Sample records for conventional 12-lead ecg

  1. 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

  2. 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.

  3. 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.

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

    Schlegel, Todd T.


    -rested arms of the subject; 6) sufficient distal placement of the arm electrodes achieves good electrode abutment to the arms without the need for adhesives, straps, bands, bracelets, or gloves; 7) padding over the sternum avoids "tenting" in the V1 through V3 (and, when present, the V3R) electrode positions; 8) easy-to-don, one-piece design with an adjustable, front-side single point of connection and an adjustable shoulder strap; and 9) Lund or "modified Lund" placement of the dry electrodes, the results of which more effectively reproduce results from "standard" 12-lead ECG placements than do results from Mason-Likar placements. The main limitation of the harness is that "one size does not fit all", meaning that an appropriately sized harness (small, medium, large, etc) must be chosen on the basis of an individual's size. To facilitate the use of the harness with inexpensive, commodity-grade cell phones and tablet devices, 12-lead ECG software is also being developed to accompany the harness for wireless use with Android. For this part of the project, NASA has teamed with TopCoder, Inc and the Harvard-affiliated NASA Tournament Lab in sponsoring java-based software programming contests through TopCoder. While ECG signals from the harness can already be wirelessly received and thoroughly processed (locally or remotely) by commercial-grade conventional (as well as advanced) 12-lead ECG software running on Microsoft Windows(TM), the Android-based software, once completed, will "cast a wider net" by allowing for a greater percentage of cell phone owners to participate in inexpensive, store-and-forward recordings of 12-lead ECGs worldwide, including for example Android cell phone users in many remote, third-world locations. At the time of writing, the Android 12-lead ECG software platform consists of a basic but expanding graphical user interface and accompanying software that: 1) wirelessly receives the 12-lead ECG data stream from a Bluetooth-based, FDA-cleared 12-lea

  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. 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.

  7. [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.

  8. Construction and Use of Resting 12-Lead High Fidelity ECG "SuperScores" in Screening for Heart Disease (United States)

    Schlegel, T. T.; Arenare, B.; Greco, E. C.; DePalma, J. L.; Starc, V.; Nunez, T.; Medina, R.; Jugo, D.; Rahman, M.A.; Delgado, R.


    We investigated the accuracy of several conventional and advanced resting ECG parameters for identifying obstructive coronary artery disease (CAD) and cardiomyopathy (CM). Advanced high-fidelity 12-lead ECG tests (approx. 5-min supine) were first performed on a "training set" of 99 individuals: 33 with ischemic or dilated CM and low ejection fraction (EF less than 40%); 33 with catheterization-proven obstructive CAD but normal EF; and 33 age-/gender-matched healthy controls. Multiple conventional and advanced ECG parameters were studied for their individual and combined retrospective accuracies in detecting underlying disease, the advanced parameters falling within the following categories: 1) Signal averaged ECG, including 12-lead high frequency QRS (150-250 Hz) plus multiple filtered and unfiltered parameters from the derived Frank leads; 2) 12-lead P, QRS and T-wave morphology via singular value decomposition (SVD) plus signal averaging; 3) Multichannel (12-lead, derived Frank lead, SVD lead) beat-to-beat QT interval variability; 4) Spatial ventricular gradient (and gradient component) variability; and 5) Heart rate variability. Several multiparameter ECG SuperScores were derivable, using stepwise and then generalized additive logistic modeling, that each had 100% retrospective accuracy in detecting underlying CM or CAD. The performance of these same SuperScores was then prospectively evaluated using a test set of another 120 individuals (40 new individuals in each of the CM, CAD and control groups, respectively). All 12-lead ECG SuperScores retrospectively generated for CM continued to perform well in prospectively identifying CM (i.e., areas under the ROC curve greater than 0.95), with one such score (containing just 4 components) maintaining 100% prospective accuracy. SuperScores retrospectively generated for CAD performed somewhat less accurately, with prospective areas under the ROC curve typically in the 0.90-0.95 range. We conclude that resting 12-lead

  9. 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.

  10. 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.

  11. 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.

  12. A Low Power Front End Analog Multiplexing Unit for 12 Lead ECG Signal Acquisition

    Directory of Open Access Journals (Sweden)

    D.Hari Priya


    Full Text Available The design of CMOS analog circuitry for acquiring 12 lead ECG is presented. The existing methods employ separate multiplexers and associated circuitry for signal acquisition operating at typical voltage of ± 5V. The proposed system employs dynamic threshold logic to achieve low power, wide dynamic range good linearity with a supply voltage of 0.4V. The power dissipation obtained was 22.12µW. Utilizing the dynamic threshold logic the proposed circuitry is implemented with 0.18µm CMOS technology. This ECG signal processor is highly suitable for wearable applications of long term cardiac monitoring.

  13. A Low Power Front End Analog Multiplexing Unit for 12 Lead ECG Signal Acquisition

    Directory of Open Access Journals (Sweden)

    D.Hari Priya


    Full Text Available The design of CMOS analog circuitry for acquiring 12 lead ECG is presented. The existing methods employ separate multiplexers and associated circuitry for signal acquisition operating at typical voltage of ± 5V. The proposed system employs dynamic threshold logic to achieve low power, wide dynamic range good linearity with a supply voltage of 0.4V. The power dissipation obtained was 22.12µW. Utilizing the dynamic threshold logic the proposed circuitry is implemented with 0.18µm CMOS technology. This ECG signal processor is highly suitable for wearable applications of long term cardiac monitoring.

  14. 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.

  15. A Low Power Front End Analog Multiplexing Unit for 12 Lead ECG Signal Acquisition



    The design of CMOS analog circuitry for acquiring 12 lead ECG is presented. The existing methods employ separate multiplexers and associated circuitry for signal acquisition operating at typical voltage of ± 5V. The proposed system employs dynamic threshold logic to achieve low power, wide dynamic range good linearity with a supply voltage of 0.4V. The power dissipation obtained was 22.12µW. Utilizing the dynamic threshold logic the proposed circuitry is implemented with 0.18µm CMOS technolog...

  16. New Padded Harness for Self-Acquisition of Resting 12-Lead ECGs (United States)

    Schlegel, T. T.; Rood, A. T.


    We have developed a dry-electrode harness that permits easy, rapid, and unsupervised self-acquisition of resting 12-lead ECGs without the use of any disposables. Various other advantageous features of the harness include: 1) padded or inflatable cushions at the lateral sides of the torso that function to press the left arm (LA) and right arm (RA) dry electrodes mounted on cushions against sideward (as shown in the Figure below) or downward-rested arms of the subject; 2) sufficient distal placement of the arm electrodes with good abutment and without the need for adhesives, straps, bands, bracelets, or gloves on the arms; 3) padding over the sternum to avoid "tenting" in the V1 through V3 (and V3R, when present) electrode positions; 4) easy-to-don, one-piece design with an adjustable single point of connection and an adjustable shoulder strap; and 5) Lund or "modified Lund" placement of the dry electrodes, the results of which more effectively reproduce results from "standard" 12-lead ECG placements than do results from Mason-Likar lead placements.

  17. 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.

  18. A Simplified 3D Model of Whole Heart Electrical Activity and 12-Lead ECG Generation

    Directory of Open Access Journals (Sweden)

    Siniša Sovilj


    Full Text Available We present a computationally efficient three-dimensional bidomain model of torso-embedded whole heart electrical activity, with spontaneous initiation of activation in the sinoatrial node, incorporating a specialized conduction system with heterogeneous action potential morphologies throughout the heart. The simplified geometry incorporates the whole heart as a volume source, with heart cavities, lungs, and torso as passive volume conductors. We placed four surface electrodes at the limbs of the torso: , , and and six electrodes on the chest to simulate the Einthoven, Goldberger-augmented and precordial leads of a standard 12-lead system. By placing additional seven electrodes at the appropriate torso positions, we were also able to calculate the vectorcardiogram of the Frank lead system. Themodel was able to simulate realistic electrocardiogram (ECG morphologies for the 12 standard leads, orthogonal , , and leads, as well as the vectorcardiogram under normal and pathological heart states. Thus, simplified and easy replicable 3D cardiac bidomain model offers a compromise between computational load and model complexity and can be used as an investigative tool to adjust cell, tissue, and whole heart properties, such as setting ischemic lesions or regions of myocardial infarction, to readily investigate their effects on whole ECG morphology.

  19. The presence of fragmented QRS on 12-lead ECG in patients with coronary slow flow. (United States)

    Yilmaz, Hale; Gungor, Baris; Kemaloglu, Tugba; Sayar, Nurten; Erer, Betul; Yilmaz, Mehmet; Cakmak, Nazmiye; Gurkan, Ufuk; Oz, Dilaver; Bolca, Osman


    Coronary slow flow (CSF) is characterised by delayed opacification of coronary arteries in the absence of epicardial occlusive disease. It has been reported that CSF may cause angina, myocardial ischaemia, and infarction. Fragmentation of QRS complex (fQRS) is an easily evaluated non-invasive electrocardiographic parameter. It has been associated with alternation of myocardial activation due to myocardial scar and/or ischaemia. Whether CSF is associated with fQRS is unknown. The presence of fQRS on ECG may be an indicator of myocardial damage in patients with CSF. To investigate the presence of fQRS in patients with CSF. Sixty patients (mean age 55.5 ± 10.5 years) with CSF and 44 patients with normal coronary arteries without associated CSF (mean age 53 ± 8.4 years) were included in this study. The fQRS was defined as the presence of an additional R wave or notching of R or S wave or the presence of fragmentation in two contiguous leads corresponding to a major coronary artery territory. The presence of fQRS was higher in the CSF group than in the controls (p = 0.005). Hypertension was significantly more common in the CSF group (p < 0.001). There was no significant association between the presence of fQRS and an increasing number of vessel involvements. Logistic regression analysis demonstrated that the presence of CSF was the independent determinant of fQRS (OR = 10.848; 95% CI 2.385-49.347; p = 0.002). Fragmented QRS, indicating increased risk for arrhythmias and cardiovascular mortality, was found to be significantly higher in patients with CSF. We have not found an association between the presence of fragmented QRS and the degree of CSF. Further prospective studies are needed to establish the significance as a possible new risk factor in patients with CSF.

  20. Development of new anatomy reconstruction software to localize cardiac isochrones to the cardiac surface from the 12 lead ECG. (United States)

    van Dam, Peter M; Gordon, Jeffrey P; Laks, Michael M; Boyle, Noel G


    medical image data (pixel size software tool has been introduced, which is able to reconstruct accurate cardiac anatomical models from MRI or CT within only a few hours. This new anatomical reconstruction tool might reduce the modeling errors within the cardiac isochrone positioning system and thus enable the clinical application of CIPS to localize the PVC/VT focus to the ventricular myocardium from only the standard 12 lead ECG. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Tissue Doppler Imaging Combined with Advanced 12-Lead ECG Analysis Might Improve Early Diagnosis of Hypertrophic Cardiomyopathy in Childhood (United States)

    Femlund, E.; Schlegel, T.; Liuba, P.


    Optimization of early diagnosis of childhood hypertrophic cardiomyopathy (HCM) is essential in lowering the risk of HCM complications. Standard echocardiography (ECHO) has shown to be less sensitive in this regard. In this study, we sought to assess whether spatial QRS-T angle deviation, which has shown to predict HCM in adults with high sensitivity, and myocardial Tissue Doppler Imaging (TDI) could be additional tools in early diagnosis of HCM in childhood. Methods: Children and adolescents with familial HCM (n=10, median age 16, range 5-27 years), and without obvious hypertrophy but with heredity for HCM (n=12, median age 16, range 4-25 years, HCM or sudden death with autopsy-verified HCM in greater than or equal to 1 first-degree relative, HCM-risk) were additionally investigated with TDI and advanced 12-lead ECG analysis using Cardiax(Registered trademark) (IMED Co Ltd, Budapest, Hungary and Houston). Spatial QRS-T angle (SA) was derived from Kors regression-related transformation. Healthy age-matched controls (n=21) were also studied. All participants underwent thorough clinical examination. Results: Spatial QRS-T angle (Figure/ Panel A) and septal E/Ea ratio (Figure/Panel B) were most increased in HCM group as compared to the HCM-risk and control groups (p less than 0.05). Of note, these 2 variables showed a trend toward higher levels in HCM-risk group than in control group (p=0.05 for E/Ea and 0.06 for QRS/T by ANOVA). In a logistic regression model, increased SA and septal E/Ea ratio appeared to significantly predict both the disease (Chi-square in HCM group: 9 and 5, respectively, p less than 0.05 for both) and the risk for HCM (Chi-square in HCM-risk group: 5 and 4 respectively, p less than 0.05 for both), with further increased predictability level when these 2 variables were combined (Chi-square 10 in HCM group, and 7 in HCM-risk group, p less than 0.01 for both). Conclusions: In this small material, Tissue Doppler Imaging and spatial mean QRS-T angle

  2. When Deriving the Spatial QRS-T Angle from the 12-lead ECG, which Transform is More Frank: Regression or Inverse Dower? (United States)

    Schlegel, Todd T.; Cortez, Daniel


    Our primary objective was to ascertain which commonly used 12-to-Frank-lead transformation yields spatial QRS-T angle values closest to those obtained from simultaneously collected true Frank-lead recordings. Simultaneous 12-lead and Frank XYZ-lead recordings were analyzed for 100 post-myocardial infarction patients and 50 controls. Relative agreement, with true Frank-lead results, of 12-to-Frank-lead transformed results for the spatial QRS-T angle using Kors regression versus inverse Dower was assessed via ANOVA, Lin s concordance and Bland-Altman plots. Spatial QRS-T angles from the true Frank leads were not significantly different than those derived from the Kors regression-related transformation but were significantly smaller than those derived from the inverse Dower-related transformation (P less than 0.001). Independent of method, spatial mean QRS-T angles were also always significantly larger than spatial maximum (peaks) QRS-T angles. Spatial QRS-T angles are best approximated by regression-related transforms. Spatial mean and spatial peaks QRS-T angles should also not be used interchangeably.

  3. Localization of precise origin of idiopathic ventricular tachycardia from the right ventricular outflow tract by a 12-lead ECG: a study of pace mapping using a multielectrode "basket" catheter. (United States)

    Yoshida, Y; Hirai, M; Murakami, Y; Kondo, T; Inden, Y; Akahoshi, M; Tsuda, M; Okamoto, M; Yamada, T; Tsuboi, N; Hirayama, H; Ito, T; Toyama, J; Saito, H


    Radiofrequency catheter ablation guided by pace-mapping techniques has proven effective in eliminating idiopathic ventricular tachycardia (VT) originating from the right ventricular outflow tract (RVOT). A method for rapidly identifying the origin of VT from 12-lead electrocardiogram (ECG) findings would be helpful for the catheter ablation procedure. The purpose of this study is to precisely localize the origin of idiopathic VT from the RVOT by a 12-lead ECG from a study of multipoint pace mapping. In one patient with premature ventricular complex (PVC) and 3 with VT, a "basket" catheter was deployed in the RVOT for bipolar pacing from 56 sites in the endocardium of RVOT. Under fluoroscopy the pacing sites were classified into the septum and free wall. We investigated the QRS morphology in leads, I, II, and III; the depth of the QS wave in leads aVR and aVL; and the height of the initial r wave in leads V1 and V2. Pacing was captured in 30-47 of 56 sites (54%-84%). As the pacing sites changed from the anterior to posterior of the septum, the QS notch (-) type in lead I shifted through rs to R, while a shift from R type to rR' or Rr' was noted in leads II and III. As the pacing sites changed from the anterior to posterior of the free wall, lead I showed a shift from the QS notch (+) type to R, while a shift from rR' to Rr' (or rR' unchanged) was found in leads II and III. The depth of the QS wave in leads aVR and aVL showed a tendency for aVR to be deeper than aVL toward the posterolateral attachment of both the septum and free wall, whereas aVL tended to be deeper than aVR toward the anterior attachment. The initial r waves in V1 and V2 became greater as the pacing site was positioned at a higher or more posterior location. These findings may provide more precise and clinically useful diagnostic information on the site of the origin of idiopathic VT originating from the RVOT by a 12-lead ECG.

  4. Surface 12 lead electrocardiogram recordings using smart phone technology. (United States)

    Baquero, Giselle A; Banchs, Javier E; Ahmed, Shameer; Naccarelli, Gerald V; Luck, Jerry C


    AliveCor ECG is an FDA approved ambulatory cardiac rhythm monitor that records a single channel (lead I) ECG rhythm strip using an iPhone. In the past few years, the use of smartphones and tablets with health related applications has significantly proliferated. In this initial feasibility trial, we attempted to reproduce the 12 lead ECG using the bipolar arrangement of the AliveCor monitor coupled to smart phone technology. We used the AliveCor heart monitor coupled with an iPhone cellular phone and the AliveECG application (APP) in 5 individuals. In our 5 individuals, recordings from both a standard 12 lead ECG and the AliveCor generated 12 lead ECG had the same interpretation. This study demonstrates the feasibility of creating a 12 lead ECG with a smart phone. The validity of the recordings would seem to suggest that this technology could become an important useful tool for clinical use. This new hand held smart phone 12 lead ECG recorder needs further development and validation. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Vectorcardiographic diagnostic & prognostic information derived from the 12-lead electrocardiogram: Historical review and clinical perspective. (United States)

    Man, Sumche; Maan, Arie C; Schalij, Martin J; Swenne, Cees A


    In the course of time, electrocardiography has assumed several modalities with varying electrode numbers, electrode positions and lead systems. 12-lead electrocardiography and 3-lead vectorcardiography have become particularly popular. These modalities developed in parallel through the mid-twentieth century. In the same time interval, the physical concepts underlying electrocardiography were defined and worked out. In particular, the vector concept (heart vector, lead vector, volume conductor) appeared to be essential to understanding the manifestations of electrical heart activity, both in the 12-lead electrocardiogram (ECG) and in the 3-lead vectorcardiogram (VCG). Not universally appreciated in the clinic, the vectorcardiogram, and with it the vector concept, went out of use. A revival of vectorcardiography started in the 90's, when VCGs were mathematically synthesized from standard 12-lead ECGs. This facilitated combined electrocardiography and vectorcardiography without the need for a special recording system. This paper gives an overview of these historical developments, elaborates on the vector concept and seeks to define where VCG analysis/interpretation can add diagnostic/prognostic value to conventional 12-lead ECG analysis.

  6. [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.

  7. 12导Holter、3导Holter和ECG对冠心病检测的对比分析%Value of 12-lead Holter compared with 3-lead Holter and ECG in the diagnosis of coronary disease

    Institute of Scientific and Technical Information of China (English)

    田新利; 王陆建



  8. Real-Time 12-Lead High-Frequency QRS Electrocardiography for Enhanced Detection of Myocardial Ischemia and Coronary Artery Disease (United States)

    Schlegel, Todd T.; Kulecz, Walter B.; DePalma, Jude L.; Feiveson, Alan H.; Wilson, John S.; Rahman, M. Atiar; Bungo, Michael W.


