Science.gov

Sample records for 12-lead electrocardiography ecg

  1. A cloud computing based 12-lead ECG telemedicine service

    PubMed Central

    2012-01-01

    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. Ambulance 12-lead electrocardiography transmission via cell phone technology to cardiologists.

    PubMed

    Hsieh, Jui-Chien; Lin, Bo-Xuan; Wu, Feng-Ren; Chang, Pei-Chann; Tsuei, Yi-Wei; Yang, Chung-Chi

    2010-10-01

    This study demonstrates transmission of 12-lead electrocardiography (ECG) in an ambulance to the cell phone of the attendant emergency medical technician and then to the hospital and to cell phones of off-site cardiologists. The emergency medical technician cell phone receives Extensible Markup Language files generated by a Phillips Extensible Markup Language ECG instrument via Wi-Fi-based wireless network and then sends them to an ECG-processing server at the hospital over the mobile telephone network. After reducing ECG noises and artifacts, the server converts files to Digital Imaging and Communications in Medicine-based ECG reports stored in Picture Archiving and Communication System. These reports are sent to the cell phones of off-site cardiologists. Consequently, on-site Emergency Department physicians and off-site cardiologists can discuss ECG reports via Picture Archiving and Communication System on their computers or cell phones to prepare for the most appropriate treatment while the patient is on the way to the hospital. In conclusion, this 12-lead ECG transmission e-technology expands the functions of a 12-lead ECG instrument and facilitates more efficient prehospital cardiac care. PMID:20925562

  3. Development and clinical study of mobile 12-lead electrocardiography based on cloud computing for cardiac emergency.

    PubMed

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

    2013-01-01

    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. PMID:23920851

  4. Discussion of "Computational Electrocardiography: Revisiting Holter ECG Monitoring".

    PubMed

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

    2016-08-01

    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. PMID:27406570

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

    ERIC Educational Resources Information Center

    Khunti, Kirti

    2014-01-01

    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. Learning how to perform a 12 lead ECG using virtual reality.

    PubMed

    Jeffries, P R

    1999-01-01

    The most common cardiac examination ordered by physicians is the 12 lead ECG, frequently obtained with a computerized recording device that not only provides the ECG tracing but, may also provide the diagnosis. In the past, only persons working in the ECG laboratory were allowed to perform a 12 lead ECG on a patient. Today, however, this task has been delegated to a variety of health professionals, including registered nurses, licensed practice nurses, and even nursing assistants in some health care facilities. New nurses are taught the skill of obtaining a 12 lead ECG during their initial hospital orientation. Because of this, it is not uncommon to have staff development nurses teaching groups of health professionals how to perform a 12 lead ECG content and skill as many as 5 times in 1 week. For delivery of repetitive content, the use of an interactive CD ROM can be very cost effective. Many health care institutions purchase commercially made CD ROM products, while elsewhere nurse educators develop their own. An interactive CD ROM based on the principles of best practice in education and using embedded virtual reality, was designed by the author to teach nurses, students, and other health professionals how to perform a 12 lead ECG. This article will: 1) describe the interactive CD ROM reality as a teaching methodology; 2) discuss the preliminary evaluation of learning outcomes using CD ROM as the instructional method; and 3) describe the applications interactive CD ROMs may have in nursing practice and education. PMID:10431313

  7. Real-Time 12-Lead High-Frequency QRS Electrocardiography for Enhanced Detection of Myocardial Ischemia and Coronary Artery Disease

    NASA Technical Reports Server (NTRS)

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

    2004-01-01

    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.

  8. The 24-lead ECG display for enhanced recognition of STEMI-equivalent patterns in the 12-lead ECG.

    PubMed

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

    2014-01-01

    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. PMID:24880763

  9. New System for Digital to Analog Transformation and Reconstruction of 12-Lead ECGs

    PubMed Central

    Kothadia, Roshni; Kulecz, Walter B.; Kofman, Igor S.; Black, Adam J.; Grier, James W.; Schlegel, Todd T.

    2013-01-01

    Introduction We describe initial validation of a new system for digital to analog conversion (DAC) and reconstruction of 12-lead ECGs. The system utilizes an open and optimized software format with a commensurately optimized DAC hardware configuration to accurately reproduce, from digital files, the original analog electrocardiographic signals of previously instrumented patients. By doing so, the system also ultimately allows for transmission of data collected on one manufacturer's 12-lead ECG hardware/software into that of any other. Materials and Methods To initially validate the system, we compared original and post-DAC re-digitized 12-lead ECG data files (∼5-minutes long) in two types of validation studies in 10 patients. The first type quantitatively compared the total waveform voltage differences between the original and re-digitized data while the second type qualitatively compared the automated electrocardiographic diagnostic statements generated by the original versus re-digitized data. Results The grand-averaged difference in root mean squared voltage between the original and re-digitized data was 20.8 µV per channel when re-digitization involved the same manufacturer's analog to digital converter (ADC) as the original digitization, and 28.4 µV per channel when it involved a different manufacturer's ADC. Automated diagnostic statements generated by the original versus reconstructed data did not differ when using the diagnostic algorithm from the same manufacturer on whose device the original data were collected, and differed only slightly for just 1 of 10 patients when using a third-party diagnostic algorithm throughout. Conclusion Original analog 12-lead ECG signals can be reconstructed from digital data files with accuracy sufficient for clinical use. Such reconstructions can readily enable automated second opinions for difficult-to-interpret 12-lead ECGs, either locally or remotely through the use of dedicated or cloud-based servers. PMID:23613787

  10. Accuracy of localization of acute myocardial infarction by 12 lead electrocardiography

    SciTech Connect

    Yasuda, T.; Ribeiro, L.G.; Holman, B.L.; Alpert, J.S.; Maroko, P.R.

    1982-04-01

    Until recently, ECG accuracy in localizing acute myocardial infarction (AMI) could be assessed only by comparing the ECGs with autopsy findings. This approach, however, preselected patients, including only those who died. It is possible that this postmortem group of patients would be different from the whole population of patients with AMI. Myocardial imaging with /sup 99/mTc-pyrophosphate offers the advantage of directly localizing the region of injured myocardium in the acute phase of AMI. In 34 patients with confirmed AMI and focal uptake of /sup 99/mTc-pyrophosphate, serial ECGs were obtained and interpreted by two independent observers. The sensitivity and specificity of serial ECGs in determining the location of AMI in the five left ventricular (LV) wall segments were determined: (1) in the anterior wall sensitivity was 86.7% and specificity was 89.5%; (2) in the lateral wall sensitivity was 73.7% and specificity was 80.0%; (3) in the high lateral wall sensitivity was 80.0% and specificity was 87.5%; (4) in the inferior wall sensitivity was 87.5% and specificity was 100%; (5) in the true posterior wall sensitivity was 83.3% and specificity was 86.4%. Overall, in the 170 LV wall segments (five per patient) examined, scans localized with a sensitivity of 81.9% and a specificity of 88.8%. After four patients with LBBB were excluded, sensitivity increased to 87.1%. Overall, localization of AMI by serial ECG was accurate in 85.9% of the 34 patients included in the study.

  11. Risk stratifying asymptomatic aortic stenosis: role of the resting 12-lead ECG.

    PubMed

    Greve, Anders M

    2014-02-01

    Despite being routinely performed in the clinical follow-up of asymptomatic AS patients, little or no evidence describes the prognostic value of ECG findings in asymptomatic AS populations. This PhD thesis examined the correlates of resting 12-lead ECG variables with echocardiographic measures of AS severity and cardiovascular outcomes in the till date largest cohort (n=1,563) of asymptomatic patients with mild-to-moderate AS. Most importantly, this PhD thesis demonstrated that QRS-duration adds independent predictive value of sudden cardiac death and that the additional presence of ECG LVH/strain for fixed AS severity represents a lethal risk attribute. Finally, ECG abnormalities displayed low/moderate concordance with echocardiographic parameters. This argues that the ECG should be regarded as a separate tool for obtaining prognostically important information. Treatment was not randomized by ECG findings, future studies should therefore examine if and which ECG variables should elicit closer follow-up and/or earlier intervention to improve prognosis in asymptomatic AS populations. PMID:24495893

  12. Wireless Self-Acquistion of 12-Lead ECG via Android Smart Phone

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.

    2012-01-01

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

  13. Atrial electrical activity detection using linear combination of 12-lead ECG signals.

    PubMed

    Perlman, Or; Katz, Amos; Weissman, Noam; Amit, Guy; Zigel, Yaniv

    2014-04-01

    ECG analysis is the method for cardiac arrhythmia diagnosis. During the diagnostic process many features should be taken into consideration, such as regularity and atrial activity. Since in some arrhythmias, the atrial electrical activity (AEA) waves are hidden in other waves, and a precise classification from surface ECG is inapplicable, a confirmation diagnosis is usually performed during an invasive procedure. In this paper, we study a "semiautomatic" method for AEA-waves detection using a linear combination of 12-lead ECG signals. This method's objective is to be applicable to a variety of arrhythmias with emphasis given to detect concealed AEA waves. It includes two variations--using maximum energy ratio and a synthetic AEA signal. In the former variation, an energy ratio-based cost function is created and maximized using the gradient ascent method. The latter variation adapted the linear combiner method, when applied on a synthetic signal, combined with surface ECG leads. A study was performed evaluating the AEA-waves detection from 63 patients (nine training, 54 validation) presenting eight arrhythmia types. Averaged sensitivity of 92.21% and averaged precision of 92.08% were achieved compared to the definite diagnosis. In conclusion, the presented method may lead to early and accurate detection of arrhythmias, which will result in a better oriented treatment. PMID:24658228

  14. New Padded Harness for Self-Acquisition of Resting 12-Lead ECGs

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

    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.

  15. 1.5 Tesla MRI-Conditional 12-lead ECG for MR Imaging and Intra-MR Intervention

    PubMed Central

    Tse, Zion Tsz Ho; Dumoulin, Charles L.; Clifford, Gari D.; Schweitzer, Jeff; Qin, Lei; Oster, Julien; Jerosch-Herold, Michael; Kwong, Raymond Y.; Michaud, Gregory; Stevenson, William G.; Schmidt, Ehud J.

    2013-01-01

    Propose High-fidelity 12-lead Electrocardiogram (ECG) is important for physiological monitoring of patients during MR-guided intervention and cardiac MR imaging. Issues in obtaining non-corrupted ECGs inside MRI include a superimposed Magneto-Hydro-Dynamic (MHD) voltage, gradient-switching induced-voltages, and radiofrequency (RF) heating. These problems increase with magnetic field. We intended to develop and clinically validate a 1.5T MRI-conditional 12-lead ECG system. Methods The system was constructed, including transmission-lines to reduce radio-frequency induction, and switching-circuits to remove induced voltages. Adaptive filters, trained by 12-lead measurements outside MRI and in two orientations inside MRI, were used to remove MHD. The system was tested on ten (one exercising) volunteers and four arrhythmia patients. Results Switching circuits removed most imaging-induced voltages (residual noise <3% of the R-wave). MHD removal provided intra-MRI ECGs that varied by <3.8% from those outside the MRI, preserving the true ST segment. In premature-ventricular-contraction (PVC) patients, clean ECGs separated PVC and sinus-rhythm beats. Measured heating was <1.5 C0. The system reliably acquired multiphase (SSFP) wall-motion-cine and phase-contrast-cine scans, including in subjects where 4-lead gating failed. The system required a minimum TR of 4ms to allow robust ECG processing. Conclusion High-fidelity intra-MRI 12-lead ECG is possible. PMID:23580148

  16. Data-driven estimation of cardiac electrical diffusivity from 12-lead ECG signals.

    PubMed

    Zettinig, Oliver; Mansi, Tommaso; Neumann, Dominik; Georgescu, Bogdan; Rapaka, Saikiran; Seegerer, Philipp; Kayvanpour, Elham; Sedaghat-Hamedani, Farbod; Amr, Ali; Haas, Jan; Steen, Henning; Katus, Hugo; Meder, Benjamin; Navab, Nassir; Kamen, Ali; Comaniciu, Dorin

    2014-12-01

    Diagnosis and treatment of dilated cardiomyopathy (DCM) is challenging due to a large variety of causes and disease stages. Computational models of cardiac electrophysiology (EP) can be used to improve the assessment and prognosis of DCM, plan therapies and predict their outcome, but require personalization. In this work, we present a data-driven approach to estimate the electrical diffusivity parameter of an EP model from standard 12-lead electrocardiograms (ECG). An efficient forward model based on a mono-domain, phenomenological Lattice-Boltzmann model of cardiac EP, and a boundary element-based mapping of potentials to the body surface is employed. The electrical diffusivity of myocardium, left ventricle and right ventricle endocardium is then estimated using polynomial regression which takes as input the QRS duration and electrical axis. After validating the forward model, we computed 9500 EP simulations on 19 different DCM patients in just under three seconds each to learn the regression model. Using this database, we quantify the intrinsic uncertainty of electrical diffusion for given ECG features and show in a leave-one-patient-out cross-validation that the regression method is able to predict myocardium diffusion within the uncertainty range. Finally, our approach is tested on the 19 cases using their clinical ECG. 84% of them could be personalized using our method, yielding mean prediction errors of 18.7ms for the QRS duration and 6.5° for the electrical axis, both values being within clinical acceptability. By providing an estimate of diffusion parameters from readily available clinical data, our data-driven approach could therefore constitute a first calibration step toward a more complete personalization of cardiac EP. PMID:24857832

  17. Construction and Use of Resting 12-Lead High Fidelity ECG "SuperScores" in Screening for Heart Disease

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

    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

  18. 3DQRS: A method to obtain reliable QRS complex detection within high field MRI using 12-lead ECG traces

    PubMed Central

    Gregory, T. Stan; Schmidt, Ehud J.; Zhang, Shelley Hualei; Tse, Zion Tsz Ho

    2014-01-01

    Purpose To develop a technique that accurately detects the QRS complex in 1.5T, 3T and 7T MRI scanners.” Theory and Methods During early systole, blood is rapidly ejected into the aortic arch, traveling perpendicular to the MRI’s main field, which produces a strong voltage (VMHD) that eclipses the QRS complex. Greater complexity arises in arrhythmia patients, since VMHD can vary between sinus-rhythm and arrhythmic beats. The 3DQRS method uses a kernel consisting of 6 ECG precordial leads, compiled from a 12-lead ECG performed outside the magnet. The kernel is cross-correlated with signals acquired inside the MRI in order to identify the QRS complex in real time. The 3DQRS method was evaluated against a Vectorcardiogram-based (VCG) approach in 2 Premature Ventricular Contraction (PVC) and 2 Atrial Fibrillation (AF) patients, a healthy exercising athlete and 8 healthy volunteers, within 1.5T and 3T MRIs, using a prototype MRI-conditional 12 lead ECG system. 2 volunteers were recorded at 7T using a Holter recorder. Results For QRS complex detection, 3DQRS subject-averaged sensitivity levels, relative to VCG were: 1.5T (100% vs. 96.7%), 3T (98.9% vs. 92.2%), 7T (96.2% vs. 77.7%). Conclusions The 3DQRS method was shown to be more effective in cardiac gating than a conventional VCG-based method. PMID:24453116

  19. Accuracy of advanced versus strictly conventional 12-lead ECG for detection and screening of coronary artery disease, left ventricular hypertrophy and left ventricular systolic dysfunction

    PubMed Central

    2010-01-01

    Background Resting conventional 12-lead ECG has low sensitivity for detection of coronary artery disease (CAD) and left ventricular hypertrophy (LVH) and low positive predictive value (PPV) for prediction of left ventricular systolic dysfunction (LVSD). We hypothesized that a ~5-min resting 12-lead advanced ECG test ("A-ECG") that combined results from both the advanced and conventional ECG could more accurately screen for these conditions than strictly conventional ECG. Methods Results from nearly every conventional and advanced resting ECG parameter known from the literature to have diagnostic or predictive value were first retrospectively evaluated in 418 healthy controls and 290 patients with imaging-proven CAD, LVH and/or LVSD. Each ECG parameter was examined for potential inclusion within multi-parameter A-ECG scores derived from multivariate regression models that were designed to optimally screen for disease in general or LVSD in particular. The performance of the best retrospectively-validated A-ECG scores was then compared against that of optimized pooled criteria from the strictly conventional ECG in a test set of 315 additional individuals. Results Compared to optimized pooled criteria from the strictly conventional ECG, a 7-parameter A-ECG score validated in the training set increased the sensitivity of resting ECG for identifying disease in the test set from 78% (72-84%) to 92% (88-96%) (P < 0.0001) while also increasing specificity from 85% (77-91%) to 94% (88-98%) (P < 0.05). In diseased patients, another 5-parameter A-ECG score increased the PPV of ECG for LVSD from 53% (41-65%) to 92% (78-98%) (P < 0.0001) without compromising related negative predictive value. Conclusion Resting 12-lead A-ECG scoring is more accurate than strictly conventional ECG in screening for CAD, LVH and LVSD. PMID:20565702

  20. The Normal Electrocardiogram: Resting 12-Lead and Electrocardiogram Monitoring in the Hospital.

    PubMed

    Harris, Patricia R E

    2016-09-01

    The electrocardiogram (ECG) is a well-established diagnostic tool extensively used in clinical settings. Knowledge of cardiac rhythm and mastery of cardiac waveform interpretation are fundamental for intensive care nurses. Recognition of the normal findings for the 12-lead ECG and understanding the significance of changes from baseline in continuous cardiac monitoring are essential steps toward ensuring safe patient care. This article highlights historical developments in electrocardiography, describes the normal resting 12-lead ECG, and discusses the need for continuous cardiac monitoring. In addition, future directions for the ECG are explored briefly. PMID:27484657

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

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

    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. Improving Use of Prehospital 12-Lead Electrocardiography for Early Identification and Treatment of Acute Coronary Syndrome and ST-Elevation Myocardial Infarction

    PubMed Central

    Daudelin, Denise H.; Sayah, Assaad J.; Kwong, Manlik; Restuccia, Marc C.; Porcaro, William A.; Ruthazer, Robin; Goetz, Jessica D.; Lane, William M.; Beshansky, Joni R.; Selker, Harry P.

    2010-01-01

    Background Performance of Prehospital electrocardiograms (PH-ECGs) expedites identification of ST-elevation myocardial infarction (STEMI) and reduces door-to-balloon (D2B) times for patients receiving reperfusion therapy. To fully realize this benefit, emergency medical service (EMS) performance must be measured and used in feedback reporting and quality improvement (QI). Methods and Results This quasi-experimental design trial tested an approach to improving EMS PH-ECG using feedback reporting and QI interventions in two cities' EMS agencies and receiving hospitals. All patients ≥ 30 years, calling 9-1-1 with possible acute coronary syndrome (ACS) were included. In total 6,994 patients were included: 1,589 patients in the baseline period without feedback and 5,405 in the intervention period when there were feedback reports and QI interventions. Mean age (SD) was 66 (±17) and women represented 51%. Feedback and QI increased PH-ECG performance for patients with ACS from 76% to 93% (p=<.0001) and for patients with STEMI from 77% to 99% (p= <.0001). Aspirin administration increased from 75% to 82% (p=0.001) but the median total EMS run time remained the same at 22 minutes. The proportion of patients with D2B times of ≤90 minutes increased from 27% to 67% (p=0.006). Conclusion Feedback reports and QI improved PH-ECG performance for patients with ACS and STEMI and increased aspirin administration, without prehospital transport delays. Improvements in D2B times were also seen. PMID:20484201

  3. Technology-based vs. traditional instruction. A comparison of two methods for teaching the skill of performing a 12-lead ECG.

    PubMed

    Jeffries, Pamela R; Woolf, Shirley; Linde, Beverly

    2003-01-01

    The purpose of this study was to compare the effectiveness of an interactive, multimedia CD-ROM with traditional methods of teaching the skill of performing a 12-lead ECG. A randomized pre/posttest experimental design was used. Seventy-seven baccalaureate nursing students in a required, senior-level critical-care course at a large midwestern university were recruited for the study. Two teaching methods were compared. The traditional method included a self-study module, a brief lecture and demonstration by an instructor, and hands-on experience using a plastic manikin and a real 12-lead ECG machine in the learning laboratory. The second method covered the same content using an interactive, multimedia CD-ROM embedded with virtual reality and supplemented with a self-study module. There were no significant (p < .05) baseline differences in pretest scores between the two groups and no significant differences by group in cognitive gains, student satisfaction with their learning method, or perception of self-efficacy in performing the skill. Overall results indicated that both groups were satisfied with their instructional method and were similar in their ability to demonstrate the skill correctly on a live, simulated patient. This evaluation study is a beginning step to assess new and potentially more cost-effective teaching methods and their effects on student learning outcomes and behaviors, including the transfer of skill acquisition via a computer simulation to a real patient. PMID:12743975

  4. Left-ventricular mechanical activation and aortic-arch orientation recovered from Magneto-hydrodynamic Voltages observed in 12-lead ECGs obtained inside MRIs: A Feasibility Study

    PubMed Central

    Gregory, T. Stan; Schmidt, Ehud J.; Zhang, Shelley Hualei; Kwong, Raymond Y.; Stevenson, William G.; Murrow, Jonathan R.; Ho Tse, Zion Tsz

    2014-01-01

    Purpose To explore use of the Magnetohydrodynamic Voltage (VMHD), observed in intra-MRI 12-lead Electrocardiograms (ECG), to indicate the timing of the onset of left-ventricular mechanical activation (LVMA) and the orientation of the aortic-arch (AAO). Theory Blood flow through the aortic arch during systole, in the presence of the MRI magnetic field (B0), generates VMHD. Since the magnitude and direction of VMHD are determined by the timing and directionality of blood flow relative to B0, we hypothesized that clinically useful measures, LVMA and AAO, could be extracted from temporal and vectorial VMHD characteristics. Methods VMHD signals were extracted from 12-lead ECG traces by comparing traces obtained inside and outside the MRI scanner. VMHD was converted into the Vectorcardiogram frame of reference. LVMA was quantified in 1 subject at 1.5T and 3 subjects at 3T, and the result compared to CINE MRI. AAO was inferred for 4 subjects at 3T and compared to anatomical imaging of the aortic arch orientation in the transverse plane. Results and Conclusions A <10% error was observed in LVMA measurements, while a <3° error was observed in aortic arch orientation measurements. The temporal and vectorial nature of VMHD is useful in estimating these clinically relevant parameters. PMID:25224074

  5. Electrocardiography Patterns and the Role of the Electrocardiography Score for Risk Stratification in Acute Pulmonary Embolism

    PubMed Central

    Ryu, Hyeon Min; Lee, Ju Hwan; Kwon, Yong Seop; Lee, Sang Hyuk; Bae, Myung Hwan; Lee, Jang Hoon; Yang, Dong Heon; Park, Hun Sik; Chae, Shung Chull; Jun, Jae-Eun; Park, Wee-Hyun

    2010-01-01

    Background and Objectives Data on the usefulness of a combination of different electrocardiography (ECG) abnormalities in risk stratification of patients with acute pulmonary embolism (PE) are limited. We thus investigated 12-lead ECG patterns in acute PE to evaluate the role of the ECG score in risk stratification of patients with acute PE. Subjects and Methods One hundred twenty-five consecutive patients (63±14 years, 56 men) with acute PE who were admitted to Kyungpook National University Hospital between November 2001 and January 2008 were included. We analyzed ECG patterns and calculated the ECG score in all patients. We evaluated right ventricular systolic pressure (RVSP) (n=75) and RV hypokinesia (n=80) using echocardiography for risk stratification of acute PE patients. Results Among several ECG findings, sinus tachycardia and inverted T waves in V1-4 (39%) were observed most frequently. The mean ECG score and RVSP were 7.36±6.32 and 49±21 mmHg, respectively. The ECG score correlated with RVSP (r=0.277, p=0.016). The patients were divided into two groups {high ECG-score group (n=38): ECG score >12 and low ECG-score group (n=87): ECG score ≤12} based on the ECG score, with the maximum area under the curve. RV hypokinesia was observed more frequently in the high ECG-score group than in the low ECG-score group (p=0.006). Multivariate analysis revealed that a high ECG score was an independent predictor of high RVSP and RV hypokinesia. Conclusion Sinus tachycardia and inverted T waves in V1-4 were commonly observed in acute PE. Moreover, the ECG score is a useful tool in risk stratification of patients with acute PE. PMID:21088753

  6. Eyewitness to history: Landmarks in the development of computerized electrocardiography.

    PubMed

    Rautaharju, Pentti M

    2016-01-01

    The use of digital computers for ECG processing was pioneered in the early 1960s by two immigrants to the US, Hubert Pipberger, who initiated a collaborative VA project to collect an ECG-independent Frank lead data base, and Cesar Caceres at NIH who selected for his ECAN program standard 12-lead ECGs processed as single leads. Ray Bonner in the early 1970s placed his IBM 5880 program in a cart to print ECGs with interpretation, and computer-ECG programs were developed by Telemed, Marquette, HP-Philips and Mortara. The "Common Standards for quantitative Electrocardiography (CSE)" directed by Jos Willems evaluated nine ECG programs and eight cardiologists in clinically-defined categories. The total accuracy by a representative "average" cardiologist (75.5%) was 5.8% higher than that of the average program (69.7, p<0.001). Future comparisons of computer-based and expert reader performance are likely to show evolving results with continuing improvement of computer-ECG algorithms and changing expertise of ECG interpreters. PMID:26620728

  7. Common standards for quantitative electrocardiography: goals and main results. CSE Working Party.

    PubMed

    Willems, J L; Arnaud, P; van Bemmel, J H; Degani, R; Macfarlane, P W; Zywietz, C

    1990-09-01

    Computer processing of electrocardiograms (ECGs) has over the last 15 years increased rapidly. Still, there are at present no standards for computer ECG interpretation. Different techniques are used not only for measurement and interpretation, but also for transmission and storage of data. In order to fill these gaps, a large international project, sponsored by the European Commission, was launched in 1980 to develop "Common Standards for Quantitative Electrocardiography (CSE)". The main objective of the first CSE study was to reduce the wide variation in wave measurements currently obtained by ECG computer programs. The second study was started in 1985 and aimed at the assessment and improvement of diagnostic classification of ECG interpretation programs. To this end reference libraries of well documented ECGs have been developed and comprehensive reviewing schemes devised for the visual and computer analysis of ECGs. This task was performed by a board of cardiologists in a Delphi review process, and by 9 VCG and 10 standard 12-lead programs developed by university research groups and by industry. A third action was started in June 1989 to harmonize acquisition, encoding, interchange and storing of digital ECG data. The action thus performed have become internationally recognized milestones for the standardization of quantitative electrocardiography. PMID:2233372

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

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Cortez, Daniel

    2010-01-01

    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.

  9. History of precordial leads in electrocardiography.

    PubMed

    Burch, G E

    1978-09-01

    Precordial leads were first used by Waller, whose capillary electroscope was too insensitive to detect the electric forces emanating from the human heart unless the electrode was placed over the precordium as near to the heart as possible. When Einthoven developed the elegant, reliable and sensitive string galvanometer, he could record the electric forces of the heart from the hands and feet of the subject without even undressing him. When Einthoven's great galvanometer became available, only the three standard limb leads were used. Thomas Lewis and others experimented with precordial direct leads and made many important discoveries in electrocardiography and cardiology. Wolferth and Wood, in 1932, introduced the first precordial lead in clinical, diagnostic cardiology. The recordings were 'upside-down', i.e. positive deflections were down and negative ones up. They called this the 4th lead (lead IV). The precordial electrode was placed on the chest over the apex of the heart, regardless of where the apex was located. This immediately opened new avenues of study in infarction, ventricular hypertrophy, bundle branch block, and all other cardiac states. Then CL, CR, CF, CB and V leads were introduced. The points considered best for placing the 'exploring' or precordial electrode became an issue, and much confusion prevailed until Wilson and his associates developed the central or isopotential terminal and until the American Heart Association and the Heart Society of Britain and Ireland met in London and published the standards for recording precordial leads in 1938. There followed, for obvious reasons, a slow settling of the confusion until the V1 through V6 precordial leads became standard procedure all over the world, as exists today. Goldberger introduced the augmented unipolar limb leads (aVR, aVL and aVF) which have resulted in the standard 12-lead electrocardiogram of routine use today. No one would consider an electrocardiographic evaluation adequate in a

  10. The impact of computers on electrocardiography.

    PubMed

    Rautaharju, P M

    1978-09-01

    The development of the electrocardiograph was the culmination of a scientific effort aimed at perfection of a device conceived for the elucidation of a physiologic phenomenon. The development of the digital computer was the culmination of a scientific effort aimed at perfection of warfare. Both of these fairly recent innovations of modern technology have been moderately successful in their initial objectives. Electrocardiography has had a profound influence on the practice of medicine. On the global scene, computers have so far had an insignificant influence on the practice of electrocardiography. In North America, however, computer interpretation of ECGs has already made a modest impact, perhaps more in terms of commercial gains rather than producing a substantial benefits to health care. The introduction of computers into clinical electrocardiography has not resulted in any widespread application of improved diagnostic criteria. The automation of ECG interpretation has not resulted in reduction of the cost of health care, on the contrary, in general it has increased the cost. Perhaps the most dismal failure has been the negligible use of computers in epidemiologic studies and heart disease prevention efforts. Palmistry, astrology, the art of palpation of the pulse, auscultation and acupuncture have had a more profound influence on the practice of medicine than computer analysis of the electrocardiogram. On the positive side, one of the beneficial effects of the use of computers has been the increasing awareness of the limited diagnostic accuracy of currently used ECG criteria, and the recognition of the fact that a substantial improvement is warranted; if such improvement can not be achieved in the foreseeable future, electrocardiography will lose much of its current clinical utility. Computers have had a profound influence on research in electrocardiology, and although a very few tangible concrete results have thus far diffused into clinical electrocardiography

  11. Single Doses up to 800 mg of E-52862 Do Not Prolong the QTc Interval – A Retrospective Validation by Pharmacokinetic-Pharmacodynamic Modelling of Electrocardiography Data Utilising the Effects of a Meal on QTc to Demonstrate ECG Assay Sensitivity

    PubMed Central

    Täubel, Jörg; Ferber, Georg; Lorch, Ulrike; Wang, Duolao; Sust, Mariano; Camm, A. John

    2015-01-01

    Background E-52862 is a Sigma-1 receptor antagonist (S1RA) currently under investigation as a potential analgesic medicine. We successfully applied a concentration-effect model retrospectively to a four-way crossover Phase I single ascending dose study and utilized the QTc shortening effects of a meal to demonstrate assay sensitivity by establishing the time course effects from baseline in all four periods, independently from any potential drug effects. Methods Thirty two healthy male and female subjects were included in four treatment periods to receive single ascending doses of 500 mg, 600 mg or 800 mg of E-52862 or placebo. PK was linear over the dose range investigated and doses up to 600 mg were well tolerated. The baseline electrocardiography (ECG) measurements on Day-1 were time-matched with ECG and pharmacokinetic (PK) samples on Day 1 (dosing day). Results In this conventional mean change to time-matched placebo analysis, the largest time-matched difference to placebo QTcI was 1.44 ms (90% CI: -4.04, 6.93 ms) for 500 mg; -0.39 ms (90% CI: -3.91, 3.13 ms) for 600 mg and 1.32 ms (90% CI: -1.89, 4.53 ms) for 800 mg of E-52862, thereby showing the absence of any QTc prolonging effect at the doses tested. In addition concentration-effect models, one based on the placebo corrected change from baseline and one for the change of QTcI from average baseline with time as fixed effect were fitted to the data confirming the results of the time course analysis. Conclusion The sensitivity of this study to detect small changes in the QTc interval was confirmed by demonstrating a shortening of QTcF of -8.1 (90% CI: -10.4, -5.9) one hour and -7.2 (90% CI: -9.4, -5.0) three hours after a standardised meal. Trial Registration EU Clinical Trials Register EudraCT 2010 020343 13 PMID:26291080

  12. Comparing twelve-lead electrocardiography with close-to-heart patch based electrocardiography.

    PubMed

    Hansen, Ingeborg H; Hoppe, Karsten; Gjerde, Anna; Kanters, Joergen K; Sorensen, Helge B D

    2015-01-01

    Electrocardiographic (ECG) recording using adhesive patch-type ECG monitors (PEMs) has several advantages over conventional ECG recorders. However, due to the unconventional electrode locations used in PEM systems, the morphology of the acquired ECG signals may differ from conventional ECG leads used in the clinic impeding clinical interpretation. In this study, recordings from an ePatch® lead system involving three torso sites are compared with concurrently recorded standard 12-lead ECG. Pearson's correlation coefficients (CC) of -0.90 and 0.91 is found between two of the PEM signals and the standard 12-lead ECG signals aVR and V2, respectively. Deriving the 12-lead ECG from the PEM leads through linear transforms on a subject-specific basis yield CC values ranging from 0.78 to 0.96 between measured and derived leads. The corresponding CC values for the PEM ECG leads range from 0.88 to 0.95. It is found that the PEM lead system captures "residual" information not contained in the standard 12-lead ECG and i.a. a negative deflection after the T-wave is discovered in the PEM signals. PMID:26736266

  13. Assessment of electrocardiography, echocardiography, and heart rate variability in dynamic and static type athletes

    PubMed Central

    Toufan, Mehrnoush; Kazemi, Babak; Akbarzadeh, Fariborz; Ataei, Amin; Khalili, Majid

    2012-01-01

    Background: Over the last two decades, morphological cardiac changes induced by athletic conditioning have been of great interest. Therefore, several studies have been orchestrated to delineate electrocardiography (ECG), echocardiography, and heart rate variability (HRV) findings in athletes. Purpose: To assess the ECG, echocardiography, and HRV in a group of dynamic and static type athletes. Methods: Fifty professional athletes (20 static and 30 dynamic exercise athletes) and 50 healthy nonathletes (control group) were recruited. Standard 12-lead ECG and transthoracic echocardiography was performed on all athletes and the control group. Through echocardiography, variables including left ventricular (LV) end-diastolic/systolic diameter, LV mass, and left atrial volume index were measured. In addition, both the athletes and the control group underwent ECG Holter monitoring for 15 minutes and several parameters related to HRV (time and frequency domain) were recorded. Results: The most common ECG abnormalities among the athletes were sinus bradycardia and incomplete right bundle branch block. LV end-diastolic diameter and left atrial volume index were significantly greater in the dynamic athletes (P < 0.001). LV end-systolic diameter was significantly lower in the static group (P < 0.001). LV mass of the dynamic and static athletes was significantly greater than that of the controls (P < 0.001). Among the ECG Holter monitoring findings, the dynamic athletes had lower systolic blood pressure than the controls (P = 0.01). Heart rate was lowest in the control group (P < 0.001). Conclusion: The most common ECG abnormalities among adolescent Iranian athletes were sinus bradycardia and incomplete right bundle branch block. Static exercise seemed to reduce LV end-systolic diameter, while dynamic exercise resulted in increased LV end-diastolic diameter and left atrial volume index. Additionally, Iranian athletes showed no differences in HRV parameters, excluding heart rate

  14. Direct and Inverse problems in Electrocardiography

    NASA Astrophysics Data System (ADS)

    Boulakia, M.; Fernández, M. A.; Gerbeau, J. F.; Zemzemi, N.

    2008-09-01

    We present numerical results related to the direct and the inverse problems in electrocardiography. The electrical activity of the heart is described by the bidomain equations. The electrocardiograms (ECGs) recorded in different points on the body surface are obtained by coupling the bidomain equation to a Laplace equation in the torso. The simulated ECGs are quite satisfactory. As regards the inverse problem, our goal is to estimate the parameters of the bidomain-torso model. Here we present some preliminary results of a parameter estimation for the torso model.

  15. ECG-ELECTRODE INDUCED HYPOPIGMENTATION.

    PubMed

    Tripi, Paul A; Parthasarathy, Supraja N; Honda, Kord

    2016-06-01

    Skin reactions following the application of electrocardiography (ECG) electrodes have been reported in adults and children, and are postulated to result from contact with the conductive gel or adhesive used on the electrodes. Although contact dermatitis is the usual cause of such reactions, contact depigmentation or hypopigmentation may also occur. We report a case of hypopigmentation in a healthy boy following continuous electrocardiography monitoring during general anesthesia for dental rehabilitation. PMID:27487645

  16. Wavelet transform in electrocardiography--data compression.

    PubMed

    Provazník, I; Kozumplík, J

    1997-06-01

    An application of the wavelet transform to electrocardiography is described in the paper. The transform is used as a first stage of a lossy compression algorithm for efficient coding of rest ECG signals. The proposed technique is based on the decomposition of the ECG signal into a set of basic functions covering the time-frequency domain. Thus, non-stationary character of ECG data is considered. Some of the time-frequency signal components are removed because of their low influence to signal characteristics. Resulting components are efficiently coded by quantization, composition into a sequence of coefficients and compression by a run-length coder and a entropic Huffman coder. The proposed wavelet-based compression algorithm can compress data to average code length about 1 bit/sample. The algorithm can be also implemented to a real-time processing system when wavelet transform is computed by fast linear filters described in the paper. PMID:9291025

  17. Historical aspects of electrocardiography.

    PubMed

    Krikler, D M

    1987-08-01

    One hundred years ago, Augustus Desiré Waller recorded the human electrocardiogram for the first time, using a capillary electrometer. Electrocardiography only became clinically relevant in 1901 when Willem Einthoven devised his string galvanometer for this purpose. Sir Thomas Lewis was the key figure in showing the value of the electrocardiography for the diagnosis of disorders of cardiac rhythm and conduction, but many others amplified the technique to encompass the assessment of structural heart disease, especially when due to ischemia. Knowledge of their role and work gives us a better perspective when considering the development of surface electrocardiography. PMID:3319160

  18. Clinical Application of Electrocardiography.

    ERIC Educational Resources Information Center

    Brammell, H. L.; Orr, William

    The scalar electrocardiogram (ECG) is one of the most important and commonly used clinical tools in medicine. A detailed description of the recordings of cardiac electrical activity made by the ECG is presented, and the vast numbers of uses made with the data provided by this diagnostic tool are cited. Clinical applications of the ECG are listed.…

  19. Comparative study of thallium-201 single-photon emission computed tomography and electrocardiography in Duchenne and other types of muscular dystrophy

    SciTech Connect

    Yamamoto, S.; Matsushima, H.; Suzuki, A.; Sotobata, I.; Indo, T.; Matsuoka, Y.

    1988-04-01

    Single-photon emission computed tomography (SPECT) using thallium-201 was compared with 12-lead electrocardiography (ECG) in patients with Duchenne (29), facioscapulohumeral (7), limb-girdle (6) and myotonic (5) dystrophies, by dividing the left ventricular (LV) wall into 5 segments. SPECT showed thallium defects (37 patients, mostly in the posteroapical wall), malrotation (23), apical aneurysm (5) and dilatation (7). ECG showed abnormal QRS (36 patients), particularly as a posterolateral pattern (13). Both methods of assessment were normal in only 7 patients. The Duchenne type frequently showed both a thallium defect (particularly in the posteroapical wall) and an abnormal QRS (predominantly in the posterolateral wall); the 3 other types showed abnormalities over the 5 LV wall segments in both tests. The percent of agreement between the 2 tests was 64, 66, 70, 72 and 72 for the lateral, apical, anteroseptal, posterior and inferior walls, respectively. The 2 tests were discordant in 31% of the LV wall, with SPECT (+) but ECG (-) in 21% (mostly in the apicoinferior wall) and SPECT (-) but ECG (+) in 10% (mostly in the lateral wall). Some patients showed large SPECT hypoperfusion despite minimal electrocardiographic changes. ECG thus appeared to underestimate LV fibrosis and to reflect posteroapical rather than posterolateral dystrophy in its posterolateral QRS pattern. In this disease, extensive SPECT hypoperfusion was also shown, irrespective of clinical subtype and skeletal involvement.

  20. Non-contact ECG monitoring

    NASA Astrophysics Data System (ADS)

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

    2016-03-01

    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.

  1. Advanced Electrocardiography Can Identify Occult Cardiomyopathy in Doberman Pinschers

    NASA Technical Reports Server (NTRS)

    Spiljak, M.; Petric, A. Domanjko; Wilberg, M.; Olsen, L. H.; Stepancic, A.; Schlegel, T. T.; Starc, V.

    2011-01-01

    Recently, multiple advanced resting electrocardiographic (A-ECG) techniques have improved the diagnostic value of short-duration ECG in detection of dilated cardiomyopathy (DCM) in humans. This study investigated whether 12-lead A-ECG recordings could accurately identify the occult phase of DCM in dogs. Short-duration (3-5 min) high-fidelity 12-lead ECG recordings were obtained from 31 privately-owned, clinically healthy Doberman Pinschers (5.4 +/- 1.7 years, 11/20 males/females). Dogs were divided into 2 groups: 1) 19 healthy dogs with normal echocardiographic M-mode measurements: left ventricular internal diameter in diastole (LVIDd . 47mm) and in systole (LVIDs . 38mm) and normal 24-hour ECG recordings (<50 ventricular premature complexes, VPCs); and 2) 12 dogs with occult DCM: 11/12 dogs had increased M-mode measurements (LVIDd . 49mm and/or LVIDs . 40mm) and 5/11 dogs had also >100 VPCs/24h; 1/12 dogs had only abnormal 24-hour ECG recordings (>100 VPCs/24h). ECG recordings were evaluated via custom software programs to calculate multiple parameters of high-frequency (HF) QRS ECG, heart rate variability, QT variability, waveform complexity and 3-D ECG. Student's t-tests determined 19 ECG parameters that were significantly different (P < 0.05) between groups. Principal component factor analysis identified a 5-factor model with 81.4% explained variance. QRS dipolar and non-dipolar voltages, Cornell voltage criteria and QRS waveform residuum were increased significantly (P < 0.05), whereas mean HF QRS amplitude was decreased significantly (P < 0.05) in dogs with occult DCM. For the 5 selected parameters the prediction of occult DCM was performed using a binary logistic regression model with Chi-square tested significance (P < 0.01). ROC analyses showed that the five selected ECG parameters could identify occult ECG with sensitivity 89% and specificity 83%. Results suggest that 12-lead A-ECG might improve diagnostic value of short-duration ECG in earlier detection

  2. An optimized lead system for long-term esophageal electrocardiography.

    PubMed

    Niederhauser, T; Haeberlin, A; Marisa, T; Mattle, D; Abächerli, R; Goette, J; Jacomet, M; Vogel, R

    2014-04-01

    Long-term electrocardiography (ECG) featuring adequate atrial and ventricular signal quality is highly desirable. Routinely used surface leads are limited in atrial signal sensitivity and recording capability impeding complete ECG delineation, i.e. in the presence of supraventricular arrhythmias. Long-term esophageal ECG might overcome these limitations but requires a dedicated lead system and recorder design. To this end, we analysed multiple-lead esophageal ECGs with respect to signal quality by describing the ECG waves as a function of the insertion level, interelectrode distance, electrode shape and amplifier's input range. The results derived from clinical data show that two bipolar esophageal leads, an atrial lead with short (15 mm) interelectrode distance and a ventricular lead with long (80 mm) interelectrode distance provide non-inferior ventricular signal strength and superior atrial signal strength compared to standard surface lead II. High atrial signal slope in particular is observed with the atrial esophageal lead. The proposed esophageal lead system in combination with an increased recorder input range of ±20 mV minimizes signal loss due to excessive electrode motion typically observed in esophageal ECGs. The design proposal might help to standardize long-term esophageal ECG registrations and facilitate novel ECG classification systems based on the independent detection of ventricular and atrial electrical activity. PMID:24577330

  3. Training and competency evaluation for interpretation of 12-lead electrocardiograms: recommendations from the American College of Physicians.

    PubMed

    Salerno, Stephen M; Alguire, Patrick C; Waxman, Herbert S

    2003-05-01

    This paper is part 1 of a 2-part series on interpretation of 12-lead resting electrocardiograms (ECGs). Part 1 is a position paper that presents recommendations for initial competency, competency assessment, and maintenance of competency on ECG interpretation, as well as recommendations for the role of computer-assisted ECG interpretation. Part 2 is a systematic review of detailed supporting evidence for the recommendations. Despite several earlier consensus-based recommendations on ECG interpretation, substantive evidence on the training needed to obtain and maintain ECG interpretation skills is not available. Some studies show that noncardiologist physicians have more ECG interpretation errors than do cardiologists, but the rate of adverse patient outcomes from ECG interpretation errors is low. Computers may decrease the time needed to interpret ECGs and can reduce ECG interpretation errors. However, they have shown less accuracy than physician interpreters and must be relied on only as an adjunct interpretation tool for a trained provider. Interpretation of ECGs varies greatly, even among expert electrocardiographers. Noncardiologists seem to be more influenced by patient history in interpreting ECGs than are cardiologists. Cardiologists also perform better than other specialists on standardized ECG examinations when minimal patient history is provided. Pending more definitive research, residency training in internal medicine with Advanced Cardiac Life Support instruction should continue to be sufficient for bedside interpretation of resting 12-lead ECGs in routine and emergency situations. Additional experience or training in ECG interpretation when the patient's clinical condition is unknown may be useful but requires further study. PMID:12729430

  4. 12-lead electrocardiogram features of arrhythmic risk: A focus on early repolarization

    PubMed Central

    Rizzo, Caterina; Monitillo, Francesco; Iacoviello, Massimo

    2016-01-01

    The 12-lead electrocardiogram (ECG) is still the most used tool in cardiology clinical practice. Considering its easy accessibility, low cost and the information that it provides, it remains the starting point for diagnosis and prognosis. More specifically, its ability to detect prognostic markers for sudden cardiac death due to arrhythmias by identifying specific patterns that express electrical disturbances of the heart muscle, which may predispose to malignant arrhythmias, is universally recognized. Alterations in the ventricular repolarization process, identifiable on a 12-lead ECG, play a role in the genesis of ventricular arrhythmias in different cardiac diseases. The aim of this paper is to focus the attention on a new marker of arrhythmic risk, the early repolarization pattern in order to highlight the prognostic role of the 12-lead ECG.

  5. 12-lead electrocardiogram features of arrhythmic risk: A focus on early repolarization.

    PubMed

    Rizzo, Caterina; Monitillo, Francesco; Iacoviello, Massimo

    2016-08-26

    The 12-lead electrocardiogram (ECG) is still the most used tool in cardiology clinical practice. Considering its easy accessibility, low cost and the information that it provides, it remains the starting point for diagnosis and prognosis. More specifically, its ability to detect prognostic markers for sudden cardiac death due to arrhythmias by identifying specific patterns that express electrical disturbances of the heart muscle, which may predispose to malignant arrhythmias, is universally recognized. Alterations in the ventricular repolarization process, identifiable on a 12-lead ECG, play a role in the genesis of ventricular arrhythmias in different cardiac diseases. The aim of this paper is to focus the attention on a new marker of arrhythmic risk, the early repolarization pattern in order to highlight the prognostic role of the 12-lead ECG. PMID:27621772

  6. A WBAN based cableless ECG acquisition system.

    PubMed

    Pan, Rui; Chua, Dingjuan; Pathmasuntharam, Jaya Shankar; Xu, Yong Ping

    2014-01-01

    A Wireless Body Area Network (WBAN) based 3-lead cableless electrocardiography (ECG) acquisition system is described. To enable truly cableless ECG monitoring, a new ECG measurement configuration and method that acquires ECG signals at individual lead locations referenced to a localized ground is proposed. The synthesized ECG signals are evaluated against the standard wired 3-lead configuration on the same test subject. Average Pearson correlation coefficients of 0.82, 0.95 and 0.86 have been achieved for Lead I, II and III signals respectively, demonstrating a high degree of similarity in the synthesized signals. Measurements are obtained via a custom wireless network platform utilizing a TDMA-based MAC protocol supporting the star topology and a proprietary front-end ECG acquisition system. PMID:25570107

  7. Electrocardiographic (ECG) criteria for determining left ventricular mass in young healthy men; data from the LARGE Heart study

    PubMed Central

    Sohaib, Syed M Afzal; Payne, John R; Shukla, Rajeev; World, Michael; Pennell, Dudley J; Montgomery, Hugh E

    2009-01-01

    Background Doubts remain over the use of the ECG in identifying those with increased left ventricular (LV) mass. This is especially so in young individuals, despite their high prevalence of ECG criteria for LV hypertrophy. We performed a study using cardiovascular magnetic resonance (CMR), which provides an in vivo non-invasive gold standard method of measuring LV mass, allowing accurate assessment of electrocardiography as a tool for defining LV hypertrophy in the young. Methods and results Standard 12-lead ECGs were obtained from 101 Caucasian male army recruits aged (mean ± SEM) 19.7 ± 0.2 years. LV mass was measured using CMR. LV mass indexed to body surface area demonstrated no significant correlation with the Cornell Amplitude criteria or Cornell Product for LV hypertrophy. Moderate correlations were seen with the Sokolow-Lyon Amplitude (0.28) and Sokolow-Lyon Product (0.284). Defining LV hypertrophy as a body surface area indexed left ventricular mass of 93 g/m2, calculated sensitivities [and specificities] were as follows; 38.7% [74.3%] for the Sokolow-Lyon criteria, 43.4% [61.4%] for the Sokolow-Lyon Product, 19.4% [91.4%] for Cornell Amplitude, and 22.6% [85.7%] for Cornell Product. These values are substantially less than those reported for older age groups. Conclusion ECG criteria for LV hypertrophy may have little value in determining LV mass or the presence of LV hypertrophy in young fit males. PMID:19149884

  8. Comparison of magnetocardiography and electrocardiography

    NASA Astrophysics Data System (ADS)

    Ho, S. C.; Ho, F. P.; Tien, C. C.; Wilkin, J. H.; Miller, J. W.

    1986-02-01

    The paper compares the MCG and ECG of two abnormal subjects. For the case of complete left bundle branch block, the MCG and ECG have similar morphology, but different signal strengths. For the case of dilated cardiomyopathy, the magnetic QRS complex divides into peaks R and R', not found in ECG.

  9. Screening for Coronary Heart Disease with Electrocardiography

    MedlinePlus

    ... Force Recommendations Screening for Coronary Heart Disease with Electrocardiography The U.S. Preventive Services Task Force (Task Force) ... recommendations on Screening for Coronary Heart Disease with Electrocardiography . These recommendations are for adult men and women ...

  10. History of research in Japan on electrocardiography in the racehorse

    PubMed Central

    HIRAGA, Atsushi; SUGANO, Shigeru

    2015-01-01

    ABSTRACT Since the first recording of electrocardiograms (ECGs) of a horse in Japan was carried out in 1944, studies on ECGs have been performed intensively. During the early stages of research from the 1950s to 1960s, leads to use for ECG recording were evaluated using several different approaches including unipolar leads, bipolar limb leads, and bipolar chest leads. Based on these studies, the AB lead, which is oriented along the long axis of the heart, became the standard reference method in Japan. Electrodes of the AB lead are placed on the upper 1/4th point along a straight line between the withers and the left shoulder blade (base: B), and 10 cm posterior to the left olecranon (apex: A). The incidence of equine arrhythmias among racehorses has been surveyed, and details of the electrocardiographic characteristics of several arrhythmias have been investigated. In particular, atrial fibrillation (AF) has been extensively studied, and papers have reported findings such as that paroxysmal AF occurs during racing and described electrocardiographic changes that occur at the onset of AF during exercise. Development of a radiotelemetry system for ECG recording enabled the first recording of equine ECGs during galloping in 1964, the detection of arrhythmias, and calculation of heart rate during exercise. Studies on comparative and developmental changes of ECGs have described characteristics of the equine ECGs. Future research on changes in cardiac function, including autonomic function, that occur with aging may lead to new developments in equine electrocardiography and contribute to improving the health and welfare of the horse. PMID:25829865

  11. Use of computers in clinical electrocardiography: an evaluation.

    PubMed Central

    Wolf, H. K.; Gregor, R. D.; Chandler, B. M.

    1977-01-01

    The use of computers in clinical electrocardiography is increasing rapidly; however, the role of computers with respect to the electrocardiographer has not been established. At present all electrocardiograms (ECGs) processed by computer are also interpreted by electrocardiographers; hense effort is duplicated. In an investigation of whether conditions can be defined under which the electrocardiographer can use the computer more profitably by eliminating some of the duplication, ECGs recorded in a university teaching hospital were processed by a computer program and subsequently reviewed by 1 of 10 electrocardiographers. For ECGs interpreted as showing normal sinus rhythm the rate of agreement between computer and human reviewer was 99%. For those showing a normal ECG pattern (contour) the rate of direct agreement was only 88%. However, the rate of occurrence of clinically significant differences was only 1.64%; hence the rate of essential agreement for this classification was 98.36%. Other classifications with good agreement were myocardial infarction, sinus bradycardia and sinus tachycardia. Therefore, in circumstances comparable to those of this investigation it is feasible for electrocardiographers to use computers to reduce greatly their workload without compromising the quality of the service provided. PMID:334353

  12. Interactive Videoconference Supported Teaching in Undergraduate Nursing: A Case Study for ECG

    ERIC Educational Resources Information Center

    Celikkan, Ufuk; Senuzun, Fisun; Sari, Dilek; Sahin, Yasar Guneri

    2013-01-01

    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…

  13. Secure chaotic transmission of electrocardiography signals with acousto-optic modulation under profiled beam propagation.

    PubMed

    Almehmadi, Fares S; Chatterjee, Monish R

    2015-01-10

    Electrocardiography (ECG) signals are used for both medical purposes and identifying individuals. It is often necessary to encrypt this highly sensitive information before it is transmitted over any channel. A closed-loop acousto-optic hybrid device acting as a chaotic modulator is applied to ECG signals to achieve this encryption. Recently improved modeling of this approach using profiled optical beams has shown it to be very sensitive to key parameters that characterize the encryption and decryption process, exhibiting its potential for secure transmission of analog and digital signals. Here the encryption and decryption is demonstrated for ECG signals, both analog and digital versions, illustrating strong encryption without significant distortion. Performance analysis pertinent to both analog and digital transmission of the ECG waveform is also carried out using output signal-to-noise, signal-to-distortion, and bit-error-rate measures relative to the key parameters and presence of channel noise in the system. PMID:25967617

  14. Hybrid Thermoelectric-Photovoltaic Generators in Wireless Electroencephalography Diadem and Electrocardiography Shirt

    NASA Astrophysics Data System (ADS)

    Leonov, Vladimir; Torfs, Tom; Vullers, Ruud J. M.; van Hoof, Chris

    2010-09-01

    Hybrid wearable energy harvesters consisting of a thermoelectric generator (TEG) and photovoltaic (PV) cells are used in this work for powering two autonomous medical devices: an electroencephalography (EEG) system and an electrocardiography (ECG) system in a shirt. Two alternative solutions for powering the systems have been implemented. In the battery-free EEG diadem, PV cells cover the outer surface of radiators used in a TEG. In the ECG shirt, thermoelectric modules are the main power supply that constantly recharges a battery, while PV cells are used mainly to provide standby power, i.e., when the shirt is not worn. Both devices are maintenance free for their entire service life.

  15. [Usefulness of exercise electro-cardiography in a THP (Total Health Promotion Plan)].

    PubMed

    Mitsumune, T; Matsuo, K; Funaki, K; Morikawa, A; Takamura, K; Aoi, T; Senoh, E; Kayashima, E; Hara, Y

    1997-09-01

    We conducted ergometer exercise electrocardiography (ergometry) on 3,477 subjects in a THP (Total Health Promotion Plan). One hundred cases in which abnormal findings were detected by ergometry were analyzed. In the hundred cases there were 3 patterns: abnormal ST change, 50 cases; abnormal reaction, 22 cases; and extreme increase in blood pressure, 28 cases. Electrocardiograms (ECG) in 78 of these 100 cases indicated no abnormalities. Of the 31 subjects who underwent further examinations, in 18 cases abnormal findings were detected, and further observation or treatment was necessary. They were over two thirds of the 26 cases requiring observation or treatment on further examination. In other words, exercise electrocardiography revealed more than 3 times as many problem cases as electrocardiography only. One hundred and four cases were analyzed, and among them abnormal findings on ECG made further examination or treatment necessary. Of 68 subjects with an abnormal ECG and who needed to undergo exercise electrocardiography, 51 (75%) had no need to undergo further examinations, because there were no abnormal findings on ergometry in the THP. Of the 104 subjects who underwent ECG examination at rest, 51 no longer needed to waste time, effort and expense on further medical evaluation. Ergometry in a THP serves as a medical check and as a means to decide the strength of exercise before the initiation of exercise training, which is very important in preventing coronary artery disease, rather than in detecting the disease. Ergometry is expensive and it takes a lot of time and labor, but it is necessary in ensuring the safety of exercise training and in prescribing proper exercise. This analysis has shown that ergometry in THP is very useful and cost effective in improving the accuracy of health examinations. PMID:9368971

  16. High-frequency ECG

    NASA Technical Reports Server (NTRS)

    Tragardh, Elin; Schlegel, Todd T.

    2006-01-01

    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

  17. [100 years' of clinical electrocardiography].

    PubMed

    Bergovec, Mijo

    2003-01-01

    In 1903 Willem Einthoven published in Pflügers Arch his classic article on the investigation of human electrocardiogram by his string galvanometer. Many historians of medicine, Einthoven also marked that publication as the beginning of clinical electrocardiography. Many investigators like Galvani, Manteucci, Kölliker, Müller, Lipmann, Waller, Ader, Einthoven, Lewis, Wilson and others participated in creation and development of electrocardiogram. From that time electrocardiogram quickly became, and has remained the most essential diagnostic laboratory tool in investigation of heart diseases. The aim of this article is to remind us of the beginning of this part of cardiology 100 years ago. PMID:15209030

  18. Integral skin electrode for electrocardiography is expendable

    NASA Technical Reports Server (NTRS)

    1966-01-01

    Inexpensive, expendable skin electrode for use in electrocardiography combines an electrical contact, conductive paste, and a skin-attachment adhesive. Application of the electrode requires only degreasing of the skin area.

