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The next stages are added to create logical R and T-wave
indicators. The third stage in Fig. 2 provides the absolute
value of the signal which makes the overall filter nonlinear.
The absolute stage makes positive the signal values. This
stage facilitates construction of logical indicators for R-peak
and T-wave. In stage four, as illustrated in Fig. 2, a low pass
filter with 50 Hz cut-off frequency is utilized to determine
signal peaks. In stage five, the signal has become smoother.
The smoothed signal will lead to better comparison where less
glitches affect the logical output. The threshold generator
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stage in Fig. 2 computes the average of the samples in a signal
block. Finally, the comparator creates R-peak and T-wave
indicators. All samples in the signal block (output of the
smoothing stage) which are higher than threshold are assigned
one, otherwise they are assigned zero. Double construction
blocks of locating filters (Fig. 2), independently identify R-
peaks and T-waves. An example of R-peak and T-wave
indicators for Unstable Angina with inverse T-wave ECG
signal is illustrated in Fig. 3.
Fig. 3 R-peak and T-wave indicators for Unstable Angina with T-wave
inversion.
Utilizing the locating filter (Fig. 2), R-peak and T-wave
locations are successfully detected in Healthy, Unstable
Angina with inverse T-wave, ST elevated, Bradycardia and
Atrial Fibrillation ECG signals.
IV. ATRIAL FIBRILLATION
Atrial Fibrillation (AF), the most common arrhythmia
encountered in clinical practice, has a very complex and
incompletely understood pathophysiology with various
triggers and substrates interacting in multiple ways. Clinically,
AF is characterized by progression from paroxysmal to
persistent AF, failure to restore and maintain sinus rhythm,
but also in an increased risk of thrombogenesis and embolism
[16]. Results of various therapeutic interventions are often
disappointing, at least in part due to their empirical application.
Subsequently, the search for diagnostic tools to better
characterize the disease process in order then to better guide
therapeutic decisions has been advocated [17]. It is a common
observation that fibrillation waves of the surface ECG have
various appearances, ranging from fine to coarse, and from
disorganized to organized, and that the ventricular rate
response varies in a rather unpredictable fashion. Even though
the first ECG documentation of human AF was made by
Einthoven 100 years ago [18], it was only very recently that
ECG analysis of fibrillatory waves was suggested for
exploring AF pathophysiology and for predicting the patients
response to therapy [19,20].
An Atrial Fibrillation signal is passed into locating filtering
stages for the purpose of R-peak indication, and the result
obtained is demonstrated in Fig. 4.
Fig. 4 R-peak indication for Atrial Fibrillation signal.
It is obvious that the heart beat rate varies in time duration
for the AF case which is detected via the R indicator. For clear
comparison, a healthy heartbeat with R-peaks identified by the
proposed locating filter is demonstrated in Fig. 5. The healthy
heart beat has fixed R-R intervals, although it varies in AF.
Fig. 5 R-peak indication for Healthy signal.
In this paper, the neural network is employed for AF
recognition. Radial Basis Function Artificial Neural
Network (RBF-ANN) [10] is applied for arrhythmia Atrial
Fibrillation (AF) heart beat recognition. Initially, data is
prepared for ANN learning the purposes and then ANN
recalling process with unseen data [10,11] is carried out in the
following steps:
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1. Data Preparation Procedure
By applying the locating filter (Section III), the R-peak
location is detected for healthy and AF signals. Subsequently,
R-R intervals are determined and normalized.
2. ANN Learning
An RBF network with 10 inputs and 1 output is trained
with varying and non-varying R-R intervals. Stable R-R
interval indicates a healthy heartbeat and sets the ANN output
to 1. Variable R-R interval signifies AF and sets the ANN
output to -1.
3. ANN Recall
ANN is recalled with healthy and AF signals to determine
the irregular heartbeat. The sample results achieved for the
RBF network output using MATLAB are tabulated in Table 1.
As illustrated in Table 1, the output of ANN is positive and
near 1 for healthy subjects, and negative and close to -1 for
AF. The results obtained in Table 1 indicate that ANN
modeling combined with the recommend filtering approach,
accurately identify Atrial Fibrillation.
