KAREEM, Murtadha Kamil Kareem (2021). Atrial fibrillation detection service for stroke prevention. Doctoral, Sheffield Hallam University. [Thesis]
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Kareem_2021_PhD_Atrial_Fibrillation_Detection_.pdf - Accepted Version
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Kareem_2021_PhD_Atrial_Fibrillation_Detection_.pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.
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Abstract
This study aims to develop a cost-effective atrial fibrillation detection service that
improves outcomes for patients. The service offers continuous Atrial Fibrillation (AF)
detection which might help to address the real-world problem of stroke prevention. AF is
the most common sustained heart rhythm disorder in adults. AF is either intermittent
(paroxysmal) or permanent. Both types increase the risk ischemic stroke around fivefold.
An accurate diagnosis of AF is mandatory for treatment initiation. AF treatment reduces
the stroke risk and for individual patients prevent stroke. Unfortunately, current AF
detection methods often fail to detect paroxysmal AF cases, because the observation
duration is too short. We propose to address this problem with real time monitoring and
artificial intelligence for AF detection. We developed two distinct deep learning models
to detect irregular heartbeats. For the first experiment, a Long Short-Term Memory
(LSTM) classifier was used to detect and differentiate AF beats and Normal beats. The
data were collected from MIT-BIH Atrial Fibrillation Database. This database
incorporates 10-hour Electrocardiogram (ECG) signals from 23 participants. The second
experiment was based on using a ResNet algorithm to detect common arrhythmias,
namely, AF, and Atrial Flutter (AFL), as well as Normal Sinus Rhythm (NSR). The
algorithm was trained with data from 4051 subject. The LSTM model achieved 98.51%
accuracy with 10-fold cross-validation (20 subjects) and 99.77% with blindfold validation
(3 subjects). Whilst, the ResNet model achieved, the following results: accuracy =
99.98%, sensitivity = 100.00%, and specificity = 99.94%. In addition, the LSTM model
was validated with five independents benchmark databases to establish the robustness and
maturity through more and more varied datasets. With the LSTM validation, we
established trust which enabled us to conduct a clinical trial study with Sheffield Teaching
Hospital. As part of this work, an AF detection service validation tool was built for hybrid
decision support where machine learning decisions are verified by a stroke consultant.
This detection method makes economic sense because Heart Rate (HR) signals are costeffective
to measure, transmit, and process. Having such a cost-effective solution might
lead to widespread long-term observation, which can help detecting arrhythmia earlier.
Detection improves the outcomes for patients and reduces healthcare cost.
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