  19. Classification of acute coronary syndromes using the 12-lead electrocardiogram as a guide.

    PubMed

    Pyne, Clifford C

    2004-01-01

    The management of patients with acute coronary syndromes (ACS) is becoming more complicated. With the advent of new therapies and surgical techniques, the likelihood that patients will make a full recovery improves. Cardiovascular disease remains the leading cause of death for adults in the United States, and with continually increasing trends such as obesity and diabetes, will likely remain so in the future. With the introduction of improved therapies, the numbers of patients dying after their first myocardial infarction continues to decline. Electrocardiogram (ECG) technology has improved, and further research has improved its sensitivity and specificity allowing for earlier, more consistent diagnosis of ACS. As a result, guidelines have been developed to assist nurses and clinicians in the management of patients with ACS. Nurses are in a unique position to provide primary triage, recognize ACS based on the patient's presentation and initial 12-lead ECG, and initiate an appropriate response. Key elements of 12-lead ECG interpretation and their application to established guidelines are essential skills for nurses working in clinical arenas frequented by patients with ACS. PMID:15586157

  20. Combination of the LSQR method and a genetic algorithm for solving the electrocardiography inverse problem

    NASA Astrophysics Data System (ADS)

    Jiang, Mingfeng; Xia, Ling; Shou, Guofa; Tang, Min

    2007-03-01

    Computing epicardial potentials from body surface potentials constitutes one form of ill-posed inverse problem of electrocardiography (ECG). To solve this ECG inverse problem, the Tikhonov regularization and truncated singular-value decomposition (TSVD) methods have been commonly used to overcome the ill-posed property by imposing constraints on the magnitudes or derivatives of the computed epicardial potentials. Such direct regularization methods, however, are impractical when the transfer matrix is large. The least-squares QR (LSQR) method, one of the iterative regularization methods based on Lanczos bidiagonalization and QR factorization, has been shown to be numerically more reliable in various circumstances than the other methods considered. This LSQR method, however, to our knowledge, has not been introduced and investigated for the ECG inverse problem. In this paper, the regularization properties of the Krylov subspace iterative method of LSQR for solving the ECG inverse problem were investigated. Due to the 'semi-convergence' property of the LSQR method, the L-curve method was used to determine the stopping iteration number. The performance of the LSQR method for solving the ECG inverse problem was also evaluated based on a realistic heart-torso model simulation protocol. The results show that the inverse solutions recovered by the LSQR method were more accurate than those recovered by the Tikhonov and TSVD methods. In addition, by combing the LSQR with genetic algorithms (GA), the performance can be improved further. It suggests that their combination may provide a good scheme for solving the ECG inverse problem.

  1. [Pathways in the development of electrocardiography].

    PubMed

    Stejfa, M

    2002-12-01

    Electrocardiography celebrates hundred years of its existence. The historical article on the cornerstones of its development was written on request of the editorial board of Vnitrní lékarství (Internal Medicine) and the Czech Society of Internal Medicine. After summarizing the beginnings of the discovery of bioelectric current and attempts of its registration the author describes the construction of the string galvanometer by Willem Einthoven. In 1901 and 1903 he published the first findings on the application of electrocardiography in man. Therefore that years are considered the years when clinical electrocardiography was born. Next we deal with the development of lead systems and modern electrocardiographs, incl. the discovery of the Braun tube, the construction of monitors, vectorcardiography and spatiocardiography. The author summarizes the principles of rational interpretation of the surface electrocardiogram and analyzes further modifications such as the use of leads from the right hemithorax, oesophageal leads, stress electrocardiography. Classical surface electrocardiography is probably a completed discipline. It will remain also in future a basic auxiliary examination method in internal medicine and allied disciplines. Due to its importance however classical electrocardiographic examination should be shifted into primary care where it may be a great enrichment and acceleration of the diagnostic process. Further development of electrocardiology is focused on non-invasive and invasive examinations and in particular treatment of arrhythmias where surface electrocardiography will be also in future important as a reference signal for the time localization of electric potentials of the intracardial electrocardiogram and programmed electrical stimulation. PMID:12744010

  2. Effects of web-based electrocardiography simulation on strategies and learning styles.

    PubMed

    Granero-Molina, José; Fernández-Sola, Cayetano; López-Domene, Esperanza; Hernández-Padilla, José Manuel; Preto, Leonel São Romão; Castro-Sánchez, Adelaida María

    2015-08-01

    OBJECTIVETo identify the association between the use of web simulation electrocardiography and the learning approaches, strategies and styles of nursing degree students.METHODA descriptive and correlational design with a one-group pretest-posttest measurement was used. The study sample included 246 students in a Basic and Advanced Cardiac Life Support nursing class of nursing degree.RESULTSNo significant differences between genders were found in any dimension of learning styles and approaches to learning. After the introduction of web simulation electrocardiography, significant differences were found in some item scores of learning styles: theorist (p < 0.040), pragmatic (p < 0.010) and approaches to learning.CONCLUSIONThe use of a web electrocardiogram (ECG) simulation is associated with the development of active and reflexive learning styles, improving motivation and a deep approach in nursing students. PMID:26353103

  3. The 12-lead electrocardiogram and risk of sudden death: current utility and future prospects.

    PubMed

    Narayanan, Kumar; Chugh, Sumeet S

    2015-10-01

    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. PMID:26842119

  4. ECG artefacts mimicking atrial flutter in posterior fossa surgery.

    PubMed

    Rudigwa, Priya; Elakkumanan, Lenin Babu; Rajan, Sakthi P; Prakash, M V Satya

    2015-01-01

    ECG artefacts are defined as abnormalities in the monitored ECG, which result from measurement of cardiac potentials on the body surface and are not related to the electrical activity of the heart. In the operation theatre, the use of various types of electrical equipment may interfere with ECG interpretation. We describe our experience with artefacts resembling atrial fibrillation when a nerve integrity monitoring device was used on a patient undergoing posterior fossa surgery for epidermoid tumour. These artefacts resemble serious arrhythmias and may result in unwanted interventions. To enable better identification of such artefacts, a 12-lead ECG should be considered as it will display rhythm in all the leads; while artefacts will present in only a few leads, true arrhythmia will be present in all the 12 leads. Our case report aims to increase awareness regarding ECG artefacts and to explain how to distinguish them from actual arrhythmias. PMID:26021382

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

    PubMed Central

    Mandellos, George J.; Koukias, Michael N.; Styliadis, Ioannis St.; Lymberopoulos, Dimitrios K.

    2010-01-01

    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. PMID:20628537

  6. Empirical mode decomposition of the ECG signal for noise removal

    NASA Astrophysics Data System (ADS)

    Khan, Jesmin; Bhuiyan, Sharif; Murphy, Gregory; Alam, Mohammad

    2011-04-01

    Electrocardiography is a diagnostic procedure for the detection and diagnosis of heart abnormalities. The electrocardiogram (ECG) signal contains important information that is utilized by physicians for the diagnosis and analysis of heart diseases. So good quality ECG signal plays a vital role for the interpretation and identification of pathological, anatomical and physiological aspects of the whole cardiac muscle. However, the ECG signals are corrupted by noise which severely limit the utility of the recorded ECG signal for medical evaluation. The most common noise presents in the ECG signal is the high frequency noise caused by the forces acting on the electrodes. In this paper, we propose a new ECG denoising method based on the empirical mode decomposition (EMD). The proposed method is able to enhance the ECG signal upon removing the noise with minimum signal distortion. Simulation is done on the MIT-BIH database to verify the efficacy of the proposed algorithm. Experiments show that the presented method offers very good results to remove noise from the ECG signal.

  7. High Frequency QRS ECG Accurately Detects Cardiomyopathy

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Arenare, Brian; Poulin, Gregory; Moser, Daniel R.; Delgado, Reynolds

    2005-01-01

    High frequency (HF, 150-250 Hz) analysis over the entire QRS interval of the ECG is more sensitive than conventional ECG for detecting myocardial ischemia. However, the accuracy of HF QRS ECG for detecting cardiomyopathy is unknown. We obtained simultaneous resting conventional and HF QRS 12-lead ECGs in 66 patients with cardiomyopathy (EF = 23.2 plus or minus 6.l%, mean plus or minus SD) and in 66 age- and gender-matched healthy controls using PC-based ECG software recently developed at NASA. The single most accurate ECG parameter for detecting cardiomyopathy was an HF QRS morphological score that takes into consideration the total number and severity of reduced amplitude zones (RAZs) present plus the clustering of RAZs together in contiguous leads. This RAZ score had an area under the receiver operator curve (ROC) of 0.91, and was 88% sensitive, 82% specific and 85% accurate for identifying cardiomyopathy at optimum score cut-off of 140 points. Although conventional ECG parameters such as the QRS and QTc intervals were also significantly longer in patients than controls (P less than 0.001, BBBs excluded), these conventional parameters were less accurate (area under the ROC = 0.77 and 0.77, respectively) than HF QRS morphological parameters for identifying underlying cardiomyopathy. The total amplitude of the HF QRS complexes, as measured by summed root mean square voltages (RMSVs), also differed between patients and controls (33.8 plus or minus 11.5 vs. 41.5 plus or minus 13.6 mV, respectively, P less than 0.003), but this parameter was even less accurate in distinguishing the two groups (area under ROC = 0.67) than the HF QRS morphologic and conventional ECG parameters. Diagnostic accuracy was optimal (86%) when the RAZ score from the HF QRS ECG and the QTc interval from the conventional ECG were used simultaneously with cut-offs of greater than or equal to 40 points and greater than or equal to 445 ms, respectively. In conclusion 12-lead HF QRS ECG employing

  8. Prehospital 12-Lead Electrocardiogram within 60 Minutes Differentiates Proximal versus Nonproximal Left Anterior Descending Artery Myocardial Infarction

    PubMed Central

    Aertker, Robert A; Barker, Colin M; Anderson, H. Vernon; Denktas, Ali E; Giesler, Gregory M; Julapalli, Vinay R; Ledoux, John F; Persse, David E; Sdringola, Stefano; Vooletich, Mary T; McCarthy, James J; Smalling, Richard W

    2011-01-01

    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 (n = 35), 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 (P = 0.007). 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 (n = 37), there was no significant difference in ST-segment deviation between the 2 groups. Conclusion The sum STE (V1-V6) and STD (II, III, a

  9. Coordinator Traffic Diffusion for Data-Intensive Zigbee Transmission in Real-time Electrocardiography Monitoring.

    PubMed

    Tseng, Chinyang Henry

    2013-12-01

    Zigbee is expected to have an explosive growth in wireless medical monitoring systems because it possesses the advantages of low cost, safe power strength, and easy deployment. However, limited work focuses on solving the bottleneck issue at the Zigbee coordinator in a data-intensive system to guarantee transmission reliability of life-critical data. This paper proposes coordinator traffic diffusion (CTD) method to redirect excessive traffic from coordinator to the sink in electrocardiography (ECG) medical application. CTD router, which implements CTD design, automatically redirects ECG data traffic to the sink node without involving the coordinator, and thus reliable real-time ECG monitoring service can be delivered precisely. CTD design is tested in both TI CC2530 Zigbee platform and NS2 simulation. Experimental result demonstrates that a CTD design can assist routers in successfully delivering real-time ECG data samples reliably with the best transmission rate, 24 kb/s. This performance cannot be achieved by the original Zigbee design. PMID:23744664

  10. A brief review: history to understand fundamentals of electrocardiography.

    PubMed

    AlGhatrif, Majd; Lindsay, Joseph

    2012-01-01

    The last decade of the 19th century witnessed the rise of a new era in which physicians used technology along with classical history taking and physical examination for the diagnosis of heart disease. The introduction of chest x-rays and the electrocardiograph (electrocardiogram) provided objective information about the structure and function of the heart. In the first half of the 20th century, a number of innovative individuals set in motion a fascinating sequence of discoveries and inventions that led to the 12-lead electrocardiogram, as we know it now. Electrocardiography, nowadays, is an essential part of the initial evaluation for patients presenting with cardiac complaints. As a first line diagnostic tool, health care providers at different levels of training and expertise frequently find it imperative to interpret electrocardiograms. It is likely that an understanding of the electrical basis of electrocardiograms would reduce the likelihood of error. An understanding of the disorders behind electrocardiographic phenomena could reduce the need for memorizing what may seem to be an endless list of patterns. In this article, we will review the important steps in the evolution of electrocardiogram. As is the case in most human endeavors, an understanding of history enables one to deal effectively with the present. PMID:23882360

  11. A brief review: history to understand fundamentals of electrocardiography

    PubMed Central

    AlGhatrif, Majd; Lindsay, Joseph

    2012-01-01

    The last decade of the 19th century witnessed the rise of a new era in which physicians used technology along with classical history taking and physical examination for the diagnosis of heart disease. The introduction of chest x-rays and the electrocardiograph (electrocardiogram) provided objective information about the structure and function of the heart. In the first half of the 20th century, a number of innovative individuals set in motion a fascinating sequence of discoveries and inventions that led to the 12-lead electrocardiogram, as we know it now. Electrocardiography, nowadays, is an essential part of the initial evaluation for patients presenting with cardiac complaints. As a first line diagnostic tool, health care providers at different levels of training and expertise frequently find it imperative to interpret electrocardiograms. It is likely that an understanding of the electrical basis of electrocardiograms would reduce the likelihood of error. An understanding of the disorders behind electrocardiographic phenomena could reduce the need for memorizing what may seem to be an endless list of patterns. In this article, we will review the important steps in the evolution of electrocardiogram. As is the case in most human endeavors, an understanding of history enables one to deal effectively with the present. PMID:23882360

  12. Heart rate variability and arrhythmic patterns of 24-hour Holter electrocardiography among Nigerians with cardiovascular diseases

    PubMed Central

    Adebayo, Rasaaq Ayodele; Ikwu, Amanze Nkemjika; Balogun, Michael Olabode; Akintomide, Anthony Olubunmi; Ajayi, Olufemi Eyitayo; Adeyeye, Victor Oladeji; Mene-Afejuku, Tuoyo Omasan; Bamikole, Olaniyi James; Ogunyemi, Suraj Adefabi; Ajibare, Adeola Olubunmi; Oketona, Omolola Abiodun

    2015-01-01

    Background Facilities for Holter electrocardiography (ECG) monitoring in many Nigerian hospitals are limited. There are few published works in Nigeria on the use of 24-hour Holter ECG in cardiac arrhythmic evaluation of patients with cardiovascular diseases. Objective To study the clinical indications, arrhythmic pattern, and heart rate variability (HRV) among subjects referred for 24-hour Holter ECG at our Cardiac Care Unit. Methods Three-hundred and ten patients (134 males and 176 females) were studied consecutively over a 48-month period using Schiller type (MT-101) Holter ECG machine. Results Out of the 310 patients reviewed, 134 were males (43.2%) and 176 were females (56.8%). The commonest indication for Holter ECG was palpitation followed by syncope in 71 (23%) and 49 (15.8%) of subjects, respectively. Premature ventricular complex and premature atrial complex were the commonest types of arrhythmia in 51.5% and 15% subjects, respectively. Ventricular arrhythmia was more prevalent in dilated cardiomyopathy patients (85.7%). The HRV of subjects with palpitation, stroke, and diabetes mellitus with autonomic neuropathy, using standard deviation of normal to normal intervals average (milliseconds), were 107.32±49.61, 79.15±49.15, and 66.50±15.54, respectively. The HRV, using standard deviation of averages of normal to normal intervals average (milliseconds), of patients with palpitation, stroke, and diabetes mellitus with autonomic neuropathy were 77.39±62.34, 57.82±37.05, and 55.50±12.71, respectively. Conclusion Palpitation and syncope were the commonest indications for Holter ECG among our subjects. The commonest arrhythmic patterns were premature ventricular complex and premature atrial complex, with ventricular arrhythmia being more prevalent in dilated cardiomyopathy. There was a reduction in HRV in patients with stroke and diabetic autonomic neuropathy. PMID:26170685

  13. The origins of electrocardiography in Poland.

    PubMed

    Gryglewski, Ryszard W

    2015-06-01

    The progress of science and technology in the 19(th) century enabled better understanding of the electrical activity that occurs during a heartbeat. However, it was only the construction and introduction of the galvanometer that cleared the way for appropriate experimental and clinical studies. Marey, Waller, Wenckebach, Einthoven, and Pardee are just examples of the world's pioneers of electrocardiography. Polish researchers, including Cybulski, Eiger, Rzętkowski, Surzycki, and Latkowski, also contributed to the development of this area of study. The following article is a review aiming to reconstruct the origins of electrocardiography in Poland, both as a measurement method used in experiments and as a diagnostic tool in clinical studies conducted in the years preceding the outbreak of World War I. PMID:26336508

  14. The origins of electrocardiography in Poland

    PubMed Central

    2015-01-01

    The progress of science and technology in the 19th century enabled better understanding of the electrical activity that occurs during a heartbeat. However, it was only the construction and introduction of the galvanometer that cleared the way for appropriate experimental and clinical studies. Marey, Waller, Wenckebach, Einthoven, and Pardee are just examples of the world's pioneers of electrocardiography. Polish researchers, including Cybulski, Eiger, Rzętkowski, Surzycki, and Latkowski, also contributed to the development of this area of study. The following article is a review aiming to reconstruct the origins of electrocardiography in Poland, both as a measurement method used in experiments and as a diagnostic tool in clinical studies conducted in the years preceding the outbreak of World War I. PMID:26336508

  15. A Review of Fetal ECG Signal Processing; Issues and Promising Directions

    PubMed Central

    Sameni, Reza; Clifford, Gari D.

    2010-01-01

    The field of electrocardiography has been in existence for over a century, yet despite significant advances in adult clinical electrocardiography, signal processing techniques and fast digital processors, the analysis of fetal ECGs is still in its infancy. This is, partly due to a lack of availability of gold standard databases, partly due to the relatively low signal-to-noise ratio of the fetal ECG compared to the maternal ECG (caused by the various media between the fetal heart and the measuring electrodes, and the fact that the fetal heart is simply smaller), and in part, due to the less complete clinical knowledge concerning fetal cardiac function and development. In this paper we review a range of promising recording and signal processing techniques for fetal ECG analysis that have been developed over the last forty years, and discuss both their shortcomings and advantages. Before doing so, however, we review fetal cardiac development, and the etiology of the fetal ECG. A selection of relevant models for the fetal/maternal ECG mixture is also discussed. In light of current understanding of the fetal ECG, we then attempt to justify recommendations for promising future directions in signal processing, and database creation. PMID:21614148

  16. Electrocardiography: A Technologist's Guide to Interpretation.

    PubMed

    Tso, Colin; Currie, Geoffrey M; Gilmore, David; Kiat, Hosen

    2015-12-01

    The nuclear medicine technologist works with electrocardiography when performing cardiac stress testing and gated cardiac imaging and when monitoring critical patients. To enhance patient care, basic electrocardiogram interpretation skills and recognition of key arrhythmias are essential for the nuclear medicine technologist. This article provides insight into the anatomy of an electrocardiogram trace, covers basic electrocardiogram interpretation methods, and describes an example case typical in the nuclear medicine environment. PMID:26471331

  17. Design intelligent wheelchair with ECG measurement and wireless transmission function.

    PubMed

    Chou, Hsi-Chiang; Wang, Yi-Ming; Chang, Huai-Yuan

    2015-01-01

    The phenomenon of aging populations has produced widespread health awareness and magnified the need for improved medical quality and technologies. Statistics show that ischemic heart disease is the leading cause of death for older people and people with reduced mobility; therefore, wheelchairs have become their primary means of transport. Hence, an arrhythmia-detecting smart wheelchair was proposed in this study to provide real-time electrocardiography (ECG)-monitoring to patients with heart disease and reduced mobility. A self-developed, handheld ECG-sensing instrument was integrated with a wheelchair and a lab-written, arrhythmia-detecting program. The measured ECG data were transmitted through a Wi-Fi module and analyzed and diagnosed using the human-machine interface. PMID:26444818

  18. Willem Einthoven and the birth of clinical electrocardiography a hundred years ago.

    PubMed

    Barold, S Serge

    2003-01-01

    The first electrocardiogram (ECG) from the intact human heart was recorded with a mercury capillary electrometer by Augustus Waller in May 1887 at St. Mary's Hospital, London. The tracings were poor and exhibited only 2 distorted deflections. Willem Einthoven (1860-1927) who was professor of physiology at the University of Leiden, The Netherlands, began his studies of the ECG with the mercury capillary electrometer, and improved its distortion mathematically so that he was finally able to register a good representation of the ECG before the beginning of the twentieth century. He later further improved ECG recordings with the introduction of a string galvanometer of his design. Einthoven published his first article about the string galvanometer in 1901, followed by a more detailed description in 1903 which included a report of ECGs taken with the new instrument. The year 2002 marks the centennial of Willem Einthoven's first recording of the ECG in a clinically applicable fashion with the string galvanometer. The clinical use of Einthoven's immobile equipment required transtelephonic transmission of the ECG from the physiology laboratory to the clinic at the Academic Hospital about a mile away as documented in the 1906 paper on the "télécardiogramme". This report contained a wealth of ECG patterns and arrhythmias. Einthoven developed a system of electrocardiographic standardization that continues to be used all over the world and introduced the triaxial bipolar system with 3 limb leads and thus established uniformity of the recording process. Einthoven also conceived the famous equilateral triangle with leads I, II, and III at its sides and the calculation of the electrical axis (in the frontal plane) depicted as a single vector with an arrow at the center of the triangle. Einthoven recognized the great potential importance of the ECG as a diagnostic and investigative tool and his achievements made him the founder of modern electrocardiography. He was awarded the

  19. Smartphone home monitoring of ECG

    NASA Astrophysics Data System (ADS)

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

    2012-06-01

    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.

  20. Incremental prognostic value of stress echocardiography as an adjunct to exercise electrocardiography after uncomplicated myocardial infarction

    PubMed Central

    Bigi, R; Desideri, A; Galati, A; Bax, J; Coletta, C; Fiorentini, C; Fioretti, P

    2001-01-01

    OBJECTIVE—To assess the prognostic value of stress echocardiography as an adjunct to exercise electrocardiography in patients with uncomplicated acute myocardial infarction.
DESIGN—496 patients underwent a maximum exercise ECG and pharmacological stress echocardiography (406 dobutamine and 90 dipyridamole) within 15 days of uncomplicated acute myocardial infarction and were followed for a mean of 25 months (range 1-74 months) for reinfarction, unstable angina, and cardiac death. Patients undergoing revascularisation were omitted.
RESULTS—Exercise ECG was positive in 162 patients (32.6%) and low threshold positive (< 100 W) in 91 (18%). Stress echocardiography was positive in 239 patients (48%) (194 with dobutamine and 45 with dipyridamole stress). The agreement between the two tests was 63% (κ = 0.24, 95% confidence interval 0.15 to 0.33). Sixty nine spontaneous events occurred (14 cardiac deaths, 26 reinfarctions, and 29 with unstable angina requiring hospital admission), and 126 patients underwent revascularisation (39 coronary angioplasty and 87 bypass surgery). By receiver operating characteristic curve analysis, stress echocardiography provided incremental prognostic information compared with clinical data. A low threshold positive exercise ECG was associated with a worse outcome, but there was a fivefold increase in risk in patients with positive stress echocardiography who also had a high threshold (> 100 W) positive exercise ECG. Event-free survival of patients with both tests positive was significantly less than in patients with only one positive test or with both tests negative.
CONCLUSIONS—Stress echocardiography provides additional prognostic information after uncomplicated acute myocardial infarction, but the greatest gain is found in patients with a high threshold positive exercise ECG.


Keywords: risk stratification; myocardial infarction; stress echocardiography; exercise stress testing PMID:11250968

  1. Exercise electrocardiography and myocardial scintigraphy in the serial evaluation of the results of percutaneous transluminal coronary angioplasty

    SciTech Connect

    Schall, J.M.; Chaitman, B.R.; David, P.R.; Dupras, G.; Brevers, G; Val, P.G.; Crepeau, J.; Lesperance, J.; Bourassa, M.G.

    1982-08-01

    The diagnostic value of exercise electrocardiography using 14 leads and thallium-201 scintigraphy were evaluated in 54 of 70 patients who underwent percutaneous transluminal coronary angioplasty (PTCA), both in the initial assessment and serial follow-up of patients after PTCA. Of the 45 patients who had successful PTCA, 36 had complete noninvasive studies performed before and 1 month after PTCA. The use of clinical symptoms in conjunction with the physiologic data, ECG and myocardial scintigram acquired during exercise provide important short-term data on the angiographic evolution of PTCA results. The noninvasive tests may be useful in determining guidelines for repeat angiography in patients who have had PTCA. (JMT)

  2. Value of posterior and right ventricular leads in comparison to the standard 12-lead electrocardiogram in evaluation of ST-segment elevation in suspected acute myocardial infarction.

    PubMed

    Zalenski, R J; Rydman, R J; Sloan, E P; Hahn, K H; Cooke, D; Fagan, J; Fligner, D J; Hessions, W; Justis, D; Kampe, L M; Shah, S; Tucker, J; Zwicke, D

    1997-06-15

    In this multicenter prospective trial, we studied posterior (V7 to V9) and right ventricular (V4R to V6R) leads to assess their accuracy compared with standard 12-lead electrocardiograms (ECGs) for the diagnosis of acute myocardial infarction (AMI). Patients aged >34 years with suspected AMI received posterior and right ventricular leads immediately after the initial 12-lead ECG. ST elevation of 0.1 mV in 2 leads was blindly determined and inter-rater reliability estimated. AMI was diagnosed by World Health Organization criteria. The diagnostic value of nonstandard leads was determined when 12-lead ST elevation was absent and present and multivariate stepwise regression analysis was also performed. Of 533 study patients, 64.7% (345 of 533) had AMI and 24.8% received thrombolytic therapy. Posterior and right ventricular leads increased sensitivity for AMI by 8.4% (p = 0.03) but decreased specificity by 7.0% (p = 0.06). The likelihood ratios of a positive test for 12, 12 + posterior, and 12 + right ventricular ECGs were 6.4, 5.6, and 4.5, respectively. Increased AMI rates (positive predictive values) were found when ST elevation was present on 6 nonstandard leads (69.1%), on 12 leads only (88.4%), and on both 6 and 12 leads (96.8%; p <0.001). Treatment rates with thrombolytic therapy increased in parallel with this electrocardiographic gradient. Logistic regression analysis showed that 4 leads were independently predictive of AMI (p <0.001): leads I, II, V3, V5R; V9 approached statistical significance (p = 0.055). The standard ECG is not optimal for detecting ST-segment elevation in AMI, but its accuracy is only modestly improved by the addition of posterior and right ventricular leads. PMID:9202344

  3. Willem Einthoven--inventor of electrocardiography.

    PubMed

    Schweitzer, P; Keller, S

    2002-12-01

    Willem Einthoven, the inventor of the string galvanometer electrocardiograph, was born in the Dutch East Indies, studied medicine in Utrecht Holland, and became chairman of the Department of Physiology at the University of Leiden. In 1924 he was awarded the Nobel Price for physiology and medicine. Einthoven became interested in electrophysiology after Waller's demonstration of the human electrogram using Lippmann's capillary electrometer. Because of important limitations of this device, Einthoven decided to construct the string galvanometer to be used for physiological research and in clinical medicine. Einthoven's main achievements in electrophysiology were the description of the normal ECG, some physiological effects on the ECG, the three ECG leads and the triangle rule. In 1906 in cooperation with the university hospital, Einthoven demonstrated the clinical usefulness of the electrocardiograph. PMID:12744012

  4. Centenary of tele-electrocardiography and telephonocardiography.

    PubMed

    Hjelm, N M; Julius, H W

    2005-01-01

    In the history of electrocardiography the names of two physiologists stand out: Augustus Waller (1865-1922) and Willem Einthoven (1860-1927). Waller was the first to show that the beating heart produces a weak electric potential, which can be registered by a measuring device connected to electrodes attached to the skin. Einthoven developed a 'string' galvanometer, which was much faster and more sensitive than the system used by Waller. Einthoven's electrocardiograph was ready for use in 1903. To facilitate investigations of patients Einthoven connected his instrument to the Academic Hospital in Leyden, by a telephone line, as suggested by his engineering colleague Johannes Bosscha in Delft. The first successful tele-electrocardiogram was transmitted on Sunday 22 March 1905. The heart tones were registered by wiring a specially developed microphone placed on the subject's chest to another string galvanometer. The event was therefore a first both for tele-electrocardiography and for telephonocardiography. We are still awaiting the full-scale implementation of these achievements, 100 years later. PMID:16238834

  5. ECG Artifact Removal from Surface EMG Signal Using an Automated Method Based on Wavelet-ICA.

    PubMed

    Abbaspour, Sara; Lindén, Maria; Gholamhosseini, Hamid

    2015-01-01

    This study aims at proposing an efficient method for automated electrocardiography (ECG) artifact removal from surface electromyography (EMG) signals recorded from upper trunk muscles. Wavelet transform is applied to the simulated data set of corrupted surface EMG signals to create multidimensional signal. Afterward, independent component analysis (ICA) is used to separate ECG artifact components from the original EMG signal. Components that correspond to the ECG artifact are then identified by an automated detection algorithm and are subsequently removed using a conventional high pass filter. Finally, the results of the proposed method are compared with wavelet transform, ICA, adaptive filter and empirical mode decomposition-ICA methods. The automated artifact removal method proposed in this study successfully removes the ECG artifacts from EMG signals with a signal to noise ratio value of 9.38 while keeping the distortion of original EMG to a minimum. PMID:25980853

  6. High-risk angina patient. Identification by clinical features, hospital course, electrocardiography and technetium-99m stannous pyrophosphate scintigraphy

    SciTech Connect

    Olson, H.G.; Lyons, K.P.; Aronow, W.S.; Stinson, P.J.; Kuperus, J.; Waters, H.J.

    1981-10-01

    We evaluated 193 consecutive unstable angina patients by clinical features, hospital course and electrocardiography. All patients were managed medically. Of the 193 patients, 150 (78%) had a technetium-99m pyrophosphate (Tc-PYP) myocardial scintigram after hospitalization. Of these, 49 (33%) had positive scintigrams. At a follow-up of 24.9 +/- 10.8 months after hospitalization, 16 of 49 patients (33%) with positive scintigrams died from cardiac causes, compared with six of 101 patients (6%) with negative scintigrams (p less than 0.001). Of 49 patients with positive scintigrams, 11 (22%) had had nonfatal myocardial infarction at follow-up, compared with seven of 101 patients (7%) with negative scintigrams (p less than 0.01). Age, duration of clinical coronary artery disease, continuing angina during hospitalization, ischemic ECG, cardiomegaly and a history of heart failure also correlated with cardiac death at follow-up. Ischemic ECG and a history of angina with a crescendo pattern also correlated with nonfatal infarction at follow-up. Patients with continuing angina, an ischemic ECG and a positive scintigram constituted a high-risk unstable angina subgroup with a survival rate of 58% at 6 months, 47% at 12 months and 42% at 24 and 36 months. We conclude that the assessment of clinical features, hospital course, ECG and Tc-PYP scintigraphy may be useful in identifying high-risk unstable angina patients.

  7. High-risk angina patient: identification by clinical features, hospital course, electrocardiography, and technetium-99m stannous pyrophosphate scintigraphy

    SciTech Connect

    Olson, H.G.; Lyons, K.P.; Aronow, W.S.; Stinson, P.J.; Kuperus, J.; Waters, H.J.

    1981-10-01

    We evaluated 193 consecutive unstable angina patients by clinical features, hospital course and electrocardiography. All patients were managed medically. Of the 193 patients, 150 (78%) had a technetium-99m pyrophosphate (Tc-PYP) myocardial scintigram after hospitalization. Of these, 49 (33%) had positive scintigrams. At a follow-up of 24.9 +- 10.8 months after hospitalization, 16 of 49 patients (33%) with positive scintigrams died from cardiac causes, compared with six of 101 patients (6%) with negative scintigrams (p < 0.001). Of 49 patients with positive scintigrams, 11 (22%) had had nonfatal myocardial infarction at follow-up, compared with seven of 101 patients (7%) with negative scintigrams (p < 0.01). Age, duration of clinical coronary artery disease, continuing angina during hospitalization, ischemic ECG, cardiomegaly and a history of heart failure also correlated with cardiac death at follow-up. Ischemic ECG and a history of angina with a crescendo pattern also correlated with nonfatal infarction at follow-up. Patients with continuing angina, an ischemic ECG and a positive scintigram constituted a high-risk unstable angina subgroup, with a survival rate of 58% at 6 months, 47% at 12 months and 42% at 24 and 36 months. We conclude that the assessment of clinical features, hospital course, ECG and Tc-PYP scintigraphy may be useful in identifying high-risk unstable angina patients.

  8. Myocardial infarction size and location: a comparative study of epicardial isopotential mapping, thallium-201 scintigraphy, electrocardiography and vectorcardiography

    SciTech Connect

    Toyama, S.; Suzuki, K.; Takahashi, T.; Yamashita, Y.

    1987-07-01

    Based on epicardial isopotential mapping (the Ep Map), which was calculated from body surface isopotential mapping (the Body Map) with Yamashita's method, using the finite element technique, we predicted the location and size of the abnormal depolarized area (the infarcted area) in 19 clinical cases of anterior and 18 cases of inferoposterior infarction. The prediction was done using Toyama's diagnostic method, previously reported. The accuracy of the prediction by the Ep Map was assessed by comparing it with findings from thallium-201 scintigraphy (SCG), electrocardiography (ECG) and vectorcardiography (VCG). In all cases of anterior infarction, the location of the abnormal depolarized areas determined on the Ep Map, which was localized at the anterior wall along the anterior intraventricular septum, agreed with the location of the abnormal findings obtained by SCG, ECG and VCG. For all inferoposterior infarction cases, the abnormal depolarized areas were localized at the posterior wall and the location also coincided with that of the abnormal findings obtained by SCG, ECG and VCG. Furthermore, we ranked and ordered the size of the abnormal depolarized areas, which were predicted by the Ep Map for both anterior and inferoposterior infarction cases. In the cases of anterior infarction, the order of the size of the abnormal depolarized area by the Ep Map was correlated to the size of the abnormal findings by SCG, as well as to the results from Selvester's QRS scoring system in ECG and to the angle of the maximum QRS vector in the horizontal plane in VCG.

  9. The non-contact measure of the heart rate variability by laser Doppler vibrometry: comparison with electrocardiography

    NASA Astrophysics Data System (ADS)

    Cosoli, G.; Casacanditella, L.; Tomasini, E. P.; Scalise, L.

    2016-06-01

    The assessment of the heart rate variability (HRV) is of utmost importance, being one of the most promising markers of the activity of the autonomic nervous system and associated to cardiovascular mortality. Different signals can be used to perform HRV, primarily electrocardiography (ECG), photoplethysmography (PPG), phonocardiography (PCG) or vibrocardiography (VCG), since the fundamental aspect is the individuation of a periodic feature strictly correlated with cardiac activity (i.e. R-peak in ECG or the first sound in PCG). In this work, the authors demonstrate that the VCG performances in HRV analysis are sufficiently accurate if compared to the ones measured by ECG (i.e. standard methodology); moreover, the authors want to prove the feasibility of such measurement in correspondence of different measurement points (i.e. carotid artery—which is the typical VCG measurement point—and the radial artery on the wrist)1. Results show that VCG has a mean deviation of  <1 bpm with respect to ECG in heart rate (HR) measurement; carotid artery is the most accurate site for the assessment, but also the radial artery is a valid site, even if with a reduced SNR. With regards to HRV parameters, the mean percentage deviation is  <10% in correspondence of carotid artery, and  ≈16% for the radial artery. So, VCG allows for non-contact monitoring of the cardiac activity.

  10. The Use of Fetal Noninvasive Electrocardiography

    PubMed Central

    2016-01-01

    Preeclampsia (PE) is one of the severe complications of pregnancy that leads to fetal deterioration. The aim was to survey the validity of fetal distress diagnostics in case of Doppler ultrasonic umbilical vein and arteries blood flow velocity investigation and ECG parameters analysis obtained from maternal abdominal signal before labor in preeclamptic patients. Fetal noninvasive ECG and umbilical arterial and venous Doppler investigation were performed in 120 patients at 34–40 weeks of gestation. And 30 of them had physiological gestation and were involved in Group I. In Group II 52 pregnant women with mild-moderate PE were observed. 38 patients with severe PE were monitored in Group III. The most considerable negative correlation was determined in pair Apgar score 1 versus T/QRS (R = −0.50; p < 0.05). So the increased T/QRS ratio was the most evident marker of fetal distress. Fetal noninvasive ECG showed sensitivity of 96.6% and specificity of 98.4% and, therefore, was determined as more accurate method for fetal monitoring. PMID:27006859

  11. The ECG as decision support in STEMI.

    PubMed

    Ripa, Maria Sejersten

    2012-03-01

    The electrocardiogram (ECG) can be used for determining the presence, location and extent of jeopardized myocardium during acute coronary occlusion. Accordingly, the ECG has become essential in the treatment of patients with acute coronary syndrome (ACS). This thesis aims at optimizing the decision support, provided by the ECG, for choosing the best treatment strategy in the individual patient with ST-segment elevation acute myocardial infarction (STEMI). ECG recorded in the prehospital setting has become the standard of care in many communities, but to achieve the full advantage of this early approach it is important that the ECG is recorded from accurately placed electrodes to produce an ECG that resembles the standard 12-lead ECG. Accurate electrode placement is difficult especially in the acute setting, and we investigated an alternative lead system with fewer electrodes in easily identified positions. We showed that the system produced waveforms similar to the standard 12-lead ECG. However, occasional diagnostic errors were seen, compromising general acceptance of the system. Once the ECG has been recorded a decision regarding triage must be made on the basis of a correct ECG diagnosis. We found that trained paramedics can diagnose STEMI correctly in patients without ECG confounding factors, while the presence of ECG confounding factors decreased their ability substantially. Consequently, since many patients do present with ECG confounding factors, transmission to an on-call cardiologist for an early correct diagnosis is needed. We showed that time to pPCI was reduced by more than 1 hour by transmitting prehospital ECG to a cardiologist's handheld device for diagnosis, triage, and activation of the catheterization laboratory when needed. The optimal treatment strategy is dependent on the duration of ischemia however patient information is often inaccurate. Accordingly, it would be advantageous if the first available ECG can help identify patients who will

  12. Troubleshooting the ECG.

    PubMed

    Hatlestad, Dan

    2003-09-01

    Improper ECG monitoring is dangerous to patient care. Artifact in ECG monitoring can be annoying, costly and produce delays in proper care. Understanding the technical sources of artifact and care in the application of monitoring electrodes can significantly reduce or even eliminate the problem. Critical to the success of ECG monitoring are the technical aspects of proper equipment selection, preventive maintenance, and timely and rapid application to the patient, all to deliver the highest quality patient care. Just as critical is the prehospital clinician's understanding of equipment capabilities and limitations. Take time to read and understand the operator's manual for the ECG monitor/defibrillator in use in your ambulance. The ECG offers invaluable diagnostic information to EMS clinicians. With recent technological advances, today's ECG monitors provide even greater ease and versatility, which results in enhanced patient monitoring. Many factors can affect the quality of the ECG trace and therefore must be controlled in order to gain the most accurate and meaningful reading. Electrode placement and selection, as well as site preparation, are key considerations when applying and monitoring a patient's ECG. PMID:14503159

  13. Noninvasive Diagnosis of Coronary Artery Disease Using 12-Lead High-Frequency Electrocardiograms

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Arenare, Brian

    2006-01-01

    method is the presence versus the absence of reduced-amplitude zones (RAZs). In terms that must be simplified for the sake of brevity, an RAZ comprises several cycles of a high-frequency QRS signal during which the amplitude of the high-frequency oscillation in a portion of the signal is abnormally low (see figure). A given signal sample exhibiting an interval of reduced amplitude may or may not be classified as an RAZ, depending on quantitative criteria regarding peaks and troughs within the reduced-amplitude portion of the high-frequency QRS signal. This analysis is performed in all 12 leads in real time.

  14. Identification of weakly coupled multiphysics problems. Application to the inverse problem of electrocardiography

    NASA Astrophysics Data System (ADS)

    Corrado, Cesare; Gerbeau, Jean-Frédéric; Moireau, Philippe

    2015-02-01

    This work addresses the inverse problem of electrocardiography from a new perspective, by combining electrical and mechanical measurements. Our strategy relies on the definition of a model of the electromechanical contraction which is registered on ECG data but also on measured mechanical displacements of the heart tissue typically extracted from medical images. In this respect, we establish in this work the convergence of a sequential estimator which combines for such coupled problems various state of the art sequential data assimilation methods in a unified consistent and efficient framework. Indeed, we aggregate a Luenberger observer for the mechanical state and a Reduced-Order Unscented Kalman Filter applied on the parameters to be identified and a POD projection of the electrical state. Then using synthetic data we show the benefits of our approach for the estimation of the electrical state of the ventricles along the heart beat compared with more classical strategies which only consider an electrophysiological model with ECG measurements. Our numerical results actually show that the mechanical measurements improve the identifiability of the electrical problem allowing to reconstruct the electrical state of the coupled system more precisely. Therefore, this work is intended to be a first proof of concept, with theoretical justifications and numerical investigations, of the advantage of using available multi-modal observations for the estimation and identification of an electromechanical model of the heart.

  15. Design and QoS of a wireless system for real-time remote electrocardiography.

    PubMed

    Kang, Kyungtae; Ryu, Junhee; Hur, Junbeom; Sha, Lui

    2013-05-01

    Quality of service (QoS) and, in particular, reliability and a bounded low latency are essential attributes of safety-critical wireless systems for medical applications. However, wireless links are typically prone to bursts of errors, with characteristics which vary over time.We propose a wireless system suitable for real-time remote patient monitoring in which the necessary reliability and guaranteed latency are both achieved by an efficient error control scheme. We have paired an example remote electrocardiography application to this wireless system. We also developed a tool chain that uses a formal description of the proposed wireless medical system architecture in the architecture analysis and design language to assess various combinations of system parameters: we can determine the QoS in terms of packet-delivery ratio and the service latency, and also the size of jitter buffer required for seamless ECG monitoring. A realistic assessment, based on data from the MIT-BIT arrhythmia database, shows that the proposed wireless system can achieve an appropriate level of QoS for real-time ECG monitoring if link-level error control is correctly implemented. Additionally, we present guidelines for the design of energy-efficient link-level error control, derived from energy data, obtained from simulations. PMID:24592475

  16. Design of electrocardiography measurement system with an algorithm to remove noise

    NASA Astrophysics Data System (ADS)

    Kwon, Hyeokjun; Oh, Sechang; Kumar, Prashanth; Varadan, Vijay K.

    2011-04-01

    Electrocardiography (ECG) is an important diagnostic tool that can provide vital information about diseases that may not be detectable with other biological signals like, SpO2(Oxygen Saturation), pulse rate, respiration, and blood pressure. For this reason, EKG measurement is mandatory for accurate diagnosis. Recent development in information technology has facilitated remote monitoring systems which can check patient's current status. Moreover, remote monitoring systems can obviate the need for patients to go to hospitals periodically. Such representative wireless communication system is Zigbee sensor network because Zigbee sensor network provides low power consumption and multi-device connection. When we measure EKG signal, another important factor that we should consider is about unexpected signals mixed to EKG signal. The unexpected signals give a severe impact in distorting original EKG signal. There are three kinds of types in noise elements such as muscle noise, movement noise, and respiration noise. This paper describes the design method for EKG measurement system with Zigbee sensor network and proposes an algorithm to remove noises from measured ECG signal.

  17. Towards the clinical use of concentric electrodes in ECG recordings: influence of ring dimensions and electrode position

    NASA Astrophysics Data System (ADS)

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

    2016-02-01

    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.

  18. A Hygroscopic Sensor Electrode for Fast Stabilized Non-Contact ECG Signal Acquisition

    PubMed Central

    Fong, Ee-May; Chung, Wan-Young

    2015-01-01

    A capacitive electrocardiography (cECG) technique using a non-invasive ECG measuring technology that does not require direct contact between the sensor and the skin has attracted much interest. The system encounters several challenges when the sensor electrode and subject’s skin are weakly coupled. Because there is no direct physical contact between the subject and any grounding point, there is no discharge path for the built-up electrostatic charge. Subsequently, the electrostatic charge build-up can temporarily contaminate the ECG signal from being clearly visible; a stabilization period (3–15 min) is required for the measurement of a clean, stable ECG signal at low humidity levels (below 55% relative humidity). Therefore, to obtain a clear ECG signal without noise and to reduce the ECG signal stabilization time to within 2 min in a dry ambient environment, we have developed a fabric electrode with embedded polymer (FEEP). The designed hygroscopic FEEP has an embedded superabsorbent polymer layer. The principle of FEEP as a conductive electrode is to provide humidity to the capacitive coupling to ensure strong coupling and to allow for the measurement of a stable, clear biomedical signal. The evaluation results show that hygroscopic FEEP is capable of rapidly measuring high-accuracy ECG signals with a higher SNR ratio. PMID:26251913

  19. Compressed ECG biometric: a fast, secured and efficient method for identification of CVD patient.

    PubMed

    Sufi, Fahim; Khalil, Ibrahim; Mahmood, Abdun

    2011-12-01

    Adoption of compression technology is often required for wireless cardiovascular monitoring, due to the enormous size of Electrocardiography (ECG) signal and limited bandwidth of Internet. However, compressed ECG must be decompressed before performing human identification using present research on ECG based biometric techniques. This additional step of decompression creates a significant processing delay for identification task. This becomes an obvious burden on a system, if this needs to be done for a trillion of compressed ECG per hour by the hospital. Even though the hospital might be able to come up with an expensive infrastructure to tame the exuberant processing, for small intermediate nodes in a multihop network identification preceded by decompression is confronting. In this paper, we report a technique by which a person can be identified directly from his / her compressed ECG. This technique completely obviates the step of decompression and therefore upholds biometric identification less intimidating for the smaller nodes in a multihop network. The biometric template created by this new technique is lower in size compared to the existing ECG based biometrics as well as other forms of biometrics like face, finger, retina etc. (up to 8302 times lower than face template and 9 times lower than existing ECG based biometric template). Lower size of the template substantially reduces the one-to-many matching time for biometric recognition, resulting in a faster biometric authentication mechanism. PMID:20703779

  20. A Hygroscopic Sensor Electrode for Fast Stabilized Non-Contact ECG Signal Acquisition.

    PubMed

    Fong, Ee-May; Chung, Wan-Young

    2015-01-01

    A capacitive electrocardiography (cECG) technique using a non-invasive ECG measuring technology that does not require direct contact between the sensor and the skin has attracted much interest. The system encounters several challenges when the sensor electrode and subject's skin are weakly coupled. Because there is no direct physical contact between the subject and any grounding point, there is no discharge path for the built-up electrostatic charge. Subsequently, the electrostatic charge build-up can temporarily contaminate the ECG signal from being clearly visible; a stabilization period (3-15 min) is required for the measurement of a clean, stable ECG signal at low humidity levels (below 55% relative humidity). Therefore, to obtain a clear ECG signal without noise and to reduce the ECG signal stabilization time to within 2 min in a dry ambient environment, we have developed a fabric electrode with embedded polymer (FEEP). The designed hygroscopic FEEP has an embedded superabsorbent polymer layer. The principle of FEEP as a conductive electrode is to provide humidity to the capacitive coupling to ensure strong coupling and to allow for the measurement of a stable, clear biomedical signal. The evaluation results show that hygroscopic FEEP is capable of rapidly measuring high-accuracy ECG signals with a higher SNR ratio. PMID:26251913

  1. An integrated healthcare information system for end-to-end standardized exchange and homogeneous management of digital ECG formats.

    PubMed

    Trigo, Jesús Daniel; Martínez, Ignacio; Alesanco, Alvaro; Kollmann, Alexander; Escayola, Javier; Hayn, Dieter; Schreier, Günter; García, José

    2012-07-01

    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. PMID:22453644

  2. Outcome of exercise electrocardiography in familial amyloidotic polyneuropathy patients, Portuguese type, under evaluation for liver transplantation.

    PubMed

    Juneblad, Kristina; Näslund, Anna; Olofsson, Bert-Ove; Suhr, Ole B

    2004-09-01

    Familial amyloidotic polyneuropathy (FAP) is a dominantly inherited systemic amyloidosis caused by mutated transthyretin (TTR). Liver transplantation is currently the only available treatment that halts the progress of the disease. Cardiovascular complications are common in FAP, and cardiac arrhythmias are typical complications in FAP Val30Met. For patients with late onset FAP, as the Swedish patients, coronary heart disease has been found in several patients, and a QS complex is not an uncommon finding in FAP-patients ECG raising the suspicion of coronary heart disease. The aim of this study was to evaluate exercise ECG in FAP patients before transplantation with regard to mortality and morbidity. Thirty-eight FAP patients who underwent examination by exercise ECG, as part of the evaluation for liver transplantation were included in the study. Of these, 30 patients were transplanted, and the surviving patients were followed for at least 2 years. Exercise ECG was performed on bicycles with standard 12 leads. Non-parametric statistical analyses were used in all calculations. Six patients died 0-5.5 years after transplantation. They were older than the survivors (p < 0.01), but their duration of disease did not deviate from that of survivors (p = 0.8). They were also less able to increase their heart rates during exercise than the survivors (p < 0.05). For all transplanted patients, a significant relationship was found between patients' increase of heart rate, blood pressure and maximal workload, and the duration of disease and also for the PND-score, signifying that the outcome of exercise ECG predominantly was related to the patients autonomic and motor function, and not to their heart function. PMID:15523924

  3. Comparison of electrocardiography and thallium-201 myocardial scintigraphy for the detection of ergonovine-induced coronary artery spasm: angiographic correlation

    SciTech Connect

    Shanes, J.G.; Pavel, D.; Blend, M.; Olea, E.; Krone, R.; Lacny, K.; Marmulstein, M.; Malik, R.; Meyer, C.; Kondos, G.T.

    1987-03-01

    This study was performed to determine the sensitivity of thallium imaging vs ECG monitoring for detecting coronary artery spasm noninvasively following intravenous ergonovine administration as compared to simultaneous coronary angiography. Thirty-two patients with insignificant coronary artery disease and chest pain underwent 12-lead ECG monitoring, thallium imaging, and coronary arteriography following the administration of 0.05, 0.1, 0.2, and 0.3 mg of ergonovine given 5 minutes apart or until chest pain occurred. One minute following the last dose of ergonovine, 2.5 mCi of thallium-201 was injected intravenously, and a final ECG was recorded and repeat coronary arteriography performed. Within 10 minutes following the injection of thallium, imaging was performed in the 40-degree and 70-degree left anterior oblique and anterior projections. The ECG, thallium study, and coronary arteriogram were read blindly and results were compared. The ECG, angiogram, and thallium study were read as positive if the following occurred, respectively: greater than or equal to 1 mm ST segment elevation, depression, or T wave reversal; greater than 50% vessel narrowing,; and reversible perfusion defect. Five patients were excluded from analysis because of either catheter-induced spasm, suboptimal thallium studies, or protocol violations. Of the 27 patients included for analysis, six had chest pain, five had a positive angiogram, five had a positive thallium study, and one had a positive ECG. The sensitivity of thallium vs ECG monitoring was 80% vs 25%, and the accuracy was 92% vs 80%. We conclude that thallium imaging greatly increases the noninvasive detection of ergonovine-induced coronary spasm as compared with the ECG with no loss of accuracy.

  4. A Study on the Optimal Positions of ECG Electrodes in a Garment for the Design of ECG-Monitoring Clothing for Male.

    PubMed

    Cho, Hakyung; Lee, Joo Hyeon

    2015-09-01

    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

  5. Diagnostic performance of coronary computed tomography angiography versus exercise electrocardiography for coronary artery disease: a systematic review and meta-analysis

    PubMed Central

    Yin, Xinxin; Zheng, Wen; Ma, Jingjing; Hao, Panpan

    2016-01-01

    Background Both coronary computed tomography angiography (CCTA) and exercise electrocardiography (ExECG) are non-invasive testing methods for the evaluation of coronary artery disease (CAD). However, there was controversy on the diagnostic performance of these methods due to the limited data in each single study. Therefore, we performed a meta-analysis to address these issues. Methods We searched PubMed and Embase databases up to May 22, 2015. Two authors identified eligible studies, extracted data and accessed quality. Pooled estimation of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), summary receiver-operating characteristic curve (SROC) and the area under curve (AUC) of CCTA and ExECG for the diagnosis of CAD were calculated using Stata, Meta-Disc and Review Manager statistical software. Results Seven articles were included. Pooled sensitivity of CCTA and ExECG were 0.98 [95% confidence intervals (CIs): 0.95–0.99] and 0.66 (95% CIs: 0.59–0.72); pooled specificity of CCTA and ExECG were 0.84 (95% CIs: 0.81–0.87) and 0.75 (95% CIs: 0.71–0.79); pooled DOR of CCTA and ExECG were 110.24 (95% CIs: 35.07–346.55) and 6.28 (95% CIs: 2.06–19.13); and AUC of CCTA and ExECG were 0.9950±0.0046 and 0.7727±0.0638, respectively. There is no heterogeneity caused by threshold effect in CCTA or ExECG analysis. The Deeks’ test showed no potential publication bias (P=0.17). Conclusions CCTA has better diagnostic performance than ExECG in the evaluation of CAD, which can provide a better solution for the clinical problem of the diagnosis for CAD. PMID:27499958

  6. High frequency QRS ECG predicts ischemic defects during myocardial perfusion imaging

    NASA Technical Reports Server (NTRS)

    2004-01-01

    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). 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 (P less than 0.00l). Analysis of 12-lead HF QRS ECG is highly sensitive and specific for detecting ischemic perfusion defects during adenosine MPI stress tests and significantly more sensitive than analysis of conventional ST segments.

  7. High frequency QRS ECG predicts ischemic defects during myocardial perfusion imaging

    NASA Technical Reports Server (NTRS)

    Rahman, Atiar

    2006-01-01

    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 (P<0.001). Conclusions: Analysis of 12-lead HF QRS ECG is highly sensitive and specific for detecting ischemic perfusion defects during adenosine MPI stress tests and significantly more sensitive than analysis of conventional ST segments.

  8. Intelligent Classification of Heartbeats for Automated Real-Time ECG Monitoring

    PubMed Central

    Park, Juyoung

    2014-01-01

    Abstract Background: The automatic interpretation of electrocardiography (ECG) data can provide continuous analysis of heart activity, allowing the effective use of wireless devices such as the Holter monitor. Materials and Methods: We propose an intelligent heartbeat monitoring system to detect the possibility of arrhythmia in real time. We detected heartbeats and extracted features such as the QRS complex and P wave from ECG signals using the Pan–Tompkins algorithm, and the heartbeats were then classified into 16 types using a decision tree. Results: We tested the sensitivity, specificity, and accuracy of our system against data from the MIT-BIH Arrhythmia Database. Our system achieved an average accuracy of 97% in heartbeat detection and an average heartbeat classification accuracy of above 96%, which is comparable with the best competing schemes. Conclusions: This work provides a guide to the systematic design of an intelligent classification system for decision support in Holter ECG monitoring. PMID:25010717

  9. Wavelet-based watermarking and compression for ECG signals with verification evaluation.

    PubMed

    Tseng, Kuo-Kun; He, Xialong; Kung, Woon-Man; Chen, Shuo-Tsung; Liao, Minghong; Huang, Huang-Nan

    2014-01-01

    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. PMID:24566636

  10. Wavelet-Based Watermarking and Compression for ECG Signals with Verification Evaluation

    PubMed Central

    Tseng, Kuo-Kun; He, Xialong; Kung, Woon-Man; Chen, Shuo-Tsung; Liao, Minghong; Huang, Huang-Nan

    2014-01-01

    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. PMID:24566636

  11. [Adaptation of Einthoven's string galvanometer for electrocardiography in the Netherlands].

    PubMed

    Wyers, P J

    2001-12-22

    After the Dutch physiologist Willem Einthoven (1860-1927) published the construction of his string galvanometer in 1901, the development of electrocardiography in the Netherlands was slow. During the next twenty years only a few string galvanometers were in use in the Netherlands, mostly in physiology laboratories. Publications concerning electrocardiographic tests on patients were scarce. In 1924, Einthoven was awarded the Nobel Prize for Physiology and Medicine for discovering the mechanism of the electrocardiogram. From that moment onwards, electrocardiography developed rapidly in the Netherlands and during the following 30 years particular use was made of the French string galvanometer designed by Boulitte. PMID:11789151

  12. The expanding role of signal-averaged electrocardiography.

    PubMed

    Gant, R H; Henkin, R; Morton, P G

    1999-10-01

    Signal-averaged electrocardiography is a valuable diagnostic tool for determining which patients recovering from myocardial infarction are at risk of sudden death due to ventricular arrhythmias. Additionally, the value of this technique in determining which patients with ischemic heart disease and unexplained syncope are likely to have inducible sustained ventricular tachycardia has been established. This noninvasive screening procedure has shown promise in other clinical situations, but more investigation is needed before definitive recommendation can be made. Critical care nurses can help promote the success of signal-averaged electrocardiography by educating patients, promoting acquisition of a quality recording, helping allay patients' concerns, and participating in research activities. PMID:10808814

  13. Sleep apnea classification using ECG-signal wavelet-PCA features.

    PubMed

    Rachim, Vega Pradana; Li, Gang; Chung, Wan-Young

    2014-01-01

    Sleep apnea is often diagnosed using an overnight sleep test called a polysomnography (PSG). Unfortunately, though it is the gold standard of sleep disorder diagnosis, a PSG is time consuming, inconvenient, and expensive. Many researchers have tried to ameliorate this problem by developing other reliable methods, such as using electrocardiography (ECG) as an observed signal source. Respiratory rate interval, ECG-derived respiration, and heart rate variability analysis have been studied recently as a means of detecting apnea events using ECG during normal sleep, but these methods have performance weaknesses. Thus, the aim of this study is to classify the subject into normal- or apnea-subject based on their single-channel ECG measurement in regular sleep. In this proposed study, ECG is decomposed into five levels using wavelet decomposition for the initial processing to determine the detail coefficients (D3-D5) of the signal. Approximately 15 features were extracted from every minute of ECG. Principal component analysis and a support vector machine are used for feature dimension reduction and classification, respectively. According to classification that been done from a data set consisting of thirty-five patients, the proposed minute-to-minute classifier specificity, sensitivity, and subject-based classification accuracy are 95.20%, 92.65%, and 94.3%, respectively. Furthermore, the proposed system can be used as a basis for future development of sleep apnea screening tools. PMID:25226993

  14. Investigations of sensitivity and resolution of ECG and MCG in a realistically shaped thorax model

    NASA Astrophysics Data System (ADS)

    Mäntynen, Ville; Konttila, Teijo; Stenroos, Matti

    2014-12-01

    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.

  15. Prediction of the effectiveness of long term β blocker treatment for dilated cardiomyopathy by signal averaged electrocardiography

    PubMed Central

    Yamada, T; Fukunami, M; Shimonagata, T; Kumagai, K; Kim, J; Sanada, S; Ogita, H; Hori, M; Hoki, N

    1998-01-01

    Objective—To determine whether the effectiveness of long term β blocker treatment for idiopathic dilated cardiomyopathy can be predicted by signal averaged electrocardiography (ECG).
Patients—31 patients with dilated cardiomyopathy and without bundle branch block were included in a retrospective study and 16 in a prospective study.
Methods—A signal averaged ECG was recorded before β blocker treatment, and three variables were measured from the vector magnitude: QRS duration, root mean square voltage for the last 40 ms (RMS40), and duration of the terminal low amplitude signals (< 40 µV) (LAS40). In the retrospective study, these variables were compared among good responders (showing ⩾ 0.10 increase in ejection fraction 12 months after start of β blocker treatment) and poor responders without such improvement. The validity of the signal averaged ECG criteria for prediction of the response to β blocker treatment was examined in the prospective study.
Results—In the retrospective study, good responders (n = 16) had a shorter QRS duration (mean (SD): 122.9 (11) v 138 (14.4) ms, p < 0.005) and LAS40 (33.1 (8.9) v 42.5 (7.8) ms, p < 0.005), and a higher RMS40 (31.6 (16.3) v 19.0 (10.3) µV, p < 0.02) than poor responders (n = 15). Signal averaged ECG criteria for good response were defined as two or more of the following: QRS duration < 130 ms, RMS40 > 20 µV, LAS40 < 40 ms (sensitivity 81%, specificity 73%). In the prospective study, six of seven patients who met these criteria showed a good response to the β blocker treatment, while eight of nine who did not showed a poor response (χ2 = 6.1, p < 0.02). The signal averaged ECG criteria gave a sensitivity of 86% and a specificity of 89% for predicting the effectiveness of β blocker treatment.
Conclusions—A signal averaged ECG might be useful in predicting the effectiveness of β blocker treatment for dilated cardiomyopathy.

