Computers in Biology and Medicine 150 (2022) 106199

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Computers in Biology and Medicine

journal homepage: www.elsevier.com/locate/compbiomed

MCA-net: A multi-task channel attention network for Myocardial infarction

detection and location using 12-lead ECGs
Weibai Pan a,b ,1 , Ying An c ,1 , Yuxia Guan a,b , Jianxin Wang a,b ,∗
a
School of Computer Science and Engineering, Central South University, Changsha, 410083, China
b
Hunan Provincial Key Lab on Bioinformatics, Central South University, Changsha, 410083, China
c
School of Big Data Institute, Central South University, Changsha Hunan, China

ARTICLE INFO ABSTRACT

Keywords: Problem: Myocardial infarction (MI) is a classic cardiovascular disease (CVD) that requires prompt diagnosis.
Electrocardiogram However, due to the complexity of its pathology, it is difficult for cardiologists to make an accurate diagnosis
Deep neural network in a short period.
Multi-task learning
Aim: In the clinical, MI can be detected and located by the morphological changes on a 12-lead electrocar-
Myocardial infarction
diogram (ECG). Therefore, we need to develop an automatic, high-performance, and easily scalable algorithm
for MI detection and location using 12-lead ECGs to effectively reduce the burden on cardiologists.
Methods: This paper proposes a multi-task channel attention network (MCA-net) for MI detection and location
using 12-lead ECGs. It employs a channel attention network based on a residual structure to efficiently capture
and integrate features from different leads. On top of this, a multi-task framework is used to additionally
introduce the shared and complementary information between MI detection and location tasks to further
enhance the model performance.
Results: Our method is evaluated on two datasets (The PTB and PTBXL datasets). It achieved more than 90%
accuracy for MI detection task on both datasets. For MI location tasks, we achieved 68.90% and 49.18%
accuracy on the PTB dataset, respectively. And on the PTBXL dataset, we achieved more than 80% accuracy.
Conclusion: Numerous comparison experiments demonstrate that MCA-net outperforms the state-of-the-art
methods and has a better generalization. Therefore, it can effectively assist cardiologists to detect and locate
MI and has important implications for the early diagnosis of MI and patient prognosis.

1. Introduction
Cardiovascular disease (CVD) is a global health problem, and its
occurrence in developing countries is continuing to rise. Myocardial
infarction (MI) is a typical CVD, which is caused by coronary artery
obstruction, and these obstructions result in a severe decrease in blood
flow to the heart muscle [1]. Since MI is difficult to detect and occurs
rapidly, it has also been described as a silent heart attack. According
to statistics from the American Heart Association (AHA), each year,
approximately 605,000 people have an episode of MI, and 200,000 MI
patients have a relapse [2]. Moreover, the locations of MI are numerous
and proximate to each other, involving different criminal vessels and
varying degrees of criticality, which can seriously affect the patient’s
prognosis. As shown in Fig. 1, they can be broadly classified as anterior
MI (AMI), anteroseptal MI (ASMI), anterolateral MI (ALMI), inferior MI
(IMI), inferolateral MI (ILMI), and others [3]. Therefore, early detection
and location of MI are essential for prolonging the life expectancy of
patients and improving the life quality of patients.
Continuous acquisition and recording of dynamic changes in the
subject’s ECG waveform can often provide critical information to the
physician making the diagnosis of MI in the clinical [4,5]. Therefore,
ECG is a necessary tool for the diagnosis of MI and should be obtained
and interpreted promptly after the first medical contact. However,
due to the complex and diverse ECG manifestations of MI, using 12-
lead ECGs to detect and locate MI are extremely time-consuming and
laborious for cardiologists, and even prone to misdiagnosis. Therefore,
automatic ECG-based diagnosis of MI has become a research hotspot in
the field of medical artificial intelligence.
The traditional methods for MI detection and location usually in-
clude three steps: feature extraction, feature selection, and classifica-
tion [6]. Early feature extraction methods usually extracted relevant

∗ Corresponding author at: School of Computer Science and Engineering, Central South University, Changsha, 410083, China.
E-mail addresses: pwb0531@csu.edu.cn (W. Pan), anying@csu.edu.cn (Y. An), guanyx1997@csu.edu.cn (Y. Guan), jxwang@csu.edu.cn (J. Wang).
1
Both authors contributed equally to this research.

