ECG arrhythmia classification using
Convolutional Neural Networks
Mounika Vasimalla Allam Jaya Prakash
Department of ECE Department of ECE
NIT Rourkela, India NIT Rourkela, India
mounidimple391@gmail.com allamjayaprakash@gmail.com
Abstract—Cardiac arrhythmias occur in a short duration of
time which can’t be distinguishable by a human eye. Detection
of cardiac arrhythmias is a tedious task since slight changes in
ECG signal may lead to life-threatening diseases. Diagnosis and
medication at an early stage could help to the reduce the high
mortality rate among the heart patients. This paper presents
an accurate technique for the classification of five types of
ECG arrhythmia namely Premature ventricular contraction(V),
Normal (N), Left bundle branch block (L), Right bundle branch
block (R), Paced (P). This technique incorporates convolutional
neural networks (CNN) that combine both feature extraction
and classification into a single body which restricts the use of
complex feature extraction techniques like DTCWT (Dual tree
complex wavelet transform) and a separate classifier to classify
these features into appropriate classes. The performance of the
proposed technique is assessed by using MIT-BIH arrhythmia
database. Overall classification accuracy of 94.79% is obtained
which is superior to many other algorithms proposed in the
literature.
Index Terms—Cardiac arrhythmia, convolution neural net-
work (CNN), feature extraction, MIT-BIH arrhythmia database
I. I NTRODUCTION
Electrocardiogram (ECG) is the recording of the electrical
phenomenon at the heart that represents the variability
of heart rate. Any deviation from the normal heart rate,
disturbance in rhythm, site of origin or conduction of
cardiac electric impulse is considered as an arrhythmia.
Most of the arrhythmias are seldom occurring and can’t
be distinguished by a person’s eye. Long duration of ECG
records are required to identify the abnormalities present in
a patient. Moreover, huge variations in temporal and some
other morphological characteristics from one patient to the
other patient make detection of abnormalities a challenging
task. Hence it is very difficult to analyze and recognize
these arrhythmias manually by an expert cardiologist. Hence
we require an automatic computer-aided diagnostic (CAD)
system that can quickly detect abnormalities within the patient.
In literature, there are many algorithms proposed on
automatic classification of ECG Arrhythmias. Most of them
have done ECG classification in the following steps i)
Pre-processing ii) feature extraction iii) classification. These
feature extraction techniques include both time and frequency
Samit Ari
Department of ECE
NIT Rourkela, India
samit.ari@gmail.com
domain features. Some of the temporal features include R-R
intervals, Q-R interval, QRS complex duration, R-S intervals,
ST time segments. These temporal features are not enough
for classification since there is a huge variation in the other
morphological patterns within the same patient. Hence some
of the researchers have reported the mixture of both frequency
and time features as reported in [1]. Many transformation
techniques like S transform, Fourier transform, wavelet
transform [2] and dual tree complex wavelet transform [3]
are used to extract the features from the pre-processed data.
Extracted features are given to the input of classifier for
classification into respective classes. Some of the classifiers
are artificial neural networks [4], linear discriminant analysis
[5], support vector machine [6].
Detection of cardiac arrhythmias by applying Hidden
Markov models is reported in [7]. This algorithm has
demonstrated very good promising results in classifying
Ventricular arrhythmias and detection of low amplitude P
wave detection. In [8], the author presented a customized
electrocardiogram (ECG) beat classifier using a mixture of
experts (MOE) approach. Linear vector quantization (LVQ)
and self-organizing maps(SOM) are two classification models
based on clustering technique, LVQ is a supervised learning
technique which classifies the feature vector corresponding
to the label of the cluster pattern (code word) into which is
clustered. In SOM, each centring of the cluster (prototype or
code word) is represented by some weights of a neuron which
is assigned to correlate in the feature map. The classifier is
modelled using mixture of SOM and LVQ approaches. The
network is designed in such a way that LVQ gives superior
classification performance for classes 1 and 3 however for
class 2 and 4 SOM gives superior performance. Overall
classification accuracy of 94% is reported using this mixture
of experts approach.