 Keywords: signal

  16. MS-QI: A Modulation Spectrum-Based ECG Quality Index for Telehealth Applications.

    PubMed

    Tobon V, Diana P; Falk, Tiago H; Maier, Martin

    2016-08-01

    As telehealth applications emerge, the need for accurate and reliable biosignal quality indices has increased. One typical modality used in remote patient monitoring is the electrocardiogram (ECG), which is inherently susceptible to several different noise sources, including environmental (e.g., powerline interference), experimental (e.g., movement artifacts), and physiological (e.g., muscle and breathing artifacts). Accurate measurement of ECG quality can allow for automated decision support systems to make intelligent decisions about patient conditions. This is particularly true for in-home monitoring applications, where the patient is mobile and the ECG signal can be severely corrupted by movement artifacts. In this paper, we propose an innovative ECG quality index based on the so-called modulation spectral signal representation. The representation quantifies the rate of change of ECG spectral components, which are shown to be different from the rate of change of typical ECG noise sources. The proposed modulation spectral-based quality index, MS-QI, was tested on 1) synthetic ECG signals corrupted by varying levels of noise, 2) single-lead recorded data using the Hexoskin garment during three activity levels (sitting, walking, running), 3) 12-lead recorded data using conventional ECG machines (Computing in Cardiology 2011 dataset), and 4) two-lead ambulatory ECG recorded from arrhythmia patients (MIT-BIH Arrhythmia Database). Experimental results showed the proposed index outperforming two conventional benchmark quality measures, particularly in the scenarios involving recorded data in real-world environments. PMID:25203983

  17. Incremental value of clinical assessment, supine exercise electrocardiography, and biplane exercise radionuclide ventriculography in the prediction of coronary artery disease in men with chest pain

    SciTech Connect

    Currie, P.J.; Kelly, M.J.; Harper, R.W.; Federman, J.; Kalff, V.; Anderson, S.T.; Pitt, A.

    1983-11-01

    The incremental value of clinical assessment, exercise electrocardiography (ECG) and biplane radionuclide ventriculography (RVG) in the prediction of coronary artery disease (CAD) was assessed in 105 men without myocardial infarction who were undergoing coronary angiography for investigation of chest pain. Independent clinical assessment of chest pain was made prospectively by 2 physicians. Graded supine bicycle exercise testing was symptom-limited. Right anterior oblique ECG-gated first-pass RVG and left anterior oblique ECG-gated equilibrium RVG were performed at rest and exercise. Regional wall motion abnormalities were defined by agreement of 2 of 3 blinded observers. A combined strongly positive exercise ECG response was defined as greater than or equal to 2 mm ST depression or 1.0 to 1.9 mm ST depression with exercise-induced chest pain. A multivariate logistic regression model for the preexercise prediction of CAD was derived from the clinical data and selected 2 variables: chest pain class and cholesterol level. A second model assessed the incremental value of the exercise test in prediction of CAD and found 2 exercise variables that improved prediction: RVG wall motion abnormalities, and a combined strongly positive ECG response. Applying the derived predictive models, 37 of the 58 patients (64%) with preexercise probabilities of 10 to 90% crossed either below the 10% probability threshold or above the 90% threshold and 28 (48%) also moved across the 5 and 95% thresholds. Supine exercise testing with ECG and biplane RVG together, but neither test alone, effectively adds to clinical prediction of CAD. It is most useful in men with atypical chest pain and when the ECG and RVG results are concordant.

  18. Prediction of multivessel coronary artery disease and prognosis early after acute myocardial infarction by exercise electrocardiography and thallium-201 myocardial perfusion scanning

    SciTech Connect

    Abraham, R.D.; Freedman, S.B.; Dunn, R.F.; Newman, H.; Roubin, G.S.; Harris, P.J.; Kelly, D.T.

    1986-09-01

    Exercise electrocardiography and thallium scanning were performed a mean of 24 days after uncomplicated acute myocardial infarction in 103 patients, aged 36 to 60 years, who also underwent coronary angiography. The purpose of the study was to determine the ability of the noninvasive tests to predict multivessel coronary artery disease (CAD) and prognosis. Patients were followed up to document medical complications (incidence 12%: 3 deaths, 1 resuscitated cardiac arrest, 4 recurrent infarctions, 4 admissions with unstable angina) and combined events (medical events or bypass surgery, incidence 23%). The sensitivity, specificity and predictive accuracy for predicting multivessel CAD were 64%, 77% and 64% for a positive exercise electrocardiographic (ECG) response, 64%, 88% and 80% for a remote thallium defect, and 42%, 96% and 88% for a combination of the 2 tests. With 2 tests yielding negative findings the probability of multivessel CAD was 13%. No variable (positive exercise ECG response, remote thallium defect and presence of multivessel CAD) predicted medical events, although there were nonsignificant trends to more events in patients with any of those findings. The relative risk of combined events was 2.5 (p less than 0.05) for a positive exercise ECG response; 1.8 (NS) for a remote thallium defect; 2.6 (p less than 0.05) for multivessel CAD; and 3.1 (p less than 0.025) for both positive ECG response and remote defect. A combination of exercise electrocardiography and thallium scanning early after acute myocardial infarction helps to identify subsets of patients with high and low probabilities of multivessel CAD and combined medical or surgical events.

  19. Use of Electrocardiography to Predict Future Development of Hypertension in the General Population

    PubMed Central

    Takase, Hiroyuki; Sugiura, Tomonori; Murai, Shunsuke; Yamashita, Sumiyo; Ohte, Nobuyuki; Dohi, Yasuaki

    2016-01-01

    Abstract Cardiac muscle responds to increased afterload by developing hypertrophy. During the early stages of hypertension, the heart can be transiently, but frequently, exposed to increased afterload. This study was designed to test the hypothesis that left ventricular hypertrophy (LVH) assessed by electrocardiography (ECG) can be used to predict future development of hypertension. Sokolow–Lyon voltage and Cornell product were calculated using ECG in 5770 normotensive participants who visited our hospital for a physical checkup (age 52.7 ± 11.3 years). LVH was defined as a Sokolow–Lyon voltage of >3.8 mV or a Cornell product of >2440 mm × ms. After baseline examination, participants were followed up with the endpoint being the development of hypertension. During the median follow-up period of 1089 days (15,789 person-years), hypertension developed in 1029 participants (65.2/1000 person-years). A Kaplan–Meier analysis demonstrated a significantly higher incidence of hypertension in participants with LVH than in those without LVH as assessed by Sokolow–Lyon voltage or Cornell product (P < 0.0001 for both). The hazard ratios for incident hypertension in participants with LVH defined by Sokolow–Lyon voltage and Cornell product were 1.49 (95% confidence interval [CI] 1.16–1.90, P < 0.01) and 1.34 (95% CI 1.09–1.65, P < 0.01), respectively, after adjustment for possible risk factors. Furthermore, in multivariable Cox hazard analysis, where Sokolow–Lyon voltage and Cornell product were taken as continuous variables, both indices were independent predictors of future hypertension (P < 0.0001). Both Sokolow–Lyon voltage and Cornell product are novel predictors of future development of hypertension in the general population. PMID:27124047

  20. [The historical bases of a super-specialty: electrocardiography].

    PubMed

    Gensini, Gian Franco; Conti, Andrea A; Lippi, Donatella; Conti, Antonio

    2004-01-01

    In the XVIII century the first structured experiments in the field of bioelectricity were performed, and the Italian scientist Luigi Galvani documented the muscular contraction of a frog undergoing an electric shock. In 1791 he showed that the electric stimulation of the heart of a frog determined the contraction of the heart itself. In the first thirty years of the XIX century galvanometers were developed, and in 1842-42 Carlo Matteucci documented that electric activity was present even in the cardiac muscle at rest. At the end of the XIX century Augustus Waller was among the first scientists to publish an electrocardiographic recording obtained from the human body surface; most of his contemporaneous, however, did not retain that electrocardiography might have been an effective clinical application. Willem Einthoven, instead, was convinced of the widespread feasibility of clinical electrocardiography, and promoted a number of improvements and refinements in electrocardiographic technique. The most important and diagnostic-technical development of electrocardiography occurred in the second half of the XX century, and still today, even if many different sophisticated instrumental examinations are available for cardiologic evaluation, electrocardiography represents an essential first-line diagnostic tool in clinical cardiology. PMID:16259095

  1. Prevalence and prognostic significance of exercise-induced silent myocardial ischemia detected by thallium scintigraphy and electrocardiography in asymptomatic volunteers

    SciTech Connect

    Fleg, J.L.; Gerstenblith, G.; Zonderman, A.B.; Becker, L.C.; Weisfeldt, M.L.; Costa, P.T. Jr.; Lakatta, E.G. )

    1990-02-01

    Although a silent ischemic electrocardiographic response to treadmill exercise in clinically healthy populations is associated with an increased likelihood of future coronary events (i.e., angina pectoris, myocardial infarction, or cardiac death), such a response has a low predictive value for future events because of the low prevalence of disease in asymptomatic populations. To examine whether detection of reduced regional perfusion by thallium scintigraphy improved the predictive value of exercise-induced ST segment depression, we performed maximal treadmill exercise electrocardiography (ECG) and thallium scintigraphy (201Tl) in 407 asymptomatic volunteers 40-96 years of age (mean = 60) from the Baltimore Longitudinal Study on Aging. The prevalence of exercise-induced silent ischemia, defined by concordant ST segment depression and a thallium perfusion defect, increased more than sevenfold from 2% in the fifth and sixth decades to 15% in the ninth decade. Over a mean follow-up period of 4.6 years, cardiac events developed in 9.8% of subjects and consisted of 20 cases of new angina pectoris, 13 myocardial infarctions, and seven deaths. Events occurred in 7% of individuals with both negative 201Tl and ECG, 8% of those with either test positive, and 48% of those in whom both tests were positive (p less than 0.001). By proportional hazards analysis, age, hypertension, exercise duration, and a concordant positive ECG and 201Tl result were independent predictors of coronary events. Furthermore, those with positive ECG and 201Tl had a 3.6-fold relative risk for subsequent coronary events, independent of conventional risk factors.

  2. Hybrid ECG signal conditioner

    NASA Technical Reports Server (NTRS)

    Rinard, G. A.; Steffen, D. A.; Sturm, R. E.

    1979-01-01

    Circuit with high common-mode rejection has ability to filter and amplify accepted analog electrocardiogram (ECG) signals of varying amplitude, shape, and polarity. In addition, low power circuit develops standardized pulses that can be counted and averaged by heart/breath rate processor.

  3. Assessment of single vessel coronary artery disease: results of exercise electrocardiography, thallium-201 myocardial perfusion imaging and radionuclide angiography

    SciTech Connect

    Port, S.C.; Oshima, M.; Ray, G.; McNamee, P.; Schmidt, D.H.

    1985-07-01

    The sensitivity of the commonly used stress tests for the diagnosis of coronary artery disease was analyzed in 46 patients with significant occlusion (greater than or equal to 70% luminal diameter obstruction) of only one major coronary artery and no prior myocardial infarction. In all patients, thallium-201 perfusion imaging (both planar and seven-pinhole tomographic) and 12 lead electrocardiography were performed during the same graded treadmill exercise test and radionuclide angiography was performed during upright bicycle exercise. Exercise rate-pressure (double) product was 22,307 +/- 6,750 on the treadmill compared with 22,995 +/- 5,622 on the bicycle (p = NS). Exercise electrocardiograms were unequivocally abnormal in 24 patients (52%). Qualitative planar thallium images were abnormal in 42 patients (91%). Quantitative analysis of the tomographic thallium images were abnormal in 41 patients (89%). An exercise ejection fraction of less than 0.56 or a new wall motion abnormality was seen in 30 patients (65%). Results were similar for the right (n = 11) and left anterior descending (n = 28) coronary arteries while all tests but the planar thallium imaging showed a lower sensitivity for isolated circumflex artery disease (n = 7). The specificity of the tests was 72, 83, 89 and 72% for electrocardiography, planar thallium imaging, tomographic thallium imaging and radionuclide angiography, respectively. The results suggest that exercise thallium-201 perfusion imaging is the most sensitive noninvasive stress test for the diagnosis of single vessel coronary artery disease.

  4. Comparison of sensor arrangements of MCG and ECG with respect to information content

    NASA Astrophysics Data System (ADS)

    Nalbach, M.; Dössel, O.

    2002-08-01

    Magnetocardiography (MCG) deals with the measurement of biomagnetic fields due to electrical excitation of the heart. The solution of the inverse problem of MCG and electrocardiography (ECG) is the reconstruction and visualization of the excitation process. The calculation is performed from MCG data recorded by multichannel systems. For a maximum of information content an optimized magnetometer arrangement is determined which is not realized at present. The information content with respect to imaging of bioelectric sources is defined by the slope of the singular values, respective the signal-to-noise ratio and the dimension of the nullspace. Reconstruction errors due to modelling errors are not taken into account in this work. The nullspace describes the set of non-detectable source patterns in MCG and ECG. A conventional commercial sensor arrangement will be compared to an improved sensor composition. Recent publications show evidence that MCG contains more or different diagnostic information in cardiac arrhythmia and infarction diagnosis than electrocardiography. Therefore, first results of a general comparison of the information content of MCG and ECG are presented.

  5. Data processing of exercise ECG's

    NASA Astrophysics Data System (ADS)

    Pahlm, Olle; Sornmo, Leif

    1987-02-01

    Computer processing of exercise ECG's is a well-established technique which aims at improving the signal-to-noise ratio of the ECG for more accurate measurements. In this way the interpretation of the ECG response to exercise is facilitated. This brief review considers the problems pertinent to signal processing in exercise ECG analysis and provides an overview of algorithms employed by research groups as well as manufacturers. The clinical utility of computer measurements and criteria for ECG changes in patients with suspected coronary artery disease is treated.

  6. Optimisation of Embryonic and Larval ECG Measurement in Zebrafish for Quantifying the Effect of QT Prolonging Drugs

    PubMed Central

    Dhillon, Sundeep Singh; Dóró, Éva; Magyary, István; Egginton, Stuart; Sík, Attila; Müller, Ferenc

    2013-01-01

    Effective chemical compound toxicity screening is of paramount importance for safe cardiac drug development. Using mammals in preliminary screening for detection of cardiac dysfunction by electrocardiography (ECG) is costly and requires a large number of animals. Alternatively, zebrafish embryos can be used as the ECG waveform is similar to mammals, a minimal amount of chemical is necessary for drug testing, while embryos are abundant, inexpensive and represent replacement in animal research with reduced bioethical concerns. We demonstrate here the utility of pre-feeding stage zebrafish larvae in detection of cardiac dysfunction by electrocardiography. We have optimised an ECG recording system by addressing key parameters such as the form of immobilization, recording temperature, electrode positioning and developmental age. Furthermore, analysis of 3 days post fertilization (dpf) zebrafish embryos treated with known QT prolonging drugs such as terfenadine, verapamil and haloperidol led to reproducible detection of QT prolongation as previously shown for adult zebrafish. In addition, calculation of Z-factor scores revealed that the assay was sensitive and specific enough to detect large drug-induced changes in QTc intervals. Thus, the ECG recording system is a useful drug-screening tool to detect alteration to cardiac cycle components and secondary effects such as heart block and arrhythmias in zebrafish larvae before free feeding stage, and thus provides a suitable replacement for mammalian experimentation. PMID:23579446

  7. Optimisation of embryonic and larval ECG measurement in zebrafish for quantifying the effect of QT prolonging drugs.

    PubMed

    Dhillon, Sundeep Singh; Dóró, Eva; Magyary, István; Egginton, Stuart; Sík, Attila; Müller, Ferenc

    2013-01-01

    Effective chemical compound toxicity screening is of paramount importance for safe cardiac drug development. Using mammals in preliminary screening for detection of cardiac dysfunction by electrocardiography (ECG) is costly and requires a large number of animals. Alternatively, zebrafish embryos can be used as the ECG waveform is similar to mammals, a minimal amount of chemical is necessary for drug testing, while embryos are abundant, inexpensive and represent replacement in animal research with reduced bioethical concerns. We demonstrate here the utility of pre-feeding stage zebrafish larvae in detection of cardiac dysfunction by electrocardiography. We have optimised an ECG recording system by addressing key parameters such as the form of immobilization, recording temperature, electrode positioning and developmental age. Furthermore, analysis of 3 days post fertilization (dpf) zebrafish embryos treated with known QT prolonging drugs such as terfenadine, verapamil and haloperidol led to reproducible detection of QT prolongation as previously shown for adult zebrafish. In addition, calculation of Z-factor scores revealed that the assay was sensitive and specific enough to detect large drug-induced changes in QTc intervals. Thus, the ECG recording system is a useful drug-screening tool to detect alteration to cardiac cycle components and secondary effects such as heart block and arrhythmias in zebrafish larvae before free feeding stage, and thus provides a suitable replacement for mammalian experimentation. PMID:23579446

  8. Subject identification via ECG fiducial-based systems: influence of the type of QT interval correction.

    PubMed

    Gargiulo, Francesco; Fratini, Antonio; Sansone, Mario; Sansone, Carlo

    2015-10-01

    Electrocardiography (ECG) has been recently proposed as biometric trait for identification purposes. Intra-individual variations of ECG might affect identification performance. These variations are mainly due to Heart Rate Variability (HRV). In particular, HRV causes changes in the QT intervals along the ECG waveforms. This work is aimed at analysing the influence of seven QT interval correction methods (based on population models) on the performance of ECG-fiducial-based identification systems. In addition, we have also considered the influence of training set size, classifier, classifier ensemble as well as the number of consecutive heartbeats in a majority voting scheme. The ECG signals used in this study were collected from thirty-nine subjects within the Physionet open access database. Public domain software was used for fiducial points detection. Results suggested that QT correction is indeed required to improve the performance. However, there is no clear choice among the seven explored approaches for QT correction (identification rate between 0.97 and 0.99). MultiLayer Perceptron and Support Vector Machine seemed to have better generalization capabilities, in terms of classification performance, with respect to Decision Tree-based classifiers. No such strong influence of the training-set size and the number of consecutive heartbeats has been observed on the majority voting scheme. PMID:26143963

  9. Advanced ECG in 2016: is there more than just a tracing?

    PubMed

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

    2016-01-01

    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

  10. Assessing ECG signal quality indices to discriminate ECGs with artefacts from pathologically different arrhythmic ECGs.

    PubMed

    Daluwatte, C; Johannesen, L; Galeotti, L; Vicente, J; Strauss, D G; Scully, C G

    2016-08-01

    False and non-actionable alarms in critical care can be reduced by developing algorithms which assess the trueness of an arrhythmia alarm from a bedside monitor. Computational approaches that automatically identify artefacts in ECG signals are an important branch of physiological signal processing which tries to address this issue. Signal quality indices (SQIs) derived considering differences between artefacts which occur in ECG signals and normal QRS morphology have the potential to discriminate pathologically different arrhythmic ECG segments as artefacts. Using ECG signals from the PhysioNet/Computing in Cardiology Challenge 2015 training set, we studied previously reported ECG SQIs in the scientific literature to differentiate ECG segments with artefacts from arrhythmic ECG segments. We found that the ability of SQIs to discriminate between ECG artefacts and arrhythmic ECG varies based on arrhythmia type since the pathology of each arrhythmic ECG waveform is different. Therefore, to reduce the risk of SQIs classifying arrhythmic events as noise it is important to validate and test SQIs with databases that include arrhythmias. Arrhythmia specific SQIs may also minimize the risk of misclassifying arrhythmic events as noise. PMID:27454007

  11. Head to Head Comparison of Stress Echocardiography with Exercise Electrocardiography for the Detection of Coronary Artery Stenosis in Women

    PubMed Central

    Kim, Mi-Na; Kim, Su-A; Kim, Yong-Hyun; Hong, Soon Jun; Park, Seong-Mi; Shin, Mi Seung; Kim, Myung-A; Hong, Kyoung-Soon; Shin, Gil Ja

    2016-01-01

    Background Exercise-stress electrocardiography (ECG) is initially recommended for the diagnosis of coronary artery disease. But its value has been questioned in women because of suboptimal diagnostic accuracy. Stress echocardiography had been reported to have comparable test accuracy in women. But the data comparing the diagnostic accuracy of exercise-stress ECG and stress echocardiography directly are few. The aim of the study was to compare the diagnostic accuracy of exercise-stress ECG and dobutamine stress echocardiography (DSE) in Korean women. Methods 202 consecutive female patients who presented with chest pain in outpatient clinic, and who underwent treadmill exercise test (TET), DSE and coronary angiography were included for the study. The diagnostic accuracy TET and DSE were calculated by the definition of > 50% or > 75% coronary artery stenosis (CAS). Results The sensitivity and specificity were higher with DSE (70.4, 94.6%) than TET (53.7, 73.6%) for detection of > 50% CAS. The higher accuracy of DSE was maintained after exclusion of the patients who could not achieve over 85% age predicted heart rate before ischemia induction. DSE also showed greater diagnostic accuracy than TET by > 75% CAS criteria, and in subsets of patient with intermediate pretest probability. Conclusion In the diagnosis of CAS, DSE showed higher accuracy than TET in female patients who presented with chest pain. As well as the test accuracy, adequate stress was more feasible with DSE than TET. These finding suggests DSE may be used as the first-line diagnostic tool in the detection of CAS in women with chest pain. PMID:27358706

  12. NOTE: Solving the ECG forward problem by means of a meshless finite element method

    NASA Astrophysics Data System (ADS)

    Li, Z. S.; Zhu, S. A.; He, Bin

    2007-07-01

    The conventional numerical computational techniques such as the finite element method (FEM) and the boundary element method (BEM) require laborious and time-consuming model meshing. The new meshless FEM only uses the boundary description and the node distribution and no meshing of the model is required. This paper presents the fundamentals and implementation of meshless FEM and the meshless FEM method is adapted to solve the electrocardiography (ECG) forward problem. The method is evaluated on a single-layer torso model, in which the analytical solution exists, and tested in a realistic geometry homogeneous torso model, with satisfactory results being obtained. The present results suggest that the meshless FEM may provide an alternative for ECG forward solutions.

  13. Minimizing interference from magnetic resonance imagers during electrocardiography.

    PubMed

    Laudon, M K; Webster, J G; Frayne, R; Grist, T M

    1998-02-01

    Magnetic resonance imaging (MRI) allows a physician to obtain images of internal organs noninvasively. Imaging a moving organ such as the heart requires a trigger so that successive scans can be synchronized. In the case of cardiac imaging this trigger is the electrocardiogram (ECG). When a patient is in an MRI scanner he/she is subjected to both static and dynamic magnetic fields which can cause interference in the ECG. The dynamic fields consist of 8- to 64-MHz radio frequency (RF) pulses and low-frequency magnetic gradient pulses with frequency components below 100 Hz. Conventional bandpass filters are only moderately effective because the passband allows magnetic gradient-induced interference to be superimposed on the ECG, causing distortion of the signal. This paper describes a technique which can be used to remove induced MRI gradient interference from an ECG recorded on a patient inside the bore of a MRI scanner. Induced signal from an external loop is subtracted from the ECG to minimize the low-frequency interference. The gradient induced low-frequency interference was reduced to approximately 20% of its magnitude when using conventional ECG amplifiers. PMID:9473839

  14. The development of wireless sensor network for ECG monitoring.

    PubMed

    Lin, Jun-Liang; Liu, Hsien-Chieh; Tai, Yu-Ting; Wu, Hsin-Hsien; Hsu, Shuo-Jen; Jaw, Fu-Shan; Chen, You-Yin

    2006-01-01

    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. PMID:17946570

  15. Foetal ECG recovery using dynamic neural networks.

    PubMed

    Camps-Valls, Gustavo; Martínez-Sober, Marcelino; Soria-Olivas, Emilio; Magdalena-Benedito, Rafael; Calpe-Maravilla, Javier; Guerrero-Martínez, Juan

    2004-07-01

    Non-invasive electrocardiography has proven to be a very interesting method for obtaining information about the foetus state and thus to assure its well-being during pregnancy. One of the main applications in this field is foetal electrocardiogram (ECG) recovery by means of automatic methods. Evident problems found in the literature are the limited number of available registers, the lack of performance indicators, and the limited use of non-linear adaptive methods. In order to circumvent these problems, we first introduce the generation of synthetic registers and discuss the influence of different kinds of noise to the modelling. Second, a method which is based on numerical (correlation coefficient) and statistical (analysis of variance, ANOVA) measures allows us to select the best recovery model. Finally, finite impulse response (FIR) and gamma neural networks are included in the adaptive noise cancellation (ANC) scheme in order to provide highly non-linear, dynamic capabilities to the recovery model. Neural networks are benchmarked with classical adaptive methods such as the least mean squares (LMS) and the normalized LMS (NLMS) algorithms in simulated and real registers and some conclusions are drawn. For synthetic registers, the most determinant factor in the identification of the models is the foetal-maternal signal-to-noise ratio (SNR). In addition, as the electromyogram contribution becomes more relevant, neural networks clearly outperform the LMS-based algorithm. From the ANOVA test, we found statistical differences between LMS-based models and neural models when complex situations (high foetal-maternal and foetal-noise SNRs) were present. These conclusions were confirmed after doing robustness tests on synthetic registers, visual inspection of the recovered signals and calculation of the recognition rates of foetal R-peaks for real situations. Finally, the best compromise between model complexity and outcomes was provided by the FIR neural network. Both

  16. Utilizing ECG-Based Heartbeat Classification for Hypertrophic Cardiomyopathy Identification.

    PubMed

    Rahman, Quazi Abidur; Tereshchenko, Larisa G; Kongkatong, Matthew; Abraham, Theodore; Abraham, M Roselle; Shatkay, Hagit

    2015-07-01

    Hypertrophic cardiomyopathy (HCM) is a cardiovascular disease where the heart muscle is partially thickened and blood flow is (potentially fatally) obstructed. A test based on electrocardiograms (ECG) that record the heart electrical activity can help in early detection of HCM patients. This paper presents a cardiovascular-patient classifier we developed to identify HCM patients using standard 10-second, 12-lead ECG signals. Patients are classified as having HCM if the majority of their recorded heartbeats are recognized as characteristic of HCM. Thus, the classifier's underlying task is to recognize individual heartbeats segmented from 12-lead ECG signals as HCM beats, where heartbeats from non-HCM cardiovascular patients are used as controls. We extracted 504 morphological and temporal features—both commonly used and newly-developed ones—from ECG signals for heartbeat classification. To assess classification performance, we trained and tested a random forest classifier and a support vector machine classifier using 5-fold cross validation. We also compared the performance of these two classifiers to that obtained by a logistic regression classifier, and the first two methods performed better than logistic regression. The patient-classification precision of random forests and of support vector machine classifiers is close to 0.85. Recall (sensitivity) and specificity are approximately 0.90. We also conducted feature selection experiments by gradually removing the least informative features; the results show that a relatively small subset of 264 highly informative features can achieve performance measures comparable to those achieved by using the complete set of features. PMID:25915962

  17. An ECG signal compressor based on the selection of optimal threshold levels of discrete wavelet transform coefficients.

    PubMed

    Al-Ajlouni, A F; Abo-Zahhad, M; Ahmed, S M; Schilling, R J

    2008-01-01

    Compression of electrocardiography (ECG) is necessary for efficient storage and transmission of the digitized ECG signals. Discrete wavelet transform (DWT) has recently emerged as a powerful technique for ECG signal compression due to its multi-resolution signal decomposition and locality properties. This paper presents an ECG compressor based on the selection of optimum threshold levels of DWT coefficients in different subbands that achieve maximum data volume reduction while preserving the significant signal morphology features upon reconstruction. First, the ECG is wavelet transformed into m subbands and the wavelet coefficients of each subband are thresholded using an optimal threshold level. Thresholding removes excessively small features and replaces them with zeroes. The threshold levels are defined for each signal so that the bit rate is minimized for a target distortion or, alternatively, the distortion is minimized for a target compression ratio. After thresholding, the resulting significant wavelet coefficients are coded using multi embedded zero tree (MEZW) coding technique. In order to assess the performance of the proposed compressor, records from the MIT-BIH Arrhythmia Database were compressed at different distortion levels, measured by the percentage rms difference (PRD), and compression ratios (CR). The method achieves good CR values with excellent reconstruction quality that compares favourably with various classical and state-of-the-art ECG compressors. Finally, it should be noted that the proposed method is flexible in controlling the quality of the reconstructed signals and the volume of the compressed signals by establishing a target PRD and a target CR a priori, respectively. PMID:19005960

  18. Cloud-ECG for real time ECG monitoring and analysis.

    PubMed

    Xia, Henian; Asif, Irfan; Zhao, Xiaopeng

    2013-06-01

    Recent advances in mobile technology and cloud computing have inspired numerous designs of cloud-based health care services and devices. Within the cloud system, medical data can be collected and transmitted automatically to medical professionals from anywhere and feedback can be returned to patients through the network. In this article, we developed a cloud-based system for clients with mobile devices or web browsers. Specially, we aim to address the issues regarding the usefulness of the ECG data collected from patients themselves. Algorithms for ECG enhancement, ECG quality evaluation and ECG parameters extraction were implemented in the system. The system was demonstrated by a use case, in which ECG data was uploaded to the web server from a mobile phone at a certain frequency and analysis was performed in real time using the server. The system has been proven to be functional, accurate and efficient. PMID:23261079

  19. A medical-grade wireless architecture for remote electrocardiography.

    PubMed

    Kang, Kyungtae; Park, Kyung-Joon; Song, Jae-Jin; Yoon, Chang-Hwan; Sha, Lui

    2011-03-01

    In telecardiology, electrocardiogram (ECG) signals from a patient are acquired by sensors and transmitted in real time to medical personnel across a wireless network. The use of IEEE 802.11 wireless LANs (WLANs), which are already deployed in many hospitals, can provide ubiquitous connectivity and thus allow cardiology patients greater mobility. However, engineering issues, including the error-prone nature of wireless channels and the unpredictable delay and jitter due to the nondeterministic nature of access to the wireless medium, need to be addressed before telecardiology can be safely realized. We propose a medical-grade WLAN architecture for remote ECG monitoring, which employs the point-coordination function (PCF) for medium access control and Reed-Solomon coding for error control. Realistic simulations with uncompressed two-lead ECG data from the MIT-BIH arrhythmia database demonstrate reliable wireless ECG monitoring; the reliability of ECG transmission exceeds 99.99% with the initial buffering delay of only 2.4 s. PMID:21216717

  20. Wireless Sensor-Based Smart-Clothing Platform for ECG Monitoring

    PubMed Central

    Wang, Jie; Lin, Chung-Chih; Yu, Yan-Shuo; Yu, Tsang-Chu

    2015-01-01

    The goal of this study is to use wireless sensor technologies to develop a smart clothes service platform for health monitoring. Our platform consists of smart clothes, a sensor node, a gateway server, and a health cloud. The smart clothes have fabric electrodes to detect electrocardiography (ECG) signals. The sensor node improves the accuracy of QRS complexes detection by morphology analysis and reduces power consumption by the power-saving transmission functionality. The gateway server provides a reconfigurable finite state machine (RFSM) software architecture for abnormal ECG detection to support online updating. Most normal ECG can be filtered out, and the abnormal ECG is further analyzed in the health cloud. Three experiments are conducted to evaluate the platform's performance. The results demonstrate that the signal-to-noise ratio (SNR) of the smart clothes exceeds 37 dB, which is within the “very good signal” interval. The average of the QRS sensitivity and positive prediction is above 99.5%. Power-saving transmission is reduced by nearly 1980 times the power consumption in the best-case analysis. PMID:26640512

  1. Coronary heart disease index based on longitudinal electrocardiography

    NASA Technical Reports Server (NTRS)

    Townsend, J. C.; Cronin, J. P.

    1977-01-01

    A coronary heart disease index was developed from longitudinal ECG (LCG) tracings to serve as a cardiac health measure in studies of working and, essentially, asymptomatic populations, such as pilots and executives. For a given subject, the index consisted of a composite score based on the presence of LCG aberrations and weighted values previously assigned to them. The index was validated by correlating it with the known presence or absence of CHD as determined by a complete physical examination, including treadmill, resting ECG, and risk factor information. The validating sample consisted of 111 subjects drawn by a stratified-random procedure from 5000 available case histories. The CHD index was found to be significantly more valid as a sole indicator of CHD than the LCG without the use of the index. The index consistently produced higher validity coefficients in identifying CHD than did treadmill testing, resting ECG, or risk factor analysis.

  2. Biomedical engineering tasks. [electrode development for electrocardiography and electroencephalography

    NASA Technical Reports Server (NTRS)

    1972-01-01

    Electrocardiographic and vectorcardiographic bioinstrumentation work centered on the development of a new electrode system harness for Project Skylab. Evaluation of several silver electrode configurations proved superior impedance voltage performance for silver/silver chloride electrodes mounted flush by using a paste adhesive. A portable ECG processor has been designed and a breadboard unit has been built to sample ECG input data at a rate of 500 samples per second for arrhythmia detection. A small real time display driver program has been developed for statistical analysis on selected QPS features. Engineering work on a sleep monitoring cap assembly continued.

  3. [ECG mapping in clinical practice].

    PubMed

    Boudík, F; Aschermann, M; Anger, Z

    2002-12-01

    First the authors present a review of important cornerstones in the history of the electrocardiogram (ECG) and ECG mapping. The first to describe the electric cardiac field based on twenty ECGs was A.D. Waller in 1889. The decisive cornerstone for practical use was the introduction of a string galvanometer in 1901 by W. Einthoven and his triaxial lead system. Another very important cornerstone in the development of ECG were the findings of F.N. Wilson. Merits as regards the development and application of ECG mapping are due to B. Taccardi. Workers of the Second Medical Clinic in Prague enhanced after 15 years of studies and comparison of ECG maps with coronarographic findings in subjects with ischaemic heart disease (IHD) and microvascular coronary dysfunction (syndrome X--SyX) substantially the specificity of this method in impaired myocardial vascularization. Better diagnosis was achieved by introduction of diagnostic tests which influence coronary vascularization such as e.g. hyperventilation, as well as other tests. After their application progression of chronic myocardial ischaemia occurs, e.g. by the mechanism of the "steal phenomenon" or restriction of the microcirculation after hyperventilation in patients with SyX. Furthermore the authors present examples of ECG maps after PTCA, after application of diagnostic tests in IHD and SyX and also regression of myocardial ischaemia after marked reduction of total cholesterol. PMID:12744039

  4. Localization of coronary artery disease with exercise electrocardiography: correlation with thallium-201 myocardial perfusion scanning

    SciTech Connect

    Dunn, R.F.; Freedman, B.; Bailey, I.K.; Uren, R.F.; Kelly, D.T.

    1981-11-01

    In 61 patients with single vessel coronary artery disease (70 percent or greater obstruction of luminal diameter in only one vessel) and no previous myocardial infarction, the sites of ischemic changes on 12 lead exercise electrocardiography and on thallium-201 myocardial perfusion scanning were related to the obstructed coronary artery. The site of exercise-induced S-T segment depression did not identify which coronary artery was obstructed. In the 37 patients with left anterior descending coronary artery disease S-T depression was most often seen in the inferior leads and leads V4 to V6, and in the 18 patients with right coronary artery disease and in the 6 patients with left circumflex artery disease S-T depression was most often seen in leads V5 and V6. Although S-T segment elevation was uncommon in most leads, it occurred in lead V1 or a VL, or both, in 51 percent of the patients with left anterior descending coronary artery disease. A reversible anterior defect on exercise thallium scanning correlated with left anterior descending coronary artery disease (probability (p) less than 0.0001) and a reversible inferior thallium defect correlated with right coronary or left circumflex artery disease (p less than 0.0001). In patients with single vessel disease, the site of S-T segment depression does not identify the obstructed coronary artery; S-T segment elevation in lead V1 or aVL, or both, identifies left anterior descending coronary artery disease; and the site of reversible perfusion defect on thallium scanning identifies the site of myocardial ischemia and the obstructed coronary artery.

  5. Visualization of cardiac dipole using a current density map: detection of cardiac current undetectable by electrocardiography using magnetocardiography.

    PubMed

    Ikefuji, Hiroyuki; Nomura, Masahiro; Nakaya, Yutaka; Mori, Toshifumi; Kondo, Noriyasu; Ieishi, Kiyoshi; Fujimoto, Sayuri; Ito, Susumu

    2007-02-01

    A close relationship exists between electric current and the magnetic field. However, electricity and magnetism have different physical characteristics, and magnetocardiography (MCG) may provide information on cardiac current that is difficult to obtain by electrocardiography (ECG). In the present study, we investigated the issue of whether the current density map method, in which cardiac current is estimated from the magnetic gradient, facilitates the visualization of cardiac current undetectable by ECG. The subjects were 50 healthy adults (N group), 40 patients with left ventricular overloading (LVO group), 15 patients with right ventricular overloading (RVO group), 10 patients with an old inferior myocardial infarction (OMI group), and 30 patients with diabetes mellitus (DM group). MCGs were recorded with a second derivative superconducting quantum interference device (SQUID) gradiometer using liquid helium. Isopotential maps and current density maps from unipolar precordial ECG leads and MCGs, respectively, were prepared, and the cardiac electric current was examined. The current density map at the ventricular depolarization phase showed one peak of current density in the N group. However, in the OMI group, the current density map showed multiple peaks of current density areas. In the RVO group, two peaks of current densities were detected at the right superior region and left thoracic region and these two diploles appeared to be from the right and left ventricular derived cardiac currents, respectively. Moreover, there was a significant correlation between the magnitude of the current density from the right ventricle and the systolic pulmonary arterial pressure. The current density map at the ventricular repolarization phase in the N group showed only a single current source. However, abnormal current sources in the current density maps were frequently detected even in patients showing no abnormalities on isopotential maps in the LVO, DM, and OMI groups. The

  6. Can Functional Cardiac Age be Predicted from ECG in a Normal Healthy Population

    NASA Technical Reports Server (NTRS)

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

    2011-01-01

    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 < 0.001) from a linear combination of 5 independent variables: QRS elevation in the frontal plane (p<0.001), a new repolarization parameter QTcorr (p<0.001), mean high frequency QRS amplitude (p=0.009), the variability parameter % VLF of RRV (p=0.021) and the P-wave width (p=0.10). Here, QTcorr represents the correlation between the calculated QT and the measured QT signal. Conclusions: In apparently healthy subjects with normal conventional 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.

  7. Deployment of an Advanced Electrocardiographic Analysis (A-ECG) to Detect Cardiovascular Risk in Career Firefighters

    NASA Technical Reports Server (NTRS)

    Dolezal, B. A.; Storer, T. W.; Abrazado, M.; Watne, R.; Schlegel, T. T.; Batalin, M.; Kaiser, W.; Smith, D. L.; Cooper, C. B.

    2011-01-01

    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

  8. Case study of ECG signal used as a reference signal in optical pulse transit time measurement of blood flow: the effect of different electrode placements on pulse transit time

    NASA Astrophysics Data System (ADS)

    Myllylä, Teemu S.; Vihriälä, Erkki V.; Korhonen, Vesa O.; Sorvoja, Hannu S. S.

    2013-02-01

    The electrocardiography (ECG) signal is often used as a reference signal when calculating pulse transit times (PTT) measured by photoplethysmographic (PPG) sensors. In addition, ECG measurements are widely used in clinical health monitoring. In clinical measurements, small changes in the time delays of R waves in relation to blood flow pulsations between each ECG measurement are not relevant. In most cases, they would not even be observed, due to the rather low sampling rates used in clinical ECG devices. However, in PTT measurements, where time delays are measured with an accuracy of milliseconds, the placement of ECG electrodes can have a distinct effect on the results. This paper presents case studies of ECG signals measured simultaneously and independently by two ECG devices. We explore what effect different placements of ECG electrodes have on the R wave of the QRS complex and how it should be taken into account when used as a reference signal in pulse transit time measurements of blood flow. Additionally, we study what kind of ECG electrode placements are most suitable for PTT measurements.

  9. Application of neural classifier to risk recognition of sustained ventricular tachycardia and flicker in patients after myocardial infarction based on high-resolution electrocardiography

    NASA Astrophysics Data System (ADS)

    Wydrzyński, Jacek; Jankowski, Stanisław; Piątkowska-Janko, Ewa

    2008-01-01

    This paper presents the application of neural networks to the risk recognition of sustained ventricular tachycardia and flicker in patients after myocardial infarction based on high-resolution electrocardiography. This work is based on dataset obtained from the Medical University of Warsaw. The studies were performed on one multiclass classifier and on binary classifiers. For each case the optimal number of hidden neurons was found. The effect of data preparation: normalization and the proper selection of parameters was considered, as well as the influence of applied filters. The best neural classifier contains 5 hidden neurons, the input ECG signal is represented by 8 parameters. The neural network classifier had high rate of successful recognitions up to 90% performed on the test data set.

  10. ECG data compression by modeling.

    PubMed Central

    Madhukar, B.; Murthy, I. S.

    1992-01-01

    This paper presents a novel algorithm for data compression of single lead Electrocardiogram (ECG) data. The method is based on Parametric modeling of the Discrete Cosine Transformed ECG signal. Improved high frequency reconstruction is achieved by separately modeling the low and the high frequency regions of the transformed signal. Differential Pulse Code Modulation is applied on the model parameters to obtain a further increase in the compression. Compression ratios up to 1:40 were achieved without significant distortion. PMID:1482940

  11. Smart ECG Monitoring Patch with Built-in R-Peak Detection for Long-Term HRV Analysis.

    PubMed

    Lee, W K; Yoon, H; Park, K S

    2016-07-01

    Since heart rate variability (HRV) analysis is widely used to evaluate the physiological status of the human body, devices specifically designed for such applications are needed. To this end, we developed a smart electrocardiography (ECG) patch. The smart patch measures ECG using three electrodes integrated into the patch, filters the measured signals to minimize noise, performs analog-to-digital conversion, and detects R-peaks. The measured raw ECG data and the interval between the detected R-peaks can be recorded to enable long-term HRV analysis. Experiments were performed to evaluate the performance of the built-in R-wave detection, robustness of the device under motion, and applicability to the evaluation of mental stress. The R-peak detection results obtained with the device exhibited a sensitivity of 99.29%, a positive predictive value of 100.00%, and an error of 0.71%. The device also exhibited less motional noise than conventional ECG recording, being stable up to a walking speed of 5 km/h. When applied to mental stress analysis, the device evaluated the variation in HRV parameters in the same way as a normal ECG, with very little difference. This device can help users better understand their state of health and provide physicians with more reliable data for objective diagnosis. PMID:26558395

  12. Saturation of the right-leg drive amplifier in low-voltage ECG monitors.

    PubMed

    Freeman, Daniel K; Gatzke, Ronald D; Mallas, Georgios; Chen, Yu; Brouse, Chris J

    2015-01-01

    Electrocardiogram (ECG) monitoring is a critical tool in patient care, but its utility is often balanced with frustration from clinicians who are constantly distracted by false alarms. This has motivated the need to readdress the major factors that contribute to ECG noise with the goal of reducing false alarms. In this study, we describe a previously unreported phenomenon in which ECG noise can result from an unintended interaction between two systems: 1) the dc lead-off circuitry that is used to detect whether electrodes fall off the patient; and 2) the right-leg drive (RLD) system that is responsible for reducing ac common-mode noise that couples into the body. Using a circuit model to study this interaction, we found that in the presence of a dc lead-off system, even moderate increases in the right-leg skin-electrode resistance can cause the RLD amplifier to saturate. Such saturation can produce ECG noise because the RLD amplifier will no longer be capable of attenuating ac common-mode noise on the body. RLD saturation is particularly a problem for modern ECG monitors that use low-voltage supply levels. For example, for a 12-lead ECG and a 2 V power supply, saturation will occur when the right-leg electrode resistance reaches only 2 MΩ. We discuss several design solutions that can be used in low-voltage monitors to avoid RLD saturation. PMID:25181288

  13. Non-contact detection of myocardium's mechanical activity by ultrawideband RF-radar and interpretation applying electrocardiography.

    PubMed

    Thiel, F; Kreiseler, D; Seifert, F

    2009-11-01

    can potentially be used to support standard electrocardiography (ECG) analysis by complementary information where sole ECG analysis fails, e.g., electromechanical dissociation. PMID:19947742

  14. Non-contact detection of myocardium's mechanical activity by ultrawideband RF-radar and interpretation applying electrocardiography

    NASA Astrophysics Data System (ADS)

    Thiel, F.; Kreiseler, D.; Seifert, F.

    2009-11-01

    can potentially be used to support standard electrocardiography (ECG) analysis by complementary information where sole ECG analysis fails, e.g., electromechanical dissociation.

  15. Approximate solutions for certain bidomain problems in electrocardiography

    NASA Astrophysics Data System (ADS)

    Johnston, Peter R.

    2008-10-01

    The simulation of problems in electrocardiography using the bidomain model for cardiac tissue often creates issues with satisfaction of the boundary conditions required to obtain a solution. Recent studies have proposed approximate methods for solving such problems by satisfying the boundary conditions only approximately. This paper presents an analysis of their approximations using a similar method, but one which ensures that the boundary conditions are satisfied during the whole solution process. Also considered are additional functional forms, used in the approximate solutions, which are more appropriate to specific boundary conditions. The analysis shows that the approximations introduced by Patel and Roth [Phys. Rev. E 72, 051931 (2005)] generally give accurate results. However, there are certain situations where functional forms based on the geometry of the problem under consideration can give improved approximations. It is also demonstrated that the recent methods are equivalent to different approaches to solving the same problems introduced 20years earlier.

  16. Theoretical study of Laplacian electrocardiography forward and inverse problem

    NASA Astrophysics Data System (ADS)

    Wu, Dongsheng

    The present study is concerned with a fundamental problem of cardiac electrophysiology, that is relating in a quantitative way the electrical activity within the heart to the signals recorded over the body surface. By computer simulation, a rigorous evaluation of the performance of the body surface Laplacian electrocardiographic maps in a physiologically reasonable and well-controlled computational setting is provided in this dissertation. The present forward heart-torso model, a three-dimensional ventricular conduction model embedded in a realistically shaped inhomogeneous torso volume conductor model, represents, up to date, the most advanced computer model, which is available for studying the Laplacian electrocardiographic fields corresponding to normal and abnormal ventricular conduction processes. Theoretical studies show that one can achieve enhanced spatial resolution of mapping cardiac electrical activity by obtaining the Laplacian ECG over the body surface. The present work demonstrates the excellent performance of the body surface Laplacian electrocardiographic maps in resolving and imaging the underlying regional myocardial electrical activity. The biophysics underlying this is that the Laplacian ECG heavily weights the contributions from the myocardial bioelectric sources that are closest to the recording location, whereas the potential ECG sums up the contributions from a large area of activated myocardial tissue. It is this regional nature of the Laplacian ECG that makes it possible to provide a more localized body surface manifestation of the underlying regional myocardial electrical activity. The feasibility of applying the Laplacian ECG to the inverse problems has also been investigated. Theoretical studies of the Laplacian electrocardiogram based inverse problem by using a homogeneous spherical volume conductor and a realistically shaped volume conductor have been conducted. The present work shows encouraging results which suggest the feasibility

  17. A New Algorithm to Diagnose Atrial Ectopic Origin from Multi Lead ECG Systems - Insights from 3D Virtual Human Atria and Torso

    PubMed Central

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

    2015-01-01

    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. PMID

  18. The future of remote ECG monitoring systems

    PubMed Central

    Guo, Shu-Li; Han, Li-Na; Liu, Hong-Wei; Si, Quan-Jin; Kong, De-Feng; Guo, Fu-Su

    2016-01-01

    Remote ECG monitoring systems are becoming commonplace medical devices for remote heart monitoring. In recent years, remote ECG monitoring systems have been applied in the monitoring of various kinds of heart diseases, and the quality of the transmission and reception of the ECG signals during remote process kept advancing. However, there remains accompanying challenges. This report focuses on the three components of the remote ECG monitoring system: patient (the end user), the doctor workstation, and the remote server, reviewing and evaluating the imminent challenges on the wearable systems, packet loss in remote transmission, portable ECG monitoring system, patient ECG data collection system, and ECG signals transmission including real-time processing ST segment, R wave, RR interval and QRS wave, etc. This paper tries to clarify the future developmental strategies of the ECG remote monitoring, which can be helpful in guiding the research and development of remote ECG monitoring. PMID:27582770

  19. The future of remote ECG monitoring systems.

    PubMed

    Guo, Shu-Li; Han, Li-Na; Liu, Hong-Wei; Si, Quan-Jin; Kong, De-Feng; Guo, Fu-Su

    2016-09-01

    Remote ECG monitoring systems are becoming commonplace medical devices for remote heart monitoring. In recent years, remote ECG monitoring systems have been applied in the monitoring of various kinds of heart diseases, and the quality of the transmission and reception of the ECG signals during remote process kept advancing. However, there remains accompanying challenges. This report focuses on the three components of the remote ECG monitoring system: patient (the end user), the doctor workstation, and the remote server, reviewing and evaluating the imminent challenges on the wearable systems, packet loss in remote transmission, portable ECG monitoring system, patient ECG data collection system, and ECG signals transmission including real-time processing ST segment, R wave, RR interval and QRS wave, etc. This paper tries to clarify the future developmental strategies of the ECG remote monitoring, which can be helpful in guiding the research and development of remote ECG monitoring. PMID:27582770

  20. A combined application of lossless and lossy compression in ECG processing and transmission via GSM-based SMS.

    PubMed

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

    2015-02-01

    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. PMID:25534118

  1. Deployment of an Advanced Electrocardiographic Analysis (A-ECG) to Detect Cardiovascular Risk in Career Firefighters

    NASA Technical Reports Server (NTRS)

    Dolezal, B. A.; Storer, T. W.; Abrazado, M.; Watne, R.; Schlegel, T. T.; Batalin, M.; Kaiser, W.; Smith, D. L.; Cooper, C. B.

    2011-01-01

    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

  2. Searching biosignal databases by content and context: Research Oriented Integration System for ECG Signals (ROISES).

    PubMed

    Kokkinaki, Alexandra; Chouvarda, Ioanna; Maglaveras, Nicos

    2012-11-01

    Technological advances in textile, biosensor and electrocardiography domain induced the wide spread use of bio-signal acquisition devices leading to the generation of massive bio-signal datasets. Among the most popular bio-signals, electrocardiogram (ECG) possesses the longest tradition in bio-signal monitoring and recording, being a strong and relatively robust signal. As research resources are fostered, research community promotes the need to extract new knowledge from bio-signals towards the adoption of new medical procedures. However, integrated access, query and management of ECGs are impeded by the diversity and heterogeneity of bio-signal storage data formats. In this scope, the proposed work introduces a new methodology for the unified access to bio-signal databases and the accompanying metadata. It allows decoupling information retrieval from actual underlying datasource structures and enables transparent content and context based searching from multiple data resources. Our approach is based on the definition of an interactive global ontology which manipulates the similarities and the differences of the underlying sources to either establish similarity mappings or enrich its terminological structure. We also introduce ROISES (Research Oriented Integration System for ECG Signals), for the definition of complex content based queries against the diverse bio-signal data sources. PMID:21397354

  3. Development and evaluation of multilead wavelet-based ECG delineation algorithms for embedded wireless sensor nodes.

    PubMed

    Rincón, Francisco; Recas, Joaquin; Khaled, Nadia; Atienza, David

    2011-11-01

    This work is devoted to the evaluation of multilead digital wavelet transform (DWT)-based electrocardiogram (ECG) wave delineation algorithms, which were optimized and ported to a commercial wearable sensor platform. More specifically, we investigate the use of root-mean squared (RMS)-based multilead followed by a single-lead online delineation algorithm, which is based on a state-of-the-art offline single-lead delineator. The algorithmic transformations and software optimizations necessary to enable embedded ECG delineation notwithstanding the limited processing and storage resources of the target platform are described, and the performance of the resulting implementations are analyzed in terms of delineation accuracy, execution time, and memory usage. Interestingly, RMS-based multilead delineation is shown to perform equivalently to the best single-lead delineation for the 2-lead QT database (QTDB), within a fraction of a sample duration of the Common Standards for Electrocardiography (CSE) committee tolerances. Finally, a comprehensive evaluation of the energy consumption entailed by the considered algorithms is proposed, which allows very relevant insights into the dominant energy-draining functionalities and which suggests suitable design guidelines for long-lasting wearable ECG monitoring systems. PMID:21827976

  4. Design, fabrication and skin-electrode contact analysis of polymer microneedle-based ECG electrodes

    NASA Astrophysics Data System (ADS)

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

    2016-08-01

    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.

  5. Methods of noninvasive electrophysiological heart examination basing on solution of inverse problem of electrocardiography

    NASA Astrophysics Data System (ADS)

    Grigoriev, M.; Babich, L.

    2015-09-01

    The article represents the main noninvasive methods of heart electrical activity examination, theoretical bases of solution of electrocardiography inverse problem, application of different methods of heart examination in clinical practice, and generalized achievements in this sphere in global experience.

  6. High-Frequency Electrocardiography: Optimizing the Diagnosis of the Acute Myocardial Infarct with ST-Elevation

    NASA Astrophysics Data System (ADS)

    Naydenov, S.; Donova, T.; Matveev, M.; Gegova, A.; Popdimitrova, N.; Zlateva, G.; Vladimirova, D.

    2007-04-01

    The analysis of the received digital signal by computer microprocessor in high-frequency electrocardiography, used in our research, makes possible synthesis of vectorcardiographic images and loops, allowing improved qualitative and quantitative diagnosing of the myocardial injury.

  7. Numerical solution of an inverse electrocardiography problem for a medium with piecewise constant electrical conductivity

    NASA Astrophysics Data System (ADS)

    Denisov, A. M.; Zakharov, E. V.; Kalinin, A. V.; Kalinin, V. V.

    2010-07-01

    A numerical method is proposed for solving an inverse electrocardiography problem for a medium with a piecewise constant electrical conductivity. The method is based on the method of boundary integral equations and Tikhonov regularization.

  8. Ambulatory respiratory rate detection using ECG and a triaxial accelerometer.

    PubMed

    Chan, Alexander M; Ferdosi, Nima; Narasimhan, Ravi

    2013-01-01

    Continuous monitoring of respiratory rate in ambulatory conditions has widespread applications for screening of respiratory diseases and remote patient monitoring. Unfortunately, minimally obtrusive techniques often suffer from low accuracy. In this paper, we describe an algorithm with low computational complexity for combining multiple respiratory measurements to estimate breathing rate from an unobtrusive chest patch sensor. Respiratory rates derived from the respiratory sinus arrhythmia (RSA) and modulation of the QRS amplitude of electrocardiography (ECG) are combined with a respiratory rate derived from tri-axial accelerometer data. The three respiration rates are combined by a weighted average using weights based on quality metrics for each signal. The algorithm was evaluated on 15 elderly subjects who performed spontaneous and metronome breathing as well as a variety of activities of daily living (ADLs). When compared to a reference device, the mean absolute error was 1.02 breaths per minute (BrPM) during metronome breathing, 1.67 BrPM during spontaneous breathing, and 2.03 BrPM during ADLs. PMID:24110623

  9. Electrocardiographic Total 12-Lead QRS Voltage in Patients Having Operative Resection of Syphilitic Aortic Aneurysm.

    PubMed

    Roberts, William C; Barbin, Clay M; Weissenborn, Matthew R; Ko, Jong M

    2015-09-15

    Electrocardiographic voltage has been used to determine the presence of left ventricular hypertrophy for about 70 years. Varying electrocardiographic criteria have been applied. We have found total 12-lead QRS voltage to be most useful in this regard. We measured total 12-lead QRS voltage in 24 patients in whom an ascending aortic aneurysm was resected and histologic study of its wall was classic of syphilitic aortitis. In these 24 patients total 12-lead QRS voltage ranged from 57 to 161 mm, averaging 120 ± 32 in the 11 men and 106 ± 24 mm in the 13 women. If normal 12-lead QRS voltage in adults is considered to be >175 mm not a single one of the 24 patients had normal voltage. Indeed, most were in the low normal area. Thus, this study provides some evidence via this indirect means that the heart itself is infrequently involved by syphilitic aortitis which produces an ascending aortic aneurysm of sufficient size to warrant resection. PMID:26209115

  10. [The design of handheld fast ECG detector].

    PubMed

    Shi, Bo; Zhang, Genxuan; Tsau, Young

    2013-03-01

    A new handheld fast ECG detector based on low gain amplifier, the high resolution analog to digital converter, the real-time digital filter, fast P-QRS-T wave detection and abstraction algorithm was designed. The results showed that the ECG detector can meet the requirements of fast detecting heart rate and ECG P-QRS-T waveforms. PMID:23777065

  11. The classical versus the Cabrera presentation system for resting electrocardiography: Impact on recognition and understanding of clinically important electrocardiographic changes.

    PubMed

    Lam, Anny; Wagner, Galen S; Pahlm, Olle

    2015-01-01

    The classical system for presentation of the 12-lead electrocardiogram (ECG) reflects the electrical activity of the heart as viewed in the transverse plane by 6 leads with a single anatomically ordered sequence, V1-V6; but in the frontal plane by 6 leads with dual sequences, I, II, and III, and aVR, aVL, and aVF. However, there is also a single anatomically ordered sequence of leads, called the Cabrera display that presents the six frontal plane leads in their anatomically ordered sequence of: aVL, I, -aVR, II, aVF, and III. Although it has been recognized that the Cabrera system has clinical diagnostic advantages compared to the classical display, it is currently only used in Sweden. The primary explanation of why the Cabrera system has not been adopted internationally has been that analog ECG recorders had technical limitations. Currently, however, the classical system is most often seen as a historical remnant that prevails because of conservatism within the cardiology community. PMID:26051487

  12. Simplified 2D Bidomain Model of Whole Heart Electrical Activity and ECG Generation

    NASA Astrophysics Data System (ADS)

    Sovilj, Siniša; Magjarević, Ratko; Abed, Amr Al; Lovell, Nigel H.; Dokos, Socrates

    2014-06-01

    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.

