Multi-arrhythmias detection with an XML rule-based system from 12-Lead Electrocardiogram

Abstract

Background: The computer-aided detection of cardiac arrhythmias stills a crucial application in medical technologies. The rule based systems RBS ensure a high level of transparency and interpretability of the obtained results. 

Aim: To facilitate the diagnosis of the cardiologists and to reduce the uncertainty made in this diagnosis. 

Methods: In this research article, we have realized a classification and automatic recognition of cardiac arrhythmias, by using XML rules that represent the cardiologist knowledge. Thirteen experiments with different knowledge bases were realized for improving the performance of the used method in the detection of 13 cardiac arrhythmias. In the first 12 experiments, we have designed a specialized knowledge base for each cardiac arrhythmia, which contains just one arrhythmia detection rule. In the last experiment, we applied the knowledge base which contains rules of 12 arrhythmias. We used, for the experiments, an international data set with 279 features and 452 records characterizing 12 leads of ECG signal and social information of patients. The data sets were constructed and published at Bilkent University of Ankara, Turkey. In addition, the second version of the self-developed software “XMLRULE” was used; the software can infer more than one class and facilitate the interpretability of the obtained results. 

Results: The 12 first experiments give 82.80% of correct detection as the mean of all experiments, the results were between 19% and 100% with a low rate in just one experiment. The last experiment in which all arrhythmias are considered, the results of correct detection was 38.33% with 90.55% of sensibility and 46.24% of specificity. It was clearly show that in these results the good choice of the classification model is very beneficial in terms of performance. The obtained results were better than the published results with other computational methods for the mono class detection, but it was less in multi-class detection.

Conclusion: The RBS is the most transparent method for cardiac arrhythmias detection and multi arrhythmias detection. It improves an exceptional recognition of arrhythmias, but due to conflicts between rules, multi-arrhythmias and uncertainty of measures, the rate of correct classification was less than the other methods.