    Several studies have shown that diminution of the high-frequency (HF; 150-250 Hz) components present within the central portion of the QRS complex of an electrocardiogram (ECG) is a more sensitive indicator for the presence of myocardial ischemia than are changes in the ST segments of the conventional low-frequency ECG. However, until now, no device has been capable of displaying, in real time on a beat-to-beat basis, changes in these HF QRS ECG components in a continuously monitored patient. Although several software programs have been designed to acquire the HF components over the entire QRS interval, such programs have involved laborious off-line calculations and postprocessing, limiting their clinical utility. We describe a personal computer-based ECG software program developed recently at the National Aeronautics and Space Administration (NASA) that acquires, analyzes, and displays HF QRS components in each of the 12 conventional ECG leads in real time. The system also updates these signals and their related derived parameters in real time on a beat-to-beat basis for any chosen monitoring period and simultaneously displays the diagnostic information from the conventional (low-frequency) 12-lead ECG. The real-time NASA HF QRS ECG software is being evaluated currently in multiple clinical settings in North America. We describe its potential usefulness in the diagnosis of myocardial ischemia and coronary artery disease.

  9. 12-lead Holter electrocardiography. Review of the literature and clinical application update. (United States)

    Su, Li; Borov, Stefan; Zrenner, Bernhard


    This brief review is focused on 12-lead Holter electrocardiogram (ECG) recording including a review of the literature and the description of the advantages of its application. The standard 12-lead ECG provides a bedside snapshot of the electrical activity of the heart including vector information, but a snapshot of a few beats for some seconds might miss the whole story. Traditional Holter ECG displaying two or three leads may record all heart beats during a prolonged period, but the limited vector information might be a cause of shortcomings in the ECG diagnosis. The 12-lead Holter ECG overcomes these disadvantages and should be preferred for detecting episodes of arrhythmias, localize their origin or the localization of myocardial ischemia. The 12-lead Holter ECG monitoring is efficient in the evaluation of the effect of drugs or interventional therapeutic procedures, i.e., efficiency of biventricular pacing in patients with heart failure and permanent atrial fibrillation (AF). The automatic analysis of parameters in 12-lead Holter ECG is also providing information for risk stratification. In order to obtain a precise diagnosis based on the criteria established on standard ECG, the "real" 12-lead ECG with ten electrodes is advocated.

  10. Dry Electrode Harness System For Wireless 12-LEAD ECG Project (United States)

    National Aeronautics and Space Administration — The dry-electrode harness is composed of a variety of components.  The harness interfaces with the human via a commercial-off-the-shelf (COTS) FDA cleared dry...

  11. Assessing computerized eye tracking technology for gaining insight into expert interpretation of the 12-lead electrocardiogram: an objective quantitative approach. (United States)

    Bond, R R; Zhu, T; Finlay, D D; Drew, B; Kligfield, P D; Guldenring, D; Breen, C; Gallagher, A G; Daly, M J; Clifford, G D


    ), the rhythm strip (3.47s), II (2.74s), V3 (2.63s), I (2.53s), aVL (2.45s), V5 (2.27s), aVF (1.74s), aVR (1.63s), V6 (1.39s), III (1.32s) and V4 (1.19s). It was also found that on average the annotator spends an equal amount of time studying leads in the frontal plane (15.89s) when compared to leads in the transverse plane (15.70s). It was found that on average the annotators fixated on lead I first followed by leads V2, aVL, V1, II, aVR, V3, rhythm strip, III, aVF, V5, V4 and V6. We found a strong correlation (r=0.67) between time to first fixation on a lead and the total fixation duration on each lead. This indicates that leads studied first are studied the longest. There was a weak negative correlation between duration and accuracy (r=-0.2) and a strong correlation between age and accuracy (r=0.67). Eye tracking facilitated a deeper insight into how expert annotators interpret the 12-lead ECG. As a result, the authors recommend ECG annotators to adopt an initial first impression/pattern recognition approach followed by a conventional systematic protocol to ECG interpretation. This recommendation is based on observing misdiagnoses given due to first impression only. In summary, this research presents eye gaze results from expert ECG annotators and provides scope for future work that involves exploiting computerized eye tracking technology to further the science of ECG interpretation. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. The Role of Conventional and Right-Sided ECG Screening for Subcutaneous ICD in a Tetralogy of Fallot Population. (United States)

    Alonso, Pau; Osca, Joaquín; Cano, Oscar; Pimenta, Pedro; Andrés, Ana; Yagüe, Jaime; Millet, José; Rueda, Joaquín; Sancho-Tello, María José


    Information regarding suitability for subcutaneous implantable cardioverter-defibrillator (S-ICD) implant in tetralogy of Fallot (ToF) population is scarce and needs to be further explored. (1) to determine the proportion of patients with ToF eligible for S-ICD, (2) to identify the optimal sensing vector in ToF patients, (3) to test specifically the eligibility for S-ICD with right-sided screening, and (4) to compare with the proportion of eligible patients in a nonselected ICD population. We recruited 60 consecutive patients with ToF and 40 consecutive nonselected patients. Conventional electrocardiographic screening was performed as usual. Right-sided alternative screening was studied by positioning the left arm and right arm electrodes 1 cm right lateral to the xiphoid midline. The Boston Scientific electrocardiogram (ECG) screening tool was utilized. We found a higher proportion of patients with right-sided positive screening in comparison with standard screening (77 ± 0.4% vs. 67 ± 0.4%; P right-sided screening (1.3 ± 1 vs. 1.1 ± 1 ms; P = 0.07). Patients who failed the screening had a longer QRS duration and longer QT interval. Standard and right-sided screening showed a higher percent of positive patients in the control group compared to ToF patients (P Right-sided screening was associated with a significant 10% increase in S-ICD eligibility in ToF patients. When comparing with an acquired cardiomyopathies group, ToF showed a lower eligibility for S-ICD. The most appropriate ECG vector was the alternate vector in contrast to what is observed in the general population. © 2017 Wiley Periodicals, Inc.

  13. 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.

  14. Evaluate the value of 12-lead ECG in patients with acute coronary syndrome undergoing percutaneous coronary intervention%12导联体表心电图在急性冠脉综合征患者经皮冠状动脉介入术中应用与评价

    Institute of Scientific and Technical Information of China (English)

    张蓉; 任平; 杨森焱


    Objective To investigate the 12-lead ECG QT dispersion (QTd and QTcd)changes in the value of diag-nostic applications in the treatment of acute coronary syndrome (ACS)in.Methods coronary angiography diagnosed 222 patients with ACS from June 2010 to June 2014 were treated for ACS group,92 cases of chest pain,chest symptoms after passing through coronary angiography to exclude coronary artery disease as the control group,which 108 patients undergoing PCI for treatment.ACS comparative observation group and control group,ACS group grouping different types of diseases,unstable angina (UA)patients in different groups and coronary stenosis undergoing PCI scores before and after treatment in the treatment of QT dispersion and QTc dispersion values.Results QTd,QTcd value ACS pa-tients were significantly higher,while the UA group was significantly higher than STEMI and NSTEMI group,NSTE-MI group was significantly higher than STEMI group,three groups were significantly higher than a packet and 2 groups,two groups were significantly higher in a group,the differences were statistically significant (P <0.05);after PCI in patients was significantly lower than before the surgery,the difference was statistically significant (P <0.05). Conclusion the use of ECG QT dispersion for ACS patients with different types and extent of the lesion,before and af-ter surgery in PCI played a good assessment of the predicted value.%目的:探讨12导联体表心电图 QT 离散度(QTd 与 QTcd)变化在急性冠脉综合征(ACS)诊断治疗中的应用价值。方法选择2010年6月至2014年6月收治的经冠状动脉造影检查确诊的222例 ACS 患者为 ACS 组,92例因胸痛、胸闷症状行经冠状动脉造影检查后排除冠心病者为对照组。比较观察 ACS 组与对照组、ACS 组不同疾病类型分组、不稳定心绞痛(UA)组不同冠状动脉狭窄评分分组以及行 PCI 术治疗的患者治疗前后心电图 QT 离散度和QTc

  15. Referral of patients with ST-segment elevation acute myocardial infarction directly to the catheterization suite based on prehospital teletransmission of 12-lead electrocardiogram

    DEFF Research Database (Denmark)

    Sillesen, Martin; Sejersten, Maria; Strange, Søren;


    BACKGROUND: Time from symptom onset to reperfusion is essential in patients with ST-segment elevation acute myocardial infarction. Prior studies have indicated that prehospital 12-lead electrocardiogram (ECG) transmission can reduce time to reperfusion. PURPOSE: Determine 12-lead ECG transmission...

  16. 12-lead Holter monitoring in diving and water sports: a preliminary investigation. (United States)

    Bosco, Gerardo; De Marzi, Elena; Michieli, Pierantonio; Omar, Hesham R; Camporesi, Enrico M; Padulo, Johnny; Paoli, Antonio; Mangar, Devanand; Schiavon, Maurizio


    To demonstrate the utility of 12-lead Holter monitoring underwater. A Holter monitor, recording a 12-lead electrocardiogram (ECG) underwater, was applied to 16 pre-trained volunteer scuba divers (13 males and three females). Dive computers were synchronized with the Holter recorder to correlate the ECG tracings with diving events. Our main objective was to demonstrate the utility of recording over a period of time a good quality 12-lead ECG underwater. The ECGs were analyzed for heart rate (HR), arrhythmias, conduction abnormalities and ischaemic events in relation to various stages of diving as follows: baseline, pre diving, diving, and post diving. The ECG tracings were of good quality with minimal artefacts. Analysis of variance (ANOVA) demonstrated a significant difference in HR during the various diving stages (P Holter monitoring underwater can produce good quality tracings. Further studies are necessary to assess its usefulness in divers at risk for or with known coronary artery disease, and its comparison with other forms of cardiac stress tests.

  17. [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.

  18. High frequency QRS ECG predicts ischemic defects during myocardial perfusion imaging (United States)

    Rahman, Atiar


    Background: Changes in high frequency QRS components of the electrocardiogram (HF QRS ECG) (150-250 Hz) are more sensitive than changes in conventional ST segments for detecting myocardial ischemia. We investigated the accuracy of 12-lead HF QRS ECG in detecting ischemia during adenosine tetrofosmin myocardial perfusion imaging (MPI). Methods and Results: 12-lead HF QRS ECG recordings were obtained from 45 patients before and during adenosine technetium-99 tetrofosmin MPI tests. Before the adenosine infusions, recordings of HF QRS were analyzed according to a morphological score that incorporated the number, type and location of reduced amplitude zones (RAZs) present in the 12 leads. During the adenosine infusions, recordings of HF QRS were analyzed according to the maximum percentage changes (in both the positive and negative directions) that occurred in root mean square (RMS) voltage amplitudes within the 12 leads. The best set of prospective HF QRS criteria had a sensitivity of 94% and a specificity of 83% for correctly identifying the MPI result. The sensitivity of simultaneous ST segment changes (18%) was significantly lower than that of any individual HF QRS criterion (Pperfusion defects during adenosine MPI stress tests and significantly more sensitive than analysis of conventional ST segments.

  19. Development of a digital signal processor-based new 12-lead synchronization electrocardiogram automatic analysis system. (United States)

    Yang, Yuxing; Yin, Dongyuan; Freyer, Richard


    This paper presents a digital signal processor (DSP)-based new multichannel electrocardiogram (ECG) system for 12-lead synchronization ECG automatic analysis in real-time with high sampling rate at 1000 Hz and 12-bits precision. Using the hardware structure of double-CPU based on Microprocessor (MPU) 89C55 and DSP TMS320F206 combines the powerful control ability of MPU with DSPs fast computation ability. Fully utilizing the double-CPUs resource, the system can distribute the reasonable CPU-time for the real-time tasks of multichannel synchronization ECG sampling, digital filter, data storing, waveform automatic analysis and print at high sampling rate. The digital ECG system has the advantages of simple structure, sampling with high speed and precision, powerful real-time processing ability and good quality. The paper discusses the system's principle and the skilful hardware design, also gives the ECG processing using the fast simple integer-coefficient filter method and the automatic calculation algorithms of the ECG parameters such as heart rate, P-R interval, Q-T interval and deflexion angle of ECG-axis etc. The system had been successfully tested and used in the ECG automatic analysis instrument.

  20. A new algorithm to diagnose atrial ectopic origin from multi lead ECG systems--insights from 3D virtual human atria and torso. (United States)

    Alday, Erick A Perez; Colman, Michael A; Langley, Philip; Butters, Timothy D; Higham, Jonathan; Workman, Antony J; Hancox, Jules C; Zhang, Henggui


    Rapid atrial arrhythmias such as atrial fibrillation (AF) predispose to ventricular arrhythmias, sudden cardiac death and stroke. Identifying the origin of atrial ectopic activity from the electrocardiogram (ECG) can help to diagnose the early onset of AF in a cost-effective manner. The complex and rapid atrial electrical activity during AF makes it difficult to obtain detailed information on atrial activation using the standard 12-lead ECG alone. Compared to conventional 12-lead ECG, more detailed ECG lead configurations may provide further information about spatio-temporal dynamics of the body surface potential (BSP) during atrial excitation. We apply a recently developed 3D human atrial model to simulate electrical activity during normal sinus rhythm and ectopic pacing. The atrial model is placed into a newly developed torso model which considers the presence of the lungs, liver and spinal cord. A boundary element method is used to compute the BSP resulting from atrial excitation. Elements of the torso mesh corresponding to the locations of the placement of the electrodes in the standard 12-lead and a more detailed 64-lead ECG configuration were selected. The ectopic focal activity was simulated at various origins across all the different regions of the atria. Simulated BSP maps during normal atrial excitation (i.e. sinoatrial node excitation) were compared to those observed experimentally (obtained from the 64-lead ECG system), showing a strong agreement between the evolution in time of the simulated and experimental data in the P-wave morphology of the ECG and dipole evolution. An algorithm to obtain the location of the stimulus from a 64-lead ECG system was developed. The algorithm presented had a success rate of 93%, meaning that it correctly identified the origin of atrial focus in 75/80 simulations, and involved a general approach relevant to any multi-lead ECG system. This represents a significant improvement over previously developed algorithms.

  1. 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 ...

  2. 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

  3. Improved recording of atrial activity by modified bipolar leads derived from the 12-lead electrocardiogram. (United States)

    Kennedy, Alan; Finlay, Dewar D; Guldenring, Daniel; Bond, Raymond R; McEneaney, David J; Peace, Aaron; McLaughlin, James


    This study investigates the use of multivariate linear regression to estimate three bipolar ECG leads from the 12-lead ECG in order to improve P-wave signal strength. The study population consisted of body surface potential maps recorded from 229 healthy subjects. P-waves were then isolated and population based transformation weights developed. A derived P-lead (measured between the right sternoclavicular joint and midway along the costal margin in line with the seventh intercostal space) demonstrated significant improvement in median P-wave root mean square (RMS) signal strength when compared to lead II (94μV vs. 76μV, p<0.001). A derived ES lead (from the EASI lead system) also showed small but significant improvement in median P-wave RMS (79μV vs. 76μV, p=0.0054). Finally, a derived modified Lewis lead did not improve median P-wave RMS when compared to lead II. However, this derived lead improved atrioventricular RMS ratio. P-wave leads derived from the 12-lead ECG can improve signal-to-noise ratio of the P-wave; this may improve the performance of detection algorithms that rely on P-wave analysis. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  4. The 12-lead electrocardiogram and risk of sudden death: current utility and future prospects. (United States)

    Narayanan, Kumar; Chugh, Sumeet S


    More than 100 years after it was first invented, the 12-lead electrocardiogram (ECG) continues to occupy an important place in the diagnostic armamentarium of the practicing clinician. With the recognition of relatively rare but important clinical entities such as Wolff-Parkinson-White and the long QT syndrome, this clinical tool was firmly established as a test for assessing risk of sudden cardiac death (SCD). However, over the past two decades the role of the ECG in risk prediction for common forms of SCD, for example in patients with coronary artery disease, has been the focus of considerable investigation. Especially in light of the limitations of current risk stratification approaches, there is a renewed focus on this broadly available and relatively inexpensive test. Various abnormalities of depolarization and repolarization on the ECG have been linked to SCD risk; however, more focused work is needed before they can be deployed in the clinical arena. The present review summarizes the current knowledge on various ECG risk markers for prediction of SCD and discusses some future directions in this field.

  5. Development and clinical study of mobile 12-lead electrocardiography based on cloud computing for cardiac emergency. (United States)

    Fujita, Hideo; Uchimura, Yuji; Waki, Kayo; Omae, Koji; Takeuchi, Ichiro; Ohe, Kazuhiko


    To improve emergency services for accurate diagnosis of cardiac emergency, we developed a low-cost new mobile electrocardiography system "Cloud Cardiology®" based upon cloud computing for prehospital diagnosis. This comprises a compact 12-lead ECG unit equipped with Bluetooth and Android Smartphone with an application for transmission. Cloud server enables us to share ECG simultaneously inside and outside the hospital. We evaluated the clinical effectiveness by conducting a clinical trial with historical comparison to evaluate this system in a rapid response car in the real emergency service settings. We found that this system has an ability to shorten the onset to balloon time of patients with acute myocardial infarction, resulting in better clinical outcome. Here we propose that cloud-computing based simultaneous data sharing could be powerful solution for emergency service for cardiology, along with its significant clinical outcome.

  6. 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

  7. 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

  8. Automated J wave detection from digital 12-lead electrocardiogram. (United States)

    Wang, Yi Grace; Wu, Hau-Tieng; Daubechies, Ingrid; Li, Yabing; Estes, E Harvey; Soliman, Elsayed Z


    In this report we provide a method for automated detection of J wave, defined as a notch or slur in the descending slope of the terminal positive wave of the QRS complex, using signal processing and functional data analysis techniques. Two different sets of ECG tracings were selected from the EPICARE ECG core laboratory, Wake Forest School of Medicine, Winston Salem, NC. The first set was a training set comprised of 100 ECGs of which 50 ECGs had J-wave and the other 50 did not. The second set was a test set (n=116 ECGs) in which the J-wave status (present/absent) was only known by the ECG Center staff. All ECGs were recorded using GE MAC 1200 (GE Marquette, Milwaukee, Wisconsin) at 10mm/mV calibration, speed of 25mm/s and 500HZ sampling rate. All ECGs were initially inspected visually for technical errors and inadequate quality, and then automatically processed with the GE Marquette 12-SL program 2001 version (GE Marquette, Milwaukee, WI). We excluded ECG tracings with major abnormalities or rhythm disorder. Confirmation of the presence or absence of a J wave was done visually by the ECG Center staff and verified once again by three of the coauthors. There was no disagreement in the identification of the J wave state. The signal processing and functional data analysis techniques applied to the ECGs were conducted at Duke University and the University of Toronto. In the training set, the automated detection had sensitivity of 100% and specificity of 94%. For the test set, sensitivity was 89% and specificity was 86%. In conclusion, test results of the automated method we developed show a good J wave detection accuracy, suggesting possible utility of this approach for defining and detection of other complex ECG waveforms.

  9. 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 ...

