Sample records for 15-minute clinical ecgs

  1. Comparison of linear–stochastic and nonlinear–deterministic algorithms in the analysis of 15-minute clinical ECGs to predict risk of arrhythmic death

    Directory of Open Access Journals (Sweden)

    James E Skinner


    Full Text Available James E Skinner1, Michael Meyer2, Brian A Nester3, Una Geary4, Pamela Taggart4, Antoinette Mangione4, George Ramalanjaona5, Carol Terregino6, William C Dalsey41Vicor Technologies, Inc., Boca Raton, FL, USA; 2Max Planck Institute for Experimental Physiology, Goettingen, Germany; 3Lehigh Valley Hospital, Allentown, PA, USA; 4Albert Einstein Medical Center, Philadelphia, PA, USA; 5North Shore University Hospital, Plainview, NY, USA; 6Cooper Medical Center, Camden, NJ, USAObjective: Comparative algorithmic evaluation of heartbeat series in low-to-high risk cardiac patients for the prospective prediction of risk of arrhythmic death (AD.Background: Heartbeat variation reflects cardiac autonomic function and risk of AD. Indices based on linear stochastic models are independent risk factors for AD in post-myocardial infarction (post-MI cohorts. Indices based on nonlinear deterministic models have superior predictability in retrospective data.Methods: Patients were enrolled (N = 397 in three emergency departments upon presenting with chest pain and were determined to be at low-to-high risk of acute MI (>7%. Brief ECGs were recorded (15 min and R-R intervals assessed by three nonlinear algorithms (PD2i, DFA, and ApEn and four conventional linear-stochastic measures (SDNN, MNN, 1/f-Slope, LF/HF. Out-of-hospital AD was determined by modified Hinkle–Thaler criteria.Results: All-cause mortality at one-year follow-up was 10.3%, with 7.7% adjudicated to be AD. The sensitivity and relative risk for predicting AD was highest at all time-points for the nonlinear PD2i algorithm (p ≤ 0.001. The sensitivity at 30 days was 100%, specificity 58%, and relative risk >100 (p ≤ 0.001; sensitivity at 360 days was 95%, specificity 58%, and relative risk >11.4 (p ≤ 0.001.Conclusions: Heartbeat analysis by the time-dependent nonlinear PD2i algorithm is comparatively the superior test.Keywords: autonomic nervous system, regulatory systems, electrophysiology, heart rate

  2. Assessment of atrial fibrillation ablation outcomes with clinic ECG, monthly 24-h Holter ECG, and twice-daily telemonitoring ECG. (United States)

    Kimura, Takehiro; Aizawa, Yoshiyasu; Kurata, Naomi; Nakajima, Kazuaki; Kashimura, Shin; Kunitomi, Akira; Nishiyama, Takahiko; Katsumata, Yoshinori; Nishiyama, Nobuhiro; Fukumoto, Kotaro; Tanimoto, Yoko; Fukuda, Keiichi; Takatsuki, Seiji


    Differences in the methodologies for evaluating atrial fibrillation (AF) ablation outcomes should be evaluated. In the present study, we compared the AF ablation outcomes among periodic clinic electrocardiography (ECG), 24-h Holter ECG, and telemonitoring ECG to evaluate the differences among these methods. In addition, we evaluated the AF-free survival rate for each method with different durations of the blanking period. A total of 30 AF patients were followed up for 6 months after initial catheter ablation, with clinic ECG on every clinic visit, monthly 24-h Holter ECG, and telemonitoring ECG twice daily and upon symptoms. AF relapse was defined as AF or atrial tachycardia detected with any of the methods. Two patients dropped out of the study, and 28 patients were followed up for 8.8 ± 2.7 months. Patients underwent 3.6 ± 0.8 clinic ECG, 5.1 ± 0.8 Holter ECG, and 273 ± 68 telemonitoring ECG examinations. During the first, second, third, fourth, fifth, and sixth months of follow-up, Holter ECG detected relapses in 11.1, 8.3, 11.5, 15.4, 4.2, and 4.8 % of patients and telemonitoring ECG detected relapses in 32.1, 25.0, 25.0, 17.9, 28.6, and 17.9 % of patients, respectively. When no duration was set for the blanking period, the AF-free survival rate was significantly lower with telemonitoring ECG (46.4 %) than with Holter ECG (78.6 %, P = 0.013) or clinic ECG (85.7 %, P = 0.002). In addition, when the duration of the blanking period was set to 3 months, the AF-free survival rate was significantly lower with telemonitoring ECG than with clinic ECG (92.9 vs. 71.4 %, P = 0.041). The AF ablation outcomes with twice-daily telemonitoring ECG might differ from those with clinic ECG when the duration of the blanking period is 0-3 months. A follow-up based solely on clinic ECG might underestimate AF recurrence.

  3. U.S. 15 Minute Precipitation Data (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — U.S. 15 Minute Precipitation Data is digital data set DSI-3260, archived at the National Climatic Data Center (NCDC). This is precipitation data. The primary source...

  4. PDF-ECG in clinical practice: A model for long-term preservation of digital 12-lead ECG data. (United States)

    Sassi, Roberto; Bond, Raymond R; Cairns, Andrew; Finlay, Dewar D; Guldenring, Daniel; Libretti, Guido; Isola, Lamberto; Vaglio, Martino; Poeta, Roberto; Campana, Marco; Cuccia, Claudio; Badilini, Fabio


    In clinical practice, data archiving of resting 12-lead electrocardiograms (ECGs) is mainly achieved by storing a PDF report in the hospital electronic health record (EHR). When available, digital ECG source data (raw samples) are only retained within the ECG management system. The widespread availability of the ECG source data would undoubtedly permit successive analysis and facilitate longitudinal studies, with both scientific and diagnostic benefits. PDF-ECG is a hybrid archival format which allows to store in the same file both the standard graphical report of an ECG together with its source ECG data (waveforms). Using PDF-ECG as a model to address the challenge of ECG data portability, long-term archiving and documentation, a real-world proof-of-concept test was conducted in a northern Italy hospital. A set of volunteers undertook a basic ECG using routine hospital equipment and the source data captured. Using dedicated web services, PDF-ECG documents were then generated and seamlessly uploaded in the hospital EHR, replacing the standard PDF reports automatically generated at the time of acquisition. Finally, the PDF-ECG files could be successfully retrieved and re-analyzed. Adding PDF-ECG to an existing EHR had a minimal impact on the hospital's workflow, while preserving the ECG digital data. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Clinical disease presentation and ECG characteristics of LMNA mutation carriers (United States)

    Ollila, Laura; Nikus, Kjell; Holmström, Miia; Jalanko, Mikko; Jurkko, Raija; Kaartinen, Maija; Koskenvuo, Juha; Kuusisto, Johanna; Kärkkäinen, Satu; Palojoki, Eeva; Reissell, Eeva; Piirilä, Päivi; Heliö, Tiina


    Objective Mutations in the LMNA gene encoding lamins A and C of the nuclear lamina are a frequent cause of cardiomyopathy accounting for 5–8% of familial dilated cardiomyopathy (DCM). Our aim was to study disease onset, presentation and progression among LMNA mutation carriers. Methods Clinical follow-up data from 27 LMNA mutation carriers and 78 patients with idiopathic DCM without an LMNA mutation were collected. In addition, ECG data were collected and analysed systematically from 20 healthy controls. Results Kaplan-Meier analysis revealed no difference in event-free survival (death, heart transplant, resuscitation and appropriate implantable cardioverter-defibrillator therapy included as events) between LMNA mutation carriers and DCM controls (p=0.5). LMNA mutation carriers presented with atrial fibrillation at a younger age than the DCM controls (47 vs 57 years, p=0.003). Male LMNA mutation carriers presented with clinical manifestations roughly a decade earlier than females. In close follow-up non-sustained ventricular tachycardia was detected in 78% of LMNA mutation carriers. ECG signs of septal remodelling were present in 81% of the LMNA mutation carriers, 21% of the DCM controls and none of the healthy controls giving a high sensitivity and specificity for the standard ECG in distinguishing LMNA mutation carriers from patients with DCM and healthy controls. Conclusions Male LMNA mutation carriers present clinical manifestations at a younger age than females. ECG septal remodelling appears to distinguish LMNA mutation carriers from healthy controls and patients with DCM without LMNA mutations. PMID:28123761

  6. Quality assessment of digital annotated ECG data from clinical trials by the FDA ECG Warehouse. (United States)

    Sarapa, Nenad


    The FDA mandates that digital electrocardiograms (ECGs) from 'thorough' QTc trials be submitted into the ECG Warehouse in Health Level 7 extended markup language format with annotated onset and offset points of waveforms. The FDA did not disclose the exact Warehouse metrics and minimal acceptable quality standards. The author describes the Warehouse scoring algorithms and metrics used by FDA, points out ways to improve FDA review and suggests Warehouse benefits for pharmaceutical sponsors. The Warehouse ranks individual ECGs according to their score for each quality metric and produces histogram distributions with Warehouse-specific thresholds that identify ECGs of questionable quality. Automatic Warehouse algorithms assess the quality of QT annotation and duration of manual QT measurement by the central ECG laboratory.

  7. Pattern recognition in paediatric ecgs: the hidden secrets to clinical ...

    African Journals Online (AJOL)

    typical ECG patterns commonly found in routine paediatric cardiac examination, ECG .... an anterolateral myocardial infarct pattern. Deep Q waves .... The light, which can penetrate tissue and bone, stimulates cell mitochondria to kick-start a ...

  8. Ral-GTPases: approaching their 15 minutes of fame. (United States)

    Feig, Larry A


    Andy Warhol, the famous pop artist, once claimed that "in the future everyone will be famous for 15 minutes". The same, it seems, can be said of proteins, because at any given time some proteins become more "fashionable" to study than others. But most proteins have been highly conserved throughout millions of years of evolution, which implies that they all have essential roles in cell biology. Thus, each one will no doubt enter the limelight if the right experiment in the right cell type is done. A good example of this is the Ras-like GTPases (Ral-GTPases), which until recently existed in the shadow of their close cousins--the Ras proto-oncogenes. Recent studies have yielded insights into previously unappreciated roles for Ral-GTPases in intensively investigated disciplines such as vesicle trafficking, cell morphology, transcription and possibly even human oncogenesis.

  9. ECG dispersion mapping predicts clinical deterioration, measured by increase in the Simple Clinical Score.

    LENUS (Irish Health Repository)

    Kellett, J


    Objective: ECG dispersion mapping (ECG-DM) is a novel technique that reports abnormal ECG microalternations. We report the ability of ECG-DM to predict clinical deterioration of acutely ill medical patients, as measured by an increase in the Simple Clinical Score (SCS) the day after admission to hospital. Methods: 453 acutely ill medical patients (mean age 69.7 +\\/- 14.0 years) had the SCS recorded and ECGDM performed immediately after admission to hospital. Results: 46 patients had an SCS increase 20.8 +\\/- 7.6 hours after admission. Abnormal micro-alternations during left ventricular re-polarization had the highest association with SCS increase (p=0.0005). Logistic regression showed that only nursing home residence and abnormal micro-alternations during re-polarization of the left ventricle were independent predictors of SCS increase with an odds ratio of 2.84 and 3.01, respectively. Conclusion: ECG-DM changes during left ventricular re-polarization are independent predictors of clinical deterioration the day after hospital admission.

  10. Clinical evaluation of a wireless ECG sensor system for arrhythmia diagnostic purposes. (United States)

    Fensli, Rune; Gundersen, Torstein; Snaprud, Tormod; Hejlesen, Ole


    In a clinical study, a novel wireless electrocardiogram (ECG) recorder has been evaluated with regard to its ability to perform arrhythmia diagnostics. As the ECG recorder will detect a "non-standard" ECG signal, it has been necessary to compare those signals to "standard" ECG recording signals in order to evaluate the arrhythmia detection ability of the new system. Simultaneous recording of ECG signals from both the new wireless ECG recorder and a conventional Holter recorder was compared by two independent cardiology specialists with regard to signal quality for performing arrhythmia diagnosis. In addition, calculated R-R intervals from the two systems were correlated. A total number of 16 patients participated in the study. It can be considered that recorded ECG signals obtained from the wireless ECG system had an acceptable quality for arrhythmia diagnosis. Some of the patients used the wireless sensor while doing physical sport activities, and the quality of the recorded ECG signals made it possible to perform arrhythmia diagnostics even under such conditions. Consequently, this makes possible improvements in correlating arrhythmias to physical activities.

  11. Hypertrophic cardiomyopathy: Prevalence, hypertrophy patterns, and their clinical and ECG findings in a hospital at Qatar

    Directory of Open Access Journals (Sweden)

    Sherif M Helmy


    Conclusion: The prevalence of HCM in our population group is 0.13% with a male predominance (12:1. There was a diversity of clinical presentation, ECG abnormalities and patterns of LV hypertrophy among HCM patients.

  12. The 15-Minute Family Interview as a learning strategy for senior undergraduate nursing students. (United States)

    Holtslander, Lorraine; Solar, Jessica; Smith, Nicole R


    Nursing care of families continues to be a challenge within complex and demanding health-care systems. Educational strategies to bridge the theory-practice gap, connecting classroom learning with clinical experiences in undergraduate nursing education, enable students to develop the skills required to form meaningful partnerships with families. This article describes how undergraduate nursing students complete a 15-Minute Family Interview in a clinical practice setting, and document the interview process in a reflective major paper. Students integrate research and theory and identify ways to improve the care of families in the clinical setting while building communication skills and confidence in interacting with families in everyday practice. The implementation of the assignment and the evaluation of the process, including quotes from 10 student papers and 2 clinical faculty members, are discussed. Implications for education and ongoing research are offered.

  13. Comparison of Digital 12-Lead ECG and Digital 12-Lead Holter ECG Recordings in Healthy Male Subjects: Results from a Randomized, Double-Blinded, Placebo-Controlled Clinical Trial. (United States)

    Wang, Duolao; Bakhai, Ameet; Arezina, Radivoj; Täubel, Jörg


    Electrocardiogram (ECG) variability is greatly affected by the ECG recording method. This study aims to compare Holter and standard ECG recording methods in terms of central locations and variations of ECG data. We used the ECG data from a double-blinded, placebo-controlled, randomized clinical trial and used a mixed model approach to assess the agreement between two methods in central locations and variations of eight ECG parameters (Heart Rate, PR, QRS, QT, RR, QTcB, QTcF, and QTcI intervals). A total of 34 heathy male subjects with mean age of 25.7 ± 4.78 years were randomized to receive either active drug or placebo. Digital 12-lead ECG and digital 12-lead Holter ECG recordings were performed to assess ECG variability. There are no significant differences in least square mean between the Holter and the standard method for all ECG parameters. The total variance is consistently higher for the Holter method than the standard method for all ECG parameters except for QRS. The intraclass correlation coefficient (ICC) values for the Holter method are consistently lower than those for the standard method for all ECG parameters except for QRS, in particular, the ICC for QTcF is reduced from 0.86 for the standard method to 0.67 for the Holter method. This study suggests that Holter ECGs recorded in a controlled environment are not significantly different but more variable than those from the standard method. © 2016 Wiley Periodicals, Inc.

  14. The clinical application of a PACS-dependent 12-lead ECG and image information system in E-medicine and telemedicine. (United States)

    Hsieh, Jui-Chien; Lo, Hsiu-Chiung


    This study presents a software technology to transform paper-based 12-lead electrocardiography (ECG) examination into (1) 12-lead ECG electronic diagnoses (e-diagnoses) and (2) mobile diagnoses (m-diagnoses) in emergency telemedicine. While Digital Imaging and Communications in Medicine (DICOM)-based images are commonly used in hospitals, the development of computerized 12-lead ECG is impeded by heterogeneous data formats of clinically used 12-lead ECG instrumentations, such as Standard Communications Protocol (SCP) ECG and Extensible Markup Language (XML) ECG. Additionally, there is no data link between clinically used 12-lead ECG instrumentations and mobile devices. To realize computerized 12-lead ECG examination procedures and ECG telemedicine, this study develops a DICOM-based 12-lead ECG information system capable of providing clinicians with medical images and waveform-based ECG diagnoses via Picture Archiving and Communication System (PACS). First, a waveform-based DICOM-ECG converter transforming clinically used SCP-ECG and XML-ECG to DICOM is applied to PACS for image- and waveform-based DICOM file manipulation. Second, a mobile Structured Query Language database communicating with PACS is installed in physicians' mobile phones so that they can retrieve images and waveform-based ECG ubiquitously. Clinical evaluations of this system indicated the following. First, this developed PACS-dependent 12-lead ECG information system improves 12-lead ECG management and interoperability. Second, this system enables the remote physicians to perform ubiquitous 12-lead ECG and image diagnoses, which enhances the efficiency of emergency telemedicine. These findings prove the effectiveness and usefulness of the PACS-dependent 12-lead ECG information system, which can be easily adopted in telemedicine.

  15. How repeated 15-minute assertiveness training sessions reduce wrist cutting in patients with borderline personality disorder. (United States)

    Hayakawa, Masaya


    The aim of this work was to examine a possible treatment for patients with borderline personality disorder who have wrist-cutting syndrome, a condition characterized by repeated, superficial wrist cutting in a non-suicidal fashion. Within the current healthcare system in Japan, the average amount of time a doctor can spend with a psychiatric outpatient is about 8 to 15 minutes. We, therefore, examined whether repeated 15-minute psychotherapy sessions to improve patient assertiveness would be effective for reducing wrist cutting and possibly other forms of self-mutilation. We treated 13 patients diagnosed with borderline personality disorder and wrist-cutting syndrome with assertiveness training during 15-minute, biweekly therapy sessions over a course of one to four years. At the conclusion of psychotherapeutic treatment, 69% of outpatients showed a statistically significant reduction in wrist-cutting behavior.

  16. Evaluation of a novel portable capacitive ECG system in the clinical practice for a fast and simple ECG assessment in patients presenting with chest pain: FIDET (Fast Infarction Diagnosis ECG Trial)


    Rasenack, Eva; Oehler, Martin; Elsässer, Albrecht; Schilling, Meinhard; Maier, Lars


    Background Electrocardiogram (ECG) assessment plays a crucial role in patients presenting with chest pain and suspected acute coronary syndrome (ACS). In a pilot study, we previously evaluated a capacitive ECG system (cECG) as a novel ECG technique for a fast and simple ECG assessment in patients with ST-elevation myocardial infarction (STEMI). In a next step, the sensitivity and specificity of this novel ECG technique have to be assessed in patients with ACS. Hypothesis The Fast Infarction D...

  17. The feasibility of bench tests for disposable ECG electrode adhesiveness. (United States)

    Baker, C D; Schoenberg, A A; Booth, H E


    The feasibility of recommending one standard bench test that adequately qualifies electrode adhesives for clinical use was examined by UBTL. Small strips, cut from whole, commercially available disposable ECG electrodes, were attached to three types of surfaces, and samples of each type of electrode were peel tested at 15 minutes, 8 hours, and 48 hours after attachment. A program was developed to average, display, and calculate peel strength parameters. Analysis of the data showed that (a) the peel strength of electrodes varied by more than a factor of 10 when measured on human skin, and by more than a factor of 3 when measured on bench test surfaces, and (b) the peel strength of the electrode adhesive strips did not correlate with intact electrode loss on ambulatory subjects. Therefore, UBTL could not recommend one bench test that would measure adhesion performance for all electrode types appropriate for inclusion in an AAMI ECG electrode standard.

  18. Clinical Significance and Changes of ECG in the Patients with Cardiac Deficiency of the Qi and the Yin

    Institute of Scientific and Technical Information of China (English)

    LIN Qi-Shanxi


    In order to explore the changes and clinical significance of ECG in the patients with cardiac deficiency of the Qi and Yin, 124 patients with heart diseases were examined by means of ECG. The results showed that the prevalence of left ventricular hypertrophy in cardiac deficiency of the Qi (CDQ) was obviously higher than that of cardiac deficiency of the Yin (CDY). The higher prevalence of tachycardia occurred in the patients with CDY.The prevalence of the Q - T interval prolongation and abnormalities of ST - T segment in the patients with CDY was also higher than that of CDQ. The difference between two groups suggests that the diagnosis of two syndromes by ECG may be of important value.

  19. Multi-lead ECG electrode array for clinical application of electrocardiographic inverse problem. (United States)

    Hintermuller, Christoph; Fischer, Gerald; Seger, Michael; Pfeifer, Bernhard; Hanser, Friedrich; Modre, Robert; Tilg, Bernhard


    Methods for noninvasive imaging of electric function of the heart might become clinical standard procedure the next years. Thus, the overall procedure has to meet clinical requirements as easy and fast application. In this study we propose a new electrode array which improves the information content in the ECG map, considering clinical constraints such as easy to apply and compatibility with routine leads. A major challenge is the development of an electrode array which yields a high information content even for a large interindividual variation in torso shape. For identifying regions of high information content we introduce the concept of a locally applied virtual electrode array. As a result of our analysis we constructed a new electrode array consisting of two L-shaped regular spaced parts and compared it to the electrode array we use for clinical studies upon activation time imaging. We assume that one side effect caused by the regular shape and spacing of the new array be that the reconstruction of electrodes placed on the patients back is simplified. It may be sufficient to record a few characteristic electrode positions and merge them with a model of the posterior array.

  20. Selective detection of 1000 B. anthracis spores within 15 minutes using a peptide functionalized SERS assay. (United States)

    Farquharson, Stuart; Shende, Chetan; Smith, Wayne; Huang, Hermes; Inscore, Frank; Sengupta, Atanu; Sperry, Jay; Sickler, Todd; Prugh, Amber; Guicheteau, Jason


    A surface-enhanced Raman spectroscopy (SERS) assay has been designed to detect Bacillus anthracis spores. The assay consists of silver nanoparticles embedded in a porous glass structure that have been functionalized with ATYPLPIR, a peptide developed to discriminately bind B. anthracis versus other species of Bacillus. Once bound, acetic acid was used to release the biomarker dipicolinic acid from the spores, which was detected by SERS through the addition of silver colloids. This SERS assay was used to selectively bind B. anthracis with a 100-fold selectivity versus B. cereus, and to detect B. anthracis Ames at concentrations of 1000 spores per mL within 15 minutes. The SERS assay measurements provide a basis for the development of systems that can detect spores collected from the air or from water supplies.

  1. Digital and preliminary bedrock geologic map of the Townshend 7.5 x 15 minute quadrangle, Vermont (United States)

    Vermont Center for Geographic Information — Digital Data from VG98-335A Armstrong, T.R., and Ratcliffe, N.M., 1998, Digital and preliminary bedrock geologic map of the Townshend 7.5 x 15 minute quadrangle,...

  2. Detection of Bacillus spores within 15 minutes by surface-enhanced Raman spectroscopy (United States)

    Shende, Chetan; Inscore, Frank; Huang, Hermes; Farquharson, Stuart; Sengupta, Atanu


    Since the distribution of Bacillus anthracis causing spores through the US Postal System, there has been a persistent fear that biological warfare agents (BWAs) will be used by terrorists against our military abroad and our civilians at home. Despite the substantial effort to develop BWA analyzers, they remain either too slow, produce high falsealarm rates, lack sensitivity, or cannot be fielded. Consequently there remains a need for a portable analyzer that can overcome these limitations as expressed at the 2011 Biological Weapons Convention. To meet this need we have been developing a sample system that selectively binds BWAs and produce surface-enhanced Raman (SER) spectra using portable Raman spectrometers. Here we describe the use of a short peptide ligand functionalized on silver nanoparticles to selectively capture Bacillus cereus spores (a surrogate of B. anthracis) and their subsequent detection by SER spectroscopy. This technique was used to specifically detect B. cereus spores over closely related species like B. subtilis belonging to the same genus within 15 minutes. Sensitivity of the method was demonstrated by detecting 104 B. cereus spores/mL of water. The technology, once developed should prove invaluable for rapid monitoring of BWAs, which will immensely help first responders and emergency personnel in implementing appropriate counter measures.

  3. Clinical use of the combined Sclarovsky Birnbaum Severity and Anderson Wilkins Acuteness scores from the pre-hospital ECG in ST-segment elevation myocardial infarction

    DEFF Research Database (Denmark)

    Fakhri, Yama; Schoos, Mikkel M; Clemmensen, Peter


    This review summarizes the electrocardiographic changes during an evolving ST segment elevation myocardial infarction and discusses associated electrocardiographic scores and the potential use of these indices in clinical practice, in particular the ECG scores developed by Anderson and Wilkins...

  4. ECG (image) (United States)

    ... electrocardiogram (ECG, EKG) is used extensively in the diagnosis of heart disease, ranging from congenital heart disease in infants to myocardial infarction and myocarditis in adults. Several different types of ...

  5. Psychomotor and cognitive effects of 15-minute inhalation of methoxyflurane in healthy volunteers: implication for post-colonoscopy care (United States)

    Nguyen, Nam Q.; Burgess, Jenna; Debreceni, Tamara L.; Toscano, Leanne


    Background and study aims: Colonoscopy with portal inhaled methoxyflurane (Penthrox) is highly feasible with low sedation risk and allows earlier discharge. It is unclear if subjects can return to highly skilled psychomotor skill task shortly after Penthrox assisted colonoscopy. We evaluated the psychomotor and cognitive effects of 15-minute inhalation of Penthrox in adults. Patients and methods: Sixty healthy volunteers (18 to 80 years) were studied on 2 occasions with either Penthrox or placebo in a randomized, double-blind fashion. On each occasion, the subject’s psychomotor function was examined before, immediately, 30, 60, 120, 180 and 240 min after a 15-minute inhalation of studied drug, using validated psychomotor tests (Digit Symbol Substitution Test (DSST), auditory reaction time (ART), eye-hand coordination (EHC) test, trail making test (TMT) and logical reasoning test (LRT). Results: Compared to placebo, a 15-minute Penthrox inhalation led to an immediate but small impairment of DSST (P < 0.001), ART (P < 0.001), EHC (P < 0.01), TMT (P = 0.02) and LRT (P = 0.04). In all subjects, the performance of all 5 tests normalized by 30 minutes after inhalation, and was comparable to that with placebo. Although increasing age was associated with a small deterioration in psychomotor testing performance, the magnitude of Penthrox effects remained comparable among all age groups. Conclusions: In all age groups, a 15-minute Penthrox inhalation induces acute but short-lasting impairment of psychomotor and cognitive performance, which returns to normal within 30 minutes , indicating that subjects who have colonoscopy with Penthrox can return to highly skilled psychomotor skills tasks such as driving and daily work the same day. PMID:27853742

  6. Ecodesign in 15 minutes

    DEFF Research Database (Denmark)

    Huulgaard, Rikke Dorothea

    enterprises (SMEs) which may have less formalised product development processes and are short of resources. This paper presents a recently developed web based ecodesign tool which specifically aims at arousing the interest of SMEs to ecodesign, introduce the concept of ecodesign and guide the SMEs in where...... product policy approach. The project focuses on the development of a digital toolbox with ten different tools that supports SMEs in the voluntary environmental efforts. These tools are freely available on the Internet. The tool is inspired by the Ecodesign Strategy Wheel developed in 1997 (Brezet and van...... Hemel, 1997). The Ecodesign strategy wheel visualises the steps and strategies that can be followed in ecodesign and allows the user to compare the environmental performance of different products. Several adjustments have been made in order for the tool a) to fit the target group, b) to update...

  7. Ecodesign in 15 minutes

    DEFF Research Database (Denmark)

    Huulgaard, Rikke Dorothea

    Strategy Wheel. 2) Update of the ecodesign strategies to the newest knowledge within ecodesign. 3) The spider web function is not part of the digital tool due to budgetary constraints During the development of the ecodesign tool several companies have been involved in the idea phase, and in the prototype...... enterprises (SMEs) which may have less formalised product development processes and are short of resources. This paper presents a recently developed web based ecodesign tool which specifically aims at arousing the interest of SMEs to ecodesign, introduce the concept of ecodesign and guide the SMEs in where...... the knowledge level to 2012 and c) to fit the web based toolbox which had limited budget. These adjustments include: 1) Danish SMEs request inspiration and easy to use tools that do not demand complicated calculations. Hence, focus is placed on the ecodesign strategies and rules of thumbs from the Ecodesign...

  8. Ecodesign in 15 minutes

    DEFF Research Database (Denmark)

    Huulgaard, Rikke Dorothea

    enterprises (SMEs) which may have less formalised product development processes and are short of resources. This paper presents a recently developed web based ecodesign tool which specifically aims at arousing the interest of SMEs to ecodesign, introduce the concept of ecodesign and guide the SMEs in where...... product policy approach. The project focuses on the development of a digital toolbox with ten different tools that supports SMEs in the voluntary environmental efforts. These tools are freely available on the Internet. The tool is inspired by the Ecodesign Strategy Wheel developed in 1997 (Brezet and van...... to start their efforts. The tool is part of the project “Clean Enterprises of the 21st Century”, which has as an overall objective to ensure that Danish enterprises and especially SMEs expand their voluntary environmental efforts in accordance with the European Sustainability Strategy and the integrated...

  9. Dimeticone 4% liquid gel found to kill all lice and eggs with a single 15 minute application

    Directory of Open Access Journals (Sweden)

    Burgess Nazma A


    Full Text Available Abstract Background Dimeticone 4% lotion is an effective and widely accepted treatment for head louse infestation. However, it is a highly mobile fluid that some people find difficult to apply and is mainly left on the hair for 8 hours or overnight. User preference is for a more manageable and viscous product that can be used with a short application time. Findings This proof of concept study in 41 people investigated dimeticone 4% liquid gel, a product that is easier to apply than the lotion, applied for 15 minutes on two occasions a week apart. We found that head lice were eliminated from all participants following the first application of product. We did not find lice of any stage on any participant during four post treatment assessments and particularly, unlike other treatments, no young nymphs on days 1 and 6 prior to the second treatment, indicating ovicidal as well as pediculicidal activity. Conclusions Dimeticone 4% liquid gel has demonstrated efficacy greater than other similar products and the evidence obtained indicates elimination of head louse infestation with a single 15 minute application. Trial registration Current Controlled Trials ISRCTN59227204

  10. Towards the clinical use of concentric electrodes in ECG recordings: influence of ring dimensions and electrode position (United States)

    Prats-Boluda, G.; Ye-Lin, Y.; Bueno-Barrachina, JM; Rodriguez de Sanabria, R.; Garcia-Casado, J.


    To overcome the limited spatial resolution of standard 12-lead ECG recordings, concentric ring electrodes (CRE) have been proposed to provide valuable data for the diagnosis of a wide range of cardiac abnormalities, including infarction and arrhythmia. Although theoretical studies indicate that the dimensions of the CRE regulate the depth of the electric dipoles sensed by these electrodes, this has not been experimentally confirmed. The aim of this work was to analyze the influence of CRE dimensions and position of a wireless multi-CRE sensor node on the cardiac signal recorded. For this, four wireless multichannel ECG recording nodes based on flexible multi-ring electrodes were placed at positions CMV1 (position comparable to V1), CMV2, CMV4R and CMV5; each node providing three bipolar concentric ECG signals (BC-ECG). Standard 12-lead ECG and 12 BC-ECG signals were recorded in 29 volunteers. The results revealed that a ring with an outer diameter of 33.5 mm achieves a balance between the ease-of-use and spatial resolution of smaller electrodes and improved detectability and higher amplitudes of signals from larger ring electrodes. Although a standard 12-lead ECG outperforms BC-ECC recordings in detectability of cardiac waves, if the relative amplitude of the wave is also considered, BC-ECG at CMV1 proved superior at picking up atrial activity. In fact, in most of the BC-ECG signals picked up at CMV1, P1 and P2 atrial activity waves were more clearly identified than in simultaneous 12-Lead ECG signals. Likewise, BC-ECG signals revealed higher spatial resolution in detecting anomalous electrical activity in local regions, such as impaired intraventricular driving, or atrioventricular blocks. Finally, the wireless multi-CRE sensor node provides enhanced comfort and handling to both patient and clinician over wired systems.

  11. The Clinical Analysis of ECG Diagnosis on Myocardial Infarction%心电图诊断心肌梗死的临床探析

    Institute of Scientific and Technical Information of China (English)



    Objective To analysis the clinical value of ECG diagnosis on myocardial infarction. Methods To analysis the 43 patients cases in myocardial infarction by ECG diagnosis.All the patients cases were chosen from January 2013 to January 2014. Results There were 25 cases (58.14%) patients without typical ECG change and 18 cases (41.86%) with typical ECG changes according to the electrocardiogram.Conclusion The electrocardiogram (ECG) as an aid to diagnosis the myocardial infarction,it is much better than others from repeatability,safe and noninvasive,convenient operation. To adopt the ECG diagnosis combine cardiac enzymes check in patients provide the comprehensive assessment. It will provide the evidence for clinical diagnosis.%目的:探析心电图诊断心肌梗死的临床价值。方法选取2013年1月~2014年1月间我院收治的心肌梗死患者43例给予心电图检测,评估心电图的改变情况。结果心电图显示,25例(58.14%)例无典型的心电图改变,18例(41.86%)有典型的心电图改变。结论心电图作为诊断心肌梗死的辅助方法重复性好、安全无创、操作方便,诊断时需与心肌酶学检查及患者临床症状综合进行评估,为临床诊断提供依据。

  12. Prospective ECG-triggered coronary CT angiography: clinical value of noise-based tube current reduction method with iterative reconstruction.

    Directory of Open Access Journals (Sweden)

    Junlin Shen

    Full Text Available OBJECTIVES: To evaluate the clinical value of noise-based tube current reduction method with iterative reconstruction for obtaining consistent image quality with dose optimization in prospective electrocardiogram (ECG-triggered coronary CT angiography (CCTA. MATERIALS AND METHODS: We performed a prospective randomized study evaluating 338 patients undergoing CCTA with prospective ECG-triggering. Patients were randomly assigned to fixed tube current with filtered back projection (Group 1, n = 113, noise-based tube current with filtered back projection (Group 2, n = 109 or with iterative reconstruction (Group 3, n = 116. Tube voltage was fixed at 120 kV. Qualitative image quality was rated on a 5-point scale (1 = impaired, to 5 = excellent, with 3-5 defined as diagnostic. Image noise and signal intensity were measured; signal-to-noise ratio was calculated; radiation dose parameters were recorded. Statistical analyses included one-way analysis of variance, chi-square test, Kruskal-Wallis test and multivariable linear regression. RESULTS: Image noise was maintained at the target value of 35HU with small interquartile range for Group 2 (35.00-35.03HU and Group 3 (34.99-35.02HU, while from 28.73 to 37.87HU for Group 1. All images in the three groups were acceptable for diagnosis. A relative 20% and 51% reduction in effective dose for Group 2 (2.9 mSv and Group 3 (1.8 mSv were achieved compared with Group 1 (3.7 mSv. After adjustment for scan characteristics, iterative reconstruction was associated with 26% reduction in effective dose. CONCLUSION: Noise-based tube current reduction method with iterative reconstruction maintains image noise precisely at the desired level and achieves consistent image quality. Meanwhile, effective dose can be reduced by more than 50%.

  13. ECG Electrocardiogram (For Parents) (United States)

    ... Old Feeding Your 1- to 2-Year-Old ECG (Electrocardiogram) KidsHealth > For Parents > ECG (Electrocardiogram) Print A ... whether there is any damage. How Is an ECG Done? There is nothing painful about getting an ...

  14. Diagnostic values of chest pain history, ECG, troponin and clinical gestalt in patients with chest pain and potential acute coronary syndrome assessed in the emergency department. (United States)

    Mokhtari, Arash; Dryver, Eric; Söderholm, Martin; Ekelund, Ulf


    In the assessment of chest pain patients with suspected acute coronary syndrome (ACS) in the emergency department (ED), physicians rely on global diagnostic impressions ('gestalt'). The aim of this study was to determine the diagnostic value of the ED physician's overall assessment of ACS likelihood, and the values of the main diagnostic modalities underlying this assessment, namely the chest pain history, the ECG and the initial troponin result. 1,151 consecutive ED chest pain patients were prospectively included. The ED physician's interpretation of the chest pain history, the ECG, and the global likelihood of ACS were recorded on special forms. The discharge diagnoses were retrieved from the medical records. A chart review was carried out to determine whether patients with a non-ACS diagnosis at the index visit had ACS or suffered cardiac death within 30 days. The gestalt was better than its components both at ruling in ("Obvious ACS", LR 29) and at ruling out ("No Suspicion of ACS", LR 0.01) ACS. In the "Strong suspicion of ACS" group, 60% of the patients did not have ACS. A positive TnT (LR 24.9) and an ischemic ECG (LR 8.3) were strong predictors of ACS and seemed superior to pain history for ruling in ACS. In patients with a normal TnT and non-ischemic ECG, chest pain history typical of AMI was not a significant predictor of AMI (LR 1.9) while pain history typical of unstable angina (UA) was a moderate predictor of UA (LR 4.7). Clinical gestalt was better than its components both at ruling in and at ruling out ACS, but overestimated the likelihood of ACS when cases were assessed as strong suspicion of ACS. Among the components of the gestalt, TnT and ECG were superior to the chest pain history for ruling in ACS, while pain history was superior for ruling out ACS.

  15. Clinical Analysis of ECG Changes in the Diagnosis of Hyperkalemia%高血钾症引起心电图改变的临床分析

    Institute of Scientific and Technical Information of China (English)



    目的:探讨心电图诊断高血钾症的临床价值。方法:对70例高血钾症患者的心电图表现与血清钾浓度的变化进行对比分析。结果:心电图异常改变和血清钾浓度测定存在一定的差异,对肾功能不全所致高血钾症诊断有较好的一致性。当血清钾浓度超过5.5 mmol/L时,心电图表现为帐蓬状高耸T波,基底变窄, Q-T间期缩短,随着血清钾浓度的继续增高,心电图异常发生率亦相应增加,主要是细胞外钾离子浓度增高引起的心电图改变。结论:心电图是评价高血钾症病情程度的重要手段,为临床诊断及治疗提供参考。%Objective: To explore clinical value of electrocardiogram (ECG) in diagnosing hyperkalemia. Methods:The changes of potassium concentrations in the serum and ECG changes of 70 patients with hyperkalemia were compared and analyzed. Results:The manifestation of abnormal ECG is not totally related to serum potassium density, however, it shows a good consistence to hyperkalemia caused by renal failure. When serum potassium den-sity is higher than 5.5mmol/L, ECG reveals a tall T wave with a broad base, a shorten Q-T interval, as serum potassi-um density is increased continually, the incidence of abnormal ECG is raised, which is mainly caused by the density increase of extracellular potassium-ion. Conclusion:ECG is an important method for diagnosing the severity of hy-perkalemia, it could provide reference for clinical diagnosis and treatment.


    Directory of Open Access Journals (Sweden)

    V. Kiran


    Full Text Available Background: Patients with COPD will have more amount of secretions. To clear the secretions by using of different bronchial hygiene techniques like postural drainage and autogenic drainage technique, manual hyperventilation technique ,active cycle breathing technique .Hence in this study to compare the short-term effects of postural drainage with clapping (PD and autogenic drainage (AD on level of oxygen saturation in blood, and amount of sputum recovery. Methodology: The study was done on 60 patients with COPD. Dividing Patients into two group and patients were treated with PD or AD in separate Groups. The effectiveness of the treatment was measured up to 6 days. Pulse oximetry was monitored and sputum was collected immediately after treatment and 15 minutes following each treatment. Results: The results of the study shown that there was significant difference in the amount of sputum recovered with AD (14.0±3.5 g vs PD (24.4±3.0 g and significant differences in Oxygen saturation; during PD fell from 93.3±0.7% to 91.2±0.8% (p<0.01 and required 15 min following treatment to return to baseline. Oxygen saturation did not fall during AD and increased to gradually following complete treatment days (baseline, 93.3±0.8%; p<0.01. Conclusion: Hence this study concludes that Autogenic drainage is more effective in improving spo2 in COPD & does not cause a sudden fall in spo2 as occurs in Postural drainage immediately after therapy. And it can be better tolerated by patients with COPD while producing fewer benefits in sputum clearance. In concern to mean amount of secretion removal Postural is found to be more effective

  17. Dynamic link between ECG and clinical data by a CORBA-based query engine and temporal mapping. (United States)

    Wang, C; Ohe, K; Kaihara, S


    It is important to create a dynamic link method to link distributed patient data across multiple hospitals on an "as needed" basis because the pre-defined links (an item of data has a character or group of characters that indicates the storage of another item of data) are difficult to be managed, or can only be established in part, or are not necessary to be pre-defined in many cases, especially in linking the descriptive data such as history data with the corresponding examination data across multiple hospitals. A method of linking electrocardiogram (ECG) with clinical data dynamically in a Common Object Request Broker Architecture (CORBA) environment has been achieved and verified in a real computing environment to approach to this goal. By this method, distributed patient data can be linked dynamically by a CORBA-based query engine and temporal mapping no matter where they are located on the Internet. The necessary temporal information is provided by either computing or human being. Since multiple time-axes for different databases are involved in, some temporal reasoning methods (such as mapping occurrences across temporal contexts and determining bounds for absolute occurrences, etc.) are applied to this study, and a series of temporal mappings including the first mapping, the secondary mapping, the contextual mapping, the extended mapping, the previous mapping and the next mapping are created. In comparison with the pre-defined link, the major strengths of this method are the dynamic link on an "as needed" basis, no limitation of institutional boundaries, easy creation, simplifying the data storage, and the high flexibility, etc.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACK GROUND: Chronic obstructive pulmonary disease (COPD is a leading cause of morbidity and mortality in countries of high, middle, and low income. Estimates from WHO’s Global Burden of Disease and Risk Factors project show that in 2001, COPD was the fifth leading cause of death in high-income countries, accounting for 3.8% of total deaths, and it was the sixth leading cause of death in nations of low and middle income, accounting for 4·9% of total deaths. OBJECTIVES: 1. To study clinical parameters of chronic obstructive pulmonary disease. 2. To find out Electrocardiographic changes of chronic obstructive pulmonary disease. 3. To confirm with echocardiogram the presence of pulmonary hypertension, tricuspid regurgitation and right heart failure and analyze the incidence of right heart failure and pulmonary hypertension. MATERIALS AND METHODS: Single center hospital based cross sectional study. Patients diagnosed as COPD based on following steps will be included in the study. The patients with cough, sputum production, dyspnoea (wheeze was chosen (sputum AFB negative will be confirmed. Pulmonary function test was done to pick up patients with reduced FEV9 mm, as this is the one of the indication for life long oxygen therapy as per American Thoracic Society (ATS. Out of 72 patients, 12 had coronary artery disease (CAHD as this increases the incidence of cor-pulmonale. CARDIOVASCULAR COMPLICATIONS: Out of 72 patients, 24% developed pulmonary hypertension, 22% developed tricuspid regurgitation, 34% had p-pulmonale, 18% had p-wave amplitude in lead-II + lead-III + lead a VF >9 mm, this is important because this is one of the indication for life long oxygen therapy. 18% had concomitant coronary artery disease (CAHD, this observation is important because systemic inflammation plays enhanced role in atherosclerosis, diabetes mellitus, tumour necrosis factor is increased in COPD patients. CONCLUSION: Pulmonary hypertension was the most common

  19. [Practical experience about the compatibility of PDF converter in ECG information system]. (United States)

    Yang, Gang; Lu, Weishi; Zhou, Jiacheng


    To find a way to view ECG from different manufacturers in electrocardiogram information system. Different format ECG data were transmitted to ECG center by different ways. Corresponding analysis software was used to make the diagnosis reports in the center. Then we use PDF convert to change all ECG reports into PDF format. The electrocardiogram information system manage these PDF format ECG data for clinic user. The ECG reports form several major ECG manufacturers were transformed to PDF format successfully. In the electrocardiogram information system it is freely to view the ECG figure. PDF format ECG report is a practicable way to solve the compatibility problem in electrocardiogram information system.

  20. Cardiac safety of tiotropium in patients with COPD: a combined analysis of Holter-ECG data from four randomised clinical trials. (United States)

    Hohlfeld, J M; Furtwaengler, A; Könen-Bergmann, M; Wallenstein, G; Walter, B; Bateman, E D


    Tiotropium is generally well tolerated; however, there has been debate whether antimuscarinics, particularly tiotropium administered via Respimat(®) Soft Mist(™) Inhaler, may induce cardiac arrhythmias in a vulnerable subpopulation with cardiovascular comorbidity. The aim of this study was to provide evidence of the cardiac safety of tiotropium maintenance therapy. Combined analysis of Holter electrocardiogram (ECG) data from clinical trials of tiotropium in chronic obstructive pulmonary disease (COPD). Trials in the Boehringer Ingelheim clinical trials database conducted between 2003 and 2012, involving tiotropium HandiHaler(®) 18 μg and/or tiotropium Respimat(®) (1.25-, 2.5-, 5.0- and 10-μg doses) were reviewed. All trials involving Holter-ECG monitoring during this period were included in the analysis. Men and women aged ≥ 40 years with a smoking history of ≥ 10 pack-years, and a clinical diagnosis of COPD were included. Holter ECGs were evaluated for heart rate (HR), supraventricular premature beats (SVPBs), ventricular premature beats (VPBs) and pauses. Quantitative and categorical end-points were derived for each of the Holter monitoring days. Four trials (n = 727) were included in the analysis. Respimat(®) (1.25-10 μg) or HandiHaler(®) (18 μg) was not associated with changes in HR, SVPBs, VPBs and pauses compared with placebo or the pretreatment baseline period. In terms of cardiac arrhythmia end-points, there was no evidence for an exposure-effect relationship. In this analysis, tiotropium maintenance therapy administered using Respimat(®) (1.25-10 μg) or HandiHaler(®) (18 μg) once daily for periods of up to 48 weeks was well tolerated with no increased risk of cardiac arrhythmia in patients with COPD. © 2014 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.

  1. ECG De-noising

    DEFF Research Database (Denmark)

    Kærgaard, Kevin; Jensen, Søren Hjøllund; Puthusserypady, Sadasivan


    Electrocardiogram (ECG) is a widely used noninvasive method to study the rhythmic activity of the heart and thereby to detect the abnormalities. However, these signals are often obscured by artifacts from various sources and minimization of these artifacts are of paramount important. This paper...... proposes two adaptive techniques, namely the EEMD-BLMS (Ensemble Empirical Mode Decomposition in conjunction with the Block Least Mean Square algorithm) and DWT-NN (Discrete Wavelet Transform followed by Neural Network) methods in minimizing the artifacts from recorded ECG signals, and compares...... their performance. These methods were first compared on two types of simulated noise corrupted ECG signals: Type-I (desired ECG+noise frequencies outside the ECG frequency band) and Type-II (ECG+noise frequencies both inside and outside the ECG frequency band). Subsequently, they were tested on real ECG recordings...

  2. Clinical application of synchronized EEG-ECG%同步EEG-ECG检查的临床应用

    Institute of Scientific and Technical Information of China (English)




  3. Digital bedrock geologic map of the Vermont part of the 7.5 x 15 minute Mount Ascutney and Springfield quadrangles, Vermont (United States)

    Vermont Center for Geographic Information — Digital Data from VG96-733A Walsh, GJ, Armstrong, TR�and Ratcliffe, NM, 1996,�Digital bedrock geologic map of the Vermont part of the 7.5 x 15 minute Mount Ascutney...

  4. Enhancement of Twins Fetal ECG Signal Extraction Based on Hybrid Blind Extraction Techniques

    Directory of Open Access Journals (Sweden)

    Ahmed Kareem Abdullah


    Full Text Available ECG machines are noninvasive system used to measure the heartbeat signal. It’s very important to monitor the fetus ECG signals during pregnancy to check the heat activity and to detect any problem early before born, therefore the monitoring of ECG signals have clinical significance and importance. For multi-fetal pregnancy case the classical filtering algorithms are not sufficient to separate the ECG signals between mother and fetal. In this paper the mixture consists of mixing from three ECG signals, the first signal is the mother ECG (M-ECG signal, second signal the Fetal-1 ECG (F1-ECG, and third signal is the Fetal-2 ECG (F2-ECG, these signals are extracted based on modified blind source extraction (BSE techniques. The proposed work based on hybridization between two BSE techniques to ensure that the extracted signals separated well. The results demonstrate that the proposed work very efficiently to extract the useful ECG signals

  5. Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias. (United States)

    Hendrikx, Tijn; Rosenqvist, Mårten; Wester, Per; Sandström, Herbert; Hörnsten, Rolf


    Many patients report symptoms of palpitations or dizziness/presyncope. These patients are often referred for 24-hour Holter ECG, although the sensitivity for detecting relevant arrhythmias is comparatively low. Intermittent short ECG recording over a longer time period might be a convenient and more sensitive alternative. The objective of this study is to compare the efficacy of 24-hour Holter ECG with intermittent short ECG recording over four weeks to detect relevant arrhythmias in patients with palpitations or dizziness/presyncope. prospective, observational, cross-sectional study. Clinical Physiology, University Hospital. 108 consecutive patients referred for ambiguous palpitations or dizziness/presyncope. All individuals underwent a 24-hour Holter ECG and additionally registered 30-second handheld ECG (Zenicor EKG® thumb) recordings at home, twice daily and when having cardiac symptoms, during 28 days. Significant arrhythmias: atrial fibrillation (AF), paroxysmal supraventricular tachycardia (PSVT), atrioventricular (AV) block II-III, sinus arrest (SA), wide complex tachycardia (WCT). 95 patients, 42 men and 53 women with a mean age of 54.1 years, completed registrations. Analysis of Holter registrations showed atrial fibrillation (AF) in two patients and atrioventricular (AV) block II in one patient (= 3.2% relevant arrhythmias [95% CI 1.1-8.9]). Intermittent handheld ECG detected nine patients with AF, three with paroxysmal supraventricular tachycardia (PSVT) and one with AV-block-II (= 13.7% relevant arrhythmias [95% CI 8.2-22.0]). There was a significant difference between the two methods in favour of intermittent ECG with regard to the ability to detect relevant arrhythmias (P = 0.0094). With Holter ECG, no symptoms were registered during any of the detected arrhythmias. With intermittent ECG, symptoms were registered during half of the arrhythmia episodes. Intermittent short ECG recording during four weeks is more effective in detecting AF and PSVT in

  6. 右位心合并急性心肌梗死的临床心电图分析%Clinical ECG Analysis of Dextrocardia with AMI

    Institute of Scientific and Technical Information of China (English)

    贺茜影; 刘仁光; 王晓梅


    Dextrocardia with acute myocardial infarction is clinically rare.Based on the ECG analysis of a case of mirror-image dextrocardia with acute myocardial infarction, this paper discusses the electrocardiogram features of mirror-image dextrocardia, diag-nosis and differential diagnosis of complicated acute myocardial infarction and the related issues.%右位心合并急性心肌梗死临床上较为少见,本文结合1例镜像右位心合并急性心肌梗死的心电图分析,讨论镜像右位心的心电图特点,合并急性心肌梗死的诊断和鉴别诊断有关问题。

  7. 心电图诊断高钾血症的临床应用价值探讨%The Clinical Value of Ecg Diagnosis of Hyperkalemia

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the clinical value of ecg diagnosis of hyperkalemia. Methods Select our hospital 117 cases of patients with hyperkalemia in research from January 2014 to February 2016, on the basis of different serum K+ concentration was divided into group I 39 cases (5.5~6.9mmol/L), II group of 40 cases (7.0~10.0mmol/L), III group of 38 patients (>10.0mmol/L). For three groups of patients with abnormal ecg diagnosis rate and characteristic performance records and analysis.Results Group I, II, III group patients successive increase the incidence of abnormal ecg, III group had a signiifcantly higher rate of abnormal electrocardiogram (ecg) in patients with group I and II group of patients,P<0.05). 117 cases of patients with hyperkalemia electrocardiogram (ecg) were characterized by tall upright T wave, hyperkalemia patients with different concentration electrocardiogram T wave amplitude and the relationship between serum K+ concentration is not parallel. Group I occasionally occur in patients with high T wave, presents the tent; II group of patients with ST segment showed a downward trend, T wave height, pointed, P wave decreased or disappeared; A wide QRS complex III group patients, and gradually merged in T wave, sine wave shape.Conclusion Using electrocardiogram diagnosis hyperkalaemia, the serum K+ concentration and different abnormal ecg showed that there was a positive correlation between the serum K+ concentration increased, the incidence of abnormal ecg patients also increased, it can be used as a reference in clinical diagnosis and treatment of hyperkalemia, has the very high clinical value.%目的:探讨心电图诊断高钾血症的临床应用价值。方法选取我院2014年1月~2016年2月期间收治的117例高钾血症患者纳入研究,依据不同的血清钾浓度划分为I组39例(5.5~6.9mmol/L)、II组40例(7.0~10.0mmol/L)、III组38例(>10.0mmol/L)。对3组患者的心电图诊断异常率及特征表现

  8. Hyperkalemia Induced Brugada Phenocopy: A Rare ECG Manifestation

    Directory of Open Access Journals (Sweden)

    Muhammad Ameen


    Full Text Available Brugada syndrome (BrS is an inherited disorder of cardiac ion channels characterized by peculiar ECG findings predisposing individuals to ventricular arrhythmias, syncope, and sudden cardiac death (SCD. Various electrolyte disturbances and ion channels blocking drugs could also provoke BrS ECG findings without genetic BrS. Clinical differentiation and recognition are essential for guiding the legitimate action. Hyperkalemia is well known to cause a wide variety of ECG manifestations. Severe hyperkalemia can even cause life threatening ventricular arrhythmias and cardiac conduction abnormalities. Most common ECG findings include peaked tall T waves with short PR interval and wide QRS complex. Since it is very commonly encountered disorder, physicians need to be aware of even its rare ECG manifestations, which include ST segment elevation and Brugada pattern ECG (BrP. We are adding a case to the limited literature about hyperkalemia induced reversible Brugada pattern ECG changes.

  9. A Novel Mobile ECG Telemonitoring System. (United States)

    Wu, Baoming; Zhuo, Yu; Zhu, Xinjian; Yan, Qingguang; Zhu, Lingyun; Li, Gang


    This paper introduces a novel mobile ECG telemonitoring system. By means of CDMA1x (GPSOne) mobile telecommunication network, the system can perform "full time and space" monitoring of human ECG signal, and once the signal of the monitored subject departed from its normal ranges, the hospital ECG monitoring center can further localize his/her geographical position and give rescue in the first time. Another feature of the system is its high anti-interference capability. In order to reduce 50Hz and RF interferences during mobile monitoring, which are usual much serious than conventional hospital monitoring, a new active recording technology was proposed and an active ECG recording electrode was designed. The system has passed the clinical test and used in China.

  10. ECG acquisition and automated remote processing

    CERN Document Server

    Gupta, Rajarshi; Bera, Jitendranath


    The book is focused on the area of remote processing of ECG in the context of telecardiology, an emerging area in the field of Biomedical Engineering Application. Considering the poor infrastructure and inadequate numbers of physicians in rural healthcare clinics in India and other developing nations, telemedicine services assume special importance. Telecardiology, a specialized area of telemedicine, is taken up in this book considering the importance of cardiac diseases, which is prevalent in the population under discussion. The main focus of this book is to discuss different aspects of ECG acquisition, its remote transmission and computerized ECG signal analysis for feature extraction. It also discusses ECG compression and application of standalone embedded systems, to develop a cost effective solution of a telecardiology system.

  11. Utility of the CORD ECG Database in Evaluating ECG Interpretation by Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Wong, Hubert E


    Full Text Available OBJECTIVES: Electrocardiograph (ECG interpretation is a vital component of Emergency Medicine (EM resident education, but few studies have formally examined ECG teaching methods used in residency training. Recently, the Council of EM Residency Directors (CORD developed an Internet database of 395 ECGs that have been extensively peer-reviewed to incorporate all findings and abnormalities. We examined the efficacy of this database in assessing EM residents' skills in ECG interpretation. METHODS: We used the CORD ECG database to evaluate residents at our academic three-year EM residency. Thirteen residents participated, including four first-year, four second-year, and five third-year residents. Twenty ECGs were selected using 14 search criteria representing a broad range of abnormalities, including infarction, rhythm, and conduction abnormalities. Exams were scored based on all abnormalities and findings listed in the teaching points accompanying each ECG. We assigned points to each abnormal finding based on clinical relevance. RESULTS: Out of a total of 183 points in our clinically weighted scoring system, first-year residents scored an average of 99 points (54.1% [9 1- 1191, second-year residents 11 1 points (60.4% [97-1261, and third-year residents 130 points (7 1.0% [94- 1501, p = 0.12. Clinically relevant abnormalities, including anterior and inferior myocardial infarctions, were most frequently diagnosed correctly, while posterior infarction was more frequently missed. Rhythm abnormalities including ventricular and supraventricular tachycardias were most frequently diagnosed correctly, while conduction abnormalities including left bundle branch block and atrioventricular (AV block were more frequently missed. CONCLUSION: The CORD database represents a valuable resource in the assessment and teaching of ECG skills, allowing more precise identification of areas upon which instruction should be further focused or individually tailored. Our

  12. Dynamic electrocardiogram (ecg) and conventional electrocardiogram (ecg) in the clinical diagnosis of coronary heart disease patients with the value of myocardial ischemia and arrhythmia%动态心电图与常规心电图在临床诊断冠心病患者心肌缺血及心律失常中的价值

    Institute of Scientific and Technical Information of China (English)



    Objective Dynamic electrocardiogram (ecg) and conventional electrocardiogram (ecg) in the clinical diagnosis of coronary heart disease patients with the value of myocardial ischemia and arrhythmia. Methods In March 2014 to November 2014 80 cases of coronary heart disease patients to the hospital to check during the period of dynamic electrocardiogram (ecg) and conventional electrocardiogram (ecg) examination. Compare two groups of two checking methods of detection of myocardial ischemia and arrhythmia. Results Dynamic electrocardiogram (ecg) were significantly higher than the conventional electrocardiogram (ecg), myocardial ischemia group, the difference is statistically significant (P < 0.05);Dynamic electrocardiogram (ecg) short array chamber on speed, atrioventricular block, ventricular/housing contracts before sexual period, sanlian law, atrial/ventricular contracts before sexual period in pairs, such as detection rate of arrhythmia was obviously higher than that of conventional electrocardiogram (ecg), statistically significant difference (P<0.05). Conclusions Dynamic ecg of myocardial ischemia in patients with coronary heart disease detection rate is higher, and the virus infection aslar-pacific perspective, angina pectoris, arrhythmia, coronary heart disease diagnosis, can make early diagnosis and treatment in patients with coronary heart disease (CHD).%目的:探讨动态心电图与常规心电图在临床诊断冠心病患者心肌缺血及心律失常中的价值。方法:对自2014年3月至2014年11月期间来我院检查的80例冠心病患者行动态心电图及常规心电图检查。比较两组两种检查方法的心肌缺血及心律失常的检出率。结果:动态心电图的心肌缺血阳性率明显高于常规心电图组,差异具有统计学意义(P<0.05);动态心电图的短阵室上速、房室传导阻滞、室性/房性期前收缩二、三联律、室性/房性期前收缩成对等心率失常的检出率明显

  13. Quasi-Periodic Oscillations of ~ 15 minutes in the Optical Light Curve of the BL Lac S5 0716+714

    CERN Document Server

    Rani, Bindu; Joshi, U C; Ganesh, S; Wiita, Paul J


    Over the course of three hours on 27 December 2008 we obtained optical (R-band) observations of the blazar S5 0716+714 at a very fast cadence of 10 s. Using several different techniques we find fluctuations with an approximately 15-minute quasi-period to be present in the first portion of that data at a > 3 sigma confidence level. This is the fastest QPO that has been claimed to be observed in any blazar at any wavelength. While this data is insufficient to strongly constrain models for such fluctuations, the presence of such a short timescale when the source is not in a very low state seems to favor the action of turbulence behind a shock in the blazar's relativistic jet.

  14. [Evaluation of sleep apnea, detected by 24-hour ECG Holter monitoring analysis in patients with stable coronary artery disease and ischemic heart failure - correlations with clinical data]. (United States)

    Frączek-Jucha, Magdalena; Rostoff, Paweł; Łach, Jacek; Nessler, Jadwiga; Gackowski, Andrzej


    Obstructive sleep apnoea (OSA) is frequently undiagnosed in patients with heart failure (HF) and coronary artery disease (CAD). Simple and widely available screening tests are needed to diagnose patients with SA. Measurements of thoracic impedance and heart rate variability during 24-hour ECG Holter (H-EKG) monitoring allows to calculate estimated apnoea-hypopnoea index (eAHI). The aim of the research was to assess prevalence of OSA evaluated with the use of H-EKG and determination of its clinical relevance in patients with CAD and ischeamic HF. The study groups comprised of: 30 consecutive patients with ischeamic HF with reduced LVEF (HFrEF) (group A) and 30 patients with CAD (group B). Control group (C) comprised of 30 patients with arterial hypertension but no CAD nor HF. H-ECG monitoring was performed and eAHI was calculated. On the basis of AHI result group A was subdivided to subgroups A1 (eAHI <15) and A2 (eAHI ≥15). Study groups differed with eAHI values (27,9±19,9 vs. 21,8±17,3 vs. 15,7±12,2; p=0,022). Post hoc analysis revealed that eAHI in group A was higher in comparison to group C (27,9±19,9 vs. 15,7±12,2; p=0,006). SA prevalence was higher in group A compared to group C (70,0% vs. 40,0%; p=0,019). Significant but weak correlation between eAHI and LVEDD was found (r=0,282; p<0,05). Subgroups A1 and A2 did not differ in terms of clinical and demographical parameters, HF symptoms, LVEF and NT-proBNP levels. OSA coexists more frequently with HF than with arterial hypertension Significant but weak correlation between eAHI and LVEDD was demonstrated. However, in patients with symptomatic ischeamic heart failure eAHI ≥15 was not related to NYHA class, lower LVEF and higher NT-proBNP levels.

  15. The clinical and pathologic features of coronary heart disease ECG%冠心病患者150例临床心电图特征和病理特点

    Institute of Scientific and Technical Information of China (English)



    Objective to investigate the clinical and pathological characters of ecG ofcoronary heart disease.Methods 150 cases of coronary heart disease (CHD) patients(A group) and 12 lead ECG examination, and 55 cases of healthy adult (group B).Results of the 150 cases of coronary heart disease (CHD) patients (A group) and 110 healthy adult (group B) have signiifcant differences in ECG changes (P < 0.05).Conclusion ECG in detecting coronary artery disease (CHD) of fast and effective method.%目的:探讨冠心病的病理和临床心电图特征。方法选择150例冠心病(cHd)患者(a组)12导联心电图检查,与55例健康成人(B组)。结果150例冠心病(cHd)患者(a组)和110例健康成人(B组)心电图的变化有显著差异(P<0.05)。结论心电图检测冠心病(cHd)的快速和有效的方法。

  16. [Analysis of pacemaker ECGs]. (United States)

    Israel, Carsten W; Ekosso-Ejangue, Lucy; Sheta, Mohamed-Karim


    The key to a successful analysis of a pacemaker electrocardiogram (ECG) is the application of the systematic approach used for any other ECG without a pacemaker: analysis of (1) basic rhythm and rate, (2) QRS axis, (3) PQ, QRS and QT intervals, (4) morphology of P waves, QRS, ST segments and T(U) waves and (5) the presence of arrhythmias. If only the most obvious abnormality of a pacemaker ECG is considered, wrong conclusions can easily be drawn. If a systematic approach is skipped it may be overlooked that e.g. atrial pacing is ineffective, the left ventricle is paced instead of the right ventricle, pacing competes with intrinsic conduction or that the atrioventricular (AV) conduction time is programmed too long. Apart from this analysis, a pacemaker ECG which is not clear should be checked for the presence of arrhythmias (e.g. atrial fibrillation, atrial flutter, junctional escape rhythm and endless loop tachycardia), pacemaker malfunction (e.g. atrial or ventricular undersensing or oversensing, atrial or ventricular loss of capture) and activity of specific pacing algorithms, such as automatic mode switching, rate adaptation, AV delay modifying algorithms, reaction to premature ventricular contractions (PVC), safety window pacing, hysteresis and noise mode. A systematic analysis of the pacemaker ECG almost always allows a probable diagnosis of arrhythmias and malfunctions to be made, which can be confirmed by pacemaker control and can often be corrected at the touch of the right button to the patient's benefit.

  17. Ambulatory ECG-based T-wave alternans monitoring for risk assessment and guiding medical therapy: mechanisms and clinical applications. (United States)

    Verrier, Richard L; Ikeda, Takanori


    Identification of individuals at risk for sudden cardiac death (SCD), the main cause of adult mortality in developed countries, remains a major challenge. The main contemporary noninvasive marker, left ventricular ejection fraction (LVEF), has not proved adequately reliable, as the majority of individuals who die suddenly have relatively preserved cardiac mechanical function. Monitoring of T-wave alternans (TWA), a beat-to-beat fluctuation in ST-segment or T-wave morphology, on ambulatory electrocardiogram (AECG) is an attractive approach on both scientific and clinical grounds. Specifically, TWA's capacity to assess risk for malignant arrhythmias has been shown to rest on sound electrophysiologic principles and AECG-based TWA monitoring can be performed in the flow of routine clinical evaluation. This review addresses: (1) electrophysiologic and ionic mechanisms underlying TWA's predictivity, (2) principles and practical aspects of AECG-based TWA monitoring, (3) clinical evidence supporting this approach to SCD risk stratification, and (4) current and potential applications in guiding medical therapy.

  18. Heart rhythm analysis using ECG recorded with a novel sternum based patch technology

    DEFF Research Database (Denmark)

    Saadi, Dorthe B.; Fauerskov, Inge; Osmanagic, Armin


    , reliable long-term ECG recordings. The device is designed for high compliance and low patient burden. This novel patch technology is CE approved for ambulatory ECG recording of two ECG channels on the sternum. This paper describes a clinical pilot study regarding the usefulness of these ECG signals...... for heart rhythm analysis. A clinical technician with experience in ECG interpretation selected 200 noise-free 7 seconds ECG segments from 25 different patients. These 200 ECG segments were evaluated by two medical doctors according to their usefulness for heart rhythm analysis. The first doctor considered...... 98.5% of the segments useful for rhythm analysis, whereas the second doctor considered 99.5% of the segments useful for rhythm analysis. The conclusion of this pilot study indicates that two channel ECG recorded on the sternum is useful for rhythm analysis and could be used as input to diagnosis...

  19. High-frequency ECG (United States)

    Tragardh, Elin; Schlegel, Todd T.


    The standard ECG is by convention limited to 0.05-150 Hz, but higher frequencies are also present in the ECG signal. With high-resolution technology, it is possible to record and analyze these higher frequencies. The highest amplitudes of the high-frequency components are found within the QRS complex. In past years, the term "high frequency", "high fidelity", and "wideband electrocardiography" have been used by several investigators to refer to the process of recording ECGs with an extended bandwidth of up to 1000 Hz. Several investigators have tried to analyze HF-QRS with the hope that additional features seen in the QRS complex would provide information enhancing the diagnostic value of the ECG. The development of computerized ECG-recording devices that made it possible to record ECG signals with high resolution in both time and amplitude, as well as better possibilities to store and process the signals digitally, offered new methods for analysis. Different techniques to extract the HF-QRS have been described. Several bandwidths and filter types have been applied for the extraction as well as different signal-averaging techniques for noise reduction. There is no standard method for acquiring and quantifying HF-QRS. The physiological mechanisms underlying HF-QRS are still not fully understood. One theory is that HF-QRS are related to the conduction velocity and the fragmentation of the depolarization wave in the myocardium. In a three-dimensional model of the ventricles with a fractal conduction system it was shown that high numbers of splitting branches are associated with HF-QRS. In this experiment, it was also shown that the changes seen in HF-QRS in patients with myocardial ischemia might be due to the slowing of the conduction velocity in the region of ischemia. This mechanism has been tested by Watanabe et al by infusing sodium channel blockers into the left anterior descending artery in dogs. In their study, 60 unipolar ECGs were recorded from the entire

  20. Evaluation of alcaftadine 0.25% ophthalmic solution in acute allergic conjunctivitis at 15 minutes and 16 hours after instillation versus placebo and olopatadine 0.1%

    Directory of Open Access Journals (Sweden)

    Jack V Greiner


    Full Text Available Jack V Greiner1,2, Kimberly Edwards-Swanson3, Avner Ingerman41Schepens Eye Research Institute, Boston, MA; 2Department of Ophthalmology, Harvard Medical School, Boston, MA; 3Johnson & Johnson Consumer and Personal Products Worldwide, Skillman, NJ; 4Ora Inc, Andover, MA, USAPurpose: To evaluate the effectiveness of alcaftadine 0.05%, 0.1%, and 0.25% ophthalmic solutions in treating the signs and symptoms of allergic conjunctivitis when compared with olopatadine hydrochloride 0.1% and placebo using the conjunctival allergen challenge (CAC model.Methods: One hundred and seventy subjects were randomized and 164 subjects completed all visits. CAC was performed to determine and confirm subjects’ eligibility at visits 1 and 2, respectively. The CAC was repeated at visit 3 (day 0 ± 3, 16 hours after study medication instillation, and at visit 4 (day 14 ± 3, 15 minutes after instillation. Ocular itching and conjunctival redness were evaluated after an allergen challenge, along with several secondary endpoints.Results: Alcaftadine 0.25% and olopatadine 0.1% treatments exhibited significantly lower mean scores compared with placebo for ocular itching and conjunctival redness at visits 3 and 4. Most adverse events were self-limiting and mild in severity. No serious treatment-related adverse events occurred.Conclusion: Treatment with alcaftadine 0.25% ophthalmic solution resulted in mean differences of >1 unit (ocular itching and approximately >1 unit (conjunctival redness, which was significant (P < 0.001 compared with placebo treatment. All doses of alcaftadine were safe and well tolerated in the population studied.Keywords: alcaftadine, allergic conjunctivitis, conjunctival allergen challenge

  1. Spatio-temporal distribution of Saharan dust source activations inferred from 15-minute MSG-SEVIRI observations and its links to meteorological processes (Invited) (United States)

    Schepanski, K.; Tegen, I.


