Review on Cardiac Arrhythmia Through Segmentation Approaches in Deep Learning

Analysis of PCG signals using quality assessment and homomorphic filters for localization and classification of heart sounds

Objective. Heart sounds can reflect detrimental changes in cardiac mechanical activity that are common pathological characteristics of chronic heart failure (CHF). The ACC/AHA heart failure (HF) stage classification is essential for clinical decision-making and the management of CHF. Herein, a machine learning model that makes use of multi-scale and multi-domain heart sound features was proposed to provide an objective aid for ACC/AHA HF stage classification. Approach. A dataset containing phonocardiogram (PCG) signals from 275 subjects was obtained from two medical institutions and used in this study. Complementary ensemble empirical mode decomposition and tunable-Q wavelet transform were used to construct self-adaptive sub-sequences and multi-level sub-band signals for PCG signals. Time-domain, frequency-domain and nonlinear feature extraction were then applied to the original PCG signal, heart sound sub-sequences and sub-band signals to construct multi-scale and multi-domain heart sound features. The features selected via the least absolute shrinkage and selection operator were fed into a machine learning classifier for ACC/AHA HF stage classification. Finally, mainstream machine learning classifiers, including least-squares support vector machine (LS-SVM), deep belief network (DBN) and random forest (RF), were compared to determine the optimal model. Main results. The results showed that the LS-SVM, which utilized a combination of multi-scale and multi-domain features, achieved better classification performance than the DBN and RF using multi-scale or/and multi-domain features alone or together, with average sensitivity, specificity, and accuracy of 0.821, 0.955 and 0.820 on the testing set, respectively. Significance. PCG signal analysis provides efficient measurement information regarding CHF severity and is a promising noninvasive method for ACC/AHA HF stage classification.

Phonocardiograms (PCG) are recordings of the acoustic waves produced by the mechanical action of the heart. They generally consist of two kinds of acoustic vibrations: heart sounds and heart murmurs. Heart murmurs are often the first signs of pathological changes of the heart valves, and are usually found during auscultation in primary health care. Heart auscultation has been recognized for a long time as an important tool for the diagnosis of heart disease, although its accuracy is still insufficient to diagnose some heart diseases. It does not enable the analyst to obtain both qualitative and quantitative characteristics of the PCG signals. The efficiency of diagnosis can be improved considerably by using modern digital signal processing techniques. Therefore, these last can provide useful and valuable information on these signals. The aim of this study is to analyse PCG signals using wavelet transform. This analysis is based on an algorithm for the detection of heart sounds (the first and second sounds, S1 and S2) and heart murmurs using the PCG signal as the only source. The segmentation algorithm, which separates the components of the heart signal, is based on denoising by wavelet transform (DWT). This algorithm makes it possible to isolate individual sounds (S1 or S2) and murmurs. Thus, the analysis of various PCGs signals using wavelet transform can provide a wide range of statistical parameters related to the phonocardiogram signal.

Phonocardiogram (PCG) signal represents recording of sounds and murmurs resulting from heart auscultation. Analysis of these PCG signals is critical in diagnosis of different heart diseases. Over the years, a variety of methods have been proposed for automatic analysis of PCG signals in time, frequency, and time-frequency domains. This paper presents a comprehensive survey of different methods proposed for automatic analysis of PCG signals with the objective to evaluate the current state-of-the-art and to determine the potential domains of effective analysis. An important aspect of our contribution is that the review is carried out as a function of domains of analysis rather than simply discussing different methods. Our method further splits analysis into pre-processing, localization, and classification, and details are presented in terms of techniques and classifiers used during these phases. Finally, results are summarized for normal heart beat, noisy heart beat, and different pathologies using metrices like accuracy and detection rate. In addition to time and frequency domain, time-frequency based methods including wavelet, empirical mode decomposition (EMD) and time-frequency representation (TFR) are selected for detailed analysis. The review concludes that the time-frequency representations like EMD and wavelets represent areas of exploration in future along with perspective of using different time-frequency techniques together.