https://doi.org/10.1016/j.compbiomed.2022.106199
Received 13 June 2022; Received in revised form 18 September 2022; Accepted 9 October 2022
Available online 13 October 2022
0010-4825/© 2022 Elsevier Ltd. All rights reserved.
W. Pan et al.
Fig. 1. Description of the standard 12-lead system and its correspondence to the MI location.
ECG features such as ST-segment elevation and Q-wave abnormali-
ties [7,8] by wavelet transform (WT) [9], principal component anal-
ysis (PCA) [10], or empirical mode decomposition (EMD) [11], etc.
Then, traditional machine learning methods such as K-nearest neigh-
bors (KNN) [12,13], random forests (RF) [14], or support vector ma-
chines (SVM) [15,16] are used for classification. However, the feature
selection process of these methods often relies on human intervention
and requires extensive medical expertise and experience. On top of
that, the classification performance of these conventional MI detection
and location methods can be greatly reduced if the morphological
characteristics of the selected ECG waveforms are not accurate enough.
Therefore, to solve the above problems, a more stable method for
end-to-end MI automatic detection and location is needed.
As deep learning methods achieve remarkable results in many fields,
they also show their advantages in CVD classification based on ECG
signals [17,18], such as Convolutional Neural Network (CNN) and Long
Short-Term Memory (LSTM). They are not only able to perform the
feature extraction and classification process simultaneously, but also
usually achieved higher accuracy compared to traditional methods.
Therefore, researchers have proposed many methods based on deep
learning methods to detect and locate MI which achieved promising
results. For example, Strodthoff et al. [19] proposed an MI detection
and interpretation algorithm based on a full CNN using eight-lead ECGs,
which extracted features directly from the raw ECG data and achieved
93.3% sensitivity and 89.7% specificity. Acharya et al. [20] proposed a
novel approach that used a CNN with eleven layers to automatically
detect MI using single-lead ECGs. This approach needed no manual
feature extraction or selection so that even in the presence of noise
it can also make accurate detection of MI. As a result, it obtained
93.53% and 95.22% accuracy in the presence and absence of noise,
respectively. He et al. [21] developed a novel 12-lead ECG-based deep
active semi-supervised learning framework for MI location which was
named multibranch densely connected convolutional network (MB-
DenseNet). It first employed active learning (AL) to improve the classi-
fication performance of the initial model and then designed a new semi-
supervised learning method named self-training with spatial match-
ing (STSM) to update the model. MB-DenseNet obtained 99.87% and
96.09% accuracy under the intra-patient and patient-specific scheme,
respectively.
The above-mentioned methods have brought some impressive im-
provements in the automatic detection and location of MI. However,
there are still many challenges that need to be solved. First, MI episodes
in different heart locations usually cause abnormal ECG waveforms in
different combinations of leads. For example, we can see from Fig. 1
that AMI may cause ST-segment elevation in leads V3 and V4, whereas
ALMI may cause ST-segment elevation in different leads (II, III, and
AVF). Therefore, incomplete lead information may lead to a lack of
2
Computers in Biology and Medicine 150 (2022) 106199
location features, thus affecting the accuracy of identification. Unlike
most existing methods that use only single-lead or partial-lead ECGs,
we fully used 12-lead ECGs to introduce more data information to
enhance the performance of our method. Second, although some studies
have also considered 12-lead ECGs, they tend to treat the MI detection
and location tasks as two independent tasks and did not consider
the correlation between them [22–25], which may severely limit the
performance and improvement space of the existing methods.
Therefore, to address the above problems, we propose a multi-
task channel attention network (MCA-net) for MI detection and loca-
tion tasks. The contributions of this paper can be summarized as the
following points:
1. We propose a novel channel attention network for feature learn-
ing from 12-lead ECGs, which employs multiple independent
channels network to extract features from individual leads. In
each channel network, the features are efficiently extracted and
integrated with different stages using the squeeze-and-excitation
(SE) [26] attention mechanism and skip connections.
2. According to the relevance of MI detection and location tasks, we
introduce a multi-task framework in MCA-net. This multi-task
framework can improve the performance and generality of MCA-
net by exploiting the shared and complementary information
among the tasks in a joint optimization loss manner. Therefore,
MCA-net can be easily extended to different tasks.
3. In the experimental part, we use two public datasets to fully
validate the performance and generalizability of MCA-net. We
use the multi-fold cross validation strategy for a more rigorous
evaluation of the model performance. We also conduct many
ablation experiments to compare and analyze the impacts of the
multi-task framework and the role of each module in the channel
attention network. The experimental results indicate that MCA-
net is superior both in performance and generality compared to
other studies.
The rest of this paper is organized as follows: The related works
about MI detection and location methods are discussed in Section 2.
Section 3 describes the dataset and preprocessing methods we used. The
details of our proposed method are described in Section 4. In Section 5,
we present the details of experimental implementation and discuss the
results. In Section 6, ablation experiments and further analysis of our
model are presented. Finally, we conclude our work in Section 7.
2. Related works
Because of its easy accessibility and noninvasive nature, ECG is
often used as a critical means for clinical MI detection and location.
W. Pan et al.
However, the traditional manual analysis of ECG is extremely time-
consuming and laborious and needs the professional knowledge and
experience of doctors. Therefore, researchers have explored and devel-
oped many automatic MI diagnosis algorithms to reduce the burden on
cardiologists.
Early automatic MI diagnosis algorithms focused on the MI de-
tection task that classified MI and HC (Healthy Control) populations.
Researchers typically use biosignal processing methods combined with
classic machine learning methods. These methods usually required
many tedious manual data processing steps before classification, such
as denoising, normalization, feature extraction, and selection. Com-
monly used methods include WT, frequency domain analysis
(FDA) [27], hidden markov model (HMM) [28] and SVM, etc.
For example, to perform automatic detection of MI based on ECGs,
Sun et al. [29] proposed a multi-instance learning (MIL) approach
named latent topic MIL. This method used the unlabeled heartbeats
in the training set to create a topic space and mapped the ECGs to
this space. Then, the ECG-level topic vectors are fed into the SVM
for the final classification. Nidhyananthan et al. [30] presented a
wavelet-based method to detect MI and user identity. This model first
used Daubechies wavelet transform to decompose the multi-layer ECG
signals and then employed an SVM classifier to classify the normal and
abnormal cases in the signals. Benameur et al. [31] based on three
parametric imaging techniques for cardiac MRI to quantify areas of
infarct-related systolic impairment to detect MI. The parametric images
generated from the monogenic signal achieved the best performance.
Pereira et al. [32] designed a method combined with wavelet decompo-
sition and eigenspace analysis to detect MI. The wavelet decomposition
is used to extract waveforms of different frequencies in the ECGs
and separate them. The eigenspace analysis provided the eigenvalues
calculated from covariance matrices. Therefore, these training features
can help to classify HC and MI patients. Liu et al. [33] used the
tunable Q-factor wavelet transform (TQWT) to design a novel ECG
signal processing method to extract high-quality ECGs and perform
MI detection. In this proposed method, the authors decomposed the
12-lead ECG signal into high and low Q-factor components, and then
manually extracted a large number of features, which were finally fed
into KNN to obtain better performance. Wah et al. [34] used SVM
and KNN as classifiers to classify cardiac conditions in ECG signals
based on extracting relevant waveforms or features from the ECG
signal and analyzing certain specific regions of the peaks and their
temporal frequencies. Fatimah et al. [13] developed two models to
automatically detect MI called primary and modified methods based
on single-lead ECGs, respectively. The primary algorithm applied the
Fourier decomposition method (FDM) on the heartbeats obtained after
the segmentation operation based on R-peaks and used a modified
algorithm to calculate its efficiency. Features obtained by these two
methods were fed into a variety of conventional machine learning
classifiers and achieved the best performance in KNN. Han et al. [16]
proposed a new method to detect MI by fusing energy entropy and
morphological features based on 12-lead ECGs. In detail, the ECGs were
first decomposed and then calculated the decomposed coefficients to
get the energy entropy, finally fused with local morphological features
as global features for more accurate classification. Sahu et al. [35]
designed a novel MI detection and location method using variational
mode decomposition (VMD) and regularized neighborhood component
analysis (RNCA). It constructed a feature set from statistical and non-
linear features computed by the intrinsic mode function of the VMD
and ranked using RNCA, then fed into a KNN and AdaBoost classifier
for classification. Unfortunately, these traditional methods based on
feature engineering rely excessively on professional medical experience
and require a long feature extraction process and a rigorous feature
selection process. As a result, they are susceptible to limitations in terms
of convenience and stability and are difficult to meet clinical standards.
However, as deep learning methods have shown great advantages
in the fields of computer vision, biosignal analysis, and machine trans-
lation, their powerful automatic feature extraction ability has been
3
Computers in Biology and Medicine 150 (2022) 106199
demonstrated. Therefore, more and more deep learning-based methods
for automatic MI detection have been proposed. For instance, Liu
et al. [36] developed a novel algorithm based on a multi-lead CNN
(ML-CNN) for MI detection via four-lead ECGs. In this method, the lead
asymmetric pooling (LAP) layers and sub-two-dimensional (2-D) convo-
lutional layers were applied to learn multi-scale feature representations
of different leads which performed 96.00% accuracy. Li et al. [37]
proposed an automatic MI detection model to synthesize single-lead
ECGs with high morphological similarity by generative adversarial
networks (GANs). It automatically detected MI using CNNs for both the
original ECG and the synthetic ECG from GANs and achieved 99.06%
accuracy. Moreover, Liu et al. [23] presented a multiple-feature-branch
convolutional bidirectional recurrent neural network (MFB-CBRNN) to
effectively perform MI automatic detection based on the 12-lead ECGs
which consisted of 12 multi-feature branches. Specifically, MFB-CBRNN
utilized multiple stacked multi-scale convolutional layers combined
with pooling operations to fully extract the features within the ECG
leads. Then, it used bidirectional LSTM to fuse features from each
multi-feature branch and achieved 99.54% and 86.29% accuracy under
inter-patient and intra-patient paradigms, respectively.
And as automatic MI detection methods continue to improve, re-
searchers are gradually shifting their research focus to the more chal-
lenging and clinically valuable task of MI location. For example, Liu
et al. [38] proposed a new multiple-feature branch CNN (MFB-CNN)
to automatically detect and locate MI based on 12-lead ECGs which
learned features of leads by corresponding feature branches. Thus, this
model obtained 98.79% and 94.82% mean accuracies on MI detection
and location tasks, respectively. Cao et al. [39] proposed a multi-scale
deep learning model based on a combination of residual network and
attention mechanism for 12-lead ECG recordings. It mainly used the
SENet model and the Grad-CAM algorithm to calculate the weights of
each lead and detected and located MI based on the weighted features,
and both achieved over 99% accuracy. Han et al. [22] designed a multi-
lead residual neural network (ML-ResNet) for MI detection and location
tasks using 12-lead ECG records. It extracted local features from differ-
ent leads to construct the global feature representation and achieved
95.49% and 55.74% accuracy under the inter-patient paradigm on MI
detection and location tasks, respectively. Cao et al. [24] proposed a
novel multichannel lightweight model (ML-Net) to provide algorithmic
support for automatic MI detection and location on portable devices. In
detail, ML-Net utilized a multi-lead framework enabling features within
each lead to be learned independently, thus preserving the unique
features of different angles represented by different leads, and finally
performed 96.00% and 66.85% classification accuracy in MI detection
and location tasks, respectively. However, most methods are designed
for specific tasks and are difficult to extend to other downstream tasks,
limiting their use in clinical practice. In contrast, methods that consider
both MI detection and location tasks usually treat MI detection and
location as two separate tasks. They do not consider the correlation
between the tasks and do not enable effective information sharing and
complementarity between the tasks during training, which may limit
their overall performance.
To tackle the limitations of existing methods, we design a multi-
task channel attention network named MCA-net. In our model, we use
a channel attention network to learn and fuse the features of each
lead and employ a multi-task framework to efficiently combine shared
and complementary information between MI detection and location
tasks. Experiments show that MCA-net can automatically perform MI
detection and location tasks and has a high application value.
3. Data description and preprocessing
The ECG data used in this paper are from the PTB [40] and PTBXL
datasets [41], respectively.
W. Pan et al. Computers in Biology and Medicine 150 (2022) 106199