    Mineral dust aerosol emitted from arid and semi-arid areas impacts on the weather and climate system by affecting e.g. radiation fluxes and nutrient cycles. The emission of dust particles depend strongly on surface wind velocity and turbulent fluxes as well as on surface characteristics like surface texture and vegetation cover. To estimate the effect of dust aerosol, detailed knowledge on the spatio-temporal distribution of active dust sources is necessary. As dust sources are mostly located over remote areas satellite observations are suitable for localizing active dust sources. Thereby the accuracy of determining dust sources from such an indirect method is limited by the temporal resolution and the ambiguities of the retrieval. A 1°x1° map on the spatial and temporal (3-hourly) distribution of dust source activations (DSA) over North Africa is compiled starting in March 2006. For dust source identification 15-minute Meteosat Second Generation (MSG) infra-red (IR) dust index images are used based on brightness temperature measurements by the Spinning enhanced Visible and Infra-Red Imager (SEVIRI) at 8.7 µm, 10.8 µm and 12.0 µm. This data set has been used (1) to identify most active dust source areas, and (2) to investigate on the temporal distribution of occurring dust source activations. Over the Sahara Desert 65% of dust sources becomes active during 06-09 UTC pointing towards an important role of the break-down of the nocturnal low-level jet (LLJ) for dust mobilization besides other meteorological features like density currents, haboobs, and cyclones. Furthermore the role of the nocturnal LLJ for dust mobilization over the Sahara is investigated by weather observations and a modelling study. DSA observations of the last 3.5 years indicate an interannual variability in frequencies of local dust source activations. The causes of this variability will be analyzed with respect to corresponding atmospheric conditions.

  2. The programmable ECG simulator. (United States)

    Caner, Candan; Engin, Mehmet; Engin, Erkan Zeki


    This paper reports the design and development of Digital Signal Controller (DSPIC)-based ECG simulator intended to use in testing, calibration and maintenance of electrocardiographic equipment, and to support biomedical engineering students' education. It generates all 12 healthy ECG derivation signals having a profile that varies with heart rate, amplitude, and different noise contamination in a manner which reflects true in vivo conditions. The heart rate can be set at the range of 30 to 120 beats/minute in four steps. The noise and power line interference effects can be set at the range of 0 to 20 dB in three steps. Since standard commercially available electronic components were used to construct the prototype simulator, the proposed design was also relatively inexpensive to produce.

  3. A method of ECG template extraction for biometrics applications. (United States)

    Zhou, Xiang; Lu, Yang; Chen, Meng; Bao, Shu-Di; Miao, Fen


    ECG has attracted widespread attention as one of the most important non-invasive physiological signals in healthcare-system related biometrics for its characteristics like ease-of-monitoring, individual uniqueness as well as important clinical value. This study proposes a method of dynamic threshold setting to extract the most stable ECG waveform as the template for the consequent ECG identification process. With the proposed method, the accuracy of ECG biometrics using the dynamic time wraping for difference measures has been significantly improved. Analysis results with the self-built electrocardiogram database show that the deployment of the proposed method was able to reduce the half total error rate of the ECG biometric system from 3.35% to 1.45%. Its average running time on the platform of android mobile terminal was around 0.06 seconds, and thus demonstrates acceptable real-time performance.

  4. Prevalence and clinical significance of incidental cardiac findings in non-ECG-gated chest CT scans; Praevalenz und klinische Bedeutung inzidenteller Herzbefunde im nicht EKG-getriggerten Thorax-CT

    Energy Technology Data Exchange (ETDEWEB)

    Quentin, M.; Kroepil, P.; Lanzman, R.S.; Blondin, D.; Miese, F.; Scherer, A. [Heinrich-Heine-Universitaet Duesseldorf, Institut fuer Radiologie, Duesseldorf (Germany); Steiner, S. [Klinikum der Heinrich-Heine-Universitaet Duesseldorf, Klinik fuer Kardiologie, Pneumologie und Angiologie, Duesseldorf (Germany); Choy, G.; Abbara, S. [Massachusetts General Hospital, Harvard Medical School, Cardiovascular Imaging Section, Boston (United States)


    The purpose of this study was to evaluate the prevalence and clinical significance of incidental cardiac findings in non-ECG-gated chest CT. Non-ECG-gated chest CT examinations of 300 patients were retrospectively analyzed for incidental cardiac findings. Subsequently, these findings were evaluated for their clinical relevance by a cardiologist. A total of 107 out of 300 examined patients had 174 incidental cardiac findings including coronary calcification (90), aortic/mitral valve calcification (42), iatrogenic changes (23), pericardial effusion (6), dilatation of the heart (4), myocardial changes (3), thrombus in the left ventricle (2), constrictive pericarditis (2) and atrial myxoma (1). Of the cardiac findings 51% were described in the written report and in 53 out of the 107 patients the cardiac findings were unknown. Newly detected incidental findings from 8 patients were rated as clinically significant: pericardial effusion (4), constrictive pericarditis (1), thrombus in the left ventricle (1), atrial myxoma (1) and dilatation of the heart (1). Incidental cardiac findings are frequent in non-ECG-gated chest CT and may have a high clinical relevance. (orig.) [German] Ziel dieser Studie war es, die Praevalenz und klinische Bedeutung inzidenteller Herzbefunde im nicht EKG-getriggerten Thorax-CT ohne primaer kardiale Fragestellung zu evaluieren. Dreihundert nicht EKG-getriggerte Thorax-CT-Untersuchungen wurden retrospektiv bzgl. inzidenteller Herzbefunde analysiert. Die klinische Bedeutung wurde von einem Kardiologen bewertet. Von 300 Patienten hatten 107 insgesamt 174 Herzbefunde: Koronarsklerose (90), Aorten-/Mitralklappenverkalkung (42), iatrogene Veraenderungen (23), Perikarderguss (6), Herzvergroesserung (4), Myokardpathologien (3), Perikardverkalkungen (2), Thrombus im linken Ventrikel (2) und Myxom (1). Im radiologischen Bericht wurden 51% aller Herzbefunde beschrieben. Bei 53 der 107 Patienten mit Herzbefund waren diese klinisch nicht bekannt. Als

  5. 36例心电监护下种植手术临床观察%Clinical Observation of 36 Cases with Implant Surgery under ECG Monitoring

    Institute of Scientific and Technical Information of China (English)

    高巍; 张晓; 姜霞


    目的:在心电监护辅助下对心脑血管疾病患者进行种植牙植入手术,观察临床效果.方法:对36例患有心脑血管疾病者,在心电监护下进行种植外科手术,观察并监测手术过程,麻醉前后、手术前后的血压、心率变化,进行对比分析.结果:36例患者全部顺利完成手术,其中男性19例,女性17例,平均年龄67.9岁(45~81岁),平均手术时间51 min(20~134) min.麻醉前、后,术前、术后血压、心率较为平稳,心电图(67.7%)变化不大.结论:对患有心脑血管疾病、全身条件较差者,在心电监护下进行种植外科手术是比较可行的方式.%Objective:In the electrocardiographic monitoring conditions,to observe the clinical effect of the oral implant surgery patients with cardio-cerebral-vascular disease.Methods:36 patients with cardio-cerebro-vascular diseases were observed and monitored blood pressure,heart rate changes before,during and after implant surgery.Results:All 36 patients successfully completed surgery,19 cases were male and 17 females,mean age 67.9years (45 to 81 years old),average operation time was 51min (20-134min).Before and after anesthesia,pre and post operation the blood pressure and heart rate were steady,little change in electrocardiogram (67.7%).Conclusion:For patients suffering from cardio-cerebro-vascular diseases,with systemic conditions worse,ECG monitoring is a more feasible way to give implant surgery.

  6. Clinical Characters of ECG in Later Gestational Diabetes%妊娠期糖尿病患者妊娠晚期心电图临床特点分析

    Institute of Scientific and Technical Information of China (English)

    余海英; 梁珊瑚; 刘士春


    Objective:To analyse the clinical characters of ECG in later gestational diabetes women.Method:Randomly selected 72 cases of gestational diabetes were as group GDM1,gestational diabetes and pregnancy induced hypertension in patients with 35 cases of GDM2 group,and 100 patients with normal pregnant women as control group,were in the hospital antenatal electrocardiogram examination,the ECG analysis.Result:Normal late pregnancy rate was 26.0%, the abnormal ecg GDM1 group was 34.7%,GDM2 group was 45.7%,the comparison group difference was statistically significant (P<0.05),sinus tachycardia is most common among them,followed by ST-T change and short PR interval period.Conclusion:The abnormal rate of ECG is high in the later gestational women, and corralate with the pregnant complication,so ECG is necessary,especially to high-risk pregnant.%目的:探讨妊娠期糖尿病患者妊娠晚期心电图改变特点。方法:随机选取妊娠期糖尿病患者72例为GDM1组,妊娠期糖尿病合并妊娠期高血压疾病患者35例为GDM2组,并以正常妊娠孕妇100例作为对照组,均在入院产前行心电图检查,对其心电图情况进行分析。结果:正常孕晚期心电图异常率为26.0%,GDM1组为34.7%,GDM2组为45.7%,三组比较差异有统计学意义(P<0.05),其中窦性心动过速最常见,其次为ST-T改变及短PR间期。结论:妊娠晚期心电图异常发生率较高,并且与妊娠并发症及严重性具有一定的相关性,对于高龄尤其有合并症的患者应常规检查心电图。

  7. 心电图检查在心房纤颤诊断中的临床价值分析%Analysis of the Clinical Value of ECG Examination in the Diagnosis of Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)



    目的:探讨心电图检查应用在心房纤颤诊断中的临床价值。方法:筛选2013年10月-2014年1月笔者所在医院收治的心房纤颤患者310例作为研究对象。所有患者均经临床症状检查且均符合心房纤颤的诊断标准,对所有患者进行心电图检查并依据心电图结果进行诊断及病情评价,探讨心电图检查在心房纤颤诊断中的价值。结果:心电图的确诊符合率为98.06%(304/310),持续性房颤确诊符合率为98.27%(171/174),阵发性房颤为98.91%(91/92),永久性房颤为95.45%(42/44),并发风湿性心脏病符合率为91.30%(21/23),甲亢心脏病符合率为100%(11/11),高血压性心脏病符合率为92.68%(38/41),肺心病符合率为100%(16/16),与临床证实结果比较差异均无统计学意义(P>0.05)。结论:应用心电图检查心房纤颤患者可提高该病的临床确诊率,同时可实现对病情及并发症的准确评价,从而指导临床心房纤颤的治疗。%Objective:To investigate the clinical value of ECG examination application on diagnosis of atrial fibrillation.Method:310 patients with atrial fibrillation from October 2013 to January 2014 in our hospital were screened as research subjects.All patients were diagnosed by clinical examination and met the diagnostic criteria for atrial fibrillation,all patients were examined by ECG and based on ECG examination results for diagnosis and disease evaluation,and investigated the value of ECG in the diagnosis of atrial fibrillation.Result:The accordance rate of ECG diagnose was 98.06%(304/310),the diagnosis coincidence rate of persistent atrial fibrillation was 98.27%(171/174),the diagnosis coincidence rate of paroxysmal atrial fibrillation was 98.91%(91/92),the diagnosis coincidence rate of permanent atrial fibrillation was 95.45%(42/44),the coincidence rate of rheumatic heart disease was 91.30%(21/23),the coincidence rate of hyperthyroid heart disease was 100%(11/11),the

  8. Diagnostic Role of ECG Recording Simultaneously With EEG Testing. (United States)

    Kendirli, Mustafa Tansel; Aparci, Mustafa; Kendirli, Nurten; Tekeli, Hakan; Karaoglan, Mustafa; Senol, Mehmet Guney; Togrol, Erdem


    Arrhythmia is not uncommon in the etiology of syncope which mimics epilepsy. Data about the epilepsy induced vagal tonus abnormalities have being increasingly reported. So we aimed to evaluate what a neurologist may gain by a simultaneous electrocardiogram (ECG) and electroencephalogram (EEG) recording in the patients who underwent EEG testing due to prediagnosis of epilepsy. We retrospectively evaluated and detected ECG abnormalities in 68 (18%) of 376 patients who underwent EEG testing. A minimum of 20 of minutes artifact-free recording were required for each patient. Standard 1-channel ECG was simultaneously recorded in conjunction with the EEG. In all, 28% of females and 14% of males had ECG abnormalities. Females (mean age 49 years, range 18-88 years) were older compared with the male group (mean age 28 years, range 16-83 years). Atrial fibrillation was more frequent in female group whereas bradycardia and respiratory sinus arrhythmia was higher in male group. One case had been detected a critical asystole indicating sick sinus syndrome in the female group and treated with a pacemaker implantation in the following period. Simultaneous ECG recording in conjunction with EEG testing is a clinical prerequisite to detect and to clarify the coexisting ECG and EEG abnormalities and their clinical relevance. Potentially rare lethal causes of syncope that mimic seizure or those that could cause resistance to antiepileptic therapy could effectively be distinguished by detecting ECG abnormalities coinciding with the signs and abnormalities during EEG recording.

  9. Wireless Smartphone ECG Enables Large-Scale Screening in Diverse Populations. (United States)

    Haberman, Zachary C; Jahn, Ryan T; Bose, Rupan; Tun, Han; Shinbane, Jerold S; Doshi, Rahul N; Chang, Philip M; Saxon, Leslie A


    The ubiquitous presence of internet-connected phones and tablets presents a new opportunity for cost-effective and efficient electrocardiogram (ECG) screening and on-demand diagnosis. Wireless, single-lead real-time ECG monitoring supported by iOS and android devices can be obtained quickly and on-demand. ECGs can be immediately downloaded and reviewed using any internet browser. We compared the standard 12-lead ECG to the smartphone ECG in healthy young adults, elite athletes, and cardiology clinic patients. Accuracy for determining baseline ECG intervals and rate and rhythm was assessed. In 381 participants, 30-second lead I ECG waveforms were obtained using an iPhone case or iPad. Standard 12-lead ECGs were acquired immediately after the smartphone tracing was obtained. De-identified ECGs were interpreted by automated algorithms and adjudicated by two board-certified electrophysiologists. Both smartphone and standard ECGs detected atrial rate and rhythm, AV block, and QRS delay with equal accuracy. Sensitivities ranged from 72% (QRS delay) to 94% (atrial fibrillation). Specificities were all above 94% for both modalities. Smartphone ECG accurately detects baseline intervals, atrial rate, and rhythm and enables screening in diverse populations. Efficient ECG analysis using automated discrimination and an enhanced smartphone application with notification capabilities are features that can be easily incorporated into the acquisition process. © 2015 Wiley Periodicals, Inc.

  10. 远程心电监测诊断心律失常及心肌缺血的临床价值%Clinical value of remote ECG monitoring in diagnosis of arrhythmia and myocardial ischemia

    Institute of Scientific and Technical Information of China (English)



    目的:评估远程心电监测在心律失常、心肌缺血患者临床诊断中的应用价值。方法选取2012年5月至2014年5月于河南大学淮河医院门诊接受远程心电图监测的64例确诊为心脏不适或心脏病的患者,同时对所有患者实施12导联心电图检查,选取其中40例患者做24 h动态心电图检查,对比观察常规导联心电图检查、24 h动态心电图及远程心电监测在诊断心律失常、心肌缺血方面的检出率。结果64例患者远程心电监测提示心律失常52例,占81.3%,其心律失常检出率明显高于常规心电图的59.4%,两种不同诊断方式比较差异有统计学意义(P0.05)。结论为提高心律失常及心肌缺血的检出率,可将远程动态监测作为常规心电图检查与24 h动态心电图检查的辅助诊断手段。%Objective To evaluate the application value of remote ECG monitoring in clinical diagnosis of arrhyth-mia, myocardial ischemia. Methods Sixty-four patients diagnosed with heart disease or heart discomfort accepted remote ECG monitoring in huaihe hospital of Henan university from May 2012 to May 2014 were selected, they were all given the 12 lead ECG examination, and 40 patients given the 24 h dynamic electrocardiogram, the positive rate of myocardial ische-mia and arrhythmia comparative diagnosed by routine lead electrocardiogram inspection, detection rate 24 h dynamic elec-trocardiogram and remote ECG monitoring were compared. Results Among the 64 cases, 52 cases of arrhythmia detected by the remote ECG, accounting for 81. 3%, arrhythmia detection rate was significantly higher than that of conventional ECG (59. 4%), the difference was significant (P0. 05). Conclusions In order to improve detectable rate of arrhythmia and myocardial ischemia, remote dynamic moni-toring can be as auxiliary diagnostic means routine ECG examination and 24 h dynamic electrocardiogram examination.


    Directory of Open Access Journals (Sweden)

    Vasudha Nannaparaju


    Full Text Available Detection of the warning signals by the heart can be diagnosed from ECG. An accurate and reliable diagnosis of ECG is very important however which is cumbersome and at times ambiguous in time domain due to the presence of noise. Study of ECG in wavelet domain using both continuous Wavelet transform (CWT and discrete Wavelet transform (DWT, with well known wavelet as well as a wavelet proposed by the authors for this investigation is found to be useful and yields fairly reliable results. In this study, Wavelet analysis of ECGs of Normal, Hypertensive, Diabetic and Cardiac are carried out. The salient feature of the study is that detection of P and T phases in wavelet domain is feasible which are otherwise feeble or absent in raw ECGs.

  12. Brugada ECG patterns in athletes. (United States)

    Chung, Eugene H


    Brugada syndrome is responsible for up to 4% of all sudden cardiac deaths worldwide and up to 20% of sudden cardiac deaths in patients with structurally normal hearts. Heterogeneity of repolarization and depolarization, particularly over the right ventricle and the outflow tract, is responsible for the arrhythmogenic substrate. The coved Type I ECG pattern is considered diagnostic of the syndrome but its prevalence is very low. Distinguishing between a saddle back Type 2 Brugada pattern and one of many "Brugada-like" patterns presents challenges especially in athletes. A number of criteria have been proposed to assess Brugada ECG patterns. Proper precordial ECG lead placement is paramount. This paper reviews Brugada syndrome, Brugada ECG patterns, and recently proposed criteria. Recommendations for evaluating a Brugada ECG pattern are provided.

  13. Variable threshold method for ECG R-peak detection. (United States)

    Kew, Hsein-Ping; Jeong, Do-Un


    In this paper, a wearable belt-type ECG electrode worn around the chest by measuring the real-time ECG is produced in order to minimize the inconvenient in wearing. ECG signal is detected using a potential instrument system. The measured ECG signal is transmits via an ultra low power consumption wireless data communications unit to personal computer using Zigbee-compatible wireless sensor node. ECG signals carry a lot of clinical information for a cardiologist especially the R-peak detection in ECG. R-peak detection generally uses the threshold value which is fixed. There will be errors in peak detection when the baseline changes due to motion artifacts and signal size changes. Preprocessing process which includes differentiation process and Hilbert transform is used as signal preprocessing algorithm. Thereafter, variable threshold method is used to detect the R-peak which is more accurate and efficient than fixed threshold value method. R-peak detection using MIT-BIH databases and Long Term Real-Time ECG is performed in this research in order to evaluate the performance analysis.

  14. Advanced DSP Technique to Remove Baseline Noise from ECG Signal

    Directory of Open Access Journals (Sweden)

    Kanhaiya Kumar


    Full Text Available Heart diseases, which are one of the death reasons, are among the several serious problems in this century and as per the latest survey, 60% of the patients die due to Heart problems. In 2011, 10 crores people are suffering from heart diseases in India. Many individuals remain unaware of the symptoms of heart attack or dismiss possible symptoms as being unrelated or not important enough to visit a doctor. Early diagnosis and medical treatment of heart diseases can prevent sudden death of the patient. One of the ways to diagnose heart diseases is to use Electrocardiogram (ECG signals. ECG measures electrical potentials on the body surface via contact electrodes. However, timely and accurate detection of arrhythmias is a complex decision-making process for a cardiologist due to contamination of ECG signals with different frequencies of noise. For reliable interpretation of real-time ECGs, computer based techniques on digital signal processing (DSP of ECG waveform have been reported. ECG signals are non-stationary signals including valuable clinical informations, but frequently these informations are corrupted by noise. Many tools, methods and algorithms based on signal processing theory have been proposed and implemented. In this paper, advanced digital signal processing is carried out in Matlab environment. And the present work basically focuses on implementation and evaluation of methods to remove noise from ECG signal.

  15. Evaluation of a Rapid Anisotropic Model for ECG Simulation

    Directory of Open Access Journals (Sweden)

    Simone Pezzuto


    Full Text Available State-of-the-art cardiac electrophysiology models that are able to deliver physiologically motivated activation maps and electrocardiograms (ECGs can only be solved on high-performance computing architectures. This makes it nearly impossible to adopt such models in clinical practice. ECG imaging tools typically rely on simplified models, but these neglect the anisotropic electric conductivity of the tissue in the forward problem. Moreover, their results are often confined to the heart-torso interface. We propose a forward model that fully accounts for the anisotropic tissue conductivity and produces the standard 12-lead ECG in a few seconds. The activation sequence is approximated with an eikonal model in the 3d myocardium, while the ECG is computed with the lead-field approach. Both solvers were implemented on graphics processing units and massively parallelized. We studied the numerical convergence and scalability of the approach. We also compared the method to the bidomain model in terms of ECGs and activation maps, using a simplified but physiologically motivated geometry and 6 patient-specific anatomies. The proposed methods provided a good approximation of activation maps and ECGs computed with a bidomain model, in only a few seconds. Both solvers scaled very well to high-end hardware. These methods are suitable for use in ECG imaging methods, and may soon become fast enough for use in interactive simulation tools.

  16. 心电图检查在冠心病诊断中的临床价值%The clinical value of ECG in the diagnosis of coronary heart disease

    Institute of Scientific and Technical Information of China (English)



    目的 探讨冠心病患者心电图(ECG)和冠状动脉造影检查结果的相关性,分析心电图检查在冠心病诊断中的临床价值.方法 回顾性分析本院收治的116例疑似冠心病患者的临床资料,以冠状动脉造影检查结果作为诊断冠心病的金标准,分析心电图检查诊断冠心病的准确性.采用Gensini评分判定冠状动脉病变的严重程度,分析心电图检查结果与冠心病病变程度相关性.结果 116例疑似冠心病患者中,87例患者确诊为冠心病;心电图检查诊断冠心病的灵敏度为78.16%、特异性为68.96%、阳性预测值为77.27%、阴性预测值为32.14%,但中度和重度冠心病患者的心电图异常率明显高于轻度冠心病患者,差异具有统计学意义(P<0.05).结论 心电图异常与冠状动脉病变程度具有一定的相关性,对于心电图异常的疑似冠心病患者,冠状动脉造影检查对于冠心病的诊断具有重要的临床价值.%Objective To study the correlation between electrocardiogram (ECG) and coronary angiography in patients with coronary heart disease,and analyze the value of electrocardiogram in the diagnosis of coronary heart disease.Methods Retrospectively analyzed the clinical data of 116 patients with suspected coronary heart disease,with coronary angiography results as golden standard for diagnosing,analyzed the accuracy of ECG in diagnosis of coronary heart disease.Evaluated the severity degree of coronary atherosclerosis with Gensini score,analyzed the correlation between ECG and coronary heart disease.Results In 116 cases of suspected coronary heart disease,87 patients were diagnosed by coronary angiography.In the diagnosis of coronary heart disease by ECG,the sensitivity was 78.16%,the specificity was 68.96%,the positive predictive value was 77.27%,and the negative predictive value was 32.14%.But the positive rate of ECG was higher in patients with moderate and severe coronary heart disease than

  17. 高钾血症应用心电图诊断的临床分析%Clinical Analysis of ECG in the Diagnosis of Hyperkalemia

    Institute of Scientific and Technical Information of China (English)

    毛洁; 彭伊


    目的:研究并分析高钾血症应用心电图诊断的效果。方法:收集高钾血症患者共85例,根据患者的血清钾浓度分为对照组56例和观察组29例,对照组患者的血清钾浓度为5.5~6.5 mmol/L,观察组的血清钾浓度为6.5 mmol/L以上,患者均接受心电图诊断,将诊断结果与实验室诊断结果进行对比。结果:观察组与实验室诊断结果的符合率显著高于对照组(P<0.05)。结论:在高钾血症患者的治疗过程中,心电图诊断具有迅速、操作简单的优势,患者的血钾浓度与心电图的改变有着密切的关联性,随着血钾浓度水平的不断升高,会逐渐加重患者心电图的异常表现,值得推广应用。%Objective:To study and analyze the effect of ECG diagnosis in the application of hyperkalemia. Method: A total of 85 cases of hyperkalemia were collected,according to the patient's serum potassium concentration they were divided into the control group(n=56) and the observation group(n=29),patients of the control group with serum potassium concentration were 5.5-6.5 mmol/L,the observation group was above 6.5 mmol/L.Patients underwent ECG diagnosis,diagnosis results and laboratory diagnosis results were compared. Result:The coincidence rate of the observation group and the laboratory diagnosis result was significantly higher than that of the control group(P<0.05).Conclusion:In the treatment of patients with hyperkalemia and ECG diagnosis with rapid,simple operation advantage and patients serum potassium concentration and ECG change has a close correlation,along with rising of the concentration of blood potassium level,gradually increase theelectrocardiogram in patients with abnormal performance.It is worthy of popularization and application.

  18. Microprocessor-based simulator of surface ECG signals

    Energy Technology Data Exchange (ETDEWEB)

    MartInez, A E [Catedra de BioingenierIa II, Facultad de Ingenieria, Universidad Nacional de Entre Rios (FI-UNER), Ruta Provincial 11 Km.10 Oro Verde (Dpto. Parana) - Entre Rios (Argentina); Rossi, E [Catedra de BioingenierIa II, Facultad de Ingenieria, Universidad Nacional de Entre Rios (FI-UNER), Ruta Provincial 11 Km.10 Oro Verde (Dpto. Parana) - Entre Rios (Argentina); Siri, L Nicola [Catedra de BioingenierIa II, Facultad de Ingenieria, Universidad Nacional de Entre Rios (FI-UNER), Ruta Provincial 11 Km.10 Oro Verde (Dpto. Parana) - Entre Rios (Argentina)


    In this work, a simulator of surface electrocardiogram recorded signals (ECG) is presented. The device, based on a microcontroller and commanded by a personal computer, produces an analog signal resembling actual ECGs, not only in time course and voltage levels, but also in source impedance. The simulator is a useful tool for electrocardiograph calibration and monitoring, to incorporate as well in educational tasks and in clinical environments for early detection of faulty behaviour.

  19. [Management of pacemaker patients by bathtub ECG]. (United States)

    Mizukami, H; Togawa, T; Toyoshima, T; Ishijima, M


    We evaluated the efficacy of a new method for recording electrocardiogram (ECG) of pacemaker patients in bathtub (bathtub ECG). ECG from the pacemaker implanted patients in the bathtub with tap water was recorded through three silver/silver chloride electrodes (4 x 4 cm) fitted on the inside wall of bathtub. Electric signal was connected to the isolated amplifier and recorded on the strip chart recorder. Contrast to the conventional method for recording standard ECG, bathtub ECG does not require body surface electrodes and is recorded at patients home. Although the amplitude of bathtub ECG was reduced approximately to a quarter of standard ECG, cardiac arrhythmia can be easily interpreted by bathtub ECG. In patients with pacemaker system, the amplitude of the pacing pulse recorded by bathtub ECG was much larger than that of QRS complex recorded by standard ECG. Therefore, we conclude that bathtub ECG would be a suitable method to follow up patients with pacemaker system.

  20. Piezoelectric extraction of ECG signal (United States)

    Ahmad, Mahmoud Al


    The monitoring and early detection of abnormalities or variations in the cardiac cycle functionality are very critical practices and have significant impact on the prevention of heart diseases and their associated complications. Currently, in the field of biomedical engineering, there is a growing need for devices capable of measuring and monitoring a wide range of cardiac cycle parameters continuously, effectively and on a real-time basis using easily accessible and reusable probes. In this paper, the revolutionary generation and extraction of the corresponding ECG signal using a piezoelectric transducer as alternative for the ECG will be discussed. The piezoelectric transducer pick up the vibrations from the heart beats and convert them into electrical output signals. To this end, piezoelectric and signal processing techniques were employed to extract the ECG corresponding signal from the piezoelectric output voltage signal. The measured electrode based and the extracted piezoelectric based ECG traces are well corroborated. Their peaks amplitudes and locations are well aligned with each other.

  1. β-受体阻滞剂干预更年期妇女心电图变化的临床价值%Clinical significance of beta-receptor blocker intervention on ECG changes in climacteric women

    Institute of Scientific and Technical Information of China (English)

    贺桦; 李针; 渠红霞; 孟凡琳; 王兵


    目的:探讨β-受体阻滞剂干预更年期妇女心电图变化的临床价值。方法选取无器质性疾病但有心电图改变的更年期妇女62例,经患者知情同意按照数字表法随机分为治疗组31例,予以β-受体阻滞剂治疗3周;另31例为对照组,不给予任何治疗。观察治疗前后2组间及治疗组心电图指标(心率、心律、ST-T)的改变。结果(1)经β-受体阻滞剂治疗3周后,2组平均心率、心律、ST-T改变(除ST上斜外)比较差异均有统计学意义(P<0.05)。(2)治疗组治疗前后比较,成对房早、ST上斜和T波倒置虽有改变,但差异无统计学意义(P>0.05);其余指标均有明显改变,差异有统计学意义(P<0.05)。结论β-受体阻滞剂应用于心电图改变的更年期妇女有一定的临床价值。%Objective To investigate the clinical significance of beta-receptor blocker intervention on ECG changes in climac-teric women.Methods Sixty-two subjects of climacteric women without organic diseases but with ECG changes were chosen and ran-domly divided into 2 groups:the control group(n=32)and the treatment group(n=30).The subjects of the control group were not giv-en any treatment, while the subjects of the treatment group were given treatment of beta-receptor blocker intervention for 3 weeks.ECG changes ( heart rate, rhythm and ST-T changes) were detected both before and after treatment, and then, comparisons were made be-tween the groups and within the groups.Results ( 1 ) After 3 weeks of beta-receptor blocker intervention, significant ECG changes could be noted in heart rate, rhythm and ST-T changes ( except ST cable) in the subjects of the treatment group, with statistical signifi-cance, when comparisons were made between the 2 groups (P0.05).There were significant changes in the remaining parameters, with statistical significance (P<0.05). Conclusion Beta-receptor blocker had its clinical


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND AND OBJECTIVES: Posterior wall myocardial infarction is not uncommon acute myocardial infarction and has got its own therapeutic and prognostic implications. Management of Posterior wall myocardial infarction differs from inferior wall myocardial infarction alone. The presence of posterior wall myocardial infarction is known to increase the incidence of cardiogenic shock, arrhythmias and conduction blocks in case of myocardial infarction. Hence the present study was taken up to find out the incidence, clinical profile and complications of posterior wall myocardial infarction in a rural hospital using simple non-invasive investigations like 15 lead electrocardiography and echocardiography. METHODS: A prospective study was conducted on 50 patients of inferior wall myocardial infarction out of 228 Acute Myocardial Infarction proved by ECG standard and posterior leads (v7, v8, v9 were taken at the time of admission and repeated as necessary. A detailed case history was taken and a detailed physical examination was done at the time of admission and during follow up. For recording ECG 12 lead (3 standard leads, 3 augmented limb leads, 6 precordial leads machine was used. The recordings were made at 25 mm/ sec. speed and 1mV=10mm. Posterior leads were taken by using 3 precordial leads fixing on the posterior axillary (v7, infrascapular (v8 and paraspinal (v9 regions all in a same line with the 5th ICS anteriorly. RESULTS: Out of 50 cases of inferior wall myocardial infarction (IWMI studied only 13 (26% had ST elevation in posterior leads indicating posterior wall myocardial infarction (PWMI. Our study showed that complications and mortality was higher in patients of IWMI with PWMI compared to IWMI without PWMI. Out of 50 patients 33 (66% were males indicating a male predominance. Syncope was present in 18% of PWMI and 14% in overall IWMI. Palpitation was seen in 53% of PWMI and 21% of IWMI without PWMI. Smoking history was present in 14% of

  3. Near Field Communication-based telemonitoring with integrated ECG recordings. (United States)

    Morak, J; Kumpusch, H; Hayn, D; Leitner, M; Scherr, D; Fruhwald, F M; Schreier, G


    Telemonitoring of vital signs is an established option in treatment of patients with chronic heart failure (CHF). In order to allow for early detection of atrial fibrillation (AF) which is highly prevalent in the CHF population telemonitoring programs should include electrocardiogram (ECG) signals. It was therefore the aim to extend our current home monitoring system based on mobile phones and Near Field Communication technology (NFC) to enable patients acquiring their ECG signals autonomously in an easy-to-use way. We prototypically developed a sensing device for the concurrent acquisition of blood pressure and ECG signals. The design of the device equipped with NFC technology and Bluetooth allowed for intuitive interaction with a mobile phone based patient terminal. This ECG monitoring system was evaluated in the course of a clinical pilot trial to assess the system's technical feasibility, usability and patient's adherence to twice daily usage. 21 patients (4f, 54 ± 14 years) suffering from CHF were included in the study and were asked to transmit two ECG recordings per day via the telemonitoring system autonomously over a monitoring period of seven days. One patient dropped out from the study. 211 data sets were transmitted over a cumulative monitoring period of 140 days (overall adherence rate 82.2%). 55% and 8% of the transmitted ECG signals were sufficient for ventricular and atrial rhythm assessment, respectively. Although ECG signal quality has to be improved for better AF detection the developed communication design of joining Bluetooth and NFC technology in our telemonitoring system allows for ambulatory ECG acquisition with high adherence rates and system usability in heart failure patients.

  4. Clinical Research into ECG in Diagnosis of MI and Related Arteries%心电图判断心肌梗塞及其相关动脉的临床研究

    Institute of Scientific and Technical Information of China (English)

    尹雪艳; 廖新学; 杨艳萍


    目的:探讨心电图对心肌梗塞诊断的临床应用价值及由此间接推断梗塞相关动脉的可靠性。方法:以经心电图确诊的有 Q性心梗 47例为实验组,非心梗 45例为对照组,用单项筛检法研究心电图,二维超声心动图对心梗诊断的可靠性;以实验组冠状动脉造影作对照,探讨以心电图定位的心梗间接推断梗塞相关动脉的可靠性。结果: (1)心电图对有 Q性心梗的定性诊断敏感性 90.4%,特异性 86.7%。 (2)心电图及超声心动图对前壁、前间壁心梗定位诊断的敏感性分别为 87.2%和 97.1%,特异性为 86.7%及 71.1%。对下壁、后壁及右室心梗的定位诊断感性不如前壁。 (3)心电图定位的前壁心梗梗塞相关动脉为左前降支为主的病变,下壁、后壁及右室梗塞的相关动脉为右冠主干及左回旋支病变。结论:心电图以其无创、可靠、重复性好等优点在心肌梗塞的定性定位诊断方面有不可替代的价值,由此可间接判断梗塞相关动脉,具有临床实用价值。若常规加打 V3R~ V6R、 V7~ V9导联则可提高诊断符合率。%Objective: To research into the clinical value of ECG in diagnosis of AML, and to indirectly assess the reliability of infarct in related arteries by ECG.Methods:Taking 47 cases with AMI as the test group and 45 cases without AMI as the control group to study the diagnostic value by using both ECG and UCG. At the same tine,the coronary angiography of the test group was taken as a cuntrol factor to indirectly predict the IRA through Localization of AMI in ECG.Results:(1) The qualitative diagnosis of ECG on the QMI showed that the sensitivity and the specificity were 90.4% and 86.7% ;(2)The qualitative diagnosis of ECG and UCG on the anterior and interval walls of the MI showed that the sensitivity were 87.2% and 97.1% , and the specificity were 86.7% and 71.2% respectively.However, the

  5. Capacitive ECG system with direct access to standard leads and body surface potential mapping. (United States)

    Oehler, Martin; Schilling, Meinhard; Esperer, Hans Dieter


    Capacitive electrodes provide the same access to the human electrocardiogram (ECG) as galvanic electrodes, but without the need of direct electrical skin contact and even through layers of clothing. Thus, potential artifacts as a result of poor electrode contact to the skin are avoided and preparation time is significantly reduced. Our system integrates such capacitive electrodes in a 15 sensor array, which is combined with a Tablet PC. This integrated lightweight ECG system (cECG) is easy to place on the chest wall and allows for simultaneous recordings of 14 ECG channels, even if the patient is slightly dressed, e.g., with a t-shirt. In this paper, we present preliminary results on the performance of the cECG regarding the capability of recording body surface potential maps (BSPMs) and obtaining reconstructed standard ECG leads including Einthoven, Goldberger and, with some limitations, Wilson leads. All signals were measured having the subject lie in a supine position and wear a cotton shirt. Signal quality and diagnostic ECG information of the extracted leads are compared with standard ECG measurements. The results show a very close correlation between both types of ECG measurements. It is concluded that the cECG lends itself to rapid screening in clinically unstable patients.

  6. A Comparison of IIR and Wavelet Filtering for Noise Reduction of the ECG. (United States)

    Sørensen, Js; Johannesen, L; Grove, Usl; Lundhus, K; Couderc, J-P; Graff, C


    This study compares the ability to preserve information and reduce noise contaminants on the ECG for five wavelet filters and three IIR filters. Two 3-lead Holter ECGs were used. White Gaussian Noise was added to the first ECG in increments of 10% coverage. The second ECG contained alternating muscle transients and noise-free segments. Computation times and SNR improvements for different noise coverages were calculated and compared. RMS errors were calculated from noise-free segments on the ECG with transient muscle noise. Wavelet filters improved SNR more than IIR filters when the signal coverage was more than 50% noise. In contrast, the computation times were shorter for IIR filters (6 s) than for wavelet filters (88 s). On the ECG with transient muscle noise there was a trade-off in performance between wavelet and IIR filtering. In a clinical setting where the amount of noise is unknown, using IIR filters appears to be preferred for consistent performance.

  7. ECG movement artefacts can be greatly reduced with the aid of a movement absorbing device

    DEFF Research Database (Denmark)

    Harrison, Adrian Paul; Wandall, Kirsten; Thorball, Jørgen


    Accurate ECG signal analysis can be confounded by electric lead, and/or electrode movements varying in origin from, for example, hiccups, tremor or patient restlessness. ECG signals recorded using either a conventional electrode holder or with the aid of an electrode holder capable of absorbing...... movement artefacts, were measured on a healthy human subject. Results show a greatly improved stability of the ECG signal recorded using an electrode holder capable of absorbing movement artefacts during periods of lead disturbance, and highlight the movement artefacts that develop when the recording lead...... of a conventional ECG electrode holder is tugged or pulled during theperiod of monitoring. It is concluded that the new design of ECG electrode holder will not only enable clearer signal recordings for clinical assessment, but will reduce the ECG artefacts associated with the transportation of patients, and may...

  8. The Telemetric and Holter ECG Warehouse (THEW): the first three years of development and research. (United States)

    Couderc, Jean-Philippe


    The Telemetric and Holter ECG Warehouse (THEW) hosts more than 3700 digital 24-Holter ECG recordings from 13 independent studies. In addition to the ECGs, the repository includes patient information in separate clinical database with content varying according to the study focus. In its third year of activities, the THEW database has been accessed by researchers from 37 universities and 16 corporations located in 16 countries worldwide. Twenty publications were released primarily focusing on the development and validation of ECG-based technologies. This communication describes the content of the databases of the repository with brief summary of the research and development projects completed using these data.

  9. An adaptive Kalman filter for ECG signal enhancement. (United States)

    Vullings, Rik; de Vries, Bert; Bergmans, Jan W M


    The ongoing trend of ECG monitoring techniques to become more ambulatory and less obtrusive generally comes at the expense of decreased signal quality. To enhance this quality, consecutive ECG complexes can be averaged triggered on the heartbeat, exploiting the quasi-periodicity of the ECG. However, this averaging constitutes a tradeoff between improvement of the SNR and loss of clinically relevant physiological signal dynamics. Using a bayesian framework, in this paper, a sequential averaging filter is developed that, in essence, adaptively varies the number of complexes included in the averaging based on the characteristics of the ECG signal. The filter has the form of an adaptive Kalman filter. The adaptive estimation of the process and measurement noise covariances is performed by maximizing the bayesian evidence function of the sequential ECG estimation and by exploiting the spatial correlation between several simultaneously recorded ECG signals, respectively. The noise covariance estimates thus obtained render the filter capable of ascribing more weight to newly arriving data when these data contain morphological variability, and of reducing this weight in cases of no morphological variability. The filter is evaluated by applying it to a variety of ECG signals. To gauge the relevance of the adaptive noise-covariance estimation, the performance of the filter is compared to that of a Kalman filter with fixed, (a posteriori) optimized noise covariance. This comparison demonstrates that, without using a priori knowledge on signal characteristics, the filter with adaptive noise estimation performs similar to the filter with optimized fixed noise covariance, favoring the adaptive filter in cases where no a priori information is available or where signal characteristics are expected to fluctuate.

  10. Advanced ECG in 2016: is there more than just a tracing? (United States)

    Reichlin, Tobias; Abächerli, Roger; Twerenbold, Raphael; Kühne, Michael; Schaer, Beat; Müller, Christian; Sticherling, Christian; Osswald, Stefan


    The 12-lead electrocardiogram (ECG) is the most frequently used technology in clinical cardiology. It is critical for evidence-based management of patients with most cardiovascular conditions, including patients with acute myocardial infarction, suspected chronic cardiac ischaemia, cardiac arrhythmias, heart failure and implantable cardiac devices. In contrast to many other techniques in cardiology, the ECG is simple, small, mobile, universally available and cheap, and therefore particularly attractive. Standard ECG interpretation mainly relies on direct visual assessment. The progress in biomedical computing and signal processing, and the available computational power offer fascinating new options for ECG analysis relevant to all fields of cardiology. Several digital ECG markers and advanced ECG technologies have shown promise in preliminary studies. This article reviews promising novel surface ECG technologies in three different fields. (1) For the detection of myocardial ischaemia and infarction, QRS morphology feature analysis, the analysis of high frequency QRS components (HF-QRS) and methods using vectorcardiography as well as ECG imaging are discussed. (2) For the identification and management of patients with cardiac arrhythmias, methods of advanced P-wave analysis are discussed and the concept of ECG imaging for noninvasive localisation of cardiac arrhythmias is presented. (3) For risk stratification of sudden cardiac death and the selection of patients for medical device therapy, several novel markers including an automated QRS-score for scar quantification, the QRS-T angle or the T-wave peak-to-end-interval are discussed. Despite the existing preliminary data, none of the advanced ECG markers and technologies has yet accomplished the transition into clinical practice. Further refinement of these technologies and broader validation in large unselected patient cohorts are the critical next step needed to facilitate translation of advanced ECG technologies

  11. Development of a portable wireless system for bipolar concentric ECG recording (United States)

    Prats-Boluda, G.; Ye-Lin, Y.; Bueno Barrachina, J. M.; Senent, E.; Rodriguez de Sanabria, R.; Garcia-Casado, J.


    Cardiovascular diseases (CVDs) remain the biggest cause of deaths worldwide. ECG monitoring is a key tool for early diagnosis of CVDs. Conventional monitors use monopolar electrodes resulting in poor spatial resolution surface recordings and requiring extensive wiring. High-spatial resolution surface electrocardiographic recordings provide valuable information for the diagnosis of a wide range of cardiac abnormalities, including infarction and arrhythmia. The aim of this work was to develop and test a wireless recording system for acquiring high spatial resolution ECG signals, based on a flexible tripolar concentric electrode (TCE) without cable wiring or external reference electrode which would make more comnfortable its use in clinical practice. For this, a portable, wireless sensor node for analogue conditioning, digitalization and transmission of a bipolar concentric ECG signal (BC-ECG) using a TCE and a Mason-likar Lead-I ECG (ML-Lead-I ECG) signal was developed. Experimental results from a total of 32 healthy volunteers showed that the ECG fiducial points in the BC-ECG signals, recorded with external and internal reference electrode, are consistent with those of simultaneous ML-Lead-I ECG. No statistically significant difference was found in either signal amplitude or morphology, regardless of the reference electrode used, being the signal-to-noise similar to that of ML-Lead-I ECG. Furthermore, it has been observed that BC-ECG signals contain information that could not available in conventional records, specially related to atria activity. The proposed wireless sensor node provides non-invasive high-local resolution ECG signals using only a TCE without additional wiring, which would have great potential in medical diagnosis of diseases such as atrial or ventricular fibrillations or arrhythmias that currently require invasive diagnostic procedures (catheterization).

  12. Non-contact ECG monitoring (United States)

    Smirnov, Alexey S.; Erlikh, Vadim V.; Kodkin, Vladimir L.; Keller, Andrei V.; Epishev, Vitaly V.


    The research is dedicated to non-contact methods of electrocardiography. The authors describe the routine of experimental procedure and suggest the approach to solving the problems which arise at indirect signal recording. The paper presents the results of experiments conducted by the authors, covers the flow charts of ECG recorders and reviews the drawbacks of filtering methods used in foreign equivalents.

  13. ECG changes in epilepsy patients

    DEFF Research Database (Denmark)

    Tigaran, S; Rasmussen, V; Dam, M


    To investigate the frequency of ECG abnormalities suggestive of myocardial ischaemia in patients with severe drug resistant epilepsy and without any indication of previous cardiac disease, assuming that these changes may be of significance for the group of epileptic patients with sudden unexpected...

  14. Analysis of ECG Using Filter Bank Approach

    Directory of Open Access Journals (Sweden)

    S. Thulasi Prasad


    Full Text Available In recent years scientists and engineers are facing several problems in the biomedical field. However Digital Signal Processing is solving many of those problems easily and effectively. The signal processing of ECG is very useful in detecting selected arrhythmia conditions from a patient’s electrocardiograph (ECG signals. In this paper we performed analysis of noisy ECG by filtering of 50 Hz power line interference using an adaptive LMS notch filter. This is very meaningful in the measurement of biomedical events, particularly when the recorded ECG signal is very weak. The basic ECG has the frequency range from 5 Hz to 100 Hz. It becomes difficult for the Specialist to diagnose the diseases if the artifacts are present in the ECG signal. Methods of noise reduction have decisive influence on performance of all electro-cardio-graphic (ECG signal processing systems. After removing 50/60 Hz powerline interference, the ECG is lowpass filtered in a digital FIR filter. We designed a Filter Bank to separate frequency ranges of ECG signal to enhance the occurrences QRS complexes. Later the positions of R-peaks are identified and shown plotted. The result shows the ECG signal before filtering and after filtering with their frequency spectrums which clearly indicates the reduction of the power line interference in the ECG signal and a filtered ECG with identified R-peaks.

  15. Thyroid hormones concentrations and ECG picture in the dog. (United States)

    Pasławska, U; Noszczyk-Nowak, A; Kungl, K; Bioły, K; Popiel, J; Nicpoń, J


    Disorders of the thyroid gland activity are the most commonly encountered disturbances of endocrine origin in the dog. Hypo- or hyperthyroidism may disturb the function of the cardiovascular system and cause arrhythmias. The aim of this study was to evaluate the influence of thyroid gland activity on electrocardiogram (ECG) picture in the dog by comparing ECG curves of healthy dogs, dogs with hypothyroidism and dogs with cardiac insufficiency caused by endocardiosis of the mitral valve. The study was performed on 38 dogs, patients of the Department of Internal and Parasitic Diseases with Clinic for Horses, Dogs and Cats in Wrocław. The animals were assigned to 3 groups: Group I--control group, 13 clinically healthy dogs; Group II--14 dogs with diagnosed cardiac insufficiency caused by endocardiosis of the mitral valve; Group III--11 dogs with hypothyroidism. Clinical examination of the animals was conducted according to the following pattern: anamnesis, general clinical examination, cardiological examination (ECG, USG of the heart) and laboratory analysis (triacylglycerydes, cholesterol, T3, T4, FT4). In this study, the significant influence of thyroid gland activity on ECG picture of the evaluated dogs was found. In the dogs with hypothyroidism a decrease in the sino-atrial node activity was observed, which led to decreased heart rate. In dogs with hypothyroidism, the innerheart conduction was reduced, which was demonstrated by prolongation of the P wave, QRS complex and the QT interval.

  16. Cardiac Electrophysiology: Normal and Ischemic Ionic Currents and the ECG (United States)

    Klabunde, Richard E.


    Basic cardiac electrophysiology is foundational to understanding normal cardiac function in terms of rate and rhythm and initiation of cardiac muscle contraction. The primary clinical tool for assessing cardiac electrical events is the electrocardiogram (ECG), which provides global and regional information on rate, rhythm, and electrical…

  17. Analysis of ECG Tp and Te interval on the clinical value of coronary heart disease%心电图 Tp-Te 间期对冠心病患者的临床诊断价值

    Institute of Scientific and Technical Information of China (English)

    丁莹; 刘海; 张民


    目的:探讨心电图T波峰末( Tp-Te )间期对冠心病患者的临床诊断价值。方法回顾性分析2010年5月-2013年5月入住的110例心脏病患者的临床资料,其中62例为冠心病患者( CHD组),48例为非冠心病患者(非CHD组)。对2组患者Tp-Te 间期、Tp-Te 间期离散度及J波进行测量,并对心电图进行记录。结果(1)2组V2导联Tp-Te 间期、V6导联Tp-Te 间期比较,差异具有统计学意义( P <0|.05, P <0.01),但Tp-Te 间期离散度比较,差异无统计学意义( P >0.05);(2)不同支数冠状动脉狭窄组间V2导联Tp-Te 间期、V6导联Tp-Te间期及Tp-Te 间期离散度比较,差异均无统计学意义( P >0.05);(3)冠心病患者中,有J波组与无J波组V2导联Tp-Te 间期、V6导联Tp-Te 间期及Tp-Te 间期离散度比较,差异均无统计学意义( P >0.05)。结论心电图Tp-Te 间期对冠心病的诊断具有一定的临床价值;冠脉狭窄支数或缺血性J波对Tp-Te 间期并非惟一的影响因素。%Objective To explore the electrocardiogram T wave end ( Tp-Te ) interval of coronary heart disease in clinical diagnostic value .Methods Retrospective analysis of May 2010 to May 2013 110 cases clinical data of inpatients with heart disease , including 62 cases of coronary heart disease ( CHD group ) , 48 cases of non-coronary heart disease ( non-CHD group).On two groups of patients T p-Te interval, Tp-Te interval dispersion and J wave measurements , and ECG recording.Re-sults (1) 2 group V2 lead Tp-Te interval, V6 lead Tp-Te interval value, the difference was statistically significant ( P 0.05);(2)Diffe rent counts coronary stenosis group V2 lead Tp-Te interval, V6 lead Tp-Te interval and Tp-Te interval dispersion,the difference was not statistically significant ( P >0.05) ;(3)Coronary artery disease patients, J wave group and non-J wave group V2 J wave ECG Tp-Te interval, V6 lead Tp-Te interval

  18. ECG by mobile technologies. (United States)

    Guzik, Przemyslaw; Malik, Marek

    Mobile electrocardiographs consist of three components: a mobile device (e.g. a smartphone), an electrocardiographic device or accessory, and a mobile application. Mobile platforms are small computers with sufficient computational power, good quality display, suitable data storage, and several possibilities of data transmission. Electrocardiographic electrodes and sensors for mobile use utilize unconventional materials, e.g. rubber, e-textile, and inkjet-printed nanoparticle electrodes. Mobile devices can be handheld, worn as vests or T-shirts, or attached to patient's skin as biopatches. Mobile electrocardiographic devices and accessories may additionally record other signals including respiratory rate, activity level, and geolocation. Large-scale clinical studies that utilize electrocardiography are easier to conduct using mobile technologies and the collected data are suitable for "big data" processing. This is expected to reveal phenomena so far inaccessible by standard electrocardiographic techniques.

  19. Left Ventricular Hypertrophy: An allometric comparative analysis of different ECG markers (United States)

    Bonomini, M. P.; Ingallina, F.; Barone, V.; Valentinuzzi, M. E.; Arini, P. D.


    Allometry, in general biology, measures the relative growth of a part in relation to the whole living organism. Left ventricular hypertrophy (LVH) is the heart adaptation to excessive load (systolic or diastolic). The increase in left ventricular mass leads to an increase in the electrocardiographic voltages. Based on clinical data, we compared the allometric behavior of three different ECG markers of LVH. To do this, the allometric fit AECG = δ + β (VM) relating left ventricular mass (estimated from ecocardiographic data) and ECG amplitudes (expressed as the Cornell-Voltage, Sokolow and the ECG overall voltage indexes) were compared. Besides, sensitivity and specifity for each index were analyzed. The more sensitive the ECG criteria, the better the allometric fit. In conclusion: The allometric paradigm should be regarded as the way to design new and more sensitive ECG-based LVH markers.

  20. Design of Low Power Algorithms for Automatic Embedded Analysis of Patch ECG Signals

    DEFF Research Database (Denmark)

    Saadi, Dorthe Bodholt

    The diagnosis of cardiac arrhythmias often depends on information from long-term ambulatory electrocardiographic (ECG) monitoring. For several decades, these recordings have been obtained by wired Holter recorders. However, to overcome some of the known disadvantages of the old technologies......, several different cable-free wireless patch-type ECG recorders have recently reached the market. One of these recorders is the ePatch designed by the Danish company DELTA. The extended monitoring period available with the patch recorders has demonstrated to increase the diagnostic yield of outpatient ECG...... monitoring. Furthermore, the patch recorders facilitate the possibility of outpatient ECG monitoring in new clinically relevant areas, e.g. telemedicine monitoring of cardiac patients in their homes. Some of these new applications could benefit from real-time embedded interpretation of the recorded ECGs...

  1. ECG Feature Extraction Techniques - A Survey Approach

    CERN Document Server

    Karpagachelvi, S; Sivakumar, M


    ECG Feature Extraction plays a significant role in diagnosing most of the cardiac diseases. One cardiac cycle in an ECG signal consists of the P-QRS-T waves. This feature extraction scheme determines the amplitudes and intervals in the ECG signal for subsequent analysis. The amplitudes and intervals value of P-QRS-T segment determines the functioning of heart of every human. Recently, numerous research and techniques have been developed for analyzing the ECG signal. The proposed schemes were mostly based on Fuzzy Logic Methods, Artificial Neural Networks (ANN), Genetic Algorithm (GA), Support Vector Machines (SVM), and other Signal Analysis techniques. All these techniques and algorithms have their advantages and limitations. This proposed paper discusses various techniques and transformations proposed earlier in literature for extracting feature from an ECG signal. In addition this paper also provides a comparative study of various methods proposed by researchers in extracting the feature from ECG signal.

  2. ECG data compression using Jacobi polynomials. (United States)

    Tchiotsop, Daniel; Wolf, Didier; Louis-Dorr, Valérie; Husson, René


    Data compression is a frequent signal processing operation applied to ECG. We present here a method of ECG data compression utilizing Jacobi polynomials. ECG signals are first divided into blocks that match with cardiac cycles before being decomposed in Jacobi polynomials bases. Gauss quadratures mechanism for numerical integration is used to compute Jacobi transforms coefficients. Coefficients of small values are discarded in the reconstruction stage. For experimental purposes, we chose height families of Jacobi polynomials. Various segmentation approaches were considered. We elaborated an efficient strategy to cancel boundary effects. We obtained interesting results compared with ECG compression by wavelet decomposition methods. Some propositions are suggested to improve the results.

  3. Feasibility of in utero telemetric fetal ECG monitoring in a lamb model. (United States)

    Hermans, Bart; Lewi, Liesbeth; Jani, Jacques; De Buck, Frederik; Deprest, Jan; Puers, Robert


    If fetal ECG (fECG) devices could be miniaturized sufficiently, one could consider their implantation at the time of fetal surgery to allow permanent monitoring of the fetus and timely intervention in the viable period. We set up an experiment to evaluate the feasibility of in utero direct fECG monitoring and telemetric transmission using a small implantable device in a lamb model. A 2-lead miniature ECG sensor (volume 1.9 cm(3); weight 3.9 g) was subcutaneously implanted in 2 fetal lambs at 122 days gestation (range 119-125; term 145 days). The ECG sensor can continuously register and transmit fECG. The signal is captured by an external receiving antenna taped to the maternal abdominal wall. We developed dedicated software running on a commercial laptop for on-line analysis of the transmitted fECG signal. This was a noninterventional study, i.e. daily readings of the fECG signal were done without clinical consequences to the observations. fECG could be successfully registered, transmitted by telemetry and analyzed from the moment of implantation till term birth in one case (24 days). In the second case, unexplained in utero fetal death occurred 12 days after implantation. In this subject, agonal fECG changes were recorded. An implanted miniature (signal in third-trimester fetal lambs. The telemetric signal could be picked up by an external antenna located within a 20-cm range. In this experiment, this was achieved through taping the external receiver to the maternal abdomen. Any acquired signal could be transmitted to a commercially available laptop that could perform on-line analysis of the signal. (c) 2008 S. Karger AG, Basel.

  4. Clinical observation of ECG in diagnosis of acute myocardial infarction with bundle branch block%心电图诊断急性心肌梗死合并束支阻滞的临床观察

    Institute of Scientific and Technical Information of China (English)



    Objective Discussion of electrocardiographic diagnosis of acute myocardial infarction clinical significance of bundle branch block..Methods From March 2014 to December 2015,72 patients with acute myocardial infarction in patients with bundle branch block as the object of study,after ECG for patients,respectively,traditional programmes and Sgarbossa diagnosis scheme for diagnostic purposes. Observation and comparison of two diagnosis results of the programme.Results The two methods in the negative predictive and diagnostic sensitivity of no significant difference but Sgarbossa positive predictive diagnosis method of rate and specificity than conventional methods.Conclusion Sgarbossa judge diagnosis,can effectively improve the accuracy of electrocardiogram in diagnosis of myocardial infarction.%目的:讨论心电图诊断急性心肌梗死合并束支阻滞的临床意义。方法选取2014年3月至2015年12月,72例患有急性心肌梗死合并束支阻滞的患者为研究对象,对患者进行心电图检查之后,分别以传统诊断方案和Sgarbossa诊断方案进行诊断。观察和比较两中诊断方案的结果。结果两种方法在阴性预测率和诊断敏感性的比较上没有显著差异,但是用Sgarbossa诊断方法的阳性预测率和特异性明显高于传统方法。结论应用Sgarbossa诊断方案进行判断,可以有效的提高心电图诊断心肌梗死的准确率。

  5. The amount of viable and dyssynchronous myocardium is associated with response to cardiac resynchronization therapy: initial clinical results using multiparametric ECG-gated [{sup 18}F]FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Lehner, Sebastian; Uebleis, Christopher; Haug, Alexander; Bartenstein, Peter [University of Munich, Department of Nuclear Medicine, Munich (Germany); Schuessler, Franziska; Kaeaeb, Stefan; Estner, Heidi [University of Munich, Medical Department I, Munich (Germany); Van Kriekinge, Serge D.; Germano, Guido [UCLA, Cedars-Sinai Medical Center, Los Angeles and David Geffen School of Medicine, Los Angeles, CA (United States); Hacker, Marcus [Medical University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Theraphy, Vienna (Austria)


    There is still a significant amount of patients who do not sufficiently respond to cardiac resynchronization therapy (CRT). Previous studies demonstrated that the amount of dyssynchronous myocardium was predictive of response to CRT. Otherwise, non-response is frequently associated with high amounts of scar tissue. The combination of these parameters might yield a more accurate prediction of response. We hypothesized that the probability of a CRT response increases with the presence of high amounts of ''viable and dyssynchronous'' myocardium. A total of 19 patients (17 male, 61 {+-} 10 years) underwent ECG-gated [{sup 18}F]fluorodeoxyglucose (FDG) myocardial positron emission tomography (PET) before CRT device implantation and were followed for 6 months. Response to CRT was defined as clinical improvement of at least one New York Heart Association (NYHA) class in combination with left ventricular (LV) ejection fraction (EF) improvement of >5 %. Twelve responders (71 %) and seven non-responders (29 %) were identified. For each patient bullseye maps of FDG uptake and phase analysis were calculated (QPS/QGS 2012, Cedars-Sinai, Los Angeles, CA, USA) and fused. Amounts of myocardium representing ''viable and synchronous'', ''scar and synchronous'', viable and dyssynchronous or ''scar and dyssynchronous'' myocardium were quantified by planimetric measurements of the fused bullseye maps. Responders by definition showed significant decrease in NYHA class and significant increase of LVEF. Furthermore, a significantly higher amount of viable and dyssynchronous myocardium was found as compared to non-responders (21 {+-} 13 % vs 6 {+-} 5 %; p < 0.05). Combined assessment of myocardial viability and LV dyssynchrony is feasible using multiparametric [{sup 18}F]FDG PET and could improve conventional response prediction criteria for CRT. (orig.)

  6. [A wireless ECG monitor based on ARM]. (United States)

    Fan, Ai-Hua; Bian, Chun-Hua; Ning, Xin-Bao; He, Ai-Jun; Zhuang, Jian-Jun; Wu, Xu-Hui


    This paper presents a novel monitor which uses ARM controller AT91SAM7S64 as its main processor, LCM (Liquid Crystal Display Module) for displaying ECG waves, SD (Secure Digital memory) card for data storage and RF module PTR8000 for radio data transmission. This portable monitor boasts alarm function for abnormality and can provide dynamic ECG monitoring for patients.

  7. Contact dermatitis caused by ECG electrode paste. (United States)

    Cochran, R J; Rosen, T


    A case of contact dermatitis caused by ECG electrode cream is presented and the pertinent literature is reviewed. Our patient was found to be allergic to propylene glycol. Patch-testing remains an invaluable tool in the evaluation of patients suspected of being allergic to ECG paste, creams, and gels.

  8. Expert knowledge for computerized ECG interpretation

    NARCIS (Netherlands)

    J.A. Kors (Jan)


    textabstractIn this study, two main questions are addressed: (1) Can the time consuming and cumbersome development and refinement of (heuristic) ECG classifiers be alleviated, and (2) Is it possible to increase diagnostic performance of ECG computer programs by combining knowledge from multiple sour

  9. A novel algorithm for Bluetooth ECG. (United States)

    Pandya, Utpal T; Desai, Uday B


    In wireless transmission of ECG, data latency will be significant when battery power level and data transmission distance are not maintained. In applications like home monitoring or personalized care, to overcome the joint effect of previous issues of wireless transmission and other ECG measurement noises, a novel filtering strategy is required. Here, a novel algorithm, identified as peak rejection adaptive sampling modified moving average (PRASMMA) algorithm for wireless ECG is introduced. This algorithm first removes error in bit pattern of received data if occurred in wireless transmission and then removes baseline drift. Afterward, a modified moving average is implemented except in the region of each QRS complexes. The algorithm also sets its filtering parameters according to different sampling rate selected for acquisition of signals. To demonstrate the work, a prototyped Bluetooth-based ECG module is used to capture ECG with different sampling rate and in different position of patient. This module transmits ECG wirelessly to Bluetooth-enabled devices where the PRASMMA algorithm is applied on captured ECG. The performance of PRASMMA algorithm is compared with moving average and S-Golay algorithms visually as well as numerically. The results show that the PRASMMA algorithm can significantly improve the ECG reconstruction by efficiently removing the noise and its use can be extended to any parameters where peaks are importance for diagnostic purpose.

  10. Heritability of ECG Biomarkers in the Netherlands Twin Registry Measured from Holter ECGs. (United States)

    Hodkinson, Emily C; Neijts, Melanie; Sadrieh, Arash; Imtiaz, Mohammad S; Baumert, Mathias; Subbiah, Rajesh N; Hayward, Christopher S; Boomsma, Dorret; Willemsen, Gonneke; Vandenberg, Jamie I; Hill, Adam P; De Geus, Eco


    The resting ECG is the most commonly used tool to assess cardiac electrophysiology. Previous studies have estimated heritability of ECG parameters based on these snapshots of the cardiac electrical activity. In this study we set out to determine whether analysis of heart rate specific data from Holter ECGs allows more complete assessment of the heritability of ECG parameters. Holter ECGs were recorded from 221 twin pairs and analyzed using a multi-parameter beat binning approach. Heart rate dependent estimates of heritability for QRS duration, QT interval, Tpeak-Tend and Theight were calculated using structural equation modeling. QRS duration is largely determined by environmental factors whereas repolarization is primarily genetically determined. Heritability estimates of both QT interval and Theight were significantly higher when measured from Holter compared to resting ECGs and the heritability estimate of each was heart rate dependent. Analysis of the genetic contribution to correlation between repolarization parameters demonstrated that covariance of individual ECG parameters at different heart rates overlap but at each specific heart rate there was relatively little overlap in the genetic determinants of the different repolarization parameters. Here we present the first study of heritability of repolarization parameters measured from Holter ECGs. Our data demonstrate that higher heritability can be estimated from the Holter than the resting ECG and reveals rate dependence in the genetic-environmental determinants of the ECG that has not previously been tractable. Future applications include deeper dissection of the ECG of participants with inherited cardiac electrical disease.

  11. Heritability of ECG Biomarkers in the Netherlands Twin Registry Measured from Holter ECGs (United States)

    Hodkinson, Emily C.; Neijts, Melanie; Sadrieh, Arash; Imtiaz, Mohammad S.; Baumert, Mathias; Subbiah, Rajesh N.; Hayward, Christopher S.; Boomsma, Dorret; Willemsen, Gonneke; Vandenberg, Jamie I.; Hill, Adam P.; De Geus, Eco


    Introduction: The resting ECG is the most commonly used tool to assess cardiac electrophysiology. Previous studies have estimated heritability of ECG parameters based on these snapshots of the cardiac electrical activity. In this study we set out to determine whether analysis of heart rate specific data from Holter ECGs allows more complete assessment of the heritability of ECG parameters. Methods and Results: Holter ECGs were recorded from 221 twin pairs and analyzed using a multi-parameter beat binning approach. Heart rate dependent estimates of heritability for QRS duration, QT interval, Tpeak–Tend and Theight were calculated using structural equation modeling. QRS duration is largely determined by environmental factors whereas repolarization is primarily genetically determined. Heritability estimates of both QT interval and Theight were significantly higher when measured from Holter compared to resting ECGs and the heritability estimate of each was heart rate dependent. Analysis of the genetic contribution to correlation between repolarization parameters demonstrated that covariance of individual ECG parameters at different heart rates overlap but at each specific heart rate there was relatively little overlap in the genetic determinants of the different repolarization parameters. Conclusions: Here we present the first study of heritability of repolarization parameters measured from Holter ECGs. Our data demonstrate that higher heritability can be estimated from the Holter than the resting ECG and reveals rate dependence in the genetic—environmental determinants of the ECG that has not previously been tractable. Future applications include deeper dissection of the ECG of participants with inherited cardiac electrical disease. PMID:27199769

  12. Are ECG monitoring recommendations before prescription of QT-prolonging drugs applied in daily practice?

    DEFF Research Database (Denmark)

    Warnier, Miriam Jacoba; Rutten, Frans Hendrik; Souverein, Patrick Cyriel


    PURPOSE: Monitoring of the QT duration by electrocardiography (ECG) prior to treatment is frequently recommended in the label of QT-prolonging drugs. It is, however, unknown how often general practitioners in daily clinical practice are adhering to these risk-minimization measures. We assessed...... the frequency of ECG measurements in patients where haloperidol was initiated in primary care. METHODS: Patients (≥18 years) with a first prescription of haloperidol in the UK Clinical Practice Research Datalink (2009-2013) were included. The proportion of ECGs made was determined in two blocks of 4 weeks......: during the exposure period when haloperidol was initiated, and during the control period, 1 year before. Conditional logistic regression analysis was applied to calculate the relative risk of having an ECG in the exposure period compared with the control period. Subgroup analyses were performed to assess...

  13. ECG signal denoising via empirical wavelet transform. (United States)

    Singh, Omkar; Sunkaria, Ramesh Kumar


    This paper presents new methods for baseline wander correction and powerline interference reduction in electrocardiogram (ECG) signals using empirical wavelet transform (EWT). During data acquisition of ECG signal, various noise sources such as powerline interference, baseline wander and muscle artifacts contaminate the information bearing ECG signal. For better analysis and interpretation, the ECG signal must be free of noise. In the present work, a new approach is used to filter baseline wander and power line interference from the ECG signal. The technique utilized is the empirical wavelet transform, which is a new method used to compute the building modes of a given signal. Its performance as a filter is compared to the standard linear filters and empirical mode decomposition.The results show that EWT delivers a better performance.

  14. [Wireless ECG measurement system with capacitive coupling]. (United States)

    Aleksandrowicz, Adrian; Walter, Marian; Leonhardt, Steffen


    This paper describes a measurement system that captures an electrocardiogram (ECG) using capacitively coupled electrodes. The measurement system was integrated into an off-the-shelf office chair (so-called "Aachen SmartChair"). Whereas for classical ECG measurement adhesive is used to attach conductively coupled electrodes to bare skin, the system presented allows ECG measurement through clothing without direct skin contact. Furthermore, a ZigBee communication module was integrated to allow wireless transmission of ECG data to a PC or an ICU patient monitor. For system validation, classical ECG using conductive electrodes was obtained simultaneously. First measurement results, including variations of cloth thickness and material, are presented and some of the system-specific problems of this approach are discussed.

  15. III Lead ECG Pulse Measurement Sensor (United States)

    Thangaraju, S. K.; Munisamy, K.


    Heart rate sensing is very important. Method of measuring heart pulse by using an electrocardiogram (ECG) technique is described. Electrocardiogram is a measurement of the potential difference (the electrical pulse) generated by a cardiac tissue, mainly the heart. This paper also reports the development of a three lead ECG hardware system that would be the basis of developing a more cost efficient, portable and easy to use ECG machine. Einthoven's Three Lead method [1] is used for ECG signal extraction. Using amplifiers such as the instrumentation amplifier AD620BN and the conventional operational amplifier Ua741 that would be used to amplify the ECG signal extracted develop this system. The signal would then be filtered from noise using Butterworth filter techniques to obtain optimum output. Also a right leg guard was implemented as a safety feature to this system. Simulation was carried out for development of the system using P-spice Program.