Analyzing the condition and function of the heart is very important because cardiovascular diseases (CVDs) are responsible for high mortality rates worldwide and can lead to strokes and heart attacks; thus, early diagnosis and treatment are important. Phonocardiogram (PCG) signals can be used to analyze heart rate characteristics to detect heart health and detect heart-related diseases. In this paper, we propose a method for designing using wavelet analysis techniques and an ensemble of deep learning models from phonocardiogram (PCG) for heart sound classification. For this purpose, we use wavelet scattering transform (WST) and continuous wavelet transform (CWT) as the wavelet analysis approaches for 1D-convolutional neural network (CNN) and 2D-CNN modeling, respectively. These features are insensitive to translations of the input on an invariance scale and are continuous with respect to deformations. Furthermore, the ensemble model is combined with 1D-CNN and 2D-CNN. The proposed method consists of four stages: a preprocessing stage for dividing signals at regular intervals, a feature extraction stage through wavelet scattering transform (WST) and continuous wavelet transform (CWT), a design stage of individual 1D-CNN and 2D-CNN, and a classification stage of heart sound by the ensemble model. The datasets used for the experiment were the PhysioNet/CinC 2016 challenge dataset and the PASCAL classifying heart sounds challenge dataset. The performance evaluation is performed by precision, recall, F1-score, sensitivity, and specificity. The experimental results revealed that the proposed method showed good performance on two datasets in comparison to the previous methods. The ensemble method of the proposed deep learning model surpasses the performance of recent studies and is suitable for predicting and diagnosing heart-related diseases by classifying heart sounds through phonocardiogram (PCG) signals.

A phonocardiogram (PCG) signal holds aural information generated by the heart during a cycle. A close examination of the PCG signal can reveal valuable cardiac information thereby allowing detection of abnormalities and diagnosis of heart diseases. An automation-aided analysis of PCG signals can play a vital role in the medical field, especially in remote patient monitoring, apart from being a very efficient approach. In this study, PCG signals are classified under 5 different classes based on the features extracted. The five classes are normal, mitral stenosis, mitral regurgitation, mitral valve prolapse, aortic stenosis (N, MS, MR, MVP, AS). Mel-Frequency Cepstral Coefficients (MFCCs) are extracted from the PCG audio signals and fed into a deep learning based convolutional neural network (CNN). The proposed approach achieves a maximum accuracy of 99.64% which outperforms the existing state-of-the-art approaches.KeywordsMel-Frequency Cepstral Coefficients2-D Convolutional Neural NetworkCross Validation

Phonocardiogram signal analysis for classification of Coronary Artery Diseases using MFCC and 1D adaptive local ternary patterns

The extraction of heart sound component from a composite signal of heart and lung is a quite challenging task in phonocardiogram signal analysis the first heart sound (S1) and the second heart sound (S2), produced by the closing of the atrioventricular valves and the closing of the semilunar valves, respectively, are the fundamental sounds of the heart. To accomplish this task a novel framework with intrinsic time scale decomposition (ITD) is designed. The capture of the PCG signal frequently hides the detection of the third heart sound (S3), which is necessary to identify cardiac failures. To separate S3, ITD method is deployed to enable signal decomposition into certain levels. Next, by applying smoothed pseudo-Wigner Ville distribution (SWVD) with reassignment, the location of S3 is detected. The proposed method is performed on 36 combinations consists of 144 cardiac cycles containing S3 obtained from different online databases. In comparison to existing approaches, the proposed work separates the S3 from other heart and lung sounds and the proposed method obtained the detection accuracy of S3 as 95.4%, which proves the superiority with other methods.

