Wireless Based System for Continuous Electrocardiography Monitoring during Surgery

This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Wavelet-Based ECG Signal Analysis and Classification

This paper presents the processing and analysis of ECG signals. The study is based on wavelet transform and uses exclusively the MATLAB environment. This study includes removing Baseline wander and further de-noising through wavelet transform and metrics such as signal-to noise ratio (SNR), Peak signal-to-noise ratio (PSNR) and the mean squared error (MSE) are used to assess the efficiency of the de-noising techniques. Feature extraction is subsequently performed whereby signal features such as heart rate, rise and fall levels are extracted and the QRS complex was detected which helped in classifying the ECG signal. The classification is the last step in the analysis of the ECG signals and it is shown that these are successfully classified as Normal rhythm or Abnormal rhythm.  The final result proved the adequacy of using wavelet transform for the analysis of ECG signals.

Diagnosing Dangerous Arrhythmia of Patients by Automatic Detecting of QRS Complexes in ECG

In this paper, an automatic detecting algorithm for QRS complex detecting was applied for analyzing ECG recordings and five criteria for dangerous arrhythmia diagnosing are applied for a protocol type of automatic arrhythmia diagnosing system. The automatic detecting algorithm applied in this paper detected the distribution of QRS complexes in ECG recordings and related information, such as heart rate and RR interval. In this investigation, twenty sampled ECG recordings of patients with different pathologic conditions were collected for off-line analysis. A combinative application of four digital filters for bettering ECG signals and promoting detecting rate for QRS complex was proposed as pre-processing. Both of hardware filters and digital filters were applied to eliminate different types of noises mixed with ECG recordings. Then, an automatic detecting algorithm of QRS complex was applied for verifying the distribution of QRS complex. Finally, the quantitative clinic criteria for diagnosing arrhythmia were programmed in a practical application for automatic arrhythmia diagnosing as a post-processor. The results of diagnoses by automatic dangerous arrhythmia diagnosing were compared with the results of off-line diagnoses by experienced clinic physicians. The results of comparison showed the application of automatic dangerous arrhythmia diagnosis performed a matching rate of 95% compared with an experienced physician-s diagnoses.

An Improved QRS Complex Detection for Online Medical Diagnosis

This paper presents the work of signal discrimination specifically for Electrocardiogram (ECG) waveform. ECG signal is comprised of P, QRS, and T waves in each normal heart beat to describe the pattern of heart rhythms corresponds to a specific individual. Further medical diagnosis could be done to determine any heart related disease using ECG information. The emphasis on QRS Complex classification is further discussed to illustrate the importance of it. Pan-Tompkins Algorithm, a widely known technique has been adapted to realize the QRS Complex classification process. There are eight steps involved namely sampling, normalization, low pass filter, high pass filter (build a band pass filter), derivation, squaring, averaging and lastly is the QRS detection. The simulation results obtained is represented in a Graphical User Interface (GUI) developed using MATLAB.

Analysis of Noise Level Effects on Signal-Averaged Electrocardiograms

Noise level has critical effects on the diagnostic performance of signal-averaged electrocardiogram (SAECG), because the true starting and end points of QRS complex would be masked by the residual noise and sensitive to the noise level. Several studies and commercial machines have used a fixed number of heart beats (typically between 200 to 600 beats) or set a predefined noise level (typically between 0.3 to 1.0 μV) in each X, Y and Z lead to perform SAECG analysis. However different criteria or methods used to perform SAECG would cause the discrepancies of the noise levels among study subjects. According to the recommendations of 1991 ESC, AHA and ACC Task Force Consensus Document for the use of SAECG, the determinations of onset and offset are related closely to the mean and standard deviation of noise sample. Hence this study would try to perform SAECG using consistent root-mean-square (RMS) noise levels among study subjects and analyze the noise level effects on SAECG. This study would also evaluate the differences between normal subjects and chronic renal failure (CRF) patients in the time-domain SAECG parameters. The study subjects were composed of 50 normal Taiwanese and 20 CRF patients. During the signal-averaged processing, different RMS noise levels were adjusted to evaluate their effects on three time domain parameters (1) filtered total QRS duration (fQRSD), (2) RMS voltage of the last QRS 40 ms (RMS40), and (3) duration of the low amplitude signals below 40 μV (LAS40). The study results demonstrated that the reduction of RMS noise level can increase fQRSD and LAS40 and decrease the RMS40, and can further increase the differences of fQRSD and RMS40 between normal subjects and CRF patients. The SAECG may also become abnormal due to the reduction of RMS noise level. In conclusion, it is essential to establish diagnostic criteria of SAECG using consistent RMS noise levels for the reduction of the noise level effects.

