CRT-Net: A Generalized and Scalable Framework for the Computer-Aided Diagnosis of Electrocardiogram Signals

Electrocardiogram (ECG) signals play critical roles in the clinical screening and diagnosis of many types of cardiovascular diseases. Despite deep neural networks that have been greatly facilitated computer-aided diagnosis (CAD) in many clinical tasks, the variability and complexity of ECG in the clinic still pose significant challenges in both diagnostic performance and clinical applications. In this paper, we develop a robust and scalable framework for the clinical recognition of ECG. Considering the fact that hospitals generally record ECG signals in the form of graphic waves of 2-D images, we first extract the graphic waves of 12-lead images into numerical 1-D ECG signals by a proposed bi-directional connectivity method. Subsequently, a novel deep neural network, namely CRT-Net, is designed for the fine-grained and comprehensive representation and recognition of 1-D ECG signals. The CRT-Net can well explore waveform features, morphological characteristics and time domain features of ECG by embedding convolution neural network(CNN), recurrent neural network(RNN), and transformer module in a scalable deep model, which is especially suitable in clinical scenarios with different lengths of ECG signals captured from different devices. The proposed framework is first evaluated on two widely investigated public repositories, demonstrating the superior performance of ECG recognition in comparison with state-of-the-art. Moreover, we validate the effectiveness of our proposed bi-directional connectivity and CRT-Net on clinical ECG images collected from the local hospital, including 258 patients with chronic kidney disease (CKD), 351 patients with Type-2 Diabetes (T2DM), and around 300 patients in the control group. In the experiments, our methods can achieve excellent performance in the recognition of these two types of disease.