用轻量级模型精准区分心电图中的室速与室上速,且可解释诊断依据。
Explainable Parallel CNN-LSTM Model for Differentiating Ventricular Tachycardia from Supraventricular Tachycardia with Aberrancy in 12-Lead ECGs
- 并行处理每导联心电图,用1D-CNN+LSTM捕捉局部与时间特征
- 准确率达95.63%,灵敏度95.10%,优于现有方法
- 通过SHAP分析揭示决策依据,适合临床部署
宽复波心动过速(WCT)的鉴别对临床至关重要但极具挑战,因室性心动过速(VT)与伴传导异常的室上性心动过速(SVT-A)在心电图形态上相似,误诊可能致命。本文提出一种计算高效、可解释的深度学习模型,以提升诊断准确率并支持临床应用。采用轻量级并行架构,各通道独立通过两个1D-CNN块提取局部特征,跨导联拼接后经LSTM捕捉时序依赖,最终由全连接层分类。通过Shapley Additive Explanations(SHAP)实现局部与全局可解释性。在包含35名患者的ECG数据库上评估,模型达到95.63%准确率(95% CI: 93.07–98.19%),灵敏度为95.10%,特异性为96.06%,F1-score为95.12%,在准确率与计算效率上均优于当前最优方法,且所需卷积块最少。SHAP分析显示关键特征具有临床可解释性。结论表明,该端到端框架具备高精度、低开销特点,结合可解释性显著增强临床信任,适用于真实世界心电图分析工具。
原文摘要 · Abstract (English)
Background and Objective: Differentiating wide complex tachycardia (WCT) is clinically critical yet challenging due to morphological similarities in electrocardiogram (ECG) signals between life-threatening ventricular tachycardia (VT) and supraventricular tachycardia with aberrancy (SVT-A). Misdiagnosis carries fatal risks. We propose a computationally efficient deep learning solution to improve diagnostic accuracy and provide model interpretability for clinical deployment. Methods: A novel lightweight parallel deep architecture is introduced. Each pipeline processes individual ECG leads using two 1D-CNN blocks to extract local features. Feature maps are concatenated across leads, followed by LSTM layers to capture temporal dependencies. Final classification employs fully connected layers. Explainability is achieved via Shapley Additive Explanations (SHAP) for local/global interpretation. The model was evaluated on a 35-subject ECG database using standard performance metrics. Results: The model achieved $95.63\%$ accuracy ($95\%$ CI: $93.07-98.19\%$), with sensitivity=$95.10\%$, specificity=$96.06\%$, and F1-score=$95.12\%$. It outperformed state-of-the-art methods in both accuracy and computational efficiency, requiring minimal CNN blocks per pipeline. SHAP analysis demonstrated clinically interpretable feature contributions. Conclusions: Our end-to-end framework delivers high-precision WCT classification with minimal computational overhead. The integration of SHAP enhances clinical trust by elucidating decision logic, supporting rapid, informed diagnosis. This approach shows significant promise for real-world ECG analysis tools.
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