用新模型实现大规模心电图波段自动测量，精度达临床可用水平。
Automated ECG Interval Measurement and Wave Delineation Using Fast Fourier Convolution ResNet
- 基于FFT增强的残差网络，融合时序与频谱特征进行波形定位。
- 在1万例心电图上测得QT误差仅17.5毫秒，多数误差在医生间差异范围内。
- 首次系统分析不同心律下的误差，提示对快速心律失常需谨慎应用。
准确测量心电图的PR、QRS持续时间及QT/QTc间隔对心脏诊断至关重要。然而现有文献多在小规模精选数据库上以特征点时间误差评估性能，而非在大规模未筛选队列中考察临床间隔测量准确性。本文通过在10,646例临床12导联心电图上评估完整端到端流程，首次报告了具有完整统计刻画的大规模间隔测量精度研究，包括偏倚、95%一致性界限（Bland-Altman）、Bootstrap置信区间及按心律分层的误差分析。核心波形分割采用快速傅里叶卷积残差网络（FFCResNet），通过FFT将局部时序卷积与全局频谱处理结合，并引入寄存器令牌以增强上下文特征学习。三个波形模型（P、QRS、T）在六个公开数据库上训练，使用心电图特异性增强。在10,646例心电图上，系统取得的QT平均绝对误差（MAE）为17.5毫秒[95% CI: 16.9–18.2]，Bland-Altman偏倚为+8.5毫秒（一致性界限：-68.5至+85.5毫秒）；QRS持续时间MAE为14.8毫秒[95% CI: 14.6–15.0]，偏倚为+12.6毫秒（一致性界限：-12.3至+37.6毫秒）；心室率误差为0.8次/分钟。所有偏倚经威尔科克森符号秩检验均显著（p < 0.001），但仍在窦性心律的已发表医者间变异范围内。按心律分层分析显示，对于房性心动过速（SVT MAE: 75.0 ms）和房室折返性心动过速（AVRT MAE: 85.3 ms），QT误差显著高于窦性心动过缓（SB MAE: 9.3 ms）和窦性心律（SR MAE: 8.9 ms），真实揭示了部署范围。波段分割内部Dice得分分别为P波95.5%、QRS波98.2%、T波96.1%；跨数据库得分分别为78.1%、85.5%、74.2%。
原文摘要 · Abstract (English)
Accurate measurement of ECG intervals, including PR, QRS duration, and QT/QTc, is central to cardiac diagnosis, yet the published ECG delineation literature evaluates performance almost exclusively as fiducial-point timing errors on small curated databases, rather than as clinical interval accuracy on large unselected cohorts. We bridge this gap by evaluating a complete end-to-end pipeline on 10,646 clinical 12-lead ECGs and reporting the first large-scale interval measurement accuracy study with full statistical characterisation, including bias, 95% limits of agreement (Bland-Altman), bootstrap confidence intervals, and rhythm-stratified error analysis. The underlying delineation is performed by a Fast Fourier Convolution ResNet (FFCResNet), adapting local temporal convolutions with global spectral processing via FFT and augmented with register tokens for contextual feature learning. Three per-wave models (P, QRS, and T) are trained on six public databases with ECG-specific augmentation. On 10,646 ECGs, the system achieves a QT MAE of 17.5 ms [95% CI: 16.9-18.2], with a Bland-Altman bias of +8.5 ms (LoA: -68.5 to +85.5 ms); a QRS duration MAE of 14.8 ms [95% CI: 14.6-15.0], with a bias of +12.6 ms (LoA: -12.3 to +37.6 ms); and a ventricular rate MAE of 0.8 beats/min. All biases are statistically significant by the Wilcoxon signed-rank test (p < 0.001) but remain within or near published inter-observer variability bounds for sinus rhythms. Rhythm-stratified analysis reveals substantially higher QT errors for supraventricular tachycardias (SVT MAE: 75.0 ms; AVRT MAE: 85.3 ms) than for sinus bradycardia (SB MAE: 9.3 ms) and sinus rhythm (SR MAE: 8.9 ms), providing an honest characterisation of the deployment scope. Wave segmentation achieves internal Dice scores of 95.5%, 98.2%, and 96.1% for P, QRS, and T waves, respectively, and cross-database Dice scores of 78.1%, 85.5%, and 74.2%.
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