Multivariate functional clustering for the morphological analysis of electrocardiograph curves

Cardiovascular ischaemic diseases are one of the main causes of death all over the world. In this class of pathologies, a quick diagnosis is essential for a good prognosis in reperfusive treatment. In particular, an automatic classification procedure based on statistical analysis of teletransmitted electrocardiograph (‘ECG’) traces would be very helpful for an early diagnosis. This work presents an analysis of ECG traces, either physiological or pathological, of patients whose 12-lead prehospital ECG has been sent to the 118 Dispatch Center in Milan by life-support personnel. The statistical analysis starts with a preprocessing step, where functional data are reconstructed from noisy observations and biological variability is removed by a non-linear registration procedure. Then, a multivariate functional k-means clustering procedure is carried out on reconstructed and registered ECGs and their first derivatives. Hence, a new semi-automatic diagnostic procedure, based solely on the ECG morphology, is proposed to classify ECG traces; finally, the performance of this classification method is evaluated.

[1]  I. Daubechies Orthonormal bases of compactly supported wavelets , 1988 .

[2]  R. E. Carlson,et al.  Monotone Piecewise Cubic Interpolation , 1980 .

[3]  Olivier Meste,et al.  Core Shape modelling of a set of curves , 2010, Comput. Stat. Data Anal..

[4]  Xueli Liu,et al.  Simultaneous curve registration and clustering for functional data , 2009, Comput. Stat. Data Anal..

[5]  R Core Team,et al.  R: A language and environment for statistical computing. , 2014 .

[6]  W. Einthoven,et al.  Weiteres über das Elektrokardiogramm , 1908, Archiv für die gesamte Physiologie des Menschen und der Tiere.

[7]  G. Lamas,et al.  ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction--executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1999 guidelines for the management of patients wi , 2004, Journal of the American College of Cardiology.

[8]  R. E. Mason,et al.  A new system of multiple-lead exercise electrocardiography. , 1966, American heart journal.

[9]  Sigle e Abbreviazioni Giuridiche T.F.R. , 2013 .

[10]  E. Goldberger,et al.  The aVl, aVr, and aVf leads , 1942 .

[11]  Laura M. Sangalli,et al.  Wavelets in functional data analysis: Estimation of multidimensional curves and their derivatives , 2012, Comput. Stat. Data Anal..

[12]  Francesca Ieva,et al.  Performance assessment using mixed effects models: a case study on coronary patient care , 2012 .

[13]  Simone Vantini,et al.  K-mean Alignment for Curve Clustering , 2010, Comput. Stat. Data Anal..

[14]  E. Goldberger,et al.  A simple, indifferent, electrocardiographic electrode of zero potential and a technique of obtaining augmented, unipolar, extremity leads , 1942 .

[15]  Thaddeus Tarpey,et al.  Clustering Functional Data , 2003, J. Classif..

[16]  Francesca Ieva,et al.  The Milano Network for Acute Coronary Syndromes and Emergency Services , 2007 .

[17]  W. Einthoven,et al.  On the direction and manifest size of the variations of potential in the human heart and on the influence of the position of the heart on the form of the electrocardiogram. , 1950, American heart journal.

[18]  Xueli Liu,et al.  Modes and clustering for time-warped gene expression profile data , 2003, Bioinform..

[19]  Mia Hubert,et al.  Clustering in an object-oriented environment , 1997 .

[20]  Franklin D. Johnston,et al.  The precordial electrocardiogram , 1935 .

[21]  Francesca Ieva,et al.  Multilevel models for clinical registers concerning STEMI patients in a complex urban reality: a statistical analysis of MOMI2 survey , 2010 .

[22]  A. C. Young,et al.  VENTRICULAR DEPOLARIZATION AND THE GENESIS OF QRS , 1957, Annals of the New York Academy of Sciences.

[23]  Christopher E. Buller,et al.  2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines , 2008, Circulation.