Unsupervised ECG Analysis: A Review.

Electrocardiography is the gold standard technique for detecting abnormal heart conditions. Automatic detection of electrocardiogram (ECG) abnormalities helps clinicians analyze the large amount of data produced daily by cardiac monitors. As thenumber of abnormal ECG samples with cardiologist-supplied labels required to train supervised machine learning models is limited, there is a growing need for unsupervised learning methods for ECG analysis. Unsupervised learning aims to partition ECG samples into distinct abnormality classes without cardiologist-supplied labels-a process referred to as ECG clustering. In addition to abnormality detection, ECG clustering has recently discovered inter and intra-individual patterns that reveal valuable information about the whole body and mind, such as emotions, mental disorders, and metabolic levels. ECG clustering can also resolve specific challenges facing supervised learning systems, such as the imbalanced data problem, and can enhance biometric systems. While several reviews exist on supervised ECG systems, a comprehensive review of unsupervised ECG analysis techniques is still lacking. This study reviews ECG clustering techniques developed mainly in the last decade. The focus will be on recent machine learning and deep learning algorithms and their practical applications. We critically review and compare these techniques, discuss their applications and limitations, and provide future research directions. This review provides further insights into ECG clustering and presents the necessary information required to adopt the appropriate algorithm for a specific application.

Toward ECG-based analysis of hypertrophic cardiomyopathy: a novel ECG segmentation method for handling abnormalities.

OBJECTIVE: Abnormalities in impulse propagation and cardiac repolarization are frequent in hypertrophic cardiomyopathy (HCM), leading to abnormalities in 12-lead electrocardiograms (ECGs). Computational ECG analysis can identify electrophysiological and structural remodeling and predict arrhythmias. This requires accurate ECG segmentation. It is unknown whether current segmentation methods developed using datasets containing annotations for mostly normal heartbeats perform well in HCM. Here, we present a segmentation method to effectively identify ECG waves across 12-lead HCM ECGs. METHODS: We develop (1) a web-based tool that permits manual annotations of P, P', QRS, R', S', T, T', U, J, epsilon waves, QRS complex slurring, and atrial fibrillation by 3 experts and (2) an easy-to-implement segmentation method that effectively identifies ECG waves in normal and abnormal heartbeats. Our method was tested on 131 12-lead HCM ECGs and 2 public ECG sets to evaluate its performance in non-HCM ECGs. RESULTS: Over the HCM dataset, our method obtained a sensitivity of 99.2% and 98.1% and a positive predictive value of 92% and 95.3% when detecting QRS complex and T-offset, respectively, significantly outperforming a state-of-the-art segmentation method previously employed for HCM analysis. Over public ECG sets, it significantly outperformed 3 state-of-the-art methods when detecting P-onset and peak, T-offset, and QRS-onset and peak regarding the positive predictive value and segmentation error. It performed at a level similar to other methods in other tasks. CONCLUSION: Our method accurately identified ECG waves in the HCM dataset, outperforming a state-of-the-art method, and demonstrated similar good performance as other methods in normal/non-HCM ECG sets.