  13. Value of Exercise ECG for Risk Stratification in Suspected or Known CAD in the Era of Advanced Imaging Technologies.

    PubMed

    Bourque, Jamieson M; Beller, George A

    2015-11-01

    Exercise stress electrocardiography (ExECG) is underutilized as the initial test modality in patients with interpretable electrocardiograms who are able to exercise. Although stress myocardial imaging techniques provide valuable diagnostic and prognostic information, variables derived from ExECG can yield substantial data for risk stratification, either supplementary to imaging variables or without concurrent imaging. In addition to exercise-induced ischemic ST-segment depression, such markers as ST-segment elevation in lead aVR, abnormal heart rate recovery post-exercise, failure to achieve target heart rate, and poor exercise capacity improve risk stratification of ExECG. For example, patients achieving ≥10 metabolic equivalents on ExECG have a very low prevalence of inducible ischemia and an excellent prognosis. In contrast, cardiac imaging techniques add diagnostic and prognostic value in higher-risk populations (e.g., poor functional capacity, diabetes, or chronic kidney disease). Optimal test selection for symptomatic patients with suspected coronary artery disease requires a patient-centered approach factoring in the risk/benefit ratio and cost-effectiveness. PMID:26563861

  14. Technology-Based vs. Traditional Instruction: A Comparison of Two Methods for Teaching the Skill of Performing a 12-Lead ECG.

    ERIC Educational Resources Information Center

    Jeffries, Pamela R.; Woolf, Shirley; Linde, Beverly

    2003-01-01

    Electrocardiogram technique was taught to 32 nursing students using a self-study module, lecture-demonstration, and hands-on learning laboratories and to 45 students using interactive multimedia CD-ROM with self-study module. Pre/postprogram data show satisfaction and score improvement was high for both, with no significant differences. (Contains…

  15. Gold-195m first-pass radionuclide ventriculography, thallium-201 single-photon emission CT, and 12-lead ECG stress testing as a combined procedure

    SciTech Connect

    Kipper, S.L.; Ashburn, W.L.; Norris, S.L.; Rimkus, D.S.; Dillon, W.A.

    1985-09-01

    Graded, sequential, rest/exercise, gold-195m, first-pass ventriculography and thallium-201 (Tl-201) single-photon emission computed tomography (SPECT) were performed simultaneously during a single, electrocardiograph-monitored, bicycle stress test in 24 individuals. The technical aspects and logistics involved in performing this combined radionuclide study are stressed in this preliminary report. Fourteen healthy volunteers each had a normal left ventricular ejection fraction and wall-motion response, along with normal T1-201 perfusion and washout, as determined by both visual and quantitative analysis of the tomographic sections. Each of ten patients with coronary artery disease had at least one abnormality of these parameters. The authors suggest that it is technically feasible to evaluate both cardiac function and myocardial perfusion simultaneously by combing Au-195m ventriculography and Tl-201 SPECT imaging into a single, noninvasive, diagnostic package.

  16. Embroidered Electrode with Silver/Titanium Coating for Long-Term ECG Monitoring

    PubMed Central

    Weder, Markus; Hegemann, Dirk; Amberg, Martin; Hess, Markus; Boesel, Luciano F.; Abächerli, Roger; Meyer, Veronika R.; Rossi, René M.

    2015-01-01

    For the long-time monitoring of electrocardiograms, electrodes must be skin-friendly and non-irritating, but in addition they must deliver leads without artifacts even if the skin is dry and the body is moving. Today's adhesive conducting gel electrodes are not suitable for such applications. We have developed an embroidered textile electrode from polyethylene terephthalate yarn which is plasma-coated with silver for electrical conductivity and with an ultra-thin titanium layer on top for passivation. Two of these electrodes are embedded into a breast belt. They are moisturized with a very low amount of water vapor from an integrated reservoir. The combination of silver, titanium and water vapor results in an excellent electrode chemistry. With this belt the long-time monitoring of electrocardiography (ECG) is possible at rest as well as when the patient is moving. PMID:25599424

  17. Embroidered electrode with silver/titanium coating for long-term ECG monitoring.

    PubMed

    Weder, Markus; Hegemann, Dirk; Amberg, Martin; Hess, Markus; Boesel, Luciano F; Abächerli, Roger; Meyer, Veronika R; Rossi, René M

    2015-01-01

    For the long-time monitoring of electrocardiograms, electrodes must be skin-friendly and non-irritating, but in addition they must deliver leads without artifacts even if the skin is dry and the body is moving. Today's adhesive conducting gel electrodes are not suitable for such applications. We have developed an embroidered textile electrode from polyethylene terephthalate yarn which is plasma-coated with silver for electrical conductivity and with an ultra-thin titanium layer on top for passivation. Two of these electrodes are embedded into a breast belt. They are moisturized with a very low amount of water vapor from an integrated reservoir. The combination of silver, titanium and water vapor results in an excellent electrode chemistry. With this belt the long-time monitoring of electrocardiography (ECG) is possible at rest as well as when the patient is moving. PMID:25599424

  18. Two hybrid regularization frameworks for solving the electrocardiography inverse problem

    NASA Astrophysics Data System (ADS)

    Jiang, Mingfeng; Xia, Ling; Shou, Guofa; Liu, Feng; Crozier, Stuart

    2008-09-01

    In this paper, two hybrid regularization frameworks, LSQR-Tik and Tik-LSQR, which integrate the properties of the direct regularization method (Tikhonov) and the iterative regularization method (LSQR), have been proposed and investigated for solving ECG inverse problems. The LSQR-Tik method is based on the Lanczos process, which yields a sequence of small bidiagonal systems to approximate the original ill-posed problem and then the Tikhonov regularization method is applied to stabilize the projected problem. The Tik-LSQR method is formulated as an iterative LSQR inverse, augmented with a Tikhonov-like prior information term. The performances of these two hybrid methods are evaluated using a realistic heart-torso model simulation protocol, in which the heart surface source method is employed to calculate the simulated epicardial potentials (EPs) from the action potentials (APs), and then the acquired EPs are used to calculate simulated body surface potentials (BSPs). The results show that the regularized solutions obtained by the LSQR-Tik method are approximate to those of the Tikhonov method, the computational cost of the LSQR-Tik method, however, is much less than that of the Tikhonov method. Moreover, the Tik-LSQR scheme can reconstruct the epcicardial potential distribution more accurately, specifically for the BSPs with large noisy cases. This investigation suggests that hybrid regularization methods may be more effective than separate regularization approaches for ECG inverse problems.

  19. Stability analysis of the inverse transmembrane potential problem in electrocardiography

    NASA Astrophysics Data System (ADS)

    Burger, Martin; Mardal, Kent-André; Nielsen, Bjørn Fredrik

    2010-10-01

    In this paper we study some mathematical properties of an inverse problem arising in connection with electrocardiograms (ECGs). More specifically, we analyze the possibility for recovering the transmembrane potential in the heart from ECG recordings, a challenge currently investigated by a growing number of groups. Our approach is based on the bidomain model for the electrical activity in the myocardium, and leads to a parameter identification problem for elliptic partial differential equations (PDEs). It turns out that this challenge can be split into two subproblems: the task of recovering the potential at the heart surface from body surface recordings; the problem of computing the transmembrane potential inside the heart from the potential determined at the heart surface. Problem (1), which can be formulated as the Cauchy problem for an elliptic PDE, has been extensively studied and is well known to be severely ill-posed. The main purpose of this paper is to prove that problem (2) is stable and well posed if a suitable prior is available. Moreover, our theoretical findings are illuminated by a series of numerical experiments. Finally, we discuss some aspects of uniqueness related to the anisotropy in the heart.

  20. Month-to-month and year-to-year reproducibility of high frequency QRS ECG signals

    NASA Technical Reports Server (NTRS)

    Batdorf, Niles J.; Feiveson, Alan H.; Schlegel, Todd T.

    2004-01-01

    High frequency electrocardiography analyzing the entire QRS complex in the frequency range of 150 to 250 Hz may prove useful in the detection of coronary artery disease, yet the long-term stability of these waveforms has not been fully characterized. Therefore, we prospectively investigated the reproducibility of the root mean squared voltage, kurtosis, and the presence versus absence of reduced amplitude zones in signal averaged 12-lead high frequency QRS recordings acquired in the supine position one month apart in 16 subjects and one year apart in 27 subjects. Reproducibility of root mean squared voltage and kurtosis was excellent over these time intervals in the limb leads, and acceptable in the precordial leads using both the V-lead and CR-lead derivations. The relative error of root mean squared voltage was 12% month-to-month and 16% year-to-year in the serial recordings when averaged over all 12 leads. Reduced amplitude zones were also reproducible up to a rate of 87% and 81%, respectively, for the month-to-month and year-to-year recordings. We conclude that 12-lead high frequency QRS electrocardiograms are sufficiently reproducible for clinical use.

  1. Month-to-Month and Year-to-Year Reproducibility of High Frequency QRS ECG signals

    NASA Technical Reports Server (NTRS)

    Batdorf, Niles; Feiveson, Alan H.; Schlegel, Todd T.

    2006-01-01

    High frequency (HF) electrocardiography analyzing the entire QRS complex in the frequency range of 150 to 250 Hz may prove useful in the detection of coronary artery disease, yet the long-term stability of these waveforms has not been fully characterized. We therefore prospectively investigated the reproducibility of the root mean squared (RMS) voltage, kurtosis, and the presence versus absence of reduced amplitude zones (RAzs) in signal averaged 12-lead HF QRS recordings acquired in the supine position one month apart in 16 subjects and one year apart in 27 subjects. Reproducibility of RMS voltage and kurtosis was excellent over these time intervals in the limb leads, and acceptable in the precordial leads using both the V-lead and CR-lead derivations. The relative error of RMS voltage was 12% month-to-month and 16% year-to-year in the serial recordings when averaged over all 12 leads. RAzs were also reproducible at a rate of up to 87% and 8 1 %, respectively, for the month-to-month and year-to-year recordings. We conclude that 12-lead HF QRS electrocardiograms are sufficiently reproducible for clinical use.

  2. Competency in ECG Interpretation Among Medical Students

    PubMed Central

    Kopeć, Grzegorz; Magoń, Wojciech; Hołda, Mateusz; Podolec, Piotr

    2015-01-01

    Background Electrocardiogram (ECG) is commonly used in diagnosis of heart diseases, including many life-threatening disorders. We aimed to assess skills in ECG interpretation among Polish medical students and to analyze the determinants of these skills. Material/Methods Undergraduates from all Polish medical schools were asked to complete a web-based survey containing 18 ECG strips. Questions concerned primary ECG parameters (rate, rhythm, and axis), emergencies, and common ECG abnormalities. Analysis was restricted to students in their clinical years (4th–6th), and students in their preclinical years (1st–3rd) were used as controls. Results We enrolled 536 medical students (females: n=299; 55.8%), aged 19 to 31 (23±1.6) years from all Polish medical schools. Most (72%) were in their clinical years. The overall rate of good response was better in students in years 4th–5th than those in years 1st–3rd (66% vs. 56%; p<0.0001). Competency in ECG interpretation was higher in students who reported ECG self-learning (69% vs. 62%; p<0.0001) but no difference was found between students who attended or did not attend regular ECG classes (66% vs. 66%; p=0.99). On multivariable analysis (p<0.0001), being in clinical years (OR: 2.45 [1.35–4.46] and self-learning (OR: 2.44 [1.46–4.08]) determined competency in ECG interpretation. Conclusions Polish medical students in their clinical years have a good level of competency in interpreting the primary ECG parameters, but their ability to recognize ECG signs of emergencies and common heart abnormalities is low. ECG interpretation skills are determined by self-education but not by attendance at regular ECG classes. Our results indicate qualitative and quantitative deficiencies in teaching ECG interpretation at medical schools. PMID:26541993

  3. Combining and benchmarking methods of foetal ECG extraction without maternal or scalp electrode data.

    PubMed

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

    2014-08-01

    Despite significant advances in adult clinical electrocardiography (ECG) signal processing techniques and the power of digital processors, the analysis of non-invasive foetal ECG (NI-FECG) is still in its infancy. The Physionet/Computing in Cardiology Challenge 2013 addresses some of these limitations by making a set of FECG data publicly available to the scientific community for evaluation of signal processing techniques.The abdominal ECG signals were first preprocessed with a band-pass filter in order to remove higher frequencies and baseline wander. A notch filter to remove power interferences at 50 Hz or 60 Hz was applied if required. The signals were then normalized before applying various source separation techniques to cancel the maternal ECG. These techniques included: template subtraction, principal/independent component analysis, extended Kalman filter and a combination of a subset of these methods (FUSE method). Foetal QRS detection was performed on all residuals using a Pan and Tompkins QRS detector and the residual channel with the smoothest foetal heart rate time series was selected.The FUSE algorithm performed better than all the individual methods on the training data set. On the validation and test sets, the best Challenge scores obtained were E1 = 179.44, E2 = 20.79, E3 = 153.07, E4 = 29.62 and E5 = 4.67 for events 1-5 respectively using the FUSE method. These were the best Challenge scores for E1 and E2 and third and second best Challenge scores for E3, E4 and E5 out of the 53 international teams that entered the Challenge. The results demonstrated that existing standard approaches for foetal heart rate estimation can be improved by fusing estimators together. We provide open source code to enable benchmarking for each of the standard approaches described. PMID:25069410

  4. Cost-effectiveness of pre-participation screening of athletes with ECG in Europe and Algeria.

    PubMed

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

    2015-03-01

    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. PMID:25164412

  5. High resolution ECG-aided early prognostic model for comatose survivors of out of hospital cardiac arrest.

    PubMed

    Rauber, Martin; Štajer, Dušan; Noč, Marko; Schlegel, Todd T; Starc, Vito

    2015-01-01

    Out of hospital cardiac arrest (OHCA) has a high mortality despite modern treatment. Reliable early prognosis in OHCA could significantly improve clinical decision making. We explored prognostic utility of advanced ECG parameters, obtained from high-resolution ECG, in combination with clinical and OHCA-related parameters during treatment with mild induced hypothermia (MIH) and after rewarming in unconscious survivors of OHCA. Ninety-two patients during MIH and 66 after rewarming were included. During MIH, a score based on initial rhythm, QRS-upslope and systolic pressure resulted in an area under curve (AUC) of 0.82 and accuracy of 80% for survival. After rewarming, a score based on admission rhythm, sum of 12 lead QRS voltages, and mean lateral ST segment level in leads I and V6 resulted in an AUC of 0.88 and accuracy of 85% for survival. ECG can assist with early prognostication in unconscious survivors of OHCA during MIH and after rewarming. PMID:25911585

  6. The Moli-sani project: computerized ECG database in a population-based cohort study.

    PubMed

    Iacoviello, Licia; Rago, Livia; Costanzo, Simona; Di Castelnuovo, Augusto; Zito, Francesco; Assanelli, Deodato; Badilini, Fabio; Donati, Maria Benedetta; de Gaetano, Giovanni

    2012-01-01

    Computerized electrocardiogram (ECG) acquisition and interpretation may be extremely useful in handling analysis of data from large cohort studies and exploit research on the use of ECG data as prognostic markers for cardiovascular disease. The Moli-sani project (http://www.moli-sani.org) is a population-based cohort study aiming at evaluating the risk factors linked to chronic-degenerative disease with particular regard to cardiovascular disease and cancer and intermediate metabolic phenotypes such as hypertension, diabetes, dyslipidemia, obesity, and metabolic syndrome. Between March 2005 and April 2010, 24 325 people aged 35 years or older, living in the Molise region (Italy), were randomly recruited. A follow-up based on linkage with hospital discharge records and mortality regional registry and reexamination of the cohort is ongoing and will be repeated at prefixed times. Each subject was administered questionnaires on personal and medical history, food consumption, quality of life (FS36), and psychometry. Plasma serum, cellular pellet, and urinary spots were stored in liquid nitrogen. Subjects were measured blood pressure, weight, height, and waist and hip circumferences, and underwent spirometry to evaluate pulmonary diffusion capacity, gas diffusion, and pulmonary volumes. Standard 12-lead resting ECG was performed by a Cardiette ar2100-view electrocardiograph and tracings stored in digital standard communication protocol format for subsequent analysis. The digital ECG database of the Moli-sani project is currently being used to assess the association between physiologic variables and pathophyiosiologic conditions and parameters derived from the ECG signal. This computerized ECG database represents a unique opportunity to identify and assess prognostic factors associated with cardiovascular and metabolic diseases. PMID:23021814

  7. Modern standards of ECG interpretation in young athletes: yield and effectiveness.

    PubMed

    Asif, Irfan M; Prutkin, Jordan M

    2015-01-01

    Although cardiovascular screening is recommended before participating in competitive sports, the role of the 12-lead electrocardiogram (ECG) has been debated. When added to the medical history and physical examination, an ECG used during the pre-participation screening (PPS) of young athletes can greatly enhance the ability to detect underlying cardiovascular pathology. Concerns over false positive rates, however, have posed an obstacle to large-scale implementation. The recent development of modern athlete-specific ECG interpretation criteria has dramatically reduced false positive rates to levels below other commonly used screening tests (e.g. breast cancer, prostate cancer) and subsequently improved cost effectiveness. There are also emerging data that certain sub-groups have a higher prevalence of ECG abnormalities, including males, athletes of Afro-Caribbean descent, basketball players, and endurance athletes. While false positive rates from a number of studies are reduced with the improved standards, there may be room for continued improvements. Future efforts should focus on refining criteria based on age, race, gender, ethnicity, and sport, while also clearly delineating the appropriate work-up strategies for those with abnormal findings, as this can lead to improved resource utilization. PMID:25595717

  8. A Wavelet-Based ECG Delineation Method: Adaptation to an Experimental Electrograms with Manifested Global Ischemia.

    PubMed

    Hejč, Jakub; Vítek, Martin; Ronzhina, Marina; Nováková, Marie; Kolářová, Jana

    2015-09-01

    We present a novel wavelet-based ECG delineation method with robust classification of P wave and T wave. The work is aimed on an adaptation of the method to long-term experimental electrograms (EGs) measured on isolated rabbit heart and to evaluate the effect of global ischemia in experimental EGs on delineation performance. The algorithm was tested on a set of 263 rabbit EGs with established reference points and on human signals using standard Common Standards for Quantitative Electrocardiography Standard Database (CSEDB). On CSEDB, standard deviation (SD) of measured errors satisfies given criterions in each point and the results are comparable to other published works. In rabbit signals, our QRS detector reached sensitivity of 99.87% and positive predictivity of 99.89% despite an overlay of spectral components of QRS complex, P wave and power line noise. The algorithm shows great performance in suppressing J-point elevation and reached low overall error in both, QRS onset (SD = 2.8 ms) and QRS offset (SD = 4.3 ms) delineation. T wave offset is detected with acceptable error (SD = 12.9 ms) and sensitivity nearly 99%. Variance of the errors during global ischemia remains relatively stable, however more failures in detection of T wave and P wave occur. Due to differences in spectral and timing characteristics parameters of rabbit based algorithm have to be highly adaptable and set more precisely than in human ECG signals to reach acceptable performance. PMID:26577367

  9. Triage tests for identifying atrial fibrillation in primary care: a diagnostic accuracy study comparing single-lead ECG and modified BP monitors

    PubMed Central

    Kearley, Karen; Selwood, Mary; Van den Bruel, Ann; Thompson, Matthew; Mant, David; Hobbs, FD Richard; Fitzmaurice, David; Heneghan, Carl

    2014-01-01

    Objective New electronic devices offer an opportunity within routine primary care settings for improving the detection of atrial fibrillation (AF), which is a common cardiac arrhythmia and a modifiable risk factor for stroke. We aimed to assess the performance of a modified blood pressure (BP) monitor and two single-lead ECG devices, as diagnostic triage tests for the detection of AF. Setting 6 General Practices in the UK. Participants 1000 ambulatory patients aged 75 years and over. Primary and secondary outcome measures Comparative diagnostic accuracy of modified BP monitor and single-lead ECG devices, compared to reference standard of 12-lead ECG, independently interpreted by cardiologists. Results A total of 79 participants (7.9%) had AF diagnosed by 12-lead ECG. All three devices had a high sensitivity (93.9–98.7%) and are useful for ruling out AF. WatchBP is a better triage test than Omron autoanalysis because it is more specific—89.7% (95% CI 87.5% to 91.6%) compared to 78.3% (95% CI 73.0% to 82.9%), respectively. This would translate into a lower follow-on ECG rate of 17% to rule in/rule out AF compared to 29.7% with the Omron text message in the study population. The overall specificity of single-lead ECGs analysed by a cardiologist was 94.6% for Omron and 90.1% for Merlin. Conclusions WatchBP performs better as a triage test for identifying AF in primary care than the single-lead ECG monitors as it does not require expertise for interpretation and its diagnostic performance is comparable to single-lead ECG analysis by cardiologists. It could be used opportunistically to screen elderly patients for undiagnosed AF at regular intervals and/or during BP measurement. PMID:24793250

  10. How can computerized interpretation algorithms adapt to gender/age differences in ECG measurements?

    PubMed

    Xue, Joel; Farrell, Robert M

    2014-01-01

    It is well known that there are gender differences in 12 lead ECG measurements, some of which can be statistically significant. It is also an accepted practice that we should consider those differences when we interpret ECGs, by either a human overreader or a computerized algorithm. There are some major gender differences in 12 lead ECG measurements based on automatic algorithms, including global measurements such as heart rate, QRS duration, QT interval, and lead-by-lead measurements like QRS amplitude, ST level, etc. The interpretation criteria used in the automatic algorithms can be adapted to the gender differences in the measurements. The analysis of a group of 1339 patients with acute inferior MI showed that for patients under age 60, women had lower ST elevations at the J point in lead II than men (57±91μV vs. 86±117μV, p<0.02). This trend was reversed for patients over age 60 (lead aVF: 102±126μV vs. 84±117μV, p<0.04; lead III: 130±146μV vs. 103±131μV, p<0.007). Therefore, the ST elevation thresholds were set based on available gender and age information, which resulted in 25% relative sensitivity improvement for women under age 60, while maintaining a high specificity of 98%. Similar analyses were done for prolonged QT interval and LVH cases. The paper uses several design examples to demonstrate (1) how to design a gender-specific algorithm, and (2) how to design a robust ECG interpretation algorithm which relies less on absolute threshold-based criteria and is instead more reliant on overall morphology features, which are especially important when gender information is unavailable for automatic analysis. PMID:25175175

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

    PubMed Central

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

    2015-01-01

    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. PMID:26587538

  12. Heritability of ECG Biomarkers in the Netherlands Twin Registry Measured from Holter ECGs

    PubMed Central

    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

    2016-01-01

    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

  13. The role of electrocardiography in the elaboration of a new paradigm in cardiac resynchronization therapy for patients with nonspecific intraventricular conduction disturbance

    PubMed Central

    Vereckei, András; Katona, Gábor; Szelényi, Zsuzsanna; Szénási, Gábor; Kozman, Bálint; Karádi, István

    2016-01-01

    Cardiac resynchronization therapy (CRT) is associated with a favorable outcome only in patients with left bundle branch block (LBBB) pattern and in patients with a QRS duration > 150 ms, in patients with non-LBBB pattern with a QRS duration of 120–150 ms usually is not beneficial. After adjusting for QRS duration, QRS morphology was no longer a determinant of the clinical response to CRT. In contrast to the mainstream view, we hypothesized that the unfavorable CRT outcome in patients with non-LBBB and a QRS duration of 120–150 ms is not due to the QRS morphology itself, but to less dyssynchrony and unfavorable patient characteristics in this subgroup, such as more ischemic etiology and greater prevalence of male patients compared with patients with LBBB pattern. Further, the current CRT technique is devised to eliminate the dyssynchrony present in patients with LBBB pattern and inappropriate to eliminate the dyssynchrony in patients with non-LBBB pattern. We also hypothesized that electrocardiography may also provide information about the presence of interventricular and left intraventricular dyssynchrony and the approximate location of the latest activated left ventricular (LV) region. To this end, we devised new ECG criteria to estimate interventricular and LV intraventricular dyssynchrony and the approximate location of the latest activated LV region. Our preliminary data demonstrated that the latest activated LV region in patients with nonspecific intraventricular conduction disturbance (NICD) pattern might be at a remote site from that present in patients with LBBB pattern, which might necessitate the invention of a novel CRT technique for patients with NICD pattern. The application of the new interventricular and LV intraventricular dyssynchrony ECG criteria and a potential novel CRT technique might decrease the currently high nonresponder rate in patients with NICD pattern. PMID:27168736

  14. The role of electrocardiography in the elaboration of a new paradigm in cardiac resynchronization therapy for patients with nonspecific intraventricular conduction disturbance.

    PubMed

    Vereckei, András; Katona, Gábor; Szelényi, Zsuzsanna; Szénási, Gábor; Kozman, Bálint; Karádi, István

    2016-02-01

    Cardiac resynchronization therapy (CRT) is associated with a favorable outcome only in patients with left bundle branch block (LBBB) pattern and in patients with a QRS duration > 150 ms, in patients with non-LBBB pattern with a QRS duration of 120-150 ms usually is not beneficial. After adjusting for QRS duration, QRS morphology was no longer a determinant of the clinical response to CRT. In contrast to the mainstream view, we hypothesized that the unfavorable CRT outcome in patients with non-LBBB and a QRS duration of 120-150 ms is not due to the QRS morphology itself, but to less dyssynchrony and unfavorable patient characteristics in this subgroup, such as more ischemic etiology and greater prevalence of male patients compared with patients with LBBB pattern. Further, the current CRT technique is devised to eliminate the dyssynchrony present in patients with LBBB pattern and inappropriate to eliminate the dyssynchrony in patients with non-LBBB pattern. We also hypothesized that electrocardiography may also provide information about the presence of interventricular and left intraventricular dyssynchrony and the approximate location of the latest activated left ventricular (LV) region. To this end, we devised new ECG criteria to estimate interventricular and LV intraventricular dyssynchrony and the approximate location of the latest activated LV region. Our preliminary data demonstrated that the latest activated LV region in patients with nonspecific intraventricular conduction disturbance (NICD) pattern might be at a remote site from that present in patients with LBBB pattern, which might necessitate the invention of a novel CRT technique for patients with NICD pattern. The application of the new interventricular and LV intraventricular dyssynchrony ECG criteria and a potential novel CRT technique might decrease the currently high nonresponder rate in patients with NICD pattern. PMID:27168736

  15. III Lead ECG Pulse Measurement Sensor

    NASA Astrophysics Data System (ADS)

    Thangaraju, S. K.; Munisamy, K.

    2015-09-01

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

  16. A 24-HOUR AMBULATORY ECG MONITORING IN ASSESSMENT OF QT INTERVAL DURATION AND DISPERSION IN ROWERS WITH PHYSIOLOGICAL MYOCARDIAL HYPERTROPHY

    PubMed Central

    Kim, Z.F.; Bilalova, R.R.; Tsibulkin, N.A.; Almetova, R.R.; Mudarisova, R.R.; Ahmetov, I.I.

    2013-01-01

    Myocardial hypertrophy (MH) due to cardiac pathology is characterized by an increase in QT interval duration and dispersion, while the findings for exercise-induced myocardial hypertrophy are contradictory. The majority of published research findings have not explored this relationship, but there have only been a few conducted studies using 24-hour ECG monitoring. The aim of the study was to determine the QT interval duration and dispersion in short-term and 24-hour ECG in endurance athletes with myocardial hypertrophy and without it. Methods: A total of 26 well-trained rowers underwent a resting 12-lead ECG, 24-hour ECG monitoring and echocardiography. Results: Athletes with MH (n = 7) at rest did not show any increase in QTc interval duration and dispersion, or mean and maximal QTc duration in Holter monitoring compared to athletes without MH (n = 19). Left ventricular mass was not significantly correlated with any QTc characteristics. Furthermore, athletes with MH had significantly longer mean QT (P = 0.01) and maximal QT (P = 0.018) intervals in Holter monitoring and higher 24-hour heart rate variability indexes due to stronger vagal effects. Conclusions: The present study demonstrated that athlete's heart syndrome with myocardial hypertrophy as a benign phenomenon does not lead to an increase in QT interval duration, or increases in maximal and mean duration in a 24-hour ECG. An increase in QT interval duration in athletes may have an autonomic nature. PMID:24744494

  17. Improving ECG Services at a Children's Hospital: Implementation of a Digital ECG System

    PubMed Central

    Osei, Frank A.; Gates, Gregory J.; Choi, Steven J.; Hsu, Daphne T.; Pass, Robert H.; Ceresnak, Scott R.

    2015-01-01

    Background. The use of digital ECG software and services is becoming common. We hypothesized that the introduction of a completely digital ECG system would increase the volume of ECGs interpreted at our children's hospital. Methods. As part of a hospital wide quality improvement initiative, a digital ECG service (MUSE, GE) was implemented at the Children's Hospital at Montefiore in June 2012. The total volume of ECGs performed in the first 6 months of the digital ECG era was compared to 18 months of the predigital era. Predigital and postdigital data were compared via t-tests. Results. The mean ECGs interpreted per month were 53 ± 16 in the predigital era and 216 ± 37 in the postdigital era (p < 0.001), a fourfold increase in ECG volume after introduction of the digital system. There was no significant change in inpatient or outpatient service volume during that time. The mean billing time decreased from 21 ± 27 days in the postdigital era to 12 ± 5 days in the postdigital era (p < 0.001). Conclusion. Implementation of a digital ECG system increased the volume of ECGs officially interpreted and reported. PMID:26451150

  18. A technique to evaluate the performance of computerized ECG analysis systems.

    PubMed

    Teppner, U; Lobodzinski, S; Neubert, D; Laks, M M

    1987-10-01

    No objective method to test computerized ECG systems has been available. Until now, tests have been conducted separately for instrumentation and algorithms. Hence, to facilitate objective verification and testing of modern computerized ECG equipment, a dedicated high resolution, low noise instrument (an "electronic test patient") has been developed. The purpose of this communication is to describe this new instrument and its electrocardiographic database. The instrument is designed not to cause any disturbances to the original ECG signals in the frequency range from 0 to 1 kHz. The input channels accommodating standard 12-lead and 3-lead Frank systems are sampled simultaneously at 10 kHz each with 90 dB dynamic range. The overall RMS noise figure of the instrument is 1 microV. The integral part of the instrument is a high resolution, high bandwidth minidatabase consisting of selected A-type and B-type verified electrocardiograms such as infarctions, ventricular hypertrophies, atrial fibrillations, etc. The minidatabase was collected with the aid of a computerized ECG system, which has a program for searching for specific electrocardiographic diagnosis. Each database record consists of simultaneous electrocardiographic signals of all standard leads and Frank leads, and a validated diagnostic report. A system under test is typically connected via its patient cable to the analog output of the instrument. The testing is performed with reference to the validated ECG from the database. In that way, our minidatabase is compatible with any electrocardiographic system. The only similar database assembled for testing purposes is that of the CSE group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3694104

  19. ECG findings after myocardial infarction in children after Kawasaki disease

    SciTech Connect

    Nakanishi, T.; Takao, A.; Kondoh, C.; Nakazawa, M.; Hiroe, M.; Matsumoto, Y.

    1988-10-01

    Standard 12-lead ECGs were evaluated in 17 children with myocardial infarction and 78 children without myocardial infarction after Kawasaki disease; sensitivity and specificity of the ECG infarction criteria were determined. The presence or absence of myocardial infarction was determined from either clinical examination results (coronary angiography, ventriculography, and thallium-201 myocardial imaging) or autopsy findings. Of seven patients with inferior infarction, abnormally deep Q waves in lead II, III, or aVF were observed in six, but the duration was greater than 0.04 second in only one (14%). The sensitivity and specificity of inferior infarction criteria based on Q wave amplitude were 86% and 97%, respectively. Of eight patients with anterior infarction, seven (88%) had abnormally deep and wide (greater than or equal to 0.04 second) Q waves in anterior chest leads. The sensitivity and specificity of the infarction criteria based on the amplitude and duration of the Q wave were 75% and 99%, respectively. Of seven patients with lateral infarction, Q waves were observed in lead I, aVL, or both in four patients, and in all of these patients Q waves were wider than 0.04 second. In two patients with both inferior and anterior infarction, Q waves were observed only in leads II, III, and aVF; in only one patient were the Q waves wider than 0.04 second. Thus deep Q waves in lead II, III, or aVF that are not wider than 0.04 second may indicate inferior infarction in children. Q waves in lead I, aVL, and chest leads associated with anterolateral infarction are in most instances deep and wide.

  20. [A USB-Based Digital ECG Sensor].

    PubMed

    Shi Bol; Kong, Xiangyong; Ma, Xiaozhi; Zhang, Genxuan

    2016-01-01

    Based on the ECG-specific BMD 101 integrated circun chip, this study designed a digital ECG sensor. In practical application, users just need to connect the ECG sensor 'o upper computer (such as PC or mobile phone) through USB interface, to realize the functions including display, alarm, saving, transfer etc. After tests, They demonstrate that the sensor can be applied to the detection of arrhythmia, such as bigeminy coupled rhythm, proiosystole etc. Besides, the sensor has various advantages in monitoring an managing the heart health of people out of hospital, including low cost, small volume, usableness, simplicity of operation etc. PMID:27197497

  1. ECG variable cine: computer program for presentation of temporal changes in ECG variables over different number of ECG leads.

    PubMed

    Viik, J; Vänttinen, H; Malmivuo, J

    2000-10-01

    The analysis of exercise electrocardiogram (ECG) is based on the alteration of the measured variables in the detection of coronary artery disease (CAD). In its existing form the analysis of the exercise ECG is laborious and requires much time. The temporal analysis of the ECG variable and the comparison between different phases of the exercise test is difficult and time consuming, especially the simultaneous examination of the variables over several leads. In this article we present a computer program, ECG Variable Cine, for the visualization of the temporal changes of values of exercise ECG variables over the selected ECG lead system. The program includes the stationary 3-D presentation for the variables' alteration simultaneously in all selected leads over the time of exercise test. In addition, the program determines two parameters; the average value of the variable over the selected leads at every sample moment, and the chronotropic index, a parameter that indicates heart rate response to exercise. According to the results the average value of ST-segment deviation at the end of the exercise over the leads and chronotropic index are clinically more competent than the maximum value of ST-segment depression in the detection of CAD. PMID:10960747

  2. Wavelets for full reconfigurable ECG acquisition system

    NASA Astrophysics Data System (ADS)

    Morales, D. P.; García, A.; Castillo, E.; Meyer-Baese, U.; Palma, A. J.

    2011-06-01

    This paper presents the use of wavelet cores for a full reconfigurable electrocardiogram signal (ECG) acquisition system. The system is compound by two reconfigurable devices, a FPGA and a FPAA. The FPAA is in charge of the ECG signal acquisition, since this device is a versatile and reconfigurable analog front-end for biosignals. The FPGA is in charge of FPAA configuration, digital signal processing and information extraction such as heart beat rate and others. Wavelet analysis has become a powerful tool for ECG signal processing since it perfectly fits ECG signal shape. The use of these cores has been integrated in the LabVIEW FPGA module development tool that makes possible to employ VHDL cores within the usual LabVIEW graphical programming environment, thus freeing the designer from tedious and time consuming design of communication interfaces. This enables rapid test and graphical representation of results.

  3. ECG Feature Extraction using Time Frequency Analysis

    NASA Astrophysics Data System (ADS)

    Nair, Mahesh A.

    The proposed algorithm is a novel method for the feature extraction of ECG beats based on Wavelet Transforms. A combination of two well-accepted methods, Pan Tompkins algorithm and Wavelet decomposition, this system is implemented with the help of MATLAB. The focus of this work is to implement the algorithm, which can extract the features of ECG beats with high accuracy. The performance of this system is evaluated in a pilot study using the MIT-BIH Arrhythmia database.

  4. Fragmented ECG as a Risk Marker in Cardiovascular Diseases

    PubMed Central

    Jain, Rahul; Singh, Robin; Yamini, Sundermurthy; Das, Mithilesh K

    2014-01-01

    Various noninvasive tests for risk stratification of sudden cardiac death (SCD) were studied, mostly in the context of structural heart disease such as coronary artery disease (CAD), cardiomyopathy and heart failure but have low positive predictive value for SCD. Fragmented QRS complexes (fQRS) on a 12-lead ECG is a marker of depolarization abnormality. fQRS include presence of various morphologies of the QRS wave with or without a Q wave and includes the presence of an additional R wave (R’) or notching in the nadir of the R’ (fragmentation) in two contiguous leads, corresponding to a major coronary artery territory. fQRS represents conduction delay from inhomogeneous activation of the ventricles due to myocardial scar. It has a high predictive value for myocardial scar and mortality in patients CAD. fQRS also predicts arrhythmic events and mortality in patients with implantable cardioverter defibrillator. It also signifies poor prognosis in patients with nonischemic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy and Brugada syndrome. However, fQRS is a nonspecific finding and its diagnostic prognostic should only be interpreted in the presence of pertinent clinical evidence and type of myocardial involvement (structural vs. structurally normal heart). PMID:24827794

  5. ECG patch monitors for assessment of cardiac rhythm abnormalities.

    PubMed

    Lobodzinski, S Suave

    2013-01-01

    The primary goal of long-term monitoring is the improvement of diagnostic yield. Despite the clear utility of Holter monitoring in clinical cardiology, issues of relatively low diagnostic yield, cost and inconvenience have motivated the development of ultra-portable devices referred to as ECG patch monitors. Although the "gold standard" for assessing cardiac rhythm abnormalities remains a 12-lead Holter, there is an increasing interest in portable monitoring devices that provide the opportunity for evaluating cardiac rhythm in real-world environments such as the workplace or home. To facilitate patient acceptance these monitors underwent a radical miniaturization and redesign to include wireless communication, water proofing and a patch carrier for attaching devices directly to the skin. We review recent developments in the field of "patch" devices primarily designed for very long-term monitoring of cardiac arrhythmic events. As the body of supporting clinical validation data grows, these devices hold promise for a variety of cardiac monitoring applications. From a clinical and research standpoint, the capacity to obtain longitudinal cardiac activity data by patch devices may have significant implications for device selection, monitoring duration, and care pathways for arrhythmia evaluation and atrial fibrillation surveillance. From a research standpoint, the new devices may allow for the development of novel diagnostic algorithms with the goal of finding patterns and correlations with exercise and drug regimens. PMID:24215754

  6. Signal processing using sparse derivatives with applications to chromatograms and ECG

    NASA Astrophysics Data System (ADS)

    Ning, Xiaoran

    In this thesis, we investigate the sparsity exist in the derivative domain. Particularly, we focus on the type of signals which posses up to Mth (M > 0) order sparse derivatives. Efforts are put on formulating proper penalty functions and optimization problems to capture properties related to sparse derivatives, searching for fast, computationally efficient solvers. Also the effectiveness of these algorithms are applied to two real world applications. In the first application, we provide an algorithm which jointly addresses the problems of chromatogram baseline correction and noise reduction. The series of chromatogram peaks are modeled as sparse with sparse derivatives, and the baseline is modeled as a low-pass signal. A convex optimization problem is formulated so as to encapsulate these non-parametric models. To account for the positivity of chromatogram peaks, an asymmetric penalty function is also utilized with symmetric penalty functions. A robust, computationally efficient, iterative algorithm is developed that is guaranteed to converge to the unique optimal solution. The approach, termed Baseline Estimation And Denoising with Sparsity (BEADS), is evaluated and compared with two state-of-the-art methods using both simulated and real chromatogram data. Promising result is obtained. In the second application, a novel Electrocardiography (ECG) enhancement algorithm is designed also based on sparse derivatives. In the real medical environment, ECG signals are often contaminated by various kinds of noise or artifacts, for example, morphological changes due to motion artifact, non-stationary noise due to muscular contraction (EMG), etc. Some of these contaminations severely affect the usefulness of ECG signals, especially when computer aided algorithms are utilized. By solving the proposed convex l1 optimization problem, artifacts are reduced by modeling the clean ECG signal as a sum of two signals whose second and third-order derivatives (differences) are sparse

  7. Comparison of heart rate variability signal features derived from electrocardiography and photoplethysmography in healthy individuals.

    PubMed

    Bolanos, M; Nazeran, H; Haltiwanger, E

    2006-01-01

    The heart rate variability (HRV) signal is indicative of autonomic regulation of the heart rate (HR). It could be used as a noninvasive marker in monitoring the physiological state of an individual. Currently, the primary method of deriving the HRV signal is to acquire the electrocardiogram (ECG) signal, apply appropriate QRS detection algorithms to locate the R wave and its peak, find the RR intervals, and perform suitable interpolation and resampling to produce a uniformly sampled tachogram. This process could sometimes result in errors in the HRV signal due to drift, electromagnetic and biologic interference, and the complex morphology of the ECG signal. The photoplethysmographic (PPG) signal has the potential to eliminate the problems with the ECG signal to derive the HRV signal. To investigate this point, a PDA-based system was developed to simultaneously record ECG and PPG signals to facilitate accurately controlled sampling and recording durations. Two healthy young volunteers participated in this pilot study to evaluate the applicability of our approach. To improve data quality, ECG and PPG recordings were acquired three times/subject. A comparison between different features of the HRV signals derived from both methods was performed to test the validity of using PPG signals in HRV analysis. We used autoregressive (AR) modeling, Poincare' plots, cross correlation, standard deviation, arithmetic mean, skewness, kurtosis, and approximate entropy (ApEn) to derive and compare different measures from both ECG and PPG signals. This study demonstrated that our PDA-based system was a convenient and reliable means for acquisition of PPG-derived and ECG-derived HRV signals. The excellent agreement between different measures of HRV signals acquired from both methods provides potential support for the idea of using PPGs instead of ECGs in HRV signal derivation and analysis in ambulatory cardiac monitoring of healthy individuals. PMID:17946618

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

    PubMed Central

    2013-01-01

    Background In Cardiovascular Magnetic Resonance (CMR), the synchronization of image acquisition with heart motion is performed in clinical practice by processing the electrocardiogram (ECG). The ECG-based synchronization is well established for MR scanners with magnetic fields up to 3 T. However, this technique is prone to errors in ultra high field environments, e.g. in 7 T MR scanners as used in research applications. The high magnetic fields cause severe magnetohydrodynamic (MHD) effects which disturb the ECG signal. Image synchronization is thus less reliable and yields artefacts in CMR images. Methods A strategy based on Independent Component Analysis (ICA) was pursued in this work to enhance the ECG contribution and attenuate the MHD effect. ICA was applied to 12-lead ECG signals recorded inside a 7 T MR scanner. An automatic source identification procedure was proposed to identify an independent component (IC) dominated by the ECG signal. The identified IC was then used for detecting the R-peaks. The presented ICA-based method was compared to other R-peak detection methods using 1) the raw ECG signal, 2) the raw vectorcardiogram (VCG), 3) the state-of-the-art gating technique based on the VCG, 4) an updated version of the VCG-based approach and 5) the ICA of the VCG. Results ECG signals from eight volunteers were recorded inside the MR scanner. Recordings with an overall length of 87 min accounting for 5457 QRS complexes were available for the analysis. The records were divided into a training and a test dataset. In terms of R-peak detection within the test dataset, the proposed ICA-based algorithm achieved a detection performance with an average sensitivity (Se) of 99.2%, a positive predictive value (+P) of 99.1%, with an average trigger delay and jitter of 5.8 ms and 5.0 ms, respectively. Long term stability of the demixing matrix was shown based on two measurements of the same subject, each being separated by one year, whereas an averaged detection

  9. In-Hospital Tele-ECG Triage and Interventional Cardiologist Activation of the Infarct Team for STEMI Patients is Associated with Improved Late Clinical Outcomes

    PubMed Central

    Chen, Kuan-Chun; Yin, Wei-Hsian; Young, Mason Shing; Wei, Jeng

    2016-01-01

    Background Due to recent advances, door-to-balloon time (D2BT) has been reduced significantly for patients with ST-segment elevation myocardial infarction (STEMI). However, whether this reduction can be translated into a concrete mortality or morbidity benefit is still the subject of controversy. We conducted a before-and-after study to determine the impact of in-hospital tele-electrocardiography (ECG) triage and interventional cardiologist activation of the infarct team on D2BT and long-term clinical outcomes in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Methods A total of 272 consecutive patients with acute STEMI undergoing PPCI were enrolled in our study, comprising 102 tele-ECG patients and 170 conventional triage patients. Major adverse cardiovascular and cerebral vascular events (MACCE), including death, recurrent nonfatal MI, nonfatal stroke, and angina-driven target vessel revascularization were recorded during a 3-year follow-up. Results The median D2BT of the tele-ECG group was significantly shorter than control group (79 minutes vs. 109 minutes, p < 0.001). The tele-ECG triage group had a higher percentage of patients reaching the D2BT goal (< 90 minutes) (78% vs. 55%; p < 0.001). The MACCE rate was significantly lower in the Tele-ECG versus the control group (23.5% vs. 38.2%, p = 0.012). Tele-ECG group had a lower mortality rate which did not reached statistical significance (2% vs. 5.9%, p = 0.102). In multivariable Cox proportional hazards analyses, the implementation of tele-ECG triage (HR = 0.43, p = 0.003) and the presence of moderate or severe mitral regurgitation at presentation (HR = 1.87, p = 0.029) were discovered as independently associated with MACCE. Conclusions In-hospital tele-ECG triage and interventional cardiologist activation can shorten D2BT and is associated with improved late clinical outcomes during a 3-year follow-up in STEMI patients undergoing PPCI. PMID:27471356

  10. High Resolution ECG for Evaluation of Heart Function During Exposure to Subacute Hypobaric Hypoxia

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

    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

  11. Tele-ECG and 24-hour physician support over telephone for rural doctors can help early treatment of acute myocardial infarction in rural areas.

    PubMed

    Vivek, Chauhan; Vikrant, Kanwar

    2016-04-01

    We observed that many patients of acute myocardial infarction (AMI) were reaching our hospital out of the 12 hour window period for thrombolysis. This led to poor patient outcomes. There were multiple reasons for the delay, prominent among them was lack of diagnostic facilities in the rural health care centers. We therefore planned a Tele-Electrocardiography (Tele-ECG) based pilot project in Kangra District of Himachal Pradesh in India, which was funded by the Indian Council of Medical Research. The intention was to reduce the pre-hospital delay in AMI by enabling the rural doctors of Kangra using Tele-ECG facility and a 24-hour physician support to manage patients of AMI. We did a baseline knowledge, attitude, and practice (KAP) assessment study of the doctors in our intervention centers to understand their needs. The data obtained through the KAP study was an eye opener for us and justifies the need for a Tele-ECG facility for rural doctors in India. PMID:26187625

  12. Robust human identification using ecg: eigenpulse revisited

    NASA Astrophysics Data System (ADS)

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

    2010-04-01

    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. Automatic sleep staging based on ECG signals using hidden Markov models.

    PubMed

    Ying Chen; Xin Zhu; Wenxi Chen

    2015-08-01

    This study is designed to investigate the feasibility of automatic sleep staging using features only derived from electrocardiography (ECG) signal. The study was carried out using the framework of hidden Markov models (HMMs). The mean, and SD values of heart rates (HRs) computed from each 30-second epoch served as the features. The two feature sequences were first detrended by ensemble empirical mode decomposition (EEMD), formed as a two-dimensional feature vector, and then converted into code vectors by vector quantization (VQ) method. The output VQ indexes were utilized to estimate parameters for HMMs. The proposed model was tested and evaluated on a group of healthy individuals using leave-one-out cross-validation. The automatic sleep staging results were compared with PSG estimated ones. Results showed accuracies of 82.2%, 76.0%, 76.1% and 85.5% for deep, light, REM and wake sleep, respectively. The findings proved that HRs-based HMM approach is feasible for automatic sleep staging and can pave a way for developing more efficient, robust, and simple sleep staging system suitable for home application. PMID:26736316

  14. ECG in neonate mice with spinal muscular atrophy allows assessment of drug efficacy.

    PubMed

    Heier, Christopher R; DiDonato, Christine J

    2015-01-01

    Molecular technologies have produced diverse arrays of animal models for studying genetic diseases and potential therapeutics. Many have neonatal phenotypes. Spinal muscular atrophy (SMA) is a neuromuscular disorder primarily affecting children, and is of great interest in translational medicine. The most widely used SMA mouse models require all phenotyping to be performed in neonates since they do not survive much past weaning. Pre-clinical studies in neonate mice can be hindered by toxicity and a lack of quality phenotyping assays, since many assays are invalid in pups or require subjective scoring with poor inter-rater variability. We find, however, that passive electrocardiography (ECG) recording in conscious 11-day old SMA mice provides sensitive outcome measures, detecting large differences in heart rate, cardiac conduction, and autonomic control resulting from disease. We find significant drug benefits upon treatment with G418, an aminoglycoside targeting the underlying protein deficiency, even in the absence of overt effects on growth and survival. These findings provide several quantitative physiological biomarkers for SMA preclinical studies, and will be of utility to diverse disease models featuring neonatal cardiac arrhythmias. PMID:25553367

  15. Independent component analysis of parameterized ECG signals.

    PubMed

    Tanskanen, Jarno M A; Viik, Jari J; Hyttinen, Jari A K

    2006-01-01

    Independent component analysis (ICA) of measured signals yields the independent sources, given certain fulfilled requirements. Properly parameterized signals provide a better view to the considered system aspects, while reducing the amount of data. It is little acknowledged that appropriately parameterized signals may be subjected to ICA, yielding independent components (ICs) displaying more clearly the investigated properties of the sources. In this paper, we propose ICA of parameterized signals, and demonstrate the concept with ICA of ST and R parameterizations of electrocardiogram (ECG) signals from ECG exercise test measurements from two coronary artery disease (CAD) patients. PMID:17945912

  16. Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias

    PubMed Central

    2014-01-01

    Background 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. Methods Design: prospective, observational, cross-sectional study. Setting: Clinical Physiology, University Hospital. Patients: 108 consecutive patients referred for ambiguous palpitations or dizziness/presyncope. Interventions: 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. Main outcome measures: Significant arrhythmias: atrial fibrillation (AF), paroxysmal supraventricular tachycardia (PSVT), atrioventricular (AV) block II–III, sinus arrest (SA), wide complex tachycardia (WCT). Results 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

  17. ECG Gated Ultrasonic Small Animal Imaging.

    PubMed

    Liu, Jian-Hung; Jeng, Geng-Shi; Wu, Tung-Ke; Li, Pai-Chi

    2005-01-01

    Echocardiography is a routine clinical procedure to diagnose cardiac functions. The organic structure of the mouse is similar to that of human so that murine echocardiography has potentially become an effective tool for the assessment of human cardiovascular disease. However, clinical ultrasonic imaging systems are not suitable for murine cardiac imaging due to its limited spatial and temporal resolution. Thus, high frequency ultrasonic imaging (≥ 20 MHz) is necessary in order to provide spatial resolution at the order of 100 μm. Furthermore, due to the lack of transducer arrays at such a high frequency, single-element transducer with mechanical scanning is typically used. Thus the frame rate is insufficient for imaging the quick motion of the mouse. In this paper, a high frequency ultrasonic imaging system with electrocardiography gating is built in order to provide both high spatial resolution and high temporal effecting resolution. The system utilizes the R-wave trigger signal from murine electrocardiography. Image data are acquired in either the block scanning mode or the line scanning mode. In block scanning, murine cardiac images in systole and diastole can be retrospectively reconstructed with a short data acquisition time. In line scanning, on the other hand, images during the entire cardiac cycle can be obtained. It is demonstrated that the effective frame rate can be up to 2 kHz, which is only limited by the pulse repetition rate of the system. PMID:17282556

  18. Usefulness of the 12-lead electrocardiogram in the follow-up of patients with cardiac resynchronization devices. Part II.

    PubMed

    Barold, S Serge; Herweg, Bengt

    2011-01-01

    The interval from the pacemaker stimulus to the onset of the earliest paced QRS complex (latency) may be prolonged during left ventricular (LV) pacing. Marked latency is more common with LV than right ventricular (RV) pacing because of indirect stimulation through a coronary vein and higher incidence of LV pathology including scars. During simultaneous biventricular (BiV) pacing a prolonged latency interval may give rise to an ECG dominated by the pattern of RV pacing with a left bundle branch block configuration and commonly a QS complex in lead V1. With marked latency programming the V-V interval (LV before RV) often restore the dominant R wave in lead V1 representing the visible contribution of the LV to overall myocardial depolarization. When faced with a negative QRS complex in lead V1 during simultaneous BiV pacing especially in setting of a relatively short PR interval, the most likely diagnosis is ventricular fusion with the intrinsic rhythm. Fusion may cause misinterpretation of the ECG because narrowing of the paced QRS complex simulates appropriate BiV capture. The diagnosis of fusion depends on temporary reprogramming a very short atrio-ventricular delay or an asynchronous BiV pacing mode. Sequential programming of various interventricular (V-V) delays may bring out a diagnostic dominant QRS complex in lead V1 that was previously negative with simultaneous LV and RV apical pacing even in the absence of an obvious latency problem. The emergence of a dominant R wave by V-V programming strongly indicates that the LV lead captures the LV from the posterior or the posterolateral coronary vein and therefore rules out pacing from the middle or anterior coronary vein. In some cardiac resynchronization systems LV pacing is achieved with the tip electrode of the LV lead as the cathode and the proximal electrode of the bipolar RV as the anode. This arrangement creates a common anode for both RV and LV pacing. RV anodal capture can occur at a high LV output during

  19. [Implementation of ECG Monitoring System Based on Internet of Things].

    PubMed

    Lu, Liangliang; Chen, Minya

    2015-11-01

    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. PMID:27066681

  20. Diagnosing Stroke in Acute Vertigo: The HINTS Family of Eye Movement Tests and the Future of the "Eye ECG".

    PubMed

    Newman-Toker, David E; Curthoys, Ian S; Halmagyi, G Michael

    2015-10-01

    Patients who present to the emergency department with symptoms of acute vertigo or dizziness are frequently misdiagnosed. Missed opportunities to promptly treat dangerous strokes can result in poor clinical outcomes. Inappropriate testing and incorrect treatments for those with benign peripheral vestibular disorders leads to patient harm and unnecessary costs. Over the past decade, novel bedside approaches to diagnose patients with the acute vestibular syndrome have been developed and refined. A battery of three bedside tests of ocular motor physiology known as "HINTS" (head impulse, nystagmus, test of skew) has been shown to identify acute strokes more accurately than even magnetic resonance imaging with diffusion-weighted imaging (MRI-DWI) when applied in the early acute period by eye-movement specialists. Recent advances in lightweight, high-speed video-oculography (VOG) technology have made possible a future in which HINTS might be applied by nonspecialists in frontline care settings using portable VOG. Use of technology to measure eye movements (VOG-HINTS) to diagnose stroke in the acute vestibular syndrome is analogous to the use of electrocardiography (ECG) to diagnose myocardial infarction in acute chest pain. This "eye ECG" approach could transform care for patients with acute vertigo and dizziness around the world. In the United States alone, successful implementation would likely result in improved quality of emergency care for hundreds of thousands of peripheral vestibular patients and tens of thousands of stroke patients, as well as an estimated national health care savings of roughly $1 billion per year. In this article, the authors review the origins of the HINTS approach, empiric evidence and pathophysiologic principles supporting its use, and possible uses for the eye ECG in teleconsultation, teaching, and triage. PMID:26444396

  1. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 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...

  2. Multichannel ECG and Noise Modeling: Application to Maternal and Fetal ECG Signals

    NASA Astrophysics Data System (ADS)

    Sameni, Reza; Clifford, Gari D.; Jutten, Christian; Shamsollahi, Mohammad B.

    2007-12-01

    A three-dimensional dynamic model of the electrical activity of the heart is presented. The model is based on the single dipole model of the heart and is later related to the body surface potentials through a linear model which accounts for the temporal movements and rotations of the cardiac dipole, together with a realistic ECG noise model. The proposed model is also generalized to maternal and fetal ECG mixtures recorded from the abdomen of pregnant women in single and multiple pregnancies. The applicability of the model for the evaluation of signal processing algorithms is illustrated using independent component analysis. Considering the difficulties and limitations of recording long-term ECG data, especially from pregnant women, the model described in this paper may serve as an effective means of simulation and analysis of a wide range of ECGs, including adults and fetuses.

  3. Preprocessing and analysis of the ECG signals

    NASA Astrophysics Data System (ADS)

    Zhu, Jianmin; Zhang, Xiaolan; Wang, Zhongyu; Wang, Xiaoling

    2008-10-01

    According to the request of automatic analysis and depressing high frequency interference of the ECG signals, this paper applies low-pass filter to preprocess ECG signals, and proposes a QRS complex detection method based on wavelet transform, which takes advantage of Marr wavelet to decompose and filter the ECG signals with Mallat algorithm, using the relationship between wavelet transform and signal singularity to detect QRS complex with amplitude threshold method in scale 3, and to detect P wave and R wave in scale 4. Meanwhile, compositive detection method is used for re-detection, thus to improving the detection accuracy ratio. At last, records from ECG database of MIT/BIH which is widely accepted in the world are used to test the algorithm. And the result shows that correction detecting ratio under this algorithm has been more than 99.8 percent. The detection method in this paper is simple and running fast, and is easy to be realized in the real-time detecting system using for clinical diagnosis.

  4. A Mathematical Model for Segmenting ECG Signals

    NASA Astrophysics Data System (ADS)

    Feier, Horea; Roşu, Doina; Falniţǎ, Lucian; Roşu, Şerban; Pater, Liana

    2010-09-01

    This paper deals with the behavior of the modulus of the continuous wavelet transform (CWT) for some known mother wavelets like the Morlet wavelet and the Mexican Hat. By exploiting these properties, the models presented can behave as a segmentation/ recognition signal processing tool by modeling the temporal structure of the observed surface ECG.

