2018 IEEE Conference on Multimedia Information Processing and Retrieval

Personalizing a Generic ECG Heartbeat Classification for Arrhythmia Detection:

A Deep Learning Approach

Meng-Hsi Wu∗ , Emily J. Chang† , Tzu-Hsuan Chu∗

∗
HTC Research & Healthcare
{jake.mh wu, felix chu}@htc.com
†
Dynamical Biomarkers Group
emilyjchang30@gmail.com

Abstract methods to assist cardiologists in the diagnosis of cardiac

We propose an end-to-end model for generic and per-
sonalized ECG arrhythmic heartbeat detection on ECG
data from both wearable and non-wearable devices. We
first develop a deep learning based model to address the
challenging problem caused by inter-patient differences in
ECG signal patterns. This model achieves the state-of-
the-art performance for ECG heartbeat arrhythmia de-
tection on the commonly used benchmark dataset from
the MIT-BIH Arrhythmia Database. We then utilize our
model in an active learning process to perform patient-
adaptive heartbeat classification tasks on the non-wearable
ECG dataset from the MIT-BIH Arrhythmia Database and
the wearable ECG dataset from the DeepQ Arrhythmia
Database. Results show that our personalization model
requires a query of less than 5% of data from each new
patient, significantly improves the precision of disease
detection from the generic model on each new subject, and
reaches nearly 100% accuracy in normal and VEB beat
predictions on both databases.
Keywords-ECG; arrhythmia detection; DeepQ Arrhythmia
Database; precision medicine
I. Introduction
Inspection of an entire electrocardiogram (ECG) record-
ing to identify heart arrhythmias can be laborious for a
human expert. This is especially the case for a long-term
ECG recording, which is usually taken over a period of
24 hours. The confounding influences of an individual’s
underlying cardiac morphology and rhythm variabilities,
together with artifacts, conspire to make the analysis
difficult. It is thus desirable to develop computer-aided
arrhythmias [1]–[15].
Developing a computer algorithm to perform arrhythmia
detection is challenging for at least two reasons. First, the
inter-individual diversity in a given heartbeat class due
to physiological characteristics elevates the difficulty of
ECG analysis. Second, non-invasive mobile devices that
are equipped with ECG monitors have increasingly been
used to detect arrhythmias. A diagnosis algorithm must
therefore be able to deal with signals with substantial
noise due to body motion and environmental factors. In
particular, when a patient is taking part in physical activi-
ties, the diminished signal quality makes his/her heartbeats
even more difficult to analyze. It is also desirable for
an algorithm to be highly effective with a single-channel
input, which is often the case in wearable devices [16].
In this paper we propose an adaptive algorithm to tackle
the aforementioned challenges. We first use MIT-BIH
Arrhythmia dataset 1 (MIT-BIH-AR DS1) [17] to train
a generic classifier. Then given a new patient’s data, we
employ active learning [18] to select the most uncertainly
classified heartbeats, and present them to cardiologists
for labeling. With the newly labeled data, we adapt the
representation learned from the generic model to develop
a personalized model. Empirical studies on MIT-BIH-AR
DS2 and the DeepQ Arrhythmia (DeepQ) dataset [19]
demonstrate our proposed algorithm to be effective in
improving arrhythmia detection accuracy despite inter-
patient physiological variations.
II. Baseline Generic Classifier
This section presents our datasets, pre-processing steps,
model training, and the accuracy of our generic model.

