Sie sind auf Seite 1von 9

Pattern Recognition Letters 28 (2007) 1142–1150

www.elsevier.com/locate/patrec

Electrocardiogram beat classification based on wavelet


transformation and probabilistic neural network
Sung-Nien Yu *, Ying-Hsiang Chen
Department of Electrical Engineering, National Chung Cheng University, 168 University Road, Ming-Hsiung, Chia-Yi 621, Taiwan

Received 6 February 2006; received in revised form 25 October 2006


Available online 27 February 2007

Communicated by A. Fred

Abstract

In this paper, an electrocardiogram (ECG) beat classification system based on wavelet transformation and probabilistic neural net-
work (PNN) is proposed to discriminate six ECG beat types. The ECG beat signals are first decomposed into components in different
subbands using discrete wavelet transformation. Three sets of statistical features of the decomposed signals as well as the AC power and
the instantaneous RR interval of the original signal are exploited to characterize the ECG signals. A PNN follows to classify the feature
vectors. The result shows a promising accuracy of 99.65%, with equally well recognition rates of over 99% throughout all type of ECG
beats. Only 11 features are required to attain this high accuracy, which is substantially smaller in quantity than that in other methods.
These observations prove the effectiveness and efficiency of the proposed method for computer-aided diagnosis of heart diseases based on
ECG signals.
Ó 2007 Elsevier B.V. All rights reserved.

Keywords: Electrocardiogram; RR interval; Discrete wavelet transform; Probabilistic neural network; Pattern classification

1. Introduction cal measures (Osowski and Linh, 2001). Although these


methods showed impressive results in some classification
The electrocardiogram (ECG) is noninvasive in nature tasks, they usually failed to demonstrate equally well dis-
and valuable in the diagnosis of heart diseases. Because crimination power throughout all types of ECG beats.
of the high mortality rate of heart diseases, faithful detec- Wavelet transformation (WT) opens another category of
tion and classification of ECG arrhythmias is essential methods that represent the signal in different translations
for the treatment of patient in the clinics. In recent years, and scales. Moreover, the discrete wavelet transformation
many algorithms have been developed for the detection (DWT) decomposes a signal into signals in different coarse-
and classification of the ECG signals (Al-Fahoum and ness. Wavelet coefficients obtained from the decomposition
Howitt, 1999; Addison et al., 2000; Osowski and Linh, process are considered as the filtered signal in the sub-
2001; Güler and Übeyli, 2005a,b). bands. Features extracted from these coefficients can effi-
ECG features can be extracted in time domain (Charllis ciently represent the characteristics of the original signal
and Kittney, 1990; Hu et al., 1997; Moraes et al., 2002; De in different details. In the consequence, DWT has attracted
Chazal and Reilly, 2003), in frequency domain (Minami interests in ECG pattern recognition (Addison et al., 2000;
et al., 1999; Moraes et al., 2002), or represented as statisti- Al-Fahoum and Howitt, 1999; Prasad and Sahambi, 2003).
As for classifiers, artificial neural networks (ANNs) have
*
Corresponding author. Tel.: +886 5 2720411x33205; fax: +886 5
been extensively employed in computer-aided diagnosis
2720862. (CAD) systems. Among them, the multilayer perceptron
E-mail address: yusn@ee.ccu.edu.tw (S.-N. Yu). (MLP) is probably the most popular (Hu et al., 1997; Min-

0167-8655/$ - see front matter Ó 2007 Elsevier B.V. All rights reserved.
doi:10.1016/j.patrec.2007.01.017
S.-N. Yu, Y.-H. Chen / Pattern Recognition Letters 28 (2007) 1142–1150 1143

