Robust Peak Detection for Holter ECGs by Self-Organized Operational Neural Networks.

Although numerous R-peak detectors have been proposed in the literature, their robustness and performance levels may significantly deteriorate in low-quality and noisy signals acquired from mobile electrocardiogram (ECG) sensors, such as Holter monitors. Recently, this issue has been addressed by deep 1-D convolutional neural networks (CNNs) that have achieved state-of-the-art performance levels in Holter monitors; however, they pose a high complexity level that requires special parallelized hardware setup for real-time processing. On the other hand, their performance deteriorates when a compact network configuration is used instead. This is an expected outcome as recent studies have demonstrated that the learning performance of CNNs is limited due to their strictly homogenous configuration with the sole linear neuron model. This has been addressed by operational neural networks (ONNs) with their heterogenous network configuration encapsulating neurons with various nonlinear operators. In this study, to further boost the peak detection performance along with an elegant computational efficiency, we propose 1-D Self-Organized ONNs (Self-ONNs) with generative neurons. The most crucial advantage of 1-D Self-ONNs over the ONNs is their self-organization capability that voids the need to search for the best operator set per neuron since each generative neuron has the ability to create the optimal operator during training. The experimental results over the China Physiological Signal Challenge-2020 (CPSC) dataset with more than one million ECG beats show that the proposed 1-D Self-ONNs can significantly surpass the state-of-the-art deep CNN with less computational complexity. Results demonstrate that the proposed solution achieves a 99.10% F1-score, 99.79% sensitivity, and 98.42% positive predictivity in the CPSC dataset, which is the best R-peak detection performance ever achieved.

Investigation of the Role of Convolutional Neural Network Architectures in the Diagnosis of Glaucoma using Color Fundus Photography.

Objectives: To evaluate the performance of convolutional neural network (CNN) architectures to distinguish eyes with glaucoma from normal eyes. Materials and Methods: A total of 9,950 fundus photographs of 5,388 patients from the database of Eskisehir Osmangazi University Faculty of Medicine Ophthalmology Clinic were labelled as glaucoma, glaucoma suspect, or normal by three different experienced ophthalmologists. The categorized fundus photographs were evaluated using a state-of-the-art two-dimensional CNN and compared with deep residual networks (ResNet) and very deep neural networks (VGG). The accuracy, sensitivity, and specificity of glaucoma detection with the different algorithms were evaluated using a dataset of 238 normal and 320 glaucomatous fundus photographs. For the detection of suspected glaucoma, ResNet-101 architectures were tested with a data set of 170 normal, 170 glaucoma, and 167 glaucoma-suspect fundus photographs. Results: Accuracy, sensitivity, and specificity in detecting glaucoma were 96.2%, 99.5%, and 93.7% with ResNet-50; 97.4%, 97.8%, and 97.1% with ResNet-101; 98.9%, 100%, and 98.1% with VGG-19, and 99.4%, 100%, and 99% with the 2D CNN, respectively. Accuracy, sensitivity, and specificity values in distinguishing glaucoma suspects from normal eyes were 62%, 68%, and 56% and those for differentiating glaucoma from suspected glaucoma were 92%, 81%, and 97%, respectively. While 55 photographs could be evaluated in 2 seconds with CNN, a clinician spent an average of 24.2 seconds to evaluate a single photograph. Conclusion: An appropriately designed and trained CNN was able to distinguish glaucoma with high accuracy even with a small number of fundus photographs.

Blind ECG Restoration by Operational Cycle-GANs.

OBJECTIVE: ECG recordings often suffer from a set of artifacts with varying types, severities, and durations, and this makes an accurate diagnosis by machines or medical doctors difficult and unreliable. Numerous studies have proposed ECG denoising; however, they naturally fail to restore the actual ECG signal corrupted with such artifacts due to their simple and naive noise model. In this pilot study, we propose a novel approach for blind ECG restoration using cycle-consistent generative adversarial networks (Cycle-GANs) where the quality of the signal can be improved to a clinical level ECG regardless of the type and severity of the artifacts corrupting the signal. METHODS: To further boost the restoration performance, we propose 1D operational Cycle-GANs with the generative neuron model. RESULTS: The proposed approach has been evaluated extensively using one of the largest benchmark ECG datasets from the China Physiological Signal Challenge (CPSC-2020) with more than one million beats. Besides the quantitative and qualitative evaluations, a group of cardiologists performed medical evaluations to validate the quality and usability of the restored ECG, especially for an accurate arrhythmia diagnosis. SIGNIFICANCE: As a pioneer study in ECG restoration, the corrupted ECG signals can be restored to clinical level quality. CONCLUSION: By means of the proposed ECG restoration, the ECG diagnosis accuracy and performance can significantly improve.