Fig. 2. The overview of MCA-net. 2D-C: The 2-D Convolution Layer. BN: The Batch Normalization Layer. LR: The LeakyReLU Layer. 2D-RB: The 2-D Residual Block. 1D-RB:
The 1-D Residual Block. GAP: The Global Average Pooling Layer. FC layer: The Fully Connected Layer. Detection: The two-category detection task. Location-5: The five-category
location task. Location-7: The seven-category location task.

Table 1 3.3. Preprocessing

Summary of the PTB dataset used in the paper.
Class Subjects Records Heartbeats For each record in the PTB dataset, we first resample it to 500 Hz.
AMI 17 47 4369 Then, we split the resampled record into some fixed-length heartbeats,
ASMI 28 79 7596
heartbeats smaller than that length are discarded. There is no overlap
ALMI 16 43 4152
IMI 30 89 7970 between each heartbeat. Since the duration of a complete ECG wave-
ILMI 23 56 5235 form is about 0.6 s, to ensure that each heartbeat contains at least one
Other 13 32 2956 complete ECG waveform, the fixed length of each heartbeat is set to
HC 52 80 7866 1.2 s (600 sampling points) in this paper. As shown in Table 1, we end
Total 179 426 40,144 up with a total of 40,144 heartbeats.
For the PTBXL dataset, we directly select the 500 Hz sampling
Table 2 frequency version to maintain uniformity with the PTB dataset. Con-
Summary of the PTBXL dataset used in the paper. sidering that each record in the PTBXL dataset may contain more than
Class Subjects Records one annotation, we do not segment it to ensure the integrity of the
AMI 348 354 multi-label information.
ASMI 2037 2363 Based on the above preprocessing, we obtain a single-labeled dataset
ALMI 245 290 with heartbeats as the basic unit and a multi-labeled dataset with ECG
IMI 2362 2685 records as the basic unit, respectively, to fully validate the effectiveness
ILMI 416 479
Other 278 302
of our method.
HC 8903 9528
Total 13,460 15,013 4. Method

As illustrated in Fig. 2, the overall structure of the MCA-net is

3.1. The PTB dataset
The PTB dataset is commonly used to train and evaluate different MI
detection and location methods. It contains 549 12-lead ECG records, of
which 368 ECG records from 52 HC subjects and 148 MI patients are
used in this paper. All ECG data in this dataset are available online.
Each ECG record consists of 12 standard leads (as shown in Fig. 1) and
3 Frank leads (VX, VY, and VZ), sampled at 1000 Hz. Moreover, these
ECG records are all annotated by cardiologists, a subject may provide
more than one ECG record, but each ECG record has only one label.
Most of these ECG records last approximately 2 min and at least 30 s.
The statistics of the used 12-lead ECGs on the PTB dataset are shown
in Table 1.
3.2. The PTBXL dataset
composed of a channel attention network based on a multi-task frame-
work. In detail, we input the 12-lead ECGs to a channel attention
network with 12 channels, each channel is assigned to a lead. For each
lead of the ECG signal, we first format the data into a 2-D matrix
by adding an extra dimension. The 2-D matrix is then fed into a 2-D
convolutional layer to capture important information in the early stages
of feature extraction. Then, to extract multi-scale features, we employ
2-D residual blocks with different kernel sizes. Immediately afterward,
we reshape the features into 1-D features before feeding them into three
1-D residual blocks to further extract finer-grained features. After the
1-D residual blocks, a global average pooling layer is used to extract
key features and improve generalization. Finally, we concatenate the
features from different channels, use dropout to avoid overfitting, and
input the flattened global features into three fully connected layers. All
the convolutions we use in MCA-net are the Same Convolution which
is one of the Standard Convolutions (both 1-D and 2-D). The details of
each part are shown in Table 3 and described below.

