Interpretable temporal fusion network of multi- and multi-class arrhythmia classification

Clinical decision support systems (CDSSs) have been widely utilized to support the decisions made by cardiologists when detecting and classifying arrhythmia from electrocardiograms. However, forming a CDSS for the arrhythmia classification task is challenging due to the varying lengths of arrhythmias. Although the onset time of arrhythmia varies, previously developed methods have not considered such conditions. Thus, we propose a framework that consists of (i) local and global extraction and (ii) local-global information fusion with attention to enable arrhythmia detection and classification within a constrained input length. The framework's performance was evaluated in terms of 10-class and 4-class arrhythmia detection, focusing on identifying the onset and ending point of arrhythmia episodes and their duration using the MIT-BIH arrhythmia database (MITDB) and the MIT-BIH atrial fibrillation database (AFDB). Duration, episode, and Dice score performances resulted in overall F1-scores of 96.45%, 82.05%, and 96.31% on the MITDB and 97.57%, 98.31%, and 97.45% on the AFDB, respectively. The results demonstrated statistically superior performance compared to those of the benchmark models. To assess the generalization capability of the proposed method, an MITDB-trained model and MIT-BIH malignant ventricular arrhythmia database-trained model were tested AFDB and MITDB, respectively. Superior performance was attained compared with that of a state-of-the-art model. The proposed method effectively captures both local and global information and dynamics without significant information loss. Consequently, arrhythmias can be detected with greater accuracy, and their occurrence times can be precisely determined, enabling the clinical field to develop more accurate treatment plans based on the proposed method.