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July 3, 2022JMIR Medical Informatics88 citationsOpen Access

State-of-the-Art Deep Learning Methods on Electrocardiogram Data: Systematic Review

ΓΠΓεώργιος ΠετμεζάςLSLeandros StefanopoulosVKVassilis Kilintzis

Key Result

Deep learning methods, predominantly Convolutional Neural Networks, demonstrated high performance in analyzing electrocardiogram data for cardiovascular disease diagnosis and other clinical applications.

Study Design

Type

Systematic Review (n=230)

Structured PICO

P
Population
230 relevant articles published between January 2020 and December 2021 applying deep learning to ECG data
I
Intervention
Deep learning methods applied to ECG data
O
Outcome
State-of-the-art deep learning strategies per field of application and major ECG data sources

This systematic review summarizes state-of-the-art deep learning methods applied to ECG data across 6 distinct medical applications.

Limitations

  • Review restricted to articles published between January 2020 and December 2021
  • Heterogeneity in ECG data characteristics (number of leads, duration, sample rate) makes comparing study results difficult
  • Many reviewed studies lacked interpatient data splitting, making their results questionable
  • Deep learning models often exhibit black box behavior and lack interpretability
  • Data imbalance in ECG databases and lack of attempts to address blood pressure variability in training datasets

Abstract

BACKGROUND: Electrocardiogram (ECG) is one of the most common noninvasive diagnostic tools that can provide useful information regarding a patient's health status. Deep learning (DL) is an area of intense exploration that leads the way in most attempts to create powerful diagnostic models based on physiological signals. OBJECTIVE: This study aimed to provide a systematic review of DL methods applied to ECG data for various clinical applications. METHODS: The PubMed search engine was systematically searched by combining "deep learning" and keywords such as "ecg," "ekg," "electrocardiogram," "electrocardiography," and "electrocardiology." Irrelevant articles were excluded from the study after screening titles and abstracts, and the remaining articles were further reviewed. The reasons for article exclusion were manuscripts written in any language other than English, absence of ECG data or DL methods involved in the study, and absence of a quantitative evaluation of the proposed approaches. RESULTS: We identified 230 relevant articles published between January 2020 and December 2021 and grouped them into 6 distinct medical applications, namely, blood pressure estimation, cardiovascular disease diagnosis, ECG analysis, biometric recognition, sleep analysis, and other clinical analyses. We provide a complete account of the state-of-the-art DL strategies per the field of application, as well as major ECG data sources. We also present open research problems, such as the lack of attempts to address the issue of blood pressure variability in training data sets, and point out potential gaps in the design and implementation of DL models. CONCLUSIONS: We expect that this review will provide insights into state-of-the-art DL methods applied to ECG data and point to future directions for research on DL to create robust models that can assist medical experts in clinical decision-making.

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Cite This Study

Πετμεζάς et al. (2022) conducted a systematic review in Electrocardiogram (ECG) data analysis (n=230). Deep learning methods (e.g., CNN, ResNet, LSTM) was evaluated on Model performance (accuracy, sensitivity, specificity) across various clinical applications. Deep learning methods, predominantly Convolutional Neural Networks, demonstrated high performance in analyzing electrocardiogram data for cardiovascular disease diagnosis and other clinical applications.

synapsesocial.com/papers/6a0f6ba9b6f5ee04015fb52chttps://doi.org/10.2196/38454
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