Enhanced Automated Diagnosis of Coronary Artery Disease Using Features Extracted From QT Interval Time Series and ST-T Waveform

There is a growing interest in automated diagnosis of coronary artery disease (CAD) with the application of machine learning (ML) methods to the body surface electrocardiograph (ECG). Although prior studies have documented associations of CAD with increased QT variability and ST-T segment abnormalities such as T-wave inversion and ST-segment elevation or depression, their efficacy in automated CAD detection has not been fully investigated. To validate their usefulness, a dataset containing related clinical characteristics and 5-min single-lead ECGs of 107 healthy controls and 93 CAD patients was first constructed. Based on this dataset, simultaneous analyses were then conducted in five scenarios, in which different ML algorithms were applied to classify the two groups with various features derived from the RR and QT interval time-series and ST-T segment waveforms. Compared with utilizing features obtained from the RR interval time-series, better classification results were achieved utilizing that obtained from the QT interval time-series. The classification results were elevated with combining utilization of features derived from both the RR and QT interval time-series. By further fusing features extracted from ST-T segment waveforms, the best performance was achieved with 96.16% accuracy, 95.75% sensitivity, and 96.40% specificity. Based the best performance, an automated CAD detection system was developed with extreme gradient boosting, an ensemble ML algorithm, and the residual neural network, namely, a deep learning method. The results of this study support the potential of information derived from the QT interval time-series and ST-T segment waveforms in ECG-based automated CAD detection.