V. UNSTABLE ANGINA WITH INVERSE T-WAVE
Unstable angina (UA) is the clinical bridge between stable
angina and myocardial infarction (MI). Signs of the three
conditions often overlap, and 15% to 25% of patients will
have an MI within the first week after angina strikes. About
one-third of patients will have an MI within 3 months of the
angina attack. If an electrocardiogram has been recorded
during an episode of chest pain, the presence or absence of
transient ST-T abnormalities is noted [21]. (The presence of
such abnormalities is associated with more severe underlying
disease.)
The significance of the development of new T-wave
inversion was studied in patients with unstable angina. The
electrocardiograms during hospitalization in the coronary care
unit were analyzed for the occurrence of new T-wave
inversions greater than or equal to 2 mm, and correlated with
findings of a coronary angiography and at a follow-up stage.
Development of new T-wave inversion greater than or equal
to 2 mm in patients with unstable angina is predictive of
significant coronary artery stenosis, and identifies a subgroup
with poor prognosis when treated medically [9]. An example
of Unstable Angina with inverse T-wave ECG signal is shown
in Fig. 6.
Comparing Figures 1 and 6 show the changes in T-waves
and characteristics of ECG signals for Unstable Angina with
inverse T-wave. Our purpose in this work is to diagnose the
abovementioned changes and type of illness in people via
ANN. The utilized RBF network is able to study changes in T-
waves. Considering the importance of ST segment in ECG
signal, referring to reference [22], the diagnosis of this
segment and its changes can be studied with personal
computers.
Fig. 6 Unstable Angina with Inverse T-wave ECG signal.
Unstable Angina (UA) with inverse T-waves are identified
with a similar approach as explained in Section 4. Where,
initially data is prepared for ANN learning and then ANN the
recall process with unseen data [10,11] is carried out in the
following steps:
1. Data Preparation Procedure
By applying the locating filter (Section 3), the T-wave start
location is detected and samples saved for 0.4 second (100
samples) then samples are shifted to zero and normalized.
2. ANN Learning
An RBF network with 100 inputs and 1 output trained with
upward Gaussian functions as a normal T-wave and
downward Gaussian functions as an abnormal T-wave. The
output of ANN for a normal T-wave is 1 and for an abnormal
T-wave is -1. A sample of inverse T-wave, upward and
downward Gaussian functions is illustrated in Fig. 7.
Fig. 7 Inverse T-wave, upward and downward Gaussian functions.
International Journal of Emerging Trends in Signal Processing
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3.
ANN Recall
ANN is recalled with healthy and abnormal ECG signals
for determining the Inverse T-wave. The sample resu
lts
achieved from the RBF network output using MATLAB a
re
tabulated in Table 2. The Figures in Table 2 confir
m that the
output of ANN is positive and near 1 for healthy su
bjects and
negative and close to -1 for UA with inverse T-wave
s. Hence,
the obtained results show that the ANN model combin
ed with
the recommend locating filter accurately determines
Unstable
Angina with inverse T-wave.
VI.
RESULTS AND COMPARISONS WITH PRIOR WORKS
The recommended methods proposed in sections IV and V
are examined with normal and abnormal heartbeat sig
nals [23].
The achieved accuracy and precision for detection o
f the AF
cases and healthy heartbeats using recommended meth
od of
section 4 are demonstrated in Table 3.
The achieved accuracy and precision for detection of the
UA with inverse T-wave cases and healthy heartbeats using
recommended method of section V are demonstrated in Table
4.
As demonstrated in Tables 3 and 4, the recommended
method classifies healthy heartbeats in two cases with 100 %
accuracy. Also, the achieved accuracy for UA with inverse T-
wave cases is 94.59 % and for AF cases is 75 %. The results
prove that this method is capable of precise discrimination of
abnormal cases. The high accuracy is resulted for healthy and
UA with inverse T-wave cases.
The prior works which have been made for heartbeat
classification has an overall accuracy of 66.3 % to 77.4 % [24],
89.1 % [25] and 86.67 % [26]. Where, the achieved overall
accuracy using the proposed method is 92.39% and its higher
than prior works.
