Electrocardiogram Cycle Research Articles

A Vehicle Passive Entry Passive Start System with the Intelligent Internet of Things

With the development of sensor and communication technologies, the Internet of Things (IoT) subsystem is gradually becoming a crucial part in vehicles. It can effectively enhance functionalities of vehicles. However, new attack types are also emerging. For example, a driver with the smart key in their pocket can push the start button to start a car. At the same time, security issues in the push-to-start scenario are pervasive, such as smart key forgery. In this study, we propose a vehicle Passive Entry Passive Start (PEPS) system that adopts deep learning algorithms to recognize the driver using the electrocardiogram (ECG) signals measured on the driver’s smart watch. ECG signals are used for personal identification. Smart watches, serving as new smart keys of the PEPS system, can improve convenience and security. In the experiment, we consider commercial smart watches capable of sensing ECG signals. The sample rate and precision are typically lower than those of a 12-lead ECG used in hospitals. The experimental results show that Long Short-Term Memory (LSTM) models achieve the best accuracy score for identity recognition (91%) when a single ECG cycle is used. However, it takes at least 30 min for training. The training of a personalized Auto Encoder model takes only 5 min for each subject. When 15 continuous ECG cycles are sensed and used, this can achieve 100% identity accuracy. As the personalized Auto Encoder model is an unsupervised learning one-class recognizer, it can be trained using only the driver’s ECG signal. This will simplify the management of ECG recordings extremely, as well as the integration of the proposed technology into PEPS vehicles. A FIDO (Fast Identify Online)-like environment for the proposed PEPS system is discussed. Public key cryptography is adopted for communication between the smart watch and the PEPS car. The driver is first verified on the smart watch via local ECG biometric authentication, and then identified by the PEPS car. Phishing attacks, MITM (man in the middle) attacks, and replay attacks can be effectively prevented.

Fundamental and Practical Feasibility of Electrocardiogram Reconstruction from Photoplethysmogram.

Electrocardiogram (ECG) reconstruction from contact photoplethysmogram (PPG) would be transformative for cardiac monitoring. We investigated the fundamental and practical feasibility of such reconstruction by first replicating pioneering work in the field, with the aim of assessing the methods and evaluation metrics used. We then expanded existing research by investigating different cycle segmentation methods and different evaluation scenarios to robustly verify both fundamental feasibility, as well as practical potential. We found that reconstruction using the discrete cosine transform (DCT) and a linear ridge regression model shows good results when PPG and ECG cycles are semantically aligned-the ECG R peak and PPG systolic peak are aligned-before training the model. Such reconstruction can be useful from a morphological perspective, but loses important physiological information (precise R peak location) due to cycle alignment. We also found better performance when personalization was used in training, while a general model in a leave-one-subject-out evaluation performed poorly, showing that a general mapping between PPG and ECG is difficult to derive. While such reconstruction is valuable, as the ECG contains more fine-grained information about the cardiac activity as well as offers a different modality (electrical signal) compared to the PPG (optical signal), our findings show that the usefulness of such reconstruction depends on the application, with a trade-off between morphological quality of QRS complexes and precise temporal placement of the R peak. Finally, we highlight future directions that may resolve existing problems and allow for reliable and robust cross-modal physiological monitoring using just PPG.

Express method of biometric person authentication based on one cycle of the ECG signal

The article is devoted to an express method of biometric authentication of a person based on an electrocardiogram (ECG). The method is characterized by high accuracy (efficiency) of authentication of a person based on only one cycle of its ECG. Such characteristics as Accuracy, Balanced Accuracy and F1-score on average are not lower than 96.1% for such binary classifiers as k-Nearest Neighbors, Linear SVM, Decision Tree, Random Forest, Multilayer Perceptron, Adaptive Boosting, Naive Bayes and Statistical Interval Classifier. The research utilized the Combined Measurement of ECG, Breathing, and Seismocardiograms database, which features data from 20 healthy people. A method of constructing confidence intervals for ECG cycles has been developed, which is based on the rhythm-adaptive statistical estimation of the mathematical expectation and the standard deviation of the ECG signal. The method of constructing confidence intervals is based on the functioning of the Statistical Interval Classifier in the system of biometric authentication of a person. The Statistical Interval Classifier has the lowest time computational complexity among the 8 studied classifiers, which justifies its use in portable biometric authentication systems that have negligible computing resources.

