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.

Heart rate is one of the most important diagnostic bases for cardiovascular disease. This paper introduces a deep autoencoding strategy into feature extraction of electrocardiogram (ECG) signals, and proposes a beat-to-beat heart rate estimation method based on convolution autoencoding and Gaussian mixture clustering. The high-level heartbeat features were first extracted in an unsupervised manner by training the convolutional autoencoder network, and then the adaptive Gaussian mixture clustering was applied to detect the heartbeat locations from the extracted features, and calculated the beat-to-beat heart rate. Compared with the existing heartbeat classification/detection methods, the proposed unsupervised feature learning and heartbeat clustering method does not rely on accurate labeling of each heartbeat location, which could save a lot of time and effort in human annotations. Experimental results demonstrate that the proposed method maintains better accuracy and generalization ability compared with the existing ECG heart rate estimation methods and could be a robust long-time heart rate monitoring solution for wearable ECG devices.

At the core of AI-driven electrocardiogram diagnosis lies the precise localization of the QRS complex. While QRS detection methods for multiple leads have been researched adequately in the last few decades, their multi-lead strategies still need to be designed manually. Therefore, a QRS detector that can fuse multiple leads automatically is still worth investigating. Methods: The proposed QRS detector comprises a leads-distillation module (LDM) and a QRS detection module. The LDM can distill multi-lead signals into single-lead ones. This procedure minimizes the weight proportions assigned to noisy leads, enabling the network to generate a novel signal that facilitates the recognition of QRS waves. The QRS detection module, utilizing U-Net, is capable of discerning QRS complexes from the novel signal. Results: Our method demonstrates outstanding performance with a parameter count of only 5216. It achieves an excellent F1 score of 99.83 on the MITBIHA database and 99.77 on the INCART database, specifically in the inter-patient pattern. In the cross-database pattern, our approach maintains a strong performance with an F1 score of 99.22 on the INCART database and an F1 score of 99.09 on the MITBIHA database. Conclusion: Our method provides a novel idea for universal multi-lead QRS detection. It possesses advantages, such as reduced computational parameters, enhanced precision, and heightened compatibility. Significance: Our method canceled the repeated deployment of the QRS detection function to different lead configurations in the electrocardiogram (ECG) diagnostic system. Moreover, the scaling operation may become a simple tool to decrease the computational load of the network.