Cardiac Arrhythmia Disease Classifier Model Based on a Fuzzy Fusion Approach

Cardiac diseases are one of the greatest global health challenges.Due to the high annual mortality rates,cardiac diseases have attracted the attention of numerous researchers in recent years.This article proposes a hybrid fuzzy fusion classification model for cardiac arrhythmia diseases.The fusion model is utilized to optimally select the highest-ranked features generated by a variety of well-known feature-selection algorithms.An ensemble of classifiers is then applied to the fusion’s results.The proposed model classifies the arrhythmia dataset from the University of California,Irvine into normal/abnormal classes as well as 16 classes of arrhythmia.Initially,at the preprocessing steps,for the miss-valued attributes,we used the average value in the linear attributes group by the same class and the most frequent value for nominal attributes.However,in order to ensure the model optimality,we eliminated all attributes which have zero or constant values that might bias the results of utilized classifiers.The preprocessing step led to 161 out of 279 attributes(features).Thereafter,a fuzzy-based feature-selection fusion method is applied to fuse high-ranked features obtained from different heuristic feature-selection algorithms.In short,our study comprises three main blocks:(1)sensing data and preprocessing;(2)feature queuing,selection,and extraction;and(3)the predictive model.Our proposed method improves classification performance in terms of accuracy,F1measure,recall,and precision when compared to state-of-the-art techniques.It achieves 98.5%accuracy for binary class mode and 98.9%accuracy for categorized class mode.

Cardiac arrhythmia and heart failure： From bench to bedside

Cardiac arrhythmia is an abnormal rate and/or rhythm of a heart due to its abnormal electrical impulse origination and/or propagation. Various etiologies can cause arrhythmias. Heart failure （HF） is a clinical syndrome due to an impaired heart that can not pump sufficient blood to meet the systemic metabolic needs.

Short-term exposure to ambient ozone associated with cardiac arrhythmias in healthy adults

Objective The exact biological mechanism whereby exposure to ambient ozone(O3)may contribute to clinical onset of cardiovascular events remains unclear.In this study,we aim to examine the impacts of O3 exposure on cardiac arrhythmias and potential pathways involved through autonomic dysfunction and myocardial injury.Methods Seventy-three non-smoking healthy adults were followed with 4 repeated measurements of 24-hour ambulatory arrhythmias,heart rate variability,ST-segment deviation,and blood pressure(BP)in Beijing,China,2014‒2016.Generalized additive mixed models coupled with distributed lag nonlinear models were constructed to evaluate the associations and potential interlinks between O3 exposure and outcome measurements.Results During the study period,24-hour average concentrations of ambient O3 were 47.4µg/m3(ranging from 1.0 to 165.9µg/m3).Increased risks of premature ventricular contraction and ventricular tachycardia were associated with interquartile range increases in O3 exposure during the last 5 days before each participant's clinic visit,with relative risks of 2.14(95%confidence interval[CI]:1.95 to 2.32)and 5.47(95%CI:3.51 to 7.43),respectively.Mediation analyses further showed that sympathetic activation,parasympathetic inhibition,and elevated BP levels,as well as heightened risks of ST-segment depression could mediate up to 47.74%of the risks of arrhythmias attributable to O3 exposure.Conclusion Our results suggest that short-term exposure to ambient O3 could prompt the genesis of arrhythmias partially through worsening autonomic function and myocardial burden.