0-7695-6354-6/18/$31.00 ©2018 IEEE 92

DOI 10.1109/MIPR.2018.00024
A. Datasets
We employ the MIT-BIH-AR database and DeepQ
database in this work to train and test the classifier as well
as for direct comparison with previously published results.
Table I presents key statistics of the datasets.
The MIT-BIH-AR database follows the Association
for the Advancement of Medical Instrumentation (AAMI)
recommendations [20], [21] for class labeling and is widely
referenced in literature. Beat-by-beat annotations were
verified by at least two independent experts. The database
contains 48 two-lead non-wearable ECG recordings from
47 different patients (recordings 202 and 203 were ob-
tained from the same patient). Each record was sampled
at 360 Hz for approximately 30 minutes.
The DeepQ database is a single-lead wearable ECG
database that contains 897 annotated ECG recordings from
299 unique patients. All ECG recordings were sampled at
250 Hz for about five minutes. Beat-by-beat annotations,
which also follow the AAMI recommendations, are first
manually labeled by a group of certified cardiographic
technicians and later audited by a cardiologist. Each
patient in the database was engaged in a sequence of
recumbent, sitting, and walking activities during the ECG
measurement and contributed three five-minute records
to the database. In this work, we used recumbent cases
from 22 patients to demonstrate the performance of our
personalization model. We plan to expand our solutions to
sitting and walking datasets in our future works.
B. Pre-processing and Segmentation
We follow the same signal filtering process as outlined
in all previous top-performing works [8]–[10] to pre-
process all ECG data and for direct performance com-
parison. The raw ECG signal first goes through a 200-
ms width median filter, followed by a 600-ms width
median filter to remove the ECG baseline. The result-
ing signal is subsequently filtered with a 12-order finite
impulse response (FIR) low-pass filter with a 35 Hz cut-
off frequency to remove power-line interference and high-
frequency artifacts.
As the focus of this work is to analyze the performance
of the heartbeat classifier, we utilize the heartbeat fiducial
points provided by the database for heartbeat detection.
Each fiducial point is marked at each local extrema of
the QRS complex (normally at the R-peak or S-peak) and
serves as the reference point for heartbeat segmentation.
From the MIT-BIH-AR database, with the sample rate of
360 Hz, an ECG beat segment is constructed by com-
prising the nearest 200 samples from the R-peak fiducial
point (about 0.6 seconds wide). The resulting heartbeat
segment is expected to include most, if not all, of the
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essential information in one heartbeat (i.e., the P-wave,
QRS-complex and T-wave). Additionally, a median heart-
beat is generated from the segmented heartbeats in each
associated recording. Segmentation of the heartbeats into
fixed interval lengths will not only provide generalization
ability but also avoid false detection of onsets and offsets
of P-waves and T-waves.
For the DeepQ database, we first resample the data to
360 Hz, and apply the same preprocessing and segmenta-
tion techniques to extract each heartbeat information out
from the data.
C. Inter-Heartbeat Intervals
Through the pre-processing and segmentation steps, we
also retrieve two inter-heartbeat intervals (RRIs) associ-
ated with each beat to be classified. An RRI is defined
as the time interval between two successive heartbeats’
fiducial points. RRIs are the most widely examined feature
in literature and clinical practice concerning arrhythmia
detection because irregularities between RRIs are common
indications of ectopic events in an ECG signal. The two
inter-beat intervals we retrieve are:
• Pre-RRI: The interval between the R-peaks of the
previous beat and the current beat, and
• Post-RRI: The interval between the R-peaks of the
current beat and the subsequent beat.
The average RRI of each given record is also calculated
for data normalization. The addition of the RRIs can help
the system model the temporal information influenced by
underlying physiological conditions.
D. Outlier Removal
We introduce a simple outlier removal scheme to MIT-
BIH-AR DS1 in the preprocessing stage to restrict the
training beats in a reasonable range. The filtering criteria is
described in Table II. Beats outside the ranges are consid-
ered outliers. To comply with realistic clinical situations,
we do not apply the outlier removal to MIT-BIH-AR DS2
and the DeepQ dataset.
E. Evaluation Strategy
We adopt the dataset division scheme depicted in Fig-
ure 1 for direct result comparison and coherence with ECG
recordings collected in more realistic situations.
Four paced beat recordings, namely records 102, 104,
107, and 217, are excluded from the analysis in accordance
with AAMI standards. We also discard the AAMI Q class
from this work since it is marginally represented in all
databases. The number of disease classes, N , is therefore
4: normal beat (N), supraventricular ectopic beat (SVEB
 Table I: Database summary
Database Dataset #Channels #Records Purpose N SVEB VEB F Q
MIT-BIH-AR DS1 2 22 Train 45809 940 3769 414 8
MIT-BIH-AR DS2 2 22 Test 44207 1836 3218 388 7
DeepQ - 1 22 Test 6852 454 663 − −
DS1: 101, 106, 108, 109, 112, 114, 115, 116, 118, 119, 122, 124, 201, 203, 205, 207, 208, 209, 215, 220, 223, 230.
DS2: 100, 103, 105, 111, 113, 117, 121, 123, 200, 202, 210, 212, 213, 214, 219, 221, 222, 228, 231, 232, 233, 234.
DeepQ: T 3042, T 3043, T 3044, T 3045, T 3049, T 3050, T 3052, T 3054, T 3056, T 3059, T 3063, T 3066, T 3068,
T 4007, T 4021, T 4024, T 5001, T 5006, T 5029, T 5047, T 5049, T 5057.

