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  1. Mandala S, Di TC
    J Med Biol Eng, 2017;37(4):441-453.
    PMID: 28867990 DOI: 10.1007/s40846-017-0281-x
    Many studies showed electrocardiogram (ECG) parameters are useful for predicting fatal ventricular arrhythmias (VAs). However, the studies have several shortcomings. Firstly, all studies lack of effective way to present behavior of various ECG parameters prior to the occurrence of the VAs. Secondly, they also lack of discussion on how to consider the parameters as abnormal. Thirdly, the reports do not include approaches to increase the detection accuracy for the abnormal patterns. The purpose of this study is to address the aforementioned issues. It identifies ten ECG parameters from various sources and then presents a review based on the identified parameters. From the review, it has been found that the increased risk of VAs can be represented by presence and certain abnormal range of the parameters. The variation of parameters range could be influenced by either gender or age. This study also has discovered the facts that averaging, outliers elimination and morphology detection algorithms can contribute to the detection accuracy.
  2. Mandala S, Cai Di T, Sunar MS, Adiwijaya
    PLoS One, 2020;15(5):e0231635.
    PMID: 32407335 DOI: 10.1371/journal.pone.0231635
    Spontaneous prediction of malignant ventricular arrhythmia (MVA) is useful to avoid delay in rescue operations. Recently, researchers have developed several algorithms to predict MVA using various features derived from electrocardiogram (ECG). However, there are several unresolved issues regarding MVA prediction such as the effect of number of ECG features on a prediction remaining unclear, possibility that an alert for occurring MVA may arrive very late and uncertainty in the performance of the algorithm predicting MVA minutes before onset. To overcome the aforementioned problems, this research conducts an in-depth study on the number and types of ECG features that are implemented in a decision tree classifier. In addition, this research also investigates an algorithm's execution time before the occurrence of MVA to minimize delays in warnings for MVA. Lastly, this research aims to study both the sensitivity and specificity of an algorithm to reveal the performance of MVA prediction algorithms from time to time. To strengthen the results of analysis, several classifiers such as support vector machine and naive Bayes are also examined for the purpose of comparison study. There are three phases required to achieve the objectives. The first phase is literature review on existing relevant studies. The second phase deals with design and development of four modules for predicting MVA. Rigorous experiments are performed in the feature selection and classification modules. The results show that eight ECG features with decision tree classifier achieved good prediction performance in terms of execution time and sensitivity. In addition, the results show that the highest percentage for sensitivity and specificity is 95% and 90% respectively, in the fourth 5-minute interval (15.1 minutes-20 minutes) that preceded the onset of an arrhythmia event. Such results imply that the fourth 5-minute interval would be the best time to perform prediction.
  3. Mandala S, Rizal A, Adiwijaya, Nurmaini S, Suci Amini S, Almayda Sudarisman G, et al.
    PLoS One, 2024;19(4):e0297551.
    PMID: 38593145 DOI: 10.1371/journal.pone.0297551
    Arrhythmia is a life-threatening cardiac condition characterized by irregular heart rhythm. Early and accurate detection is crucial for effective treatment. However, single-lead electrocardiogram (ECG) methods have limited sensitivity and specificity. This study propose an improved ensemble learning approach for arrhythmia detection using multi-lead ECG data. Proposed method, based on a boosting algorithm, namely Fine Tuned Boosting (FTBO) model detects multiple arrhythmia classes. For the feature extraction, introduce a new technique that utilizes a sliding window with a window size of 5 R-peaks. This study compared it with other models, including bagging and stacking, and assessed the impact of parameter tuning. Rigorous experiments on the MIT-BIH arrhythmia database focused on Premature Ventricular Contraction (PVC), Atrial Premature Contraction (PAC), and Atrial Fibrillation (AF) have been performed. The results showed that the proposed method achieved high sensitivity, specificity, and accuracy for all three classes of arrhythmia. It accurately detected Atrial Fibrillation (AF) with 100% sensitivity and specificity. For Premature Ventricular Contraction (PVC) detection, it achieved 99% sensitivity and specificity in both leads. Similarly, for Atrial Premature Contraction (PAC) detection, proposed method achieved almost 96% sensitivity and specificity in both leads. The proposed method shows great potential for early arrhythmia detection using multi-lead ECG data.
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