A unique technique is proposed in [9] for a patient-adapted
ECG heartbeat classification that consists of four stages
namely, preprocessing, feature extraction, feature selection
and classification. Features are extracted in temporal and
frequency domain. Frequency domain features include
coefficients obtained by applying stock well transform. 184
samples around each R peak are taken by combining 4
temporal features (Pre R-R, Post R-R, average R-R, local
R-R) and 180 samples of frequency domain features. BFO
algorithm used to select the best features and reduce the
redundant features. These features are given to the LMS
based multi-class classifier and obtained better classification
results as reported in [9]. In [10], Features are extracted from
the ECG signals by using discrete wavelet transform (DWT)
for classification of ECG beats. Classification of the extracted
features is done by using Random Forest algorithm. Five
types of ECG beats are classified with a success rate of 99.8%.
In [11], a novel classification system based on particle
swarm optimization and Support Vector Machine (SVM )
classifier is presented. The optimization of SVM classifier
is done by detecting three best discriminative features. This
classification method has attained an accuracy of 89.72% on
testing over 20 files of MIT-BIH database.
ECG beat recognition and classification is reported in [12].
This is a new classification algorithm consists of multi layer
perceptron (MLP) and fuzzy self-organizing subnetwork
connected in series called hybrid fuzzy neural network. The
fuzzy self-organizing layer analyses and distributes the data,
groups them into clusters with different membership values.
On the basis of these membership values, the MLP network
classifies the applied input vector, presenting the heartbeat
into corresponding classes.
All these fixed, handcrafted feature extraction techniques
do not contribute reliable information when classifying new
patients data since the same set of features are used for all
patients under all circumstances. Also due to the several intra
patients variations, this particular feature set can give poor
performance results when classifying the same patients data
afterwards. Extracting several features using transformation
techniques, removing the redundancies and selecting the best
features using Bacteria Foraging Algorithm (BFO), reducing
dimensions of features set using Principal component analysis
(PCA) increases the complexity of the feature extraction
techniques.
In order to address the above limitations a novel approach
based on Convolutional Neural networks is proposed for
the classification of ECG arrhythmias. Convolutional neural
networks (CNNs) are widely used for image classification,
object recognition [13], natural language processing [14],
visual recognition [15] and many other pattern recognition
applications. CNN are special kind of neural networks works
similar to human visual cortex. These are used for processing
data that has patterns like grid topology. The unique ability
to extract the features from the input sequence makes CNN
extensively useful in pattern recognition applications.
The remaining paper is organized as follows: Section II
presents MIT-BIH database that is used to evaluate the per-
formance of the proposed algorithm. Section III contains pro-
posed framework. Section IV shows the results and discussion
of the proposed algorithm. The conclusion is explained in
section V.
II. ECG DATA PROCESSING
MIT-BIH ECG Arrhythmia database is utilized for assessing
the performance of the proposed technique. The database
consists of some deadly arrhythmias. Most of the researchers
consider as the standard database for detection of cardiac
arrhythmias. The database contains forty-eight files of ECG
recordings, every file contains 30 min of ECG segment
selected from 24 hours recordings of 48 specific patients.
The first 23 recordings correspond to the routine clinical
recordings while the remaining recordings contain the complex
ventricular, junctional, and supraventricular arrhythmias [16].
These ECG recordings are sampled at 360 Hz and band-pass
filtered at 0.1-100 Hz. Annotation file contains labels for each
rhythm that are detected by using a simple slope sensitive
detector. The results are cross-checked by two independent
cardiologists for the verification. These labels are used in the
training and testing phase of the implemented algorithm. In
this work, five different types of cardiac arrhythmias namely,
normal (N), paced (P), right bundle branch block (R), left
bundle branch block (L) and premature ventricular contraction
(V) arrhythmias are classified by implementing the proposed
method.
III. P ROPOSED F RAMEWORK
The proposed algorithm consists of three stages, Pre-
processing, Beat detection, Classification as shown in Fig
1. In pre-processing stage, ECG data is normalized to zero
mean and standard deviation of unity to reduce amplitude
variations of the data from the file to file. ECG signal is
sampled at 360Hz and then band pass filtered at 0.1-100
Hz to eliminate various noises embedded in the signal. R
peak locations are found by following the algorithm as
reported in [17]. Exact locations of the beat are detected
for each and every file. 256 samples around each beat are
selected and fed into the input of CNN. CNN has the ability
to extract the reliable features from the raw ECG data
and classify these features into respective classes by using
a simple MLP which is present at the last stage of the network.
CNN is used for both feature extraction and classification of
each individuals patients raw ECG data. CNN is a multistage
network. First stages of the network consist of convolutional
layers that can extract global and local patterns from the
input raw data. The unique ability to extract feature maps
from the input sequence makes them widely used in many
pattern recognition applications. A simple CNN architecture
consists of several convolutional layers followed by pooling
layers, a simple MLP and a soft-max layer at the end.