Table II: Heartbeat outlier removal criteria

cross-entropy loss function of each heartbeat input as
Lower Upper
Name
bound bound L(X, y; θ) = −log p (y | X ), (1)
Morphology amplitude (mV) −4 4
Inter-beat intervals (Sec) 0.2 4
where p(·) is the estimated class probability and θ is the
estimation of the network parameters.
To construct an end-to-end beat-by-beat classification
model, we stack multiple convolutional neural networks
or S), ventricular ectopic beat (VEB or V), and fusion beat and fully-connected (dense) networks. The high-level
(F). model architecture is illustrated in Figure 2.
Finally, we down-sample each filtered ECG signal to 50
samples and normalize each heartbeat against the channel
median beat of a recording. The RRIs are also normalized
against the average RRI of a recording. The normalized
signals and RRIs are then used as the input to our deep
neural network model.

F. Model Architecture and Training

The ECG arrhythmic heartbeat detection is a beat-

by-beat classification task which takes an input of a
set of per-beat feature vectors and inter-beat intervals
X = {[x1 , x2 , ...xK ], [r1 , r2 , ...rM ]}, and outputs a corre-
sponding disease class label y. Each y belongs to one of
the N different disease classes and each heartbeat can be
a single-channel or multi-channel input. We optimize the

Figure 2: Model architecture.

Prior to the convolutional phase, the 2×1 RRI input vec-

tor is first up-sampled by the network to a 50-dimensional
vector through a fully-connected (dense) layer and then
merged with the 50 × c signal input to form an output
of a 50 × (c + 1) matrix in which c is the number of
input channels. This output matrix is passed through two
convolutional blocks for feature extraction followed by two
densely connected blocks for classification. The final layer
produces estimated class probabilities for class labeling.
Each convolutional block contains a convolutional layer,
a non-linear activation layer, and a max-pooling layer.
The blocks are structured as follows: (1) Conv: feature
Figure 1: Classifier performance evaluation scheme.
maps=32, kernel=1 × 3, stride=1, (2) ReLU, (3) Max

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pool: stride=2. Each densely connected block consists of Table III: Beat-by-beat performance
a fully-connected layer, a non-linear activation layer, and (a) One-lead
a dropout layer. The first dense block is structured as
follows: (1) Dense: 64, (2) ReLU, (3) Dropout: 0.5. The Predicted
second dense block is structured as follows: (1) Dense: 16, N S V F Total
Se
(%)
(2) ReLU, (3) Dropout: 0.5. A softmax regression is used
N 41297 2358 116 436 44207 93
as the output layer to perform the multi-class classification. S 46 1779 11 0 1836 97

True
We train the network with the Adam optimizer, an initial V 17 79 2908 214 3218 90
learning rate of 0.0001, and a batch size of 128. Class F 86 4 8 290 388 75
weights are adjusted inversely proportional to the class Total 41446 4220 3043 940 49649 89
+P (%) 100 42 96 31 67 93
frequencies to account for the class imbalance in the input
data. We save the best model based on the leave-one-out (b) Two-lead
validation scheme depicted in Figure 1.
Predicted
Se
G. Classification Performance Measures N S V F Total
(%)
N 41599 2129 72 407 44207 94
Since 90% of the heartbeats are from the N class, a S 55 1769 12 0 1836 96