  5. Allometry of ECG waves in mammals.

    PubMed

    Günther, B; Morgado, E

    1997-01-01

    The present allometric study deals with the duration of three electrocardiographic intervals (PQ, QRS, QT) and their relationships with the corresponding cardiac cycle length (R-R interval) in mammals across a wide body mass range. The numerical values of the different ECG intervals were obtained from Grauwiler's (1965) monograph on the subject. Because the corresponding body masses were not given by this author, Heusner's (1991) data on basal metabolic rate as function of body mass were used to establish the most likely body mass figure for each case, based on the taxonomic identity between the corresponding specimens. On the other hand, in a recent study we established the "duality" of physiological times (Günther & Morgado, 1996) and, therefore, we adopted this novel approach to investigate the ECG intervals and their relationships with the R-R interval (heart rate reciprocal). Considering that the anatomy and physiology of auricles and ventricles are different (spheroids versus quasi-cylinders), and that excitation (sino-atrial node and His-Purkinje's system) and contraction processes can be described either by Euclidean or fractal geometries, only a quantitative analysis of the different ECG waves could resolve the dilemma. From the present preliminary study we can conclude that fractal geometry is prevalent with regard to ECG intervals. PMID:9711327

  6. QRS detection based ECG quality assessment.

    PubMed

    Hayn, Dieter; Jammerbund, Bernhard; Schreier, Günter

    2012-09-01

    Although immediate feedback concerning ECG signal quality during recording is useful, up to now not much literature describing quality measures is available. We have implemented and evaluated four ECG quality measures. Empty lead criterion (A), spike detection criterion (B) and lead crossing point criterion (C) were calculated from basic signal properties. Measure D quantified the robustness of QRS detection when applied to the signal. An advanced Matlab-based algorithm combining all four measures and a simplified algorithm for Android platforms, excluding measure D, were developed. Both algorithms were evaluated by taking part in the Computing in Cardiology Challenge 2011. Each measure's accuracy and computing time was evaluated separately. During the challenge, the advanced algorithm correctly classified 93.3% of the ECGs in the training-set and 91.6 % in the test-set. Scores for the simplified algorithm were 0.834 in event 2 and 0.873 in event 3. Computing time for measure D was almost five times higher than for other measures. Required accuracy levels depend on the application and are related to computing time. While our simplified algorithm may be accurate for real-time feedback during ECG self-recordings, QRS detection based measures can further increase the performance if sufficient computing power is available. PMID:22902864

  7. A Computer Language for ECG Contour Analysis

    PubMed Central

    McConnochie, John W.

    1982-01-01

    The purpose of this paper is to demonstrate contructively that criteria for ECG contour analysis can be interpreted directly by a computer. Thereby, the programming task is greatly reduced. Direct interpretation is achieved by the creation of a computer language that is well-suited for the expression of such criteria. Further development of the language is planned.

  8. Human Identification Using Compressed ECG Signals.

    PubMed

    Camara, Carmen; Peris-Lopez, Pedro; Tapiador, Juan E

    2015-11-01

    As a result of the increased demand for improved life styles and the increment of senior citizens over the age of 65, new home care services are demanded. Simultaneously, the medical sector is increasingly becoming the new target of cybercriminals due the potential value of users' medical information. The use of biometrics seems an effective tool as a deterrent for many of such attacks. In this paper, we propose the use of electrocardiograms (ECGs) for the identification of individuals. For instance, for a telecare service, a user could be authenticated using the information extracted from her ECG signal. The majority of ECG-based biometrics systems extract information (fiducial features) from the characteristics points of an ECG wave. In this article, we propose the use of non-fiducial features via the Hadamard Transform (HT). We show how the use of highly compressed signals (only 24 coefficients of HT) is enough to unequivocally identify individuals with a high performance (classification accuracy of 0.97 and with identification system errors in the order of 10(-2)). PMID:26364201

  9. ECG biometric identification: A compression based approach.

    PubMed

    Bras, Susana; Pinho, Armando J

    2015-08-01

    Using the electrocardiogram signal (ECG) to identify and/or authenticate persons are problems still lacking satisfactory solutions. Yet, ECG possesses characteristics that are unique or difficult to get from other signals used in biometrics: (1) it requires contact and liveliness for acquisition (2) it changes under stress, rendering it potentially useless if acquired under threatening. Our main objective is to present an innovative and robust solution to the above-mentioned problem. To successfully conduct this goal, we rely on information-theoretic data models for data compression and on similarity metrics related to the approximation of the Kolmogorov complexity. The proposed measure allows the comparison of two (or more) ECG segments, without having to follow traditional approaches that require heartbeat segmentation (described as highly influenced by external or internal interferences). As a first approach, the method was able to cluster the data in three groups: identical record, same participant, different participant, by the stratification of the proposed measure with values near 0 for the same participant and closer to 1 for different participants. A leave-one-out strategy was implemented in order to identify the participant in the database based on his/her ECG. A 1NN classifier was implemented, using as distance measure the method proposed in this work. The classifier was able to identify correctly almost all participants, with an accuracy of 99% in the database used. PMID:26737619

  10. Computer Interpretations of ECGs in Rural Hospitals

    PubMed Central

    Thompson, James M.

    1992-01-01

    Computer-assisted interpretation of electrocardiograms offers theoretical benefits to rural physicians. This study compared computer-assisted interpretations by a rural physician certified to read ECGs with interpretations by the computer alone. The computer interpretation alone could have led to major errors in patient management, but was correct sufficiently often to warrant purchase by small rural hospitals. PMID:21221365

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

    PubMed Central

    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

    2015-01-01

    Background 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. Methods 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). Results 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. Conclusions 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. PMID:24948082

  12. Novel electrodes for underwater ECG monitoring.

    PubMed

    Reyes, Bersain A; Posada-Quintero, Hugo F; Bales, Justin R; Clement, Amanda L; Pins, George D; Swiston, Albert; Riistama, Jarno; Florian, John P; Shykoff, Barbara; Qin, Michael; Chon, Ki H

    2014-06-01

    We have developed hydrophobic electrodes that provide all morphological waveforms without distortion of an ECG signal for both dry and water-immersed conditions. Our electrode is comprised of a mixture of carbon black powder (CB) and polydimethylsiloxane (PDMS). For feasibility testing of the CB/PDMS electrodes, various tests were performed. One of the tests included evaluation of the electrode-to-skin contact impedance for different diameters, thicknesses, and different pressure levels. As expected, the larger the diameter of the electrodes, the lower the impedance and the difference between the large sized CB/PDMS and the similarly-sized Ag/AgCl hydrogel electrodes was at most 200 kΩ, in favor of the latter. Performance comparison of CB/PDMS electrodes to Ag/AgCl hydrogel electrodes was carried out in three different scenarios: a dry surface, water immersion, and postwater immersion conditions. In the dry condition, no statistical differences were found for both the temporal and spectral indices of the heart rate variability analysis between the CB/PDMS and Ag/AgCl hydrogel (p > 0.05) electrodes. During water immersion, there was significant ECG amplitude reduction with CB/PDMS electrodes when compared to wet Ag/AgCl electrodes kept dry by their waterproof adhesive tape, but the reduction was not severe enough to obscure the readability of the recordings, and all morphological waveforms of the ECG signal were discernible even when motion artifacts were introduced. When water did not penetrate tape-wrapped Ag/AgCl electrodes, high fidelity ECG signals were observed. However, when water penetrated the Ag/AgCl electrodes, the signal quality degraded to the point where ECG morphological waveforms were not discernible. PMID:24845297

  13. Comparison of exercise electrocardiography and quantitative thallium imaging for one-vessel coronary artery disease

    SciTech Connect

    Kaul, S.; Kiess, M.; Liu, P.; Guiney, T.E.; Pohost, G.M.; Okada, R.D.; Boucher, C.A.

    1985-08-01

    The relative value of exercise electrocardiography and computer analyzed thallium-201 imaging was compared in 124 patients with 1-vessel coronary artery disease (CAD). Of these, 78 had left anterior descending (LAD), 32 right and 14 left circumflex (LC) CAD. In patients with no previous myocardial infarction (MI), thallium imaging was more sensitive than the electrocardiogram (78% vs 64%, p less than 0.01), but in patients with previous MI, sensitivity was similar. Further, thallium imaging was more sensitive only in LAD and LC disease. Redistribution was compared with ST-segment depression as a marker of ischemia. Only in patients with prior MI (76% vs 44%, p less than 0.01) and only in LC and right CAD did redistribution occur more often than ST depression. Thallium imaging was more accurate in localizing stenoses than the electrocardiogram (p less than 0.001), but did not always correctly predict coronary anatomy. Septal thallium defects were associated with LAD disease in 84%, inferior defects with right CAD in 40% and posterolateral lesion defects with LC CAD in 22%. The results indicate the overall superiority of thallium imaging in 1-vessel CAD compared with exercise electrocardiography; however, there is a wide spectrum of extent and location of perfusion defects associated with each coronary artery. Thallium imaging complements coronary angiography by demonstrating the functional impact of CAD on myocardial perfusion.

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

    PubMed Central

    Tseng, Kuo-Kun; Luo, Jiao; Wang, Wenmin; Haiting, Dong

    2015-01-01

    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. PMID:25961074

  15. Denoising ECG signal based on ensemble empirical mode decomposition

    NASA Astrophysics Data System (ADS)

    Zhi-dong, Zhao; Liu, Juan; Wang, Sheng-tao

    2011-10-01

    The electrocardiogram (ECG) has been used extensively for detection of heart disease. Frequently the signal is corrupted by various kinds of noise such as muscle noise, electromyogram (EMG) interference, instrument noise etc. In this paper, a new ECG denoising method is proposed based on the recently developed ensemble empirical mode decomposition (EEMD). Noisy ECG signal is decomposed into a series of intrinsic mode functions (IMFs). The statistically significant information content is build by the empirical energy model of IMFs. Noisy ECG signal collected from clinic recording is processed using the method. The results show that on contrast with traditional methods, the novel denoising method can achieve the optimal denoising of the ECG signal.

  16. The Development of a Portable ECG Monitor Based on DSP

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

    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

    2014-06-01

    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. PMID:24687081

  18. Electrocardiography in two subspecies of manatee (Trichechus manatus latirostris and Trichechus manatus manatus)

    USGS Publications Warehouse

    Siegal-Willott, J.; Estrada, A.; Bonde, R.K.; Wong, A.; Estrada, D.J.; Harr, K.

    2006-01-01

    Electrocardiographic (ECG) measurements were recorded in two subspecies of awake, apparently healthy, wild manatees (Trichechus manatus latirostris and T. m. manatus) undergoing routine field examinations in Florida and Belize. Six unsedated juveniles (dependent and independent calves) and 6 adults were restrained in ventral recumbency for ECG measurements. Six lead ECGs were recorded for all manatees and the following parameters were determined: heart rate and rhythm; P, QRS, and T wave morphology, amplitude, and duration; and mean electrical axis (MEA). Statistical differences using a t-test for equality of means were determined. No statistical difference was seen based on sex or subspecies of manatees in the above measured criteria. Statistical differences existed in heart rate (P = 0.047), P wave duration (P = 0.019), PR interval (P = 0.025), and MEA (P = 0.021) between adult manatees and calves. Our findings revealed normal sinus rhythms, no detectable arrhythmias, prolonged PR and QT intervals, prolonged P wave duration, and small R wave amplitude as compared with cetacea and other marine mammals. This paper documents the techniques for and baseline recordings of ECGs in juvenile and adult free-living manatees. It also demonstrates that continual assessment of cardiac electrical activity in the awake manatee can be completed and can be used to aid veterinarians and biologists in routine health assessment, during procedures, and in detecting the presence of cardiac disease or dysfunction.

  19. Electrocardiography in two subspecies of manatee (Trichechus manatus latirostris and T. m. manatus).

    PubMed

    Siegal-Willott, Jessica; Estrada, Amara; Bonde, Robert; Wong, Arthur; Estrada, Daniel J; Harr, Kendal

    2006-12-01

    Electrocardiographic (ECG) measurements were recorded in two subspecies of awake, apparently healthy, wild manatees (Trichechus manatus latirostris and T. m. manatus) undergoing routine field examinations in Florida and Belize. Six unsedated juveniles (dependent and independent calves) and 6 adults were restrained in ventral recumbency for ECG measurements. Six lead ECGs were recorded for all manatees and the following parameters were determined: heart rate and rhythm; P, QRS, and T wave morphology, amplitude, and duration; and mean electrical axis (MEA). Statistical differences using a t-test for equality of means were determined. No statistical difference was seen based on sex or subspecies of manatees in the above measured criteria. Statistical differences existed in heart rate (P = 0.047), P wave duration (P = 0.019), PR interval (P = 0.025), and MEA (P = 0.021) between adult manatees and calves. Our findings revealed normal sinus rhythms, no detectable arrhythmias, prolonged PR and QT intervals, prolonged P wave duration, and small R wave amplitude as compared with cetacea and other marine mammals. This paper documents the techniques for and baseline recordings of ECGs in juvenile and adult free-living manatees. It also demonstrates that continual assessment of cardiac electrical activity in the awake manatee can be completed and can be used to aid veterinarians and biologists in routine health assessment, during procedures, and in detecting the presence of cardiac disease or dysfunction. PMID:17315428

  20. High Resolution ECG for Evaluation of QT Interval Variability during Exposure to Acute Hypoxia

    NASA Technical Reports Server (NTRS)

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

    2010-01-01

    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.

  1. Single frequency RF powered ECG telemetry system

    NASA Technical Reports Server (NTRS)

    Ko, W. H.; Hynecek, J.; Homa, J.

    1979-01-01

    It has been demonstrated that a radio frequency magnetic field can be used to power implanted electronic circuitry for short range telemetry to replace batteries. A substantial reduction in implanted volume can be achieved by using only one RF tank circuit for receiving the RF power and transmitting the telemetered information. A single channel telemetry system of this type, using time sharing techniques, was developed and employed to transmit the ECG signal from Rhesus monkeys in primate chairs. The signal from the implant is received during the period when the RF powering radiation is interrupted. The ECG signal is carried by 20-microsec pulse position modulated pulses, referred to the trailing edge of the RF powering pulse. Satisfactory results have been obtained with this single frequency system. The concept and the design presented may be useful for short-range long-term implant telemetry systems.

  2. An unusual ECG pattern in restrictive cardimyopathy

    PubMed Central

    Selvaganesh, M.; Arul, A.S.; Balasubramanian, S.; Ganesan, N.; Naina Mohammed, S.; Sivakumar, G.S.; Veeramani, S.R.; Jeyasingh, P.; Sathishkumar, S.; Selvaraju, S.

    2015-01-01

    Restrictive cardiomyopathy is the least common type of primary cardiomyopathies. Electrocardiographic recording is abnormal in 99% of patients with RCM. Biatrial enlargement, obliquely elevated ST segment with notched or biphasic late peaking T waves are considered characteristic ECG finding. Significant ST depression with T inversion mimicking subendocardial ischemia has also been reported in patients with RCM and is even suggested as a predictor of sudden cardiac death. We noted a similar ECG pattern in a 16 yr girl with Idiopathic restrictive cardiomyopathy. Coronaries were normal, stress perfusion imaging did not show any perfusion defect. This diffuse resting ST depression with T inversion in precordial & inferior leads along with ST elevation in aVR was persistent for more than six months. PMID:26304570

  3. An unusual ECG pattern in restrictive cardimyopathy.

    PubMed

    Selvaganesh, M; Arul, A S; Balasubramanian, S; Ganesan, N; Naina Mohammed, S; Sivakumar, G S; Veeramani, S R; Jeyasingh, P; Sathishkumar, S; Selvaraju, S

    2015-01-01

    Restrictive cardiomyopathy is the least common type of primary cardiomyopathies. Electrocardiographic recording is abnormal in 99% of patients with RCM. Biatrial enlargement, obliquely elevated ST segment with notched or biphasic late peaking T waves are considered characteristic ECG finding. Significant ST depression with T inversion mimicking subendocardial ischemia has also been reported in patients with RCM and is even suggested as a predictor of sudden cardiac death. We noted a similar ECG pattern in a 16 yr girl with Idiopathic restrictive cardiomyopathy. Coronaries were normal, stress perfusion imaging did not show any perfusion defect. This diffuse resting ST depression with T inversion in precordial & inferior leads along with ST elevation in aVR was persistent for more than six months. PMID:26304570

  4. Capacitive measurement of ECG for ubiquitous healthcare.

    PubMed

    Lim, Yong Gyu; Lee, Jeong Su; Lee, Seung Min; Lee, Hong Ji; Park, Kwang Suk

    2014-11-01

    The technology for measuring ECG using capacitive electrodes and its applications are reviewed. Capacitive electrodes are built with a high-input-impedance preamplifier and a shield on their rear side. Guarding and driving ground are used to reduce noise. An analysis of the intrinsic noise shows that the thermal noise caused by the resistance in the preamplifier is the dominant factor of the intrinsic noise. A fully non-contact capacitive measurement has been developed using capacitive grounding and applied to a non-intrusive ECG measurement in daily life. Many ongoing studies are examining how to enhance the quality and ease of applying electrodes, thus extending their applications in ubiquitous healthcare from attached-on-object measurements to wearable or EEG measurements. PMID:25052344

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

    PubMed

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

    2015-01-01

    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

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

    PubMed Central

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

    2015-01-01

    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

  7. Interpretation module for screening normal ECG.

    PubMed

    Holzmann, C; Hasseldieck, U; Rosselot, E; Estévez, P; Andrade, A; Acuña, G

    1990-01-01

    This work concerns the development of a module for automatic recognition of normal ECGs, i.e. those whose waves morphology do not suggest physiopathological or structural heart alterations. Such a unit constitutes the central part of an administrative system under development which will aid in the management of ECG testing in the primary care delivery level in Chile. This system greatly contributes to the optimal allocation of resources in order to increase the test delivery coverage and to reduce the social and private costs involved. A main feature of the system is that it operates through the screening of normal ECG. This process is performed in a computerized unit whose core is the interpretation module. The design of such a module uses concepts and methods previously developed for the general problem of medical diagnosis, based on fuzzy set theory. The interpretation module parameters were adjusted considering hypothetical and real data covering a wide variety of normal and pathological cases. Then its performance was tested using more than one hundred patients' records chosen at random. Results of this test are given and a discussion, including a comparison with similar commercial equipment, is provided. PMID:2146480

  8. A model-based approach to human identification using ECG

    NASA Astrophysics Data System (ADS)

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

    2009-05-01

    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.

  9. Comparative electrocardiography in four species of macaws (genera Anodorhynchus and Ara).

    PubMed

    Casares, M; Enders, F; Montoya, J A

    2000-06-01

    Electrocardiograms (ECGs) were recorded during isoflurane anaesthesia from 52 macaws of four species of the genera Anodorhynchus and Ara in order to establish electrocardiographic reference values. The birds examined were clinically healthy macaws of the following species: hyacinth macaw (HM; Anodorhynchus hyacinthinus, n = 14); green-winged macaw (GWM; Ara chloroptera, n = 11); blue-throated macaw (BTM; Ara glaucogularis, n = 15); and red-fronted macaw (RFM; Ara rubrogenys, n = 12). All ECGs were recorded using a paper speed of 50 mm/s and a calibration of 10 mm = 1 mV. Significant differences were determined between species for the heart rate, duration and amplitude of the P wave, amplitude of the T wave, and amplitude of the QRS complex, specially comparing the RFM to the other macaw species. No significant differences were found between two species of similar body weight: the HM and the GWM. PMID:10932524

  10. [A telemedicine electrocardiography system based on the component-architecture soft].

    PubMed

    Potapov, I V; Selishchev, S V

    2004-01-01

    The paper deals with a universal component-oriented architecture for creating the telemedicine applications. The worked-out system ensures the ECG reading, pressure measurements and pulsometry. The system design comprises a central database server and a client telemedicine module. Data can be transmitted via different interfaces--from an ordinary local network to digital satellite phones. The data protection is guaranteed by microchip charts that were used to realize the authentication 3DES algorithm. PMID:15293500

  11. [Transtelephonic electrocardiography in Mexico. A report of the first 3434 cases].

    PubMed

    González-Espino, J F; Robledo Nolasco, R; Alcedo Miranda, J A; Vadillo Ortega, E; Iturralde Torres, P; Colín Lizalde, L; Kershenovich, S; de la Fuente Magallanes, F; Gershoni, O

    1995-01-01

    The transtelephonic electrocardiographic system started in the 70's and it was used mainly in the study of heart disease, cardiac arrhythmias, syncope and sudden death. This report, include 3434 electrocardiogram (ECG) of patients whom visit the emergency room at the General Hospital and private clinic, using three different forms of transtelephonic monitors. The total population were 1715 males and 1719 females with average age of 52.2 +/- 28.8 years. 26.9% had was present in history of systemic hypertension, non-insulin dependent diabetes 12.3% and myocardial ischemic disease in 5.3%. The main ECG indications were chest pain 38.7%, most of them atypical angina, palpitations in 6.9% and dyspnea in 6.5%. 50.1% of the ECG were abnormal. The most important diagnosis were: tachyarrhythmias (25.2%), intraventricular conduction abnormalities (17.7%), myocardial ischemic disease (16%), and premature ventricular and supraventricular beats (11.6%). We concluded that the transtelephonic electrocardiographic system is a very useful method, and available now in Mexico. We detected a high percentage of electrocardiographic abnormalities, it was possible to give the right diagnosis of arrhythmias, acute myocardial infarction, old infarction, and to evaluate the pacemaker functionality. Finally, it helped to get in brief time the diagnosis and treatment in cases of acute myocardial infarction or severe arrhythmias. PMID:7575020

  12. Comparison of minimum-norm estimation and beamforming in electrocardiography with acute ischemia.

    PubMed

    Konttila, Teijo; Mäntynen, Ville; Stenroos, Matti

    2014-04-01

    In the electrocardiographic (ECG) inverse problem, the electrical activity of the heart is estimated from measured electrocardiogram. A model of thorax conductivities and a model of the cardiac generator is required for the ECG inverse problem. Limitations and errors in methods, models, and data will lead to errors in the estimates. However, in experimental applications, the use of limited or erroneous models is often inevitable due to necessary model simplifications and the difficulty of obtaining accurate 3D anatomical imaging data. In this work, we focus on two methods for solving the inverse problem of ECG in the case of acute ischemia: minimum-norm (MN) estimation and linearly constrained minimum-variance beamforming. We study how these methods perform with different sizes of ischemia and with erroneous conductivity models. The results indicate that the beamformer can localize small ischemia given an accurate model, but it cannot be used for estimating the size of ischemia. The MN estimator is tolerant to geometry errors and excels in estimating the size of ischemia, although the beamformer performs better with accurate model and small ischemia. PMID:24621883

  13. Assessment of Cardiac Rate and Rhythm in Fetuses with Arrhythmia via Maternal Abdominal Fetal Electrocardiography

    PubMed Central

    Narayan, Hari K.; Vignola, Emilia F.; Fifer, William P.; Williams, Ismee A.

    2015-01-01

    Objective This study aims to report our experience using the Monica AN24 (Monica Healthcare Ltd., Nottingham, United Kingdom), a maternal transabdominal fetal electrocardiographic monitor, in a case series of fetuses with arrhythmias. Study Design We recorded fetal electrocardiograms (fECGs) on subjects with fetal arrhythmias diagnosed by fetal echocardiogram. Fetal heart rate and rhythm were determined via manual fECG analysis. Results Overall, 20 fECGs were recorded from a pool of 13 subjects. Fetal heart rate acquisition was determined to be high, medium, and poor quality in 10, 3, and 7 tracings, respectively. High-quality tracings were obtained in 9 of 11 subjects with gestational age < 26 or > 34 weeks. P waves were detectable in five tracings. Conclusion In subjects < 26 or > 34 weeks' gestational age, there was reasonable success in fetal heart rate acquisition. Further study is warranted to determine the potential role of this device in the monitoring of subjects with fetal arrhythmias. PMID:26495180

  14. ST/HR hysteresis: exercise and recovery phase ST depression/heart rate analysis of the exercise ECG.

    PubMed

    Lehtinen, R

    1999-01-01

    ST segment depression/heart rate (ST/HR) hysteresis is a recently introduced novel computer method for integrating the exercise and recovery phase ST/HR analysis for improved detection of coronary artery disease (CAD). It is a continuous diagnostic variable that extracts the prevailing direction and average magnitude of the hysteresis in ST depression against HR during the first 3 consecutive minutes of postexercise recovery. This article reviews the development and evaluation of this new method in a clinical population of 347 patients referred for a routine bicycle exercise electrocardiographic (ECG) test at Tampere University Hospital, Finland. Of these patients, 127 had angiographically proven CAD, whereas 13 had no CAD according to angiography, 18 had no perfusion defect according to Tc-99m-sestamibi myocardial imaging and single photon emission computed tomography, and 189 were clinically normal with respect to cardiac diseases. For each patient, the values for ST/HR hysteresis, ST/HR index, end-exercise ST depression, and recovery ST depression were determined for each lead of the Mason-Likar modification of the standard 12-lead exercise ECG and maximum value from the lead system (aVL, aVR, and V1 excluded). The area under the receiver operating characteristics curve (ie, the discriminative capacity) of the ST/HR hysteresis was 89%, which was significantly larger than that of the end-exercise ST depression (76%, P < .0001), recovery ST depression (84%, P = .0063) or ST/HR index (83%, P = .0023), indicating the best diagnostic performance of the ST/HR hysteresis in detection of CAD regardless of the partition value selection. Furthermore, the superior diagnostic performance of the method was relatively insensitive to the ST segment measurement point or to the ECG lead selection. These results suggest that the ST/HR hysteresis improves the clinical utility of the exercise ECG test in detection of CAD. PMID:10688326

  15. ECG feature extraction and disease diagnosis.

    PubMed

    Bhyri, Channappa; Hamde, S T; Waghmare, L M

    2011-01-01

    An important factor to consider when using findings on electrocardiograms for clinical decision making is that the waveforms are influenced by normal physiological and technical factors as well as by pathophysiological factors. In this paper, we propose a method for the feature extraction and heart disease diagnosis using wavelet transform (WT) technique and LabVIEW (Laboratory Virtual Instrument Engineering workbench). LabVIEW signal processing tools are used to denoise the signal before applying the developed algorithm for feature extraction. First, we have developed an algorithm for R-peak detection using Haar wavelet. After 4th level decomposition of the ECG signal, the detailed coefficient is squared and the standard deviation of the squared detailed coefficient is used as the threshold for detection of R-peaks. Second, we have used daubechies (db6) wavelet for the low resolution signals. After cross checking the R-peak location in 4th level, low resolution signal of daubechies wavelet P waves and T waves are detected. Other features of diagnostic importance, mainly heart rate, R-wave width, Q-wave width, T-wave amplitude and duration, ST segment and frontal plane axis are also extracted and scoring pattern is applied for the purpose of heart disease diagnosis. In this study, detection of tachycardia, bradycardia, left ventricular hypertrophy, right ventricular hypertrophy and myocardial infarction have been considered. In this work, CSE ECG data base which contains 5000 samples recorded at a sampling frequency of 500 Hz and the ECG data base created by the S.G.G.S. Institute of Engineering and Technology, Nanded (Maharashtra) have been used. PMID:21770825

  16. ECG signal compression and classification algorithm with quad level vector for ECG holter system.

    PubMed

    Kim, Hyejung; Yazicioglu, Refet Firat; Merken, Patrick; Van Hoof, Chris; Yoo, Hoi-Jun

    2010-01-01

    An ECG signal processing method with quad level vector (QLV) is proposed for the ECG holter system. The ECG processing consists of the compression flow and the classification flow, and the QLV is proposed for both flows to achieve better performance with low-computation complexity. The compression algorithm is performed by using ECG skeleton and the Huffman coding. Unit block size optimization, adaptive threshold adjustment, and 4-bit-wise Huffman coding methods are applied to reduce the processing cost while maintaining the signal quality. The heartbeat segmentation and the R-peak detection methods are employed for the classification algorithm. The performance is evaluated by using the Massachusetts Institute of Technology-Boston's Beth Israel Hospital Arrhythmia Database, and the noise robust test is also performed for the reliability of the algorithm. Its average compression ratio is 16.9:1 with 0.641% percentage root mean square difference value and the encoding rate is 6.4 kbps. The accuracy performance of the R-peak detection is 100% without noise and 95.63% at the worst case with -10-dB SNR noise. The overall processing cost is reduced by 45.3% with the proposed compression techniques. PMID:19775975

  17. A novel biometric authentication approach using ECG and EMG signals.

    PubMed

    Belgacem, Noureddine; Fournier, Régis; Nait-Ali, Amine; Bereksi-Reguig, Fethi

    2015-05-01

    Security biometrics is a secure alternative to traditional methods of identity verification of individuals, such as authentication systems based on user name and password. Recently, it has been found that the electrocardiogram (ECG) signal formed by five successive waves (P, Q, R, S and T) is unique to each individual. In fact, better than any other biometrics' measures, it delivers proof of subject's being alive as extra information which other biometrics cannot deliver. The main purpose of this work is to present a low-cost method for online acquisition and processing of ECG signals for person authentication and to study the possibility of providing additional information and retrieve personal data from an electrocardiogram signal to yield a reliable decision. This study explores the effectiveness of a novel biometric system resulting from the fusion of information and knowledge provided by ECG and EMG (Electromyogram) physiological recordings. It is shown that biometrics based on these ECG/EMG signals offers a novel way to robustly authenticate subjects. Five ECG databases (MIT-BIH, ST-T, NSR, PTB and ECG-ID) and several ECG signals collected in-house from volunteers were exploited. A palm-based ECG biometric system was developed where the signals are collected from the palm of the subject through a minimally intrusive one-lead ECG set-up. A total of 3750 ECG beats were used in this work. Feature extraction was performed on ECG signals using Fourier descriptors (spectral coefficients). Optimum-Path Forest classifier was used to calculate the degree of similarity between individuals. The obtained results from the proposed approach look promising for individuals' authentication. PMID:25836061

  18. Expert system designed to assist in the interpretation and evaluation of thoracic surface maps produced by high-resolution electrocardiography

    SciTech Connect

    Johnson, J.K.

    1988-01-01

    An expert system is an artificial intelligence program that relies on a knowledge base composed of information derived from an expert and is designed to perform a difficult task. The system is usually domain specific and provides an interactive consultation with the user in problem solving. High-resolution electrocardiography is a technique for acquiring information about the heart's electrical activity with the use of multilead electrodes. Thoracic surface maps are presented at precise intervals during the depolarization/repolarization stages of a heartbeat. Cardiologists have determined methods for relating the thoracic maps to the actual tissue condition of the heart giving a basis for diagnoses. This work shows the anatomy of the heart, techniques for measuring that activity, and in detail, the techniques used with High Resolution Electrocardiography. The field of artificial intelligence is explored with an emphasis on expert systems. An expert system developed to diagnose the HRE record is presented.

  19. Advances in ambulatory monitoring: regulatory considerations.

    PubMed

    Buckles, David; Aguel, Felipe; Brockman, Randall; Cheng, James; Demian, Cindy; Ho, Charles; Jensen, Donald; Mallis, Elias

    2004-01-01

    Conventional ambulatory electrocardiogram (ECG) (Holter) monitoring involves 2 or 3 surface leads recorded with electrode positions and signal characteristics that are different from diagnostic quality 12-lead ECGs due to the limitations imposed by technology on the ambulatory recorders. The rapid pace of technological development for medical devices, particularly electrocardiography, has now enabled the recording of diagnostic quality 12-lead ECG waveforms for extended time periods. This capability allows Holter recording to become another source for diagnostic 12-lead ECG records on a par with other modalities such as resting ECG and exercise stress testing. Additionally, other diagnostic techniques such as S-T segment analysis and Q-T interval analysis that rely on diagnostic quality waveforms can now be applied. All of these enhancements to the traditional Holter modality have altered the regulatory perspective of these devices, since the enhancements may represent a new intended use for the device. PMID:15534803

  20. Heart morphology differences induced by intrauterine growth restriction and preterm birth measured on the ECG at preadolescent age.

    PubMed

    Ortigosa, Nuria; Rodriguez-Lopez, Merida; Bailón, Raquel; Sarvari, Sebastian Imre; Sitges, Marta; Gratacos, Eduard; Bijnens, Bart; Crispi, Fatima; Laguna, Pablo

    2016-01-01

    Intrauterine Growth Restriction (IUGR) and premature birth are associated with higher risk of cardiovascular diseases throughout adulthood. The aim of this study was to evaluate the influence of these factors in ventricular electrical remodeling in preadolescents. Electrocardiography was performed in a cohort of 33-IUGR, 32-preterm with appropriate weight and 60 controls. Depolarization and repolarization processes were studied by means of the surface ECG, including loops and angles corresponding to QRS and T-waves. The angles between the dominant vector of QRS and the frontal plane XY were different among the study groups: controls [20.03°(10.11°-28.64°)], preterm [25.48°(19.79°-33.56°)], and IUGR [27.77°(16.59°-33.23°)]. When compared to controls, IUGR subjects also presented wider angles between the difference of QRS and T-wave dominant vectors and the XY-plane [5.28°±12.15° vs 0.49°±14.15°, p<0.05] while preterm ones showed smaller frontal QRS-T angle [4.68°(2.20°-12.89°) vs 6.57°(2.72°-11.31°), p<0.05]. Thus, electrical remodeling is present in IUGR and preterm preadolescents, and might predispose them to cardiovascular diseases in adulthood. Follow-up studies are warranted. PMID:27036371

  1. Multiprocessor system for Holter tape analysis (ECG)

    SciTech Connect

    Feldman, C.L.; Hubelbank, M.; Valvo, V.; Lane, B.

    1983-01-01

    Although techniques for recording and analyzing longterm ambulatory ECGS have been in existence for more than 20 years, the clinical usefulness and frequency of application of the technique continue to grow at an extraordinary rate. To meet the need for faster, more efficient processing of Holter tapes and the growing requirement that the analysis of the tape be quantitatively accurate, a new Holter analysis system has been developed. This system is built around two LSI11 microprocessors and a special purpose byte processor which incorporates an AMD 2903 bit slice chip. It includes 30 MB of mass storage and an impact printer with alphanumeric and graphic capabilities. In a test which included 55 separate readings of 34 12- or 24-hour tapes, correlations with hand counts of vpbs was greater than .99. The system processes either cassette or reel-to-reel tapes at 120* with simultaneous print/process capabilities, has a variety of user interactive displays to assure continuous operator validation, is remarkably nonfatiguing to operate, and automatically produces reports with tables, graphs, and sample ECG strips. 8 references.

  2. Autoadaptivity and optimization in distributed ECG interpretation.

    PubMed

    Augustyniak, Piotr

    2010-03-01

    This paper addresses principal issues of the ECG interpretation adaptivity in a distributed surveillance network. In the age of pervasive access to wireless digital communication, distributed biosignal interpretation networks may not only optimally solve difficult medical cases, but also adapt the data acquisition, interpretation, and transmission to the variable patient's status and availability of technical resources. The background of such adaptivity is the innovative use of results from the automatic ECG analysis to the seamless remote modification of the interpreting software. Since the medical relevance of issued diagnostic data depends on the patient's status, the interpretation adaptivity implies the flexibility of report content and frequency. Proposed solutions are based on the research on human experts behavior, procedures reliability, and usage statistics. Despite the limited scale of our prototype client-server application, the tests yielded very promising results: the transmission channel occupation was reduced by 2.6 to 5.6 times comparing to the rigid reporting mode and the improvement of the remotely computed diagnostic outcome was achieved in case of over 80% of software adaptation attempts. PMID:20064764

  3. The evolution of ambulatory ECG monitoring.

    PubMed

    Kennedy, Harold L

    2013-01-01

    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. PMID:24215744

  4. The common, less common and uncommon examples of exercise ECG.

    PubMed

    Jacob, M J; Kumar, Puneet; Ravina, Mudalsha; Sharma, Amit; Jora, Charu; Jain, Anurag; Kumar, Rajeev

    2013-07-01

    We present three interesting and representative cases of exercise ECGs which were done as part of Stress Myocardial Perfusion study. Aim is to emphasize the point that the stress part of the test should be conducted by an expert in the field and recovery phase ECG records should be analyzed carefully for maximum benefit from this test. PMID:24772761

  5. A method of ECG template extraction for biometrics applications.

    PubMed

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

    2014-01-01

    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. PMID:25570031

  6. ECG Signal Analysis and Arrhythmia Detection using Wavelet Transform

    NASA Astrophysics Data System (ADS)

    Kaur, Inderbir; Rajni, Rajni; Marwaha, Anupma

    2016-06-01

    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.

  7. Noncontact ECG system for unobtrusive long-term monitoring.

    PubMed

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

    2012-01-01

    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. PMID:23366215

  8. Sequential Total Variation Denoising for the Extraction of Fetal ECG from Single-Channel Maternal Abdominal ECG

    PubMed Central

    Lee, Kwang Jin; Lee, Boreom

    2016-01-01

    Fetal heart rate (FHR) is an important determinant of fetal health. Cardiotocography (CTG) is widely used for measuring the FHR in the clinical field. However, fetal movement and blood flow through the maternal blood vessels can critically influence Doppler ultrasound signals. Moreover, CTG is not suitable for long-term monitoring. Therefore, researchers have been developing algorithms to estimate the FHR using electrocardiograms (ECGs) from the abdomen of pregnant women. However, separating the weak fetal ECG signal from the abdominal ECG signal is a challenging problem. In this paper, we propose a method for estimating the FHR using sequential total variation denoising and compare its performance with that of other single-channel fetal ECG extraction methods via simulation using the Fetal ECG Synthetic Database (FECGSYNDB). Moreover, we used real data from PhysioNet fetal ECG databases for the evaluation of the algorithm performance. The R-peak detection rate is calculated to evaluate the performance of our algorithm. Our approach could not only separate the fetal ECG signals from the abdominal ECG signals but also accurately estimate the FHR. PMID:27376296

  9. Sequential Total Variation Denoising for the Extraction of Fetal ECG from Single-Channel Maternal Abdominal ECG.

    PubMed

    Lee, Kwang Jin; Lee, Boreom

    2016-01-01

    Fetal heart rate (FHR) is an important determinant of fetal health. Cardiotocography (CTG) is widely used for measuring the FHR in the clinical field. However, fetal movement and blood flow through the maternal blood vessels can critically influence Doppler ultrasound signals. Moreover, CTG is not suitable for long-term monitoring. Therefore, researchers have been developing algorithms to estimate the FHR using electrocardiograms (ECGs) from the abdomen of pregnant women. However, separating the weak fetal ECG signal from the abdominal ECG signal is a challenging problem. In this paper, we propose a method for estimating the FHR using sequential total variation denoising and compare its performance with that of other single-channel fetal ECG extraction methods via simulation using the Fetal ECG Synthetic Database (FECGSYNDB). Moreover, we used real data from PhysioNet fetal ECG databases for the evaluation of the algorithm performance. The R-peak detection rate is calculated to evaluate the performance of our algorithm. Our approach could not only separate the fetal ECG signals from the abdominal ECG signals but also accurately estimate the FHR. PMID:27376296

  10. Differential Prognostic Value of Coronary Computed Tomography Angiography in Relation to Exercise Electrocardiography in Asymptomatic Subjects

    PubMed Central

    Lee, Sang-Eun; Cho, Iksung; Hong, Geu-Ru; Sung, Ji Min; Cho, In-Jeong; Shim, Chi Young; Choi, Byoung Wook; Chung, Namsik

    2015-01-01

    Background To explore the prognostic performance of coronary computed tomography angiography (CCTA) and exercise electrocardiography (XECG) in asymptomatic subjects. Methods We retrospectively enrolled 812 (59 ± 9 years, 60.8% male) asymptomatic subjects who underwent CCTA and XECG concurrently from 2003 through 2009. Subjects were followed-up for major adverse cardiac events (MACE) including cardiac death, nonfatal myocardial infarction, unstable angina, and revascularization after 90 days from index CCTA. Results The prevalence of occult coronary artery disease (CAD) detected by CCTA was 17.5% and 120 subjects (14.8%) had positive XECG. During a mean follow-up of 37 ± 16 months, nine subjects experienced MACE. In multivariable Cox-regression analysis, only the presence of CAD by CCTA independently predicted future MACE (p = 0.002). Moreover, CAD by CCTA improved the predictive value when added to a clinical risk factor model using the likelihood ratio test (p < 0.001). Notably, the prognostic value of CCTA persisted in the moderate-to-high-risk group as classified by the Duke treadmill score (p = 0.040), but not in the low-risk group (p = 0.991). Conclusion CCTA provides incremental prognostic benefit over and above XECG in an asymptomatic population, especially for those in a moderate-to-high-risk group as classified by the Duke treadmill score. Risk stratification using XECG may prove valuable for identifying asymptomatic subjects who can benefit from CCTA. PMID:26755933

  11. Exercise thallium-201 scintigraphy and prognosis in typical angina pectoris and negative exercise electrocardiography

    SciTech Connect

    Bairey, C.N.; Rozanski, A.; Maddahi, J.; Resser, K.J.; Berman, D.S. )

    1989-08-01

    Patients with a history of typical angina but negative exercise electrocardiography represent a subgroup with an intermediate likelihood of having coronary artery disease and future cardiac events. A retrospective study of the prognostic utility of stress-redistribution thallium-201 scintigraphy was performed in 190 such patients. A second group of 203 patients with typical angina and a positive exercise electrocardiogram were analyzed for comparative scintigraphic purposes. The cardiac event rate for the 144 negative exercise electrocardiogram patients with normal thallium results was 5 vs 15% in the 46 patients with abnormal thallium results (p = 0.01). These patients were further stratified into high (14 to 18%), intermediate (9%) and low (less than 2%) risk groups for future cardiac events based on combining the thallium results with the percentage of maximal predicted heart rate achieved. A multivariate analysis revealed that an abnormal thallium result was the only significant correlate of future cardiac events. Mechanisms responsible for the discordant finding of a negative exercise electrocardiogram in patients with typical angina include (1) false-positive angina symptomatology in low prevalence coronary artery disease groups in whom the thallium test is negative, and (2) electrocardiographically silent ischemia in patients in whom the thallium test is positive. These findings reveal that thallium stress-redistribution scintigraphy can be used to stratify 1-year prognosis in this subgroup of patients with typical angina and negative exercise electrocardiograms.

  12. Application of the Method of Fundamental Solutions to Potential-based Inverse Electrocardiography

    PubMed Central

    Wang, Yong; Rudy, Yoram

    2007-01-01

    Potential-based inverse electrocardiography is a method for the noninvasive computation of epicardial potentials from measured body surface electrocardiographic data. From the computed epicardial potentials, epicardial electrograms and isochrones (activation sequences), as well as repolarization patterns can be constructed. We term this noninvasive procedure Electrocardiographic Imaging (ECGI). The method of choice for computing epicardial potentials has been the Boundary Element Method (BEM) which requires meshing the heart and torso surfaces and optimizing the mesh, a very time-consuming operation that requires manual editing. Moreover, it can introduce mesh-related artifacts in the reconstructed epicardial images. Here we introduce the application of a meshless method, the Method of Fundamental Solutions (MFS) to ECGI. This new approach that does not require meshing is evaluated on data from animal experiments and human studies, and compared to BEM. Results demonstrate similar accuracy, with the following advantages: 1. Elimination of meshing and manual mesh optimization processes, thereby enhancing automation and speeding the ECGI procedure. 2. Elimination of mesh-induced artifacts. 3. Elimination of complex singular integrals that must be carefully computed in BEM. 4. Simpler implementation. These properties of MFS enhance the practical application of ECGI as a clinical diagnostic tool. PMID:16807788

  13. Arrhythmic risk stratification after myocardial infarction using ambulatory electrocardiography signal averaging.

    PubMed

    Roche, Frédéric; DaCosta, Antoine; Karnib, Ibrahim; Triomphe, Géraldine; Roche, Christian; Isaaz, Karl; Geyssant, André; Barthélémy, Jean-Claude

    2002-05-01

    Ambulatory ECG had been proposed to examine the amplified high resolution signal-averaged electrocardiogram (SAECG). Clinical investigations are required to confirm the predictive value of such a high resolution technique in arrhythmic risk stratification. The prognostic value of ambulatory Holter SAECG was evaluated in 108 postinfarction patients for the purpose of predicting the occurrence of serious arrhythmic (SARR) events (sudden cardiac death [SCD], VT, or VF) in comparison with classical real-time SAECG. During the 42+/-8 months of follow-up, the sudden cardiac death mortality was 4.6% (five deaths), six (5.6%) patients had VT, and one (0.9%) VF. QRSd was found to be the most predictive parameter using ROC curves analysis for SAAR + outcome (W = 0.833 and W = 0.803 for 25-250 Hz and 40-250 Hz filters, respectively) followed by RMS (W = 0.766 and W = 0.721) and LAS (W = 0.759, W = 0.709) (all P < 0.01). Abnormal Holter SAECG for 25 and 40-Hz LP filter were significant predictors of SARR+ by log-rank test (P < 0.01, P < 0.05, respectively). This study confirms that valuable prognostic information can be obtained from the ambulatory high resolution ECG technique and that Holter SAECG may predict arrhythmic risk in a postinfarction population. PMID:12049370

  14. The application of subspace preconditioned LSQR algorithm for solving the electrocardiography inverse problem.

    PubMed

    Jiang, Mingfeng; Xia, Ling; Huang, Wenqing; Shou, Guofa; Liu, Feng; Crozier, Stuart

    2009-10-01

    Regularization is an effective method for the solution of ill-posed ECG inverse problems, such as computing epicardial potentials from body surface potentials. The aim of this work was to explore more robust regularization-based solutions through the application of subspace preconditioned LSQR (SP-LSQR) to the study of model-based ECG inverse problems. Here, we presented three different subspace splitting methods, i.e., SVD, wavelet transform and cosine transform schemes, to the design of the preconditioners for ill-posed problems, and to evaluate the performance of algorithms using a realistic heart-torso model simulation protocol. The results demonstrated that when compared with the LSQR, LSQR-Tik and Tik-LSQR method, the SP-LSQR produced higher efficiency and reconstructed more accurate epcicardial potential distributions. Amongst the three applied subspace splitting schemes, the SVD-based preconditioner yielded the best convergence rate and outperformed the other two in seeking the inverse solutions. Moreover, when optimized by the genetic algorithms (GA), the performances of SP-LSQR method were enhanced. The results from this investigation suggested that the SP-LSQR was a useful regularization technique for cardiac inverse problems. PMID:19564127

  15. Simultaneous comparison of 1 gel with 4 dry electrode types for electrocardiography.

    PubMed

    Meziane, N; Yang, S; Shokoueinejad, M; Webster, J G; Attari, M; Eren, H

    2015-03-01

    We designed a spandex tank top with dry electrodes for continuous electrocardiogram (ECG) recording. This pilot study determined the best fabric, the best electrode types, sizes, and locations. Optimal electrodes provide high signal to artifact ratio (SAR) and reliability by meeting the following criteria: 1) low baseline shift, 2) high adhesion, 3) good physical stability, 4) large effective area, 5) thin with high flexibility (Luo et al 1992). We compared electrodes from three main groups: Ag/AgCl gel electrode, commercial conductive rubber and foam-metal based electrodes. Ag/AgCl gel electrodes are easy to apply, make good body contact and do not slip during the course of an experiment. We found that higher SARs are obtained when electrode area is increased (40 mm diameter) and the two dry measurement electrodes are located on convex areas (over chest muscle) rather than concave areas (over sternum), so the spandex will apply light pressure to the dry electrode to yield good electrode to skin contact. We experimentally validated findings with 24 subjects: 12 men and 12 women wearing the tank top with gel and dry electrodes, by monitoring movements imitating daily life while continuously recording their ECGs. PMID:25684219

  16. Performance characterstics of a commerical ECG gate

    SciTech Connect

    Graham, M.; Cavailloles, F.; Ritchie, J.L.; Williams, D.L.; Hamilton, G.W.

    1980-04-01

    A commercial ECG gate was tested to evaluate its ability to predict accurately the time of end-systole. The predicted times followed the manufacturer's specifications quite well. These times were compared with the actual times of end-systole as determined by computer-derived left-ventricular time-activity curves using Tc-99m-labeled red blood cells. Although there was moderate scatter, the predicted times of end-systole correlated well with the actual time (n = 59, r = 0.829). If the left-ventricular ejection fraction was calculated using the predicted time of end-systole, the error would be 0.03, or less, for 95% of the subjects.

  17. Nonlocal means denoising of ECG signals.

    PubMed

    Tracey, Brian H; Miller, Eric L

    2012-09-01

    Patch-based methods have attracted significant attention in recent years within the field of image processing for a variety of problems including denoising, inpainting, and super-resolution interpolation. Despite their prevalence for processing 2-D signals, they have received little attention in the 1-D signal processing literature. In this letter, we explore application of one such method, the nonlocal means (NLM) approach, to the denoising of biomedical signals. Using ECG as an example, we demonstrate that a straightforward NLM-based denoising scheme provides signal-to-noise ratio improvements very similar to state of the art wavelet-based methods, while giving ~3 × or greater reduction in metrics measuring distortion of the denoised waveform. PMID:22829361

  18. An ECG simulator for generating maternal-foetal activity mixtures on abdominal ECG recordings.

    PubMed

    Behar, Joachim; Andreotti, Fernando; Zaunseder, Sebastian; Li, Qiao; Oster, Julien; Clifford, Gari D

    2014-08-01

    Accurate foetal electrocardiogram (FECG) morphology extraction from non-invasive sensors remains an open problem. This is partly due to the paucity of available public databases. Even when gold standard information (i.e derived from the scalp electrode) is present, the collection of FECG can be problematic, particularly during stressful or clinically important events.In order to address this problem we have introduced an FECG simulator based on earlier work on foetal and adult ECG modelling. The open source foetal ECG synthetic simulator, fecgsyn, is able to generate maternal-foetal ECG mixtures with realistic amplitudes, morphology, beat-to-beat variability, heart rate changes and noise. Positional (rotation and translation-related) movements in the foetal and maternal heart due to respiration, foetal activity and uterine contractions were also added to the simulator.The simulator was used to generate some of the signals that were part of the 2013 PhysioNet Computing in Cardiology Challenge dataset and has been posted on Physionet.org (together with scripts to generate realistic scenarios) under an open source license. The toolbox enables further research in the field and provides part of a standard for industry and regulatory testing of rare pathological scenarios. PMID:25071094

  19. ECG of the Month: ECG in a 30-Year-Old Woman.

    PubMed

    Glancy, D Luke; Diwan, Pranav M

    2015-01-01

    Sinus rhythm; an atrial premature complex; sagging ST-segments, low T-waves, and prominent U-waves suggesting hypokalemia. The ST-T and U-wave changes described above are characteristic of hypokalemia. When the serum potassium level is between 3.0 and 3.5 mEq/L, one or more of the findings may be present. All three are common when the serum potassium level is below 2.5 mEq/L. At the lowest serum potassium levels the T-wave becomes a notch on the upstroke of a giant U-wave, as occurs here in the ECG of this woman with a serum potassium of 1.7 mEq/L.1,2 This configuration is occasionally mistaken for the ST-segment depression and long QT interval of myocardial ischemia.3 Atrial premature complexes are common with hypokalemia, and atrial fibrillation may occur. This patient's potassium was repleted, and the following day her ECG was essentially normal (Figure 2) and virtually unchanged from an ECG recorded two years earlier. PMID:27159459

  20. Variable threshold method for ECG R-peak detection.

    PubMed

    Kew, Hsein-Ping; Jeong, Do-Un

    2011-10-01

    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. PMID:21695499

  1. ECG signals denoising using wavelet transform and independent component analysis

    NASA Astrophysics Data System (ADS)

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

    2015-08-01

    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.

  2. True Unipolar ECG Machine for Wilson Central Terminal Measurements

    PubMed Central

    Gargiulo, Gaetano D.

    2015-01-01

    Since its invention (more than 80 years ago), modern electrocardiography has employed a supposedly stable voltage reference (with little variation during the cardiac cycle) for half of the signals. This reference, known by the name of “Wilson Central Terminal” in honor of its inventor, is obtained by averaging the three active limb electrode voltages measured with respect to the return ground electrode. However, concerns have been raised by researchers about problems (biasing and misdiagnosis) associated with the ambiguous value and behavior of this reference voltage, which requires perfect and balanced contact of at least four electrodes to work properly. The Wilson Central Terminal has received scant research attention in the last few decades even though consideration of recent widespread medical practice (limb electrodes are repositioned closer to the torso for resting electrocardiography) has also sparkled concerns about the validity and diagnostic fitness of leads not referred to the Wilson Central Terminal. Using a true unipolar electrocardiography device capable of precisely measuring the Wilson Central Terminal, we show its unpredictable variability during the cardiac cycle and confirm that the integrity of cardinal leads is compromised as well as the Wilson Central Terminal when limb electrodes are placed close to the torso. PMID:26495303

  3. ECG risk markers for atrial fibrillation and sudden cardiac death in minimally symptomatic obstructive sleep apnoea: the MOSAIC randomised trial

    PubMed Central

    Schlatzer, Christian; Bratton, Daniel J; Craig, Sonja E; Kohler, Malcolm; Stradling, John R

    2016-01-01

    Objective Obstructive sleep apnoea (OSA), atrial fibrillation (AF) and sudden cardiac death (SCD) may occur concomitantly, and are of considerable epidemiological interest, potentially leading to morbidity and mortality. Effective treatment of OSA with continuous positive airway pressure (CPAP) could prevent progression and/or recurrence of AF and factors leading to SCD. Recently, a randomised controlled trial showed a statistically and clinically significant prolongation of measures of cardiac repolarisation after CPAP withdrawal in symptomatic patients with moderate to severe OSA. Whether or not CPAP therapy improves ECG risk markers of AF and SCD in patients with minimally symptomatic OSA as well, is unknown. Methods 3 centres taking part in the MOSAIC (Multicentre Obstructive Sleep Apnoea Interventional Cardiovascular) trial randomisd 303 patients with minimally symptomatic OSA to receive either CPAP or standard care for 6 months. Treatment effects of CPAP on P-wave duration, P-wave dispersion, QT interval, QT dispersion, Tpeak-to-Tend (TpTe) and TpTe/QT ratio were analysed. Results Participants were primarily men (83%). Mean age was 57.8 (7.2) and mean ODI (Oxygen Desaturation Index) at baseline was 13.1/h (12.3). Full 12-lead ECG data was available in 250 patients. Mean (SD) baseline intervals of P-wave duration, P-wave dispersion, QTc interval, QT dispersion, TpTe and TpTe/QT ratio in ms were 87.4 (8.3), 42.3 (11.9), 397.8 (22.7), 43.1 (16.7), 73.5 (13.7) and 0.19 (0.0), respectively. No treatment effect of CPAP on risk markers for AF and SCD was found. Conclusions There seems to be no effect of CPAP on ECG measures of arrhythmia risk in patients with minimally symptomatic OSA. Trial registration number ISRCTN34164388; Post-results. PMID:26983946

  4. ECG scores for a triage of patients with acute myocardial infarction transported by the emergency medical system.

    PubMed

    Zalenski, R J; Grzybowski, M; Ross, M A; Blaustein, N; Bock, B

    2000-01-01

    Prehospital triage of cardiac patients for bypass from community hospitals to cardiac centers may improve survival. This article determines if electrocardiogram (ECG)-based scoring triage methods (Aldrich MI scoring, QRS distortion, and the TIMI classification) and location of infarct (via 12 lead ECG) are associated with mortality before and after adjusting for age, sex, and race. It is a retrospective study of 291 AMI adult patients transported by ambulance to community hospitals or cardiac centers. Patients with an ED chief complaint of chest pain or dyspnea, presence of MI as defined by ECG findings of 0.1 mV of ST segment elevation in two leads or positive CPK-MB were eligible for the study. The primary outcome variable was 2-year mortality as determined with a metropolitan Detroit tri-county death index. Logistic regression was used to calculate the unadjusted and adjusted odds ratios (with 95% CIs) of the predictor variables with mortality. Of the initial population selected for the study (n = 291), 229 patients were eligible for the analysis. The mean age was 66 years (SD of 14.4) with 63.8% being male and 54% being white. The overall mortality point estimate was 21.3% (95% CI of 15.2 to 27.3%). Aldrich scores and QRS distortion (yes/no) were not associated with mortality. Patients classified as a "high risk" for AMI per TIMI status were almost 3 times more likely to die than those at "low risk" and reached borderline statistical significance (P = .06) after adjusting for the covariates. Having an anterior infarct, as opposed to an inferior infarct, was significantly associated with death before and after adjusting for the covariates (Unadjusted OR = 2.6, Adjusted OR = 2.8). Properly training emergency medical system professionals in this area may prove useful for identifying higher risk AMI patients in the prehospital setting. PMID:11265729

  5. A Differential ECG Amplifier with Single-Ended Output

    NASA Technical Reports Server (NTRS)

    Katchis, L.

    1972-01-01

    Three-stage amplifier is used for ECG measurements which require conversion of differential input to single-ended output. Circuit may be useful in biological telemetry for amplification of signals from specimen-implanted sensors.

  6. A method for the determination of ECG gate signal delays

    SciTech Connect

    Wery, R.; Hill, J.; Dworkin, H.J.

    1981-06-01

    A simple device using a rotating radioactive source was developed to monitor the presence of a delay between the patient's R wave and the gate signal being sent to the computer. Three commercial ECG gates were tested and significant delays were found in two of them. Identical patient data evaluated using ECG gates with and without significant delays produced calculated left-ventricular ejection fractions of 0.05 and 0.64, respectively.

  7. Human ECG signal parameters estimation during controlled physical activity

    NASA Astrophysics Data System (ADS)

    Maciejewski, Marcin; Surtel, Wojciech; Dzida, Grzegorz

    2015-09-01

    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.

  8. Near Field Communication-based telemonitoring with integrated ECG recordings

    PubMed Central

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

    2011-01-01

    Objectives 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. Methods 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. Results 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. Conclusions 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. PMID:23616890

  9. Microprocessor-based simulator of surface ECG signals

    NASA Astrophysics Data System (ADS)

    Martínez, A. E.; Rossi, E.; Siri, L. Nicola

    2007-11-01

    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. [The development of ECG trans-telephone popular monitoring system].

    PubMed

    Luo, Q; Fang, Z; Yang, C; Shen, Z

    1997-05-01

    In this essay a new kind of ECG telemetry and monitoring system based on public telephone network is presented, which is able to transfer four channels of ECG of two patients to monitoring center sited at hospital synchronizingly. At the same time doctors may make diagnosis and give instruction for treatment. The system has the functions of real time sample, reviewing, freezing, store, windows, and printing, etc. PMID:11189346

  11. Variability in surface ECG morphology: signal or noise?

    NASA Technical Reports Server (NTRS)

    Smith, J. M.; Rosenbaum, D. S.; Cohen, R. J.

    1988-01-01

    Using data collected from canine models of acute myocardial ischemia, we investigated two issues of major relevance to electrocardiographic signal averaging: ECG epoch alignment, and the spectral characteristics of the beat-to-beat variability in ECG morphology. With initial digitization rates of 1 kHz, an iterative a posteriori matched filtering alignment scheme, and linear interpolation, we demonstrated that there is sufficient information in the body surface ECG to merit alignment to a precision of 0.1 msecs. Applying this technique to align QRS complexes and atrial pacing artifacts independently, we demonstrated that the conduction delay from atrial stimulus to ventricular activation may be so variable as to preclude using atrial pacing as an alignment mechanism, and that this variability in conduction time be modulated at the frequency of respiration and at a much lower frequency (0.02-0.03Hz). Using a multidimensional spectral technique, we investigated the beat-to-beat variability in ECG morphology, demonstrating that the frequency spectrum of ECG morphological variation reveals a readily discernable modulation at the frequency of respiration. In addition, this technique detects a subtle beat-to-beat alternation in surface ECG morphology which accompanies transient coronary artery occlusion. We conclude that physiologically important information may be stored in the variability in the surface electrocardiogram, and that this information is lost by conventional averaging techniques.

