Device agnostic AI-based analysis of ambulatory ECG recordings

Alan Kennedy, Peter Doggart, Stephen W. Smith, D Finlay, D Guldenring, RR Bond, Christopher McCausland, James McLaughlin

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Deep Convolutional Neural Networks (DCNNs) have been shown to provide improved performance over traditional heuristic algorithms for the detection of arrhythmias from ambulatory ECG recordings. However, these DCNNs have primarily been trained and tested on device-specific databases with standardized electrode positions and uniform sampling frequencies. This work explores the possibility of training a DCNN for Atrial Fibrillation (AF) detection on a database of single‑lead ECG rhythm strips extracted from resting 12‑lead ECGs. We then test the performance of the DCNN on recordings from ambulatory ECG devices with different recording leads and sampling frequencies.

We developed an extensive proprietary resting 12‑lead ECG dataset of 549,211 patients. This dataset was randomly split into a training set of 494,289 patients and a testing set of the remaining 54,922 patients. We trained a 34-layer convolutional DCNN to detect AF and other arrhythmias on this dataset. The DCNN was then validated on two Physionet databases commonly used to benchmark automated ECG algorithms (1) MIT-BIH Arrhythmia Database and (2) MIT-BIH Atrial Fibrillation Database. Validation was performed following the EC57 guidelines, with performance assessed by gross episode and duration sensitivity and positive predictive value (PPV). Finally, validation was also performed on a selection of rhythm strips from an ambulatory ECG patch that a committee of board-certified cardiologists annotated.

On MIT-BIH, The DCNN achieved a sensitivity of 100% and 84% PPV in detecting episodes of AF. and 100% sensitivity and 94% PPV in quantifying AF episode duration. On AFDB, The DCNN achieved a sensitivity of 94% and PPV of 98% in detecting episodes of AF, and 98% sensitivity and 100% PPV in quantifying AF episode duration. On the patch database, the DCNN demonstrated performance that was closely comparable to that of a cardiologist.

The results indicate that DCNN models can learn features that generalize between resting 12‑lead and ambulatory ECG recordings, allowing DCNNs to be device agnostic for detecting arrhythmias from single‑lead ECG recordings and enabling a range of clinical applications.
Original languageEnglish
Pages (from-to)154-157
Number of pages4
JournalJournal of Electrocardiology
Early online date16 Sept 2022
Publication statusPublished (in print/issue) - 22 Oct 2022

Bibliographical note

Funding Information:
Funding to present this research was provided by the European Union's INTERREG VA Programme , managed by the Special EU Programmes Body (SEUPB) , which is part of the Eastern Corridor Medical Engineering centre (ECME) .

Publisher Copyright:
© 2022

Copyright © 2022. Published by Elsevier Inc.


  • ECG
  • AI
  • deep learning
  • machine learning
  • Cardiology
  • Electrocardiogram
  • Deep learning
  • Atrial fibrillation


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