  10. Role of a 12-lead electrocardiogram in the diagnosis of cardiac tamponade as diagnosed by transthoracic echocardiography in patients with malignant pericardial effusion. (United States)

    Argula, Rahul G; Negi, Smita I; Banchs, Jose; Yusuf, Syed Wamique


    Few studies have looked at the utility of the 12-lead electrocardiogram (ECG) in diagnosing cardiac tamponade in malignant pericardial effusion (PE). The aim of this study was to determine the sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of 12-lead ECG in diagnosing cardiac tamponade in PE. Abnormalities on a 12 lead ECG can be used to diagnose or exclude cardiac tamponade in patients with malignant PE. Using echocardiography as the gold standard for diagnosis of cardiac tamponade, we determined the Se, Sp, PPV, and NPV for individual and combinations of the 3 ECG abnormalities (low-voltage complexes, electrical alternans, and sinus tachycardia). For PEs of all sizes, the Se, Sp, PPV, and NPV for detecting cardiac tamponade were: low-voltage complexes (56%, 74%, 81%, 46%), electrical alternans (23%, 98%, 95%, 39%), and sinus tachycardia (76%, 60%, 79%, 56%), respectively. Presence of all 3 and any of the 3 ECG abnormalities had a Se, Sp, PPV, and NPV of 8%, 100%, 100%, 36% and 89%, 47%, 77%, 69%, respectively, for cardiac tamponade. The odds ratios for cardiac tamponade in PE were 3.7 (95% confidence interval [CI]: 1.65-8.30) for low-voltage complexes, 12.3 (95% CI: 1.58-95.17) for electrical alternans, and 4.9 (95% CI: 2.22-10.80) for sinus tachycardia. Presence of any of 3 ECG abnormalities had an odds ratio of 7.3 (95% CI: 2.9-18.1) for cardiac tamponade. In malignant PE, combination of ECG abnormalities can supplement clinical examination in the diagnosis of echocardiographic cardiac tamponade. Due to its low NPV, 12-lead ECG cannot be used as a screening tool to exclude cardiac tamponade with malignant PE. © 2015 Wiley Periodicals, Inc.

  11. Pre-Hospital 12-Lead Electrocardiogram within 60 Minutes Differentiates Proximal versus Nonproximal Left Anterior Descending Artery Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    James J McCarthy


    Full Text Available Introduction: Acute anterior myocardial infarctions caused by proximal left anterior descending (LAD artery occlusions are associated with a higher morbidity and mortality. Early identification of high-risk patients via the 12-lead electrocardiogram (ECG could assist physicians and emergency response teams in providing early and aggressive care for patients with anterior ST-elevation myocardial infarctions (STEMI. Approximately 25% of US hospitals have primary percutaneous coronary intervention (PCI capability for the treatment of acute myocardial infarctions. Given the paucity of hospitals capable of PCI, early identification of more severe myocardial infarction may prompt emergency medical service routing of these patients to PCI-capable hospitals. We sought to determine if the 12 lead ECG is capable of predicting proximal LAD artery occlusions. Methods: In a retrospective, post-hoc analysis of the Pre-Hospital Administration of Thrombolytic Therapy with Urgent Culprit Artery Revascularization pilot trial, we compared the ECG findings of proximal and nonproximal LAD occlusions for patients who had undergone an ECG within 180 minutes of symptom onset. Results: In this study, 72 patients had anterior STEMIs, with ECGs performed within 180 minutes of symptom onset. In patients who had undergone ECGs within 60 minutes (n¼35, the mean sum of ST elevation (STE in leads V1 through V6 plus ST depression (STD in leads II, III, and aVF was 19.2 mm for proximal LAD occlusions and 11.7 mm for nonproximal LAD occlusions (P¼0.007. A sum STE in V1 through V6 plus STD in II, III, and aVF of at least 17.5 mm had a sensitivity of 52.3%, specificity of 92.9%, positive predictive value of 91.7%, and negative predictive value of 56.5% for proximal LAD occlusions. When the ECG was performed more than 60 minutes after symptom onset (n¼37, there was no significant difference in ST-segment deviation between the 2 groups. Conclusion: The sum STE (V1-V6 and STD (II

  12. 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.

  13. 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.

  14. 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...

  15. Sensitivity of CIPS-computed PVC location to measurement errors in ECG electrode position: the need for the 3D Camera

    NARCIS (Netherlands)

    Dam, P.M. van; Gordon, J.P.; Laks, M.


    BACKGROUND: The Cardiac Isochrone Positioning System (CIPS) is a non-invasive method able to localize the origins of PVCs, VT and WPW from the 12 lead ECG. The CIPS model integrates a standard 12-lead ECG with an MRI derived model of the heart, lungs, and torso in order to compute the precise electr

  16. Diagnostic and prognostic values of the V-index, a novel ECG marker quantifying spatial heterogeneity of ventricular repolarization, in patients with symptoms suggestive of non-ST-elevation myocardial infarction. (United States)

    Abächerli, Roger; Twerenbold, Raphael; Boeddinghaus, Jasper; Nestelberger, Thomas; Mächler, Patrick; Sassi, Roberto; Rivolta, Massimo W; Roonizi, Ebadollah Kheirati; Mainardi, Luca T; Kozhuharov, Nikola; Rubini Giménez, Maria; Wildi, Karin; Grimm, Karin; Sabti, Zaid; Hillinger, Petra; Puelacher, Christian; Strebel, Ivo; Cupa, Janosch; Badertscher, Patrick; Roux, Isabelle; Schmid, Ramun; Leber, Remo; Osswald, Stefan; Mueller, Christian; Reichlin, Tobias


    The V-index is an ECG marker quantifying spatial heterogeneity of ventricular repolarization. We prospectively assessed the diagnostic and prognostic values of the V-index in patients with suspected non-ST-elevation myocardial infarction (NSTEMI). We prospectively enrolled 497 patients presenting with suspected NSTEMI to the emergency department (ED). Digital 12-lead ECGs of five-minute duration were recorded at presentation. The V-index was automatically calculated in a blinded fashion. Patients with a QRS duration >120ms were ruled out from analysis. The final diagnosis was adjudicated by two independent cardiologists. The prognostic endpoint was all-cause mortality during 24months of follow-up. NSTEMI was the final diagnosis in 14% of patients. V-index levels were higher in patients with AMI compared to other causes of chest pain (median 23ms vs. 18ms, pV-index in addition to conventional ECG-criteria improved the diagnostic accuracy for the diagnosis of NSTEMI as quantified by area under the ROC curve from 0.66 to 0.73 (p=0.001) and the sensitivity of the ECG for AMI from 41% to 86% (pV-index (pV-index remained an independent predictor of death. The V-index, an ECG marker quantifying spatial heterogeneity of ventricular repolarization, significantly improves the accuracy and sensitivity of the ECG for the diagnosis of NSTEMI and independently predicts mortality during follow-up. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. 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.

  18. 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.

  19. Development of new anatomy reconstruction software to localize cardiac isochrones to the cardiac surface from the 12 lead ECG

    NARCIS (Netherlands)

    Dam, P.M. van; Gordon, J.P.; Laks, M.M.; Boyle, N.G.


    Non-invasive electrocardiographic imaging (ECGI) of the cardiac muscle can help the pre-procedure planning of the ablation of ventricular arrhythmias by reducing the time to localize the origin. Our non-invasive ECGI system, the cardiac isochrone positioning system (CIPS), requires non-intersecting

  20. Utility of 12-lead electrocardiogram for differentiating paroxysmal supraventricular tachycardias in dogs. (United States)

    Santilli, R A; Perego, M; Crosara, S; Gardini, F; Bellino, C; Moretti, P; Spadacini, G


    The 12-lead surface ECG is validated for differentiating supraventricular tachycardias (SVT) in humans. Despite the description of SVT in veterinary medicine, no studies have analyzed the electrocardiographic features of this type of arrhythmias in dogs. To describe the specific electrocardiographic criteria used to differentiate the most common SVT in dogs. Twenty-three dogs examined at Clinica Veterinaria Malpensa for SVT with the mechanism documented by electrophysiologic studies (EPS). Twelve-lead electrocardiographic variables obtained from 14 dogs with orthodromic atrioventricular reciprocating tachycardia (OAVRT) and 9 dogs with focal atrial tachycardia (FAT) were compared. Dogs with FAT had faster heart rates (278 +/- 62 versus 229 +/- 42 bpm; P= .049) and less QRS alternans (33 versus 86%; P= .022). P waves appeared during tachycardia in 22 dogs, with a superior axis in 100% of OAVRT and 22% of FAT (P < .001). OAVRT was characterized by a shorter RP interval (85.0 +/- 16.8 versus 157.1 +/- 37.3 ms; P < .001) and smaller RP/PR ratio (0.60 +/- 0.18 versus 1.45 +/- 0.52; P < .001). Repolarization anomalies were present in 64% of OAVRT and no FAT (P < .001). Multivariate analysis identified QRS alternans and a positive P wave in aVR during tachycardia as independent predictors of arrhythmia type. Electrocardiographic criteria used in people for differentiating SVT can also be applied in dogs.

  1. Utility of 12-lead and signal-averaged Holter electrocardiograms after pilsicainide provocation for risk stratification in Brugada syndrome. (United States)

    Kakihara, Jun; Takagi, Masahiko; Hayashi, Yusuke; Tatsumi, Hiroaki; Doi, Atsushi; Yoshiyama, Minoru


    Non-invasive risk stratification for ventricular fibrillation (VF) in Brugada syndrome (BrS) has not been fully evaluated. The aim of this study was to assess the utility of signal-averaged Holter electrocardiogram (Holter SAECG) and 12-lead Holter electrocardiogram (Holter ECG) after a pilsicainide provocation test for non-invasive risk stratification in BrS. We enrolled 30 consecutive patients with BrS [divided into 2 groups: the VF group, those with a previous history of VF (n = 10); and the non-VF group, those without a history of VF (n = 20)] and 10 control subjects without type 1 ECG. We evaluated late potentials [LP: filtered QRS (f-QRS), RMS40, and LAS40] on the Holter SAECG for 4 h after the pilsicainide provocation and in the same patients on another day without performing the pilsicainide provocation. Furthermore, we measured QRS duration and QTc interval in leads V2 and V5, and J amplitude in lead V2 on the Holter ECG after the pilsicainide provocation. On the Holter SAECG, the f-QRS at 1 h and LAS40 at 3 h after the pilsicainide provocation were significantly larger in the VF group than in the non-VF group (f-QRS at 1 h: 113.9 ± 8.9 vs. 104.9 ± 8 ms; p = 0.01, LAS40 at 3 h: 45.4 ± 5.9 vs. 35.5 ± 7.4 ms; p Holter ECG, there were no significant differences in these parameters between the VF and non-VF groups. In conclusion, the LP after the pilsicainide provocation using Holter SAECG may be useful for risk stratification of VF episodes in patients with BrS.

  2. High Resolution ECG for Evaluation of Heart Function During Exposure to Subacute Hypobaric Hypoxia (United States)

    Zupet, Petra; Finderle, Zarko; Schlegel, Todd T.; Princi, Tanja; Starc, Vito


    High altitude climbing presents a wide spectrum of health risks, including exposure to hypobaric hypoxia. Risks are also typically exacerbated by the difficulty in appropriately monitoring for early signs of organ dysfunction in remote areas. We investigated whether high resolution advanced ECG analysis might be helpful as a non-invasive and easy-to-use tool (e.g., instead of Doppler echocardiography) for evaluating early signs of heart overload in hypobaric hypoxia. Nine non-acclimatized healthy trained alpine rescuers (age 43.7 plus or minus 7.3 years) climbed in four days to the altitude of 4,200 m on Mount Ararat. Five-minute high-resolution 12-lead electrocardiograms (ECGs) were recorded (Cardiosoft) in each subject at rest in the supine position on different days but at the same time of day at four different altitudes: 400 m (reference altitude), 1,700 m, 3,200 m and 4,200 m. Changes in conventional and advanced resting ECG parameters, including in beat-to-beat QT and RR variability, waveform complexity, signal-averaged, high-frequency and spatial/spatiotemporal ECG was estimated by calculation of the regression coefficients in independent linear regression models. A p-value of less than 0.05 was adopted as statistically significant. As expected, the RR interval and its variability both decreased with increasing altitude, with trends k = -96 ms/1000 m with p = 0.000 and k = -9 ms/1000 m with p = 0.001, respectively. Significant changes were found in P-wave amplitude, which nearly doubled from the lowest to the highest altitude (k = 41.6 microvolt/1000 m with p = 0.000), and nearly significant changes in P-wave duration (k = 2.9 ms/1000 m with p = 0.059). Changes were less significant or non-significant in other studied parameters including those of waveform complexity, signal-averaged, high-frequency and spatial/spatiotemporal ECG. High resolution ECG analysis, particularly of the P wave, shows promise as a tool for monitoring early changes in heart function

  3. A computer-human interaction model to improve the diagnostic accuracy and clinical decision-making during 12-lead electrocardiogram interpretation. (United States)

    Cairns, Andrew W; Bond, Raymond R; Finlay, Dewar D; Breen, Cathal; Guldenring, Daniel; Gaffney, Robert; Gallagher, Anthony G; Peace, Aaron J; Henn, Pat


    The 12-lead Electrocardiogram (ECG) presents a plethora of information and demands extensive knowledge and a high cognitive workload to interpret. Whilst the ECG is an important clinical tool, it is frequently incorrectly interpreted. Even expert clinicians are known to impulsively provide a diagnosis based on their first impression and often miss co-abnormalities. Given it is widely reported that there is a lack of competency in ECG interpretation, it is imperative to optimise the interpretation process. Predominantly the ECG interpretation process remains a paper based approach and whilst computer algorithms are used to assist interpreters by providing printed computerised diagnoses, there are a lack of interactive human-computer interfaces to guide and assist the interpreter. An interactive computing system was developed to guide the decision making process of a clinician when interpreting the ECG. The system decomposes the interpretation process into a series of interactive sub-tasks and encourages the clinician to systematically interpret the ECG. We have named this model 'Interactive Progressive based Interpretation' (IPI) as the user cannot 'progress' unless they complete each sub-task. Using this model, the ECG is segmented into five parts and presented over five user interfaces (1: Rhythm interpretation, 2: Interpretation of the P-wave morphology, 3: Limb lead interpretation, 4: QRS morphology interpretation with chest lead and rhythm strip presentation and 5: Final review of 12-lead ECG). The IPI model was implemented using emerging web technologies (i.e. HTML5, CSS3, AJAX, PHP and MySQL). It was hypothesised that this system would reduce the number of interpretation errors and increase diagnostic accuracy in ECG interpreters. To test this, we compared the diagnostic accuracy of clinicians when they used the standard approach (control cohort) with clinicians who interpreted the same ECGs using the IPI approach (IPI cohort). For the control cohort, the

  4. 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.

  5. [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.

  6. 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%.

  7. 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.

  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%.


    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

  10. 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.

  11. Validation of infarct size and location from the ECG by inverse body surface mapping

    NARCIS (Netherlands)

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


    textabstractThis paper describes the incorporation of body surface mapping algorithms to detect the position and size of acute myocardial infarctions using standard 12 lead ECG recording. The results are compared with the results from cardiac MRI scan analysis. In case patient specific volume

  12. 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.

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. The Contrastive Analysis Between the Dynamic Electrocardiogram(ECG) and the Conventional Electrocardiogram on the Diagnosis of Coronary Heart Disease%动态心电图与常规心电图诊断冠心病的对比分析

    Institute of Scientific and Technical Information of China (English)

    陈岩; 王亚伟; 赵欣


    Objective To analysis the clinical effect between the dynamic electrocardiogram (ecg) and the conventional electrocardiogram on the diagnosis of coronary heart disease.MethodsTo divide the 69 cases patients into the control group(33 cases) and the observation group (36 cases). All the patients were chosen from February 2012 to June 2015. To observe and compare the value between the dynamic electrocardiogram (ecg) and the conventional electrocardiogram.Results The positive rate of myocardial ischemia on observation group patients was 86.1%, it was significantly higher than that in the control group 60.6%, It was in a high treatment efficiency and obvious difference and the statistically significant (P < 0.05).ConclusionThe dynamic electrocardiogram on the diagnosis of coronary heart disease was much higher than that on the conventional electrocardiogram(ecg), it can improve the detection rate on myocardial ischemia and arrhythmia.%目的:对动态心电图与常规心电图诊断冠心病的临床效果进行对比分析。方法选取于2012年2月~2015年6月期间在我院接受治疗的冠心病患者69例,根据诊断方法的不同将患者分为对照组33例、观察组36例患者进行对照研究,观察并比较常规心电图和动态心电图的诊断价值。结果观察组患者的心肌缺血阳性检出率为86.1%,高于对照组患者的60.6%,差异具有统计学意义(P <0.05)。结论动态心电图诊断冠心病的诊断正确率要高于常规心电图,能够使心肌缺血和心律失常的检出率提高。


    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.

  1. 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.

  2. Comparative analysis diagnosis of coronary heart disease and latent coronary heart disease by high frequency electrocardiogram(HFECG)and conventional electrocardiogram(ECG)%对比分析高频心电图与常规心电图诊断隐匿型冠心病的结果

    Institute of Scientific and Technical Information of China (English)

    陈少华; 于斌


    Objective To contrast application value of diagnosis of coronary heart disease and latent coronary heart disease by high frequency electrocardiogram( HFECG)and conventional electrocardiogram( ECG). Method 100 cases with latent coronary heart disease were selected as the research object. All patients were confirmed by selective coronary angiography and divided into the observation group and control group,50 cases in each group according to stochastic indicator. Control group patients with sim-ple routine ECG examination,observation group based on the control group added high frequency electrocardiogram( ECG)re-view,according to two groups of patients’electrocardiogram diagnosis,the sensitivity and accuracy of inspection had been com-pared. Results There were 48 cases diagnosed latent coronary heart disease. The accuracy was 96. 00% and the sensitivity was 94. 00%,the diagnostic sensitivity and accuracy of observation group was obviously higher than that of control group,the differ-ence was statistically significant(P﹤0. 05). Conclusion There some shortcomings for conventional electrocardiogram(ECG) in diagnosing latent coronary heart disease,while high frequency electrocardiogram( ECG)for latent coronary heart disease has higher accuracy,and can be used to clinical suspected cases review diagnosis of the latent coronary heart disease.%目的:对比高频心电图与常规心电图在隐匿性冠心病临床诊断中的应用价值。方法:选取隐匿性冠心病患者100例,作为研究对象。所有患者均经选择性冠脉造影确诊,采用随机数表法将其分为观察组与对照组,每组50例,其中对照组患者单纯进行常规心电图检查,观察组在对照组基础上进行高频心电图复查,根据两组患者心电图表现进行诊断,比较两组检查方案的敏感度与准确性。结果:观察组检查确诊为隐匿性心脏病48例,准确率为96.00%,敏感度为94.00%,观察组诊断敏感度与

  3. 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...

  4. 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.

  5. 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.

  6. 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).

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. 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.

  13. 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).

  14. 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.

  15. 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.

  16. 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...

  17. 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.

  18. Circadian variation in QT dispersion determined from a 12-lead Holter recording

    DEFF Research Database (Denmark)

    Hansen, Stig; Rasmussen, Verner; Larsen, Klaus;


    Background: QT dispersion is considered to reflect inhomogeneity of myocardial repolarization. Method: The circadian variation of QT interval dispersion was examined in 95 healthy subjects using 24-hour Holter monitoring. Three different methods of lead selection were applied: all 12 leads (QTdisp...