ami et al., 1999). The conventional MLP has demonstrated g(n) ↓2 D1


impressive accuracy in classifying the ECG beats into two
(normal and abnormal) categories. However, in order to D2
x(n) g(n) ↓2
extend the imposing power to the multi-category classifica-
tion tasks, hierarchical systems that combine MLP and h(n) ↓2 A1
another ANN are usually indispensable (Minami et al., A2
1999; Osowski and Linh, 2001; Engin, 2004; Güler and h(n) ↓2
Übeyli, 2005b). In these systems, the first-level neural net-
Fig. 1. Subband decomposition with two-level discrete wavelet transform,
works are responsible for pre-classifying the beats into nor- where g(n) is a high-pass filter and h(n) is a low-pass filter.
mal and abnormal categories (Minami et al., 1999), or
building a model for the input features (Osowski and Linh,
2001; Engin, 2004; Güler and Übeyli, 2005b). An MLP
then follows to complete the multi-category classification lution at high frequency and good frequency resolution
tasks in the second level. at low frequency. Because of its great time and frequency
Although the MLP-based systems have achieved high localization ability, the DWT can reveal the local charac-
accuracy in the classification of multi-category ECG beats, teristics of the input signal. Moreover, the multi-scale fea-
the inherited backpropagation algorithms produce serious ture of the DWT allows the decomposition of an ECG
computation load. The multi-ANN structure of the hierar- signal into different scales, each of which represents partic-
chical systems makes the situation worse. Opposing to the ular coarseness of the signal. Among the various wavelet
intensive computation in MLP, radial basis-function net- bases, the Haar wavelet is the shortest and simplest basis
works (RBFNs) have been attracting a great deal of inter- and it provides satisfactory localization of signal character-
ests because of their rapid training, generality, and istics in time domain; hence it is ideal for short time signals
simplicity characteristics (Al-Fahoum and Howitt, 1999). analysis (Scholl et al., 1999). Therefore, the Haar wavelet
Among the various paradigms of RBFNs, the probabilistic was chosen as the mother wavelet in this study.
neural networks (PNNs) inherit many of these characteris- The procedure of a two-level wavelet decomposition of a
tics and are particularly suitable for classification tasks signal x(n) is illustrated in Fig. 1 (Güler and Übeyli, 2005a).
(Wasserman, 1992; Al-Fahoum and Howitt, 1999). There- The decomposed signal is obtained by convoluting the
fore, we choose PNN in this study. input signal with specially designed filters and downsam-
In this paper, we propose a method to discriminate six pling the filtered signal. As shown in Fig. 1, a high-pass fil-
types of ECG beats. Two-level discrete wavelet decomposi- ter g(Æ) and a low-pass filter h(Æ) are employed in the
tion is applied to divide the original QRS complex signals decomposition process. The symbol #2 represents down-
into signals in different subbands. Three categories of fea- sampling the filtered signal by two. The detail D1 and the
tures are extracted from the signal in each subband. For approximation A1 represent the downsampled signal of
some heart diseases, the interval between two successive the first level decomposition using the high-pass and the
beats, called the RR interval, provides useful information low-pass filters, respectively. Following the first level of
for clinical diagnosis. Thus, the instantaneous RR interval decomposition, the approximation A1 is further decom-
is considered as another important feature for ECG dis- posed in the second level using the same filters. This pro-
crimination. Include the AC power of the original signal, cess can continue. Interested readers should refer to
resulting in totally 11 features for an ECG beat. A PNN related literature for more details (Güler and Übeyli,
is then employed to perform the classification task. The 2005a). Considering the short length of the QRS segments
experimental results demonstrate the effectiveness and effi- (64 points/segment) used in this study, we empirically
ciency of the proposed method. The roles of the instanta- determined to use only two-level discrete wavelet decompo-
neous RR interval and the training data size in ECG sition (DWT), which was later proved to achieve satisfac-
beat recognition are investigated. tory results.

2. Proposed method
2.2. Feature extraction
In this section, the discrete wavelet transformation, the
proposed wavelet-based feature extraction, feature normal- The two-level discrete wavelet decomposition produces
ization, and the probabilistic neural classifier are described signal components in different subbands. Several features
separately. are important in characterizing these signals. First of all,
signal variances in a subband represent the averaged AC
2.1. Discrete wavelet transformation (DWT) power in that band. With a discrete-time signal x of N sam-
ples, the sample variance is defined as
The discrete wavelet transformation has been widely
1 XN
2
used in signal processing tasks in recent years. The major r2x ¼ ½xðnÞ  x ð1Þ
advantage of the DWT is that it provides good time reso- N n¼1
1144 S.-N. Yu, Y.-H. Chen / Pattern Recognition Letters 28 (2007) 1142–1150

where x is the sample mean of the signal. We use the vari- 2.3. Normalization of feature vectors
ance of the decomposed signal in each subband as the first
feature set in our method. Because the quantities of the features may be quite dif-
The autocorrelation function is considered as a measure ferent, a normalization process is necessary to standardize
of similarity or coherence between a signal x(n) and its all the features to the same level. The formula of the nor-
shifted version. If x(n) is of length N, the autocorrelation malization is defined as follows:
function is expressed as  
xij  xj
x0ij ¼ tansig ð4Þ
X
N jkj1 rxj
Rxx ðlÞ ¼ xðnÞxðn  lÞ ð2Þ
n¼i where xij is the jth component of the ith feature vector, xj
and rxj are the mean and standard deviation, respectively,
where l is the time shift index, i = l, k = 0 for l P 0, and of the jth component of the feature vectors, and tansig(Æ) is
i = 0, k = l for l < 0. The variance of the autocorrelation a hyperbolic tangent sigmoid transfer function. The expres-
calculated as the averaged AC power of the autocorrelation sion in the brackets makes the jth component to be normal
function, which measures the coherence of the signal in distributed with zero-mean and unity standard deviation.
each subband (Goumas et al., 2002). Thus, we use it as The hyperbolic tangent sigmoid function maps a wide-ran-
the second feature for subband signals. ged signal to that with limited range [1, +1]. In our exper-
The relative amplitude of the decomposed signal x(n) in iment, the mean and the standard deviation of each
each subband is defined as component in the feature vectors are calculated from the
training dataset and are used throughout the experiments.
minðxðnÞÞ= maxðxðnÞÞ ð3Þ