Robust R-Peak Detection in Low-Quality Holter ECGs Using 1D Convolutional Neural Network.

OBJECTIVE: Noise and low quality of ECG signals acquired from Holter or wearable devices deteriorate the accuracy and robustness of R-peak detection algorithms. This paper presents a generic and robust system for R-peak detection in Holter ECG signals. While many proposed algorithms have successfully addressed the problem of ECG R-peak detection, there is still a notable gap in the performance of these detectors on such low-quality ECG records. METHODS: In this study, a novel implementation of the 1D Convolutional Neural Network (CNN) is used integrated with a verification model to reduce the number of false alarms. This CNN architecture consists of an encoder block and a corresponding decoder block followed by a sample-wise classification layer to construct the 1D segmentation map of R-peaks from the input ECG signal. Once the proposed model has been trained, it can solely be used to detect R-peaks possibly in a single channel ECG data stream quickly and accurately, or alternatively, such a solution can be conveniently employed for real-time monitoring on a lightweight portable device. RESULTS: The model is tested on two open-access ECG databases: The China Physiological Signal Challenge (2020) database (CPSC-DB) with more than one million beats, and the commonly used MIT-BIH Arrhythmia Database (MIT-DB). Experimental results demonstrate that the proposed systematic approach achieves 99.30% F1-score, 99.69% recall, and 98.91% precision in CPSC-DB, which is the best R-peak detection performance ever achieved. Results also demonstrate similar or better performance than most competing algorithms on MIT-DB with 99.83% F1-score, 99.85% recall, and 99.82% precision. SIGNIFICANCE: Compared to all competing methods, the proposed approach can reduce the false-positives and false-negatives in Holter ECG signals by more than 54% and 82%, respectively. CONCLUSION: Finally, the simple and invariant nature of the parameters leads to a highly generic system and therefore applicable to any ECG dataset.

Real-Time Patient-Specific ECG Classification by 1D Self-Operational Neural Networks.

OBJECTIVE: Despitethe proliferation of numerous deep learning methods proposed for generic ECG classification and arrhythmia detection, compact systems with the real-time ability and high accuracy for classifying patient-specific ECG are still few. Particularly, the scarcity of patient-specific data poses an ultimate challenge to any classifier. Recently, compact 1D Convolutional Neural Networks (CNNs) have achieved the state-of-the-art performance level for the accurate classification of ventricular and supraventricular ectopic beats. However, several studies have demonstrated the fact that the learning performance of the conventional CNNs is limited because they are homogenous networks with a basic (linear) neuron model. In order to address this deficiency and further boost the patient-specific ECG classification performance, in this study, we propose 1D Self-organized Operational Neural Networks (1D Self-ONNs). METHODS: Due to its self-organization capability, Self-ONNs have the utmost advantage and superiority over conventional ONNs where the prior operator search within the operator set library to find the best possible set of operators is entirely avoided. RESULTS: Under AAMI recommendations and with minimal common training data used, over the entire MIT-BIH dataset 1D Self-ONNs have achieved 98% and 99.04% average accuracies, 76.6% and 93.7% average F1 scores on supra-ventricular and ventricular ectopic beat (VEB) classifications, respectively, which is the highest performance level ever reported. CONCLUSION: As the first study where 1D Self-ONNs are ever proposed for a classification task, our results over the MIT-BIH arrhythmia benchmark database demonstrate that 1D Self-ONNs can surpass 1D CNNs with a significant margin while having a similar computational complexity.

Self-organized Operational Neural Networks with Generative Neurons.

