Electrocardiograph Monitoring System Research Articles

Feasibility of a T-Shirt-Type Wearable Electrocardiography Monitor for Detection of Covert Atrial Fibrillation in Young Healthy Adults

Covert atrial fibrillation (AF) accounts for cryptogenic stroke aetiology in elderly patients and in younger populations. However, asymptomatic AF is difficult to diagnose based on a short electrocardiography (ECG) recording. We evaluated the feasibility of a self-applied continuous ECG monitoring device that can record automatically, easily, and noninvasively in a younger population. We investigated community screening for asymptomatic AF using a wireless single-lead ECG with an electrode embedded in a T-shirt. One hundred men with a CHADS2 score ≥1 who were free from AF and <65 years of age were enrolled. We instructed the participants to wear ECG monitoring devices for at least 4 days/week over 2 months. The proportion of participants with newly detected AF (NDAF) and the monitoring time were evaluated. The mean CHADS2 score was 1.43 ± 0.62. The mean patient age was 52.5 ± 5.4 years. The mean monitoring time was 222 ± 199 hours. NDAF continuing for >30 seconds was detected in 10 participants (10.0%). AF continuing for >6 minutes was detected in 2 participants (2.0%). The T-shirt-type wearable ECG monitoring system was suitable for continuous, daily long-term use among young people with high physical activity, and it had the distinct capability of identifying covert AF.

A general framework for improving electrocardiography monitoring system with machine learning

As one of the most important health monitoring systems, electrocardiography (ECG) is used to obtain information about the structure and functions of the human heart for detecting and preventing cardiovascular disease. Given its important role, it is vital that the ECG monitoring system provides relevant and accurate information about the heart. Over the years, numerous attempts were made to design and develop more effective ECG monitoring system. Nonetheless, the literature reveals not only several limitations in conventional ECG monitoring system but also emphasizes on the need to adopt new technology such as machine learning to improve the monitoring system as well as its medical applications. This paper reviews previous works on machine learning to explain its key features, capabilities as well as presents a general framework for improving ECG monitoring system.

The Utililization Of Electrocardiograph (ECG) Monitoring System For Patient With Cardiovascular Disease Based On Community: A Literature Review

Introduction: Cardiovascular disease is one of diseases which the highest mortality rate in Indonesia, to solve that problem, patients with cardiovascular diseases should be monitored and controlled.Method: The design of this manuscript uses literature review. Data was retrieved from database research journal used in Science Direct, Proquest, SpringerLink and Wiley and internet searches Online in the period of 2012-2017. Analysis result from paper research was there were 13 journals.Results: Electrocardiogram in the community use wireless sensor, mobile and community platform used receiving, analysing, and transmitting data. The system will make easier to monitor the patient's condition for 24 hours and send data from remote and unlimited locations.Conclutions: This monitoring system can help to detect altered electrical cardiac signal, that will automatically send alarms to server accompanied by google maps to show patient’s location. This system makes nurses easy to change diet plans, cure, and the changes. This system is very flexible, easy to use, cheap, and confidentially ensure patient. This system using online system leads to decrease individual social contacts and allow for delay in data transmission process. This study show that the implementation system can develope to reduce mortality due to heart disease.

Internet of Things with Maximal Overlap Discrete Wavelet Transform for Remote Health Monitoring of Abnormal ECG Signals.

In this paper, MODWT is used to decompose the Electrocardiography (ECG) signals and to identify the changes of R waves in the noisy input ECG signal. The MODWT is used to handle the arbitrary changes in the input signal. The R wave's detctected by the proposed framework is used by the doctors and careholders to take necessary action for the patients. MATLAB simulink model is used to develop the simulation model for the MODWT method. The performance of the MODWT based remote health monitoring system method is comparatively analyzed with other ECG monitoring approaches such as Haar Wavelet Transformation (HWT) and Discrete Wavelet Transform (DWT). Sensitivity, specificity, and Receiver Operating Characteristic (ROC) curve are calculated to evaluate the proposed Internet of Things with MODWT based ECG monitoring system. We have used MIT-BIH Arrythmia Database to perform the experiments.

