Camila R Restivo, Gabriel V Costa, I. Sandoval, M. Guillem, J. Salinet
{"title":"Validation of a Customized Method for Estimating Electrical Potentials in the Torso From Atrial Signals: a Computational-Clinical Study","authors":"Camila R Restivo, Gabriel V Costa, I. Sandoval, M. Guillem, J. Salinet","doi":"10.22489/CinC.2022.369","DOIUrl":"https://doi.org/10.22489/CinC.2022.369","url":null,"abstract":"Atrial fibrillation (AF) is a common supraventricular arrhythmia (SVA) in clinical practice and is characterized by uncoordinated electrical activity of the atria. This study aims to evaluate the influence on the forward solution of AF torso biomarkers under different levels of noise, 3D cardiorespiratory torso/atria morphologies, and number of atria electrodes. 2,048 atrial epicardium electrograms (AEGs) from 5 AF mathematical models were used to estimate 771 body surface potentials (BSPs). The BSPs and respective frequency/phase maps of are obtained after: (i) introduction of noise in the AEGs, (ii) 3D geometry torso/atria modification, and (iii) reduction in electrodes (from 2,048 to 256, 128, 64 e 32; interpolation methods: Linear/Laplacian). To reduce biomarkers disparity, a Butterworth bandpass filter (BPF) at different cut-off frequencies (0.5-30, 3–30 and HDF±1 Hz) is applied on the AEGs prior BSPs estimation. The above methodology is extended to two AF patients (EDGAR database). The estimation of AF BSPs, in different noise ranges, limits the effectiveness of the forward solution. Phase biomarkers are sensitive to the AEGs' pre-processing strategy. The BPF around HDF showed the best agreement between the different SNR levels. Due to the 3D morphological changes, HDF areas variability increased.","PeriodicalId":117840,"journal":{"name":"2022 Computing in Cardiology (CinC)","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134258352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Duport, V. Rolle, Gustavo Guerrero, A. Beuchée, Alfredo I. Hernández
{"title":"Model-Based Analysis of Apnea-Bradycardia events in Newborns","authors":"O. Duport, V. Rolle, Gustavo Guerrero, A. Beuchée, Alfredo I. Hernández","doi":"10.22489/CinC.2022.305","DOIUrl":"https://doi.org/10.22489/CinC.2022.305","url":null,"abstract":"In preterm infants, recurrent episodes of apnea, bradycardia and severe intermittent hypoxia are mainly related to cardiorespiratory immaturity. These episodes are associated with major risks during the first weeks of life. Cardiorespiratory data consisting of a continuous 12 hours recording of transthoracic impedance and ECG signals were acquired in 18 preterm neonates. 106 isolated apnea events (>10 sec) were manually annotated from the database, of which 19 apneas with bradycardia. A system-level physiological model of cardio-respiratory interactions in the newborn is proposed and used to reproduce simulations of mixed apneas with and without bradycardia, by modifying the functional residual capacity. A first qualitative comparison between the simulations and the clinical data shows a close match between the experimental and simulated heart rate series during apnea with bradycardia (RMSE 4.96 bpm) and without (RMSE 2.02 bpm).","PeriodicalId":117840,"journal":{"name":"2022 Computing in Cardiology (CinC)","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116678008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
María Fernanda Rodríguez, A. Ravelo-García, E. Alvarez, Luz Alexandra Díaz, D. Cornejo, Victor Cabrera-Caso, Dante Condori-Merma, Miguel Vizcardo Cornejo
{"title":"Approximate Entropy and Densely Connected Neural Network in the Early Diagnostic of Patients with Chagas Disease","authors":"María Fernanda Rodríguez, A. Ravelo-García, E. Alvarez, Luz Alexandra Díaz, D. Cornejo, Victor Cabrera-Caso, Dante Condori-Merma, Miguel Vizcardo Cornejo","doi":"10.22489/CinC.2022.313","DOIUrl":"https://doi.org/10.22489/CinC.2022.313","url":null,"abstract":"It is estimated that in the world there are between 6 and 8 million people infected with Chagas disease, mainly in endemic areas of 21 Latin American countries, and in recent years it is slowly becoming a health problem in more urban areas and countries. In that sense, developing diagnosis methods is primordial. That is why this work used a deep neural network to classify 292 subjects (volunteers and patients) composed of 83 health volunteers (Control group); 102 asymptomatic chagasic patients (CH1 group) and 107 seropositive chagasic patients