Three-dimensional Phase Space Characteristics of Electrocardiogram Segments in Online and Early Prediction of Sudden Cardiac Death

Document Type : Original Paper

Authors

Department of Biomedical Engineering, Imam Reza International University, Mashhad, Razavi Khorasan, Iran

Abstract

Introduction: Predicting sudden cardiac death (SCD) using electrocardiogram (ECG) signals has come to the attention of researchers in recent years. One of the most common SCD identifiers is ventricular fibrillation (VF). The main objective of the present study was to provide an online prediction system of SCD using innovative ECG measures 10 minutes before VF onset. Additionally, it aimed to evaluate the different segments of the ECG signal (which depend on ventricular function) comparatively to determine the efficient component in predicting SCD. The ECG segments were QS, RT, QR, QT, and ST.
Material and Methods: After defining the ECG characteristic points and segments, innovative measures were appraised using the three-dimensional phase space of the ECG component. Tracking signal dynamics and lowering the computational cost make the feature suitable for online and offline applications. Finally, the prediction was performed using the support vector machine (SVM).
Results: Using the QR measures, SCD detection was realized ten minutes before its occurrence with an accuracy, specificity, and sensitivity of 100%.
Conclusion: The superiority of the proposed system compared to the state-of-the-art SCD prediction schemes was revealed in terms of both classification performances and computational speed.

