QRS Detection Algorithm Research Articles

A new QRS detector stress test combining temporal jitter and F-score (JF) reveals significant performance differences amongst popular detectors.

QRS detection within an electrocardiogram (ECG) is the basis of virtually any further processing and any error caused by this detection will propagate to further processing stages. However, standard benchmarking procedures of QRS detectors are seriously flawed because they report almost always close to 100% accuracy for any QRS detection algorithm. This is due to the use of large temporal error margins and noise-free ECG databases which grossly overestimate their performance. The use of a large fixed error margin masks temporal jitter between detection and ground truth measurements. Here, we present a new performance measure (JF) which combines temporal jitter with the F-score, and also an ECG database with decreasing levels of signal to noise ratios based on noise generated from different tasks. Our new performance measure JF fully encompasses all the types of errors that can occur, equally weights them and provides a percentage value which allows direct comparison between QRS detection algorithms. In combination with the new noisy ECG database, the JF performance measure now varies between 50% and 100% for different detectors and signal to noise conditions thereby making it possible to find the best detector for an application.

Power-MF: robust fetal QRS detection from non-invasive fetal electrocardiogram recordings

Objective. Perinatal asphyxia poses a significant risk to neonatal health, necessitating accurate fetal heart rate monitoring for effective detection and management. The current gold standard, cardiotocography, has inherent limitations, highlighting the need for alternative approaches. The emerging technology of non-invasive fetal electrocardiography shows promise as a new sensing technology for fetal cardiac activity, offering potential advancements in the detection and management of perinatal asphyxia. Although algorithms for fetal QRS detection have been developed in the past, only a few of them demonstrate accurate performance in the presence of noise and artifacts. Approach. In this work, we propose Power-MF, a new algorithm for fetal QRS detection combining power spectral density and matched filter techniques. We benchmark Power-MF against three open-source algorithms on two recently published datasets (Abdominal and Direct Fetal ECG Database: ADFECG, subsets B1 Pregnancy and B2 Labour; Non-invasive Multimodal Foetal ECG-Doppler Dataset for Antenatal Cardiology Research: NInFEA). Main results. Our results show that Power-MF outperforms state-of-the-art algorithms on ADFECG (B1 Pregnancy: 99.5% ± 0.5% F1-score, B2 Labour: 98.0% ± 3.0% F1-score) and on NInFEA in three of six electrode configurations by being more robust against noise. Significance. Through this work, we contribute to improving the accuracy and reliability of fetal cardiac monitoring, an essential step toward early detection of perinatal asphyxia with the long-term goal of reducing costs and making prenatal care more accessible.

QRS Detector Performance Evaluation Aware of Temporal Accuracy and Presence of Noise.

Algorithms for QRS detection are fundamental in the ECG interpretive processing chain. They must meet several challenges, such as high reliability, high temporal accuracy, high immunity to noise, and low computational complexity. Unfortunately, the accuracy expressed by missed or redundant events statistics is often the only parameter used to evaluate the detector's performance. In this paper, we first notice that statistics of true positive detections rely on researchers' arbitrary selection of time tolerance between QRS detector output and the database reference. Next, we propose a multidimensional algorithm evaluation method and present its use on four example QRS detectors. The dimensions are (a) influence of detection temporal tolerance, tested for values between 8.33 and 164 ms; (b) noise immunity, tested with an ECG signal with an added muscular noise pattern and signal-to-noise ratio to the effect of "no added noise", 15, 7, 3 dB; and (c) influence of QRS morphology, tested on the six most frequently represented morphology types in the MIT-BIH Arrhythmia Database. The multidimensional evaluation, as proposed in this paper, allows an in-depth comparison of QRS detection algorithms removing the limitations of existing one-dimensional methods. The method enables the assessment of the QRS detection algorithms according to the medical device application area and corresponding requirements of temporal accuracy, immunity to noise, and QRS morphology types. The analysis shows also that, for some algorithms, adding muscular noise to the ECG signal improves algorithm accuracy results.