Wenxin granule for cardiac arrhythmia: an overview of systematic reviews

Objectives: Evaluating the quality of systematic reviews/meta-analysis of Wenxin granule in treating cardiac arrhythmia to provide evidence for clinical practice, and analyzing the problems in the research to identify potential research priorities for researchers. Method: The systematic reviews of Wenxin granule in treating cardiac arrhythmia were searched from 8 databases. The methodological quality and evidence quality were assessed by AMSTAR and GRADE respectively. Results: Nineteen eligible systematic reviews with 52,905 participants were included. The overall scores of AMSTAR ranged from 3 to 10 with a mean score of 6.5, the median score was 6. There were 9 (9/19, 47.37%) systematic reviews had the score of 7 or more. 6 of them with appropriate information were assessed the quality of evidence by GRADE. The results showed that the overall quality of evidence was limited (range from “very low” to “low”), no “moderate” or “high” quality of evidence existed. For the outcome reporting, no systematic reviews reported endpoints and limited evidence showed that there is causality between Wenxin granule and adverse effects/events. The outcome matrix showed that there are obvious heterogeneity and incompleteness for the outcome reporting in included systematic reviews, so that some included studies cannot be conducted meta-analysis. Meanwhile, there were studies excluded because of inappropriate outcome measures, such as outcome measures did not meet inclusion criteria, treatment time did not meet inclusion criteria, treatment time was unclear, incomplete data or the data cannot be extracted. Conclusions: Wenxin granule have limited efficacy and safety for treating arrhythmia. In the future, high quality of RCTs and systematic reviews should be conducted. Core outcome set for cardiac arrhythmia is needed to improve outcome reporting and decrease waste.

Cardiac arrhythmias and cardiac arrest related to mushroom poisoning: A case report

BACKGROUND Mushroom exposure is a global health issue.The manifestations of mushroom poisoning (MP) may vary.Some species have been reported as rhabdomyolytic,hallucinogenic,or gastrointestinal poisons.Critical or even fatal MPs are mostly attributable to Amanita phalloides,with the development of severe liver or renal failure.Myocardial injury and even cases mimicking ST-segment elevation myocardial infarction (STEMI) have been previously reported,while cardiac arrhythmia or cardiac arrest is not commonly seen.CASE SUMMARY We report a 68-year-old woman with MP who suffered from delirium,seizure,long QT syndrome on electrocardiogram (ECG),severe cardiac arrhythmias of multiple origins,and cardiac arrest.She was intubated and put on blood perfusion.Her kidney and liver functions were intact;creatine kinase-MB was mildly elevated,and then fell within normal range during her hospital stay.We sent the mushrooms she left for translation elongation factor subunit 1α,ribosomal RNA gene sequence,and internal transcribed spacer sequence analyses.There were four kinds of mushrooms identified,two of which were found to be toxic.CONCLUSION This is the first time that we found cardiac toxicity caused by Panaeolus subbalteatus and Conocybe lactea,which were believed to be toxic to the liver,kidney,and brain.We suggest that intensive monitoring and ECG follow-up are essential to diagnose prolonged QT interval and different forms of tachycardia in MP patients,even without the development of severe liver or renal failure.The mechanisms need to be further investigated and clarified based on animal experiments and molecular signal pathways.

Associations between cardiac arrhythmia,incident disability in activities of daily living and physical performance:the ILSA study

Background Cardiac arrhythmias are common conditions in older people.Unfortunately,there is limited literature on associations between cardiac arrhythmias and physical performance or disability.We therefore aimed to prospectively investigate associations between cardiac arrhythmias and changes in disability and physical performance during 8 years of follow-up,using data from the Italian Longitudinal Study on Aging(ILSA).Methods Cardiac arrhythmias diagnosis was posed through a screening phase,confirmed by a physician.The onset of disability in activities of daily living(ADL)and the changes in several physical performance tests during follow-up were considered as outcomes.Fully-adjusted and propensity-score Cox Proportional Hazard models and mixed models were used for exploring associations between cardiac arrhythmia and the outcomes of interest.Results The prevalence of cardiac arrhythmia at baseline was 23.3%.People reporting cardiac arrhythmia at the baseline were significantly older,more frequently male,smokers and reported a higher presence of all medical conditions investigated(hypertension,heart failure,angina,myocardial infarction,diabetes,stroke),but no difference in dementia,Parkinsonism,cognitive or mood disorder.Cardiac arrhythmia at baseline was significantly associated with the incidence of disability in ADL(HR=1.23;95%:CI:1.01–1.50;P=0.0478 in propensity score analyses;HR=1.28;95%CI:1.01–1.61;P=0.0401 in fully adjusted models).Cardiac arrhythmia at baseline was also associated with a significant worsening in balance test(P=0.0436).Conclusions The presence of cardiac arrhythmia at baseline was associated with a significant higher risk of disability and of worsening in some physical performance tests,particularly those relating to balance.Screening and frequently assessing physical performance in older people affected by cardiac arrhythmia can be important to prevent a loss of physical performance,with further,potential,complications of medical management.

