Abstract: A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.
Abstract: This paper presents wavelet based classification of various heart diseases. Electrocardiogram signals of different heart patients have been studied. Statistical natures of electrocardiogram signals for different heart diseases have been compared with the statistical nature of electrocardiograms for normal persons. Under this study four different heart diseases have been considered as follows: Myocardial Ischemia (MI), Congestive Heart Failure (CHF), Arrhythmia and Sleep Apnea. Statistical nature of electrocardiograms for each case has been considered in terms of kurtosis values of two types of wavelet coefficients: approximate and detail. Nine wavelet decomposition levels have been considered in each case. Kurtosis corresponding to both approximate and detail coefficients has been considered for decomposition level one to decomposition level nine. Based on significant difference, few decomposition levels have been chosen and then used for classification.
Abstract: This paper aims at bringing a scientific contribution to the cardiac arrhythmia biomedical diagnosis systems; more precisely to the study of the amelioration of cardiac arrhythmia classification performance using artificial neural network, adaptive neuro-fuzzy and fuzzy inference systems classifiers. The purpose of this amelioration is to enable cardiologists to make reliable diagnosis through automatic cardiac arrhythmia analyzes and classifications based on high confidence classifiers. In this study, six classes of the most commonly encountered arrhythmias are considered: the Right Bundle Branch Block, the Left Bundle Branch Block, the Ventricular Extrasystole, the Auricular Extrasystole, the Atrial Fibrillation and the Normal Cardiac rate beat. From the electrocardiogram (ECG) extracted parameters, we constructed a matrix (360x360) serving as an input data sample for the classifiers based on neural networks and a matrix (1x6) for the classifier based on fuzzy logic. By varying three parameters (the quality of the neural network learning, the data size and the quality of the input parameters) the automatic classification permitted us to obtain the following performances: in terms of correct classification rate, 83.6% was obtained using the fuzzy logic based classifier, 99.7% using the neural network based classifier and 99.8% for the adaptive neuro-fuzzy based classifier. These results are based on signals containing at least 360 cardiac cycles. Based on the comparative analysis of the aforementioned three arrhythmia classifiers, the classifiers based on neural networks exhibit a better performance.
Abstract: In most developing countries, although the vast majority of the people are living in the rural areas, the qualified medical doctors are not available there. Health care workers and paramedics, called village doctors, informal healthcare providers, are largely responsible for the rural medical care. Mishaps due to wrong diagnosis and inappropriate medication have been causing serious suffering that is preventable. While innovators have created many devices, the vast majority of these technologies do not find applications to address the needs and conditions in low-resource settings. The primary motive is to address the acute lack of affordable medical technologies for the poor people in low-resource settings. A low cost smart medical device that is portable, battery operated and can be used at any point of care has been developed to detect breathing rate, electrocardiogram (ECG) and arterial pulse rate to improve diagnosis and monitoring of patients and thus improve care and safety. This simple and easy to use smart medical device can be used, managed and maintained effectively and safely by any health worker with some training. In order to empower the health workers and village doctors, our device is being further developed to integrate with ICT tools like smart phones and connect to the medical experts wherever available, to manage the serious health problems.
Abstract: Based on fast discrete cosine transform (FDCT), the authors present a high capacity and high perceived quality method for electrocardiogram (ECG) signal. By using a simple adjusting policy to the 1-dimentional (1-D) DCT coefficients, a large volume of secret message can be effectively embedded in an ECG host signal and be successfully extracted at the intended receiver. Simulations confirmed that the resulting perceived quality is good, while the hiding capability of the proposed method significantly outperforms that of existing techniques. In addition, our proposed method has a certain degree of robustness. Since the computational complexity is low, it is feasible for our method being employed in real-time applications.
Abstract: This paper presents an automatic normal and abnormal heart sound classification model developed based on deep learning algorithm. MITHSDB heart sounds datasets obtained from the 2016 PhysioNet/Computing in Cardiology Challenge database were used in this research with the assumption that the electrocardiograms (ECG) were recorded simultaneously with the heart sounds (phonocardiogram, PCG). The PCG time series are segmented per heart beat, and each sub-segment is converted to form a square intensity matrix, and classified using convolutional neural network (CNN) models. This approach removes the need to provide classification features for the supervised machine learning algorithm. Instead, the features are determined automatically through training, from the time series provided. The result proves that the prediction model is able to provide reasonable and comparable classification accuracy despite simple implementation. This approach can be used for real-time classification of heart sounds in Internet of Medical Things (IoMT), e.g. remote monitoring applications of PCG signal.
Abstract: Multiscale entropy (MSE) is an extensively used index to provide a general understanding of multiple complexity of physiologic mechanism of heart rate variability (HRV) that operates on a wide range of time scales. Accurate selection of electrocardiogram (ECG) sampling frequency is an essential concern for clinically significant HRV quantification; high ECG sampling rate increase memory requirements and processing time, whereas low sampling rate degrade signal quality and results in clinically misinterpreted HRV. In this work, the impact of ECG sampling frequency on MSE based HRV have been quantified. MSE measures are found to be sensitive to ECG sampling frequency and effect of sampling frequency will be a function of time scale.
