Cuong D. Do

Khiem H. Le, Hieu H. Pham, Thao B. T. Nguyen et al.

Nowadays, an increasing number of people are being diagnosed with cardiovascular diseases (CVDs), the leading cause of death globally. The gold standard for identifying these heart problems is via electrocardiogram (ECG). The standard 12-lead ECG is widely used in clinical practice and the majority of current research. However, using a lower number of leads can make ECG more pervasive as it can be integrated with portable or wearable devices. This article introduces two novel techniques to improve the performance of the current deep learning system for 3-lead ECG classification, making it comparable with models that are trained using standard 12-lead ECG. Specifically, we propose a multi-task learning scheme in the form of the number of heartbeats regression and an effective mechanism to integrate patient demographic data into the system. With these two advancements, we got classification performance in terms of F1 scores of 0.9796 and 0.8140 on two large-scale ECG datasets, i.e., Chapman and CPSC-2018, respectively, which surpassed current state-of-the-art ECG classification methods, even those trained on 12-lead data. To encourage further development, our source code is publicly available at https://github.com/lhkhiem28/LightX3ECG.

Hieu X. Nguyen, Duong V. Nguyen, Hieu H. Pham et al.

Sleep apnea (SA) is a significant respiratory condition that poses a major global health challenge. Previous studies have investigated several machine and deep learning models for electrocardiogram (ECG)-based SA diagnoses. Despite these advancements, conventional feature extractions derived from ECG signals, such as R-peaks and RR intervals, may fail to capture crucial information encompassed within the complete PQRST segments. In this study, we propose an innovative approach to address this diagnostic gap by delving deeper into the comprehensive segments of the ECG signal. The proposed methodology draws inspiration from Matrix Profile algorithms, which generate an Euclidean distance profile from fixed-length signal subsequences. From this, we derived the Min Distance Profile (MinDP), Max Distance Profile (MaxDP), and Mean Distance Profile (MeanDP) based on the minimum, maximum, and mean of the profile distances, respectively. To validate the effectiveness of our approach, we use the modified LeNet-5 architecture as the primary CNN model, along with two existing lightweight models, BAFNet and SE-MSCNN, for ECG classification tasks. Our extensive experimental results on the PhysioNet Apnea-ECG dataset revealed that with the new feature extraction method, we achieved a per-segment accuracy up to 92.11 \% and a per-recording accuracy of 100\%. Moreover, it yielded the highest correlation compared to state-of-the-art methods, with a correlation coefficient of 0.989. By introducing a new feature extraction method based on distance relationships, we enhanced the performance of certain lightweight models, showing potential for home sleep apnea test (HSAT) and SA detection in IoT devices. The source code for this work is made publicly available in GitHub: https://github.com/vinuni-vishc/MPCNN-Sleep-Apnea.

Khiem H. Le, Hieu H. Pham, Thao BT. Nguyen et al.

Cardiovascular diseases (CVDs) are a group of heart and blood vessel disorders that is one of the most serious dangers to human health, and the number of such patients is still growing. Early and accurate detection plays a key role in successful treatment and intervention. Electrocardiogram (ECG) is the gold standard for identifying a variety of cardiovascular abnormalities. In clinical practices and most of the current research, standard 12-lead ECG is mainly used. However, using a lower number of leads can make ECG more prevalent as it can be conveniently recorded by portable or wearable devices. In this research, we develop a novel deep learning system to accurately identify multiple cardiovascular abnormalities by using only three ECG leads.

Cuong V. Nguyen, Hieu Minh Duong, Cuong D. Do

In practical electrocardiography (ECG) interpretation, the scarcity of well-annotated data is a common challenge. Transfer learning techniques are valuable in such situations, yet the assessment of transferability has received limited attention. To tackle this issue, we introduce MELEP, which stands for Muti-label Expected Log of Empirical Predictions, a measure designed to estimate the effectiveness of knowledge transfer from a pre-trained model to a downstream multi-label ECG diagnosis task. MELEP is generic, working with new target data with different label sets, and computationally efficient, requiring only a single forward pass through the pre-trained model. To the best of our knowledge, MELEP is the first transferability metric specifically designed for multi-label ECG classification problems. Our experiments show that MELEP can predict the performance of pre-trained convolutional and recurrent deep neural networks, on small and imbalanced ECG data. Specifically, we observed strong correlation coefficients (with absolute values exceeding 0.6 in most cases) between MELEP and the actual average F1 scores of the fine-tuned models. Our work highlights the potential of MELEP to expedite the selection of suitable pre-trained models for ECG diagnosis tasks, saving time and effort that would otherwise be spent on fine-tuning these models.

Cuong V. Nguyen, Cuong D. Do

The adoption of deep learning in ECG diagnosis is often hindered by the scarcity of large, well-labeled datasets in real-world scenarios, leading to the use of transfer learning to leverage features learned from larger datasets. Yet the prevailing assumption that transfer learning consistently outperforms training from scratch has never been systematically validated. In this study, we conduct the first extensive empirical study on the effectiveness of transfer learning in multi-label ECG classification, by investigating comparing the fine-tuning performance with that of training from scratch, covering a variety of ECG datasets and deep neural networks. We confirm that fine-tuning is the preferable choice for small downstream datasets; however, when the dataset is sufficiently large, training from scratch can achieve comparable performance, albeit requiring a longer training time to catch up. Furthermore, we find that transfer learning exhibits better compatibility with convolutional neural networks than with recurrent neural networks, which are the two most prevalent architectures for time-series ECG applications. Our results underscore the importance of transfer learning in ECG diagnosis, yet depending on the amount of available data, researchers may opt not to use it, considering the non-negligible cost associated with pre-training.

Cuong V. Nguyen, Hieu X. Nguyen, Dung D. Pham Minh et al.

Automated ECG diagnosis has seen significant advancements with deep learning techniques, but real-world applications still face challenges when dealing with scanned paper ECGs. In this study, we explore multi-label classification of ECGs extracted from scanned images, moving beyond traditional binary classification (normal/abnormal). We evaluate the performance of multiple deep neural network architectures, including AlexNet, VGG, ResNet, and Vision Transformer, on scanned ECG datasets. Our comparative analysis examines model accuracy, robustness to image artifacts, and generalizability across different ECG conditions. Additionally, we investigate whether ECG signals extracted from scanned images retain sufficient diagnostic information for reliable automated classification. The findings highlight the strengths and limitations of each architecture, providing insights into the feasibility of image-based ECG diagnosis and its potential integration into clinical workflows.