The aim of this study is to describe a robust unified framework for segmentation of the phonocardiogram (PCG) signal sounds based on the false-alarm probability (FAP) bounded segmentation of a properly calculated detection measure. To this end, first the original PCG signal is appropriately pre-processed and then, a fixed sample size sliding window is moved on the pre-processed signal. In each slid, the area under the excerpted segment is multiplied by its curve-length to generate the Area Curve Length (ACL) metric to be used as the segmentation decision statistic (DS). Afterwards, histogram parameters of the nonlinearly enhanced DS metric are used for regulation of the α-level Neyman-Pearson classifier for FAP-bounded delineation of the PCG events. The proposed method was applied to all 85 records of Nursing Student Heart Sounds database (NSHSDB) including stenosis, insufficiency, regurgitation, gallop, septal defect, split sound, rumble, murmur, clicks, friction rub and snap disorders with different sampling frequencies. Also, the method was applied to the records obtained from an electronic stethoscope board designed for fulfillment of this study in the presence of high-level power-line noise and external disturbing sounds and as the results, no false positive (FP) or false negative (FN) errors were detected. High noise robustness, acceptable detection-segmentation accuracy of PCG events in various cardiac system conditions, and having no parameters dependency to the acquisition sampling frequency can be mentioned as the principal virtues and abilities of the proposed ACL-based PCG events detection-segmentation algorithm.

Phonocardiogram (PCG), the digital recording of heart sounds is becoming increasingly popular as a primary detection system for diagnosing heart disorders and it is relatively inexpensive. Electrocardiogram (ECG) is used during the PCG in order to identify the systolic and diastolic parts manually. In this study a heart sound segmentation algorithm has been developed which separates the heart sound signal into these parts automatically. This study was carried out on 100 patients with normal and abnormal heart sounds. The algorithm uses discrete wavelet decomposition and reconstruction to produce PCG intensity envelopes and separates that into four parts: the first heart sound, the systolic period, the second heart sound and the diastolic period. The performance of the algorithm has been evaluated using 14,000 cardiac periods from 100 digital PCG recordings, including normal and abnormal heart sounds. In tests, the algorithm was over 93% correct in detecting the first and second heart sounds. The presented automatic segmentation algorithm using wavelet decomposition and reconstruction to select suitable frequency band for envelope calculations has been found to be effective to segment PCG signals into four parts without using an ECG.

ABSTRACTCardiovascular disease is one of the leading causes of death worldwide. Early and accurate detection of abnormal cardiac activity can be an effective way to prevent serious cardiovascular events. Electrocardiogram (ECG) and phonocardiogram (PCG) signals provide an objective evaluation of the heart's electrical and acoustic functions, enabling medical professionals to make an accurate diagnosis. Therefore, the cardiologists often use them to make a preliminary diagnosis of abnormal cardiac activity in clinical practice. For this reason, many diagnostic models have been proposed. However, these models fail to utilize the interaction information within and between the signals to aid the diagnosis of disease. To address this issue, we designed a residual dual‐attention network (ResAN) for the detection of abnormal cardiac activity using synchronized ECG and PCG signals. First, ResAN uses a feature learning module with two parallel residual networks, for example, ECG‐ResNet and PCG‐ResNet to automatically learn the deep modal‐specific features from the ECG and PCG sequences, respectively. Second, to fully utilize the available information of different modal signals, ResAN uses a dual‐attention fusion module to capture the salient features of the integrated ECG and PCG features learned by the feature learning module, as well as the alternating features between them based on the attention mechanisms. Finally, these fused features are merged and fed to the classification module to detect abnormal cardiac activity. Our model achieves an accuracy of 96.1%, surpassing the performances of comparison models by 1.0% to 9.9% when using synchronized ECG and PCG signals. Furthermore, the ablation study confirmed the efficacy of the components in ResAN and also showed that ResAN performs better with synchronized ECG and PCG signals compared to using single‐modal signals. Overall, ResAN provides a valid solution for the early detection of abnormal cardiac activity using ECG and PCG signals.