Operational Neural Networks (ONNs) have recently been proposed to address the well-known limitations and drawbacks of conventional Convolutional Neural Networks (CNNs) such as network homogeneity with the sole linear neuron model. ONNs are heterogeneous networks with a generalized neuron model. However the operator search method in ONNs is not only computationally demanding, but the network heterogeneity is also limited since the same set of operators will then be used for all neurons in each layer. Moreover, the performance of ONNs directly depends on the operator set library used, which introduces a certain risk of performance degradation especially when the optimal operator set required for a particular task is missing from the library. In order to address these issues and achieve an ultimate heterogeneity level to boost the network diversity along with computational efficiency, in this study we propose Self-organized ONNs (Self-ONNs) with generative neurons that can adapt (optimize) the nodal operator of each connection during the training process. Moreover, this ability voids the need of having a fixed operator set library and the prior operator search within the library in order to find the best possible set of operators. We further formulate the training method to back-propagate the error through the operational layers of Self-ONNs. Experimental results over four challenging problems demonstrate the superior learning capability and computational efficiency of Self-ONNs over conventional ONNs and CNNs.

Personalized Monitoring and Advance Warning System for Cardiac Arrhythmias.

Each year more than 7 million people die from cardiac arrhythmias. Yet no robust solution exists today to detect such heart anomalies right at the moment they occur. The purpose of this study was to design a personalized health monitoring system that can detect early occurrences of arrhythmias from an individual's electrocardiogram (ECG) signal. We first modelled the common causes of arrhythmias in the signal domain as a degradation of normal ECG beats to abnormal beats. Using the degradation models, we performed abnormal beat synthesis which created potential abnormal beats from the average normal beat of the individual. Finally, a Convolutional Neural Network (CNN) was trained using real normal and synthesized abnormal beats. As a personalized classifier, the trained CNN can monitor ECG beats in real time for arrhythmia detection. Over 34 patients' ECG records with a total of 63,341 ECG beats from the MIT-BIH arrhythmia benchmark database, we have shown that the probability of detecting one or more abnormal ECG beats among the first three occurrences is higher than 99.4% with a very low false-alarm rate.

Analysis of High-Dimensional Phase Space via Poincaré Section for Patient-Specific Seizure Detection.

In this paper, the performance of the phase space representation in interpreting the underlying dynamics of epileptic seizures is investigated and a novel patient-specific seizure detection approach is proposed based on the dynamics of EEG signals. To accomplish this, the trajectories of seizure and nonseizure segments are reconstructed in a high dimensional space using time-delay embedding method. Afterwards, Principal Component Analysis (PCA) was used in order to reduce the dimension of the reconstructed phase spaces. The geometry of the trajectories in the lower dimensions is then characterized using Poincaré section and seven features were extracted from the obtained intersection sequence. Once the features are formed, they are fed into a two-layer classification scheme, comprising the Linear Discriminant Analysis (LDA) and Naive Bayesian classifiers. The performance of the proposed method is then evaluated over the CHB-MIT benchmark database and the proposed approach achieved 88.27% sensitivity and 93.21% specificity on average with 25% training data. Finally, we perform comparative performance evaluations against the state-of-the-art methods in this domain which demonstrate the superiority of the proposed method.

Real-Time Patient-Specific ECG Classification by 1-D Convolutional Neural Networks.

GOAL: This paper presents a fast and accurate patient-specific electrocardiogram (ECG) classification and monitoring system. METHODS: An adaptive implementation of 1-D convolutional neural networks (CNNs) is inherently used to fuse the two major blocks of the ECG classification into a single learning body: feature extraction and classification. Therefore, for each patient, an individual and simple CNN will be trained by using relatively small common and patient-specific training data, and thus, such patient-specific feature extraction ability can further improve the classification performance. Since this also negates the necessity to extract hand-crafted manual features, once a dedicated CNN is trained for a particular patient, it can solely be used to classify possibly long ECG data stream in a fast and accurate manner or alternatively, such a solution can conveniently be used for real-time ECG monitoring and early alert system on a light-weight wearable device. RESULTS: The results over the MIT-BIH arrhythmia benchmark database demonstrate that the proposed solution achieves a superior classification performance than most of the state-of-the-art methods for the detection of ventricular ectopic beats and supraventricular ectopic beats. CONCLUSION: Besides the speed and computational efficiency achieved, once a dedicated CNN is trained for an individual patient, it can solely be used to classify his/her long ECG records such as Holter registers in a fast and accurate manner. SIGNIFICANCE: Due to its simple and parameter invariant nature, the proposed system is highly generic, and, thus, applicable to any ECG dataset.

Convolutional Neural Networks for patient-specific ECG classification.

