Will Two Do? Varying Dimensions in Electrocardiography: The PhysioNet/Computing in Cardiology Challenge 2021

The electrocardiogram (ECG) is a non-invasive representation of the electrical activity of the heart. Although the twelve-lead ECG is the standard diagnostic screening system for many cardiological issues, the limited accessibility of twelve-lead ECG devices provides a rationale for smaller, lower-cost, and easier to use devices. While single-lead ECGs are limiting [1], reduced-lead ECG systems hold promise, with evidence that subsets of the standard twelve leads can capture useful information [2], [3], [4] and even be comparable to twelve-lead ECGs in some limited contexts. In 2017 we challenged the public to classify AF from a single-lead ECG, and in 2020 we challenged the public to diagnose a much larger number of cardiac problems using twelve-lead recordings. However, there is limited evidence to demonstrate the utility of reduced-lead ECGs for capturing a wide range of diagnostic information.

In this year’s Challenge, we ask the following question: ‘Will two do?’ This year’s Challenge builds on last year’s Challenge [5], which asked participants to classify cardiac abnormalities from twelve-lead ECGs. We are asking you to build an algorithm that can classify cardiac abnormalities from twelve-lead, six-lead, four-lead, three-lead, and two-lead ECGs. We will test each algorithm on databases of these reduced-lead ECGs, and the differences in performances of the algorithms on these databases will reveal the utility of reduced-lead ECGs in comparison to standard twelve-lead EGCs.

心电图（ECG）是对心脏电活动的非侵入性表征。尽管十二导联心电图是许多心血管疾病的常规诊断筛查系统，但十二导联心电图设备的有限可及性为开发更小、成本更低且易于使用的设备提供了理论依据。虽然单导联心电图存在局限性[1]，但简化导联心电图系统展现出巨大的潜力，已有证据表明，标准十二导联心电图的部分子集可以捕捉到有用的信息[2]、[3]、[4]，甚至在某些有限情境下可与十二导联心电图相媲美。2017年，我们向公众提出了从单导联心电图分类房颤的挑战，而到了2020年，我们则要求公众利用十二导联记录来诊断更多的心血管问题。然而，目前尚缺乏充分证据来证明简化导联心电图在捕捉广泛诊断信息方面的实用性。在本年度的挑战中，我们提出了以下问题：‘两个导联是否足够？’今年的挑战建立在去年的挑战[5]之上，后者要求参与者从十二导联心电图分类心血管异常。我们要求您构建一个算法，能够从十二导联、六导联、四导联、三导联和两导联心电图分类心血管异常。我们将对包含这些简化导联心电图的数据库进行算法测试，算法在这些数据库上的性能差异将揭示简化导联心电图相对于标准十二导联心电图在实用性方面的优劣。