which represents the morphological characteristics of the 2.4. Classification using the probabilistic neural network
signal and is regarded as the third feature for subband
signals. Probabilistic neural network (PNN) is a special type of
Certain ECG arrhythmias, such as APB and PVC, are radial basis-function networks (Wasserman, 1992). The
related with premature heart beats that provide shorter structure of the PNN classifier is illustrated in Fig. 2. It
RR intervals than other types of ECG signals. Changes consists of an input layer, a hidden layer, and an output
in the RR intervals play an important role in characterizing layer. The input layer is merely a distribution layer. No
these types of arrhythmias. Hence, we exploit the instanta- computation is performed in this layer. The hidden layer
neous RR interval as another feature component, which is is also called the pattern layer. Neurons in the hidden layer
defined as the time elapse between the current and previous utilize multi-dimensional kernels to estimate the probabil-
R peaks. ity density function for classification. One of the most pop-
In order to test the effect of instantaneous RR interval, ular kernels is Gaussian function since it guarantees the
two feature sets are designed in this study. Feature set one, convergence of the neural network (Rutkowski, 2004).
FS1, consists of the following statistical features: The output layer is a competition layer. The number of
neurons in the competition layer is the same as that of
1. AC power of the original signal, i.e. variance of the ori- the desired classes, i.e. six neurons in the competition layer
ginal QRS complex signal. in our experiments.
2. AC power of the wavelet coefficients in each subband.
3. AC power of the autocorrelation function of the wavelet
coefficients in each subband.
4. Ratio of the minimum to the maximum of the wavelet
coefficients in each subband.

Feature set two, FS2, contains all the features in FS1


and the instantaneous RR interval. Among these features,
features 1 and 2 represent the powers in the original and
different subbands of the signal, feature 3 represents the
coherence of the signal in each subband, and feature 4 rep-
resents the morphological characteristic of each subband.
With two-level Haar wavelet decomposition performed in
this study, one approximation and two detailed signal com-
ponents result for each QRS complex. Therefore, feature
set one, FS1, for each QRS complex contains 10 features.
Feature set two, FS2, which also includes the instantaneous
RR interval, has 11 features. Fig. 2. Probabilistic neural network for pattern classification.
S.-N. Yu, Y.-H. Chen / Pattern Recognition Letters 28 (2007) 1142–1150 1145

3. Experiment design might affect the efficiency of the classification system are
the smoothing factor, which is the standard deviation of
In this study, 23 ECG records were selected from the the Gaussian kernel, and the training data size. The origi-
MIT-BIH arrhythmia database for analysis and recogni- nal data set was evenly divided into training and testing
tion. These records contain six ECG beat types, including groups. Experiments were performed to test the effect of
the normal beat (N), the left bundle branch block beat the smoothing parameter. Furthermore, to test the effects
(LBBB), the right bundle branch block beat (RBBB), the of the training data size to the result, the training data
atrial premature beat (APB), the premature ventricular con- set was halved in each iteration and the effect was studied.
traction (PVC), and the paced beat (PB). For the purpose of The performance of the PNN classifier is determined by
conformity, signals recorded with ML (Mason–Likar leads the following seven statistical parameters:
system) II were employed in the present experiment. The
originality of the ECG beats is summarized in Table 1. (1) Specificity: number of correct classified normal beats
Since the QRS complex is one of the most important over total number of normal beats.
ECG components, in the sense that it is associated with (2) Sensitivity (LBBB): number of correct classified left
electrical ventricular activation, we segmented the QRS bundle branch block beats over total number of left
complexes from the ECG data files. Based on the R-peak bundle branch block beats.
position identified in the annotation file provided by the (3) Sensitivity (RBBB): number of correct classified right
MIT/BIH database (Goldberger et al., 2000; Physiobank, bundle branch block beats over total number of right
2003), 64-point QRS segments centered at R-peaks were bundle branch block beats.
extracted from the record. Because the R-peaks were man- (4) Sensitivity (PVC): number of correct classified pre-
ually annotated, a preprocessor was developed to adjust mature ventricular contraction beats over total num-
the ECG signal to place the position of R-peak precisely ber of premature ventricular contraction beats.
centered in the window. The DC value of each 64-points (5) Sensitivity (APB): number of correct classified atrial
QRS segment was removed. premature beats over total number of atrial prema-
Considering the short lengths of the QRS segments, we ture beats.
empirically determined to use only two-level discrete wave- (6) Sensitivity (PB): number of correct classified paced
let decomposition (DWT), which was later proved to beats over total number of paced beats.
achieve satisfactory results. The two-level DWT decom- (7) Overall classification accuracy: number of correct
poses each QRS signal into three sets of wavelet coeffi- classified beats over number of total beats.
cients, D1, D2, and A2, as illustrated in Fig. 1. The
corresponding features for the original QRS signal and Two other performance indices for the classification sys-
the decomposed wavelet coefficients were then calculated. tem are false positive and false negative. False negative is
Two feature sets were studied in this paper. Feature set 1 defined as the misclassification of the desired data to other
(FS1) contains the 10 features described in Section 2.2. categories, which is also called target missing. False posi-
Feature set 2 (FS2) contains the 10 features of FS1 and tive is defined as the misclassification of the classified data
the instantaneous RR interval, resulting in totally 11 that does not belong to this class, which is also called false
features. These arrangements intend to study the role of alarm. A good classification system should have both low-
RR interval in ECG beat classification. ered false negative and false positive.
In our experiments, we used the probabilistic neural net-
work (PNN) as the pattern classifier. Two factors that
4. Experimental results