Cardiac arrhythmias detection in an ECG beat signal using fast fourier transform and artificial neural network

Cardiac Arrhythmias shows a condition of abnor-mal electrical activity in the heart which is a threat to humans. This paper presents a method to analyze electrocardiogram (ECG) signal, extract the fea-tures, for the classification of heart beats according to different arrhythmias. Data were obtained from 40 records of the MIT-BIH arrhythmia database (only one lead). Cardiac arrhythmias which are found are Tachycardia, Bradycardia, Supraventricular Tachycardia, Incomplete Bundle Branch Block, Bundle Branch Block, Ventricular Tachycardia. A learning dataset for the neural network was obtained from a twenty records set which were manually classified using MIT-BIH Arrhythmia Database Directory and docu- mentation, taking advantage of the professional experience of a cardiologist. Fast Fourier transforms are used to identify the peaks in the ECG signal and then Neural Networks are applied to identify the diseases. Levenberg Marquardt Back-Propagation algorithm is used to train the network. The results obtained have better efficiency then the previously proposed methods.

Amiodarone Therapy for Cardiac Arrhythmias: Is It Associated with the Development of Cancers?

Amiodarone is used worldwide to treat cardiac arrhythmias, as well as highly symptomatic cases of atrial fibrillation. With this expanded use, especially following its 1985 United States Food and Drug Administration approval, and its use as a long-term therapy in common practice, reports of cancers temporarily related to amiodarone have begun to increase. Animal studies, several clinical trials, numerous case reports, and a population-based cohort study have suggested that cancers may be associated with amiodarone use. This review focuses on the ever increasing evidence in the literature that suggests amiodarone therapy, especially with long-term use, may increase the potential risk of cancer development. It also expresses the need for more definitive studies to be conducted to provide clinicians with a clear answer to this important question.

Ambient Particulate Matter Pollution and Hospital Visits for Cardiac Arrhythmia in Beijing,China

Cardiac arrhythmia is a serious public health problem in many countries.Previous studies estimated that 33.5 million people are affected by cardiac arrhythmia worldwide,and this number will continue to grow as society ages.Despite improvements in diagnostic and therapeutic interventions in electrophysiology,the disease burden,incidence and prevalence of cardiac arrhythmia continue to increase and have aroused public health concern.Increasing evidence has indicated that air pollution may be associated with cardiac autonomic nervous system.Among air pollutants,particulate matter with an aerodynamic diameter of≤2.5μm(PM_(2.5))is considered exert more toxicity than other air pollutants,as it provides a larger surface area and absorbs or condenses more toxic substances per unit mass.

Diagnostic Dilemma of Intracardiac Mass: Tumor versus Thrombus-Case Series and Systematic Review

Background: The differential diagnosis for intracavitary cardiac masses is limited, typically including vegetations, tumors, or thrombi. Cardiac thrombi can often mimic cardiac tumors on imaging, creating a diagnostic challenge. Primary cardiac tumors are rare and usually benign, whereas most cardiac tumors result from metastases, commonly originating from malignancies in the breast, lung, or melanoma. Aim: This report highlights the importance of distinguishing various cardiac masses based on clinical presentations, clinical courses, and radiological features. Case Presentation: We describe two cases of cardiac masses with unique and diverse clinical features. Each case posed significant diagnostic challenges due to their distinct presentations and clinical progressions. Conclusion: These cases underscore the importance of considering both benign and metastatic origins in the differential diagnosis of intracavitary cardiac masses. Accurate differentiation between thrombi and tumors is crucial for appropriate management and treatment.