Study on Reusable Electrodes for Personal Electrocardiography

Electrodes are an important part of electrocardiography (ECG); disposable electrodes have been extensively used. However, personal ECG monitoring devices for Internet of Things applications require reusable electrodes. As there have been no systematic studies on the characteristics of reusable electrodes to date, we conducted this study to assess the performance and feasibility of electrodes with different materials. We built reusable electrodes using twelve different metallic materials, including commonly used copper, silver, zinc, plating materials, chemically inert titanium, stainless steel, and aluminum. Each electrode was fabricated to a size of 5 × 10 mm. Their characteristics such as offset, baseline drift, stabilization time, and chemical inertness were compared. A personal ECG monitoring system was used to test the manufactured electrodes. The performances of the Ag, Cu, and Zn electrodes were better than the performances of other electrodes. However, these materials may not be used owing to the chemical changes that occur when the electrodes are in contact with the skin, such as discoloration and corrosion, which deteriorate their electrical characteristics. Titanium, stainless steel, and aluminum are chemically stable. The titanium electrode showed the best performance among the three, and it is our recommendation as a material for manufacturing reusable electrodes.

The Design of Wireless Portable Electrocardiograph Monitoring System Based on ZigBee

The emerging trend in wireless hospitals requires the development of bio-signal acquisition devices to be easily integrated into a single clinical routine. The wired devices used in hospitals and clinics, which makes setup very inconvenient, costly, and difficult to manage patients. It is crucial to develop and design a clinical diagnostic system that takes bio-signal from the body of the patient and transmits wirelessly to the physicians/hospital. In this paper, we have designed a novel portable system for ECG signal acquisition, processing, and wireless transmission using a ZigBee module. Our portable design enhances mobility, small in size, and very cheap for long term monitoring of cardiac patients. The results show that the ECG wave successfully transmitted to the physician, and heartbeat values are visible to the patient. Furthermore, the results of the ECG wave are unclear when the position of electrodes is dislocated.

Real-time Evaluation of ECG Acquisition Systems through Signal Quality Assessment in Horses during Submaximal Treadmill Test.

This paper reports on a novel real time index designed to assess the quality of electrocardiographic (ECG) traces recorded in a group of five horses during a submaximal treadmill test procedure. During the experimental protocol two ECG monitoring systems were simultaneously applied to the animals. The first system was equipped with textile electrodes while the second one with standard red-dot electrodes. The procedure comprised four phases with an increased treadmill velocity, specifically, Walk 1, Trot 1, Trot 2 and Gallop. Three signal quality levels have been fixed according to the amount of noise present in the ECG trace: good (G), acceptable (A), and unacceptable (U). Moreover, a statistical comparison between textile and red-dot electrodes has been performed in terms of percentage of signal belonging to each class. Even if preliminary, results showed that in each experimental phase textile electrodes are more robust to movement artifacts with respect to the reddot showing a significant evidence of their better performance. These results enable to design robust wearable monitoring systems suitable to improve the quality of collected ECG, reducing the great amount of motion artifacts due to red-dot electrode application and leading to a more accurate diagnosis of high speed arrhythmias.

Design and Development of Intelligent Electrodes for Future Digital Health Monitoring: A Review

Electrodes are sensors used in electrocardiography (ECG) monitoring system to diagnose heart diseases. Over the years, diverse types of electrodes have been designed and developed to improve ECG monitoring system. However, more recently, with the technological advances and capabilities from the Internet of Things (IoT), cloud computing and data analytics in personalized healthcare, researchers are attempting to design and develop more effective as well as flexible ECG devices by using intelligent electrodes. This paper reviews previous works on electrodes used in electrocardiography (ECG) monitoring devices to identify the key ftures for designing and developing intelligent electrodes in digital health monitoring devices.

Noncontact Wearable Wireless ECG Systems for Long-Term Monitoring.