Left ventricular hypertrophy detection using electrocardiographic signal

Left ventricular hypertrophy (LVH) indicates subclinical organ damage, associating with the incidence of cardiovascular diseases. From the medical perspective, electrocardiogram (ECG) is a low-cost, non-invasive, and easily reproducible tool that is often used as a preliminary diagnosis for the detection of heart disease. Nowadays, there are many criteria for assessing LVH by ECG. These criteria usually include that voltage combination of RS peaks in multi-lead ECG must be greater than one or more thresholds for diagnosis. We developed a system for detecting LVH using ECG signals by two steps: firstly, the R-peak and S-valley amplitudes of the 12-lead ECG were extracted to automatically obtain a total of 24 features and ECG beats of each case (LVH or non-LVH) were segmented; secondly, a back propagation neural network (BPN) was trained using a dataset with these features. Echocardiography (ECHO) was used as the gold standard for diagnosing LVH. The number of LVH cases (of a Taiwanese population) identified was 173. As each ECG sequence generally included 8 to 13 cycles (heartbeats) due to differences in heart rate, etc., we identified 1466 ECG cycles of LVH patients after beat segmentation. Results showed that our BPN model for detecting LVH reached the testing accuracy, precision, sensitivity, and specificity of 0.961, 0.958, 0.966 and 0.956, respectively. Detection performances of our BPN model, on the whole, outperform 7 methods using ECG criteria and many ECG-based artificial intelligence (AI) models reported previously for detecting LVH.

A Novel Radial Basis Function Neural Network Approach for ECG Signal Classification

Electrocardiogram (ECG) is a diagnostic method that helps to assess and record the electrical impulses of heart. The traditional methods in the extraction of ECG features is inneffective for avoiding the computational abstractions in the ECG signal. The cardiologist and medical specialist find numerous difficulties in the process of traditional approaches. The specified restrictions are eliminated in the proposed classifier. The fundamental aim of this work is to find the R-R interval. To analyze the blockage, different approaches are implemented, which make the computation as facile with high accuracy. The information are recovered from the MIT-BIH dataset. The retrieved data contain normal and pathological ECG signals. To obtain a noiseless signal, Gabor filter is employed and to compute the amplitude of the signal, DCT-DOST (Discrete cosine based Discrete orthogonal stock well transform) is implemented. The amplitude is computed to detect the cardiac abnormality. The R peak of the underlying ECG signal is noted and the segment length of the ECG cycle is identified. The Genetic algorithm (GA) retrieves the primary highlights and the classifier integrates the data with the chosen attributes to optimize the identification. In addition, the GA helps in performing hereditary calculations to reduce the problem of multi-target enhancement. Finally, the RBFNN (Radial basis function neural network) is applied, which diminishes the local minima present in the signal. It shows enhancement in characterizing the ordinary and anomalous ECG signals.

New Heart Features for More Effective Human Identification

Biometric verification is a process to authenticate whether the subject is what it claims to be, based on the characteristics of the human body. These characteristics must meet seven (7) conditions to enable them to be used in a practical biometric system. These conditions are namely distinctiveness, performance, collectability, acceptability, universality, circumvention, and permanence. Electrocardiogram (ECG) is a human body characteristic measured from the heart that meets these seven conditions. Choosing the correct features from the ECG is important to get a high authentication rate. This paper proposed a new algorithm known as Bipolar Slope Feature (BSF) for ECG features selection. It is developed based on the relationship of slopes between several locations in a complete ECG cycle. The Receiver Operating Characteristic (ROC) curve is used to measure the effectiveness of this technique for the application of biometric verification.

The Identification of ECG Signals Using Wavelet Transform and WOA-PNN.

Electrocardiogram (ECG) signal identification technology is rapidly replacing traditional fingerprint, face, iris and other recognition technologies, avoiding the vulnerability of traditional recognition technologies. This paper proposes an ECG signal identification method based on the wavelet transform algorithm and the probabilistic neural network by whale optimization algorithm (WOA-PNN). Firstly, Q, R and S waves are detected by wavelet transform, and the P and T waves are detected by local windowed wavelet transform. The characteristic values are constructed by the detected time points, and the ECG data dimension is smaller than that of the non-reference detection. Secondly, combined with the probabilistic neural network, the mean impact value algorithm is used to screen the characteristic values, the characteristic values with low influence are eliminated, and the input and complexity of the model are simplified. Finally, a WOA-PNN combined classification method is proposed to intelligently optimize the hyper parameters in the probabilistic neural network algorithm to improve the model accuracy. According to the simulation verification on three databases, ECG-ID, MIT-BIH Normal Sinus Rhythm and MIT-BIH Arrhythmia, the identification accuracy of a single ECG cycle is 96.97%, and the identification accuracy of three ECG cycles is 99.43%.