We propose a fast and accurate patient-specific electrocardiogram (ECG) classification and monitoring system using an adaptive implementation of 1D Convolutional Neural Networks (CNNs) that can fuse feature extraction and classification into a unified learner. In this way, a dedicated CNN will be trained for each patient by using relatively small common and patient-specific training data and thus it can also be used to classify long ECG records such as Holter registers in a fast and accurate manner. Alternatively, such a solution can conveniently be used for real-time ECG monitoring and early alert system on a light-weight wearable device. The experimental results demonstrate that the proposed system achieves a superior classification performance for the detection of ventricular ectopic beats (VEB) and supraventricular ectopic beats (SVEB).

Automated patient-specific classification of long-term Electroencephalography.

This paper presents a novel systematic approach for patient-specific classification of long-term Electroencephalography (EEG). The goal is to extract the seizure sections with a high accuracy to ease the Neurologist's burden of inspecting such long-term EEG data. We aim to achieve this using the minimum feedback from the Neurologist. To accomplish this, we use the majority of the state-of-the-art features proposed in this domain for evolving a collective network of binary classifiers (CNBC) using multi-dimensional particle swarm optimization (MD PSO). Multiple CNBCs are then used to form a CNBC ensemble (CNBC-E), which aggregates epileptic seizure frames from the classification map of each CNBC in order to maximize the sensitivity rate. Finally, a morphological filter forms the final epileptic segments while filtering out the outliers in the form of classification noise. The proposed system is fully generic, which does not require any a priori information about the patient such as the list of relevant EEG channels. The results of the classification experiments, which are performed over the benchmark CHB-MIT scalp long-term EEG database show that the proposed system can achieve all the aforementioned objectives and exhibits a significantly superior performance compared to several other state-of-the-art methods. Using a limited training dataset that is formed by less than 2 min of seizure and 24 min of non-seizure data on the average taken from the early 25% section of the EEG record of each patient, the proposed system establishes an average sensitivity rate above 89% along with an average specificity rate above 93% over the test set.

Collective Network of Binary Classifier Framework for Polarimetric SAR Image Classification: An Evolutionary Approach.

Terrain classification over polarimetric synthetic aperture radar (SAR) images has been an active research field where several features and classifiers have been proposed up to date. However, some key questions, e.g., 1) how to select certain features so as to achieve highest discrimination over certain classes?, 2) how to combine them in the most effective way?, 3) which distance metric to apply?, 4) how to find the optimal classifier configuration for the classification problem in hand?, 5) how to scale/adapt the classifier if large number of classes/features are present?, and finally, 6) how to train the classifier efficiently to maximize the classification accuracy?, still remain unanswered. In this paper, we propose a collective network of (evolutionary) binary classifier (CNBC) framework to address all these problems and to achieve high classification performance. The CNBC framework adapts a "Divide and Conquer" type approach by allocating several NBCs to discriminate each class and performs evolutionary search to find the optimal BC in each NBC. In such an (incremental) evolution session, the CNBC body can further dynamically adapt itself with each new incoming class/feature set without a full-scale retraining or reconfiguration. Both visual and numerical performance evaluations of the proposed framework over two benchmark SAR images demonstrate its superiority and a significant performance gap against several major classifiers in this field.

Classification and retrieval on macroinvertebrate image databases.

Aquatic ecosystems are continuously threatened by a growing number of human induced changes. Macroinvertebrate biomonitoring is particularly efficient in pinpointing the cause-effect structure between slow and subtle changes and their detrimental consequences in aquatic ecosystems. The greatest obstacle to implementing efficient biomonitoring is currently the cost-intensive human expert taxonomic identification of samples. While there is evidence that automated recognition techniques can match human taxa identification accuracy at greatly reduced costs, so far the development of automated identification techniques for aquatic organisms has been minimal. In this paper, we focus on advancing classification and data retrieval that are instrumental when processing large macroinvertebrate image datasets. To accomplish this for routine biomonitoring, in this paper we shall investigate the feasibility of automated river macroinvertebrate classification and retrieval with high precision. Besides the state-of-the-art classifiers such as Support Vector Machines (SVMs) and Bayesian Classifiers (BCs), the focus is particularly drawn on feed-forward artificial neural networks (ANNs), namely multilayer perceptrons (MLPs) and radial basis function networks (RBFNs). Since both ANN types have been proclaimed superior by different investigations even for the same benchmark problems, we shall first show that the main reason for this ambiguity lies in the static and rather poor comparison methodologies applied in most earlier works. Especially the most common drawback occurs due to the limited evaluation of the ANN performances over just one or few network architecture(s). Therefore, in this study, an extensive evaluation of each classifier performance over an ANN architecture space is performed. The best classifier among all, which is trained over a dataset of river macroinvertebrate specimens, is then used in the MUVIS framework for the efficient search and retrieval of particular macroinvertebrate peculiars. Classification and retrieval results present high accuracy and can match an experts' ability for taxonomic identification.