QRS Detection Based on Discrete Wavelet Transform for ECG Signal with Motion Artifacts

Motion artifacts in ECG signals recorded during physical exercises activities can affect the diagnosis of arrhythmia. To minimize the faults in arrhythmia detection, it was important to choose accurate algorithm for detecting QRS in ECG signal with noises produced during physical movements of the patients. Therefore, choosing the QRS detection algorithm with good competency for the signal affected by noises and motion artifacts is needed for arrhythmia detection analysis. The QRS detection based on Discrete Wavelet Transform was implemented and presented in this paper. The performance of the algorithm was assessed using the MIT-BIH Arrhythmia Database and MIT-BIH Noise Stress Database. For the MIT-BIH Arrhythmia database, the average Sensitivity (Se) and positive Predictivity (+P) of the algorithm were 98.24% and 98.61%, respectively. The algorithms had a lower average false negative rate (FNR) than the pan Tompkins algorithm when applied to the MIT-BIH noise stress test database, which was 0.033% for record 118 and 0.032% for record 119, respectively. The results demonstrated that the algorithms perform well when dealing with arrhythmia data and motion artifact at various levels of signal to noise ratio.

Clinical Evaluation of the ECG Noise Extraction Tool as a Component of ECG Analysis Algorithms Evaluation.

The aim of this work is to demonstrate the performance of the ECG noise extraction tool (ECGNExT) which provides estimates of ECG noise that are not significantly different from the inherent noise in an ECG generated by motion artifacts and other sources. In addition, this paper elaborates on use of ECGNExT in an algorithm evaluation context comparing two QRS detection algorithms. 140 simultaneous pairs of clean ECGs and ECGs corrupted with motion-induced noise from 29 participants under five different and separate motion conditions were collected and analyzed. Estimates of the noise component of the ECGs recorded with noise were obtained using ECGNExT and were then added to the clean ECGs yielding estimated ECGs with noise. Root mean squared error (RMSE) between the recorded and estimated ECGs with noise was calculated for temporal comparison, and band powers of the signals were calculated for spectral comparison. A t-test revealed that the mean RMSE < 150-microvolts with p-value < 0.001 and, and equivalence tests showed that the band powers of the two ECGs were statistically equivalent with . ECGNExT can reliably estimate the underlying ECG noise while preserving temporal and spectral features. We previously proposed ECGNExT as a component of ECG analysis algorithm testing during noise conditions and reported its performance based on simulated ECG data. This work provides additional support of the performance and functionality of the ECGNExT algorithm from a study with pairs of simultaneously recorded ECGs with and without noise from human subjects.

Noise reduction and QRS detection in ECG signal using EEMD with modified sigmoid thresholding.

Novel noise reduction and QRS detection algorithms in Electrocardiogram (ECG) signal based on Empirical Mode Decomposition (EMD), Ensemble Empirical Mode Decomposition (EEMD) and the Modified Sigmoid Thresholding Function (MSTF) are proposed in this paper. EMD and EEMD algorithms are used to decompose the noisy ECG signal into series of Intrinsic Mode Functions (IMFs). Then, these IMFs are thresholded by the MSTF for reduction of noises and preservation of QRS complexes. After that, the thresholded IMFs are used to obtain the clean ECG signal. The characteristic points P, Q, R, S and T peaks are detected using peak detection algorithm. The proposed methods are validated through experiments on the MIT-BIH arrhythmia database and Additive White Gaussian Noise (AWGN) is added to the clean ECG signal at different input SNR (SNR in). Standard performance parameters output SNR (SNR out), mean square error (MSE), root mean square error (RMSE), SNR improvement (SNR imp) and percentage root mean square difference (PRD) are employed for evaluation of the efficacy of the proposed methods. The results showed that the proposed methods provide significant quantitative and qualitative improvements in denoising performance, compared with existing state-of-the-art methods such as wavelet denoising, conventional EMD (EMD-Conv), conventional EEMD (EEMD-Conv, Stockwell Transform (ST) and Complete EEMD with Adaptative Noise with hybrid interval thresholding and higher order statistic to select relevant modes (CEEMDAN-HIT). A detail quantitative analysis demonstrate that for abnormal ECG records 207 m and 214 m at input SNR of-2 dB the SNR imp value is 12.22 and 11.58 dB respectively, which indicates that the proposed algorithm can be used as an effective tool for denoising of ECG signals.

Domain Agnostic Post-Processing for QRS Detection Using Recurrent Neural Network.

