Design of an Integrated Arrhythmia Detection
Model using Connectivity Features and Multivariate Time Series
Classification
PUSHPAM JAIN, AMEY DESHMUKH, HIMANSHU PADOLE
School of Electrical Sciences,
IIT Bhubaneswar,
Argul, Khordha, Odisha, 752050,
INDIA
Abstract: - Cardiac arrhythmia, characterized by irregular heart rhythms, represents a widespread concern
within the realm of cardiology. It encompasses a range of rhythm irregularities, with some being benign and
others carrying substantial health risks. Therefore, the timely detection of arrhythmia holds considerable
importance. Existing methods to detect arrhythmia mainly utilize either the traditional machine learning
classifiers like SVM, and random forest or the recent deep learning-based models like CNN, LSTM, and RNN
for the classification while few other methods use the classical signal processing-based transforms to extract the
discriminating features. This paper proposes a novel integrated approach to classify the ECG signals for
arrhythmia detection. Unlike existing methods, it considers the multivariate time series nature of the input
along with the interrelationships among different ECG leads. The approach utilizes multivariate time series
features extracted using ROCKET (RandOM Convolutional KErnal Transform) and introduces new
connectivity-based features such as correlation and coherence for improved ECG signal classification. The
state-of-the-art classification performance of the proposed integrated model on the PTB-XL PhysioNet dataset
attested to the efficacy of the same.
Key-Words: - Arrhythmia detection, cardiovascular disease, disease diagnosis, electrocardiogram, multivariate
times series classification, ROCKET, connectivity, feature extraction.
Received: May 9, 2023. Revised: December 8, 2023. Accepted: January 7, 2023. Published: February 20, 2024.
1 Introduction
Cardiac arrhythmia, which refers to irregular heart
rhythms, is a prevalent concern in the field of
cardiology. It encompasses a spectrum of rhythm
abnormalities, some of which are harmless while
others could pose serious threats to health. As a
result, the prompt identification of arrhythmia holds
significant clinical significance and has the potential
to be life-saving, [1], [2]. In cardiology, the most
widely employed approach to identify cardiac
arrhythmia involves the use of the
electrocardiogram (ECG). This diagnostic method
captures the heart’s electrical activity. The standard
procedure records a 12-lead ECG, which is gathered
over a duration of 10 seconds. The diagnosis of
cardiac arrhythmia involves inspection of these 12
lead ECG signals by an expert doctor which
introduces the possibility of human error and
observer bias, [2], [3]. To mitigate these challenges,
various methods have been proposed in the
literature to automatically identify cardiac
arrhythmia from ECG signals using the concepts of
signal processing, machine learning, and more
recently deep learning, [4], [5], [6], [7], [8], [9],
[10], [11]. While conventional signal processing and
machine learning-based approaches typically
necessitate the creation of manually crafted features,
deep learning-based algorithms, on the other hand,
can be used to automate feature extraction. From the
detailed investigation of the work devoted to
address the arrhythmia detection problem, [4], [5],
[6], [7], [8], [9], [10], [11], it can be concluded that
the cutting-edge approaches predominantly employ
deep learning-based methods, specifically,
convolutional neural networks (CNN) and recurrent
neural networks (RNN). To have more insights into
the same, we next discuss some representative
existing state-of-the-art methods for arrhythmia
detection.
Starting with an interesting work in [4], the
authors here put forth a modified U-net model to
distinguish between five distinct beat categories.
Their model achieved an impressive accuracy of
97.3%, making use of a dataset of 83,648 beats from
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47 subjects. In a separate investigation, [5], the
authors utilized the discrete wavelet transform
(DWT) to extract features, combined with a support
vector machine (SVM) as the classifier, resulting in
an accuracy of approximately 95.9%. [6],
introduced a convolutional neural network model
for the purpose of categorizing 17 different cardiac
rhythms. Their reported accuracy stood at 91.3%,
derived from the analysis of 1,000 ECG fragments.
