Improving Diffusion Models for ECG Imputation with an Augmented Template Prior

Pulsative signals such as the electrocardiogram (ECG) are extensively collected as part of routine clinical care. However, noisy and poor-quality recordings, leading to missing values, are a major issue for signals collected using mobile health systems, decreasing the signal quality and affecting the automated downstream tasks. Recent studies have explored imputation of missing values for ECG with probabilistic time-series models. Nevertheless, in comparison with the deterministic models, their performance is still limited, as the variations across subjects and heart-beat relationships are not explicitly considered in the training objective. In this work, to improve the ECG imputation and forecasting accuracy with probabilistic models, we present an template-guided denoising diffusion probabilistic model, PulseDiff, which is conditioned an informative prior for a range of health conditions. Specifically, 1) we first extract a subject-level pulsative template from the observation as an informative prior of missing values, which captures the personal characteristics; 2) we then add beat-level stochastic shift terms on the template for prior augmentation, which considers the beat-level variance of positioning and amplitude; 3) we finally design a confidence score to consider the health condition of subject, which ensures our prior is provided in a safe way. Experiments with the PTBXL dataset reveal PulseDiff improves the performance of two strong DDPMs baseline models, CSDI and SSSD$^{S4}$, verifying our method guides the generation of DDPMs while managing the uncertainty. When combining with SSSD$^{S4}$, our PulseDiff method outperforms the leading deterministic model for short-interval missing data and is comparable for long-interval data loss.

Rethinking multiscale cardiac electrophysiology with machine learning and predictive modelling

We review some of the latest approaches to analysing cardiac electrophysiology data using machine learning and predictive modelling. Cardiac arrhythmias, particularly atrial fibrillation, are a major global healthcare challenge. Treatment is often through catheter ablation, which involves the targeted localized destruction of regions of the myocardium responsible for initiating or perpetuating the arrhythmia. Ablation targets are either anatomically defined, or identified based on their functional properties as determined through the analysis of contact intracardiac electrograms acquired with increasing spatial density by modern electroanatomic mapping systems. While numerous quantitative approaches have been investigated over the past decades for identifying these critical curative sites, few have provided a reliable and reproducible advance in success rates. Machine learning techniques, including recent deep-learning approaches, offer a potential route to gaining new insight from this wealth of highly complex spatio-temporal information that existing methods struggle to analyse. Coupled with predictive modelling, these techniques offer exciting opportunities to advance the field and produce more accurate diagnoses and robust personalised treatment. We outline some of these methods and illustrate their use in making predictions from the contact electrogram and augmenting predictive modelling tools, both by more rapidly predicting future states of the system and by inferring the parameters of these models from experimental observations.