A novel lightweight computerized ECG interpretation approach based on clinical 12-lead data

Although 12-lead electrocardiograms(ECGs)provide a wide range of spatiotemporal characteristics,interpreting them for arrhythmia detection is difficult due to a lack of reliable large-scale clinical datasets.Herein,we proposed an innovative lightweight computerized ECG interpretation approach based on 12-lead data.Our model was trained,validated,and tested on 53845 standard 12-lead ECG records collected at Shanghai First People’s Hospital in affiliation with Shanghai Jiao Tong University.The experiments revealed that our approach had a classification accuracy of 94.41%in the classification task of seven types of rhythms,which was markedly superior to related single-lead and 12-lead ECG classification methods.Moreover,the average receiver operating characteristic area under the curve reached a value of 0.940,and the precision values for sinus tachycardia and sinus bradycardia were 0.945 and 0.91,respectively,with specificity values of 0.996 and 0.994.By employing our boosting method,we were able to improve the accuracy to 94.85%.To investigate the performance degradation of the proposed neural network in some classes,an ECG cardiologist was enlisted to review questionable ECGs;this process provides a promising direction for network performance improvement.Therefore,the proposed computerized ECG interpretation approach has practical significance because it could help professional physicians analyze patients’heart conditions based on real-time 12-lead ECG or grade their disease severity in advance.

Lyapunov exponents for synchronous 12-lead ECG signals

The Lyapunov exponents of synchronous 12-lead ECG signals have been investigated for the first time using a multi-sensor (electrode) technique. The results show that the Lyapunov exponents computed from different locations on the body surface are not the same, but have a distribution characteristic for the ECG signals recorded from coronary artery disease (CAD) patients with sinus rhythms and for signals from healthy older people. The maximum Lyapunov exponent L1 of all signals is positive. While all the others are negative, so the ECG signal has chaotic characteristics. With the same leads, L1 of CAD patients is less than that of healthy people, so the CAD patients and healthy people can be classified by L1, L1 therefore has potential values in the diagnosis of heart disease.

Multi-class 12-lead ECG automatic diagnosis based on a novel subdomain adaptive deep network

Arrhythmia is a common type of cardiovascular disease,which has become the leading cause of global deaths.Recently,the automatic 12-lead ECG diagnosis system based on numerous labelled data has attracted increasing attention.However,labelling 12-lead ECG recordings is a complex and time-consuming task for clinicians.And then,the existence of data distribution differences limits the direct cross domain use of the trained model.Enlighted by subdomain adaptation methods,this paper designs a novel subdomain adaptative deep network(SADN)for excavating diagnosis knowledge from source domain datasets.Firstly,the convolutional layer,residual blocks and SE-Residual blocks are utilized for extracting meaningful deep features automatically.Additionally,the feature classifier uses these deep features for obtaining the final diagnosis predictions.Further,designing a novel loss function with local maximum mean discrepancy is utilized for restricting data distribution discrepancy from different datasets.Finally,the Clinical Outcomes in Digital ECG and 1st China Physiological Signal Challenge datasets are utilized for evaluating the superiority of SADN,which presents that SADN enhances algorithm performance on the unlabelled target domain dataset.Further,compared with the existing methods,the proposed network structure acquires better performance with a F1-macro of 89.43%and a F1-macro1 of 87.09%.Besides,among the 4 kinds of ECG abnormalities,the diagnostic effect of the SADN is better than that of cardiology residents.Thus,SADN has promising potential as an auxiliary diagnostic tool for the clinical environment.

运动员不同心电图表现与评估

为了评估我国运动员运动过程中生理表现与病理表现,该文通过对国内外文献的分析,更加精准地了解运动员在不同负荷状态及相关心理压力作用下心电图的变化情况。在过去的15年里,心电图的分析标准进行了很多次修正,以提高运动员潜在的致命性及危险性心脏疾病诊断的准确性,并对运动员的身体状况及时做出评估。据统计,心血管系统相关疾病是大多数运动员在高强度训练中猝死的主要原因之一。而多数发生心血管意外的运动参加者在安静状态下的普通心电图都会存在异常的波形。可以用来对身体猝死发生风险进行提醒和识别。