In their another work, the authors took a different
approach, utilizing both convolutional layers and
long short-term memory (LSTM) units to
simultaneously address representation and sequence
learning tasks that led to an accuracy of about
92.2%, [7]. Authors in [8], leveraged specific ECG
features, such as peak-to-peak interval (R-R
interval), beats per minute (BPM), and P wave to
QRS peak interval, in conjunction with an SVM
classifier, resulting in a classification accuracy of
91.0%. Meanwhile, [9], introduced a novel deep-
learning methodology involving the transformation
of 1-D ECG signals into 2-D time–frequency
spectrograms using a superlet transform (SLT). This
innovative approach yielded an impressive overall
accuracy of 96.2%. [10], used an LSTM model to
identify 12 different heart rhythm categories. This
was achieved by analyzing a dataset consisting of
65,932 digital 12-lead ECG signals obtained from
38,899 patients and got an accuracy of around
90.0%. [11], proposed an attention-based time-
incremental convolutional neural network
(ATICNN), a deep neural network model achieving
both spatial and temporal fusion of information
from ECG signals and was able to get an accuracy
of about 81.2%.
So, although serious efforts have been made to
solve the arrhythmia detection problem, none of
these existing methods take into consideration the
multivariate time series nature of the input multi-
lead ECG signal and the interrelationship among
these leads. To circumvent these limitations of the
existing approaches, in this paper, we propose an
innovative approach to classify the ECG signals
using multivariate time series features extracted
using ROCKET (RandOM Convolutional KErnal
Transform), [12] and the novel connectivity-based
features such as correlation and coherence.
Traditional methods for classifying time series
typically use specific aspects like shape, frequency,
or variance as representations. The ROCKET’s
convolutional kernels replace the need for manually
crafting these representations with a single
mechanism that can capture similar features
effectively. Furthermore, unlike the existing state-
of-the-art methods, here for the first time, we
exploited the relational information among different
leads of the ECG for arrhythmia detection. Having
verified the efficacy of the multivariate time series-
based approach and connectivity-based approach
individually, finally, both approaches are integrated
using feature concatenation to construct an
integrated arrhythmia detection model. This
integrated model essentially exploits both the
multivariate time series-based features and the
connectivity-based features simultaneously to
improve the performance of the model further.
The remaining paper is organized as follows:
Section II is devoted to basic preliminaries and
related work required to appreciate the proposed
work. A detailed explanation of the proposed
arrhythmia detection model is presented in section
III. Section IV consists of the performance analysis
of the proposed model and its comparison with the
existing methods. Section V concludes the paper by
summarizing the proposed work and the possible
future scope.
2 Basic Preliminaries and Related
Work
2.1 Multivariate Time Series Classification
Multivariate time series classification is the process
of predicting a class or categorical label for multiple
concurrent series of sequential data points. Each
data point in a multivariate time series is
characterized by several variables or features. The
data points in the multivariate time series are
ordered by time. In other words, multivariate
classification involves classifying a series of
observations over a period of time wherein each
observation is characterized by several attributes or
measurements.
Conventionally, a variety of techniques have
been employed to solve this multivariate time series
classification problem, ranging from random forest,
and support vector machines (SVM) to the recent
convolutional neural networks (CNN), [13],[14].
While all these techniques consider the time series
data as non-sequential wherein the order of data
points does not matter, the more recent deep
learning-based techniques like LSTM and other
recurrent neural networks (RNNs) can be used to
exploit the sequential nature of a time series, [13].
Multivariate time series classification finds
application in various domains and contexts with
some of the major applications as follows, [13],
[15], [16]:
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1) Healthcare: Time series classification can used
to detect different diseases like arrhythmia with
the help of ECG signals, epilepsy with the help
of EEG, and diseases like Parkinson’s. It can
also be used to monitor vital signs like heart
rate, blood pressure, and oxygen levels in blood.
2) Finance: It can be used to analyze the stock
price of a particular company depending on the
previously available stock market data.
