The electrocardiogram (ECG) is a highly effective non-invasive tool for monitoring heart activity and diagnosing cardiovascular diseases (CVDs). Automatic detection of arrhythmia based on ECG plays a critical role in the early prevention and diagnosis of CVDs. In recent years, numerous studies have focused on using deep learning methods to address arrhythmia classification problems. However, the transformer-based neural network in current research still has a limited performance in detecting arrhythmias for the multi-lead ECG. In this study, we propose an end-to-end multi-label arrhythmia classification model for the 12-lead ECG with varied-length recordings. Our model, called CNN-DVIT, is based on a combination of convolutional neural networks (CNNs) with depthwise separable convolution, and a vision transformer structure with deformable attention. Specifically, we introduce the spatial pyramid pooling layer to accept varied-length ECG signals. Experimental results show that our model achieved an F1 score of 82.9% in CPSC-2018. Notably, our CNN-DVIT outperforms the latest transformer-based ECG classification algorithms. Furthermore, ablation experiments reveal that the deformable multi-head attention and depthwise separable convolution are both efficient in extracting features from multi-lead ECG signals for diagnosis. The CNN-DVIT achieved good performance for the automatic arrhythmia detection of ECG signals. This indicates that our research can assist doctors in clinical ECG analysis, providing important support for the diagnosis of arrhythmia and contributing to the development of computer-aided diagnosis technology.

Blood pressure (BP) is an essential physiological indicator to identify and determine health status. Compared with the isolated BP measurement conducted by traditional cuff approaches, cuffless BP monitoring can reflect the dynamic changes in BP values and is more helpful to evaluate the effectiveness of BP control. In this paper, we designed a wearable device for continuous physiological signal acquisition. Based on the collected electrocardiogram (ECG) and photoplethysmogram (PPG), we proposed a multi-parameter fusion method for noninvasive BP estimation. An amount of 25 features were extracted from processed waveforms and Gaussian copula mutual information (MI) was introduced to reduce feature redundancy. After feature selection, random forest (RF) was trained to realize systolic BP (SBP) and diastolic BP (DBP) estimation. Moreover, we used the records in public MIMIC-III as the training set and private data as the testing set to avoid data leakage. The mean absolute error (MAE) and standard deviation (STD) for SBP and DBP were reduced from 9.12 ± 9.83 mmHg and 8.31 ± 9.23 mmHg to 7.93 ± 9.12 mmHg and 7.63 ± 8.61 mmHg by feature selection. After calibration, the MAE was further reduced to 5.21 mmHg and 4.15 mmHg. The result showed that MI has great potential in feature selection during BP prediction and the proposed multi-parameter fusion method can be used for long-term BP monitoring.

Non-invasive continuous blood pressure monitoring is of great significance for the preventing, diagnosing, and treating of cardiovascular diseases (CVDs). Studies have demonstrated that photoplethysmogram (PPG) and electrocardiogram (ECG) signals can effectively and continuously predict blood pressure (BP). However, most of the BP estimation models focus on the waveform features of the PPG signal, while the peak value of R-wave in ECG is only used as a time reference, and few references investigated the ECG waveforms. This paper aims to evaluate the influence of three characteristic waveforms in ECG on the improvement of BP estimation. PPG is the primary signal, and five input combinations are formed by adding ECG, P wave, QRS complex, T wave, and none. We employ five common convolutional neural networks (CNN) to validate the consistency of the contribution. Meanwhile, with the visualization of Gradient-weighted class activation mapping (Grad-CAM), we generate the heat maps and further visualize the distribution of CNN’s attention to each waveform of PPG and ECG. The heat maps show that networks pay more attention to the QRS complex and T wave. In the comparison results, the QRS complex and T wave have more contribution to minimizing errors than P wave. By separately adding P wave, QRS complex, and T wave, the average MAE of these networks reaches 7.87 mmHg, 6.57 mmHg, and 6.21 mmHg for systolic blood pressure (SBP), and 4.27 mmHg, 3.65 mmHg, and 3.73 mmHg, respectively, for diastolic blood pressure (DBP). The results of the experiment show that QRS complex and T wave deserves more attention and feature extraction like PPG waveform features in the continuous BP estimation.