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A Comparative Study

David Cuesta-Frau, Juan C. Pérez-Cortés, Gabriela Andreu-García, ♦Daniel Novák Department of Systems Informatics and Computers, Polytechnic University of Valencia ♦ Department of Cybernetics, Czech Technical University in Prague dcuesta@disca.upv.es Abstract

In this paper, a method to automatically extract the main information from a long-term electrocardiographic signal is presented. This method is based on techniques of pattern recognition applied to speech processing, like dynamic time warping, and trace segmentation. In order to fulfill this objective, a clustering process is applied to the set of beats present within the electrocardiographic signal. From each group obtained, one beat is taken as representative of all the beats in that cluster. Since the discrete sequences of beat features can have different length, the clustering process takes place in a pseudo-metric space, and the dissimilarity measure is calculated using dynamic programming. Due to the same reason, the clustering algorithm employed is the KMedians, including some optimizations to reduce the computational cost. An experimental comparative study, using four different feature extraction methods, linear, and non-linear temporal alignment of sequences, is performed using labeled registers from the MIT database. pattern recognition applications, which are very common in the medical field. Therefore, it would be convenient to add pattern recognition capabilities to biosignal processing tools, which is the general goal of the research presented in this paper. We have focused the biosignal processing possibilities on a particular, but very important, case: the processing of electrocardiographic signals. These signals are crucial in diagnosing many cardiac diseases. They are probably the most studied and used biological signals, and in some registers, like those known as Holter registers, their length is greater than 24 hours, which turns manual inspection into a very tedious task. Beats present in an electrocardiographic signal have some interesting features to take into account when implementing any automatic process. They form a semiperiodic signal, and, within the same register, variability is relatively small, namely, only a few different waveforms can be found. Finally, in the time scale, the component intervals and waves of each beat behave in a non-linear way. This means changes in beat duration do not affect equally the waves and intervals included in it [1], which is similar to what happens in speech processing, where changes in word duration do not affect vowels and consonant length the same way. For example, in figure 1, a standard beat, with the main component waves and intervals, is shown.

R

1. Introduction

Computer-aided medical applications is a field of enormous development in recent years. One of these applications consists of extracting significant information from raw data like ultrasonic and X-Ray images, biosignal registers (electrocardiogram, electroencephalogram, electronystagmogram, electrogastrogram, etc), echocardiograms, magnetic resonance imaging, tomography, etc . In all these applications, information is presented to doctors in a suitable way to provide an accurate diagnosis. In fact, there is a field of great importance, biosignal processing, where the use of computer as a medical tool is becoming more and more popular, thanks to its relatively low cost and the availability of many signal processing algorithms. Nevertheless, this algorithms are mainly focused on tasks such as noise reduction, domain transform, signal thresholding, etc. This could be appropriate in some cases, but not for those related to

P Q PR S

T

U

QRS

Interval Interval

Figure 1. Standard beat including main component waves: P,Q,R,S,T and U, and main intervals: PR and QRS. Making the most of these properties, we propose a method based on pattern recognition techniques, focused on long-term electrocardiographic registers, or Holter registers, to automatically extract significant beats from