Deep-learning-based QRS-detection algorithms often require essential post-processing to refine the output prediction-stream for R-peak localisation. The post-processing involves basic signal-processing tasks including the removal of random noise in the model's prediction stream using a basic Salt and Pepper filter, as well as, tasks that use domain-specific thresholds, including a minimum QRS size, and a minimum or maximum R-R distance. These thresholds were found to vary among QRS-detection studies and empirically determined for the target dataset, which may have implications if the target dataset differs such as the drop of performance in unknown test datasets. Moreover, these studies, in general, fail to identify the relative strengths of deep-learning models and the post-processing to weigh them appropriately. This study identifies the domain-specific post-processing, as found in the QRS-detection literature, as three steps based on the required domain knowledge. It was found that the use of minimal domain-specific post-processing is often sufficient for most of the cases and the use of additional domain-specific refinement ensures superior performance, however, it makes the process biased towards the training data and lacks generalisability. As a remedy, a domain-agnostic automated post-processing is introduced where a separate recurrent neural network (RNN)-based model learns required post-processing from the output generated from a QRS-segmenting deep learning model, which is, to the best of our knowledge, the first of its kind. The RNN-based post-processing shows superiority over the domain-specific post-processing for most of the cases (with shallow variants of the QRS-segmenting model and datasets like TWADB) and lags behind for others but with a small margin ( ≤ 2%). The consistency of the RNN-based post-processor is an important characteristic which can be utilised in designing a stable and domain agnostic QRS detector.

A Comprehensive Comparison of Six Publicly Available Algorithms for Localization of QRS Complex on Electrocardiograph.

The QRS complex is the most prominent feature of the electrocardiogram (ECG) that is used as a marker to identify the cardiac cycles. Identification of QRS complex locations enables arrhythmia detection and heart rate variability estimation. Therefore, accurate and consistent localization of the QRS complex is an important component of automated ECG analysis which is necessary for the early detection of cardiovascular diseases. This study evaluates the performance of six popular publicly available QRS complex detection methods on a large dataset of over half a million ECGs in a diverse population of patients. We found that a deep-learning method that won first place in the 2019 Chinese physiological challenge (CPSC-1) outperforms the remaining five QRS complex detection methods with an F1 score of 98.8% and an absolute sdRR error of 5.5 ms. We also examined the stratified performance of the studied methods on various cardiac conditions. All six methods had a lower performance in the detection of QRS complexes in ECG signals of patients with pacemakers, complete atrioventricular block, or indeterminate cardiac axis. We also concluded that, in the presence of different cardiac conditions, CPSC-1 is more robust than Pan-Tompkins which is the most popular model for QRS complex detection. We expect that this study can potentially serve as a guide for researchers on the appropriate QRS detection method for their target applications.Clinical Relevance-This study highlights the overall performance of publicly available QRS detection algorithms in a large dataset of diverse patients. We showed that there are specific cardiac conditions that are associated with the poor performance of QRS detection algorithms and may adversely influence the performance of algorithms that rely on accurate and reliable QRS detection.

Patient specific higher order tensor based approach for the detection and localization of myocardial infarction using 12-lead ECG

Myocardial Infarction (MI) is an emergency condition that requires immediate medical treatment. The rapid and accurate diagnosis of MI using a 12-lead electrocardiogram (ECG) is extremely important in a clinical study to save the patient’s life. The manual interpretation of MI using a 12-lead ECG is tedious and time-consuming. Therefore, a patient-specific software-based computer-aided diagnosis framework is helpful to detect and localize MI disease accurately. This paper proposes a patient-specific higher-order tensor-based approach to detect and localize MI automatically using 12-lead ECG recordings. The 12-lead ECG recordings are segmented into 12-lead ECG beats using the multi-lead fusion-based QRS detection algorithm. The fast and adaptive multivariate empirical mode decomposition (FA-MVEMD) based multiscale analysis method decomposes 12-lead ECG beat into a third-order tensor containing the information from the samples, beat, and intrinsic mode functions (IMFs). Furthermore, a fourth-order tensor is formulated by considering beats, samples, lead, and IMFs information of 12-lead ECG recording. The multilinear singular value decomposition (MLSVD) extracts features from the fourth-order tensors and third-order tensors of 12-lead ECG. The K-nearest neighbor (KNN), support vector machine (SVM), and stacked autoencoder-based deep neural network (SAE-DNN) models are used for the detection and localization of MI using fourth-order and third-order tensor domain features. The proposed approach is evaluated using 73 healthy control (HC) and 100 different types of MI-based 12-lead ECG recordings from a public database. The proposed approach has obtained the classification accuracy values of (98.84%, 98.27%, 98.27%) and (86.64%, 83.17%, and 81.98%) using (KNN, SVM, and SAE-DNN) models for MI detection, and localization, respectively using 30-min duration of 12-lead ECG recordings. For MI detection and localization, the suggested approach has obtained accuracy values of 96.53% and 93.32%, respectively, using the 4-s duration of 12-lead ECG recordings. Our approach outperformed existing MI detection and localization methods using 12-lead ECG recordings regarding classification performance.

Algorithm for Mobile Platform-Based Real-Time QRS Detection.