  16. Ecg Monitoring Using Android Smart App

    Directory of Open Access Journals (Sweden)

    Pooja Pawar


    Full Text Available This paper describes a mixed-signal ECG system that is capable of implementing configurable functionality with low-power consumption for portable ECG monitoring applications. A low-voltage and high performance analog front-end extracts 3-channel ECG signals and single channelelectrode-tissue-impedance (ETI measurement with high signalquality. Design effective and low cost solution for ECG machine. . Wave forms of ECG can be observed on Android smartphones. Its availability and cost is significant and affordable. That makes this system upgradable and effective for every class of people.. Our system is portable so anyone can handle this in a simple way with android based smartphone. It doesn’t cost much. It reduces work, efforts and expenses for patients and their relatives.

  17. Prevalence of Brugada-type ECG pattern and early ventricular repolarization pattern in Tunisian athletes

    Directory of Open Access Journals (Sweden)

    Ouali S


    Full Text Available Sana Ouali1, Helmi Ben Salem1, Sami Hammas1, Elyes Neffeti1, Fahmi Remedi1, Abdallah Mahdhaoui2, Essia Boughzela1, Rafik Mankai31Department of Cardiology, Sahloul Hospital, Sousse, Tunisia; 2Department of Cardiology, Farhat Hached, Sousse, Tunisia; 3Central Sports Medicine Centre of El Menzah, TunisiaIntroduction: No data regarding the prevalence of the Brugada-type electrocardiogram (ECG pattern and the early ventricular repolarization pattern (ERP in the North African population were available. The aims of this study were to determine the frequency of Brugada-type ECG pattern and ERP in Tunisia and to evaluate ECG descriptors of ventricular repolarization in a population of athletes.Methods: Over a 2-year period, resting 12-lead ECG recordings were analyzed from athletes (n = 540; 348 males; age 18.3 ± 2.4 years. Brugada-type ECG pattern was defined as Type 1, 2, or 3, and ERP was characterized by an elevation of the J point in the inferior and/or lateral leads. The population was divided into three groups of athletes: ERP group; Brugada-type ECG pattern group; and control group, with neither ERP nor Brugada ECG pattern. Clinical and electrocardiographic parameters were compared among the study groups.Results: Nine subjects (1.66% had a Brugada-type ECG pattern. None of them had the coved-type, 3 (0.6% had the Type 2, and 6 (1.1% had the Type 3. All subjects were asymptomatic. A Brugada-type ECG pattern was observed in seven males. No female had the Type 2 Brugada ECG pattern. ECG parameters were similar among Brugada-type ECG pattern and control athletes. ERP (119 subjects, 22% was obtained in 98 males. Heart rate was lower, the QRS duration shorter and QT and Tpeak–Tend intervals were longer in ERP than control groups.Conclusion: The results indicate that the frequency of the Brugada-type ECG pattern and ERP were respectively 1.66% and 22.00% in athletes, being more prevalent in males. The ERP group experienced shorter QRS duration and

  18. 低钾血症致心律失常的心电图特点与临床分析%Hypokalemia Induced Arrhythmia ECG Characteristics and Clinical Analysis

    Institute of Scientific and Technical Information of China (English)



    目的:探讨低钾血症致心律失常的心电图特点与临床的关系。方法分析160例低钾血症所致心律失常的低钾病因、临床表现、血钾浓度与心律失常关系及心律失常的转归。结果低钾血症所致的心律失常多见于急性失钾的青壮年,血钾降低的程度与心律失常的发生率,其差异有高度显著性P<0.01;血钾越低,心律失常发生率越高。结论除重症室性心律失常外,通常的病例经积极有效补钾后,病情好转快,预后好,不急于使用抗心律失常药物,以避免引发更严重的心律失常。%Objective To study the hypokalemia induced arrhythmia characteristics and the relationship between clinical electrocardiogram (ECG). Methods Analysis of 160 cases with arrhythmia induced by hypokalemia low potassium etiology, clinical manifestation, potassium concentration relation with arrhythmia and outcome of cardiac arrhythmias.Results The cardiac arrhythmias of hypokalemia caused by acute potassium loss of young adults, see more at the extent of the potassium lower and the incidence of arrhythmia, highly signifi cant difference (P < 0.01); Potassium is lower, the higher the incidence of arrhythmia. Conclusion In addition to the severe ventricular arrhythmia, usually cases after positive and effective complement potassium, improved fast, prognosis is good, don't rush to the use of anti-arrhythmic drugs, in order to avoid caused more serious arrhythmia.

  19. Usefulness of multichannel Holter ECG recording in the third intercostal space for detecting type 1 Brugada ECG: comparison with repeated 12-lead ECGs. (United States)

    Shimeno, Kenji; Takagi, Masahiko; Maeda, Keiko; Tatsumi, Hiroaki; Doi, Atsushi; Yoshiyama, Minoru


    Type 1 Brugada ECG is essential for the diagnosis of Brugada syndrome. We aimed to evaluate the usefulness of multichannel Holter ECG recording in the third intercostal space for detecting type 1 Brugada ECG. We enrolled 60 consecutive individuals with type 1 Brugada ECG and 31 individuals with type 2 or 3 Brugada ECG, in the presence or absence of Na+ channel blockers. All individuals underwent 12-lead ECGs recorded in the standard position and the third intercostal space at least 5 times every 3 months (4L-ECGs, 3L-ECGs, respectively) and multichannel Holter ECG. On multichannel Holter ECG, the precordial electrodes were attached at standard positions (4L-Holter) and the third intercostal space (3L-Holter) for leads V1 and V2. Among the 60 individuals, type 1 Brugada ECG in 4L-ECGs, 3L-ECGs, 4L-Holter, and 3L-Holter was detected in 15 (25%), 26 (43.3%), 23 (38.3%), and 33 individuals (55%), respectively, whereas detected in none of the 31 individuals. The documented duration of type 1 Brugada ECG on 3L-Holter was significantly longer than that on 4L-Holter (700 +/- 467 vs 372 +/- 422 min; P = 0.01, 3L-Holter vs 4L-Holter, respectively), and type 1 Brugada ECG was most frequently observed between 6 pm and 12 pm. Neither the presence nor the duration of the appearance of type 1 Brugada ECG differed significantly between symptomatic and asymptomatic individuals. Multichannel Holter ECG recording in the third intercostal space is more sensitive and useful for the diagnosis of type 1 Brugada ECG than repeated 12-lead ECGs or multichannel Holter ECG in the standard position.

  20. Extraction of fetal ECG signal by an improved method using extended Kalman smoother framework from single channel abdominal ECG signal. (United States)

    Panigrahy, D; Sahu, P K


    This paper proposes a five-stage based methodology to extract the fetal electrocardiogram (FECG) from the single channel abdominal ECG using differential evolution (DE) algorithm, extended Kalman smoother (EKS) and adaptive neuro fuzzy inference system (ANFIS) framework. The heart rate of the fetus can easily be detected after estimation of the fetal ECG signal. The abdominal ECG signal contains fetal ECG signal, maternal ECG component, and noise. To estimate the fetal ECG signal from the abdominal ECG signal, removal of the noise and the maternal ECG component presented in it is necessary. The pre-processing stage is used to remove the noise from the abdominal ECG signal. The EKS framework is used to estimate the maternal ECG signal from the abdominal ECG signal. The optimized parameters of the maternal ECG components are required to develop the state and measurement equation of the EKS framework. These optimized maternal ECG parameters are selected by the differential evolution algorithm. The relationship between the maternal ECG signal and the available maternal ECG component in the abdominal ECG signal is nonlinear. To estimate the actual maternal ECG component present in the abdominal ECG signal and also to recognize this nonlinear relationship the ANFIS is used. Inputs to the ANFIS framework are the output of EKS and the pre-processed abdominal ECG signal. The fetal ECG signal is computed by subtracting the output of ANFIS from the pre-processed abdominal ECG signal. Non-invasive fetal ECG database and set A of 2013 physionet/computing in cardiology challenge database (PCDB) are used for validation of the proposed methodology. The proposed methodology shows a sensitivity of 94.21%, accuracy of 90.66%, and positive predictive value of 96.05% from the non-invasive fetal ECG database. The proposed methodology also shows a sensitivity of 91.47%, accuracy of 84.89%, and positive predictive value of 92.18% from the set A of PCDB.

  1. Fetal Electrocardiogram (fECG Gated MRI

    Directory of Open Access Journals (Sweden)

    Martyn N.J. Paley


    Full Text Available We have developed a Magnetic Resonance Imaging (MRI-compatible system to enable gating of a scanner to the heartbeat of a foetus for cardiac, umbilical cord flow and other possible imaging applications. We performed radiofrequency safety testing prior to a fetal electrocardiogram (fECG gated imaging study in pregnant volunteers (n = 3. A compact monitoring device with advanced software capable of reliably detecting both the maternal electrocardiogram (mECG and fECG simultaneously was modified by the manufacturer (Monica Healthcare, Nottingham, UK to provide an external TTL trigger signal from the detected fECG which could be used to trigger a standard 1.5 T MR (GE Healthcare, Milwaukee, WI, USA gating system with suitable attenuation. The MR scanner was tested by triggering rapidly during image acquisition at a typical fetal heart rate (123 beats per minute using a simulated fECG waveform fed into the gating system. Gated MR images were also acquired from volunteers who were attending for a repeat fetal Central Nervous System (CNS examination using an additional rapid cardiac imaging sequence triggered from the measured fECG. No adverse safety effects were encountered. This is the first time fECG gating has been used with MRI and opens up a range of new possibilities to study a developing foetus.

  2. ECG manifestations of left ventricular electrical remodeling. (United States)

    Estes, E Harvey


    Research and thinking about the electrocardiographic manifestations of left ventricular hypertrophy has been constrained by a limited conceptual model of the process: heart disease produces chamber enlargement (increased mass), which in turn produces an altered electrocardiogram. The process is much more complex than can be represented in this simple model. A more robust and intricate model is proposed, in which heart (and vascular) disease causes structural changes, electrical changes, biochemical changes, and others, all of which interact to produce electrical remodeling of ventricular myocardium. This electrical remodeling results in a variety of ECG changes. All of these changes interact, leading to an altered clinical course, and to premature death. It is suggested that research, based on this model, can provide new clues to the processes involved, and improve the prediction of clinical outcomes. New directions in research, in recording equipment, and in organizational activities are suggested to test this new model, and to improve the usefulness of the electrocardiogram as a research and diagnostic tool.

  3. Nonlinear filtering in ECG Signal Enhancement

    Directory of Open Access Journals (Sweden)

    N. Siddiah


    Full Text Available High resolution ECG signals are needed in measuring cardiac abnormalities analysis. Generally baseline wander is one of the important artifact occurred in ECG signal extraction, this strongly affects the signal quality. In order to facilitate proper diagnosis these artifacts have to be removed. In this paper various non linear, non adaptive filtering techniques are presented for the removal of baseline wander removal from ECG signals. The performance characteristics of various filtering techniques are measured in terms of signal to noise ratio.


    Directory of Open Access Journals (Sweden)



    Full Text Available The power line interference (50/60 Hz is the main source of noise in most of bio-electric signal. In this paper second order infinite impulse response (IIR notch filter, adaptive notch filtering technique with LMS (least mean square algorithm and Discrete Wavelet transform method has been proposed for the removal of power line interference from ECG signal. Different ECG signals from MIT/BIH arrhythmia database are used with added power-line interference noise which is common in ECG signal. The result is analyzed using MATLABsoftware. Basically two synthesis parameters MSE and SNR have been used. The prime aim of this paper is to adapt the discrete wavelet transform (DWT to improve the ECG signal quality for better clinical diagnosis. The proposed method shows improvement in output SNR is 97.60%.

  5. Wireless and Non-contact ECG Measurement System – the “Aachen SmartChair”

    Directory of Open Access Journals (Sweden)

    A. Aleksandrowicz


    Full Text Available This publication describes a measurement system that obtains an electrocardiogram (ECG by capacitively coupled electrodes. Fordemonstration purposes, this measurement system was integrated into an off-the-shelf office chair (so-called “Aachen SmartChair”.Whereas in usual clinical applications adhesive, conductively-coupled electrodes have to be attached to the skin, the described system is able to measure an ECG without direct skin contact through the cloth. A wireless communication module was integrated for transmitting theECG data to a PC or to an ICU patient monitor. For system validation, a classical ECG with conductive electrodes and an oxygensaturation signal (SpO2 were obtained simultaneously. Finally, system-specific problems of the presented device are discussed.

  6. Low-cost compact ECG with graphic LCD and phonocardiogram system design. (United States)

    Kara, Sadik; Kemaloğlu, Semra; Kirbaş, Samil


    Till today, many different ECG devices are made in developing countries. In this study, low cost, small size, portable LCD screen ECG device, and phonocardiograph were designed. With designed system, heart sounds that take synchronously with ECG signal are heard as sensitive. Improved system consist three units; Unit 1, ECG circuit, filter and amplifier structure. Unit 2, heart sound acquisition circuit. Unit 3, microcontroller, graphic LCD and ECG signal sending unit to computer. Our system can be used easily in different departments of the hospital, health institution and clinics, village clinic and also in houses because of its small size structure and other benefits. In this way, it is possible that to see ECG signal and hear heart sounds as synchronously and sensitively. In conclusion, heart sounds are heard on the part of both doctor and patient because sounds are given to environment with a tiny speaker. Thus, the patient knows and hears heart sounds him/herself and is acquainted by doctor about healthy condition.

  7. Comparison of Different ECG Signals on MATLAB

    Directory of Open Access Journals (Sweden)

    Rajan Chaudhary


    Full Text Available In this paper we discuss about biomedical engineering and then a brief description of ECG signal. We have generated a new method to compare different arrhythmic heart signals with normal sinus signals at MATLAB. This is making the comparison very easy. ECG is used to measure the rate and regularity of heartbeats, as well as the position and size of the chambers, the existence of any damage to the heart, and the effects of devices or drugs used to regulate the heart, such as a pacemaker. Uttermost ECGs are performed for diagnostic or research purposes on human hearts, but may also be performed on heart of animals, usually for diagnosis of heart abnormalities or research. Result obtained showing that Comparison of Normal (Sinus and Abnormal (arrhythmia ECG signal. Through this method we can compare any type of disordered signal of heart.

  8. Matching a wavelet to ECG signal. (United States)

    Takla, George F; Nair, Bala G; Loparo, Kenneth A


    In this paper we develop an approach to synthesize a wavelet that matches the ECG signal. Matching a wavelet to a signal of interest has potential advantages in extracting signal features with greater accuracy, particularly when the signal is contaminated with noise. The approach that we have taken is based on the theoretical work done by Chapa and Rao. We have applied their technique to a noise-free ECG signal representing one cardiac cycle. Results indicate that a matched wavelet, that was able to capture the broad ECG features, could be obtained. Such a wavelet could be used to extract ECG features such as QRS complexes and P&T waves with greater accuracy.

  9. Wearable Textile Electrodes for ECG Measurement

    Directory of Open Access Journals (Sweden)

    Lukas Vojtech


    Full Text Available The electrocardiogram (ECG is one of the most important parameters for monitoring of the physiological state of a person. Currently available systems for ECG monitoring are both stationary and wearable, but the comfort of the monitored person is not at a satisfactory level because these systems are not part of standard clothing. This article is therefore devoted to the development and measurement of wearable textile electrodes for ECG measurement device with high comfort for the user. The electrode material is made of electrically conductive textile. This creates a textile composite that guarantees high comfort for the user while ensuring good quality of ECG measurements. The composite is implemented by a carrier (a T-shirt with flame retardant and sensing electrodes embroidered with yarn based on a mixture of polyester coated with silver nanoparticles and cotton. The electrodes not only provide great comfort but are also antibacterial and antiallergic due to silver nanoparticles.

  10. ECG Signal Feature Selection for Emotion Recognition

    Directory of Open Access Journals (Sweden)

    Lichen Xun


    Full Text Available This paper aims to study the selection of features based on ECG in emotion recognition. In the process of features selection, we start from existing feature selection algorithm, and pay special attention to some of the intuitive value on ECG waveform as well. Through the use of ANOVA and heuristic search, we picked out the different features to distinguish joy and pleasure these two emotions, then we combine this with pathological analysis of ECG signals by the view of the medical experts to discuss the logic corresponding relation between ECG waveform and emotion distinguish. Through experiment, using the method in this paper we only picked out five features and reached 92% of accuracy rate in the recognition of joy and pleasure.

  11. Specificity of elevated intercostal space ECG recording for the type 1 Brugada ECG pattern

    DEFF Research Database (Denmark)

    Holst, Anders G; Tangø, Mogens; Batchvarov, Velislav


    Right precordial (V1-3) elevated electrode placement ECG (EEP-ECG) is often used in the diagnosis of Brugada syndrome (BrS). However, the specificity of this has only been studied in smaller studies in Asian populations. We aimed to study this in a larger European population.......Right precordial (V1-3) elevated electrode placement ECG (EEP-ECG) is often used in the diagnosis of Brugada syndrome (BrS). However, the specificity of this has only been studied in smaller studies in Asian populations. We aimed to study this in a larger European population....

  12. Smartphone home monitoring of ECG (United States)

    Szu, Harold; Hsu, Charles; Moon, Gyu; Landa, Joseph; Nakajima, Hiroshi; Hata, Yutaka


    A system of ambulatory, halter, electrocardiography (ECG) monitoring system has already been commercially available for recording and transmitting heartbeats data by the Internet. However, it enjoys the confidence with a reservation and thus a limited market penetration, our system was targeting at aging global villagers having an increasingly biomedical wellness (BMW) homecare needs, not hospital related BMI (biomedical illness). It was designed within SWaP-C (Size, Weight, and Power, Cost) using 3 innovative modules: (i) Smart Electrode (lowpower mixed signal embedded with modern compressive sensing and nanotechnology to improve the electrodes' contact impedance); (ii) Learnable Database (in terms of adaptive wavelets transform QRST feature extraction, Sequential Query Relational database allowing home care monitoring retrievable Aided Target Recognition); (iii) Smartphone (touch screen interface, powerful computation capability, caretaker reporting with GPI, ID, and patient panic button for programmable emergence procedure). It can provide a supplementary home screening system for the post or the pre-diagnosis care at home with a build-in database searchable with the time, the place, and the degree of urgency happened, using in-situ screening.

  13. Classification of ECG Using Chaotic Models

    Directory of Open Access Journals (Sweden)

    Khandakar Mohammad Ishtiak


    Full Text Available Chaotic analysis has been shown to be useful in a variety of medical applications, particularly in cardiology. Chaotic parameters have shown potential in the identification of diseases, especially in the analysis of biomedical signals like electrocardiogram (ECG. In this work, underlying chaos in ECG signals has been analyzed using various non-linear techniques. First, the ECG signal is processed through a series of steps to extract the QRS complex. From this extracted feature, bit-to-bit interval (BBI and instantaneous heart rate (IHR have been calculated. Then some nonlinear parameters like standard deviation, and coefficient of variation and nonlinear techniques like central tendency measure (CTM, and phase space portrait have been determined from both the BBI and IHR. Standard database of MIT-BIH is used as the reference data where each ECG record contains 650000 samples. CTM is calculated for both BBI and IHR for each ECG record of the database. A much higher value of CTM for IHR is observed for eleven patients with normal beats with a mean of 0.7737 and SD of 0.0946. On the contrary, the CTM for IHR of eleven patients with abnormal rhythm shows low value with a mean of 0.0833 and SD 0.0748. CTM for BBI of the same eleven normal rhythm records also shows high values with a mean of 0.6172 and SD 0.1472. CTM for BBI of eleven abnormal rhythm records show low values with a mean of 0.0478 and SD 0.0308. Phase space portrait also demonstrates visible attractor with little dispersion for a healthy person’s ECG and a widely dispersed plot in 2-D plane for the ailing person’s ECG. These results indicate that ECG can be classified based on this chaotic modeling which works on the nonlinear dynamics of the system.

  14. Frequency-domain Analysis of ECG Signal

    Institute of Scientific and Technical Information of China (English)

    Tu Chengyuan; Zeng Yanjun; Li Shuxin


    A new simple approach to effectively detect QRS-T complexes in ECG curve is described, so as to easily get the P-wave (when AF does not happen)or the f-wave (when AF happens). By means of signal processing techniques such as the power spectrum function, the auto-correlation function and cross-correlation function,two kinds of ECG signal when AF does or does not happen were successively analyzed, showing the evident differences between them.

  15. The prediction of the in-hospital mortality of acutely ill medical patients by electrocardiogram (ECG) dispersion mapping compared with established risk factors and predictive scores--a pilot study.

    LENUS (Irish Health Repository)

    Kellett, John


    ECG dispersion mapping (ECG-DM) is a novel technique that analyzes low amplitude ECG oscillations and reports them as the myocardial micro-alternation index (MMI). This study compared the ability of ECG-DM to predict in-hospital mortality with traditional risk factors such as age, vital signs and co-morbid diagnoses, as well as three predictive scores: the Simple Clinical Score (SCS)--based on clinical and ECG findings, and two Medical Admission Risk System scores--one based on vital signs and laboratory data (MARS), and one only on laboratory data (LD).

  16. Application of Handheld Tele-ECG for Health Care Delivery in Rural India

    Directory of Open Access Journals (Sweden)

    Meenu Singh


    Full Text Available Telemonitoring is a medical practice that involves remotely monitoring patients who are not at the same location as the health care provider. The purpose of our study was to use handheld tele-electrocardiogram (ECG developed by Bhabha Atomic Research Center (BARC to identify heart conditions in the rural underserved population where the doctor-patient ratio is low and access to health care is difficult. The objective of our study was clinical validation of handheld tele-ECG as a screening tool for evaluation of cardiac diseases in the rural population. ECG was obtained in 450 individuals (mean age 31.49 ± 20.058 residing in the periphery of Chandigarh, India, from April 2011 to March 2013, using the handheld tele-ECG machine. The data were then transmitted to physicians in Postgraduate Institute of Medical Education and Research (PGIMER, Chandigarh, for their expert opinion. ECG was interpreted as normal in 70% individuals. Left ventricular hypertrophy (9.3% was the commonest abnormality followed closely by old myocardial infarction (5.3%. Patient satisfaction was reported to be ~95%. Thus, it can be safely concluded that tele-ECG is a portable, cost-effective, and convenient tool for diagnosis and monitoring of heart diseases and thus improves quality and accessibility, especially in rural areas.

  17. An efficient unsupervised fetal QRS complex detection from abdominal maternal ECG. (United States)

    Varanini, M; Tartarisco, G; Billeci, L; Macerata, A; Pioggia, G; Balocchi, R


    Non-invasive fetal heart rate is of great relevance in clinical practice to monitor fetal health state during pregnancy. To date, however, despite significant advances in the field of electrocardiography, the analysis of abdominal fetal ECG is considered a challenging problem for biomedical and signal processing communities. This is mainly due to the low signal-to-noise ratio of fetal ECG and difficulties in cancellation of maternal QRS complexes, motion and electromyographic artefacts. In this paper we present an efficient unsupervised algorithm for fetal QRS complex detection from abdominal multichannel signal recordings combining ICA and maternal ECG cancelling, which outperforms each single method. The signal is first pre-processed to remove impulsive artefacts, baseline wandering and power line interference. The following steps are then applied: maternal ECG extraction through independent component analysis (ICA); maternal QRS detection; maternal ECG cancelling through weighted singular value decomposition; enhancing of fetal ECG through ICA and fetal QRS detection. We participated in the Physionet/Computing in Cardiology Challenge 2013, obtaining the top official scores of the challenge (among 53 teams of participants) of event 1 and event 2 concerning fetal heart rate and fetal interbeat intervals estimation section. The developed algorithms are released as open-source on the Physionet website.

  18. Anatomic distribution of culprit lesions in patients with non-ST-segment elevation myocardial infarction and normal ECG. (United States)

    Moustafa, Abdelmoniem; Abi-Saleh, Bernard; El-Baba, Mohammad; Hamoui, Omar; AlJaroudi, Wael


    In patients presenting with non-ST-elevation myocardial infarction (NSTEMI), left anterior descending (LAD) coronary artery and three-vessel disease are the most commonly encountered culprit lesions in the presence of ST depression, while one third of patients with left circumflex (LCX) artery related infarction have normal ECG. We sought to determine the predictors of presence of culprit lesion in NSTEMI patients based on ECG, echocardiographic, and clinical characteristics. Patients admitted to the coronary care unit with the diagnosis of NSTEMI between June 2012 and December 2013 were retrospectively identified. Admission ECG was interpreted by an electrophysiologist that was blinded to the result of the coronary angiogram. Patients were dichotomized into either normal or abnormal ECG group. The primary endpoint was presence of culprit lesion. Secondary endpoints included length of stay, re-hospitalization within 60 days, and in-hospital mortality. A total of 118 patients that were identified; 47 with normal and 71 with abnormal ECG. At least one culprit lesion was identified in 101 patients (86%), and significantly more among those with abnormal ECG (91.5% vs. 76.6%, P=0.041).The LAD was the most frequently detected culprit lesion in both groups. There was a higher incidence of two and three-vessel disease in the abnormal ECG group (P=0.041).On the other hand, there was a trend of higher LCX involvement (25% vs. 13.8%, P=0.18) and more normal coronary arteries in the normal ECG group (23.4% vs. 8.5%, P=0.041). On multivariate analysis, prior history of coronary artery disease (CAD) [odds ratio (OR) 6.4 (0.8-52)], male gender [OR 5.0 (1.5-17)], and abnormal admission ECG [OR 3.6 (1.12-12)], were independent predictors of a culprit lesion. There was no difference in secondary endpoints between those with normal and abnormal ECG. Among patients presenting with NSTEMI, prior history of CAD, male gender and abnormal admission ECG were independent predictors of a


    Directory of Open Access Journals (Sweden)

    I.S. Siva Rao


    Full Text Available Electrocardiogram (ECG is a graphical representation generated by heart muscle. ECG plays an important role in diagnosis and monitoring of heart’s condition. The real time analyzer based on filtering, beat recognition, clustering, classification of signal with maximum few seconds delay can be done to recognize the life threatening arrhythmia. ECG signal examines and study of anatomic and physiologic facets of the entire cardiac muscle. The inceptive task for proficient scrutiny is the expulsion of noise. It is attained by the use of wavelet transform analysis. Wavelets yield temporal and spectral information concurrently and offer stretchability with a possibility of wavelet functions of different properties. This paper is concerned with the extraction of QRS complexes of ECG signals using Discrete Wavelet Transform based algorithms aided with MATLAB. By removing the inconsistent wavelet transform coefficient, denoising is done in ECG signal. In continuation, QRS complexes are identified and in which each peak can be utilized to discover the peak of separate waves like P and T with their derivatives. Here we put forth a new combinatory algorithm builded on using Pan-Tompkins' method and multi-wavelet transform.

  20. Prevalence and prognostic significance of ECG abnormalities in HIV-infected patients: results from the Strategies for Management of Antiretroviral Therapy study

    DEFF Research Database (Denmark)

    Soliman, Elsayed Z; Prineas, Ronald J; Roediger, Mollie P


    BACKGROUND: It remains debated whether to include resting electrocardiogram (ECG) in the routine care of human immunodeficiency virus (HIV)-infected patients. METHODS: This analysis included 4518 HIV-infected patients (28% women and 29% blacks) from the Strategies for Management of Antiretroviral...... Therapy study, a clinical trial aimed to compare 2 HIV treatment strategies. ECG abnormalities were classified using the Minnesota Code. Cox proportional hazards analysis was used to examine the association between baseline ECG abnormalities and incident cardiovascular disease (CVD). RESULTS: More than...... half of the participants (n = 2325, or 51.5%) had either minor or major ECG abnormalities. Minor ECG abnormalities (48.6%) were more common than major ECG abnormalities (7.7%). During a median follow-up of 28.7 months, 155 participants (3.4%) developed incident CVD. After adjusting for the study...

  1. Image quality, radiation dose, and diagnostic accuracy of prospectively ECG-triggered high-pitch coronary CT angiography at 70 kVp in a clinical setting: comparison with invasive coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Long Jiang; Qi, Li; Zhou, Chang Sheng; Zhao, Yan E.; Li, Xie; Lu, Guang Ming [Jinling Hospital, Medical School of Nanjing University, Department of Medical Imaging, Nanjing, Jiangsu (China); Wang, Yining; Cao, Jian; Jin, Zhengyu [Peking Union Medical College Hospital, Department of Radiology, Beijing (China); Schoepf, U.J. [Jinling Hospital, Medical School of Nanjing University, Department of Medical Imaging, Nanjing, Jiangsu (China); Medical University of South Carolina, Division of Cardiovascular Imaging, Charleston, SC (United States); Meinel, Felix G. [Medical University of South Carolina, Division of Cardiovascular Imaging, Charleston, SC (United States); Ludwig-Maximilians-University Hospital, Institute for Clinical Radiology, Munich (Germany); Bayer, Richard R. [Medical University of South Carolina, Division of Cardiovascular Imaging, Charleston, SC (United States); Gong, Jian Bin [Jinling Hospital, Medical School of Nanjing University, Department of Cardiology, Nanjing, Jiangsu (China)


    To investigate image quality, radiation dose, and diagnostic performance of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) at 70 kVp compared to invasive coronary angiography (ICA) as reference standard. Forty-three patients underwent prospectively ECG-triggered high-pitch CCTA at 70 kVp using 30 cc (11 g iodine) contrast medium and ICA. Subjective and objective image quality was evaluated for each CCTA study. CCTA performance for diagnosing ≥50 % stenosis was assessed. Results were stratified according to heart rate (HR), body mass index (BMI), Agatston score, and image quality. At CCTA, 94.3 % (500/530) of coronary segments were of diagnostic quality. Using ICA as reference standard, sensitivity and accuracy were 100 % and 93.0 % on a per-patient basis. Per-vessel and per-segment performances were 92.2 % and 89.5 %; 79.5 % and 88.3 %, respectively. No differences were found in diagnostic accuracy between different HR, BMI, and calcification subgroups (all P > 0.05) on a per-patient basis. However, low image quality reduced diagnostic accuracy on a per-patient, per-vessel and per-segment basis (all P < 0.05). The mean effective radiation dose was 0.2 ± 0.0 mSv. Our presented protocol results in an effective radiation dose of 0.2 mSv and high diagnostic accuracy for stenosis detection in a selected, non-obese population. (orig.)

  2. A portable ECG monitoring device with Bluetooth and Holter capabilities for telemedicine applications. (United States)

    Lucani, Daniel; Cataldo, Giancarlos; Cruz, Julio; Villegas, Guillermo; Wong, Sara


    A prototype of a portable ECG-monitoring device has been developed for clinical and non-clinical environments as part of a telemedicine system to provide remote and continuous surveillance of patients. The device can acquire, store and/or transmit ECG signals to computer-based platforms or specially configured access points (AP) with Intranet/Internet capabilities in order to reach remote monitoring stations. Acquired data can be stored in a flash memory card in FAT16 format for later recovery, or transmitted via Bluetooth or USB to a local station or AP. This data acquisition module (DAM) operates in two modes: Holter and on-line transmission.

  3. Robust human identification using ecg: eigenpulse revisited (United States)

    Jang, Daniel; Wendelken, Suzanne; Irvine, John M.


    Biometrics, such as fingerprint, iris scan, and face recognition, offer methods for identifying individuals based on a unique physiological measurement. Recent studies indicate that a person's electrocardiogram (ECG) may also provide a unique biometric signature. Several methods for processing ECG data have appeared in the literature and most approaches rest on an initial detection and segmentation of the heartbeats. Various sources of noise, such as sensor noise, poor sensor placement, or muscle movements, can degrade the ECG signal and introduce errors into the heartbeat segmentation. This paper presents a screening technique for assessing the quality of each segmented heartbeat. Using this technique, a higher quality signal can be extracted to support the identification task. We demonstrate the benefits of this quality screening using a principal component technique known as eigenpulse. The analysis demonstrated the improvement in performance attributable to the quality screening.

  4. Designing for reliable textile neonatal ECG monitoring using multi-sensor recordings. (United States)

    Bouwstra, S; Chen, W; Oetomo, S Bambang; Feijs, L M G; Cluitmans, P J M


    When designing an ECG monitoring system embedded with textile electrodes for comfort, it is challenging to ensure reliable monitoring, because textile electrodes suffer from motion artifacts and incidental poor signal quality. For the design of a comfortable monitoring system for prematurely born babies in the Neonatal Intensive Care Unit (NICU), we propose the concepts of 'diversity measurement' and 'context awareness' to improve reliability. Clinical multi-modal sensor data was collected in the NICU with the Smart Jacket connected to a state-of-the-art amplifier. We found that the ECG signals quality varied among sensors and varied over time, and found correlations between ECG signal, acceleration data, and context, which supports the feasibility of the concepts. Our explorative system level approach has lead to design parameters and meta-insights into the role of clinical validation in the design process.

  5. A Mixed Approach Of Automated ECG Analysis (United States)

    De, A. K.; Das, J.; Majumder, D. Dutta


    ECG is one of the non-invasive and risk-free technique for collecting data about the functional state of the heart. However, all these data-processing techniques can be classified into two basically different approaches -- the first and second generation ECG computer program. Not the opposition, but simbiosis of these two approaches will lead to systems with the highest accuracy. In our paper we are going to describe a mixed approach which will show higher accuracy with lesser amount of computational work. Key Words : Primary features, Patients' parameter matrix, Screening, Logical comparison technique, Multivariate statistical analysis, Mixed approach.

  6. Principal Component Analysis in ECG Signal Processing

    Directory of Open Access Journals (Sweden)

    Andreas Bollmann


    Full Text Available This paper reviews the current status of principal component analysis in the area of ECG signal processing. The fundamentals of PCA are briefly described and the relationship between PCA and Karhunen-Loève transform is explained. Aspects on PCA related to data with temporal and spatial correlations are considered as adaptive estimation of principal components is. Several ECG applications are reviewed where PCA techniques have been successfully employed, including data compression, ST-T segment analysis for the detection of myocardial ischemia and abnormalities in ventricular repolarization, extraction of atrial fibrillatory waves for detailed characterization of atrial fibrillation, and analysis of body surface potential maps.

  7. Concentration-Response Modeling of ECG Data From Early-Phase Clinical Studies as an Alternative Clinical and Regulatory Approach to Assessing QT Risk - Experience From the Development Program of Lemborexant. (United States)

    Murphy, Patricia J; Yasuda, Sanae; Nakai, Kenya; Yoshinaga, Takashi; Hall, Nancy; Zhou, Meijian; Aluri, Jagadeesh; Rege, Bhaskar; Moline, Margaret; Ferry, Jim; Darpo, Borje


    Lemborexant is a novel dual orexin receptor antagonist being developed to treat insomnia. Its potential to cause QT prolongation was evaluated using plasma concentration-response (CR) modeling applied to data from 2 multiple ascending-dose (MAD) studies. In the primary MAD study, placebo or lemborexant (2.5 to 75 mg) was administered for 14 consecutive nights. In another MAD study designed to "bridge" pharmacokinetic and safety data between Japanese and non-Japanese subjects (J-MAD), placebo or lemborexant (2.5, 10, or 25 mg) was administered for 14 consecutive nights. QT intervals were estimated using a high-precision measurement technique and evaluated using a linear mixed-effects CR model, for each study separately and for the pooled data set. When each study was analyzed separately, the slopes of the CR relationship were shallow and not statistically significant. In the pooled analysis, the slope of the CR relationship was -0.00002 milliseconds per ng/mL (90%CI, -0.01019 to 0.01014 milliseconds). The highest observed Cmax was 400 ng/mL, representing a margin 8-fold above exposures expected for the highest planned clinical dose. The model-predicted QTc effect at 400 ng/mL was 1.1 milliseconds (90%CI, -3.49 to 5.78 milliseconds). In neither the J-MAD study nor the pooled analysis was an effect of race identified. CR modeling of data from early-phase clinical studies, including plasma levels far exceeding those anticipated clinically, indicated that a QT effect >10 milliseconds could be excluded. Regulatory agreement with this methodology demonstrates the effectiveness of a CR modeling approach as an alternative to thorough QT studies. © 2016, The American College of Clinical Pharmacology.

  8. 心电门控CTA评价急性主动脉夹层的临床应用研究%Clinical Application of ECG Gated CTA in Evaluation of Acute Aortic Dissection

    Institute of Scientific and Technical Information of China (English)

    陈凤丽; 刘挨师


    Objective: In this study, we would compare to the routine aorta CTA and ECG gated aorta CTA image quality, in order to know the advantage of ECG gated aorta CTA in evaluation of aortic dissection. Methods:Through the imaging system retrospectively selected 62 patients who underwent aorta CTA from 2013 January to 2016 March, divided into two groups. Group A underwent triple rule out scanning (13 cases), group B underwent aortic CTA (49 cases). Evaluation of aortic image quality and assessment of various indexes of aortic dissection. The measurement data were compared by two independent samplesttest, and count data were compared using chi-square test. A(P0.05). Conclusions: Applying the ECG gated aortic CTA compared with the conventional spiral aorta CTA, it could clearly displaythe index of aortic dissection, evaluate prognosis ofaortic dissection, guide the therapy and formulate operation /endovascular treatment plan.%目的:本研究通过主动脉CTA与胸痛三联排查扫描(心电门控)CTA主动脉图像质量的比较,明确施加心电门控的 CTA 在临床选择与评价主动脉夹层治疗方案中的价值。方法:通过影像数据存储与传输系统(PACS)回顾性选取2013年1月至2016年3月间行胸痛三联排查与主动脉CTA 的患者62例,分为两组,A 组行胸痛三联排查扫描(13例),B 组行主动脉 CTA(49例)。评价主动脉图像质量与主动脉夹层各项指标可评估性。计量资料比较采用两独立样本t检验,计数资料比较采用χ2检验。P0.05)。结论:施加心电门控的主动脉CTA较常规螺旋扫描主动脉CTA可以更加清晰地显示主动脉夹层各项指标,在进行疾病预后评估、指导治疗方案与制定手术/血管内治疗计划中具有一定作用。

  9. ECG-6511故障维修%The troublity repair of ECG-6511

    Institute of Scientific and Technical Information of China (English)



    @@ 日本光电ECG-6511型心电图机是在ECG-6151型心电图机的基础上设计生产的一种便携式单导心电图机.它操作简单、携带方便,被广泛应用.我院的心电图机,大部分都是ECG-6511型.现把它的几种故障维修经验介绍给大家,以供参考:

  10. [Implementation of ECG Monitoring System Based on Internet of Things]. (United States)

    Lu, Liangliang; Chen, Minya


    In order to expand the capabilities of hospital's traditional ECG device and enhance medical staff's work efficiency, an ECG monitoring system based on internet of things is introduced. The system can monitor ECG signals in real time and analyze data using ECG sensor, PDA, Web servers, which embeds C language, Android systems, .NET, wireless network and other technologies. After experiments, it can be showed that the system has high reliability and stability and can bring the convenience to medical staffs.

  11. Changes in ECG features and clinical prognosis of ventricular electrical storm in patients with left ventricular hypertrophy and acute myocardial infarction%左心室肥厚并急性心肌梗死室性电风暴心电图对预后的影响

    Institute of Scientific and Technical Information of China (English)

    于文江; 王为民


    目的 探讨沿海居民高血压性左室肥厚(left ventricular hypertrophy,LNH)并急性心肌梗死(acute myocardial infarction,AMI)后心电图特征性改变,评估室性电风暴与临床预后危险分层.方法 选择急诊住院有高皿压性LVH并AMI室性电风暴(室速或室颤)317例(Ⅱ组),另选无高血压性LVH室性电风暴AMI 109例(Ⅰ组)进行心电图检查和持续心电监护,分析心电图特征与临床高危特点.结果 室性电风暴组以高血压LVH并AMI患者心电图指标心房终末电势异常、∑ST段抬高振幅、ST段抬高导联数、QTc间期延长、对应导联ST段振幅下移等特征,梗死部位以前壁或复合前壁,并以左前降支合并回旋支或/和右冠脉完全闭塞多支病变为主,与Ⅰ组比较差异有统计学意义(P<0.05或P<0.01),临床并发泵衰竭、AMI扩展、住院病死率、室性电风暴AMI发病后6 h内发生率明显增多(P<0.01).结论 高血压性LVH并AMI室性电风暴患者,心电图多项指标异常对临床预后有预测作用.%Objective To investigate changes in ECG feature and clinical prognosis of ventricular electrical storm (VES) in patients with left ventricular hypertrophy (LVH) and acute myocardial infarction (AMI). Methods Three hundred and seventeen cases of left ventricular hypertrophy induced by hypertension and combined with AMI (Group Ⅱ) from emergency inpatients, and another 109 patients without LVH induced by hypertension and accompanied with AMI (Group Ⅰ) were chosen to have sustained ECG monitoring, analyze ECG features and clinical high risks. Results Clinical features, such as abnormality in PTFvl,ΣST segment elevation amplitude, ST segment elevation leads, ST segment reduction amplitude leads, QTc interval prolongation could be noted in the VES group. Infarction could be seen at sites of anterior and complex anterior walls, and dominant clinical signs were mainly at left descending branches accompanied by circumflex arteries and

  12. ECG-based gating in ultra high field cardiovascular magnetic resonance using an independent component analysis approach


    Krug, Johannes W; Rose, Georg; Clifford, Gari D.; Oster, Julien


    Background In Cardiovascular Magnetic Resonance (CMR), the synchronization of image acquisition with heart motion is performed in clinical practice by processing the electrocardiogram (ECG). The ECG-based synchronization is well established for MR scanners with magnetic fields up to 3 T. However, this technique is prone to errors in ultra high field environments, e.g. in 7 T MR scanners as used in research applications. The high magnetic fields cause severe magnetohydrodynamic (MHD) effects w...

  13. A Case of Isolated Left Ventricular Noncompaction with Basal ECG-Tracing Strongly Suggestive for Type-2 Brugada Syndrome

    Directory of Open Access Journals (Sweden)

    Maria Banci


    Full Text Available Isolated left ventricular noncompaction (ILVNC is a cardiomyopathy caused by intrauterine arrest of compaction of the myocardial fibres and meshwork, an important process in myocardial development. ILVNC is clinically accompanied by depressed ventricular function, arrhythmias, and systemic embolization. We reported a case of ILVNC with basal ECG-tracing strongly suggestive for type-2 Brugada syndrome (BrS. Up to now, this is the first report investigating the association between ILVNC and this particular ECG pattern.

  14. Two surgeons and the ECG-a double blind study

    Directory of Open Access Journals (Sweden)

    Ulf Martin Schilling


    Conclusions: Abdominal and orthopaedic surgeons provided an answering scheme are able to interprete the ECG and identify both the normal and the ECG showing life-threatening pathology. The hypothesis that surgeons were unable to interprete the ECG must be rejected.

  15. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic ECG/respirator synchronizer. 892.1970... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic ECG/respirator synchronizer. (a) Identification. A radiographic ECG/respirator synchronizer is a device intended to be used...

  16. A comparison of photoplethysmography and ECG recording to analyse heart rate variability in healthy subjects. (United States)

    Lu, G; Yang, F; Taylor, J A; Stein, J F


    Measures of heart rate variability (HRV) are widely used to assess autonomic nervous system (ANS) function. The signal from which they are derived requires accurate determination of the interval between successive heartbeats; it can be recorded via electrocardiography (ECG), which is both non-invasive and widely available. However, methodological problems inherent in the recording and analysis of ECG traces have motivated a search for alternatives. Photoplethysmography (PPG) constitutes another means of determining the timing of cardiac cycles via continuous monitoring of changes in blood volume in a portion of the peripheral microvasculature. This technique measures pulse waveforms, which in some instances may prove a practical basis for HRV analysis. We investigated the feasibility of using earlobe PPG to analyse HRV by applying the same analytic process to PPG and ECG recordings made simultaneously. Comparison of 5-minute recordings demonstrated a very high degree of correlation in the temporal and frequency domains and in nonlinear dynamic analyses between HRV measures derived from PPG and ECG. Our results confirm that PPG provides accurate interpulse intervals from which HRV measures can be accurately derived in healthy subjects under ideal conditions, suggesting this technique may prove a practical alternative to ECG for HRV analysis. This finding is of particular relevance to the care of patients suffering from peripheral hyperkinesia or tremor, which make fingertip PPG recording impractical, and following clinical interventions known to introduce electrical artefacts into the electrocardiogram.

  17. Modeling left and right atrial contributions to the ECG: A dipole-current source approach. (United States)

    Jacquemet, Vincent


    This paper presents the mathematical formulation, the numerical validation and several illustrations of a forward-modeling approach based on dipole-current sources to compute the contribution of a part of the heart to the electrocardiogram (ECG). Clinically relevant applications include identifying in the ECG the contributions from the right and the left atrium. In a Courtemanche-based monodomain computer model of the atria and torso, 1000 dipoles distributed throughout the atrial mid-myocardium are found to be sufficient to reproduce body surface potential maps with a relative error approach enables fast offline computation of the ECG contribution of any anatomical part of the atria by applying the principle of superposition to the dipole sources. In the presence of a right-left activation delay (sinus rhythm), pulmonary vein isolation (sinus rhythm) or left-right differences in refractory period (atrial fibrillation), the decomposition of the ECG is shown to help interpret ECG morphology in relation to the atrial substrate. These tools provide a theoretical basis for a deeper understanding of the genesis of the P wave or fibrillatory waves in normal and pathological cases.

  18. Prospective evaluation of a Holter-ECG derived severity index for screening of sleep disordered breathing. (United States)

    Maier, Christoph; Friedrich, Jörg; Katus, Hugo; Dickhaus, Hartmut

    To prospectively evaluate the applicability of a method to screen overnight Holter-ECGs for sleep disordered breathing (SDB) in an unselected clinical routine Holter sample. Holter-ECG recordings in 50 cardiologic inpatients were complemented with nocturnal respiratory polygraphy (PG). The respiratory event index (REI) and apnea/hypopnea index (AHI) from the PG served as a reference for an ECG-derived SDB severity estimate using a previously developed method. Agreement with the PG was investigated using Bland-Altman plots color-coded by ectopy level, and screening accuracy for REI≥15/h and AHI≥15/h was assessed. Prevalence for REI≥15/h was 52%, and 32% for AHI≥15/h. We observed better agreement of the ECG-based estimate with the REI compared to the AHI. Ectopy did not limit the detection of SDB. Binary screening for REI≥15/h provided excellent specificity of 0.96 with a sensitivity of 0.77. Ternary screening for AHI≥15/h yielded 16% borderline classifications and specificity/sensitivity of 0.96/0.86 for the remaining data. Screening of routine Holter-ECGs for sleep disordered breathing is reasonable and promises earlier identification of a significant part of patients at no additional cost. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. A computer based wireless system for online acquisition, monitoring and digital processing of ECG waveforms. (United States)

    Bansal, Dipali; Khan, Munna; Salhan, Ashok K


    Various ECG instruments have addressed a wide variety of clinical and technical issues. However, there is still scope for improvement in them particularly in the area of their susceptibility to noise, lack of universal connectivity and off-line processing. A prototype system has been developed that caters to these limitations. It includes an analog system and a FM transceiver pair interfaced through sound port of the computer. The real time acquired data is viewed and filtered using MATLAB software. The ECG system described captures the bio-signal faithfully in real time wireless mode with minimum noise and has universal connectivity.

  20. An ECG storage and retrieval system embedded in client server HIS utilizing object-oriented DB. (United States)

    Wang, C; Ohe, K; Sakurai, T; Nagase, T; Kaihara, S


    In the University of Tokyo Hospital, the improved client server HIS has been applied to clinical practice and physicians can order prescription, laboratory examination, ECG examination and radiographic examination, etc. directly by themselves and read results of these examinations, except medical signal waves, schema and image, on UNIX workstations. Recently, we designed and developed an ECG storage and retrieval system embedded in the client server HIS utilizing object-oriented database to take the first step in dealing with digitized signal, schema and image data and show waves, graphics, and images directly to physicians by the client server HIS. The system was developed based on object-oriented analysis and design, and implemented with object-oriented database management system (OODMS) and C++ programming language. In this paper, we describe the ECG data model, functions of the storage and retrieval system, features of user interface and the result of its implementation in the HIS.

  1. Powerline interference reduction in ECG signals using empirical wavelet transform and adaptive filtering. (United States)

    Singh, Omkar; Sunkaria, Ramesh Kumar


    Separating an information-bearing signal from the background noise is a general problem in signal processing. In a clinical environment during acquisition of an electrocardiogram (ECG) signal, The ECG signal is corrupted by various noise sources such as powerline interference (PLI), baseline wander and muscle artifacts. This paper presents novel methods for reduction of powerline interference in ECG signals using empirical wavelet transform (EWT) and adaptive filtering. The proposed methods are compared with the empirical mode decomposition (EMD) based PLI cancellation methods. A total of six methods for PLI reduction based on EMD and EWT are analysed and their results are presented in this paper. The EWT-based de-noising methods have less computational complexity and are more efficient as compared with the EMD-based de-noising methods.

  2. Development of standard test methods for evaluating defibrillation recovery characteristics of disposable ECG electrodes. (United States)

    Schoenberg, A A; Booth, H E; Lyon, P C


    A clinically relevant test for the measurement of defibrillation overload recovery of prefilled disposable ECG electrodes was developed and is proposed for use in an ECG electrode standard under development by AAMI. Defibrillation overload voltages and currents, as well as electrode polarization recovery voltages, were first measured in animal tests on 12 types of electrodes to allow correlation with various bench tests using a capacitor discharge at 10, 200, or 1000 V. Current overloads absorbed by the electrodes under worst conditions in animal tests were in the range of 2 percent of the defibrillation current flowing through the chest. These overloads were absorbed by most Ag-AgCl electrodes without excessive polarization. However, stainless steel, brass, and tin electrodes tended to polarize to levels that would saturate many ECG monitors. A standard bench test using a 200-V 10-muF capacitor was recommended for inclusion in the AAMI standard to determine whether electrodes are acceptable for use during defibrillation.

  3. Estimating infarct severity from the ECG using a realistic heart model

    NARCIS (Netherlands)

    J.W. Van Dam (Jan Willem); W. Arnold Dijk; N.H.J.J. van der Putten (Niek); A.C. Maan (Arie); M.J.J. De Jongste (Mike)


    textabstractThe early phase of myocardial infarction is accompanied by changes in the ST segment of the ECG. This makes the ST segment the clinical marker for the detection of acute myocardial infarction. The determination of the infarct severity, location and size of the myocardial tissue at risk

  4. Sparse Matrix for ECG Identification with Two-Lead Features

    Directory of Open Access Journals (Sweden)

    Kuo-Kun Tseng


    Full Text Available Electrocardiograph (ECG human identification has the potential to improve biometric security. However, improvements in ECG identification and feature extraction are required. Previous work has focused on single lead ECG signals. Our work proposes a new algorithm for human identification by mapping two-lead ECG signals onto a two-dimensional matrix then employing a sparse matrix method to process the matrix. And that is the first application of sparse matrix techniques for ECG identification. Moreover, the results of our experiments demonstrate the benefits of our approach over existing methods.

  5. The Development of a Portable ECG Monitor Based on DSP (United States)

    Nan, CHI Jian; Tao, YAN Yan; Meng Chen, LIU; Li, YANG

    With the advent of global information, researches of Smart Home system are in the ascendant, the ECG real-time detection, and wireless transmission of ECG become more useful. In order to achieve the purpose we developed a portable ECG monitor which achieves the purpose of cardiac disease remote monitoring, and will be used in the physical and psychological disease surveillance in smart home system, we developed this portable ECG Monitor, based on the analysis of existing ECG Monitor, using TMS320F2812 as the core controller, which complete the signal collection, storage, processing, waveform display and transmission.

  6. Comparative analysis of clinical effect of cardiac B ultrasound and ECG in the diagnosis of hypertensive heart disease%心脏超声与心电图在高血压性心脏病诊断中的临床效果对比分析

    Institute of Scientific and Technical Information of China (English)



    Objective:To compare the clinical effect of heart B ultrasound and ECG in the diagnosis of hypertensive heart disease. Methods:Retrospective analysis of the clinical data of 53 patients with hypertensive heart disease.Results:The left ventricular hypertrophy in patients with B ultrasound examination,the expansion of the heart,left atrial enlargement detection rate was significantly higher than the ECG of patients.Conclusion:Visible heart B ultrasound is more sensitive to changes in the heart patients,is a noninvasive,effective detection method.%目的:比较心脏超声与心电图在高血压性心脏病诊断中的临床效果。方法:回顾性分析53例高血压性心脏病患者的临床资料,对其进行心脏超声检查及心电图检查,比较两种检查方法的检查结果。结果:心脏超声检查患者左室肥厚、左室扩大、左房增大检出率显著高于心电图检查患者,差异具统计学意义(P<0.05)。结论:针对高血压性心脏病患者,心脏超声检测的检出率显著高于心电图检查,可见心脏超声对患者的心脏变化比较敏感,是一种无创、有效的检测方法。

  7. The Safety Assessment and Clinical Countermeasure of the Elderly Hypertensive Patients with ECG Monitoring Dental Treatment%老年高血压患者监护治牙安全评估及临床对策

    Institute of Scientific and Technical Information of China (English)

    郑立娟; 汤晨; 赵旭


    观察在心电监护下局麻治疗急性牙髓炎,对老年高血压患者的影响,为其安全治疗提供参考。监测522名老年高血压患者在急性牙髓炎治疗前后及过程中的血压、心率等变化,将测量结果进行分析。患者血压在麻醉即刻及术中比治疗前明显升高(P<0.05),其中收缩压较舒张压变化更为明显。心率在麻醉即刻及治疗中均明显高于治疗前(P<0.05)。病情稳定的老年高血压患者可在心电监护下治牙,Ⅱ、Ⅲ级高血压,可据情况,静脉给药控制性降压,避免高血压危象的发生,严格掌握老年高血压患者治牙适应症,可明显降低治疗中并发症发生的风险,可提高老年高血压患者治牙的安全系数。%ECG monitoring was observed under local anesthesia treatment of acute pulpitis, the impact on elderly hypertensive patients, and to provide for their safe treatment. Monitoring 522 elderly hypertensive patients’ blood pressure, heart rate and other changes in the treatment of acute pulpitis before and during, the measurement results were analyzed. Patient's blood pressure in anesthetized instantly and intraoperative significantly higher than before treatment (P<0.05), the change of systolic blood pressure than diastolic blood pressure was more obvious (P<0.05). In a stable condition of elderly patients with high blood pressure can be dental treatment under ECG monitor, II and III high blood pressure, can according to the situation, intravenous dosing control step-down, avoid the happening of hypertensive crisis, strictly grasp the indications in elderly patients with hypertension treated teeth, can obviously reduce the risk of complications in the treatment, can improve the elderly cardiovascular disease cure tooth safety coefficient.

  8. Effect of cervical traction on cardiovascular and selected ECG variables of cervical spondylosis patients using various weights. (United States)

    Akinbo, S R A; Noronha, C C; Oke, D A; Okanlawon, A O; Danesi, M A


    There is currently no consensus among the clinicians regarding the tractive force to be employed during cervical traction (CT) that will correlate precisely with the percentage body weight of the patient and reduce the side effects associated with CT therapy. This study therefore aimed to investigate the response of cervical spondylosis (CS) patients to different CT weights and to establish the effect of CT on the cardiovascular system of patients with cervical spondylosis (CS). Sixty out of 78 subjects participated in the study. They were randomly assigned into three experimental groups A, B and C. Their systolic and diastolic blood pressures (SBP and DBP) and heart rates (HR) were measured. Rate pressure product (RPP) was calculated using standard equation18 and ECG recorded using the KENZ, 201 machine. Subjects' cardiovascular and ECG responses were monitored in a supine resting position (baseline) and under three experimental conditions using the subjects' 7.5% kg total body weights (TBW), 10% kg TBW and 15% TBW at different time intervals (5, 10 and 15 minutes respectively). Compared with the baseline values, there was a drop in SBP, DBP and RPP for all subjects in the three groups. The SBP, DBP and RPP alteration were not significant for the 7.5% TBW CT, but significant (p tractions. The HR and ECG variables revealed no significant difference in all the groups, these results signified that the cardiac muscles were not adversely affected by any of the traction weights during application. Twenty subjects had side-effects including 5 subjects that terminated the treatment due to pain during the CT application. Cardiovascular alterations do occur during the application of cervical traction weights resulting in untoward patient's reactions. Efforts should be made to monitor the cardiovascular variables during and immediately after CT especially in "high risk" patients, that is, elderly patients and patients with unstable cardiovascular systems.

  9. A combined application of lossless and lossy compression in ECG processing and transmission via GSM-based SMS. (United States)

    Mukhopadhyay, S K; Mitra, S; Mitra, M


    This paper presents a software-based scheme for reliable and robust Electrocardiogram (ECG) data compression and its efficient transmission using Second Generation (2G) Global System for Mobile Communication (GSM) based Short Message Service (SMS). To achieve a firm lossless compression in high standard deviating QRS complex regions and an acceptable lossy compression in the rest of the signal, two different algorithms have been used. The combined compression module is such that it outputs only American Standard Code for Information Interchange (ASCII) characters and, hence, SMS service is found to be most suitable for transmitting the compressed signal. At the receiving end, the ECG signal is reconstructed using just the reverse algorithm. The module has been tested to all the 12 leads of different types of ECG signals (healthy and abnormal) collected from the PTB Diagnostic ECG Database. The compression algorithm achieves an average compression ratio of ∼22.51, without any major alteration of clinical morphology.

  10. The effect of ECG interference on pattern-recognition-based myoelectric control for targeted muscle reinnervated patients. (United States)

    Hargrove, Levi; Zhou, Ping; Englehart, Kevin; Kuiken, Todd A


    Targeted muscle reinnervation has been introduced as an effective neural machine interface. In the case of a shoulder disarticulation patient, an effective site for a nerve transfer involves the pectoralis muscles, as these perform little useful function with a missing limb. Consequently, the myoelectric signals measured from the reinnervated muscles may be corrupted by a large amount of ECG interference. This paper investigates the effect of ECG upon the accuracy of a pattern-classification-based scheme for myoelectric control of powered upper limb prostheses. The results suggest that ECG interference, at levels typically encountered in a clinical measurement, has little effect upon classification accuracy, but can affect the estimate of myoelectric activity used to convey the velocity of motion (commonly referred to as proportional control). High-pass filtering at approximately 100 Hz appears to effectively mitigate the effect of ECG interference.

  11. Repair of Common Trouble ECG Monitor%心电监护仪常见故障维修研究

    Institute of Scientific and Technical Information of China (English)



    心电监护仪属于一项临床设备,专门用于无创监测,医务人员通过心电监护仪,观察病人的心电图、心率等,发挥计量的功能。心电监护仪的精密性强,其可在同一时间,监护病人的多项生理参数,临床中,必须确保心电监护仪处于正常的状态,因此,本文以心电监护仪为例,分析常见的故障及维修策略。%the ECG monitor belongs to a clinical equipment, speciifcaly for noninvasive monitoring. The medical personnel through the ECG monitor, observe the patient's ECG, heart rate measurement, play function. ECG monitor precision, which can at the same time, patient monitoring of multiple physiological parameters, clinical must ensure that ECG monitor in the normal state. Therefore, this paper to ECG monitor for example. Analysis common faults and maintenance strategy.

  12. Computationally efficient sub-band coding of ECG signals. (United States)

    Husøy, J H; Gjerde, T


    A data compression technique is presented for the compression of discrete time electrocardiogram (ECG) signals. The compression system is based on sub-band coding, a technique traditionally used for compressing speech and images. The sub-band coder employs quadrature mirror filter banks (QMF) with up to 32 critically sampled sub-bands. Both finite impulse response (FIR) and the more computationally efficient infinite impulse response (IIR) filter banks are considered as candidates in a complete ECG coding system. The sub-bands are threshold, quantized using uniform quantizers and run-length coded. The output of the run-length coder is further compressed by a Huffman coder. Extensive simulations indicate that 16 sub-bands are a suitable choice for this application. Furthermore, IIR filter banks are preferable due to their superiority in terms of computational efficiency. We conclude that the present scheme, which is suitable for real time implementation on a PC, can provide compression ratios between 5 and 15 without loss of clinical information.

  13. A new microcomputer-based ECG analysis system. (United States)

    Kyle, M C; Klingeman, J D; Conrad, J D; Freis, E D; Pipberger, H V


    A new automated ECG system using advances in microprocessor technology and computerized electrocardiography is described. This microcomputer-based system is self-contained and mobile. It acquires both the 12-lead and orthogonal lead (Frank) electrocardiograms and analyzes the latter within minutes. Software includes the program developed in the Veterans Administration which uses advanced statistical classification techniques and a large well-documented patient data base. Diagnostic probabilities are computed using a Bayesian approach. Diagnostic performance has been tested using independent clinical criteria and found to be quite accurate. This system enables the clinician to immediately review the computer's identifications, measurements, and diagnostic classifications and quickly use these results in clinical decision making. Serial comparisons are readily made since all previous recordings are stored on floppy diskettes. The use of microprocessors in this system makes it economically feasible for practicing physicians.


    Directory of Open Access Journals (Sweden)

    Syamala Devi


    Full Text Available This study is intended to evaluate the changes in Electrocardiogram (ECG in apparently healthy adult male smokers. This cross-sectional study covers 40 smokers, who smoked on an average 10 cigarettes per day for at least 5 years, and 40 non-smokers to find out the possible risk factors for cardiovascular disorders. This study was conducted during April 2011 to April 2012 in the Department of Physiology of Andhra Medical College, on subjects whose age ranged from 20 to 60 years. The ECG results were evaluated for different parameters like heart rate, P-wave, P-R interval, QRS complex, QT interval, and T-wave. The results were analyzed using student’s t-test. The probability (p value was calculated. The analysis showed that QRS and QT interval were shortened and that the QTc interval was widened in the smokers, although the values did not show any statistical significance. From the statistical analysis of the results obtained in the present study and their comparison with those of published reports, it appears that smoking 10 cigarettes per day for 5 Years does not cause major change in ECG wave forms.

  15. Omnipresent ECG-Oversee Android Watch

    Directory of Open Access Journals (Sweden)

    K Navaneetha Krishnan


    Full Text Available “ Omnipresent ECG -oversee android watch” is designed to implement the increasing awareness of alteration in the rhythm of heart beat and coronary heart diseases due to stress and other risk factors. Death caused by heart diseases are high it can be reduced when a person’s heart beat rate is monitored continuously for this purpose “Omnipresent ECG -oversee android watch” is used. It can be used by higher officials/patients to keep track of their heart beat rate by self-opinion or for remote diagnosis of chronic heart disease patients before sudden flicker. This watch works by ceaseless monitoring over a person’s heart beat rate if any deflection is found it generates an alert. It is mainly used by people who are living alone or by those who suffer from any heart disease. It scales the ECG using three lead electrocardiography and impart three signals to smart watch for processing and for generating alert.

  16. Increased prevalence of ECG markers for sudden cardiac arrest in refractory epilepsy. (United States)

    Lamberts, R J; Blom, M T; Novy, J; Belluzzo, M; Seldenrijk, A; Penninx, B W; Sander, J W; Tan, H L; Thijs, R D


    People with epilepsy are at increased risk of sudden cardiac arrest (SCA) due to ECG-confirmed ventricular tachycardia/fibrillation, as seen in a community-based study. We aimed to determine whether ECG-risk markers of SCA are more prevalent in people with epilepsy. In a cross-sectional, retrospective study, we analysed the ECG recordings of 185 people with refractory epilepsy and 178 controls without epilepsy. Data on epilepsy characteristics, cardiac comorbidity, and drug use were collected, and general ECG variables (heart rate (HR), PQ and QRS intervals) assessed. We analysed ECGs for three markers of SCA risk: severe QTc prolongation (male >450 ms, female >470 ms), Brugada ECG pattern, and early repolarisation pattern (ERP). Multivariate regression models were used to analyse differences between groups, and to identify associated clinical and epilepsy-related characteristics. People with epilepsy had higher HR (71 vs 62 bpm, pepilepsy (QTc prolongation: 5% vs 0%; p=0.002; ERP: 34% vs 13%, p0.999). After adjustment for covariates, epilepsy remained associated with ERP (ORadj 2.4, 95% CI 1.1 to 5.5) and severe QTc prolongation (ORadj 9.9, 95% CI 1.1 to 1317.7). ERP and severe QTc prolongation appear to be more prevalent in people with refractory epilepsy. Future studies must determine whether this contributes to increased SCA risk in people with epilepsy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  17. ECG Sensor Card with Evolving RBP Algorithms for Human Verification (United States)

    Tseng, Kuo-Kun; Huang, Huang-Nan; Zeng, Fufu; Tu, Shu-Yi


    It is known that cardiac and respiratory rhythms in electrocardiograms (ECGs) are highly nonlinear and non-stationary. As a result, most traditional time-domain algorithms are inadequate for characterizing the complex dynamics of the ECG. This paper proposes a new ECG sensor card and a statistical-based ECG algorithm, with the aid of a reduced binary pattern (RBP), with the aim of achieving faster ECG human identity recognition with high accuracy. The proposed algorithm has one advantage that previous ECG algorithms lack—the waveform complex information and de-noising preprocessing can be bypassed; therefore, it is more suitable for non-stationary ECG signals. Experimental results tested on two public ECG databases (MIT-BIH) from MIT University confirm that the proposed scheme is feasible with excellent accuracy, low complexity, and speedy processing. To be more specific, the advanced RBP algorithm achieves high accuracy in human identity recognition and is executed at least nine times faster than previous algorithms. Moreover, based on the test results from a long-term ECG database, the evolving RBP algorithm also demonstrates superior capability in handling long-term and non-stationary ECG signals. PMID:26307995

  18. Electrocardiogram (ECG) pattern modeling and recognition via deterministic learning

    Institute of Scientific and Technical Information of China (English)

    Xunde DONG; Cong WANG; Junmin HU; Shanxing OU


    A method for electrocardiogram (ECG) pattern modeling and recognition via deterministic learning theory is presented in this paper. Instead of recognizing ECG signals beat-to-beat, each ECG signal which contains a number of heartbeats is recognized. The method is based entirely on the temporal features (i.e., the dynamics) of ECG patterns, which contains complete information of ECG patterns. A dynamical model is employed to demonstrate the method, which is capable of generating synthetic ECG signals. Based on the dynamical model, the method is shown in the following two phases:the identification (training) phase and the recognition (test) phase. In the identification phase, the dynamics of ECG patterns is accurately modeled and expressed as constant RBF neural weights through the deterministic learning. In the recognition phase, the modeling results are used for ECG pattern recognition. The main feature of the proposed method is that the dynamics of ECG patterns is accurately modeled and is used for ECG pattern recognition. Experimental studies using the Physikalisch-Technische Bundesanstalt (PTB) database are included to demonstrate the effectiveness of the approach.

  19. ECG Sensor Card with Evolving RBP Algorithms for Human Verification

    Directory of Open Access Journals (Sweden)

    Kuo-Kun Tseng


    Full Text Available It is known that cardiac and respiratory rhythms in electrocardiograms (ECGs are highly nonlinear and non-stationary. As a result, most traditional time-domain algorithms are inadequate for characterizing the complex dynamics of the ECG. This paper proposes a new ECG sensor card and a statistical-based ECG algorithm, with the aid of a reduced binary pattern (RBP, with the aim of achieving faster ECG human identity recognition with high accuracy. The proposed algorithm has one advantage that previous ECG algorithms lack—the waveform complex information and de-noising preprocessing can be bypassed; therefore, it is more suitable for non-stationary ECG signals. Experimental results tested on two public ECG databases (MIT-BIH from MIT University confirm that the proposed scheme is feasible with excellent accuracy, low complexity, and speedy processing. To be more specific, the advanced RBP algorithm achieves high accuracy in human identity recognition and is executed at least nine times faster than previous algorithms. Moreover, based on the test results from a long-term ECG database, the evolving RBP algorithm also demonstrates superior capability in handling long-term and non-stationary ECG signals.

  20. ECG Sensor Card with Evolving RBP Algorithms for Human Verification. (United States)

    Tseng, Kuo-Kun; Huang, Huang-Nan; Zeng, Fufu; Tu, Shu-Yi


    It is known that cardiac and respiratory rhythms in electrocardiograms (ECGs) are highly nonlinear and non-stationary. As a result, most traditional time-domain algorithms are inadequate for characterizing the complex dynamics of the ECG. This paper proposes a new ECG sensor card and a statistical-based ECG algorithm, with the aid of a reduced binary pattern (RBP), with the aim of achieving faster ECG human identity recognition with high accuracy. The proposed algorithm has one advantage that previous ECG algorithms lack-the waveform complex information and de-noising preprocessing can be bypassed; therefore, it is more suitable for non-stationary ECG signals. Experimental results tested on two public ECG databases (MIT-BIH) from MIT University confirm that the proposed scheme is feasible with excellent accuracy, low complexity, and speedy processing. To be more specific, the advanced RBP algorithm achieves high accuracy in human identity recognition and is executed at least nine times faster than previous algorithms. Moreover, based on the test results from a long-term ECG database, the evolving RBP algorithm also demonstrates superior capability in handling long-term and non-stationary ECG signals.

