Advancing ECG Diagnosis Using Reinforcement Learning on Global Waveform Variations Related to P Wave and PR Interval

Abstract: The reliable diagnosis of cardiac conditions through electrocardiogram (ECG) analysis critically depends on accurately detecting P waves and measuring the PR interval. However, achieving consistent and generalizable diagnoses across diverse populations presents challenges due to the inherent global variations observed in ECG signals. This paper is focused on applying the Q learning reinforcement algorithm to the various ECG datasets available in the PhysioNet/Computing in Cardiology Challenge (CinC). Five ECG beats, including Normal Sinus Rhythm, Atrial Flutter, Atrial Fibrillation, 1st Degree Atrioventricular Block, and Left Atrial Enlargement, are included to study variations of P waves and PR Interval on Lead II and Lead V1. Q-Agent classified 71,672 beat samples in 8,867 patients with an average accuracy of 90.4% and only 9.6% average hamming loss over misclassification. The average classification time at the 100th episode containing around 40,000 samples is 0.04 seconds. An average training reward of 344.05 is achieved at an alpha, gamma, and SoftMax temperature rate of 0.001, 0.9, and 0.1, respectively.