3) Earthquake Warning Systems: Utilizing
multivariate time series classification we can
identify seismic activity patterns and offer early
alerts for potential earthquakes.
4) Energy Management: Using the previously
available data, time series classification can be
used to forecast energy demand and optimize
energy generation and distribution processes.
5) Environment Monitoring and Fault Detection: It
can be used to analyze climate data to predict
weather patterns and extreme events. It can also
be used to determine the level of pollution and
detect various faults with the help of proper
sensors.
With this general overview of the multivariate
time series classification, we next discuss ROCKET
(RandOM Convolutional KErnal Transform), one of
the best performing multivariate time series
classifiers, which is used in our proposed arrhythmia
detection model for classification purpose.
2.2 ROCKET (RandOM Convolutional
KErnal Transform)
Typically, most of the state-of-the-art time series
classification techniques focus on high accuracy but
have complex computation requirements that are
insufficient on small datasets and take a huge
amount of time on large datasets. In contrast to this,
ROCKET (RandOM Convolutional KErnal
Transform), [12], achieves comparable accuracy
levels while demanding considerably less time than
competing state-of-the-art algorithms, including
convolutional neural networks.
Due to its capacity to deliver high baseline
findings on different time series classification
benchmarks, ROCKET has gained popularity in a
variety of applications, [12], [13]. It provides a
novel method for feature engineering for time series
data, which can be useful when working with huge
datasets or when computational resources are few.
The basic working principle of the ROCKET
algorithm is described below.
As shown in Figure 1, the ROCKET algorithm
first extracts features from the input multivariate
time series using convolutional kernels and then
passes these features to a linear classifier. It uses a
large set of kernels, typically 10,000 and the reason
for this is that computing convolutions is
inexpensive due to the kernels having fixed weights
and a single convolutional layer. These kernels are
similar the those used in a CNN, the difference
being each of these kernels has randomly allocated
lengths, weights, bias, and dilation and it does not
use nonlinear transforms such as Rectified Linear
Unit (ReLU). Every individual kernel undergoes
convolution with each time series, resulting in the
creation of a feature map. Each kernel generates two
features: the highest value and the proportion of
positive values. So, a model with 10,000 kernels
generates a total of 20,000 features. These features
are then used to classify an input multivariate time
series using different linear classifiers. Typically, a
ridge regression classifier is used for a small dataset
whereas logistic regression with stochastic gradient
works well for the larger dataset, [12].
Fig. 1: Block diagram of the ROCKET multivariate
time series classifier
2.3 Connectivity Features
Connectivity features of a time series are measures
that describe how different variables in time series
data are connected or interact with each other. In
this work, we extracted the connectivity information
from the ECG data using the following four widely
used connectivity features, [17]:
1) Coherence: Coherence quantifies the similarity
among the frequency components of two-time
series signals. It indicates how well the phases
and amplitudes of the signals’ frequency
components are correlated at different
frequencies.
2) Correlation: Correlation examines the broader
linear connection between two variables,
without considering their frequency. It is
frequently employed to quantify the degree of
correlation between two time series and its
value ranges between -1 to 1.
3) Phase-lag index: Phase-lag index (PLI) is a
statistical metric employed to analyze the extent
of phase synchronization or phase coupling
between two time series signals. Its evaluation
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includes the calculation of the instantaneous
phase, followed by an examination of the
stability and consistency of phase differences
over time.
4) Phase-lag value: Phase-lag value (PLV)
generally signifies the degree to which one
signal is delayed compared to another with
respect to their phase. It quantifies the time
delay or difference in phase components
between two signals at a particular frequency or
over a specific time span.
Now, with this sufficient background about the
multivariate time series classification and
connectivity features, we discuss the details of our
proposed arrhythmia detection models in the
following section.
3 Proposed Arrhythmia Detection
Models
In this section, we explain in detail the proposed
multivariate time series-based arrhythmia detection
model, followed by the connectivity-based model
and finally discuss the integration of these two
models. However, before that, a brief overview of
the dataset and the preprocessing techniques is
presented.
