Goto Shinichi, Goto Shinya
Department of Cardiology, Keio University School of Medicine Tokyo Japan.
Department of Medicine (Cardiology), Tokai University School of Medicine Isehara Japan.
Circ Rep. 2019 Nov 2;1(11):481-486. doi: 10.1253/circrep.CR-19-0096.
The 12-lead electrocardiogram (ECG) is a fast, non-invasive, powerful tool to diagnose or to evaluate the risk of various cardiac diseases. The vast majority of arrhythmias are diagnosed solely on 12-lead ECG. Initial detection of myocardial ischemia such as myocardial infarction (MI), acute coronary syndrome (ACS) and effort angina is also dependent upon 12-lead ECG. ECG reflects the electrophysiological state of the heart through body mass, and thus contains important information on the electricity-dependent function of the human heart. Indeed, 12-lead ECG data are complex. Therefore, the clinical interpretation of 12-lead ECG requires intense training, but still is prone to interobserver variability. Even with rich clinically relevant data, non-trained physicians cannot efficiently use this powerful tool. Furthermore, recent studies have shown that 12-lead ECG may contain information that is not recognized even by well-trained experts but which can be extracted by computer. Artificial intelligence (AI) based on neural networks (NN) has emerged as a strong tool to extract valuable information from ECG for clinical decision making. This article reviews the current status of the application of NN-based AI to the interpretation of 12-lead ECG and also discusses the current problems and future directions.
12导联心电图(ECG)是一种快速、无创且强大的工具,可用于诊断或评估各种心脏疾病的风险。绝大多数心律失常仅通过12导联心电图即可诊断。心肌缺血(如心肌梗死(MI)、急性冠状动脉综合征(ACS)和劳力性心绞痛)的初步检测也依赖于12导联心电图。心电图通过身体质量反映心脏的电生理状态,因此包含有关人体心脏电依赖性功能的重要信息。实际上,12导联心电图数据很复杂。因此,12导联心电图的临床解读需要强化训练,但仍容易出现观察者间的差异。即使有丰富的临床相关数据,未经训练的医生也无法有效使用这一强大工具。此外,最近的研究表明,12导联心电图可能包含即使是训练有素的专家也未识别的信息,但可由计算机提取。基于神经网络(NN)的人工智能(AI)已成为从心电图中提取有价值信息以用于临床决策的强大工具。本文回顾了基于NN的AI在12导联心电图解读中的应用现状,并讨论了当前存在的问题和未来发展方向。