease in the United States. , 2007, JAMA.

[17]  Lukasz Kaiser,et al.  Attention is All you Need , 2017, NIPS.

[18]  Shoushui Wei,et al.  An Open Access Database for Evaluating the Algorithms of Electrocardiogram Rhythm and Morphology Abnormality Detection , 2018, Journal of Medical Imaging and Health Informatics.

[19]  B. V. K. Vijaya Kumar,et al.  Heartbeat Classification Using Morphological and Dynamic Features of ECG Signals , 2012, IEEE Transactions on Biomedical Engineering.

[20]  Mohammad Bagher Shamsollahi,et al.  Model-Based Fiducial Points Extraction for Baseline Wandered Electrocardiograms , 2008, IEEE Transactions on Biomedical Engineering.

[21]  Moncef Gabbouj,et al.  Real-Time Patient-Specific ECG Classification by 1-D Convolutional Neural Networks , 2016, IEEE Transactions on Biomedical Engineering.

[22]  G.B. Moody,et al.  The impact of the MIT-BIH Arrhythmia Database , 2001, IEEE Engineering in Medicine and Biology Magazine.

[23]  Moncef Gabbouj,et al.  A Generic and Robust System for Automated Patient-Specific Classification of ECG Signals , 2009, IEEE Transactions on Biomedical Engineering.

[24]  Jian Sun,et al.  Deep Residual Learning for Image Recognition , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[25]  Naomie Salim,et al.  Arrhythmia recognition and classification using combined linear and nonlinear features of ECG signals , 2016, Comput. Methods Programs Biomed..

[26]  Wen-June Wang,et al.  Feature selection algorithm for ECG signals using Range-Overlaps Method , 2010, Expert Syst. Appl..

[27]  Edward S. C. Shih,et al.  Detection and Classification of Cardiac Arrhythmias by a Challenge-Best Deep Learning Neural Network Model , 2019, bioRxiv.