Nonalcoholic Fatty Liver Disease (NAFLD) and Risk of Cardiac Arrhythmias: A New Aspect of the Liver-heart Axis

Nonalcoholic fatty liver disease (NAFLD) is a pathologic condition frequently observed in clinical practice.To date,the prevalence of NAFLD is approximately 25-30% among adults of the general population in Western countries but increases to approximately 70-75% among patients with type 2 diabetes mellitus.In the last decade,accumulating evidence has clearly demonstrated that patients with NAFLD have not only an increased liver-related morbidity and mortality but also an increased risk of fatal and non-fatal cardiovascular events.In particular,several studies have documented the existence of an independent association among NAFLD and cardiac changes in structure and function in both non-diabetic and diabetic patients.In addition,mounting evidence also suggests that there is a strong relationship between NAFLD and cardiac arrhythmias,such as atrial fibrillation,QTc prolongation and ventricular arrhythmias.This is of clinical interest,as it could explain,at least in part,the increased risk of death for cardiovascular disease in patients with NAFLD.Therefore,seeing that cardiovascular disease complications are the leading cause of disability and death in NAFLD patients,the recent European clinical practice guidelines advised to check the cardiovascular system in all patients with NAFLD.This clinical mini review will briefly describe the increasing body of evidence regarding the association between NAFLD and cardiac arrhythmias,and discuss the potential biological mechanisms underlying this association.

Expert Consensus on Wenxin Granule for Treatment of Cardiac Arrhythmias

INTRODUCTIONAntiarrhythmic drugs remain a critically important component of the approach to therapy of cardiac arrhythmias. Over the past 20 years, despite their antiarrhythmic efficacy in many pathological settings, Class Ⅰ and Ⅲ antiarrhythmic drugs have been shown to be associated with the development of proarrhythmias and an increase in the likelihood of causing higher mortality by inducing torsade de pointes ventricular tachycardia and other serious adverse reactions. Consequently, the development of safe and effective antiarrhythmic regimens remains a primary focus of contemporary cardiovascular research.

Conventional Acupuncture for Cardiac Arrhythmia：A Systematic Review of Randomized Controlled Trials

Objective：To exam the effect and safety of conventional acupuncture（CA） on cardiac arrhythmia.Methods：Nine medical databases were searched until February 2016 for randomized controlled trials.Heterogeneity was measured by Cochran Q test.Meta-analysis was conducted if I2 was less than 85% and the characteristics of included trials were similar.Results：Nine qualified studies involving 638 patients were included.Only 1 study had definitely low risk of bias,while 7 trials were rated as unclear and 1 as high.Meta-analysis of CA alone did not have a significant benefit on response rate compared to amiodarone in patients with atrial fibrillation（Af） and atrial flutter（AF） [relative risk（RR）：1.09;95% confidence interval（CI）：0.79–1.49;P=0.61;I2=61%,P=0.11].However,1 study with higher methodological quality detected a lower recurrence rate of Af in CA alone as compared with sham acupuncture plus no treatment,and benefits on ventricular rate and time of conversion to normal sinus rhythm were found in CA alone group by 1 study,as well as the response rate in CA plus deslanoside group by another study.Meta-analysis of CA plus anti-arrhythmia drug（AAD） was associated with a significant benefit on the response rate when compared with AAD alone in ventricular premature beat（VPB） patients（RR,1.19,95% CI：1.05–1.34;P=0.005;I2=13%,P=0.32）,and an improvement in quality-of-life score（QOLS） of VPB also showed in 1 individual study.Besides,a lower heart rate was detected in the CA alone group by 1 individual study when compared with no treatment in sinus tachycardia patients（MD –21.84 [–27.21,–16.47]） and lower adverse events of CA alone were reported than amiodarone.Conclusions：CA may be a useful and safe alternative or additive approach to AADs for cardiac arrhythmia,especially in VPB and Af patients,which mainly based on a pooled estimate and result from 1 study with higher methodological quality.However,we could not reach a robust conclusion due to low quality of overall evidence.