Classification of holter registers by dynamic clustering using multi-dimensional particle swarm optimization.

In this paper, we address dynamic clustering in high dimensional data or feature spaces as an optimization problem where multi-dimensional particle swarm optimization (MD PSO) is used to find out the true number of clusters, while fractional global best formation (FGBF) is applied to avoid local optima. Based on these techniques we then present a novel and personalized long-term ECG classification system, which addresses the problem of labeling the beats within a long-term ECG signal, known as Holter register, recorded from an individual patient. Due to the massive amount of ECG beats in a Holter register, visual inspection is quite difficult and cumbersome, if not impossible. Therefore the proposed system helps professionals to quickly and accurately diagnose any latent heart disease by examining only the representative beats (the so called master key-beats) each of which is representing a cluster of homogeneous (similar) beats. We tested the system on a benchmark database where the beats of each Holter register have been manually labeled by cardiologists. The selection of the right master key-beats is the key factor for achieving a highly accurate classification and the proposed systematic approach produced results that were consistent with the manual labels with 99.5% average accuracy, which basically shows the efficiency of the system.

Fractional particle swarm optimization in multidimensional search space.

In this paper, we propose two novel techniques, which successfully address several major problems in the field of particle swarm optimization (PSO) and promise a significant breakthrough over complex multimodal optimization problems at high dimensions. The first one, which is the so-called multidimensional (MD) PSO, re-forms the native structure of swarm particles in such a way that they can make interdimensional passes with a dedicated dimensional PSO process. Therefore, in an MD search space, where the optimum dimension is unknown, swarm particles can seek both positional and dimensional optima. This eventually removes the necessity of setting a fixed dimension a priori, which is a common drawback for the family of swarm optimizers. Nevertheless, MD PSO is still susceptible to premature convergences due to lack of divergence. Among many PSO variants in the literature, none yields a robust solution, particularly over multimodal complex problems at high dimensions. To address this problem, we propose the fractional global best formation (FGBF) technique, which basically collects all the best dimensional components and fractionally creates an artificial global best (aGB) particle that has the potential to be a better "guide" than the PSO's native gbest particle. This way, the potential diversity that is present among the dimensions of swarm particles can be efficiently used within the aGB particle. We investigated both individual and mutual applications of the proposed techniques over the following two well-known domains: 1) nonlinear function minimization and 2) data clustering. An extensive set of experiments shows that in both application domains, MD PSO with FGBF exhibits an impressive speed gain and converges to the global optima at the true dimension regardless of the search space dimension, swarm size, and the complexity of the problem.

A personalized classification system for Holter registers.

In this paper we present a personalized long-term electrocardiogram (ECG) classification framework, which can be applied to any Holter register recorded from an individual patient. Due to the massive amount of ECG beats in a Holter register, visual inspection is quite difficult and cumbersome, if not impossible. Therefore the proposed system helps professionals to quickly and accurately diagnose any latent heart disease by examining only the representative beats (the so called master key-beats) each of which is automatically extracted from a time frame of homogeneous (similar) beats. We tested the system on a benchmark database where beats of each Holter register have been manually labeled by cardiologists. The selection of the right master key-beats is the key factor for achieving a highly accurate classification and thus we used exhaustive K-means clustering in order to find out (near-) optimal number of key-beats as well as the master key-beats. The classification process produced results that were consistent with the manual labels with over 99% average accuracy, which basically shows the efficiency and the robustness of the proposed system over massive data (feature) collections in high dimensions.

Evolutionary artificial neural networks by multi-dimensional particle swarm optimization.

