用可解释的心电图形态模式,实现长期心电监测的早期异常预警。
Motif-based morphology signatures for interpretable ECG screening and monitoring

- 基于动态时间规整算法提取代表性心搏模式,实现心电图形态的量化表征。
- 在MIT-BIH和PTB-XL数据集上,显著区分正常与心律失常者(p<0.01)。
- 提供可视化叠加与波形定位,适合临床医生快速识别形态变化。
心电图仍是心血管筛查的核心工具,但解读仍以人工为主且多为短暂静息记录。当需要时采用长时程动态记录,数据量大且需大量人力审查,导致细微形态变化或渐进性漂移常被忽略。本文提出一种基于形态模式的框架,将对齐心搏的典型周期定义为可解释的心脏信号,并量化短长期监测中的形态漂移与偏离。模式通过固定窗口内最小化动态时间规整(DTW)距离选取,以捕捉主导形态。引入三种可解释的漂移指标:与正常窦性心律(NSR)的偏离、与个性化基线的偏离、以及模式不稳定性指数。在短时(PTB-XL)和长时(MIT-BIH Arrhythmia)心电图数据集上评估,结果表明:在MIT-BIH中,该方法能显著区分多数正常与心律失常受试者(p<0.01);在PTB-XL中,NSR偏离可有效区分正常与异常心电图,跨主要诊断亚型的显著性达p<1e-4,Cliff's delta最高达0.93。心电图模式提供了可解释的心脏形态表示,支持可扩展的纵向监测与形态驱动的早期异常检测。
原文摘要 · Abstract (English)
Electrocardiography (ECG) remains central to cardiovascular screening, yet interpretation remains largely manual and episodic. Clinical practice relies on brief resting ECGs and, when required, long-duration ambulatory recordings, both generating data that require resource-intensive review. Consequently, subtle morphological changes or progressive drift preceding clinically apparent abnormalities may go unnoticed. We propose a motif-based framework that defines beat-aligned ECG motifs as interpretable cardiac signatures and quantifies morphological drift and deviation across short and long-term monitoring. Motifs are representative cardiac cycles capturing dominant morphology. We introduce three interpretable drift metrics: deviation from a normal sinus rhythm (NSR), deviation from a personalised baseline, and a motif instability index. Motifs are extracted by selecting beats that minimise Dynamic Time Warping (DTW) distance within fixed windows. We evaluate these metrics on short (PTB-XL) and long-duration (MIT-BIH Arrhythmia) ECG datasets. Interpretability is achieved through representative motif overlays and fiducial-based visualisations, enabling direct inspection of morphological changes. In MIT-BIH, the proposed metrics significantly separated predominantly normal from arrhythmic subjects (p<0.01). In PTB-XL, NSR deviation distinguished normal from abnormal ECGs across major diagnostic subtypes (p<1e-4, Cliff's delta up to 0.93). ECG motifs provide an interpretable representation of cardiac morphology, supporting scalable longitudinal monitoring and early detection of morphology-driven change.
Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。