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AMIA Jt Summits Transl Sci Proc. 2018 May 18;2017:256-262. eCollection 2018.

A Deep Learning Approach to Examine Ischemic ST Changes in Ambulatory ECG Recordings.

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Department of Physiological Nursing, University of California, San Francisco, CA.
Department of Neurological Surgery, University of California, San Francisco, CA.
Institute for Computational Health Sciences, University of California, San Francisco, CA.
Core Faculty, UCB/UCSF Graduate Group in Bioengineering, University of California, San Francisco, CA.


Patients with suspected acute coronary syndrome (ACS) are at risk of transient myocardial ischemia (TMI), which could lead to serious morbidity or even mortality. Early detection of myocardial ischemia can reduce damage to heart tissues and improve patient condition. Significant ST change in the electrocardiogram (ECG) is an important marker for detecting myocardial ischemia during the rule-out phase of potential ACS. However, current ECG monitoring software is vastly underused due to excessive false alarms. The present study aims to tackle this problem by combining a novel image-based approach with deep learning techniques to improve the detection accuracy of significant ST depression change. The obtained convolutional neural network (CNN) model yields an average area under the curve (AUC) at 89.6% from an independent testing set. At selected optimal cutoff thresholds, the proposed model yields a mean sensitivity at 84.4% while maintaining specificity at 84.9%.


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