  19. Circadian variation in QT dispersion determined from a 12-lead Holter recording

    DEFF Research Database (Denmark)

    Hansen, S; Rasmussen, Verner; Larsen, Klaus


    Background: QT dispersion is considered to reflect inhomogeneity of myocardial repolarization. Method: The circadian variation of QT interval dispersion was examined in 95 healthy subjects using 24-hour Holter monitoring. Three different methods of lead selection were applied: all 12 leads (QTdis...

  20. Circadian variation in QT dispersion determined from a 12-lead Holter recording

    DEFF Research Database (Denmark)

    Hansen, S; Rasmussen, Verner; Larsen, Klaus


    Background: QT dispersion is considered to reflect inhomogeneity of myocardial repolarization. Method: The circadian variation of QT interval dispersion was examined in 95 healthy subjects using 24-hour Holter monitoring. Three different methods of lead selection were applied: all 12 leads (QTdisp...

  1. The application of root mean square electrocardiography (RMS ECG for the detection of acquired and congenital long QT syndrome.

    Directory of Open Access Journals (Sweden)

    Robert L Lux

    Full Text Available BACKGROUND: Precise measurement of the QT interval is often hampered by difficulty determining the end of the low amplitude T wave. Root mean square electrocardiography (RMS ECG provides a novel alternative measure of ventricular repolarization. Experimental data have shown that the interval between the RMS ECG QRS and T wave peaks (RTPK closely reflects the mean ventricular action potential duration while the RMS T wave width (TW tracks the dispersion of repolarization timing. Here, we tested the precision of RMS ECG to assess ventricular repolarization in humans in the setting of drug-induced and congenital Long QT Syndrome (LQTS. METHODS: RMS ECG signals were derived from high-resolution 24 hour Holter monitor recordings from 68 subjects after receiving placebo and moxifloxacin and from standard 12 lead ECGs obtained in 97 subjects with LQTS and 97 age- and sex-matched controls. RTPK, QTRMS and RMS TW intervals were automatically measured using custom software and compared to traditional QT measures using lead II. RESULTS: All measures of repolarization were prolonged during moxifloxacin administration and in LQTS subjects, but the variance of RMS intervals was significantly smaller than traditional lead II measurements. TW was prolonged during moxifloxacin and in subjects with LQT-2, but not LQT-1 or LQT-3. CONCLUSION: These data validate the application of RMS ECG for the detection of drug-induced and congenital LQTS. RMS ECG measurements are more precise than the current standard of care lead II measurements.

  2. The application of root mean square electrocardiography (RMS ECG) for the detection of acquired and congenital long QT syndrome. (United States)

    Lux, Robert L; Sower, Christopher Todd; Allen, Nancy; Etheridge, Susan P; Tristani-Firouzi, Martin; Saarel, Elizabeth V


    Precise measurement of the QT interval is often hampered by difficulty determining the end of the low amplitude T wave. Root mean square electrocardiography (RMS ECG) provides a novel alternative measure of ventricular repolarization. Experimental data have shown that the interval between the RMS ECG QRS and T wave peaks (RTPK) closely reflects the mean ventricular action potential duration while the RMS T wave width (TW) tracks the dispersion of repolarization timing. Here, we tested the precision of RMS ECG to assess ventricular repolarization in humans in the setting of drug-induced and congenital Long QT Syndrome (LQTS). RMS ECG signals were derived from high-resolution 24 hour Holter monitor recordings from 68 subjects after receiving placebo and moxifloxacin and from standard 12 lead ECGs obtained in 97 subjects with LQTS and 97 age- and sex-matched controls. RTPK, QTRMS and RMS TW intervals were automatically measured using custom software and compared to traditional QT measures using lead II. All measures of repolarization were prolonged during moxifloxacin administration and in LQTS subjects, but the variance of RMS intervals was significantly smaller than traditional lead II measurements. TW was prolonged during moxifloxacin and in subjects with LQT-2, but not LQT-1 or LQT-3. These data validate the application of RMS ECG for the detection of drug-induced and congenital LQTS. RMS ECG measurements are more precise than the current standard of care lead II measurements.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. T-wave alternans in LQTS: repolarization-rate dynamics from digital 12-lead Holter data. (United States)

    Brockmeier, K; Aslan, I; Hilbel, T; Eberle, T; Ulmer, H E; Lux, R L


    T-wave alternans (TWA) is a harbinger of ventricular vulnerability and an important prognostic indicator for torsade de pointes and likely sudden death in patients with LQTS. We analyzed the occurrence of TWA in 18 patients with LQTS (7 males, 11 females, ages ranging from 6 months to 32 years--median 8.4 years). Analysis was performed with software to investigate dynamics of cycle length mediated repolarization changes. Digital Holter ECG analysis revealed macroscopic, true TWA in 3 of 18 patients. TWA showed a variable morphological expression. One patient had continuous changes of T wave polarity, but not on a periodic beat-to-beat basis. Onsets of macroscopic TWA were preceded by long/short cycle length sequences and tachycardic rates above 130 to 140 bpm. Impact of ventricular premature beats on TWA onset was insignificant. Two of the identified patients with TWA had sudden cardiac death during follow-up (one refused PM therapy). At present, TWA cannot be detected automatically from Holter ECGs and therefore may be missed, despite the potential danger for the individuals. The observation that predominantly high beat rates and not beat rate changes, per se, triggered episodes of TWA renders difficult general therapeutic recommendations for the identified patients at risk.

  8. 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.

  9. Cost-effectiveness of pre-participation screening of athletes with ECG in Europe and Algeria. (United States)

    Assanelli, Deodato; Levaggi, Rosella; Carré, François; Sharma, Sanjay; Deligiannis, Asterios; Mellwig, Klaus Peter; Tahmi, Mohamed; Vinetti, Giovanni; Aliverti, Paola


    The aim of this study is to evaluate the cost-effectiveness of ECG in combination with family and personal history and physical examination in order to detect cardiovascular diseases that might cause sudden death in athletes. The study was conducted on a cohort of 6,634, mainly young professional and recreational athletes, 1,071 from Algeria and 5,563 from Europe (France, Germany and Greece). Each athlete underwent medical history, physical examination, and resting 12-lead ECG. 293 athletes (4.4 %), 149 in Europe (2.7 %) and 144 in Algeria (13.4 %) required further tests, and 56 were diagnosed with cardiovascular disease and thus disqualified. The cost-effectiveness ratio (CER) was calculated as the ratio between the cost of screening and the number of statistical life-years saved by the intervention. The estimated reduced risk of death deriving from treatment or disqualification resulted in the saving of 79.1 statistical life-years in Europe and 136.3 in Algeria. CER of screening was 4,071 purchasing-power-parity-adjusted US dollars ($PPP) in Europe and 582 $PPP in Algeria. The results of this study strongly support the utilisation of 12-lead ECG in the pre-participation screening of young athletes, especially in countries where secondary preventive care is not highly developed.

  10. 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.

  11. 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.

  12. [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.

  13. [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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. [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.

  1. 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.

  2. 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.

  3. Cardiac Repolarization Abnormalities and Potential Evidence for Loss of Cardiac Sodium Currents on ECGs of Patients with Chagas' Heart Disease (United States)

    Schlegel, T. T.; Medina, R.; Jugo, D.; Nunez, T. J.; Borrego, A.; Arellano, E.; Arenare, B.; DePalma, J. L.; Greco, E. C.; Starc, V.


    Some individuals with Chagas disease develop right precordial lead ST segment elevation in response to an ajmaline challenge test, and the prevalence of right bundle branch block (RBBB) is also high in Chagas disease. Because these same electrocardiographic abnormalities occur in the Brugada syndrome, which involves genetically defective cardiac sodium channels, acquired damage to cardiac sodium channels may also occur in Chagas disease. We studied several conventional and advanced resting 12-lead/derived Frank-lead ECG parameters in 34 patients with Chagas -related heart disease (mean age 39 14 years) and in 34 age-/gender-matched healthy controls. All ECG recordings were of 5-10 min duration, obtained in the supine position using high fidelity hardware/software (CardioSoft, Houston, TX). Even after excluding those Chagas patients who had resting BBBs, tachycardia and/or pathologic arrhythmia (n=8), significant differences remained in multiple conventional and advanced ECG parameters between the Chagas and control groups (n=26/group), especially in their respective QT interval variability indices, maximal spatial QRS-T angles and low frequency HRV powers (p=0.0006, p=0.0015 and p=0.0314 respectively). In relation to the issue of potential damage to cardiac sodium channels, the Chagas patients had: 1) greater than or equal to twice the incidence of resting ST segment elevation in leads V1-V3 (n=10/26 vs. n=5/26) and of both leftward (n=5/26 versus n=0/26) and rightward (n=7/26 versus n=3/26) QRS axis deviation than controls; 2) significantly increased filtered (40-250 Hz) QRS interval durations (92.1 8.5 versus 85.3 plus or minus 9.0 ms, p=0.022) versus controls; and 3) significantly decreased QT and especially JT interval durations versus controls (QT interval: 387.5 plus or minus 26.4 versus 408.9 plus or minus 34.6 ms, p=0.013; JT interval: 290.5 plus or minus 26.3 versus 314.8 plus or minus 31.3 ms; p=0.0029). Heart rates and Bazett-corrected QTc/JTc intervals

  4. 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.

  5. Modulations of Heart Rate, ECG, and Cardio-Respiratory Coupling Observed in Polysomnography

    Directory of Open Access Journals (Sweden)

    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.

  6. ECG-Based Detection of Early Myocardial Ischemia in a Computational Model: Impact of Additional Electrodes, Optimal Placement, and a New Feature for ST Deviation. (United States)

    Loewe, Axel; Schulze, Walther H W; Jiang, Yuan; Wilhelms, Mathias; Luik, Armin; Dössel, Olaf; Seemann, Gunnar


    In case of chest pain, immediate diagnosis of myocardial ischemia is required to respond with an appropriate treatment. The diagnostic capability of the electrocardiogram (ECG), however, is strongly limited for ischemic events that do not lead to ST elevation. This computational study investigates the potential of different electrode setups in detecting early ischemia at 10 minutes after onset: standard 3-channel and 12-lead ECG as well as body surface potential maps (BSPMs). Further, it was assessed if an additional ECG electrode with optimized position or the right-sided Wilson leads can improve sensitivity of the standard 12-lead ECG. To this end, a simulation study was performed for 765 different locations and sizes of ischemia in the left ventricle. Improvements by adding a single, subject specifically optimized electrode were similar to those of the BSPM: 2-11% increased detection rate depending on the desired specificity. Adding right-sided Wilson leads had negligible effect. Absence of ST deviation could not be related to specific locations of the ischemic region or its transmurality. As alternative to the ST time integral as a feature of ST deviation, the K point deviation was introduced: the baseline deviation at the minimum of the ST-segment envelope signal, which increased 12-lead detection rate by 7% for a reasonable threshold.

  7. ECG-Based Detection of Early Myocardial Ischemia in a Computational Model: Impact of Additional Electrodes, Optimal Placement, and a New Feature for ST Deviation

    Directory of Open Access Journals (Sweden)

    Axel Loewe


    Full Text Available In case of chest pain, immediate diagnosis of myocardial ischemia is required to respond with an appropriate treatment. The diagnostic capability of the electrocardiogram (ECG, however, is strongly limited for ischemic events that do not lead to ST elevation. This computational study investigates the potential of different electrode setups in detecting early ischemia at 10 minutes after onset: standard 3-channel and 12-lead ECG as well as body surface potential maps (BSPMs. Further, it was assessed if an additional ECG electrode with optimized position or the right-sided Wilson leads can improve sensitivity of the standard 12-lead ECG. To this end, a simulation study was performed for 765 different locations and sizes of ischemia in the left ventricle. Improvements by adding a single, subject specifically optimized electrode were similar to those of the BSPM: 2–11% increased detection rate depending on the desired specificity. Adding right-sided Wilson leads had negligible effect. Absence of ST deviation could not be related to specific locations of the ischemic region or its transmurality. As alternative to the ST time integral as a feature of ST deviation, the K point deviation was introduced: the baseline deviation at the minimum of the ST-segment envelope signal, which increased 12-lead detection rate by 7% for a reasonable threshold.

  8. 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.

  9. 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.

  10. 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.

  11. Non-ECG-gated myocardial perfusion MRI using continuous magnetization-driven radial sampling. (United States)

    Sharif, Behzad; Dharmakumar, Rohan; Arsanjani, Reza; Thomson, Louise; Bairey Merz, C Noel; Berman, Daniel S; Li, Debiao


    Establishing a high-resolution non-ECG-gated first-pass perfusion (FPP) cardiac MRI technique may improve accessibility and diagnostic capability of FPP imaging. We propose a non-ECG-gated FPP imaging technique using continuous magnetization-driven golden-angle radial acquisition. The main purpose of this preliminary study is to evaluate whether, in the simple case of single-slice two-dimensional imaging, adequate myocardial contrast can be obtained for accurate visualization of hypoperfused territories in the setting of myocardial ischemia. A T1-weighted pulse sequence with continuous golden-angle radial sampling was developed for non-ECG-gated FPP imaging. A sliding-window scheme with no temporal acceleration was used to reconstruct 8 frames/s. Canines were imaged at 3T with and without coronary stenosis using the proposed scheme and a conventional magnetization-prepared ECG-gated FPP method. Our studies showed that the proposed non-ECG-gated method is capable of generating high-resolution (1.7 × 1.7 × 6 mm(3) ) artifact-free FPP images of a single slice at high heart rates (92 ± 21 beats/min), while matching the performance of conventional FPP imaging in terms of hypoperfused-to-normal myocardial contrast-to-noise ratio (proposed: 5.18 ± 0.70, conventional: 4.88 ± 0.43). Furthermore, the detected perfusion defect areas were consistent with the conventional FPP images. Non-ECG-gated FPP imaging using optimized continuous golden-angle radial acquisition achieves desirable image quality (i.e., adequate myocardial contrast, high spatial resolution, and minimal artifacts) in the setting of ischemia. © 2014 Wiley Periodicals, Inc.

  12. QT interval prolongation in opioid agonist treatment: analysis of continuous 12-lead electrocardiogram recordings. (United States)

    Isbister, Geoffrey K; Brown, Amanda L; Gill, Anthony; Scott, Alexander J; Calver, Leonie; Dunlop, Adrian J


    Methadone is a widely used opioid agonist treatment associated with QT prolongation and torsades de pointes. We investigated the QT interval in patients treated with methadone or buprenorphine using continuous 12-lead Holter recordings. We prospectively made 24-h Holter recordings in patients prescribed methadone or buprenorphine, compared to controls. After their normal dose a continuous 12-lead Holter recorder was attached for 24 h. Digital electrocardiograms were extracted hourly from the Holter recordings. The QT interval was measured automatically (H-scribe software, Mortara Pty Ltd) and checked manually. The QT interval was plotted against heart rate (HR) on the QT nomogram to determine abnormality. Demographics, dosing, medical history and laboratory investigations were recorded. There were 58 patients (19 methadone, 20 buprenorphine and 19 control); median age 35 years (20-56 years); 33 males. Baseline characteristics were similar. Median dose of methadone was 110 mg day(-1) (70-170 mg day(-1) ) and buprenorphine was 16 mg day(-1) (12-32 mg day(-1) ). Seven participants had abnormal QT intervals. There was a significant difference in the proportion of prescribed methadone with abnormal QT intervals, 7/19 (37%; 95% confidence interval: 17-61%), compared to controls 0/19 (0%; 95% confidence interval: 0-21%; P = 0.008), but no difference between buprenorphine and controls (0/20). QT vs. HR plots showed patients prescribed methadone had higher QT-HR pairs over 24 h compared to controls. There was no difference in dose for patients prescribed methadone with abnormal QT intervals and those without. Methadone is associated with prolonged QT intervals, but there was no association with dose. Buprenorphine did not prolong the QT interval. Twenty four-hour Holter recordings using the QT nomogram is a feasible method to assess the QT interval in patients prescribed methadone. © 2017 The Authors. British Journal of Clinical Pharmacology published by John

  13. 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.

  14. Atrial Fibrillation and Beta Thalassemia Major: The Predictive Role of the 12-lead Electrocardiogram Analysis. (United States)

    Russo, Vincenzo; Rago, Anna; Pannone, Bruno; Papa, Andrea Antonio; Mayer, Maria Carolina; Spasiano, Anna; Calabro, Raffaele; Russo, Maria Giovanna; Gerardo, Nigro


    Paroxysmal atrial tachyarrhythmias frequently occur in beta-thalassemia major (β-TM) patients.The aim of our study was to investigate the role of maximum P-wave duration (P max) and dispersion (PD), calculated trough a new manually performed measurement with the use of computer software from all 12-ECG-leads,as predictors of atrial-fibrillation (AF) in β-TM patients with conserved systolic or diastolic cardiac function during a twelve-months follow-up. 50 β-TM-patients (age38.4±10.1; 38M) and 50-healthy subjects used as controls, matched for age and gender, were studied for the occurrence of atrial arrhythmias during a 1-year follow-up, through ECG-Holter-monitoring performed every three months. The β-TM-patients were divided into two groups according to number and complexity of premature-supraventricular-complexes at the Holter-Monitoring (Group1: 30/h or couplets, or run of supraventricular tachycardia and AF, n:15). Compared to the healthy control-group, β-TM patients presented increased P-max (107.5± 21.2 vs 92.1±11ms, P=0.03) and PD-values (41.2±13 vs 25.1±5 ms,P=0.03). In the β-TM population, the Group2 showed a statistically significant increase in PD (42.8±8.6 vs 33.2±6.5ms, P<0.001) and P-max (118.1±8.7 vs 103.1±7.5ms, P<0.001) compared to the Group1. Seven β-TM patients who showed paroxysmal AF during this study had significantly increased P-max and PD than the other patients of the Group2. Moreover, P-max (OR:2.01; CI:1.12-3.59; P=0.01) and PD (OR=2.06;CI:1.17-3.64;P=0.01) demonstrated a statistically significant association with the occurrence of paroxysmal AF,P min was not associated with AF-risk (OR=0.99; CI:0.25-3.40; P=0.9) in β-TM-patients. A cut-off value of 111ms for P-max had a sensitivity of 80% and a specificity of 87%, a cut-off value of 35.5ms for PD had a sensitivity of 90% and a specificity of 85% in identifying β-TM patients at risk for AF. Our results indicate that P-max and PD are useful electrocardiographic markers

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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....

  2. 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.

  3. 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.

  4. 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.

  5. [Orthogonal ECG and a statistical system for computer diagnosis with ECG in chronic obstructive pneumopathy]. (United States)

    Loperfido, F; Franchetta, R; Marchei, M; Pistelli, R; Bellocci, F; Zeppilli, P; Fanelli, R; Zecchi, P


    In 92 patients affected from chronic obstructive pulmonary disease (C.O.P.) undergoing spirometric evaluation, the ability of the Pipberger computer program for electrocardiographic interpretation to predict the presence of pulmonary disease with or without right ventricular hipertrophy was compared with that of the manually measured conventional and orthogonal (Frank system) electrocardiogram. The patients were classified as having mild, moderate and severe C.O.P. on the basis of spirometric data. Each system predicted the presence of C.O.P. with low sensitivity. P voltage in D2 greater than or equal to 2 mm (27,1%) and R/S voltage ratio in V5-V6 greater than or equal to 1 (22,8%) were the single conventional criteria more frequently satisfied. Results for 3 lead manual readings were only slightly lower: recognition rate of the R/S voltage ration in x lead less than or equal to 1,3 was 15,7%. The Pipberger program probabilistic answers were divided in "completely" and "partially" correct. Combined completely or partially correct diagnoses were made by the program 14,3% of patients with mild C.O.P., 17,2% of moderate and 48,8% of severe C.O.P. These results suggests that the Pipberger program has at least similar ability to predict C.O.P. compared with the 12 lead and orthogonal manually measured electrocardiogram.

