F177. Automated R-peak detection algorithm for patients with epilepsy using portable ECG

Abstract

Earlier studies have shown that short term heart rate variability (HRV) analysis of ECG is a promising biomarker for detection of epileptic seizures. A precise and accurate automatic R-peak detection algorithm is a necessity in a real-time, continuous measurement of HRV, in a portable ECG device. We used the portable CE marked ePatch® heart monitor to record the ECG of 14 patients, who were enrolled in the video-EEG long term monitoring unit for clinical workup of epilepsy. Recordings of the first 7 patients (356 recording hours) were used as training set of data to optimize the R-peak detection algorithm and the recordings of the last 7 patients (467.6 recording hours) were used to test the performance of the algorithm. We aimed to modify and optimize an existing QRS-detection algorithm to a more precise R-peak detection algorithm to avoid the possible jitter Q- and S-peaks can create in the tachogram, which causes error in short-term HRV-analysis. The proposed R-peak detection algorithm showed a high sensitivity (Se = 99.979%) and positive predictive value (P+ = 99.976%), which was comparable with a previously published QRS-detection algorithm for the ePatch®ECG device, when testing the same dataset. The novel R-peak detection algorithm designed to avoid jitter has very high sensitivity and specificity and thus is a suitable tool for a robust, fast, real-time HRV-analysis in patients with epilepsy. The R-peak detection algorithm is the first important step in creating a portable fully automatic real-time seizure detection for these patients.