A Phonocardiogram (PCG) signal represents murmurs and sounds signals made by vibrations caused for the period of a cardiac cycle. Acoustic wave generated through the beat of the cardiac cycle propagates through the chest wall. It can be easily recorded by a low-cost small handheld digital device called a stethoscope. It provides information like heart rate, intensity, tone, quality, frequency, and location of various components of cardiac sound. Due to these characteristics, phonocardiogram signals can be used to detect heart status at an early stage in a non-invasive manner. In previous studies, the Convolutional Neural Network (ConvNet) is the most studied architecture, which was fed by features, namely Mel Frequency Cepstral (MFC), Chroma Energy Normalized Statistics (CENS), and Constant-Q Transform (CQT). This work has proposed a ConvNet model trained by Hybrid Constant-Q Transform (HCQT) for heart sound beat classification. CQT, Variable-Q Transform (VQT), and HCQT are extracted from each phonocardiogram signal as the acoustic features, including the dominant MFCC features, feed into five-layer regularized ConvNets. After analyzing the literature in the same domain, it can be stated that this is the first time HCQT is being utilized for PCG signals. The findings of the experiments demonstrate that HCQT is more effective than standard CQT and other variants. Also, the accuracies of the system proposed in this work on the validation datasets are 96% in multi-class classification, which outperforms the proposed work relative to other models significantly. The source code is available on the Github repository https://github.com/shamiktiwari/ PCG-signal-Classification-using-Hybrid-Constant-Q-Transform to support the research community.

Heart Sound (also known as phonocardiogram (PCG)) analysis, is a popular way that detects cardiovascular diseases (CVDs). Most PCG analysis uses supervised way, which demands both normal and abnormal samples. This paper proposes a method of unsupervised PCG analysis that uses beta variational auto-encoder (β – VAE) to model the normal PCG signals. The best performed model reaches an AUC (Area Under Curve) value of 0.91 in ROC (Receiver Operating Characteristic) test for PCG signals collected from the same source. Unlike majority of β – VAEs that are used as generative models, the best-performed β – VAE has a β value smaller than 1. This fact demonstrates that the resampling process helps the improvements on anomaly PCG detection through reconstruction loss worth a heavier weight. Further investigations suggest that anomaly score based on reconstruction loss may be better than anomaly scores based on latent vectors of samples in PCG analysis based on VAE systems.

The use of efficient feature extraction methods is very important to correctly classify the heart sound signal and to diagnosis the heart disease. In this paper, we propose two feature extraction algorithms for feature extraction of cardiac phonocardiography (PCG) signal. The both methods use the sequence discipline of PCG obtained by curve fitting model. In the first and the second methods, the sequence information is fused with features extracted by filter banks and by wavelets respectively. We used a dataset of PCG signals which contains the heart sounds of 98 persons (40 cases without heart disease and either no murmur or an innocent murmur and 58 cases with a variety of cardiac diagnoses and a pathologic systolic murmur). The experimental results show the efficiency of our proposed methods compared to some popular feature extraction methods from five different classification accuracy measures point of view.

The first step in any non linear time series analysis, is to characterize signals in terms of periodicity, stationarity ,linearity and predictability. In this work we aim to find if PCG (phonocardiogram) and ECG (electrocardiogram) time series are generated by a deterministic system and not from a random stochastic process. If PCG and ECG are non-linear deterministic systems and they are not very contaminated with noise, data should be confined to a finite dimensional manifold, which means there are structures hidden under the signal that could be used to increase our knowledge in forecasting future values of the time series. A non-linear process can give rise to very complex dynamic behaviours, even though the underlying process is purely deterministic and probably low-dimensional. To test this hypothesis, we have generated 99 surrogates and then we compared the fitting capability of AR (auto-regressive) models on the original and surrogate data. The results show with a 99% of confidence level that PCG and ECG were generated by a deterministic process. We compared the fitting capability of an ECG and PCG to AR linear models, using a multi-channel approach. We make an assumption that if a signal is more linearly predictable than another one, it may adjust better to these AR linear models. The results showed that ECG is more linearly predictable (for both channels) than PCG, although a filtering step is needed for the first channel. Finally we show that the false nearest neighbour method is insufficient to identify the correct dimension of the attractor in the reconstructed state space for both PCG and ECG signals.