Comparative Study of QRS Complex Detection in ECG

The processing of the electrocardiogram (ECG) signal consists essentially in the detection of the characteristic points of signal which are an important tool in the diagnosis of heart diseases. The most suitable are the detection of R waves. In this paper, we present various mathematical tools used for filtering ECG using digital filtering and Discreet Wavelet Transform (DWT) filtering. In addition, this paper will include two main R peak detection methods by applying a windowing process: The first method is based on calculations derived, the second is a time-frequency method based on Dyadic Wavelet Transform DyWT.

Combination of Different Classifiers for Cardiac Arrhythmia Recognition

This paper describes a new supervised fusion (hybrid) electrocardiogram (ECG) classification solution consisting of a new QRS complex geometrical feature extraction as well as a new version of the learning vector quantization (LVQ) classification algorithm aimed for overcoming the stability-plasticity dilemma. Toward this objective, after detection and delineation of the major events of ECG signal via an appropriate algorithm, each QRS region and also its corresponding discrete wavelet transform (DWT) are supposed as virtual images and each of them is divided into eight polar sectors. Then, the curve length of each excerpted segment is calculated and is used as the element of the feature space. To increase the robustness of the proposed classification algorithm versus noise, artifacts and arrhythmic outliers, a fusion structure consisting of five different classifiers namely as Support Vector Machine (SVM), Modified Learning Vector Quantization (MLVQ) and three Multi Layer Perceptron-Back Propagation (MLP–BP) neural networks with different topologies were designed and implemented. The new proposed algorithm was applied to all 48 MIT–BIH Arrhythmia Database records (within–record analysis) and the discrimination power of the classifier in isolation of different beat types of each record was assessed and as the result, the average accuracy value Acc=98.51% was obtained. Also, the proposed method was applied to 6 number of arrhythmias (Normal, LBBB, RBBB, PVC, APB, PB) belonging to 20 different records of the aforementioned database (between– record analysis) and the average value of Acc=95.6% was achieved. To evaluate performance quality of the new proposed hybrid learning machine, the obtained results were compared with similar peer– reviewed studies in this area.

ROC Analysis of PVC Detection Algorithm using ECG and Vector-ECG Charateristics

ECG analysis method was developed using ROC analysis of PVC detecting algorithm. ECG signal of MIT-BIH arrhythmia database was analyzed by MATLAB. First of all, the baseline was removed by median filter to preprocess the ECG signal. R peaks were detected for ECG analysis method, and normal VCG was extracted for VCG analysis method. Four PVC detecting algorithm was analyzed by ROC curve, which parameters are maximum amplitude of QRS complex, width of QRS complex, r-r interval and geometric mean of VCG. To set cut-off value of parameters, ROC curve was estimated by true-positive rate (sensitivity) and false-positive rate. sensitivity and false negative rate (specificity) of ROC curve calculated, and ECG was analyzed using cut-off value which was estimated from ROC curve. As a result, PVC detecting algorithm of VCG geometric mean have high availability, and PVC could be detected more accurately with amplitude and width of QRS complex.

Robust Detection of R-Wave Using Wavelet Technique

Electrocardiogram (ECG) is considered to be the backbone of cardiology. ECG is composed of P, QRS & T waves and information related to cardiac diseases can be extracted from the intervals and amplitudes of these waves. The first step in extracting ECG features starts from the accurate detection of R peaks in the QRS complex. We have developed a robust R wave detector using wavelets. The wavelets used for detection are Daubechies and Symmetric. The method does not require any preprocessing therefore, only needs the ECG correct recordings while implementing the detection. The database has been collected from MIT-BIH arrhythmia database and the signals from Lead-II have been analyzed. MatLab 7.0 has been used to develop the algorithm. The ECG signal under test has been decomposed to the required level using the selected wavelet and the selection of detail coefficient d4 has been done based on energy, frequency and cross-correlation analysis of decomposition structure of ECG signal. The robustness of the method is apparent from the obtained results.