Automatic Classification of Cardiac Arrhythmias Based on Hybrid Features and Decision Tree Algorithm

Accurate classification of cardiac arrhythmias is a crucial task because of the non-stationary nature of electrocardiogram(ECG)signals.In a life-threatening situation,an automated system is necessary for early detection of beat abnormalities in order to reduce the mortality rate.In this paper,we propose an automatic classification system of ECG beats based on the multi-domain features derived from the ECG signals.The experimental study was evaluated on ECG signals obtained from the MIT-BIH Arrhythmia Database.The feature set comprises eight empirical mode decomposition(EMD)based features,three features from variational mode decomposition(VMD)and four features from RR intervals.In total,15 features are ranked according to a ranker search approach and then used as input to the support vector machine(SVM)and C4.5 decision tree classifiers for classifying six types of arrhythmia beats.The proposed method achieved best result in C4.5 decision tree classifier with an accuracy of 98.89%compared to cubic-SVM classifier which achieved an accuracy of 95.35%only.Besides accuracy measures,all other parameters such as sensitivity(Se),specificity(Sp)and precision rates of 95.68%,99.28%and 95.8%was achieved better in C4.5 classifier.Also the computational time of 0.65 s with an error rate of 0.11 was achieved which is very less compared to SVM.The multi-domain based features with decision tree classifier obtained the best results in classifying cardiac arrhythmias hence the system could be used efficiently in clinical practices.

CARDIAC ARRHYTHMIA AFTER LUNG CANCER SURGERY －－ANALYSIS OF 140 PNEUMONECTTOMY CASES

Among 808 surgically resected lung cancer cases at Shanghai Chest Hospital during 1991 to 1992, 140 of them (17.3%) underwent Pneumonectomy. Of the 140 cases:124 male, 16 female; aged 27-74 yrs, 35.7% elder (60 and over), preoperative abnormal EKG was found in 38 cases, operative mortality was 4.3%. The histopathological diagnosis were: squamous 43.6%, adeno. 36.4%, small cell 8.6%, mixed type 11.4%. The pTNM stages: stage I 2.9%, II 17.1%, IIIa 55.0%, IIIb 21.4%, IV 3.6%.Postoperatively, arrhythmia occuried in 76 cases, with an incidence of 54.3%. Of the 76 arrhythmias, atrial fibrillation was seen in 7 patients, atrial premature beats in 2, supraventricular tachycardia in 1, and sinus tachycardia in 66. The incidences of cadiac arrhythmia during the postoperative day (DO), first day (D1), D2, D3,and D4 were 48.7%, 35.5%, 7.9%, 4.0%and 2.6%respectively. Conclusion: the cardiac arrhythmia is the most common complication after pneumonectomy for lung cancer surgery. The major causes were incisional pain, hypovolemia due to blood loss and respirative insufficiency due to anomia. The perioperative prevention and treatment for arrhythmia were also discussed.

Dysglycemia and arrhythmias

Disorders in glucose metabolism can be divided into three separate but interrelated domains,namely hyperglycemia,hypoglycemia,and glycemic variability.Intensive glycemic control in patients with diabetes might increase the risk of hypoglycemic incidents and glucose fluctuations.These three dysglycemic states occur not only amongst patients with diabetes,but are frequently present in other clinical settings,such as during critically ill.A growing body of evidence has focused on the relationships between these dysglycemic domains with cardiac arrhythmias,including supraventricular arrhythmias(primarily atrial fibrillation),ventricular arrhythmias(malignant ventricular arrhythmias and QT interval prolongation),and bradyarrhythmias(bradycardia and heart block).Different mechanisms by which these dysglycemic states might provoke cardiac arrhythmias have been identified in experimental studies.A customized glycemic control strategy to minimize the risk of hyperglycemia,hypoglycemia and glucose variability is of the utmost importance in order to mitigate the risk of cardiac arrhythmias.