True
V 17 75 2848 278 3218 89
dummy classifier could always predict this dominant class F 21 1 5 361 388 93
and still get 90% accuracy all the time. For this reason, it is Total 41692 3974 2937 1046 49649 89
important to utilize other performance measures to evaluate +P (%) 100 45 97 35 67 94
the classifier performance. In compliance with the AAMI
recommendations, two performance measures, precision top-performing heartbeat classification results reported pre-
(positive predictive value, +P) and recall (sensitivity, Se), viously to serve as baselines for comparison. Table IV
are used to evaluate the classifier performance. These two shows that our proposed model achieves the state-of-the-
measures focus on assessing the ability of an algorithm to art performance and outperforms all previous methods that
discriminate VEB beats from non-VEB beats and SVEB used handcrafted features on the MIT-BIH-AR dataset.
beats from non-SVEB beats. Works in [8]–[11], [15], [22]
also employ this performance assessment. III. Model Personalization
H. Results This section details our method to achieve personalized
ECG arrhythmic heartbeat detection using standard and
Our method tops all nine metrics in the one-lead wearable databases.
analysis group and eight out of the nine metrics in the
two-lead analysis group by a large margin. Our sensitivity A. Approach
performance for F beats is a marginal 2% lower than the
state-of-the-art metric in the two-lead approach. It is also The advantage of deep learning is the ability to auto-
worth noting that our approach performs almost equally matically learn good feature representation from the input
well for one-lead and two-lead inputs. This had not been data [23]. In this context, we utilize our deep learning
achievable with previous methods. model to tackle the challenging problem created by the
The beat-by-beat confusion matrix table provides in- inter-patient ECG signal differences and to achieve two
sight into how the classifier performs on each beat type main objectives: (1) a good feature representation learner,
classification. Both one-lead and two-lead performances and (2) an active patient-adaptation learner to help its
are assessed and deemed unbiased as no records from human counterpart in cardiac disease detection. Given a
MIT-BIH-AR DS2 were used to generate the classifica- new patient’s ECG data, we first transform the data into a
tion models. Table III summarizes the overall beat-by- set of estimated class outputs using our pre-trained generic
beat performance for one-lead inputs and two-lead inputs. model. Through an interactive phase, we select a set of the
According to the beat-by-beat results, the loss of positive most ambiguously classified heartbeats and ask a human
predictivity for SVEB and F classes is mainly attributed expert to annotate their true classes. We then apply this
to the imbalanced dataset. newly labeled dataset to fine-tune and tailor our pre-trained
This work showcases the extraordinary feature extrac- model’s classifier section (dense blocks) to increase its
tion and discrimination ability of deep neural networks and generalization ability for the new patient.
demonstrates their effectiveness over the heuristic-based The main consideration in designing a systematic beat
and shallow architecture approaches. We include the four selection method is to increase the model’s disease dis-

95
 Table IV: Methods comparison
(a) One-lead performance

Method Acc N S V F
Se +P Se +P Se +P Se +P
(%)
(%) (%) (%) (%) (%) (%) (%) (%)
Proposed 93 93 100 97 42 90 96 75 31
de Chazal [11] 90 91 99 74 37 88 80 19 5

(b) Two-lead performance

Method Acc N S V F
Se +P Se +P Se +P Se +P
(%)
(%) (%) (%) (%) (%) (%) (%) (%)
Proposed 94 94 100 96 45 89 97 93 35
Zhang et al. [10] 86 89 99 79 36 85 93 94 14
Llamedo et al. [9] 78 78 99 76 41 83 88 95 4
de Chazal et al. [8] 83 87 99 75 39 80 81 89 9

crimination capability while minimizing the number fine-
tuning samples and amount of human-labeling effort. To
wisely reach this objective, we apply a confidence score
to each predicted heartbeat and select the least confident
samples to be labeled. Concretely, we measure the entropy
level of the estimated posterior probabilities associating a
given heartbeat to a given class. The entropy measure is
defined as follows:
n is used to derive best models. Algorithm 1 illustrates the