Electrocardiography (ECG) is the most common and extensively used vital sign monitoring method in modern healthcare systems. Different designs of ambulatory ECG systems were developed as alternatives to the commonly used 12-lead clinical ECG systems. These designs primarily focus on portability and user convenience, while maintaining signal integrity and lowering power consumption. Here, a wireless ECG monitoring system is developed using flexible and dry capacitive electrodes for long-term monitoring of cardiovascular health. Our capacitive-coupled dry electrodes can measure ECG signals over a textile-based interface material between the skin and electrodes. The electrodes are connected to a data acquisition system that receives the raw ECG signals from the electrodes and transmits the data using Bluetooth to a computer. A software application was developed to process, store, and display the ECG signal in real time. ECG measurements were obtained over different types of textile materials and in the presence of body movements. Our experimental results show that the performance of our ECG system is comparable to other reported ECG monitoring systems. In addition, to put this research into perspective, recent ambulatory ECG monitoring systems, ECG systems-on-chip, commercial ECG monitoring systems, and different state-of-the-art ECG systems are reviewed, compared, and critically discussed.

Development of Electrocardiograph Monitoring System

Electrocardiograph (ECG) monitoring system is one of the diagnostic tools which can help in reduce the risk of heart attack. A cardiologist may be able to determine heart condition from the ECG signal that recorded from subject. The purpose was to design an ECG monitoring system which consists of ECG circuit and digital signal processing system to deny the unwanted signal. In general, the ECG signal is nature weak and only around 1mV amplitude. Therefore filter and amplifier circuits were designed into 3 stages with a total gain of 1000 to bring the signal to around 1V. Circuit designed included of instrumentation amplifier, bandpass filter and notch filter. The frequency bandwidth of ECG is between 0.05Hz until 100Hz. Schematic circuit was tested by software simulation before proceeding to hardware implementation. Simulation analysis was done by using Software Proteus 8 Professional while the further signal processing was done in MATLAB software environment. A PQRST ECG waveform can be seen clearly after digital filtering stage in MATLAB environment. Digital signal processing in MATLAB software included of pre-filtering, Fast Fourier transform and peak detection. As conclusion, the time interval between peaks can be determined automatically which can provide useful information in clinical aspect.

Utility of duranta®, a wireless patch-type electrocardiographic monitoring system, for detecting atrial fibrillation in patients with cryptogenic stroke

Utility of duranta®, a wireless patch-type electrocardiographic monitoring system, for detecting atrial fibrillation in patients with cryptogenic stroke

Flexible Graphene Electrodes for Prolonged Dynamic ECG Monitoring.

This paper describes the development of a graphene-based dry flexible electrocardiography (ECG) electrode and a portable wireless ECG measurement system. First, graphene films on polyethylene terephthalate (PET) substrates and graphene paper were used to construct the ECG electrode. Then, a graphene textile was synthesized for the fabrication of a wearable ECG monitoring system. The structure and the electrical properties of the graphene electrodes were evaluated using Raman spectroscopy, scanning electron microscopy (SEM), and alternating current impedance spectroscopy. ECG signals were then collected from healthy subjects using the developed graphene electrode and portable measurement system. The results show that the graphene electrode was able to acquire the typical characteristics and features of human ECG signals with a high signal-to-noise (SNR) ratio in different states of motion. A week-long continuous wearability test showed no degradation in the ECG signal quality over time. The graphene-based flexible electrode demonstrates comfortability, good biocompatibility, and high electrophysiological detection sensitivity. The graphene electrode also combines the potential for use in long-term wearable dynamic cardiac activity monitoring systems with convenience and comfort for use in home health care of elderly and high-risk adults.

English

English

A Wearable System for the Evaluation of the Human-Horse Interaction: A Preliminary Study

This study reports on a preliminary estimation of the human-horse interaction through the analysis of the heart rate variability (HRV) in both human and animal by using the dynamic time warping (DTW) algorithm. Here, we present a wearable system for HRV monitoring in horses. Specifically, we first present a validation of a wearable electrocardiographic (ECG) monitoring system for horses in terms of comfort and robustness, then we introduce a preliminary objective estimation of the human-horse interaction. The performance of the proposed wearable system for horses was compared with a standard system in terms of movement artifact (MA) percentage. Seven healthy horses were monitored without any movement constraints. As a result, the lower amount of MA% of the wearable system suggests that it could be profitably used for reliable measurement of physiological parameters related to the autonomic nervous system (ANS) activity in horses, such as the HRV. Human-horse interaction estimation was achieved through the analysis of their HRV time series. Specifically, DTW was applied to estimate dynamic coupling between human and horse in a group of fourteen human subjects and one horse. Moreover, a support vector machine (SVM) classifier was able to recognize the three classes of interaction with an accuracy greater than 78%. Preliminary significant results showed the discrimination of three distinct real human-animal interaction levels. These results open the measurement and characterization of the already empirically-proven relationship between human and horse.