with incipient heart disease (CH2 group). Approximate Entropy ApEn was calculated from the tachograms of the circadian profiles of 24 hours every 5 minutes (288 frames) of each subject, and part of this data were used to train the network. The classification work done by the deep neural network had 98% of accuracy and 98% of precision, validated with the ROC curve, whose AUC values were approximately the unit for each group. Taking into account the good performance, we can consider this deep neural network and approximate entropy as useful tools to have a good early diagnosis about Chagas disease and its cardiac compromise.","PeriodicalId":117840,"journal":{"name":"2022 Computing in Cardiology (CinC)","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115686382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alex Gaudio, Miguel Coimbra, A. Campilho, A. Smailagic, S. Schmidt, F. Renna
{"title":"Explainable Deep Learning for Non-Invasive Detection of Pulmonary Artery Hypertension from Heart Sounds","authors":"Alex Gaudio, Miguel Coimbra, A. Campilho, A. Smailagic, S. Schmidt, F. Renna","doi":"10.22489/CinC.2022.295","DOIUrl":"https://doi.org/10.22489/CinC.2022.295","url":null,"abstract":"Late diagnoses of patients affected by pulmonary artery hypertension (PH) have a poor outcome. This observation has led to a call for earlier, non-invasive PH detection. Cardiac auscultation offers a non-invasive and cost-effective alternative to both right heart catheterization and doppler analysis in analysis of PH. We propose to detect PH via analysis of digital heart sound recordings with over-parameterized deep neural networks. In contrast with previous approaches in the literature, we assess the impact of a pre-processing step aiming to separate S2 sound into the aortic (A2) and pulmonary (P2) components. We obtain an area under the ROC curve of. 95, improving over our adaptation of a state-of-the-art Gaussian mixture model PH detector by +.17. Post-hoc explanations and analysis show that the availability of separated A2 and P2 components contributes significantly to prediction. Analysis of stethoscope heart sound recordings with deep networks is an effective, low-cost and non-invasive solution for the detection of pulmonary hypertension.","PeriodicalId":117840,"journal":{"name":"2022 Computing in Cardiology (CinC)","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115326896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Cairo, V. Bari, F. Gelpi, Beatrice De Maria, Anita Mollo, F. Bandera, A. Porta
{"title":"Comparison Between ECG-Derived Respiration and Respiratory Flow for the Assessment of Cardiorespiratory Coupling Before and After Cardiopulmonary Exercise Test Protocol","authors":"B. Cairo, V. Bari, F. Gelpi, Beatrice De Maria, Anita Mollo, F. Bandera, A. Porta","doi":"10.22489/CinC.2022.103","DOIUrl":"https://doi.org/10.22489/CinC.2022.103","url":null,"abstract":"Evaluation of cardiorespiratory coupling (CRC) usually requires the simultaneous recording of heart period (HP) variability, derived from the electrocardiogram (ECG), and respiration. ECG-derived respiration (ECGDR) exploits the cardiac axis movement due to respiration to estimate respiratory activity directly from the ECG. Since CRC indexes could theoretically be computed using ECGDR, a comparison with results obtained through a more precise monitoring of respiratory activity such as the respiratory flow (RF) is warranted. Therefore, a mixed unpredictability index (MUPI) of HP variability from respiratory dynamics, computed via local k-nearest-neighbor approach, was calculated using ECGDR and RF in patients with preserved functional capacity (PFC) and with reduced functional capacity (RFC) before and after cardiopulmonary exercise test (CPET) protocol. The MUPI computed from RF was found to be significantly increased in PFC patients after CPET protocol, while no effect could be observed when considering the ECGDR. Moreover, the correlation between the two MUPI indexes was limited. We conclude that indexes of CRC might require more direct measures of respiration than ECGDR to detect pathophysiological differences.","PeriodicalId":117840,"journal":{"name":"2022 Computing in Cardiology (CinC)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114595141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Zlahtic, D. Žižek, M. Mrak, A. Z. Mežnar, V. Starc