Cardiac arrhythmia with premature ventricular contractures induced by interferon beta in a patient with multiple sclerosis

Multiple sclerosis(MS)is an immune‑mediated inflammatory and neurodegenerative disease of the central nervous system.Interferon(IFN)beta is an active ingredient of five out of twelve disease modifying treatments approved for MS.We report a case of IFN‑beta‑induced cardiac arrhythmia with premature ventricular contractures in a patient recently diagnosed with MS.

Repeated atrial arrhythmia induced by cochineal red poisoning:A case report

BACKGROUND Cochineal red is an organic compound widely used in food,cosmetics,pharmaceuticals,textiles,and other fields due to its excellent safety profile.Poisoning caused by eating foods containing cochineal red is rare,and repeated atrial arrhythmia due to cochineal red poisoning is even rarer.CASE SUMMARY An 88-year-old Asian female patient was admitted to hospital due to a disturbance of consciousness.Twelve hours prior to presentation,the patient consumed 12 eggs containing cochineal red over a period of 2 h.At presentation,the patient was in a coma and had a score of 6 on the Glasgow Coma Scale(E2+VT+M4).The patient’s skin and mucous membranes were pink.Electrocardiography(ECG)revealed rapid atrial fibrillation without any signs of ischemia.We prescribed cedilan and fluid replacement for arrhythmia correction.Shortly after admission,the atrial fibrillation corrected to a normal sinus rhythm.On the day 2 of admission,the patient had a sudden atrial flutter accompanied by hemodynamic instability and rapidly declining arterial oxygen saturation between 85%and 90%.The sinus rhythm returned to normal after two electrical cardioversions.Six days after admission,the skin color of the patient returned to normal,and the ECG results were normal.The patient was transferred out of the intensive care unit and eventually discharged after 12 d in hospital.At the 2-mo follow-up visit,the patient was in good health with no recurrence of arrhythmia.CONCLUSION Although cochineal red is a safe,natural food additive,excessive consumption or occupational exposure can induce cardiac arrhythmias.

Cardiac autonomic nerve distribution and arrhythmia

OBJECTIVE： To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia. DATA RETRIEVAL： A computer-based retrieval was performed for papers examining the distribution of cardiac autonomic nerves, using “heart, autonomic nerve, sympathetic nerve, vagus nerve, nerve distribution, rhythm and atrial fibrillation” as the key words. SELECTION CRITERIA： A total of 165 studies examining the distribution of cardiac autonomic nerve were screened, and 46 of them were eventually included. MAIN OUTCOME MEASURES： The distribution and characteristics of cardiac autonomic nerves were observed, and immunohistochemical staining was applied to determine the levels of tyrosine hydroxylase and acetylcholine transferase （main markers of cardiac autonomic nerve distribution）. In addition, the correlation between cardiac autonomic nerve distribution and cardiac arrhythmia was investigated. RESULTS： Cardiac autonomic nerves were reported to exhibit a disordered distribution in different sites, mainly at the surface of the cardiac atrium and pulmonary vein, forming a ganglia plexus. The distribution of the pulmonary vein autonomic nerve was prominent at the proximal end rather than the distal end, at the upper left rather than the lower right, at the epicardial membrane rather than the endocardial membrane, at the left atrium rather than the right atrium, and at the posterior wall rather than the anterior wall. The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution, and the distribution density of autonomic nerves was determined using a computer-aided morphometric analysis system. CONCLUSION： The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the occurrence, maintenance, and symptoms of arrhythmia.

Spontaneous type 1 pattern, ventricular arrhythmias and sudden cardiac death in Brugada Syndrome： an updated systematic review and meta-analysis

Brugada syndrome （BrS） is primary electrical disorder characterized by ST segment elevation with right bundle branch block morphology in patients with apparent structurally normal hearts, It predisposes affected individuals to ventricular tachycardia/fibrillation （VT/VF） and sudden cardiac death （SCD）.A number of studies have identified risk factors that are associated with a more malignant course of disease. These include male gender, syncope, a spontaneous type 1 ECG pattern, family history of SCD, family history of Brugada syndrome,