  6. Noise-aware dictionary-learning-based sparse representation framework for detection and removal of single and combined noises from ECG signal. (United States)

    Satija, Udit; Ramkumar, Barathram; Sabarimalai Manikandan, M


    Automatic electrocardiogram (ECG) signal enhancement has become a crucial pre-processing step in most ECG signal analysis applications. In this Letter, the authors propose an automated noise-aware dictionary learning-based generalised ECG signal enhancement framework which can automatically learn the dictionaries based on the ECG noise type for effective representation of ECG signal and noises, and can reduce the computational load of sparse representation-based ECG enhancement system. The proposed framework consists of noise detection and identification, noise-aware dictionary learning, sparse signal decomposition and reconstruction. The noise detection and identification is performed based on the moving average filter, first-order difference, and temporal features such as number of turning points, maximum absolute amplitude, zerocrossings, and autocorrelation features. The representation dictionary is learned based on the type of noise identified in the previous stage. The proposed framework is evaluated using noise-free and noisy ECG signals. Results demonstrate that the proposed method can significantly reduce computational load as compared with conventional dictionary learning-based ECG denoising approaches. Further, comparative results show that the method outperforms existing methods in automatically removing noises such as baseline wanders, power-line interference, muscle artefacts and their combinations without distorting the morphological content of local waves of ECG signal.


    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.

  8. 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.

  9. 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.


    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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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

  16. Effects of noise and filtering on SVD-based morphological parameters of the T wave in the ECG. (United States)

    Lehtola, L; Karsikas, M; Koskinen, M; Huikuri, H; Seppanen, T


    Singular value decomposition (SVD) based electrocardiogram (ECG) morphology analysis is a novel method in the assessment of subtle abnormalities in the T wave morphology of 12-lead ECG. As various types of noise contaminate the ECG signal and create a bias for the morphological analyses, this study was designed to estimate the effects of noise on the SVD method in an experimental setup. Ideal signals were generated by filtering real ECG signals several times with the Savitzky-Golay filter. Random and real noise samples were superimposed on the ideal signals. The noisy signals were filtered with a power line interference filter combined with the Savitzky-Golay or the wavelet filter. Results show that noise increased both the dipolar and non-dipolar components significantly unless filtering was applied. R-TWR (relative T wave residuum) and A-TWR (absolute T wave residuum) were four to eight times higher in noisy signals. The experiments with patient data demonstrated that certain types of noise may even lead to erroneous classification of patients. Filtering brings the median values closer to the correct ones and decreases significantly the variance of the values of parameters.

  17. Accelerated free breathing ECG triggered contrast enhanced pulmonary vein magnetic resonance angiography using compressed sensing. (United States)

    Roujol, Sébastien; Foppa, Murilo; Basha, Tamer A; Akçakaya, Mehmet; Kissinger, Kraig V; Goddu, Beth; Berg, Sophie; Nezafat, Reza


    To investigate the feasibility of accelerated electrocardiogram (ECG)-triggered contrast enhanced pulmonary vein magnetic resonance angiography (CE-PV MRA) with isotropic spatial resolution using compressed sensing (CS). Nineteen patients (59±13 y, 11 M) referred for MR were scanned using the proposed accelerated free breathing ECG-triggered 3D CE-PV MRA sequence (FOV=340×340×110 mm3, spatial resolution=1.5×1.5×1.5 mm3, acquisition window=140 ms at mid diastole and CS acceleration factor=5) and a conventional first-pass breath-hold non ECG-triggered 3D CE-PV MRA sequence. CS data were reconstructed offline using low-dimensional-structure self-learning and thresholding reconstruction (LOST) CS reconstruction. Quantitative analysis of PV sharpness and subjective qualitative analysis of overall image quality were performed using a 4-point scale (1: poor; 4: excellent). Quantitative PV sharpness was increased using the proposed approach (0.73±0.09 vs. 0.51±0.07 for the conventional CE-PV MRA protocol, p<0.001). There were no significant differences in the subjective image quality scores between the techniques (3.32±0.94 vs. 3.53±0.77 using the proposed technique). CS-accelerated free-breathing ECG-triggered CE-PV MRA allows evaluation of PV anatomy with improved sharpness compared to conventional non-ECG gated first-pass CE-PV MRA. This technique may be a valuable alternative for patients in which the first pass CE-PV MRA fails due to inaccurate first pass timing or inability of the patient to perform a 20-25 seconds breath-hold.

  18. 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:

  19. 老龄患者常规静息心电图ST-T改变的冠心病诊断精度探析%An analysis on the diagnosis of coronary heart disease in old patients with conventional precision resting ECG ST-T changes

    Institute of Scientific and Technical Information of China (English)



    Objective The diagnostic accuracy of coronary heart disease in old patients with normal resting ECG ST-T changes. Methods Total 247 elderly patients with coronary heart disease in our hospital from September 2012 to January 2014 were implemented resting ECG examination, with the examination results accepted coronary angiography by other hospital were compared. Results all the 247 patients, the resting ECG of 120 cases had ST-T changes, coronary heart disease diagnosis rate was 48.58%; 66 cases confirmed coronary slight stenosis by coronary angiography, 165 cases with severe stenosis were diagnosed, a total of 231 confirmed by coronary angiography in coronary heart disease, the total diagnostic rate was 93.52%. The diagnostic accuracy of coronary heart disease by coronary angiography was significantly higher than that by resting electrocardiogram(P<0.05). Conclusion Resting electrocardiogram ST-T change of elderly patients is not enough to reflect the severity of coronary heart disease, but can not simply as a clinical diagnosis standard of coronary heart disease, otherwise it will significantly increase the missed diagnosis rate. At the present stage of coronary angiography become a gold standard for diagnosing coronary heart disease, resting ECG can only plays an auxiliary diagnosis effect.%目的:探讨老龄患者常规静息心电图ST-T改变的冠心病诊断精度。方法为我院2012年9月~2014年1月确诊并收治的冠心病老龄患者合计247例实施静息心电图检查,同时结合外院为其实施冠脉造影的检查结果作以对比。结果所有247例患者中,120例其静息心电图呈显著的ST-T改变,冠心病诊断率为48.58%;66例经冠状动脉造影确诊冠脉轻度狭窄,165例确诊重度狭窄,合计231例经冠状动脉造影确诊冠心病,合计诊断率为93.52%。二者比较冠脉造影的冠心病诊断精度显著高于静息心电图(P<0.05)。结论老龄患者常规静息心电图ST-T

  20. 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 ...

  1. [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.

  2. 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.

  3. 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...

  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. Identifying drug-induced repolarization abnormalities from distinct ECG patterns in congenital long QT syndrome: a study of sotalol effects on T-wave morphology

    DEFF Research Database (Denmark)

    Graff, Claus; Andersen, Mads P; Xue, Joel Q


    BACKGROUND: The electrocardiographic QT interval is used to identify drugs with potential harmful effects on cardiac repolarization in drug trials, but the variability of the measurement can mask drug-induced ECG changes. The use of complementary electrocardiographic indices of abnormal repolariz......BACKGROUND: The electrocardiographic QT interval is used to identify drugs with potential harmful effects on cardiac repolarization in drug trials, but the variability of the measurement can mask drug-induced ECG changes. The use of complementary electrocardiographic indices of abnormal...... are typical ECG patterns in LQT2. Blinded to labels, the new morphology measures were tested in a third group of 39 healthy subjects receiving sotalol. Over 3 days the sotalol group received 0, 160 and 320 mg doses, respectively, and a 12-lead Holter ECG was recorded for 22.5 hours each day. Drug...... with QTcF, p ECG patterns in LQT2 carriers effectively quantified repolarization changes induced by sotalol. Further studies are needed to validate whether this measure has...

  7. 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.

  8. 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...

  9. Cost-effectiveness analysis of computerized ECG interpretation system in an ambulatory health care organization. (United States)

    Carel, R S


    The cost-effectiveness of a computerized ECG interpretation system in an ambulatory health care organization has been evaluated in comparison with a conventional (manual) system. The automated system was shown to be more cost-effective at a minimum load of 2,500 patients/month. At larger monthly loads an even greater cost-effectiveness was found, the average cost/ECG being about $2. In the manual system the cost/unit is practically independent of patient load. This is primarily due to the fact that 87% of the cost/ECG is attributable to wages and fees of highly trained personnel. In the automated system, on the other hand, the cost/ECG is heavily dependent on examinee load. This is due to the relatively large impact of equipment depreciation on fixed (and total) cost. Utilization of a computer-assisted system leads to marked reduction in cardiologists' interpretation time, substantially shorter turnaround time (of unconfirmed reports), and potential provision of simultaneous service at several remotely located "heart stations."

  10. An ultra-low power (ULP) bandage-type ECG sensor for efficient cardiac disease management. (United States)

    Shin, Kunsoo; Park, G G; Kim, J P; Lee, T H; Ko, B H; Kim, Y H


    This paper proposed an ultra-low power bandage-type ECG sensor (the size: 76 × 34 × 3 (mm(3)) and the power consumption: 1 mW) which allows for a continuous and real-time monitoring of a user's ECG signals over 24h during daily activities. For its compact size and lower power consumption, we designed the analog front-end, the SRP (Samsung Reconfigurable Processor) based DSP of 30 uW/MHz, and the ULP wireless RF of 1 nJ/bit. Also, to tackle motion artifacts(MA), a MA monitoring technique based on the HCP (Half-cell Potential) is proposed which resulted in the high correlation between the MA and the HCP, the correlation coefficient of 0.75 ± 0.18. To assess its feasibility and validity as a wearable health monitor, we performed the comparison of two ECG signals recorded form it and a conventional Holter device. As a result, the performance of the former is a little lower as compared with the latter, although showing no statistical significant difference (the quality of the signal: 94.3% vs 99.4%; the accuracy of arrhythmia detection: 93.7% vs 98.7%). With those results, it has been confirmed that it can be used as a wearable health monitor due to its comfortability, its long operation lifetime and the good quality of the measured ECG signal.

  11. ECG quality assessment based on a kernel support vector machine and genetic algorithm with a feature matrix

    Institute of Scientific and Technical Information of China (English)

    Ya-tao ZHANG; Cheng-yu LIU; Shou-shui WEI; Chang-zhi WEI; Fei-fei LIU


    We propose a systematic ECG quality classification method based on a kernel support vector machine (KSVM) and genetic algorithm (GA) to determine whether ECGs collected via mobile phone are acceptable or not. This method includes mainly three modules, i.e., lead-fall detection, feature extraction, and intelligent classification. First, lead-fall detection is executed to make the initial classification. Then the power spectrum, baseline drifts, amplitude difference, and other time-domain features for ECGs are analyzed and quantified to form the feature matrix. Finally, the feature matrix is assessed using KSVM and GA to determine the ECG quality classification results. A Gaussian radial basis function (GRBF) is employed as the kernel function of KSVM and its performance is compared with that of the Mexican hat wavelet function (MHWF). GA is used to determine the optimal parameters of the KSVM classifier and its performance is compared with that of the grid search (GS) method. The performance of the proposed method was tested on a database from PhysioNet/Computing in Cardiology Challenge 2011, which includes 1500 12-lead ECG recordings. True positive (TP), false positive (FP), and classification accuracy were used as the assessment indices. For training database set A (1000 recordings), the optimal results were obtained using the combination of lead-fall, GA, and GRBF methods, and the corresponding results were:TP 92.89%, FP 5.68%, and classification accuracy 94.00%. For test database set B (500 recordings), the optimal results were also obtained using the combination of lead-fall, GA, and GRBF methods, and the classification accuracy was 91.80%.

  12. Cardiovascular screening in adolescents and young adults: a prospective study comparing the Pre-participation Physical Evaluation Monograph 4th Edition and ECG. (United States)

    Fudge, Jessie; Harmon, Kimberly G; Owens, David S; Prutkin, Jordan M; Salerno, Jack C; Asif, Irfan M; Haruta, Alison; Pelto, Hank; Rao, Ashwin L; Toresdahl, Brett G; Drezner, Jonathan A


    This study compares the accuracy of cardiovascular screening in active adolescents and young adults using a standardised history, physical examination and resting 12-lead ECG. Participants were prospectively screened using a standardised questionnaire based on the Pre-participation Physical Evaluation Monograph 4th Edition (PPE-4), physical examination and ECG interpreted using modern standards. Participants with abnormal findings had focused echocardiography and further evaluation. Primary outcomes included disorders associated with sudden cardiac arrest (SCA). From September 2010 to July 2011, 1339 participants underwent screening: age 13-24 (mean 16) years, 49% male, 68% Caucasian, 17% African-American and 1071 (80%) participating in organised sports. Abnormal history responses were reported on 916 (68%) questionnaires. After physician review, 495/916 (54%) participants with positive questionnaires were thought to have non-cardiac symptoms and/or a benign family history and did not warrant additional evaluation. Physical examination was abnormal in 124 (9.3%) participants, and 72 (5.4%) had ECG abnormalities. Echocardiograms were performed in 586 (44%) participants for abnormal history (31%), physical examination (8%) or ECG (5%). Five participants (0.4%) were identified with a disorder associated with SCA, all with ECG-detected Wolff-Parkinson-White. The false-positive rates for history, physical examination and ECG were 31.3%, 9.3% and 5%, respectively. A standardised history and physical examination using the PPE-4 yields a high false-positive rate in a young active population with limited sensitivity to identify those at risk for SCA. ECG screening has a low false-positive rate using modern interpretation standards and improves detection of primary electrical disease at risk of SCA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to


    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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. Biomedical implementation of liquid metal ink as drawable ECG electrode and skin circuit.

    Directory of Open Access Journals (Sweden)

    Yang Yu

    Full Text Available BACKGROUND: Conventional ways of making bio-electrodes are generally complicated, expensive and unconformable. Here we describe for the first time the method of applying Ga-based liquid metal ink as drawable electrocardiogram (ECG electrodes. Such material owns unique merits in both liquid phase conformability and high electrical conductivity, which provides flexible ways for making electrical circuits on skin surface and a prospective substitution of conventional rigid printed circuit boards (PCBs. METHODS: Fundamental measurements of impedance and polarization voltage of the liquid metal ink were carried out to evaluate its basic electrical properties. Conceptual experiments were performed to draw the alloy as bio-electrodes to acquire ECG signals from both rabbit and human via a wireless module developed on the mobile phone. Further, a typical electrical circuit was drawn in the palm with the ink to demonstrate its potential of implementing more sophisticated skin circuits. RESULTS: With an oxide concentration of 0.34%, the resistivity of the liquid metal ink was measured as 44.1 µΩ·cm with quite low reactance in the form of straight line. Its peak polarization voltage with the physiological saline was detected as -0.73 V. The quality of ECG wave detected from the liquid metal electrodes was found as good as that of conventional electrodes, from both rabbit and human experiments. In addition, the circuit drawn with the liquid metal ink in the palm also runs efficiently. When the loop was switched on, all the light emitting diodes (LEDs were lit and emitted colorful lights. CONCLUSIONS: The liquid metal ink promises unique printable electrical properties as both bio-electrodes and electrical wires. The implemented ECG measurement on biological surface and the successfully run skin circuit demonstrated the conformability and attachment of the liquid metal. The present method is expected to innovate future physiological measurement and

  20. A comprehensive performance analysis of EEMD-BLMS and DWT-NN hybrid algorithms for ECG denoising

    DEFF Research Database (Denmark)

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


    Electrocardiogram (ECG) is a widely used non-invasive method to study the rhythmic activity of theheart. These signals, however, are often obscured by artifacts/noises from various sources and mini-mization of these artifacts is of paramount importance for detecting anomalies. This paper presents......), named the Wavelet NN (WNN)) for denoising the ECG signals. These methods arecompared to the conventional EMD (C-EMD), C-EEMD, EEMD-LMS as well as the DWT thresholding(DWT-Th) based methods through extensive simulation studies on real as well as noise corrupted ECGsignals. Results clearly show...

  1. Feasibility and cost-effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies. The SEARCH-AF study. (United States)

    Lowres, Nicole; Neubeck, Lis; Salkeld, Glenn; Krass, Ines; McLachlan, Andrew J; Redfern, Julie; Bennett, Alexandra A; Briffa, Tom; Bauman, Adrian; Martinez, Carlos; Wallenhorst, Christopher; Lau, Jerrett K; Brieger, David B; Sy, Raymond W; Freedman, S Ben


    Atrial fibrillation (AF) causes a third of all strokes, but often goes undetected before stroke. Identification of unknown AF in the community and subsequent anti-thrombotic treatment could reduce stroke burden. We investigated community screening for unknown AF using an iPhone electrocardiogram (iECG) in pharmacies, and determined the cost-effectiveness of this strategy.Pharmacists performedpulse palpation and iECG recordings, with cardiologist iECG over-reading. General practitioner review/12-lead ECG was facilitated for suspected new AF. An automated AF algorithm was retrospectively applied to collected iECGs. Cost-effectiveness analysis incorporated costs of iECG screening, and treatment/outcome data from a United Kingdom cohort of 5,555 patients with incidentally detected asymptomatic AF. A total of 1,000 pharmacy customers aged ≥65 years (mean 76 ± 7 years; 44% male) were screened. Newly identified AF was found in 1.5% (95% CI, 0.8-2.5%); mean age 79 ± 6 years; all had CHA2DS2-VASc score ≥2. AF prevalence was 6.7% (67/1,000). The automated iECG algorithm showed 98.5% (CI, 92-100%) sensitivity for AF detection and 91.4% (CI, 89-93%) specificity. The incremental cost-effectiveness ratio of extending iECG screening into the community, based on 55% warfarin prescription adherence, would be $AUD5,988 (€3,142; $USD4,066) per Quality Adjusted Life Year gained and $AUD30,481 (€15,993; $USD20,695) for preventing one stroke. Sensitivity analysis indicated cost-effectiveness improved with increased treatment adherence.Screening with iECG in pharmacies with an automated algorithm is both feasible and cost-effective. The high and largely preventable stroke/thromboembolism risk of those with newly identified AF highlights the likely benefits of community AF screening. Guideline recommendation of community iECG AF screening should be considered.

  2. 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

  3. High Resolution ECG for Evaluation of QT Interval Variability during Exposure to Acute Hypoxia (United States)

    Zupet, P.; Finderle, Z.; Schlegel, Todd T.; Starc, V.


