Edmond Adib

Edmond Adib, Amanda Fernandez, Fatemeh Afghah et al.

Deep learning image processing models have had remarkable success in recent years in generating high quality images. Particularly, the Improved Denoising Diffusion Probabilistic Models (DDPM) have shown superiority in image quality to the state-of-the-art generative models, which motivated us to investigate their capability in the generation of the synthetic electrocardiogram (ECG) signals. In this work, synthetic ECG signals are generated by the Improved DDPM and by the Wasserstein GAN with Gradient Penalty (WGAN-GP) models and then compared. To this end, we devise a pipeline to utilize DDPM in its original $2D$ form. First, the $1D$ ECG time series data are embedded into the $2D$ space, for which we employed the Gramian Angular Summation/Difference Fields (GASF/GADF) as well as Markov Transition Fields (MTF) to generate three $2D$ matrices from each ECG time series, which when put together, form a $3$-channel $2D$ datum. Then $2D$ DDPM is used to generate $2D$ $3$-channel synthetic ECG images. The $1D$ ECG signals are created by de-embedding the $2D$ generated image files back into the $1D$ space. This work focuses on unconditional models and the generation of \emph{Normal Sinus Beat} ECG signals exclusively, where the Normal Sinus Beat class from the MIT-BIH Arrhythmia dataset is used in the training phase. The \emph{quality}, \emph{distribution}, and the \emph{authenticity} of the generated ECG signals by each model are quantitatively evaluated and compared. Our results show that in the proposed pipeline and in the particular setting of this paper, the WGAN-GP model is consistently superior to DDPM in all the considered metrics.

Edmond Adib, Fatemeh Afghah, John J. Prevost

ECG databases are usually highly imbalanced due to the abundance of Normal ECG and scarcity of abnormal cases. As such, deep learning classifiers trained on imbalanced datasets usually perform poorly, especially on minor classes. One solution is to generate realistic synthetic ECG signals using Generative Adversarial Networks (GAN) to augment imbalanced datasets. In this study, we combined conditional GAN with WGAN-GP and developed AC-WGAN-GP in 1D form for the first time to be applied on MIT-BIH Arrhythmia dataset. We investigated the impact of data augmentation on arrhythmia classification. We employed two models for ECG generation: (i) unconditional GAN; Wasserstein GAN with gradient penalty (WGAN-GP) is trained on each class individually; (ii) conditional GAN; one Auxiliary Classifier WGAN-GP (AC-WGAN-GP) model is trained on all classes and then used to generate synthetic beats in all classes. Two scenarios are defined for each case: (a) unscreened; all the generated synthetic beats were used, and (b) screened; only a portion of generated beats are selected and used, based on their Dynamic Time Warping (DTW) distance to a designated template. A state-of-the-art ResNet classifier (EcgResNet34) is trained on each of the augmented datasets and the performance metrics (precision/recall/F1-Score micro- and macro-averaged, confusion matrices, multiclass precision-recall curves) were compared with those of the unaugmented imbalanced case. We also used a simple metric Net Improvement. All the three metrics show consistently that net improvement (total and minor-class), unconditional GAN with raw generated data (not screened) creates the best improvements.

Edmond Adib, Fatemeh Afghah, John J. Prevost

Electrocardiogram (ECG) datasets tend to be highly imbalanced due to the scarcity of abnormal cases. Additionally, the use of real patients' ECGs is highly regulated due to privacy issues. Therefore, there is always a need for more ECG data, especially for the training of automatic diagnosis machine learning models, which perform better when trained on a balanced dataset. We studied the synthetic ECG generation capability of 5 different models from the generative adversarial network (GAN) family and compared their performances, the focus being only on Normal cardiac cycles. Dynamic Time Warping (DTW), Fréchet, and Euclidean distance functions were employed to quantitatively measure performance. Five different methods for evaluating generated beats were proposed and applied. We also proposed 3 new concepts (threshold, accepted beat and productivity rate) and employed them along with the aforementioned methods as a systematic way for comparison between models. The results show that all the tested models can, to an extent, successfully mass-generate acceptable heartbeats with high similarity in morphological features, and potentially all of them can be used to augment imbalanced datasets. However, visual inspections of generated beats favors BiLSTM-DC GAN and WGAN, as they produce statistically more acceptable beats. Also, with regards to productivity rate, the Classic GAN is superior with a 72% productivity rate. We also designed a simple experiment with the state-of-the-art classifier (ECGResNet34) to show empirically that the augmentation of the imbalanced dataset by synthetic ECG signals could improve the performance of classification significantly.