The classification results using FS1 and FS2 are summa-


Table 1
Originalities and numbers of ECG samples used in the study rized in Tables 2 and 3, respectively. The diagonal elements
in each table are the number of correctly classified beats of
Type MIT/BIH file Training (#/file) Testing (#/file)
specific ECG types using the proposed method. In the clin-
N 103, 113, 115, 123, 220, 234 600 600
ical diagnosis based on ECG, premature ventricular con-
LBBB 109, 111, 207, 214 600 600
RBBB 118, 124, 212, 231 600 600 traction (PVC) and atrial premature beats (APB) have
PVC 119 200 200 higher risk of sudden death than the other pathological
221 150 150 types considered in our experiments (Charbonnier, 1996;
200, 233 400 400 Minami et al., 1999; Addison et al., 2000; Zhou, 2003).
APB 209 150 150 Therefore, it is important to minimize the possible lose
222 100 100 (false negative) in recognizing these beat types. In Table
232 600 600 2, FS1 provides generally well recognition power through-
PB 107, 217 600 600 out all categories. However, slightly higher false negative
rates were observed in LBBB, PVC and APB. Twelve
Total 11 600 11 600 LBBB beats and 10 RBBB beats were misclassified as high
1146 S.-N. Yu, Y.-H. Chen / Pattern Recognition Letters 28 (2007) 1142–1150

Table 2 Comparing the recognition rates of PNN classifier using


Classification results using feature set 1 (FS1) the two different feature sets in Tables 2 and 3, both of
Output/ N LBBB RBBB PVC APB PB them demonstrate imposing results. However, FS2 contrib-
desired utes to slightly higher overall classification accuracy. The
N 3595 0 0 1 5 0 discrimination power of the method on PVC and APB
LBBB 1 2377 4 19 1 0 using FS2 outperforms that using FS1 at about 1.4% and
RBBB 1 11 2386 6 4 0
PVC 0 10 4 1123 0 0
0.9%, respectively, which is revealed as the increases in clas-
APB 3 2 6 1 840 0 sifier sensitivity.
PB 0 0 0 0 0 1200 To examine more precisely the effect of RR interval in
Recognition 99.86 99.04 99.42 97.65 98.82 100.00 ECG beat classification, the misclassification numbers rep-
rate (%) resented as false negative and false positive are illustrated
Overall classification accuracy using FS1 = 99.32%. in Fig. 3a and b, respectively. In both figures, the false neg-
ative and false positive rates are both zero in the PB cate-
gory, no matter whether FS1 or FS2 was used. The paced
beats (PBs) are triggered by the artificial pacemaker, which
makes the PBs quite different from the beats in other cate-
Table 3
Classification results using feature set 2 (FS2) gories. Both of the two wavelet-based feature sets in this
study were proven effective in classifying the PBs. In
Output/ N LBBB RBBB PVC APB PB
desired Fig. 3a, the other five categories demonstrate relatively
lowered false negative by using FS2 than FS1. The
N 3599 0 0 1 0 0
LBBB 1 2384 5 9 0 0 decreases in the false negative for these categories using
RBBB 0 9 2389 1 2 0 FS2 are large: 80% for N, 59.26% for PVC, and 80% for
PVC 0 6 3 1139 0 0 APB. It is especially important to note that more than
APB 0 1 3 0 848 0 50% improvements in the false negative rates have achieved
PB 0 0 0 0 0 1200
in the N, PVC, or APB categories, which confirms the clin-
Recognition 99.97 99.33 99.54 99.04 99.76 100.00 ical importance of the RR intervals in these beat types.
rate (%) Fig. 3b demonstrates the effect of the false positive of the
Overall classification accuracy using FS2 = 99.65%. classifier using FS1 and FS2. Similar to the false negative
index, FS2 outperforms FS1 in reducing the false positives.
The decreases in the false positive rates for the other five
risk beats. Twenty-six PVC beats and 10 APB beats were categories using FS2 are large: 83.33% for N, 40% for
misclassified as LBBB, RBBB, or normal sinus beats. LBBB, 45.45% for RBBB, 35.71% for PVC, and 66.67%
Table 3 summarizes the classification results using FS2 for APB. Again, more than 50% decrease in the false posi-
which includes FS1 and the instantaneous RR interval. tive rate is achieved in categories N and APB.
Instantaneous RR intervals obtained from premature The smoothing factor of the Gaussian kernel function is
beats, such as PVC and APB, are relative shorter than that a control parameter of the probabilistic neural network. To
of other types of ECG beat types. Using FS2 as the features study the effect of the smoothing factor to the performance
for classification, the number of beats misclassified as high of the PNN classifier, a series of experiments were con-
risk for groups LBBB and RBBB decreased from 12 to 7 ducted and the results are summarized in Table 4. The
and 10 to 6, respectively. Similarly, the number of beats results show that when the smoothing factor increases,
misclassified as low risk beats for groups PVC and APB the specificity, sensitivities, and the overall classification
also decreases from 26 to 11 and 10 to 2, respectively. It accuracy decrease. Although the classification accuracy
is obvious that FS2 substantially improve the effectiveness decreases with the increasing of the smoothing factor, the
of the classifier. specificity and sensitivities of all categories are higher than