    Ventricular repolarization instability as quantified by the index of QT interval variability (QTVI) is one of the best predictors for risk of malignant ventricular arrhythmias and sudden cardiac death. Because it is difficult to appropriately monitor early signs of organ dysfunction at high altitude, we investigated whether high resolution advanced ECG (HR-ECG) analysis might be helpful as a non-invasive and easy-to-use tool for evaluating the risk of cardiac arrhythmias during exposure to acute hypoxia. 19 non-acclimatized healthy trained alpinists (age 37, 8 plus or minus 4,7 years) participated in the study. Five-minute high-resolution 12-lead electrocardiograms (ECGs) were recorded (Cardiosoft) in each subject at rest in the supine position breathing room air and then after breathing 12.5% oxygen for 30 min. For beat-to-beat RR and QT variability, the program of Starc was utilized to derive standard time domain measures such as root mean square of the successive interval difference (rMSSD) of RRV and QTV, the corrected QT interval (QTc) and the QTVI in lead II. Changes were evaluated with paired-samples t-test with p-values less than 0.05 considered statistically significant. As expected, the RR interval and its variability both decreased with increasing altitude, with p = 0.000 and p = 0.005, respectively. Significant increases were found in both the rMSSDQT and the QTVI in lead II, with p = 0.002 and p = 0.003, respectively. There was no change in QTc interval length (p = non significant). QT variability parameters may be useful for evaluating changes in ventricular repolarization caused by hypoxia. These changes might be driven by increases in sympathetic nervous system activity at ventricular level.

  4. 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.

  5. Design, fabrication and skin-electrode contact analysis of polymer microneedle-based ECG electrodes (United States)

    O'Mahony, Conor; Grygoryev, Konstantin; Ciarlone, Antonio; Giannoni, Giuseppe; Kenthao, Anan; Galvin, Paul


    Microneedle-based ‘dry’ electrodes have immense potential for use in diagnostic procedures such as electrocardiography (ECG) analysis, as they eliminate several of the drawbacks associated with the conventional ‘wet’ electrodes currently used for physiological signal recording. To be commercially successful in such a competitive market, it is essential that dry electrodes are manufacturable in high volumes and at low cost. In addition, the topographical nature of these emerging devices means that electrode performance is likely to be highly dependent on the quality of the skin-electrode contact. This paper presents a low-cost, wafer-level micromoulding technology for the fabrication of polymeric ECG electrodes that use microneedle structures to make a direct electrical contact to the body. The double-sided moulding process can be used to eliminate post-process via creation and wafer dicing steps. In addition, measurement techniques have been developed to characterize the skin-electrode contact force. We perform the first analysis of signal-to-noise ratio dependency on contact force, and show that although microneedle-based electrodes can outperform conventional gel electrodes, the quality of ECG recordings is significantly dependent on temporal and mechanical aspects of the skin-electrode interface.

  6. 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.

  7. [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.

  8. 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.

  9. 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.

  10. Improving ECG classification accuracy using an ensemble of neural network modules.

    Directory of Open Access Journals (Sweden)

    Mehrdad Javadi

    Full Text Available This paper illustrates the use of a combined neural network model based on Stacked Generalization method for classification of electrocardiogram (ECG beats. In conventional Stacked Generalization method, the combiner learns to map the base classifiers' outputs to the target data. We claim adding the input pattern to the base classifiers' outputs helps the combiner to obtain knowledge about the input space and as the result, performs better on the same task. Experimental results support our claim that the additional knowledge according to the input space, improves the performance of the proposed method which is called Modified Stacked Generalization. In particular, for classification of 14966 ECG beats that were not previously seen during training phase, the Modified Stacked Generalization method reduced the error rate for 12.41% in comparison with the best of ten popular classifier fusion methods including Max, Min, Average, Product, Majority Voting, Borda Count, Decision Templates, Weighted Averaging based on Particle Swarm Optimization and Stacked Generalization.

  11. Manifold learning based ECG-free free-breathing cardiac CINE MRI. (United States)

    Usman, Muhammad; Atkinson, David; Kolbitsch, Christoph; Schaeffter, Tobias; Prieto, Claudia


    To present and validate a manifold learning (ML)-based method that can estimate both cardiac and respiratory navigator signals from electrocardiogram (ECG)-free free-breathing cardiac magnetic resonance imaging (MRI) data to achieve self-gated retrospective CINE reconstruction. In this work the use of the ML method is demonstrated for 2D cardiac CINE to achieve both cardiac and respiratory self-gating without the need of an external navigator or ECG signal. This is achieved by sequentially applying ML to two sets of retrospectively reconstructed real-time images with differing temporal resolutions. A 1D cardiac signal is estimated by applying ML to high temporal resolution real-time images reconstructed from the acquired data. Using the estimated cardiac signal, a 1D respiratory signal was obtained by applying the ML method to low temporal resolution images reconstructed from the same acquired data for each cardiac cycle. Data were acquired in five volunteers with a 2D golden angle radial trajectory in a balanced steady-state free precession (b-SSFP) acquisition. The accuracy of the estimated cardiac signal was calculated as the standard deviation of the temporal difference between the estimated signal and the recorded ECG. The correlation between the estimated respiratory signal and standard pencil beam navigator signal was evaluated. Gated CINE reconstructions (20 cardiac phases per cycle, temporal resolution ∼30 msec) using the estimated cardiac and respiratory signals were qualitatively compared against conventional ECG-gated breath-hold CINE acquisitions. Accurate cardiac signals were estimated with the proposed method, with an error standard deviation in comparison to ECG lower than 20 msec. Respiratory signals estimated with the proposed method achieved a mean cross-correlation of 94% with respect to standard pencil beam navigator signals. Good quality visual scores of 2.80 ± 0.45 (scores from 0, bad, to 4, excellent quality) were observed for the

  12. 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.

  13. 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...

  14. 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...

  15. 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.

  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. 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

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. 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.

  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. 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. A novel feature extracting method of QRS complex classification for mobile ECG signals (United States)

    Zhu, Lingyun; Wang, Dong; Huang, Xianying; Wang, Yue


    The conventional classification parameters of QRS complex suffer from larger activity rang of patients and lower signal to noise ratio in mobile cardiac telemonitoring system and can not meet the identification needs of ECG signal. Based on individual sinus heart rhythm template built with mobile ECG signals in time window, we present semblance index to extract the classification features of QRS complex precisely and expeditiously. Relative approximation r2 and absolute error r3 are used as estimating parameters of semblance between testing QRS complex and template. The evaluate parameters corresponding to QRS width and types are demonstrated to choose the proper index. The results show that 99.99 percent of the QRS complex for sinus and superventricular ECG signals can be distinguished through r2 but its average accurate ratio is only 46.16%. More than 97.84 percent of QRS complexes are identified using r3 but its accurate ratio to the sinus and superventricular is not better than r2. By the feature parameter of width, only 42.65 percent of QRS complexes are classified correctly, but its accurate ratio to the ventricular is superior to r2. To combine the respective superiority of three parameters, a nonlinear weighing computation of QRS width, r2 and r3 is introduced and the total classification accuracy up to 99.48% by combing indexes.

  7. Block sparsity-based joint compressed sensing recovery of multi-channel ECG signals. (United States)

    Singh, Anurag; Dandapat, Samarendra


    In recent years, compressed sensing (CS) has emerged as an effective alternative to conventional wavelet based data compression techniques. This is due to its simple and energy-efficient data reduction procedure, which makes it suitable for resource-constrained wireless body area network (WBAN)-enabled electrocardiogram (ECG) telemonitoring applications. Both spatial and temporal correlations exist simultaneously in multi-channel ECG (MECG) signals. Exploitation of both types of correlations is very important in CS-based ECG telemonitoring systems for better performance. However, most of the existing CS-based works exploit either of the correlations, which results in a suboptimal performance. In this work, within a CS framework, the authors propose to exploit both types of correlations simultaneously using a sparse Bayesian learning-based approach. A spatiotemporal sparse model is employed for joint compression/reconstruction of MECG signals. Discrete wavelets transform domain block sparsity of MECG signals is exploited for simultaneous reconstruction of all the channels. Performance evaluations using Physikalisch-Technische Bundesanstalt MECG diagnostic database show a significant gain in the diagnostic reconstruction quality of the MECG signals compared with the state-of-the art techniques at reduced number of measurements. Low measurement requirement may lead to significant savings in the energy-cost of the existing CS-based WBAN systems.

  8. Cardiac Autonomic Alteration and Metabolic Syndrome: An Ambulatory ECG-based Study in A General Population (United States)

    Ma, Yan; Tseng, Ping-Huei; Ahn, Andrew; Wu, Ming-Shiang; Ho, Yi-Lwun; Chen, Ming-Fong; Peng, Chung-Kang


    Metabolic syndrome (MetS) has been associated with chronic damage to the cardiovascular system. This study aimed to evaluate early stage cardiac autonomic dysfunction with electrocardiography (ECG)-based measures in MetS subjects. During 2012–2013, 175 subjects with MetS and 226 healthy controls underwent ECG recordings of at least 4 hours starting in the morning with ambulatory one-lead ECG monitors. MetS was diagnosed using the criteria defined in the Adult Treatment Panel III, with a modification of waist circumference for Asians. Conventional heart rate variability (HRV) analysis, and complexity index (CI1–20) calculated from 20 scales of entropy (multiscale entropy, MSE), were compared between subjects with MetS and controls. Compared with the healthy controls, subjects with MetS had significantly reduced HRV, including SDNN and pNN20 in time domain, VLF, LF and HF in frequency domain, as well as SD2 in Poincaré analysis. MetS subjects have significantly lower complexity index (CI1–20) than healthy subjects (1.69 ± 0.18 vs. 1.77 ± 0.12, p < 0.001). MetS severity was inversely associated with the CI1–20 (r = −0.27, p < 0.001). MetS is associated with significant alterations in heart rate dynamics, including HRV and complexity. PMID:28290487

  9. Prospective and retrospective ECG-gating for CT coronary angiography perform similarly accurate at low heart rates

    Energy Technology Data Exchange (ETDEWEB)

    Stolzmann, Paul, E-mail: [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Goetti, Robert; Baumueller, Stephan [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Plass, Andre; Falk, Volkmar [Clinic for Cardiovascular Surgery, University Hospital Zurich (Switzerland); Scheffel, Hans; Feuchtner, Gudrun; Marincek, Borut [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Alkadhi, Hatem [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland); Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States); Leschka, Sebastian [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich (Switzerland)


    Objective: To compare, in patients with suspicion of coronary artery disease (CAD) and low heart rates, image quality, diagnostic performance, and radiation dose values of prospectively and retrospectively electrocardiography (ECG)-gated dual-source computed tomography coronary angiography (CTCA) for the diagnosis of significant coronary stenoses. Materials and methods: Two-hundred consecutive patients with heart rates {<=}70 bpm were retrospectively enrolled; 100 patients undergoing prospectively ECG-gated CTCA (group 1) and 100 patients undergoing retrospectively-gated CTCA (group 2). Coronary artery segments were assessed for image quality and significant luminal diameter narrowing. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and accuracy of both CTCA groups were determined using conventional catheter angiography (CCA) as reference standard. Radiation dose values were calculated. Results: Both groups were comparable regarding gender, body weight, cardiovascular risk profile, severity of CAD, mean heart rate, heart rate variability, and Agatston score (all p > 0.05). There was no significant difference in the rate of non-assessable coronary segments between group 1 (1.6%, 24/1404) and group 2 (1.4%, 19/1385; p = 0.77); non-diagnostic image quality was significantly (p < 0.001) more often attributed to stair step artifacts in group 1. Segment-based sensitivity, specificity, PPV, NPV, and accuracy were 98%, 98%, 88%, 100%, and 100% among group 1; 96%, 99%, 90%, 100%, and 98% among group 2, respectively. Parameters of diagnostic performance were similar (all p > 0.05). Mean effective radiation dose of prospectively ECG-gated CTCA (2.2 {+-} 0.4 mSv) was significantly (p < 0.0001) smaller than that of retrospectively ECG-gated CTCA (8.1 {+-} 0.6 mSv). Conclusion: Prospectively ECG-gated CTCA yields similar image quality, performs as accurately as retrospectively ECG-gated CTCA in patients having heart rates {<=}70 bpm

  10. 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.

  11. Reliability and Reproducibility of Advanced ECG Parameters in Month-to-Month and Year-to-Year Recordings in Healthy Subjects (United States)

    Starc, Vito; Abughazaleh, Ahmed S.; Schlegel, Todd T.


    Advanced resting ECG parameters such the spatial mean QRS-T angle and the QT variability index (QTVI) have important diagnostic and prognostic utility, but their reliability and reproducibility (R&R) are not well characterized. We hypothesized that the spatial QRS-T angle would have relatively higher R&R than parameters such as QTVI that are more responsive to transient changes in the autonomic nervous system. The R&R of several conventional and advanced ECG para-meters were studied via intraclass correlation coefficients (ICCs) and coefficients of variation (CVs) in: (1) 15 supine healthy subjects from month-to-month; (2) 27 supine healthy subjects from year-to-year; and (3) 25 subjects after transition from the supine to the seated posture. As hypothesized, for the spatial mean QRS-T angle and many conventional ECG parameters, ICCs we-re higher, and CVs lower than QTVI, suggesting that the former parameters are more reliable and reproducible.

  12. 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.

  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. 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.

  16. 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.

  17. 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.

  18. 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...

  19. 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.

  20. 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.

  1. 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.

  2. 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 ...

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. [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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. Biosignal PI, an Affordable Open-Source ECG and Respiration Measurement System

    Directory of Open Access Journals (Sweden)

    Farhad Abtahi


    Full Text Available Bioimedical pilot projects e.g., telemedicine, homecare, animal and human trials usually involve several physiological measurements. Technical development of these projects is time consuming and in particular costly. A versatile but affordable biosignal measurement platform can help to reduce time and risk while keeping the focus on the important goal and making an efficient use of resources. In this work, an affordable and open source platform for development of physiological signals is proposed. As a first step an 8–12 leads electrocardiogram (ECG and respiration monitoring system is developed. Chips based on iCoupler technology have been used to achieve electrical isolation as required by IEC 60601 for patient safety. The result shows the potential of this platform as a base for prototyping compact, affordable, and medically safe measurement systems. Further work involves both hardware and software development to develop modules. These modules may require development of front-ends for other biosignals or just collect data wirelessly from different devices e.g., blood pressure, weight, bioimpedance spectrum, blood glucose, e.g., through Bluetooth. All design and development documents, files and source codes will be available for non-commercial use through project website,

  17. 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.

  18. Validation of heart rate derived from a physiological status monitor-embedded compression shirt against criterion ECG. (United States)

    Dolezal, B A; Boland, D M; Carney, J; Abrazado, M; Smith, D L; Cooper, C B


    Firefighters are subject to extreme environments and high physical demands when performing duty-related tasks. Recently, physiological status monitors (PSM) have been embedded into a compression shirt to enable firefighters to measure, visualize, log, and transmit vital metrics such as heart rate (HR) to aid in cardiovascular risk identification and mitigation, thereby attempting to improve the health, fitness, and safety of this population. The purpose of this study was to validate HR recorded by the PSM-embedded compression shirt against a criterion standard laboratory ECG-derived HR when worn concurrently with structural firefighting personal protective equipment (PPE) during four simulated firefighting activities. Ten healthy, college-age men (mean ± SD: age: 21 ± 1 yr; body mass: 91 ± 10 kg; body mass index: 26.9 ± 3.1 kg/m(2)) completed four tasks that are routinely performed during firefighting operations: outdoor fast-paced walking (FW), treadmill walking (TW), searching/crawling (SC), and ascending/descending stairs (AD). They wore the PSM-embedded compression shirt under structural firefighting PPE. HR was recorded concurrently by the PSM-embedded compression shirt and a portable metabolic measurement system accompanied with a standard 12-lead electrocardiograph that was used to provide criterion measures of HR. For all four tasks combined there was very high correlation of PSM and ECG HR (r > 0.99; SEE 0.84 /min) with a mean difference (bias) of -0.02 /min and limits of agreement of -0.07 to 0.02 /min. For individual tasks, the correlations were also high (r-values = 0.99; SEE 0.81-0.89). The mean bias (limits of agreement) was: FW 0.03 (-0.09 to 0.14); TW 0.04 (-0.05 to 0.12); SC -0.01 (-0.12 to 0.10); AD -0.13 (-0.21 to -0.04) /min. These findings demonstrate that the PSM-embedded compression shirt provides a valid measure of HR during simulated firefighting activities when compared with a standard 12-lead ECG.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.


    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.

  6. 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.

  7. 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.

  8. 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).

  9. 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.

  10. 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....

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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。

  17. 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.

  18. Effect of a real-time tele-transmission system of 12-lead electrocardiogram on the first-aid for athletes with ST-elevation myocardial infarction. (United States)

    Zhang, Huan; Song, Donghan; An, Lina


    To study the effect of a real-time tele-transmission system of 12-lead electrocardiogram on door-to-balloon time in athletes with ST-elevation myocardial infarction. A total of 60 athletes with chest pain diagnosed as ST-elevation myocardial infarction (STEMI) from our hospital were randomly divided into group A (n=35) and group B (n=25), the patients in group A transmitted the real-time tele-transmission system of 12-lead electrocardiogram to the chest pain center before arriving in hospital, however, the patients in group B not. The median door-to-balloon time was significant shorter in-group A than group B (38min vs 94 min, p0.05). The median length of stay was significant reduced in-group A (5 days vs 7 days, pelectrocardiogram is beneficial to the pre-hospital diagnosis of STEMI.

