This paper introduces a winning solution (team ISIBrno-AIMT) to the official round of PhysioNet Challenge 2021. The main goal of the challenge was a classification of ECG recordings into 26 multi-label pathological classes with variable number of leads (e.g., 12,6,4,3,2). We introduced an ECG classification method based on the ResNet architecture with a multi-head attention mechanism for the official round of the challenge. However, empirical findings collected during model development suggested that the multi-head attention layer might not significantly impact the final classification performance. For this reason, during the follow-up round, we removed a multi-head attention layer to test the influence on model performance. Like the official round, the model is optimized using a mixture of loss functions, i.e., binary cross-entropy, custom challenge score loss function, and custom sparsity loss function. Probability thresholds for each classification class are estimated using the evolutionary optimization method. The final architecture consists of three submodels forming a majority voting classification ensemble. Our findings from the follow- up submission support the fact that the multi-head attention layer in the proposed architecture does not significantly affect the classification performance. The modified model without the multi-head attention layer increased the overall challenge score to 0.59 compared to the 0.58 from the official round.
While various QRS detection and classification methods were developed in the past, the Holter ECG data acquired during daily activities by wearable devices represent new challenges such as increased noise and artefacts due to patient movements. Here, we present a deep-learning model to detect and classify QRS complexes in single-lead Holter ECG. We introduce a novel approach, delivering QRS detection and classification in one inference step. We used a private dataset (12,111 Holter ECG recordings, length of 30 s) for training, validation, and testing the method. Twelve public databases were used to further test method performance. We built a software tool to rapidly annotate QRS complexes in a private dataset, and we annotated 619,681 QRS complexes. The standardised and down-sampled ECG signal forms a 30-s long input for the deep-learning model. The model consists of five ResNet blocks and a gated recurrent unit layer. The model's output is a 30-s long 4-channel probability vector (no-QRS, normal QRS, premature ventricular contraction, premature atrial contraction). Output probabilities are post-processed to receive predicted QRS annotation marks. For the QRS detection task, the proposed method achieved the F1 score of 0.99 on the private test set. An overall mean F1 cross-database score through twelve external public databases was 0.96 ± 0.06. In terms of QRS classification, the presented method showed micro and macro F1 scores of 0.96 and 0.74 on the private test set, respectively. Cross-database results using four external public datasets showed micro and macro F1 scores of 0.95 ± 0.03 and 0.73 ± 0.06, respectively. Presented results showed that QRS detection and classification could be reliably computed in one inference step. The cross-database tests showed higher overall QRS detection performance than any of compared methods.
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