The PTBXL dataset is a large publicly available ECG dataset that
is newly published in April 2020 [41] which has 18,885 subjects and
provides approximately 21,837 ECG records. Among them, there are
5486 MI records and 9528 HC records. Similar to the PTB dataset,
there are 12 standard leads in each record, and two sampling frequency
versions of 100 Hz and 200 Hz are available. Each record lasts 10 s.
Each subject in this dataset provides one to multiple annotated ECG
records, and most records contain multiple annotations. The statistics
for the 12-lead ECGs used in the PTBXL dataset are shown in Table 2.
4.1. Channel attention network
The overview of our channel attention network structure is shown
inside the dashed box in Fig. 2. Conventional 12-lead ECG data can
reflect different views of cardiac activity and provide a large number
of different informative representations. Especially in the MI location
task, the features provided by different leads may point to different
locations of infarction. Therefore, it is crucial to make full use of the key
information in 12-lead ECGs. In the channel attention network, each

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W. Pan et al. Computers in Biology and Medicine 150 (2022) 106199

Table 3 Table 4
Detailed information of Channel Attention network. Detailed information of the 2-D residual block.
Part Layer Kernels Input size Type Kernel size Kernels
PTB PTBXL 2D-C 17 2/4/8/16
Expand_dims – 600 × 1 5000 × 1 BN+LR – –
I 2D-C 2 600 × 1 × 1 5000 × 1 × 1 2D-C 11 2/4/8/16
BN+LR – – –
BN+LR – –
II 2D-RB 4 600 × 1 × 2 5000 × 1 × 2 2D-C 5 2/4/8/16
Reshape – 600 × 1 × 4 5000 × 1 × 4 BN+LR – –
1D-RB 4 300 × 4 2500 × 4
III SE – –
1D-RB 8 100 × 4 833 × 4
Skip connection 1 –
1D-RB 16 33 × 8 277 × 8
LR – –
IV GAP – 11 × 16 92 × 16
Concatenate – 1 × 16 1 × 16
V Dropout – 1 × 192 1 × 192
Flatten – 1 × 192 1 × 192 representation. Then, we combine the features from the SE module
and the skip connection (including a 2-D convolutional layer) to avoid
the loss of important information. Finally, feed the features into a
LeakyReLU layer.

4.1.3. The 1-D residual blocks layer

Fig. 3. The 2-D residual block structure.
lead is represented by its independent channel to generate features.
Each channel consists of five components that take full account of
the different scales of features at different stages, which is given in
Table 3. Ultimately, the features learned by the 12-channel network
are integrated into the final patient ECG representation and fed into the
fully connected layer for classification. Details of the channel attention
network are described in the following.
4.1.1. The 2-D convolutional layer
First, the raw 1-D signal of each lead is converted into a 2-D matrix
(as shown in Table 3, Part I) and input to a 2-D convolutional layer for
feature extraction. The 2-D convolutional layer can be described as :
⎛∑ ⎞ Finally, we concatenate the features learned by each channel and
𝒙𝑙𝑗 = 𝑓 ⎜ 𝒙𝑙−1 ∗ 𝒘𝑙𝑖𝑗 + 𝑏𝑙𝑗 ⎟
⎜𝑖∈𝑀 𝑗 ⎟
⎝ 𝑗 ⎠ representation. This feature representation is then fed into different
where 𝒙𝑙−1
𝑗 is the output of the 𝑗-th convolution kernel at the (𝑙 − 1)-th
layer which is used as the input of the 𝑙-th layer. It is operated with
the bias coefficients 𝒘𝑙𝑖𝑗 and the corresponding bias 𝑏𝑙𝑗 of this layer
under the receptive field of 𝑀𝑗 . Where ∗ refers to the 2-D convolutional
operation. And then the rectified linear unit (ReLU) is applied as the
activation function 𝑓 (∙) to output 𝒙𝑙𝑗 .
Then, a batch normalization layer and a LeakyReLU activation func-
tion are used to alleviate the vanishing gradient problem and accelerate
the convergence.
4.1.2. The 2-D residual block layer
After the 2-D convolutional layer, we input the learned features
into the 2-D residual block layer. As illustrated in Fig. 3 and Table 4,
this 2-D residual block layer mainly consists of three 2-D convolutional
layers with different sizes of convolutional kernels. After these three
stacked 2-D convolutional layers, we use the SE module to process
and fuse the learned feature maps to obtain a more efficient feature
To further learn finer-grained features in each channel, we design
a 1-D residual blocks layer that has three stacked 1-D residual blocks
after 2-D residual blocks layers. Before this, the feature representations
extracted from the 2-D residual block layer are reshaped into 1-D ten-
sors. The structure of the 1-D residual blocks is similar to that of the 2-D
residual blocks in Fig. 3. The difference is that the 2-D convolutional
layers in the 2-D residual block are replaced by the 1-D convolutional
layers, and an additional average pooling layer is added to reduce the
dimensionality of the features and provide better generalization after
the LeakyReLU activation function. The 1-D average pooling operates
as :
[ ]
𝒙𝑙𝑗 (𝑘) = 𝐴𝑣𝑔 𝒙𝑙−1
𝑗 (𝑘 × 𝑠 + 𝑎) (2)
𝑎∈𝐴
where the feature representations 𝒙𝑙𝑗 (𝑘) use 𝑘 as the sampling point
index. 𝑠 denotes the strides of the pooling operation, which is all set to
1 in this paper. 𝑅 represents the whole pooling region which is divided
into 𝑟 parts. Finally, we use 𝐴𝑣𝑔 (∙) to obtain the average values of the
pooling windows.
4.1.4. The global average pooling layer
Before performing feature fusion of the multi-lead, we use a global
average pooling layer to reduce feature dimension and provide a more
specific internal representation for each channel.
4.1.5. The feature fusion layer
(1)
feed them into a dropout layer, then use a flatten layer to get a feature
fully connected layers to obtain the corresponding classification results
of MI detection and location tasks.
4.2. Multi-task framework
From the basic process of clinical diagnosis, cardiologists usually
detected MI first and then located MI after confirming the diagnosis.
Meanwhile, the MI detection result can also be verified from the
results of location. However, existing approaches are usually designed
to implement only one specific task or multiple independent tasks
which did not take into account the relationship between these two
tasks and the additional information they may bring. These approaches
limited the classification performance and improvement space of the
existing methods. Therefore, for MI detection and location tasks, a
model that can perform both of them at the same time is more reliable
than several independent models. Moreover, this kind of model may
be more effective in terms of generalizability and performance, since