  19. Acurácia de critérios para vagotonia no eletrocardiograma de repouso de 12 derivações: uma análise com curvas ROC Accuracy of vagotonia criteria in the 12-lead resting electrocardiogram: analysis with ROC curves

    Directory of Open Access Journals (Sweden)

    José Kawazoe Lazzoli


    ível de segmento S-T em cinco ou mais derivações e presença de transição precordial rápida. DISCUSSÃO E CONCLUSÃO: O desempenho dos critérios eletrocardiográficos em termos de VPP, VPN e AC foi muito limitado, com a exceção da duração do intervalo R-R. A combinação de outros critérios como amplitude da onda T em V5 e V6, amplitude da onda R em V4 e presença de supradesnível de ponto J e do segmento S-T em várias derivações pode auxiliar na predição de vagotonia.OBJECTIVE: To determine sensitivity (Sens, specificity (Spec, positive (PPV and negative (NPV predictive value, and accuracy of different electrocardiographic criteria for vagotonia. METHODS: Seventy-four Olympic athletes (51 male and 23 female; age = 24 ± 5 years underwent an evaluation consisting of a 12-lead resting electrocardiogram (ECG, and an assessment of cardiac vagal tone (CVT by the 4-second cycling exercise testing (4-sET, with the B/C index utilized as the gold standard. The 4-sET is a well-standardized and valid protocol for CVT assessment based on the mechanism of exercise-onset tachycardia regardless of the sympathetic component. Using ROC (receiver operating characteristic curves, the authors selected the cut-point with the best sensitivity (Sens/specificity (Spec ratio for each ECG variable, and calculated the positive (PPV and negative predictive values (NPV, and accuracy (AC. The authors also correlated B/C index with ECG variables. RESULTS: B/C index showed a poor association with ECG variables, with the exception of R-R interval (r = 0.353; P = 0.004, that also presented a significant ROC curve (chi2= 0.863; P = 0.002, whereas the R-R interval > or = 990 ms criterion showed the following results: Sens - 100%; Spec - 73%; VPP 20%; VPN 100%; AC 75%. The ECG variables that presented cut-points with accuracy > 80% were: T-wave amplitude in lead V5 > or = 8.0 mm; T-wave amplitude in lead V6 > or = 7.0 mm; Q-wave amplitude in V5 > or = 7.0 mm; R-wave amplitude in V4 > or

  20. 入院前电话通知对中老年ST段抬高心肌梗死患者进急诊室至球囊扩张时间的影响%The effect of prehospital 12-lead electrocardiogram and transtelephonic notifiication on door-to-balloon time in patients with ST-segment elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    程姝娟; 迟云鹏; 吴铮; 马芹; 徐方兴; 颜红兵; 王健; 赵汉军; 李世英; 李庆祥; 郑文斌; 宋莉; 王新


    Objective To explore the effect of prehospital 12-lead electrocardiogram (ECG) and transtelephonic notification on door-to-balloon time in patients with ST-segment elevation myocardial infarction (STEMI). Methods Four hundred and two patients with STEMI who underwent primary PCI from January 2006 to December 2007 in Beijng Anzhen Hospital were analyzed. They were divided into 3 groups: 137 patients without prehospital ECG (group A), 176 patients with prehospital ECG (group B) and 89 patients with prehospital ECG and early transtelephonie notification (group C). Door-to-balloon time and in-hospital mortality were compared among the groups. Results There were no significant differences in age, sex, past medical history and infarcted area among three groups. Compared with group A, patients in group B and group C had much shorter door-to-balloon time (96 minutes and 86 minutes vs. 113 minntes in group A, all P 0. 05). Conclusions Prehospital ECG and early transtelephonic notification can significantly shorten door-to-balloon time in patients with STEMI. Coordinated system including prehospital ECG and transtelephonie notification is proved to be feasible and effective.%目的 探讨入院前心电图采集和电话通知对ST段抬高心肌梗死(STEMI)患者进入急诊室至球囊扩张时间[进门至球囊扩张(door to balloon,D2B)时间]的影响. 方法 对2006年1月至2007年12月就诊于北京安贞医院抢救中心并接受直接经皮冠状动脉介入治疗(PCI)的STEMI患者的临床资料进行分析.将患者分为3组:无入院前心电图(无心电图)组、有入院前心电图(有心电图)组和依据入院前心电图进行电话通知(电话通知)组.主要分析指标为D2B时间.次要分析指标为住院期间患者病死率. 结果 纳入研究患者402例,其中无心电图组137例(34.1%),有心电图组176例(43.8%),电话通知组89例(22.1%).3组患者年龄、性别、既往病史及心肌梗死部位比

  1. 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.

  2. 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...

  3. 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.

  4. [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.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. [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.

  13. 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.

  14. 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.

  15. 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

  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. 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…

  18. 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.

  19. 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...

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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…

  5. 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

  6. 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.

  7. Benchmarking ventricular arrhythmias in the mouse--revisiting the 'Lambeth Conventions' 20 years on. (United States)

    Huggins, Catherine E; Bell, James R; Pepe, Salvatore; Delbridge, Lea M D


    The isolated Langendorff-mode perfused heart has become a valuable experimental model, used extensively to examine cardiac function, pathophysiology and pharmacology. For the clinical cardiologist an ECG is often a simple practicality, however in experimental circumstances, particularly with ex vivo murine hearts it is not always possible to obtain an ECG due to experimental recording constraints. However, the mechanical record of ventricular contractile function can be highly informative in relation to electrical state. It is difficult though to achieve consistency in these evaluations of arrhythmia as a validated common reference framework is lacking. In 1988, a group of investigators developed the 'Lambeth Conventions'--a standardised reference for the definition and classification of arrhythmias in animal experimental models of ischaemia, infarction and reperfusion in vivo. Now, two decades later it is timely to revisit the Lambeth Conventions, and to update the guidelines in the context of the marked increase in murine heart study in experimental cardiac pathophysiology. Here we describe an adjunct to the Lambeth Conventions for the reporting of ventricular arrhythmias post-ischaemia in ex vivo mouse hearts when ECG recordings are not employed. Of seven discrete and identifiable patterns of mechanical dysrhythmia observed in reperfusion, five could be classified using conventional ECG terminology: ventricular premature beat, bigeminy, trigeminy, ventricular tachycardia and ventricular fibrillation. Two additional rhythm variations detected from the pressure record are described (potentiated contraction and alternans).

  8. QT intervals and QT dispersion determined from a 12-lead 24-hour Holter recording in patients with coronary artery disease and patients with heart failure

    DEFF Research Database (Denmark)

    Hansen, S.; Rasmussen, V.; Torp-Pedersen, C.;


    modes of lead selection was used: all 12-leads (QTdisp 12), only precordial leads (QTdisp 6), and one pair of preselected leads (QTdisp 2) in a 24-hour Holter recording every fourth hour each comprising 10 consecutive measurements in 54 healthy subjects, 29 patients with coronary artery disease (CAD......), and 29 patients with heart failure (HF). RESULTS: A significant circadian variation was observed in healthy subjects when modes QTdisp 12 and QTdisp 6 were used (Mean +/- SD 35.58 +/- 16.48 ms; P ... in QTdisp 12 (Mean +/- SD 33.13 +/- 14.86 ms; P detected in healthy subjects and in patients with uncomplicated CAD, but not in those who...

  9. 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.

  10. [Development of 12 LEAD holter]. (United States)

    Jiang, Hao; Lao, Zhe


    This article presents a kind of design of hardware and software for the Dynamic Electrocardiogrphs base on 8051F020. It includes 12-channel cardiac amplifier and A/D converter, This system with a simple composition realizes the system's minialurization and low power composition.

  11. 第45课运动员12导联心电图解释的建议%Recommendations for Interpretation of 12-lead Electrocardiogram in the Athlete

    Institute of Scientific and Technical Information of China (English)



    @@ Electrocardiogram changes in athletes are common and usually reflect structural and electrical remodelling of the heart as an adaptation to regular physical training (athlete's heart).However, abnormalities of athlete's ECG may be an expression of an underlying heart disease which carries a risk of SCD during sport.It is important that ECG abnormalities resulting from intensive physical training and those potentially associated with an increased cardiovascular risk are correctly distinguished.The athlete's ECG changes are divided into two groups: common and training-related and training-unrelated.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. [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.

  19. 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.

  20. 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.

  1. 我国成功研制出12导同步HOLTER仪器应用临床%12-lead Synchronous Holter Developed by China

    Institute of Scientific and Technical Information of China (English)

    卢喜烈; 吴英森


    1957年美国物理学博士,实验物理学家Nor-man J·Holter发明了动态心电图(Aiululatory ECG),故动态心电图简称Holter.近半世纪以来,随着动态监护技术在医学临床及科研中的广泛应用,HOLTER技术得到了飞速发展.我国成功研制出12导同步Holter仪器并应用临床,本文对新型12导同步HOLTER的特点进行介绍,以及在临床中的应用价值.

  2. 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

  3. [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.

  4. 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.

  5. 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

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    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

  6. Performance Comparison of Windowing Techniques for ECG Signal Enhancement

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    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.

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

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    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.

  8. 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.

  9. 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.

  10. ECG-gated HYPR reconstruction for undersampled CT myocardial perfusion imaging (United States)

    Speidel, Michael A.; Van Lysel, Michael S.; Reeder, Scott B.; Supanich, Mark; Nett, Brian E.; Zambelli, Joseph; Chang, Su Min; Hsieh, Jiang; Chen, Guang-Hong; Mistretta, Charles A.


    In this study we develop a novel ECG-gated method of HYPR (HighlY constrained backPRojection) CT reconstruction for low-dose myocardial perfusion imaging and present its first application in a porcine model. HYPR is a method of reconstructing time-resolved images from view-undersampled projection data. Scanning and reconstruction techniques were explored using x-ray projections from a 50 sec contrast-enhanced axial scan of a 47 kg swine on a 64-slice MDCT system. Scans were generated with view undersampling factors from 2 to 10. A HYPR reconstruction algorithm was developed in which a fully-sampled composite image is generated from views collected from multiple cardiac cycles within a diastolic window. A time frame image for a heartbeat was produced by modifying the composite with projections from the cycle of interest. Heart rate variations were handled by automatically selecting cardiac window size and number of cycles per composite within defined limits. Cardiac window size averaged 35% of the R-R interval for 2x undersampling and increased to 64% R-R using 10x undersampling. The selected window size and cycles per composite was sensitive to synchrony between heart rate, gantry rate, and the view undersampling pattern. Temporal dynamics and perfusion metrics measured in conventional short-scan (FBP) images were well-reproduced in the undersampled HYPR time series. Mean transit times determined from HYPR myocardial time-density curves agreed to within 8% with the FBP results. The results indicate potential for an order of magnitude reduction in dose requirement per image in cardiac perfusion CT via undersampled scanning and ECG-gated HYPR reconstruction.

  11. ECG marker of adverse electrical remodeling post-myocardial infarction predicts outcomes in MADIT II study.

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    Larisa G Tereshchenko

    Full Text Available BACKGROUND: Post-myocardial infarction (MI structural remodeling is characterized by left ventricular dilatation, fibrosis, and hypertrophy of the non-infarcted myocardium. OBJECTIVE: The goal of our study was to quantify post-MI electrical remodeling by measuring the sum absolute QRST integral (SAI QRST. We hypothesized that adverse electrical remodeling predicts outcomes in MADIT II study participants. METHODS: Baseline orthogonal ECGs of 750 MADIT II study participants (448 [59.7%] ICD arm were analyzed. SAI QRST was measured as the arithmetic sum of absolute QRST integrals over all three orthogonal ECG leads. The primary endpoint was defined as sudden cardiac death (SCD or sustained ventricular tachycardia (VT/ventricular fibrillation (VF with appropriate ICD therapies. All-cause mortality served as a secondary endpoint. RESULTS: Adverse electrical remodeling in post-MI patients was characterized by wide QRS, increased magnitudes of spatial QRS and T vectors, J-point deviation, and QTc prolongation. In multivariable Cox regression analysis after adjustment for age, QRS duration, atrial fibrillation, New York Heart Association heart failure class and blood urea nitrogen, SAI QRST predicted SCD/VT/VF (HR 1.33 per 100 mV*ms (95%CI 1.11-1.59; P = 0.002, and all-cause death (HR 1.27 per 100 mV*ms (95%CI 1.03-1.55, P = 0.022 in both arms. No interaction with therapy arm and bundle branch block (BBB status was found. CONCLUSIONS: In MADIT II patients, increased SAI QRST is associated with increased risk of sustained VT/VF with appropriate ICD therapies and all-cause death in both ICD and in conventional medical therapy arms, and in patients with and without BBB. Further studies of SAI QRST are warranted.

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

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    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.


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    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.

  14. 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.

  15. [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.

  16. 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.

  17. 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.

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

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    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

  19. 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.

  20. Soft, Comfortable Polymer Dry Electrodes for High Quality ECG and EEG Recording

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    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.

  1. 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

  2. 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...

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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.

  9. 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.

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

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    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.

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

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    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.

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. The Hague Judgments Convention

    DEFF Research Database (Denmark)

    Nielsen, Peter Arnt


    The Hague Judgments Convention of 2005 is the first global convention on international jurisdiction and recognition and enforcement of judgments in civil and commercial matters. The author explains the political and legal background of the Convention, its content and certain crucial issues during...

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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

  5. High-pitch dual-source CT angiography of the whole aorta without ECG synchronisation: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Beeres, Martin; Schell, Boris; Mastragelopoulos, Aristidis; Kerl, Josef Matthias; Gruber-Rouh, Tatjana; Lee, Clara; Siebenhandl, Petra; Bodelle, Boris; Zangos, Stephan; Vogl, Thomas J.; Jacobi, Volkmar; Bauer, Ralf W. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Herrmann, Eva [Clinic of the Goethe University, Department of Biostatistics, Frankfurt (Germany)


    To investigate the feasibility, image quality and radiation dose for high-pitch dual-source CT angiography (CTA) of the whole aorta without ECG synchronisation. Each group of 40 patients underwent CTA either on a 16-slice (group 1) or dual-source CT device with conventional single-source (group 2) or high-pitch mode with a pitch of 3.0 (group 3). The presence of motion or stair-step artefacts of the thoracic aorta was independently assessed by two readers. Subjective and objective scoring of motion and artefacts were significantly reduced in the high-pitch examination protocol (p < 0.05). The imaging length was not significantly different, but the imaging time was significantly (p < 0.001) shorter in the high-pitch group (12.2 vs. 7.4 vs. 1.7 s for groups 1, 2 and 3). The ascending aorta and the coronary ostia were reliably evaluable in all patients of group 3 without motion artefacts as well. High-pitch dual-source CT angiography of the whole aorta is feasible in unselected patients. As a significant advantage over regular pitch protocols, motion-free imaging of the aorta is possible without ECG synchronisation. Thus, this CT mode bears potential to become a standard CT protocol before trans-catheter aortic valve implantation (TAVI). (orig.)

  6. 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.

  7. 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

  8. 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.

  9. 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

  10. 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

  11. 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

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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…

  17. 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.

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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...

  3. 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...

  4. 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.

  5. Contrast material and radiation dose reduction strategy for triple-rule-out cardiac CT angiography: feasibility study of non-ECG-gated low kVp scan of the whole chest following coronary CT angiography. (United States)

    Kidoh, Masafumi; Nakaura, Takeshi; Nakamura, Shinichi; Namimoto, Tomohiro; Nozaki, Toshimitsu; Sakaino, Naritsugu; Harada, Kazunori; Yamashita, Yasuyuki


    Dedicated coronary computed tomography (CT) scan has been proven to be an accurate diagnostic modality in evaluating coronary artery disease. A second phase scan starting immediately after the coronary CT scan might enable visualization of the different vascular territories of the entire chest. To investigate the feasibility of a contrast material and radiation dose reduction triple-rule-out (TRO) CT angiography (CTA) protocol with serial non-ECG-gated low kVp scan of the whole chest, which utilizes a recirculated contrast agent. Thirty patients were scanned with the new TRO-CTA protocol; after the coronary scan with retrospective ECG-gating, non-ECG-gated whole-chest CTA was performed at 80 kVp to evaluate aortic arch (AAr) and pulmonary trunk (PT). Another 30 patients were scanned by our conventional TRO-CTA protocol at 120 kVp with retrospective ECG-gating. We compared the estimated effective dose (ED), contrast material (CM) dose, contrast-to-noise ratio (CNR) of the ascending aorta (AAo), and the rate of patients who could achieve adequate attenuation of the AAr and PT between the two protocols. The total ED of the new TRO-CTA protocol was 29.6% lower than that of the conventional protocol (P TRO-CTA protocol was significantly lower than in the conventional protocol (60.1 ± 9.6 mL vs. 91.8 ± 22.6 mL, P TRO-CTA protocol than with the conventional protocol (P 0.05). The new TRO-CTA protocol can reduce the total dose of radiation and the contrast dose and yield adequate vascular enhancement compared with the conventional protocol. © The Foundation Acta Radiologica 2013 Reprints and permissions:

  6. Varieties of conventional implicature

    Directory of Open Access Journals (Sweden)

    Eric Scott McCready


    Full Text Available This paper provides a system capable of analyzing the combinatorics of a wide range of conventionally implicated and expressive constructions in natural language via an extension of Potts's (2005 L_CI logic for supplementary conventional implicatures. In particular, the system is capable of analyzing objects of mixed conventionally implicated/expressive and at-issue type, and objects with conventionally implicated or expressive meanings which provide the main content of their utterances. The logic is applied to a range of constructions and lexical items in several languages. doi:10.3765/sp.3.8 BibTeX info

  7. Low-dose prospective ECG-triggering dual-source CT angiography in infants and children with complex congenital heart disease: first experience

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  8. 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...

  9. 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.

  10. [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.

  11. 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).

  12. Design and Implementation of Digital Chebyshev Type II Filter using XSG for Noise Reduction in ECG Signal

    Directory of Open Access Journals (Sweden)

    Kaustubh Gaikwad


    Full Text Available ASIC Chips and Digital Signal Processors are generally used for implementing digital filters. Now days the advanced technologies lead to use of field programmable Gate Array (FPGA for the implementation of Digital Filters.The present paper deals with Design and Implementation of Digital IIR Chebyshev type II filter using Xilinx System Generator. The Quantization and Overflow are main crucial parameters while designing the filter on FPGA and that need to be consider for getting the stability of the filter. As compare to the conventional DSP the speed of the system is increased by implementation on FPGA. Digital Chebyshev type II filter is initially designed analytically for the desired Specifications and simulated using Simulink in Matlab environment. This paper also proposes the method to implement Digital IIR Chebyshev type II Filter by using XSG platform. The filter has shown good performance for noise removal in ECG

  13. Effect on treatment delay of prehospital teletransmission of 12-lead electrocardiogram to a cardiologist for immediate triage and direct referral of patients with ST-segment elevation acute myocardial infarction to primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Sejersten, M.; Sillesen, M.; Hansen, Peter Riis;


    Prehospital electrocardiogram (ECG) transmission to hospitals was shown to reduce time to treatment in patients with acute myocardial infarction. However, new technologies allow transmission directly to a mobile unit so an attending physician can respond irrespective of presence within or outside...

  14. Evaluation of exposure dose reduction in multislice CT coronary angiography (MS-CTA) with prospective ECG-gated helical scan (United States)

    Ota, Takamasa; Tsuyuki, Masaharu; Okumura, Miwa; Sano, Tomonari; Kondo, Takeshi; Takase, Shinichi


    A novel low-dose ECG-gated helical scan method to investigate coronary artery diseases was developed. This method uses a high pitch for scanning (based on the patient's heart rate) and X-rays are generated only during the optimal cardiac phases. The dose reduction was obtained using a two-level approach: 1) To use a 64-slice CT scanner (Aquilion, Toshiba, Otawara, Tochigi, Japan) with a scan speed of 0.35 s/rot. to helically scan the heart at a high pitch based on the patient's heart rate. By changing the pitch from the conventional 0.175 to 0.271 for a heart rate of 60 bpm, the exposure dose was reduced to 65%. 2) To employ tube current gating that predicts the timing of optimal cardiac phases from the previous cardiac cycle and generates X-rays only during the required cardiac phases. The combination of high speed scanning with a high pitch and appropriate X-ray generation only in the cardiac phases from 60% to 90% allows the exposure dose to be reduced to 5.6 mSv for patients with a heart rate lower than 65 bpm. This is a dose reduction of approximately 70% compared to the conventional scanning method recommended by the manufacturer when segmental reconstruction is considered. This low-dose protocol seamlessly allows for wide scan ranges (e.g., aortic dissection) with the benefits of ECG-gated helical scanning: smooth continuity for longitudinal direction and utilization of data from all cardiac cycles.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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%).

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. The Geometry of Conventionality

    CERN Document Server

    Weatherall, James Owen


    Hans Reichenbach famously argued that the geometry of spacetime is conventional in relativity theory, in the sense that one can freely choose the spacetime metric so long as one is willing to postulate a "universal force field". Here we make precise a sense in which the field Reichenbach defines fails to be a "force". We then argue that there is an interesting and perhaps tenable sense in which geometry is conventional in classical spacetimes. We conclude with a no-go result showing that the variety of conventionalism available in classical spacetimes does not extend to relativistic spacetimes.

  11. 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%.

