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In PhysioNet/Computing in Cardiology Challenge 2020, we developed an ensembled model based on SE-ResNet to classify cardiac abnormalities from 12-lead electrocardiogram (ECG) signals. We employed two residual neural network modules with squeeze-and-excitation blocks to learn from the first 10-second and 30-second segments of the signals. We used external open-source data for validation and fine-tuning during the model development phase. We designed a multi-label loss to emphasize the impact of wrong predictions during training. We built a rule-based bradycardia model based on clinical knowledge to correct the output. All these efforts helped us to achieve a robust classification performance. Our final model achieved a challenge validation score of 0.682 and a full test score of 0.514, placing our team HeartBeats 3rd out of 41 in the official ranking. We believed that our model has a great potential to be applied in the actual clinical practice, and planned to further extend the research after the challenge.

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Objective. Cardiovascular disease is a major threat to health and one of the primary causes of death globally. The 12-lead ECG is a cheap and commonly accessible tool to identify cardiac abnormalities. Early and accurate diagnosis will allow early treatment and intervention to prevent severe complications of cardiovascular disease. Our objective is to develop an algorithm that automatically identifies 27 ECG abnormalities from 12-lead ECG databases. Approach. Firstly, a series of pre-processing methods were proposed and applied on various data sources in order to mitigate the problem of data divergence. Secondly, we ensembled two SE_ResNet models and one rule-based model to enhance the performance of various ECG abnormalities’ classification. Thirdly, we introduce a Sign Loss to tackle the problem of class imbalance, and thus improve the model's generalizability. Main results. In the PhysioNet/Computing in Cardiology Challenge (2020), our proposed approach achieved a challenge validation score of 0.682, and a full test score of 0.514, placed us 3rd out of 40 in the official ranking. Significance. We proposed an accurate and robust predictive framework that combines deep neural networks and clinical knowledge to automatically classify multiple ECG abnormalities. Our framework is able to identify 27 ECG abnormalities from multi-lead ECG signals regardless of discrepancies in data sources and the imbalance of data labeling. We trained our framework on five datasets and validated it on six datasets from various countries. The outstanding performance demonstrate the effectiveness of our proposed framework.