  1. Rapid assessment of ECG for hypokalemia%心电图对低钾血症的快速评价作用

    Institute of Scientific and Technical Information of China (English)

    周军荣; 王晋丽


    目的 了解心电图(ECG)对低钾血症的快速评价作用,应用于临床急诊治疗低钾血症.方法 选取有低血钾ECG特征表现的患者130例,对照同步12导联ECG并同时查阅当时的血清K+,观察不同血清K+患者的ECG特征并进行分析.结果 130例有低血钾ECG表现患者中115例血清K+降低,ECG对低钾血症的诊断敏感度为88.5%.结论 ECG可作为快速筛查低钾血症的简捷方法 之一,ECG的特征表现对低钾血症有较高的预测价值,对临床急诊治疗低钾血症有快速、及时的指导意义.%Objective To understand the rapid assessment of electrocardiography ( ECG) for hypokalemia and the application of ECG for hypokalemia therapy in clinical emergency. Methods 130patients with low serum potassium under ECG were selected, their synchronous 12 leads ECG were analyzed and the concentration of serum potassiuM was observed at the same time, and the characteristics of ECG at the different concentration of serum potassium were analyzed. Results There are 115 cases of hypokalemia in 130 patients with low serum potassium under ECG. The diagnostic sensitivity of ECG for hypokalemia was 88.5%. Conclusion ECG could Be one of the effective methods in screening hypokalemia rapidly, and has great predictive value for hypokalemia. Also, ECG may instruct the hypokalemia therapy in clinical emergency timely.

  2. Prospectively ECG Gated CT pulmonary angiography versus helical ungated CT pulmonary angiography: Impact on cardiac related motion artifacts and patient radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Shuman, William P., E-mail: [Department of Radiology, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195 (United States); Leipsic, Jonathon A., E-mail: [University of British Columbia and St. Paul' s Hospital, Department of Radiology, 1081 Burrard Street, Vancouver, BC, V6Z1Y6 (Canada); Busey, Janet M., E-mail: [Department of Radiology, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195 (United States); Green, Douglas E., E-mail: [Department of Radiology, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195 (United States); Pipavath, Sudhakar N., E-mail: [Department of Radiology, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195 (United States); Hague, Cameron J., E-mail: [University of British Columbia and St. Paul' s Hospital, Department of Radiology, 1081 Burrard Street, Vancouver, BC, V6Z1Y6 (Canada); Koprowicz, Kent M., E-mail: [Department of Radiology, 1959 NE Pacific Street, Box 357115, Seattle, WA 98195 (United States)


    Objective: To compare prospectively ECG gated CT pulmonary angiography (CTPA) with routine helical ungated CTPA for cardiac related motion artifacts and patient radiation dose. Subjects and methods: Twenty patients with signs and symptoms suspicious for pulmonary embolism and who had a heart rate below 85 were scanned with prospectively ECG gated CTPA. These gated exams were matched for several clinical parameters to exams from twenty similar clinical patients scanned with routine ungated helical CTPA. Three blinded independent reviewers subjectively evaluated all exams for overall pulmonary artery enhancement and for several cardiac motion related artifacts, including vessel blurring, intravascular shading, and double line. Reviewers also measured pulmonary artery intravascular density and image noise. Patient radiation dose for each technique was compared. Fourteen clinical prospectively ECG gated CTPA exams from a second institution were evaluated for the same parameters. Results: Prospectively ECG gated CTPA resulted in significantly decreased motion-related image artifact scores in lung segments adjacent to the heart compared to ungated CTPA. Measured image noise was not significantly different between the two types of CTPA exams. Effective dose was 28% less for prospectively ECG gated CTPA (4.9 mSv versus 6.8 mSv, p = 0.02). Similar results were found in the prospectively ECG gated exams from the second institution. Conclusion: Compared to routine helical ungated CTPA, prospectively ECG gated CTPA may result in less cardiac related motion artifact in lung segments adjacent to the heart and significantly less patient radiation dose.

  3. A model-based approach to human identification using ECG (United States)

    Homer, Mark; Irvine, John M.; Wendelken, Suzanne


    Biometrics, such as fingerprint, iris scan, and face recognition, offer methods for identifying individuals based on a unique physiological measurement. Recent studies indicate that a person's electrocardiogram (ECG) may also provide a unique biometric signature. Current techniques for identification using ECG rely on empirical methods for extracting features from the ECG signal. This paper presents an alternative approach based on a time-domain model of the ECG trace. Because Auto-Regressive Integrated Moving Average (ARIMA) models form a rich class of descriptors for representing the structure of periodic time series data, they are well-suited to characterizing the ECG signal. We present a method for modeling the ECG, extracting features from the model representation, and identifying individuals using these features.

  4. Compressed domain ECG biometric with two-lead features (United States)

    Lee, Wan-Jou; Chang, Wen-Whei


    This study presents a new method to combine ECG biometrics with data compression within a common JPEG2000 framework. We target the two-lead ECG configuration that is routinely used in long-term heart monitoring. Incorporation of compressed-domain biometric techniques enables faster person identification as it by-passes the full decompression. Experiments on public ECG databases demonstrate the validity of the proposed method for biometric identification with high accuracies on both healthy and diseased subjects.

  5. Arrhythmia ECG Noise Reduction by Ensemble Empirical Mode Decomposition

    Directory of Open Access Journals (Sweden)

    Kang-Ming Chang


    Full Text Available A novel noise filtering algorithm based on ensemble empirical mode decomposition (EEMD is proposed to remove artifacts in electrocardiogram (ECG traces. Three noise patterns with different power—50 Hz, EMG, and base line wander – were embedded into simulated and real ECG signals. Traditional IIR filter, Wiener filter, empirical mode decomposition (EMD and EEMD were used to compare filtering performance. Mean square error between clean and filtered ECGs was used as filtering performance indexes. Results showed that high noise reduction is the major advantage of the EEMD based filter, especially on arrhythmia ECGs.

  6. Denoising of ECG signal during spaceflight using singular value decomposition (United States)

    Li, Zhuo; Wang, Li


    The Singular Value Decomposition (SVD) method is introduced to denoise the ECG signal during spaceflight. The theory base of SVD method is given briefly. The denoising process of the strategy is presented combining a segment of real ECG signal. We improve the algorithm of calculating Singular Value Ratio (SVR) spectrum, and propose a constructive approach of analysis characteristic patterns. We reproduce the ECG signal very well and compress the noise effectively. The SVD method is proved to be suitable for denoising the ECG signal.

  7. 3-lead acquisition using single channel ECG device developed on AD8232 analog front end for wireless ECG application (United States)

    Agung, Mochammad Anugrah; Basari


    Electrocardiogram (ECG) devices measure electrical activity of the heart muscle to determine heart conditions. ECG signal quality is the key factor in determining the diseases of the heart. This paper presents the design of 3-lead acquistion on single channel wireless ECG device developed on AD8232 chip platform using microcontroller. To make the system different from others, monopole antenna 2.4 GHz is used in order to send and receive ECG signal. The results show that the system still can receive ECG signal up to 15 meters by line of sight (LOS) condition. The shape of ECG signals is precisely similar with the expected signal, although some delays occur between two consecutive pulses. For further step, the system will be applied with on-body antenna in order to investigate body to body communication that will give variation in connectivity from the others.

  8. Extract fetal ECG from single-lead abdominal ECG by de-shape short time Fourier transform and nonlocal median

    CERN Document Server

    Li, Su


    The multiple fundamental frequency detection problem and the source separation problem from a single-channel signal containing multiple oscillatory components and a nonstationary noise are both challenging tasks. To extract the fetal electrocardiogram (ECG) from a single-lead maternal abdominal ECG, we face both challenges. In this paper, we propose a novel method to extract the fetal ECG signal from the single channel maternal abdominal ECG signal, without any additional measurement. The algorithm is composed of three main ingredients. First, the maternal and fetal heart rates are estimated by the de-shape short time Fourier transform, which is a recently proposed nonlinear time-frequency analysis technique; second, the beat tracking technique is applied to accurately obtain the maternal and fetal R peaks; third, the maternal and fetal ECG waveforms are established by the nonlocal median. The algorithm is evaluated on a simulated fetal ECG signal database ({\\em fecgsyn} database), and tested on two real data...

  9. The acquisition and retention of ECG interpretation skills after a standardized web-based ECG tutorial-a randomised study

    DEFF Research Database (Denmark)

    Rolskov Bojsen, Signe; Räder, Sune Bernd Emil Werner; Holst, Anders Gaardsdal


    BACKGROUND: Electrocardiogram (ECG) interpretation is of great importance for patient management. However, medical students frequently lack proficiency in ECG interpretation and rate their ECG training as inadequate. Our aim was to examine the effect of a standalone web-based ECG tutorial...... and to assess the retention of skills using multiple follow-up intervals. METHODS: 203 medical students were included in the study. All participants completed a pre-test, an ECG tutorial, and a post-test. The participants were also randomised to complete a retention-test after short (2-4 weeks), medium (10.......6), respectively). When comparing the pre-test to retention-test delta scores, junior students had learned significantly more than senior students (junior students improved 10.7 points and senior students improved 4.7 points, p = 0.003). CONCLUSION: A standalone web-based ECG tutorial can be an effective means...

  10. Spectral Statistics of RR Intervals in ECG

    CERN Document Server

    Martinis, M; Knezevic, A; Crnugelj, J


    The statistical properties (fluctuations) of heartbeat intervals (RR intervals) in ECG are studied and compared with the predictions of Random Matrix Theory (RMT). It is found that heartbeat intervals only locally exhibit the fluctuation patterns (universality) predicted by the RMT. This finding shows that heartbeat dynamics is of the mixed type where regular and irregular (chaotic) regimes coexist and the Berry-Robnik theory can be applied. It is also observed that the distribution of heartbeat intervals is well described by the one-parameter Brody distribution. The parameter $\\beta $ of the Brody distribution is seen to be connected with the dynamical state of the heart.

  11. An intelligent telecardiology system using a wearable and wireless ECG to detect atrial fibrillation. (United States)

    Lin, Chin-Teng; Chang, Kuan-Cheng; Lin, Chun-Ling; Chiang, Chia-Cheng; Lu, Shao-Wei; Chang, Shih-Sheng; Lin, Bor-Shyh; Liang, Hsin-Yueh; Chen, Ray-Jade; Lee, Yuan-Teh; Ko, Li-Wei


    This study presents a novel wireless, ambulatory, real-time, and autoalarm intelligent telecardiology system to improve healthcare for cardiovascular disease, which is one of the most prevalent and costly health problems in the world. This system consists of a lightweight and power-saving wireless ECG device equipped with a built-in automatic warning expert system. This device is connected to a mobile and ubiquitous real-time display platform. The acquired ECG signals are instantaneously transmitted to mobile devices, such as netbooks or mobile phones through Bluetooth, and then, processed by the expert system. An alert signal is sent to the remote database server, which can be accessed by an Internet browser, once an abnormal ECG is detected. The current version of the expert system can identify five types of abnormal cardiac rhythms in real-time, including sinus tachycardia, sinus bradycardia, wide QRS complex, atrial fibrillation (AF), and cardiac asystole, which is very important for both the subjects who are being monitored and the healthcare personnel tracking cardiac-rhythm disorders. The proposed system also activates an emergency medical alarm system when problems occur. Clinical testing reveals that the proposed system is approximately 94% accurate, with high sensitivity, specificity, and positive prediction rates for ten normal subjects and 20 AF patients. We believe that in the future a business-card-like ECG device, accompanied with a mobile phone, can make universal cardiac protection service possible.

  12. Multiadaptive Bionic Wavelet Transform: Application to ECG Denoising and Baseline Wandering Reduction

    Directory of Open Access Journals (Sweden)

    Sayadi Omid


    Full Text Available We present a new modified wavelet transform, called the multiadaptive bionic wavelet transform (MABWT, that can be applied to ECG signals in order to remove noise from them under a wide range of variations for noise. By using the definition of bionic wavelet transform and adaptively determining both the center frequency of each scale together with the -function, the problem of desired signal decomposition is solved. Applying a new proposed thresholding rule works successfully in denoising the ECG. Moreover by using the multiadaptation scheme, lowpass noisy interference effects on the baseline of ECG will be removed as a direct task. The method was extensively clinically tested with real and simulated ECG signals which showed high performance of noise reduction, comparable to those of wavelet transform (WT. Quantitative evaluation of the proposed algorithm shows that the average SNR improvement of MABWT is 1.82 dB more than the WT-based results, for the best case. Also the procedure has largely proved advantageous over wavelet-based methods for baseline wandering cancellation, including both DC components and baseline drifts.


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION : Chronic obstructive pulmonary disease (COPD is a major cause of morbidity and mortality in India especially in rural areas. COPD is the 5th leading cause of death worldwide. COPD causes hypoxia in lungs triggering the pulmonary vasoconstriction which lead s to increase in pulmonary vascular resistance finally involving the heart and causes right sided cardiac complications which can be evidenced by Electrocardiography (ECG. Therefore , the present study was conducted to evaluate the diagnostic values of ECG changes among COPD patients. MATERIAL AND METHODS : This was a cross - sectional study done in the Medicine department of Chirayu Medical College and Hospital , Bhopal during the period from January 2012 to June 2012. 60 cases of COPD were selected for study. The diagnosis of COPD is based upon the clinical history , clinical examination , X - ray chest and Pulmonary Function Test (PFT. ECG was done in all the 60 patients and looked for heart axis , Right Ventricular Enlargement (RVE , Right Atrial Enlargement (RA E and Right Bundle Branch Block (RBBB. RESULTS : ECG analysis shows the features suggestive of RAE in >40% of COPD patients having duration of >10 yrs. Out of total 60 patients 24 patients had Forced Expiratory Volume First(FEV1 ≥80% (mild COPD , 30 had FEV1 50 % to 79% (moderate COPD , 5 patients had FEV1 30 - 49% (severe COPD and 1 patient had FEV1 < 30% (very severe COPD. When the disease severity is compared with the Manifestations in ECG RAE , RVE and RBBB was found in 3 (60% of the patients out of 5 patients who had severe disease. CONCLUSION : The prevalence of ECG abnormalities related to cardiac diseases , in general is higher in those with more severe pulmonary obstruction and ECG findings should be taken into consideration when diagnosing these pa tients of COPD for delivering a more integrated pulmonary and cardiovascular care.

  14. 15 Minutes of Shame? Copyright Issues in Celebrity Sex Videos


    Rosenfeld, Shelly


    It's the tape that launched a thousand clips Paris Hilton's Celebrity Sex Video became a form of "Must See TV". Celebrities are used to performing for the camera. But when Hilton was caught on video, she reacted as many participants do when their celebrity sex tapes are revealed they file a lawsuit. This article explores the vario...

  15. The evolution of ambulatory ECG monitoring. (United States)

    Kennedy, Harold L


    Ambulatory Holter electrocardiographic (ECG) monitoring has undergone continuous technological evolution since its invention and development in the 1950s era. With commercial introduction in 1963, there has been an evolution of Holter recorders from 1 channel to 12 channel recorders with increasingly smaller storage media, and there has evolved Holter analysis systems employing increasingly technologically advanced electronics providing a myriad of data displays. This evolution of smaller physical instruments with increasing technological capacity has characterized the development of electronics over the past 50 years. Currently the technology has been focused upon the conventional continuous 24 to 48 hour ambulatory ECG examination, and conventional extended ambulatory monitoring strategies for infrequent to rare arrhythmic events. However, the emergence of the Internet, Wi-Fi, cellular networks, and broad-band transmission has positioned these modalities at the doorway of the digital world. This has led to an adoption of more cost-effective strategies to these conventional methods of performing the examination. As a result, the emergence of the mobile smartphone coupled with this digital capacity is leading to the recent development of Holter smartphone applications. The potential of point-of-care applications utilizing the Holter smartphone and a vast array of new non-invasive sensors is evident in the not too distant future. The Holter smartphone is anticipated to contribute significantly in the future to the field of global health.

  16. The Research of ECG Signal Automatic Segmentation Algorithm Based on Fractal Dimension Trajectory

    Institute of Scientific and Technical Information of China (English)


    <正>In this paper a kind of ECG signal automatic segmentation algorithm based on ECG fractal dimension trajectory is put forward.First,the ECG signal will be analyzed,then constructing the fractal dimension trajectory of ECG signal according to the fractal dimension trajectory constructing algorithm,finally,obtaining ECG signal feature points and ECG automatic segmentation will be realized by the feature of ECG signal fractal dimension trajectory and the feature of ECG frequency domain characteristics.Through Matlab simulation of the algorithm,the results showed that by constructing the ECG fractal dimension trajectory enables ECG location of each component displayed clearly and obtains high success rate of sub-ECG,providing a basis to identify the various components of ECG signal accurately.

  17. Brugada Syndrome ECG Is Highly Prevalent in Schizophrenia

    NARCIS (Netherlands)

    Blom, Marieke T.; Cohen, Dan; Seldenrijk, Adrie; Penninx, Brenda W. J. H.; Nijpels, Giel; Stehouwer, Coen D. A.; Dekker, Jacqueline M.; Tan, Hanno L.


    Background The causes of increased risk of sudden cardiac death in schizophrenia are not resolved. We aimed to establish (1) whether ECG markers of sudden cardiac death risk, in particular Brugada-ECG pattern, are more prevalent among patients with schizophrenia, and (2) whether increased prevalence

  18. Telemedicine supported by Augmented Reality: an interactive guide for untrained people in performing an ECG test. (United States)

    Bifulco, Paolo; Narducci, Fabio; Vertucci, Raffaele; Ambruosi, Pasquale; Cesarelli, Mario; Romano, Maria


    application and the validity of clinical ECG recordings. This application can be adapted to support the use of other medical equipment as well as other telemedicine tasks and it could be performed with a Tablet or a Smartphone.

  19. ECG is an inefficient screening-tool for left ventricular hypertrophy in normotensive African children population

    Directory of Open Access Journals (Sweden)

    Giuseppe Di Gioia


    Full Text Available Background Left ventricular hypertrophy (LVH is a marker of pediatric hypertension and predicts development of cardiovascular events. Electrocardiography (ECG screening is used in pediatrics to detect LVH thanks to major accessibility, reproducibility and easy to use compared to transthoracic echocardiography (TTE, that remains the standard technique. Several diseases were previously investigated, but no data exists regarding our study population. The aim of our study was to evaluate the relationship between electrocardiographic and echocardiographic criteria of LVH in normotensive African children. Methods We studied 313 children (mean age 7,8 ± 3 yo, in north-Madagascar. They underwent ECG and TTE. Sokolow-Lyon index was calculated to identify ECG-LVH (>35 mm. Left ventricle mass (LVM with TTE was calculated and indexed by height2.7 (LVMI2.7 and weight (LVMIw. We report the prevalence of TTE-LVH using three methods: (1 calculating percentiles age- and sex- specific with values >95th percentile identifying LVH; (2 LVMI2.7 >51 g/m2.7; (3 LVMIw >3.4 g/weight. Results 40 (13% children showed LVMI values >95th percentile, 24 children (8% an LVMI2.7 >51 g/m2.7 while 19 children (6% an LVMIw >3.4 g/kg. LVH-ECG by Sokolow-Lyon index was present in five, three and three children respectively, with poor values of sensitivity (ranging from 13 to 16%, positive predictive value (from 11 to 18% and high values of specificity (up to 92%. The effects of anthropometrics parameters on Sokolow-Lyon were analyzed and showed poor correlation. Conclusion ECG is a poor screening test for detecting LVH in children. In clinical practice, TTE remains the only tool to be used to exclude LVH.

  20. QT interval variability in body surface ECG : measurement, physiological basis, and clinical value: position statement and consensus guidance endorsed by the European Heart Rhythm Association jointly with the ESC Working Group on Cardiac Cellular Electrophysiology

    NARCIS (Netherlands)

    Baumert, Mathias; Porta, Alberto; Vos, Marc A; Malik, Marek; Couderc, Jean-Philippe; Laguna, Pablo; Piccirillo, Gianfranco; Smith, Godfrey L; Tereshchenko, Larisa G; Volders, Paul G A


    This consensus guideline discusses the electrocardiographic phenomenon of beat-to-beat QT interval variability (QTV) on surface electrocardiograms. The text covers measurement principles, physiological basis, and clinical value of QTV. Technical considerations include QT interval measurement and the

  1. A novel similarity comparison approach for dynamic ECG series. (United States)

    Yin, Hong; Zhu, Xiaoqian; Ma, Shaodong; Yang, Shuqiang; Chen, Liqian


    The heart sound signal is a reflection of heart and vascular system motion. Long-term continuous electrocardiogram (ECG) contains important information which can be helpful to prevent heart failure. A single piece of a long-term ECG recording usually consists of more than one hundred thousand data points in length, making it difficult to derive hidden features that may be reflected through dynamic ECG monitoring, which is also very time-consuming to analyze. In this paper, a Dynamic Time Warping based on MapReduce (MRDTW) is proposed to make prognoses of possible lesions in patients. Through comparison of a real-time ECG of a patient with the reference sets of normal and problematic cardiac waveforms, the experimental results reveal that our approach not only retains high accuracy, but also greatly improves the efficiency of the similarity measure in dynamic ECG series.

  2. Advances in Modern Capacitive ECG Systems for Continuous Cardiovascular Monitoring

    Directory of Open Access Journals (Sweden)

    A. Schommartz


    Full Text Available The technique of capacitive electrocardiography (cECG is very promising in a flexible manner. Already integrated into several everyday objects, the single lead cECG system has shown that easy-to-use measurements of electrocardiograms are possible without difficult preparation of the patients. Multi-channel cECG systems enable the extraction of ECG signals even in the presence of coupled interferences, due to the additional redundant information. Thus, this paper presents challenges for electronic hardware design to build on developments in recent years, going from the one-lead cECG system to multi-channel systems in order to provide robust measurements - e.g. even while driving an automobile.

  3. Adaptive Non-Linear Bayesian Filter for ECG Denoising

    Directory of Open Access Journals (Sweden)

    Mitesh Kumar Sao


    Full Text Available The cycles of an electrocardiogram (ECG signal contain three components P-wave, QRS complex and the T-wave. Noise is present in cardiograph as signals being measured in which biological resources (muscle contraction, base line drift, motion noise and environmental resources (power line interference, electrode contact noise, instrumentation noise are normally pollute ECG signal detected at the electrode. Visu-Shrink thresholding and Bayesian thresholding are the two filters based technique on wavelet method which is denoising the PLI noisy ECG signal. So thresholding techniques are applied for the effectiveness of ECG interval and compared the results with the wavelet soft and hard thresholding methods. The outputs are evaluated by calculating the root mean square (RMS, signal to noise ratio (SNR, correlation coefficient (CC and power spectral density (PSD using MATLAB software. The clean ECG signal shows Bayesian thresholding technique is more powerful algorithm for denoising.

  4. Noncontact ECG system for unobtrusive long-term monitoring. (United States)

    McDonald, Neil J; Anumula, Harini A; Duff, Eric; Soussou, Walid


    This paper describes measurements made using an ECG system with QUASAR's capacitive bioelectrodes integrated into a pad system that is placed over a chair. QUASAR's capacitive bioelectrode has the property of measuring bioelectric potentials at a small separation from the body. This enables the measurement of ECG signals through fabric, without the removal of clothing or preparation of skin. The ECG was measured through the subject's clothing while the subject sat in the chair without any supporting action from the subject. The ECG pad system is an example of a high compliance system that places minimal requirements upon the subject and, consequently, can be used to generate a long-term record from ECG segments collected on a daily basis, providing valuable information on long-term trends in cardiac health.

  5. ECG Signal Analysis and Arrhythmia Detection using Wavelet Transform (United States)

    Kaur, Inderbir; Rajni, Rajni; Marwaha, Anupma


    Electrocardiogram (ECG) is used to record the electrical activity of the heart. The ECG signal being non-stationary in nature, makes the analysis and interpretation of the signal very difficult. Hence accurate analysis of ECG signal with a powerful tool like discrete wavelet transform (DWT) becomes imperative. In this paper, ECG signal is denoised to remove the artifacts and analyzed using Wavelet Transform to detect the QRS complex and arrhythmia. This work is implemented in MATLAB software for MIT/BIH Arrhythmia database and yields the sensitivity of 99.85 %, positive predictivity of 99.92 % and detection error rate of 0.221 % with wavelet transform. It is also inferred that DWT outperforms principle component analysis technique in detection of ECG signal.

  6. Reduced Comparator Flash ADC for ECG Applications

    Directory of Open Access Journals (Sweden)

    Saravanan. V. A


    Full Text Available A CMOS based low power 4-bit Flash Analog to Digital Converter (ADC design with reduced number of comparators than the conventional Flash Analog to Digital Converter and multiplexer based architecture is proposed. For improving the conversion rate, both the analog and digital parts of the ADC are fully modified and the architecture uses only 4 comparators instead of 15 as used in conventional flash ADC, thus saving considerable amount of power. The proposed 4-bit ADC is designed and simulated in TANNER tools with 1.2 V supply voltage using TSpice simulation. The proposed design consumes low power of 2.15mW and operates at a faster rate hence it is suitable for ECG applications.

  7. Preprocessing and Analysis of Digitized ECGs (United States)

    Villalpando, L. E. Piña; Kurmyshev, E.; Ramírez, S. Luna; Leal, L. Delgado


    In this work we propose a methodology and programs in MatlabTM that perform the preprocessing and analysis of the derivative D1 of ECGs. The program makes the correction to isoelectric line for each beat, calculates the average cardiac frequency and its standard deviation, generates a file of amplitude of P, Q and T waves, as well as the segments and intervals important of each beat. Software makes the normalization of beats to a standard rate of 80 beats per minute, the superposition of beats is done centering R waves, before and after normalizing the amplitude of each beat. The data and graphics provide relevant information to the doctor for diagnosis. In addition, some results are displayed similar to those presented by a Holter recording.

  8. ECG signals denoising using wavelet transform and independent component analysis (United States)

    Liu, Manjin; Hui, Mei; Liu, Ming; Dong, Liquan; Zhao, Zhu; Zhao, Yuejin


    A method of two channel exercise electrocardiograms (ECG) signals denoising based on wavelet transform and independent component analysis is proposed in this paper. First of all, two channel exercise ECG signals are acquired. We decompose these two channel ECG signals into eight layers and add up the useful wavelet coefficients separately, getting two channel ECG signals with no baseline drift and other interference components. However, it still contains electrode movement noise, power frequency interference and other interferences. Secondly, we use these two channel ECG signals processed and one channel signal constructed manually to make further process with independent component analysis, getting the separated ECG signal. We can see the residual noises are removed effectively. Finally, comparative experiment is made with two same channel exercise ECG signals processed directly with independent component analysis and the method this paper proposed, which shows the indexes of signal to noise ratio (SNR) increases 21.916 and the root mean square error (MSE) decreases 2.522, proving the method this paper proposed has high reliability.

  9. A cloud computing based 12-lead ECG telemedicine service (United States)


    Background Due to the great variability of 12-lead ECG instruments and medical specialists’ interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists’ decision making support in emergency telecardiology. Methods We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis. Results This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. Conclusions This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan. PMID:22838382

  10. Flexible Graphene Electrodes for Prolonged Dynamic ECG Monitoring

    Directory of Open Access Journals (Sweden)

    Cunguang Lou


    Full Text Available This paper describes the development of a graphene-based dry flexible electrocardiography (ECG electrode and a portable wireless ECG measurement system. First, graphene films on polyethylene terephthalate (PET substrates and graphene paper were used to construct the ECG electrode. Then, a graphene textile was synthesized for the fabrication of a wearable ECG monitoring system. The structure and the electrical properties of the graphene electrodes were evaluated using Raman spectroscopy, scanning electron microscopy (SEM, and alternating current impedance spectroscopy. ECG signals were then collected from healthy subjects using the developed graphene electrode and portable measurement system. The results show that the graphene electrode was able to acquire the typical characteristics and features of human ECG signals with a high signal-to-noise (SNR ratio in different states of motion. A week-long continuous wearability test showed no degradation in the ECG signal quality over time. The graphene-based flexible electrode demonstrates comfortability, good biocompatibility, and high electrophysiological detection sensitivity. The graphene electrode also combines the potential for use in long-term wearable dynamic cardiac activity monitoring systems with convenience and comfort for use in home health care of elderly and high-risk adults.

  11. Sparse representation-based ECG signal enhancement and QRS detection. (United States)

    Zhou, Yichao; Hu, Xiyuan; Tang, Zhenmin; Ahn, Andrew C


    Electrocardiogram (ECG) signal enhancement and QRS complex detection is a critical preprocessing step for further heart disease analysis and diagnosis. In this paper, we propose a sparse representation-based ECG signal enhancement and QRS complex detection algorithm. Unlike traditional Fourier or wavelet transform-based methods, which use fixed bases, the proposed algorithm models the ECG signal as the superposition of a few inner structures plus additive random noise, where these structures (referred to here as atoms) can be learned from the input signal or a training set. Using these atoms and their properties, we can accurately approximate the original ECG signal and remove the noise and other artifacts such as baseline wandering. Additionally, some of the atoms with larger kurtosis values can be modified and used as an indication function to detect and locate the QRS complexes in the enhanced ECG signals. To demonstrate the robustness and efficacy of the proposed algorithm, we compare it with several state-of-the-art ECG enhancement and QRS detection algorithms using both simulated and real-life ECG recordings.

  12. A practical approach for a patient-tailored dose protocol in coronary CT angiography using prospective ECG triggering

    NARCIS (Netherlands)

    Dijk, van J.D.; Huizing, E.D.; Jager, P.L.; Ottervanger, J.P.; Knollema, S.; Slump, C.H.; Dalen, van J.A.


    To derive and validate a practical patient-specific dose protocol to obtain an image quality, expressed by the image noise, independent of patients’ size and a better radiation dose justification in coronary CT angiography (CCTA) using prospective ECG triggering. 43 patients underwent clinically ind

  13. ECG signal analysis with wavelets and neural networks in FPGA


    Klaus Raizer


    Resumo: Este trabalho apresenta a implementação de um sistema de análise de sinais de ECGs (eletrocardiogramas) embarcado em FPGA (field programmable gate array), capaz de classificar cardiopatias. A análise de ECGs é de grande importância devido a sua natureza potencialmente não-invasiva, baixo custo e alta eficiência na identificação de patologias cardíacas. Visto que um sinal de ECG pode ser composto por horas de gravação da atividade cardíaca, uma abordagem computacional para a sua anális...

  14. Residual motion compensation in ECG-gated interventional cardiac vasculature reconstruction (United States)

    Schwemmer, C.; Rohkohl, C.; Lauritsch, G.; Müller, K.; Hornegger, J.


    Three-dimensional reconstruction of cardiac vasculature from angiographic C-arm CT (rotational angiography) data is a major challenge. Motion artefacts corrupt image quality, reducing usability for diagnosis and guidance. Many state-of-the-art approaches depend on retrospective ECG-gating of projection data for image reconstruction. A trade-off has to be made regarding the size of the ECG-gating window. A large temporal window is desirable to avoid undersampling. However, residual motion will occur in a large window, causing motion artefacts. We present an algorithm to correct for residual motion. Our approach is based on a deformable 2D-2D registration between the forward projection of an initial, ECG-gated reconstruction, and the original projection data. The approach is fully automatic and does not require any complex segmentation of vasculature, or landmarks. The estimated motion is compensated for during the backprojection step of a subsequent reconstruction. We evaluated the method using the publicly available CAVAREV platform and on six human clinical datasets. We found a better visibility of structure, reduced motion artefacts, and increased sharpness of the vessels in the compensated reconstructions compared to the initial reconstructions. At the time of writing, our algorithm outperforms the leading result of the CAVAREV ranking list. For the clinical datasets, we found an average reduction of motion artefacts by 13 ± 6%. Vessel sharpness was improved by 25 ± 12% on average.

  15. Dual-source computed tomography: Estimation of radiation exposure of ECG-gated and ECG-triggered coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ketelsen, Dominik [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany)], E-mail:; Thomas, Christoph; Werner, Matthias; Luetkhoff, Marie H. [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Buchgeister, Markus [Departments of Radiotherapy and Radiooncology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Tsiflikas, Ilias; Reimann, Anja [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Burgstahler, Christof [Department of Cardiology, University Hospital Tuebingen, Ottfried-Mueller-Strasse 10, 72076 Tuebingen (Germany); Brodoefel, Harald; Kopp, Andreas F.; Claussen, Claus D.; Heuschmid, Martin [Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany)


    Purpose: The aim of the study was to estimate radiation exposure of coronary calcium scoring and angiography using ECG-gated and ECG-triggered dual-source computed tomography. Materials and methods: An Alderson Rando phantom equipped with thermoluminescent dosimeters was used for all dose measurements. Effective dose was calculated according to ICRP 103. Radiation exposure was performed on a dual-source computed tomography (DSCT) scanner with standard protocols for calcium scoring (DSCT-Ca) and coronary angiography (DSCTA) at different heart rates (40-100 beats/min). Furthermore, a scanning protocol with ECG-triggering as well as a standard chest CT scan were evaluated. Results: Depending on gender, heart rate and ECG-pulsing, the effective dose of a complete cardiac DSCT (DSCT-Ca and DSCTA) scan varies from 10.2 to 32.6 mSv. The effective radiation dose increased significantly with lower heart rates (p < 0.035). ECG-pulsing reduced the radiation exposure significantly in DSCTA (p < 0.001). Due to breast tissue in the primary scan range, females' doses showed an increase up to 69.9% compared to males in scan protocols without ECG-pulsing. Prospective ECG-triggered DSCTA resulted in estimated effective doses from 2.8 mSv (males) to 4.1 mSv (females). Conclusion: The ECG-pulsing technique has proven its effectiveness to reduce effective dose in coronary CT angiography and is recommended for all patients with regular heart rates. The patient's heart rate influences the radiation exposure with a significant decrease at higher heart rates. Due to its lower dose, ECG-triggered DSCTA should be implemented for special indications, i.e. for diagnosis of pathologies of the aortic root and the ascending aorta.

  16. The 24-lead ECG display for enhanced recognition of STEMI-equivalent patterns in the 12-lead ECG. (United States)

    Pahlm, Ulrika; Pahlm, Olle; Wagner, Galen S


    In a patient with chest pain and suspected acute coronary syndrome, the electrocardiogram (ECG) is the only readily available diagnostic tool. It is important to maximize its usefulness to detect acute myocardial ischemia that may evolve to myocardial infarction unless the patient is treated expediently with reperfusion therapy. Since diagnostic guidelines have usually included only ST-elevation myocardial infarction (STEMI) as the entity that should be diagnosed and treated urgently, a patient with coronary occlusion represented on ECG as ST depression is likely not to be considered a candidate for receiving immediate coronary angiography and coronary intervention. ECG criteria for STEMI detection require that ST elevation meet predetermined millivolt thresholds and appear in at least two spatially contiguous ECG leads. The typical ECG reader recognizes only three contiguous pairs: aVL and I; II and aVF; aVF and III. However, viewing the "orderly sequenced" 12-lead ECG display, two more contiguous pairs become obvious in the frontal plane: +I and -aVR; -aVR and +II. The 24-lead ECG is a display of the standard 12-lead ECG as both the classical positive leads and their negative (inverted) counterparts. Leads +V1, +V2, +V3, +V4, +V5, and +V6 and their inverted counterparts are used to generate a "clock-face display" for the transverse plane. Similarly, +aVL, +I, -aVR, +II, +aVF, +III in the frontal plane and their inverted counterparts are used to generate a clock-face display for the frontal plane. Optimum results, 78% sensitivity and 93% specificity, were obtained using the following 19 ECG leads: frontal plane: +aVR, -III, +aVL, +I, -aVR, +II, +aVF, +III, -aVL; transverse plane: +V1, +V2, +V3, +V4, +V5, +V6, -V1, -V2, -V3.

  17. [Informative value of programmed electric stimulation of the ventricles, 24-hour ECG monitoring and bicycle ergometry in the diagnosis of electric instability of the myocardium in various clinical variants of stenocardia]. (United States)

    Makhotina, V N; Rimsha, E; Kaĭk, Iu


    The informative value of programmed ventricular pacing (PVP), Holter monitoring (HM), and bicycle ergometry (BEM) in the diagnosis of myocardial electric instability was assessed in various clinical types of angina pectoris. An examination was made of 20 patients with first exercise-induced angina (FEIA), 33 with progressive exercise-induced angina (PEIA), 17 with spontaneous angina (SA), 30 with stable exercise-induced angina (SEIA), and postinfarction angina. Myocardial electric instability was estimated from HM and BEM findings in patients with FEIA, SA, as well as in PEIA, SEIA in the presence of preserved myocardial contractility as evidenced by ventriculography. A clear-cut correlation was found between transient myocardial ischemia and the occurrence of high-grade ventricular arrhythmias for the patients from the above-mentioned groups. Lower myocardial contractility despite the nature of angina is an indication for PVP.

  18. ST segment depression in hypertensive patients: A comparison of exercise test versus Holter ECG

    Directory of Open Access Journals (Sweden)

    Sakir Uen


    Full Text Available Sakir Uen1, Rolf Fimmers2, Burkhard Weisser3, Osman Balta1, Georg Nickenig1, Thomas Mengden11Division of Hypertension and Vascular Medicine, Department of Internal Medicine II, University Clinic, Bonn, Germany; 2Department of Biometry and Medical Statistics, University of Bonn, Bonn, Germany; 3Department of Sports Medicine, University of Kiel, Kiel, GermanyIntroduction: This study compared ST segment depression (ST depression during cycle ergometry (ergometry versus simultaneous 24-hour ambulatory blood pressure measurement and electrocardiogram recording (24-h ABPM/ECG during everyday life.Methods: In a German multicenter study, ergometry and 24-h ABPM/ECG records of 239 hypertensive patients were retrospectively analyzed. ST depression was defined as an ST segment depression (1 mm limb or chest recordings V1 to V6 in an incremental cycle ergometry, or 1 mm in the 24-h ABPM/ECG recording under everyday conditions. Blood pressure parameters at the onset of ST depression in the context of the respective method were compared.Results: 18 patients had ST depression only in ergometry (group B, 23 had ST depression only during 24-h ABPM/ECG monitoring (group C and 28 patients had ST depression with both methods (group D. Group A had no ST depression with any method. In group D, at the onset of ST depression with 24-h ABPM/ECG investigation, all parameters except diastolic blood pressure were significantly lower compared with the corresponding parameters at the onset of ST depression with ergometry (systolic blood pressure: 148 ± 19 vers 188 ± 35 mmHg, p < 0.001; heart rate: 93 ± 12 vs 120 ± 21 beat/min, p < 0.0001; double product: 13,714 ± 2315 vs 22,992 ± 3,985 mmHg/min, p < 0.0001.Conclusion: ST depressions during everyday life detected by 24-h ABPM/ECG are characterized by a substantially lower triggering threshold for blood pressure level parameters compared with ergometry. The two methods detecting ischemia do not replace but complement

  19. A harmonic linear dynamical system for prominent ECG feature extraction. (United States)

    Thi, Ngoc Anh Nguyen; Yang, Hyung-Jeong; Kim, SunHee; Do, Luu Ngoc


    Unsupervised mining of electrocardiography (ECG) time series is a crucial task in biomedical applications. To have efficiency of the clustering results, the prominent features extracted from preprocessing analysis on multiple ECG time series need to be investigated. In this paper, a Harmonic Linear Dynamical System is applied to discover vital prominent features via mining the evolving hidden dynamics and correlations in ECG time series. The discovery of the comprehensible and interpretable features of the proposed feature extraction methodology effectively represents the accuracy and the reliability of clustering results. Particularly, the empirical evaluation results of the proposed method demonstrate the improved performance of clustering compared to the previous main stream feature extraction approaches for ECG time series clustering tasks. Furthermore, the experimental results on real-world datasets show scalability with linear computation time to the duration of the time series.

  20. A Harmonic Linear Dynamical System for Prominent ECG Feature Extraction

    Directory of Open Access Journals (Sweden)

    Ngoc Anh Nguyen Thi


    Full Text Available Unsupervised mining of electrocardiography (ECG time series is a crucial task in biomedical applications. To have efficiency of the clustering results, the prominent features extracted from preprocessing analysis on multiple ECG time series need to be investigated. In this paper, a Harmonic Linear Dynamical System is applied to discover vital prominent features via mining the evolving hidden dynamics and correlations in ECG time series. The discovery of the comprehensible and interpretable features of the proposed feature extraction methodology effectively represents the accuracy and the reliability of clustering results. Particularly, the empirical evaluation results of the proposed method demonstrate the improved performance of clustering compared to the previous main stream feature extraction approaches for ECG time series clustering tasks. Furthermore, the experimental results on real-world datasets show scalability with linear computation time to the duration of the time series.

  1. ECG Changes In Patients On Chronic Psychotropic medication

    African Journals Online (AJOL)


    Aug 31, 2006 ... lack of exercise, obesity, substance misuse) and high autonomic ... heart; however, it might precipitate complete heart block in the presence of .... ECG changes such as rate, rhythm, T waves and QT interval changes have ...

  2. Lifestyle support through efficient ECG acquisition and analysis. (United States)

    Devlin, Steven; Nugent, Chris; Finlay, Dewar


    People are becoming more aware of their health and the lifestyles they live. As people use computers more and more in a wide variety of occupations, they would find it desirable to monitor their lifestyle without having to leave their desk. Through the analysis of the Electrocardiogram (ECG), it is possible to obtain a person's heartrate and diagnose a number of conditions associated with abnormal heart function. To obtain an accurate heartrate, the ECG signals have to be analysed and calculations performed to find occurrences of the QRS complex, a major component of the ECG signal. This research entailed creating the software required to interpret ECG signals recorded from an innovative computer peripheral allowing recordings from the user's forearms as they operate the computer. The user could therefore effortlessly monitor their lifestyle during normal computer usage.

  3. ECG Data Encryption Then Compression Using Singular Value Decomposition. (United States)

    Liu, Ting Yu; Lin, Kuan Jen; Wu, Hsi-Chun


    Electrocardiogram (ECG) monitoring systems are widely used in healthcare. ECG data must be compressed for transmission and storage. Furthermore, there is a need to be able to directly process biomedical signals in encrypted domains to ensure the protection of patients' privacy. Existing encryption-then-compression (ETC) approaches for multimedia using the state-of-the-art encryption techniques inevitably sacrifice the compression efficiency or signal quality. This paper presents the first ETC approach for processing ECG data. The proposed approach not only can protect data privacy but also provide the same quality of the reconstructed signals without sacrificing the compression efficiency relative to unencrypted compressions. Specifically, the singular value decomposition (SVD) technique is used to compress the data such that the proposed system can provide quality-control compressed data, even though the data has been encrypted. Experimental results prove the proposed system to be an effective technique for assuring data security as well as compression performance for ECG data.

  4. Wireless Self-Acquistion of 12-Lead ECG via Android Smart Phone (United States)

    Schlegel, Todd T.


    Researchers at NASA s Johnson Space Center and at Orbital Research, Inc. (a NASA SBIR grant recipient) have recently developed a dry-electrode harness that allows for self-acquisition of resting 12-lead ECGs by minimally trained laypersons. When used in conjunction with commercial wireless (e.g., Bluetooth(TM) or 802.11-enabled) 12-lead ECG devices and custom smart phone-based software, the collected 12-lead ECG data can also immediately be forwarded from any geographic location within cellular range to the user s physician(s) of choice. The system can also be used to immediately forward to central receiving stations 12-lead ECG data collected during space flight or during activities in any remote terrestrial location supported by an internet or cellular phone infrastructure. The main novel aspects of the system are first, the dry-electrode 12-lead ECG harness itself, and second, an accompanying Android(TM) smart phone-based wireless 12-lead ECG capability. The ECG harness nominally employs dry electrodes manufactured by Orbital Research, Inc, recently cleared through the Food and Drug Administration (FDA). However, other dry electrodes that are not yet FDA cleared, for example those recently developed by Nanosonic, Inc as part of another NASA SBIR grant, can also be used. The various advantageous features of the harness include: 1) laypersons can be quickly instructed on its correct use, remotely if necessary; 2) all tangled "leadwire spaghetti" is eliminated, as is the common clinical problem of "leadwire reversal"; 3) all adhesives and disposables are also eliminated, the harness being fully reusable; if multiple individuals intend to use use the same harness, then standard antimicrobial wipes can be employed to sterilize the dry electrodes (and harness surface if needed) between users; 5) padded cushions at the lateral sides of the torso function to press the left arm (LA) and right arm (RA) dry electrodes mounted on the cushions against sideward or downward

  5. Sampling Rate Independent Filtration Approach for Automatic ECG Delineation

    CERN Document Server

    Chereda, Hryhorii; Tymoshenko, Yury


    In this paper different types of ECG automatic delineation approaches were overviewed. A combination of these approaches was used to create sampling rate independent filtration algorithm for automatic ECG delineation that is capable of distinguishing different morphologies of T and P waves and QRS complexes. Created filtration algorithm was compared with algorithme \\`a trous. It was investigated that continuous wavelets transform with proposed automatic adaptation for different sampling rates procedure can be used for delineation problem.

  6. Human ECG signal parameters estimation during controlled physical activity (United States)

    Maciejewski, Marcin; Surtel, Wojciech; Dzida, Grzegorz


    ECG signal parameters are commonly used indicators of human health condition. In most cases the patient should remain stationary during the examination to decrease the influence of muscle artifacts. During physical activity, the noise level increases significantly. The ECG signals were acquired during controlled physical activity on a stationary bicycle and during rest. Afterwards, the signals were processed using a method based on Pan-Tompkins algorithms to estimate their parameters and to test the method.

  7. [ECG abnormalities in the MONICA Gent-Charleroi study population]. (United States)

    De Backer, G


    In a survey of a random sample of the adult population (aged 25-64 yr) from Ghent and Charleroi (n = 1693), 103 (6.1%) showed ECG-abnormalities suggestive of coronary heart disease (Minnesota code I, IV, or V); prevalence was equal in men (6.2%) as in women (6.0%). In men, 30% of ECG-abnormalities suggested an old myocardial infarction as compared to 23.4% in women. Men with abnormal ECG had a positive history of acute myocardial infarction in 23%, as compared to 23.4% in women. Multivariate discriminant function analysis shows that men with abnormal ECG are older, have a higher systolic blood pressure and were more often married. Women with ECG abnormalities were significantly older, had a lower HDL-level and were less educated. So, although the prevalence of ECG abnormalities is almost similar between sexes, they correlate differently with antecedents of infarction and are poorly related to different sets of risk factors in men as compared to women.

  8. Live ECG readings using Google Glass in emergency situations. (United States)

    Schaer, Roger; Salamin, Fanny; Jimenez Del Toro, Oscar Alfonso; Atzori, Manfredo; Muller, Henning; Widmer, Antoine


    Most sudden cardiac problems require rapid treatment to preserve life. In this regard, electrocardiograms (ECG) shown on vital parameter monitoring systems help medical staff to detect problems. In some situations, such monitoring systems may display information in a less than convenient way for medical staff. For example, vital parameters are displayed on large screens outside the field of view of a surgeon during cardiac surgery. This may lead to losing time and to mistakes when problems occur during cardiac operations. In this paper we present a novel approach to display vital parameters such as the second derivative of the ECG rhythm and heart rate close to the field of view of a surgeon using Google Glass. As a preliminary assessment, we run an experimental study to verify the possibility for medical staff to identify abnormal ECG rhythms from Google Glass. This study compares 6 ECG rhythms readings from a 13.3 inch laptop screen and from the prism of Google Glass. Seven medical residents in internal medicine participated in the study. The preliminary results show that there is no difference between identifying these 6 ECG rhythms from the laptop screen versus Google Glass. Both allow close to perfect identification of the 6 common ECG rhythms. This shows the potential of connected glasses such as Google Glass to be useful in selected medical applications.

  9. Two surgeons and the ECG-a double blind study

    Institute of Scientific and Technical Information of China (English)

    Ulf Martin Schilling


    Objective: To assess the capability of operating abdominal and orthopaedic surgeons to analyze a set of standardized ECG. Methods: Twenty operating abdominal and orthopaedic surgeons at a university hospital were included. Each participant analyzed a set of five standardized ECG with an answering scheme for eight different items, giving a maximum score of 40. The answers were matched according to specialty and experience of the doctors of less than 5 years, between 5 and 10 years or more than 10 years. The reference standard was set by two independent consultants in cardiology. Results: The mean overall score was 25.25 (63.13%±4.78%) varying between 38 (95%) and 20(50%). Abdominal surgeons performed a mean score of 27.625 (69.06%±9.53%), and orthopaedic surgeons 23.67 points (59.17%±3.69%). The difference between the performance of abdominal and orthopaedic surgeons was not significant (P=0.09). 20/20 surgeons identified ST-elevation and no surgeon accepted the ECG showing acute ST-elevation myocardial infarction as normal. Conclusions: Abdominal and orthopaedic surgeons provided an answering scheme are able to interprete the ECG and identify both the normal and the ECG showing life-threatening pathology. The hypothesis that surgeons were unable to interprete the ECG must be rejected.

  10. 妊娠晚期心电图的异常分析%Analysis of ECG Abnormalities in Late Pregnancy

    Institute of Scientific and Technical Information of China (English)

    吐逊古•阿西木; 迪丽拜尔•克尤木


    Objective The ecg changes in late pregnancy women and the relationship between the clinical and treatment method.Methods The guangdong state built ECG- 9803 type routine eeg, ECG machine, analysis the change of electrocardiogram (ECG), 148 cases of late pregnancy women.Results The types of abnormal ecg in 148 cases of late pregnancy women were,electrical axis left 75 cases,40 cases of sinus tachycardia,sinus arrhythmia,12 cases were shortened period between P-R 10 cases,5 cases of premature beat,QRS low voltage 4 cases,S T-T change in 2 cases.Conclusion See more quite late pregnancy women abnormal ecg, should be focus on change, timely intervention treatment when necessary, to ensure life safety of pregnant women and fetus.%目的探讨妊娠晚期妇女心电图改变与临床的关系及处理方法。方法采用美国M 1772A型心电图机进行常规描记,分析148例妊娠晚期女性的心电图的改变。结果148例孕晚期妇女中心电图异常的种类分别是,电轴左偏75例,窦性心动过速40例、窦性心律不齐12例,P-R间期缩短10例、早搏5例、QRS低电压4例,ST-T改变2例。结论妊娠晚期妇女心电图异常比较多见,应予关注改变,必要时及时进行干预治疗,以保障孕妇和胎儿的生命安全。

  11. e-SCP-ECG+ Protocol: An Expansion on SCP-ECG Protocol for Health Telemonitoring—Pilot Implementation

    Directory of Open Access Journals (Sweden)

    George J. Mandellos


    Full Text Available Standard Communication Protocol for Computer-assisted Electrocardiography (SCP-ECG provides standardized communication among different ECG devices and medical information systems. This paper extends the use of this protocol in order to be included in health monitoring systems. It introduces new sections into SCP-ECG structure for transferring data for positioning, allergies, and five additional biosignals: noninvasive blood pressure (NiBP, body temperature (Temp, Carbon dioxide (CO2, blood oxygen saturation (SPO2, and pulse rate. It also introduces new tags in existing sections for transferring comprehensive demographic data. The proposed enhanced version is referred to as e-SCP-ECG+ protocol. This paper also considers the pilot implementation of the new protocol as a software component in a Health Telemonitoring System.

  12. Sudden cardiac arrest risk stratification based on 24-hour Holter ECG statistics. (United States)

    Kasahara, Keisuke; Shiobara, Masahito; Nakamura, Saya; Yamashiro, Koichiro; Yana, Kazuo; Ono, Takuya


    This study examined the feasibility of using indices obtained from a long term Holter ECG record for sudden cardiac arrest (SCA) risk stratification. The ndices tested were the QT-RR interval co-variability and the alternans ratio percentile (ARP(θ)) which is defined as the θ(th) percentile of alternans ratios over a 24 hour period. The QT-RR interval co-variabilities are evaluated by the serial correlation coefficient between QT and RR trend sequences (QTRC). Previously reported Kalman filter technique and a simple smoothing spline method for the trend estimation are compared. Parameter θ in the alternans ratio percentile index was optimized to achieve the best classification accuracy. These indices were estimated from 26 cardiovascular outpatients for Holter ECG record. Patients were classified into high and low risk groups according to their clinical diagnosis, and the obtained indices were compared with those of 25 control subjects. A risk stratification using the two indices QTRC and ARP(θ) yielded an average sensitivity of 0.812 and a specificity of 0.925. The sensitivities and specificities of all three categories exceeded 0.8 except for the sensitivity to detect the high-risk patient group. Other short-term ECG parameters may need to be incorporated in order to improve the sensitivity.

  13. A robust and simple security extension for the medical standard SCP-ECG. (United States)

    Rubio, Oscar J; Alesanco, Alvaro; García, José


    This paper proposes a SCP-ECG security extension after having analyzed the features of this standard, its security requirements and the current measures implemented by other medical protocols. Our approach permits SCP-ECG files to be stored safely and proper access to be granted (or denied) to users for different purposes: interpretation of the test, consultation, clinical research or teaching. The access privileges are scaled by means of role-based profiles supported by cryptographic elements (ciphering, digital certificates and digital signatures). These elements are arranged as metadata into a new section which extends the protocol and protects the remaining sections. The application built to implement this approach has been extensively tested, showing its capacity to authenticate users and to protect the integrity of files and the privacy of sensitive data, with a low impact on file size and access time. In addition, this solution is compatible with any version of the SCP-ECG and can be easily integrated into e-health platforms.

  14. Combining and benchmarking methods of foetal ECG extraction without maternal or scalp electrode data. (United States)

    Behar, Joachim; Oster, Julien; Clifford, Gari D


    Despite significant advances in adult clinical electrocardiography (ECG) signal processing techniques and the power of digital processors, the analysis of non-invasive foetal ECG (NI-FECG) is still in its infancy. The Physionet/Computing in Cardiology Challenge 2013 addresses some of these limitations by making a set of FECG data publicly available to the scientific community for evaluation of signal processing techniques.The abdominal ECG signals were first preprocessed with a band-pass filter in order to remove higher frequencies and baseline wander. A notch filter to remove power interferences at 50 Hz or 60 Hz was applied if required. The signals were then normalized before applying various source separation techniques to cancel the maternal ECG. These techniques included: template subtraction, principal/independent component analysis, extended Kalman filter and a combination of a subset of these methods (FUSE method). Foetal QRS detection was performed on all residuals using a Pan and Tompkins QRS detector and the residual channel with the smoothest foetal heart rate time series was selected.The FUSE algorithm performed better than all the individual methods on the training data set. On the validation and test sets, the best Challenge scores obtained were E1 = 179.44, E2 = 20.79, E3 = 153.07, E4 = 29.62 and E5 = 4.67 for events 1-5 respectively using the FUSE method. These were the best Challenge scores for E1 and E2 and third and second best Challenge scores for E3, E4 and E5 out of the 53 international teams that entered the Challenge. The results demonstrated that existing standard approaches for foetal heart rate estimation can be improved by fusing estimators together. We provide open source code to enable benchmarking for each of the standard approaches described.

  15. Architecture design of the multi-functional wavelet-based ECG microprocessor for realtime detection of abnormal cardiac events. (United States)

    Cheng, Li-Fang; Chen, Tung-Chien; Chen, Liang-Gee


    Most of the abnormal cardiac events such as myocardial ischemia, acute myocardial infarction (AMI) and fatal arrhythmia can be diagnosed through continuous electrocardiogram (ECG) analysis. According to recent clinical research, early detection and alarming of such cardiac events can reduce the time delay to the hospital, and the clinical outcomes of these individuals can be greatly improved. Therefore, it would be helpful if there is a long-term ECG monitoring system with the ability to identify abnormal cardiac events and provide realtime warning for the users. The combination of the wireless body area sensor network (BASN) and the on-sensor ECG processor is a possible solution for this application. In this paper, we aim to design and implement a digital signal processor that is suitable for continuous ECG monitoring and alarming based on the continuous wavelet transform (CWT) through the proposed architectures--using both programmable RISC processor and application specific integrated circuits (ASIC) for performance optimization. According to the implementation results, the power consumption of the proposed processor integrated with an ASIC for CWT computation is only 79.4 mW. Compared with the single-RISC processor, about 91.6% of the power reduction is achieved.

  16. Standard-compliant real-time transmission of ECGs: harmonization of ISO/IEEE 11073-PHD and SCP-ECG. (United States)

    Trigo, Jesús D; Chiarugi, Franco; Alesanco, Alvaro; Martínez-Espronceda, Miguel; Chronaki, Catherine E; Escayola, Javier; Martínez, Ignacio; García, José


    Ambient assisted living and integrated care in an aging society is based on the vision of the lifelong Electronic Health Record calling for HealthCare Information Systems and medical device interoperability. For medical devices this aim can be achieved by the consistent implementation of harmonized international interoperability standards. The ISO/IEEE 11073 (x73) family of standards is a reference standard for medical device interoperability. In its Personal Health Device (PHD) version several devices have been included, but an ECG device specialization is not yet available. On the other hand, the SCP-ECG standard for short-term diagnostic ECGs (EN1064) has been recently approved as an international standard ISO/IEEE 11073-91064:2009. In this paper, the relationships between a proposed x73-PHD model for an ECG device and the fields of the SCP-ECG standard are investigated. A proof-of-concept implementation of the proposed x73-PHD ECG model is also presented, identifying open issues to be addressed by standards development for the wider interoperability adoption of x73-PHD standards.

  17. Usefulness of ST elevation score by using vector-projected virtual 187-channel ECG for risk stratification in patients with Brugada-type ECG pattern

    Directory of Open Access Journals (Sweden)

    Shoko Ishikawa


    Conclusion: The ST elevation score in VP-ECG objectively documented the degree of ST elevation in surface ECG in Brugada-type ECG patterns. The ST-elevation score might be useful for risk stratification in patients with asymptomatic Brugada syndrome.

  18. A Simple Method for Guaranteeing ECG Quality in Real-Time Wavelet Lossy Coding

    Directory of Open Access Journals (Sweden)

    Alesanco Álvaro


    Full Text Available Guaranteeing ECG signal quality in wavelet lossy compression methods is essential for clinical acceptability of reconstructed signals. In this paper, we present a simple and efficient method for guaranteeing reconstruction quality measured using the new distortion index wavelet weighted PRD (WWPRD, which reflects in a more accurate way the real clinical distortion of the compressed signal. The method is based on the wavelet transform and its subsequent coding using the set partitioning in hierarchical trees (SPIHT algorithm. By thresholding the WWPRD in the wavelet transform domain, a very precise reconstruction error can be achieved thus enabling to obtain clinically useful reconstructed signals. Because of its computational efficiency, the method is suitable to work in a real-time operation, thus being very useful for real-time telecardiology systems. The method is extensively tested using two different ECG databases. Results led to an excellent conclusion: the method controls the quality in a very accurate way not only in mean value but also with a low-standard deviation. The effects of ECG baseline wandering as well as noise in compression are also discussed. Baseline wandering provokes negative effects when using WWPRD index to guarantee quality because this index is normalized by the signal energy. Therefore, it is better to remove it before compression. On the other hand, noise causes an increase in signal energy provoking an artificial increase of the coded signal bit rate. Clinical validation by cardiologists showed that a WWPRD value of 10 preserves the signal quality and thus they recommend this value to be used in the compression system.

  19. A Simple Method for Guaranteeing ECG Quality in Real-Time Wavelet Lossy Coding

    Directory of Open Access Journals (Sweden)

    José García


    Full Text Available Guaranteeing ECG signal quality in wavelet lossy compression methods is essential for clinical acceptability of reconstructed signals. In this paper, we present a simple and efficient method for guaranteeing reconstruction quality measured using the new distortion index wavelet weighted PRD (WWPRD, which reflects in a more accurate way the real clinical distortion of the compressed signal. The method is based on the wavelet transform and its subsequent coding using the set partitioning in hierarchical trees (SPIHT algorithm. By thresholding the WWPRD in the wavelet transform domain, a very precise reconstruction error can be achieved thus enabling to obtain clinically useful reconstructed signals. Because of its computational efficiency, the method is suitable to work in a real-time operation, thus being very useful for real-time telecardiology systems. The method is extensively tested using two different ECG databases. Results led to an excellent conclusion: the method controls the quality in a very accurate way not only in mean value but also with a low-standard deviation. The effects of ECG baseline wandering as well as noise in compression are also discussed. Baseline wandering provokes negative effects when using WWPRD index to guarantee quality because this index is normalized by the signal energy. Therefore, it is better to remove it before compression. On the other hand, noise causes an increase in signal energy provoking an artificial increase of the coded signal bit rate. Clinical validation by cardiologists showed that a WWPRD value of 10% preserves the signal quality and thus they recommend this value to be used in the compression system.

  20. Comparison of diagnostic value using a small, single channel, P-wave centric sternal ECG monitoring patch with a standard 3-lead Holter system over 24 hours. (United States)

    Smith, Warren M; Riddell, Fiona; Madon, Morag; Gleva, Marye J


    To compare simultaneous recordings from an external patch system specifically designed to ensure better P-wave recordings and standard Holter monitor to determine diagnostic efficacy. Holter monitors are a mainstay of clinical practice, but are cumbersome to access and wear and P-wave signal quality is frequently inadequate. This study compared the diagnostic efficacy of the P-wave centric electrocardiogram (ECG) patch (Carnation Ambulatory Monitor) to standard 3-channel (leads V1, II, and V5) Holter monitor (Northeast Monitoring, Maynard, MA). Patients were referred to a hospital Holter clinic for standard clinical indications. Each patient wore both devices simultaneously and served as their own control. Holter and Patch reports were read in a blinded fashion by experienced electrophysiologists unaware of the findings in the other corresponding ECG recording. All patients, technicians, and physicians completed a questionnaire on comfort and ease of use, and potential complications. In all 50 patients, the P-wave centric patch recording system identified rhythms in 23 patients (46%) that altered management, compared to 6 Holter patients (12%), PHolter ECG intervals having correlation coefficients of 0.93, 0.86, and 0.94, respectively. Finally, 48 patients (96%) preferred wearing the patch monitor. A single-channel ambulatory patch ECG monitor, designed specifically to ensure that the P-wave component of the ECG be visible, resulted in a significantly improved rhythm diagnosis and avoided inaccurate diagnoses made by the standard 3-channel Holter monitor. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Fast multi-scale feature fusion for ECG heartbeat classification (United States)

    Ai, Danni; Yang, Jian; Wang, Zeyu; Fan, Jingfan; Ai, Changbin; Wang, Yongtian


    Electrocardiogram (ECG) is conducted to monitor the electrical activity of the heart by presenting small amplitude and duration signals; as a result, hidden information present in ECG data is difficult to determine. However, this concealed information can be used to detect abnormalities. In our study, a fast feature-fusion method of ECG heartbeat classification based on multi-linear subspace learning is proposed. The method consists of four stages. First, baseline and high frequencies are removed to segment heartbeat. Second, as an extension of wavelets, wavelet-packet decomposition is conducted to extract features. With wavelet-packet decomposition, good time and frequency resolutions can be provided simultaneously. Third, decomposed confidences are arranged as a two-way tensor, in which feature fusion is directly implemented with generalized N dimensional ICA (GND-ICA). In this method, co-relationship among different data information is considered, and disadvantages of dimensionality are prevented; this method can also be used to reduce computing compared with linear subspace-learning methods (PCA). Finally, support vector machine (SVM) is considered as a classifier in heartbeat classification. In this study, ECG records are obtained from the MIT-BIT arrhythmia database. Four main heartbeat classes are used to examine the proposed algorithm. Based on the results of five measurements, sensitivity, positive predictivity, accuracy, average accuracy, and t-test, our conclusion is that a GND-ICA-based strategy can be used to provide enhanced ECG heartbeat classification. Furthermore, large redundant features are eliminated, and classification time is reduced.

  2. Electroconvulsive therapy-induced ECG changes simulating a myocardial infarction. (United States)

    Gould, L; Gopalaswamy, C; Chandy, F; Kim, B


    Electroconvulsive therapy (ECT) can produce various cardiac arrhythmias; however, to our knowledge, no other alterations have been described in the ECG. A 75-year-old woman was admitted to the Methodist Hospital in Brooklyn, NY, because of depression. She had had no cardiac symptoms and had been in good health. She was not receiving any medications. Physical examination showed no abnormalities. Findings from the routine laboratory tests, a chest roentgenogram, and the initial ECG were normal. In view of the severe depression, a series of ECTs were given to the patient during a two-week period. A repeated ECG showed deep T-wave inversions in leads I, II, III, aVF, and V1 to V6. The patient was completely asymptomatic. Serial enzyme determinations were normal. A brain scan, gated-pool scan, computed tomography scan of the head, and a technetium Tc 99m pyrophosphate scan were all normal. Serial ECGs showed a persistence of the deep T-wave inversions. There were no QRS changes. There was no evidence of a cerebral vascular accident or pericarditis. The T-wave changes in our patient were not due to a myocardial infarction. Thus, ECT can produce striking T-wave abnormalities in the ECG that can simulate an acute myocardial infarction.

  3. Shannon's Energy Based Algorithm in ECG Signal Processing (United States)


    Physikalisch-Technische Bundesanstalt (PTB) database is electrocardiograms (ECGs) set from healthy volunteers and patients with different heart diseases. PTB is provided for research and teaching purposes by National Metrology Institute of Germany. The analysis method of complex QRS in ECG signals for diagnosis of heart disease is extremely important. In this article, a method on Shannon energy (SE) in order to detect QRS complex in 12 leads of ECG signal is provided. At first, this algorithm computes the Shannon energy (SE) and then makes an envelope of Shannon energy (SE) by using the defined threshold. Then, the signal peaks are determined. The efficiency of the algorithm is tested on 70 cases. Of all 12 standard leads, ECG signals include 840 leads of the PTB Diagnostic ECG Database (PTBDB). The algorithm shows that the Shannon energy (SE) sensitivity is equal to 99.924%, the detection error rate (DER) is equal to 0.155%, Positive Predictivity (+P) is equal to 99.922%, and Classification Accuracy (Acc) is equal to 99.846%.

  4. A controlled study of a new ECG electrode system. (United States)

    Sheffield, L T; Roitman, D I; Kansal, S


    A newly marketed resting ECG electrode system was compared with conventional metal suction and plate electrodes, electrode cream and patient cable. Two experienced technicians were given special training in the use of the new electrode, electrolyte and patient cable system and alternated daily in using new and conventional equipment. Nearly equal numbers of perfect-scoring ECGs were recorded with each system, attesting to the impartiality of the technicians. A total of 1,062 ECGs were evaluated, 554 with the new system and 508 with the conventional one. ECG tracings were evaluated by electrocardiographers unaware of which system was used for each. A quantitative scoring system was used to measure the technical quality of each tracing in terms of baseline drift, powerline artifact and myographic plus miscellaneous artifacts. The new system received mean scores of 2.33, 3.08, and 2.72, respectively, while the conventional electrodes received scores of 2.56, 3.03 and 2.79. We concluded that the two types of electrodes produced ECGs of essentially equal quality.

  5. A system for intelligent home care ECG upload and priorisation. (United States)

    D'Angelo, Lorenzo T; Tarita, Eugeniu; Zywietz, Tosja K; Lueth, Tim C


    In this contribution, a system for internet based, automated home care ECG upload and priorisation is presented for the first time. It unifies the advantages of existing telemonitoring ECG systems adding functionalities such as automated priorisation and usability for home care. Chronic cardiac diseases are a big group in the geriatric field. Most of them can be easily diagnosed with help of an electrocardiogram. A frequent or long-term ECG analysis allows early diagnosis of e.g. a cardiac infarction. Nevertheless, patients often aren't willing to visit a doctor for prophylactic purposes. Possible solutions of this problem are home care devices, which are used to investigate patients at home without the presence of a doctor on site. As the diffusion of such systems leads to a huge amount of data which has to be managed and evaluated, the presented approach focuses on an easy to use software for ECG upload from home, a web based management application and an algorithm for ECG preanalysis and priorisation.

  6. Effect of ECG filter settings on J-waves. (United States)

    Nakagawa, Mikiko; Tsunemitsu, Chie; Katoh, Sayo; Kamiyama, Yukari; Sano, Nario; Ezaki, Kaori; Miyazaki, Hiroko; Teshima, Yasushi; Yufu, Kunio; Takahashi, Naohiko; Saikawa, Tetsunori


    While J-waves were observed in healthy populations, variations in their reported incidence may be partly explicable by the ECG filter setting. We obtained resting 12-lead ECG recordings in 665 consecutive patients and enrolled 112 (56 men, 56 women, mean age 59.3±16.1years) who manifested J-waves on ECGs acquired with a 150-Hz low-pass filter. We then studied the J-waves on individual ECGs to look for morphological changes when 25-, 35-, 75-, 100-, and 150Hz filters were used. The notching observed with the 150-Hz filter changed to slurring (42%) or was eliminated (28%) with the 25-Hz filter. Similarly, the slurring seen with the 150-Hz filter was eliminated on 71% of ECGs recorded with the 25-Hz filter. The amplitude of J-waves was significantly lower with 25- and 35-Hz than 75-, 100-, and 150-Hz filters (pfilter setting significantly affects the J-wave morphology. © 2013.

  7. PIC microcontroller-based RF wireless ECG monitoring system. (United States)

    Oweis, R J; Barhoum, A


    This paper presents a radio-telemetry system that provides the possibility of ECG signal transmission from a patient detection circuit via an RF data link. A PC then receives the signal through the National Instrument data acquisition card (NIDAQ). The PC is equipped with software allowing the received ECG signals to be saved, analysed, and sent by email to another part of the world. The proposed telemetry system consists of a patient unit and a PC unit. The amplified and filtered ECG signal is sampled 360 times per second, and the A/D conversion is performed by a PIC16f877 microcontroller. The major contribution of the final proposed system is that it detects, processes and sends patients ECG data over a wireless RF link to a maximum distance of 200 m. Transmitted ECG data with different numbers of samples were received, decoded by means of another PIC microcontroller, and displayed using MATLAB program. The designed software is presented in a graphical user interface utility.