5
W. Pan et al.
MI detection and location tasks may have overlapping key features and
additional information that can be complementary.
Multi-task frameworks have been shown to play a gainful role
in similar tasks by learning shared and complementary information
between multiple tasks to optimize the performance of all tasks [42–
44]. And we use the most classical multi-task framework, a shared-
bottom model [42]. This model achieves improved classification per-
formance by sharing the bottom representation across multiple tasks
and performing loss optimization within multiple tasks. Thus, MCA-net
based on this multi-task framework can more effectively combine MI
detection and location tasks. The framework can be expressed by :
𝑦𝑛 = 𝐹 𝑛 (𝑪(𝑥)) (3)
In this paper, we design three related tasks: (1) a two-category MI
detection task (Detection), which aims to identify whether people are
MI or HC; (2) a five-category MI location task (Location-5), whose
goal is to distinguish AMI, ASMI, ALMI, other and HC populations; (3)
a seven-category MI location task (Location-7), which objective is to
distinguish AMI, ASMI, ALMI, IMI, ILMI, other and HC populations. For
the Location-5 task, we select it because a large proportion of patients
with MI have Generalized Anterior MI (GAMI) [36], which is consisting
of AMI, ASMI, and ALMI, so we first focus our task on differentiating
GAMI and classifying the remaining MI labels into other categories. We
then consider the task for most of the existing studies and the relevance
of that task to the Location-5 task, as well as the distribution of labels
on the dataset. Ultimately, the IMI and ILMI are additionally selected
for classification based on the Location-5 task to form the Location-7
task.
Specifically, the multi-task framework shares parameters and fea-
ture representations among the three tasks in the channel attention
network, which is represented as a function 𝑪. While 𝑛 = 1, 2, 3 for
each task, respectively. Then we get each task output 𝑦𝑛 after passing
through the corresponding fully connected layer 𝐹 𝑛 .
The losses of these tasks in the multi-task framework are combined
in the form of a weighted sum for joint optimization, and the total loss
can be expressed as :
𝑳𝑡𝑜𝑡𝑎𝑙 = 𝑎𝑳𝑑 + 𝑏𝑳𝑙−5 + 𝑐𝑳𝑙−7 (4)
where 𝑳𝑑 , 𝑳𝑙−5 , 𝑳𝑙−7 correspond to the Detection, Location-5 and
Location-7 tasks, respectively, and 𝑎, 𝑏, 𝑐 are the weights for the three
related tasks.
5. Experiments and results
In this section, we fully evaluate MCA-net on the PTB and PTBXL
datasets and compare it with state-of-the-art methods for automatic MI
detection and location. In addition, we perform a significance test of the
results of our experiments to show the improvements in our approach.
5.1. Comparison methods
For a comprehensive assessment, we conduct comparative experi-
ments on our method and other three state-of-the-art MI classification
methods, i.e., MFB-CBRNN [23], ML-ResNet [22], and ML-Net [24] on
both the PTB and PTBXL datasets.
• MFB-CBRNN: MFB-CBRNN used a multi-lead framework for MI
detection based on the 12-lead ECGs. To fully utilize the ECG
waveform information contained in all 12 leads. 12 multiple-
feature-branch was employed to extract features within each lead
which was mainly composed of convolutional blocks. For effective
feature fusion, MFB-CBRNN also used a bidirectional LSTM to
integrate all the features output from each lead branch.
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Computers in Biology and Medicine 150 (2022) 106199
• ML-ResNet: ML-ResNet also employed a multi-lead framework
for MI detection and location, but it used a residual-based net-
work structure in designing multi-feature branches. Each multi-
feature branch mainly consisted of three stacked residual blocks,
each of which included three convolutional layers and a skip
connection. Thus, ML-ResNet can be layered to learn feature
representations within the leads and perform feature fusion.
• ML-Net: ML-Net also had a novel channel branch structure based
on a multi-lead framework. The branch structure is designed as
three parallel convolutional networks which used setting different
convolutional kernel sizes to integrate multi-scale features within
the leads. However, unlike the above two approaches, ML-Net
only used four leads ECG data to accommodate the lightweight
needs of portable devices.
Unlike these methods, our approach combines 2-D and 1-D residual
blocks for extracting early significant features and finer-grained fea-
tures. And we also used the SE module and skip connections in the
MCA-net for feature weighting and to prevent loss of valid information.
Finally, by introducing a multi-task framework, the inter-task correla-
tion and complementarity are fully exploited to extend the MCA-net to
individual tasks and improve the overall classification performance.
Because MFB-CBRNN, ML-ResNet, and ML-Net are all originally
designed for different MI classification tasks, using different amounts
of data and different means of data processing. We extend them to
our task by unifying the data inputs and modifying their corresponding
classification layers for a fair comparison.
5.2. Implementation details
All methods involved in this paper were developed based on Keras
and the TensorFlow framework [45] which are trained and tested using
python 3.6. The relevant experiments were performed on a server
with an Intel(R) Xeon(R) Gold 6230 CPU @ 2.10 GHz and 251 GB
memory. We set the initial learning rate of the model to 0.001 and
optimized it during the training process using the callback function
ReduceLROnPlateau. The number of epochs and batch sizes were set to
100 and 64, respectively. Moreover, we also deploy the Adam and early
stop strategies to speed up the learning process and prevent overfitting.
5.3. Evaluation metrics
In this work, the model performances on the PTB dataset are eval-
uated by three metrics, namely, sensitivity (Sen), specificity (Spe), and
accuracy (Acc). The Sen, also called recall, represents the percentage
of positive samples correctly predicted by the model over the overall
positive samples. Conversely, Spe represents the percentage of negative
samples correctly predicted by the model over the overall negative
samples. While, the accuracy rate (Acc) is the percentage of all cor-
rectly identified samples over the total samples. These three evaluation
metrics can be calculated by the following equation:
TP
Sen = . (5)
TP + FN
TN
Spe = . (6)
TN + FP
TP + TN
Acc = . (7)
TP + TN + FP + FN
Where TP (True Positive) and TN (True Negative) refer to the
number of samples where both the true categories and the predicted
categories are positive or negative. While FP (False Positive) and FN
(False Negative) refer to the number of samples where the true cat-
egories and the predicted categories are positive and negative, or
negative and positive, respectively.
For the multi-label dataset PTBXL, we use the same metrics to
evaluate the model performances on the MI detection task. But for the
MI location task, we select the accuracy and the area under the roc
W. Pan et al.
Table 5
Performance comparison of MCA-net with three state-of-the-art methods on the PTB dataset under the inter-patient scheme.
Model Detection Location-5
Sen(%) Spe(%) Acc(%) Sen(%)
MFB-CBRNN 93.34 ± 0.11 73.94 ± 0.73 89.53 ± 0.16 54.41 ± 0.37
ML-ResNet 96.07 ± 0.06 71.60 ± 1.45 91.28 ± 0.10 53.38 ± 0.48
ML-Net 95.24 ± 0.03 77.69 ± 0.53 91.81 ± 0.04 54.23 ± 0.16
MCA-net 98.01 ± 0.05𝑏𝑐 86.01 ± 0.18𝑐 95.57 ± 0.06𝑐 55.35 ± 0.10
Location-5: The five-category MI location task. Location-7: The seven-category MI location task.
𝑎,𝑏,𝑐
indicates that the MCA-net showed a significant improvement in this column compared to the MFB-CBRNN, ML-ResNet, and ML-net in the T-test experiment at the 0.05
significance level, respectively.
curve (AUROC) suggested by the dataset publishers [41] to evaluate
the model performances. It refers to the expected value of a uniformly
drawn random positive sample ranked ahead of a negative sample. In
our work, we set each label in turn as a positive sample and set the
remaining labels as negative samples to calculate their AUROCs and
average them.
All evaluation metrics are shown as mean–variance in the cross val-
idation experimental results to measure the classification performance
and stability of involved methods.
5.4. Experimental results on the PTB dataset
Unlike the intra-patient schemes which are often used in previous
studies, the inter-patient schemes are of greater clinical significance to
prove the model generalization.
Therefore, we perform 5-fold cross validation experiments on the
PTB dataset under an inter-patient scheme to verify the effectiveness
and generalizability of our approach, the mean sensitivity, specificity,
and accuracy of our model are shown in Table 5 where the opti-
mal solution is highlighted. We can see that MCA-net achieves the
best performance for all tasks. In the detection task, the sensitivity,
specificity, and accuracy of MCA-net are improved compared with
other comparative methods, reaching 98.01%, 89.01%, and 95.57%,
respectively, while the improvement in specificity is extremely obvious.
The classification performance of MCA-net is also improved in the
Location-5 task, achieving 55.35%, 67.96%, and 68.90%, respectively.
For the Location-7 task, the MCA-net is achieving 41.80%, 49.01%, and
49.18%, with an improvement of more than 6% on accuracy.
We can also observe that MFB-CBRNN performs slightly worse in all
tasks compared to the other methods. And ML-ResNet achieves good
classification accuracy on both detection and location tasks. And ML-
Net performs a little better than ML-ResNet on both the Detection
and Location-5 tasks, but slightly worse on the Location-7 task. This
indicates that they lack adaptability to different tasks. In contrast, our
method has not only superior performance but also high generalizabil-
ity. This is mainly because we use multiple convolutional layers with
different convolutional kernel sizes and SE module to learn important
features at different granularities. On the other hand, it also benefits
from the multi-task framework which can effectively share underlying
parameters and complementary information between different tasks.
In addition to the mean result of the evaluation metrics, we also
calculate their ranges of variance to compare the stability between
methods. As can be seen in Table 5, the range of variance fluctuation
of our method is smaller than that of the comparison method for most
of the evaluation indicators, which proves that our method ensures
reliable stability while maintaining superior performance. Moreover, a
T-test at a 0.05 significance level was used to analyze whether the MCA-
net was significantly better than other comparative methods for each
evaluation metric. As can be seen, our method has some performance
advantages on the Detection and Location-7 tasks, especially in terms of
sensitivity. However, in the Location-5 task, which may be influenced
by the label imbalance and distribution, a higher demand is placed on
the model’s ability to differentiate.
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Computers in Biology and Medicine 150 (2022) 106199
Location-7
Spe(%) Acc(%) Sen(%) Spe(%) Acc(%)
63.04 ± 0.18 63.79 ± 0.19 36.96 ± 0.33 41.59 ± 0.39 41.71 ± 0.39
64.04 ± 0.23 65.00 ± 0.21 36.61 ± 0.34 42.37 ± 0.51 42.51 ± 0.52
64.80 ± 0.12 65.62 ± 0.12 36.57 ± 0.30 41.90 ± 0.32 42.03 ± 0.32
67.96 ± 0.10 68.90 ± 0.10 41.80 ± 0.10𝑎𝑏𝑐 49.01 ± 0.09 49.18 ± 0.09𝑎
5.5. Experimental results on the PTBXL dataset
Different from the PTB dataset, the PTBXL dataset involves a larger
number and wider range of patients, and each patient can provide
one to more ECG records, allowing for richer sample information and
longer ECG sequences. In addition, the PTBXL dataset is closer to the
actual clinical situation than the PTB dataset because its ECG records
usually contain multiple labels. We extract HC and MI records from the
PTBXL dataset for MI detection and location experiments to validate
the performance of the MCA-net. Longer duration ECG records are used
as input units to validate the effectiveness of the MCA-net in learning
long time series features. To more closely resemble the real-world data
distribution, the PTBXL dataset is divided by its publisher into ten folds
of the inter-patient paradigm [41] which represents that there is no
overlap of patient origin for ECG records in all folds. Therefore, we
perform 10-fold cross validation based on these sets to obtain more
reliable results. As shown in Table 6, our method still outperforms other
comparative methods, achieving a sensitivity of 88.59%, specificity of
96.55%, and accuracy of 93.65% on the detection task. Meanwhile,
MCA-net also performs better than other methods on the Location-5
and Location-7 tasks, achieving 84.03% and 81.47% accuracy as well
as 78.76% and 74.05% AUROC, respectively. This demonstrates the
effectiveness and generalizability of our method across the different
datasets.
We also can see that in contrast to the results on the PTB dataset,
ML-Net performs the worst on the PTBXL dataset. The possible reason
is that the length of data provided by the PTBXL dataset is much
longer (typically more than several thousand sampling points), while
the lightweight framework adopted by ML-Net cannot effectively learn
long-term dependencies from such long ECG sequences. And MFB-
CBRNN performs relatively well on both datasets, which demonstrates
the stability of the convolutional layer. In addition, the average per-
formance of ML-ResNet performs better than the other two comparison
methods, which proves the effectiveness of the residual module. Our
approach not only combines the stability of the convolutional layer
with the effectiveness of the residual module but is also better able to
learn the long-term dependence of ECG sequences thus achieving better
performance.
Again, the reliable stability of the MCA-net is further verified by the
range of variance fluctuations of the experimental results. In addition
to this, we still use the T-test to verify the significance of MCA-net
on the PTBXL dataset. As can be seen in Table 6, MCA-net achieves
significant improvements in most tasks relative to the comparison
method, especially the Location-5 and Location-7 tasks.
6. Discussion
In this paper, we design a multi-task channel attention network
named MCA-net for MI detection and location tasks. Our approach
shows an improvement in its overall performance compared to other
methods. To further evaluate the effectiveness of the various compo-
nents within the MCA-net, we first discuss the gains brought by the
multi-task framework to the MCA-net. Then, ablation experiments are
performed for the main modules of the channel attention network
inside the MCA-net. Finally, a further analysis was carried out.
W. Pan et al. Computers in Biology and Medicine 150 (2022) 106199