30 30
FS1 FS1
Misclassified Beats

Misclassified Beats

25 25
FS2 FS2
20 20
15 15
10 10
5 5
0 0
N LBBB RBBB PVC APB PB N LBBB RBBB PVC APB PB
Category Classification

Fig. 3. Effects of instantaneous RR interval on the classifier, where FS2 = {FS1, RR}. (a) Number of misclassified beats in each desired category (false
negative). (b) Number of misclassified beats in each classified category (false positive).
S.-N. Yu, Y.-H. Chen / Pattern Recognition Letters 28 (2007) 1142–1150 1147

Table 4
Effects of different smoothing factors in the probabilistic neural network
Smoothing factor Training data size Feature set Specificity (%) Sensitivity (%) Classification accuracy (%)
LBBB RBBB PVC APB PB
0.10 11 600 FS1 99.86 99.04 99.42 97.65 98.82 100.00 99.32
0.20 11 600 FS1 99.69 99.33 99.21 97.39 98.24 100.00 99.22
0.30 11 600 FS1 99.53 99.25 98.92 96.17 96.24 100.00 98.82
0.40 11 600 FS1 99.44 99.21 97.79 94.70 87.53 100.00 97.77
0.50 11 600 FS1 99.44 99.17 95.83 91.04 82.71 100.00 96.64
0.60 11 600 FS1 99.47 99.08 91.92 83.74 81.76 99.75 95.00
0.70 11 600 FS1 99.44 98.96 86.25 81.13 80.00 99.75 93.41
0.80 11 600 FS1 99.58 98.71 79.46 80.52 77.76 99.75 91.78
0.90 11 600 FS1 99.61 98.42 73.25 79.48 76.94 99.75 90.28
1.00 11 600 FS1 99.69 97.79 66.96 77.39 75.29 99.75 88.54

0.10 11 600 FS2 99.97 99.33 99.54 99.04 99.76 100.00 99.65
0.20 11 600 FS2 99.92 99.38 99.58 99.13 99.41 100.00 99.63
0.30 11 600 FS2 99.78 99.38 99.58 98.35 97.65 100.00 99.38
0.40 11 600 FS2 99.53 99.12 99.13 97.83 94.59 100.00 98.89
0.50 11 600 FS2 99.44 99.08 97.96 97.39 90.00 100.00 98.22
0.60 11 600 FS2 99.53 98.88 94.50 96.43 83.29 99.83 96.90
0.70 11 600 FS2 99.58 98.88 88.50 95.57 80.24 99.83 95.36
0.80 11 600 FS2 99.69 98.71 81.46 91.39 79.76 99.75 93.45
0.90 11 600 FS2 99.75 98.46 75.83 83.22 80.24 99.75 91.47
1.00 11 600 FS2 99.83 98.25 70.79 81.30 79.06 99.75 90.14

90% when the smoothing factor is chosen in the range from This process continued until the size of the training set
0.1 to 0.3 for FS1 and in the range from 0.1 to 0.5 for FS2. reached 1/32 of the original training data size. The result
It is obvious that classification accuracy is relatively insen- shows that the performance of the PNN classifier only
sitive to the smoothing factor, which confirms with the slightly degraded with the decrease of training data size.
result of Wasserman (1992). Moreover, the specificity of Even with the smallest data size, i.e. 360 training data,
the normal beats is more insensitive than the sensitivities degradations of the specificity and the sensitivities of the
of the other abnormal beats. One possible reason is that LBBB, APB, and PB for both of the two feature sets are
the number of the employed normal beats is much larger less than 1%. The most serious degradation due to the
than that of the other categories. To justify this assump- decrease in training data size occurs in PVC with FS1:
tion, we studied the influence of the training data size for about 4% decrease in sensitivity results when the data size
the PNN classifier in the following experiments with differ- decreases to 1/32. Nevertheless, when substituting FS1 with
ent training data size. FS2, the degradation due to decrease in training data size
Table 5 summarizes the classification results of different becomes less significant: only 2.87% degradation results
training data size. The smoothing factor was set at 0.1 and in the PVC category.
the training data size was halved by evenly selecting the It is obvious that the specificity is less sensitive to the
training signals from the training set in the previous test. decrease in training data size than the sensitivities of the