  8. Shannon's Energy Based Algorithm in ECG Signal Processing. (United States)

    Beyramienanlou, Hamed; Lotfivand, Nasser


    Physikalisch-Technische Bundesanstalt (PTB) database is electrocardiograms (ECGs) set from healthy volunteers and patients with different heart diseases. PTB is provided for research and teaching purposes by National Metrology Institute of Germany. The analysis method of complex QRS in ECG signals for diagnosis of heart disease is extremely important. In this article, a method on Shannon energy (SE) in order to detect QRS complex in 12 leads of ECG signal is provided. At first, this algorithm computes the Shannon energy (SE) and then makes an envelope of Shannon energy (SE) by using the defined threshold. Then, the signal peaks are determined. The efficiency of the algorithm is tested on 70 cases. Of all 12 standard leads, ECG signals include 840 leads of the PTB Diagnostic ECG Database (PTBDB). The algorithm shows that the Shannon energy (SE) sensitivity is equal to 99.924%, the detection error rate (DER) is equal to 0.155%, Positive Predictivity (+P) is equal to 99.922%, and Classification Accuracy (Acc) is equal to 99.846%.

  9. A new technique of ECG analysis and its application to evaluation of disorders during ventricular tachycardia

    Energy Technology Data Exchange (ETDEWEB)

    Moskalenko, A.V. [Institute of Theoretical and Experimental Biophysics RAS, Institutskaya Street, 3, Pushchino 142290 (Russian Federation)], E-mail:; Rusakov, A.V. [Institute of Theoretical and Experimental Biophysics RAS, Institutskaya Street, 3, Pushchino 142290 (Russian Federation); Elkin, Yu.E. [Institute of Mathematical Problems of Biology RAS, Institutskaya Street, 4, Pushchino 142290 (Russian Federation)


    We propose a new technique of ECG analysis to characterize the properties of polymorphic ventricular arrhythmias, potentially life-threatening disorders of cardiac activation. The technique is based on extracting two indices from the ECG fragment. The result is a new detailed quantitative description of polymorphic ECGs. Our observations suggest that the proposed ECG processing algorithm provides information that supplements the traditional visual ECG analysis. The estimates of ECG variation in this study reveal some unexpected details of ventricular activation dynamics, which are possibly useful for diagnosing cardiac rhythm disturbances.

  10. The ECG measurement in the bathtub using the insulated electrodes. (United States)

    Lim, Yong Kyu; Kim, Ko Keun; Park, Kwang Suk


    The ECG recording in the bathtub was studied using insulated electrode. Prior studies of the ECG recording in the bathtub used conductive electrodes having some problems such as the possibility of the electric shock and sensitivity to contamination of the electrode surfaces. The insulated electrodes were made of copper plate coated with PET film. The electrodes were attached on bathtub at both sides of the chest. High-input-impedance amplifier was designed to amplify ECG signal sensed by insulated electrodes of high impedance. The recorded signals in this study were noisier than those recorded with conventional conductive electrodes. But the R peaks in the recorded signals were large enough to be auto-detected. Further study will improve SNR by reducing of power line noise and common-mode noise.


    Directory of Open Access Journals (Sweden)

    Azhar A N


    Full Text Available The heart is one of vital organs in human body. Incidence of heart disease can be fatal for the patient. Myocardial ischemia, the disease that is often suffered by the human, is a disease due to clogged heart arteries blood vessels. One of the ways to detect this disease is by reading the graph output of electrocardiogram (ECG signal. ECG signal represents the condition and activity of the heart. Specialized knowledge, accuration and expertise are required to read ECG graph. To help expert or doctor, expert system based on artificial intelligent, such as Fuzzy Logic approach, can be applied to improve diagnostic accuracy and thoroughness. Fuzzy logic can be applied because of it flexibility to understand the linguistic variables used in identifying myocardial ischemia disease.

  12. ECG compression: evaluation of FFT, DCT, and WT performance. (United States)

    GholamHosseini, H; Nazeran, H; Moran, B


    This work investigates a set of ECG data compression schemes to compare their performances in compressing and preparing ECG signals for automatic cardiac arrhythmia classification. These schemes are based on transform methods such as fast Fourier transform (FFT), discrete cosine transform (DCT), wavelet transform (WT), and their combinations. Each specific transform is applied to a pre-selected data segment from the MIT-BIH database and then compression is performed in the new domain. These transformation methods are known as an important class of ECG compression techniques. The WT has been shown as the most efficient method for further improvement. A compression ratio of 7.98 to 1 has been achieved with a percent of root mean square difference (PRD) of 0.25%, indicating that the wavelet compression technique offers the best performance over the other evaluated methods.

  13. On ECG reconstruction using weighted-compressive sensing. (United States)

    Zonoobi, Dornoosh; Kassim, Ashraf A


    The potential of the new weighted-compressive sensing approach for efficient reconstruction of electrocardiograph (ECG) signals is investigated. This is motivated by the observation that ECG signals are hugely sparse in the frequency domain and the sparsity changes slowly over time. The underlying idea of this approach is to extract an estimated probability model for the signal of interest, and then use this model to guide the reconstruction process. The authors show that the weighted-compressive sensing approach is able to achieve reconstruction performance comparable with the current state-of-the-art discrete wavelet transform-based method, but with substantially less computational cost to enable it to be considered for use in the next generation of miniaturised wearable ECG monitoring devices.

  14. Convolutional Neural Networks for patient-specific ECG classification. (United States)

    Kiranyaz, Serkan; Ince, Turker; Hamila, Ridha; Gabbouj, Moncef


    We propose a fast and accurate patient-specific electrocardiogram (ECG) classification and monitoring system using an adaptive implementation of 1D Convolutional Neural Networks (CNNs) that can fuse feature extraction and classification into a unified learner. In this way, a dedicated CNN will be trained for each patient by using relatively small common and patient-specific training data and thus it can also be used to classify long ECG records such as Holter registers in a fast and accurate manner. Alternatively, such a solution can conveniently be used for real-time ECG monitoring and early alert system on a light-weight wearable device. The experimental results demonstrate that the proposed system achieves a superior classification performance for the detection of ventricular ectopic beats (VEB) and supraventricular ectopic beats (SVEB).

  15. ECG Holter monitor with alert system and mobile application (United States)

    Teron, Abigail C.; Rivera, Pedro A.; Goenaga, Miguel A.


    This paper proposes a new approach on the Holter monitor by creating a portable Electrocardiogram (ECG) Holter monitor that will alert the user by detecting abnormal heart beats using a digital signal processing software. The alarm will be triggered when the patient experiences arrhythmias such as bradycardia and tachycardia. The equipment is simple, comfortable and small in size that fit in the hand. It can be used at any time and any moment by placing three leads to the person's chest which is connected to an electronic circuit. The ECG data will be transmitted via Bluetooth to the memory of a selected mobile phone using an application that will store the collected data for up to 24 hrs. The arrhythmia is identified by comparing the reference signals with the user's signal. The diagnostic results demonstrate that the ECG Holter monitor alerts the user when an arrhythmia is detected thru the Holter monitor and mobile application.

  16. Lyapunov exponents for synchronous 12-lead ECG signals

    Institute of Scientific and Technical Information of China (English)


    The Lyapunov exponents of synchronous 12-lead ECG signals have been investigated for the first time using a multi-sensor (electrode) technique. The results show that the Lyapunov exponents computed from different locations on the body surface are not the same, but have a distribution characteristic for the ECG signals recorded from coronary artery disease (CAD) patients with sinus rhythms and for signals from healthy older people. The maximum Lyapunov exponent L1 of all signals is positive. While all the others are negative, so the ECG signal has chaotic characteristics. With the same leads, L1 of CAD patients is less than that of healthy people, so the CAD patients and healthy people can be classified by L1, L1 therefore has potential values in the diagnosis of heart disease.

  17. ECG-Based Measurements of Drug-induced Repolarization Changes

    DEFF Research Database (Denmark)

    Bhuiyan, Tanveer Ahmed

    The purpose of this thesis is to investigate the abnormal repolarization both in the cellular and the surface ECG along with their relationship. It has been identified that the certain morphological changes of the monophasic action potential are predictor of TdP arrhythmia. Therefore the proporti......The purpose of this thesis is to investigate the abnormal repolarization both in the cellular and the surface ECG along with their relationship. It has been identified that the certain morphological changes of the monophasic action potential are predictor of TdP arrhythmia. Therefore...... the proportional changes of the surface ECG which corresponds to the arrhythmia-triggering MAP morphology is warranted to increase the confidence of determining cardiotoxicity of drugs....

  18. Chaos control applied to cardiac rhythms represented by ECG signals (United States)

    Borem Ferreira, Bianca; Amorim Savi, Marcelo; Souza de Paula, Aline


    The control of irregular or chaotic heartbeats is a key issue in cardiology. In this regard, chaos control techniques represent a good alternative since they suggest treatments different from those traditionally used. This paper deals with the application of the extended time-delayed feedback control method to stabilize pathological chaotic heart rhythms. Electrocardiogram (ECG) signals are employed to represent the cardiovascular behavior. A mathematical model is employed to generate ECG signals using three modified Van der Pol oscillators connected with time delay couplings. This model provides results that qualitatively capture the general behavior of the heart. Controlled ECG signals show the ability of the strategy either to control or to suppress the chaotic heart dynamics generating less-critical behaviors.

  19. A novel approach for the diagnosis of ventricular tachycardia based on phase space reconstruction of ECG

    CERN Document Server

    Koulaouzidis, George; Cappiello, Grazia; Mazomenos, Evangelos B; Maharatna, Koushik; Morgan, John


    Ventricular arrhythmias comprise a group of disorders which manifest clinically in a variety of ways from ventricular premature beats (VPB) and no sustained ventricular tachycardia (in healthy subjects) to sudden cardiac death due to ventricular tachyarrhythmia in patients with and/or without structural heart disease. Ventricular fibrillation (VF) and ventricular tachycardia (VT) are the most common electrical mechanisms for cardiac arrest. Accurate and automatic recognition of these arrhythmias from electrocardiography (ECG) is a crucial task for medical professionals. The purpose of this research is to develop a new index for the differential diagnosis of normal sinus rhythm (SR) and ventricular arrhythmias, based on phase space reconstruction (PSR).

  20. Adaptive filtering for ECG rejection from surface EMG recordings. (United States)

    Marque, C; Bisch, C; Dantas, R; Elayoubi, S; Brosse, V; Pérot, C


    Surface electromyograms (EMG) of back muscles are often corrupted by electrocardiogram (ECG) signals. This noise in the EMG signals does not allow to appreciate correctly the spectral content of the EMG signals and to follow its evolution during, for example, a fatigue process. Several methods have been proposed to reject the ECG noise from EMG recordings, but seldom taking into account the eventual changes in ECG characteristics during the experiment. In this paper we propose an adaptive filtering algorithm specifically developed for the rejection of the electrocardiogram corrupting surface electromyograms (SEMG). The first step of the study was to choose the ECG electrode position in order to record the ECG with a shape similar to that found in the noised SEMGs. Then, the efficiency of different algorithms were tested on 28 erector spinae SEMG recordings. The best algorithm belongs to the fast recursive least square family (FRLS). More precisely, the best results were obtained with the simplified formulation of a FRLS algorithm. As an application of the adaptive filtering, the paper compares the evolutions of spectral parameters of noised or denoised (after adaptive filtering) surface EMGs recorded on erector spinae muscles during a trunk extension. The fatigue test was analyzed on 16 EMG recordings. After adaptive filtering, mean initial values of energy and of mean power frequency (MPF) were significantly lower and higher respectively. The differences corresponded to the removal of the ECG components. Furthermore, classical fatigue criteria (increase in energy and decrease in MPF values over time during the fatigue test) were better observed on the denoised EMGs. The mean values of the slopes of the energy-time and MPF-time linear relationships differed significantly when established before and after adaptive filtering. These results account for the efficacy of the adaptive filtering method proposed here to denoise electrophysiological signals.

  1. The role of the ECG in diagnosis, risk estimation, and catheterization laboratory activation in patients with acute coronary syndromes: a consensus document. (United States)

    Birnbaum, Yochai; Nikus, Kjell; Kligfield, Paul; Fiol, Miguel; Barrabés, Jose Antonio; Sionis, Alessandro; Pahlm, Olle; Niebla, J Garcia; de Luna, Antonio Bayès


    The electrocardiogram (ECG) is the most widely used imaging tool helping in diagnosis and initial management of patients presenting with symptoms compatible with acute coronary syndrome. Acute ischemia affects the configuration of the QRS complexes, the ST segments and the T waves. The ECG should be read along with the clinical assessment of the patient. ST segment elevation (and ST depression in leads V1 -V3 ) in patients with active symptoms usually indicates acute occlusion of an epicardial artery with ongoing transmural ischemia. These patients should be triaged for emergent reperfusion therapy per current guidelines. However, many patients have ST segment elevation secondary to nonischemic causes. ST depression in leads other than V1 -V3 usually are indicative of subendocardial ischemia secondary to subocclusion of the epicardial artery, distal embolization to small arteries or spasm supply/demand mismatch. ST depression may also be secondary to nonischemic etiologies, such as left ventricular hypertrophy, cardiomyopathies, etc. Knowing the clinical scenario, comparison to previous ECG and subsequent ECGs (in cases that there are changes in the quality or severity of symptoms) may add in the diagnosis and interpretation in difficult cases. This review addresses the different ECG patterns, typically seen in patients with active symptoms, after resolution of symptoms and the significance of such changes when seen in asymptomatic patients.

  2. Hemodynamic, ventilator, and ECG changes in pediatric patients undergoing extraction

    Directory of Open Access Journals (Sweden)

    Y K Sanadhya


    Full Text Available Background: Dental treatment induces pain anxiety and fear. This study was conducted to assess the changes in hemodynamic, ventilator, and electrocardiograph changes during extraction procedure among 12-15-year-old children and compare these changes with anxiety, fear, and pain. Materials and Methods: A purposive sample of 60 patients selected based on inclusion and exclusion criteria underwent study procedure in the dental OPD of a medical college and hospital. The anxiety, fear, and pain were recorded by dental anxiety scale, dental fear scale, and visual analogue scale, respectively, before the start of the procedure. The systolic blood pressure, diastolic blood pressure, heart rate, oxygen saturation, and electrocardiogram changes were monitored during the extraction procedure. The recording was taken four times (preinjection phase, injection, extraction, and postextraction and was analyzed. Results: At the preinjection phase the mean vales were systolic blood pressure (128 ± 11.2, diastolic blood pressure (85.7 ± 6.3, heart rate (79.7 ± 9.3, and oxygen saturation (97.9 ± 5.8. These values increased in injection phases and decreased in extraction phase and the least values were found after 10 min of procedure and this relation was significant for all parameters except oxygen saturation (P = 0.48, NS. ECG abnormalities were seen among 22 patients and were significant before and after injection of Local anesthetic (P = 0.0001, S. Conclusions: Anxiety, fear, and pain have an effect on hemodynamic, ventilator, and cardiovascular parameters during the extraction procedure and hence behavioral management has to be emphasized among children in dental clinics.

  3. Fault Tolerant Neural Network for ECG Signal Classification Systems

    Directory of Open Access Journals (Sweden)

    MERAH, M.


    Full Text Available The aim of this paper is to apply a new robust hardware Artificial Neural Network (ANN for ECG classification systems. This ANN includes a penalization criterion which makes the performances in terms of robustness. Specifically, in this method, the ANN weights are normalized using the auto-prune method. Simulations performed on the MIT ? BIH ECG signals, have shown that significant robustness improvements are obtained regarding potential hardware artificial neuron failures. Moreover, we show that the proposed design achieves better generalization performances, compared to the standard back-propagation algorithm.

  4. Amplifier input impedance in dry electrode ECG recording. (United States)

    Assambo, Cedric; Burke, Martin J


    This paper presents a novel approach for designing the front-end of instrumentation amplifiers for use in dry electrode recording of the human electrocardiogram (ECG). The method relies on information provided by the characterization of the skin-electrode interface and the analysis of low frequency ECG criteria defined by international standards. Marginal measurements of capacitive elements of the skin-electrode interface as small as 0.01 microF, suggest values of input impedance in the order of 1.3 GOmega. However, results in 99% of the data analyzed indicate that a recording amplifier providing an input impedance of 500 MOmega should ensure clear signal sensing without distortion.

  5. Left bundle branch block: a rare ECG manifestation of hyperkalemia

    Directory of Open Access Journals (Sweden)

    Venkata Madhav M


    Full Text Available A 20-year-old female patient with chronic kidney disease was brought to our emergency medical department with symptoms of pain in chest and abdomen, vomitings. Laboratory testing revealed serum potassium 7.7 mEq/L, serum creatinine 9.1 mg/dL. Electrocardiogram (ECG showed left bundle branch block (LBBB pattern with left axis deviation, tall T waves and ST elevation. Among ECG alterations in hyperkalemia, LBBB is rare and is being reported in our case.

  6. Ischemic ECG abnormalities are associated with an increased risk for death among subjects with COPD, also among those without known heart disease

    Directory of Open Access Journals (Sweden)

    Nilsson U


    Full Text Available Ulf Nilsson,1 Anders Blomberg,1 Bengt Johansson,1 Helena Backman,2 Berne Eriksson,3 Anne Lindberg1 1Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden; 2Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, the OLIN Unit, Umeå University, Umeå, 3Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Abstract presentation: An abstract, including parts of the results, has been presented at an oral session at the European Respiratory Society International Conference, London, UK, September 2016.Background: Cardiovascular comorbidity contributes to increased mortality among subjects with COPD. However, the prognostic value of ECG abnormalities in COPD has rarely been studied in population-based surveys.Aim: To assess the impact of ischemic ECG abnormalities (I-ECG on mortality among individuals with COPD, compared to subjects with normal lung function (NLF, in a population-based study.Methods: During 2002–2004, all subjects with FEV1/VC <0.70 (COPD, n=993 were identified from population-based cohorts, together with age- and sex-matched referents without COPD. Re-examination in 2005 included interview, spirometry, and 12-lead ECG in COPD (n=635 and referents [n=991, whereof 786 had NLF]. All ECGs were Minnesota-coded. Mortality data were collected until December 31, 2010.Results: I-ECG was equally common in COPD and NLF. The 5-year cumulative mortality was higher among subjects with I-ECG in both groups (29.6% vs 10.6%, P<0.001 and 17.1% vs 6.6%, P<0.001. COPD, but not NLF, with I-ECG had increased risk for death assessed as the mortality risk ratio [95% confidence interval (CI] when compared with NLF without I-ECG, 2.36 (1.45–3.85 and 1.65 (0.94–2.90 when adjusted for common confounders. When analyzed separately among the COPD cohort, the increased risk for death associated with I-ECG

  7. A Novel Automatic Detection System for ECG Arrhythmias Using Maximum Margin Clustering with Immune Evolutionary Algorithm

    Directory of Open Access Journals (Sweden)

    Bohui Zhu


    Full Text Available This paper presents a novel maximum margin clustering method with immune evolution (IEMMC for automatic diagnosis of electrocardiogram (ECG arrhythmias. This diagnostic system consists of signal processing, feature extraction, and the IEMMC algorithm for clustering of ECG arrhythmias. First, raw ECG signal is processed by an adaptive ECG filter based on wavelet transforms, and waveform of the ECG signal is detected; then, features are extracted from ECG signal to cluster different types of arrhythmias by the IEMMC algorithm. Three types of performance evaluation indicators are used to assess the effect of the IEMMC method for ECG arrhythmias, such as sensitivity, specificity, and accuracy. Compared with K-means and iterSVR algorithms, the IEMMC algorithm reflects better performance not only in clustering result but also in terms of global search ability and convergence ability, which proves its effectiveness for the detection of ECG arrhythmias.

  8. Antiequine chorionic gonadotropin (eCG) antibodies generated in goats treated with eCG for the induction of ovulation modulate the luteinizing hormone and follicle-stimulating hormone bioactivities of eCG differently. (United States)

    Hervé, Virginie; Roy, François; Bertin, Jean; Guillou, Florian; Maurel, Marie-Christine


    In dairy goats, treatments associating a progestogen and the equine chorionic gonadotropin (eCG) are the easiest way to induce and synchronize estrus and ovulation and to permit artificial insemination (AI) and/or out of season breeding. From the first treatment, the injection of eCG induces, in some females, the production of anti-eCG antibodies (Abs) that will interfere with the effectiveness of subsequent treatments. These anti-eCG Abs delay the preovulatory LH surge and the ovulation time, leading to poor fertility of the treated females. In this study, by in vitro bioassays, we show that anti-eCG Abs can positively or negatively modulate the LH and/or FSH bioactivities of eCG. Moreover, the modulation level of eCG bioactivity does not depend on the anti-eCG Ab affinity for eCG, as shown by surface plasmon resonance technology. The specificity of anti-eCG Abs tested by competitive ELISA highlighted the importance of a glycan environment in the recognition mechanism, especially the sialic acids specific to eCG. The different effects of anti-eCG Abs on eCG bioactivities could be explained by two hypotheses. First, steric hindrance preventing the interaction of eCG with its receptors would explain the inhibitory effect of some anti-eCG Abs; second, a conformational change in eCG by anti-eCG Abs could induce inhibition or potentiation of eCG bioactivities. It is significant that these modulations of eCG bioactivities by anti-eCG Abs impact mainly on the FSH bioactivity of eCG, which is essential for ovarian stimulation and subsequent fertility after treatment and AI, and to a lesser extent on LH bioactivity.

  9. [Development of software of the 24-hour dynamic ECG monitoring and analyzing system]. (United States)

    An, Y; Fang, K R; Ren, C S


    This paper describes a PC-computer program of a digital remote ECG monitoring system. In addition to current monitor's capabilities of real time displaying of dynamic ECG wave, over-limit alarming, and so on, it has developed most functions of the Holter system, that are recording the data of ECG more than 24 hours, reviewing and analyzing the ECG data, and giving out reports.

  10. ECG baseline wander reduction using linear phase filters

    NARCIS (Netherlands)

    Alsté, van J.A.; Eck, van W.; Hermann, O.E.


    The continuous real time reduction of baseline wander is a considerable problem in electrocardiography during exercises. Our solution consists of spectral filtering. The legitimacy of high-pass filtering of the ECG by means of digital linear phase filters with a low cut-off frequency as high as the

  11. Using Intracardiac Vectorcardiographic Loop for Surface ECG Synthesis

    Directory of Open Access Journals (Sweden)

    G. Carrault


    Full Text Available Current cardiac implantable devices offer improved processing power and recording capabilities. Some of these devices already provide basic telemonitoring features that may help to reduce health care expenditure. A challenge is posed in particular for the telemonitoring of the patient's cardiac electrical activity. Indeed, only intracardiac electrograms (EGMs are acquired by the implanted device and these signals are difficult to analyze directly by clinicians. In this paper, we propose a patient-specific method to synthesize the surface electrocardiogram (ECG from a set of EGM signals, based on a 3D representation of the cardiac electrical activity and principal component analysis (PCA. The results, in the case of sinus rhythm, show a correlation coefficient between the real ECG and the synthesized ECG of about 0.85. Moreover, the application of the proposed method to the patients who present an abnormal heart rhythm exhibits promising results, especially for characterizing the bundle branch blocs. Finally, in order to evaluate the behavior of our procedure in some practical situations, the quality of the ECG reconstruction is studied as a function of the number of EGM electrodes provided by the CIDs.

  12. Disease Classification and Biomarker Discovery Using ECG Data

    Directory of Open Access Journals (Sweden)

    Rong Huang


    Full Text Available In the recent decade, disease classification and biomarker discovery have become increasingly important in modern biological and medical research. ECGs are comparatively low-cost and noninvasive in screening and diagnosing heart diseases. With the development of personal ECG monitors, large amounts of ECGs are recorded and stored; therefore, fast and efficient algorithms are called for to analyze the data and make diagnosis. In this paper, an efficient and easy-to-interpret procedure of cardiac disease classification is developed through novel feature extraction methods and comparison of classifiers. Motivated by the observation that the distributions of various measures on ECGs of the diseased group are often skewed, heavy-tailed, or multimodal, we characterize the distributions by sample quantiles which outperform sample means. Three classifiers are compared in application both to all features and to dimension-reduced features by PCA: stepwise discriminant analysis (SDA, SVM, and LASSO logistic regression. It is found that SDA applied to dimension-reduced features by PCA is the most stable and effective procedure, with sensitivity, specificity, and accuracy being 89.68%, 84.62%, and 88.52%, respectively.

  13. Portable ECG design and application based on wireless sensor network

    Directory of Open Access Journals (Sweden)

    Gül Fatma TÜRKER


    Full Text Available In this study, in order to follow the heart signals of patients that needs to be monitored instantly and continuously without mobility restrictions, a portable electrocardiogram circuit is designed. After performing the detection, upgrading, cleaning and digitizing of ECG signal received from patient via disposable electrodes, ECG signals was performed that transmit to a central node with Wireless Sensor Network (WSN based on ZigBee 802.11.4 standard. Central node is connected to the serial port of a computer. Received data from the central node is processed on computer and continuous flow graph is obtained. The obligation to use wires for tracing patients’ ECG has been removed with this portable system. As it can be seen in this study, thanks to WSN’s property of forming network by itself and its augmentable loop property, the restrain of ECG signals to reach far away distances can be surmounted. The transmission of biological signals with WSN will light on many studies that follow of patients from a distance.

  14. ECG classification and abnormality detection using cascade forward ...

    African Journals Online (AJOL)


    This paper describes the use of MATLAB based artificial neural network tools for ... as well as tools to analyse the results, makes it a good option to solve this complex problem .... ECG & AMT Teacher's Source Book,2006, Government of Kerala, Department of ... and uses the artificial intelligence techniques in her research.

  15. Continuous control systems for non-contact ECG (United States)

    Kodkin, Vladimir L.; Yakovleva, Galina V.; Smirnov, Alexey S.


    South Ural State University is still conducting the research work dedicated to innovations in biomedicine. Development of system for continuous control and diagnosis of the functional state in large groups of people is based on studies of non-contact ECG recording reported by the authors at the SPIE conference in 2016. The next stage of studies has been performed this year.

  16. [Fetal ECG monitoring system based on MCU processing]. (United States)

    Hu, Gang; Chen, Wei; Xie, Xicheng; Zhang, Hao


    In order to monitor the fetus in labor, the signal characteristic from fetal scalp electrode is researched, An adaptation algorithm and a peak to peak detecting technology are adopted in signal processing, and an adaptation gain control method is used to eliminate disturber from base-line shift. A fetal ECG monitoring system is designed on the basis of C8051F020 MCU.

  17. Holter ECG monitoring of sympathovagal fluctuation during bronchoscopy. (United States)

    Ali, Abdellah Hamed Khalil; Toba, Hiroaki; Sakiyama, Shoji; Yamamoto, Ryo; Takizawa, Hiromitsu; Kenzaki, Koichiro; Kondo, Kazuya; Tangoku, Akira


    The changes of autonomic nervous activity during bronchoscopic procedures are closely related to the development of cardiovascular complications. We aimed to evaluate the changes of autonomic nervous activity during bronchoscopic procedures using R-R interval variability from electrocardiograms (ECGs) obtained during diagnostic bronchoscopy. Twenty-four patients who underwent bronchoscopy were included. Continuous ECG was recorded prior to, during and after the bronchoscopic procedure. Time and frequency domain analyses of heart rate variability were performed. Heart rate increased significantly after pre-medication compared with that before pre-medication and increased further during bronchoscopy. The coefficient of variation (CVRR ) values after pre-medication and during bronchoscopy were significantly higher than those before pre-medication (P = 0.031 and P = 0.041, respectively). The low frequency (LF) power decreased during bronchoscopy. LF powers obtained after bronchoscopy were significantly lower than those obtained before bronchoscopy (P Holter ECG monitoring during diagnostic bronchoscopy was associated with activation of cardiac sympathetic and withdrawal of cardiac parasympathetic regulation, which may contribute to the occurrence of cardiac events during bronchoscopic procedures. So, Holter ECG monitoring during bronchoscopic procedures may confer reduction in cardiovascular events. © 2014 John Wiley & Sons Ltd.

  18. ECG-based heartbeat classification for arrhythmia detection: A survey. (United States)

    Luz, Eduardo José da S; Schwartz, William Robson; Cámara-Chávez, Guillermo; Menotti, David


    An electrocardiogram (ECG) measures the electric activity of the heart and has been widely used for detecting heart diseases due to its simplicity and non-invasive nature. By analyzing the electrical signal of each heartbeat, i.e., the combination of action impulse waveforms produced by different specialized cardiac tissues found in the heart, it is possible to detect some of its abnormalities. In the last decades, several works were developed to produce automatic ECG-based heartbeat classification methods. In this work, we survey the current state-of-the-art methods of ECG-based automated abnormalities heartbeat classification by presenting the ECG signal preprocessing, the heartbeat segmentation techniques, the feature description methods and the learning algorithms used. In addition, we describe some of the databases used for evaluation of methods indicated by a well-known standard developed by the Association for the Advancement of Medical Instrumentation (AAMI) and described in ANSI/AAMI EC57:1998/(R)2008 (ANSI/AAMI, 2008). Finally, we discuss limitations and drawbacks of the methods in the literature presenting concluding remarks and future challenges, and also we propose an evaluation process workflow to guide authors in future works.

  19. Are ECG abnormalities in Noonan syndrome characteristic for the syndrome?

    NARCIS (Netherlands)

    Raaijmakers, R.; Noordam, C.; Noonan, J.A.; Croonen, E.A.; Burgt, C.J. van der; Draaisma, J.M.T.


    Of all patients with Noonan syndrome, 50-90% have one or more congenital heart defects. The most frequent occurring are pulmonary stenosis (PS) and hypertrophic cardiomyopathy. The electrocardiogram (ECG) of a patient with Noonan syndrome often shows a characteristic pattern, with a left axis deviat

  20. ECG Monitoring in Cardiac Rehabilitation: Is It Needed? (United States)

    Greenland, Philip; Pomilla, Paul V.


    Discusses the controversial use of continuous electrocardiogram (ECG) monitoring as a safety measure in cardiac rehabilitation exercise programs. Little evidence substantiates its value for all patients during exercise. In the absence of empirical evidence documenting the worth of this expensive procedure, it is recommended for use with high-risk…

  1. Confidential Data Hiding Using Wavlet Based Ecg Stegnography

    Directory of Open Access Journals (Sweden)

    Malashree K S


    Full Text Available With the growing number of aging population and a significant portion of that suffering from cardiac diseases, it is conceivable that remote ECG patient monitoring systems are expected to be widely used as Point-of-Care (PoC applications in hospitals around the world. Therefore, huge amount of ECG signal collected by Body Sensor Networks (BSNs from remote patients at homes will be transmitted along with other physiological readings such as blood pressure, temperature, glucose level etc. and diagnosed by those remote patient monitoring systems. It is utterly important that patient confidentiality is protected while data is being transmitted over the public network as well as when they are stored in hospital servers used by remote monitoring systems. In this project, a wavelet based steganography technique has been introduced which combines encryption and scrambling technique to protect patient confidential data. The proposed method allows ECG signal to hide its corresponding patient confidential data and other physiological information thus guaranteeing the integration between ECG and the rest.

  2. Late postoperative episodic and constant hypoxaemia and associated ECG abnormalities

    DEFF Research Database (Denmark)

    Rosenberg, J; Rasmussen, Verner; von Jessen, F


    heart rate increased 16 beat min-1 (P less than 0.001) and mean oxygen saturation (SaO2) decreased 2.6% (P less than 0.001) after operation. Episodic oxygen desaturation to less than 80% occurred in four patients before operation, but in 13 patients after operation (P less than 0.05). ECG abnormalities...

  3. ECG-cryptography and authentication in body area networks. (United States)

    Zhang, Zhaoyang; Wang, Honggang; Vasilakos, Athanasios V; Fang, Hua


    Wireless body area networks (BANs) have drawn much attention from research community and industry in recent years. Multimedia healthcare services provided by BANs can be available to anyone, anywhere, and anytime seamlessly. A critical issue in BANs is how to preserve the integrity and privacy of a person's medical data over wireless environments in a resource efficient manner. This paper presents a novel key agreement scheme that allows neighboring nodes in BANs to share a common key generated by electrocardiogram (ECG) signals. The improved Jules Sudan (IJS) algorithm is proposed to set up the key agreement for the message authentication. The proposed ECG-IJS key agreement can secure data communications over BANs in a plug-n-play manner without any key distribution overheads. Both the simulation and experimental results are presented, which demonstrate that the proposed ECG-IJS scheme can achieve better security performance in terms of serval performance metrics such as false acceptance rate (FAR) and false rejection rate (FRR) than other existing approaches. In addition, the power consumption analysis also shows that the proposed ECG-IJS scheme can achieve energy efficiency for BANs.

  4. Robust and accurate anomaly detection in ECG artifacts using time series motif discovery. (United States)

    Sivaraks, Haemwaan; Ratanamahatana, Chotirat Ann


    Electrocardiogram (ECG) anomaly detection is an important technique for detecting dissimilar heartbeats which helps identify abnormal ECGs before the diagnosis process. Currently available ECG anomaly detection methods, ranging from academic research to commercial ECG machines, still suffer from a high false alarm rate because these methods are not able to differentiate ECG artifacts from real ECG signal, especially, in ECG artifacts that are similar to ECG signals in terms of shape and/or frequency. The problem leads to high vigilance for physicians and misinterpretation risk for nonspecialists. Therefore, this work proposes a novel anomaly detection technique that is highly robust and accurate in the presence of ECG artifacts which can effectively reduce the false alarm rate. Expert knowledge from cardiologists and motif discovery technique is utilized in our design. In addition, every step of the algorithm conforms to the interpretation of cardiologists. Our method can be utilized to both single-lead ECGs and multilead ECGs. Our experiment results on real ECG datasets are interpreted and evaluated by cardiologists. Our proposed algorithm can mostly achieve 100% of accuracy on detection (AoD), sensitivity, specificity, and positive predictive value with 0% false alarm rate. The results demonstrate that our proposed method is highly accurate and robust to artifacts, compared with competitive anomaly detection methods.

  5. Accurate Interpretation of the 12-Lead ECG Electrode Placement: A Systematic Review (United States)

    Khunti, Kirti


    Background: Coronary heart disease (CHD) patients require monitoring through ECGs; the 12-lead electrocardiogram (ECG) is considered to be the non-invasive gold standard. Examples of incorrect treatment because of inaccurate or poor ECG monitoring techniques have been reported in the literature. The findings that only 50% of nurses and less than…

  6. Diagnostic quality of time-averaged ECG-gated CT data

    NARCIS (Netherlands)

    Klein, A.; Oostveen, L.J.; Greuter, M.J.W.; Hoogeveen, Y.; Schultze Kool, L.J.; Slump, C.H.; Renema, W.K.J.; Samei, Ehsan; Hsieh, Jiang


    Purpose: ECG-gated CTA allows visualization of the aneurysm and stentgraft during the different phases of the cardiac cycle, although with a lower SNR per cardiac phase than without ECG gating using the same dose. In our institution, abdominal aortic aneurysm (AAA) is evaluated using non-ECG-gated C

  7. ECG Identification System Using Neural Network with Global and Local Features (United States)

    Tseng, Kuo-Kun; Lee, Dachao; Chen, Charles


    This paper proposes a human identification system via extracted electrocardiogram (ECG) signals. Two hierarchical classification structures based on global shape feature and local statistical feature is used to extract ECG signals. Global shape feature represents the outline information of ECG signals and local statistical feature extracts the…

  8. Value of Automated ECG Interpretation in Diagnosis of Cardiac Disorders

    Directory of Open Access Journals (Sweden)

    Afsaneh Mohammadi


    Full Text Available Background: Electrocardiography (ECG is a valuable device in the assessment of cardiovascular diseases. Recent medical software developments such as the invention of modern automated ECG interpreters have greatly facilitated the work of electrocardiographers and cardiologists. We present our experience in the use of one such device in the routine reporting of 200 successive ECGs recorded in our Cardiac Care Unit and Cardiac Emergency Ward. Methods: The interpretations of 200 ECGs provided by the GE-digital ECG device were chosen and compared with those supplied by four cardiologists in a single blind manner. All statistical analyses were performed by using SPSS version 11.5 for windows. A p value of less than 0.05 was considered statistically significant.Results: There was a diagnostic match between the interpretations by the device and those by the cardiologists in 107 (53.5% cases as opposed to a diagnostic mismatch in 93 cases (46.5%. The matching rate in the interpretations of myocardial ischemic disorders was high, which means practically all the ischemic cases diagnosed by the device were confirmed by the cardiologists. Only in 12 cases myocardial infarction or ischemic changes were reported by the cardiologists, while they were missed by the device. As regards rhythm disorders, the sensitivity and specificity of the device were 67.7% and 75.7%, respectively. With respect to conductive disorders, the respective sensitivity and specificity of the device were 70% and 96.6%, respectively. Finally, in the case of structural disorders, the interpretations of the device were 92.8% sensitive and 83.3% specific.Conclusion: According to the results of our study and similar researches, it seems that the interpretations of an automated ECG device in diagnosing the ischemic and structural disorders of the heart are reliable. The device, however, should not be relied upon when assessing conduction disorders and dysrhythmias. We, therefore, recommend

  9. Optimization of Ecg Gating in Quantitative Femoral Angiography

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, S.; Berglund, I.; Erikson, U. [Univ. Hospital, Uppsala (Sweden). Dept. of Oncology, Radiology and Clinical Immunology; Johansson, J.; Walldius, G. [Karolinska Hospital, Stockholm (Sweden). King Gustav V Research Inst.


    Purpose: To determine which phase of the heart cycle would yield the highest reproducibility in measuring atherosclerosis-related variables such as arterial lumen volume and edge roughness. Material and Methods: 35 patients with hypercholesterolemia underwent select ive femoral angiography, repeated four times at 10-min intervals. The angiographies were performed with Ecg-gated exposures. In angiographies 1 and 2 the delay from R-wave maximum to each exposure was 0.1 s, in angiographies 3 and 4 the delay was 0.1, 0.3, 0.5 or 0.7 s or the exposures were performed 1/s without Ecg gating. Arterial lumen volume and edge roughness were measured in a 20-cm segment of the superficial femoral artery using a computer-based densitometric method. Measurement reproducibility was determined by comparing angiographies 1-2 and angiographies 3-4. Results: When measuring arterial lumen volume and edge roughness of a 20-cm segment of the femoral artery, reproducibility was not dependent on Ecg gating. In measuring single arterial diameters and cross-sectional areas, the reproducibility was better when exposures were made 0.1 s after the R-wave maximum than when using other settings of the Ecg gating device or without Ecg gating. Conclusion: The influence of pulsatile flow upon quantitative measurement in femoral angiograms seems to be the smallest possible in early systole, as can be demonstrated when measuring single diameters and cross-sectional areas. In variables based on integration over longer segments, measurement reproducibility seems to be independent of phase.

  10. Imaging the pericardium: appearances on ECG-gated 64-detector row cardiac computed tomography (United States)

    O'Leary, S M; Williams, P L; Williams, M P; Edwards, A J; Roobottom, C A; Morgan-Hughes, G J; Manghat, N E


    Multidetector row computed tomography (MDCT) with its high spatial and temporal resolution has now become an established and complementary method for cardiac imaging. It can now be used reliably to exclude significant coronary artery disease and delineate complex coronary artery anomalies, and has become a valuable problem-solving tool. Our experience with MDCT imaging suggests that it is clinically useful for imaging the pericardium. It is important to be aware of the normal anatomy of the pericardium and not mistake normal variations for pathology. The pericardial recesses are visible in up to 44% of non-electrocardiogram (ECG)-gated MDCT images. Abnormalities of the pericardium can now be identified with increasing certainty on 64-detector row CT; they may be the key to diagnosis and therefore must not be overlooked. This educational review of the pericardium will cover different imaging techniques, with a significant emphasis on MDCT. We have a large research and clinical experience of ECG-gated cardiac CT and will demonstrate examples of pericardial recesses, their variations and a wide variety of pericardial abnormalities and systemic conditions affecting the pericardium. We give a brief relevant background of the conditions and reinforce the key imaging features. We aim to provide a pictorial demonstration of the wide variety of abnormalities of the pericardium and the pitfalls in the diagnosis of pericardial disease. PMID:20197434

  11. Reliability of an external loop recorder for automatic recognition and transtelephonic ECG transmission of atrial fibrillation. (United States)

    Müller, Axel; Scharner, Wilfried; Borchardt, Tilo; Och, Wolfgang; Korb, Harald


    In order to test a newly developed algorithm for detecting atrial fibrillation in clinical practice, we carried out parallel recordings using a conventional 24-h electrocardiogram (ECG) monitor and telemonitoring with an external loop recorder. Recordings were made in 24 patients with persistent atrial fibrillation and in another 24 patients with sinus rhythm. Atrial fibrillation was detected immediately in 23 of 24 patients with persistent atrial fibrillation and 20 min after fitting the single-channel loop recorder in the 24th patient (sensitivity 100%). On average, 3.1 false positives (i.e. detection of an episode, including the end or beginning of atrial fibrillation) were transmitted per patient. The sensitivity of the algorithms for automatically detecting bradycardiac and tachycardiac atrial fibrillation was also high. In 12 of 24 patients with sinus rhythm, false-positive tele-ECGs were transmitted. These were caused by supraventricular or ventricular extrasystoles and by sinus arrhythmias or sinoatrial (SA) blocks. The external loop recorder was very effective at detecting paroxysmal atrial fibrillation. Possible indications for the clinical use of this recorder include, in addition to diagnosis, monitoring patients for atrial fibrillation recurrence after cardioversion or catheter ablation.

  12. Noninvasive quantification of blood potassium concentration from ECG in hemodialysis patients (United States)

    Corsi, Cristiana; Cortesi, Marilisa; Callisesi, Giulia; De Bie, Johan; Napolitano, Carlo; Santoro, Antonio; Mortara, David; Severi, Stefano


    Blood potassium concentration ([K+]) influences the electrocardiogram (ECG), particularly T-wave morphology. We developed a new method to quantify [K+] from T-wave analysis and tested its clinical applicability on data from dialysis patients, in whom [K+] varies significantly during the therapy. To elucidate the mechanism linking [K+] and T-wave, we also analysed data from long QT syndrome type 2 (LQT2) patients, testing the hypothesis that our method would have underestimated [K+] in these patients. Moreover, a computational model was used to explore the physiological processes underlying our estimator at the cellular level. We analysed 12-lead ECGs from 45 haemodialysis and 12 LQT2 patients. T-wave amplitude and downslope were calculated from the first two eigenleads. The T-wave slope-to-amplitude ratio (TS/A) was used as starting point for an ECG-based [K+] estimate (KECG). Leave-one-out cross-validation was performed. Agreement between KECG and reference [K+] from blood samples was promising (error: −0.09 ± 0.59 mM, absolute error: 0.46 ± 0.39 mM). The analysis on LQT2 patients, also supported by the outcome of computational analysis, reinforces our interpretation that, at the cellular level, delayed-rectifier potassium current is a main contributor of KECG correlation to blood [K+]. Following a comprehensive validation, this method could be effectively applied to monitor patients at risk for hyper/hypokalemia. PMID:28198403

  13. An integrated bioimpedance—ECG gating technique for respiratory and cardiac motion compensation in cardiac PET (United States)

    Koivumäki, Tuomas; Nekolla, Stephan G.; Fürst, Sebastian; Loher, Simone; Vauhkonen, Marko; Schwaiger, Markus; Hakulinen, Mikko A.


    Respiratory motion may degrade image quality in cardiac PET imaging. Since cardiac PET studies often involve cardiac gating by ECG, a separate respiratory monitoring system is required increasing the logistic complexity of the examination, in case respiratory gating is also needed. Thus, we investigated the simultaneous acquisition of both respiratory and cardiac gating signals using II limb lead mimicking electrode configuration during cardiac PET scans of 11 patients. In addition to conventional static and ECG-gated images, bioimpedance technique was utilized to generate respiratory- and dual-gated images. The ability of the bioimpedance technique to monitor intrathoracic respiratory motion was assessed estimating cardiac displacement between end-inspiration and -expiration. The relevance of dual gating was evaluated in left ventricular volume and myocardial wall thickness measurements. An average 7.6  ±  3.3 mm respiratory motion was observed in the study population. Dual gating showed a small but significant increase (4 ml, p = 0.042) in left ventricular myocardial volume compared to plain cardiac gating. In addition, a thinner myocardial wall was observed in dual-gated images (9.3  ±  1.3 mm) compared to cardiac-gated images (11.3  ±  1.3 mm, p = 0.003). This study shows the feasibility of bioimpedance measurements for dual gating in a clinical setting. The method enables simultaneous acquisition of respiratory and cardiac gating signals using a single device with standard ECG electrodes.

  14. Noninvasive ECG as a tool for predicting termination of paroxysmal atrial fibrillation. (United States)

    Chiarugi, Franco; Varanini, Maurizio; Cantini, Federico; Conforti, Fabrizio; Vrouchos, Giorgos


    Atrial fibrillation (AF) is the most common cardiac arrhythmia and entails an increased risk of thromboembolic events. Prediction of the termination of an AF episode, based on noninvasive techniques, can benefit patients, doctors and health systems. The method described in this paper is based on two-lead surface electrocardiograms (ECGs): 1-min ECG recordings of AF episodes including N-type (not terminating within an hour after the end of the record), S-type (terminating 1 min after the end of the record) and T-type (terminating immediately after the end of the record). These records are organised into three learning sets (N, S and T) and two test sets (A and B). Starting from these ECGs, the atrial and ventricular activities were separated using beat classification and class averaged beat subtraction, followed by the evaluation of seven parameters representing atrial or ventricular activity. Stepwise discriminant analysis selected the set including dominant atrial frequency (DAF, index of atrial activity) and average HR (HRmean, index of ventricular activity) as optimal for discrimination between N/T-type episodes. The linear classifier, estimated on the 20 cases of the N and T learning sets, provided a performance of 90% on the 30 cases of a test set for the N/T-type discrimination. The same classifier led to correct classification in 89% of the 46 cases for N/S-type discrimination. The method has shown good results and seems to be suitable for clinical application, although a larger dataset would be very useful for improvement and validation of the algorithms and the development of an earlier predictor of paroxysmal AF spontaneous termination time.

  15. [Design of portable 12-lead digital ECG with low power consumption]. (United States)

    Sheng, Chuanguang; Yang, Cuiwei; Wu, Xiaomei; Wang, Yuanyuan; Qin, Yajie


    The design of portable and low power consumption 12-lead ECG is based on the digital signal processor TMS320C5515 and the analog front end ADS1298. The ADS1298 collects the ECG signals and deliver them to TMS320C5515. The preprocessed ECG signals are displayed real-time on a LCD and can be stored without compression for a long time. The ECG signals can also be sent to an up computer by a USB connector so that ECG data can be analyzed offline. The system has small volume, high precision and low power consumption.

  16. Brugada phenocopy in a patient with pectus excavatum: systematic review of the ECG manifestations associated with pectus excavatum. (United States)

    Awad, Sara F M; Barbosa-Barros, Raimundo; Belem, Lucia de Sousa; Cavalcante, Camila Pinto; Riera, Andrés Ricardo Pérez; Garcia-Niebla, Javier; Anselm, Daniel D; Baranchuk, Adrian


    Brugada phenocopies (BrP) have emerged as new clinical entities that are etiologically distinct from true Brugada syndrome (BrS). BrP are characterized by an ECG pattern that is phenotypically identical to true BrS (type 1 or type 2); however, BrP are caused by various other factors such as mechanical mediastinal compression, myocardial ischemia, pericarditis, myocarditis, pulmonary embolism, and metabolic disturbances. We report a case of an electrocardiographic BrP in a patient with pectus excavatum deformity in the absence of true BrS using currently defined BrP diagnostic criteria. A systematic review of ECG manifestations associated with pectus excavatum is also discussed.

  17. ECG-Derived Respiration and Instantaneous Frequency based on the Synchrosqueezing Transform: Application to Patients with Atrial Fibrillation

    CERN Document Server

    Yi-Hsin, Chan; Shu-Shya, Hseu; Chi-Tai, Kuo; Yung-Hsin, Yeh


    The acquisition of information about respiratory patterns without directly recording the respiratory signals would be beneficial in many clinical settings. The electrocardiogram (ECG)-derived respiration (EDR) algorithm, which derives the respiratory pattern by using the information encoded in ECG signals, enables data acquisition in this manner. However, the traditional EDR algorithm cannot be used in patients with atrial fibrillation (AF) because they have highly irregular heart rates. In this paper, we first provide a definition of ideal instantaneous frequency (IIF) of respiratory signals and then describe how a novel time-frequency representation technique referred to as the Synchrosqueezing transform (SST) was used for the accurate estimation of the IIF of respiratory signals, i.e., SST-IF. Then, we introduce a new EDR algorithm based on the evaluation of the SST-IF. We tested the applicability of our new EDR algorithm in patients with comorbid cardiovascular diseases, most of which were complicated by ...

  18. Mapping the ECG in the live rabbit heart using Ultrasound Current Source Density Imaging with coded excitation. (United States)

    Qin, Yexian; Li, Qian; Ingram, Pier; Witte, Russell S


    Ultrasound current source density imaging (UCSDI) is a noninvasive technique for mapping electric current fields in 4D (space + time) with the resolution of ultrasound imaging. This approach can potentially overcome limitations of conventional electrical mapping procedures often used during treatment of cardiac arrhythmia or epilepsy. However, at physiologic currents, the detected acoustoelectric (AE) interaction signal in tissue is very weak. In this work, we evaluated coded ultrasound excitation (chirps) for improving the sensitivity of UCSDI for mapping the electrocardiogram (ECG) in a live rabbit heart preparation. Results confirmed that chirps improved detection of the AE signal by as much as 6.1 dB compared to a square pulse. We further demonstrated mapping the ECG using a clinical intracardiac catheter, 1 MHz ultrasound transducer and coded excitation. B-mode pulse echo and UCSDI revealed regions of high current flow in the heart wall during the peak of the ECG. These improvements to UCSDI are important steps towards translation of this new technology to the clinic for rapidly mapping the cardiac activation wave.

  19. 动态与常规心电图诊断冠心病的对比分析%Comparative Analysis on Dynamic ECG and Routine ECG in Diagnosis of Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)



    目的:探讨动态与常规心电图诊断冠心病的对比分析。方法选取2013年11月到2014年11月我院接诊的43例冠心病患者,按照入院的先后顺序分为两组,实验组23例和对照组20例,实验组采用动态心电图法,对照组采用常规心电图组,观察两组患者的诊断结果。结果实验组患者的心肌缺血阳性检出率、心律失常检测结果明显高于对照组,差异显著,有统计学意义(P<0.05)。结论动态心电图诊断冠心病的检出率高,可以有效提高心肌缺血和心律失常的诊断率,更好地进行针对性的治疗,值得临床推广。%Objective Comparative analysis on dynamic ECG and routine ECG in diagnosis of coronary heart disease is to be comparatively studied. Methods Choose 43 patients of coronary heart disease who are received and treated in hospital from November 2013 to November 2014 and separate them into two groups according to their hospitalization sequence with 23 patients in study group and 20 patients in control group;patients in study group are given dynamic ECG diagnosis;while patients in control group are given routine ECG diagnosis,and then observe and compare diagnosis results between two groups. Results Patients’positive detection rate of myocardial ischemia as wel as their arrhythmia detection rate in study group are much higher than counterparts in control group; there is a treatment differential between two groups,and such a differential has statistic value(P<0.05).Conclusion Dynamic ECG is of efficacy in diagnosis of coronary heart disease;it is conducive to increasing patients’positive detection rate of myocardial ischemia as wel as their arrhythmia detection rate,which is significant to cure patients with targeted treatment;thus,dynamic ECG diagnosis is quite worthwhile to be promoted and applied clinical y.

  20. Screening For Atrial Fibrillation In The Community Using A Novel ECG Recorder. (United States)

    Battipaglia Md, Irma; Gilbert BSc, Katrina; Hogarth Md PhD, Andrew J; Tayebjee Md, Muzahir H


    Aims: MyDiagnostick (MDK) is a novel portable ECG recorder. We conducted this study to evaluate its role in screening for atrial fibrillation (AF). Methods: The device is a cylindrical rod with metallic electrodes at both ends recording electrocardiogram (ECG) when both electrodes are held. Individuals were requested to hold the device for approximately 15 s, the device was then connected to a laptop (with proprietary software downloaded) and analysed. Anonymised ECGs were stored for further analysis. A total of 855 ECGs were recorded and analysed offline by two arrhythmia specialists assessing ECG quality, in particular the level of noise. A noise score (NS) was devised regarding ECG quality. Results: Seven individuals were found with unknown AF (0,8%). In general ECG quality was good and rhythm diagnosis was certain with total interobserver agreement. Conclusion: The MDK provided a rapid and accurate rhythm analysis and has potential implications in preventing ischaemic cardio-embolic stroke.

  1. A model presented for classification ECG signals base on Case-Based Reasoning

    Directory of Open Access Journals (Sweden)

    Elaheh Sayari


    Full Text Available Early detection of heart diseases/abnormalities can prolong life and enhance the quality of living through appropriate treatment; thus classifying cardiac signals will be helped to immediate diagnosing of heart beat type in cardiac patients. The present paper utilizes the case base reasoning (CBR for classification of ECG signals. Four types of ECG beats (normal beat, congestive heart failure beat, ventricular tachyarrhythmia beat and atrial fibrillation beat obtained from the PhysioBank database was classified by the proposed CBR model. The main purpose of this article is classifying heart signals and diagnosing the type of heart beat in cardiac patients that in proposed CBR (Case Base Reasoning system, Training and testing data for diagnosing and classifying types of heart beat have been used. The evaluation results from the model are shown that the proposed model has high accuracy in classifying heart signals and helps to clinical decisions for diagnosing the type of heart beat in cardiac patients which indeed has high impact on diagnosing the type of heart beat aided computer.

  2. Enhanced real-time ECG coder for packetized telecardiology applications. (United States)

    Alesanco, Alvaro; Olmos, Salvador; Istepanian, Robert S H; García, José


    A new real-time compression method for electrocardiogram (ECG) signals has been developed based on the wavelet transform approach. The method is specifically adaptable for packetized telecardiology applications. The signal is segmented into beats and a beat template is subtracted from them, producing a residual signal. Beat templates and residual signals are coded with a wavelet expansion. Compression is achieved by selecting a subset of wavelet coefficients. The number of selected coefficients depends on a threshold which has different definitions depending on the operational mode of the coder. Compression performance has been tested using a subset of ECG records from MIT-BIH Arrhythmia database. This method has been designed for real-time packetized telecardiology scenarios both in wired and wireless environments.

  3. QRS complex detection in ECG signal for wearable devices. (United States)

    Arefin, M Riadh; Tavakolian, Kouhyar; Fazel-Rezai, Reza


    This paper presents QRS complex detection algorithm based on dual slope technique, which is suitable for wearable electrocardiogram (ECG) applications. For cardiac patients of different arrhythmias, ECG signals are needed to be monitored over an extensive period of time. Thus, the wearable heart monitoring system needs computationally efficient QRS detection technique with good accuracy. In this paper, a method of QRS detection based on two slopes on both sides of an R peak is presented which is computationally efficient. Based on the slopes, first, a variable measuring steepness is developed, then by introducing an adjustable R-R interval based window and adaptive thresholding techniques, depending on the number of peaks detected in such window, R peaks are detected. The algorithm was evaluated against MIT/BIH arrhythmia database and achieved 99.16% detection rate with sensitivity of 0.9935 and positive predictivity of 0.9981. The method was compared with two widely used R peaks detection algorithms.

  4. Combining Wavelet Transform and Hidden Markov Models for ECG Segmentation

    Directory of Open Access Journals (Sweden)

    Jérôme Boudy


    Full Text Available This work aims at providing new insights on the electrocardiogram (ECG segmentation problem using wavelets. The wavelet transform has been originally combined with a hidden Markov models (HMMs framework in order to carry out beat segmentation and classification. A group of five continuous wavelet functions commonly used in ECG analysis has been implemented and compared using the same framework. All experiments were realized on the QT database, which is composed of a representative number of ambulatory recordings of several individuals and is supplied with manual labels made by a physician. Our main contribution relies on the consistent set of experiments performed. Moreover, the results obtained in terms of beat segmentation and premature ventricular beat (PVC detection are comparable to others works reported in the literature, independently of the type of the wavelet. Finally, through an original concept of combining two wavelet functions in the segmentation stage, we achieve our best performances.

  5. Wavelet transform based ECG signal filtering implemented on FPGA

    Directory of Open Access Journals (Sweden)

    Germán-Salló Zoltán


    Full Text Available Filtering electrocardiographic (ECG signals is always a challenge because the accuracy of their interpretation depends strongly on filtering results. The Discrete Wavelet Transform (DWT is an efficient, new and useful tool for signal processing applications and it’s adopted in many domains as biomedical signal filtering. This transform came about from different fields, including mathematics, physics and signal processing, it has a growing applicability due to its so-called multiresolution analyzing capabilities. FPGAs are reconfigurable logic devices made up of arrays of logic cells and routing channels having some specific characteristics which allow to use them in signal processing applications. This paper presents a DWT based ECG signal denoising method implemented on FPGA, using Matlab specific Xilinx tool, as System Generator, the procedure is simulated and evaluated through filtering specific parameters.

  6. Heart detection and diagnosis based on ECG and EPCG relationships (United States)

    Phanphaisarn, W; Roeksabutr, A; Wardkein, P; Koseeyaporn, J; Yupapin, PP


    A new design of a system for preliminary detection of defective hearts is proposed which is composed of two subsystems, in which one is based on the relationship between the electrocardiogram (ECG) and phonocardiogram (PCG) signals. The relationship between both signals is determined as an impulse response (h(n)) of a system, where the decision is made based on the linear predictive coding coefficients of a heart’s impulse response. The other subsystem uses a phase space approach, in which the mean squared error between the distance vectors of the phase space of the normal heart and abnormal heart is judged by the likelihood ratio test (Λ) value, on which the decision is made. The advantage of the proposed system is that a heart’s diagnosis system based on the ECG and EPCG signals can lead to high performance heart diagnostics. PMID:22915940

  7. [Changes in ECG examination of patients with trichinosis]. (United States)

    Siwak, E; Droń, D; Pancewicz, S; Zajkowska, J; Snarska, I; Szpakowicz, T; Januszkiewicz, E


    In the years 1963-1992, 560 patients with the diagnosis of trichinosis were treated in the Department of Parasitic Diseases and Neuroinfections, including 310 women (55.3%) and 250 men (44.7%) aged from 6 to 75 years. Out of this number of patients in 59 cases (10.5%) myocardial damage was found in the course of the disease. The most frequently found changes in ECG record were ventricular repolarization disturbances (66.1%) which persisted in 18.6% of cases before discharge from the hospital. Depolarization disturbances accounted for 32.2% of cases and persisted before discharge from the hospital in 10.1% of patients. In 6.7% of patients, persistence of pathological ECG record was found during the 4th month after the hospitalization which may be an evidence of prolongation of the inflammatory process within the myocardium.

  8. ECG contamination of EEG signals: effect on entropy. (United States)

    Chakrabarti, Dhritiman; Bansal, Sonia


    Entropy™ is a proprietary algorithm which uses spectral entropy analysis of electroencephalographic (EEG) signals to produce indices which are used as a measure of depth of hypnosis. We describe a report of electrocardiographic (ECG) contamination of EEG signals leading to fluctuating erroneous Entropy values. An explanation is provided for mechanism behind this observation by describing the spread of ECG signals in head and neck and its influence on EEG/Entropy by correlating the observation with the published Entropy algorithm. While the Entropy algorithm has been well conceived, there are still instances in which it can produce erroneous values. Such erroneous values and their cause may be identified by close scrutiny of the EEG waveform if Entropy values seem out of sync with that expected at given anaesthetic levels.

  9. An extensive Markov system for ECG exact coding. (United States)

    Tai, S C


    In this paper, an extensive Markov process, which considers both the coding redundancy and the intersample redundancy, is presented to measure the entropy value of an ECG signal more accurately. It utilizes the intersample correlations by predicting the incoming n samples based on the previous m samples which constitute an extensive Markov process state. Theories of the extensive Markov process and conventional n repeated applications of m-th order Markov process are studied first in this paper. After that, they are realized for ECG exact coding. Results show that a better performance can be achieved by our system. The average code length for the extensive Markov system on the second difference signals was 2.512 b/sample, while the average Huffman code length for the second difference signals was 3.326 b/sample.

  10. Using ordinal partition transition networks to analyze ECG data (United States)

    Kulp, Christopher W.; Chobot, Jeremy M.; Freitas, Helena R.; Sprechini, Gene D.


    Electrocardiogram (ECG) data from patients with a variety of heart conditions are studied using ordinal pattern partition networks. The ordinal pattern partition networks are formed from the ECG time series by symbolizing the data into ordinal patterns. The ordinal patterns form the nodes of the network and edges are defined through the time ordering of the ordinal patterns in the symbolized time series. A network measure, called the mean degree, is computed from each time series-generated network. In addition, the entropy and number of non-occurring ordinal patterns (NFP) is computed for each series. The distribution of mean degrees, entropies, and NFPs for each heart condition studied is compared. A statistically significant difference between healthy patients and several groups of unhealthy patients with varying heart conditions is found for the distributions of the mean degrees, unlike for any of the distributions of the entropies or NFPs.

  11. [Development of a portable dynamic state ECG based on DSP]. (United States)

    Song, Li; Meng, Qing-jian; Zhang, Guang-yu; Cao, Wei-fang


    The Portable dynamic state electrocardiogram collecting system is introduced by using TMS302VC5402, TLC320AD50C, liquid crystal display model, and so on. This dissertation describes the work principle of the system and uses the united algorithm based on wavelet to identify and locate the ECG characteristic waves. This system has as follows of advantages: big memory, low noise,high common mode rejection ratio, the low power consume,the long record time etc.

  12. Discussion of "Computational Electrocardiography: Revisiting Holter ECG Monitoring". (United States)

    Baumgartner, Christian; Caiani, Enrico G; Dickhaus, Hartmut; Kulikowski, Casimir A; Schiecke, Karin; van Bemmel, Jan H; Witte, Herbert


    This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Computational Electrocardiography: Revisiting Holter ECG Monitoring" written by Thomas M. Deserno and Nikolaus Marx. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the paper of Deserno and Marx. In subsequent issues the discussion can continue through letters to the editor.

  13. Performance Comparison of Windowing Techniques for ECG Signal Enhancement

    Directory of Open Access Journals (Sweden)

    K.Sravan Kumar


    Full Text Available Electrocardiogram (ECG signal is generally corrupted by various artifacts like baseline wander, power line interference (50/60 Hz and electromyography noise and these must be removed before diagnosis. The task propounded in this article is removal of low frequency interference i.e. baseline wandering and high frequency noise i.e. electromyography in ECG signal and digital filters are implemented to delete it. The digital filters accomplished are FIR with various windowing methods as of Rectangular, Hann, Blackman, Hamming, and Kaiser. The results received are at order of 300,450,600.The signal taken of the MIT-BIH database which contains the normal and abnormal waveforms. The work has been in MATLAB where filters are implemented in FDA Tool. The result received for entire FIR filters with various windows are evaluated the waveforms, power spectrums density, signal to noise ratio (SNR and means square error (MSE of the noisy and filtered ECG signals. The filter which shows the excellent outcomes is the Kaiser Window.

  14. ECG Analysis based on Wavelet Transform and Modulus Maxima

    Directory of Open Access Journals (Sweden)

    Mourad Talbi


    Full Text Available In this paper, we have developed a new technique of P, Q, R, S and T Peaks detection using Wavelet Transform (WT and Modulus maxima. One of the commonest problems in electrocardiogram (ECG signal processing, is baseline wander removal suppression. Therefore we have removed the baseline wander in order to make easier the detection of the peaks P and T. Those peaks are detected after the QRS detection. The proposed method is based on the application of the discritized continuous wavelet transform (Mycwt used for the Bionic wavelet transform, to the ECG signal in order to detect R-peaks in the first stage and in the second stage, the Q and S peaks are detected using the R-peaks localization. Finally the Modulus maxima are used in the undecimated wavelet transform (UDWT domain in order to detect the others peaks (P, T. This detection is performed by using a varying-length window that is moving along the whole signal. For evaluating the proposed method, we have compared it to others techniques based on wavelets. In this evaluation, we have used many ECG signals taken from MIT-BIH database. The obtained results show that the proposed method outperforms a number of conventional techniques used for our evaluation.

  15. Non-Invasive Fetal Monitoring: A Maternal Surface ECG Electrode Placement-Based Novel Approach for Optimization of Adaptive Filter Control Parameters Using the LMS and RLS Algorithms. (United States)

    Martinek, Radek; Kahankova, Radana; Nazeran, Homer; Konecny, Jaromir; Jezewski, Janusz; Janku, Petr; Bilik, Petr; Zidek, Jan; Nedoma, Jan; Fajkus, Marcel


    This paper is focused on the design, implementation and verification of a novel method for the optimization of the control parameters (such as step size μ and filter order N) of LMS and RLS adaptive filters used for noninvasive fetal monitoring. The optimization algorithm is driven by considering the ECG electrode positions on the maternal body surface in improving the performance of these adaptive filters. The main criterion for optimal parameter selection was the Signal-to-Noise Ratio (SNR). We conducted experiments using signals supplied by the latest version of our LabVIEW-Based Multi-Channel Non-Invasive Abdominal Maternal-Fetal Electrocardiogram Signal Generator, which provides the flexibility and capability of modeling the principal distribution of maternal/fetal ECGs in the human body. Our novel algorithm enabled us to find the optimal settings of the adaptive filters based on maternal surface ECG electrode placements. The experimental results further confirmed the theoretical assumption that the optimal settings of these adaptive filters are dependent on the ECG electrode positions on the maternal body, and therefore, we were able to achieve far better results than without the use of optimization. These improvements in turn could lead to a more accurate detection of fetal hypoxia. Consequently, our approach could offer the potential to be used in clinical practice to establish recommendations for standard electrode placement and find the optimal adaptive filter settings for extracting high quality fetal ECG signals for further processing. Ultimately, diagnostic-grade fetal ECG signals would ensure the reliable detection of fetal hypoxia.

  16. Measurements on wireless transmission of ECG signals (United States)

    Gabrielli, A.; Lax, I.


    The scope of this research is to design an electronic prototype, an operative system as a proof of concept, to transmit and receive biological parameters, in particular electrocardiogram signals, through dedicated wireless circuits. The apparatus features microelectronics chips that were developed for more general biomedical applications, here adapted to deal with cardiac signals. The paper mainly focuses on the electronic aspects, as in this study we do not face medical or clinical aspects of the system. The transmitter circuit uses a commercial instrumentation amplifier and the receiver has been equipped with wide-band amplifiers along with made-in-the-lab band-pass filters centered at the carrier. We have been able to mount the entire system prototype into a preliminary data acquisition chain that reads out the electrocardiogram signal. The prototype allows acquiring the waveform, converting it to a digital pattern and open the transmission through a series of high-frequency packets exploiting the Ultra Wide Band protocol. The sensor value is embedded in the transmission through the rate of the digital packets. In fact, these are sent wireless at a specific packet-frequency that depends on the sensor amplitude and are detected into a receiver circuit that recovers the information.

  17. Capacitive driven-right-leg grounding in Indirect-contact ECG measurement. (United States)

    Lim, Yong Gyu; Chung, Gih Sung; Park, Kwang Suk


    For the reduction of common-mode noise level in Indirect-contact ECG (IDC-ECG) measurement, a driven-right-leg grounding method was applied to the IDC-ECG. Because the IDC-ECG does not require any direct contact between the electrodes and the human skin, it is adequate for un-constraining long-term ECG measurement at home and its various applications are now under development. However, larger 60 Hz noise induced by power line appears in IDC-ECG than in conventional ECG, that is a restriction of IDC-ECG application. In this study, the driven-right-leg ground which has been used in conventional direct-contact ECG, was adapted to the IDC-ECG measurement, by feedback of the inversion of amplified common-mode noise to the body through the conductive textile laid on the chair seat. It was shown that the level of 60Hz power line noise was reduced to about -40 dB when the driven-right-leg gain was 1000.

  18. Accuracy Assessment for Multi-Channel ECG Waveforms Using Soft Computing Methodologies

    Directory of Open Access Journals (Sweden)

    Menta Srinivasulu


    Full Text Available ECG waveform rhythmic analysis is very important. In recent trends, analysis processes of ECG waveform applications are available in smart devices. Still, existing methods are not able to accomplish the complete accuracy assessment while classify the multi-channel ECG waveforms. In this paper, proposed analysis of accuracy assessment of the classification of multi-channel ECG waveforms using most popular Soft Computing algorithms. In this research, main focus is on the better rule generation to analyze the multi-channel ECG waveforms. Analysis is mainly done inSoft Computing methods like the Decision Trees with different pruning analysis, Logistic Model Trees with different regression process and Support Vector Machine with Particle Swarm Optimization (SVM-PSO. All these analysis methods are trained and tested with MIT-BIH 12 channel ECG waveforms. Before trained these methods, MSO-FIR filter should be used as data preprocessing for removal of noise from original multi-channel ECG waveforms. MSO technique is used for automatically finding out the cutoff frequency of multichannel ECG waveforms which is used in low-pass filtering process. The classification performance is discussed using mean squared error, member function, classification accuracy, complexity of design, and area under curve on MIT-BIH data. Additionally, this research work is extended for the samples of multi-channel ECG waveforms from the Scope diagnostic center, Hyderabad. Our study assets the best process using the Soft Computing methods for analysis of multi-channel ECG waveforms.

