An integrated index for detection of Sudden Cardiac Death using Discrete Wavelet Transform and nonlinear features

Display Omitted Novel Sudden Cardiac Death Index (SCDI) is proposed using ECG signals.Nonlinear features are extracted from DWT coefficients.SCDI is formulated using nonlinear features.SCDI predicts accurately SCD 4min before its onset. Early prediction of person at risk of Sudden Cardiac Death (SCD) with or without the onset of Ventricular Tachycardia (VT) or Ventricular Fibrillation (VF) still remains a continuing challenge to clinicians. In this work, we have presented a novel integrated index for prediction of SCD with a high level of accuracy by using electrocardiogram (ECG) signals. To achieve this, nonlinear features (Fractal Dimension (FD), Hurst's exponent (H), Detrended Fluctuation Analysis (DFA), Approximate Entropy (ApproxEnt), Sample Entropy (SampEnt), and Correlation Dimension (CD)) are first extracted from the second level Discrete Wavelet Transform (DWT) decomposed ECG signal. The extracted nonlinear features are ranked using t-value and then, a combination of highly ranked features are used in the formulation and employment of an integrated Sudden Cardiac Death Index (SCDI). This calculated novel SCDI can be used to accurately predict SCD (four minutes before the occurrence) by using just one numerical value four minutes before the SCD episode. Also, the nonlinear features are fed to the following classifiers: Decision Tree (DT), k-Nearest Neighbour (KNN), and Support Vector Machine (SVM). The combination of DWT and nonlinear analysis of ECG signals is able to predict SCD with an accuracy of 92.11% (KNN), 98.68% (SVM), 93.42% (KNN) and 92.11% (SVM) for first, second, third and fourth minutes before the occurrence of SCD, respectively. The proposed SCDI will constitute a valuable tool for the medical professionals to enable them in SCD prediction.

[1]  Ching-Heng Lin,et al.  Detection and Prediction of Sudden Cardiac Death (SCD) For Personal Healthcare , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[2]  B. Gersh,et al.  Sudden cardiac death: epidemiology and risk factors , 2010, Nature Reviews Cardiology.

[3]  Scott David Greenwald,et al.  The development and analysis of a ventricular fibrillation detector , 1986 .

[4]  Federico Girosi,et al.  Support Vector Machines: Training and Applications , 1997 .

[5]  A. Castellanos,et al.  Indications for implantable cardioverter-defibrillators based on evidence and judgment. , 2009, Journal of the American College of Cardiology.

[6]  Peter Scarborough,et al.  Trends in age-specific coronary heart disease mortality in the European Union over three decades: 1980–2009 , 2013, European heart journal.

[7]  Neha J. Pagidipati,et al.  Estimating Deaths From Cardiovascular Disease: A Review of Global Methodologies of Mortality Measurement , 2013, Circulation.

[8]  Daniel T. Larose,et al.  Discovering Knowledge in Data: An Introduction to Data Mining , 2005 .

[9]  P. Grassberger,et al.  Measuring the Strangeness of Strange Attractors , 1983 .

[10]  Dhanjoo N. Ghista Applied Biomedical Engineering Mechanics , 2008 .

[11]  S. Chugh,et al.  Sudden Cardiac Death with Apparently Normal Heart: Clinical Implications of Progress in Pathophysiology , 2001 .

[12]  J. Kurths,et al.  The application of methods of non-linear dynamics for the improved and predictive recognition of patients threatened by sudden cardiac death. , 1996, Cardiovascular research.

[13]  J J Heger,et al.  Sudden cardiac death. , 1998, Circulation.

[14]  Mohammad Pooyan,et al.  A Novel Approach to Predict Sudden Cardiac Death (SCD) Using Nonlinear and Time-Frequency Analyses from HRV Signals , 2014, PloS one.

[15]  G. Breithardt,et al.  Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. , 1996 .

[16]  D. Singer,et al.  Spectrum of heart rate variability , 1989, [1989] Proceedings. Computers in Cardiology.

[17]  Kurt Ulm,et al.  Characteristics of heart beat intervals and prediction of death. , 2005, International journal of cardiology.

[18]  Mark D. Huffman,et al.  Executive summary: heart disease and stroke statistics--2013 update: a report from the American Heart Association. , 2013, Circulation.

[19]  M. J. Katz,et al.  Fractals and the analysis of waveforms. , 1988, Computers in biology and medicine.

[20]  Paul S Addison,et al.  Wavelet transforms and the ECG: a review , 2005, Physiological measurement.

[21]  Thomas D Rea,et al.  Community approaches to improve resuscitation after out-of-hospital sudden cardiac arrest. , 2010, Circulation.

[22]  Heikki V Huikuri,et al.  Prediction of sudden cardiac death: appraisal of the studies and methods assessing the risk of sudden arrhythmic death. , 2003, Circulation.

[23]  Nicolas Danchin,et al.  The (possibly) deceptive figures of decreased coronary heart disease mortality in Europe. , 2013, European heart journal.

[24]  Pekka Raatikainen,et al.  Prediction of sudden cardiac death after myocardial infarction in the beta-blocking era. , 2003, Journal of the American College of Cardiology.