1051-4651/02 $17.00 (c) 2002 IEEE

... a QRS detection algorithm is applied in order to fix the beginning and ending of each beat as described in [2]. Then. which allows us to work with sequences in an Euclidean space. the process is similar to a nonuniform sampling procedure. all the beats are normalized in amplitude. Process stages. p i [ni − 1] } representative of a beat. with signal amplitude values. The process starts processing every beat pi by calculating its associated accumulated derivative up to sample j . Besides. It starts with signal acquisition by means of an electrocardiogram system and finishes with the diagnosis through examining a beat from each resultant cluster. Trace Segmentation Amplitude Coefficients Segmentation Wavelet Coefficients Normalization Feature extraction Clustering Dissimilarity measure Visual inspection (Diagnosis) Figure 2. Feature extraction The first two stages allow us to have a set of discrete sequences P . Method The stages of the method are schematically shown in figure 2. the output sequences will have the same length and therefore.1. 2. there are other feature extraction As can be noticed. and Wavelet transform coefficients... Thus. which is the reference taken to calculate the [ ] sampling points.. The set obtained will be referenced as P . It is of particular interest the accumulated derivative obtained with the complete input sequence. Following segmentation. Given that in this research the goal is to reduce the quantity of beats. since uniform changes in the amplitude do not represent differences in beat clinical meaning. above all when the vocabulary is relatively great [3]. and the number of beats as n . It is remarkable the trace segmentation method.. Feature extraction methods utilized.1): pi [m ] p i' [m] Figure 3.the whole initial set. p n −1 } (1) Trace segmentation is a technique used in isolated word recognition strategies to reduce the computational complexity and memory requirements. We also consider that standard signal processing methods like noise and baseline wandering reduction are included. i.e. and so calculate the dissimilarity between pairs. the output sequence is one sample shorter than the input sequence due to the need of q + 1 values to calculate q consecutive differences among them. in some cases. using the amplitude coefficients as the input. we assume the acquisition to be from any kind of long-term register. In this manner. In fact. 2. as shown in equation 2: where pi stands for the discrete sequence: pi [m] = {p i [0] . pi [1] . using some kind of temporal alignment to make them have the same length. P = {p 0 . in order to get a new discrete sequence with a fixed length.00 (c) 2002 IEEE .. ∆[ j ] = ∑ pi [k ] − pi [k − 1] k =1 j +1 Pseudo-metric space Polygonal Approximation Euclidean Space (2) where j + 1 ≤ ni − 1 . this value ∆[ni − 2] is divided by 1051-4651/02 $17. So. Data Acquisition methods used in some pattern recognition problems which allows less computational cost and better performance than the raw amplitude values. the whole set expression is (eq. To realize it. p1 . polygonal approximation. we can work in an Euclidean space. could be used in the clustering process. cardiologist will offer diagnosis more easily. ∆ ni − 2 . These sequences. a segmentation process takes place to separate all the beats within the signal. In this case we have adapted this method to unidimensional discrete amplitude sequences. in this research. The first one consists of acquiring the electrocardiographic signal. Figure 3 shows relationship between the feature extraction methods. Therefore.. where each sample corresponds to points of great variation in the original input sequence. three more feature extraction methods have been tested: trace segmentation. However.

( j 0 i 0 n i' −1 . due to this pseudo-metric nature. of the same length... p i ni − 1 ) .. The second feature extraction method. the objective function becomes: J (C ) = ∑ where k i =1 ∀p∈Ci ∑ d ( p. p ∑ j l ∀p j ∈C i ∀p l ∈C i (6) as described in equation #: all the points between the extremes are examined in order to find the furthest from this line. Clustering algorithm The clustering algorithm utilized is the K-Medians algorithm [7]. to get the interval length L .. The final iteration is reached when all the lines involved in the polygonal approximation fulfill the threshold restriction. the WT is applied to each beat. In this case the planar curve to approximate is the input discrete signal representing the beat. It is based on the well-known K-Means algorithm. provides a value in the x axis corresponding to the sampling point. Being C = {C1 . pi' [m] = pi [r ] r = arg max j (∆[ j ] ≤ (m + 1) L ) (3) 0≤ m ≤ ni' −1 Finally. in general. p [ j ]).. the main features or approximation of a signal [5]. but adapted to a non-Euclidean sample space. In this case. in the discrete domain. this process is shown in equation 3.00 (c) 2002 IEEE . Analytically. m ) i (5) [] [ ] mi = pr . only a subset Ci will be used to obtain the median beat. adapted to the unidimensional electrocardiographic signals. j − 1)] (4) Further details of this algorithm can be found in [6]. Entering in the curve from multiples of L . the new output sequence is: of In order to reduce the computational cost. The elastic matching scheme used in dynamic programming has been used in this case. the method of trace segmentation is depicted. are not. we have chosen that proposed in [4]. we will refer to this measure as dissimilarity instead. the projection in x axis offers the sampling points. where C ∈ ℵ . j )(i − 1. and the vertices list will form the output sequence.. There are many methods to carry out this task. Graphically the process can be explained as follows: each intersection of the ∆ curve with an y = C ⋅ L line. In figure 4. such cluster median mi . ∆[ j ] = ∑ pi [k ] − pi [k − 1] k =1 j +1 2. according to a distance measure between two values of such sequences. This method starts with a raw approximation consisting of a line from (0. Finally.the number of samples ' i ni' desired for the final sequence pi' [m ] = {( j . obtained ( ) r = arg min j d p . using k clusters. j )] G[i − 1. p i jn ' −1 i [ ])} p . based on Wavelet transform (WT). will be examined in order to 1051-4651/02 $17. in a coefficient list form. and the coefficients obtained are included in the output sequence pi' [m] . Dissimilarity measure As has been stated in the previous section.3. j )(i − 1. Thus it is that a time normalization procedure is necessary prior to any distance measure calculation. G[i. j − 1] + 2d [(i.2. is a method to calculate a list of vertices which match a planar curve according to certain conditions of error threshold. C k } the partition resulting from the clustering process. j )(i. j − 1] + d [(i. j − 1)] G[i. j ] = min G[i − 1. In fact. is the median of the cluster Ci . taking the points where ∆ exceeds multiples of L ... Trace segmentation process... j ] + d [(i. Next. Therefore. Next. 2. it is taken as a new vertex and the algorithm proceeds iteratively with each resultant new line. The cost at each node of the dynamic programming matrix is calculated in equation 4: ∆[ni − 2] . pi 0 ) to (ni − 1. The curve corresponds to the union of ∆ values. 4L 3L 2L L 0 j0 j1 j2 . we indirectly obtain the points where pi must be sampled. If the threshold is exceeded at this point. the set of sequences obtained from feature extraction methods.. C 2 . j Figure 4.. polygonal approximation. takes advantage of the possibility of this mathematical tool to extract. the third feature extraction method. It provides an algorithm to find the dissimilarity between two discrete sequences. For its simplicity.