Table 6
Performance comparison of MCA-net with three state-of-the-art methods on the PTBXL dataset under the inter-patient scheme.
Model Detection Location-5 Location-7
Sen(%) Spe(%) Acc(%) Acc(%) AUROC(%) Acc(%) AUROC(%)
MFB-CBRNN 83.12 ± 0.71 96.41 ± 0.02 91.55 ± 0.06 81.96 ± 0.02 74.51 ± 0.09 79.17 ± 0.024 69.21 ± 0.09
ML-ResNet 86.87 ± 0.08 96.93 ± 0.01 93.24 ± 0.01 83.25 ± 0.00 76.15 ± 0.01 80.23 ± 0.01 72.07 ± 0.03
ML-Net 73.32 ± 0.08 91.56 ± 0.02 84.89 ± 0.00 68.30 ± 0.01 68.11 ± 0.00 64.64 ± 0.00 62.98 ± 0.00
MCA-net 88.59 ± 0.06𝑎𝑏𝑐 96.55 ± 0.01𝑐 93.65 ± 0.01𝑎𝑐 84.03 ± 0.005𝑎𝑏𝑐 78.76 ± 0.02𝑎𝑏𝑐 81.47 ± 0.01𝑎𝑏𝑐 74.05 ± 0.03𝑎𝑏𝑐

