The Construe abductive framework combined with machine learning provides a highly accurate and interpretable method for detecting atrial fibrillation and other arrhythmias from short single-lead ECGs.
High challenge performance supports refinement of interpretable ML for single-lead ECG arrhythmia detection; leaves open prospective clinical validation.
OBJECTIVE: This work aims at providing a new method for the automatic detection of atrial fibrillation, other arrhythmia and noise on short single-lead ECG signals, emphasizing the importance of the interpretability of the classification results. APPROACH: A morphological and rhythm description of the cardiac behavior is obtained by a knowledge-based interpretation of the signal using the Construe abductive framework. Then, a set of meaningful features are extracted for each individual heartbeat and as a summary of the full record. The feature distributions can be used to elucidate the expert criteria underlying the labeling of the 2017 PhysioNet/CinC Challenge dataset, enabling a manual partial relabeling to improve the consistency of the training set. Finally, a tree gradient boosting model and a recurrent neural network are combined using the stacking technique to provide an answer on the basis of the feature values. MAIN RESULTS: score of 0.83 and tying for the first place in the official stage of the Challenge. This result was even improved in the follow-up stage to 0.85 with a significant simplification of the model, attaining the highest score so far reported on the hidden dataset. SIGNIFICANCE: The obtained results demonstrate the potential of Construe to provide robust and valuable descriptions of temporal data, even with the presence of significant amounts of noise. Furthermore, the importance of consistent classification criteria in manually labeled training datasets is emphasized, and the fundamental advantages of knowledge-based approaches to formalize and validate those criteria are discussed.
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