梳理心电图心律失常分类研究,推动标准化与实际部署可行性
A Systematic Review of ECG Arrhythmia Classification: Adherence to Standards, Fair Evaluation, and Embedded Feasibility
- 按E3C标准评估2017-2024年心电图分类研究,关注跨患者划分与嵌入式可行性
- 发现多数模型虽高准确率,但缺乏真实设备部署考量,内存与能耗未达标
- 提出报告规范,助力未来研究实现公平比较与临床实用
心电图(ECG)信号分类对早期发现心律失常等心脏疾病至关重要。尽管机器学习技术进步显著,许多研究仍未遵循标准化流程,导致性能评估不一致且难以实际应用。此外,植入式设备如起搏器、动态心电监测仪及可穿戴贴片等硬件限制常被忽视。由于实际影响依赖于资源受限设备的可行性,确保高效部署至关重要。本综述系统分析了2017至2024年间发表的ECG分类研究,聚焦符合嵌入式(Embedded)、临床(Clinical)和对比(Comparative)标准(E3C)的研究,涵盖跨患者划分、遵循美国医学仪器促进协会(AAMI)建议,以及模型在嵌入式系统中的可行性。尽管多数研究报告高准确率,但很少充分考虑患者无关划分和硬件约束。我们识别出满足E3C标准的前沿方法,并对比其准确性、推理时间、能耗与内存使用。最后,提出标准化报告实践,以保障模型比较的公平性与临床适用性。通过填补这些空白,本研究旨在引导未来研究构建更稳健、可落地的ECG分类系统。
原文摘要 · Abstract (English)
The classification of electrocardiogram (ECG) signals is crucial for early detection of arrhythmias and other cardiac conditions. However, despite advances in machine learning, many studies fail to follow standardization protocols, leading to inconsistencies in performance evaluation and real-world applicability. Additionally, hardware constraints essential for practical deployment, such as in pacemakers, Holter monitors, and wearable ECG patches, are often overlooked. Since real-world impact depends on feasibility in resource-constrained devices, ensuring efficient deployment is critical for continuous monitoring. This review systematically analyzes ECG classification studies published between 2017 and 2024, focusing on those adhering to the E3C (Embedded, Clinical, and Comparative Criteria), which include inter-patient paradigm implementation, compliance with Association for the Advancement of Medical Instrumentation (AAMI) recommendations, and model feasibility for embedded systems. While many studies report high accuracy, few properly consider patient-independent partitioning and hardware limitations. We identify state-of-the-art methods meeting E3C criteria and conduct a comparative analysis of accuracy, inference time, energy consumption, and memory usage. Finally, we propose standardized reporting practices to ensure fair comparisons and practical applicability of ECG classification models. By addressing these gaps, this study aims to guide future research toward more robust and clinically viable ECG classification systems.
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