3.1 Dataset
In this work, we used PTB-XL Physionet dataset,
[18], which consisted of 45,152 ECGs from various
patients. The conversion rate from volts to A/D bits
was 4.88, utilizing a 32-bit resolution A/D
converter. The amplitude unit was measured in
microvolts, with a maximum value of 32,767 and a
minimum of -32,768. The study received ethical
approval from the institutional review boards of
Shaoxing People’s Hospital and Ningbo First
Hospital. Informed consent requirements were
waived, and the data was permitted for public
sharing following de-identification. From this
dataset, we focused on atrial fibrillation patients,
which represent the most common type of
arrhythmia. In the given dataset there are 1780
patients of the type atrial fibrillation. We used
another PTB-XL dataset to get the data of 5000
normal individuals. Both the datasets had the same
time length of about 10 seconds and the sampling
frequency of these datasets was also identical
(500Hz).
3.2 Preprocessing
To assure the dataset’s quality and suitability for
analysis, a number of essential preprocessing
activities were carried out throughout the data
preprocessing phase. The first phase involves
managing missing values, where imputation
techniques are used to fill up dataset gaps.
Detrending was employed to eliminate baseline
wander, a low-frequency variation brought on by
things like electrode movement. In order to focus
more clearly on the signal’s important components,
the baseline wander was mathematically removed
during this step. Last but not least, feature scaling
was done to scale all features uniformly, preventing
any feature from dominating others based on
magnitude. Together, these preprocessing methods
refined the unprocessed dataset, preserving its
integrity and setting the stage for accurate and
meaningful analyses. The sampling frequency of the
data set is 500 Hz, and the total length of the signal
is about 10 seconds, so we get about 5000 samples
per time series. We then used the windowing
technique to divide each time series into multiple
parts to increase the data size and found that a
window length of 2 seconds, which corresponds to
1000 samples, gives the highest accuracy. After
performing these preprocessing steps, we applied
three novel approaches to classify the 12-lead ECG
data that are explained in detail below.
3.3 Multivariate Time Series-based
Approach
In this approach, for the first time, the input 12-lead
ECG signal was modeled as a multivariate time
series signal. Once the input is modeled as a
multivariate time series, the arrhythmia detection
problem reduces to a multivariate time series
classification problem which is then solved using
the ROCKET algorithm. As described in the last
section, the ROCKET (RandOM Convolutional
Kernel Transform) algorithm extracts abstract
features from the multivariate time series input, i.e.,
12-lead ECG signals. These features are then used
to train a logistic regression model using stochastic
gradient descent as the optimization technique that
determines the optimal set of parameters (weights
and biases) to minimize the loss function and
improve the accuracy of the predictions.
Here, we experimented with different numbers
of kernels to generate different sets of features
wherein each kernel contributes two different
features. We also investigated different window
lengths and found that a window size of 2 seconds
gave the most accurate results. With this windowing
technique, the ECG signal was divided into discrete
2-second intervals, each containing 1000 data
samples. This balance between temporal resolution
and computational efficiency was key to our
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methodology. To classify a particular patient, we
used a majority decision strategy, wherein each
subject was classified with a label of the majority
segments. For each sample, the 12-lead ECG signal
was divided into segments of 2-second length
(consisting of 1000 samples), and the predominant
class among all these segments was considered as
the class for the given sample. This approach helped
to mitigate potential fluctuations or anomalies
within shorter segments and ensured reliable
predictions.
Although this multivariate time series-based
classification approach indirectly utilizes the
interrelationship among different time series, to
exploit this relational information further, we next
propose a connectivity-based classifier that is
discussed below.
