Manifold Learning for Personalized and Label-Free Detection of Cardiac Arrhythmias

Electrocardiograms (ECGs) provide direct, non-invasive measurements of heart activity and are well-established tools for detecting and monitoring cardiovascular disease. However, manual ECG analysis can be time-consuming and prone to errors. Machine learning has emerged as a promising approach for automated heartbeat recognition and classification, but substantial variations in ECG signals make it challenging to develop generalizable models. ECG signals can vary widely across individuals and leads, while datasets often follow different labeling standards and may be biased, all of which greatly hinder supervised methods. Conventional unsupervised methods, e.g. principal component analysis, prioritize large (and often obvious) variances in the data and typically overlook subtle yet clinically relevant patterns. If labels are missing and/or variations are significant but small, both approaches fail. Here, we show that nonlinear dimensionality reduction (NLDR) can accommodate these issues and identify medically relevant features in ECG signals, with no need for training or prior information. Using the MLII and V1 leads of the MIT-BIH dataset, we demonstrate that t-distributed stochastic neighbor embedding and uniform manifold approximation and projection can discriminate individual recordings in mixed populations with >= 90% accuracy and distinguish different arrhythmias in individual patients with a median accuracy of 98.96% and a median F1-score of 91.02%. The results show that NLDR holds much promise for cardiac monitoring, including the limiting cases of single-lead ECG and the current 12-lead standard of care, and for personalized health care beyond cardiology.