H=− pi log (pi ) ,
i=1
When there are no new samples to query or the maximum
number of queries is reached, we terminate our query
iteration and assume the classification task has reached a
conclusion. We use our two-lead generic classifiers to cre-
ate adapted models for patients in MIT-BIH-AR DS2. As
DeepQ is a single-channel dataset, we utilize our one-lead
generic classifiers to build the patient-adaptation model
with the DeepQ dataset. Two-fold cross-validation scheme
(2) main steps of our active learning approach.

where pi is the estimated probability for the heartbeat B. Results

being the ith class.
Ideally, a high entropy value indicates that the tested
heartbeat is classified with low confidence and suggests
possible misclassification. Low confidence heartbeats are
used to query a cardiologist for annotation. The choice
of each query is crucial. Since heartbeat classes are often
imbalanced within a given ECG signal, it would be ideal
to include at least one sample from each beat class in each
outward query to help improve our model’s classification.
Unfortunately, we are unable to know the true class label
for each heartbeat until we receive its annotation from
a cardiologist. Our approach is therefore to have a set
of k samples in each query, and consider the k/4 least
confident samples from each predicted class. In this way,
the annotated set will have a higher chance of including
a sample from each beat class, and help balance our
classification model.
The total time required for an expert to annotate 200
beats is about 10 minutes. In our work, we set k as 40
in each query and the maximum query number as 5. The
expected number of least confident samples queried per
beat class is therefore 10. We expect to query no more than
200 total samples, using at most 10 minutes of an expert’s
time for each new patient to achieve model personalization.
The results are presented based on two datasets.
1) MIT-BIH-AR DS2: For each record of MIT-BIH-AR
DS2, we record the total number of beats queried and the
performance of our approach. Table V shows the results
of our active learning scheme.
Overall, our approach queries less than 5% of ECG
data from each patient, further improves the prediction
result from the generic model, and resolves most of the
misclassified beats. This suggests that the features learned
by our generic model is robust and the adaption process
is productive.
It is observable that 20 of the 22 patients have their
heartbeat classification results considerably improved, with
the exceptions being patients 202 and 219. In patient 202,
the adaptive process misclassifies the single F class beat
in the record as a non-F beat. In patient 219, the learning
process misclassifies all seven SVEB beats as non-SVEB
beats. In these two cases, the misclassified F and SVEB
beats are all categorized as N class beats. We find that
although we try to select the 10 least confident samples
from each predicted class in each query during the patient-
adaptation and classifier fine-tuning process, the resulting
fine-tuned set is not always guaranteed to contain at least