Abstract: 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.
Abstract: Electromyography (EMG) is one of the most important interfaces between humans and robots for rehabilitation. Decoding this signal helps to recognize muscle activation and converts it into smooth motion for the robots. Detecting each muscle’s pattern during walking and running is vital for improving the quality of a patient’s life. In this study, EMG data from 10 muscles in 10 subjects at 4 different speeds were analyzed. EMG signals are nonlinear with high dimensionality. To deal with this challenge, we extracted some features in time-frequency domain and used manifold learning and Laplacian Eigenmaps algorithm to find the intrinsic features that represent data in low-dimensional space. We then used the Bayesian classifier to identify various patterns of EMG signals for different muscles across a range of running speeds. The best result for vastus medialis muscle corresponds to 97.87±0.69 for sensitivity and 88.37±0.79 for specificity with 97.07±0.29 accuracy using Bayesian classifier. The results of this study provide important insight into human movement and its application for robotics research.
Abstract: This paper presents an efficient method of electrocardiogram signal denoising based on a hybrid approach. Two techniques are brought together to create an efficient denoising process. The first is an Adaptive Dual Threshold Filter (ADTF) and the second is the Discrete Wavelet Transform (DWT). The presented approach is based on three steps of denoising, the DWT decomposition, the ADTF step and the highest peaks correction step. This paper presents some application of the approach on some electrocardiogram signals of the MIT-BIH database. The results of these applications are promising compared to other recently published techniques.
Abstract: For electrocardiogram (ECG) biometrics system, it is a tedious process to pre-install user’s high-intensity heart rate (HR) templates in ECG biometric systems. Based on only resting enrollment templates, it is a challenge to identify human by using ECG with the high-intensity HR caused from exercises and stress. This research provides a heartbeat segment method with slope-oriented neural networks against the ECG morphology changes due to high intensity HRs. The method has overall system accuracy at 97.73% which includes six levels of HR intensities. A cumulative match characteristic curve is also used to compare with other traditional ECG biometric methods.
Abstract: In this paper, a data-driven dictionary approach is proposed for the automatic detection and classification of cardiovascular abnormalities. Electrocardiography (ECG) signal is represented by the trained complete dictionaries that contain prototypes or atoms to avoid the limitations of pre-defined dictionaries. The data-driven trained dictionaries simply take the ECG signal as input rather than extracting features to study the set of parameters that yield the most descriptive dictionary. The approach inherently learns the complicated morphological changes in ECG waveform, which is then used to improve the classification. The classification performance was evaluated with ECG data under two different preprocessing environments. In the first category, QT-database is baseline drift corrected with notch filter and it filters the 60 Hz power line noise. In the second category, the data are further filtered using fast moving average smoother. The experimental results on QT database confirm that our proposed algorithm shows a classification accuracy of 92%.
Abstract: In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.
Abstract: Health diseases have a vital significance affecting human being's life and life quality. Sudden death events can be prevented owing to early diagnosis and treatment methods. Electrical signals, taken from the human being's body using non-invasive methods and showing the heart activity is called Electrocardiogram (ECG). The ECG signal is used for following daily activity of the heart by clinicians. Heart Rate Variability (HRV) is a physiological parameter giving the variation between the heart beats. ECG data taken from MITBIH Arrhythmia Database is used in the model employed in this study. The detection of arrhythmic heart beats is aimed utilizing the features extracted from the HRV time domain parameters. The developed model provides a satisfactory performance with ~89% accuracy, 91.7 % sensitivity and 85% specificity rates for the detection of arrhythmic beats.
Abstract: In recent years, the power system has been changed
and a flexible power pricing system such as demand response has been
sought in Japan. The demand response system works simply in the
household sector and the owner as the decision-maker, can benefit
from power saving. On the other hand, the execution of demand
response in the office building is more complex than in the household
because various people such as owners, building administrators and
occupants are involved in the decision-making process. While the
owners benefit from demand saving, the occupants are exposed to
restricted benefits of a demand-saved environment. One of the reasons
is that building systems are usually under centralized management and
each occupant cannot choose freely whether to participate in demand
response or not. In addition, it is unclear whether incentives give
occupants the motivation to participate. However, the recent
development of IT and building systems enables the personalized
control of the office environment where each occupant can control the
lighting level or temperature individually. Therefore, it can be possible
to have a system which each occupant can make a decision of whether
or not to participate in demand response in the office building. This study investigates personal responses to demand response
requests, under the condition where each occupant can adjust their
brightness individually in their workspace. Once workers participate
in the demand response, their desk-lights are automatically turned off.