静息12导联心电图碎裂QRS波群诊断非ST段抬高型急性心肌梗死的价值

目的探讨静息12导联心电图碎裂QRS波群诊断非ST段抬高型急性心肌梗死中价值。方法回顾性分析我院2016年12月~2018年12月收治的104例非ST段抬高型急性心肌梗死患者的临床资料,按照静息12导联心电图检查结果将其分为碎裂QRS波群阴性组(n=34)和碎裂QRS波群阳性组(n=70),比较两组超声心动图指标及实验室检查指标。结果碎裂QRS波群阳性组左心室舒张末期内径、室壁瘤占比高于碎裂QRS波群阴性组,左室射血分数及室壁运动异常占比低于碎裂QRS波群阴性组(P<0.05);碎裂QRS波群阳性组肌酸激酶同工酶水平低于碎裂QRS波群阴性组,肌钙蛋白Ⅰ水平高于碎裂QRS波群阴性组(P<0.05)。结论静息12导联心电图碎裂QRS波群能够有效判断非ST段抬高型急性心肌梗死患者实验室检查水平、左心室舒张末期内径及左室射血分数,可为临床诊断及治疗提供有效参考依据。

Athletes ECG Stress Characteristics in Division Ⅱ College Athletes:A Preliminary Analysis

Purpose Two-thirds of sudden cardiac deaths are attributable to underlying cardiovascular conditions in young collegiate athletes.A 12-lead exercise stress test is a screening tool that can detect these abnormalities that may predispose collegiate athletes to sudden cardiac death,and can ensure athletes meet the physical demands of training and competition.The pur-pose of this study was to evaluate the electrocardiographic(ECG)characteristics of DivisionⅡcollegiate athletes using the Seattle Criteria.Methods Fifty two athletes(males=26;females=26)of various ethnicities(Caucasian=65%,Latino/Hispanic=20%,and African American=15%);from soccer(27%),tennis(17%),basketball(15%),softball(14%),cross country(9%),volleyball(6%),football(6%),and swimming(6%)completed cardiovascular screening with resting and exercise 12-lead ECG analy-sis.ECG abnormalities and anthropometrics were compared across race,gender,and sports using an ANOVA.Chi-square analysis was used to test for differences in the frequency of ECG findings across gender,race,and sports.Results Although sport was not a predictor for an abnormal ECG,73%of the athletes presented with athletes'heart con-figuration,which was significantly higher in males than females(P=0.02).The highest occurrence of these adaptations was observed in 100%of Latino/Hispanic athletes,compared to 75%of African American and 64%of Caucasian athletes.Conclusion With newer and more sensitive ECG screening criteria,the prevalence of false-positive tests is declining.Future research should focus on advancing the sensitivity and specificity of ECG interpretation in more diverse athletic populations regarding race and gender.The increasing incidence of sudden cardiac death in collegiate athletes warrants future research that evaluates the impact of implementing the 12-lead ECG as a standard screening tool for collegiate athletes.

Comparison of the‘Seattle’and‘International’Criteria Electrocardiogram Interpretation in Division II Female Collegiate Athletes:A Preliminary Study

Purpose A 12-lead electrocardiogram(ECG)is a screening tool to detect abnormalities that may predispose athletes to sud-den cardiac death.Newer standardized criteria have been introduced to better interpret ECG data,however this research has predominantly focused on male athletes.It is important to include female athletes in research to better define ECG character-istics in this population.The purpose of this study was to compare the Seattle and International Criteria ECG abnormalities in Division II female collegiate athletes of various ethnicities.Methods Fifty-six females(age 20.2±1.4 years;height 1.70±0.7 m;weight 69.5±8.9 kg)completed a resting 12-lead ECG protocol.ECG data was classified as‘normal’and‘abnormal’according to the parameters of each criterion and abnormal conditions were noted.Chi-square analysis was used to assess statistical comparisons between criteria.Results There was a significant difference in abnormal classifications as the total number of ECGs identified as abnormal using the Seattle Criteria decreased from 12(21.4%)to 2(3.6%)when using the International Criteria(P<0.05).African American athletes had a higher number of abnormal ECG’s compared to White and Latina athletes using the Seattle Criteria(P=0.03).Conclusions The International Criteria significantly reduces the total number of abnormal ECG readings in female collegiate athletes compared to the Seattle Criteria and did not overly identify African American athletes with abnormalities.Further research is necessary to expand on this study and clearly define criteria for female athletes of various ethnicities.