  19. Extended Kalman smoother with differential evolution technique for denoising of ECG signal. (United States)

    Panigrahy, D; Sahu, P K


    Electrocardiogram (ECG) signal gives a lot of information on the physiology of heart. In reality, noise from various sources interfere with the ECG signal. To get the correct information on physiology of the heart, noise cancellation of the ECG signal is required. In this paper, the effectiveness of extended Kalman smoother (EKS) with the differential evolution (DE) technique for noise cancellation of the ECG signal is investigated. DE is used as an automatic parameter selection method for the selection of ten optimized components of the ECG signal, and those are used to create the ECG signal according to the real ECG signal. These parameters are used by the EKS for the development of the state equation and also for initialization of the parameters of EKS. EKS framework is used for denoising the ECG signal from the single channel. The effectiveness of proposed noise cancellation technique has been evaluated by adding white, colored Gaussian noise and real muscle artifact noise at different SNR to some visually clean ECG signals from the MIT-BIH arrhythmia database. The proposed noise cancellation technique of ECG signal shows better signal to noise ratio (SNR) improvement, lesser mean square error (MSE) and percent of distortion (PRD) compared to other well-known methods.

  20. 窦性心律的20例心电图分析%ECG Analysis of 20 Cases of Sinus

    Institute of Scientific and Technical Information of China (English)



    Objective Analyzing the ECG data from 20 cases of sinus in order to provide exact information for clinical diagnosis and treatment. Methods Analyzing ECG data of 20 cases of sinus to summarize diagnosis experience and methods.Results With ECG analysis,there are 8 cases diagnosed as sinus,6 cases are sinus arrhythmia and other 6 cases are sinus tachycardia.Conclusion ECG is quite precise to examine and diagnose sinus arrhythmia,which is an indispensable method of clinical inspection.%目的:对20例窦性心律心电图资料进行分析,为临床诊断和治疗提供准确的依据。方法回顾分析20例窦性心律心电图资料,总结诊断经验和方法。结果所有研究对象经心电检查分析,证实窦性心律8例,窦性心律不齐6例,窦性心律过速6例。结论心电影像检查在窦性心律失常的诊断中准确率高,是临床检查必不可缺的手段之一。

  1. 瘤段截骨加热70℃蒸馏水中15 min:灭活回植治疗腓骨近端骨肿瘤%Replantation of inactivated tumor segment boiled in 70℃ distilled water for 15 minutes in the treatment of proximal fibular tumors

    Institute of Scientific and Technical Information of China (English)

    包毅敏; 张国梁; 杜佩晋; 王跃文


    BACKGROUND:Apart from a complete resection of tumor tissues, the therapeutic goal for bone tumors is to maximize the repair and restoration of tissue defects and damaged functions. Autologous inactivated bone graft is of practical value for transplantation and reconstruction. OBJECTIVE:To investigate the effect of improved Malawer method combined with replantation of inactivated tumor segment in the treatment of proximal fibular tumors. METHODS: Since 2007, five patients with proximal fibular tumors (six sides) were admitted in the Affiliated Hospital of Inner Mongolia Medical University. These five patients were subjected to distal femoral amputation, intralesional curettage and bone grafting, upper fibular osteotomy + tumor segment heating (boiling in 70℃ distiled water for 15 minutes) + inactivated bone replantation. Therapeutic effects were folowed. RESULTS AND CONCLUSION: One case of amputation had no recurrence and systemic metastasis during 4 years of folow-up; one case of intralesional curettage and bone grafting relapsed 1 year after operation; three cases of upper fibular osteotomy + tumor segment heating + inactivated bone replantation folowed for 5 months recovered walking function and exhibited good healing of the outer structure of the knee, showing non-healing of inactivated tumor segment, non-remarkable calus formation, no local tumor recurrence, no loosening of internal fixation, and inactivated bone without fracture and absorption. These results confirmed that the tumor curettage and amputation both have obvious limitations; based on Malawer method, the replantation of inactive tumor segment can better ensure the structure integrity of the lower leg and in suit reconstruct the lateral biceps femoris tendon and the lateral colateral ligament, but geneticaly the revascularization and healing of inactivated bones wil be difficult and slow with temperature increases, and therefore the period of postoperative brace protection should be relatively

  2. Review Paper :Comparative Analysis Of Mother Wavelet Functions With The ECG Signals

    Directory of Open Access Journals (Sweden)

    Kapil Tajane


    Full Text Available Electrocardiographic ECG gives the information about electrical activity of the heart captured over time by attaching an external electrode to the skin. Now a days ECG signal is used as a baseline to determine the hearts condition. It is very much essential to detect and process ECG signal accurately. ECG consists of various types of noise such as muscle noise, baseline wander and power line interference etc. To remove such types of noise wavelet transform is used. Mother wavelet is an effective tool for denoising such signals. But selection of proper mother wavelet for the ECG signal is again a challenging task. This paper gives the survey about the wavelet transforms useful for ECG denoising. The different wavelet transform are compared and from that we can decide which one is more suitable.


    Directory of Open Access Journals (Sweden)

    Mrs. A. R. Chitupe


    Full Text Available In recent years due to physical and mental stress in the working environments the cases of medicaldiagnosis using ECG are increasing up-bounds. The critical decisions in diagnosis referring to the normal ECG or indicative dysfunctions of the heart results into overlapped data values causing ambiguities. This research paper performs analytical processing and related mining to classify normal and abnormalities of the ECG. The ECG is agraphical representation generated due to polarities of the weak electrical signals generated in certain defined timely manner. With reference to time an ECG is used to measure the rate and regularity of heartbeats, as well as some special behaviour of the patient. ECG can be used to investigate heart abnormalities.

  4. Reducing of gradient induced artifacts on the ECG signal during MRI examinations using Wilcoxon filter

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    Schmidt Marcus


    Full Text Available The electrocardiogramm (ECG is the state-of-the-art signal for gating in cardiovascular magnetic resonance imaging and patient monitoring. Using the ECG for gating and monitoring during the magnetic resonance imaging examination is a high challenging task due to the superimposition of the magnetohydrodynamic effect, radio-frequency (RF pulses and fast switching gradient magnetic fields. The gradient induced artifacts hamper the correct QRS detection which is needed for correct gating and heart rate calculation and ECG displaying for patient monitoring. To suppress the gradient artifacts from the ECG signal acquired during MRI, a technique based on the Wilcoxon filter was developed. It was evaluated using ECG signals of 14 different subjects acquired in a 3 T MRI scanner. It could be shown reliable results for reducing gradient induced artifacts in the ECG signal in real-time.

  5. [Design of the Mobile ECG Monitoring System Based on Android 4.3]. (United States)

    Zhang, Shun; Lian, Yuxi; Qin, Yajie; Wang, Yuanyuan


    To monitor and record Electrocardiograph (ECG) signals for 24 hours, a mobile ECG monitoring system is designed based on Android 4.3. In this system, domestic indigenous E9622A is used to acquire ECG signals and TI CC2541 is adopted to communicate with mobile phones. The program is implemented on the Android platform to display and process ECG signals. The whole system is integrated on a 2 cm x 2 cm PCB. From experiments, it is shown that ECG signals can be obtained effectively when this system is worn, and clear ECG waveforms and parameters can be shown on the phones. With this system, arrhythmia can be diagnosed preliminarily. It is also shown that the system is low-power, low-cost, flexible and portable.

  6. Design of a smart ECG garment based on conductive textile electrode and flexible printed circuit board. (United States)

    Cai, Zhipeng; Luo, Kan; Liu, Chengyu; Li, Jianqing


    A smart electrocardiogram (ECG) garment system was designed for continuous, non-invasive and comfortable ECG monitoring, which mainly consists of four components: Conductive textile electrode, garment, flexible printed circuit board (FPCB)-based ECG processing module and android application program. Conductive textile electrode and FPCB-based ECG processing module (6.8 g, 55 mm × 53 mm × 5 mm) are identified as two key techniques to improve the system's comfort and flexibility. Preliminary experimental results verified that the textile electrodes with circle shape, 40 mm size in diameter, and 5 mm thickness sponge are best suited for the long-term ECG monitoring application. The tests on the whole system confirmed that the designed smart garment can obtain long-term ECG recordings with high signal quality.

  7. The Combined Effect of Filters in ECG Signals for Pre-Processing

    Directory of Open Access Journals (Sweden)

    Isha V. Upganlawar


    Full Text Available The ECG signal is abruptly changing and continuous in nature. The heart disease such as paroxysmal of heart, arrhythmia diagnosing, are related with the intelligent health care decision this ECG signal need to be pre-process accurately for further action on it such as extracting the features, wavelet decomposition, distribution of QRS complexes in ECG recordings and related information such as heart rate and RR interval, classification of the signal by using various classifiers etc. Filters plays very important role in analyzing the low frequency components in ECG signal. The biomedical signals are of low frequency, the removal of power line interference and baseline wander is a very important step at the pre-processing stage of ECG. In these paper we deal with the study of Median filtering and FIR (Finite Impulse Responsefiltering of ECG signals under noisy condition

  8. Riemann Liouvelle Fractional Integral based Empirical Mode Decomposition for ECG Denoising. (United States)

    Jain, Shweta; Bajaj, Varun; Kumar, Anil


    Electrocardiograph (ECG) denoising is the most important step in diagnosis of heart related diseases, as the diagnosis gets influenced with noises. In this paper, a new method for ECG denoising is proposed, which incorporates empirical mode decomposition algorithm and Riemann Liouvelle (RL) fractional integral filtering. In the proposed method, noisy ECG signal is decomposed into its intrinsic mode functions (IMFs); from which noisy IMFs are identified by proposed noisy-IMFs identification methodology. RL fractional integral filtering is applied on noisy IMFs to get denoised IMFs; ECG signal is reconstructed with denoised IMFs and remaining signal dominant IMFs to obtain noise-free ECG signal. Proposed methodology is tested with MIT-BIH arrhythmia database. Its performance, in terms of signal to noise ratio (SNR) and mean square error (MSE), is compared with other related fractional integral and EMD based ECG denoising methods. The obtained results by proposed method prove that the proposed method gives efficient noise removal performance.

  9. Application of Holter ECG Signal Analysis Based on Wavelet and Data Mining Technique

    Institute of Scientific and Technical Information of China (English)

    余辉; 谢远国; 周仲兴; 吕扬生


    A new model based on dyadic differential wavelet was developed for detecting the R peak in Holter ECG signal according to the design of data mining. The Mallat recursive filter algorithm was introduced to calculate wavelet and optimize the detection algorithm which is based on the equivalent filter technique. The detection algorithm has been verified by MIT arrhythmia database with a high efficiency of 99%. After optimization,the algorithm was put into clinical experiment and tested in the Air Force Hospital in Tianjin for about two months. After about 108 hearts beating test of more than 100 patients, the total efficient detection rate has reached 97%. Now this algorithm module has been applied in business software and shows perfect performance under the complex conditions such as the inversion of heart beating, the falling off of the electrodes, the excursion of base line and so on.

  10. The Combined Effect of Filters in ECG Signals for Pre-Processing


    Isha V. Upganlawar; Harshal Chowhan


    The ECG signal is abruptly changing and continuous in nature. The heart disease such as paroxysmal of heart, arrhythmia diagnosing, are related with the intelligent health care decision this ECG signal need to be pre-process accurately for further action on it such as extracting the features, wavelet decomposition, distribution of QRS complexes in ECG recordings and related information such as heart rate and RR interval, classification of the signal by using various classifiers etc. Filters p...

  11. A dynamic Fourier series for the compression of ECG using FFT and adaptive coefficient estimation. (United States)

    al-Nashash, H A


    In this article, a new ECG data compression technique is proposed. The method relies on modelling quasi-periodic ECG signals as a dynamic Fourier series. Fourier coefficients are continuously estimated using either an FFT algorithm or the adaptive least mean square algorithm. Results from simulated normal and pathological ECGs are presented and discussed. The merits of each of the above two methods are also illustrated. Furthermore, a comparison with other compression techniques is also discussed.

  12. A Novel 12-Lead ECG T-Shirt with Active Electrodes

    Directory of Open Access Journals (Sweden)

    Anna Boehm


    Full Text Available We developed an ECG T-shirt with a portable recorder for unobtrusive and long-term multichannel ECG monitoring with active electrodes. A major drawback of conventional 12-lead ECGs is the use of adhesive gel electrodes, which are uncomfortable during long-term application and may even cause skin irritations and allergic reactions. Therefore, we integrated comfortable patches of conductive textile into the ECG T-shirt in order to replace the adhesive gel electrodes. In order to prevent signal deterioration, as reported for other textile ECG systems, we attached active circuits on the outside of the T-shirt to further improve the signal quality of the dry electrodes. Finally, we validated the ECG T-shirt against a commercial Holter ECG with healthy volunteers during phases of lying down, sitting, and walking. The 12-lead ECG was successfully recorded with a resulting mean relative error of the RR intervals of 0.96% and mean coverage of 96.6%. Furthermore, the ECG waves of the 12 leads were analyzed separately and showed high accordance. The P-wave had a correlation of 0.703 for walking subjects, while the T-wave demonstrated lower correlations for all three scenarios (lying: 0.817, sitting: 0.710, walking: 0.403. The other correlations for the P, Q, R, and S-waves were all higher than 0.9. This work demonstrates that our ECG T-shirt is suitable for 12-lead ECG recordings while providing a higher level of comfort compared with a commercial Holter ECG.

  13. On the improved correlative prediction scheme for aliased electrocardiogram (ECG) data compression. (United States)

    Gao, Xin


    An improved scheme for aliased electrocardiogram (ECG) data compression has been constructed, where the predictor exploits the correlative characteristics of adjacent QRS waveforms. The twin-R correlation prediction and lifting wavelet transform (LWT) for periodical ECG waves exhibits feasibility and high efficiency to achieve lower distortion rates with realizable compression ratio (CR); grey predictions via GM(1, 1) model have been adopted to evaluate the parametric performance for ECG data compression. Simulation results illuminate the validity of our approach.

  14. Fetal electrocardiogram (ECG) for fetal monitoring during labour. (United States)

    Neilson, James P


    Hypoxaemia during labour can alter the shape of the fetal electrocardiogram (ECG) waveform, notably the relation of the PR to RR intervals, and elevation or depression of the ST segment. Technical systems have therefore been developed to monitor the fetal ECG during labour as an adjunct to continuous electronic fetal heart rate monitoring with the aim of improving fetal outcome and minimising unnecessary obstetric interference. To compare the effects of analysis of fetal ECG waveforms during labour with alternative methods of fetal monitoring. The Cochrane Pregnancy and Childbirth Group's Trials Register (latest search 23 September 2015) and reference lists of retrieved studies. Randomised trials comparing fetal ECG waveform analysis with alternative methods of fetal monitoring during labour. One review author independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. One review author assessed the quality of the evidence using the GRADE approach. Seven trials (27,403 women) were included: six trials of ST waveform analysis (26,446 women) and one trial of PR interval analysis (957 women). The trials were generally at low risk of bias for most domains and the quality of evidence for ST waveform analysis trials was graded moderate to high. In comparison to continuous electronic fetal heart rate monitoring alone, the use of adjunctive ST waveform analysis made no obvious difference to primary outcomes: births by caesarean section (risk ratio (RR) 1.02, 95% confidence interval (CI) 0.96 to 1.08; six trials, 26,446 women; high quality evidence); the number of babies with severe metabolic acidosis at birth (cord arterial pH less than 7.05 and base deficit greater than 12 mmol/L) (average RR 0.72, 95% CI 0.43 to 1.20; six trials, 25,682 babies; moderate quality evidence); or babies with neonatal encephalopathy (RR 0.61, 95% CI 0.30 to 1.22; six trials, 26,410 babies; high quality evidence). There were, however, on average

  15. Analysis of ECG-trunk muscle signal amplitude and heart rate relationship. (United States)

    Benosman, Mourad-M; Bereksi-Reguig, Fethi; Salerud, E Göran


    The objective of this paper is to investigate if bioelectrical signals, generated from trunk muscles identified in an electrocardiogram (ECG) signal presented in this paper as ECG-Trunk Muscles Signals amplitude (Ecg-TMSA) are correlated with Heart rate (HR) during different levels of physical activity and also if Ecg-TMSA is not influenced by mental activity. HR and Ecg-TMSA were derived from ECG in 14 subjects when walking and jogging at different treadmill velocities from 4-10 (km h(-1)). The mean relationship for all 14 subjects was HR = (42.3 ± 0.2) + (45.3 ± 2.8) Ecg-TMSA, r(2 )= 0.91. The result of one individual data points example for a 21 min experiment was (r(2 )= 0.93, p Ecg-TMSA and HR. Moreover, the Ecg-TMSA was not affected by mental activity.

  16. A novel approach to ECG classification based upon two-layered HMMs in body sensor networks. (United States)

    Liang, Wei; Zhang, Yinlong; Tan, Jindong; Li, Yang


    This paper presents a novel approach to ECG signal filtering and classification. Unlike the traditional techniques which aim at collecting and processing the ECG signals with the patient being still, lying in bed in hospitals, our proposed algorithm is intentionally designed for monitoring and classifying the patient's ECG signals in the free-living environment. The patients are equipped with wearable ambulatory devices the whole day, which facilitates the real-time heart attack detection. In ECG preprocessing, an integral-coefficient-band-stop (ICBS) filter is applied, which omits time-consuming floating-point computations. In addition, two-layered Hidden Markov Models (HMMs) are applied to achieve ECG feature extraction and classification. The periodic ECG waveforms are segmented into ISO intervals, P subwave, QRS complex and T subwave respectively in the first HMM layer where expert-annotation assisted Baum-Welch algorithm is utilized in HMM modeling. Then the corresponding interval features are selected and applied to categorize the ECG into normal type or abnormal type (PVC, APC) in the second HMM layer. For verifying the effectiveness of our algorithm on abnormal signal detection, we have developed an ECG body sensor network (BSN) platform, whereby real-time ECG signals are collected, transmitted, displayed and the corresponding classification outcomes are deduced and shown on the BSN screen.

  17. A Low Power Linear Phase Digital FIR Filter for Wearable ECG Devices. (United States)

    Lian, Yong; Yu, Jianghong


    In this paper we present a low power linear phase digital FIR filter which is a part of an ECG-on-Chip. The ECG-on-Chip can be embedded into clothing to acquire the electrocardiogram (ECG) signal and send a warning message to a mobile phone or PDA if an abnormal ECG is detected. The proposed new filter structure significantly reduces the arithmetic operations for each sample which in turn lowers the power consumption. The filter is developed based on the interpolated finite impulse filter technique and is very attractive for a low cost and low power VLSI implementation.

  18. A Novel Approach to ECG Classification Based upon Two-Layered HMMs in Body Sensor Networks

    Directory of Open Access Journals (Sweden)

    Wei Liang


    Full Text Available This paper presents a novel approach to ECG signal filtering and classification. Unlike the traditional techniques which aim at collecting and processing the ECG signals with the patient being still, lying in bed in hospitals, our proposed algorithm is intentionally designed for monitoring and classifying the patient’s ECG signals in the free-living environment. The patients are equipped with wearable ambulatory devices the whole day, which facilitates the real-time heart attack detection. In ECG preprocessing, an integral-coefficient-band-stop (ICBS filter is applied, which omits time-consuming floating-point computations. In addition, two-layered Hidden Markov Models (HMMs are applied to achieve ECG feature extraction and classification. The periodic ECG waveforms are segmented into ISO intervals, P subwave, QRS complex and T subwave respectively in the first HMM layer where expert-annotation assisted Baum-Welch algorithm is utilized in HMM modeling. Then the corresponding interval features are selected and applied to categorize the ECG into normal type or abnormal type (PVC, APC in the second HMM layer. For verifying the effectiveness of our algorithm on abnormal signal detection, we have developed an ECG body sensor network (BSN platform, whereby real-time ECG signals are collected, transmitted, displayed and the corresponding classification outcomes are deduced and shown on the BSN screen.

  19. Arrhythmia Classification Based on Multi-Domain Feature Extraction for an ECG Recognition System

    Directory of Open Access Journals (Sweden)

    Hongqiang Li


    Full Text Available Automatic recognition of arrhythmias is particularly important in the diagnosis of heart diseases. This study presents an electrocardiogram (ECG recognition system based on multi-domain feature extraction to classify ECG beats. An improved wavelet threshold method for ECG signal pre-processing is applied to remove noise interference. A novel multi-domain feature extraction method is proposed; this method employs kernel-independent component analysis in nonlinear feature extraction and uses discrete wavelet transform to extract frequency domain features. The proposed system utilises a support vector machine classifier optimized with a genetic algorithm to recognize different types of heartbeats. An ECG acquisition experimental platform, in which ECG beats are collected as ECG data for classification, is constructed to demonstrate the effectiveness of the system in ECG beat classification. The presented system, when applied to the MIT-BIH arrhythmia database, achieves a high classification accuracy of 98.8%. Experimental results based on the ECG acquisition experimental platform show that the system obtains a satisfactory classification accuracy of 97.3% and is able to classify ECG beats efficiently for the automatic identification of cardiac arrhythmias.

  20. ECG De-noising: A comparison between EEMD-BLMS and DWT-NN algorithms. (United States)

    Kærgaard, Kevin; Jensen, Søren Hjøllund; Puthusserypady, Sadasivan


    Electrocardiogram (ECG) is a widely used non-invasive method to study the rhythmic activity of the heart and thereby to detect the abnormalities. However, these signals are often obscured by artifacts from various sources and minimization of these artifacts are of paramount important. This paper proposes two adaptive techniques, namely the EEMD-BLMS (Ensemble Empirical Mode Decomposition in conjunction with the Block Least Mean Square algorithm) and DWT-NN (Discrete Wavelet Transform followed by Neural Network) methods in minimizing the artifacts from recorded ECG signals, and compares their performance. These methods were first compared on two types of simulated noise corrupted ECG signals: Type-I (desired ECG+noise frequencies outside the ECG frequency band) and Type-II (ECG+noise frequencies both inside and outside the ECG frequency band). Subsequently, they were tested on real ECG recordings. Results clearly show that both the methods works equally well when used on Type-I signals. However, on Type-II signals the DWT-NN performed better. In the case of real ECG data, though both methods performed similar, the DWT-NN method was a slightly better in terms of minimizing the high frequency artifacts.

  1. Can Functional Cardiac Age be Predicted from ECG in a Normal Healthy Population (United States)

    Schlegel, Todd; Starc, Vito; Leban, Manja; Sinigoj, Petra; Vrhovec, Milos


    In a normal healthy population, we desired to determine the most age-dependent conventional and advanced ECG parameters. We hypothesized that changes in several ECG parameters might correlate with age and together reliably characterize the functional age of the heart. Methods: An initial study population of 313 apparently healthy subjects was ultimately reduced to 148 subjects (74 men, 84 women, in the range from 10 to 75 years of age) after exclusion criteria. In all subjects, ECG recordings (resting 5-minute 12-lead high frequency ECG) were evaluated via custom software programs to calculate up to 85 different conventional and advanced ECG parameters including beat-to-beat QT and RR variability, waveform complexity, and signal-averaged, high-frequency and spatial/spatiotemporal ECG parameters. The prediction of functional age was evaluated by multiple linear regression analysis using the best 5 univariate predictors. Results: Ignoring what were ultimately small differences between males and females, the functional age was found to be predicted (R2= 0.69, P ECGs, functional cardiac age can be estimated by multiple linear regression analysis of mostly advanced ECG results. Because some parameters in the regression formula, such as QTcorr, high frequency QRS amplitude and P-wave width also change with disease in the same direction as with increased age, increased functional age of the heart may reflect subtle age-related pathologies in cardiac electrical function that are usually hidden on conventional ECG.

  2. Comparative Analysis of the Equivital EQ02 Lifemonitor with Holter Ambulatory ECG Device for Continuous Measurement of ECG, Heart Rate, and Heart Rate Variability: A Validation Study for Precision and Accuracy. (United States)

    Akintola, Abimbola A; van de Pol, Vera; Bimmel, Daniel; Maan, Arie C; van Heemst, Diana


    Background: The Equivital (EQ02) is a multi-parameter telemetric device offering both real-time and/or retrospective, synchronized monitoring of ECG, HR, and HRV, respiration, activity, and temperature. Unlike the Holter, which is the gold standard for continuous ECG measurement, EQO2 continuously monitors ECG via electrodes interwoven in the textile of a wearable belt. Objective: To compare EQ02 with the Holter for continuous home measurement of ECG, heart rate (HR), and heart rate variability (HRV). Methods: Eighteen healthy participants wore, simultaneously for 24 h, the Holter and EQ02 monitors. Per participant, averaged HR, and HRV per 5 min from the two devices were compared using Pearson correlation, paired T-test, and Bland-Altman analyses. Accuracy and precision metrics included mean absolute relative difference (MARD). Results: Artifact content of EQ02 data varied widely between (range 1.93-56.45%) and within (range 0.75-9.61%) participants. Comparing the EQ02 to the Holter, the Pearson correlations were respectively 0.724, 0.955, and 0.997 for datasets containing all data and data with < 50 or < 20% artifacts respectively. For datasets containing respectively all data, data with < 50, or < 20% artifacts, bias estimated by Bland-Altman analysis was -2.8, -1.0, and -0.8 beats per minute and 24 h MARD was 7.08, 3.01, and 1.5. After selecting a 3-h stretch of data containing 1.15% artifacts, Pearson correlation was 0.786 for HRV measured as standard deviation of NN intervals (SDNN). Conclusions: Although the EQ02 can accurately measure ECG and HRV, its accuracy and precision is highly dependent on artifact content. This is a limitation for clinical use in individual patients. However, the advantages of the EQ02 (ability to simultaneously monitor several physiologic parameters) may outweigh its disadvantages (higher artifact load) for research purposes and/ or for home monitoring in larger groups of study participants. Further studies can be aimed at

  3. A Study on the Optimal Positions of ECG Electrodes in a Garment for the Design of ECG-Monitoring Clothing for Male. (United States)

    Cho, Hakyung; Lee, Joo Hyeon


    Smart clothing is a sort of wearable device used for ubiquitous health monitoring. It provides comfort and efficiency in vital sign measurements and has been studied and developed in various types of monitoring platforms such as T-shirt and sports bra. However, despite these previous approaches, smart clothing for electrocardiography (ECG) monitoring has encountered a serious shortcoming relevant to motion artifacts caused by wearer movement. In effect, motion artifacts are one of the major problems in practical implementation of most wearable health-monitoring devices. In the ECG measurements collected by a garment, motion artifacts are usually caused by improper location of the electrode, leading to lack of contact between the electrode and skin with body motion. The aim of this study was to suggest a design for ECG-monitoring clothing contributing to reduction of motion artifacts. Based on the clothing science theory, it was assumed in this study that the stability of the electrode in a dynamic state differed depending on the electrode location in an ECG-monitoring garment. Founded on this assumption, effects of 56 electrode positions were determined by sectioning the surface of the garment into grids with 6 cm intervals in the front and back of the bodice. In order to determine the optimal locations of the ECG electrodes from the 56 positions, ECG measurements were collected from 10 participants at every electrode position in the garment while the wearer was in motion. The electrode locations indicating both an ECG measurement rate higher than 80.0 % and a large amplitude during motion were selected as the optimal electrode locations. The results of this analysis show four electrode locations with consistently higher ECG measurement rates and larger amplitudes amongst the 56 locations. These four locations were abstracted to be least affected by wearer movement in this research. Based on this result, a design of the garment-formed ECG monitoring platform

  4. Mouse ECG findings in aging, with conduction system affecting drugs and in cardiac pathologies: Development and validation of ECG analysis algorithm in mice. (United States)

    Merentie, Mari; Lipponen, Jukka A; Hedman, Marja; Hedman, Antti; Hartikainen, Juha; Huusko, Jenni; Lottonen-Raikaslehto, Line; Parviainen, Viktor; Laidinen, Svetlana; Karjalainen, Pasi A; Ylä-Herttuala, Seppo


    Mouse models are extremely important in studying cardiac pathologies and related electrophysiology, but very few mouse ECG analysis programs are readily available. Therefore, a mouse ECG analysis algorithm was developed and validated. Surface ECG (lead II) was acquired during transthoracic echocardiography from C57Bl/6J mice under isoflurane anesthesia. The effect of aging was studied in young (2-3 months), middle-aged (14 months) and old (20-24 months) mice. The ECG changes associated with pharmacological interventions and common cardiac pathologies, that is, acute myocardial infarction (AMI) and progressive left ventricular hypertrophy (LVH), were studied. The ECG raw data were analyzed with an in-house ECG analysis program, modified specially for mouse ECG. Aging led to increases in P-wave duration, atrioventricular conduction time (PQ interval), and intraventricular conduction time (QRS complex width), while the R-wave amplitude decreased. In addition, the prevalence of arrhythmias increased during aging. Anticholinergic atropine shortened PQ time, and beta blocker metoprolol and calcium-channel blocker verapamil increased PQ interval and decreased heart rate. The ECG changes after AMI included early JT elevation, development of Q waves, decreased R-wave amplitude, and later changes in JT/T segment. In progressive LVH model, QRS complex width was increased at 2 and especially 4 weeks timepoint, and also repolarization abnormalities were seen. Aging, drugs, AMI, and LVH led to similar ECG changes in mice as seen in humans, which could be reliably detected with this new algorithm. The developed method will be very useful for studies on cardiovascular diseases in mice.

  5. Quantification of motion artifact in ECG electrode design. (United States)

    Kearney, Kenneth; Thomas, Chris; McAdams, Eric


    We have developed a more accurate and reproducible method of quantifying motion artifact in ECG (electrocardiogram) electrodes to assist in electrode assessment and design. It uses an algorithm developed by Sensor Technology & Devices Ltd. to reliably overcome the variation in results due to differing skin types and other causes of spurious readings such as reproducibility of movements used. The method combines a clear, concise experimental protocol with a software package and DSP algorithm to produce a transferable result for one pair of electrodes that can be used for comparison.

  6. The human ECG nonlinear deterministic versus stochastic aspects

    CERN Document Server

    Kantz, H; Kantz, Holger; Schreiber, Thomas


    We discuss aspects of randomness and of determinism in electrocardiographic signals. In particular, we take a critical look at attempts to apply methods of nonlinear time series analysis derived from the theory of deterministic dynamical systems. We will argue that deterministic chaos is not a likely explanation for the short time variablity of the inter-beat interval times, except for certain pathologies. Conversely, densely sampled full ECG recordings possess properties typical of deterministic signals. In the latter case, methods of deterministic nonlinear time series analysis can yield new insights.

  7. Economic analysis of the use of coronary calcium scoring as an alternative to stress ECG in the non-invasive diagnosis of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Raman, Vivek [Brighton and Sussex University Hospitals, Brighton (United Kingdom); Royal Sussex County Hospital, Brighton (United Kingdom); McWilliams, Eric T.M. [Conquest Hospital, Hastings (United Kingdom); Holmberg, Stephen R.M.; Miles, Ken [Brighton and Sussex University Hospitals, Brighton (United Kingdom)


    To conduct an economic analysis (EA) of coronary calcium scoring (CCS) using a 0 score, as alternative to stress electrocardiography (sECG) in diagnosing coronary artery disease (CAD). A decision tree was constructed to compare four strategies for investigation of suspected CAD previously assessed in the formulation of clinical guidelines for the United Kingdom (UK) to two new strategies incorporating CCS. Sensitivity (96%; 95% CI 95.4-96.4%) and specificity (40%; 95% CI 38.7-41.4%) values for CCS were derived from a meta-analysis of 10,760 patients. Other input variables were obtained from a previous EA and average prices for hospital procedures in the UK. A threshold of pound 30,000/Quality-adjusted Life Year (QALY) was considered cost-effective. Using net monetary benefit calculations, CCS-based strategies were found to be cost-effective compared to sECG equivalents at all assessed prevalence of CAD. Using CCS prior to myocardial perfusion scintigraphy (MPS) and catheter angiography (CA) was found to be cost-effective at pre-test probabilities (PTP) below 30%. Adoption of CCS as an alternative to sECG in investigating suspected stable angina in low PTP population (<30%) would be cost-effective. In patients with PTP of CAD >30%, proceeding to MPS or CA would be more cost-effective than performing either CCS or sECG. (orig.)

  8. Effect of physiological heart rate variability on quantitative T2 measurement with ECG-gated Fast Spin Echo (FSE) sequence and its retrospective correction. (United States)

    de Roquefeuil, Marion; Vuissoz, Pierre-André; Escanyé, Jean-Marie; Felblinger, Jacques


    Quantitative T2 measurement is applied in cardiac Magnetic Resonance Imaging (MRI) for the diagnosis and follow-up of myocardial pathologies. Standard Electrocardiogram (ECG)-gated fast spin echo pulse sequences can be used clinically for T2 assessment, with multiple breath-holds. However, heart rate is subject to physiological variability, which causes repetition time variations and affects the recovery of longitudinal magnetization between TR periods. The bias caused by heart rate variability on quantitative T2 measurements is evaluated for fast spin echo pulse sequence. Its retrospective correction based on an effective TR is proposed. Heart rate variations during breath-holds are provided by the ECG recordings from healthy volunteers. T2 measurements were performed on a phantom with known T2 values, by synchronizing the sequence with the recorded ECG. Cardiac T2 measurements were performed twice on six volunteers. The impact of T1 on T2 is also studied. Maximum error in T2 is 26% for phantoms and 18% for myocardial measurement. It is reduced by the proposed compensation method to 20% for phantoms and 10% for in vivo measurements. Only approximate knowledge of T1 is needed for T2 correction. Heart rate variability may cause a bias in T2 measurement with ECG-gated FSE. It needs to be taken into account to avoid a misleading diagnosis from the measurements. © 2013.

  9. Wearable ECG Based on Impulse-Radio-Type Human Body Communication. (United States)

    Wang, Jianqing; Fujiwara, Takuya; Kato, Taku; Anzai, Daisuke


    Human body communication (HBC) provides a promising physical layer for wireless body area networks (BANs) in healthcare and medical applications, because of its low propagation loss and high security characteristics. In this study, we have developed a wearable electrocardiogram (ECG) which employs impulse radio (IR)-type HBC technology for transmitting vital signals on the human body in a wearable BAN scenario. The HBC-based wearable ECG has two excellent features. First, the wideband performance of the IR scheme contributed to very low radiation power so that the transceiver is easy to satisfy the extremely weak radio laws, which does not need a license. This feature can provide big convenience in the use and spread of the wearable ECG. Second, the realization of common use of sensing and transmitting electrodes based on time sharing and capacitive coupling largely simplified the HBC-based ECG structure and contributed to its miniaturization. To verify the validity of the HBC-based ECG, we evaluated its communication performance and ECG acquisition performance. The measured bit error rate, smaller than 10 (-3) at 1.25 Mb/s, showed a good physical layer communication performance, and the acquired ECG waveform and various heart-rate variability parameters in time and frequency domains exhibited good agreement with a commercially available radio-frequency ECG and a Holter ECG. These results sufficiently showed the validity and feasibility of the HBC-based ECG for healthcare applications. This should be the first time to have realized a real-time ECG transmission by using the HBC technology.

  10. High Resolution of the ECG Signal by Polynomial Approximation

    Directory of Open Access Journals (Sweden)

    G. Rozinaj


    Full Text Available Averaging techniques as temporal averaging and space averaging have been successfully used in many applications for attenuating interference [6], [7], [8], [9], [10]. In this paper we introduce interference removing of the ECG signal by polynomial approximation, with smoothing discrete dependencies, to make up for averaging methods. The method is suitable for low-level signals of the electrical activity of the heart often less than 10 m V. Most low-level signals arising from PR, ST and TP segments which can be detected eventually and their physiologic meaning can be appreciated. Of special importance for the diagnostic of the electrical activity of the heart is the activity bundle of His between P and R waveforms. We have established an artificial sine wave to ECG signal between P and R wave. The aim focus is to verify the smoothing method by polynomial approximation if the SNR (signal-to-noise ratio is negative (i.e. a signal is lower than noise.

  11. Lossless Compression Schemes for ECG Signals Using Neural Network Predictors

    Directory of Open Access Journals (Sweden)

    C. Eswaran


    Full Text Available This paper presents lossless compression schemes for ECG signals based on neural network predictors and entropy encoders. Decorrelation is achieved by nonlinear prediction in the first stage and encoding of the residues is done by using lossless entropy encoders in the second stage. Different types of lossless encoders, such as Huffman, arithmetic, and runlength encoders, are used. The performances of the proposed neural network predictor-based compression schemes are evaluated using standard distortion and compression efficiency measures. Selected records from MIT-BIH arrhythmia database are used for performance evaluation. The proposed compression schemes are compared with linear predictor-based compression schemes and it is shown that about 11% improvement in compression efficiency can be achieved for neural network predictor-based schemes with the same quality and similar setup. They are also compared with other known ECG compression methods and the experimental results show that superior performances in terms of the distortion parameters of the reconstructed signals can be achieved with the proposed schemes.

  12. The development of wireless sensor network for ECG monitoring. (United States)

    Lin, Jun-Liang; Liu, Hsien-Chieh; Tai, Yu-Ting; Wu, Hsin-Hsien; Hsu, Shuo-Jen; Jaw, Fu-Shan; Chen, You-Yin


    The main problem we want to solve contains two subjects: The first one is the patient's pressure due to wired physiological signal estimation. With wireless sensor network technique, patients only need to carry a few small nodes, and then the physiological signal can be transmitted in the air. The other subject of the vital problem is that some protocols, like Bluetooth, provide a peer to peer wireless communication technique, but such peer to peer network may need a complex algorithm to find the best data transmission path. In this study, we use the hierarchy routing as network topology that three-layer architecture contains PAN coordinator, router and device. The study focuses on implementation of a prototype electrocardiography (ECG) system which replaces wired connections between sensor points and a central node with wireless links. Successful implementation of the final system would be of benefit to all involved in the use of ECG as access to and movement of the patient would not be impeded by the physical constraints imposed by the cables. Most aspects of the design would also be portable to other sensor applications, making the work relevant to a vast range of systems where movement of sensors is desirable and constrained by hard-wired links.

  13. Ubiquitous wireless ECG recording: a powerful tool physicians should embrace. (United States)

    Saxon, Leslie A


    The use of smart phones has increased dramatically and there are nearly a billion users on 3G and 4G networks worldwide. Nearly 60% of the U.S. population uses smart phones to access the internet, and smart phone sales now surpass those of desktop and laptop computers. The speed of wireless communication technology on 3G and 4G networks and the widespread adoption and use of iOS equipped smart phones (Apple Inc., Cupertino, CA, USA) provide infrastructure for the transmission of wireless biomedical data, including ECG data. These technologies provide an unprecedented opportunity for physicians to continually access data that can be used to detect issues before symptoms occur or to have definitive data when symptoms are present. The technology also greatly empowers and enables the possibility for unprecedented patient participation in their own medical education and health status as well as that of their social network. As patient advocates, physicians and particularly cardiac electrophysiologists should embrace the future and promise of wireless ECG recording, a technology solution that can truly scale across the global population. © 2013 Wiley Periodicals, Inc.

  14. Retrospectively ECG-gated multi-detector row CT of the chest: does ECG-gating improve three-dimensional visualization of the bronchial tree?

    Energy Technology Data Exchange (ETDEWEB)

    Schertler, T.; Wildermuth, S.; Willmann, J.K.; Crook, D.W.; Marincek, B.; Boehm, T. [Dept. Medical Radiology, Inst. of Diagnostic Radiology, Univ. Hospital Zurich (Switzerland)


    Purpose: To determine the impact of retrospectively ECG-gated multi-detector row CT (MDCT) on three-dimensional (3D) visualization of the bronchial tree and virtual bronchoscopy (VB) as compared to non-ECG-gated data acquisition. Materials and Methods: Contrast-enhanced retrospectively ECG-gated and non-ECG-gated MDCT of the chest was performed in 25 consecutive patients referred for assessment of coronary artery bypass grafts and pathology of the ascending aorta. ECG-gated MDCT data were reconstructed in diastole using an absolute reverse delay of -400 msec in all patients. In 10 patients additional reconstructions at -200 msec, -300 msec, and -500 msec prior to the R-wave were performed. Shaded surface display (SSD) and virtual bronchoscopy (VB) for visualization of the bronchial segments was performed with ECG-gated and non-ECG-gated MDCT data. The visualization of the bronchial tree underwent blinded scoring. Effective radiation dose and signal-to-noise ratio (SNR) for both techniques were compared. Results: There was no significant difference in visualizing single bronchial segments using ECG-gated compared to non-ECG-gated MDCT data. However, the total sum of scores for all bronchial segments visualized with non-ECG-gated MDCT was significantly higher compared to ECG-gated MDCT (P<0.05). The summary scores for visualization of bronchial segments for different diastolic reconstructions did not differ significantly. The effective radiation dose and the SNR were significantly higher with the ECG-gated acquisition technique (P<0.05). Conclusion: The bronchial tree is significantly better visualized when using non-ECG-gated MDCT compared to ECG-gated MDCT. Additionally, non-ECG-gated techniques require less radiation exposure. Thus, the current retrospective ECG-gating technique does not provide any additional benefit for 3D visualization of the bronchial tree and VB. (orig.) [German] Ziel: Untersuchung des Einflusses der retrospektiven EKG-Synchronisierung auf

  15. Suppression of baseline wander in the ECG using a bilinearly transformed, null-phase filter. (United States)

    Pottala, E W; Bailey, J J; Horton, M R; Gradwohl, J R


    The purpose of this study was to design and test a bilinearly transformed, null-phase (BLT/NP) filter for removing baseline wander and to compare it with the cubic spline for performance. For this purpose, the ECG data were filtered to remove high-frequency noise and low-frequency baseline wander to form a set of "clean" ECGs. Artificial low-frequency noise mimicking typical baseline wander was constructed from sine and cosine waves at 0.20 and 0.45 Hz and with amplitudes of 400 and 300 microV, respectively, and added to the "clean" ECGs to form the "test" ECGs. The BLT/NP filter and the cubic spline method each were applied to a "test" ECG to form a "restored" ECG. The measure of performance was the root mean square difference (RMSD) between the "restored" ECG and the initial "clean" ECG. RMSD values showed that on the average the BLT/NP filter performed as well as the cubic spline method and has the advantage that accurate determination of the QRS onset is not required.

  16. An automated ECG system in a large hospital: coding, storage and retrieval of tracings

    NARCIS (Netherlands)

    Meijler, F.L.; Robles de Medina, E.O.; Helder, J.C.


    This paper describes an automated ECG-system as it is used in the 1000-bed University Hospital Utrecht, The Netherlands. The system involves a "hybride" approach, combining computer analysis of the ECG by means of the Pipberger program with the reading by a cardiologist via a specially developed cod

  17. A novel approach for an ECG electrode integrated into a transcutaneous sensor. (United States)

    Hölscher, U


    The integration of an ECG-electrode into a common transcutaneous sensor allows simple handling and leads to a reduction of the physiological stress of pre-term infants. Furthermore it may allow future replacement of an invasive method to measure the ECG under labour by a non-invasive one.

  18. ECG movement artefacts can be greatly reduced with the aid of a movement absorbing device

    DEFF Research Database (Denmark)

    Harrison, Adrian Paul; Wandall, Kirsten; Thorball, Jørgen


    Accurate ECG signal analysis can be confounded by electric lead, and/or electrode movements varying in origin from, for example, hiccups, tremor or patient restlessness. ECG signals recorded using either a conventional electrode holder or with the aid of an electrode holder capable of absorbing m...

  19. Detectability of motions in AAA with ECG-gated CTA: A quantitative study

    NARCIS (Netherlands)

    Klein, Almar; Oostveen, Luuk J.; Greuter, Marcel J.W.; Hoogeveen, Yvonne; Schultze Kool, Leo J.; Slump, Cornelis H.; Renema, W. Klaas Jan


    Purpose: ECG-gated CT enables the visualization of motions caused by the beating of the heart. Although ECG gating is frequently used in cardiac CT imaging, this technique is also very promising for evaluating vessel wall motion of the aortic artery and the motions of (stent grafts inside) abdominal

  20. Detectability of motions in AAA with ECG-gated CTA: a quantitative study.

    NARCIS (Netherlands)

    Klein, A.; Oostveen, L.J.; Greuter, M.J.; Hoogeveen, Y.L.; Kool, L.J.; Slump, C.H.; Renema, W.K.J.


    PURPOSE: ECG-gated CT enables the visualization of motions caused by the beating of the heart. Although ECG gating is frequently used in cardiac CT imaging, this technique is also very promising for evaluating vessel wall motion of the aortic artery and the motions of (stent grafts inside) abdominal

  1. Detectability of motions in AAA with ECG-gated CTA : A quantitative study

    NARCIS (Netherlands)

    Klein, Almar; Oostveen, Luuk J.; Greuter, Marcel J. W.; Hoogeveen, Yvonne; Kool, Leo J. Schultze; Slump, Cornelis H.; Renema, W. Klaas Jan


    Purpose: ECG-gated CT enables the visualization of motions caused by the beating of the heart. Although ECG gating is frequently used in cardiac CT imaging, this technique is also very promising for evaluating vessel wall motion of the aortic artery and the motions of (stent grafts inside) abdominal

  2. Simple electrocardiogram (ECG) signal analyzer for homecare system among the elderly. (United States)

    Lin, Liuh-Chii; Yeh, Yun-Chi; Ho, Kuei-Jung


    This study presents a simple electrocardiogram (ECG) signal analyzer for homecare system among the elderly. It can transmit ECG signals of patient around his/her house through Bluetooth to computers in house. ECG signals are analyzed by the computer. If abnormal case of heartbeat is found, the emergency call is automatically dialed. Meanwhile, the determined heartbeat case of ECG signals will be forwarded to patient's MD through internet. Therefore, the patient can do whatever he/she wants around his/her house with our proposed simple cardiac arrhythmias signal analyzer. The proposed consists of five major processing stages: (i) preprocessing stage for enlarging ECG signals' amplitude and eliminating noises; (ii) ECG signal transmitter/receiver stage, ECG signals are transmitted through Bluetooth to the signal receiver in patient's house; (iii) QRS extraction stage for detecting QRS waveform using the Difference Operation Method (DOM) method; (iv) qualitative features stage for qualitative feature selection on ECG signals; and (v) classification stage for determining patient's heartbeat cases using the Principal Component Analysis (PCA) method. In the experiment, the total classification accuracy (TCA) was approximately 93.19% in average.

  3. Interoperability in digital electrocardiography: harmonization of ISO/IEEE x73-PHD and SCP-ECG. (United States)

    Trigo, Jesús D; Chiarugi, Franco; Alesanco, Alvaro; Martínez-Espronceda, Miguel; Serrano, Luis; Chronaki, Catherine E; Escayola, Javier; Martínez, Ignacio; García, José


    The ISO/IEEE 11073 (x73) family of standards is a reference frame for medical device interoperability. A draft for an ECG device specialization (ISO/IEEE 11073-10406-d02) has already been presented to the Personal Health Device (PHD) Working Group, and the Standard Communications Protocol for Computer-Assisted ElectroCardioGraphy (SCP-ECG) Standard for short-term diagnostic ECGs (EN1064:2005+A1:2007) has recently been approved as part of the x73 family (ISO 11073-91064:2009). These factors suggest the coordinated use of these two standards in foreseeable telecardiology environments, and hence the need to harmonize them. Such harmonization is the subject of this paper. Thus, a mapping of the mandatory attributes defined in the second draft of the ISO/IEEE 11073-10406-d02 and the minimum SCP-ECG fields is presented, and various other capabilities of the SCP-ECG Standard (such as the messaging part) are also analyzed from an x73-PHD point of view. As a result, this paper addresses and analyzes the implications of some inconsistencies in the coordinated use of these two standards. Finally, a proof-of-concept implementation of the draft x73-PHD ECG device specialization is presented, along with the conversion from x73-PHD to SCP-ECG. This paper, therefore, provides recommendations for future implementations of telecardiology systems that are compliant with both x73-PHD and SCP-ECG.

  4. An automated ECG system in a large hospital: coding, storage and retrieval of tracings

    NARCIS (Netherlands)

    Meijler, F.L.; Robles de Medina, E.O.; Helder, J.C.


    This paper describes an automated ECG-system as it is used in the 1000-bed University Hospital Utrecht, The Netherlands. The system involves a "hybride" approach, combining computer analysis of the ECG by means of the Pipberger program with the reading by a cardiologist via a specially developed cod

  5. Effects of electrocardiography contamination and comparison of ECG removal methods on upper trapezius electromyography recordings. (United States)

    Marker, Ryan J; Maluf, Katrina S


    Electromyography (EMG) recordings from the trapezius are often contaminated by the electrocardiography (ECG) signal, making it difficult to distinguish low-level muscle activity from muscular rest. This study investigates the influence of ECG contamination on EMG amplitude and frequency estimations in the upper trapezius during muscular rest and low-level contractions. A new method of ECG contamination removal, filtered template subtraction (FTS), is described and compared to 30 Hz high-pass filter (HPF) and averaged template subtraction (ATS) methods. FTS creates a unique template of each ECG artifact using a low-pass filtered copy of the contaminated signal, which is subtracted from contaminated periods in the original signal. ECG contamination results in an over-estimation of EMG amplitude during rest in the upper trapezius, with negligible effects on amplitude and frequency estimations during low-intensity isometric contractions. FTS and HPF successfully removed ECG contamination from periods of muscular rest, yet introduced errors during muscle contraction. Conversely, ATS failed to fully remove ECG contamination during muscular rest, yet did not introduce errors during muscle contraction. The relative advantages and disadvantages of different ECG contamination removal methods should be considered in the context of the specific motor tasks that require analysis.

  6. Interactive Videoconference Supported Teaching in Undergraduate Nursing: A Case Study for ECG (United States)

    Celikkan, Ufuk; Senuzun, Fisun; Sari, Dilek; Sahin, Yasar Guneri


    This paper describes how interactive videoconference can benefit the Electrocardiography (ECG) skills of undergraduate nursing students. We have implemented a learning system that interactively transfers the visual and practical aspects of ECG from a nursing skills lab into a classroom where the theoretical part of the course is taught. The…

  7. Detection of myocardial viability by means of Single Proton Emission Computed Tomography (Perfused SPECT) dual {sup 201} Tl (rest of 15 minutes, 24 late hours and 24 hours reinjection) and gated-SPECT {sup 99m} Tc-SESTAMIBI in effort or stimulation of the coronary reserves; Deteccion de viabilidad miocardica mediante tomografia por emision de foton unico (SPECT perfusorio) dual {sup 201} Talio (Reposo de 15 minutos, 24 horas tardio y 24 horas reinyeccion) y gated-SPECT {sup 99m} Tc-SESTAMIBI en esfuerzo o estimulo de reserva coronaria

    Energy Technology Data Exchange (ETDEWEB)

    Mendoza V, R


    The objective of this work was to determine if the images of SPECT {sup 201} TI in rest of 15 minutes, 24 late hours and Gated-SPECT {sup 99m} Tc-SESTAMIBI in effort or stimulation of coronary reservation correlate with the study of 24 hours post reinjection of {sup 201}TI to determine the presence of having knitted viable myocardium. Material and methods: 29 patients were studied with coronary arterial illness (EAC) to who are carried out SPECT {sup 201} TI in rest with images of 15 minutes, 24 late hours and 24 hours reinjection, by means of the administration of {sup 201}TI to dose of 130 MBq and reinjection with 37 MBq. and Gated-SPECT {sup 99m}Tc-SESTAMIBI in effort or stimulation of coronary reservation, later to the administration of 1110 MBq. Results: 29 patients were included according to inclusion approaches and exclusion, of those which 22 (75.86%) they correspond at the masculine sex and 7 (24.13%) to the feminine one, with an average of 62.1 year-old age, 2320 segments myocardial were analysed so much it is phase post-effort as rest; they were diagnosed a total of 264 segments with heart attack, of which viability myocardium was observed in 174 segments. The statistical tests are analysis of frequencies. The non parametric test of Wilcoxon and Mann-Whitney. Conclusions: the viability myocardial at the 24 late hours and 24 hours reinjection was similar; significant difference exists between the study of 15 minutes and 24 hours reinjection, ischemic illness was also demonstrated in territories different to the heart attack area in the studies of 15 minutes, late 24 hours and 24 hours reinjection. (Author)

  8. Relative Amplitude based Features of characteristic ECG-Peaks for Identification of Coronary Artery Disease (United States)

    Gohel, Bakul; Tiwary, U. S.; Lahiri, T.

    Coronary artery disease or Myocardial Infarction is the leading cause of death and disability in the world. ECG is widely used as a cheap diagnostic tool for diagnosis of coronary artery disease but has low sensitivity with the present criteria based on ST-segment, T wave and Q wave changes. So to increase the sensitivity of the ECG we have introduced relative amplitude based new features of characteristic ‘R’ and ‘S’ ECG-peaks between two leads. Relative amplitude based features shows remarkable capability in discriminating Myocardial Infarction and Healthy pattern using backpropogation neural network classifier yield results with 81.82% sensitivity and 81.82% specificity. Also relative amplitude might be an efficient method in minimizing the effect of body composition on ECG amplitude based features without use of any information from other than ECG

  9. Performance of human body communication-based wearable ECG with capacitive coupling electrodes. (United States)

    Sakuma, Jun; Anzai, Daisuke; Wang, Jianqing


    Wearable electrocardiogram (ECG) is attracting much attention in daily healthcare applications, and human body communication (HBC) technology provides an evident advantage in making the sensing electrodes of ECG also working for transmission through the human body. In view of actual usage in daily life, however, non-contact electrodes to the human body are desirable. In this Letter, the authors discussed the ECG circuit structure in the HBC-based wearable ECG for removing the common mode noise when employing non-contact capacitive coupling electrodes. Through the comparison of experimental results, they have shown that the authors' proposed circuit structure with the third electrode directly connected to signal ground can provide an effect on common mode noise reduction similar to the usual drive-right-leg circuit, and a sufficiently good acquisition performance of ECG signals.

  10. Application of the Wireless Digital Transmission Technology in Remote ECG Monitoring System

    Institute of Scientific and Technical Information of China (English)

    Xu,Lixin; Li,Qingliang; Chen,Zhen; Qi,Xinbo; Zhang,Xincheng


    Heart disease is one of the main diseases menace human' s health. The limited monitoring ability and limited serving ability are shortcomings of the existing remote ECG (electrocardiograph) monitoring system. It is practical to bring ECG monitoring from hospital to home. A new method is introduced that the application of wireless digital transmission technology in remote ECG monitoring system. In the system, the portable ECG monitoring device to collect and transmit patient""s electrocardiogram signals and the device to transmit and receive ECG signals are designed by using the PTR2000. The method solves the remote collection and transmission of patient's electrocardiogram signals, and creates the condition of the transmitting of patient"" s electrocardiogram signals through the Broadband network.

  11. Application of the Wireless Digital Transmission Technology in Remote ECG Monitoring System

    Institute of Scientific and Technical Information of China (English)

    Xu,Lixin; Li,Qingliang; Chen,Zhen; Qi,Xinbo; Zhang,Xincheng


    Heart disease is one of the main diseases menace human's health. The limited monitoring ability and limited serving ability are shortcomings of the existing remote ECG (electrocardiograph) monitoring system. It is practical to bring ECG monitoring from hospital to home. A new method is introduced that the application of wireless digital transmission technology in remote ECG monitoring system. In the system, the portable ECG monitoring device to collect and transmit patient's electrocardiogram signals and the device to transmit and receive ECG signals are designed by using the PTR2000. The method solves the remote collection and transmission of patient s electrocardiogram signals, and creates the condition of the transmitting of patient's electrocardiogram signals through the Broadband network.

  12. ECG Signal Processing, Classification and Interpretation A Comprehensive Framework of Computational Intelligence

    CERN Document Server

    Pedrycz, Witold


    Electrocardiogram (ECG) signals are among the most important sources of diagnostic information in healthcare so improvements in their analysis may also have telling consequences. Both the underlying signal technology and a burgeoning variety of algorithms and systems developments have proved successful targets for recent rapid advances in research. ECG Signal Processing, Classification and Interpretation shows how the various paradigms of Computational Intelligence, employed either singly or in combination, can produce an effective structure for obtaining often vital information from ECG signals. Neural networks do well at capturing the nonlinear nature of the signals, information granules realized as fuzzy sets help to confer interpretability on the data and evolutionary optimization may be critical in supporting the structural development of ECG classifiers and models of ECG signals. The contributors address concepts, methodology, algorithms, and case studies and applications exploiting the paradigm of Comp...

  13. HIN4/397: Designing the Web- and Fax-based Consultancy and Information Service "EcgConsult" for Clinicians Dealing with ECG Diagnostics and Rhythmologic Problems (United States)

    Elsner, C; Hindricks, G; Kottkamp, H


    /patient identification have been developed. Discussion The platform "EcgConsult" provides a network with fast and easy access to a specific target group and thus allows easy information exchange between the Heart Center Leipzig and rhythmologic experts and non-experts. This exchange may generate synergy effects by offering both groups a variety of data and information. Due to the use of web- and fax-based technology, the access to the service is easy and does not require PC-equipment or a scanner. The requests can be answered by the Heart Center consultants from any remote location world-wide. For the future open-ended architecture allows the participation of further consultants from clinics all over the world. The knowledge gathered from this project may help setting up guidelines for the development of other web-based medical competence centers / information services.

  14. Performance of short ECG recordings twice daily to detect paroxysmal atrial fibrillation in stroke and transient ischemic attack patients

    DEFF Research Database (Denmark)

    Poulsen, Mai B; Binici, Zeynep; Dominguez Vall-Lamora, Maria Helena


    AIMS: Prolonged cardiac monitoring after stroke is recommended though there is no consensus on optimal methods. Short-term ECG recordings with a "thumb-ECG" device have shown promising preliminary results regarding effectiveness and cost benefit. We aimed to examine the performance of thumb-ECG a...

  15. An awareness approach to analyze ECG streaming data. (United States)

    Don, S; Chung, Duckwon; Choi, Eunmi; Min, Dugki


    Real-time remote health monitoring systems are experiencing tremendous advancement resulting from improvements in low power, reliable sensors; yet they are still constrained to low-level interpretation. Automatic data analysis continues to be a tedious task due to a lack of efficient, reliable platforms for data analysis. In this paper, we present a system for monitoring patients remotely by emphasizing the strength of Complex Event Processing (CEP) and Situation Awareness. In this approach, the system makes decisions in a declarative way, which helps medical experts to understand the situation in a more realistic manner. The primary objective of this paper is to explicate the different components inside the system. To verify the technical feasibility of each component, the proposed system is implemented and tested using ECG data.

  16. [ECG indices in dogs after inhalation of 239Pu]. (United States)

    Karpova, V N


    Dogs of both sexes aged 2 to 4 were subjected to inhalation inoculation with polymer 239Pu or submicron 239PuO2 aerosols in amounts close to acute, subacute and chronically effective ones. ECG was recorded in standard, amplified and single leads (V3). All calculations were done by lead II. Signs of the right heart overburdening were noted in the presence of the P-pulmonale complex, deep S1 wave or cardiac electrical axis of SI-SII-SIII type. Signs of the right heart overburdening were revealed after inhalation of polimer 239Pu (70%). The absence of similar changes in damage caused by 239Pu could be attributed to its fast resorption from the lungs resulting in more moderate lesion of the respiratory organs.

  17. Microcontroller-based underwater acoustic ECG telemetry system. (United States)

    Istepanian, R S; Woodward, B


    This paper presents a microcontroller-based underwater acoustic telemetry system for digital transmission of the electrocardiogram (ECG). The system is designed for the real time, through-water transmission of data representing any parameter, and it was used initially for transmitting in multiplexed format the heart rate, breathing rate and depth of a diver using self-contained underwater breathing apparatus (SCUBA). Here, it is used to monitor cardiovascular reflexes during diving and swimming. The programmable capability of the system provides an effective solution to the problem of transmitting data in the presence of multipath interference. An important feature of the paper is a comparative performance analysis of two encoding methods, Pulse Code Modulation (PCM) and Pulse Position Modulation (PPM).

  18. "ECG variability contour" method reveals amplitude changes in both ischemic patients and normal subjects during Dipyridamole stress: a preliminary report. (United States)

    Dori, Guy; Gershinsky, Michal; Ben-Haim, Simona; Lewis, Basil S; Bitterman, Haim


    To detect and quantify consistent ECG amplitude changes, the "ECG variability contour" (EVC) method was proposed. Using this method we investigated amplitude changes in subjects undergoing myocardial perfusion imaging (MPI) with Dipyridamole (Dp). Fifty-three patients having reversible perfusion defects and 19 normal subjects (NS) who were free of: perfusion defects on their MPI, standard ST-T changes during Dp stress, and a negative clinical follow up. Mean ∏¹() was similar for the NS and patient group (6.2 ± 6.1 vs. 6.3 ± 6.2, P = 0.95). was 4.6 ± 3.0 in patients not having ST-T changes during Dp stress (n = 42), whereas in patients having ST-T changes (n = 11) it was 13.1 ± 10.2 (P was smaller than , which in turn was smaller than . The values of , , and for the NS, patients without and with ST-T changes were: 26.8 ± 28.6, 42.6 ± 41.8, 44.9 ± 36.5; 19.6 ± 20.8, 26.4 ± 31.4, 38.7 ± 27.3; 51.0 ± 30.0, 71.0 ± 36.8, 75.1 ± 20.9, respectively (P EVC method. The EVC method did not distinguish between NS and patients in this clinical setting.

  19. Integration of multivariate empirical mode decomposition and independent component analysis for fetal ECG separation from abdominal signals. (United States)

    Thanaraj, Palani; Roshini, Mable; Balasubramanian, Parvathavarthini


    The fetal electrocardiogram (FECG) signals are essential to monitor the health condition of the baby. Fetal heart rate (FHR) is commonly used for diagnosing certain abnormalities in the formation of the heart. Usually, non-invasive abdominal electrocardiogram (AbECG) signals are obtained by placing surface electrodes in the abdomen region of the pregnant woman. AbECG signals are often not suitable for the direct analysis of fetal heart activity. Moreover, the strength and magnitude of the FECG signals are low compared to the maternal electrocardiogram (MECG) signals. The MECG signals are often superimposed with the FECG signals that make the monitoring of FECG signals a difficult task. Primary goal of the paper is to separate the fetal electrocardiogram (FECG) signals from the unwanted maternal electrocardiogram (MECG) signals. A multivariate signal processing procedure is proposed here that combines the Multivariate Empirical Mode Decomposition (MEMD) and Independent Component Analysis (ICA). The proposed method is evaluated with clinical abdominal signals taken from three pregnant women (N= 3) recorded during the 38-41 weeks of the gestation period. The number of fetal R-wave detected (NEFQRS), the number of unwanted maternal peaks (NMQRS), the number of undetected fetal R-wave (NUFQRS) and the FHR detection accuracy quantifies the performance of our method. Clinical investigation with three test subjects shows an overall detection accuracy of 92.8%. Comparative analysis with benchmark signal processing method such as ICA suggests the noteworthy performance of our method.

  20. Ambulatory recorded ST segment depression on ECG is associated with lower cognitive function in healthy elderly men

    Directory of Open Access Journals (Sweden)

    Sölve Elmståhl


    Full Text Available Sölve Elmståhl, Linda FuruängDepartment of Health Sciences, Division of Geriatric Medicine, Lund University, Malmö University Hospital, Malmö, SwedenAbstract: ST segment depression (STDE has been found to be associated with cardiovascular disease in the elderly. Studies of the relation of ambulatory STDE to cognitive function in elderly persons aged 80 years or above is lacking.Objective: To study the association between STDE and cognition.Design and participants: A cross-sectional cohort study of 88 81-year-old men from the population study “Men born in 1914” investigated in an outpatient research clinic. Measurements included ambulatory 24-hour electrocardiogram (ECG monitoring and a cognitive test battery of six tests. Proportion of lower cognitive function was calculated for each test in relation to STDE during the day and at night-time.Results: Fifty-eight percent of the men had STDE and a higher proportion with low visuospatial cognitive function was found among those with STDE compared to the others (84% vs 59%; p = 0.014. A significant trend was noted for subjects without STDE compared to STDE night-time less than 60 minutes and night-time more than 60 minutes for spatial and verbal cognitive functions (p = 0.022. No trends were noted for STDE daytime. Maximal STDE during night showed similar association to spatial function (Benton Visual Retention test, r = -0.26; p = 0.028. Even when seven subjects with a history of stroke were excluded, the occurrence of STDE was associated to lower visuospatial cognitive function compared to those without STDE (87% vs 57%; p = 0.004.Conclusion: ST segment depression on ECG is common among elderly men and might be a vascular risk factor for cognitive deterioration.Keywords: aged 80 and over, ST segment depression, ambulatory long-term ECG, cognition, cohort study, risk factors

  1. Cardiopulmonary exercise testing is more accurate than ECG-stress testing in diagnosing myocardial ischemia in subjects with chest pain. (United States)

    Belardinelli, Romualdo; Lacalaprice, Francesca; Tiano, Luca; Muçai, Andi; Perna, Gian Piero


    Cardiopulmonary exercise stress testing (CPET) is used to grade the severity of heart failure and to assess its prognosis. However it is unknown whether CPET may improve diagnostic accuracy of standard ECG stress testing to identify or exclude obstructive coronary artery disease (O-CAD) in patients with chest pain. We prospectively studied 1265 consecutive subjects (55 ± 8 years, 156 women) who were evaluated with ECG stress testing (ET) for chest pain. No one had a documented O-CAD. All patients performed an incremental CPET with ECG recordings on an electronically braked cycle ergometer. Of 1265 patients, 73 had a positive CPET and 1192 had a negative CPET. Seventy-three patients with a positive CPET and 71 patients with a negative CPET agreed to undergo nuclear SPECT imaging and coronary angiography. Follow-up lasted 48 ± 7 months. As compared with ET, sensitivity, specificity, PPV and NPV were all improved significantly (ET: 48%, 55%, 33%, 95%; CPET: 88%, 98%, 73%, 99%, respectively, PVO2>91% of predicted VO2 max and absence of VO2-related signs of myocardial ischemia had no evidence of O-CAD in 100% of cases. Cardiac events occurred in 32 patients with a positive CPET and 8 patients with a negative CPET (log rank 18.2, P<0.0001). In patients with chest pain, CPET showed a better diagnostic and predictive accuracy than traditional ET to detect/exclude myocardial ischemia. Its use should be encouraged among physicians as a first line diagnostic tool in clinical practice. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Assurance of energy efficiency and data security for ECG transmission in BASNs. (United States)

    Ma, Tao; Shrestha, Pradhumna Lal; Hempel, Michael; Peng, Dongming; Sharif, Hamid; Chen, Hsiao-Hwa


    With the technological advancement in body area sensor networks (BASNs), low cost high quality electrocardiographic (ECG) diagnosis systems have become important equipment for healthcare service providers. However, energy consumption and data security with ECG systems in BASNs are still two major challenges to tackle. In this study, we investigate the properties of compressed ECG data for energy saving as an effort to devise a selective encryption mechanism and a two-rate unequal error protection (UEP) scheme. The proposed selective encryption mechanism provides a simple and yet effective security solution for an ECG sensor-based communication platform, where only one percent of data is encrypted without compromising ECG data security. This part of the encrypted data is essential to ECG data quality due to its unequally important contribution to distortion reduction. The two-rate UEP scheme achieves a significant additional energy saving due to its unequal investment of communication energy to the outcomes of the selective encryption, and thus, it maintains a high ECG data transmission quality. Our results show the improvements in communication energy saving of about 40%, and demonstrate a higher transmission quality and security measured in terms of wavelet-based weighted percent root-mean-squared difference.

  3. A low-power portable ECG sensor interface with dry electrodes (United States)

    Xiaofei, Pu; Lei, Wan; Hui, Zhang; Yajie, Qin; Zhiliang, Hong


    This paper describes a low-power portable sensor interface dedicated to sensing and processing electrocardiogram (ECG) signals. Dry electrodes were employed in this ECG sensor, which eliminates the need of conductive gel and avoids complicated and mandatory skin preparation before electrode attachment. This ECG sensor system consists of two ICs, an analog front-end (AFE) and a successive approximation register analog-to-digital converter (SAR ADC) containing a relaxation oscillator. This proposed design was fabricated in a 0.18 μm 1P6M standard CMOS process. The AFE for extracting the biopotential signals is essential in this ECG sensor. In measurements, the AFE obtains a mid-band gain of 45 dB, a bandwidth from 0.6 to 160 Hz, and a total input referred noise of 2.8 μV rms while consuming 1 μW from the 1.8 V supply. The noise efficiency factor (NEF) of our design is 3.4. After conditioning, the amplified ECG signal is digitized by a 12-bit SAR ADC with 61.8 dB SNDR and 220 fJ/conversion-step. Finally, a complete ECG sensor interface with three dry copper electrodes is demonstrated in real-word setting, showing successful recordings of a capture ECG waveform.

  4. [The relationship between conventional ECG and the culprit coronary artery in acute myocardial infarct]. (United States)

    César, L A; Moretti, M A; Ramires, J A; Nussbacher, A; Consolim, F M; Moffa, P J; da Luz, P L; Bellotti, G M; Pileggi, F


    To evaluate electrocardiogram (ECG) in detecting acute myocardial infarction (AMI) during the first 12 hours of symptoms and its relationship to the culprit coronary artery. We studied 68 patients aged 55.6 (30 to 76) years, 61 males, with AMI confirmed by elevated CKMB isoenzyme and cinecoronariography (CINE). In all of them we obtained two ECG: first (i), with or = 5 days during evolution. ECG were analyzed in order to disclose up and downward ST-T segments > or = 1 mm, new Q waves > or = 0.04 s and R/S > or = 1 plus downward ST-T segment in leads V1 and V2. Then we have done correlation between these and the culprit coronary lesions at CINE. The culprit coronary lesions were: right coronary artery (RCA) in 16, left circumflex (LC) in 26 and left anterior descending (LAD) in 31 cases. According to the ECG, the RCA determined inferior AMI in all patients and the LC only in 62% of cases. Posterior AMI due to LC was seen in 81% of cases at ECG and, associated with lateral AMI, in 52%. Lone lateral AMI was seen in 5% and true posterior in 14% of cases, all of them due to LC. False negative ECG (i) in AMI is in fact due to LC occlusion which, frequently, causes posterior wall more then inferior wall myocardial infarction at ECG.