The participation rates in the demand response events are compared
among four groups, which are divided by different motivation, the
presence, or absence of incentives and the method of participation. The
result shows that there are significant differences of participation rates
in demand response event between four groups. The method of
participation has a large effect on the participation rate. The “Opt-out”
groups where the occupants are automatically enrolled in a demand
response event if they do not express non-participation have the
highest participation rate in the four groups. Incentives also have an
effect on the participation rate. This study also reports on the impact of low illumination office
environment on the occupants, such as stress or fatigue. The
electrocardiogram and the questionnaire are used to investigate the
autonomic nervous activity and subjective fatigue symptoms of the
occupants. There is no big difference between dim workspace during
demand response event and bright workspace in autonomic nervous
activity and fatigue.
Abstract: Measuring the Electrocardiogram (ECG) signal is an
essential process for the diagnosis of the heart diseases. The ECG
signal has the information of the degree of how much the heart
performs its functions. In medical diagnosis and treatment systems,
Decision Support Systems processing the ECG signal are being
developed for the use of clinicians while medical examination. In this
study, a modular wireless ECG (WECG) measuring and recording
system using a single board computer and e-Health sensor platform
is developed. In this designed modular system, after the ECG signal
is taken from the body surface by the electrodes first, it is filtered and
converted to digital form. Then, it is recorded to the health database
using Wi-Fi communication technology. The real time access of the
ECG data is provided through the internet utilizing the developed
web interface.
Abstract: Noise removal techniques play a vital role in the performance of electrocardiographic (ECG) signal processing systems. ECG signals can be corrupted by various kinds of noise such as baseline wander noise, electromyographic interference, and powerline interference. One of the significant challenges in ECG signal processing is the degradation caused by additive 50 or 60 Hz powerline interference. This work investigates the removal of power line interference and suppression of transient response for filtering noise corrupted ECG signals. We demonstrate the effectiveness of infinite impulse response (IIR) notch filter with time varying pole radius for improving the transient behavior. The temporary change in the pole radius of the filter diminishes the transient behavior. Simulation results show that the proposed IIR filter with time varying pole radius outperforms traditional IIR notch filters in terms of mean square error and transient suppression.
Abstract: Upper gastrointestinal endoscopy is a commonly performed diagnostic and therapeutic procedure and has many adverse effects like cardiopulmonary complications, complications related to sedation, infectious complications, bleeding and perforation. So this study was undertaken to evaluate important variables like patient’s age, gender and stage of the procedure in relation to the cardiopulmonary changes during diagnostic upper gastrointestinal endoscopy by monitoring oxygen saturation, blood pressure, heart rate and electrocardiogram. This is a prospective longitudinal hospital based study involving a total of 140 consecutive patients, at Sri. B. M. Patil Medical College, Hospital and Research Centre. Cardiopulmonary changes during upper gastrointestinal endoscopy are more common in the age groups of 51-60 years, with equal frequency in both male and female. Oxygen saturation levels decreased by about 4% in both sexes during introduction of endoscopy. Mild to moderate hypoxia was found in 32% of the study group. Severe hypoxia was found in 5% of the patients, mostly in those patients who are above 50 years of age. Tachycardia was noted in 88% of the study group patients. Blood pressure increased to hypertension levels in 22 patients (15.7%) which returned to normal within few minutes after the procedure. S-T depression was noticed in 4% of patients and T wave inversion in 8% of patients during upper gastrointestinal endoscopy. All these changes disappeared after 10 minutes after the endoscopy. Cardiopulmonary changes are common during upper gastrointestinal endoscopy. Maximum changes in oxygen saturation, heart rate and blood pressure occurred immediately after the introduction of endoscope. The cardiopulmonary changes did not manifest into any identifiable clinical symptoms. The rate of recovery was faster in younger age groups and women.
Abstract: This paper presents a new Quality-Controlled, wavelet based, compression method for electrocardiogram (ECG) signals. Initially, an ECG signal is decomposed using the wavelet transform. Then, the resulting coefficients are iteratively thresholded to guarantee that a predefined goal percent root mean square difference (GPRD) is matched within tolerable boundaries. The quantization strategy of extracted non-zero wavelet coefficients (NZWC), according to the combination of RLE, HUFFMAN and arithmetic encoding of the NZWC and a resulting look up table, allow the accomplishment of high compression ratios with good quality reconstructed signals.
Abstract: In this paper we are to find the optimum multiwavelet for compression of electrocardiogram (ECG) signals and then, selecting it for using with SPIHT codec. At present, it is not well known which multiwavelet is the best choice for optimum compression of ECG. In this work, we examine different multiwavelets on 24 sets of ECG data with entirely different characteristics, selected from MIT-BIH database. For assessing the functionality of the different multiwavelets in compressing ECG signals, in addition to known factors such as Compression Ratio (CR), Percent Root Difference (PRD), Distortion (D), Root Mean Square Error (RMSE) in compression literature, we also employed the Cross Correlation (CC) criterion for studying the morphological relations between the reconstructed and the original ECG signal and Signal to reconstruction Noise Ratio (SNR). The simulation results show that the Cardinal Balanced Multiwavelet (cardbal2) by the means of identity (Id) prefiltering method to be the best effective transformation. After finding the most efficient multiwavelet, we apply SPIHT coding algorithm on the transformed signal by this multiwavelet.