Table 5
Effects of different training data size: smoothing factor = 0.10
Training data size Feature set Specificity (%) Sensitivity (%) Classification accuracy (%)
LBBB RBBB PVC APB PB
11 600 FS1 99.86 99.04 99.42 97.65 98.82 100.00 99.32
5800 FS1 99.81 98.79 99.33 97.74 98.47 100.00 99.22
2900 FS1 99.67 98.63 98.92 97.30 98.71 100.00 99.03
1450 FS1 99.67 98.42 98.33 95.22 98.35 100.00 98.63
725 FS1 99.58 98.46 98.21 94.17 98.47 99.83 98.48
362 FS1 99.53 98.71 97.50 93.57 98.24 99.83 98.29

11600 FS2 99.97 99.33 99.54 99.04 99.76 100.00 99.65


5800 FS2 99.89 99.00 99.58 98.78 99.53 100.00 99.52
2900 FS2 99.92 98.96 99.42 98.70 99.41 100.00 99.47
1450 FS2 99.94 98.88 99.08 97.74 99.29 100.00 99.28
725 FS2 99.69 98.58 99.08 97.04 99.29 99.83 99.07
362 FS2 99.47 98.92 98.58 96.17 99.06 99.83 98.86
1148 S.-N. Yu, Y.-H. Chen / Pattern Recognition Letters 28 (2007) 1142–1150

abnormal beats. Using FS2, instead of FS1, not only raises 20 dB, i.e. noise with 10% of signal amplitude. Equally well
the accuracy and sensitivities of the classifier but also recognition rates were observed throughout all types of
increases the robustness of the system. Comparing to the ECG beats. With SNR lower than 20 dB, more significant
smoothing factor, decrease in the training data size shows decreases in accuracy were observed. However, even at
less influence to the PNN classifier. In summary, the pro- 10 dB in SNR, i.e. noise with 31.62% of signal amplitude,
posed wavelet-based features and PNN classifier make an a recognition accuracy of higher than 90% still remains.
effective and robust ECG beat classification system. The The accuracy represented as (mean±s.d.)% also reveals
instantaneous RR interval further improves the robustness the influence of random noises on the uncertainty of the
of the system. PNN classifier. Higher level of noise introduces slightly
higher uncertainty to the classifier. However, this uncer-
5. Discussions tainty is minor, e.g. only 0.24% s.d. results at 10 dB. The
results demonstrate the high noise-resistant capacity and
With all the advantages of the proposed method, the robustness of the proposed method.
there are some important issues we want to explore in
more depth, including the effect of noises on the classifier,
the comparison of the PNN classifier to the most popular 5.2. Comparison of PNN with feed-forward backpropagation
neural network classifier, and the comparison of the neural network
proposed method to the other methods published in the
literature. The feed-forward backpropagation neural network
(FFBNN) is a well-known neural network which is consid-
ered a powerful nonlinear classifier capable of representing
5.1. Effects of noise on classification complex nonlinear functions (Haykin, 1999). In order to
compare the performance of PNN to other neural net-
It is important to consider the effects of noise on classi- works, we designated to adopt a typical three-layer
fication. The degree of noise was represented as signal-to- FFBNN. The hyperbolic tangent sigmoid function was
noise ratio (SNR) which is defined as used as the activation function and the weights between lay-
 2
r ers were modified by backpropagating the error signals
SNR ¼ 10 log s2 ð5Þ (computed by the output neurons), layer by layer, with
re
the quasi-Newton Broyden–Fletcher–Goldfarb–Shanno
where r2s and r2e are the power of the signal and noise, (BFGS) algorithm (Haykin, 1999).
respectively. In this study, different levels of Gaussian noise The optimal number of neurons in the hidden layer was
ranging from 40 dB to 10 dB in SNR, corresponding to determined by varying the number of neurons in the hidden
noises with 1–31.62% of the signal amplitude, were added layer and comparing the performances. Since the result can
to each segment. Because of the random nature of the be affected by initial weights in the network, we repeated
noises, each experiment was repeated for 10 times and each experiment for 10 times and the results were averaged.
the average accuracy was calculated. Table 6 summarizes The result is depicted in Fig. 4. The averaged accuracy
the results. To make the display clear and lucid, only aver- increases sharply at small numbers of neurons in the hid-
aged specificities and sensitivities were shown. Also in- den layer and saturates with increasing number of neurons
cluded in the table are the classification accuracies in that layer. On the contrary, the standard deviation (s.d.)
depicted in mean and standard deviation. of the accuracies decreased with the number of hidden neu-
The results reflect the high noise-resistant power of our rons, which implies that FFBNN with larger number of
method. Impressively high average accuracies of higher hidden neurons tends to be less sensitive on initial weights.
than 98% could be achieved even with SNR down to In view of the tendency in Fig. 4 and the smaller s.d., we

