Abstract
BACKGROUND: Early detection and diagnosis of myocardial infarction (MI) help physicians save lives through timely treatment. Vectorcardiography (VCG) is an alternative to the 12-lead electrocardiography, providing not only characteristic changes in cardiac electrical activity in MI patients but also unique spatial information often overlooked by traditional methods. Despite its potential, comprehensive comparative studies applying machine learning (ML) techniques specifically to VCG data remain limited. METHODS: This study proposes a novel VCG processing methodology using a comparative analysis of machine learning-based algorithms for the automated detection of MI patients from VCG recordings, utilizing extracted domain knowledge VCG features that monitor morphological changes in cardiac activity. For this purpose, records from the PTB Diagnostic dataset were used. The extracted domain knowledge dataset of morphological features was then fed into a diverse set of 210 machine learning configurations, including K-nearest neighbor, Support Vector Machine, Discriminant Analysis, Artificial Neural Network, Decision Tree, Random Forest, Naive Bayes, Logistic Regression, and Ensemble Methods. To further improve classification performance, we combined analyzed high-performing models using a stacking ensemble strategy, which integrates multiple base classifiers into a meta-classifier. RESULTS: The stacking-based decision-level fusion achieved high accuracy of 95.55%, sensitivity of 97.70%, specificity of 86.25%, positive predictive value of 96.86%, negative predictive value of 89.61% and f1-score of 97.27%. CONCLUSION: The results demonstrate that decision-level fusion via stacking improves classification performance and enhances the reliability of MI detection from VCG recordings, supporting cardiologists in decision-making.