Location-5: The five-category MI location task. Location-7: The seven-category MI location task.
𝑎,𝑏,𝑐
indicates that the MCA-net showed a significant improvement in this column compared to the MFB-CBRNN, ML-ResNet, and ML-net in the T-test experiment at the 0.05
significance level, respectively.

Table 7
Ablation experiments in Multi-Task Framework under inter-patient scheme.
Model The PTB dataset The PTBXL dataset
Acc-2(%) Acc-5(%) Acc-7(%) Acc-2(%) Acc-5(%) AUROC-5(%) Acc-7(%) AUROC-7(%)
Cnet 94.52 ± 0.06 66.45 ± 0.5131 46.41 ± 0.47 93.57 ± 0.00 83.95 ± 0.00 76.99 ± 0.02 81.34 ± 0.01 73.43 ± 0.02
MCA-net25 95.04 ± 0.06 67.06 ± 0.36 – 93.60 ± 0.01 83.74 ± 0.01 77.77 ± 0.03 – –
MCA-net27 95.21 ± 0.07 – 48.12 ± 0.03 93.65 ± 0.01 – – 81.14 ± 0.01 73.48 ± 0.02
MCA-net 95.57 ± 0.06 68.90 ± 0.10 49.18 ± 0.09 93.65 ± 0.01 84.03 ± 0.00 78.76 ± 0.02 81.47 ± 0.01 74.05 ± 0.03

Acc-2: Accuracy of the MI detection task. Acc-5: Accuracy of the five-category MI location task. Acc-7: Accuracy of the seven-category MI location task. AUROC-5: AUROC of the
five-category MI location task. AUROC-7: AUROC of the seven-category MI location task.

6.1. The benefits of the multi-task framework Table 8

Training time comparison of MCA-net with three state-of-the-art methods.

To validate the impact of the multi-task framework in MCA-net, Model The PTB dataset The PTBXL dataset

we design a single-task model and two dual-task models to perform
the same experiments as our model on the PTB and PTBXL datasets.
The results of the ablation experiments can be seen in Table 7. Here,
Cnet refers to the single-task model, MCA-net25 refers to the dual-task
model for the Detection and Location-5 tasks, MCA-net27 refers to the
dual-task model for Detection and Location-7 tasks.
We can find that the single-task model Cnet performs well on dif-
ferent fine-grained tasks based on Table 7, especially the MI detection
task. Meanwhile, we can also find that the results of the experiments are
continuously optimized as the number of tasks increases and the gran-
ularity of the tasks refines. In particular, our model achieves the best
results, not only on different datasets but also on different tasks. On the
PTB dataset, the improvement rates for MI detection and location tasks
are 1.05%, 2.45%, and 2.77%, respectively. On the PTBXL dataset, we
improve the AUROC by 0.08%, 1.77%, and 0.62% respectively, while
maintaining the high accuracy. This proves that the multi-task learning
framework we adopt can effectively capture common information and
task-specific features related to different tasks, and enhance the final
feature representation through information complementation between
tasks. We can also observe that increasing the number of tasks enables
more aggregation of features learned from different tasks and enhances
the final learned representations. And the increased number of clas-
sification categories leads the model to learn more accurate features,
which affects the final decision.
By the way, combine with Tables 5 and 6, we can also observe
that the single-task model Cnet still has higher classification accuracy
than all the comparison methods, which further demonstrates that the
channel attention network structure can capture the relevant features
in the 12-lead ECGs more effectively.
6.2. The benefits of the channel attention network
In this subsection, to further understand the impacts of each mod-
ule on the final classification performance, we remove the different
modules of the channel attention network and conduct experiments
in the same configuration, respectively. We compare the classifica-
tion accuracy between our model MCA-net and MCA-net variants,
i.e., MCA-net without the 2-D residual block, MCA-net without the 1-
D residual blocks, and MCA-net without the SE modules. The ablation
experimental results on the PTB and PTBXL datasets are shown in
Fig. 4.
Epoch(s) Fold(s) Epoch(s) Fold(s)
MFB-CBRNN 93.78 37205.48 156.74 2743.85
ML-ResNet 115.11 4595.61 84.64 1847.15
ML-Net 98.55 3145.82 85.54 3413.86
MCA-net 77.23 2276.68 135.44 2682.60
• No 2-D Residual Block: We can see from Fig. 4 that the model
without the 2-D residual block exhibits a decrease in accuracy
compared to MCA-net. This demonstrates that the 2-D residual
block can help the model learn the morphological features of the
ECG waveforms inside the leads in the early feature extraction
stage of the model. In addition, we can see that the 2-D residual
block has a better impact on model performance in the PTB
dataset, which suggests that the 2-D residual block may be more
effective in extracting short ECG sequences.
• No 1-D Residual Blocks: And we can also see that the model
without the stacked 1-D residual blocks also shows a degradation
in performance. However, the impact of the 1-D residual block
on the model shows noticeable differences across the datasets.
As shown in Fig. 4a, the 1-D residual block brings less than
2% improvement in accuracy per task on the PTB dataset, while
on the PTBXL dataset (shown in Fig. 4b), It is more effective
than the other modules, with gains of 3.77%, 5.36%, and 7.18%,
respectively. This proves that the stacked 1-D residual blocks
can more effectively enhance the model’s ability to capture fine-
grained features from long ECG sequences, and are more suitable
for processing relatively complex learning tasks.
• No SE: To explore the benefits brought by the SE modules, we
remove the SE modules from the 2-D residual block and the 1-D
residual blocks and then conduct experiments. We can see from
Fig. 4 that the classification performance of MCA-net decreases
after removing the SE modules. This is particularly evident on the
PTB dataset, where the accuracy drops on the three classification
tasks reach 2.83%, 4.62%, and 6.63%, respectively. This shows
that the SE modules can strengthen the important features and
weaken the non-important features on the ECG classification
task, thus achieving the purpose of improving the classification
performance.