In this paper, we propose a novel technique for the automatic design of Artificial Neural Networks (ANNs) by evolving to the optimal network configuration(s) within an architecture space. It is entirely based on a multi-dimensional Particle Swarm Optimization (MD PSO) technique, which re-forms the native structure of swarm particles in such a way that they can make inter-dimensional passes with a dedicated dimensional PSO process. Therefore, in a multidimensional search space where the optimum dimension is unknown, swarm particles can seek both positional and dimensional optima. This eventually removes the necessity of setting a fixed dimension a priori, which is a common drawback for the family of swarm optimizers. With the proper encoding of the network configurations and parameters into particles, MD PSO can then seek the positional optimum in the error space and the dimensional optimum in the architecture space. The optimum dimension converged at the end of a MD PSO process corresponds to a unique ANN configuration where the network parameters (connections, weights and biases) can then be resolved from the positional optimum reached on that dimension. In addition to this, the proposed technique generates a ranked list of network configurations, from the best to the worst. This is indeed a crucial piece of information, indicating what potential configurations can be alternatives to the best one, and which configurations should not be used at all for a particular problem. In this study, the architecture space is defined over feed-forward, fully-connected ANNs so as to use the conventional techniques such as back-propagation and some other evolutionary methods in this field. The proposed technique is applied over the most challenging synthetic problems to test its optimality on evolving networks and over the benchmark problems to test its generalization capability as well as to make comparative evaluations with the several competing techniques. The experimental results show that the MD PSO evolves to optimum or near-optimum networks in general and has a superior generalization capability. Furthermore, the MD PSO naturally favors a low-dimension solution when it exhibits a competitive performance with a high dimension counterpart and such a native tendency eventually yields the evolution process to the compact network configurations in the architecture space rather than the complex ones, as long as the optimality prevails.

A generic and robust system for automated patient-specific classification of ECG signals.

This paper presents a generic and patient-specific classification system designed for robust and accurate detection of ECG heartbeat patterns. The proposed feature extraction process utilizes morphological wavelet transform features, which are projected onto a lower dimensional feature space using principal component analysis, and temporal features from the ECG data. For the pattern recognition unit, feedforward and fully connected artificial neural networks, which are optimally designed for each patient by the proposed multidimensional particle swarm optimization technique, are employed. By using relatively small common and patient-specific training data, the proposed classification system can adapt to significant interpatient variations in ECG patterns by training the optimal network structure, and thus, achieves higher accuracy over larger datasets. The classification experiments over a benchmark database demonstrate that the proposed system achieves such average accuracies and sensitivities better than most of the current state-of-the-art algorithms for detection of ventricular ectopic beats (VEBs) and supra-VEBs (SVEBs). Over the entire database, the average accuracy-sensitivity performances of the proposed system for VEB and SVEB detections are 98.3%-84.6% and 97.4%-63.5%, respectively. Finally, due to its parameter-invariant nature, the proposed system is highly generic, and thus, applicable to any ECG dataset.

Early forest fire detection using radio-acoustic sounding system.

Automated early fire detection systems have recently received a significant amount of attention due to their importance in protecting the global environment. Some emergent technologies such as ground-based, satellite-based remote sensing and distributed sensor networks systems have been used to detect forest fires in the early stages. In this study, a radio-acoustic sounding system with fine space and time resolution capabilities for continuous monitoring and early detection of forest fires is proposed. Simulations show that remote thermal mapping of a particular forest region by the proposed system could be a potential solution to the problem of early detection of forest fires.

Automated patient-specific classification of premature ventricular contractions.

In this paper, we present an automated patient-specific electrocardiogram (ECG) beat classifier designed for accurate detection of premature ventricular contractions (PVCs). In the proposed feature extraction scheme, the principal component analysis (PCA) is applied to the dyadic wavelet transform (DWT) of the ECG signal to extract morphological ECG features, which are then combined with the temporal features to form a resultant efficient feature vector. For the classification scheme, we selected the feed-forward artificial neural networks (ANNs) optimally designed by the multi-dimensional particle swarm optimization (MD-PSO) technique, which evolves the structure and weights of the network specifically for each patient. Training data for the ANN classifier include both global (total of 150 representative beats randomly sampled from each class in selected training files) and local (the first 5 min of a patient's ECG recording) training patterns. Simulation results using 40 files in the MIT/BIH arrhythmia database achieved high average accuracy of 97% for differentiating normal, PVC, and other beats.