Electrocardiographic characteristics of significant factors of detected atrial fibrillation using WEMS

The wireless electrocardiographic monitoring system(WDMS) is designed to be long term monitoring for the early detection of cardiac disorders. The current version of the WDMS can identify two types of cardiac rhythms in real-time, such as atrial fibrillation(AF) and normal sinus rhythm(NSR), which are very important to track cardiac-rhythm disorders. In this study, we proposed the analysis method to discriminate the characteristics statistically evaluated in both time and frequency domains between AF and NSR using various parameters in the heart rate variability(HRV). And we applied various ECG detection methods (e.g., difference operation method) and compared the results with those of the discrete wavelet transform(DWT) method. From the statistically results, we found that the parameters such as STD RR, STD HR, RMSSD, NN50, pNN50, RR Trian, and TNN(p<0.05) are significantly different between the AF and NSR patients in time domain. On the other hand, the frequency domain analysis results showed a significant difference in VLF power(<TEX>$ms^2$</TEX>), LF power(<TEX>$ms^2$</TEX>), HF power(<TEX>$ms^2$</TEX>), VLF(%), LF(%), and HF(%). In particular, the parameters such as STD RR, RMSSD, NN50, pNN50, VLF power, LF power and HF power were considered as the most useful parameters in both AF and NSR patient groups. Our proposed method can be efficiently applied to early detection of abnormal conditions and prevent the such abnormals from becoming serious.

Abstract 16305: Incidence and Timing of High-Risk Arrhythmias With Long-Term Continuous Ambulatory Electrocardiographic Monitoring

Background: Ambulatory electrocardiographic (ECG) monitoring is the standard of care to screen patients for arrhythmias. However, there is marked variation in the technological features and patient adherence among different ECG monitoring systems. We evaluated a novel adhesive, wireless, single-lead, full-disclosure, up to 14-day ECG monitoring system to measure the burden and timing of high-risk arrhythmias. Methods: We examined data from 122,815 long term continuous ambulatory ECG Monitors. (ZIO® Patch Service, iRhythm Technologies, San Francisco, CA) from 2011-2013 and categorized high-risk arrhythmias into two types: (1) ventricular arrhythmias including non-sustained and sustained ventricular tachycardia and (2) high risk bradyarrhythmias including sinus pauses &gt;3 seconds, atrial fibrillation pauses &gt;5 seconds, and high grade heart block including Mobitz Type II or third-degree heart block. We calculated the proportion of patients with each arrhythmia and the elapsed wear time until each arrhythmia. Results: Of 122,815 Ziopatch recordings, median wear time was 9.9 (IQR 6.8-13.8) days and median analyzable time was 9.1 (IQR 6.4-13.1) days. There were 22,443 (18.3%) with at least one episode of non-sustained ventricular tachycardia (NSVT), 238 (0.2%) with sustained VT, 1,766 (1.4%) with a sinus pause &gt;3 seconds (SP), 520 (0.4%) with a pause during atrial fibrillation &gt;5 seconds (AFP), and 1,486 (1.2%) with high-grade heart block. Median time to first arrhythmia was 74 hours (IQR 26 -149 hours) for NSVT, 22 hours (IQR 5-73 hours) for sustained VT, 22 hours (IQR 7-64 hours) for SP, 31 hours (IQR 11-82 hours) for AFP, and 40 hours (SD 10-118 hours) for high-grade heart block. The yield over time is shown in the Figure 1. Conclusions: A significant percentage of high-risk arrhythmias can be identified by long term continuous monitoring for longer than 24 to 48 hours. The clinical impact from better identification of high-risk arrhythmias warrants further study.