  12. Conventional Spinal Anaesthesia

    African Journals Online (AJOL)

    patients scheduled for clcctive unilateral lower limb surgery. ... the conventional group were turned supine immediately after injection. Blood pressure, heart rate, respiratory rate and oxygen .... Characteristic Type of spinal anaesthcsia P-value.

  13. 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.

  14. 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%.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.  

  2. 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:

  3. 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.


    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. 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.

  6. 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.

  7. 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.

  8. 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...

  9. 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.

  10. 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.

  11. 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...

  12. 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

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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...

  19. 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...

  20. 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.

  1. 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...

  2. 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...

  3. 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.

  4. 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

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Prospectively ECG-triggered sequential dual-source coronary CT angiography in patients with atrial fibrillation: comparison with retrospectively ECG-gated helical CT

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  18. 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.

  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. 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.

  1. [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.

  2. 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.

  3. ECG-gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  4. [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.

  5. 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。

  6. Conventional cerebrospinal fluid scanning

    Energy Technology Data Exchange (ETDEWEB)

    Schicha, H.


    Conventional cerebrospinal fluid scanning (CSF scanning) today is mainly carried out in addition to computerized tomography to obtain information about liquor flow kinetics. Especially in patients with communicating obstructive hydrocephalus, CSF scanning is clinically useful for the decision for shunt surgery. In patients with intracranial cysts, CSF scanning can provide information about liquor circulation. Further indications for CSF scanning include the assessment of shunt patency especially in children, as well as the detection and localization of cerebrospinal fluid leaks.

  7. 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.

  8. [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.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. 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.

  14. 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.

  16. 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.

  17. 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.

  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. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Fixed-time induction of ovulation in camels superovulated by different eCG modalities during the transition period in Egypt : Superovulation in camels during the transition period. (United States)

    Khalifa, Marwa Ahmed; Rateb, Sherif Abdel-Razzak; El-Bahrawy, Khalid Ahmed


    The current investigation aimed to establish a fixed-time induction of ovulation/ insemination protocol in camels superovulated by different equine chorionic gonadotropin (eCG) regimens during the transition period in Egypt (mid-October to mid-November). Seventeen pluriparous camels, Camelus dromedarius, were used. All females retained controlled intra-vaginal drug releasers (CIDRs) for 13 consecutive days, and at CIDR withdrawal, the camels were randomly divided into three groups. The control group (n = 5) received 1 ml saline intra-muscularly (i.m.), whereas remaining camels were superovulated by 2500 IU eCG either in a single shot (SS, n = 6) or in serial decreasing doses over 3 days (DD, n = 6). Ovarian dynamics were monitored by transrectal ultrasonography at 2-day intervals, and ovulation was induced by 5000 IU hCG i.m. The changes in reproductive hormones throughout the period of the study were determined. The results showed that mean values of total no. of follicles and size of dominant follicles remained low (P superovulated groups compared to the control, where the dominant follicles attained the highest (P 25 mm), which did not respond to induction to ovulation. These results elucidate that eCG administration in serial decreasing doses generates a reliable superovulatory response in camels, and ovulation can be blindly induced 12 days after the gonadotropin treatment. This fixed-time hormonal protocol represents a sufficient alternative to conventional day-to-day ultrasonography and would have profound implication for enhanced fertility in dromedary camels by facilitating infield application of embryo transfer technique.

  4. Conventional and unconventional superconductivity (United States)

    Fernandes, R. M.


    Superconductivity has been one of the most fruitful areas of research in condensed matter physics, bringing together researchers with distinct interests in a collaborative effort to understand from its microscopic basis to its potential for unprecedented technological applications. The concepts, techniques, and methods developed along its centennial history have gone beyond the realm of condensed matter physics and influenced the development of other fascinating areas, such as particle physics and atomic physics. These notes, based on a set of lectures given at the 2011 Advanced Summer School of Cinvestav, aim to motivate the young undergraduate student in getting involved in the exciting world of conventional and unconventional superconductors.

  5. Strategic interaction and conventions

    Directory of Open Access Journals (Sweden)

    Espinosa, María Paz


    Full Text Available The scope of the paper is to review the literature that employs coordination games to study social norms and conventions from the viewpoint of game theory and cognitive psychology. We claim that those two alternative approaches are in fact complementary, as they provide different insights to explain how people converge to a unique system of self-fulfilling expectations in presence of multiple, equally viable, conventions. While game theory explains the emergence of conventions relying on efficiency and risk considerations, the psychological view is more concerned with frame and labeling effects. The interaction between these alternative (and, sometimes, competing effects leads to the result that coordination failures may well occur and, even when coordination takes place, there is no guarantee that the convention eventually established will be the most efficient.

    El objetivo de este artículo es presentar la literatura que emplea los juegos de coordinación para el estudio de normas y convenciones sociales, que se han analizado tanto desde el punto de vista de la teoría de juegos como de la psicología cognitiva. Argumentamos en este trabajo que estos dos enfoques alternativos son en realidad complementarios, dado que ambos contribuyen al entendimiento de los procesos mediante los cuales las personas llegan a coordinarse en un único sistema de expectativas autorrealizadas, en presencia de múltiples convenciones todas ellas igualmente viables. Mientras que la teoría de juegos explica la aparición de convenciones basándose en argumentos de eficiencia y comportamientos frente al riesgo, el enfoque de la psicología cognitiva utiliza en mayor medida consideraciones referidas al entorno y naturaleza de las decisiones. La interacción entre estos efectos diferentes (y en ocasiones, rivales desemboca con frecuencia en fallos de coordinación y, aun cuando la coordinación se produce, no hay garantía de que la convención en vigor sea la m

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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...

  2. 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.

  3. 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

  4. Semisupervised ECG Ventricular Beat Classification With Novelty Detection Based on Switching Kalman Filters. (United States)

    Oster, Julien; Behar, Joachim; Sayadi, Omid; Nemati, Shamim; Johnson, Alistair E W; Clifford, Gari D


    Automatic processing and accurate diagnosis of pathological electrocardiogram (ECG) signals remains a challenge. As long-term ECG recordings continue to increase in prevalence, driven partly by the ease of remote monitoring technology usage, the need to automate ECG analysis continues to grow. In previous studies, a model-based ECG filtering approach to ECG data from healthy subjects has been applied to facilitate accurate online filtering and analysis of physiological signals. We propose an extension of this approach, which models not only normal and ventricular heartbeats, but also morphologies not previously encountered. A switching Kalman filter approach is introduced to enable the automatic selection of the most likely mode (beat type), while simultaneously filtering the signal using appropriate prior knowledge. Novelty detection is also made possible by incorporating a third mode for the detection of unknown (not previously observed) morphologies, and denoted as X-factor. This new approach is compared to state-of-the-art techniques for the ventricular heartbeat classification in the MIT-BIH arrhythmia and Incart databases. F1 scores of 98.3% and 99.5% were found on each database, respectively, which are superior to other published algorithms' results reported on the same databases. Only 3% of all the beats were discarded as X-factor, and the majority of these beats contained high levels of noise. The proposed technique demonstrates accurate beat classification in the presence of previously unseen (and unlearned) morphologies and noise, and provides an automated method for morphological analysis of arbitrary (unknown) ECG leads.

  5. Skin-electrode impedance measurement during ECG acquisition: method’s validation (United States)

    Casal, Leonardo; La Mura, Guillermo


    Skm-electrode impedance measurement can provide valuable information prior. dunng and post electrocardiographic (ECG) or electroencephalographs (EEG) acquisitions. In this work we validate a method for skm-electrode impedance measurement using test circuits with known resistance and capacitor values, at different frequencies for injected excitation current. Finally the method is successfully used for impedance measurement during ECG acquisition on a subject usmg 125 Hz and 6 nA square wave excitation signal at instrumentation amplifier mput. The method can be used for many electrodes configuration.

  6. Simulation methods for the online extraction of ECG parameters under Matlab/Simulink. (United States)

    von Wagner, G; Kunzmann, U; Schöchlin, J; Bolz, A


    The classification of cardiac pathologies in the human ECG greatly depends on the reliable extraction of characteristic features. This work presents a complete simulation environment for testing ECG classification algorithms under Matlab/Simulink. Evaluation of algorithm performance is undertaken in full compliance with the ANSI/AAMI standards EC38 and EC57, and ranges from beat-to-beat analysis to the comparison of episode markers (e.g., for VT/VF detection algorithms). For testing the quality of waveform boundary detection, our own testing methods have been implemented in compliance with existing literature.

  7. ECG Denoising Using Marginalized Particle Extended Kalman Filter With an Automatic Particle Weighting Strategy. (United States)

    Hesar, Hamed Danandeh; Mohebbi, Maryam


    In this paper, a model-based Bayesian filtering framework called the "marginalized particle-extended Kalman filter (MP-EKF) algorithm" is proposed for electrocardiogram (ECG) denoising. This algorithm does not have the extended Kalman filter (EKF) shortcoming in handling non-Gaussian nonstationary situations because of its nonlinear framework. In addition, it has less computational complexity compared with particle filter. This filter improves ECG denoising performance by implementing marginalized particle filter framework while reducing its computational complexity using EKF framework. An automatic particle weighting strategy is also proposed here that controls the reliance of our framework to the acquired measurements. We evaluated the proposed filter on several normal ECGs selected from MIT-BIH normal sinus rhythm database. To do so, artificial white Gaussian and colored noises as well as nonstationary real muscle artifact (MA) noise over a range of low SNRs from 10 to -5 dB were added to these normal ECG segments. The benchmark methods were the EKF and extended Kalman smoother (EKS) algorithms which are the first model-based Bayesian algorithms introduced in the field of ECG denoising. From SNR viewpoint, the experiments showed that in the presence of Gaussian white noise, the proposed framework outperforms the EKF and EKS algorithms in lower input SNRs where the measurements and state model are not reliable. Owing to its nonlinear framework and particle weighting strategy, the proposed algorithm attained better results at all input SNRs in non-Gaussian nonstationary situations (such as presence of pink noise, brown noise, and real MA). In addition, the impact of the proposed filtering method on the distortion of diagnostic features of the ECG was investigated and compared with EKF/EKS methods using an ECG diagnostic distortion measure called the "Multi-Scale Entropy Based Weighted Distortion Measure" or MSEWPRD. The results revealed that our proposed

  8. 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.

  9. ECG baseline wander correction based on mean-median filter and empirical mode decomposition. (United States)

    Xin, Yi; Chen, Yu; Hao, Wei Tuo


    A novel approach of ECG baseline wander correction based on mean-median filter and empirical mode decomposition is presented in this paper. The low frequency parts of the original signals were removed by the mean median filter in a nonlinear way to obtain the baseline wander estimation, then its series of IMFs were sifted by t-test after empirical mode decomposition. The proposed method, tested by the ECG signals in MIT-BIH Arrhythmia database and European ST_T database, is more effective compared with other baseline wander removal methods.

  10. Electrode positions, transformation coordinates for ECG reconstruction from S-ICD vectors

    Directory of Open Access Journals (Sweden)

    David G. Wilson


    Full Text Available The article contains data pertaining to the reconstruction of an 8-lead ECG from 2 subcutaneous implantable cardioverter defibrillator vectors. The location of electrodes on the precordium required for the data collection are detailed; the flow chart for patient selection and exclusion is shown; the summary data of the root mean square error (RMSE (in microvolts and Pearson r for the ECG transformation all cases and the pearson correlation for all the leads measured and reconstructed leads are also shown. Detailed background, methodology and discussion can be found in the linked research article.

  11. Triagem pré-participação com ECG em recrutas militares

    Directory of Open Access Journals (Sweden)

    Alon Grossman


    Full Text Available FUNDAMENTO: Os achados e investigações adicionais necessários com base na triagem pré-participação com eletrocardiograma (ECG entre os recrutas militares estão mal definidos na literatura. OBJETIVOS: Este estudo foi elaborado para avaliar a taxa de achados anormais na triagem pré-participação com ECG em adultos jovens e as avaliações adicionais necessárias com base nestes resultados. MÉTODOS: Um estudo de coorte retrospectivo foi realizado no centro aero-médico da Força Aérea de Israel (IAF, para candidatos das unidades das academias de voo e de tropa s de elite. Os candidatos das unidades das Academias de voo e de elite passam por uma triagem pré-participação com ECG antes do alistamento nas Forças de Defesa de Israel (IDF. Desde 2010, todos os ECGs são realizados no centro aero-médico da IAF. Todos os ECGs realizados desde janeiro de 2010 foram analisados por um de três cardiologistas e todos aqueles nos quais resultados significativos foram identificados foram encaminhados para uma avaliação mais detalhada, a pedido do cardiologista. As causas de encaminhamento para avaliação posterior, as avaliações realizadas e os resultados dessas avaliações são notificados para a população de estudo. RESULTADOS: 1.455 ECGs foram realizados nos anos 2010-2011. Desses, 1.388 (95,39% foram interpretadas como normais. 67 indivíduos foram encaminhados para uma avaliação mais detalhada com base nos achados do ECG. Os achados mais comuns levando a uma avaliação mais detalhada foram alterações da onda T (16 casos, 23,88%, padrão de pré-excitação (14, 20,89% e critérios de voltagem para hipertrofia ventricular esquerda (11; 16,41%. Apenas 7 indivíduos (10,44% tinham resultados anormais que foram considerados clinicamente significativos no final da avaliação médica. CONCLUSÕES: A taxa de achados significantes levando à desqualificação para a atividade militar é extremamente baixa e o encaminhamento para

  12. Comparison between retrospective gating and ECG triggering in magnetic resonance velocity mapping

    DEFF Research Database (Denmark)

    Søndergaard, L; Ståhlberg, F; Thomsen, C


    ECG-triggered cinematographic studies of the cardiovascular system are hampered by several technical restrictions such as the inability to image end-diastole, ghosting, varying signal intensity, and phase contributions from eddy currents. Retrospective gating may solve these problems, but involves...... of flow pulses. However, by reducing the time window retrospectively gated flow measurements were in good agreement with those that are ECG triggered. When fulfilling the demand of a narrow time window for interpolation, retrospective gating offers several advantages in MR velocity mapping....

  13. 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.

  14. Prospective ECG triggering versus low-dose retrospective ECG-gated 128-channel CT coronary angiography: comparison of image quality and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Q.; Yin, Y.; Hua, X.; Zhu, R.; Hua, J. [Department of Radiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai (China); Xu, J., E-mail: [Department of Radiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai (China)


    Aim: To evaluate image quality and radiation dose for 128-detector prospective electrocardiogram (ECG)-gated computed tomography coronary angiography (CTCA) compared with a low-dose retrospective ECG-gated imaging protocol. Materials and methods: Thirty-one and 47 patients suspected of having coronary artery disease were enrolled into groups examined using prospective and low-dose retrospective ECG-gated CT protocols respectively. All examinations were performed on a 128-detector CT system (Definition AS, Siemens Healthcare, Forchheim, Germany). Prospective CTCA was performed using following parameters: tube voltage 100 kV; tube current 205 mAs; centre of acquisition window 70% of the RR interval. The tube current for low-dose retrospective ECG-gated CTCA was full dose during 40-70% of the RR interval and partial dose for the rest of RR interval. The pitch varied between 0.2 and 0.5 depending on heart rate and patient size. Image quality of coronary arteries was evaluated using a four-point grading scale. The signal-to-noise ratios (SNRs) of enhanced arteries and myocardium were also measured, corresponding contrast-to-noise ratios (CNRs) were calculated, and the radiation doses received were recorded. Results: There was a significant difference in the image quality scores between the retrospective and prospective gating protocols (Chi-square = 15.331, p = 0.009). There was no significant difference between the SNRs of the contrasted artery and myocardium in these two groups, but the CNRs were increased in the prospective group. The mean radiation dose of prospective gating group was 2.71 {+-} 0.67 mSv (range, 1.67-3.59 mSv), which was significantly lower than that of the retrospective group (p < 0.001). Conclusion: Prospective CT angiography can achieve lower radiation dose than that of low-dose retrospective CT angiography, with preserved image quality.

  15. Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG

    National Research Council Canada - National Science Library

    Lindberg, Terese; Bohman, Doris M; Elmståhl, Sölve; Jogréus, Claes; Sanmartin Berglund, Johan


    ... (LTR) using the ECG-BodyKom(®). Two hundred elderly persons aged 66-93 years were recruited from the Swedish National Study on Aging and Care in 2010-2013, and data were collected via wireless LTR ECG-BodyKom...

  16. Comparative study of T-amplitude features for fitness monitoring using the ePatch® ECG recorder

    DEFF Research Database (Denmark)

    Thorpe, Julia Rosemary; Saida, Trine; Mehlsen, Jesper


    This study investigates ECG features, focusing on T-wave amplitude, from a wearable ECG device as a potential method for fitness monitoring in exercise rehabilitation. An automatic T-peak detection algorithm is presented that uses local baseline detection to overcome baseline drift without the need...

  17. Biodiesel from conventional feedstocks. (United States)

    Du, Wei; Liu, De-Hua


    At present, traditional fossil fuels are used predominantly in China, presenting the country with challenges that include sustainable energy supply, energy efficiency improvement, and reduction of greenhouse gas emissions. In 2007, China issued The Strategic Plan of the Mid-and-Long Term Development of Renewable Energy, which aims to increase the share of clean energy in the country's energy consumption to 15% by 2020 from only 7.5% in 2005. Biodiesel, an important renewable fuel with significant advantages over fossil diesel, has attracted great attention in the USA and European countries. However, biodiesel is still in its infancy in China, although its future is promising. This chapter reviews biodiesel production from conventional feedstocks in the country, including feedstock supply and state of the art technologies for the transesterification reaction through which biodiesel is made, particularly the enzymatic catalytic process developed by Chinese scientists. Finally, the constraints and perspectives for China's biodiesel development are highlighted.

  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

  19. Regression of ECG-LVH is associated with lower risk of new-onset heart failure and mortality in patients with isolated systolic hypertension; The LIFE study

    DEFF Research Database (Denmark)

    Larstorp, Anne Cecilie K; Okin, Peter M; Devereux, Richard B


    Hypertension and electrocardiographic left ventricular hypertrophy (ECG-LVH) are strong predictors of heart failure (HF). It is unclear whether regression of ECG-LVH during treatment predicts less new-onset HF in patients with isolated systolic hypertension (ISH)....

  20. Selecting Features of Single Lead ECG Signal for Automatic Sleep Stages Classification using Correlation-based Feature Subset Selection

    Directory of Open Access Journals (Sweden)

    Ary Noviyanto


    Full Text Available Knowing about our sleep quality will help human life to maximize our life performance. ECG signal has potency to determine the sleep stages so that sleep quality can be measured. The data that used in this research is single lead ECG signal from the MIT-BIH Polysomnographic Database. The ECGs features can be derived from RR interval, EDR information and raw ECG signal. Correlation-based Feature Subset Selection (CFS is used to choose the features which are significant to determine the sleep stages. Those features will be evaluated using four different characteristic classifiers (Bayesian network, multilayer perceptron, IB1 and random forest. Performance evaluations by Bayesian network, IB1 and random forest show that CFS performs excellent. It can reduce the number of features significantly with small decreasing accuracy. The best classification result based on this research is a combination of the feature set derived from raw ECG signal and the random forest classifier.