Development of a multivariable clinical prediction model for liposomal doxorubicin-induced cardiotoxicity in adult breast cancer patients: a retrospective multicenter study

BackgroundThe clinical use of anthracyclines is limited by the risk of cardiotoxicity. So, we aim to develop a clinical prediction model for liposomal doxorubicin-induced cardiotoxicity in adult breast cancer patients.MethodsWe designed a multicenter retrospective cohort study. A total of 257 hospitalized breast cancer patients treated with doxorubicin liposomes were finally enrolled in the study, including 58 patients from Beijing Friendship Hospital and 199 from Beijing Cancer Hospital. In all, 32 cases developed cardiotoxicity, including 4 at the Beijing Friendship Hospital and 28 at the Beijing Cancer Hospital. The study involved breast cancer patients with no pre-existing heart disease, whose clinical data were collected from their medical records. All patients underwent electrocardiogram (ECG) and/or left ventricular ejection fraction (LVEF) measurements prior to treatment with doxorubicin liposomes. Patients were clinically assessed after each cycle of treatment, and ECG and/or LVEF measurements were performed at least once after treatment. Liposomal doxorubicin-induced cardiotoxicity was defined when one of the following three conditions was met: (I) a reduction in LVEF of at least 5% from the baseline and the absolute value was less than 55%, accompanied by congestive heart failure (CHF) symptoms or signs; (II) a reduction in LVEF of at least 10% to an absolute value of less than 55%, without CHF symptoms or signs; (III) the definite diagnosis of CHF. Variables associated with cardiotoxicity were identified by univariate and multivariate logistic regression, and the consistency and differentiation of the final model were evaluated.ResultsIn our final model, age [odds ratio (OR): 5.626, 95% confidence interval (CI): 2.321 to 13.639], cancer metastasis (OR: 3.873, 95% CI: 1.220 to 12.299), paclitaxel (OR: 3.601, 95% CI: 1.010 to 12.843), and hypertension (OR: 2.435, 95% CI: 1.046 to 5.671) were significantly associated with cardiotoxicity. The final model was tested for Hosmer-Lemeshow goodness-of-fit, the χ2 was 2.696 and the P value was 0.747, and the resultant predictive model had an area under the receiver operating characteristic (ROC; AUC) curve of 0.781.ConclusionsThis study established a risk prediction model for liposomal doxorubicin-induced cardiotoxicity in breast cancer patients and performed a stratified risk scores

Learning Your Heart Actions From Pulse: ECG Waveform Reconstruction From PPG

This article studies the relation between electrocardiogram (ECG) and photoplethysmogram (PPG) and investigates the inference of the ECG waveforms from the PPG signals that can be obtained from affordable wearable Internet-of-Things (IoT) devices for mobile health. In order to address this inverse problem, a transform is proposed to map the discrete cosine transform (DCT) coefficients of each PPG cycle to those of the corresponding ECG cycle based on the proposed cardiovascular signal model. The proposed method is evaluated with different morphologies of the PPG and ECG signals on three benchmark data sets with a variety of combinations of age, weight, and health conditions under several training setups. The experimental results show that the proposed method can achieve a high prediction accuracy greater than 0.92 in averaged correlation for each data set when the model is trained subjectwise. With a signal processing and learning system that is designed synergistically, we are able to reconstruct ECG signals by exploiting the relation of these two types of cardiovascular measurement. The reconstruction capability of the proposed method can enable low-cost ECG screening from affordable wearable IoT devices for continuous and long-term monitoring. This work opens up a new research direction to transfer the clinical ECG knowledge base to build a knowledge base for PPG and sensing data from wearable devices.