  5. An IoT-cloud Based Wearable ECG Monitoring System for Smart Healthcare. (United States)

    Yang, Zhe; Zhou, Qihao; Lei, Lei; Zheng, Kan; Xiang, Wei


    Public healthcare has been paid an increasing attention given the exponential growth human population and medical expenses. It is well known that an effective health monitoring system can detect abnormalities of health conditions in time and make diagnoses according to the gleaned data. As a vital approach to diagnose heart diseases, ECG monitoring is widely studied and applied. However, nearly all existing portable ECG monitoring systems cannot work without a mobile application, which is responsible for data collection and display. In this paper, we propose a new method for ECG monitoring based on Internet-of-Things (IoT) techniques. ECG data are gathered using a wearable monitoring node and are transmitted directly to the IoT cloud using Wi-Fi. Both the HTTP and MQTT protocols are employed in the IoT cloud in order to provide visual and timely ECG data to users. Nearly all smart terminals with a web browser can acquire ECG data conveniently, which has greatly alleviated the cross-platform issue. Experiments are carried out on healthy volunteers in order to verify the reliability of the entire system. Experimental results reveal that the proposed system is reliable in collecting and displaying real-time ECG data, which can aid in the primary diagnosis of certain heart diseases.

  6. A low-power portable ECG sensor interface with dry electrodes

    Institute of Scientific and Technical Information of China (English)

    Pu Xiaofei; Wan Lei; Zhang Hui; Qin Yajie; Hong Zhiliang


    This paper describes a low-power portable sensor interface dedicated to sensing and processing electrocardiogram (ECG) signals.Dry electrodes were employed in this ECG sensor,which eliminates the need of conductive gel and avoids complicated and mandatory skin preparation before electrode attachment.This ECG sensor system consists of two ICs,an analog front-end (AFE) and a successive approximation register analog-to-digital converter (SAR ADC) containing a relaxation oscillator.This proposed design was fabricated in a 0.18 μm 1P6M standard CMOS process.The AFE for extracting the biopotential signals is essential in this ECG sensor.In measurements,the AFE obtains a mid-band gain of 45 dB,a bandwidth from 0.6 to 160 Hz,and a total input referred noise of 2.8 μV rms while consuming 1 μW from the 1.8 V supply.The noise efficiency factor (NEF) of our design is 3.4.After conditioning,the amplified ECG signal is digitized by a 12-bit SAR ADC with 61.8 dB SNDR and 220 fJ/conversion-step.Finally,a complete ECG sensor interface with three dry copper electrodes is demonstrated in real-word setting,showing successful recordings of a capture ECG waveform.

  7. Low-power analog integrated circuits for wireless ECG acquisition systems. (United States)

    Tsai, Tsung-Heng; Hong, Jia-Hua; Wang, Liang-Hung; Lee, Shuenn-Yuh


    This paper presents low-power analog ICs for wireless ECG acquisition systems. Considering the power-efficient communication in the body sensor network, the required low-power analog ICs are developed for a healthcare system through miniaturization and system integration. To acquire the ECG signal, a low-power analog front-end system, including an ECG signal acquisition board, an on-chip low-pass filter, and an on-chip successive-approximation analog-to-digital converter for portable ECG detection devices is presented. A quadrature CMOS voltage-controlled oscillator and a 2.4 GHz direct-conversion transmitter with a power amplifier and upconversion mixer are also developed to transmit the ECG signal through wireless communication. In the receiver, a 2.4 GHz fully integrated CMOS RF front end with a low-noise amplifier, differential power splitter, and quadrature mixer based on current-reused folded architecture is proposed. The circuits have been implemented to meet the specifications of the IEEE 802.15.4 2.4 GHz standard. The low-power ICs of the wireless ECG acquisition systems have been fabricated using a 0.18 μm Taiwan Semiconductor Manufacturing Company (TSMC) CMOS standard process. The measured results on the human body reveal that ECG signals can be acquired effectively by the proposed low-power analog front-end ICs.

  8. A novel low-complexity digital filter design for wearable ECG devices. (United States)

    Asgari, Shadnaz; Mehrnia, Alireza


    Wearable and implantable Electrocardiograph (ECG) devices are becoming prevailing tools for continuous real-time personal health monitoring. The ECG signal can be contaminated by various types of noise and artifacts (e.g., powerline interference, baseline wandering) that must be removed or suppressed for accurate ECG signal processing. Limited device size, power consumption and cost are critical issues that need to be carefully considered when designing any portable health monitoring device, including a battery-powered ECG device. This work presents a novel low-complexity noise suppression reconfigurable finite impulse response (FIR) filter structure for wearable ECG and heart monitoring devices. The design relies on a recently introduced optimally-factored FIR filter method. The new filter structure and several of its useful features are presented in detail. We also studied the hardware complexity of the proposed structure and compared it with the state-of-the-art. The results showed that the new ECG filter has a lower hardware complexity relative to the state-of-the-art ECG filters.

  9. Using simulated noise to define optimal QT intervals for computer analysis of ambulatory ECG. (United States)

    Tikkanen, P E; Sellin, L C; Kinnunen, H O; Huikuri, H V


    The ambulatory electrocardiogram (ECG) is an important medical tool, not only for diagnosis of adverse cardiac events, but also to predict the risk of such events occurring. The 24-hour ambulatory ECG has certain problems and drawbacks because the signal is corrupted by noise from various sources and also several other conditions which may alter the ECG morphology. We have developed a Windows based program for the computer analysis of ambulatory ECG which attempts to address these problems. The software includes options for importing ECG data, different methods of waveform analysis, data-viewing, and exporting the extracted time series. In addition, the modular structure allows for flexible maintenance and expansion of the software. The ECG was recorded using a Holter device and oversampled to enhance the fidelity of the low sampling rate of the ambulatory ECG. The influence of different sampling rates on the interval variability were studied. The noise sensitivity of the implemented algorithm was tested with several types of simulated noise and the precision of the interval measurement was reported with SD values. Our simulations showed that, in most of the cases, defining the end of QT interval at the maximum of the T wave gave the most precise measurement. The definition of the onset of the ventricular repolarization duration is most precisely made on the maximum or descending maximal slope of the R wave. We also analyzed some examples of time series from patients using power spectrum estimates in order to validate the low level QT interval variability.

  10. Wavelet-based Encoding Scheme for Controlling Size of Compressed ECG Segments in Telecardiology Systems. (United States)

    Al-Busaidi, Asiya M; Khriji, Lazhar; Touati, Farid; Rasid, Mohd Fadlee; Mnaouer, Adel Ben


    One of the major issues in time-critical medical applications using wireless technology is the size of the payload packet, which is generally designed to be very small to improve the transmission process. Using small packets to transmit continuous ECG data is still costly. Thus, data compression is commonly used to reduce the huge amount of ECG data transmitted through telecardiology devices. In this paper, a new ECG compression scheme is introduced to ensure that the compressed ECG segments fit into the available limited payload packets, while maintaining a fixed CR to preserve the diagnostic information. The scheme automatically divides the ECG block into segments, while maintaining other compression parameters fixed. This scheme adopts discrete wavelet transform (DWT) method to decompose the ECG data, bit-field preserving (BFP) method to preserve the quality of the DWT coefficients, and a modified running-length encoding (RLE) scheme to encode the coefficients. The proposed dynamic compression scheme showed promising results with a percentage packet reduction (PR) of about 85.39% at low percentage root-mean square difference (PRD) values, less than 1%. ECG records from MIT-BIH Arrhythmia Database were used to test the proposed method. The simulation results showed promising performance that satisfies the needs of portable telecardiology systems, like the limited payload size and low power consumption.

  11. Classification of a Driver's cognitive workload levels using artificial neural network on ECG signals. (United States)

    Tjolleng, Amir; Jung, Kihyo; Hong, Wongi; Lee, Wonsup; Lee, Baekhee; You, Heecheon; Son, Joonwoo; Park, Seikwon


    An artificial neural network (ANN) model was developed in the present study to classify the level of a driver's cognitive workload based on electrocardiography (ECG). ECG signals were measured on 15 male participants while they performed a simulated driving task as a primary task with/without an N-back task as a secondary task. Three time-domain ECG measures (mean inter-beat interval (IBI), standard deviation of IBIs, and root mean squared difference of adjacent IBIs) and three frequencydomain ECG measures (power in low frequency, power in high frequency, and ratio of power in low and high frequencies) were calculated. To compensate for individual differences in heart response during the driving tasks, a three-step data processing procedure was performed to ECG signals of each participant: (1) selection of two most sensitive ECG measures, (2) definition of three (low, medium, and high) cognitive workload levels, and (3) normalization of the selected ECG measures. An ANN model was constructed using a feed-forward network and scaled conjugate gradient as a back-propagation learning rule. The accuracy of the ANN classification model was found satisfactory for learning data (95%) and testing data (82%).

  12. Fetal cardiac time intervals in healthy pregnancies - an observational study by fetal ECG (Monica Healthcare System). (United States)

    Wacker-Gussmann, Annette; Plankl, Cordula; Sewald, Maria; Schneider, Karl-Theo Maria; Oberhoffer, Renate; Lobmaier, Silvia M


    Fetal electrocardiogram (fECG) can detect QRS signals in fetuses from as early as 17 weeks' gestation; however, the technique is limited by the minute size of the fetal signal relative to noise ratio. The aim of this study was to evaluate precise fetal cardiac time intervals (fCTIs) with the help of a newly developed fetal ECG device (Monica Healthcare System). In a prospective manner we included 15-18 healthy fetuses per gestational week from 32 weeks onwards. The small and wearable Monica AN24 monitoring system uses standard ECG electrodes placed on the maternal abdomen to monitor fECG, maternal ECG and uterine electromyogram (EMG). Fetal CTIs were estimated on 1000 averaged fetal heart beats. Detection was deemed successful if there was a global signal loss of less than 30% and an analysis loss of the Monica AN24 signal separation analysis of less than 50%. Fetal CTIs were determined visually by three independent measurements. A total of 149 fECGs were performed. After applying the requirements 117 fECGs remained for CTI analysis. While the onset and termination of P-wave and QRS-complex could be easily identified in most ECG patterns (97% for P-wave, PQ and PR interval and 100% for QRS-complex), the T-wave was detectable in only 41% of the datasets. The CTI results were comparable to other available methods such as fetal magnetocardiography (fMCG). Although limited and preclinical in its use, fECG (Monica Healthcare System) could be an additional useful tool to detect precise fCTIs from 32 weeks' gestational age onwards.

  13. Deployment of an Advanced Electrocardiographic Analysis (A-ECG) to Detect Cardiovascular Risk in Career Firefighters (United States)

    Dolezal, B. A.; Storer, T. W.; Abrazado, M.; Watne, R.; Schlegel, T. T.; Batalin, M.; Kaiser, W.; Smith, D. L.; Cooper, C. B.


    INTRODUCTION: Sudden cardiac death is the leading cause of line of duty death among firefighters, accounting for approximately 45% of fatalities annually. Firefighters perform strenuous muscular work while wearing heavy, encapsulating personal protective equipment in high ambient temperatures, under chaotic and emotionally stressful conditions. These factors can precipitate sudden cardiac events like myocardial infarction, serious dysrhythmias, or cerebrovascular accidents in firefighters with underlying cardiovascular disease. PURPOSE: The purpose of this study was to deploy and then evaluate the contribution of resting advanced ECG (A-ECG) in addition to other screening tools (family history, lipid profiles, and cardiopulmonary exercise tests, XT) in assessment of an individual fs cardiac risk profile. METHODS: Forty-four career firefighters were recruited to perform comprehensive baseline assessments including tests of aerobic performance, fasting lipids and glucose. Five-min resting 12-lead A-ECGs were obtained in a subset of firefighters (n=21) and transmitted over a secure networked system to a NASA physician collaborator. Using myocardial perfusion and other imaging as the gold standard, A-ECG scoring has been proven useful in accurately identifying a number of cardiac pathologies including coronary artery disease (CAD), left ventricular hypertrophy, hypertrophic cardiomyopathy, and non-ischemic and ischemic cardiomyopathy. RESULTS: Subjects f mean (SD) age was 43 (8) years, weight 91 (13) kg, and BMI 28 (3) kg/m2. Fifty-one percent of subjects had .3 cardiovascular risk factors. One subject had ST depression on XT ECG, at least one positive A-ECG score for CAD, and documented CAD based on cardiology referral. While all other subjects, including those with fewer risk factors, higher aerobic fitness, and normal exercise ECGs, were classified as healthy by A-ECG, there was no trend for association between risk factors and any of 20 A-ECG parameters in the

  14. Detection of Cardiac Abnormalities from Multilead ECG using Multiscale Phase Alternation Features. (United States)

    Tripathy, R K; Dandapat, S


    The cardiac activities such as the depolarization and the relaxation of atria and ventricles are observed in electrocardiogram (ECG). The changes in the morphological features of ECG are the symptoms of particular heart pathology. It is a cumbersome task for medical experts to visually identify any subtle changes in the morphological features during 24 hours of ECG recording. Therefore, the automated analysis of ECG signal is a need for accurate detection of cardiac abnormalities. In this paper, a novel method for automated detection of cardiac abnormalities from multilead ECG is proposed. The method uses multiscale phase alternation (PA) features of multilead ECG and two classifiers, k-nearest neighbor (KNN) and fuzzy KNN for classification of bundle branch block (BBB), myocardial infarction (MI), heart muscle defect (HMD) and healthy control (HC). The dual tree complex wavelet transform (DTCWT) is used to decompose the ECG signal of each lead into complex wavelet coefficients at different scales. The phase of the complex wavelet coefficients is computed and the PA values at each wavelet scale are used as features for detection and classification of cardiac abnormalities. A publicly available multilead ECG database (PTB database) is used for testing of the proposed method. The experimental results show that, the proposed multiscale PA features and the fuzzy KNN classifier have better performance for detection of cardiac abnormalities with sensitivity values of 78.12 %, 80.90 % and 94.31 % for BBB, HMD and MI classes. The sensitivity value of proposed method for MI class is compared with the state-of-art techniques from multilead ECG.

  15. A importância de um EGC normal em síndromes coronarianas agudas sem supradesnivelamento do segmento ST La importancia de un ECG normal en síndromes coronarios agudos sin supradesnivel del segmento ST The importance of a normal ECG in non-ST elevation acute coronary syndromes

    Directory of Open Access Journals (Sweden)

    Rogério Teixeira


    . METHODS: Patients were divided in 2 groups: A (n=538 - Abnormal ECG and B (n=264 - Normal ECG. Normal ECG was synonymous of sinus rhythm and no acute ischemic changes. A one-year clinical follow up was performed targeting all causes of mortality and the MACE rate. RESULTS: Group A patients were older (68.7±11.7 vs. 63.4±12.7Y, p<0.001, had higher Killip classes and peak myocardial necrosis biomarkers. Furthermore, they had lower left ventricular ejection fraction (LVEF (52.01±10.55 vs. 55.34± 9.51%, p<0.001, glomerular filtration rate, initial hemoglobin, and total cholesterol levels. Group B patients were more frequently submitted to invasive strategy (63.6 vs. 46.5%, p<0.001 and treated with aspirin, clopidogrel, beta blockers and statins. They also more often presented normal coronary anatomy (26.2 vs. 18.0%, p=0.45. There was a trend to higher in-hospital mortality in group A (4.6 vs. 1.9%, p=0.054. Kaplan-Meyer analysis showed that at one month and one year (95.1 vs. 89.5%, p=0.012 survival was higher in group B and the result remained significant on a Cox regression model (normal ECG HR 0.45 (0.21 - 0.97. There were no differences regarding the MACE rate. CONCLUSION: In our non-ST elevation ACS population, a normal ECG was an early marker for good prognosis.

  16. Single Channel Fetal ECG Detection Using LMS and RLS Adaptive Filters

    Institute of Scientific and Technical Information of China (English)

    Alaa Aldoori; Ali Buniya; ZHENG Zheng


    ECG is an important tool for the primary diagnosis of heart diseases, which shows the electrophysiology of the heart. In our method, a single maternal abdominal ECG signal is taken as an input signal and the maternal P-QRS-T complexes of original signal is averaged and repeated and taken as a reference signal. LMS and RLS adaptive filters algorithms are applied. The results showed that the fetal ECGs have been successfully detected. The accuracy of Daisy database was up to 84%of LMS and 88%of RLS while PhysioNet was up to 98%and 96%for LMS and RLS respectively.

  17. Evaluation of novel ECG signal processing on quantification of transient ischemia and baseline wander suppression. (United States)

    Kostic, Marko N; Fakhar, Sina; Foxall, Tom; Drakulic, Budimir S; Krucoff, Mitchell W


    The performance assessment of a novel ECG signal processing technology in Fidelity 100 (test) and four modern ECG systems (controls) was conducted. A quantitative evaluation for one control and a test system was done by simultaneous recordings on 54 patients undergoing percutaneous coronary intervention (PCI) and on a biological reference signal from an ECG simulator. A qualitative performance of baseline wander suppression was done on all five systems. The results showed that the Fidelity 100 system provided excellent detection and quantification of transient ischemia and baseline wander suppression.

  18. Real-time ECG emulation: a multiple dipole model for electrocardiography simulation. (United States)

    Abkai, Ciamak; Hesser, Jürgen


    A new model for describing electrocardiography (ECG) is presented, which is based on multiple dipoles compared to standard single dipole approaches in vector electrocardiography. The multiple dipole parameters are derived from real data (e.g. four dipoles from 12-channel ECG) by solving the backward problem of ECG numerically. Results are transformed to a waveform description based on Gaussian mixture for every dimension of each dipole. These compact parameterized descriptors are used for a very realistic real-time simulation applying the forward solution of the proposed model.

  19. Principal component cluster analysis of ECG time series based on Lyapunov exponent spectrum

    Institute of Scientific and Technical Information of China (English)

    WANG Nai; RUAN Jiong


    In this paper we propose an approach of principal component cluster analysis based on Lyapunov exponent spectrum (LES) to analyze the ECG time series. Analysis results of 22 sample-files of ECG from the MIT-BIH database confirmed the validity of our approach. Another technique named improved teacher selecting student (TSS) algorithm is presented to analyze unknown samples by means of some known ones, which is of better accuracy. This technique combines the advantages of both statistical and nonlinear dynamical methods and is shown to be significant to the analysis of nonlinear ECG time series.

  20. [Prediction of cardiac function deviations (ECG data) in the course of permanent cosmonaut's monitoring starting from selection till return to earth after short-duration space flight]. (United States)

    Kotovskaia, A R; Koloteva, M I; Luk'ianiuk, V Iu; Stepanova, G P; Filatova, L M; Buĭlov, S P; Zhernavkov, A F; Kondratiuk, L L


    Analyzed were deviations in cardiac function in 29 cosmonauts with previous aviation and other occupations ranging of 29 to 61 y.o. who made 8- to 30-day space flights (totai number of flights = 34) between 1982 and 2006. The deviations were identified in ECG records collected during clinical selection, clinical physiological examination (CPE) before flight, insertion and deorbit in transport vehicles, and post-flight CPE. Based on the analysis, the cosmonauts were distributed into three groups. The first group (55.2% of the cosmonauts) did not exhibit noticeable shifts and unfavorable trends in ECG at any time of the period of observation. The second group (34.5%) showed some deviations during selection and pre-flight CPE that became more apparent in the period of deorbit and were still present in post-flight ECG records. The third group (10.3%) displayed health-threatening deviations in cardiac function during deorbit. These findings give start to important investigations with the purpose to define permissible medical risks and ensuing establishment and perfection of medical criteria for candidates to cosmonauts with certain health problems.

  1. Improving local PCA in pseudo phase space for fetal heart rate estimation from single lead abdominal ECG. (United States)

    Wei, Zheng; Hongxing, Liu; Jianchun, Cheng


    This paper proposes an improved local principal component analysis (LPCA) in pseudo phase space for fetal heart rate estimation from a single lead abdominal ECG signal. The improved LPCA process can extract both the maternal ECG component and the fetal ECG component in an abdominal signal. The instantaneous fetal heart rate can then be estimated from the extracted fetal ECG waveform. Compared with the classical LPCA procedure and another single lead based fetal heart rate estimation method, our improved LPCA method has shown better robustness and efficiency in fetal heart estimation, testing with synthetic ECG signals and a real fetal ECG database from PhysioBank. For the real fetal ECG validating dataset of six long-duration recordings (obtained between the 22(nd) and 40(th) week of gestation), the average accuracy of the improved LPCA method is 84.1%.

  2. Feasibility of epicardial adipose tissue quantification in non-ECG-gated low-radiation-dose CT: comparison with prospectively ECG-gated cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Simon-Yarza, Isabel; Viteri-Ramirez, Guillermo; Saiz-Mendiguren, Ramon; Slon-Roblero, Pedro J.; Paramo, Maria [Dept. of Radiology, Clinica Univ. de Navarra, Pamplona (Spain); Bastarrika, Gorka [Dept. of Radiology, Clinica Univ. de Navarra, Pamplona (Spain); Cardiac Imaging Unit, Clinica Univ. de Navarra, Pamplona (Spain)], e-mail:


    Background: Epicardial adipose tissue (EAT) is an important indicator of cardiovascular risk. This parameter is generally assessed on ECG-gated computed tomography (CT) images. Purpose: To evaluate feasibility and reliability of EAT quantification on non-gated thoracic low-radiation-dose CT examinations with respect to prospectively ECG-gated cardiac CT acquisition. Material and Methods: Sixty consecutive asymptomatic smokers (47 men; mean age 64 {+-} 9.8 years) underwent low-dose CT of the chest and prospectively ECG-gated cardiac CT acquisitions (64-slice dual-source CT). The two examinations were reconstructed with the same range, field of view, slice thickness, and convolution algorithm. Two independent observers blindly quantified EAT volume using commercially available software. Data were compared with paired sample Student t-test, concordance correlation coefficients (CCC), and Bland-Altman plots. Results: No statistically significant difference was observed for EAT volume quantification with low-dose-CT (141.7 {+-} 58.3 mL) with respect to ECG-gated CT (142.7 {+-} 57.9 mL). Estimation of CCC showed almost perfect concordance between the two techniques for EAT-volume assessment (CCC, 0.99; mean difference, 0.98 {+-} 5.1 mL). Inter-observer agreement for EAT volume estimation was CCC: 0.96 for low-dose-CT examinations and 0.95 for ECG-gated CT. Conclusion: Non-gated low-dose CT allows quantifying EAT with almost the same concordance and reliability as using dedicated prospectively ECG-gated cardiac CT acquisition protocols.

  3. Heart Beat Detection in Noisy ECG Signals Using Statistical Analysis of the Automatically Detected Annotations

    Directory of Open Access Journals (Sweden)

    Andrius Gudiškis


    Full Text Available This paper proposes an algorithm to reduce the noise distortion influence in heartbeat annotation detection in electrocardiogram (ECG signals. Boundary estimation module is based on energy detector. Heartbeat detection is usually performed by QRS detectors that are able to find QRS regions in a ECG signal that are a direct representation of a heartbeat. However, QRS performs as intended only in cases where ECG signals have high signal to noise ratio, when there are more noticeable signal distortion detectors accuracy decreases. Proposed algorithm uses additional data, taken from arterial blood pressure signal which was recorded in parallel to ECG signal, and uses it to support the QRS detection process in distorted signal areas. Proposed algorithm performs as well as classical QRS detectors in cases where signal to noise ratio is high, compared to the heartbeat annotations provided by experts. In signals with considerably lower signal to noise ratio proposed algorithm improved the detection accuracy to up to 6%.

  4. Unobtrusive monitoring of ECG-derived features during daily smartphone use. (United States)

    Kwon, Sungjun; Kang, Seungwoo; Lee, Youngki; Yoo, Chungkuk; Park, Kwangsuk


    Heart rate variability (HRV) is known to be one of the representative ECG-derived features that are useful for diverse pervasive healthcare applications. The advancement in daily physiological monitoring technology is enabling monitoring of HRV in people's everyday lives. In this study, we evaluate the feasibility of measuring ECG-derived features such as HRV, only using the smartphone-integrated ECG sensors system named Sinabro. We conducted the evaluation with 13 subjects in five predetermined smartphone use cases. The result shows the potential that the smartphone-based sensing system can support daily monitoring of ECG-derived features; The average errors of HRV over all participants ranged from 1.65% to 5.83% (SD: 2.54~10.87) for five use cases. Also, all of individual HRV parameters showed less than 5% of average errors for the three reliable cases.

  5. ECG Sensor Verification System with Mean-Interval Algorithm for Handling Sport Issue

    Directory of Open Access Journals (Sweden)

    Kuo-Kun Tseng


    Full Text Available With the development of biometric verification, we proposed a new algorithm and personal mobile sensor card system for ECG verification. The proposed new mean-interval approach can identify the user quickly with high accuracy and consumes a small amount of flash memory in the microprocessor. The new framework of the mobile card system makes ECG verification become a feasible application to overcome the issues of a centralized database. For a fair and comprehensive evaluation, the experimental results have been tested on public MIT-BIH ECG databases and our circuit system; they confirm that the proposed scheme is able to provide excellent accuracy and low complexity. Moreover, we also proposed a multiple-state solution to handle the heat rate changes of sports problem. It should be the first to address the issue of sports in ECG verification.

  6. A Human ECG Identification System Based on Ensemble Empirical Mode Decomposition

    Directory of Open Access Journals (Sweden)

    Yi Luo


    Full Text Available In this paper, a human electrocardiogram (ECG identification system based on ensemble empirical mode decomposition (EEMD is designed. A robust preprocessing method comprising noise elimination, heartbeat normalization and quality measurement is proposed to eliminate the effects of noise and heart rate variability. The system is independent of the heart rate. The ECG signal is decomposed into a number of intrinsic mode functions (IMFs and Welch spectral analysis is used to extract the significant heartbeat signal features. Principal component analysis is used reduce the dimensionality of the feature space, and the K-nearest neighbors (K-NN method is applied as the classifier tool. The proposed human ECG identification system was tested on standard MIT-BIH ECG databases: the ST change database, the long-term ST database, and the PTB database. The system achieved an identification accuracy of 95% for 90 subjects, demonstrating the effectiveness of the proposed method in terms of accuracy and robustness.

  7. Design of wavelet-based ECG detector for implantable cardiac pacemakers. (United States)

    Min, Young-Jae; Kim, Hoon-Ki; Kang, Yu-Ri; Kim, Gil-Su; Park, Jongsun; Kim, Soo-Won


    A wavelet Electrocardiogram (ECG) detector for low-power implantable cardiac pacemakers is presented in this paper. The proposed wavelet-based ECG detector consists of a wavelet decomposer with wavelet filter banks, a QRS complex detector of hypothesis testing with wavelet-demodulated ECG signals, and a noise detector with zero-crossing points. In order to achieve high detection accuracy with low power consumption, a multi-scaled product algorithm and soft-threshold algorithm are efficiently exploited in our ECG detector implementation. Our algorithmic and architectural level approaches have been implemented and fabricated in a standard 0.35 μm CMOS technology. The testchip including a low-power analog-to-digital converter (ADC) shows a low detection error-rate of 0.196% and low power consumption of 19.02 μW with a 3 V supply voltage.

  8. Periodic Noise Suppression from ECG Signal using Novel Adaptive Filtering Techniques

    Directory of Open Access Journals (Sweden)

    Yogesh Sharma


    Full Text Available Electrocardiogram signal most commonly known recognized and used biomedical signal for medical examination of heart. The ECG signal is very sensitive in nature, and even if small noise mixed with original signal, the various characteristics of the signal changes, Data corrupted with noise must either filtered or discarded, filtering is important issue for design consideration of real time heart monitoring systems. Various filters used for removing the noise from ECG signals, most commonly used filters are Notch Filters, FIR filters, IIR filters, Wiener filter, Adaptive filters etc. Performance analysis shows that the best result is obtained by using Adaptive filter to remove various noises from ECG signal and get significant SNR andMSE results. In this paper a novel adaptive approach by using LMS algorithm and delay has shown whichcan be used for pre-processing of ECG signal and give appreciable result.

  9. An ECG Compressed Sensing Method of Low Power Body Area Network

    Directory of Open Access Journals (Sweden)

    Jizhong Liu


    Full Text Available Aimed at low power problem in body area network, an ECG compressed sensing method of low power body area network based on the compressed sensing theory was proposed. Random binary matrices were used as the sensing matrix to measure ECG signals on the sensor nodes. After measured value is transmitted to remote monitoring center, ECG signal sparse representation under the discrete cosine transform and block sparse Bayesian learning reconstruction algorithm is used to reconstruct the ECG signals. The simulation results show that the 30% of overall signal can get reconstruction signal which’s SNR is more than 60dB, each numbers in each rank of sensing matrix can be controlled below 5, which reduces the power of sensor node sampling, calculation and transmission. The method has the advantages of low power, high accuracy of signal reconstruction and easy to hardware implementation.  

  10. Quantification of Intracranial Aneurysm Morphodynamics from ECG-gated CT Angiography

    NARCIS (Netherlands)

    Firouzian, A.; Manniesing, R.; Metz, C.T.; Risselada, R.; Klein, S.; Kooten, F. van; Sturkenboom, M.C.; Lugt, A. van der; Niessen, W.J.


    Rationale and Objectives: Aneurysm morphodynamics is potentially relevant for assessing aneurysm rupture risk. A method is proposed for automated quantification and visualization of intracranial aneurysm morphodynamics from ECG-gated computed tomography angiography (CTA) data. Materials and Methods:

  11. Check your biosignals here: a new dataset for off-the-person ECG biometrics. (United States)

    da Silva, Hugo Plácido; Lourenço, André; Fred, Ana; Raposo, Nuno; Aires-de-Sousa, Marta


    The Check Your Biosignals Here initiative (CYBHi) was developed as a way of creating a dataset and consistently repeatable acquisition framework, to further extend research in electrocardiographic (ECG) biometrics. In particular, our work targets the novel trend towards off-the-person data acquisition, which opens a broad new set of challenges and opportunities both for research and industry. While datasets with ECG signals collected using medical grade equipment at the chest can be easily found, for off-the-person ECG data the solution is generally for each team to collect their own corpus at considerable expense of resources. In this paper we describe the context, experimental considerations, methods, and preliminary findings of two public datasets created by our team, one for short-term and another for long-term assessment, with ECG data collected at the hand palms and fingers.

  12. Performance analysis of adjustable window based FIR filter for noisy ECG Signal Filtering

    Directory of Open Access Journals (Sweden)

    N. Mahawar


    Full Text Available Recording of the electrical activity associated to heart functioning is known as Electrocardiogram (ECG. ECG is a quasi-periodical, rhythmically signal synchronized by the function of the heart, which acts as a generator of bioelectric events. ECG signals are low level signals and sensitive to external contaminations. Electrocardiogram signals are often corrupted by noise which may have electrical or electrophysiological origin. The noise signal tends to alter the signal morphology, thereby hindering the correct diagnosis. In order to remove the unwanted noise, a digital filtering technique based on adjustable windows is proposed in this paper. Finite Impulse Response (FIR low pass is designed using windowing method for the ECG signal. The results obtained from different techniques are compared on the basis of popularly used signal error measures like SNR, PRD, PRD1, and MSE.

  13. Compression and Encryption of ECG Signal Using Wavelet and Chaotically Huffman Code in Telemedicine Application. (United States)

    Raeiatibanadkooki, Mahsa; Quchani, Saeed Rahati; KhalilZade, MohammadMahdi; Bahaadinbeigy, Kambiz


    In mobile health care monitoring, compression is an essential tool for solving storage and transmission problems. The important issue is able to recover the original signal from the compressed signal. The main purpose of this paper is compressing the ECG signal with no loss of essential data and also encrypting the signal to keep it confidential from everyone, except for physicians. In this paper, mobile processors are used and there is no need for any computers to serve this purpose. After initial preprocessing such as removal of the baseline noise, Gaussian noise, peak detection and determination of heart rate, the ECG signal is compressed. In compression stage, after 3 steps of wavelet transform (db04), thresholding techniques are used. Then, Huffman coding with chaos for compression and encryption of the ECG signal are used. The compression rates of proposed algorithm is 97.72 %. Then, the ECG signals are sent to a telemedicine center to acquire specialist diagnosis by TCP/IP protocol.

  14. Practical Non-contact ECG Electrodes for Prep-free Monitoring Project (United States)

    National Aeronautics and Space Administration — Cognionics has developed a high-quality, low-noise, dry/non-contact ECG electrode that can obtain signals even through layers of clothing without any skin...

  15. CinC Challenge 2013: comparing three algorithms to extract fetal ECG (United States)

    Loja, Juan; Velecela, Esteban; Palacio-Baus, Kenneth; Astudillo, Darwin; Medina, Rubén.; Wong, Sara


    This paper reports a comparison between three fetal ECG (fECG) detectors developed during the CinC 2013 challenge for fECG detection. Algorithm A1 is based on Independent Component Analysis, A2 is based on fECG detection of RS Slope and A3 is based on Expectation-Weighted Estimation of Fiducial Points. The proposed methodology was validated using the annotated database available for the challenge. Each detector was characterized in terms of its performance by using measures of sensitivity, (Se), positive predictive value (P+) and delay time (td). Additionally, the database was contaminated with white noise for two SNR conditions. Decision fusion was tested considering the most common types of combination of detectors. Results show that the decision fusion of A1 and A2 improves fQRS detection, maintaining high Se and P+ even under low SNR conditions without a significant td increase.

  16. ECG Based Heart Arrhythmia Detection Using Wavelet Coherence and Bat Algorithm (United States)

    Kora, Padmavathi; Sri Rama Krishna, K.


    Atrial fibrillation (AF) is a type of heart abnormality, during the AF electrical discharges in the atrium are rapid, results in abnormal heart beat. The morphology of ECG changes due to the abnormalities in the heart. This paper consists of three major steps for the detection of heart diseases: signal pre-processing, feature extraction and classification. Feature extraction is the key process in detecting the heart abnormality. Most of the ECG detection systems depend on the time domain features for cardiac signal classification. In this paper we proposed a wavelet coherence (WTC) technique for ECG signal analysis. The WTC calculates the similarity between two waveforms in frequency domain. Parameters extracted from WTC function is used as the features of the ECG signal. These features are optimized using Bat algorithm. The Levenberg Marquardt neural network classifier is used to classify the optimized features. The performance of the classifier can be improved with the optimized features.

  17. [Study on mobile phone based wireless ECG monitoring technology system typical demonstration applications]. (United States)

    Yu, Yang; Liu, Jing


    Based on the mobile phone platform with wireless real-time ECG monitoring system developed in our lab, this article is dedicated to evaluate its practical value in people test. A series of new conceptual experiments were designed and performed. Particularly, ECG characteristics under different age, gender, health and motion conditions are evaluated. Effects of living habits such as drinking wine, coffee including various psychological conditions such as excitation, anxiety etc. to the ECG response are investigated. The human ECG under different time in a day such as morning, afternoon and late-night was evaluated. These conceptual experiments, which are hard to conduct otherwise using conventional devices, demonstrate the pervasive merits of the new system for fundamental study of heart disease as well as daily healthcare.

  18. Left ventricular hypertrophy by ECG versus cardiac MRI as a predictor for heart failure. (United States)

    Oseni, Abdullahi O; Qureshi, Waqas T; Almahmoud, Mohamed F; Bertoni, Alain G; Bluemke, David A; Hundley, William G; Lima, Joao A C; Herrington, David M; Soliman, Elsayed Z


    To determine if there is a significant difference in the predictive abilities of left ventricular hypertrophy (LVH) detected by ECG-LVH versus LVH ascertained by cardiac MRI-LVH in a model similar to the Framingham Heart Failure Risk Score (FHFRS). This study included 4745 (mean age 61±10 years, 53.5% women, 61.7% non-whites) participants in the Multi-Ethnic Study of Atherosclerosis. ECG-LVH was defined using Cornell voltage product while MRI-LVH was derived from left ventricular mass. Cox proportional hazard regression was used to examine the association between ECG-LVH and MRI-LVH with incident heart failure (HF). Harrell's concordance C-index was used to estimate the predictive ability of the model when either ECG-LVH or MRI-LVH was included as one of its components. ECG-LVH was present in 291 (6.1%), while MRI-LVH was present in 499 (10.5%) of the participants. Both ECG-LVH (HR 2.25, 95% CI 1.38 to 3.69) and MRI-LVH (HR 3.80, 95% CI 1.56 to 5.63) were predictive of HF. The absolute risk of developing HF was 8.81% for MRI-LVH versus 2.26% for absence of MRI-LVH with a relative risk of 3.9. With ECG-LVH, the absolute risk of developing HF 6.87% compared with 2.69% for absence of ECG-LVH with a relative risk of 2.55. The ability of the model to predict HF was better with MRI-LVH (C-index 0.871, 95% CI 0.842 to 0.899) than with ECG-LVH (C-index 0.860, 95% CI 0.833 to 0.888) (p<0.0001). ECG-LVH and MRI-LVH are predictive of HF. Substituting MRI-LVH for ECG-LVH improves the predictive ability of a model similar to the FHFRS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  19. The RR interval spectrum, the ECG signal and aliasing

    CERN Document Server

    Gersten, A; Ronen, A; Cassuto, Y


    A reliable spectral analysis requires sampling rate at least twice as large as the frequency bound, otherwise the analysis will be unreliable and plagued with aliasing distortions. The RR samplings do not satisfy the above requirements and therefore their spectral analysis might be unreliable. In order to demonstrate the feasibility of aliasing in RR spectral analysis, we have done an experiment which have shown clearly how the aliasing was developed. In the experiments, one of us (A.G) had kept his high breathing rate constant with the aid of metronome for more than 5 minutes. The breathing rate was larger than one-half the heart rate. Very accurate results were obtained and the resulting aliasing well understood. To our best knowledge this is the first controlled experiment of this kind coducted on humans. We compared the RR spectral analysis with the spectrum of the ECG signals from which the RR intervals were extracted. In the significant for RR analysis frequencies (below one-half Hertz) significant diff...

  20. ECG response of koalas to tourists proximity: a preliminary study.

    Directory of Open Access Journals (Sweden)

    Yan Ropert-Coudert

    Full Text Available Koalas operate on a tight energy budget and, thus, may not always display behavioral avoidance reaction when placed in a stressful condition. We investigated the physiological response of captive koalas Phascolarctos cinereus in a conservation centre to the presence of tourists walking through their habitat. We compared, using animal-attached data-recorders, the electrocardiogram activity of female koalas in contact with tourists and in a human-free area. One of the koalas in the tourist zone presented elevated heart rate values and variability throughout the recording period. The remaining female in the exhibit area showed a higher field resting heart rates during the daytime than that in the isolated area. In the evening, heart rate profiles changed drastically and both the koalas in the exhibit and in the tourist-free zones displayed similar field resting heart rates, which were lower than those during the day. In parallel, the autonomic nervous systems of these two individuals evolved from sympathetic-dominant during the day to parasympathetic-dominant in the evening. Our results report ECG of free-living koalas for the first time. Although they are preliminary due to the difficulty of having sufficient samples of animals of the same sex and age, our results stress out the importance of studies investigating the physiological reaction of animals to tourists.

  1. Efficient noise cancellers for ECG signal enhancement for telecardiology applications

    Directory of Open Access Journals (Sweden)



    Full Text Available In this paper some effective noise cancellers were proposed using the variants of Least Mean Fourth (LMF Algorithm to remove the artifacts that occur during the acquisition stage of an ECG signal. In order to accelerate the performance of the LMF algorithm we introduce data normalization in weight update process. This results two variants of LMF algorithm, called normalized LMF (NLMF and global NLMF (GNLMF algorithms. Further, to minimize their computational complexity and improve convergence characteristics, tracking ability, filtering capability we apply signum and block processing on the two versions of normalized algorithms. Both the two treatments results six more algorithms. Using these algorithms we develop various adaptive noise cancellers (ANCs. These ANCs are tested with the help of standard MIT-BIH arrhythmia database for various records. The Signal to noise ratio, Excess Mean Square Error and misadjustment are taken as performances measures to analyze the performance of proposed methods. These ANCs exhibit improved performance over the LMF based ANC.

  2. ECG response of koalas to tourists proximity: a preliminary study. (United States)

    Ropert-Coudert, Yan; Brooks, Lisa; Yamamoto, Maki; Kato, Akiko


    Koalas operate on a tight energy budget and, thus, may not always display behavioral avoidance reaction when placed in a stressful condition. We investigated the physiological response of captive koalas Phascolarctos cinereus in a conservation centre to the presence of tourists walking through their habitat. We compared, using animal-attached data-recorders, the electrocardiogram activity of female koalas in contact with tourists and in a human-free area. One of the koalas in the tourist zone presented elevated heart rate values and variability throughout the recording period. The remaining female in the exhibit area showed a higher field resting heart rates during the daytime than that in the isolated area. In the evening, heart rate profiles changed drastically and both the koalas in the exhibit and in the tourist-free zones displayed similar field resting heart rates, which were lower than those during the day. In parallel, the autonomic nervous systems of these two individuals evolved from sympathetic-dominant during the day to parasympathetic-dominant in the evening. Our results report ECG of free-living koalas for the first time. Although they are preliminary due to the difficulty of having sufficient samples of animals of the same sex and age, our results stress out the importance of studies investigating the physiological reaction of animals to tourists.

  3. Human ECG indicators for fast screening and evaluation (United States)

    Maciejewski, Marcin; DzierŻak, RóŻa; Surtel, Wojciech; Saran, Tomasz


    Telemedical system design and implementation requires numerous steps. It is necessary to evaluate the operation of algorithms responsible for analysis and detection of life-threatening situations. By performing ECG analysis it is possible to obtain information about the overall patient health condition as well as detailed information about the circulatory system condition. To achieve that goal one must gather, filter and process data. Data was gathered using a purposely built device from a group of four volunteers. Available data set was processed to obtain information about the patients condition. Pan-Tompkins algorithm was used to detect R peaks and calculate heart rhythm. Afterward the rest of parameters were extracted in time domain using windowed peak detection and polynomial estimation. The parameters were calculated as delays between appropriate points in the signal. The method proved to be able to extract parameters in some of the cases, and proved limited effectiveness in situations where physical activity was significant. It was nevertheless possible to eliminate noise from the mains, the trend and higher frequency noise Further improvements need to be introduced to increase the method's robustness in the presence of significant muscle noise.

  4. Modulations of Heart Rate, ECG, and Cardio-Respiratory Coupling Observed in Polysomnography


    Penzel, Thomas; Kantelhardt, Jan W.; Bartsch, Ronny P.; Riedl, Maik; Kraemer, Jan F.; Wessel, Niels; Garcia, Carmen; Glos, Martin; Fietze, Ingo; Schöbel, Christoph


    The cardiac component of cardio-respiratory polysomnography is covered by ECG and heart rate recordings. However, their evaluation is often underrepresented in summarizing reports. As complements to EEG, EOG, and EMG, these signals provide diagnostic information for autonomic nervous activity during sleep. This review presents major methodological developments in sleep research regarding heart rate, ECG, and cardio-respiratory couplings in a chronological (historical) sequence. It presents ph...

  5. Modulations of Heart Rate, ECG, and Cardio-Respiratory Coupling Observed in Polysomnography


    Thomas Penzel; Kantelhardt, Jan W.; Bartsch, Ronny P.; Maik Riedl; Jan Krämer; Niels Wessel; Carmen Garcia; Martin Glos; Ingo Fietze; Christoph Schöbel


    The cardiac component of cardio-respiratory polysomnography is covered by ECG and heart rate recordings. However their evaluation is often underrepresented in summarizing reports. As complements to EEG, EOG, and EMG, these signals provide diagnostic information for autonomic nervous activity during sleep. This review presents major methodological developments in sleep research regarding heart rate, ECG and cardio-respiratory couplings in a chronological (historical) sequence. It presents phys...

  6. Agreement between a smart-phone pulse sensor application and ECG for determining lnRMSSD. (United States)

    Esco, Michael R; Flatt, Andrew A; Nakamura, Fabio Y


    The purpose of this study was to determine the agreement between a smartphone pulse finger sensor (SPFS) and electrocardiography (ECG) for determining ultra-short-term heart rate variability (HRV) in three different positions. Thirty college-aged men (n = 15) and women (n = 15) volunteered to participate in this study. Sixty second heart rate measures were simultaneously taken with the SPFS and ECG in supine, seated and standing positions. lnRMSSD was calculated from the SPFS and ECG. The lnRMSSD values were 81.5 ± 11.7 via ECG and 81.6 ± 11.3 via SPFS (p = 0.63, Cohen's d = 0.01) in the supine position, 76.5 ± 8.2 via ECG and 77.5 ± 8.2 via SPFS (p = 0.007, Cohen's d = 0.11) in the seated position, and 66.5 ± 9.2 via ECG and 67.8 ± 9.1 via SPFS (p < 0.001, Cohen's d = 0.15) in the standing positions. The SPFS showed a possibly strong correlation to the ECG in all three positions (r values from 0.98 to 0.99). In addition, the limits of agreement (CE ± 1.98 SD) were -0.13 ± 2.83 for the supine values, -0.94± 3.47 for the seated values, and -1.37 ± 3.56 for the standing values. The results of the study suggest good agreement between the SPFS and ECG for measuring lnRMSSD in supine, seated, and standing positions. Though significant differences were noted between the two methods in the seated and standing positions, the effect sizes were trivial.

  7. Removal of Baseline Wander Noise from Electrocardiogram (ECG) using Fifth-order Spline Interpolation


    John A. OJO; Temilade B. ADETOYI; Solomon A. Adeniran


    Baseline wandering can mask some important features of the Electrocardiogram (ECG) signal hence it is desirable to remove this noise for proper analysis and display of the ECG signal. This paper presents the implementation and evaluation of spline interpolation and linear phase FIR filtering methods to remove this noise. Spline interpolation method requires the QRS waves to be first detected and fifth-order (quintic) interpolation technique applied to determine the smo...

  8. A wavelet-based ECG delineation algorithm for 32-bit integer online processing


    Chiari Lorenzo; Di Marco Luigi Y


    Abstract Background Since the first well-known electrocardiogram (ECG) delineator based on Wavelet Transform (WT) presented by Li et al. in 1995, a significant research effort has been devoted to the exploitation of this promising method. Its ability to reliably delineate the major waveform components (mono- or bi-phasic P wave, QRS, and mono- or bi-phasic T wave) would make it a suitable candidate for efficient online processing of ambulatory ECG signals. Unfortunately, previous implementati...

  9. Motion artifact removal algorithm by ICA for e-bra: a women ECG measurement system (United States)

    Kwon, Hyeokjun; Oh, Sechang; Varadan, Vijay K.


    Wearable ECG(ElectroCardioGram) measurement systems have increasingly been developing for people who suffer from CVD(CardioVascular Disease) and have very active lifestyles. Especially, in the case of female CVD patients, several abnormal CVD symptoms are accompanied with CVDs. Therefore, monitoring women's ECG signal is a significant diagnostic method to prevent from sudden heart attack. The E-bra ECG measurement system from our previous work provides more convenient option for women than Holter monitor system. The e-bra system was developed with a motion artifact removal algorithm by using an adaptive filter with LMS(least mean square) and a wandering noise baseline detection algorithm. In this paper, ICA(independent component analysis) algorithms are suggested to remove motion artifact factor for the e-bra system. Firstly, the ICA algorithms are developed with two kinds of statistical theories: Kurtosis, Endropy and evaluated by performing simulations with a ECG signal created by sgolayfilt function of MATLAB, a noise signal including 0.4Hz, 1.1Hz and 1.9Hz, and a weighed vector W estimated by kurtosis or entropy. A correlation value is shown as the degree of similarity between the created ECG signal and the estimated new ECG signal. In the real time E-Bra system, two pseudo signals are extracted by multiplying with a random weighted vector W, the measured ECG signal from E-bra system, and the noise component signal by noise extraction algorithm from our previous work. The suggested ICA algorithm basing on kurtosis or entropy is used to estimate the new ECG signal Y without noise component.

  10. Arrhythmia recognition and classification using combined linear and nonlinear features of ECG signals. (United States)

    Elhaj, Fatin A; Salim, Naomie; Harris, Arief R; Swee, Tan Tian; Ahmed, Taqwa


    Arrhythmia is a cardiac condition caused by abnormal electrical activity of the heart, and an electrocardiogram (ECG) is the non-invasive method used to detect arrhythmias or heart abnormalities. Due to the presence of noise, the non-stationary nature of the ECG signal (i.e. the changing morphology of the ECG signal with respect to time) and the irregularity of the heartbeat, physicians face difficulties in the diagnosis of arrhythmias. The computer-aided analysis of ECG results assists physicians to detect cardiovascular diseases. The development of many existing arrhythmia systems has depended on the findings from linear experiments on ECG data which achieve high performance on noise-free data. However, nonlinear experiments characterize the ECG signal more effectively sense, extract hidden information in the ECG signal, and achieve good performance under noisy conditions. This paper investigates the representation ability of linear and nonlinear features and proposes a combination of such features in order to improve the classification of ECG data. In this study, five types of beat classes of arrhythmia as recommended by the Association for Advancement of Medical Instrumentation are analyzed: non-ectopic beats (N), supra-ventricular ectopic beats (S), ventricular ectopic beats (V), fusion beats (F) and unclassifiable and paced beats (U). The characterization ability of nonlinear features such as high order statistics and cumulants and nonlinear feature reduction methods such as independent component analysis are combined with linear features, namely, the principal component analysis of discrete wavelet transform coefficients. The features are tested for their ability to differentiate different classes of data using different classifiers, namely, the support vector machine and neural network methods with tenfold cross-validation. Our proposed method is able to classify the N, S, V, F and U arrhythmia classes with high accuracy (98.91%) using a combined support

  11. Heart rate detection in low amplitude non-invasive fetal ECG recordings. (United States)

    Peters, Chris; Vullings, Rik; Bergmans, Jan; Oei, Guid; Wijn, Pieter


    Multi-electrode electrical measurements on the maternal abdomen may provide a valuable alternative to standard fetal monitoring. Removal of the maternal ECG from these recordings by means of subtracting a weighted linear combination of segments from preceding maternal ECG complexes, results in fetal ECG traces from which the fetal heart rate can be determined. Unfortunately, these traces often contain too much noise to determine the heart rate by R-peak detection. To overcome this limitation, an algorithm has been developed that calculates the heart rate based on cross-correlation. To validate the algorithm, noise was added to a fetal scalp ECG recording to simulate low amplitude abdominal recordings. Heart rates calculated by the algorithm were compared to the heart rates from the original scalp ECG. For simulated signals with a signal to noise ratio of 2, the coefficient of correlation was 0.99 (pheart rate, multi-electrode electrical measurements on the maternal abdomen now can be used for fetal monitoring in relatively early stages of pregnancy or other situations where ECG amplitudes are low or noise levels are high.

  12. Development of a portable Linux-based ECG measurement and monitoring system. (United States)

    Tan, Tan-Hsu; Chang, Ching-Su; Huang, Yung-Fa; Chen, Yung-Fu; Lee, Cheng


    This work presents a portable Linux-based electrocardiogram (ECG) signals measurement and monitoring system. The proposed system consists of an ECG front end and an embedded Linux platform (ELP). The ECG front end digitizes 12-lead ECG signals acquired from electrodes and then delivers them to the ELP via a universal serial bus (USB) interface for storage, signal processing, and graphic display. The proposed system can be installed anywhere (e.g., offices, homes, healthcare centers and ambulances) to allow people to self-monitor their health conditions at any time. The proposed system also enables remote diagnosis via Internet. Additionally, the system has a 7-in. interactive TFT-LCD touch screen that enables users to execute various functions, such as scaling a single-lead or multiple-lead ECG waveforms. The effectiveness of the proposed system was verified by using a commercial 12-lead ECG signal simulator and in vivo experiments. In addition to its portability, the proposed system is license-free as Linux, an open-source code, is utilized during software development. The cost-effectiveness of the system significantly enhances its practical application for personal healthcare.

  13. Wavelet-Based ECG Steganography for Protecting Patient Confidential Information in Point-of-Care Systems. (United States)

    Ibaida, Ayman; Khalil, Ibrahim


    With the growing number of aging population and a significant portion of that suffering from cardiac diseases, it is conceivable that remote ECG patient monitoring systems are expected to be widely used as point-of-care (PoC) applications in hospitals around the world. Therefore, huge amount of ECG signal collected by body sensor networks from remote patients at homes will be transmitted along with other physiological readings such as blood pressure, temperature, glucose level, etc., and diagnosed by those remote patient monitoring systems. It is utterly important that patient confidentiality is protected while data are being transmitted over the public network as well as when they are stored in hospital servers used by remote monitoring systems. In this paper, a wavelet-based steganography technique has been introduced which combines encryption and scrambling technique to protect patient confidential data. The proposed method allows ECG signal to hide its corresponding patient confidential data and other physiological information thus guaranteeing the integration between ECG and the rest. To evaluate the effectiveness of the proposed technique on the ECG signal, two distortion measurement metrics have been used: the percentage residual difference and the wavelet weighted PRD. It is found that the proposed technique provides high-security protection for patients data with low (less than 1%) distortion and ECG data remain diagnosable after watermarking (i.e., hiding patient confidential data) and as well as after watermarks (i.e., hidden data) are removed from the watermarked data.

  14. CNT/PDMS composite flexible dry electrodes for long-term ECG monitoring. (United States)

    Jung, Ha-Chul; Moon, Jin-Hee; Baek, Dong-Hyun; Lee, Jae-Hee; Choi, Yoon-Young; Hong, Joung-Sook; Lee, Sang-Hoon


    We fabricated a carbon nanotube (CNT)/ polydimethylsiloxane (PDMS) composite-based dry ECG electrode that can be readily connected to conventional ECG devices, and showed its long-term wearable monitoring capability and robustness to motion and sweat. While the dispersion of CNTs in PDMS is challenging, we optimized the process to disperse untreated CNTs within PDMS by mechanical force only. The electrical and mechanical characteristics of the CNT/PDMS electrode were tested according to the concentration of CNTs and its thickness. The performances of ECG electrodes were evaluated by using 36 types of electrodes which were fabricated with different concentrations of CNTs, and with a differing diameter and thickness. The ECG signals were obtained by using electrodes of diverse sizes to observe the effects of motion and sweat, and the proposed electrode was shown to be robust to both factors. The CNT concentration and diameter of the electrodes were critical parameters in obtaining high-quality ECG signals. The electrode was shown to be biocompatible from the cytotoxicity test. A seven-day continuous wearability test showed that the quality of the ECG signal did not degrade over time, and skin reactions such as itching or erythema were not observed. This electrode could be used for the long-term measurement of other electrical biosignals for ubiquitous health monitoring including EMG, EEG, and ERG.

  15. Treatment of anestrous Nili-Ravi buffaloes using eCG and CIDR protocols

    Institute of Scientific and Technical Information of China (English)

    Zahid Naseer; Ejaz Ahmad; Nemat Ullah; Muhammad Yaqoob; Zeeshan Akbar


    Objective: To determine the effect of equine chorionic gonadotropin (eCG) and controlled internal drug releasing (CIDR) on estrus response, ovulation and pregnancy rate in Nili-Ravi buffaloes under field condition. Methods: Twenty anestrous buffaloes with more than 150 days postpartum were used in this study. To confirm anestrous condition, ovarian status and serum progesterone concentration were determined before the start of study. Buffaloes were randomly divided into eCG (n=10) and CIDR (n=10) groups. eCG group were treated with eCG (Chronogest 1000 I.U. i.m.), while CIDR group received CIDR devices for 7 days. All buffaloes in CIDR group were injected PGF2α (0.25 ug/mL; 2 mL; i.m.) one day before CIDR removal. Buffaloes were observed for estrus visually and were inseminated with frozen-thawed semen at detected estrus. Ovulation was confirmed by presence of CL 12 day post AI. Pregnancy diagnosis was done 50 days post AI. Results: Estrus response, ovulation rate and pregnancy rate were similar (P>0.05) among eCG and CIDR groups (90% vs. 80%; 78% vs. 75% and 50% vs. 60% respectively). Conclusion: It is concluded that both CIDR and eCG protocols are effective and promising remedies for the anestrous buffaloes under commercial as well as under field conditions.

  16. Performance Evaluation of Plain Weave and Honeycomb Weave Electrodes for Human ECG Monitoring

    Directory of Open Access Journals (Sweden)

    Xueliang Xiao


    Full Text Available Long-time monitoring of physiological parameters can scrutinize human health conditions so as to use electrocardiogram (ECG for diagnosis of some human’s chronic cardiovascular diseases. The continuous monitoring requires the wearable electrodes to be breathable, flexible, biocompatible, and skin-affinity friendly. Weave electrodes are innovative materials to supply these potential performances. In this paper, four conductive weave electrodes in plain and honeycomb weave patterns were developed to monitor human ECG signals. A wearable belt platform was developed to mount such electrodes for acquisition of ECG signals using a back-end electronic circuit and a signal transfer unit. The performance of weave ECG electrodes was evaluated in terms of skin-electrode contacting impedance, comfortability, ECG electrical characteristics, and signal fidelity. Such performances were then compared with the values from Ag/AgCl reference electrode. The test results showed that lower skin-electrode impedance, higher R-peak amplitude, and signal-to-noise ratio (SNR value were obtained with the increased density of conductive filaments in weave and honeycomb weave electrode presented higher comfort but poorer signal quality of ECG. This study inspires an acceptable way of weave electrodes in long- and real-time of human biosignal monitoring.

  17. An estimate of the dispersion of repolarization times based on a biophysical model of the ECG. (United States)

    Sassi, Roberto; Mainardi, Luca T


    Temporal heterogeneity of ventricular repolarization is a key quantity for the development of ventricular reentrant arrhythmia. In this paper, we introduce the V-index, a novel ECG-based estimator of the standard deviation of ventricular myocytes' repolarization times s(ϑ). Differently from other ECG metrics of repolarization heterogeneity, the V-index was derived from the analysis of a biophysical model of the ECG, where repolarization is described by the dominant T-wave (DTW) paradigm. The model explains the shape of T-waves in each lead as a projection of a main waveform (the DTW) and its derivatives weighted by scalars, the lead factors. A mathematical formula is derived to link the heterogeneity of ventricular repolarization s(ϑ) and the V-index. The formula was verified using synthetic 12-lead ECGs generated with a direct electrophysiological model for increasing values of s(ϑ) (in the range 20-70 ms). A linear relationship between the V-index and s(ϑ) was observed, V ≈ 0.675 s(ϑ) + 1.8 ms (R(2) = 0.9992). Finally, 68 ECGs from the E-OTH-12-0068-010 database of the Telemetric and Holter ECG Warehouse were analyzed. The V-index coherently increased after sotalol administration, a drug known to have QT-prolonging potential (p < 0.001).

  18. Self-organized neural network for the quality control of 12-lead ECG signals. (United States)

    Chen, Yun; Yang, Hui


    Telemedicine is very important for the timely delivery of health care to cardiovascular patients, especially those who live in the rural areas of developing countries. However, there are a number of uncertainty factors inherent to the mobile-phone-based recording of electrocardiogram (ECG) signals such as personnel with minimal training and other extraneous noises. PhysioNet organized a challenge in 2011 to develop efficient algorithms that can assess the ECG signal quality in telemedicine settings. This paper presents our efforts in this challenge to integrate multiscale recurrence analysis with a self-organizing map for controlling the ECG signal quality. As opposed to directly evaluating the 12-lead ECG, we utilize an information-preserving transform, i.e. Dower transform, to derive the 3-lead vectorcardiogram (VCG) from the 12-lead ECG in the first place. Secondly, we delineate the nonlinear and nonstationary characteristics underlying the 3-lead VCG signals into multiple time-frequency scales. Furthermore, a self-organizing map is trained, in both supervised and unsupervised ways, to identify the correlations between signal quality and multiscale recurrence features. The efficacy and robustness of this approach are validated using real-world ECG recordings available from PhysioNet. The average performance was demonstrated to be 95.25% for the training dataset and 90.0% for the independent test dataset with unknown labels.

  19. A configurable and low-power mixed signal SoC for portable ECG monitoring applications. (United States)

    Kim, Hyejung; Kim, Sunyoung; Van Helleputte, Nick; Artes, Antonio; Konijnenburg, Mario; Huisken, Jos; Van Hoof, Chris; Yazicioglu, Refet Firat


    This paper describes a mixed-signal ECG System-on-Chip (SoC) that is capable of implementing configurable functionality with low-power consumption for portable ECG monitoring applications. A low-voltage and high performance analog front-end extracts 3-channel ECG signals and single channel electrode-tissue-impedance (ETI) measurement with high signal quality. This can be used to evaluate the quality of the ECG measurement and to filter motion artifacts. A custom digital signal processor consisting of 4-way SIMD processor provides the configurability and advanced functionality like motion artifact removal and R peak detection. A built-in 12-bit analog-to-digital converter (ADC) is capable of adaptive sampling achieving a compression ratio of up to 7, and loop buffer integration reduces the power consumption for on-chip memory access. The SoC is implemented in 0.18 μm CMOS process and consumes 32 μ W from a 1.2 V while heart beat detection application is running, and integrated in a wireless ECG monitoring system with Bluetooth protocol. Thanks to the ECG SoC, the overall system power consumption can be reduced significantly.

  20. Real-time CHF detection from ECG signals using a novel discretization method. (United States)

    Orhan, Umut


    This study proposes a new method, equal frequency in amplitude and equal width in time (EFiA-EWiT) discretization, to discriminate between congestive heart failure (CHF) and normal sinus rhythm (NSR) patterns in ECG signals. The ECG unit pattern concept was introduced to represent the standard RR interval, and our method extracted certain features from the unit patterns to classify by a primitive classifier. The proposed method was tested on two classification experiments by using ECG records in Physiobank databases and the results were compared to those from several previous studies. In the first experiment, an off-line classification was performed with unit patterns selected from long ECG segments. The method was also used to detect CHF by real-time ECG waveform analysis. In addition to demonstrating the success of the proposed method, the results showed that some unit patterns in a long ECG segment from a heart patient were more suggestive of disease than the others. These results indicate that the proposed approach merits additional research.

  1. Genetic algorithm for the optimization of features and neural networks in ECG signals classification (United States)

    Li, Hongqiang; Yuan, Danyang; Ma, Xiangdong; Cui, Dianyin; Cao, Lu


    Feature extraction and classification of electrocardiogram (ECG) signals are necessary for the automatic diagnosis of cardiac diseases. In this study, a novel method based on genetic algorithm-back propagation neural network (GA-BPNN) for classifying ECG signals with feature extraction using wavelet packet decomposition (WPD) is proposed. WPD combined with the statistical method is utilized to extract the effective features of ECG signals. The statistical features of the wavelet packet coefficients are calculated as the feature sets. GA is employed to decrease the dimensions of the feature sets and to optimize the weights and biases of the back propagation neural network (BPNN). Thereafter, the optimized BPNN classifier is applied to classify six types of ECG signals. In addition, an experimental platform is constructed for ECG signal acquisition to supply the ECG data for verifying the effectiveness of the proposed method. The GA-BPNN method with the MIT-BIH arrhythmia database achieved a dimension reduction of nearly 50% and produced good classification results with an accuracy of 97.78%. The experimental results based on the established acquisition platform indicated that the GA-BPNN method achieved a high classification accuracy of 99.33% and could be efficiently applied in the automatic identification of cardiac arrhythmias.

  2. Investigations of sensitivity and resolution of ECG and MCG in a realistically shaped thorax model. (United States)

    Mäntynen, Ville; Konttila, Teijo; Stenroos, Matti


    Solving the inverse problem of electrocardiography (ECG) and magnetocardiography (MCG) is often referred to as cardiac source imaging. Spatial properties of ECG and MCG as imaging systems are, however, not well known. In this modelling study, we investigate the sensitivity and point-spread function (PSF) of ECG, MCG, and combined ECG+MCG as a function of source position and orientation, globally around the ventricles: signal topographies are modelled using a realistically-shaped volume conductor model, and the inverse problem is solved using a distributed source model and linear source estimation with minimal use of prior information. The results show that the sensitivity depends not only on the modality but also on the location and orientation of the source and that the sensitivity distribution is clearly reflected in the PSF. MCG can better characterize tangential anterior sources (with respect to the heart surface), while ECG excels with normally-oriented and posterior sources. Compared to either modality used alone, the sensitivity of combined ECG+MCG is less dependent on source orientation per source location, leading to better source estimates. Thus, for maximal sensitivity and optimal source estimation, the electric and magnetic measurements should be combined.

  3. Artificial neural network-based classification of body movements in ambulatory ECG signal. (United States)

    Darji, Sachin T; Kher, Rahul K


    Abstract Ambulatory ECG monitoring provides electrical activity of the heart when a person is involved in doing normal routine activities. Thus, the recorded ECG signal consists of cardiac signal along with motion artifacts introduced due to a person's body movements during routine activities. Detection of motion artifacts due to different physical activities might help in further cardiac diagnosis. Ambulatory ECG signal analysis for detection of various motion artifacts using adaptive filtering approach is addressed in this paper. We have used BIOPAC MP 36 system for acquiring ECG signal. The ECG signals of five healthy subjects (aged between 22-30 years) were recorded while the person performed various body movements like up and down movement of the left hand, up and down movement of the right hand, waist twisting movement while standing and change from sitting down on a chair to standing up movement in lead I configuration. An adaptive filter-based approach has been used to extract the motion artifact component from the ambulatory ECG signal. The features of motion artifact signal, extracted using Gabor transform, have been used to train the artificial neural network (ANN) for classifying body movements.

  4. Modulations of Heart Rate, ECG, and Cardio-Respiratory Coupling Observed in Polysomnography

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    Thomas Penzel


    Full Text Available The cardiac component of cardio-respiratory polysomnography is covered by ECG and heart rate recordings. However their evaluation is often underrepresented in summarizing reports. As complements to EEG, EOG, and EMG, these signals provide diagnostic information for autonomic nervous activity during sleep. This review presents major methodological developments in sleep research regarding heart rate, ECG and cardio-respiratory couplings in a chronological (historical sequence. It presents physiological and pathophysiological insights related to sleep medicine obtained by new technical developments. Recorded nocturnal ECG facilitates conventional heart rate variability analysis, studies of cyclical variations of heart rate, and analysis of ECG waveform. In healthy adults, the autonomous nervous system is regulated in totally different ways during wakefulness, slow-wave sleep, and REM sleep. Analysis of beat-to-beat heart-rate variations with statistical methods enables us to estimate sleep stages based on the differences in autonomic nervous system regulation. Furthermore, up to some degree, it is possible to track transitions from wakefulness to sleep by analysis of heart-rate variations. ECG and heart rate analysis allow assessment of selected sleep disorders as well. Sleep disordered breathing can be detected reliably by studying cyclical variation of heart rate combined with respiration-modulated changes in ECG morphology (amplitude of R wave and T wave.

  5. Clinically relevant QTc prolongation due to overridden drug-drug interaction alerts: A retrospective cohort study

    NARCIS (Netherlands)

    I.H. van der Sijs (Heleen); R. Kowlesar (Ravi); A.P.J. Klootwijk (Peter); S.P. Nelwan (Stefan); A.G. Vulto (Arnold); T. van Gelder (Teun)


    textabstractAIMS: To investigate whether, in patients in whom drug-drug interaction (DDI) alerts on QTc prolongation were overridden, the physician had requested an electrocardiogram (ECG), and if these ECGs showed clinically relevant QTc prolongation. METHODS: For all patients with overridden DDI a

  6. Beat-to-beat heart rate detection in multi-lead abdominal fetal ECG recordings. (United States)

    Peters, C H L; van Laar, J O E H; Vullings, R; Oei, S G; Wijn, P F F


    Reliable monitoring of fetal condition often requires more information than is provided by cardiotocography, the standard technique for fetal monitoring. Abdominal recording of the fetal electrocardiogram may offer valuable additional information, but unfortunately is troubled by poor signal-to-noise ratios during certain parts of pregnancy. To increase the usability of abdominal fetal ECG recordings, an algorithm was developed that enhances fetal QRS complexes in these recordings and thereby provides a promising method for detecting the beat-to-beat fetal heart rate in recordings with poor signal-to-noise ratios. The method was evaluated on generated recordings with controlled signal-to-noise ratios and on actual recordings that were performed in clinical practice and were annotated by two independent experts. The evaluation on the generated signals demonstrated excellent results (sensitivity of 0.98 for SNR≥1.5). Only for SNRheart rate detection exceeded 2 ms, which may still suffice for cardiotocography but is unacceptable for analysis of the beat-to-beat fetal heart rate variability. The sensitivity and positive predictive value of the method in actual recordings were reduced to approximately 90% for SNR≤2.4, but were excellent for higher signal-to-noise ratios.

  7. Application of Wavelet Entropy to Predict Atrial Fibrillation Progression from the Surface ECG

    Directory of Open Access Journals (Sweden)

    Raúl Alcaraz


    Full Text Available Atrial fibrillation (AF is the most common supraventricular arrhythmia in clinical practice, thus, being the subject of intensive research both in medicine and engineering. Wavelet Entropy (WE is a measure of the disorder degree of a specific phenomena in both time and frequency domains, allowing to reveal underlying dynamical processes out of sight for other methods. The present work introduces two different WE applications to the electrocardiogram (ECG of patients in AF. The first application predicts the spontaneous termination of paroxysmal AF (PAF, whereas the second one deals with the electrical cardioversion (ECV outcome in persistent AF patients. In both applications, WE was used with the objective of assessing the atrial fibrillatory (f waves organization. Structural changes into the f waves reflect the atrial activity organization variation, and this fact can be used to predict AF progression. To this respect, results in the prediction of PAF termination regarding sensitivity, specificity, and accuracy were 95.38%, 91.67%, and 93.60%, respectively. On the other hand, for ECV outcome prediction, 85.24% sensitivity, 81.82% specificity, and 84.05% accuracy were obtained. These results turn WE as the highest single predictor of spontaneous PAF termination and ECV outcome, thus being a promising tool to characterize non-invasive AF signals.