{"title":"Conduction System Pacing Versus Biventricular Pacing For Cardiac Resynchronization - Preliminary Electrocardiographic Results","authors":"T. Zlahtic, D. Žižek, M. Mrak, A. Z. Mežnar, V. Starc","doi":"10.22489/CinC.2022.297","DOIUrl":"https://doi.org/10.22489/CinC.2022.297","url":null,"abstract":"Cardiac resynchronization therapy with biventricular pacing (BiV) is the cornerstone treatment for heart failure patients with ventricular dyssynchrony. Recently, the conduction system pacing (CSP) has being introduced as a possible alternative. We hypothesized that CSP could produce a more complete electrical resynchronization compared to conventional BIV pacing. To trace the spreading of myocardial depolarization, we assessed equivalent dipole (ED) trajectories utilizing the BEM method with a tailored human torso from the high resolution 12-lead ECG before and after device implantation in 17 patients included in our ongoing randomized CSP-SYNC study. We observed a similar relative shortening of the QRS duration (0,23 in CSP and 0,25 in BiV) and relative ED trajectory length (0,16 in CSP and 0,20 in BiV). However, a significant change of ED trajectory direction occurred after the therapy. In BiV pacing, the trajectory direction shifted more towards the base of the heart, but more apically in CSP, mimicking normal heart depolarization Resynchronization with CSP seems to restore more physiological depolarization compared to BiV pacing. The assessment of the ED trajectories provides additional insight into the electrical heart remodelling after the therapy.","PeriodicalId":117840,"journal":{"name":"2022 Computing in Cardiology (CinC)","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121708496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. J. Hill, Alistair A. Young, R. Rajani, A. Vecchi
{"title":"Assessment of Transcatheter Heart Valve Migration and Embolization Risk Following Valve-in-MAC","authors":"S. J. Hill, Alistair A. Young, R. Rajani, A. Vecchi","doi":"10.22489/CinC.2022.428","DOIUrl":"https://doi.org/10.22489/CinC.2022.428","url":null,"abstract":"Transcatheter Valve Embolization and Migration (TVEM) is a rare, but catastrophic event where the prosthesis moves due to heamodynamic forces acting on the frame. TVEM following Transcatheter Mitral Valve Replacement (TMVR) is largely undocumented. Haemodynamic forces cannot be estimated during pre-procedural planning and conventional imaging does not allow to compute them after replacement. To shed light on this issue, this study focusses on modelling haemodynamics after TMVR in 3 patients with Mitral Annular Calcification (MAC) known as Valve-in-MAC (ViMAC). Three-dimensional flow simulations are performed using the computational fluid dynamics (CFD) package STARCCM+. Results of the simulation are processed to compute the fluid forces acting on the device and pressure gradients in the left ventricular outflow tract (LVOT). Anatomical measurements are performed on CT data sets to assess the mitral valve size and shape, the extent and location of the calcification and the size of the LVOT after implantation. Our results show that the force distribution on the device is largely influenced by LVOT anatomy and contraction patterns.","PeriodicalId":117840,"journal":{"name":"2022 Computing in Cardiology (CinC)","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123245906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Cornejo, A. Ravelo-García, E. Alvarez, María Fernanda Rodríguez, Luz Alexandra Díaz, Victor Cabrera-Caso, Dante Condori-Merma, Miguel Vizcardo Cornejo
{"title":"Deep Learning and Permutation Entropy in the Stratification of Patients with Chagas Disease","authors":"D. Cornejo, A. Ravelo-García, E. Alvarez, María Fernanda Rodríguez, Luz Alexandra Díaz, Victor Cabrera-Caso, Dante Condori-Merma, Miguel Vizcardo Cornejo","doi":"10.22489/CinC.2022.311","DOIUrl":"https://doi.org/10.22489/CinC.2022.311","url":null,"abstract":"Chagas disease is a life threatening illness that in the last decades was becoming a public health problem because of the change in the epidemiological pattern. It may be silent and asymptomatic in the chronic phase. Hence the necessity of the development of early markers. To achieve this, we propose a deep neural network architecture in order to classify 292 patients into three groups: The Control group with 83 volunteers, the CH1 group with 102 patients with positive serology and no cardiac involvement and the CH2 group with 107 patients with positive serology and incipient heart failure. The