Biosensor Interface Controller for Chronic Kidney Disease Monitoring Using Internet of Things (IoT)

This paper describes the simulation done on a low-cost biosensor interface controller for Chronic Kidney Disease (CKD) monitoring system using Internet of Things (IoT). Healthcare monitoring systems are devices that keep track of human activities and health conditions using biosensors. The developed monitoring system will aid in chronic disease patients for early detection of prevailing diseases. Early prevention can be done by monitoring the electrocardiogram (ECG). However, ECG signals typically contain contaminants that cause inaccuracy in the ECG signals produced and difficulty in diagnosing the heart’s activity. The objective is to design and simulate a system to perform pre-processing of ECG signals to prevent ECG measurements from signal contamination. Next, to calculate the heart rate using filtered ECG signals and the Pan-Tompkins algorithm. The simulation was done on MATLAB and Simulink by generating pre-recorded ECG signals that will be pre-processed to obtain viable results when compared to a normal ECG cycle wave. The results show that the filtered ECG produced has all the elements of a normal ECG cycle wave with less signal contamination within the range of 0.8 – 1.3mV. The filtered ECG signals were processed for QRS peak detection to obtain the heart rate. Results show that the heart rate displayed was within the range of the pre-recorded heart rate which is 79 – 82 beats per minute (BPM). The QRS peaks detected were also identical to the results from the Pan-Tompkins algorithm.

Evaluating Morphological Features of Electrocardiogram Signals for Diagnosing of Myocardial Infarction Using Classification-Based Feature Selection.

Background:Cardiovascular disease (CVD) is the first cause of world death, and myocardial infarction (MI) is one of the five primary disorders of CVDs which the patient electrocardiogram (ECG) analysis plays a dominant role in MI diagnosis. This research aims to evaluate some extracted features of ECG data to diagnose MI.Methods:In this paper, we used the Physikalisch-Technische Bundesanstalt database and extracted some morphological features, such as total integral of ECG, integral of the T-wave section, integral of the QRS complex, and J-point elevation from a cycle of normal and abnormal ECG waveforms. Since the morphology of healthy and abnormal ECG signals is different, we applied integral to different ECG cycles and intervals. We executed 100 of iterations on a 10-fold and 5-fold cross-validation method and calculated the average of statistical parameters to show the performance and stability of four classifiers, namely logistic regression (LR), simple decision tree, weighted K-nearest neighbor, and linear support vector machine. Furthermore, different combinations of proposed features were employed as a feature selection procedure based on classifier's performance using the aforementioned trained classifiers.Results:The results of our proposed method to diagnose MI utilizing all the proposed features with an LR classifier include 90.37%, 94.87%, and 86.44% for accuracy, sensitivity, specificity, respectively. Also, we calculated the standard deviation value for the accuracy of 0.006.Conclusion:Our proposed classification-based method successfully classified and diagnosed MI using different combinations of presented features. Consequently, all proposed features are valuable in MI diagnosis and are praiseworthy for future works.

Recognition System Using Fusion Normalization Based on Morphological Features of Post-Exercise ECG for Intelligent Biometrics

Although biometrics systems using an electrocardiogram (ECG) have been actively researched, there is a characteristic that the morphological features of the ECG signal are measured differently depending on the measurement environment. In general, post-exercise ECG is not matched with the morphological features of the pre-exercise ECG because of the temporary tachycardia. This can degrade the user recognition performance. Although normalization studies have been conducted to match the post- and pre-exercise ECG, limitations related to the distortion of the P wave, QRS complexes, and T wave, which are morphological features, often arise. In this paper, we propose a method for matching pre- and post-exercise ECG cycles based on time and frequency fusion normalization in consideration of morphological features and classifying users with high performance by an optimized system. One cycle of post-exercise ECG is expanded by linear interpolation and filtered with an optimized frequency through the fusion normalization method. The fusion normalization method aims to match one post-exercise ECG cycle to one pre-exercise ECG cycle. The experimental results show that the average similarity between the pre- and post-exercise states improves by 25.6% after normalization, for 30 ECG cycles. Additionally, the normalization algorithm improves the maximum user recognition performance from 96.4 to 98%.

REAL-TIME METHOD FOR ECG R-PEAK DETECTION COMBINING AUTOMATIC THRESHOLD AND DIFFERENTIATION

This paper proposed a novel real-time algorithm for electrocardiogram (ECG) signal analysis using the first derivative and automatic threshold to locate the R-peaks. First, the ECG signals are filtered by Butterworth low pass filter to reduce the high frequency noise. Then, the first 10[Formula: see text]s datasets of the first derivative of ECG signal are analyzed to search the maximum value. Three process thresholds are computed using this maximum value, which is used to avoid the missed and false peak detections. Thus, a threshold is automatically calculated using these searched maximum values, and divide the differentiated ECG to obtain two intersection points. Recording the time of these two intersection points, a time interval is formed for the differentiated ECG. Delaying this time interval for specific sampling periods, a new time interval is acquired for the corresponding ECG cycle. Finally, the local maximum in an ECG cycle is narrowed down in this new time interval such that the R-peak can be located. The MIT-BIH Arrhythmia Database of 48 ECG recordings is used to verify the proposed algorithm. On this dataset, the proposed algorithm yielded mean sensitivity of 99.17%, positive predictivity of 97.37% and average time error of 1.01[Formula: see text]ms.