Keywords

Main Subjects


  1. Ebrahimzadeh E, Pooyan M. Prediction sudden cardiac death (SCD) using time-frequency analysis of ECG signal. Computational Intelligence in Electrical Engineering. 2013: 3(4):15-26.
  2. Sheela CJ, Vanitha L. Prediction of sudden cardiac death using support vector machine. In: International Conference on Circuits, Power and Computing Technologies: 20-21 March 2014; Nagercoil, India. 2014: 377-81
  3. Ploux S, Strik M, Caillol T, Ramirez FD, Abu-Alrub S, Marchand H, et al. Beyond the wrist: using a smartwatch electrocardiogram to detect electrocardiographic abnormalities. Archives of Cardiovascular Diseases. 2022 Jan 1;115(1):29-36.
  4. Arvanaghi R, Daneshvar S, Seyedarabi H, Goshvarpour A. Fusion of ECG and ABP signals based on wavelet transform for cardiac arrhythmias classification, Computer Methods and Programs in Biomedicine. 2017; 151: 71-8. DOI: 10.1016/j.cmpb.2017.08.013.
  5. Goshvarpour A, Abbasi A, Goshvarpour A, Daneshvar S. Fusion Framework for Emotional Electrocardiogram and Galvanic Skin Response Recognition. Applying Wavelet Transform. Iranian Journal of Medical Physics. 2016; 13(3): 163-73. DOI: 10.22038/ijmp.2016.7960.
  6. Goshvarpour A, Goshvarpour A. Human identification using information theory-based indices of ECG characteristic points, Expert Systems With Applications. 2019; 127: 25-34. DOI: 10.1016/j.eswa.2019.02.038.
  7. Goshvarpour A, Goshvarpour A. Human identification using a new Matching Pursuit-based feature set of ECG, Computer Methods and Programs in Biomedicine. 2019; 172: 87– DOI: 10.1016/j.cmpb.2019.02.009.
  8. Saiedi Zadeh S, Nassiri P, Zeraati H, Jahangiri R. The Study of ECG Changes in Humans Exposed to 50 Hz Electromagnetic Fields. Iranian Journal of Medical Physics. 2007; 4(Issue 3,4): 43-52. DOI: 10.22038/ijmp.2007.7550.
  9. Goshvarpour A, Goshvarpour A. The impact of gravitational stress on cardiac dynamics using entropy. Iranian Journal of Medical Physics. 2022; (In Press). DOI: 10.22038/ijmp.2022.56462.1944.
  10. Acharya UR, Fujita H, Sudarshan V K, Sree V, Eugene LWJ, Ghista DN, et al. An Integrated Index for Detection of Sudden Cardiac Death Using Discrete Wavelet Transform and Nonlinear Features: Jr Knowl Based Syst. 2015; 83:149-58.
  11. Fujita H, Acharya UR, Sudarshan VK, Ghista DN, Sree SV, Eugene LWJ, et al. Sudden Cardiac Death (SCD) Prediction based on Nonlinear Heart Rate Variability Features and SCD Index. Appl. Soft Comput. 2016; 43:510-9.
  12. Ebrahimzadeh E, Najararaabi B. A Novel Approach to Predict Sudden Cardiac Death Using Local Feature Selection and Mixture of Experts. Intelligent Systems in Electrical Engineering. 2016; 7(3): 15-32.
  13. Ebrahimzadeh E. Predicting sudden cardiac death using signals ECG and HRV with time-frequency processing. (MSc. Thesis). Shahed University, Tehran, Iran. 2011.
  14. Houshyarifar V, Chehel Amirani M. An approach to predict Sudden Cardiac Death (SCD) using time domain and bispectrum features from HRV signal. Bio-Medical Materials and Engineering. 2016;27(2-3): 275-85.
  15. Alizadeh F. Time-frequency analysis of cardiac signals to predict sudden cardiac death. 2018 (MSc.Thesis). Urmia University, Urmia, Iran. 2017.
  16. Khazaei M, Raeisi KH, Goshvarpour A, Ahmadzadeh M. Early detection of sudden cardiac death using nonlinear analysis of heart rate variability. Biocybern Biomed Eng. 2018;38: 931-40.
  17. Ebrahimzadeh E, Fayaz F, Ahmadi F, Rahimi Dolatabad M. Linear and nonlinear analyses for detection of sudden cardiac death using ECG and HRV signals. Trends in Research. 2018;1(1): 1-8.
  18. Amezquita-Sanchez JP, Valtierra Rodriguez M, Adeli H, Perez-Ramirez CA. A Novel Wavelet Transform-Homogeneity Model for Sudden Cardiac Death Prediction Using ECG Signals. Jr Med Syst. 2018; 42:176.
  19. Devi R, Tyagi HK, Kumar D. A novel multi class approach for early stage prediction of sudden cardiac death. Biocybern Biomed Eng. 2019; 39(3): 586-98.
  20. Li R, Zhang X, Dai H, Zhou B, Wang Z. Interpretability Analysis of Heartbeat Classification Based on Heartbeat Activity’s Global Sequence Features and BiLSTM-Attention Neural Network. IEEE Access. 2019;7: 109870-83.
  21. Lai D, Zhang Y, Zhang X, Su Y, Bin Heyat MB. An Automated Strategy for Early Risk Identification of Sudden Cardiac Death by using Machine Learning Approach on Measurable Arrhythmic Risk Markers. IEEE Access. 2019;7: 94701-16.
  22. Ebrahimzadeh E, Manuchehri MS, Amoozegar S, Araabi BN, Soltanian-Zadeh H. A time local subset feature selection for prediction of sudden cardiac death from ECG signal. Med Biol Eng Comput. 2018 Jul;56(7):1253-70.
  23. Kahroba F, Mohebbi M, Danandeh Hesar H. Early detection of sudden cardiac death in electrocardiogram signals using extended kalman filter. Iranian Journal of Biomedical Engineering. 2017; 11(2): 187-99.
  24. Shen TW, Lin CC, Shen HP, Ou YL, Lin CH. A personal Sudden Cardiac Death (SCD) detector based on ECG biometric technology. InWorld Congress on Medical Physics and Biomedical Engineering 2006: August 27–September 1, 2006 COEX Seoul, Korea “Imaging the Future Medicine” 2007 (pp. 1249-1252).
  25. Sajadi Moghadam F, Karimi Moridani M, Jalilehvand Y. Analysis of heart rate dynamics based on nonlinear lagged returned map for sudden cardiac death prediction in cardiovascular patients. Multidim Syst Sign Process. 2021;32: 693–
  26. Murugappan M, Murugesan L, Jerritta S, Adeli H. Sudden Cardiac Arrest Prediction Using ECG Morphological Features. Arab J Sci Eng. 2020; 46: 947–
  27. Zimmerman MW, Povinelli RJ, Johnson MT, Ropella KM. A reconstructed phase space approach for distinguishing ischemic from non-ischemic ST changes using Holter ECG data, Computers in Cardiology. 2003; 243-6. DOI: 10.1109/CIC.2003.1291136.
  28. Goldberger A, Amaral L, Glass L, Hausdorff J, Ivanov PC, Mark R, et al. PhysioBank, PhysioToolkit, and PhysioNet. Components of a new research resource for complex physiologic signals:. Circulation [Online]. 2000; 101(23): e215–
  29. Greenwald SD. Development and analysis of a ventricular fibrillation detector. (M.S. thesis), MIT Dept. of Electrical Engineering and Computer Science, 1986. (Sudden Cardiac Death Holter Database is available at: https://www.physionet.org/content/sddb/1.0.0/)
  30. Wagner, J., Kim, J., André, E. From physiological signals to emotions: Implementing and comparing selected methods for feature extraction and classification. In: IEEE International Conference on Multimedia and Expo: 6 July 2005, Amsterdam, Netherlands. 2005: 940-3.
  31. Brugada P, Brugada J. Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol. 1992;20(6):1391-6. DOI:10.1016/0735-1097(92)90253-j.
  32. Straus SM, Kors JA, De Bruin ML, et al. Prolonged QTc interval and risk of sudden cardiac death in a population of older adults. J Am Coll Cardiol. 2006;47(2):362-7. DOI:10.1016/j.jacc.2005.08.067.
  33. Niemeijer MN, van den Berg ME, Eijgelsheim M. Short-term QT variability markers for the prediction of ventricular arrhythmias and sudden cardiac death: a systematic review. Heart. 2014;100(23):1831-1836. DOI:10.1136/heartjnl-2014-305671.
  34. O’Neal WT, Singleton MJ, Roberts JD, Tereshchenko LG, Sotoodehnia N, Chen LY, et al. Association between QT-interval components and sudden cardiac death: the ARIC study (Atherosclerosis Risk in Communities). Circulation: Arrhythmia and Electrophysiology. 2017 Oct;10(10):e005485. DOI:10.1161/CIRCEP.117.005485.
  35. Ye M, Zhang JW, Liu J, Zhang M, Yao FJ, Cheng YJ. Association between dynamic change of QT interval and long-term cardiovascular outcomes: a prospective cohort study. Frontiers in cardiovascular medicine. 2021 Nov 30;8:756213.
  36. Kim SH, Kim DY, Kim HJ, Jung SM, Han SW, Suh SY, et al. Early repolarization with horizontal ST segment may be associated with aborted sudden cardiac arrest: a retrospective case control study. BMC cardiovascular disorders. 2012 Dec;12:1-5.