used data comes from 24-hour ECG, the RR intervals from each subject was divided in 288 frames of 5 minutes each. Then it was preprocessed using permutation entropy obtaining the circadian profile for each patient. And by applying PCA each patient ended up represented by a vector of 144 entries. This was in turn used for the training of the proposed NN architecture. The classification performed with 91% accuracy and an average of 92% precision, consisting in a great work of classification validated by the AUC in each ROC curve. As this results were obtained with a limited quantity of data, this study can be improved provided with more samples, making this model a tool for analyzing ECG in order to try to do an early evaluation and diagnosis of a cardiac compromise related to the generally silent chronic phase.","PeriodicalId":117840,"journal":{"name":"2022 Computing in Cardiology (CinC)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123427664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of Pre-Processing Decisions on Automated ECG Classification Accuracy","authors":"Adrian K. Cornely, Grace M. Mirsky","doi":"10.22489/CinC.2022.252","DOIUrl":"https://doi.org/10.22489/CinC.2022.252","url":null,"abstract":"Electrocardiography is well established as an effective clinical tool for detection and diagnosis of cardiac arrhythmias and abnormalities. The objective of the 2021 PhysioNet/Computing in Cardiology Challenge was for teams to develop automated classification algorithms for reduced-lead ECGs. While it is well-known that proper pre-processing is very important for the success of classification algorithms, there is not universal agreement as to the appropriate pre-processing steps for automated ECG classification. Papers from the top 15 finishers in the Challenge as well as the bottom ten finishers were examined to determine what pre-processing steps were applied by each team. The most commonly used pre-processing steps included resampling to a consistent sampling rate, applying a bandpass filter, normalizing and using a fixed signal length. There were a number of similarities in the preprocessing steps used by the top 15 teams, whereas all of these steps were not applied in the majority of approaches for the bottom ten teams. In the bottom ten participants, less than half used a bandpass filter, and only three applied some type of normalization. This investigation underscores the importance of appropriate pre-processing for strong classification accuracy and the need for a universal approach to pre-processing techniques in automated ECG classification.","PeriodicalId":117840,"journal":{"name":"2022 Computing in Cardiology (CinC)","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124724460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cycle Length Estimation Using Accurate Adaptive Detection of Local Activations in Atrial Intracardiac Electrograms","authors":"Dinara Veshchezerova, C. Bars, J. Seitz","doi":"10.22489/CinC.2022.142","DOIUrl":"https://doi.org/10.22489/CinC.2022.142","url":null,"abstract":"The normal electrical potential propagates throughout the atria periodically. During atrial arrhythmias its prop-agation is modified because the substrate is not homoge-neous and new sources of punctual electrical activity appear. The periodic behavior of activation remains predom-inant, but becomes local in different parts of the atria. It is characterized by cycle length (CL) which measures the frequency of activation and can be computed from intrac-ardiac bipolar electrograms (EGM) recorded by a mapping catheter during the catheter ablation procedure. The CL value of different mapped zones is an extremely important resource for physicians when performing persis-tent Atrial Fibrillation (AF) ablation because it helps to identify pathological zones and define the ablation strat-egy. Thus, a reliable estimation of the CL of atrial tissue is essential. The complexity of this task stems from the large variability in EGM morphology influenced by mul-tiple wavefronts, fragmentation and added noise. In this work, we propose a cycle length estimator that can process the complex mapping signals recorded during atrial arrhythmias ablation and reliably provide the frequency of their periodic activity.","PeriodicalId":117840,"journal":{"name":"2022 Computing in Cardiology (CinC)","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125435098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}