A novel adaptive window based technique for T wave detection and delineation in the ECG

Abstract The electrocardiogram (ECG) morphology determines the overall activity of the heart and is the most widely used tool in the diagnostic processes. T wave is a crucial wave component that reveals very useful information regarding various cardiac disorders. In this paper we have proposed a novel T wave detection technique based on adaptive window and simple decision rule. The proposed technique uses two-stage median filters followed by the Savitzky-Golay filter at the pre-processing stage to remove the noises in the ECG signal. The QRS complex is detected for locating the T wave as a reference in one ECG cycle. An R-R interval based window is considered for detecting the T wave, and decision logic depends on the iso-electric line value. The proposed technique is tested on the QT database and self-recorded dataset for its performance evaluation. In the present work, the results achieved for T wave detection sensitivity (Se), positive predictivity (+P), detection error rate (DER), and accuracy (Acc) on the QT database are Se = 97.57%, +P = 99.63%, DER = 2.78%, and Acc = 97.22% with an average time error of (3.468 ± 5.732) ms. The proposed technique shows Se = 99.94%, +P = 99.94%, DER = 0.01%, and Acc = 99.89% on the self-recorded dataset. The proposed technique is also capable of detecting both the upward and downward T wave efficiently in the ECG signal.

A lightweight piecewise linear synthesis method for standard 12-lead ECG signals based on adaptive region segmentation.

This paper presents a lightweight synthesis algorithm, named adaptive region segmentation based piecewise linear (ARSPL) algorithm, for reconstructing standard 12-lead electrocardiogram (ECG) signals from a 3-lead subset (I, II and V2). Such a lightweight algorithm is particularly suitable for healthcare mobile devices with limited resources for computing, communication and data storage. After detection of R-peaks, the ECGs are segmented by cardiac cycles. Each cycle is further divided into four regions according to different cardiac electrical activity stages. A personalized linear regression algorithm is then applied to these regions respectively for improved ECG synthesis. The proposed ARSPL method has been tested on 39 subjects randomly selected from the PTB diagnostic ECG database and achieved accurate synthesis of remaining leads with an average correlation coefficient of 0.947, an average root-mean-square error of 55.4μV, and an average runtime performance of 114ms. Overall, these results are significantly better than those of the common linear regression method, the back propagation (BP) neural network and the BP optimized using the genetic algorithm. We have also used the reconstructed ECG signals to evaluate the denivelation of ST segment, which is a potential symptom of intrinsic myocardial disease. After ARSPL, only 10.71% of the synthesized ECG cycles are with a ST-level synthesis error larger than 0.1mV, which is also better than those of the three above-mentioned methods.

The application of ECG cancellation in diaphragmatic electromyographic by using stationary wavelet transform.

In this paper, we present and investigate a special kind of stationary wavelet algorithm using "inverse" hard threshold to eliminate the electrocardiogram (ECG) interference included in diaphragmatic electromyographic (EMGdi). Differing from traditional wavelet hard threshold, "inverse" hard threshold is used to shrink strong coefficients of ECG interference and reserve weak coefficients of EMGdi signal. Meanwhile, a novel QRS location algorithm is proposed for the position detection of R wave by using low frequency coefficients in this paper. With the proposed method, raw EMGdi is decomposed by wavelet at fifth scale. Then, each ECG interference threshold is calculated by mean square, which is estimated by wavelet coefficients in the ECG cycle at each level. Finally, ECG interference wavelet coefficients are removed by "inverse" hard threshold, and then the de-noised signal is reconstructed by wavelet coefficients. The simulation and clinical EMGdi de-noising results show that the "inverse" hard threshold investigated in this paper removes the ECG interference in EMGdi availably and reserves its signal characteristics effectively, as compared to wavelet threshold.

