HAN-ECG: An Interpretable Atrial Fibrillation Detection Model Using Hierarchical Attention Networks

Atrial fibrillation (AF) is one of the most prevalent cardiac arrhythmias that affects the lives of more than 3 million people in the U.S. and over 33 million people around the world and is associated with a five-fold increased risk of stroke and mortality. like other problems in healthcare domain, AI-based algorithms have been used to reliably detect AF from patients' physiological signals. The cardiologist level performance in detecting this arrhythmia is often achieved by deep learning-based methods, however, they suffer from the lack of interpretability. In other words, these approaches are unable to explain the reasons behind their decisions. The lack of interpretability is a common challenge toward a wide application of machine learning-based approaches in the healthcare which limits the trust of clinicians in such methods. To address this challenge, we propose HAN-ECG, an interpretable bidirectional-recurrent-neural-network-based approach for the AF detection task. The HAN-ECG employs three attention mechanism levels to provide a multi-resolution analysis of the patterns in ECG leading to AF. The first level, wave level, computes the wave weights, the second level, heartbeat level, calculates the heartbeat weights, and third level, window (i.e., multiple heartbeats) level, produces the window weights in triggering a class of interest. The detected patterns by this hierarchical attention model facilitate the interpretation of the neural network decision process in identifying the patterns in the signal which contributed the most to the final prediction. Experimental results on two AF databases demonstrate that our proposed model performs significantly better than the existing algorithms. Visualization of these attention layers illustrates that our model decides upon the important waves and heartbeats which are clinically meaningful in the detection task.