3.4 Connectivity-based Approach
Typical machine learning models often consider
every time series in a multivariate time series as an
independent entity, thus neglecting the relational
information amongst them, which can be exploited
for classification purpose. In particular, as far as the
multi-lead ECG signal is concerned, the neighboring
ECG leads can share meaningful relational
information, which can be quite useful for the
present arrhythmia detection purpose. With this
hypothesis, we propose here a detection model that
extracts this relational information among different
ECG leads and then use the same for classification
purpose.
Fig. 2: Block diagram of the proposed connectivity-
based arrhythmia detection model
In this proposed model, we first extract the
connectivity information from the ECG time series
using four widely used connectivity measures, viz.,
coherence, correlation, phase-lag index, and phase-
lag value. Each of these characteristics generates a
12x12 matrix, representing distinct qualities related
to each separate segment in the time series. Then we
merge these matrices to create a comprehensive
24x24 matrix of the lead connectivity features. This
matrix includes intricate connections and
interdependencies among the segments, enhancing
how the data is represented by offering a complete
view of the sequential nature of the time series. To
classify into classes from this feature matrix, we
employed a convolutional neural network (CNN),
[19], as shown in Figure 2.
In our experimentation, we explored various
configurations of the CNN architecture. We tested
different numbers of layers and neurons within each
layer to determine the optimal structure. Our
findings revealed that a neural network with three
hidden layers yielded the most accurate results.
Furthermore, we fine-tuned the number of neurons
in each layer, settling on 256 neurons for the first
(input layer), 10 for the second (hidden layer), and 1
for the third (output layer). This neural network’s
architecture comprised a convolutional layer as the
initial processing step, extracting distinctive patterns
from the feature space. Subsequently, a max pooling
layer distilled the essential information, followed by
a flattening step, which prepared the data for the
final classification or prediction stage.
3.5 Integrated Approach
Fig. 3: Block diagram of the proposed integrated
arrhythmia detection model
Having verified the efficacy of the multivariate
time series-based approach and connectivity-based
approach independently, inspired by similar
applications, [20], we next integrate these
approaches to enhance the detection performance
further as indicated in Figure 3. In this integrated
model, the multivariate time series-based features
extracted from the ROCKET algorithm were
concatenated with the comprehensive connectivity
matrix to create a combined feature vector. This
combined feature vector was then used as an input
to a logistic regression classifier with a stochastic
gradient descent optimizer. This integration aimed
to harness the combined power of these features to
produce a further comprehensive and robust model.
The results of this concerted effort have indeed been
promising. Through careful experimentation and
analysis, it was found that the accuracy achieved
with this model exceeded that of the first two
models. This observation represents a tangible
advance in our quest for more accurate and reliable
predictions or classifications. The quantitative
performance of these proposed models, along with
the comparative analysis is presented in the next
section.
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4 Experimental Results and
Discussion
In this section, we first present the classification
performance of all three proposed models. Then we
compare their performance with the performance of
the existing arrhythmia detection methods. To
quantify the classification performance of the
detection model, we employed three performance
measures, viz., accuracy, sensitivity, and specificity
that are defined as:
Accuracy = 𝑇𝑃+𝑇𝑁
𝑇𝑃+𝑇𝑁+𝐹𝑃+𝐹𝑁 (1)
Sensitivity = 𝑇𝑃
𝑇𝑃+𝐹𝑁 (2)
Specificity = 𝑇𝑁
𝑇𝑁+𝐹𝑃 (3)
where TP: True Positives represent cases where the
model accurately forecasts the positive class,
TN: True Negatives occur when the model
accurately predicts the negative class,
FP: False Positives happen when the model
inaccurately forecasts the positive class despite the
actual ground truth being negative, and
FN: False Negatives happen when the model
incorrectly predicts the negative class when the
actual ground truth is positive.
We used 5-fold cross-validation on all the above
models to validate our results. By calculating the
average performance over several folds, the
fluctuation in the performance measurement is
minimized, enhancing its reliability and hence
providing a better estimate of how well a model is
likely to perform on unseen data.