Clinical value of remote electrocardiogram monitoring in patients with acute ST-segment elevation myocardial infarction

Objective To investigate the reliability of electrocardiographic (ECG) signal for the accurate assessment of myocardial ischemia in order to evaluate the clinical value of remote real-time ECG monitoring system based on GPRS in patients with acute ST-elevation myocardial infarction (STEMI).Methods A total of 60 STEMI patients admitted between April 2008 and December 2010 were enrolled.All subjects were given the remote real-time ECG monitoring and routine 12 leads ECG monitoring at the same time.They were divided into remote ECG group and the 12 leads ECG group.The remote real-time ECG monitoring collects electrocardiosignal to imitate V1,V3,V5 lead and Ⅰ lead.P wave duration,PR interval,duration of time limit of QRS wave and T wave,QT interval,and the P wave amplitude,QRS wave amplitude,R-(Q + S),T wave amplitude were measured,and the detectability rate of arrhythmia and the definited diagnosis rate of ST segment elevation in accordance with clinical manifestion were compared in each group with different parameters.The data were analyzed by t test,rank sum test,Pearson correlation analysis,Spearman's rank correlation and the chi-square test.Results In STEMI patients,there were no statistical differences in time limits and amplitude of waves on ECG between the two groups (P ＞ 0.05),and the correlations between parameters of two groups were found to be close (P ＜ 0.01).There was no difference in the detectability rate of cardiac arrhythmia between two groups (P ＞ 0.05),and no difference in the rate of correct diagnosis of elevated ST segment between two groups (P ＞ 0.05),except V1 lead (P ＜ 0.05).Conclusions The sensitivity of the change in ST segment of the two groups is similar,and the remote real-time ECG monitoring can help determine the location of myocardial ischemia. Key words: Remote monitoring; Tele-ECG; Mobile ECG; Acute ST-elevation myocardial infarction

Design of Data Management System for Remote ECG Monitoring

This paper presents a design schema about remote electrocardiograph (ECG) monitoring system. There are three parts in this system which include hardware detection system based on MSP430, Zigbee wireless sensor network and data management software system on PC. This paper mainly provides information for study and design of the data management software system using visual C++ program to realize immediate communication of medical monitoring. The data management software system will achieve many functions such as serial communication, real-time dynamic display of 12-lead ECG waveform and physiological parameter which include Heart Rate (HR).

유비쿼터스 환경 하의 실시간 심전도 신호 모니터링

In this paper, we present a method of transmitting ECG signals in real-time mobile environment to be possible to implement the ubiquitous healthcare system. Because of the excessive amount of data transmission of ECG signals, it is necessary to propose a limitation to the real-time transmission. We propose a real-time electrocardiographic monitoring system based on the proposal of unusual waveform detection algorithm which detects the R-wave distortions from the arrhythmia ECG signals having unusual waveform of about 10% on average. It is very effective in terms of time and cost for medical staffs to monitor and analyze ECG signals for a long period of time. Monitoring unusual waveform by gradually adjusting the threshold values of potential and kurtosis makes the amount of data transmitted decrease and significance level of waveform to be enhanced. The unusual waveform detection algorithm is implemented with ubiquitous environment inter-working device client. It is applicable to ubiquitous healthcare system capable of real-time monitoring the ECG signal. While ensuring the mobility, it allows for real-time continuous monitoring of ECG signals.

A Feasibility Study Scheme of an Android-based Integrated Wearable ECG Monitoring System

Ubiquitous healthcare system is becoming essential in the attempt to improve healthcare delivery. Not only it is able to facilitate two-way communication between physician and patient, but it is also useful for the caregivers to maximize efficiency in running daily activities. Managing ischemia heart disease, one of the deadly diseases, would definitely benefit from such ubiquitous healthcare system. The current treatment method for ischemia requires patients to be physically present at their respective treatment centres for regular monitoring. This increases the need for remote monitoring method, due to the urgent nature of treating ischemia heart attack. Therefore, this paper presents preliminary system architecture and feasibility study of HeartPals, a low-cost Android-based integrated wearable electrocardiography (ECG) monitoring system that enables ischemia patients to be remotely monitored by their physicians. We also propose TOFUSER, a Technology-Oriented Feasibility stUdy Scheme for End-useRs as an extended feasibility study scheme to allow users to verify the preliminary requirements of the technology and users’ requirements of HeartPals.