This processed data is given to the input of convolutional
layer. Multiple filters present in the convolutional Layer
automatically convolves with the input raw data to produce
output feature maps. Each of these convolutional layers is
 Fig. 1. Overview of the proposed ECG arrhythmia classification system.
followed by a pooling layer that reduces the resolution of the
convolved feature maps by sub-sampling. This feature maps
are subsampled and given to an MLP in the fully connected
layer that classifies the arrhythmias into respective classes.
Let us consider input data samples are represented as x0i =
[x1 , x2 , x3 ....xN ] . As the name suggests that the convolution
layer performs a mathematical operation called convolution.
This is described by the following equation
M
X
Fjl,i = σ(bi + wki x0i
j+k−1 )
k=1
Where wki is the weight in the ith feature map at k th filter
index. bi is the bias term of the ith feature map. M is the
size of the kernel or filter. The output obtained from the
convolutional layer is sub-sampled by using the following
operation in the pooling layer. This equation 2 represents the
Max-pooling operation, it is a downsampling strategy across
a window of a particular size, Maximum value across this
window is the resulting output of this operation.
l,j
Pil,j = max(Fi×S+r )
r∈H
where H is the size of window stride and S is the size of
the pooling stride. The main advantage of this max-pooling
operation is, it facilitates generalization and reduction in
number of parameters within the model. The output feature
maps are fed into MLP. This is a feed-forward neural network
that separates the nonlinear patterns. Simple MLP layer
present at the end of the network that maps input features to
the respective classes. Gradient descent algorithm is used to
minimize the mean square error. Since the number of classes
to be classified is more than two we use soft-max layer at last
stage of the network for representing features into appropriate
classes.
The proposed technique consists of raw data representation.
Raw data representation includes temporal (average RR
interval, pre RR and post RR interval, local RR interval ) and
morphological characteristics of the signal. Morphological
characteristics are represented by taking 256 samples around
each heartbeat. Training dataset contains mixture of first
five minutes segment from each ECG record and 75 beats
randomly taken from five classes of ECG beats.
(1)
In this work, we have implemented a basic 1D CNN by
following the network architecture explained in [18], [19].
The proposed architecture consists of multiple blocks. The
first block is for feature extraction that consists of input
layer in which 256 samples of the ECG signal are given
into the network. This is Followed by a convolutional, Relu,
and Max pooling layers in further stages. All of these three
layers are used for feature extraction from the input samples.
This structure is repeated once again to enable the CNN for
(2) better feature extraction. The extracted features are fed to a
fully connected layer followed by soft-max layer. The size
of the soft-max layer is kept as 5 (the number classes to be
classified). The kernel size for first and second convolutional
layer was set to 5,3 respectively and both the pooling layers
contain a sub-sampling factor of 2 is used for Max pooling
operation. The maximum number of epochs is set to 50, the
initial learning rate is 0.001 which is changed in accordance
with the mean squared error (MSE) in each iteration. When
the trained mean-squared error decreases in the present
iteration then the learning rate is increased by 2% in the next
iteration else we decrease learning rate by 15% for the next
training iteration.
 IV. R ESULTS AND D ISCUSSION from the confusion matrix.
Performance of the proposed technique is evaluated by using
48 files of MIT-BIH arrhythmia database. The network is Table II shows the accuracy, sensitivity, specificity, positive-
trained by using 9945 beats which indicate that only 10% predictivity obtained on by using CNN for classification. All
of them are used for training and remaining 90% (94,979) 48 files including four files of paced beats also included for
of them are used for testing, which demonstrates that only a the performance evaluation. The overall accuracy of 94.79%
small amount of data is used for training. Table 1 shows the is obtained which shows that the proposed method attained
comparison of the confusion matrices obtained on classifying superior performance compared to all the other classification
48 files of the MIT-BIH arrhythmia database using dual techniques. Fig .2, shows the ROC curve plotted between true
tree complex wavelet (DTCWT) features and artificial neural
TABLE II
network (ANN) classifier and CNN respectively. Diagonal C LASSIFICATION P ERFORMANCE USING CNN
elements of the confusion matrix show the correctly classified
beats. From the Table I, we can see that 963 N beats, Method Class Acc(%) Sens(%) Spe(%) PPr(%)
N 95.24 98.59 86.43 95.01
1156 P beats, 721 L beats, 274 R beats and 890 V beats CNN P 98.49 85.55 99.73 96.80
are misclassified.This shows that less number of beats are (Proposed L 98.99 83.69 99.77 94.89
misclassified as compared to technique reported in [20] small method ) R 98.17 86.93 99.44 94.67
V 98.45 81.36 99.39 88.08
amount (only 10% of data). This shows that the proposed
technique has classified arrhythmias with good accuracy. positive rate (TPR) and false positive rate (FPR) that explains
the relationship between sensitivity and specificity. Perfect
TABLE I classification model contains TPR of unity and zero FPR
C OMPARISON OF THE R ESULTS OBTAINED ON CLASSIFYING OF 48 FILES
FROM MIT-BIH A RRHYTHMIA DATABASE that coincides with the coordinate at upper left corner. The
proposed method achieved an average sensitivity of 94.79%.