8
W. Pan et al. Computers in Biology and Medicine 150 (2022) 106199

Fig. 4. Ablation experiments in channel attention network.

Fig. 5. An example from the learning curve (fold 10 on the PTBXL dataset).

Fig. 6. 5-fold cross validation results on the PTB dataset.

9
W. Pan et al.
Fig. 7. 10-fold cross validation results on the PTBXL dataset.
Table 9
Training resources comparison of MCA-net with three
state-of-the-art methods.
Model Trainable params
MFB-CBRNN 14,462
ML-ResNet 83,006
ML-Net 3,849,314
MCA-net 112,250
6.3. Further analysis
• Time and Resource: To demonstrate that our method is rela-
tively economical in terms of time and resources compared to
other methods. We first count the average time overhead for
each method to complete one epoch and one fold for each task.
For the MCA-net multi-task model, each task would complete at
the same time. For the comparison methods, we execute three
tasks in parallel and choose the training time of the last finished
one as the benchmark for comparison. Then, we further compare
the resource overheads of the models by considering the sum of
trainable params required for each task. From Tables 8 and 9,
we can see that MFB-CBRNN requires the least trainable params,
but has a relatively long training time, especially the time over-
head of one fold on the PTB dataset. In contrast, ML-Net has a
relatively low time overhead on both datasets but requires far
more trainable params than the other methods. Both ML-ResNet
and our method, in relative terms, balance the time and resource
overheads better, but our method achieves better classification
performance on each task than ML-ResNet. In the future, we will
further optimize our model to reduce the overhead of the model
while ensuring high classification accuracy.
• Convergence: We perform a convergence analysis of the MCA-net
based on the learning curve on the PTB and PTBXL datasets. Due
to space constraints, we only randomly give part of the learning
curve of the PTBXL dataset, as shown in Fig. 5. It shows the
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Computers in Biology and Medicine 150 (2022) 106199
dynamics of accuracy and loss on both training and validation sets
under the three tasks. we can easily observe that the performance
of MCA-net gradually improves on each task and quickly reaches
stability with increasing epochs. Full results of the learning curve
on the PTBXL and PTB datasets are shown in the supplementary
material (Fig. S1–15).
• Qualitative results: We use 5-fold and 10-fold cross validation
on the PTB and PTBXL datasets to obtain more reliable results,
respectively. In this case, each fold is used in turn as the test
set and the remaining data as the training set. Therefore, for
further qualitative analysis of the experimental results, we detail
the performance results and the corresponding number of records
and patients for each fold, as shown in Figs. 6 and 7. We can
see that MCA-net achieves good overall performance on the MI
detection task, with an accuracy of over 95% in most folds. On
the PTB dataset, there is some variation in the results across folds,
which may be influenced by patient specificity, as the number of
patients involved in each fold is limited. In contrast, the results
are relatively stable across folds on the PTBXL dataset. This
demonstrates the good adaptability and stability of the MCA-net.
• Limitations: Although our method demonstrates some advan-
tages for each task, it still has some limitations. Firstly, the model
suffers from under-learning on some of the labels due to data
imbalance, leading to a performance bottleneck in the model.
For example, as shown in Fig. 8 (Since the PTBXL dataset is a
multi-label dataset, we only give the confusion matrix for each
task on the PTB dataset), the classification accuracy of ALMI was
significantly lower than that of the other labels in MI location
task. Secondly, on the MI location task, we can find that ALMI
and AMI as well as IMI and ILMI are easily confused. This may be
because the proximity of infarct locations usually leads to similar
ECG waveform abnormalities, thus making it more difficult for
our model to distinguish them which indicates that our method
needs further improvement in its ability to identify the location
of adjacent infarcts.
W. Pan et al.
Fig. 8. Confusion matrixs of MI detection and location tasks on the PTB dataset.
7. Conclusion
In clinical practice, cardiologists can make a preliminary diagnosis
of MI by analyzing abnormal ECG signals, but it is very difficult to
give a rapid and accurate diagnosis. Therefore, providing an automatic
computer-aided method can effectively reduce the burden on health-
care professionals while providing reliable support for the prognostic
assessment of patients.
In this paper, we design a multi-task channel attention network
named MCA-net. It uses multiple independent channels to more com-
prehensively extract valid features from each lead. Each channel in-
cludes multiple stacked convolutional layers which contain SE modules
to better assign feature weights. We also add a multi-task framework to
additionally take into account the shared and complementary informa-
tion between the MI detection and location tasks to further improve the
MCA-net performance. The experimental results show that our model
has state-of-the-art performance.
Although our method demonstrates some advantages for each task,
it still has some limitations. Firstly, the model suffers from under-
learning on some of the labels due to data imbalance. Secondly, MCA-
net is prone to confusion when differentiating the relevant labels. To
address the above issues, in the future, we will consider collecting more
clinical data while further improving our MCA-net with the help of
data augmentation such as contrastive learning. Moreover, considering
the multi-view nature of the 12-lead ECGs, more effective lead fusion
methods can be considered from a multi-view fusion perspective to
obtain a richer feature representation.
Declaration of competing interest
The authors declare that they have no known competing finan-
cial interests or personal relationships that could have appeared to
influence the work reported in this paper.
Acknowledgments
This work was supported in part by the National Key Research
and Development Program of China (No. 2021YFF1201200), the NSFC-
Zhejiang Joint Fund for the Integration of Industrialization and In-
formatization (No. U1909208), 111 Project (No. B18059) and the
Science and Technology Major Project of Changsha (No. kh2202004).
This work was carried out in part using computing resources at the High
Performance Computing Center of Central South University.
Appendix A. Supplementary data
Supplementary material related to this article can be found online
at https://doi.org/10.1016/j.compbiomed.2022.106199.
11
Computers in Biology and Medicine 150 (2022) 106199
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