Electrocardiogram-synchronized Rotational Speed Modulation System Can Reduce the Recirculation Due to Aortic Insufficiency in LVAD Support

Aortic Insufficiency (AI) is a worrisome problem in left ventricular assist device (LVAD) support. The reduced pressure in the left ventricle (LV) causes larger pressure difference on aortic valve, which can lead to increasing recirculation from LVAD to LV. We have previously developed Electrocardiogram(ECG)-Synchronized Rotational Speed Modulation System (ESRSM), which can change the rotational speed of LVAD synchronously to ECG cycle, thus enabling to change pump flow dynamically like pulsatile pump. We hypothesize that the enhance of the pulsatility can prevent the continuous larger pressure difference, resulting in reducing the LVAD-LV recirculation. The aim of this study was to reduce the recirculation by controlling the pressure difference using ESRSM in acute animal experiments.

On the Design of an Efficient Cardiac Health Monitoring System Through Combined Analysis of ECG and SCG Signals.

Cardiovascular disease (CVD) is a major public concern and socioeconomic problem across the globe. The popular high-end cardiac health monitoring systems such as magnetic resonance imaging (MRI), computerized tomography scan (CT scan), and echocardiography (Echo) are highly expensive and do not support long-term continuous monitoring of patients without disrupting their activities of daily living (ADL). In this paper, the continuous and non-invasive cardiac health monitoring using unobtrusive sensors is explored aiming to provide a feasible and low-cost alternative to foresee possible cardiac anomalies in an early stage. It is learned that cardiac health monitoring based on sole usage of electrocardiogram (ECG) signals may not provide powerful insights as ECG provides shallow information on various cardiac activities in the form of electrical impulses only. Hence, a novel low-cost, non-invasive seismocardiogram (SCG) signal along with ECG signals are jointly investigated for the robust cardiac health monitoring. For this purpose, the in-laboratory data collection model is designed for simultaneous acquisition of ECG and SCG signals followed by mechanisms for the automatic delineation of relevant feature points in acquired ECG and SCG signals. In addition, separate feature points based novel approach is adopted to distinguish between normal and abnormal morphology in each ECG and SCG cardiac cycle. Finally, a combined analysis of ECG and SCG is carried out by designing a Naïve Bayes conditional probability model. Experiments on Institutional Review Board (IRB) approved licensed ECG/SCG signals acquired from real subjects containing 12,000 cardiac cycles show that the proposed feature point delineation mechanisms and abnormal morphology detection methods consistently perform well and give promising results. In addition, experimental results show that the combined analysis of ECG and SCG signals provide more reliable cardiac health monitoring compared to the standalone use of ECG and SCG.

Multichannel electrocardiogram diagnostics for the diagnosis of arrhythmogenic right ventricular dysplasia.

The identification of arrhythmogenic right ventricular dysplasia (ARVD) from 12-channel standard electrocardiogram (ECG) is challenging. High density ECG data may identify lead locations and criteria with a higher sensitivity. Eighty-channel ECG recording from patients diagnosed with ARVD and controls were quantified by magnitude and integral measures of QRS and T waves and by a measure (the average silhouette width) of differences in the shapes of the normalized ECG cycles. The channels with the best separability between ARVD patients and controls were near the right ventricular wall, at the third intercostal space. These channels showed pronounced differences in P waves compared to controls as well as the expected differences in QRS and T waves. Multichannel recordings, as in body surface mapping, add little to the reliability of diagnosing ARVD from ECGs. However, repositioning ECG electrodes to a high anterior position can improve the identification of ECG variations in ARVD. Additionally, increased P wave amplitude appears to be associated with ARVD.

Realtime Detection of ECG Signal R-peaks Using a Lightweight RREADER Algorithm

The accurate identification of the R-peak of an electrocardiogram (ECG) cycle is the first step towards automated classification of the cycle. In this paper we present a lightweight algorithm, known as R-READER: a Rapid-Ramp Effective Algorithm for Detection of ECG R-peaks. It is based on an intuitive and effective identification of inflexion points in the ECG cycle through the calculation of adjacent slopes between the signals. It is compared with the Pan-Tompkins (P-T) algorithm a popular algorithm used for ECG QRS detection. We have used the best (#100) and worst (#108) cases in the MIT-BIH Arrhythmia Database for our analysis and had average accuracy, positive predictivity and sensitivity values of 97.79%, 98.23% and 99.54% for worst-case scenarios respectively when compared to values of 87.47%, 88.57% and 98.59% for the P-T algorithm, all only at a fraction of the latency and resource demands.