96
one beat from each class. All of the least confident samples and VEB beats from the expert. Results from cases 202 and
that we queried in the 202 and 219 cases were labeled as N 219 support our initial theory that fine-tuning the classifier
without the necessary beat classes (e.g., new SVEB and F
beats in this case) may result in no improvement on the
Algorithm 1 Framework of classifier personalization classification performance.
Input: 2) DeepQ Dataset: We specifically include the DeepQ
S = {(xi , yi )}ni=1 : training set; dataset in the model personalization phase for testing and
T = {(xj }mj=1 : test set;
evaluating our model performance with data collected from
D: pre-trained model; the wearable ECG monitoring device.
Q: number of queries; The record-by-record evaluation presented in Table VI
k: number of beats to be labeled in each query; shows our model’s effectiveness in feature extraction and
N : heartbeat classes generalization abilities when applied to new patients in
Output: the DeepQ dataset. Our model achieves overall scores of
Y = {(xj , yj )}m j=1 : classification result;
100% positive predictivity and 97% sensitivity in N class
detection, 99% positive predictivity and 73% sensitivity in
1: p ← estimated class probability; SVEB class detection, and 77% positive predictivity and
2: P ← set of estimated class probability; 98% sensitivity in VEB class detection.
3: h ← confidence score; The errors made in the VEB and SVEB detections from
4: H ← set of confidence score; the generic model are mainly contributed from the T3050
5: F ← fine-tune set; and T3068 patient records. These errors are later remedied
6: Fp ← previous fine-tune set; in our active learning process.
7: K ← query set; In the personalization process, our approach rarely
8: Db ← best model from the cross-validation; queries more than 10% of the data from each patient and
9: initialization: p = ∅; F = ∅; Fp = ∅; K = ∅; obtains a precise disease detection performance. Out of 22
10: for each t ∈ T do patients, 21 patients’ results are further improved from the
11: compute p using D; initial outputs. It is worth noting that our proposed con-
12: P ← P ∪ {p}; figuration values sensitivity over positive predictivity for
13: end for ectopic beats. This bias is reflected on patients T3045 and
14: compute Y with T and P ; T5057, whose sensitivity scores are higher but the positive
15: for q = 1; q ≤ Q; q ++ do predictivity scores are lower than the initial outputs after
16: for each t ∈ T do the query process. The only case of performance loss is in
17: compute h with Eq. 2; patient T3068, whose single VEB beat is misclassified as a
18: H ← H ∪ {h}; non-VEB diseased beat (an F beat). This is understandable
19: end for as F beats share similar morphological features to normal
20: sort T in descending order by H; and VEB beats.
21: for all n such that n ∈ N do In general, our model’s behavior complies with that of
22: Kn ← a set of top k/N beats; clinical practice where the essential objective is to identify
23: K ← K ∪ Kn ; all the cardiac abnormalities within a patient. Similar
24: end for results are obtained in the DeepQ dataset when compared
25: F ← Fp ∪ K; to the MIT-BIH-AR DS2 set. Our model demonstrates
26: If F = Fp , EXIT. its effectiveness in arrhythmic heartbeat detection on both
27: query an expert to label K; non-wearable and wearable ECG data and reaches near
28: divide F into V folds; 100% accuracy in the normal and VEB beat predictions in
29: for each of the V folds do both cases.
30: repeat
31: fine-tune model’s dense blocks with F ; IV. Conclusions and Future Works
32: until validation loss converges
33: end for In this work, we first presented an end-to-end generic
34: compute Db from V folds; ECG heartbeat classification model that addresses inter-
35: D ← Db ; Fp ← F ; F ← ∅; patient variability and achieves the state-of-the-art per-
36: update P using T and D; formance for arrhythmia detection on the MIT-BIH-AR
37: update Y by relabeling T with P ; database. The key to exceeding all previous heuristic-based
38: end for and shallow architecture baselines is utilizing the extraor-

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 Table V: Model personalization on the MIT-BIH-AR database
#Beats Generic Model Output After 5 Queries
Record N S V F N S V F
#Beats
N S V F
+P Se +P Se +P Se +P Se Queried +P Se +P Se +P Se +P Se
(%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%)
100 2237 33 1 0 100 100 100 100 100 100 - - 28 100 100 100 100 100 100 - -
103 2080 2 0 0 100 98 11 50 - - - - 37 100 100 100 100 - - - -
105 2514 0 41 0 100 93 - - 44 90 - - 81 100 97 - - 47 100 - -
111 2121 0 1 0 100 99 - - 0 0 - - 24 100 100 - - 100 100 - -
113 1787 6 0 0 100 99 19 100 - - - - 32 100 100 100 100 - - - -
117 1532 1 0 0 100 100 50 100 - - - - 34 100 100 100 100 - - - -
121 1859 1 1 0 100 100 25 100 100 100 - - 19 100 100 100 100 100 100 - -
123 1513 0 3 0 100 99 - - 100 100 - - 27 100 100 - - 100 100 - -
200 1742 30 825 2 99 98 23 73 99 90 2 50 101 100 98 42 80 99 98 17 100
202 2059 55 19 1 100 67 7 87 72 95 4 100 114 100 95 32 93 100 100 0 0
210 2421 22 195 10 99 97 21 100 100 71 3 10 105 100 100 60 100 100 90 40 70
212 2746 0 0 0 100 100 - - - - - - 36 100 100 - - - - - -
213 2639 28 220 362 100 99 78 89 93 29 66 97 117 100 99 82 100 96 79 82 96
214 2000 0 255 1 100 95 - - 100 98 0 0 49 100 100 - - 100 100 100 100
219 2080 7 64 1 100 79 1 57 98 91 0 0 69 100 100 0 0 99 100 0 0
221 2029 0 396 0 100 94 - - 100 99 - - 65 100 100 - - 100 100 - -
222 2272 209 0 0 99 75 26 94 - - - - 46 98 85 34 83 - - - -
228 1686 3 362 0 100 95 0 0 100 100 - - 56 100 100 60 100 100 100 - -
231 1566 1 2 0 100 92 0 0 100 100 - - 38 100 100 0 0 100 100 - -
232 397 1381 0 0 97 96 99 99 - - - - 55 100 100 100 100 - - - -
233 2229 7 830 11 199 95 83 71 100 94 4 64 84 100 100 88 100 100 100 64 64
234 2698 50 3 0 99 100 97 64 100 100 - - 46 100 100 94 98 100 100 - -

