A Machine-Learning Approach for Detection and Quantification of QRS Fragmentation

Objective: Fragmented QRS (fQRS) is an accessible biomarker and indication of myocardial scarring that can be detected from the electrocardiogram (ECG). Nowadays, fQRS scoring is done on a visual basis, which is time consuming and leads to subjective results. This study proposes an automated method to detect and quantify fQRS in a continuous way using features extracted from variational mode decomposition (VMD) and phase-rectified signal averaging (PRSA). Methods: In the proposed framework, QRS complexes in the ECG signals were first segmented using VMD. Then, ten VMD- and PRSA-based features were computed and fed into well-known classifiers such as support vector machine (SVM), K-nearest neighbors (KNN), Naive Bayesian (NB), and TreeBagger (TB) in order to compare their performance. The proposed method was evaluated with 12-lead ECG data of 616 patients from the University Hospitals Leuven. The presence of fQRS in each ECG lead was scored by five raters. Both detection and quantification of fQRS could be achieved in this way. Results: The experimental results indicated that the proposed method achieved AUC values of 0.95, 0.94, 0.90, and 0.89 using SVM, KNN, NB, and TB classifiers, respectively, for detecting QRS fragmentation. Assessment of quantification performance was done by comparing the fQRS score with the total score, obtained by summing the scores from the individual raters. Results showed that the fQRS score clearly correlated with this estimate of fQRS certainty. Conclusion: The proposed method obtained good results in both fQRS detection and quantification, and is a novel way of assessing the certainty of QRS fragmentation in the ECG signal.