Method Class N P L R V From Fig 2, we can see that the proposed method has higher
N 65968 134 625 207 334
P 68 6225 35 14 24 TPR and lower FPR than DTCWT method.
DTCWT features L 981 157 5925 11 273
and R 1024 2 114 5341 12
ANN classifier V 639 144 169 59 5409
N 67562 127 156 367 313
CNN P 1005 6843 13 50 88
(Proposed L 649 13 3699 25 34
method) R 105 71 7 8145 91
V 835 15 23 17 3885

The classification results are evaluated using five statistical

metrics found in the literature [8]. Accuracy,specificity sen-
sitivity and positive-predictivity. Accuracy is defined as the
ratio of correctly classified patterns to the total no of patterns
classified.
TP + TN
Accuracy(Acc) = (3) Fig. 2. Analogy between TPR and FPR for proposed method and DTCWT
TP + TN + FP + FN
Sensitivity is defined as the rate of correctly classified events Table 3 represents the comparative performance of the
among all events. proposed method with different techniques reported on ECG
TP arrhythmia classification technique. In De Chazal et al [21],
Sensitivity(Sen) = (4) Features are selected based on heartbeat morphology and some
TP + FN
temporal features like heartbeat intervals and RR intervals
Specificity is defined as the rate of correctly classified non
are taken and are classified using linear discriminant that has
events among all non events.
attained a low accuracy of 85.9%. In [20], 1D DTCWT is per-
TN formed by decomposing QRS complex up to five scales. The
Specif icity(Spe) = (5)
TN + FP absolute value of the DTCWT coefficients is taken and 1D FFT
Positive-Predictivity is defined as the rate of correctly classi- is calculated. All these features extracted using DTCWT and
fied events in all detected events are combined with temporal features extracted around QRS
complex of each beat. These features are fed into the ANN
TP
P ositive predctivity(P pr) = (6) network and reported a classification accuracy of 94.64%.
TP + FP Although this method yields very good classification accuracy
where TP, TN, FP, FN are true positive, true negative, false it has the following disadvantages (i) A fixed handcrafted
positive, false negative respectively which can be calculated feature extraction method may not be suitable for extracting
 TABLE III
S UMMARY OF DIFFERENT CLASSIFICATION TECHNIQUES USING MIT-BIH DATABASE
literature Feature extraction and classification method
De Chazal et al [21] morphological and heart beat interval features are classified using Linear Discriminent
Manu Thomas et al [20] DTCWT features and ANN classifier
proposed method (CNN) Feature extraction of raw data, classification using CNN
patient-specific features when classifying beats of a particular
person (ii) Complexity in the structure of this technique
imposes difficulty in implementation. As mentioned in table
3, the proposed method has attained an average accuracy of
94.79% when trained with the small amount (only 10%) of
data. This shows that the proposed technique has classified
beats with good accuracy.
V. C ONCLUSION
In this work, ECG arrhythmia classification technique by
using CNN is proposed. CNN simplifies two main blocks,
feature extraction and classification into a single entity. If a
particular CNN is trained, it can be used to classify any other
patients data. The proposed method assists implementation
of CNN in low resolution using only few samples of data.
Hence, we conclude that the proposed method is robust, fast
and achieves superior classification accuracy, which shows that
it is a unique method that can be suited for any new patients
data. The proposed technique can be used in applications
like remote patient monitoring, automatic cardiac arrhythmia
monitoring systems, cardiac pacemakers, lightweight wearable
heart monitoring systems.
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