  12. Automatic ECG quality scoring methodology: mimicking human annotators.

    PubMed

    Johannesen, Lars; Galeotti, Loriano

    2012-09-01

    An algorithm to determine the quality of electrocardiograms (ECGs) can enable inexperienced nurses and paramedics to record ECGs of sufficient diagnostic quality. Previously, we proposed an algorithm for determining if ECG recordings are of acceptable quality, which was entered in the PhysioNet Challenge 2011. In the present work, we propose an improved two-step algorithm, which first rejects ECGs with macroscopic errors (signal absent, large voltage shifts or saturation) and subsequently quantifies the noise (baseline, powerline or muscular noise) on a continuous scale. The performance of the improved algorithm was evaluated using the PhysioNet Challenge database (1500 ECGs rated by humans for signal quality). We achieved a classification accuracy of 92.3% on the training set and 90.0% on the test set. The improved algorithm is capable of detecting ECGs with macroscopic errors and giving the user a score of the overall quality. This allows the user to assess the degree of noise and decide if it is acceptable depending on the purpose of the recording. PMID:22902927

  13. Unveiling the Biometric Potential of Finger-Based ECG Signals

    PubMed Central

    Lourenço, André; Silva, Hugo; Fred, Ana

    2011-01-01

    The ECG signal has been shown to contain relevant information for human identification. Even though results validate the potential of these signals, data acquisition methods and apparatus explored so far compromise user acceptability, requiring the acquisition of ECG at the chest. In this paper, we propose a finger-based ECG biometric system, that uses signals collected at the fingers, through a minimally intrusive 1-lead ECG setup recurring to Ag/AgCl electrodes without gel as interface with the skin. The collected signal is significantly more noisy than the ECG acquired at the chest, motivating the application of feature extraction and signal processing techniques to the problem. Time domain ECG signal processing is performed, which comprises the usual steps of filtering, peak detection, heartbeat waveform segmentation, and amplitude normalization, plus an additional step of time normalization. Through a simple minimum distance criterion between the test patterns and the enrollment database, results have revealed this to be a promising technique for biometric applications. PMID:21837235

  14. Live ECG readings using Google Glass in emergency situations.

    PubMed

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

    2015-01-01

    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. PMID:26736263

  15. [Continuous ECG recording for freely moving patients].

    PubMed

    Shi, Bo; Liu, Shengyang; Chen, Jianfang; Zhang, Genxuan; Tsau, Young

    2013-04-01

    As more and more people are becoming aged in China and many of them tend to suffer from chronic cardiac problems, the long-term dynamic cardiac monitoring for freely moving patients becomes essential. A new design for continuous ECG recording on the freely moving patients at home and/or at work is proposed here. It is miniature in size, using digital technologies of the low gain amplifier, the high resolution analog to digital converter and the real-time digital filter that features > 100dB input signal dynamic range (ISDR), > 100dB common-mode rejection ratio (CMRR), and < 5microV (RMS) internal noise. The device works continuously more than 24 hours with a pair of AAA batteries, and is capable of storing the recorded data into a storage card. The preliminary tests showed that the P-QRS-T waveforms were captured and displayed smoothly in resting, walking, and activities, making the device useful in monitoring and analyzing for the patients on the move. PMID:23858751

  16. The value of electrocardiography for differential diagnosis in wide QRS complex tachycardia.

    PubMed

    Sousa, Pedro A; Pereira, Salomé; Candeias, Rui; de Jesus, Ilídio

    2014-03-01

    Correct diagnosis in wide QRS complex tachycardia remains a challenge. Differential diagnosis between ventricular and supraventricular tachycardia has important therapeutic and prognostic implications, and although data from clinical history and physical examination may suggest a particular origin, it is the 12-lead surface electrocardiogram that usually enables this differentiation. Since 1978, various electrocardiographic criteria have been proposed for the differential diagnosis of wide complex tachycardias, particularly the presence of atrioventricular dissociation, and the axis, duration and morphology of QRS complexes. Despite the wide variety of criteria, diagnosis is still often difficult, and errors can have serious consequences. To reduce such errors, several differential diagnosis algorithms have been proposed since 1991. However, in a small percentage of wide QRS tachycardias the diagnosis remains uncertain and in these the wisest decision is to treat them as ventricular tachycardias. The authors' objective was to review the main electrocardiographic criteria and differential diagnosis algorithms of wide QRS tachycardia. PMID:24656320

  17. Biosignal PI, an affordable open-source ECG and respiration measurement system.

    PubMed

    Abtahi, Farhad; Snäll, Jonatan; Aslamy, Benjamin; Abtahi, Shirin; Seoane, Fernando; Lindecrantz, Kaj

    2015-01-01

    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, BiosignalPI.org. PMID:25545268

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

    PubMed Central

    Abtahi, Farhad; Snäll, Jonatan; Aslamy, Benjamin; Abtahi, Shirin; Seoane, Fernando; Lindecrantz, Kaj

    2015-01-01

    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, BiosignalPI.org. PMID:25545268

  19. Standard-compliant real-time transmission of ECGs: harmonization of ISO/IEEE 11073-PHD and SCP-ECG.

    PubMed

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

    2009-01-01

    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. PMID:19963856

  20. Graphics-processor-unit-based parallelization of optimized baseline wander filtering algorithms for long-term electrocardiography.

    PubMed

    Niederhauser, Thomas; Wyss-Balmer, Thomas; Haeberlin, Andreas; Marisa, Thanks; Wildhaber, Reto A; Goette, Josef; Jacomet, Marcel; Vogel, Rolf

    2015-06-01

    Long-term electrocardiogram (ECG) often suffers from relevant noise. Baseline wander in particular is pronounced in ECG recordings using dry or esophageal electrodes, which are dedicated for prolonged registration. While analog high-pass filters introduce phase distortions, reliable offline filtering of the baseline wander implies a computational burden that has to be put in relation to the increase in signal-to-baseline ratio (SBR). Here, we present a graphics processor unit (GPU)-based parallelization method to speed up offline baseline wander filter algorithms, namely the wavelet, finite, and infinite impulse response, moving mean, and moving median filter. Individual filter parameters were optimized with respect to the SBR increase based on ECGs from the Physionet database superimposed to autoregressive modeled, real baseline wander. A Monte-Carlo simulation showed that for low input SBR the moving median filter outperforms any other method but negatively affects ECG wave detection. In contrast, the infinite impulse response filter is preferred in case of high input SBR. However, the parallelized wavelet filter is processed 500 and four times faster than these two algorithms on the GPU, respectively, and offers superior baseline wander suppression in low SBR situations. Using a signal segment of 64 mega samples that is filtered as entire unit, wavelet filtering of a seven-day high-resolution ECG is computed within less than 3 s. Taking the high filtering speed into account, the GPU wavelet filter is the most efficient method to remove baseline wander present in long-term ECGs, with which computational burden can be strongly reduced. PMID:25675449

  1. Properties of screen printed electrocardiography smartware electrodes investigated in an electro-chemical cell

    PubMed Central

    2013-01-01

    Background ECG (Electrocardiogram) measurements in home health care demands new sensor solutions. In this study, six different configurations of screen printed conductive ink electrodes have been evaluated with respect to electrode potential variations and electrode impedance. Methods The electrode surfaces consisted of a Ag/AgCl-based ink with a conduction line of carbon or Ag-based ink underneath. On top, a lacquer layer was used to define the electrode area and to cover the conduction lines. Measurements were performed under well-defined electro-chemical conditions in a physiologic saline solution. Results The results showed that all printed electrodes were stable and have a very small potential drift (less than 3 mV/30 min). The contribution to the total impedance was 2% of the set maximal allowed impedance (maximally 1 kΩ at 50 Hz), assuming common values of input impedance and common mode rejection ratio of a regular amplifier. Conclusion Our conclusions are that the tested electrodes show satisfying properties to be used as elements in a skin electrode design that could be suitable for further investigations by applying the electrodes on the skin. PMID:23827015

  2. Fast multi-scale feature fusion for ECG heartbeat classification

    NASA Astrophysics Data System (ADS)

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

    2015-12-01

    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.

  3. Prediction of implantable ECG lead systems by using thorax models.

    PubMed

    Vaisanen, J; Hyttinen, J; Puurtinen, M; Kauppinen, P; Malmivuo, J

    2004-01-01

    New implantable ECG devices may provide more stable and noiseless measurements compared to body surface ECG measurements. When the electrodes are moved to inside of the body the way the ECG measurement is done is changing. Modeling can be an effective way to study effects of implantation to the capacity of electrodes to measure ECG compared to surface measurements. This work introduces a project where effects of electrode implantation to the magnitude and direction of lead sensitivity to detect cardiac source, lead field, was studied with a model of the thorax as a volume conductor. The study was based on 3D finite difference method (FDM) featuring visible human man. The results of the study indicate that the effect of electrode implantation under the skin (5-15 mm) to the way they measure ECG is rather small. Magnitude change is dependent of the studied lead and the change of the sensitivity to heart's equivalent sources in direction of lead field is minor. PMID:17271800

  4. SLOPE--a real-time ECG data compressor.

    PubMed

    Tai, S C

    1991-03-01

    An ECG sampled at a rate of 250 samples s-1 or more produces a large amount of redundant data that are difficult to store and transmit. In the paper, a real-time ECG data compressor, SLOPE, is presented. SLOPE considers some adjacent samples as a vector, and this vector is extended if the coming sample falls in a fan spanned by this vector and a threshold angle; otherwise, it is delimited as a linear segment. By this means SLOPE repeatedly delimits linear segments of different lengths and different slopes. The Huffman codes for the parameters to describe this linear segment are transmitted for that linear segment. SLOPEa, which is a slightly modified version of SLOPE, is used to compress ambulatory ECG data. All the operations used by SLOPE and SLOPEa are simple integer operations, both SLOPE and SLOPEa being real-time compressors. Experimental results show that an average of 192 bits per channel per second (bpcs) for each ECG signal is obtained by SLOPE and an average of 148 bpcs for each ECG signal is obtained by SLOPEa. PMID:1857123

  5. An Effective Feature Set for ECG Pattern Classification

    NASA Astrophysics Data System (ADS)

    Ghongade, Rajesh; Ghatol, Ashok

    In this paper, QRS morphological features and the artificial neural network method was used for Electrocardiogram (ECG) pattern classification. Four types of ECG patterns were chosen from the MIT-BIH database to be recognized, including normal sinus rhythm, premature ventricular contraction, atrial premature beat and left bundle branch block beat. Authors propose a set of six ECG morphological features to reduce the feature vector size considerably and make the training process fast in addition to a simple but effective ECG heartbeat extraction scheme. Three types of artificial neural network models, MLP, RBF neural networks and SOFM were separately trained and tested for ECG pattern recognition and the experimental results of the different models have been compared. The MLP network exhibited the best performance and reached an overall test accuracy of 99.65%, and RBF and SOFM network both reached 99.1%. The performance of these classifiers was also evaluated in presence of additive Gaussian noise. MLP network was found to be more robust in this respect.

  6. Human Authentication Based on ECG Waves Using Radon Transform

    NASA Astrophysics Data System (ADS)

    Hegde, Chetana; Prabhu, H. Rahul; Sagar, D. S.; Shenoy, P. Deepa; Venugopal, K. R.; Patnaik, L. M.

    Automated security is one of the major concerns of modern times. Secure and reliable authentication systems are in great demand. A biometric trait like electrocardiogram (ECG) of a person is unique and secure. In this paper, we propose a human authentication system based on ECG waves considering a plotted ECG wave signal as an image. The Radon Transform is applied on the preprocessed ECG image to get a radon image consisting of projections for θ varying from 0 o to 180 o . The pairwise distance between the columns of Radon image is computed to get a feature vector. Correlation Coefficient between feature vector stored in the database and that of input image is computed to check the authenticity of a person. Then the confusion matrix is generated to find False Acceptance Ratio (FAR) and False Rejection Ratio (FRR). This methodology of authentication is tested on ECG wave data set of 105 individuals taken from Physionet QT Database. The proposed authentication system is found to have FAR of about 3.19% and FRR of about 0.128%. The overall accuracy of the system is found to be 99.85%.

  7. Professor Herman Burger (1893-1965), eminent teacher and scientist, who laid the theoretical foundations of vectorcardiography--and electrocardiography.

    PubMed

    van Herpen, Gerard

    2014-01-01

    Einthoven not only designed a high quality instrument, the string galvanometer, for recording the ECG, he also shaped the conceptual framework to understand it. He reduced the body to an equilateral triangle and the cardiac electric activity to a dipole, represented by an arrow (i.e. a vector) in the triangle's center. Up to the present day the interpretation of the ECG is based on the model of a dipole vector being projected on the various leads. The model is practical but intuitive, not physically founded. Burger analysed the relation between heart vector and leads according to the principles of physics. It then follows that an ECG lead must be treated as a vector (lead vector) and that the lead voltage is not simply proportional to the projection of the vector on the lead, but must be multiplied by the value (length) of the lead vector, the lead strength. Anatomical lead axis and electrical lead axis are different entities and the anatomical body space must be distinguished from electrical space. Appreciation of these underlying physical principles should contribute to a better understanding of the ECG. The development of these principles by Burger is described, together with some personal notes and a sketch of the personality of this pioneer of medical physics. PMID:24506911

  8. Improving the ECG classification of inferior and lateral myocardial infarction by inversion of lead aVR

    PubMed Central

    Menown, I; Adgey, A

    2000-01-01

    OBJECTIVE—To assess whether the use of inverted lead aVR (−aVR) would improve the classification of acute inferior or lateral myocardial infarction presenting with ST elevation.
DESIGN—Observational study. The presence of ⩾ 1 mm ST elevation in lead −aVR (derived by manual assessment of ST depression in conventional lead aVR) was determined by a single investigator, blinded to patient outcome.
PATIENTS—173 consecutive patients with chest pain for ⩽ 12 hours and ST elevation of ⩾ 1 mm in inferior leads (II, III, aVF) or lateral leads (I, aVL, V5, V6), excluding those with anterolateral ST elevation.
MAIN OUTCOME MEASURE—Incidence of ST elevation in lead −aVR in patients with inferior or lateral ST elevation, or both.
RESULTS—ST elevation in lead −aVR was present in 25 of 136 patients (18%) with inferior but no lateral ST elevation (indicating greater superior involvement) and in three of 11 patients (27%) with lateral but no inferior ST elevation (indicating greater inferior involvement). ST elevation in lead −aVR bridged the gap between inferior and lateral ST elevation in 15 of 25 (60%) patients with inferior and lateral chest lead (V5/V6) ST elevation, and in all patients with inferior and lateral limb lead (I/aVL) ST elevation. The presence of ST elevation in lead −aVR was associated with a larger infarct size as defined by median peak creatine kinase on serial sampling: 1780 v 987  mmol/l; p = 0.021.
CONCLUSIONS—Use of lead −aVR improves the ECG classification of acute inferior or lateral acute myocardial infarction and thus may be useful as part of the routine 12 lead ECG assessment of such patients.


Keywords: electrocardiography; acute myocardial infarction PMID:10814623

  9. The Metabolic Syndrome and ECG Detected Left Ventricular Hypertrophy – Influences from IGF-1 and IGF-Binding Protein-1

    PubMed Central

    Halldin, Mats; Brismar, Kerstin; Fahlstadius, Per; Vikström, Max; de Faire, Ulf; Hellénius, Mai-Lis

    2014-01-01

    Background and Aims The metabolic syndrome (MetS) is associated with an increased risk for left ventricular hypertrophy (LVH) and cardiovascular mortality. The aim of this study was to investigate potential influences from insulin-like growth factor-1 (IGF-1) and IGF binding protein-1 (IGFBP-1) on the relationship between the MetS and LVH, also taking into account the role of physical activity (PA), use of oestrogen and gender. Methods and Results In a population-based cross-sectional study of 60-year-old men (n = 1822) and women (n = 2049) participants underwent physical examination and laboratory tests, including electrocardiography (ECG), and completed an extensive questionnaire. Women showed higher levels of IGFBP-1 than men (37.0 vs. 28.0 µg/l, p<0.001), and women with LVH had lower levels of IGFBP-1 than women without LVH (31.0 µg/l vs. 37.0 µg/l, p<0.001). Furthermore, women with low levels of IGFBP-1 had a significantly increased risk of having LVH (crude OR≈2.5). When stratifying for PA and oestrogen, respectively, a weaker association between IGFBP-1 and LVH was demonstrated in physically active men and women, compared to inactive individuals, as well as in women using oestrogen, compared to non-users. Conclusion In a representative sample of 60-year-old Swedish men and women, the main findings were higher levels of IGFBP-1 in women than in men; lower levels of IGFBP-1 in women with LVH, compared to women without LVH; and an increased risk of having LVH in women with low levels of IGFBP-1. The association between IGFBP-1 and LVH was diminished in physically active men and women, as well as in women using oestrogen. PMID:25461385

  10. [An improved wavelet threshold algorithm for ECG denoising].

    PubMed

    Liu, Xiuling; Qiao, Lei; Yang, Jianli; Dong, Bin; Wang, Hongrui

    2014-06-01

    Due to the characteristics and environmental factors, electrocardiogram (ECG) signals are usually interfered by noises in the course of signal acquisition, so it is crucial for ECG intelligent analysis to eliminate noises in ECG signals. On the basis of wavelet transform, threshold parameters were improved and a more appropriate threshold expression was proposed. The discrete wavelet coefficients were processed using the improved threshold parameters, the accurate wavelet coefficients without noises were gained through inverse discrete wavelet transform, and then more original signal coefficients could be preserved. MIT-BIH arrythmia database was used to validate the method. Simulation results showed that the improved method could achieve better denoising effect than the traditional ones. PMID:25219225

  11. Statistical performance evaluation of ECG transmission using wireless networks.

    PubMed

    Shakhatreh, Walid; Gharaibeh, Khaled; Al-Zaben, Awad

    2013-07-01

    This paper presents simulation of the transmission of biomedical signals (using ECG signal as an example) over wireless networks. Investigation of the effect of channel impairments including SNR, pathloss exponent, path delay and network impairments such as packet loss probability; on the diagnosability of the received ECG signal are presented. The ECG signal is transmitted through a wireless network system composed of two communication protocols; an 802.15.4- ZigBee protocol and an 802.11b protocol. The performance of the transmission is evaluated using higher order statistics parameters such as kurtosis and Negative Entropy in addition to the common techniques such as the PRD, RMS and Cross Correlation. PMID:23777301

  12. ECG-synchronized DSA exposure control: improved cervicothoracic image quality

    SciTech Connect

    Kelly, W.M.; Gould, R.; Norman, D.; Brant-Zawadzki, M.; Cox, L.

    1984-10-01

    An electrocardiogram (ECG)-synchronized x-ray exposure sequence was used to acquire digital subtraction angiographic (DSA) images during 13 arterial injection studies of the aortic arch or carotid bifurcations. These gated images were compared with matched ungated DSA images acquired using the same technical factors, contrast material volume, and patient positioning. Subjective assessments by five experienced observers of edge definition, vessel conspicuousness, and overall diagnostic quality showed overall preference for one of the two acquisition methods in 69% of cases studied. Of these, the ECG-synchronized exposure series were rated superior in 76%. These results, as well as the relatively simple and inexpensive modifications required, suggest that routine use of ECG exposure control can facilitate improved arterial DSA evaluations of suspected cervicothoracic vascular disease.

  13. The use of the Hilbert transform in ECG signal analysis.

    PubMed

    Benitez, D; Gaydecki, P A; Zaidi, A; Fitzpatrick, A P

    2001-09-01

    This paper presents a new robust algorithm for QRS detection using the first differential of the ECG signal and its Hilbert transformed data to locate the R wave peaks in the ECG waveform. Using this method, the differentiation of R waves from large, peaked T and P waves is achieved with a high degree of accuracy. In addition, problems with baseline drift, motion artifacts and muscular noise are minimised. The performance of the algorithm was tested using standard ECG waveform records from the MIT-BITH Arrhythmia database. An average detection rate of 99.87%, a sensitivity (Se) of 99.94% and a positive prediction (+P) of 99.93% have been achieved against study records from the MIT-BITH Arrhythmia database. A detection error rate of less than 0.8% was achieved in every study case. The reliability of the proposed detector compares very favorably with published results for other QRS detectors. PMID:11535204

  14. On ECG reconstruction using weighted-compressive sensing

    PubMed Central

    Kassim, Ashraf A.

    2014-01-01

    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. PMID:26609381

  15. Performance evaluation of cellular phone network based portable ECG device.

    PubMed

    Hong, Joo-Hyun; Cha, Eun-Jong; Lee, Tae-Soo

    2008-01-01

    In this study, cellular phone network based portable ECG device was developed and three experiments were performed to evaluate the accuracy, reliability and operability, applicability during daily life of the developed device. First, ECG signals were measured using the developed device and Biopac device (reference device) during sitting and marking time and compared to verify the accuracy of R-R intervals. Second, the reliable data transmission to remote server was verified on two types of simulated emergency event using patient simulator. Third, during daily life with five types of motion, accuracy of data transmission to remote server was verified on two types of event occurring. By acquiring and comparing subject's biomedical signal and motion signal, the accuracy, reliability and operability, applicability during daily life of the developed device were verified. Therefore, cellular phone network based portable ECG device can monitor patient with inobtrusive manner. PMID:19162767

  16. On ECG reconstruction using weighted-compressive sensing.

    PubMed

    Zonoobi, Dornoosh; Kassim, Ashraf A

    2014-06-01

    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. PMID:26609381

  17. Chaos control applied to cardiac rhythms represented by ECG signals

    NASA Astrophysics Data System (ADS)

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

    2014-10-01

    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.

  18. Conditional Random Fields for Morphological Analysis of Wireless ECG Signals

    PubMed Central

    Natarajan, Annamalai; Gaiser, Edward; Angarita, Gustavo; Malison, Robert; Ganesan, Deepak; Marlin, Benjamin

    2015-01-01

    Thanks to advances in mobile sensing technologies, it has recently become practical to deploy wireless electrocardiograph sensors for continuous recording of ECG signals. This capability has diverse applications in the study of human health and behavior, but to realize its full potential, new computational tools are required to effectively deal with the uncertainty that results from the noisy and highly non-stationary signals collected using these devices. In this work, we present a novel approach to the problem of extracting the morphological structure of ECG signals based on the use of dynamically structured conditional random field (CRF) models. We apply this framework to the problem of extracting morphological structure from wireless ECG sensor data collected in a lab-based study of habituated cocaine users. Our results show that the proposed CRF-based approach significantly out-performs independent prediction models using the same features, as well as a widely cited open source toolkit. PMID:26726321

  19. ECG Interpretation Using the CRISP Method: A Guide for Nurses.

    PubMed

    Atwood, Denise; Wadlund, Diana L

    2015-10-01

    Nurses often struggle with identifying electrocardiogram (ECG) rhythms, but rapidly interpreting these rhythms is an essential skill that every nurse should master, especially in the perioperative setting. The CRISP (Cardiac Rhythm Identification for Simple People) method is an algorithm designed to help nurses rapidly interpret ECGs. Key aspects of assisting patients with suspected cardiac issues include the nursing assessment, correct three-lead ECG placement, and calculation of the heart rate. Then the perioperative nurse can use the steps of the CRISP method to identify nursing actions related to specific arrhythmias, including determining whether QRS complexes are present, P waves are present, and QRS complexes are wide or narrow or whether there are more P waves than QRS complexes. PMID:26411823

  20. Wavelet transformation based watermarking technique for human electrocardiogram (ECG).

    PubMed

    Engin, Mehmet; Cidam, Oğuz; Engin, Erkan Zeki

    2005-12-01

    Nowadays, watermarking has become a technology of choice for a broad range of multimedia copyright protection applications. Watermarks have also been used to embed prespecified data in biomedical signals. Thus, the watermarked biomedical signals being transmitted through communication are resistant to some attacks. This paper investigates discrete wavelet transform based watermarking technique for signal integrity verification in an Electrocardiogram (ECG) coming from four ECG classes for monitoring application of cardiovascular diseases. The proposed technique is evaluated under different noisy conditions for different wavelet functions. Daubechies (db2) wavelet function based technique performs better than those of Biorthogonal (bior5.5) wavelet function. For the beat-to-beat applications, all performance results belonging to four ECG classes are highly moderate. PMID:16235811

  1. Convolutional Neural Networks for patient-specific ECG classification.

    PubMed

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

    2015-08-01

    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). PMID:26736826

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

    PubMed

    Zhang, Huan; Song, Donghan; An, Lina

    2016-05-01

    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, p<0.01) and the ratio of door-to-balloon time below 90 min was remarkable higher in-group A (94.2% vs 60%, p<0.01). The rate of catheter laboratory occupied was 5.7% in-group A and 40% in group B respectively (p=0.001). There was no statistically difference in mortality between the two groups (5.7% vs 4%, p>0.05). The median length of stay was significant reduced in-group A (5 days vs 7 days, p<0.01). Real-time tele-transmission system of 12 lead electrocardiogram is beneficial to the pre-hospital diagnosis of STEMI. PMID:27383498

  3. From agonal to output: An ECG history of a successful pre-hospital thoracotomy.

    PubMed

    Deakin, Charles D

    2007-12-01

    This case report describes the first reported successful UK pre-hospital thoracotomy performed outside the London HEMS system. Continuous ECG monitoring during the procedure has allowed presentation of sequential ECGs recorded during the procedure. PMID:17697740

  4. A methodology for the development of software agent based interoperable telemedicine systems: a tele-electrocardiography perspective.

    PubMed

    Ganguly, P; Ray, P

    2000-01-01

    Telemedicine involves the integration of information, human-machine, and healthcare technologies. Because different modalities of patient care require applications running on heterogeneous computing environment, software interoperability is a major issue in telemedicine. Software agent technology provides a range of promising techniques to solve this problem. This article discusses the development of a methodology for the design of interoperable telemedicine systems (illustrated with a tele-electrocardiography application). Software interoperability between different applications can be modeled at different levels of abstraction such as physical interoperability, data-type interoperability, specification-level interoperability, and semantic interoperability. Software agents address the issue of software interoperability at semantic level. A popular object-oriented software development methodology - unified modeling language (UML) - has been used for this development. This research has demonstrated the feasibility of the development of agent-based interoperable telemedicine systems. More research is needed before widespread deployment of such systems can take place. PMID:10957742

  5. A wireless ECG monitoring system for pervasive healthcare.

    PubMed

    Sneha, Sweta; Varshney, Upkar

    2007-01-01

    This paper presents an architectural framework of a system utilising mobile technologies to enable continuous, wireless, electrocardiogram (ECG) monitoring of cardiac patients. The proposed system has the potential to improve patients' quality of life by allowing them to move around freely while undergoing continuous heart monitoring and to reduce healthcare costs associated with prolonged hospitalisation, treatment and monitoring. PMID:18048260

  6. ECG Monitoring in Cardiac Rehabilitation: Is It Needed?

    ERIC Educational Resources Information Center

    Greenland, Philip; Pomilla, Paul V.

    1989-01-01

    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…

  7. ECG gated NMR-CT for cardiovascular diseases

    SciTech Connect

    Nishikawa, J.; Ohtake, T.; Machida, K.; Iio, M.; Yoshimoto, N.; Sugimoto, T.

    1985-05-01

    The authors have been applying ECG gated NMR-CT to mainly patients with myocardial infarction (MI), and hypertrophic cardiomyopathy (HCM). Thirteen patients with MI, 8 with HCM and 5 without any heart diseases were studied by ECG gated NMR imaging (spin-echo technique, TR: depends on patient heart rate, TE: 35 and 70 msec.) with 0.35 T superconducting magnet. On NMR images (MRI), the authors examined the wall thickness, wall motion and T/sub 2/ relaxation time in the area of diseased myocardium. The lesions of old MI were depicted as the area of thin wall and T/sub 2/ relaxation time of those lesions were similar to the area of non-infarcted myocardium. The lesions of recent MI (up to 3.5 months from the recent attack) were shown as the same wall thickness as the non-infarcted myocardium and the area of prolonged T/sub 2/ relaxation time compared with that of non-infarcted myocardium. MRI demonstrated diffusely thick myocardium in all patients with HCM. T/sub 2/ relaxation time of the areas of HCM was almost the same as that of normal myocardium, and it's difference among each ventricular wall in patients with HCM was not statistically significant. The authors conclude that ECG gated NMR-CT offers 3-D morphological information of the heart without any contrast material nor radioisotopes. ECG gated MRI provides the useful informations to diagnose MI, especially in the differential diagnosis between old and recent MI.

  8. Measurement of ventricular function by ECG gating during atrial fibrillation

    SciTech Connect

    Bacharach, S.L.; Green, M.V.; Bonow, R.O.; Findley, S.L.; Ostrow, H.G.; Johnston, G.S.

    1981-03-01

    The assumptions necessary to perform ECG-gated cardiac studies are seemingly not valid for patients in atrial fibrillation (AF). To evaluate the effect of AF on equilibrium gated scintigraphy, beat-by-beat measurements of left-ventricular function were made on seven subjects in AF (mean heart rate 64 bpm), using a high-efficiency nonimaging detector. The parameters evaluated were ejection fraction (EF), time to end-systole (TES), peak rates of ejection and filling (PER,PFR), and their times of occurrence (TPER, TPFR). By averaging together single-beat values of EF, PER, etc., it was possible to determine the true mean values of these parameters. The single-beam mean values were compared with the corresponding parameters calculated from one ECG-gated time-activity curve (TAC) obtained by superimposing all the single-beat TACs irrespective of their length. For this population with slow heart rates, we find that the values for EF, etc., produced from ECG-gated time-activity curves, are very similar to those obtained from the single-beat data. Thus use of ECG gating at low heart rates may allow reliable estimation of average cardiac function even in subjects with AF.

  9. Disease Classification and Biomarker Discovery Using ECG Data

    PubMed Central

    Huang, Rong; Zhou, Yingchun

    2015-01-01

    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. PMID:26688816

  10. Thyroid hormones concentrations and ECG picture in the dog.

    PubMed

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

    2006-01-01

    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. PMID:17203744

  11. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic ECG/respirator synchronizer. 892.1970 Section 892.1970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic...

  12. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic ECG/respirator synchronizer. 892.1970 Section 892.1970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic...

  13. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic ECG/respirator synchronizer. 892.1970 Section 892.1970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic...

  14. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic ECG/respirator synchronizer. 892.1970 Section 892.1970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic...

  15. Effective ECG reference ranges for Northern Thai people

    PubMed Central

    Khumrin, Piyapong; Srisuwan, Pratya; Lertprayoonmit, Wongsapat; Leelarphat, Linlada; Phumphuang, Chitawat

    2015-01-01

    Background The numerical values and ranges of the ECG are used as criteria for classifying types of arrhythmia. However, one criterion cannot be generically applied for all patient groups. Several studies have shown that age, gender, and race are the major key factors which produce variations in ECG values. Methods From May 2013 to February 2014, we collected 12 993 normal ECG data from 9853 Northern Thai patients at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand, to analyse their ECG reference ranges. Results The results showed that the average heart rate decreased, while the PR interval and QTcB increased with increasing age in both genders. The normal range of heart rate was lower than the standard interval. QRS duration was stable in all age groups but longer in males than females. QRS axis deviated to the left with increasing age. SV1+RV5 amplitude slightly changed in both genders, but the upper limit crossed over the criteria of ventricular hypertrophy. Conclusions We observed that the general trend of data was mainly similar to that found in other studies in Chinese, American, and African populations. However, some minor differences should be considered specifically for the Northern Thai population. Flexible criteria on conditions depending on age and gender should be adjusted for Northern Thai patients according to the results of this research. PMID:27326211

  16. A Sequential Procedure for Individual Identity Verification Using ECG

    NASA Astrophysics Data System (ADS)

    Irvine, John M.; Israel, Steven A.

    2009-12-01

    The electrocardiogram (ECG) is an emerging novel biometric for human identification. One challenge for the practical use of ECG as a biometric is minimizing the time needed to acquire user data. We present a methodology for identity verification that quantifies the minimum number of heartbeats required to authenticate an enrolled individual. The approach rests on the statistical theory of sequential procedures. The procedure extracts fiducial features from each heartbeat to compute the test statistics. Sampling of heartbeats continues until a decision is reached—either verifying that the acquired ECG matches the stored credentials of the individual or that the ECG clearly does not match the stored credentials for the declared identity. We present the mathematical formulation of the sequential procedure and illustrate the performance with measured data. The initial test was performed on a limited population, twenty-nine individuals. The sequential procedure arrives at the correct decision in fifteen heartbeats or fewer in all but one instance and in most cases the decision is reached with half as many heartbeats. Analysis of an additional 75 subjects measured under different conditions indicates similar performance. Issues of generalizing beyond the laboratory setting are discussed and several avenues for future investigation are identified.

  17. ECG-cryptography and authentication in body area networks.

    PubMed

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

    2012-11-01

    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. PMID:22752143

  18. ECG-based heartbeat classification for arrhythmia detection: A survey.

    PubMed

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

    2016-04-01

    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. PMID:26775139

  19. Some regularity on how to locate electrodes for higher fECG SNRs

    NASA Astrophysics Data System (ADS)

    Zhang, Jie-Min; Huang, Xiao-Lin; Guan, Qun; Liu, Tie-Bing; Li, Ping; Zhao, Ying; Liu, Hong-Xing

    2015-03-01

    The electrocardiogram (ECG) recorded from the abdominal surface of a pregnant woman is a composite of maternal ECG, fetal ECG (fECG) and other noises, while only the fECG component is always needed by us. With different locations of electrode pairs on the maternal abdominal surface to measure fECGs, the signal-to-noise ratios (SNRs) of the recorded abdominal ECGs are also correspondingly different. Some regularity on how to locate electrodes to obtain higher fECG SNRs is needed practically. In this paper, 343 groups of abdominal ECG records were acquired from 78 pregnant women with different electrode pairs locating, and an appropriate extended research database is formed. Then the regularity on fECG SNRs corresponding to different electrode pairs locating was studied. Based on statistical analysis, it is shown that the fECG SNRs are significantly higher in certain locations than others. Reasonable explanation is also provided to the statistical result using the theories of the fetal cardiac electrical axis and the signal phase delay. Project supported by the National Natural Science Foundation of China (Grant No. 61271079) and the Supporting Plan Project of Jiangsu Province, China (Grant No. BE2010720).

  20. A new feature detection mechanism and its application in secured ECG transmission with noise masking.

    PubMed

    Sufi, Fahim; Khalil, Ibrahim

    2009-04-01

    With cardiovascular disease as the number one killer of modern era, Electrocardiogram (ECG) is collected, stored and transmitted in greater frequency than ever before. However, in reality, ECG is rarely transmitted and stored in a secured manner. Recent research shows that eavesdropper can reveal the identity and cardiovascular condition from an intercepted ECG. Therefore, ECG data must be anonymized before transmission over the network and also stored as such in medical repositories. To achieve this, first of all, this paper presents a new ECG feature detection mechanism, which was compared against existing cross correlation (CC) based template matching algorithms. Two types of CC methods were used for comparison. Compared to the CC based approaches, which had 40% and 53% misclassification rates, the proposed detection algorithm did not perform any single misclassification. Secondly, a new ECG obfuscation method was designed and implemented on 15 subjects using added noises corresponding to each of the ECG features. This obfuscated ECG can be freely distributed over the internet without the necessity of encryption, since the original features needed to identify personal information of the patient remain concealed. Only authorized personnel possessing a secret key will be able to reconstruct the original ECG from the obfuscated ECG. Distribution of the would appear as regular ECG without encryption. Therefore, traditional decryption techniques including powerful brute force attack are useless against this obfuscation. PMID:19397097

  1. Mobile measurement system of ECG signal in vehicle environment

    NASA Astrophysics Data System (ADS)

    Oh, Kwang-seok; Lee, Sang-Ryong; Lee, Choon-Young; Kim, Myun-Hee

    2005-12-01

    This paper proposed a new method to measure the ECG signal from the driver. The ECG signal is often measured in the room. But it is mixed with many kinds of noise when it is measured during the vehicle moving. Noise occupied most many parts as the experimental among them was classified. And one suitable filter for each noise was designed. It used ALE(Adaptive Line Enhancement) to remove the noise occurred to electromagnetic wave in vehicle. To remove the noise occurred to steering or vibration of vehicle, the paper used Wavelet transformation after ALE(preprocessing filter). To realize unconscious measurement, this research used the stainless steel(not the electrode) fixed at steering wheel and designed the adaptive filter without using reference signal.

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

    NASA Astrophysics Data System (ADS)

    Andreão, Rodrigo Varejão; Boudy, Jérôme

    2006-12-01

    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.

  3. Patient ECG recording control for an automatic implantable defibrillator

    NASA Technical Reports Server (NTRS)

    Fountain, Glen H. (Inventor); Lee, Jr., David G. (Inventor); Kitchin, David A. (Inventor)

    1986-01-01

    An implantable automatic defibrillator includes sensors which are placed on or near the patient's heart to detect electrical signals indicative of the physiology of the heart. The signals are digitally converted and stored into a FIFO region of a RAM by operation of a direct memory access (DMA) controller. The DMA controller operates transparently with respect to the microprocessor which is part of the defibrillator. The implantable defibrillator includes a telemetry communications circuit for sending data outbound from the defibrillator to an external device (either a patient controller or a physician's console or other) and a receiver for sensing at least an externally generated patient ECG recording command signal. The patient recording command signal is generated by the hand held patient controller. Upon detection of the patient ECG recording command, DMA copies the contents of the FIFO into a specific region of the RAM.

  4. ECG contamination of EEG signals: effect on entropy.

    PubMed

    Chakrabarti, Dhritiman; Bansal, Sonia

    2016-02-01

    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. PMID:25900143

  5. Using ordinal partition transition networks to analyze ECG data

    NASA Astrophysics Data System (ADS)

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

    2016-07-01

    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.

  6. An extensive Markov system for ECG exact coding.

    PubMed

    Tai, S C

    1995-02-01

    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. PMID:7868151

  7. Diverse and composite features for ECG signals processing.

    PubMed

    Ubeyli, Elif Derya

    2008-01-01

    The automated diagnostic systems employing diverse and composite features for electrocardiogram (ECG) signals were analyzed and their accuracies were determined. Because of the importance of making the right decision, classification procedures classifying the ECG signals with high accuracy were investigated. The classification accuracies of multilayer perceptron neural network (MLPNN), recurrent neural network (RNN), and mixture of experts (ME) trained on composite features and modified mixture of experts (MME) trained on diverse features were compared. The inputs of these automated diagnostic systems were composed of diverse or composite features (wavelet coefficients and power levels of the power spectral density estimates obtained by the eigenvector methods) and were chosen according to the network structures. The conclusions of this study demonstrated that the MME trained on diverse features achieved accuracy rates which were higher than that of the other automated diagnostic systems trained on composite features. PMID:18408257

  8. Psychophysiology of disgust: ECG noise entropy as a biomarker.

    PubMed

    Bras, Susana; Ferreira, Jacqueline; Soares, Sandra C; Silva, Carlos F

    2015-08-01

    The identification or classification of emotions allows the description of the person's state and, therefore, the inference of their preferences. The basic emotion of disgust, in particular, allows the organism to protect itself against diseases. Usually, the decrease in heart rate is associated with this emotion. As an avoidance behavior, when facing with disgust stimuli, the body reacts with movements, such as muscle contraction, etc. These reactions are evidenced in the electrocardiogram (ECG) as noise responses. In this paper, we propose the amount of ECG noise measured by the noise entropy as a new biomarker in emotion identification, which has been neglected in the literature. Our results showed that the noise entropy was able to discriminate between disgust, fear and neutral conditions in 88% (p<;0.05). It was also evidenced in this dataset that the median noise entropy in disgust was higher than in neutral and in fear conditions. PMID:26736765

  9. Wavelet based ECG compression with adaptive thresholding and efficient coding.

    PubMed

    Alshamali, A

    2010-01-01

    This paper proposes a new wavelet-based ECG compression technique. It is based on optimized thresholds to determine significant wavelet coefficients and an efficient coding for their positions. Huffman encoding is used to enhance the compression ratio. The proposed technique is tested using several records taken from the MIT-BIH arrhythmia database. Simulation results show that the proposed technique outperforms others obtained by previously published schemes. PMID:20608811

  10. Capacitive driven-right-leg grounding in Indirect-contact ECG measurement.

    PubMed

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

    2010-01-01

    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. PMID:21095911

  11. Compressive sensing exploiting wavelet-domain dependencies for ECG compression

    NASA Astrophysics Data System (ADS)

    Polania, Luisa F.; Carrillo, Rafael E.; Blanco-Velasco, Manuel; Barner, Kenneth E.

    2012-06-01

    Compressive sensing (CS) is an emerging signal processing paradigm that enables sub-Nyquist sampling of sparse signals. Extensive previous work has exploited the sparse representation of ECG signals in compression applications. In this paper, we propose the use of wavelet domain dependencies to further reduce the number of samples in compressive sensing-based ECG compression while decreasing the computational complexity. R wave events manifest themselves as chains of large coefficients propagating across scales to form a connected subtree of the wavelet coefficient tree. We show that the incorporation of this connectedness as additional prior information into a modified version of the CoSaMP algorithm can significantly reduce the required number of samples to achieve good quality in the reconstruction. This approach also allows more control over the ECG signal reconstruction, in particular, the QRS complex, which is typically distorted when prior information is not included in the recovery. The compression algorithm was tested upon records selected from the MIT-BIH arrhythmia database. Simulation results show that the proposed algorithm leads to high compression ratios associated with low distortion levels relative to state-of-the-art compression algorithms.

  12. A constrained two-layer compression technique for ECG waves.

    PubMed

    Byun, Kyungguen; Song, Eunwoo; Shim, Hwan; Lim, Hyungjoon; Kang, Hong-Goo

    2015-08-01

    This paper proposes a constrained two-layer compression technique for electrocardiogram (ECG) waves, of which encoded parameters can be directly used for the diagnosis of arrhythmia. In the first layer, a single ECG beat is represented by one of the registered templates in the codebook. Since the required coding parameter in this layer is only the codebook index of the selected template, its compression ratio (CR) is very high. Note that the distribution of registered templates is also related to the characteristics of ECG waves, thus it can be used as a metric to detect various types of arrhythmias. The residual error between the input and the selected template is encoded by a wavelet-based transform coding in the second layer. The number of wavelet coefficients is constrained by pre-defined maximum distortion to be allowed. The MIT-BIH arrhythmia database is used to evaluate the performance of the proposed algorithm. The proposed algorithm shows around 7.18 CR when the reference value of percentage root mean square difference (PRD) is set to ten. PMID:26737691

  13. The use of the SPSA method in ECG analysis.

    PubMed

    Gerencsér, László; Kozmann, György; Vágó, Zsuzsanna; Haraszti, Kristóf

    2002-10-01

    The classification, monitoring, and compression of electrocardiogram (ECG) signals recorded of a single patient over a relatively long period of time is considered. The particular application we have in mind is high-resolution ECG analysis, such as late potential analysis, morphology changes in QRS during arrythmias, T-wave alternants, or the study of drug effects on ventricular activation. We propose to apply a modification of a classical method of cluster analysis or vector quantization. The novelty of our approach is that we use a new distortion measure to quantify the distance of two ECG cycles, and the class-distortion measure is defined using a min-max criterion. The new class-distortion-measure is much more sensitive to outliers than the usual distortion measures using average-distance. The price of this practical advantage is that computational complexity is significantly increased. The resulting nonsmooth optimization problem is solved by an adapted version of the simultaneous perturbation stochastic approximation (SPSA) method of. The main idea is to generate a smooth approximation by a randomization procedure. The viability of the method is demonstrated on both simulated and real data. An experimental comparison with the widely used correlation method is given on real data. PMID:12374333

  14. A comparison of single channel fetal ECG extraction methods.

    PubMed

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

    2014-06-01

    The abdominal electrocardiogram (ECG) provides a non-invasive method for monitoring the fetal cardiac activity in pregnant women. However, the temporal and frequency overlap between the fetal ECG (FECG), the maternal ECG (MECG) and noise results in a challenging source separation problem. This work seeks to compare temporal extraction methods for extracting the fetal signal and estimating fetal heart rate. A novel method for MECG cancelation using an echo state neural network (ESN) based filtering approach was compared with the least mean square (LMS), the recursive least square (RLS) adaptive filter and template subtraction (TS) techniques. Analysis was performed using real signals from two databases composing a total of 4 h 22 min of data from nine pregnant women with 37,452 reference fetal beats. The effects of preprocessing the signals was empirically evaluated. The results demonstrate that the ESN based algorithm performs best on the test data with an F1 measure of 90.2% as compared to the LMS (87.9%), RLS (88.2%) and the TS (89.3%) techniques. Results suggest that a higher baseline wander high pass cut-off frequency than traditionally used for FECG analysis significantly increases performance for all evaluated methods. Open source code for the benchmark methods are made available to allow comparison and reproducibility on the public domain data. PMID:24604619

  15. Tensor-based detection of T wave alternans using ECG.

    PubMed

    Goovaerts, Griet; Vandenberk, Bert; Willems, Rik; Van Huffel, Sabine

    2015-08-01

    T wave alternans is defined as changes in the T wave amplitude in an ABABAB-pattern. It can be found in ECG signals of patients with heart diseases and is a possible indicator to predict the risk on sudden cardiac death. Due to its low amplitude, robust automatic T wave alternans detection is a difficult task. We present a new method to detect T wave alternans in multichannel ECG signals. The use of tensors (multidimensional matrices) permits the combination of the information present in different channels, making detection more reliable. The possibility of decomposition of incomplete tensors is exploited to deal with noisy ECG segments. Using a sliding window of 128 heartbeats, a tensor is constructed of the T waves of all channels. Canonical Polyadic Decomposition is applied to this tensor and the resulting loading vectors are examined for information about the T wave behavior in three dimensions. T wave alternans is detected using a sign change counting method that is able to extract both the T wave alternans length and magnitude. When applying this novel method to a database of patients with multiple positive T wave alternans tests using the clinically available spectral method tests, both the length and the magnitude of the detected T wave alternans is larger for these subjects than for subjects in a control group. PMID:26737901

  16. QTc prolongation with antipsychotics: is routine ECG monitoring recommended?

    PubMed

    Shah, Asim A; Aftab, Awais; Coverdale, John

    2014-05-01

    Whether or not QTc interval should be routinely monitored in patients receiving antipsychotics is a controversial issue, given logistic and fiscal dilemmas. There is a link between antipsychotic medications and prolongation of QTc interval, which is associated with an increased risk of torsade de pointes (TdP). Our goal is to provide clinically practical guidelines for monitoring QTc intervals in patients being treated with antipsychotics. We provide an overview of the pathophysiology of the QT interval, its relationship to TdP, and a discussion of the QT prolonging effects of antipsychotics. A literature search for articles relevant to the QTc prolonging effects of antipsychotics and TdP was conducted utilizing the databases PubMed and Embase with various combinations of search words. The overall risk of TdP and sudden death associated with antipsychotics has been observed to be low. Medications, genetics, gender, cardiovascular status, pathological conditions, and electrolyte disturbances have been found to be related to prolongation of the QTc interval. We conclude that, while electrocardiogram (ECG) monitoring is useful when administering antipsychotic medications in the presence of co-existing risk factors, it is not mandatory to perform ECG monitoring as a prerequisite in the absence of cardiac risk factors. An ECG should be performed if the initial evaluation suggests increased cardiac risk or if the antipsychotic to be prescribed has been established to have an increased risk of TdP and sudden death. PMID:24847993

  17. Real-time ECG transmission via Internet for nonclinical applications.

    PubMed

    Hernández, A I; Mora, F; Villegas, G; Passariello, G; Carrault, G

    2001-09-01

    Telemedicine is producing a great impact in the monitoring of patients located in remote nonclinical environments such as homes, elder communities, gymnasiums, schools, remote military bases, ships, and the like. A number of applications, ranging from data collection, to chronic patient surveillance, and even to the control of therapeutic procedures, are being implemented in many parts of the world. As part of this growing trend, this paper discusses the problems in electrocardiogram (ECG) real-time data acquisition, transmission, and visualization over the Internet. ECG signals are transmitted in real time from a patient in a remote nonclinical environment to the specialist in a hospital or clinic using the current capabilities and availability of the Internet. A prototype system is composed of a portable data acquisition and preprocessing module connected to the computer in the remote site via its RS-232 port, a Java-based client-server platform, and software modules to handle communication protocols between data acquisition module and the patient's personal computer, and to handle client-server communication. The purpose of the system is the provision of extended monitoring for patients under drug therapy after infarction, data collection in some particular cases, remote consultation, and low-cost ECG monitoring for the elderly. PMID:11550848

  18. [The athletes' ECG and the exercise related sudden cardiac death].

    PubMed

    Trachsel, Lukas-Daniel; Wilhelm, Matthias

    2015-05-01

    Regular physical activity induces structural, electrical and functional cardiac adaptations. The main challenge for the athletes' physician is to distinguish abnormal structural changes of the heart from training-induced adaptations (so-called “athlete's heart”). In athletes with underlying cardiac disease, physical activity may be a trigger, not the cause of exercise-induced tachyarrhythmia's and sudden cardiac death (SCD). To identify athletes with cardiac diseases and increased risk for an SCD, the European society of cardiology (ESC) recommends a pre-participation screening in elite athletes which was adopted by the Swiss society of sports medicine. The screening includes a specific medical history, cardiac auscultation and a resting ECG. Due to the high number of false-positive cases of athletes' ECGs based on traditional criteria, the ESC assessment criteria were adjusted to account for training-related changes of the ECG. The sensitivity and especially the specificity could be improved in the “revised Seattle criteria” in 2014. During the last years main attention has been shifted to the early repolarization pattern: additionally to (endurance-) training there is a clear association with male gender, ethnicity, changes in autonomic nervous system activity and high QRS-voltage criteria PMID:26098068

  19. Adjustment of QT dispersion assessed from 12 lead electrocardiograms for different numbers of analysed electrocardiographic leads: comparison of stability of different methods.

    PubMed Central

    Hnatkova, K; Malik, M; Kautzner, J; Gang, Y; Camm, A J

    1994-01-01

    OBJECTIVE--Normal electrocardiographic recordings were analysed to establish the influence of measurement of different numbers of electrocardiographic leads on the results of different formulas expressing QT dispersion and the effects of adjustment of QT dispersion obtained from a subset of an electrocardiogram to approximate to the true QT dispersion obtained from a complete electrocardiogram. SUBJECTS AND METHODS--Resting 12 lead electrocardiograms of 27 healthy people were investigated. In each lead, the QT interval was measured with a digitising board and QT dispersion was evaluated by three formulas: (A) the difference between the longest and the shortest QT interval among all leads; (B) the difference between the second longest and the second shortest QT interval; (C) SD of QT intervals in different leads. For each formula, the "true" dispersion was assessed from all measurable leads and then different combinations of leads were omitted. The mean relative differences between the QT dispersion with a given number of omitted leads and the "true" QT dispersion (mean relative errors) and the coefficients of variance of the results of QT dispersion obtained when omitting combinations of leads were compared for the different formulas. The procedure was repeated with an adjustment of each formula dividing its results by the square root of the number of measured leads. The same approach was used for the measurement of QT dispersion from the chest leads including a fourth formula (D) the SD of interlead differences weighted according to the distances between leads. For different formulas, the mean relative errors caused by omitting individual electrocardiographic leads were also assessed and the importance of individual leads for correct measurement of QT dispersion was investigated. RESULTS--The study found important differences between different formulas for assessment of QT dispersion with respect to compensation for missing measurements of QT interval. The

  20. Delineation of QRS offset by instantaneous changes in ECG vector angle can improve detection of acute inferior myocardial infarctions.

    PubMed

    Starc, Vito; Schlegel, Todd T

    2016-01-01

    We developed an automated new method for determining QRS offset, based on angular velocity (AV) changes around the QRS loop, and compared the method's performance to that of manual and more established automated methods for determining QRS offset in both healthy subjects and patients with acute myocardial infarction (AMI). Specifically, using Frank leads reconstructed from standard 12-lead ECGs, we determined AV in the direction of change raised to the 4th power, d(t). We found that the d(t)-determined AV transition (ΔAV) nearly coincided with manually determined QRS offset in healthy subjects, and in 27 patients with anterior AMI. However, in 31 patients with inferior AMI, ΔAV typically preceded that of QRS offset determined by the established automated methods, and by more than 10ms in 32% of cases. While this "ΔAV precedence" coincided with diagnostic ST elevation in only a minority of patients with recent inferior AMI, the use of ΔAV precedence as a complement to traditional determination of ST elevation increased the sensitivity for detecting inferior AMIs from 23 to 42%. PMID:26979381

  1. ECG recording on a bed during sleep without direct skin-contact.

    PubMed

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

    2007-04-01

    A new indirect contact (IDC) electrocardiogram (ECG) measurement method (IDC-ECG) for monitoring ECG during sleep that is adequate for long-term use is provided. The provided method did not require any direct conductive contact between the instrument and bare skin. This method utilizes an array of high-input-impedance active electrodes fixed on the mattress and an indirect-skin-contact ground made of a large conductive textile sheet. A thin cotton bedcover covered the mattress, electrodes, and conductive textile, and the participants were positioned on the mattress over the bedcover. An ECG was successfully obtained, although the signal quality was lower and the motion artifact was larger than in conventional direct-contact measurements (DC-ECG). The results showed that further studies are required to apply the provided method to an ECG diagnosis of cardiovascular diseases. However, currently the method can be used for HRV assessment with easy discrimination of R-peaks. PMID:17405379

  2. [Design of the Mobile ECG Monitoring System Based on Android 4.3].

    PubMed

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

    2015-07-01

    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. PMID:26665945

  3. Software design of a remote real-time ECG monitoring system

    NASA Astrophysics Data System (ADS)

    Yu, Chengbo; Tao, Hongyan

    2005-12-01

    Heart disease is one of the main diseases that threaten the health and lives of human beings. At present, the normal remote ECG monitoring system has the disadvantages of a short testing distance and limitation of monitoring lines. Because of accident and paroxysmal disease, ECG monitoring has extended from the hospital to the family. Therefore, remote ECG monitoring through the Internet has the actual value and significance. The principle and design method of software of the remote dynamic ECG monitor was presented and discussed. The monitoring software is programmed with Delphi software based on client-sever interactive mode. The application program of the system, which makes use of multithreading technology, is shown to perform in an excellent manner. The program includes remote link users and ECG processing, i.e. ECG data's receiving, real-time displaying, recording and replaying. The system can connect many clients simultaneously and perform real-time monitoring to patients.

  4. Interchangeability of Electrocardiography and Blood Pressure Measurement for Determining Heart Rate and Heart Rate Variability in Free-Moving Domestic Pigs in Various Behavioral Contexts

    PubMed Central

    Krause, Annika; Tuchscherer, Armin; Puppe, Birger; Langbein, Jan

    2015-01-01

    This study assessed the interchangeability between heart rate (HR) and heart rate variability (HRV) measures derived from a series of interbeat intervals (IBIs) recorded via electrocardiogram (ECG) and intra-arterial blood pressure (BP) in various behavioral contexts. Five minutes of simultaneously recorded IBIs from ECG and BP signals in 11 female domestic pigs during resting, feeding, and active behavior were analyzed. Comparisons were made for measures of HR, the standard deviation of IBIs, and the root mean of the squared distances of subsequent IBIs derived from ECG and BP signals for each behavior category using statistical procedures with different explanatory power [linear regression, intraclass correlation coefficient (ICC), Bland and Altman plots, and analysis of variance (ANOVA)]. Linear regression showed a strong relationship for HR during all behaviors and for HRV during resting. Excellent ICCs [lower 95% confidence intervals (CI) >0.75] and narrow limits of agreement in all behavior categories were found for HR. ICCs for HRV reached the critical lower 95% CI value of 0.75 only during resting. Using Bland and Altman plots, HRV agreement was unacceptable for all of the behavior categories. ANOVA showed significant differences between the methods in terms of HRV. BP systematically overestimated HRV compared with ECG. Our findings reveal that HR data recorded via BP agree well those recorded using ECG independently of the activity of the subject, whereas ECG and BP cannot be used interchangeably in the context of HRV in free-moving domestic pigs. PMID:26664979

  5. Development of a portable wireless system for bipolar concentric ECG recording

    NASA Astrophysics Data System (ADS)

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

    2015-07-01

    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).

  6. ECG De-noising: A comparison between EEMD-BLMS and DWT-NN algorithms.

    PubMed

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

    2015-08-01

    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. PMID:26737124

  7. Wavelet-based ECG compression by bit-field preserving and running length encoding.

    PubMed

    Chan, Hsiao-Lung; Siao, You-Chen; Chen, Szi-Wen; Yu, Shih-Fan

    2008-04-01

    Efficient electrocardiogram (ECG) compression can reduce the payload of real-time ECG transmission as well as reduce the amount of data storage in long-term ECG recording. In this paper an ECG compression/decompression architecture based on the bit-field preserving (BFP) and running length encoding (RLE)/decoding schemes incorporated with the discrete wavelet transform (DWT) is proposed. Compared to complex and repetitive manipulations in the set partitioning in hierarchical tree (SPIHT) coding and the vector quantization (VQ), the proposed algorithm has advantages of simple manipulations and a feedforward structure that would be suitable to implement on very-large-scale integrated circuits and general microcontrollers. PMID:18164098

  8. Embedding patients confidential data in ECG signal for healthcare information systems.

    PubMed

    Ibaida, Ayman; Khalil, Ibrahim; Al-Shammary, Dhiah

    2010-01-01

    In Wireless tele-cardiology applications, ECG signal is widely used to monitor cardiac activities of patients. Accordingly, in most e-health applications, ECG signals need to be combined with patient confidential information. Data hiding and watermarking techniques can play a crucial role in ECG wireless tele-monitoring systems by combining the confidential information with the ECG signal since digital ECG data is huge enough to act as host to carry tiny amount of additional secret data. In this paper, a new steganography technique is proposed that helps embed confidential information of patients into specific locations (called special range numbers) of digital ECG host signal that will cause minimal distortion to ECG, and at the same time, any secret information embedded is completely extractable. We show that there are 2.1475 × 10(9) possible special range numbers making it extremely difficult for intruders to identify locations of secret bits. Experiments show that percentage residual difference (PRD) of watermarked ECGs can be as low as 0.0247% and 0.0678% for normal and abnormal ECG segments (taken from MIT-BIH Arrhythmia database) respectively. PMID:21097076

  9. The Telemetric and Holter ECG Warehouse (THEW) The first three years of development and Research

    PubMed Central

    Couderc, Jean-Philippe

    2012-01-01

    The Telemetric and Holter ECG Warehouse (THEW) hosts more than 3,700 digital 24-Holter ECG recordings from 13 independent studies. In addition to the ECGs, the repository includes patient information in separate clinical database with a 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 have been 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. PMID:23022305

  10. A Practical and Cheap Circuit for ECG Sensing and Heart Frequency Alarm

    NASA Astrophysics Data System (ADS)

    Aviña-Cervantes, J. G.; González-García, A. E.; Alvarado-Méndez, E.; Trejo-Durán, M.; Torres-Cisneros, M.; Sánchez-Yáñez, R.; Ayala-Ramírez, V.