  8. Assessment of left ventricular performance by ECG-gated SPECT. Comparison with magnetic resonance imaging

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    Tadamura, Eiji; Inubushi, Masayuki; Kubo, Shigeto; Matsumoto, Keiichi; Yokoyama, Hiroshi; Fujita, Toru; Konishi, Junji [Kyoto Univ. (Japan). Faculty of Medicine


    In the measurement of a left ventricular volume, MIBI-QGS was compared with MRI. Because it became clear by the experiment using phantom that a volume calculated with QGS was smaller than the actual volume, data of clinical study were corrected. Subjects were 20 patients with coronary artery disease. Fourteen patients had anamnesis of myocardial infarct. ECG-gated SPECT was performed one hour after intravenous injection of MIBI (600 MBq) in rest. End diastolic volume (EDV), end systolic volume (ESV) and ejection fraction (EF) were calculated using QGS. Cine-MR image was obtained by using MR system of 1.5 Tesla within 1 week after SPECT. A condition was as follows; segmented k-space gradient echo with view sharing, TR=11 ms, TE=1.4 ms, flip angle 20 degree, field of view 32 cm, matrix 256 x 196, 8 lines per segment. LVEF, ESV and EF were analysed by Bland-Altman method, and the difference between MIBI-gated-SPECT and MRI was no problem. Horizontal dislocation image and vertical major axis dislocation image were provided. Minor axis crossing images of 10-12 slice were also filmed in order to cover all left ventricles. As a result, availability of MIBI-QGS became clear. Some factors which produces the measurement error are examined. (K.H.)

  9. Soft, Comfortable Polymer Dry Electrodes for High Quality ECG and EEG Recording

    Directory of Open Access Journals (Sweden)

    Yun-Hsuan Chen


    Full Text Available Conventional gel electrodes are widely used for biopotential measurements, despite important drawbacks such as skin irritation, long set-up time and uncomfortable removal. Recently introduced dry electrodes with rigid metal pins overcome most of these problems; however, their rigidity causes discomfort and pain. This paper presents dry electrodes offering high user comfort, since they are fabricated from EPDM rubber containing various additives for optimum conductivity, flexibility and ease of fabrication. The electrode impedance is measured on phantoms and human skin. After optimization of the polymer composition, the skin-electrode impedance is only ~10 times larger than that of gel electrodes. Therefore, these electrodes are directly capable of recording strong biopotential signals such as ECG while for low-amplitude signals such as EEG, the electrodes need to be coupled with an active circuit. EEG recordings using active polymer electrodes connected to a clinical EEG system show very promising results: alpha waves can be clearly observed when subjects close their eyes, and correlation and coherence analyses reveal high similarity between dry and gel electrode signals. Moreover, all subjects reported that our polymer electrodes did not cause discomfort. Hence, the polymer-based dry electrodes are promising alternatives to either rigid dry electrodes or conventional gel electrodes.

  10. Soft, Comfortable Polymer Dry Electrodes for High Quality ECG and EEG Recording (United States)

    Chen, Yun-Hsuan; de Beeck, Maaike Op; Vanderheyden, Luc; Carrette, Evelien; Mihajlović, Vojkan; Vanstreels, Kris; Grundlehner, Bernard; Gadeyne, Stefanie; Boon, Paul; Van Hoof, Chris


    Conventional gel electrodes are widely used for biopotential measurements, despite important drawbacks such as skin irritation, long set-up time and uncomfortable removal. Recently introduced dry electrodes with rigid metal pins overcome most of these problems; however, their rigidity causes discomfort and pain. This paper presents dry electrodes offering high user comfort, since they are fabricated from EPDM rubber containing various additives for optimum conductivity, flexibility and ease of fabrication. The electrode impedance is measured on phantoms and human skin. After optimization of the polymer composition, the skin-electrode impedance is only ∼10 times larger than that of gel electrodes. Therefore, these electrodes are directly capable of recording strong biopotential signals such as ECG while for low-amplitude signals such as EEG, the electrodes need to be coupled with an active circuit. EEG recordings using active polymer electrodes connected to a clinical EEG system show very promising results: alpha waves can be clearly observed when subjects close their eyes, and correlation and coherence analyses reveal high similarity between dry and gel electrode signals. Moreover, all subjects reported that our polymer electrodes did not cause discomfort. Hence, the polymer-based dry electrodes are promising alternatives to either rigid dry electrodes or conventional gel electrodes. PMID:25513825

  11. Deployment of an Advanced Electrocardiographic Analysis (A-ECG) to Detect Cardiovascular Risk in Career Firefighters (United States)

    Dolezal, B. A.; Storer, T. W.; Abrazado, M.; Watne, R.; Schlegel, T. T.; Batalin, M.; Kaiser, W.; Smith, D. L.; Cooper, C. B.


    INTRODUCTION Sudden cardiac death is the leading cause of line of duty death among firefighters, accounting for approximately 45% of fatalities annually. Firefighters perform strenuous muscular work while wearing heavy, encapsulating personal protective equipment in high ambient temperatures, under chaotic and emotionally stressful conditions. These factors can precipitate sudden cardiac events like myocardial infarction, serious dysrhythmias, or cerebrovascular accidents in firefighters with underlying cardiovascular disease. Screening for cardiovascular risk factors is recommended but not always followed in this population. PHASER is a project charged with identifying and prioritizing risk factors in emergency responders. We have deployed an advanced ECG (A-ECG) system developed at NASA for improved sensitivity and specificity in the detection of cardiac risk. METHODS Forty-four professional firefighters were recruited to perform comprehensive baseline assessments including tests of aerobic performance and laboratory tests for fasting lipid profiles and glucose. Heart rate and conventional 12-lead ECG were obtained at rest and during incremental treadmill exercise testing (XT). In addition, a 5-min resting 12-lead A-ECG was obtained in a subset of firefighters (n=18) and transmitted over a secure networked system to a physician collaborator at NASA for advanced-ECG analysis. This A-ECG system has been proven, using myocardial perfusion and other imaging, to accurately identify a number of cardiac pathologies including coronary artery disease (CAD), left ventricular hypertrophy, hypertrophic cardiomyopathy, non-ischemic cardiomyopathy, and ischemic cardiomyopathy. RESULTS Subjects mean (SD) age was 43 (8) years, weight 91 (13) kg, and BMI of 28 (3) kg/square meter. Maximum oxygen uptake (VO2max) was 39 (9) ml/kg/min. This compares with the 45th %ile in healthy reference values and a recommended standard of 42 ml/kg/min for firefighters. The metabolic threshold (VO

  12. Diagnostic value of ECG-gated multidetector computed tomography in the early phase of suspected acute myocarditis. A preliminary comparative study with cardiac MRI

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    Dambrin, Gregoire; Caussin, Christophe; Lancelin, Bernard; Paul, Jean F. [Centre Chirurgical Marie Lannelongue, Departments of Cardiology and Radiology, Le Plessis Robinson (France); Laissy, Jean P.; Serfaty, Jean M. [AP-HP, Hospital Bichat, Department of Radiology, Paris (France)


    The aim of the study was to determine the potential diagnostic value of contrast-enhanced echocardiogram (ECG)-gated multidetector computed tomography (MDCT) in the setting of suspected acute myocarditis compared with contrast-enhanced magnetic resonance imaging (MRI). The study group consisted of 12 consecutive patients admitted for suspected acute myocarditis less than 10 days after onset of symptoms. All patients had clinical, electrocardiographic signs, and laboratory findings consistent with the diagnosis. All patients but one (severe claustrophobia) underwent cardiac MRI using T1-weighted delayed-enhancement images after injection of gadolinium. ECG-gated MDCT was performed in all patients and included a first-pass contrast-enhanced acquisition and a delayed acquisition. MRI revealed abnormal focal or multifocal myocardial enhancement and confirmed the diagnosis in 11 patients. The first-pass MDCT acquisition showed homogenous left-ventricle contrast enhancement and absence of coronary stenosis in all patients. Delayed MDCT acquisition, performed 5 min later without reinjection of contrast medium revealed multiple areas of myocardial hyperenhancement in a focal or a multifocal pattern (six and six patients, respectively). Extent and location of hyperenhancement at MDCT correlated well with that observed at MR examination for all 11 patients evaluated by both techniques (r=0.9167, p=0.0004). These preliminary results show that ECG-gated MDCT could be a useful alternative noninvasive diagnostic test in the early phase of acute myocarditis. (orig.)

  13. The value of low-dose prospective ECG-gated dual-source CT angiography in the diagnosis of coarctation of the aorta in infants and children

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    Nie, P. [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Wang, X., E-mail: [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Cheng, Z.; Duan, Y.; Ji, X. [Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Diseases, Shandong Medical Imaging Research Institute, Shandong University, Jinan, Shandong (China); Chen, J. [CT Research Collaboration, Siemens, Beijing (China); Zhang, H. [Department of Cardiovascular Surgery, Shandong Provincial Hospital, Jinan, Shandong (China)


    Aim: To investigate the value of prospective electrocardiogram (ECG)-gated dual-source computed tomography (DSCT) in the diagnosis of coarctation of the aorta (CoA). Materials and methods: Seventeen patients clinically suspected of having CoA underwent prospective ECG-gated DSCT angiography and transthoracic echocardiography (TTE). Surgery was performed in all patients. The diagnostic accuracy of DSCT angiography and TTE was compared with the surgical findings as the reference standard. Image quality was evaluated using a five-point scale. Effective radiation dose was calculated from the dose-length product (DLP). Results: CoA was diagnosed in 17 patients by DSCT angiography and in 16 patients by TTE. A total of 46 separate cardiovascular abnormalities were confirmed by surgical findings. The diagnostic accuracy of DSCT angiography and TTE was 96.32% and 97.06%, respectively. There was no significant difference in the diagnostic accuracy between DSCT angiography and TTE ({chi}{sup 2} = 0, p > 0.05). The mean score of image quality was 4.2 {+-} 0.8. The mean effective dose was 0.69 {+-} 0.09 mSv. Conclusion: Prospective ECG-gated DSCT with a low radiation dose is a valuable technique in the diagnosis of CoA in infants and children.

  14. Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience

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    Cheng, Zhaoping; Wang, Ximing; Duan, Yanhua; Wu, Lebin; Wu, Dawei; Chao, Baoting; Liu, Cheng; Xu, Zhuodong [Shandong University, Shandong Medical Imaging Research Institute, Jinan, Shandong (China); Li, Hongxin; Liang, Fei [Shandong Provincial Hospital, Department of Cardiovascular Surgery, Jinan, Shandong (China); Xu, Jian; Chen, Jiuhong [Siemens. Ltd. China, CT Research Collaboration, Beijing (China)


    To explore the clinical value of low-dose prospective ECG-triggering dual-source CT (DSCT) angiography in infants and children with complex congenital heart disease (CHD) compared with transthoracic echocardiography (TTE). Thirty-five patients (mean age: 16 months, range: 2 months to 6 years; male 15; mean weight: 12 kg) underwent low-dose prospective ECG-triggering DSCT angiography and TTE. Surgeries were performed in 29 patients, and conventional cardiac angiography (CCA) was performed in 8 patients. The accuracy was calculated based on the surgical and/or CCA findings. The overall imaging quality was evaluated on a five-point scale. A total of 146 separate cardiovascular deformities were confirmed. DSCT missed three atrial septal defects and a patent ductus arteriosus. The accuracy of DSCT angiography and TTE was 97.3% (142/146) and 92.5% (135/146), respectively. Overall test parameters for DSCT angiography and TTE were similar (sensitivity, 97.3% vs 92.5%; specificity, 99.8% vs 99.8%). The average subjective image quality score was 4.3 {+-} 0.7. The mean effective dose was 0.38 {+-} 0.09 mSv. Prospective ECG-triggering DSCT angiography with a very low effective radiation dose allows the accurate diagnosis of anomalies in infants and children with complex CHD compared with TTE. It has great promise to become a commonly used second-line technique for complex CHD. (orig.)

  15. Prospectively ECG-triggered sequential dual-source coronary CT angiography in patients with atrial fibrillation: comparison with retrospectively ECG-gated helical CT

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    Xu, Lei; Yang, Lin; Zhang, Zhaoqi [Capital Medical University, Department of Radiology, Beijing Anzhen Hospital, Beijing (China); Wang, Yining; Jin, Zhengyu [Chinese Academy of Medical Sciences, Department of Radiology, Peking Union Medical College Hospital, Beijing (China); Zhang, Longjiang; Lu, Guangming [Nanjing University, Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing, Jiangsu (China)


    To investigate the feasibility of applying prospectively ECG-triggered sequential coronary CT angiography (CCTA) to patients with atrial fibrillation (AF) and evaluate the image quality and radiation dose compared with a retrospectively ECG-gated helical protocol. 100 patients with persistent AF were enrolled. Fifty patients were randomly assigned to a prospective protocol and the other patients to a retrospective protocol using a second-generation dual-source CT (DS-CT). Image quality was evaluated using a four-point grading scale (1 = excellent, 2 = good, 3 = moderate, 4 = poor) by two reviewers on a per-segment basis. The coronary artery segments were considered non-diagnostic with a quality score of 4. The radiation dose was evaluated. Diagnostic segment rate in the prospective group was 99.4 % (642/646 segments), while that in the retrospective group was 96.5 % (604/626 segments) (P < 0.001). Effective dose was 4.29 {+-} 1.86 and 11.95 {+-} 5.34 mSv for each of the two protocols (P < 0.001), which was a 64 % reduction in the radiation dose for prospective sequential imaging compared with retrospective helical imaging. In AF patients, prospectively ECG-triggered sequential CCTA is feasible using second-generation DS-CT and can decrease >60 % radiation exposure compared with retrospectively ECG-gated helical imaging while improving diagnostic image quality. (orig.)

  16. Recommendations for the standardization and interpretation of the electrocardiogram: part I: the electrocardiogram and its technology a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society endorsed by the International Society for Computerized Electrocardiology. (United States)

    Kligfield, Paul; Gettes, Leonard S; Bailey, James J; Childers, Rory; Deal, Barbara J; Hancock, E William; van Herpen, Gerard; Kors, Jan A; Macfarlane, Peter; Mirvis, David M; Pahlm, Olle; Rautaharju, Pentti; Wagner, Galen S; Josephson, Mark; Mason, Jay W; Okin, Peter; Surawicz, Borys; Wellens, Hein


    This statement examines the relation of the resting ECG to its technology. Its purpose is to foster understanding of how the modern ECG is derived and displayed and to establish standards that will improve the accuracy and usefulness of the ECG in practice. Derivation of representative waveforms and measurements based on global intervals are described. Special emphasis is placed on digital signal acquisition and computer-based signal processing, which provide automated measurements that lead to computer-generated diagnostic statements. Lead placement, recording methods, and waveform presentation are reviewed. Throughout the statement, recommendations for ECG standards are placed in context of the clinical implications of evolving ECG technology.

  17. Recommendations for the standardization and interpretation of the electrocardiogram: part I: The electrocardiogram and its technology: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: endorsed by the International Society for Computerized Electrocardiology. (United States)

    Kligfield, Paul; Gettes, Leonard S; Bailey, James J; Childers, Rory; Deal, Barbara J; Hancock, E William; van Herpen, Gerard; Kors, Jan A; Macfarlane, Peter; Mirvis, David M; Pahlm, Olle; Rautaharju, Pentti; Wagner, Galen S; Josephson, Mark; Mason, Jay W; Okin, Peter; Surawicz, Borys; Wellens, Hein


    This statement examines the relation of the resting ECG to its technology. Its purpose is to foster understanding of how the modern ECG is derived and displayed and to establish standards that will improve the accuracy and usefulness of the ECG in practice. Derivation of representative waveforms and measurements based on global intervals are described. Special emphasis is placed on digital signal acquisition and computer-based signal processing, which provide automated measurements that lead to computer-generated diagnostic statements. Lead placement, recording methods, and waveform presentation are reviewed. Throughout the statement, recommendations for ECG standards are placed in context of the clinical implications of evolving ECG technology.

  18. Geology of the Aspen 15-minute quadrangle, Pitkin and Gunnison counties, Colorado (United States)

    Bryant, Bruce


    The Aspen area, located 170 km southwest of Denver, Colo., lies at the intersection of the northeast-trending Colorado mineral belt and the west margin of the north-trending Sawatch uplift of Laramide age; it is within the southwest part of the northwest-trending late Paleozoic Eagle basin. Precambrian shales and graywackes, perhaps as old as 2 billion years (b.y.), were converted to sillimanite-bearing gneiss and muscovite-biotite schist 1.65-1.70 b.y. ago. They were deformed into northeast-plunging folds and were migmatized, and they were intruded by quartz diorite, porphyritic quartz monzonite, and granite. Muscovite-biotite quartz monzonite intruded this older Precambrian terrane about 1.45 b.y. ago and is the predominant Precambrian rock near Aspen. Uplift, some faulting, and much erosion occurred during the 900-million year (m.y.) interval between emplacement of the plutonic rocks and deposition of Upper Cambrian sediments. From Late Cambrian through Mississippian the region was part of a broad area alternately covered by shallow seas or occupied by low-lying land. Quartzite, dolomite, and limestone 200-320 m thick, comprising the Sawatch Quartzite and Peerless Formation (Cambrian), Manitou Dolomite (Ordovician), Chaffee Group (Mississippian(?) and Devonian), and Leadville Limestone (Mississippian) were deposited during this interval. After an hiatus during which soil formation and solution of the Leadville Limestone took place in the Late Mississippian, a thick sequence of marine and nonmarine clastic rocks was deposited in the newly developing Eagle basin during the late Paleozoic and early Mesozoic. Deposition of about 300 m of carbonaceous shale, limestone, dolomite, and minor siltstone and evaporite of the Belden Formation began in a shallow sea in Early and Middle Pennsylvanian time. Facies relations indicate that the northwest-trending Uncompahgre uplift southwest of Aspen, if present at that time, had very low relief. The overlying Middle Pennsylvanian Gothic Formation of Langenheim (1952) contains calcareous sandstone, siltstone, shale, limestone, and evaporite. Its clastic debris, significantly coarser than that in the Belden, signals the initial rise of the Uncompahgre uplift bordering the Eagle basin on the southwest; the Gothic here lacks the conglomerates and fossiliferous marine limestones found closer to the uplift. Red terrigenous clastic rocks and minor limestone and evaporite of the Maroon Formation as much as 3,200 m thick, deposited mainly in a fluvial flood-plain environment during the rest of the Pennsylvanian and the Early Permian, indicate withdrawal of the sea caused by further uplift of the Uncompahgre highland. Following an hiatus accompanied by local folding, the red conglomerate, sandstone, and siltstone of the State Bridge Formation (Late Permian and Early Triassic) was deposited in a fluvial-lacustrine environment adjacent to a much-expanded Uncompahgre uplift; a significant part of the State Bridge is material recycled from the Maroon Formation exposed to erosion on the flank of the uplift. The State Bridge, absent towards the south, becomes thicker and finer grained towards the north. The Chinle Formation (Late Triassic) rests with angular unconformity on the State Bridge Formation. The Chinle contains a basal discontinuous quartz-pebble conglomerate (Gartra Member) and is chiefly calcareous siltstone and limestone, with some beds of sandstone and conglomerate composed of fragments derived from the limestone beds. The Chinle was deposited on flood plains and in lakes by streams. Storms may have disrupted the sediments in the lakes producing the limestone pebble conglomerates. The lack of feldspar in the Chinle indicates that the nearby part of the Uncompahgre uplift was not a sediment source, or was covered by a deeply weathered feldspar-free mantle. The formation, absent towards the south, thickens toward the north. Thicknesses of the Maroon, State Bridge, and Ch

  19. The chaos and order in human ECG under the influence of the external perturbations (United States)

    Ragulskaya, Maria; Valeriy, Pipin

    The results of the many-year telecommunication heliomedical monitoring "Heliomed" show, that space weather and geophysical factor variations serve as a training factor for the adaptation-resistant member of the human population. Here we discuss the specific properties of the human ECG discovered in our experiment. The program "Heliomed" is carried out simultaneously at the different geographical areas that cover the different latitudes. The daily registered param-eters include: the psycho-emotional tests and the 1-st lead ECG, the arterial pressure, the variability cardiac contraction, the electric conduction of bioactive points on skin. The results time series compared with daily values of space weather and geomagnetic parameters. The analysis of ECG signal proceeds as follows. At first step we construct the ECG embedding into 3D phase space using the first 3 Principal Components of the ECG time series. Next, we divide ECG on the separate cycles using the maxima of the ECG's QRS complex. Then, we filter out the non-typical ECG beats by means of the Housdorff distance. Finally, we average the example of the ECG time series along the reference trajectory and study of the dynamical characteristics of the averaged ECG beat. It is found, that the ECG signal embeded in 3D phase space can be considered as a mix of a few states. At the rest, the occurrence of the primary ECG state compare to additional ones is about 8:2. The occurrence of the primary state increases after the stress. The main effect of the external perturbation is observed in structural change of the cardio-cycle and not in the variability of the R-R interval. The num-ber of none-typical cycles increase during an isolated magnetic storm. At the all monitoring centers participating experiment the same type of changes in the cardiac activity parameters is detected to go nearly simultaneously during an isolated magnetic storm. To understand the origin of the standard cardio-cycle changes we use the dynamical

  20. Evaluation of ECG changes after Radiotherapy of left chest wall by Electron in patients with left breast cancer who receive Anthracycline based chemotherapy following mastectomy

    Directory of Open Access Journals (Sweden)

    J Emami


    Full Text Available Background: Cardiovascular damage after Radiotherapy of left chest wall for left breast cancer is a potential fear, therefore studing both the possible causes of radiation-induced heart damage and preventive measures are crucial issues in radiation therapy of breast cancer. The present study investigates noninvasively the possible acute and chronic ECG changes and their incidences after Radiotherapy in patients with left sided breast cancer who have received 6-8 courses of Anthracycline based chemotherapy following mastectomy. Methods: 56 patients with breast cancer (invasive ductal carcinoma who had been undergone modified radical mastectomy, adjuvant Anthracycline based chemotherapy, and left sided chest wall electron therapy with direct field, have been evaluated. All patients investigated with physical examination and standard 12 leads ECG before, and immediately after completion of radiation therapy, and 6 months afterward. Results: New electrocardiographic changes after therapy were seen in 3 patients (5.35% and reduced to 2 cases (3.57% after 6 months. there was no significant difference in T wave findings before and after radiation therapy(P=0.521.Also there wasn’t any correlation between stage of cancer and any changes in ECG findings after radiation therapy (P=0.56. Conclusion: There were no clinical cardiac symptoms or signs after Radiotherapy. Most affected leads in ECG were V1-V4 and the main abnormality was Inverted T wave. This findings suggest that the most acute and chronic electrocardiographic effect of irradiation on heart is repolarization abnormality. This study suggests that there are no significant ECG changes after Radiotherapy of left chest wall by electron beam in patients with left sided breast cancer who has received Anthracycline based chemotherapy following mastectomy. Also Radiotherapy by electron doesn't induce any clinical cardiac symptoms and signs in these patients. Therefore, we recommend

  1. A reversed-phase HPLC-UV assay for simultaneous analysis of EGCG and ECG of tea polyphenols in rat plasma

    Institute of Scientific and Technical Information of China (English)

    FU Ting; LIANG Jun; HAN Guo-zhu; L(U) Li; LI Nan


    pharmacokinetically behaved as the two-compartment model and first-order kinetics, with t1/2β 122.9 min and 59.2 min, Vd 7.96 L·kg-1 and 1.22 L·kg-1, CL 0.044 L·kg-1·min-1 and 0.015 L·kg-1·min-1 for EGCG and ECG, respectively. Conclusions The method developed in the present study is highly specific, precise, accurate, and suitable for the non-clinical pharmacokinetie study of the TP in rats.

  2. QRS classification and spatial combination for robust heart rate detection in low-quality fetal ECG recordings. (United States)

    Warmerdam, G; Vullings, R; Van Pul, C; Andriessen, P; Oei, S G; Wijn, P


    Non-invasive fetal electrocardiography (ECG) can be used for prolonged monitoring of the fetal heart rate (FHR). However, the signal-to-noise-ratio (SNR) of non-invasive ECG recordings is often insufficient for reliable detection of the FHR. To overcome this problem, source separation techniques can be used to enhance the fetal ECG. This study uses a physiology-based source separation (PBSS) technique that has already been demonstrated to outperform widely used blind source separation techniques. Despite the relatively good performance of PBSS in enhancing the fetal ECG, PBSS is still susceptible to artifacts. In this study an augmented PBSS technique is developed to reduce the influence of artifacts. The performance of the developed method is compared to PBSS on multi-channel non-invasive fetal ECG recordings. Based on this comparison, the developed method is shown to outperform PBSS for the enhancement of the fetal ECG.

  3. [Monitor of ECG signal and heart rate using a mobile phone with Bluetooth communication protocol]. (United States)

    Becerra-Luna, Brayans; Dávila-García, Rodrigo; Salgado-Rodríguez, Paola; Martínez-Memije, Raúl; Infante-Vázquez, Oscar


    To develop a portable signal monitoring equipment for electrocardiography (ECG) and heart rate (HR), communicated with a mobile phone using the Bluetooth (BT) communication protocol for display of the signal on screen. A monitoring system was designed in which the electronic section performs the ECG signal acquisition, as well as amplification, filtering, analog to digital conversion and transmission of the ECG and HR using BT. Two programs were developed for the system. The first one calculates HR through QRS identification and sends the ECG signals and HR to the mobile, and the second program is an application to acquire and display them on the mobile screen. We developed a portable electronic system powered by a 9 volt battery, with amplification and bandwidth meeting the international standards for ECG monitoring. The QRS complex identification was performed using the second derivative algorithm, while the programs allow sending and receiving information from the ECG and HR via BT, and viewing it on the mobile screen. The monitoring is feasible within distances of 15 m and it has been tested in various mobiles telephones of brands Nokia®, Sony Ericsson® and Samsung®. This system shows an alternative for mobile monitoring using BT and Java 2 Micro Edition (J2ME) programming. It allows the register of the ECG trace and HR, and it can be implemented in different phones. Copyright © 2011 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  4. QT dispersion on ECG Holter monitoring and risk of ventricular arrhythmias in patients with dilated cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Polyxeni Garyfallidis


    Full Text Available Background. QT dispersion (QTd is increased in patients with dilated cardiomyopathy. Increased QTd has been associated with the risk of sudden death. We studied: a the relation between QTd on 12-lead ECG and QTd-ECG Holter; b the relation between QTd apex (QTda and QTd end (QTde on ECG Holter and the risk of ventricular arrhythmias in patients with dilated cardiomyopathy. Methods and Results. 65 patients with dilated cardiomyopathy (33 idiopathic and 32 post-ischemic etiology; NYHA II-III were studied. We divided the patients into: Group A -patients with not-sustained ventricular arrhythmias-; and Group B -patients without arrhythmias-. A significant direct correlation between QTd calculated from 12-lead ECG and from ECG Holter was found in all patients. QTda/24h was not significantly different in the two groups (Gr.A 59.9±7.8 msec vs Gr.B 53.6±8.4 msec p=ns while QTde/24h was significantly higher in Group A (Gr.A 81.9±5.9 msec vs Gr.B 44.5±6.8 msec; p<0.005. In post-ischemic etiology (32 pts; 17 with arrhythmias the correlation between QTde/24h and ventricular arrhythmias was confirmed (Gr.A 81.4±7.8 msec vs Gr.B 42.6±6.2 msec p<0.002. Conclusions. ECG Holter recordings can evaluate QTd as well as the QTd on 12-lead ECG. An increased QTde/24h seems to be correlated with the occurence of ventricular arrhythmias in patients with dilated cardiomyopathy and can then be a useful tool to select patients at high risk for sudden death.

  5. Paroxysmal atrial fibrillation in young cryptogenic ischemic stroke: A 3-week ECG Holter monitoring study. (United States)

    Sanak, Daniel; Hutyra, Martin; Kral, Michal; Bartkova, Andrea; Zapletalova, Jana; Fedorco, Marian; Veverka, Tomas; Vindis, David; Dornak, Tomas; Skala, Tomas; Skoloudik, David; Taborsky, Milos; Kanovsky, Petr


    Atrial fibrillation is known very frequent cause of ischemic stroke. Undetected paroxysmal atrial fibrillation (PAF) is thus often considered a possible cause of cryptogenic ischemic stroke (CIS). The aim of this prospective study was to detect PAF using ECG Holter monitoring and determinate whether prolongation of the Holter monitoring to 3 weeks would increase the detection rates of PAF in young CIS patients ≤ 50 years. The study set consisted of IS patients ≤ 50 years enrolled in the HISTORY (Heart and Ischemic STrOke Relationship studY) study (NCT01541163). CIS was defined according to the TOAST criteria including the absence of ultrasonographic or angiographic signs of atherosclerosis, vasculitis or dissection. Admission ECG, serum levels of high sensitive Troponin T (hs TnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP), markers of thrombophilia, transoesophageal echocardiography (TEE) and 24-hour ECG-Holter monitoring were performed in all patients. In case of negative 24-h ECG Holter, an additional 3-weeks monitoring was done. Of the 105 enrolled patients ≤ 50 years, 95 (90%) were identified as cryptogenic (49 males, mean age 39.1 ± 8.2 years). All CIS patients had normal admission ECG. In total, PAF was detected in 9 (9.5%, 95% CI: 3.5% - 17.8%) patients; in two during 24-h ECG Holter and in seven during 3-weeks Holter monitoring. Patients with PAF had more frequently elevated admission hs TnT and NT-proBNP levels (P - 0.0001). PAF was detected in 9.5% of young CIS patients and 3-weeks ECG Holter monitoring increased the detection rate.

  6. ECG-gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis

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    Fagman, Erika; Flinck, Agneta; Lamm, Carl [Sahlgrenska University Hospital, Department of Radiology, Gothenburg (Sweden); Perrotta, Sossio [Sahlgrenska University Hospital, Department of Cardiovascular Surgery and Anaesthesia, Gothenburg (Sweden); Bech-Hanssen, Odd [Sahlgrenska University Hospital, Department of Clinical Physiology, Gothenburg (Sweden); Sahlgrenska University Hospital, Department of Cardiology, Gothenburg (Sweden); Olaison, Lars [Sahlgrenska University Hospital, Department of Infectious Diseases, Gothenburg (Sweden); Svensson, Gunnar [Sahlgrenska University Hospital, Department of Cardiovascular Surgery and Anaesthesia, Gothenburg (Sweden); The Sahlgrenska Academy at the University of Gothenburg, Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg (Sweden)


    The aim of this prospective study was to investigate the agreement in findings between ECG-gated CT and transoesophageal echocardiography (TEE) in patients with aortic prosthetic valve endocarditis (PVE). Twenty-seven consecutive patients with PVE underwent 64-slice ECG-gated CT and TEE and the results were compared. Imaging was compared with surgical findings (surgery was performed in 16 patients). TEE suggested the presence of PVE in all patients [thickened aortic wall (n = 17), vegetation (n = 13), abscess (n = 16), valvular dehiscence (n = 10)]. ECG-gated CT was positive in 25 patients (93 %) [thickened aortic wall (n = 19), vegetation (n = 7), abscess (n = 18), valvular dehiscence (n = 7)]. The strength of agreement [kappa (95 % CI)] between ECG-gated CT and TEE was very good for thickened wall [0.83 (0.62-1.0)], good for abscess [0.68 (0.40-0.97)] and dehiscence [0.75 (0.48-1.0)], and moderate for vegetation [0.55 (0.26-0.88)]. The agreement was good between surgical findings (abscess, vegetation and dehiscence) and imaging for ECG-gated CT [0.66 (0.49-0.87)] and TEE [0.79 (0.62-0.96)] and very good for the combination of ECG-gated CT and TEE [0.88 (0.74-1.0)]. Our results indicate that ECG-gated CT has comparable diagnostic performance to TEE and may be a valuable complement in the preoperative evaluation of patients with aortic PVE. (orig.)

  7. [Normal values of temporal parameters of ECG in children according to results of clinico-epidemiological study ECG-screening of children and adolescents in Russian federation]. (United States)

    Miklashevich, I M; Shkol'nikova, M A; Kalinin, L A; Abdullatipova, I V; Osokina, G G; Deev, A D; Blinova, A V; Drozdova, A I; Lebed'kova, S E; Muratov, R A; Verevkina, O N; Timukova, A K; Lunegova, E V; Kozlova, L V; Svintsova, L I; Khomiakova, O I; Ashcheulova, N L


    In order to obtain reliable information about time-domain ECG parameters in Russian children and to analyse their links with physiological changes the Project "ECG screening of children and adolescents of the Russian Federation" was carried out in 2003-2008. Time domain ECG parameters were studied in the representative sample of 5387 healthy individuals aged 0 to 18 years. In each age group, lower and upper limits of the norm for heart rate (HR), P wave, PQ and QRS intervals were defined as 2nd and 98th percentiles of their distribution. The equivalent limits of QT interval duration were defined as its 5th and 95th percentiles. Relationship between time domain parameters of pediatric ECG and HR was analyzed as well as relationship of these parameters with sex and age. The most important differences from prior pediatric studies completed 30 years ago were obtained for the heart rate limits. Among children aged 0 to 3, there was a tendency toward lowering of age-specific lower limits and elevation of age-specific upper limits. At ages older than 3 years, there was a tendency toward lowering of both the upper and the lower limits of HR. The newly obtained 2nd percentiles of the heart rate were lower than the known lower limits in nearly all ages. This indicates the necessity for revision of criteria of bradicardia in children. The present study showed that 5th and 95th percentiles of QTc interval (Bazett's formula) varied between 340 ms and 465 ms and were not significantly dependent on children's age and only for ages under 13 also on sex. Results of the study allowed to build age-specific ranges of norm for the time domain ECG parameters presented in a tabular form.

  8. ECG -6511心电图机常见故障的维修分析

    Institute of Scientific and Technical Information of China (English)



    ECG -6511心电图机作为重要的医疗设备需要具有良好的稳定性。本文从阐述 ECG -6511心电图机常见故障入手,对于 ECG -6511心电图机故障维修进行了分析。

  9. Extraction of fetal electrocardiogram (ECG) by extended state Kalman filtering and adaptive neuro-fuzzy inference system (ANFIS) based on single channel abdominal recording

    Indian Academy of Sciences (India)

    D Panigrahy; P K Sahu


    Fetal electrocardiogram (ECG) gives information about the health status of fetus and so, an early diagnosis of any cardiac defect before delivery increases the effectiveness of appropriate treatment. In this paper, authors investigate the use of adaptive neuro-fuzzy inference system (ANFIS) with extended Kalman filter for fetal ECG extraction from one ECG signal recorded at the abdominal areas of the mother’s skin. The abdominal ECG is considered to be composite as it contains both mother’s and fetus’ ECG signals. We use extended Kalman filter framework to estimate the maternal component from abdominal ECG. The maternal component in the abdominal ECG signal is a nonlinear transformed version of maternal ECG. ANFIS network has been used to identify this nonlinear relationship, and to align the estimated maternal ECG signal with the maternal component in the abdominal ECG signal. Thus, we extract the fetal ECG component by subtracting the aligned version of the estimated maternal ECG from the abdominal signal. Our results demonstrate the effectiveness of the proposed technique in extracting the fetal ECG component from abdominal signal at different noise levels. The proposed technique is also validated on the extraction of fetal ECG from both actual abdominal recordings and synthetic abdominal recording.

  10. [Research on ECG de-noising method based on ensemble empirical mode decomposition and wavelet transform using improved threshold function]. (United States)

    Ye, Linlin; Yang, Dan; Wang, Xu


    A de-noising method for electrocardiogram (ECG) based on ensemble empirical mode decomposition (EEMD) and wavelet threshold de-noising theory is proposed in our school. We decomposed noised ECG signals with the proposed method using the EEMD and calculated a series of intrinsic mode functions (IMFs). Then we selected IMFs and reconstructed them to realize the de-noising for ECG. The processed ECG signals were filtered again with wavelet transform using improved threshold function. In the experiments, MIT-BIH ECG database was used for evaluating the performance of the proposed method, contrasting with de-noising method based on EEMD and wavelet transform with improved threshold function alone in parameters of signal to noise ratio (SNR) and mean square error (MSE). The results showed that the ECG waveforms de-noised with the proposed method were smooth and the amplitudes of ECG features did not attenuate. In conclusion, the method discussed in this paper can realize the ECG denoising and meanwhile keep the characteristics of original ECG signal.

  11. An integrated healthcare information system for end-to-end standardized exchange and homogeneous management of digital ECG formats. (United States)

    Trigo, Jesús Daniel; Martínez, Ignacio; Alesanco, Alvaro; Kollmann, Alexander; Escayola, Javier; Hayn, Dieter; Schreier, Günter; García, José


    This paper investigates the application of the enterprise information system (EIS) paradigm to standardized cardiovascular condition monitoring. There are many specifications in cardiology, particularly in the ECG standardization arena. The existence of ECG formats, however, does not guarantee the implementation of homogeneous, standardized solutions for ECG management. In fact, hospital management services need to cope with various ECG formats and, moreover, several different visualization applications. This heterogeneity hampers the normalization of integrated, standardized healthcare information systems, hence the need for finding an appropriate combination of ECG formats and a suitable EIS-based software architecture that enables standardized exchange and homogeneous management of ECG formats. Determining such a combination is one objective of this paper. The second aim is to design and develop the integrated healthcare information system that satisfies the requirements posed by the previous determination. The ECG formats selected include ISO/IEEE11073, Standard Communications Protocol for Computer-Assisted Electrocardiography, and an ECG ontology. The EIS-enabling techniques and technologies selected include web services, simple object access protocol, extensible markup language, or business process execution language. Such a selection ensures the standardized exchange of ECGs within, or across, healthcare information systems while providing modularity and accessibility.

  12. A Wearable Context-Aware ECG Monitoring System Integrated with Built-in Kinematic Sensors of the Smartphone

    Directory of Open Access Journals (Sweden)

    Fen Miao


    Full Text Available Continuously monitoring the ECG signals over hours combined with activity status is very important for preventing cardiovascular diseases. A traditional ECG holter is often inconvenient to carry because it has many electrodes attached to the chest and because it is heavy. This work proposes a wearable, low power context-aware ECG monitoring system integrated built-in kinetic sensors of the smartphone with a self-designed ECG sensor. The wearable ECG sensor is comprised of a fully integrated analog front-end (AFE, a commercial micro control unit (MCU, a secure digital (SD card, and a Bluetooth module. The whole sensor is very small with a size of only 58 × 50 × 10 mm for wearable monitoring application due to the AFE design, and the total power dissipation in a full round of ECG acquisition is only 12.5 mW. With the help of built-in kinetic sensors of the smartphone, the proposed system can compute and recognize user’s physical activity, and thus provide context-aware information for the continuous ECG monitoring. The experimental results demonstrated the performance of proposed system in improving diagnosis accuracy for arrhythmias and identifying the most common abnormal ECG patterns in different activities. In conclusion, we provide a wearable, accurate and energy-efficient system for long-term and context-aware ECG monitoring without any extra cost on kinetic sensor design but with the help of the widespread smartphone.

  13. Online digital filter and QRS detector applicable in low resource ECG monitoring systems. (United States)

    Tabakov, Serafim; Iliev, Ivo; Krasteva, Vessela


    The present work describes fast computation methods for real-time digital filtration and QRS detection, both applicable in autonomous personal ECG systems for long-term monitoring. Since such devices work under considerable artifacts of intensive body and electrode movements, the input filtering should provide high-quality ECG signals supporting the accurate ECG interpretation. In this respect, we propose a combined high-pass and power-line interference rejection filter, introducing the simple principle of averaging of samples with a predefined distance between them. In our implementation (sampling frequency of 250 Hz), we applied averaging over 17 samples distanced by 10 samples (Filter10x17), thus realizing a comb filter with a zero at 50 Hz and high-pass cut-off at 1.1 Hz. Filter10x17 affords very fast filtering procedure at the price of minimal computing resources. Another benefit concerns the small ECG distortions introduced by the filter, providing its powerful application in the preprocessing module of diagnostic systems analyzing the ECG morphology. Filter10x17 does not attenuate the QRS amplitude, or introduce significant ST-segment elevation/depression. The filter output produces a constant error, leading to uniform shifting of the entire P-QRS-T segment toward about 5% of the R-peak amplitude. Tests with standardized ECG signals proved that Filter10x17 is capable to remove very strong baseline wanderings, and to fully suppress 50 Hz interferences. By changing the number of the averaged samples and the distance between them, a filter design with different cut-off and zero frequency could be easily achieved. The real-time QRS detector is designed with simplified computations over single channel, low-resolution ECGs. It relies on simple evaluations of amplitudes and slopes, including history of their mean values estimated over the preceding beats, smart adjustable thresholds, as well as linear logical rules for identification of the R-peaks in real

  14. Removal of Baseline Wander Noise from Electrocardiogram (ECG using Fifth-order Spline Interpolation

    Directory of Open Access Journals (Sweden)

    John A. OJO


    Full Text Available Baseline wandering can mask some important features of the Electrocardiogram (ECG signal hence it is desirable to remove this noise for proper analysis and display of the ECG signal. This paper presents the implementation and evaluation of spline interpolation and linear phase FIR filtering methods to remove this noise. Spline interpolation method requires the QRS waves to be first detected and fifth-order (quintic interpolation technique applied to determine the smoothest curve joining several QRS points. Filtering of the ECG baseline wander was performed by using the difference between the estimated baseline wander and the noisy ECG signal. ECG signals from the MIT-BIT arrhythmia database was used to test the system, while the technique was implemented in MATLAB. The performance of the system was evaluated using Average Power (AP after filtering, Mean Square Error (MSE and the Signal to Noise Ratio (SNR. The quintic spline interpolation gave the best performance in terms of AP, MSE and SNR when compared with linear phase filtering and cubic (3rd-order spline interpolation methods.

  15. Discrete wavelet transform and singular value decomposition based ECG steganography for secured patient information transmission. (United States)

    Edward Jero, S; Ramu, Palaniappan; Ramakrishnan, S


    ECG Steganography provides secured transmission of secret information such as patient personal information through ECG signals. This paper proposes an approach that uses discrete wavelet transform to decompose signals and singular value decomposition (SVD) to embed the secret information into the decomposed ECG signal. The novelty of the proposed method is to embed the watermark using SVD into the two dimensional (2D) ECG image. The embedding of secret information in a selected sub band of the decomposed ECG is achieved by replacing the singular values of the decomposed cover image by the singular values of the secret data. The performance assessment of the proposed approach allows understanding the suitable sub-band to hide secret data and the signal degradation that will affect diagnosability. Performance is measured using metrics like Kullback-Leibler divergence (KL), percentage residual difference (PRD), peak signal to noise ratio (PSNR) and bit error rate (BER). A dynamic location selection approach for embedding the singular values is also discussed. The proposed approach is demonstrated on a MIT-BIH database and the observations validate that HH is the ideal sub-band to hide data. It is also observed that the signal degradation (less than 0.6%) is very less in the proposed approach even with the secret data being as large as the sub band size. So, it does not affect the diagnosability and is reliable to transmit patient information.


    Directory of Open Access Journals (Sweden)

    Mbachu C.B


    Full Text Available Heart attacks mostly occur in people who suffer from heart or heart-relate diseases if these diseases are not detected early enough and treated. There is therefore the need for a reliable means of detecting these diseases to save the patients from these attacks which are increasing in proportion all over the world. Electrocardiography (ECG, which is the electrical activity of the heart, generates a signal referred to as ECG signal or simply ECG and the shape of this signal tells much about the condition of the heart of a patient. Naturally the ECG signal gets distorted by different artifacts which must be removed otherwise it will convey an incorrect information regarding the patients heart condition. The work in this paper is the design of FIR digital filters with Kaiser Window to remove the interferences or the artifacts. Three filters are considered: low pass, high pass and notch filters. Each filter is used to filter the raw noisy ECG signal after which the three filters are used in cascade. Results are observed and recorded in each case, using FDA tool.

  17. Real-time QRS detection using integrated variance for ECG gated cardiac MRI

    Directory of Open Access Journals (Sweden)

    Schmidt Marcus


    Full Text Available During magnetic resonance imaging (MRI, a patient’s vital signs are required for different purposes. In cardiac MRI (CMR, an electrocardiogram (ECG of the patient is required for triggering the image acquisition process. However, a reliable QRS detection of an ECG signal acquired inside an MRI scanner is a challenging task due to the magnetohydrodynamic (MHD effect which interferes with the ECG. The aim of this work was to develop a reliable QRS detector usable inside the MRI which also fulfills the standards for medical devices (IEC 60601-2-27. Therefore, a novel real-time QRS detector based on integrated variance measurements is presented. The algorithm was trained on ANSI/AAMI EC13 test waveforms and was then applied to two databases with 12-lead ECG signals recorded inside and outside an MRI scanner. Reliable results for both databases were achieved for the ECG signals recorded inside (DBMRI: sensitivity Se = 99.94%, positive predictive value +P = 99.84% and outside (DBInCarT: Se = 99.29%, +P = 99.72% the MRI. Due to the accurate R-peak detection in real-time this can be used for monitoring and triggering in MRI exams.

  18. Performance evaluation of wavelet-based ECG compression algorithms for telecardiology application over CDMA network. (United States)

    Kim, Byung S; Yoo, Sun K


    The use of wireless networks bears great practical importance in instantaneous transmission of ECG signals during movement. In this paper, three typical wavelet-based ECG compression algorithms, Rajoub (RA), Embedded Zerotree Wavelet (EZ), and Wavelet Transform Higher-Order Statistics Coding (WH), were evaluated to find an appropriate ECG compression algorithm for scalable and reliable wireless tele-cardiology applications, particularly over a CDMA network. The short-term and long-term performance characteristics of the three algorithms were analyzed using normal, abnormal, and measurement noise-contaminated ECG signals from the MIT-BIH database. In addition to the processing delay measurement, compression efficiency and reconstruction sensitivity to error were also evaluated via simulation models including the noise-free channel model, random noise channel model, and CDMA channel model, as well as over an actual CDMA network currently operating in Korea. This study found that the EZ algorithm achieves the best compression efficiency within a low-noise environment, and that the WH algorithm is competitive for use in high-error environments with degraded short-term performance with abnormal or contaminated ECG signals.

  19. Simplified 2D Bidomain Model of Whole Heart Electrical Activity and ECG Generation (United States)

    Sovilj, Siniša; Magjarević, Ratko; Abed, Amr Al; Lovell, Nigel H.; Dokos, Socrates


    The aim of this study was the development of a geometrically simple and highly computationally-efficient two dimensional (2D) biophysical model of whole heart electrical activity, incorporating spontaneous activation of the sinoatrial node (SAN), the specialized conduction system, and realistic surface ECG morphology computed on the torso. The FitzHugh-Nagumo (FHN) equations were incorporated into a bidomain finite element model of cardiac electrical activity, which was comprised of a simplified geometry of the whole heart with the blood cavities, the lungs and the torso as an extracellular volume conductor. To model the ECG, we placed four electrodes on the surface of the torso to simulate three Einthoven leads VI, VII and VIII from the standard 12-lead system. The 2D model was able to reconstruct ECG morphology on the torso from action potentials generated at various regions of the heart, including the sinoatrial node, atria, atrioventricular node, His bundle, bundle branches, Purkinje fibers, and ventricles. Our 2D cardiac model offers a good compromise between computational load and model complexity, and can be used as a first step towards three dimensional (3D) ECG models with more complex, precise and accurate geometry of anatomical structures, to investigate the effect of various cardiac electrophysiological parameters on ECG morphology.

  20. ECG-derived Cheyne-Stokes respiration and periodic breathing in healthy and hospitalized populations. (United States)

    Tinoco, Adelita; Drew, Barbara J; Hu, Xiao; Mortara, David; Cooper, Bruce A; Pelter, Michele M


    Cheyne-Stokes respiration (CSR) has been investigated primarily in outpatients with heart failure. In this study we compare CSR and periodic breathing (PB) between healthy and cardiac groups. We compared CSR and PB, measured during 24 hr of continuous 12-lead electrocardiographic (ECG) Holter recording, in a group of 90 hospitalized patients presenting to the emergency department with symptoms suggestive of acute coronary syndrome (ACS) to a group of 100 healthy ambulatory participants. We also examined CSR and PB in the 90 patients presenting with ACS symptoms, divided into a group of 39 (43%) with confirmed ACS, and 51 (57%) with a cardiac diagnosis but non-ACS. SuperECG software was used to derive respiration and then calculate CSR and PB episodes from the ECG Holter data. Regression analyses were used to analyze the data. We hypothesized SuperECG software would differentiate between the groups by detecting less CSR and PB in the healthy group than the group of patients presenting to the emergency department with ACS symptoms. Hospitalized patients with suspected ACS had 7.3 times more CSR episodes and 1.6 times more PB episodes than healthy ambulatory participants. Patients with confirmed ACS had 6.0 times more CSR episodes and 1.3 times more PB episodes than cardiac non-ACS patients. Continuous 12-lead ECG derived CSR and PB appear to differentiate between healthy participants and hospitalized patients. © 2017 Wiley Periodicals, Inc.

  1. Wearable technology and ECG processing for fall risk assessment, prevention and detection. (United States)

    Melillo, Paolo; Castaldo, Rossana; Sannino, Giovanna; Orrico, Ada; de Pietro, Giuseppe; Pecchia, Leandro


    Falls represent one of the most common causes of injury-related morbidity and mortality in later life. Subjects with cardiovascular disorders (e.g., related to autonomic dysfunctions and postural hypotension) are at higher risk of falling. Autonomic dysfunctions increasing the risk of falling in the short and mid-term could be assessed by Heart Rate Variability (HRV) extracted by electrocardiograph (ECG). We developed three trials for assessing the usefulness of ECG monitoring using wearable devices for: risk assessment of falling in the next few weeks; prevention of imminent falls due to standing hypotension; and fall detection. Statistical and data-mining methods are adopted to develop classification and regression models, validated with the cross-validation approach. The first classifier based on HRV features enabled to identify future fallers among hypertensive patients with an accuracy of 72% (sensitivity: 51.1%, specificity: 80.2%). The regression model to predict falls due to orthostatic dropdown from HRV recorded before standing achieved an overall accuracy of 80% (sensitivity: 92%, specificity: 90%). Finally, the classifier to detect simulated falls using ECG achieved an accuracy of 77.3% (sensitivity: 81.8%, specificity: 72.7%). The evidence from these three studies showed that ECG monitoring and processing could achieve satisfactory performances compared to other system for risk assessment, fall prevention and detection. This is interesting as differently from other technologies actually employed to prevent falls, ECG is recommended for many other pathologies of later life and is more accepted by senior citizens.

  2. Support vector machines for automated recognition of obstructive sleep apnea syndrome from ECG recordings. (United States)

    Khandoker, Ahsan H; Palaniswami, Marimuthu; Karmakar, Chandan K


    Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular morbidity as well as excessive daytime sleepiness and poor quality of life. In this study, we apply a machine learning technique [support vector machines (SVMs)] for automated recognition of OSAS types from their nocturnal ECG recordings. A total of 125 sets of nocturnal ECG recordings acquired from normal subjects (OSAS - ) and subjects with OSAS (OSAS +), each of approximately 8 h in duration, were analyzed. Features extracted from successive wavelet coefficient levels after wavelet decomposition of signals due to heart rate variability (HRV) from RR intervals and ECG-derived respiration (EDR) from R waves of QRS amplitudes were used as inputs to the SVMs to recognize OSAS +/- subjects. Using leave-one-out technique, the maximum accuracy of classification for 83 training sets was found to be 100% for SVMs using a subset of selected combination of HRV and EDR features. Independent test results on 42 subjects showed that it correctly recognized 24 out of 26 OSAS + subjects and 15 out of 16 OSAS - subjects (accuracy = 92.85%; Cohen's kappa value of 0.85). For estimating the relative severity of OSAS, the posterior probabilities of SVM outputs were calculated and compared with respective apnea/hypopnea index. These results suggest superior performance of SVMs in OSAS recognition supported by wavelet-based features of ECG. The results demonstrate considerable potential in applying SVMs in an ECG-based screening device that can aid a sleep specialist in the initial assessment of patients with suspected OSAS.

  3. ECG pattern in reverse takotsubo cardiomyopathy demonstrated in 5 cases with intracranial hemorrhage. (United States)

    Elikowski, Waldemar; Małek-Elikowska, Małgorzata; Kudliński, Bartosz; Skrzywanek, Paweł; Smól, Sławomir; Rzymski, Stanisław


    In typical takotsubo cardiomyopathy (TC) apical transient left ventricular dysfunction with concomitant ECG changes mimicking acute anterior myocardial infarction can be observed. Reverse TC (RTC) characterized by contractile disturbances in all basal and often simultaneous mid-ventricular segments is definitely less frequent. ECG pattern of RTC is less known. The authors present ECG findings in 5 cases of RTC in course of intracranial hemorrhage (ICH); 3 patients were diagnosed with subarachnoid hemorrhage (SAH) and the other two with intracerebral hemorrhage or subdural posttraumatic hematoma. In all patients, initial ECG appearance was dominated by ST segment depression in inferior leads (II, III, avF) and/or lateral leads (V4-6). In 4 patients, concurrent ST segment elevation in avR and avL leads was seen, additionally 4 patients had low QRS voltage in high lateral leads (I, avL). Potential normalization of these changes did not influence the patient`s survival. In one woman, immediately before death, early repolarization was recorded. In subjects with an increased risk of TC, for example in intracranial hemorrhage, particularly in SAH, the ECG abnormalities presented may indicate a need for further search of its atypical echocardiographic variants.

  4. Development and feasibility of a smartphone, ECG and GPS based system for remotely monitoring exercise in cardiac rehabilitation.

    Directory of Open Access Journals (Sweden)

    Charles Worringham

    Full Text Available BACKGROUND: Despite its efficacy and cost-effectiveness, exercise-based cardiac rehabilitation is undertaken by less than one-third of clinically eligible cardiac patients in every country for which data is available. Reasons for non-participation include the unavailability of hospital-based rehabilitation programs, or excessive travel time and distance. For this reason, there have been calls for the development of more flexible alternatives. METHODOLOGY AND PRINCIPAL FINDINGS: We developed a system to enable walking-based cardiac rehabilitation in which the patient's single-lead ECG, heart rate, GPS-based speed and location are transmitted by a programmed smartphone to a secure server for real-time monitoring by a qualified exercise scientist. The feasibility of this approach was evaluated in 134 remotely-monitored exercise assessment and exercise sessions in cardiac patients unable to undertake hospital-based rehabilitation. Completion rates, rates of technical problems, detection of ECG changes, pre- and post-intervention six minute walk test (6 MWT, cardiac depression and Quality of Life (QOL were key measures. The system was rated as easy and quick to use. It allowed participants to complete six weeks of exercise-based rehabilitation near their homes, worksites, or when travelling. The majority of sessions were completed without any technical problems, although periodic signal loss in areas of poor coverage was an occasional limitation. Several exercise and post-exercise ECG changes were detected. Participants showed improvements comparable to those reported for hospital-based programs, walking significantly further on the post-intervention 6 MWT, 637 m (95% CI: 565-726, than on the pre-test, 524 m (95% CI: 420-655, and reporting significantly reduced levels of cardiac depression and significantly improved physical health-related QOL. CONCLUSIONS AND SIGNIFICANCE: The system provided a feasible and very flexible alternative form of


    Institute of Scientific and Technical Information of China (English)


    In view of the shortcomes of conventional ElectroCardioGram (ECG) compression algorithms, such as high complexity of operation and distortion of reconstructed signal, a new ECG compression encoding algorithm based on Set Partitioning In Hierarchical Trees (SPIHT) is brought out after studying the integer lifting scheme wavelet transform in detail. The proposed algorithm modifies zero-tree structure of SPIHT, establishes single dimensional wavelet coefficient tree of ECG signals and enhances the efficiency of SPIHT-encoding by distributing bits rationally, improving zero-tree set and ameliorating classifying method. For this improved algorithm, floating-point computation and storage are left out of consideration and it is easy to be implemented by hardware and software. Experimental results prove that the new algorithm has admirable features of low complexity,high speed and good performance in signal reconstruction. High compression ratio is obtained with high signal fidelity as well.

  6. A novel ECG telemetry and monitoring system based on Z-Wave communication. (United States)

    Csernath, Geza; Szilagyi, Laszlo; Fordos, Gergely; Szilagyi, Sandor M


    This paper presents a novel ECG telemetry system based on Z-Wave communication protocol. The proposed system consists of small portable devices that acquire, compress and transmit the ECG to a RF-USB interface connected to a central monitoring computer. The received signals are filtered, QRS complexes and P and T waves are localized, and different waveforms are classified in order to be able to provide diagnosis tools like heart rate variability and turbulence analysis. Due to the limitation of communication bandwidth, the maximum number of measuring devices connected to a central monitor is four. The proposed system composed of inexpensive components can serve as flexible alternative to current ECG monitoring systems.

  7. ECG processing techniques based on neural networks and bidirectional associative memories. (United States)

    Maglaveras, N; Stamkopoulos, T; Pappas, C; Strintzis, M


    Two ECG processing techniques are described for the classification of QRSs, PVCs and normal and ischaemic beats. The techniques use neural network (NN) technology in two ways. The first technique, uses nonlinear ECG mapping preprocessing and subsequently for classification uses a shrinking algorithm based on NNs. This technique is applied to the QRS/PVC problem with good result. The second technique is based on the Bidirectional Associative Memory (BAM) NN and is used to distinguish normal from ischaemic beats. In this technique the ECG beat is treated as a digitized image which is then transformed into a bipolar vector suitable for input in the BAM. The results show that this method, if properly calibrated, can result in a fast and reliable ischaemic beat detection algorithm.


    Directory of Open Access Journals (Sweden)

    Ruchita Gautam,


    Full Text Available The electrocardiogram (ECG is quite important tool to find out more information about the heart. The main tasks in ECG signal analysis are the detection of QRS complex (i.e. R wave, and the estimation ofinstantaneous heart rate by measuring the time interval between two consecutive R-waves. After recognizing R wave, other components like P, Q, S and T can be detected by using window method. In this paper, we describe a QRS complex detector based on the Dyadic wavelet transform (DyWT which is robust in comparison with time- varying QRS complex morphology and to noise. We illustrate the performance of the DyWT-based QRS detector by considering problematic ECG signals from Common Standard for Electrocardiography (CSE database. We also compare and analyze its performance to some of the QRS detectors developed in the past.

  9. Independent component analysis and decision trees for ECG holter recording de-noising.

    Directory of Open Access Journals (Sweden)

    Jakub Kuzilek

    Full Text Available We have developed a method focusing on ECG signal de-noising using Independent component analysis (ICA. This approach combines JADE source separation and binary decision tree for identification and subsequent ECG noise removal. In order to to test the efficiency of this method comparison to standard filtering a wavelet- based de-noising method was used. Freely data available at Physionet medical data storage were evaluated. Evaluation criteria was root mean square error (RMSE between original ECG and filtered data contaminated with artificial noise. Proposed algorithm achieved comparable result in terms of standard noises (power line interference, base line wander, EMG, but noticeably significantly better results were achieved when uncommon noise (electrode cable movement artefact were compared.

  10. Reliable resource-constrained telecardiology via compressive detection of anomalous ECG signals. (United States)

    Chandra, Bollepalli S; Sastry, Challa S; Jana, Soumya


    Telecardiology is envisaged as a supplement to inadequate local cardiac care, especially, in infrastructure deficient communities. Yet the associated infrastructure constraints are often ignored while designing a traditional telecardiology system that simply records and transmits user electrocardiogram (ECG) signals to a professional diagnostic facility. Against this backdrop, we propose a two-tier telecardiology framework, where constraints on resources, such as power and bandwidth, are met by compressively sampling ECG signals, identifying anomalous signals, and transmitting only the anomalous signals. Specifically, we design practical compressive classifiers based on inherent properties of ECG signals, such as self-similarity and periodicity, and illustrate their efficacy by plotting receiver operating characteristics (ROC). Using such classifiers, we realize a resource-constrained telecardiology system, which, for the PhysioNet databases, allows no more than 0.5% undetected patients even at an average downsampling factor of five, reducing the power requirement by 80% and bandwidth requirement by 83.4% compared to traditional telecardiology.

  11. Wavelet-Based Watermarking and Compression for ECG Signals with Verification Evaluation

    Directory of Open Access Journals (Sweden)

    Kuo-Kun Tseng


    Full Text Available In the current open society and with the growth of human rights, people are more and more concerned about the privacy of their information and other important data. This study makes use of electrocardiography (ECG data in order to protect individual information. An ECG signal can not only be used to analyze disease, but also to provide crucial biometric information for identification and authentication. In this study, we propose a new idea of integrating electrocardiogram watermarking and compression approach, which has never been researched before. ECG watermarking can ensure the confidentiality and reliability of a user’s data while reducing the amount of data. In the evaluation, we apply the embedding capacity, bit error rate (BER, signal-to-noise ratio (SNR, compression ratio (CR, and compressed-signal to noise ratio (CNR methods to assess the proposed algorithm. After comprehensive evaluation the final results show that our algorithm is robust and feasible.

  12. An ultra low power ECG signal processor design for cardiovascular disease detection. (United States)

    Jain, Sanjeev Kumar; Bhaumik, Basabi


    This paper presents an ultra low power ASIC design based on a new cardiovascular disease diagnostic algorithm. This new algorithm based on forward search is designed for real time ECG signal processing. The algorithm is evaluated for Physionet PTB database from the point of view of cardiovascular disease diagnosis. The failed detection rate of QRS complex peak detection of our algorithm ranges from 0.07% to 0.26% for multi lead ECG signal. The ASIC is designed using 130-nm CMOS low leakage process technology. The area of ASIC is 1.21 mm(2). This ASIC consumes only 96 nW at an operating frequency of 1 kHz with a supply voltage of 0.9 V. Due to ultra low power consumption, our proposed ASIC design is most suitable for energy efficient wearable ECG monitoring devices.

  13. Wavelet-based watermarking and compression for ECG signals with verification evaluation. (United States)

    Tseng, Kuo-Kun; He, Xialong; Kung, Woon-Man; Chen, Shuo-Tsung; Liao, Minghong; Huang, Huang-Nan


    In the current open society and with the growth of human rights, people are more and more concerned about the privacy of their information and other important data. This study makes use of electrocardiography (ECG) data in order to protect individual information. An ECG signal can not only be used to analyze disease, but also to provide crucial biometric information for identification and authentication. In this study, we propose a new idea of integrating electrocardiogram watermarking and compression approach, which has never been researched before. ECG watermarking can ensure the confidentiality and reliability of a user's data while reducing the amount of data. In the evaluation, we apply the embedding capacity, bit error rate (BER), signal-to-noise ratio (SNR), compression ratio (CR), and compressed-signal to noise ratio (CNR) methods to assess the proposed algorithm. After comprehensive evaluation the final results show that our algorithm is robust and feasible.

  14. Using an injection signal to reduce motion artifacts in capacitive ECG measurements. (United States)

    Serteyn, Aline; Vullings, Rik; Meftah, Mohammed; Bergmans, Jan


    Capacitive electrodes are a promising alternative to the conventional adhesive ECG electrodes. They provide more comfort to the patient when integrated in everyday objects (e.g. beds or seats) for long-term monitoring. However, the application of such electrodes is limited by their high sensitivity to motion artifacts. Artifacts caused by variation of the coupling capacitance are studied here. An injection signal is proposed to track these variations in real-time. An adaptive filter then estimates the motion artifact and cancels it from the recorded ECG. The amplitude of the motion artifact is reduced in average by 29 dB in simulation and by 20 dB in a lab environment. Our method has the advantages that it is able to reduce motion artifacts occurring in the frequency band of the ECG and that it does not require knowledge about the measurement system.

  15. Continuous ECG Monitoring in Patients With Acute Coronary Syndrome or Heart Failure: EASI Versus Gold Standard. (United States)

    Lancia, Loreto; Toccaceli, Andrea; Petrucci, Cristina; Romano, Silvio; Penco, Maria


    The purpose of the study was to compare the EASI system with the standard 12-lead surface electrocardiogram (ECG) for the accuracy in detecting the main electrocardiographic parameters (J point, PR, QT, and QRS) commonly monitored in patients with acute coronary syndromes or heart failure. In this observational comparative study, 253 patients who were consecutively admitted to the coronary care unit with acute coronary syndrome or heart failure were evaluated. In all patients, two complete 12-lead ECGs were acquired simultaneously. A total of 6,072 electrocardiographic leads were compared (3,036 standard and 3,036 EASI). No significant differences were found between the investigate parameters of the two measurement methods, either in patients with acute coronary syndrome or in those with heart failure. This study confirmed the accuracy of the EASI system in monitoring the main ECG parameters in patients admitted to the coronary care unit with acute coronary syndrome or heart failure.

  16. A PC-based generator of surface ECG potentials for computer electrocardiograph testing. (United States)

    Franchi, D; Palagi, G; Bedini, R


    The system is composed of an electronic circuit, connected to a PC, whose outputs, starting from ECGs digitally collected by commercial interpretative electrocardiographs, simulate virtual patients' limb and chest electrode potentials. Appropriate software manages the D/A conversion and lines up the original short-term signal in a ring buffer to generate continuous ECG traces. The device also permits the addition of artifacts and/or baseline wanders/shifts on each lead separately. The system has been accurately tested and statistical indexes have been computed to quantify the reproduction accuracy analyzing, in the generated signal, both the errors induced on the fiducial point measurements and the capability to retain the diagnostic significance. The device integrated with an annotated ECG data base constitutes a reliable and powerful system to be used in the quality assurance testing of computer electrocardiographs.

  17. Labview Based ECG Patient Monitoring System for Cardiovascular Patient Using SMTP Technology. (United States)

    Singh, Om Prakash; Mekonnen, Dawit; Malarvili, M B


    This paper leads to developing a Labview based ECG patient monitoring system for cardiovascular patient using Simple Mail Transfer Protocol technology. The designed device has been divided into three parts. First part is ECG amplifier circuit, built using instrumentation amplifier (AD620) followed by signal conditioning circuit with the operation amplifier (lm741). Secondly, the DAQ card is used to convert the analog signal into digital form for the further process. Furthermore, the data has been processed in Labview where the digital filter techniques have been implemented to remove the noise from the acquired signal. After processing, the algorithm was developed to calculate the heart rate and to analyze the arrhythmia condition. Finally, SMTP technology has been added in our work to make device more communicative and much more cost-effective solution in telemedicine technology which has been key-problem to realize the telediagnosis and monitoring of ECG signals. The technology also can be easily implemented over already existing Internet.

  18. Community-Based ECG Monitoring System for Patients with Cardiovascular Diseases. (United States)

    Lin, Bor-Shyh; Wong, Alice M; Tseng, Kevin C


    This study aims to develop a community-based electrocardiogram (ECG) monitoring system for cardiac outpatients to wirelessly detect heart rate, provide personalized healthcare, and enhance interactive social contact because of the prevalence of deaths from cardiovascular disease and the growing problem of aging in the world. The system not only strengthens the performance of the ECG monitoring system but also emphasizes the ergonomic design of wearable devices and user interfaces. In addition, it enables medical professionals to diagnose cardiac symptoms remotely and electronically manage medical reports and suggestions. The experimental result shows high performance of the dry electrode, even in dynamic conditions. The comparison result with different ECG healthcare systems shows the essential factors that the system should possess and the capability of the proposed system. Finally, a user survey was conducted based on the unified theory of acceptance and users of technology (UTAUT) model.

  19. ECG and enzymatic indicators of therapeutic success after intravenous streptokinase for acute myocardial infarction

    DEFF Research Database (Denmark)

    Clemmensen, P; Grande, P; Pedersen, F


    Thrombolytic therapy has been documented to result in reperfusion of jeopardized myocardium and reduction in the size of the acute myocardial infarction (AMI). The effect of intravenous streptokinase on a creatine kinase-MB (CK-MB) reperfusion index and an ECG estimate of myocardial salvage...... was therefore studied in 65 patients with a first AMI, randomized to treatment with streptokinase (n = 33) or placebo (control group, n = 32). Reperfusion was defined as a CK-MB appearance rate constant (k1) greater than 0.185. The final AMI size was first predicted from the admission standard ECG by previously...... developed formulas based on ST segment elevation. The final AMI size was estimated from the QRS score on the predischarge ECG. Myocardial salvage was defined as a greater than or equal to 20% decrease from predicted to final AMI size. The k1 value in the control group was significantly lower than...

  20. Prolonged corrected QT interval is predictive of future stroke events even in subjects without ECG-diagnosed left ventricular hypertrophy. (United States)

    Ishikawa, Joji; Ishikawa, Shizukiyo; Kario, Kazuomi


    We attempted to evaluate whether subjects who exhibit prolonged corrected QT (QTc) interval (≥440 ms in men and ≥460 ms in women) on ECG, with and without ECG-diagnosed left ventricular hypertrophy (ECG-LVH; Cornell product, ≥244 mV×ms), are at increased risk of stroke. Among the 10 643 subjects, there were a total of 375 stroke events during the follow-up period (128.7±28.1 months; 114 142 person-years). The subjects with prolonged QTc interval (hazard ratio, 2.13; 95% confidence interval, 1.22-3.73) had an increased risk of stroke even after adjustment for ECG-LVH (hazard ratio, 1.71; 95% confidence interval, 1.22-2.40). When we stratified the subjects into those with neither a prolonged QTc interval nor ECG-LVH, those with a prolonged QTc interval but without ECG-LVH, and those with ECG-LVH, multivariate-adjusted Cox proportional hazards analysis demonstrated that the subjects with prolonged QTc intervals but not ECG-LVH (1.2% of all subjects; incidence, 10.7%; hazard ratio, 2.70, 95% confidence interval, 1.48-4.94) and those with ECG-LVH (incidence, 7.9%; hazard ratio, 1.83; 95% confidence interval, 1.31-2.57) had an increased risk of stroke events, compared with those with neither a prolonged QTc interval nor ECG-LVH. In conclusion, prolonged QTc interval was associated with stroke risk even among patients without ECG-LVH in the general population.