[25]  J. Bigger,et al.  Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction , 1998, The Lancet.

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

[27]  Dae-Jin Kim,et al.  Detrended fluctuation analysis of EEG in sleep apnea using MIT/BIH polysomnography data , 2002, Comput. Biol. Medicine.

[28]  Brij N. Singh,et al.  Optimal selection of wavelet basis function applied to ECG signal denoising , 2006, Digit. Signal Process..

[29]  F Lombardi,et al.  Sudden cardiac death: role of heart rate variability to identify patients at risk. , 2001, Cardiovascular research.

[30]  J. Ornato,et al.  ACC/AHA/ESC PRACTICE GUIDELINES ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death , 2006 .

[31]  T. Tamura,et al.  An integrated diabetic index using heart rate variability signal features for diagnosis of diabetes , 2013, Computer methods in biomechanics and biomedical engineering.

[32]  S M Pincus,et al.  Approximate entropy as a measure of system complexity. , 1991, Proceedings of the National Academy of Sciences of the United States of America.

[33]  D E Ward,et al.  QT Dispersion: Problems of Methodology and Clinical Significance , 1994, Journal of cardiovascular electrophysiology.

[34]  Steven M. Pincus,et al.  Quantification of hormone pulsatility via an approximate entropy algorithm. , 1992, The American journal of physiology.

[35]  C. M. Lim,et al.  Analysis of cardiac health using fractal dimension and wavelet transformation , 2005 .

[36]  Wei-Yin Loh,et al.  Classification and regression trees , 2011, WIREs Data Mining Knowl. Discov..

[37]  D. Levy,et al.  Predicting survival in heart failure case and control subjects by use of fully automated methods for deriving nonlinear and conventional indices of heart rate dynamics. , 1997, Circulation.

[38]  U. Rajendra Acharya,et al.  Computer-aided diagnosis of diabetic subjects by heart rate variability signals using discrete wavelet transform method , 2015, Knowl. Based Syst..

[39]  A L Goldberger,et al.  Fractal correlation properties of R-R interval dynamics and mortality in patients with depressed left ventricular function after an acute myocardial infarction. , 2000, Circulation.

[40]  Johan A. K. Suykens,et al.  Least Squares Support Vector Machines , 2002 .

[41]  George Manis,et al.  Risk stratification for Arrhythmic Sudden Cardiac Death in heart failure patients using machine learning techniques , 2013, Computing in Cardiology 2013.

[42]  T. Higuchi Approach to an irregular time series on the basis of the fractal theory , 1988 .

[43]  P Ducimetière,et al.  Predicting sudden death in the population: the Paris Prospective Study I. , 1999, Circulation.

[44]  R. Maestri,et al.  Short-Term Heart Rate Variability Strongly Predicts Sudden Cardiac Death in Chronic Heart Failure Patients , 2003, Circulation.

[45]  Joan Fisher Box,et al.  Guinness, Gosset, Fisher, and Small Samples , 1987 .

[46]  Peter Scarborough,et al.  Cardiovascular disease in Europe: epidemiological update. , 2014, European heart journal.

[47]  Mohammad Pooyan,et al.  Early detection of sudden cardiac death by using classical linear techniques and time-frequency methods on electrocardiogram signals , 2011 .

[48]  J. Richman,et al.  Physiological time-series analysis using approximate entropy and sample entropy. , 2000, American journal of physiology. Heart and circulatory physiology.

[49]  K. Reinier,et al.  Epidemiology of sudden cardiac death: clinical and research implications. , 2008, Progress in cardiovascular diseases.

[50]  Benoit B. Mandelbrot,et al.  Fractal Geometry of Nature , 1984 .

[51]  H V Huikuri,et al.  Prediction of sudden cardiac death by fractal analysis of heart rate variability in elderly subjects. , 2001, Journal of the American College of Cardiology.

[52]  J. E. Skinner,et al.  Nonlinear analysis of the heartbeats in public patient ECGs using an automated PD2i algorithm for risk stratification of arrhythmic death , 2008, Therapeutics and clinical risk management.

[53]  H. Stanley,et al.  Quantification of scaling exponents and crossover phenomena in nonstationary heartbeat time series. , 1995, Chaos.

[54]  Dhanjoo N. Ghista,et al.  PHYSIOLOGICAL SYSTEMS' NUMBERS IN MEDICAL DIAGNOSIS AND HOSPITAL COST-EFFECTIVE OPERATION , 2004 .

[55]  Dhanjoo N. Ghista,et al.  NONDIMENSIONAL PHYSIOLOGICAL INDICES FOR MEDICAL ASSESSMENT , 2009 .

[56]  Jan Pool,et al.  QTc Prolongation Measured by Standard 12‐Lead Electrocardiography Is an Independent Risk Factor for Sudden Death Due to Cardiac Arrest , 1991, Circulation.

[57]  Segyeong Joo,et al.  Prediction of spontaneous ventricular tachyarrhythmia by an artificial neural network using parameters gleaned from short-term heart rate variability , 2012, Expert Syst. Appl..

[58]  J. Kurths,et al.  Quantitative analysis of heart rate variability. , 1995, Chaos.