    2006-09-01

    A practical electronic circuit for ECG sensing, using high gain instrumentation amplifiers, a PIC microcontroller and two electrodes is presented. It allows to identify and to amplify a well-delimited ECG signal for a further wave analysis, and using a zero crossing detector a heart frequency detector is also implemented. By the moment, the conventional electrocardiogram (ECG) configurations making use of separate electrical connections to the arms and legs (bipolar limb lead 1) is exploited. This device is a practical and cheap way to monitoring ECG signal and some heart anomalies (e.g., arrhythmias, tachycardia) that can be used in a network to communicate anytime with a far health supervisor.

  11. Simulation of ECG Repolarization Phase with Improved Model of Cell Action Potentials

    NASA Astrophysics Data System (ADS)

    Trobec, Roman; Depolli, Matjaž; Avbelj, Viktor

    An improved model of action potentials (AP) is proposed to increase the accuracy of simulated electrocardiograms (ECGs). ECG simulator is based on a spatial model of a left ventricle, composed of cubic cells. Three distinct APs, modeled with functions proposed by Wohlfard, have been assigned to the cells, forming epicardial, mid, and endocardial layers. Identification of exact parameter values for AP models has been done through optimization of the simulated ECGs. Results have shown that only through an introduction of a minor extension to the AP model, simulator is able to produce more realistic ECGs. The same extension also proves essential for achieving a better fit between the measured and modeled APs.

  12. Mouse ECG findings in aging, with conduction system affecting drugs and in cardiac pathologies: Development and validation of ECG analysis algorithm in mice.

    PubMed

    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

    2015-12-01

    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. PMID:26660552

  13. Energy-efficient Compressed Sensing for ambulatory ECG monitoring.

    PubMed

    Craven, Darren; McGinley, Brian; Kilmartin, Liam; Glavin, Martin; Jones, Edward

    2016-04-01

    Advances in Compressed Sensing (CS) are enabling promising low-energy implementation solutions for wireless Body Area Networks (BAN). While studies demonstrate the potential of CS in terms of overall energy efficiency compared to state-of-the-art lossy compression techniques, the performance of CS remains limited. The aim of this study is to improve the performance of CS-based compression for electrocardiogram (ECG) signals. This paper proposes a CS architecture that combines a novel redundancy removal scheme with quantization and Huffman entropy coding to effectively extend the Compression Ratio (CR). Reconstruction is performed using overcomplete sparse dictionaries created with Dictionary Learning (DL) techniques to exploit the highly structured nature of ECG signals. Performance of the proposed CS implementation is evaluated by analyzing energy-based distortion metrics and diagnostic metrics including QRS beat-detection accuracy across a range of CRs. The proposed CS approach offers superior performance to the most recent state-of-the-art CS implementations in terms of signal reconstruction quality across all CRs tested. Furthermore, QRS detection accuracy of the technique is compared with the well-known lossy Set Partitioning in Hierarchical Trees (SPIHT) compression technique. The proposed CS approach outperforms SPIHT in terms of achievable CR, using the area under the receiver operator characteristic (ROC) curve (AUC). For an application where a minimum AUC performance threshold of 0.9 is required, the proposed technique extends the CR from 64.6 to 90.45 compared with SPIHT, ensuring a 40% saving on wireless transmission costs. Therefore, the results highlight the potential of the proposed technique for ECG computer-aided diagnostic systems. PMID:26854730

  14. Cardiac Repolarization Abnormalities and Potential Evidence for Loss of Cardiac Sodium Currents on ECGs of Patients with Chagas' Heart Disease

    NASA Technical Reports Server (NTRS)

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

    2007-01-01

    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

  15. The study and design of a wireless ECG monitoring system.

    PubMed

    Yang, Hongli; Chai, Jihong

    2012-01-01

    This paper describes a research project on wireless electrocardiogram (ECG) monitoring systems. A detection and measurement processor designed by a MSP430 microcontroller accomplishes the analog-to-digital conversion, digital filtering, QRS wave detection, and heart rate calculation. The data of detection can be sent to the central controller and personal computer (PC) by wireless on-chip MG2455 through a ZigBee network. This design can be used widely in home healthcare, community healthcare, and sports training, as well as in healthcare facilities, due to its characteristics of low power consumption, small size, and reliability. PMID:23039742

  16. Holter triage ambulatory ECG analysis. Accuracy and time efficiency.

    PubMed

    Cooper, D H; Kennedy, H L; Lyyski, D S; Sprague, M K

    1996-01-01

    Triage ambulatory electrocardiographic (ECG) analysis permits relatively unskilled office workers to submit 24-hour ambulatory ECG Holter tapes to an automatic instrument (model 563, Del Mar Avionics, Irvine, CA) for interpretation. The instrument system "triages" what it is capable of automatically interpreting and rejects those tapes (with high ventricular arrhythmia density) requiring thorough analysis. Nevertheless, a trained cardiovascular technician ultimately edits what is accepted for analysis. This study examined the clinical validity of one manufacturer's triage instrumentation with regard to accuracy and time efficiency for interpreting ventricular arrhythmia. A database of 50 Holter tapes stratified for frequency of ventricular ectopic beats (VEBs) was examined by triage, conventional, and full-disclosure hand-count Holter analysis. Half of the tapes were found to be automatically analyzable by the triage method. Comparison of the VEB accuracy of triage versus conventional analysis using the full-disclosure hand count as the standard showed that triage analysis overall appeared as accurate as conventional Holter analysis but had limitations in detecting ventricular tachycardia (VT) runs. Overall sensitivity, positive predictive accuracy, and false positive rate for the triage ambulatory ECG analysis were 96, 99, and 0.9%, respectively, for isolated VEBs, 92, 93, and 7%, respectively, for ventricular couplets, and 48, 93, and 7%, respectively, for VT. Error in VT detection by triage analysis occurred on a single tape. Of the remaining 11 tapes containing VT runs, accuracy was significantly increased, with a sensitivity of 86%, positive predictive accuracy of 90%, and false positive rate of 10%. Stopwatch-recorded time efficiency was carefully logged during both triage and conventional ambulatory ECG analysis and divided into five time phases: secretarial, machine, analysis, editing, and total time. Triage analysis was significantly (P < .05) more time

  17. Independent Prognostic Value of Single and Multiple Non-Specific 12-Lead Electrocardiographic Findings for Long-Term Cardiovascular Outcomes: A Prospective Cohort Study

    PubMed Central

    Sawano, Mitsuaki; Kohsaka, Shun; Okamura, Tomonori; Inohara, Taku; Sugiyama, Daisuke; Shiraishi, Yasuyuki; Watanabe, Makoto; Nakamura, Yasuyuki; Higashiyama, Aya; Kadota, Aya; Okuda, Nagako; Murakami, Yoshitaka; Ohkubo, Takayoshi; Fujiyoshi, Akira; Miura, Katsuyuki; Okayama, Akira; Ueshima, Hirotsugu

    2016-01-01

    Aims The long-term prognostic effect of non-specific 12-lead electrocardiogram findings is unknown. We aimed to evaluate the cumulative prognostic impact of axial, structural, and repolarization categorical abnormalities on cardiovascular death, independent from traditional risk scoring systems such as the Framingham risk score and the NIPPON DATA80 risk chart. Methods and Results A total of 16,816 healthy men and women from two prospective, longitudinal cohort studies were evaluated. 3,794 (22.6%) individuals died during a median follow-up of 15 years (range, 2.0–24 years). Hazard ratios for cardiovascular death, all-cause death, coronary death and stroke death were calculated for the cumulative and independent axial, structural, and repolarization categorical abnormalities adjusted for the Framingham risk score and the NIPPON DATA80 risk chart. Individuals with two or more abnormal categories had a higher risk of cardiovascular death after adjustment for Framingham risk score (men: HR 4.27, 95%CI 3.35–5.45; women: HR 4.83, 95%CI 3.76–6.22) and NIPPON DATA80 risk chart (men: HR 2.39, 95%CI 1.87–3.07; women: HR 2.04, 95%CI 1.58–2.64). Conclusion Cumulative findings of axial, structural, and repolarization abnormalities are significant predictors of long-term cardiovascular death in asymptomatic, healthy individuals independent of traditional risk stratification systems. PMID:27362562

  18. ECG of the Month: Subtle ECG Change in a 31 Year-Old Man with Recent Chest Pain.

    PubMed

    Glancy, D Luke

    2016-01-01

    A 31-year-old man had an hour of pain across the upper portion of his chest anteriorly, and it radiated down the inner aspects of both arms. The pain came while he was walking and gradually disappeared as he sat quietly. Six Rolaid tablets did not seem to alter the pain. The pain was unaccompanied by dyspnea, sweating, nausea or vomiting. The night before the patient had had similar pain relieved by Rolaids and belching. After the second episode of pain, he went to the emergency department of a local hospital where an ECG was recorded. PMID:27598900

  19. Prognostic utility of predischarge dipyridamole-thallium imaging compared to predischarge submaximal exercise electrocardiography and maximal exercise thallium imaging after uncomplicated acute myocardial infarction

    SciTech Connect

    Gimple, L.W.; Hutter, A.M. Jr.; Guiney, T.E.; Boucher, C.A. )

    1989-12-01

    The prognostic value of predischarge dipyridamole-thallium scanning after uncomplicated myocardial infarction was determined by comparison with submaximal exercise electrocardiography and 6-week maximal exercise thallium imaging and by correlation with clinical events. Two endpoints were defined: cardiac events and severe ischemic potential. Of the 40 patients studied, 8 had cardiac events within 6 months (1 died, 3 had myocardial infarction and 4 had unstable angina requiring hospitalization). The finding of any redistribution on dipyridamole-thallium scanning was common (77%) in these patients and had poor specificity (29%). Redistribution outside of the infarct zone, however, had equivalent sensitivity (63%) and better specificity (75%) for events (p less than 0.05). Both predischarge dipyridamole-thallium and submaximal exercise electrocardiography identified 5 of the 8 events (p = 0.04 and 0.07, respectively). The negative predictive accuracy for events for both dipyridamole-thallium and submaximal exercise electrocardiography was 88%. In addition to the 8 patients with events, 16 other patients had severe ischemic potential (6 had coronary bypass surgery, 1 had inoperable 3-vessel disease and 9 had markedly abnormal 6-week maximal exercise tests). Predischarge dipyridamole-thallium and submaximal exercise testing also identified 8 and 7 of these 16 patients with severe ischemic potential, respectively. Six of the 8 cardiac events occurred before 6-week follow-up. A maximal exercise thallium test at 6 weeks identified 1 of the 2 additional events within 6 months correctly. Thallium redistribution after dipyridamole in coronary territories outside the infarct zone is a sensitive and specific predictor of subsequent cardiac events and identifies patients with severe ischemic potential.

  20. Analysis of ECG from pole-zero models.

    PubMed

    Murthy, I S; Prasad, G S

    1992-07-01

    A complete solution to the fundamental problem of ECG analysis, viz., delineation of the signal into its component waves, is proposed from a system theoretic point of view. The discrete cosine transform of a bell shaped biphasic function is approximated mathematically by a system function with two poles and two zeros, i.e., of order (2, 2). Using this concept as the basis, a pole-zero model of suitable order is derived from the discrete cosine transform (DCT) of the given signal using Steiglitz-McBride method. This model is expanded into a unique set of partial fractions each of order (2, 2), and a biphasic function is recovered from each one of these fractions in the inverse process. Each of the P and T waves usually requires only one biphasic function, while the QRS complex needs two or at most three such fractions. A one-to-one relationship between the pole pattern in the z-plane and component wave pattern in the time signal is established. Results of analysis of continuous strips of ECG show that the delineated component waves are in excellent agreement with the original waves both qualitatively and quantitatively. The method is robust for the analysis of signals with artifacts of various kinds, independent of the sampling rate used, and is free from ad hoc back and forth search procedures. PMID:1516941

  1. Respiration effect on single and multi lead ECG delineation strategies.

    PubMed

    Noriega, M; Martinez, J P; Laguna, P; Romero, D; Bailon, R; Almeida, R

    2010-01-01

    The main purpose of this work is to study the influence of the mechanical effect of the respiration over T wave end delineation. The performance of automatic delineation systems based in Wavelet Transform (WT) was compared, considering single lead (SL), post processing selection rules (SLR) and multi lead (ML) approaches. The T wave locations obtained over real and simulated ECG signals were analyzed together with the respective respiratory signal (ECG-derived or simulated). The linear relation between the variations on obtained marks and the mechanical effect of the respiration was measured using spectral coherence. With respect to the ML strategy we also explored the evolution of the vectorcardiographic spatial loop using the direction of maximum projection of the WT in the region close to the T wave end (T(e)). The relation between this direction and the respiration is also explored. The marks obtained from the SLR and ML delineation strategies show advantage over the SL strategy based marks. The coherence around the respiratory frequency between the respiratory signal and the error in T end marks was found to be higher using SLR (a minimum of 0.92) than using ML (a maximum of 0.80). According to obtained results, the multi lead delineation presents a lower sensibility to the mechanical effect of the respiration for the T wave end delineation, particularly the obtained with ML. PMID:21096831

  2. A Mobile Device System for Early Warning of ECG Anomalies

    PubMed Central

    Szczepański, Adam; Saeed, Khalid

    2014-01-01

    With the rapid increase in computational power of mobile devices the amount of ambient intelligence-based smart environment systems has increased greatly in recent years. A proposition of such a solution is described in this paper, namely real time monitoring of an electrocardiogram (ECG) signal during everyday activities for identification of life threatening situations. The paper, being both research and review, describes previous work of the authors, current state of the art in the context of the authors' work and the proposed aforementioned system. Although parts of the solution were described in earlier publications of the authors, the whole concept is presented completely for the first time along with the prototype implementation on mobile device—a Windows 8 tablet with Modern UI. The system has three main purposes. The first goal is the detection of sudden rapid cardiac malfunctions and informing the people in the patient's surroundings, family and friends and the nearest emergency station about the deteriorating health of the monitored person. The second goal is a monitoring of ECG signals under non-clinical conditions to detect anomalies that are typically not found during diagnostic tests. The third goal is to register and analyze repeatable, long-term disturbances in the regular signal and finding their patterns. PMID:24955946

  3. Ubiquitous wireless ECG recording: a powerful tool physicians should embrace.

    PubMed

    Saxon, Leslie A

    2013-04-01

    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. PMID:23421574

  4. An XML based middleware for ECG format conversion.

    PubMed

    Li, Xuchen; Vojisavljevic, Vuk; Fang, Qiang

    2009-01-01

    With the rapid development of information and communication technologies, various e-health solutions have been proposed. The digitized medical images as well as the mono-dimension medical signals are two major forms of medical information that are stored and manipulated within an electronic medical environment. Though a variety of industrial and international standards such as DICOM and HL7 have been proposed, many proprietary formats are still pervasively used by many Hospital Information System (HIS) and Picture Archiving and Communication System (PACS) vendors. Those proprietary formats are the big hurdle to form a nationwide or even worldwide e-health network. Thus there is an imperative need to solve the medical data integration problem. Moreover, many small clinics, many hospitals in developing countries and some regional hospitals in developed countries, which have limited budget, have been shunned from embracing the latest medical information technologies due to their high costs. In this paper, we propose an XML based middleware which acts as a translation engine to seamlessly integrate clinical ECG data from a variety of proprietary data formats. Furthermore, this ECG translation engine is designed in a way that it can be integrated into an existing PACS to provide a low cost medical information integration and storage solution. PMID:19964551

  5. Computationally efficient sub-band coding of ECG signals.

    PubMed

    Husøy, J H; Gjerde, T

    1996-03-01

    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. PMID:8673319

  6. A mobile device system for early warning of ECG anomalies.

    PubMed

    Szczepański, Adam; Saeed, Khalid

    2014-01-01

    With the rapid increase in computational power of mobile devices the amount of ambient intelligence-based smart environment systems has increased greatly in recent years. A proposition of such a solution is described in this paper, namely real time monitoring of an electrocardiogram (ECG) signal during everyday activities for identification of life threatening situations. The paper, being both research and review, describes previous work of the authors, current state of the art in the context of the authors' work and the proposed aforementioned system. Although parts of the solution were described in earlier publications of the authors, the whole concept is presented completely for the first time along with the prototype implementation on mobile device-a Windows 8 tablet with Modern UI. The system has three main purposes. The first goal is the detection of sudden rapid cardiac malfunctions and informing the people in the patient's surroundings, family and friends and the nearest emergency station about the deteriorating health of the monitored person. The second goal is a monitoring of ECG signals under non-clinical conditions to detect anomalies that are typically not found during diagnostic tests. The third goal is to register and analyze repeatable, long-term disturbances in the regular signal and finding their patterns. PMID:24955946

  7. Scoring consensus of multiple ECG annotators by optimal sequence alignment.

    PubMed

    Haghpanahi, Masoumeh; Sameni, Reza; Borkholder, David A

    2014-01-01

    Development of ECG delineation algorithms has been an area of intense research in the field of computational cardiology for the past few decades. However, devising evaluation techniques for scoring and/or merging the results of such algorithms, both in the presence or absence of gold standards, still remains as a challenge. This is mainly due to existence of missed or erroneous determination of fiducial points in the results of different annotation algorithms. The discrepancy between different annotators increases when the reference signal includes arrhythmias or significant noise and its morphology deviates from a clean ECG signal. In this work, we propose a new approach to evaluate and compare the results of different annotators under such conditions. Specifically, we use sequence alignment techniques similar to those used in bioinformatics for the alignment of gene sequences. Our approach is based on dynamic programming where adequate mismatch penalties, depending on the type of the fiducial point and the underlying signal, are defined to optimally align the annotation sequences. We also discuss how to extend the algorithm for more than two sequences by using suitable data structures to align multiple annotation sequences with each other. Once the sequences are aligned, different heuristics are devised to evaluate the performance against a gold standard annotation, or to merge the results of multiple annotations when no gold standard exists. PMID:25570339

  8. An Adaptive Framework for Real-Time ECG Transmission in Mobile Environments

    PubMed Central

    2014-01-01

    Wireless electrocardiogram (ECG) monitoring involves the measurement of ECG signals and their timely transmission over wireless networks to remote healthcare professionals. However, fluctuations in wireless channel conditions pose quality-of-service challenges for real-time ECG monitoring services in a mobile environment. We present an adaptive framework for layered coding and transmission of ECG data that can cope with a time-varying wireless channel. The ECG is segmented into layers with differing importance with respect to the quality of the reconstructed signal. According to this observation, we have devised a simple and efficient real-time scheduling algorithm based on the earliest deadline first (EDF) policy, which decides the order of transmitting or retransmitting packets that contain ECG data at any given time for the delivery of scalable ECG data over a lossy channel. The algorithm takes into account the differing priorities of packets in each layer, which prevents the perceived quality of the reconstructed ECG signal from degrading abruptly as channel conditions worsen, while using the available bandwidth efficiently. Extensive simulations demonstrate this improvement in perceived quality. PMID:25097886

  9. Simple electrocardiogram (ECG) signal analyzer for homecare system among the elderly.

    PubMed

    Lin, Liuh-Chii; Yeh, Yun-Chi; Ho, Kuei-Jung

    2015-01-01

    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. PMID:26684565

  10. ECG telemonitoring during home-based cardiac rehabilitation in heart failure patients.

    PubMed

    Piotrowicz, Ewa; Jasionowska, Anna; Banaszak-Bednarczyk, Maria; Gwilkowska, Joanna; Piotrowicz, Ryszard

    2012-06-01

    We assessed ECGs recorded during home-based telemonitored cardiac rehabilitation (HTCR) in stable patients with heart-failure. The study included 75 patients with heart failure (NYHA II, III), with a mean age of 56 years. They participated in an eight-week programme of home cardiac rehabilitation which was telemonitored with a device which recorded 16-s fragments of their ECG. These fragments were transmitted via mobile phone to a monitoring centre. The times of the automatic ECG recordings were pre-set and coordinated with the cardiac rehabilitation. Patients were able to make additional recordings when they felt unwell using a tele-event-Holter ECG facility. During the study, 5757 HTCR sessions were recorded and 11,534 transmitted ECG fragments were evaluated. Most ECGs originated from the automatic recordings. Singular supraventricular and ventricular premature beats and ventricular couplets were detected in 16%, 69% and 16% of patients, respectively. Twenty ECGs were recorded when patients felt unwell: non sustained ventricular tachycardia occurred in three patients and paroxysmal atrial fibrillation episode in two patients. Heart failure patients undergoing HTCR did not develop any arrhythmia which required a change of the procedure, confirming it was safe. Cardiac rehabilitation at home was improved by utilizing the tele-event-Holter ECG facility. PMID:22604276

  11. Anomaly Detection using Multi-channel FLAC for Supporting Diagnosis of ECG

    NASA Astrophysics Data System (ADS)

    Ye, Jiaxing; Kobayashi, Takumi; Murakawa, Masahiro; Higuchi, Tetsuya; Otsu, Nobuyuki

    In this paper, we propose an approach for abnormality detection in multi-channel ECG signals. This system serves as front end to detect the irregular sections in ECG signals, where symptoms may be observed. Thereby, the doctor can focus on only the detected suspected symptom sections, ignoring the disease-free parts. Hence the workload of the inspection by the doctors is significantly reduced and the diagnosis efficiency can be sharply improved. For extracting the predominant characteristics of multi-channel ECG signals, we propose multi-channel Fourier local auto-correlations (m-FLAC) features on multi-channel complex spectrograms. The method characterizes the amplitude and phase information as well as temporal dynamics of the multi-channel ECG signal. At the anomaly detection stage, we employ complex subspace method for statistically modeling the normal (healthy) ECG patterns as in one-class learning. Then, we investigate the input ECG signals by measuring its deviation distance to the trained subspace. The ECG sections with disordered spectral distributions can be effectively discerned based on such distance metric. To validate the proposed approach, we conducted experiments on ECG dataset. The experimental results demonstrated the effectiveness of the proposed approach including promising performance and high efficiency, compared to conventional methods.

  12. How can we identify the best implantation site for an ECG event recorder?

    PubMed

    Zellerhoff, C; Himmrich, E; Nebeling, D; Przibille, O; Nowak, B; Liebrich, A

    2000-10-01

    The aim of this study was to show how to find the preferable implantation site for an ECG event recorder (ECG-ER). We compared the quality of bipolar ECG recordings (4-cm electrode distance, vertical position) in 65 patients at the following sites: left and right subclavicular, left and right anterior axillary line (4th-5th interspace), left and right of the sternum (4th-5th interspace), heart apex, and subxyphoidal. The results were compared to the standard ECG lead II. In 30 patients, an additional comparison between vertical and horizontal ECG registrations was done using the same sites. ECG signals in five patients were compared positioning the electrodes towards the skin with turning them towards the muscle during ECG-ER implantation. The best ECG quality (defined as highest QRS amplitude, best visible P wave and/or pacemaker spike, best measurable QRS duration, and QT interval) and best agreement with the standard lead II was found in 68% on the left of the sternum, significantly less often (P < 0.001) on the right of the sternum (14.1%), left subclavicular (6.9%), apical (5.5%) and subxyphoidal (4.2%). A significantly higher QRS amplitude was measured and the P wave was more often visible in the vertical electrode position than in the horizontal position. In all five ECG-ER patients, there was a good agreement between the bipolar surface ECG at the implantation site and ECG-ER stored signals. A significant noise signal occurred in all five patients when the ECG-ER was implanted with electrodes towards the muscle. A P wave was visible in only three of those patients, but there was an insignificantly higher QRS amplitude than in ECG-ERs implanted with electrodes towards the skin. From these results, it can be concluded that the best implantation site for an ECG-ER is right or left of the sternum, positioning the electrodes vertically and towards the skin. PMID:11060877

  13. Identification of hypoglycemia and hyperglycemia in type 1 diabetic patients using ECG parameters.

    PubMed

    Nguyen, Linh Lan; Su, Steven; Nguyen, Hung T

    2012-01-01

    Hypoglycemia and Hyperglycemia are both serious diseases related to diabetes mellitus. Among Type 1 Diabetic patients, there are who experience both hypoglycemic and hyperglycemic events. The aim of this study was to identify of hypoglycemia and hyperglycemia based on ECG changes in this population. An ECG Acquisition and Analysis System based on LabVIEW software has been developed for collecting ECG signals and extracting features with abnormal changes. ECG parameters included Heart rate (HR), corrected QT interval (QTeC), PR interval, corrected RT interval (RTC) and corrected TpTe interval (TpTe(C)). Blood glucose levels were used to classify glycemic states in subjects as hypoglycemic state (≤ 60 mml/l, Hypo), as normoglycemic state (80 to 110 mmol/l, Normo), and as hyperglycemic state 150 mml/l, Hyper). The results indicated that hypoglycemic and hyperglycemic states produce significant inverse changes on those ECG parameters. PMID:23366486

  14. Left Ventricular Hypertrophy: An allometric comparative analysis of different ECG markers

    NASA Astrophysics Data System (ADS)

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

    2011-12-01

    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.

  15. [ECG QRS signal detection and control system design of ventricular assist device].

    PubMed

    Liao, Huogen; Yang, Ming; Zhuang, Xiaoqi; Huang, Huan

    2013-06-01

    In order to achieve auxiliary timing of ventricular assisting device to automatically track the ECG signals, we designed a set of ECG acquisition circuit in our study for the first time. Then we carried out ECG acquisition, smoothing filter and QRS detection on the LabVIEW. With the QRS signal as a benchmark, the control system immediately triggered ventricular assisting device to trigger the heart to contract for ejection for about 300 ms, and then to assist to make it relax. The practical effects of the experiment proved that ECG acquisition circuit had the feature of strong anti-interference, and control system had no false QRS detection and no false triggering of assist device. This achieves the auxiliary timing which could automatically track the ECG signal. PMID:23865330

  16. The Abnormal vs. Normal ECG Classification Based on Key Features and Statistical Learning

    NASA Astrophysics Data System (ADS)

    Dong, Jun; Tong, Jia-Fei; Liu, Xia

    As cardiovascular diseases appear frequently in modern society, the medicine and health system should be adjusted to meet the new requirements. Chinese government has planned to establish basic community medical insurance system (BCMIS) before 2020, where remote medical service is one of core issues. Therefore, we have developed the "remote network hospital system" which includes data server and diagnosis terminal by the aid of wireless detector to sample ECG. To improve the efficiency of ECG processing, in this paper, abnormal vs. normal ECG classification approach based on key features and statistical learning is presented, and the results are analyzed. Large amount of normal ECG could be filtered by computer automatically and abnormal ECG is left to be diagnosed specially by physicians.

  17. Non-invasive Foetal ECG – a Comparable Alternative to the Doppler CTG?

    PubMed Central

    Reinhard, J.; Louwen, F.

    2012-01-01

    This review discusses the alternative of using the non-invasive foetal ECG compared with the conventionally used Doppler CTG. Non-invasive abdominal electrocardiograms (ECG) have been approved for clinical routine since 2008; subsequently they were also approved for antepartum and subpartum procedures. The first study results have been published. Non-invasive foetal ECG is especially indicated during early pregnancy, while the Doppler CTG is recommended for the vernix period. Beyond the vernix period no difference has been recorded in the success rate of either approach. The foetal ECG signal quality is independent of the BMI, whereas the success rate of the Doppler CTG is diminished with an increased BMI. During the first stage of labour, non-invasive foetal ECG demonstrates better signal quality; however during the second stage of labour no difference has been identified between the methods. PMID:25308981

  18. Capacitive ECG recording and beat-to-beat interval estimation after major cardiac event.

    PubMed

    Leicht, Lennart; Skobel, Erik; Mathissen, Marcel; Leonhardt, Steffen; Weyer, Soren; Wartzek, Tobias; Reith, Sebastian; Mohler, Werner; Teichmann, Daniel

    2015-08-01

    Today, heart diseases are the most common cause of death in the U.S.. Due to improved healthcare, more and more patients survive a major cardiac event, e.g. a heart attack. However, participation in everyday activity (e.g. driving a car) can be impaired afterwards. Patients might benefit from heart activity monitoring while driving using a capacitive ECG (cECG). However, it is unknown whether cECG is an appropriate monitoring tool for such patients. In this work, first results from a study including 10 patients having survived at least one major cardiac event are presented. It is shown that cECG can be used to diagnose heart rhythm deviations and estimate beat-to-beat intervals similar to conventional ECG. PMID:26738055

  19. Relative Amplitude based Features of characteristic ECG-Peaks for Identification of Coronary Artery Disease

    NASA Astrophysics Data System (ADS)

    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

  20. A mixed signal ECG processing platform with an adaptive sampling ADC for portable monitoring applications.

    PubMed

    Kim, Hyejung; Van Hoof, Chris; Yazicioglu, Refet Firat

    2011-01-01

    This paper describes a mixed-signal ECG processing platform with an 12-bit ADC architecture that can adapt its sampling rate according to the input signals rate of change. This enables the sampling of ECG signals with significantly reduced data rate without loss of information. The presented adaptive sampling scheme reduces the ADC power consumption, enables the processing of ECG signals with lower power consumption, and reduces the power consumption of the radio while streaming the ECG signals. The test results show that running a CWT-based R peak detection algorithm using the adaptively sampled ECG signals consumes only 45.6 μW and it leads to 36% less overall system power consumption. PMID:22254775

  1. Enhancement of low sampling frequency recordings for ECG biometric matching using interpolation.

    PubMed

    Sidek, Khairul Azami; Khalil, Ibrahim

    2013-01-01

    Electrocardiogram (ECG) based biometric matching suffers from high misclassification error with lower sampling frequency data. This situation may lead to an unreliable and vulnerable identity authentication process in high security applications. In this paper, quality enhancement techniques for ECG data with low sampling frequency has been proposed for person identification based on piecewise cubic Hermite interpolation (PCHIP) and piecewise cubic spline interpolation (SPLINE). A total of 70 ECG recordings from 4 different public ECG databases with 2 different sampling frequencies were applied for development and performance comparison purposes. An analytical method was used for feature extraction. The ECG recordings were segmented into two parts: the enrolment and recognition datasets. Three biometric matching methods, namely, Cross Correlation (CC), Percent Root-Mean-Square Deviation (PRD) and Wavelet Distance Measurement (WDM) were used for performance evaluation before and after applying interpolation techniques. Results of the experiments suggest that biometric matching with interpolated ECG data on average achieved higher matching percentage value of up to 4% for CC, 3% for PRD and 94% for WDM. These results are compared with the existing method when using ECG recordings with lower sampling frequency. Moreover, increasing the sample size from 56 to 70 subjects improves the results of the experiment by 4% for CC, 14.6% for PRD and 0.3% for WDM. Furthermore, higher classification accuracy of up to 99.1% for PCHIP and 99.2% for SPLINE with interpolated ECG data as compared of up to 97.2% without interpolation ECG data verifies the study claim that applying interpolation techniques enhances the quality of the ECG data. PMID:23062461

  2. Noninvasive diagnostic test choices for the evaluation of coronary artery disease in women: a multivariate comparison of cardiac fluoroscopy, exercise electrocardiography and exercise thallium myocardial perfusion scintigraphy

    SciTech Connect

    Hung, J.; Chaitman, B.R.; Lam, J.; Lesperance, J.; Dupras, G.; Fines, P.; Bourassa, M.G.

    1984-07-01

    Several diagnostic noninvasive tests to detect coronary and multivessel coronary disease are available for women. However, all are imperfect and it is not yet clear whether one particular test provides substantially more information than others. The aim of this study was to evaluate clinical findings, exercise electrocardiography, exercise thallium myocardial scintigraphy and cardiac fluoroscopy in 92 symptomatic women without previous infarction and determine which tests were most useful in determining the presence of coronary disease and its severity. Univariate analysis revealed two clinical, eight exercise electrocardiographic, seven myocardial scintigraphic and seven fluoroscopic variables predictive of coronary or multivessel disease with 70% or greater stenosis. The multivariate discriminant function analysis selected a reversible thallium defect, coronary calcification and character of chest pain syndrome as the variables most predictive of presence or absence of coronary disease. The ranked order of variables most predictive of multivessel disease were cardiac fluoroscopy score, thallium score and extent of ST segment depression in 14 electrocardiographic leads. Each provided statistically significant information to the model. The estimate of predictive accuracy was 89% for coronary disease and 97% for multivessel coronary disease. The results suggest that cardiac fluoroscopy or thallium scintigraphy provide significantly more diagnostic information than exercise electrocardiography in women over a wide range of clinical patient subsets.

  3. P and T wave detection on multichannel ECG using FRI.

    PubMed

    Nair, Amrish; Marziliano, Pina

    2014-01-01

    This paper proposes a new method for detecting P and T waves in multilead ECG based on the Finite Rate of Innovation(FRI) technique [8]. A simple QRS detection scheme will be presented followed by a novel P and T wave detection algorithm. The novelty here is the modelling of the P and T wave using a Gaussian kernel. Using a 2D wavelet decomposition, the approximation coefficients are windowed based on the QRS locations. The FRI method is then used to identify the Gaussian distribution present in the window which will in turn provide the locations of the P and T wave. This method was tested on more than an hour of clean and noisy data and shows good performance in the noisy case. PMID:25570440

  4. Continuous ECG monitoring on civil air crews during flight operations.

    PubMed

    Sekiguchi, C; Yamaguchi, O; Kitajima, T; Ueda, Y

    1977-09-01

    Cardiovascular disease is one of the disorders resulting in sudden incapacitation and is the most common malady leading to medical retirement. It is very important for us to control this disease among pilots. Generally, pilots undergo medical checkups at health control service on the ground, but they do not undergo these checkups during flight operations. We obtained a continuous ECG recording on four pilots to assess cardiac reserve capacity for mental load during flight operation. Results show that no significant ischemic changes of ST-segment and T-wave during flight were noticed except in one case of atrial fibrillation in which significant depression of ST-segment occurred while walking up a stairway after flight. An increased number of ectopic beats was found in another normal case. In general, it was suspected that mental load is greater at landing than takeoff. PMID:907598

  5. ECG R-R peak detection on mobile phones.

    PubMed

    Sufi, F; Fang, Q; Cosic, I

    2007-01-01

    Mobile phones have become an integral part of modern life. Due to the ever increasing processing power, mobile phones are rapidly expanding its arena from a sole device of telecommunication to organizer, calculator, gaming device, web browser, music player, audio/video recording device, navigator etc. The processing power of modern mobile phones has been utilized by many innovative purposes. In this paper, we are proposing the utilization of mobile phones for monitoring and analysis of biosignal. The computation performed inside the mobile phone's processor will now be exploited for healthcare delivery. We performed literature review on RR interval detection from ECG and selected few PC based algorithms. Then, three of those existing RR interval detection algorithms were programmed on Java platform. Performance monitoring and comparison studies were carried out on three different mobile devices to determine their application on a realtime telemonitoring scenario. PMID:18002800

  6. Personalized USB Biosensor Module for Effective ECG Monitoring.

    PubMed

    Sladojević, Srdjan; Arsenović, Marko; Lončar-Turukalo, Tatjana; Sladojević, Miroslava; Ćulibrk, Dubravko

    2016-01-01

    The burden of chronic disease and associated disability present a major threat to financial sustainability of healthcare delivery systems. The need for cost-effective early diagnosis and disease prevention is evident driving the development of personalized home health solutions. The proposed solution presents an easy to use ECG monitoring system. The core hardware component is a biosensor dongle with sensing probes at one end, and micro USB interface at the other end, offering reliable and unobtrusive sensing, preprocessing and storage. An additional component is a smart phone, providing both the biosensor's power supply and an intuitive user application for the real-time data reading. The system usage is simplified, with innovative solutions offering plug and play functionality avoiding additional driver installation. Personalized needs could be met with different sensor combinations enabling adequate monitoring in chronic disease, during physical activity and in the rehabilitation process. PMID:27225580

  7. Modes of heart rate compensations during exercise ECG test.

    PubMed

    Viik, Jari

    2005-12-01

    Heart rate (HR) compensation of electrocardiographic (ECG) parameters is not an unique concept. However, in the detection of coronary artery disease (CAD) ST-segment plotted as a function HR has been studied extensively during the last 20 years. In clinical practice quantitative methods are evolved for the exercise phase of the exercise test and post-exercise recovery phase has not been studied as extensively. Quantitative parameters, as ST/HR hysteresis, which represents the average difference in ST depressions between the exercise and recovery phases at an identical HR up to three minutes of recovery, has been shown to improve the detection of CAD. Furthermore, the ST/HR parameters have been demonstrated to be very competent in a prediction of mortality. PMID:16330399

  8. [ECG indices in dogs after inhalation of 239Pu].

    PubMed

    Karpova, V N

    1985-11-01

    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. PMID:4068946

  9. Accurate and consistent automatic seismocardiogram annotation without concurrent ECG.

    PubMed

    Laurin, A; Khosrow-Khavar, F; Blaber, A P; Tavakolian, Kouhyar

    2016-09-01

    Seismocardiography (SCG) is the measurement of vibrations in the sternum caused by the beating of the heart. Precise cardiac mechanical timings that are easily obtained from SCG are critically dependent on accurate identification of fiducial points. So far, SCG annotation has relied on concurrent ECG measurements. An algorithm capable of annotating SCG without the use any other concurrent measurement was designed. We subjected 18 participants to graded lower body negative pressure. We collected ECG and SCG, obtained R peaks from the former, and annotated the latter by hand, using these identified peaks. We also annotated the SCG automatically. We compared the isovolumic moment timings obtained by hand to those obtained using our algorithm. Mean  ±  confidence interval of the percentage of accurately annotated cardiac cycles were [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] for levels of negative pressure 0, -20, -30, -40, and  -50 mmHg. LF/HF ratios, the relative power of low-frequency variations to high-frequency variations in heart beat intervals, obtained from isovolumic moments were also compared to those obtained from R peaks. The mean differences  ±  confidence interval were [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] for increasing levels of negative pressure. The accuracy and consistency of the algorithm enables the use of SCG as a stand-alone heart monitoring tool in healthy individuals at rest, and could serve as a basis for an eventual application in pathological cases. PMID:27510446

  10. Low-power analog integrated circuits for wireless ECG acquisition systems.

    PubMed

    Tsai, Tsung-Heng; Hong, Jia-Hua; Wang, Liang-Hung; Lee, Shuenn-Yuh

    2012-09-01

    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. PMID:22374371

  11. Assurance of energy efficiency and data security for ECG transmission in BASNs.

    PubMed

    Ma, Tao; Shrestha, Pradhumna Lal; Hempel, Michael; Peng, Dongming; Sharif, Hamid; Chen, Hsiao-Hwa

    2012-04-01

    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. PMID:22231147

  12. Aromatase knockout mice reveal an impact of estrogen on drug-induced alternation of murine electrocardiography parameters.

    PubMed

    Kurokawa, Junko; Sasano, Tetsuo; Kodama, Masami; Li, Min; Ebana, Yusuke; Harada, Nobuhiro; Honda, Shin-ichiro; Nakaya, Haruaki; Furukawa, Tetsushi

    2015-06-01

    Our in vitro characterization showed that physiological concentrations of estrogen partially suppressed the I(Kr) channel current in guinea pig ventricular myocytes and the human ether-a-go-go-related gene (hERG) channel currents in CHO-K1 cells regardless of estrogen receptor signaling and revealed that the partially suppressed hERG currents enhanced the sensitivity to the hERG blocker E-4031. To obtain in vivo proof-of-concept data to support the effects of estrogen on cardiac electrophysiology, we here employed an aromatase knockout mouse as an in vivo estrogen-null model and compared the acute effects of E-4031 on cardiac electrophysiological parameters with those in wild-type mice (C57/BL6J) by recording surface electrocardiogram (ECG). The ablation of circulating estrogens blunted the effects of E-4031 on heart rate and QT interval in mice under a denervation condition. Our result provides in vivo proof of principle and demonstrates that endogenous estrogens increase the sensitivity of E-4031 to cardiac electrophysiology. PMID:25972195

  13. Detection of Cardiac Abnormalities from Multilead ECG using Multiscale Phase Alternation Features.

    PubMed

    Tripathy, R K; Dandapat, S

    2016-06-01

    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. PMID:27118009

  14. Faxing ECGs from peripheral hospitals to Tertiary Paediatric Cardiology Units- Is it Safe and Sustainable?

    PubMed Central

    McGrath, Sam; Skinner, Greg; Morgan, Gareth J

    2014-01-01

    Intoduction Recent local involvement with the United Kingdom“Safe and Sustainable review of paediatric cardiology services” has highlighted the need for development of clinical networks and improvement of the communication infrastructure within and between teams. One common communication between peripheral and tertiary hospitals is facsimile transfer of electrocardiograms. The quality of fax transmission can be variable, raising concerns regarding the quality of the received image, accuracy of the diagnosis and appropriateness of the resultant advice. Methods We performed a systematic quality evaluation of faxed ECGs to determine whether they should be replaced on the basis of patient safety and information governance. A sample of 50 ECGs was selected from over 300 which had been faxed to our tertiary department. These were scored according to a structured system leading to a 10 point Likert scale, assessing technical quality and the ability to make a clinically relevant assessment of the information. Results Only 1 from 50 faxed ECGs fulfilled all 9 objective criteria set. Heart rate and quadrant of the QRS axis were only identifiable in 10%. Comparing the faxed ECGs with the rating given to an original ECG confirmed a significant difference in the interpretability of faxed and original ECGs (p<0.05). Conclusion Our study suggests that faxed ECGs do not provide consistent, accurate diagnostic information. It suggests that this currently widespread practice should be considered as a potential patient safety issue within developing paediatric cardiology networks. We would recommend that faxing of ECGs be replaced with scanning of ECGs, transmitted via secure email. PMID:24757263

  15. Diagnosis of cardiovascular abnormalities from compressed ECG: a data mining-based approach.

    PubMed

    Sufi, Fahim; Khalil, Ibrahim

    2011-01-01

    Usage of compressed ECG for fast and efficient telecardiology application is crucial, as ECG signals are enormously large in size. However, conventional ECG diagnosis algorithms require the compressed ECG packets to be decompressed before diagnosis can be performed. This added step of decompression before performing diagnosis for every ECG packet introduces unnecessary delay, which is undesirable for cardiovascular diseased (CVD) patients. In this paper, we are demonstrating an innovative technique that performs real-time classification of CVD. With the help of this real-time classification of CVD, the emergency personnel or the hospital can automatically be notified via SMS/MMS/e-mail when a life-threatening cardiac abnormality of the CVD affected patient is detected. Our proposed system initially uses data mining techniques, such as attribute selection (i.e., selects only a few features from the compressed ECG) and expectation maximization (EM)-based clustering. These data mining techniques running on a hospital server generate a set of constraints for representing each of the abnormalities. Then, the patient's mobile phone receives these set of constraints and employs a rule-based system that can identify each of abnormal beats in real time. Our experimentation results on 50 MIT-BIH ECG entries reveal that the proposed approach can successfully detect cardiac abnormalities (e.g., ventricular flutter/fibrillation, premature ventricular contraction, atrial fibrillation, etc.) with 97% accuracy on average. This innovative data mining technique on compressed ECG packets enables faster identification of cardiac abnormality directly from the compressed ECG, helping to build an efficient telecardiology diagnosis system. PMID:21097383

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

    NASA Astrophysics Data System (ADS)

    Klein, Almar; Oostveen, Luuk J.; Greuter, Marcel J. W.; Hoogeveen, Yvonne; Schultze Kool, Leo J.; Slump, Cornelis H.; Renema, W. Klaas Jan

    2009-02-01

    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 CTA. Some common CT scanners cannot reconstruct a non-gated volume from ECG-gated acquired data. In order to obtain the same diagnostic image quality, we propose offline temporal averaging of the ECG-gated data. This process, though straightforward, is fundamentally different from taking a non-gated scan, and its result will certainly differ as well. The purpose of this study is to quantitatively investigate how good off-line averaging approximates a non-gated scan. Method: Non-gated and ECG-gated CT scans have been performed on a phantom (Catphan 500). Afterwards the phases of the ECG-gated CTA data were averaged to create a third dataset. The three sets are compared with respect to noise properties (NPS) and frequency response (MTF). To study motion artifacts identical scans were acquired on a programmable dynamic phantom. Results and Conclusions: The experiments show that the spatial frequency content is not affected by the averaging process. The minor differences observed for the noise properties and motion artifacts are in favor of the averaged data. Therefore the averaged ECG-gated phases can be used for diagnosis. This enables the use of ECG-gating for research on stentgrafts in AAA, without impairing clinical patient care.

  17. The Impact of 3:1 Ketogenic Diet on Cardiac Repolarization Changes in Children with Refractory Seizures: A Prospective Follow-Up Study.

    PubMed

    Özdemir, Rahmi; Güzel, Orkide; Küçük, Mehmet; Karadeniz, Cem; Yılmaz, Ünsal; Calik, Tansel; Meşe, Timur

    2016-06-01

    Background The association between ketogenic diet (KD) and prolonged QT interval, life-threatening ventricular arrhythmias, and sudden death is controversial. Aim We aimed to prospectively evaluate the effect of KD on electrocardiography (ECG) measures in children with refractory epilepsy. Method A total of 70 children with drug-resistant epilepsy who received a KD for at least 12 months were included in the study. The standard 12-lead electrocardiography was performed in all patients before the beginning and in the 12th month of KD. Heart rate, P-wave duration and dispersion, corrected QT interval and QT dispersion, and Tp-e interval were measured. Results All ECG-derived parameters, but P-wave dispersion increased after 12 months of KD compared with the baseline values. However, these changes were not statistically significant. Conclusion A 12-month long 3:1 KD treatment exerts no deleterious effect on cardiac repolarization measures. PMID:27043293

  18. Screening of sarcomere gene mutations in young athletes with abnormal findings in electrocardiography: identification of a MYH7 mutation and MYBPC3 mutations.

    PubMed

    Kadota, Chika; Arimura, Takuro; Hayashi, Takeharu; Naruse, Taeko K; Kawai, Sachio; Kimura, Akinori

    2015-10-01

    There is an overlap between the physiological cardiac remodeling associated with training in athletes, the so-called athlete's heart, and mild forms of hypertrophic cardiomyopathy (HCM), the most common hereditary cardiac disease. HCM is often accompanied by unfavorable outcomes including a sudden cardiac death in the adolescents. Because one of the initial signs of HCM is abnormality in electrocardiogram (ECG), athletes may need to monitor for ECG findings to prevent any unfavorable outcomes. HCM is caused by mutations in genes for sarcomere proteins, but there is no report on the systematic screening of gene mutations in athletes. One hundred and two genetically unrelated young Japanese athletes with abnormal ECG findings were the subjects for the analysis of four sarcomere genes, MYH7, MYBPC3, TNNT2 and TNNI3. We found that 5 out of 102 (4.9%) athletes carried mutations: a heterozygous MYH7 Glu935Lys mutation, a heterozygous MYBPC3 Arg160Trp mutation and another heterozygous MYBPC3 Thr1046Met mutation, all of which had been reported as HCM-associated mutations, in 1, 2 and 2 subjects, respectively. This is the first study of systematic screening of sarcomere gene mutations in a cohort of athletes with abnormal ECG, demonstrating the presence of sarcomere gene mutations in the athlete's heart. PMID:26178432

  19. Pharmacokinetics of eCG and induction of fertile estrus in bitches using eCG followed by hCG.

    PubMed

    Stornelli, M C; García Mitacek, M C; Giménez, F; Bonaura, M C; Videla Dorna, I; de la Sota, R L; Stornelli, M A

    2012-09-15

    The aim was to design a protocol combining eCG followed by hCG for estrus induction in the bitch. In Experiment 1, three ovariohysterectomized bitches received 10 000 IU of eCG iv, and 15 days later 10 000 IU of eCG im. Blood samples were taken up to 144 h after each injection to measure eCG concentrations. In Experiment 2, 25 healthy, intact late anestrous bitches were assigned to one of five doses of eCG (5, 10, 15, 20, 44, or 50 IU/kg eCG im; [TRT5-TRT50]). Sexual behavior (SB), clinical signs of estrus (CSE) and vaginal cytology (VC) samples were obtained and scored before eCG administration and every other day until onset of estrus, or for 14 days. In Experiment 3, intact late anestrous bitches were assigned to a treatment group (TRT; n = 16) and received eCG (50 IU/kg im) followed by hCG (500 IU im) 7 days later; or to a placebo group (PLA; n = 8) where they received 1 mL saline solution im. All bitches that were induced in estrus were mated or AI with fresh semen. In Experiment 1, maximum observed concentration (C(max)) eCG were similar between im and iv routes (6.1 ± 0.9 vs. 8.6 ± 0.5 IU/mL, P > 0.08), whereas time for maximum observed concentration (T(max.)) was longer for im compared to iv routes (17.5 ± 0.5 vs. 11.6 ± 0.3 h, P < 0.01). The area under the curve (AUC) was similar for im and iv routes (P > 0.48), and eCG was detectable in serum for at least 144 h for both routes. In Experiment 2, 3 days or 3 to 5 days after treatment, all bitches in TRT50 had higher scores compared to TRT5-44 animals (P < 0.01). In TRT50, the mean interval from treatment to estrus was 4.0 ± 0.4 days. In Experiment 3, the mean interval from treatment to estrus was shorter in the TRT group compared to the PLA group (4.1 ± 3.3 vs. 68.5 ± 4.4 days, P < 0.01). The previous interestrus interval was similar for TRT and PLA groups (199.6 ± 7.2 vs. 197.5 ± 10.2 days), but the new interestrus interval was shorter for the TRT compared to the PLA group (164.0 ± 7.2 vs. 212

  20. Segmentation of ECG from Surface EMG Using DWT and EMD: A Comparison Study

    NASA Astrophysics Data System (ADS)

    Shahbakhti, Mohammad; Heydari, Elnaz; Luu, Gia Thien

    2014-10-01

    The electrocardiographic (ECG) signal is a major artifact during recording the surface electromyography (SEMG). Removal of this artifact is one of the important tasks before SEMG analysis for biomedical goals. In this paper, the application of discrete wavelet transform (DWT) and empirical mode decomposition (EMD) for elimination of ECG artifact from SEMG is investigated. The focus of this research is to reach the optimized number of decomposed levels using mean power frequency (MPF) by both techniques. In order to implement the proposed methods, ten simulated and three real ECG contaminated SEMG signals have been tested. Signal-to-noise ratio (SNR) and mean square error (MSE) between the filtered and the pure signals are applied as the performance indexes of this research. The obtained results suggest both techniques could remove ECG artifact from SEMG signals fair enough, however, DWT performs much better and faster in real data.

  1. Removing movement artifacts from equine ECG recordings acquired with textile electrodes.

    PubMed

    Lanata, Antonio; Guidi, Andrea; Baragli, Paolo; Paradiso, Rita; Valenza, Gaetano; Scilingo, Enzo Pasquale

    2015-08-01

    This study reports on the implementation of a novel system to detect and reduce movement artifact (MA) contribution in electrocardiogram (ECG) recordings acquired from horses in free movement conditions. The system comprises both integrated textile electrodes for ECG acquisition and one triaxial accelerometer for movement monitoring. Here, ECG and physical activity are continuously acquired from seven horses through the wearable system and a model that integrates cardiovascular and movement information to estimate the MA contribution is implemented. Moreover, in this study we propose a new algorithm where the Stationary Wavelet Transform (SWT) decomposition algorithm is employed to identify and remove movement artifacts from ECG recodigns. Achieved results showed a reduction of MA percentage greater than 40% between before- and after- the application of the proposed algorithm to seven hours of recordings. PMID:26736667

  2. A Primary Study of Indirect ECG Monitor Embedded in a Bed for Home Health Care

    NASA Astrophysics Data System (ADS)

    Ueno, Akinori; Shiogai, Yuuki; Ishiyama, Yoji

    A system for monitoring electrocardiogram (ECG) through clothes inserted between the measuring electrodes and the body surface of a subject when lying on a mattress has been proposed. The principle of the system is based on capacitive coupling involving the electrode, the clothes, and the skin. Validation of the system revealed the following: (1) In spite of the gain attenuation in the pass band of the system, distortion of the detected signal was subtle even when clothes thicker than 1mm were inserted, (2) The system was able to yield a stable ECG from a subject particularly during sound sleep, (3) The system succeeded in detecting ECG after changing the posture into any of supine, right lateral, or left lateral positions by adopting a newly devised electrode configuration. Therefore, the proposed system appears promising for application to bedding as a non-invasive and awareness-free system for ECG monitoring during sleep.

  3. A Human ECG Identification System Based on Ensemble Empirical Mode Decomposition

    PubMed Central

    Zhao, Zhidong; Yang, Lei; Chen, Diandian; Luo, Yi

    2013-01-01

    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. PMID:23698274

  4. Study of features based on nonlinear dynamical modeling in ECG arrhythmia detection and classification.

    PubMed

    Owis, Mohamed I; Abou-Zied, Ahmed H; Youssef, Abou-Bakr M; Kadah, Yasser M

    2002-07-01

    We present a study of the nonlinear dynamics of electrocardiogram (ECG) signals for arrhythmia characterization. The correlation dimension and largest Lyapunov exponent are used to model the chaotic nature of five different classes of ECG signals. The model parameters are evaluated for a large number of real ECG signals within each class and the results are reported. The presented algorithms allow automatic calculation of the features. The statistical analysis of the calculated features indicates that they differ significantly between normal heart rhythm and the different arrhythmia types and, hence, can be rather useful in ECG arrhythmia detection. On the other hand, the results indicate that the discrimination between different arrhythmia types is difficult using such features. The results of this work are supported by statistical analysis that provides a clear outline for the potential uses and limitations of these features. PMID:12083309

  5. An ECG ambulatory system with mobile embedded architecture for ST-segment analysis.

    PubMed

    Miranda-Cid, Alejandro; Alvarado-Serrano, Carlos

    2010-01-01

    A prototype of a ECG ambulatory system for long term monitoring of ST segment of 3 leads, low power, portability and data storage in solid state memory cards has been developed. The solution presented is based in a mobile embedded architecture of a portable entertainment device used as a tool for storage and processing of bioelectric signals, and a mid-range RISC microcontroller, PIC 16F877, which performs the digitalization and transmission of ECG. The ECG amplifier stage is a low power, unipolar voltage and presents minimal distortion of the phase response of high pass filter in the ST segment. We developed an algorithm that manages access to files through an implementation for FAT32, and the ECG display on the device screen. The records are stored in TXT format for further processing. After the acquisition, the system implemented works as a standard USB mass storage device. PMID:21095640

  6. An innovative non-contact ECG sensor for monitoring heart disease

    NASA Astrophysics Data System (ADS)

    Sun, Ye; Yu, Xiong (Bill); Berilla, Jim

    2011-06-01

    This paper describes the development of a non-contact sensing platform to monitor the ECG signals. The non-contact sensing will be based on capacitive coupling the bioelectricity produced by cardiovascular activities around the heart. High sensitivity sensor and electronics are designed to amplify the signals. Our preliminary study has pointed to the promise of this sensing concept. A sensor prototype was able to clearly detect the ECG signals from 10 cm away from the body. Research tasks continue improving the sensor design to detect the polarization in the ECG signals. The final goal is a non-contact sensing platform for ECG signals and for real time diagnostics of the mental distress and cardiovascular diseases.

  7. CinC Challenge 2013: comparing three algorithms to extract fetal ECG

    NASA Astrophysics Data System (ADS)

    Loja, Juan; Velecela, Esteban; Palacio-Baus, Kenneth; Astudillo, Darwin; Medina, Rubén.; Wong, Sara

    2015-12-01

    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.

  8. Broadband noise suppression and feature identification of ECG waveforms using mathematical morphology and embedding theorem.

    PubMed

    Ji, T Y; Wu, Q H

    2013-12-01

    The paper presents an adaptive morphological filter developed using multiscale mathematical morphology (MM) to reject broadband noise from ECG signals without affecting the feature waveforms. As a pre-processing procedure, the adaptive morphological filter cleans an ECG signal to prepare it for further analysis. The noiseless ECG signal is embedded within a two-dimensional phase space to form a binary image and the identification of the feature waveforms is carried out based on the information presented by the image. The classification of the feature waveforms is implemented by an adaptive clustering technique according to the geometric information represented by the image in the phase space. Simulation studies on ECG records from the MIT-BIH and BIDMC databases have demonstrated the effectiveness and accuracy of the proposed methods. PMID:24094825

  9. A PD control-based QRS detection algorithm for wearable ECG applications.

    PubMed

    Choi, Changmok; Kim, Younho; Shin, Kunsoo

    2012-01-01

    We present a QRS detection algorithm for wearable ECG applications using a proportional-derivative (PD) control. ECG data of arrhythmia have irregular intervals and magnitudes of QRS waves that impede correct QRS detection. To resolve the problem, PD control is applied to avoid missing a small QRS wave followed from a large QRS wave and to avoid falsely detecting noise as QRS waves when an interval between two adjacent QRS waves is large (e.g. bradycardia, pause, and arioventricular block). ECG data was obtained from 78 patients with various cardiovascular diseases and tested for the performance evaluation of the proposed algorithm. The overall sensitivity and positive predictive value were 99.28% and 99.26%, respectively. The proposed algorithm has low computational complexity, so that it can be suitable to apply mobile ECG monitoring system in real time. PMID:23367208

  10. Design and implementation of a 3-lead ECG wireless remote monitoring system

    NASA Astrophysics Data System (ADS)

    Zhang, Shi; Jia, Xiaonan; Shang, Shuai

    2006-11-01

    Cardiovascular disease is one of the main diseases that menaces human health. It is necessary to monitor the patient's real-time electrocardiograph (ECG) for a long time to realize diagnosis and salvage. Remote ECG monitoring system is the solution. This paper introduces the design and implement of a 3-lead ECG wireless remote monitoring system. It collects, stores and transmits user's ECG which can be received by hospital and diagnosed by doctors. The development of the whole system contains three parts, the hardware and embedded software implementation of MONITOR, software of the MONITORING CENTER, and the routing software of NETWORK CENTER. According to the clinic experimentation, this system has high reliability and utility. There will be great social and economic benefit if this system is put into use.

