通过周期内与周期间感知机制,提升心电图自监督学习对房颤的检测精度。
Self-supervised inter-intra period-aware ECG representation learning for detecting atrial fibrillation
- 设计周期内/间特征分离的预训练任务,捕捉心电图稳定形态与关键周期间变化
- 在BTCH数据集上对阵发性和持续性房颤检测的AUC分别达0.953和0.996
- 适用于缺乏标注数据但需高精度房颤识别的临床场景
房颤是一种常见且与中风及死亡率升高相关的心律失常。由于需专业医学知识进行标注,利用大量心电图数据开发精准的监督式房颤算法仍具挑战。自监督学习(SSL)为泛化心电图表征学习提供了可行路径,可避免昂贵的人工标注。然而,若未充分融入房颤相关先验知识,现有SSL方法往往难以捕捉鲁棒的心电图表征。本文提出一种跨周期-内周期感知的心电图表征学习方法。考虑到房颤患者心电图呈现RR间期不规则及无P波特征,我们设计了针对周期间与周期内表征的特定预训练任务,旨在学习单周期稳定波形特征的同时保留关键周期间信息。经进一步微调后,该方法在BTCH数据集上对阵发性和持续性房颤检测的AUC分别达到0.953和0.996。在CinC2017和CPSC2021等常用基准上,其泛化能力与有效性亦得到验证,结果具有竞争力。
原文摘要 · Abstract (English)
Atrial fibrillation is a commonly encountered clinical arrhythmia associated with stroke and increased mortality. Since professional medical knowledge is required for annotation, exploiting a large corpus of ECGs to develop accurate supervised learning-based atrial fibrillation algorithms remains challenging. Self-supervised learning (SSL) is a promising recipe for generalized ECG representation learning, eliminating the dependence on expensive labeling. However, without well-designed incorporations of knowledge related to atrial fibrillation, existing SSL approaches typically suffer from unsatisfactory capture of robust ECG representations. In this paper, we propose an inter-intra period-aware ECG representation learning approach. Considering ECGs of atrial fibrillation patients exhibit the irregularity in RR intervals and the absence of P-waves, we develop specific pre-training tasks for interperiod and intraperiod representations, aiming to learn the single-period stable morphology representation while retaining crucial interperiod features. After further fine-tuning, our approach demonstrates remarkable AUC performances on the BTCH dataset, \textit{i.e.}, 0.953/0.996 for paroxysmal/persistent atrial fibrillation detection. On commonly used benchmarks of CinC2017 and CPSC2021, the generalization capability and effectiveness of our methodology are substantiated with competitive results.
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