pp. Comparative results of the four feature extraction methods. Computer Graphics and Image Processing. 2000. with k << n . Juan. [5] I. 215-220. “Pattern Compression in Isolated Word Recognition”. The major drawback is the computational cost.Ramer.00% 90. “An Iterative Procedure for the Polygonal Approximation of Plane Curves”. whereupon the quantity of beats to inspect has been reduced from n to k .00% 20. Discussion and Conclusion In this paper a method to group electrocardiographic signals. Error(%) 100.00% 50. From the results it can be clearly noticed that the best method is based on non-linear temporal alignment and trace segmentation as the feature extraction method.Provaznik et al. pp. 70% 60% 50% Error(%) 40% 30% 20% 10% 0% 2 3 4 5 6 7 8 9 10 11 12 Clusters 60. 1.“Dynamic Time Warping Applied to the Clustering of Electrocardiographic Signals”.00% 0. Clustering results using amplitude values. pp. in an unsupervised way. The error value corresponds to the percentage of beats that do not belong to the majority class in the same cluster. “A Method for Evaluation of QRS Shape Features Using a Mathematical Model for the ECG”. Polygonal approximation is only realized with non-linear temporal alignment. PhysioToolkit. “Wavelet Transform in ECG signal Processing”. has been presented.provide a diagnosis.00% 10. Pieraccini. “Optimization of non-supervised learning techniques and its application to pattern recognition” (in Spanish). 7 and 8. 1984. 85-98. since the dynamic programming based dissimilarity and the K·Medians algorithm need many calculations. References [1] L. 1999..00 (c) 2002 IEEE . Signal Processing.. and feature extraction methods. pp. Vol. 1990. 31.. as described in section 2. 244-256. Vol.00% 40. Results using different time normalization techniques (linear and non-linear).00% 2 3 4 5 6 7 8 9 10 11 12 A Clusters Amplitude Trace WT Polygon Figure 8.00% 80.1. pp 504-505. European Medical and Biological Engineering Conference. 1972. [7] A. The method is based on some techniques used in speech processing. [8] AL Goldberger et al. DTW Linear Figure 6. The number of clusters is increased from 2 to 12. Proceedings of the 15th Biennial Eurasip Conference BIOSIGNAL 2000. 6. Clustering segmentation.. and a comparative study of different feature extraction methods has been also carried out. [2] G. Cuesta et al. Num. “A comparison of the Noise Sensitivity of Nine QRS Detection Algorithms”. are shown in figures 5. [4] U. IEEE Transactions on Biomedical Engineering.00% 30. PhysioBank. 70% 60% 50% Error(%) 40% 30% 20% 10% 0% 2 3 4 5 6 7 8 9 10 11 12 Clusters 5. 101(23). 1-15. 4. 7. [6] D. 100% Error(%) 80% 60% 40% 20% 0% 2 3 4 5 6 results using trace 7 8 9 10 11 12 Clusters DTW Linear Figure 7.M Friesen et al. coefficients. 10 . and Physionet: Components of a New Research Resource for Complex Physiologic Signals. Results A set of experiments using more than 27000 labeled beats from the MIT Database [8] has been carried out. DTW Linear Figure 5. 1.00% 70.00% 3. 1981. Circulation. Thesis. [3] R. Polytechnic University of Valencia 1999. Clustering results using Wavelet 1051-4651/02 $17. Sörnmo et al. Num. pp. IEEE Transactions on Biomedical Engineering. 21-25.

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