Table 6
Effects of noises on the discrimination of ECG beat types
Specificity (%) Sensitivity (%) Accuracy (mean± s.d.)%
LBBB RBBB PVC APB PB
Original 99.97 99.33 99.54 99.04 99.76 100.00 99.65
Contaminated ECG signals
40 dB 99.98 99.32 99.55 99.12 99.78 99.92 99.65 ± 0.02
35 dB 99.97 99.27 99.62 99.14 99.76 99.92 99.65 ± 0.03
30 dB 99.96 99.24 99.56 98.92 99.71 99.90 99.61 ± 0.03
25 dB 99.81 98.98 99.14 98.46 99.28 99.90 99.34 ± 0.05
20 dB 98.94 98.15 97.19 97.41 98.11 99.77 98.30 ± 0.11
15 dB 96.49 96.53 92.07 96.43 94.79 98.50 95.67 ± 0.23
10 dB 92.87 94.25 82.31 94.24 90.27 91.67 90.80 ± 0.24
S.-N. Yu, Y.-H. Chen / Pattern Recognition Letters 28 (2007) 1142–1150 1149

100

99.5

99
Average Classification Rate (%)

98.5

98

97.5

97

96.5

96
10 20 30 40 50 60 70 80 90 100
Number of Neurons in the Hidden Layer

Fig. 4. Effect of number of neurons in the hidden layer on classification accuracy with feed-forward backpropagation neural network, repeated for 10
times and the accuracies are illustrated as (mean ± s.d.)%.

chose an FFBNN with 60 neurons in the hidden layer to Table 7


compare with PNN. Comparative results of using PNN and FFBNN classifiers
The number of training cycles was limited at 100 epochs, Statistical parameters PNN FFBNN
which was empirically determined to limit the training pro- FS1 FS2 FS1 FS2
cess in a reasonable period of time while keeping the root-
Specificity 99.86 99.97 99.69 99.83
mean-square errors in the output less than 102. Table 7 Sensitivity (LBBB) 99.04 99.33 99.29 99.08
compares the accuracies by using these two neural network Sensitivity (RBBB) 99.42 99.54 98.72 99.23
classifiers, associated with the two feature vectors FS1 and Sensitivity (PVC) 97.65 99.04 95.31 98.12
FS2. The result reveals that PNN outperforms FFBNN in Sensitivity (APB) 98.82 99.76 96.15 98.99
Sensitivity (PB) 100.00 100.00 99.82 99.83
classifying most beat types, resulting in 0.41% and 0.33%
superior in overall classification accuracy with FS1 and Overall classification accuracy 99.32 99.65 98.73 99.32
FS2, respectively. It is especially important to note that
the sensitivities of PVC and APB based on FS2 using
FFBNN classifier are below 99%, while high values with Table 8
Comparative results of different ECG beat classification methods
PNN still remains. This observation depicts the superior
discrimination power of PNN when compared to FFBNN. Method Number of beat types Accuracy (%)
Proposed 6 99.65
FHyb-HOSA 7 96.06
5.3. Comparison of the proposed method to other ECG beat MME 5 97.78
classification systems Neuro-fuzzy 4 98.00
SOM-SVD 4 92.2
It is interesting to compare our method with other ECG MLP-LVQ 2 96.8
MLP-Fourier 3 98
beat recognition systems presented in the literature. Some
representative ECG beat recognition systems are chosen
for this comparison: ECG recognition using fuzzy hybrid
neural network (FHyb-HOSA) (Osowski and Linh, compares the accuracy of these systems. Since different
2001), a modified mixture of experts network structure numbers of beat types were exploited in different systems,
for ECG beats classification with diverse features (MME) the averaged classification accuracy was calculated for
(Güler and Übeyli, 2005a), ECG beat classification using comparison. The result shows that our proposed method
neuro-fuzzy network (Neuro-Fuzzy) (Engin, 2004), expert provides relatively higher classification accuracy than the
system using Kohonen and SVD (SOM-SVD) (Hu et al., other systems. However, please note that, although the
1997), ECG beat classification using LVQ and autoregres- same MIT-BIH database was utilized to testify the perfor-
sion AR MLP (MLP-LVQ) (Oien et al., 1996), and Fourier mance of these systems, different numbers of beat types
and MLP (MLP-Fourier) (Minami et al., 1999). Table 8 belonging to different patient records were selected to
1150 S.-N. Yu, Y.-H. Chen / Pattern Recognition Letters 28 (2007) 1142–1150