Table VI: Model personalization on the DeepQ database

#Beats Generic Model Output After 5 Queries
Record N S V N S V
#Beats
N S V
+P Se +P Se +P Se Queried +P Se +P Se +P Se
(%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%)
T3042 424 26 5 100 99 100 96 83 100 34 100 100 100 100 100 100
T3043 367 0 18 100 77 - - 19 100 69 100 100 - - 18 100
T3044 203 61 0 100 96 100 100 - - 39 100 100 100 100 - -
T3045 401 13 0 98 96 100 15 - - 38 99 97 42 77 - -
T3049 338 4 6 100 100 100 50 75 100 25 100 100 100 100 100 100
T3050 312 0 79 100 100 - - 100 81 38 100 100 - - 100 100
T3052 361 0 43 100 99 - - 100 100 27 100 100 - - 100 100
T3054 322 0 17 100 99 - - 100 100 28 100 100 - - 100 100
T3056 309 7 0 100 100 100 71 - - 21 100 100 100 100 - -
T3059 271 0 93 100 92 - - 100 100 38 100 100 - - 100 100
T3063 324 0 12 100 96 - - 100 100 34 100 100 - - 100 100
T3066 317 0 61 100 98 - - 100 100 26 100 100 - - 100 100
T3068 237 96 1 100 85 0 0 1 100 66 100 100 98 100 0 0
T4007 318 0 7 100 100 - - 100 100 18 100 100 - - 100 100
T4021 305 1 23 100 97 100 100 100 100 30 100 100 100 100 100 100
T4024 367 0 7 100 100 - - 100 100 20 100 100 - - 100 100
T5001 307 0 1 100 97 - - 25 100 19 100 100 - - 50 100
T5006 300 88 0 100 97 100 99 - - 43 100 100 100 100 - -
T5029 207 0 176 100 98 - - 100 100 26 100 100 - - 100 100
T5047 239 76 0 100 98 100 100 - - 34 100 100 100 100 - -
T5049 220 0 108 100 100 - - 100 100 24 100 100 - - 100 100
T5057 403 82 6 98 100 97 89 86 100 46 100 97 86 98 86 100

dinary feature learning and discrimination capability of the
deep neural network, which maps the input ECG data to
the corresponding arrhythmia class. We then showcased an
efficient active learning approach to tailor our pre-trained
generic model to achieve model personalization, and sig-
nificantly improved the precision of disease detection on
each new patient. Our proposed active learning algorithm
ranks the prediction with an entropy measure and queries
the 10 least confident beats from each predicted class.
Within five iterations and 5% of the total beats, we are

98
able to improve the performance of the generic classifier on
each new patient in both MIT-BIH-AR DS2 and the DeepQ
dataset, reaching nearly 100% accuracy in the normal
and VEB beat predictions. It is worth noting that with
our model, predicting using one-lead input data performs
almost as well as using two-lead input data. Our result
provides flexibility to improve a wearable device’s user
experience and reduce its cost. With this input channel
expansion capability, our proposed method is expected to
also work well with 12-lead ECG input data.
Our future work plans to include sitting and walking
cases from the DeepQ Arrhythmia Database and apply
active one-shot learning on the deep neural network model.
The disease classifier performance can be further strength-
ened with the help of increasing diversity and sizable
labeled datasets for approaches like deep learning based
machine learning models.
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