Why the study?
Holter ECG interpretation is difficult and time-consuming because every heartbeat requires classification, creating a need for accurate, noise-resilient methods for automatic interpretation.
Does a three-stage machine learning approach improve the automatic interpretation of Holter ECG recordings compared to commercial software and existing methods?
Does a three-stage machine learning approach improve the automatic interpretation of Holter ECG recordings compared to commercial software and existing methods?
Absolute Event Rate: 0.917% vs 0.687%
A novel three-stage machine learning approach improves the automatic interpretation and noise resilience of Holter ECG recordings compared to existing commercial software.
May aid automated Holter ECG analysis; leaves open prospective validation before clinical adoption.
Holter monitoring, a long-term ECG recording (24-hours and more), contains a large amount of valuable diagnostic information about the patient. Its interpretation becomes a difficult and time-consuming task for the doctor who analyzes them because every heartbeat needs to be classified, thus requiring highly accurate methods for automatic interpretation. In this paper, we present a three-stage process for analysing Holter recordings with robustness to noisy signal. First stage is a segmentation neural network (NN) with encoderdecoder architecture which detects positions of heartbeats. Second stage is a classification NN which will classify heartbeats as wide or narrow. Third stage in gradient boosting decision trees (GBDT) on top of NN features that incorporates patient-wise features and further increases performance of our approach. As a part of this work we acquired 5095 Holter recordings of patients annotated by an experienced cardiologist. A committee of three cardiologists served as a ground truth annotators for the 291 examples in the test set. We show that the proposed method outperforms the selected baselines, including two commercial-grade software packages and some methods previously published in the literature.
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Egorov et al. (2020) studied Arrhythmia (ECG Interpretation) (n=5,095). Neural Network and Gradient Boosting Decision Trees (NN + GBDT) algorithm vs. Commercial ECG analysis software (Vendor 1 and Vendor 2) was evaluated on QRS classification sensitivity.
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