Table 1 RBF network output for Atrial Fibrillation and Healthy signals.
Table 2 RBF network output for UA with inverse T-wave and Healthy signals.
Samples 1 2 3 4 5
UA with inverse T-wave -
1
-0.6366
-0.2605
-0.9141
-0.8252
-0.6218
UA with inverse T-wave
-
2
-1.1329
-1.0232
-1.1102
-0.9529
-1.0787
UA with inverse T-wave - 3 -0.7502 -0.7531 -0.6029 -0.3868 -0.8907
UA with inverse T-wave - 4 -0.7849 -0.7446 -0.9576 -1.1538 -1.0671
Healthy - 1 0.9551 0.8465 0.9943 1.0805 0.9979
Healthy - 2 0.8383 0.7835 0.8314 0.7987 0.8379
Healthy -
3
1.0163
1.0118
0.9740
1.0165
1.0935
Healthy -
4
0.7842
0.8210
0.8190
0.7865
0.7457
Table 3 The accuracy and precision of proposed method for AF detection.
Case Accuracy Precision
Healthy
100 %
96.06 %
AF
75 %
54.66 %
Table 4 The accuracy and precision of proposed method for UA with inverse T-wave detection.
Case Accuracy Precision
Healthy
100 %
90.16 %
UA with inverse T-wave 94.59 % 83.32 %
Samples 1 2 3 4 5
AF - 1 -0.5940 -0.4678 -0.7242 -0.4500 -0.4971
Healthy -
1
0.8912
0.9275
0.9263
0.8236
0.7740
Healthy -
2
0.8301
0.8134
0.9536
0.9495
0.8002
Healthy -
3
0.9684
0.9854
0.9868
0.9812
0.9729
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International Journal of Emerging Trends in Signal Processing
ISSN(Online)2319-9784, Volume 1 ,Issue 2, January 2013
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VII.
DISCUSSION
The proposed method is examined on one AF case and 3
normal healthy subjects. The ANN output results were
negative and near -1 for AF case and positive and close to 1
for healthy subjects. Also, the proposed method is examined
on 4 UA with inverse T-wave cases and 4 normal healthy
subjects. The ANN output results were negative and near -1
for cases of UA with inverse T-waves and positive and near 1
for healthy subjects. The results achieved verify that the
recommended procedure is able to precisely and accurately
distinguish normal and abnormal heartbeats in two different
cases. Hence, we will be able to develop the proposed method
for the recognition other abnormal heartbeats. It is also
possible to train ANN with irregular parts of the ECG signal
for cardiac disease recognition. The recommended locating
filter indicates PQRST segments and recalling ANN results
indicate the healthiness rate.
VIII.
CONCLUSION
In this paper, we proposed a new method for R-peak and T-
wave recognition in ECG signals using a nonlinear filtering
technique. The approach used in this method is able to
accurately detect R-peaks and T-waves in normal and
abnormal ECG signals. The locating filter precisely detects R-
peaks and T-waves in Healthy, Unstable Angina with inverse
T-wave, ST elevated, Bradycardia and Atrial Fibrillation cases.
This method facilitates the classifying of different ECG
signals. Applying the ANN method for the detection of
heartbeat abnormalities and a combination of ANN with the
proposed filter creates an innovative method for cardiac
disease identification. The proposed method easily identifies
Atrial Fibrillation by introducing irregular heartbeat R-R
intervals into ANN. Additionally in this work, T-wave
inversion in Unstable Angina is recognized using the ANN
model. The results obtained indicate that ANN is capable of
precisely and accurately discriminating Unstable Angina with
inverse T-wave heartbeats from healthy heartbeats.
Furthermore, the procedure is developable for the
identification of many other irregular heartbeats. The
classification accuracies of proposed method are 100 %,
94.59 % and 75 % for Healthy, Unstable Angina with inverse
T-wave and AF cases. The results verify that recommended
method discriminates healthy heartbeats with 100 % certainty.
Also, the achieved overall accuracy is 92.39 %.
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ISSN(Online)2319-9784, Volume 1 ,Issue 2, January 2013
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