As far as the classification performance of the
multivariate time series-based model is concerned,
as the performance of the model depends on the
number of kernels in ROCKET and the ECG
window length, determining their optimal values
becomes extremely important. So, to find the
optimal values of the number of kernels N in
ROCKET and the ECG time series window length
w, we constructed the models with different values
of N and w and examined the resulting performance
(as shown in Figure 4).
Fig. 4: Classification accuracy of the proposed
multivariate time series-based arrhythmia detection
model for different values of N and w
From the results in Figure 4, it can be observed
that 10000 kernels and a window length of 2 s
performs best and hence was selected in the final
model. Having evaluated the performance of the
multivariate time series-based approach, we next
evaluate the performance of the connectivity-based
approach.
In the connectivity-based model, as the input
information to the classifier changes with the chosen
measure of connectivity, the performance of the
classifier is expected to depend on the connectivity
measure, viz., coherence, correlation, phase-lag
index, and phase-lag value. So, to obtain the optimal
connectivity measure for the present application, we
evaluated the performance of the same CNN
classifier presented with different connectivity
matrices. The results of the same are shown in
Figure 5.
Fig. 5: Classification performance of the proposed
connectivity-based arrhythmia detection model
using different connectivity measures
From the results in Figure 5, it can be observed
that coherence is the optimal connectivity measure
for arrhythmia detection. Now, as each of the
connectivity measures carries unique information,
fusing the information from all should improve the
model performance. To verify this hypothesis, we
concatenated all four 12x12 connectivity matrices to
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construct a comprehensive 24x24 matrix and then
used it as an input to the same CNN classifier. The
superior performance of the combined feature
matrix, as observed in Figure 5, verified our
hypothesis.
Having validated the performance of the
multivariate time series-based model and the
connectivity-based model, we next validate the
performance of our integrated arrhythmia detection
model which exploits both the sequential and
relational information of the ECG data.
Classification performance of the integrated model
and its comparison with our earlier proposed models
is shown in Figure 6.
Fig. 6: Classification performance of the proposed
arrhythmia detection models.
It is evident from Figure 6 that the proposed
integrated model outperforms our proposed
individual models, thus verifying its efficacy.
Finally, we compared the classification
performance of our proposed integrated arrhythmia
detection model with the existing state-of-the-art
methods, the results of which are shown in Table 1.
Table 1. Classification accuracies of different
arrhythmia detection methods.
Method
Classification
Accuracy (%)
Mod U-Net [4]
97.32
SVM [5]
95.92
DNN [7]
92.24
Superlet-DNN [9]
96.20
LSTM [10]
90.00
Prop. Integrated Model
98.96
Results in Table 1 corroborates the superiority
of our proposed integrated arrhythmia detection
model which can be attributed to its unique
capability to exploit both the sequential and the
relational information in the multi-lead ECG data.
5 Conclusion and Future Scope
In this paper, we addressed an important problem of
cardiac arrhythmia detection using ECG signals.
The problem was first formulated as a novel
multivariate time series classification problem
which was then solved using state-of-the-art
ROCKET multivariate time series classifier. To
exploit the relational information among different
ECG electrodes for detection purpose, the
classification problem was then uniquely solved by
extracting the different connectivity-based features.
Finally, both the proposed models were integrated to
design a novel integrated arrhythmia detection
model that exploited both the sequential and the
relational information of the ECG data
simultaneously. Application of the proposed
integrated model on PTB-XL PhysioNet dataset
yielded state-of-the-art detection performance with
reduced computational complexity and thus verified
the applicability of the same.
Although our proposed integrated model
equipped with the ROCKET algorithm achieved
state-of-the-art detection performance, its
performance may be improved further by employing
other multivariate time series classifiers like
multivariate DTW-NN, and InceptionTime, and
hence can be an interesting extension of the present
work. Also, the applicability of the proposed
integrated approach can be extended in various
other applications, e.g., Alzheimer’s disease
detection, Schizophrenia detection which also
involve multivariate time series data as an input.
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