conduct the experiments. Therefore, it is difficult to com- Charllis, R.E., Kittney, R.I., 1990. Biomedical signal processing (in four
pare the result fairly. Only the averaged accuracy and the parts). Part 1: time domain methods. Med. Biog. Eng. Comput. (28),
509–524.
overall performance of the systems are justified. De Chazal, P., Reilly, R.B., 2003. Automatic classification of ECG beats
using waveform shape and heart beat interval features. In: Proceedings
6. Conclusion of the IEEE International Conference on Acoustic, Speech and Signal
Processing (ICASSP’03), Hong Kong, China, (2), pp. 269–272.
In this study, we proposed an ECG classification scheme Engin, M., 2004. ECG beat classification using neuro-fuzzy network.
Pattern Recognition Lett. (25), 1715–1722.
based on wavelet transform and PNN classifier. The QRS Goldberger, A.L., Amaral, L.A.N., Glass, L., Hausdorff, J.M., Ivanov,
complexes were first decomposed into subband compo- P.Ch., Mark, R.G., Mietus, J.E., Moddy, G.B., Peng, C.K., Stanley,
nents with two levels of DWT. Three categories of features H.E., 2000. PhysioBank, PhysioToolkit, and PhysioNet: components
corresponding to the energy, the coherence, and the mor- of a new research resource for complex physiologic signals. Circulation
phological characteristics were first extracted from the (101), e215–e220.
Goumas, S.K., Zervakis, M.E., Stavrakakis, G.S., 2002. Classification of
decomposed waveforms. A PNN classifier was then washing machines vibration signals using discrete wavelet analysis for
employed to discriminate six types of ECG beats. The feature extraction. IEEE Trans. Instrum. Measure. (51), 497–508.
results show a promising accuracy of 99.65%, with equally _ Übeyli, E.D., 2005a. A modified mixture of experts network
Güler, I.,
outstanding discrimination power of over 99% throughout structure for ECG beats classification with diverse features. Eng. Appl.
all types of ECG beats under study. The number of fea- Artificial Intell. (18), 845–856.
_ Übeyli, E.D., 2005b. ECG beat classifier designed by combined
Güler, I.,
tures need to attain this high accuracy is only 11, which neural network model. Pattern Recognit. (38), 199–208.
is substantially lower than that in the other methods. The Haykin, S., 1999. Neural Networks: A Comprehensive Foundation,
influences of training data size and added noise to the second ed. Prentice Hall, pp. 156–255.
PNN classifier are minor. From the results, we conclude Hu, Y.H., Palreddy, S., Tompkins, W., 1997. A patient adaptable ECG
that different pathological changes in ECG beats can be beat classifier using a mixture of experts approach. IEEE Trans.
Biomed. Eng. (44), 891–900.
faithfully represents by the three categories of features Minami, K., Nakajima, H., Toyoshima, T., 1999. Real-time discrimina-
extracted from the decomposed waveforms. The instanta- tion of ventricular tachyarrhythmia with Fourier-transform neural
neous RR interval plays an important role to further fur- network. IEEE Trans. Biomed. Eng. (46), 179–185.
nish the capability of the system, especially in the Moraes, J.C.T.B., Seixas, M.O., Vilani, F.N., Costa, E.V., 2002. A real
discrimination of high risk heart diseases such as PVCs time QRS complex classification method using Mahalanobis distance.
Comput. Cardiol., 201–204.
and APBs. This study proves that the proposed method Oien, G.E., Bertelsen, N.A., Eftestol, T., Husoy, J.H., 1996. ECG rhythm
is an excellent model for the computer-aided diagnosis of classification using artificial neural networks. In: IEEE Digital Signal
heart diseases based on ECG signals. Processing Workshop, pp. 514–517.
Osowski, S., Linh, T.H., 2001. ECG beat recognition using fuzzy hybrid
Acknowledgement neural network. IEEE Trans. Biomed. Eng. (48), 1265–1271.
Physiobank Archieve Index, MIT-BIH Arrhythmia Database. <http://
www.physionet.org/physiobank/database> (Access time: 10.12.2003).
This study was supported in part by the grant NSC94- Prasad, G.K., Sahambi, J.S., 2003. Classification of ECG arrhythmias
2213-E-194-049 from the National Science Council, using multi-resolution analysis and neural networks. In: IEEE Con-
Taiwan. ference on Convergent Technologies, Bangalore, India, vol. 1, pp. 227–
231.
Rutkowski, L., 2004. Adaptive probabilistic neural networks for pattern
References classification in time-varying environment. IEEE Trans. Neural
Networks (15), 811–827.
Addison, P.S., Watson, J.N., Clegg, G.R., Holzer, M., Sterz, F., Scholl, J.F., Agre, J.R., Clare, L.P., Gill, M.C., 1999. A low power
Robertson, C.E., 2000. Evaluating arrhythmias in ECG signals using impulse signal classifier using the Haar wavelet transform. Proc. SPIE
wavelet transforms. IEEE Eng. Med. Biol. (19), 104–109. Sensors (3577), 136–145.
Al-Fahoum, A.S., Howitt, I., 1999. Combined wavelet transformation and Wasserman, P.D., 1992. Advanced Methods in Neural Computing. VNR
radial basis neural networks for classifying life-threatening cardiac Press, pp. 35–55.
arrhythmias. Med. Biol. Eng. Comput. (37), 566–573. Zhou, J., 2003. Automatic detection of premature ventricular contraction
Charbonnier, F., 1996. External defibrillaors and emergency external using quantum neural networks. IEEE Symp. Bioinform. Bioeng.,
pacemakers. Proc. IEEE (84), 487–499. 169–173.