  11. Misinterpretation of the mouse ECG: ‘musing the waves of Mus musculus’

    PubMed Central

    Boukens, Bastiaan J; Rivaud, Mathilde R; Rentschler, Stacey; Coronel, Ruben

    2014-01-01

    The ECG is a primary diagnostic tool in patients suffering from heart disease, underscoring the importance of understanding factors contributing to normal and abnormal electrical patterns. Over the past few decades, transgenic mouse models have been increasingly used to study pathophysiological mechanisms of human heart diseases. In order to allow extrapolation of insights gained from murine models to the human condition, knowledge of the similarities and differences between the mouse and human ECG is of crucial importance. In this review, we briefly discuss the physiological mechanisms underlying differences between the baseline ECG of humans and mice, and provide a framework for understanding how these inherent differences are relevant to the interpretation of the mouse ECG during pathology and to the translation of the results from the mouse to man. PMID:25260630

  12. Wavelet packets feasibility study for the design of an ECG compressor.

    PubMed

    Blanco-Velasco, Manuel; Cruz-Roldán, Fernando; Godino-Llorente, Juan Ignacio; Barner, Kenneth E

    2007-04-01

    Most of the recent electrocardiogram (ECG) compression approaches developed with the wavelet transform are implemented using the discrete wavelet transform. Conversely, wavelet packets (WP) are not extensively used, although they are an adaptive decomposition for representing signals. In this paper, we present a thresholding-based method to encode ECG signals using WP. The design of the compressor has been carried out according to two main goals: (1) The scheme should be simple to allow real-time implementation; (2) quality, i.e., the reconstructed signal should be as similar as possible to the original signal. The proposed scheme is versatile as far as neither QRS detection nor a priori signal information is required. As such, it can thus be applied to any ECG. Results show that WP perform efficiently and can now be considered as an alternative in ECG compression applications. PMID:17405386

  13. [An algorithm based on ECG signal for sleep apnea syndrome detection].

    PubMed

    Yu, Xiaomin; Tu, Yuewen; Huang, Chao; Ye, Shuming; Chen, Hang

    2013-10-01

    The diagnosis of sleep apnea syndrome (SAS) has a significant importance in clinic for preventing diseases of hypertention, coronary heart disease, arrhythmia and cerebrovascular disorder, etc. This study presents a novel method for SAS detection based on single-channel electrocardiogram (ECG) signal. The method preprocessed ECG and detected QRS waves to get RR signal and ECG-derived respiratory (EDR) signal. Then 40 time- and spectral-domain features were extracted to normalize the signals. After that support vector machine (SVM) was used to classify the signals as "apnea" or "normal". Finally, the performance of the method was evaluated by the MIT-BIH Apnea-ECG database, and an accuracy of 95% in train sets and an accuracy of 88% in test sets were achieved. PMID:24459959

  14. Arrhythmia recognition and classification using combined linear and nonlinear features of ECG signals.

    PubMed

    Elhaj, Fatin A; Salim, Naomie; Harris, Arief R; Swee, Tan Tian; Ahmed, Taqwa

    2016-04-01

    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

  15. [The design of ECG sample device based on Windows 98/95].

    PubMed

    Li, Y; Sha, X Z; Yin, Y; Wang, X Z

    2001-05-01

    The ECG sample system which is based on Microsoft Windows98/95 and IBM-compatible PCs ISA bus, is introduced here. It includes ECG sample device, virtual device driver(VxD) and application program, By the method, we can design the device simply and make good use of the computer to programming powerful auto recognition software and telediagnosis software. The system is a cheap and mini medical apparatus. Applications in family care and community medical treatment are encouraging. PMID:12583282

  16. Motion artifact removal algorithm by ICA for e-bra: a women ECG measurement system

    NASA Astrophysics Data System (ADS)

    Kwon, Hyeokjun; Oh, Sechang; Varadan, Vijay K.

    2013-04-01

    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.

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

    PubMed Central

    Singh, Meenu; Sinha, Vineet; Manoj Kumar, Rohit; Pant, Pankaj; Kumar, Munish

    2014-01-01

    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. PMID:25368654

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

    PubMed

    Singh, Meenu; Agarwal, Amit; Sinha, Vineet; Manoj Kumar, Rohit; Jaiswal, Nishant; Jindal, Ishita; Pant, Pankaj; Kumar, Munish

    2014-01-01

    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. PMID:25368654

  19. Wavelet-Based ECG Steganography for Protecting Patient Confidential Information in Point-of-Care Systems.

    PubMed

    Ibaida, Ayman; Khalil, Ibrahim

    2013-12-01

    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. PMID:23708767

  20. A robust approach for ECG-based analysis of cardiopulmonary coupling.

    PubMed

    Zheng, Jiewen; Wang, Weidong; Zhang, Zhengbo; Wu, Dalei; Wu, Hao; Peng, Chung-Kang

    2016-07-01

    Deriving respiratory signal from a surface electrocardiogram (ECG) measurement has advantage of simultaneously monitoring of cardiac and respiratory activities. ECG-based cardiopulmonary coupling (CPC) analysis estimated by heart period variability and ECG-derived respiration (EDR) shows promising applications in medical field. The aim of this paper is to provide a quantitative analysis of the ECG-based CPC, and further improve its performance. Two conventional strategies were tested to obtain EDR signal: R-S wave amplitude and area of the QRS complex. An adaptive filter was utilized to extract the common component of inter-beat interval (RRI) and EDR, generating enhanced versions of EDR signal. CPC is assessed through probing the nonlinear phase interactions between RRI series and respiratory signal. Respiratory oscillations presented in both RRI series and respiratory signals were extracted by ensemble empirical mode decomposition for coupling analysis via phase synchronization index. The results demonstrated that CPC estimated from conventional EDR series exhibits constant and proportional biases, while that estimated from enhanced EDR series is more reliable. Adaptive filtering can improve the accuracy of the ECG-based CPC estimation significantly and achieve robust CPC analysis. The improved ECG-based CPC estimation may provide additional prognostic information for both sleep medicine and autonomic function analysis. PMID:27118307

  1. A configurable and low-power mixed signal SoC for portable ECG monitoring applications.

    PubMed

    Kim, Hyejung; Kim, Sunyoung; Van Helleputte, Nick; Artes, Antonio; Konijnenburg, Mario; Huisken, Jos; Van Hoof, Chris; Yazicioglu, Refet Firat

    2014-04-01

    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. PMID:24875285

  2. Performance evaluation of carbon black based electrodes for underwater ECG monitoring.

    PubMed

    Reyes, Bersain A; Posada-Quintero, Hugo F; Bales, Justin R; Chon, Ki H

    2014-01-01

    Underwater electrocardiogram (ECG) monitoring currently uses Ag/AgCl electrodes and requires sealing of the electrodes to avoid water intrusion, but this procedure is time consuming and often results in severe irritations or even tearing of the skin. To alleviate these problems, our research team developed hydrophobic electrodes comprised of a mixture of carbon black powder (CB) and polydimethylsiloxane (PDMS) that provide all morphological waveforms without distortion of an ECG signal for dry and water-immersed conditions. Performance comparison of CB/PDMS electrodes to adhesive Ag/AgCl hydrogel electrodes was carried out in three different scenarios which included recordings from a dry surface, water immersion, and post-water immersion conditions. CB/PDMS electrodes were able to acquire ECG signals highly correlated with those from adhesive Ag/AgCl electrodes during all conditions. Statistical reduction in ECG amplitude (p<0.05) was only found during the immersed condition with CB/PDMS electrodes when compared to Ag/AgCl electrodes sealed with their waterproof adhesive tape. Besides this reduction readability of the recordings was not obscured and all morphological waveforms of the ECG signal were discernible. The advantages of our CB/PDMS electrodes are that they are reusable, can be fabricated economically, and most importantly, high-fidelity underwater ECG signals can be acquired without relying on the heavy use of waterproof sealing. PMID:25570300

  3. ECG Wave-Maven: a self-assessment program for students and clinicians.

    PubMed Central

    Nathanson, L. A.; Safran, C.; McClennen, S.; Goldberger, A. L.

    2001-01-01

    Proficiency in the interpretation of electrocardiograms (ECGs) is an essential skill for medical students, house officers, and attending physicians. However, resources to develop and upgrade the necessary high level of "ECG literacy" are limited. A small number of centers have attempted to address this challenge by developing "ECG of the week" internet sites. These resources are difficult to maintain and update, and many of them quickly become stagnant. We present "ECG Wave-Maven," an innovative web-based tutorial that overcomes these obstacles via a direct link to the hospital's extensive and increasing clinical ECG repository. By interfacing our educational tool to live data, we can greatly decrease the time and effort required from the time a practitioner notes an interesting case to its inclusion in the program. Users can opt to encounter the test cases sequentially or randomly, or by reviewing a list of questions or diagnoses, making this not just a quiz, but a basic educational reference. This tool may be useful in meeting the challenge of reducing serious medical errors related to ECG misinterpretation. PMID:11825236

  4. Regional Mapping of Aortic Wall Stress by Using Deformable, Motion-coherent Modeling based on Electrocardiography-gated Multidetector CT Angiography: Feasibility Study.

    PubMed

    Mileto, Achille; Heye, Tobias J; Makar, Ryan A; Hurwitz, Lynne M; Marin, Daniele; Boll, Daniel T

    2016-07-01

    Purpose To investigate the feasibility of deformable, motion-coherent modeling based on electrocardiography-gated multidetector computed tomographic (CT) angiography of the thoracic aorta and to evaluate whether quantifiable information on aortic wall stress as a function of patient-specific cardiovascular parameters can be gained. Materials and Methods For this institutional review board-approved, HIPAA-compliant study, thoracic electrocardiography-gated dual-source multidetector CT angiographic images were used from 250 prospectively enrolled patients (150 men, 100 women; mean age, 79 years). On reconstructed 50-phase CT angiographic images, aortic strain and deformation were determined at seven cardiac and aortic locations. One-way analysis of variance was used by assessing the magnitude for longitudinal and axial strain and axial deformation, as well as time-resolved peak and maxima count for longitudinal strain and axial deformation. Interdependencies between aortic strain and deformation with extracted hemodynamic parameters were evaluated. Results With increasing heart rates, there was a significant decrease in longitudinal strain (P = .009, R(2) = 0.95) and a decrease in the number of longitudinal strain peaks (P < .001, R(2) = 0.79); however, a significant increase in axial deformation (P < .001, R(2) = 0.31) and axial strain (P = .009, R(2) = 0.61) was observed. Increasing aortic blood velocity led to increased longitudinal strain (P = .018, R(2) = 0.42) and longitudinal strain peak counts (P = .011, R(2) = 0.48). Pronounced motion in the longitudinal direction limited motion in the axial plane (P < .019, R(2) = 0.29-0.31). Conclusion The results of this study render a clinical basis and provide proof of principle for the use of deformable, motion-coherent modeling to provide quantitative information on physiological motion of the aorta under various hemodynamic circumstances. (©) RSNA, 2016 Online supplemental material is available for this article

  5. The influence of beta-adrenoceptor blockers with and without intrinsic sympathomimetic activity on heart rate, arrhythmias and ST-T segments, using ambulatory electrocardiography.

    PubMed Central

    Northcote, R J; Ballantyne, D

    1988-01-01

    1. Ambulatory electrocardiography was used to compare the effects of propranolol and pindolol on symptoms, heart rate, arrhythmias and ST segments. Seventeen males (mean age 54 years) with a diagnosis of chronic stable angina pectoris (New York Heart Association Class II-III) were studied. Patients were treated on a double-blind cross-over basis with propranolol 80 mg three times daily or pindolol 5 mg three times daily for 14 days each. During the last 48 h of each treatment period ambulatory electrocardiography was performed. 2. Propranolol resulted in a significantly lower mean hourly, mean 24 h and minimum heart rate. Likewise propranolol caused a lower mean daytime and nocturnal heart rate. There was no significant difference in the frequency of angina between the treatments. The number of episodes of ST segment depression was not significantly different between the two drugs, although there was a trend in favour of propranolol. 3. Both the mean 24 h ST level and the maximum ST segment depression were lower during treatment with pindolol. Propranolol was associated with a total of 117 nocturnal pauses or episodes of asystole ranging in length from 1.5 to 2.8 s. During treatment with pindolol only one such period occurred. The number of premature ventricular contractions occurring during treatment with pindolol (1316 beats) was less than on propranolol (2010) and the mean hourly frequency of premature ventricular contractions was significantly lower during pindolol administration. 4. Pindolol is not significantly different from propranolol in the control of symptomatic and asymptomatic myocardial ischaemia and is associated with fewer premature ventricular contractions. However, there is no advantage in using pindolol in chronic stable angina. PMID:3358881

  6. Anomalous ECG downloads from semi-automatic external defibrillators.

    PubMed

    Calle, P A; Vanhaute, O; Ranhoff, J F; Buylaert, W A

    1998-08-01

    The coincidental print-out by two different Laerdal systems (subsequently called 'system A' and 'system B') of the same medical control module (MCM) for a Laerdal Heartstart 2000 semi-automatic external defibrillator (SAED) led to the discovery of three deficiencies in the information storage and printing processes. First, we noted that the impedance reported via system A was consistently higher. Second, we found the attachment of 'mysterious' ECG samples in the reports from system B, but not from system A. A third problem was the unpredictable (in)ability of system B to print out the information from the MCMs. Further investigations with help from the company suggested that the above-mentioned problems were caused by incompatibilities between the software in the different parts of equipment used (i.e. SAED devices, MCMs, printing systems and a computer program to store the information in a database). These observations demonstrate the need for strict medical supervision on all aspects of a SAED project, and for feed-back from clinicians to manufacturers. PMID:9863574

  7. Web access to data in a mobile ECG monitoring system.

    PubMed

    Rodriguez, Jimena; Dranca, Lacramioara; Goñi, Alfredo; Illarramendi, Arantza

    2004-01-01

    Cardiovascular diseases and, in particular, diseases related to arrhythmias are a problem that affects a significant percentage of the population, being one of the major causes of death in Europe. New advances in the fields of PDAs, mobile phones, wireless communications and vital parameter sensors have permitted the development of revolutionary medical monitoring systems, which strikingly improve the lifestyle of patients. However, not all those monitoring systems provide patients with real assistance - anywhere and at any time. We have developed a system that goes a step further than the previous approaches, being designed to capture, record and, as a distinctive feature, locally analyze the ECG signals in a PDA carried by the patient. In that sense, the system has a decision support module based on decision tree methods that can detect, with high precision, any arrhythmias that the user may be suffering. Alarms can then be activated in time to alert a medical center in order to provide the proper medical assistance. One of our aims when building the system has been to optimize limited and expensive resources like PDA memory size and wireless communication costs. Moreover, accessibility is also an important feature of the system that has been achieved by the development of web services to query the data computed in the PDA. In this way, authorized personnel (physicians and relatives) can easily obtain access to that data. PMID:15718599

  8. ECG gated NMR-CT for cardiovascular diseases

    SciTech Connect

    Nishikawa, J.; Machida, K.; Iio, M.; Yoshimoto, N.; Sugimoto, T.; Kawaguchi, H.; Mano, H.

    1984-01-01

    The authors applied NMR-CT to cardiac study with ECG gated technique to evaluate the left ventricular (LV) function and compared it with cardiovascular nuclear medicine study (NM). The NMR-CT machine has resistive air-core magnet with 0.15 Tesla. The saturation recovery image or inversion recovery image were obtained as 256 x 256 matrix and 15 mm in thickness. The study population was ten patients who were evaluated both by NMR image and by NM performed within one week interval. The heart muscle was able to be visualized without any contrast material nor radioisotopes in inversion recovery images, whereas saturation recovery images failed to separate heart muscle from blood pool. The wall motions of LV in both methods were well correlated except for inferior wall. The values of ejection fraction in NMR image were moderately low, but two modalities showed satisfactory correlation (r=0.85). The region of myocardial infarction was revealed as wall thinning and/or wall motion abnormality. It is still preliminary to draw a conclusion, however, it can be said that in the evaluation of LV function, method by NMR might be of equal value to those of NM. It can be certain that eventually gated NMR-CT will become more effective method for various aspects of cardiovascular evaluation.

  9. ECG response of koalas to tourists proximity: a preliminary study.

    PubMed

    Ropert-Coudert, Yan; Brooks, Lisa; Yamamoto, Maki; Kato, Akiko

    2009-01-01

    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. PMID:19823679

  10. Clinically accurate fetal ECG parameters acquired from maternal abdominal sensors

    PubMed Central

    CLIFFORD, Gari; SAMENI, Reza; WARD, Mr. Jay; ROBINSON, Julian; WOLFBERG, Adam J.

    2011-01-01

    OBJECTIVE To evaluate the accuracy of a novel system for measuring fetal heart rate and ST-segment changes using non-invasive electrodes on the maternal abdomen. STUDY DESIGN Fetal ECGs were recorded using abdominal sensors from 32 term laboring women who had a fetal scalp electrode (FSE) placed for a clinical indication. RESULTS Good quality data for FHR estimation was available in 91.2% of the FSE segments, and 89.9% of the abdominal electrode segments. The root mean square (RMS) error between the FHR data calculated by both methods over all processed segments was 0.36 beats per minute. ST deviation from the isoelectric point ranged from 0 to 14.2% of R-wave amplitude. The RMS error between the ST change calculated by both methods averaged over all processed segments was 3.2%. CONCLUSION FHR and ST change acquired from the maternal abdomen is highly accurate and on average is clinically indistinguishable from FHR and ST change calculated using FSE data. PMID:21514560

  11. Continuous electrocardiogram reveals differenced in the short-term cardiotoxic response of Wistar-Kyoto and spontaneously hypertensive rats to doxorubicin

    EPA Science Inventory

    Electrocardiography (ECG) is one of the standard technologies used to monitor and assess cardiac function, and provide insight into the mechanisms driving myocardial pathology. Increased understanding of the effects of cardiovascular disease on rat ECG may help make ECG assessmen...

  12. The chaos and order in human ECG under the influence of the external perturbations

    NASA Astrophysics Data System (ADS)

    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

  13. Construction of a Resting High Fidelity ECG "SuperScore" for Management and Screening of Heart Disease

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Delgado, Reynolds; Poulin, Greg; Starc, Vito; Arenare, Brian; Rahman, M. A.

    2006-01-01

    Resting conventional ECG is notoriously insensitive for detecting coronary artery disease (CAD) and only nominally useful in screening for cardiomyopathy (CM). Similarly, conventional exercise stress test ECG is both time- and labor-consuming and its accuracy in identifying CAD is suboptimal for use in population screening. We retrospectively investigated the accuracy of several advanced resting electrocardiographic (ECG) parameters, both alone and in combination, for detecting CAD and cardiomyopathy (CM).

  14. [A Smart Low-Power-Consumption ECG Monitor Based on MSP430F5529 and CC2540].

    PubMed

    Gong, Yuan; Cao, Jin; Luo, Zehui; Zhou, Guohui

    2015-07-01

    A design of ECG monitor was presented in this paper. It is based on the latest MCU and BLE4.0 technologies and can interact with multi-platform smart devices with extra low power consumption. Besides, a clinical expansion part can realize functions including displaying the real-time ECG and heart rate curve, reading abnormal ECG signals stored in the monitor, and setting alarm threshold. These functions are suitable for follow-up use. PMID:26665940

  15. The emergency department ECG and immediately life-threatening complications in initially uncomplicated suspected myocardial ischemia.

    PubMed

    Zalenski, R J; Sloan, E P; Chen, E H; Hayden, R F; Gold, I W; Cooke, D

    1988-03-01

    The emergency physician's disposition of patients with suspected myocardial ischemia is currently debated; some physicians believe that a subgroup of patients can be managed safely outside the coronary care unit. Clinical predictors are needed in assessing the patient with suspected myocardial ischemia to help identify this subgroup. Through a retrospective cohort study, we investigated the value of the initial emergency department ECG in discriminating between chest pain patients with low and high risk for immediately life-threatening complications. Two hundred eleven initially uncomplicated consecutive coronary care unit admissions with suspected unstable angina or myocardial infarction were studied. Patient outcome, including the incidence of myocardial infarction, complications, and mechanical and pharmacologic interventions, was reviewed. Immediately life-threatening complications included ventricular fibrillation, ventricular tachycardia, shock, 2 degrees and 3 degrees block, and death. Mechanical interventions included electrocardioversion or defibrillation, endotracheal intubation, intra-aortic balloon pump, Swan-Ganz catheter, or pacemaker insertion. Pressors, antiarrhythmics, and vasodilators were the reviewed pharmacologic interventions. A positive ECG was defined by the presence of ST elevation or depression, T wave inversion, left ventricular hypertrophy, left bundle branch block, paced rhythm, or new Q waves. All other ECG interpretations were considered negative. Patients were divided into two groups based on this initial emergency physician ECG interpretation and their complication incidences compared. Of the 211 patients, 96 had a positive ECG; 115 had negative ECGs. Patients with positive ECGs were older, had a greater history and concurrent incidence of myocardial infarction, and more complications and intensive interventions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3345014

  16. Finite difference and lead field methods in designing implantable ECG monitor.

    PubMed

    Väisänen, Juho; Hyttinen, Jari; Malmivuo, Jaakko

    2006-10-01

    To minimize time-consuming and expensive in vitro and in vivo testing, information regarding the effects of implantation and the implants on measurements should be available during the designing of active implantable devices measuring bioelectric signals such as electrocardiograms (ECG). Modeling offers a fairly inexpensive and effective means of studying and demonstrating the effects of implantation on ECG measurements prior to any in vivo tests, and can thus provide the designer with valuable information. Finite difference model (FDM) and lead field approaches offer straightforward and effective modeling methods supporting the designing of active implantable ECG devices. The present study demonstrates such methods in developing and studying ECG implants. They were applied in demonstrating the effects of implant dimensions and of electrode implantation on the measurement sensitivity of the ECG device. The results of the simulations indicated that the interelectrode distance is the factor of the implant design determining the lead sensitivity. Other parameters related implant dimensions and shape have minor effect on the morphology of the ECG or on the average sensitivity of the measurement. This is shown for example when the interelectrode distance was reduced to 1/3 of original the average lead sensitivity decreased by 69.1% while larger relative changes in other dimensions produced clearly smaller changes. It was also observed here that implanting the electrodes deeper under the skin has major effects on the local sensitivities in heart muscle and thus affect to the morphology of the ECG. The study indicated also that non-conducting medium (i.e. implant insulated body) between the electrodes increases the sensitivity on heart muscle compared to cases where only electrodes are implanted. PMID:17031715

  17. Transform Domain Robust Variable Step Size Griffiths' Adaptive Algorithm for Noise Cancellation in ECG

    NASA Astrophysics Data System (ADS)

    Hegde, Veena; Deekshit, Ravishankar; Satyanarayana, P. S.

    2011-12-01

    The electrocardiogram (ECG) is widely used for diagnosis of heart diseases. Good quality of ECG is utilized by physicians for interpretation and identification of physiological and pathological phenomena. However, in real situations, ECG recordings are often corrupted by artifacts or noise. Noise severely limits the utility of the recorded ECG and thus needs to be removed, for better clinical evaluation. In the present paper a new noise cancellation technique is proposed for removal of random noise like muscle artifact from ECG signal. A transform domain robust variable step size Griffiths' LMS algorithm (TVGLMS) is proposed for noise cancellation. For the TVGLMS, the robust variable step size has been achieved by using the Griffiths' gradient which uses cross-correlation between the desired signal contaminated with observation or random noise and the input. The algorithm is discrete cosine transform (DCT) based and uses symmetric property of the signal to represent the signal in frequency domain with lesser number of frequency coefficients when compared to that of discrete Fourier transform (DFT). The algorithm is implemented for adaptive line enhancer (ALE) filter which extracts the ECG signal in a noisy environment using LMS filter adaptation. The proposed algorithm is found to have better convergence error/misadjustment when compared to that of ordinary transform domain LMS (TLMS) algorithm, both in the presence of white/colored observation noise. The reduction in convergence error achieved by the new algorithm with desired signal decomposition is found to be lower than that obtained without decomposition. The experimental results indicate that the proposed method is better than traditional adaptive filter using LMS algorithm in the aspects of retaining geometrical characteristics of ECG signal.

  18. [Research on ECG de-noising method based on ensemble empirical mode decomposition and wavelet transform using improved threshold function].

    PubMed

    Ye, Linlin; Yang, Dan; Wang, Xu

    2014-06-01

    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. PMID:25219236

  19. Reduction of Motion Artifacts and Improvement of R Peak Detecting Accuracy Using Adjacent Non-Intrusive ECG Sensors

    PubMed Central

    Choi, Minho; Jeong, Jae Jin; Kim, Seung Hun; Kim, Sang Woo

    2016-01-01

    Non-intrusive electrocardiogram (ECG) monitoring has many advantages: easy to measure and apply in daily life. However, motion noise in the measured signal is the major problem of non-intrusive measurement. This paper proposes a method to reduce the noise and to detect the R peaks of ECG in a stable manner in a sitting arrangement using non-intrusive sensors. The method utilizes two capacitive ECG sensors (cECGs) to measure ECG, and another two cECGs located adjacent to the sensors for ECG are added to obtain the information on motion. Then, active noise cancellation technique and the motion information are used to reduce motion noise. To verify the proposed method, ECG was measured indoors and during driving, and the accuracy of the detected R peaks was compared. After applying the method, the sum of sensitivity and positive predictivity increased 8.39% on average and 26.26% maximally in the data. Based on the results, it was confirmed that the motion noise was reduced and that more reliable R peak positions could be obtained by the proposed method. The robustness of the new ECG measurement method will elicit benefits to various health care systems that require noninvasive heart rate or heart rate variability measurements. PMID:27196910

  20. Reduction of Motion Artifacts and Improvement of R Peak Detecting Accuracy Using Adjacent Non-Intrusive ECG Sensors.

    PubMed

    Choi, Minho; Jeong, Jae Jin; Kim, Seung Hun; Kim, Sang Woo

    2016-01-01

    Non-intrusive electrocardiogram (ECG) monitoring has many advantages: easy to measure and apply in daily life. However, motion noise in the measured signal is the major problem of non-intrusive measurement. This paper proposes a method to reduce the noise and to detect the R peaks of ECG in a stable manner in a sitting arrangement using non-intrusive sensors. The method utilizes two capacitive ECG sensors (cECGs) to measure ECG, and another two cECGs located adjacent to the sensors for ECG are added to obtain the information on motion. Then, active noise cancellation technique and the motion information are used to reduce motion noise. To verify the proposed method, ECG was measured indoors and during driving, and the accuracy of the detected R peaks was compared. After applying the method, the sum of sensitivity and positive predictivity increased 8.39% on average and 26.26% maximally in the data. Based on the results, it was confirmed that the motion noise was reduced and that more reliable R peak positions could be obtained by the proposed method. The robustness of the new ECG measurement method will elicit benefits to various health care systems that require noninvasive heart rate or heart rate variability measurements. PMID:27196910

  1. A Wearable Context-Aware ECG Monitoring System Integrated with Built-in Kinematic Sensors of the Smartphone.

    PubMed

    Miao, Fen; Cheng, Yayu; He, Yi; He, Qingyun; Li, Ye

    2015-01-01

    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. PMID:25996508

  2. A Wearable Context-Aware ECG Monitoring System Integrated with Built-in Kinematic Sensors of the Smartphone

    PubMed Central

    Miao, Fen; Cheng, Yayu; He, Yi; He, Qingyun; Li, Ye

    2015-01-01

    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. PMID:25996508

  3. Discrete wavelet transform and singular value decomposition based ECG steganography for secured patient information transmission.

    PubMed

    Edward Jero, S; Ramu, Palaniappan; Ramakrishnan, S

    2014-10-01

    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. PMID:25187409

  4. Apnea MedAssist: real-time sleep apnea monitor using single-lead ECG.

    PubMed

    Bsoul, Majdi; Minn, Hlaing; Tamil, Lakshman

    2011-05-01

    We have developed a low-cost, real-time sleep apnea monitoring system ''Apnea MedAssist" for recognizing obstructive sleep apnea episodes with a high degree of accuracy for both home and clinical care applications. The fully automated system uses patient's single channel nocturnal ECG to extract feature sets, and uses the support vector classifier (SVC) to detect apnea episodes. "Apnea MedAssist" is implemented on Android operating system (OS) based smartphones, uses either the general adult subject-independent SVC model or subject-dependent SVC model, and achieves a classification F-measure of 90% and a sensitivity of 96% for the subject-independent SVC. The real-time capability comes from the use of 1-min segments of ECG epochs for feature extraction and classification. The reduced complexity of "Apnea MedAssist" comes from efficient optimization of the ECG processing, and use of techniques to reduce SVC model complexity by reducing the dimension of feature set from ECG and ECG-derived respiration signals and by reducing the number of support vectors. PMID:20952340

  5. A new statistical PCA-ICA algorithm for location of R-peaks in ECG.

    PubMed

    Chawla, M P S; Verma, H K; Kumar, Vinod

    2008-09-16

    The success of ICA to separate the independent components from the mixture depends on the properties of the electrocardiogram (ECG) recordings. This paper discusses some of the conditions of independent component analysis (ICA) that could affect the reliability of the separation and evaluation of issues related to the properties of the signals and number of sources. Principal component analysis (PCA) scatter plots are plotted to indicate the diagnostic features in the presence and absence of base-line wander in interpreting the ECG signals. In this analysis, a newly developed statistical algorithm by authors, based on the use of combined PCA-ICA for two correlated channels of 12-channel ECG data is proposed. ICA technique has been successfully implemented in identifying and removal of noise and artifacts from ECG signals. Cleaned ECG signals are obtained using statistical measures like kurtosis and variance of variance after ICA processing. This analysis also paper deals with the detection of QRS complexes in electrocardiograms using combined PCA-ICA algorithm. The efficacy of the combined PCA-ICA algorithm lies in the fact that the location of the R-peaks is bounded from above and below by the location of the cross-over points, hence none of the peaks are ignored or missed. PMID:17655943

  6. A new ECG biomarker for drug toxicity: a combined signal processing and computational modeling study.

    PubMed

    Jie, Xiao; Rodriguez, Blanca; Pueyo, Esther

    2010-01-01

    QT prolongation is the only clinically proven, yet insufficient, electrocardiogram (ECG) biomarker for drug-induced cardiac toxicity. The goal of this study is to evaluate whether JT area, i.e., total area of the T-wave, can serve as an ECG biomarker for drug-induced cardiac toxicity using both signal processing and computational modeling approaches. An ECG dataset that contained recordings from patients under control and sotalol condition was analyzed. In order to relate sotalol-induced ECG changes to its effect on ion channel level, i.e., blockade of the rapid component of the delayed rectifier potassium channel (I(Kr)), varied degrees of I(Kr) blockade were simulated in a slab of ventricular tissue. The mean JT area increased by 36.5% following the administration of sotalol in patients. Simulations in the slab tissue showed that sotalol increased action potential duration preferentially in the midmyocardium, which led to increased transmural dispersion of repolarization and JT area. In conclusion, JT area reflects the transmural dispersion of repolarization and may be a potentially useful surrogate/supplemental ECG biomarker to assess drug safety. PMID:21096447

  7. Real-Time Online Monitoring of Electrocardiogram (ECG) using Very Low Cost for Developing Countries

    NASA Astrophysics Data System (ADS)

    Singh, Gavendra; Gupta, Varun; Sekharmantri, Anil Kumar; Gupta, Akash; Kumar, Pankaj

    2010-11-01

    An electrocardiogram or ECG (also known as EKG—abbreviated from the German word Elektro-Kardiographie), is an electrical recording of the heart and is used in the investigation of heart disease. `An electrocardiogram (ECG) is a graphic tracing of the electric current generated by the heart muscle during a heartbeat'. The electrocardiogram (ECG)/(EKG) is a surface measurement of the electrical potential generated by electrical activity in cardiac tissue. It has been used extensively in medicine sine its inventions in the early 1900' sand has been proven to be invaluable in various diagnostics applications such as the detection of irregular heartbeat patterns (i.e. fibrillation & arrhythmia), hearts murmurs (other abnormal sounds), tissue/structural damage (such as valve malfunction) and coronary artery blockage. In this paper we made a circuit network by using this circuit we can acquire an ECG signal of the heart electrical activity. This is one of the cheapest circuit to acquire ECG signal. It's whole cost around Rs.250/- only. Instrumentation amplifier AD620AN, notch filter, various resistances, capacitors, wires etc. are used to made this circuit.

  8. Performance evaluation of wavelet-based ECG compression algorithms for telecardiology application over CDMA network.

    PubMed

    Kim, Byung S; Yoo, Sun K

    2007-09-01

    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. PMID:17701824

  9. Revisiting QRS Detection Methodologies for Portable, Wearable, Battery-Operated, and Wireless ECG Systems

    PubMed Central

    Elgendi, Mohamed; Eskofier, Björn; Dokos, Socrates; Abbott, Derek

    2014-01-01

    Cardiovascular diseases are the number one cause of death worldwide. Currently, portable battery-operated systems such as mobile phones with wireless ECG sensors have the potential to be used in continuous cardiac function assessment that can be easily integrated into daily life. These portable point-of-care diagnostic systems can therefore help unveil and treat cardiovascular diseases. The basis for ECG analysis is a robust detection of the prominent QRS complex, as well as other ECG signal characteristics. However, it is not clear from the literature which ECG analysis algorithms are suited for an implementation on a mobile device. We investigate current QRS detection algorithms based on three assessment criteria: 1) robustness to noise, 2) parameter choice, and 3) numerical efficiency, in order to target a universal fast-robust detector. Furthermore, existing QRS detection algorithms may provide an acceptable solution only on small segments of ECG signals, within a certain amplitude range, or amid particular types of arrhythmia and/or noise. These issues are discussed in the context of a comparison with the most conventional algorithms, followed by future recommendations for developing reliable QRS detection schemes suitable for implementation on battery-operated mobile devices. PMID:24409290

  10. Mass exponent spectrum analysis of human ECG signals and its application to complexity detection

    NASA Astrophysics Data System (ADS)

    Yang, Xiaodong; Du, Sidan; Ning, Xinbao; Bian, Chunhua

    2008-06-01

    The complexity of electrocardiogram (ECG) signal may reflect the physiological function and healthy status of the heart. In this paper, we introduced two novel intermediate parameters of multifractality, the mass exponent spectrum curvature and area, to characterize the nonlinear complexity of ECG signal. These indicators express the nonlinear superposition of the discrepancies of singularity strengths from all the adjacent points of the spectrum curve and thus overall subsets of original fractal structure. The evaluation of binomial multifractal sets validated these two variables were entirely effective in exploring the complexity of this time series. We then studied the ECG mass exponent spectra taken from the cohorts of healthy, ischemia and myocardial infarction (MI) sufferer based on a large sets of 12 leads’ recordings, and took the statistical averages among each crowd. Experimental results suggest the two values from healthy ECG are apparently larger than those from the heart diseased. While the values from ECG of MI sufferer are much smaller than those from the other two groups. As for the ischemia sufferer, they are almost of moderate magnitude. Afterward, we compared these new indicators with the nonlinear parameters of singularity spectrum. The classification indexes and results of total separating ratios (TSR, defined in the paper) both indicated that our method could achieve a better effect. These conclusions may be of some values in early diagnoses and clinical applications.

  11. Wearable technology and ECG processing for fall risk assessment, prevention and detection.

    PubMed

    Melillo, Paolo; Castaldo, Rossana; Sannino, Giovanna; Orrico, Ada; de Pietro, Giuseppe; Pecchia, Leandro

    2015-08-01

    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. PMID:26738086

  12. Modeling left and right atrial contributions to the ECG: A dipole-current source approach.

    PubMed

    Jacquemet, Vincent

    2015-10-01

    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 <1% during both sinus rhythm and atrial fibrillation. When the boundary element method is applied to solve the forward problem, this 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. PMID:26149374

  13. A Novel Technique for Muscle Onset Detection Using Surface EMG Signals without Removal of ECG Artifacts

    PubMed Central

    Zhou, Ping; Zhang, Xu

    2014-01-01

    Surface electromyogram (EMG) signal from trunk muscles is often contaminated by electrocardiogram (ECG) artifacts. This study presents a novel method for muscle activity onset detection by processing surface EMG against ECG artifacts. The method does not require removal of ECG artifacts from raw surface EMG signals. Instead, it applies the sample entropy (SampEn) analysis to highlight EMG activity and suppress ECG artifacts in the signal complexity domain. A SampEn threshold can then be determined for detection of muscle activity. The performance of the proposed method was examined with different SampEn analysis window lengths, using a series of combinations of “clean” experimental EMG and ECG recordings over a wide range of signal to noise ratios (SNRs) from −10 dB to 10 dB. For all the examined SNRs, the window length of 128 ms yielded the best performance among all the tested lengths. Compared with the conventional amplitude thresholding and integrated profile methods, the SampEn analysis based method achieved significantly better performance, demonstrated as the shortest average latency or error among the three methods (p<0.001 for any of the examined SNRs except 10 dB). PMID:24345857

  14. Noninvasive functional cardiac electrical source imaging: combining MRI and ECG mapping for imaging electrical function

    NASA Astrophysics Data System (ADS)

    Tilg, Bernhard; Modre, Robert; Fischer, Gerald; Hanser, Friedrich; Messnarz, Bernd; Schocke, Michael F. H.; Kremser, Christian; Roithinger, Franz

    2002-04-01

    Inverse electrocardiography has been developing for several years. By coupling electrocardiographic mapping and 3D+time anatomical data, the electrical excitation sequence can be imaged completely noninvasively in the human heart. In this study, a bidomain theory based surface heart model activation time imaging approach was applied to single beat data of atrial and ventricular depolarization. For sinus and paced rhythms, the sites of early activation and the areas with late activation were estimated with sufficient accuracy. In particular for focal arrhythmias, this model-based imaging approach might allow the guidance and evaluation of antiarrhythmic interventions, for instance, in case of catheter ablation or drug therapy.

  15. Semisupervised classifier of signal-average ECG based on k-means clustering

    NASA Astrophysics Data System (ADS)

    Wydrzynski, Jacek; Jankowski, Stanislaw; Piatkowska-Janko, Ewa

    2008-11-01

    This paper presents the method of risk recognition of sustained ventricular tachycardia and flicker in patients after myocardial infarction based on high-resolution and signal-averaged electrocardiography. Described semisupervised method is combination of k-means clustering and support vector machine classifier. The work is based on dataset obtained from the Medical University of Warsaw. While learning process there were used only 5% examples labels. Evolutionary optimization of coefficients for each signal parameter was executed. It let show the most important parameters. The method of classification had high rate of successful recognition about 94.9%.

  16. Prognostic significance of electrical alternans versus signal averaged electrocardiography in predicting the outcome of electrophysiological testing and arrhythmia-free survival

    PubMed Central

    Armoundas, A; Rosenbaum, D; Ruskin, J; Garan, H; Cohen, R

    1998-01-01

    Objective—To investigate the accuracy of signal averaged electrocardiography (SAECG) and measurement of microvolt level T wave alternans as predictors of susceptibility to ventricular arrhythmias.
Design—Analysis of new data from a previously published prospective investigation.
Setting—Electrophysiology laboratory of a major referral hospital.
Patients and interventions—43 patients, not on class I or class III antiarrhythmic drug treatment, undergoing invasive electrophysiological testing had SAECG and T wave alternans measurements. The SAECG was considered positive in the presence of one (SAECG-I) or two (SAECG-II) of three standard criteria. T wave alternans was considered positive if the alternans ratio exceeded 3.0.
Main outcome measures—Inducibility of sustained ventricular tachycardia or fibrillation during electrophysiological testing, and 20 month arrhythmia-free survival.
Results—The accuracy of T wave alternans in predicting the outcome of electrophysiological testing was 84% (p < 0.0001). Neither SAECG-I (accuracy 60%; p < 0.29) nor SAECG-II (accuracy 71%; p < 0.10) was a statistically significant predictor of electrophysiological testing. SAECG, T wave alternans, electrophysiological testing, and follow up data were available in 36 patients while not on class I or III antiarrhythmic agents. The accuracy of T wave alternans in predicting the outcome of arrhythmia-free survival was 86% (p < 0.030). Neither SAECG-I (accuracy 65%; p < 0.21) nor SAECG-II (accuracy 71%; p < 0.48) was a statistically significant predictor of arrhythmia-free survival. 
Conclusions—T wave alternans was a highly significant predictor of the outcome of electrophysiological testing and arrhythmia-free survival, while SAECG was not a statistically significant predictor. Although these results need to be confirmed in prospective clinical studies, they suggest that T wave alternans may serve as a non-invasive probe for screening high risk

  17. Scuba diving, acute left anterior descending artery occlusion and normal ECG

    PubMed Central

    Doll, Sébastien Xavier; Rigamonti, Fabio; Roffi, Marco; Noble, Stéphane

    2013-01-01

    We report the case of an acute proximal occlusion of the left anterior descending coronary (LAD) artery following a scuba diving decompression accident and associated with normal ECG. Following uneventful thromboaspiration and coronary stenting, the patient was discharged on day  4 with secondary preventative therapies. A transthoracic echocardiography performed at this point showed a complete recovery compared with an initial localised akinesia involving the anterior and apical portion of the left ventricle upon admission. This case highlights that significant acute coronary lesions involving the LAD can occur without any ECG anomaly. The presence of acute and persistent angina associated with troponin elevation should prompt physicians to consider coronary angiography without delay, independently of the ECG results. PMID:23376677

  18. On the application of optimal wavelet filter banks for ECG signal classification

    NASA Astrophysics Data System (ADS)

    Hadjiloucas, S.; Jannah, N.; Hwang, F.; Galvão, R. K. H.

    2014-03-01

    This paper discusses ECG signal classification after parametrizing the ECG waveforms in the wavelet domain. Signal decomposition using perfect reconstruction quadrature mirror filter banks can provide a very parsimonious representation of ECG signals. In the current work, the filter parameters are adjusted by a numerical optimization algorithm in order to minimize a cost function associated to the filter cut-off sharpness. The goal consists of achieving a better compromise between frequency selectivity and time resolution at each decomposition level than standard orthogonal filter banks such as those of the Daubechies and Coiflet families. Our aim is to optimally decompose the signals in the wavelet domain so that they can be subsequently used as inputs for training to a neural network classifier.

  19. ECG Prediction Based on Classification via Neural Networks and Linguistic Fuzzy Logic Forecaster.

    PubMed

    Volna, Eva; Kotyrba, Martin; Habiballa, Hashim

    2015-01-01

    The paper deals with ECG prediction based on neural networks classification of different types of time courses of ECG signals. The main objective is to recognise normal cycles and arrhythmias and perform further diagnosis. We proposed two detection systems that have been created with usage of neural networks. The experimental part makes it possible to load ECG signals, preprocess them, and classify them into given classes. Outputs from the classifiers carry a predictive character. All experimental results from both of the proposed classifiers are mutually compared in the conclusion. We also experimented with the new method of time series transparent prediction based on fuzzy transform with linguistic IF-THEN rules. Preliminary results show interesting results based on the unique capability of this approach bringing natural language interpretation of particular prediction, that is, the properties of time series. PMID:26221620

  20. Powerline interference reduction in ECG signals using empirical wavelet transform and adaptive filtering.

    PubMed

    Singh, Omkar; Sunkaria, Ramesh Kumar

    2015-01-01

    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. PMID:25412942

  1. Hiding patients confidential datainthe ECG signal viaa transform-domain quantization scheme.

    PubMed

    Chen, Shuo-Tsung; Guo, Yuan-Jie; Huang, Huang-Nan; Kung, Woon-Man; Tseng, Kuo-Kun; Tu, Shu-Yi

    2014-06-01

    Watermarking is the most widely used technology in the field of copyright and biological information protection. In this paper, we use quantization based digital watermark encryption technology on the Electrocardiogram (ECG) to protect patient rights and information. Three transform domains, DWT, DCT, and DFT are adopted to implement the quantization based watermarking technique. Although the watermark embedding process is not invertible, the change of the PQRST complexes and amplitude of the ECG signal is very small and so the watermarked data can meet the requirements of physiological diagnostics. In addition, the hidden information can be extracted without knowledge of the original ECG data. In other words, the proposed watermarking scheme is blind. Experimental results verify the efficiency of the proposed scheme. PMID:24832688

  2. A PC-based generator of surface ECG potentials for computer electrocardiograph testing.

    PubMed

    Franchi, D; Palagi, G; Bedini, R

    1994-02-01

    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. PMID:8004944

  3. Community-Based ECG Monitoring System for Patients with Cardiovascular Diseases.

    PubMed

    Lin, Bor-Shyh; Wong, Alice M; Tseng, Kevin C

    2016-04-01

    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. PMID:26802010

  4. Cardiac loop ECG recording: a new noninvasive diagnostic test in recurrent syncope.

    PubMed

    Cumbee, S R; Pryor, R E; Linzer, M

    1990-01-01

    The most crucial step in diagnosing syncope is determining whether or not an arrhythmia is the cause. A new recording device, the continuous cardiac loop ECG recorder, affords prolonged ambulatory monitoring and can capture the rhythm at the time of syncope. To determine the impact of cardiac loop ECG recorders in diagnosing syncope, we reviewed the records of the first 48 patients referred for cardiac loop recording because of unexplained syncope or presyncope. Previous cardiac studies were nondiagnostic in all patients. In 36% of these patients, loop recording definitively determined whether an arrhythmia was the cause of symptoms. Median duration of monitoring was 28 days, with an average charge of $180 per month. Cardiac loop ECG recording is a convenient, safe, inexpensive, and potentially highly effective means of diagnosing unexplained syncope. PMID:2300833

  5. A Hierarchical Method for Removal of Baseline Drift from Biomedical Signals: Application in ECG Analysis

    PubMed Central

    Luo, Yurong; Hargraves, Rosalyn H.; Bai, Ou; Qi, Xuguang; Ward, Kevin R.; Pfaffenberger, Michael Paul

    2013-01-01

    Noise can compromise the extraction of some fundamental and important features from biomedical signals and hence prohibit accurate analysis of these signals. Baseline wander in electrocardiogram (ECG) signals is one such example, which can be caused by factors such as respiration, variations in electrode impedance, and excessive body movements. Unless baseline wander is effectively removed, the accuracy of any feature extracted from the ECG, such as timing and duration of the ST-segment, is compromised. This paper approaches this filtering task from a novel standpoint by assuming that the ECG baseline wander comes from an independent and unknown source. The technique utilizes a hierarchical method including a blind source separation (BSS) step, in particular independent component analysis, to eliminate the effect of the baseline wander. We examine the specifics of the components causing the baseline wander and the factors that affect the separation process. Experimental results reveal the superiority of the proposed algorithm in removing the baseline wander. PMID:23766720

  6. Asymptomatic coronary artery spasm with acute pathological ST elevation on routine ECG: Is it common?

    PubMed Central

    Mohammed, Ishaq; Zaatari, Mohamad Sadek El; Tyrogalas, Nikos; Khalid, M I

    2014-01-01

    Asymptomatic spontaneous coronary artery spasm is rare and there are no case reports in literature presenting with acute ST elevation on routine ECG. We present the case of a 68-year-old Caucasian man who presented to a primary care physician for a routine ECG as part of hypertension follow-up. ECG revealed ST elevation in inferior leads II, III and aVF with reciprocal ST depression in leads I, aVL and also ST depression in anterior leads V1, V2 and V3 suggesting ongoing inferoposterior ST elevation myocardial infarction. The patient was completely well, stable and asymptomatic and he was rushed immediately to the coronary care unit via emergency ambulance. The patient was subjected to a battery of urgent investigations which were all normal. Also an urgent coronary angiogram was undertaken which showed completely normal coronary anatomy. PMID:25115779

  7. [Various systems of long-term ECG (Holter) monitoring in clinical practice].

    PubMed

    Janousek, J

    1989-03-31

    Seven various 24-hour ambulatory ECG systems from six producers (Trendsetter 9000A--Del Mar Avionics, Epicardia HC and PC--Medicomp, Epicardia FD--Hellige, Spacelabs 90,101-Spacelabs, Medilog 4000--Oxford, Laser Holter 8000T--Marquette) were used over a 4-year period to gather the experience with a total of 449 24-hour ECG recordings. The quality of the automatic analysis, the mode of access to the ECG data, control and correction possibilities, operator time consumption, report quality, costs and availability of consumeables were individually evaluated. In the country's specific conditions/shortage of some type of consumeables), Laser Holter 8000T was regarded as the most useful device followed by Epicardia FD and Medilog 4000. PMID:2731211

  8. Sleep apnoea episodes recognition by a committee of ELM classifiers from ECG signal.

    PubMed

    Sadr, Nadi; de Chazal, Philip; van Schaik, Andre; Breen, Paul

    2015-08-01

    This paper describes a system for the recognition of sleep apnoea episodes from ECG signals using a committee of extreme learning machine (ELM) classifiers. RR-interval parameters (heart rate variability) have been used as the identifying features as they are directly affected by sleep apnoea. The MIT PhysioNet Apnea-ECG database was used. A committee of five ELM classifiers has been employed to classify one-minute epochs of ECG into normal or apnoeic epochs. Our results show that the classification performance from the committee of networks was superior to the results of a single ELM classifier for fan-outs from 1 to 100. Classification performance reached a plateau at a fan-out of 10. The maximum accuracy was 82.5% with a sensitivity of 81.9% and a specificity of 82.8%. The results were comparable to other published research with the same input data. PMID:26738070

  9. A linear quality control design for high efficient wavelet-based ECG data compression.

    PubMed

    Hung, King-Chu; Tsai, Chin-Feng; Ku, Cheng-Tung; Wang, Huan-Sheng

    2009-05-01

    In ECG data compression, maintaining reconstructed signal with desired quality is crucial for clinical application. In this paper, a linear quality control design based on the reversible round-off non-recursive discrete periodized wavelet transform (RRO-NRDPWT) is proposed for high efficient ECG data compression. With the advantages of error propagation resistance and octave coefficient normalization, RRO-NRDPWT enables the non-linear quantization control to obtain an approximately linear distortion by using a single control variable. Based on the linear programming, a linear quantization scale prediction model is presented for the quality control of reconstructed ECG signal. Following the use of the MIT-BIH arrhythmia database, the experimental results show that the proposed system, with lower computational complexity, can obtain much better quality control performance than that of other wavelet-based systems. PMID:19070935

  10. ECG Prediction Based on Classification via Neural Networks and Linguistic Fuzzy Logic Forecaster

    PubMed Central

    Volna, Eva; Kotyrba, Martin; Habiballa, Hashim

    2015-01-01

    The paper deals with ECG prediction based on neural networks classification of different types of time courses of ECG signals. The main objective is to recognise normal cycles and arrhythmias and perform further diagnosis. We proposed two detection systems that have been created with usage of neural networks. The experimental part makes it possible to load ECG signals, preprocess them, and classify them into given classes. Outputs from the classifiers carry a predictive character. All experimental results from both of the proposed classifiers are mutually compared in the conclusion. We also experimented with the new method of time series transparent prediction based on fuzzy transform with linguistic IF-THEN rules. Preliminary results show interesting results based on the unique capability of this approach bringing natural language interpretation of particular prediction, that is, the properties of time series. PMID:26221620

  11. Robust off-line heartbeat detection using ECG and pressure-signals.

    PubMed

    Hoeben, Bart; Teo, Soo Kng; Yang, Bo; Su, Yi

    2016-01-01

    Artefacts in pressure- and ECG-signals generally arise due to different causes. Therefore, the combined analysis of both signals can increase the effectiveness of heartbeat detection compared to analysis using solely ECG-signals. In this paper, we present an algorithm for heartbeat annotation by combining the analysis of both the pressure- and ECG-signals. The novelties of our algorithm are as follows: (1) development of a new approach for annotating heartbeats using pressure-signals, (2) development of a mechanism that identifies and corrects paced rhythms, and (3) development of a noise detection approach. Our algorithm is tested on the datasets from the extended phase of the Physionet CINC-2014 challenge and produces an overall score of 87.31%. Finally, we put forth several recommendations that could further improve our algorithm. PMID:26641478

  12. Pseudo-ischaemic ECG in a patient with amyotrophic lateral sclerosis surviving for a decade

    PubMed Central

    Zhang, Jian; Yang, Shi-Wei; Wang, Zheng; Wei, Guang-Ru; Zhou, Yu-Jie

    2012-01-01

    A 58-year-old female with no history of heart disease was admitted to our hospital for abnormal ECG mimicking myocardial ischaemia. The ECG revealed persistent T-wave inversion in almost all leads, especially in precordial leads V2–V6. The patient had no complaints of chest pain, chest distress, short of breath or other atypical myocardial ischaemia symptoms. She had a history of amyotrophic lateral sclerosis (ALS) with a disease course more than 20 years. Examinations help rule out other diseases causing persistent T-wave inversion. Importantly, cardiac catheterisation showed nearly normal coronary arteries that could rule out myocardial ischaemia. Accordingly, the authors presumed that the pseudo-ischaemic ECG was associated with ALS in this patient. The findings of the present case provide new evidence that autonomic nervous system may involve in the pathophysiological progress of ALS. PMID:22665549

  13. Prenatal Foetal Non-invasive ECG instead of Doppler CTG – A Better Alternative?

    PubMed Central

    Sänger, N.; Hayes-Gill, B. R.; Schiermeier, S.; Hatzmann, W.; Yuan, J.; Herrmann, E.; Louwen, F.; Reinhard, J.

    2012-01-01

    Introduction: This study aimed to evaluate foetal signal quality obtained using an antenatal foetal ECG system (Monica 24™) and compare it with Doppler ultrasound CTG monitoring (Corometrics® 250 series). Material and Methods: Seventy pregnant women (gestational age: between 20 + 0 weeks and 40 + 0 weeks) were examined using the Monica AN24™ system and also underwent Doppler CTG. The signal quality of both methods was compared and correlated with gestational age and pre-pregnancy body mass index (BMI). Results: Overall, ECG had a signal quality of 77.4 % and CTG had a signal quality of 73.1 % (p > 0.05). In gestational weeks (GW) 20–26, the signal quality of ECG was significantly better compared to that obtained with CTG (75.5 vs. 45.3 %; p = 0.003), while in GW 27–36, the signal quality was better with CTG (72.3 vs. 83.0 %, p = 0.001). No difference in signal quality was found between the two methods after the 37th GW (87.7 vs. 86.1 %; p > 0.05). CTG showed a statistically significant correlation with BMI (rho 0.25, p < 0.05) while ECG showed no such correlation. Conclusion: The use of non-invasive ECG is particularly indicated in the early weeks of pregnancy, while CTG offers superior results during the vernix period. There was no difference in signal quality after the vernix period. The signal quality with ECG was found to be independent of BMI, while the signal quality of CTG deteriorated with increasing BMI. PMID:25278624

  14. Semisupervised ECG Ventricular Beat Classification With Novelty Detection Based on Switching Kalman Filters.

    PubMed

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

    2015-09-01

    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. PMID:25680203

  15. Non-ECG-Gated Myocardial Perfusion MRI Using Continuous Magnetization-Driven Radial Sampling

    PubMed Central

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

    2014-01-01

    Purpose 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 2D imaging, adequate myocardial contrast can be obtained for accurate visualization of hypoperfused territories in the setting of myocardial ischemia. Methods 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/second. Canines were imaged at 3T with and without coronary stenosis using the proposed scheme and a conventional magnetization-prepared ECG-gated FPP method. Results Our studies showed that the proposed non-ECG-gated method is capable of generating high-resolution (1.7×1.7×6 mm3) artifact-free FPP images of a single slice at high heart rates (92±21 beats/minute), 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. Conclusion 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. PMID:24443160

  16. A portable ECG monitoring device with Bluetooth and Holter capabilities for telemedicine applications.

    PubMed

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

    2006-01-01

    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. PMID:17946295

  17. Inkjet printed ECG electrodes for long term biosignal monitoring in personalized and ubiquitous healthcare.

    PubMed

    Batchelor, John C; Casson, Alexander J

    2015-08-01

    This paper investigates the performance of inkjet printed electrodes for electrocardiogram (ECG) monitoring in personalized and ubiquitous healthcare. As a rapid prototyping, additive manufacturing approach, inkjet printing can allow personalization of electrode sizes and shapes and can be used with a range of substrates to achieve good long term connections to the skin. We compare the performance of two types of inkjet electrodes printed using different substrates. Results demonstrate that both new electrodes can record ECG information, with comparable signal-to-noise ratios to conventional Ag/AgCl electrodes. The time-frequency decomposition of the collected signals is also explored. PMID:26737174

  18. Skin-electrode impedance measurement during ECG acquisition: method’s validation

    NASA Astrophysics Data System (ADS)

    Casal, Leonardo; La Mura, Guillermo

    2016-04-01

    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.

  19. ECG boy: low-cost medical instrumentation using mass-produced, hand-held entertainment computers. A preliminary report.

    PubMed

    Rohde, M M; Bement, S L; Lupa, R S

    1998-01-01

    A prototype low-cost, portable ECG monitor, the "ECG Boy," is described. A mass produced hand-held video game platform is the basis for a complete three-lead, driven right-leg electrocardiogram (ECG). The ECG circuitry is planned to fit in a standard modular cartridge that is inserted in a production Nintendo "Gameboy." The combination is slightly smaller than a paperback book and weighs less than 500 g. The unit contains essential safety features such as optical isolation and is powered by 9-V and AA batteries. Functionally, the ECG Boy permits viewing ECG recordings in real time on the integrated screen. The user can select both the lead displayed on the screen and the time scale used. A 1-mV reference allows for calibration. Other ECG enhancements such as data transmission via telephone can be easily and inexpensively added to this system. The ECG Boy is intended as a proof of concept for a new class of low-cost biomedical instruments. Rising health care costs coupled with tightened funding have created an acute demand for low-cost medical equipment that satisfies safety and quality standards. A mass-produced microprocessor-based platform designed for the entertainment market can keep costs low while providing a functional basis for a biomedical instrument. PMID:9800006

  20. Assessment of a single monomorphic ventricular ectopy from the right ventricular outflow tract in standard and high resolution electrocardiogram

    PubMed Central

    Kosiński, Adam; Dąbrowska-Kugacka, Alicja; Lewicka-Nowak, Ewa; Dudziak, Maria; Grzybiak, Marek; Raczak, Grzegorz

    2010-01-01

    Introduction High-resolution electrocardiography (ECG-CREM) is a method based on digital electrocardiography. In order to facilitate the interpretation of the Crem records the technique of vectorcardiography was used. In comparison the origin of the ventricular premature complexes (VPCs) could be estimated based on a standard 12-lead electrocardiogram. The aim of the study was to assess the point of origin of the VPCs in ECG-CREM and correlate it with standard electrocardiography (ECG-Stand). Material and methods Our study included 26 patients (16 females, 10 males), aged 51-83 years (avg. 58.1 ±12.3), who presented with recurrent, during at least 6 months’ observation, VPCs. The point of origin of VPCs was compared in both methods. Results The performed analysis of collected ECG-Stand records revealed the presence of arrhythmogenic focal points in six different locations (1, 3, 5, 7, 8, 9). However, we did not affirm their presence in points 2,4,6. They were most commonly located in RVOT zones 8 (30.7%), 9 (23.0%), 5 (23.0%), and most seldom in zones 1, 3, 7 (7.6% each). In the simultaneous record of ECG-CREM with a single VPC it was confirmed that the FPb zone was activated the most frequently (40.0%); the next in relation to frequency were SD and ST (20.0%). Less frequent VPCs have their origin in Crem zones SP, FPa and SB (6.6%). Conclusions Electrocardiogram of high signal resolution (ECG-CREM) might be useful in recognition of the origin of ventricular premature complexes from RVOT. PMID:22419930