ECG Arrhythmia Detection Using Disease-specific Attention-based Deep Learning Model

Abstract

The electrocardiogram (ECG) is one of the most commonly-used tools to diagnose cardiovascular disease in clinical practice. Although deep learning models have achieved very impressive success in the field of automatic ECG analysis, they often lack model interpretability that is significantly important in the healthcare applications. To this end, many schemes such as general-purpose attention mechanism, Grad-CAM technique and ECG knowledge graph were proposed to be integrated with deep learning models. However, they either result in decreased classification performance or do not consist with the one in cardiologists' mind when interpreting ECG. In this study, we propose a novel disease-specific attention-based deep learning model (DANet) for arrhythmia detection from short ECG recordings. The novel idea is to introduce a soft-coding or hard-coding waveform enhanced module into existing deep neural networks, which amends original ECG signals with the guidance of the rule for diagnosis of a given disease type before being fed into the classification module. For the soft-coding DANet, we also develop a learning framework combining self-supervised pre-training with two-stage supervised training. To verify the effectiveness of our proposed DANet, we applied it to the problem of atrial premature contraction detection and the experimental results shows that it demonstrates superior performance compared to the benchmark model. Moreover, it also provides the waveform regions that deserve special attention in the model's decision-making process, allowing it to be a medical diagnostic assistant for physicians.