Abstract

The adaptability of heart to external and internal stimuli is reflected by the heart rate variability (HRV). Reduced HRV can be a predictor of negative cardiovascular outcomes. Based on the nonlinear, nonstationary, and highly complex dynamics of the controlling mechanism of the cardiovascular system, linear HRV measures have limited capability to accurately analyze the underlying dynamics. In this study, we propose an automated system to analyze HRV signals by extracting multimodal features to capture temporal, spectral, and complex dynamics. Robust machine learning techniques, such as support vector machine (SVM) with its kernel (linear, Gaussian, radial base function, and polynomial), decision tree (DT), k-nearest neighbor (KNN), and ensemble classifiers, were employed to evaluate the detection performance. Performance was evaluated in terms of specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC). The highest performance was obtained using SVM linear kernel (TA = 93.1%, AUC = 0.97, 95% CI [lower bound = 0.04, upper bound = 0.89]), followed by ensemble subspace discriminant (TA = 91.4%, AUC = 0.96, 95% CI [lower bound 0.07, upper bound = 0.81]) and SVM medium Gaussian kernel (TA = 90.5%, AUC = 0.95, 95% CI [lower bound = 0.07, upper bound = 0.86]). The results reveal that the proposed approach can provide an effective and computationally efficient tool for automatic detection of congestive heart failure patients.

Highlights

  • Heart rate variability (HRV) signals are extracted from electrocardiogram (ECG) [1], which is a noninvasive marker for monitoring an individual’s health. e time interval between two consecutive R-peaks in an ECG is called an RR interval or interbeat interval. e analysis of variations in the interbeat intervals is called heart rate variability (HRV) analysis, which has diverse applications in various fields of clinical research to examine a wide range of cardiac and noncardiac diseases, including myocardial infarction (MI) [2], hypertension [3], sudden cardiac death (SCD) and ventricular arrhythmias [4], and diabetes mellitus (DM) [5]

  • Dataset. e RR interval time series data were taken from the Physionet databases [25]. e fluctuations in the cardiac interbeat interval (RR interval) time series data of normal sinus rhythm (NSR) subjects, congestive heart failure (CHF) subjects, and atrial fibrillation (AF) subjects were studied [25]. e data of NSR subjects were taken from 24-hour Holter monitor recordings of 72 subjects consisting of 35 men and 37 women (54 from the RR interval normal sinus rhythm database and 18 from the Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH) normal sinus rhythm database). e age of the measured group was 54.6 ± 16.2 years, range 20–78 years

  • Various kinds of defects can be detected by analyzing the oscillations between consecutive heart beats. e analysis of HRV is the subject of different clinical studies investigating a wide spectrum of cardiological and noncardiological diseases and clinical conditions

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Summary

Introduction

Heart rate variability (HRV) signals are extracted from electrocardiogram (ECG) [1], which is a noninvasive marker for monitoring an individual’s health. e time interval between two consecutive R-peaks in an ECG is called an RR interval or interbeat interval. e analysis of variations in the interbeat intervals is called HRV analysis, which has diverse applications in various fields of clinical research to examine a wide range of cardiac and noncardiac diseases, including myocardial infarction (MI) [2], hypertension [3], sudden cardiac death (SCD) and ventricular arrhythmias [4], and diabetes mellitus (DM) [5]. Heart rate variability (HRV) signals are extracted from electrocardiogram (ECG) [1], which is a noninvasive marker for monitoring an individual’s health. E analysis of variations in the interbeat intervals is called HRV analysis, which has diverse applications in various fields of clinical research to examine a wide range of cardiac and noncardiac diseases, including myocardial infarction (MI) [2], hypertension [3], sudden cardiac death (SCD) and ventricular arrhythmias [4], and diabetes mellitus (DM) [5]. Us, analysis of such type of signals using traditional methods and visual detection is challenging, inappropriate, and timeconsuming. We aim to develop a system that can automatically distinguish between normal persons and CHF patients using heart rate variability (HRV) signals

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