Detection and Classification of Cardiac Arrhythmias by a Challenge-Best Deep Learning Neural Network Model

Abstract

BackgroundElectrocardiogram (ECG) is widely used to detect cardiac arrhythmia (CA) and heart diseases. The development of deep learning modeling tools and publicly available large ECG data in recent years has made accurate machine diagnosis of CA an attractive task to showcase the power of artificial intelligence (AI) in clinical applications.\n\nMethods and FindingsWe have developed a convolution neural network (CNN)-based model to detect and classify nine types of heart rhythms using a large 12-lead ECG dataset (6877 recordings) provided by the China Physiological Signal Challenge (CPSC) 2018. Our model achieved a median overall F1-score of 0.84 for the 9-type classification on CPSC2018s hidden test set (2954 ECG recordings), which ranked first in this latest AI competition of ECG-based CA diagnosis challenge. Further analysis showed that concurrent CAs observed in the same patient were adequately predicted for the 476 patients diagnosed with multiple CA types in the dataset. Analysis also showed that the performances of using only single lead data were only slightly worse than using the full 12 lead data, with leads aVR and V1 being the most prominent. These results are extensively discussed in the context of their agreement with and relevance to clinical observations.\n\nConclusionsAn AI model for automatic CA diagnosis achieving state-of-the-art accuracy was developed as the result of a community-based AI challenge advocating open-source research. In- depth analysis further reveals the models ability for concurrent CA diagnosis and potential use of certain single leads such as aVR in clinical applications.\n\nAbbreviationsCA, cardiac arrhythmia; AF, Atrial fibrillation; I-AVB, first-degree atrioventricular block; LBBB, left bundle branch block; RBBB, right bundle branch block; PAC, premature atrial contraction; PVC, premature ventricular contraction; STD, ST-segment depression; STE, ST-segment elevation.