Recent advancements in smart, wearable technologies have allowed the detection of various medical conditions. In particular, continuous collection and real-time analysis of electrocardiogram data have enabled the early identification of pathologic cardiac rhythms. Various algorithms to assess cardiac rhythms have been developed, but these utilize excessive computational power. Therefore, adoption to mobile platforms requires more computationally efficient algorithms that do not sacrifice correctness. This study presents a modified QRS detection algorithm, the AccYouRate Modified Pan-Tompkins (AMPT), which is a simplified version of the well-established Pan-Tompkins algorithm. Using archived ECG data from a variety of publicly available datasets, relative to the Pan-Tompkins, the AMPT algorithm demonstrated improved computational efficiency by 5-20×, while also universally enhancing correctness, both of which favor translation to a mobile platform for continuous, real-time QRS detection.

Adaptif eşik temelli az karmaşık QRS algılama algoritması

In this study, a QRS detection algorithm with a low processing load based on time-domain thresholding is proposed. The ECG signal is filtered only with a low pass filter to reduce the computational load. After the filtering, derivation and squaring are also performed. In the Thresholding stage, a linear decreasing threshold voltage method using addition operation instead of multiplication is proposed. Simulations on MIT-BIT Arrhythmia Database have yielded 99.2925% sensitivity (% Se) and 99.6759% positive predictivity (+ P). The proposed algorithm is compared with two similar algorithms in terms of both performance and processing load. It is shown that the proposed algorithm is better than its counterparts, especially in terms of processing load. However, it is observed that it gave worse results in terms of Sensitivity (% Se).

Robust QRS complex detection in noisy electrocardiogram based on underdamped periodic stochastic resonance

&lt;abstract&gt; &lt;p&gt;Robust QRS detection is crucial for accurate diagnosis and monitoring of cardiovascular diseases. During the detection process, various types of noise and artifacts in the electrocardiogram (ECG) can degrade the accuracy of algorithm. Previous QRS detectors have employed various filtering methods to minimize the negative impact of noise. However, their performance still significantly deteriorates in large-noise environments. To further enhance the robustness of QRS detectors on noisy electrocardiograms (ECGs), we proposed a QRS detection algorithm based on an underdamped. This method utilizes the period nonlinearity-induced stochastic resonance to enhance QRS complexes while suppressing noise and non-QRS components in the ECG. In contrast to neural network-based algorithms, our proposed algorithm does not rely on large datasets or prior knowledge. Through testing on three widely used ECG datasets, we demonstrated that the proposed algorithm achieves state-of-the-art detection performance. Furthermore, compared to traditional stochastic resonance-based method, our algorithm has increased noise robustness by 25% to 100% across various real-world environments. This enables the proposed method to maintain its optimal performance within a certain range even in the presence of additional injected noise, thus providing an excellent approach for robust QRS detection in noisy ECGs.&lt;/p&gt; &lt;/abstract&gt;

Novel QRS detection based on the Adaptive Improved Permutation Entropy

Detection of the QRS complex is the most important step in analyzing ECG signals for heart monitoring and diagnosis. There have been several QRS-peak detection methods reported in the literature. Most of these methods have low performance under noisy conditions. In this paper, we propose a novel QRS detection algorithm based on a new Permutation Entropy (PE) method that we developed and referred to as the Adaptive Improved Permutation Entropy (AIPE) method. The parameters of the AIPE method are determined based on the specific signal properties. Implementing the AIPE method leads to prominently preserving the QRS complex and eliminating noises of the ECG signal without smoothing the ECG signal. Our simulations show that the proposed QRS detection algorithm is effective and robust under noisy conditions. The algorithm is validated on the MIT-BIH Noise Stress Test Database for various SNR values. In addition, we examined the algorithm’s performance under motion noise conditions, mimicking a practical scenario. We used the metrics of sensitivity, positive predictive, and F1 score to evaluate the performance of our algorithm and compare it with several other algorithms explained in the literature. Our investigation shows that the proposed algorithm is efficient and effective. More importantly, it is robust under noisy conditions providing superior performance over other recent and popular QRS detection algorithms, including the popular Pan–Tompkins and the recent Advanced Adaptive Multilevel Thresholding (AAMT) algorithms.

QRS complex detection using stationary wavelet transform and adaptive thresholding

Purpose. Electrocardiogram (ECG) signal is a record of the electrical activity of the heart and contains important clinical data about cardiovascular-related misfunctioning. The goal of the present work is to develop an improved QRS detection algorithm for the detection of heart abnormalities. Methods. In this present work stationary wavelet transforms (SWT) based method has been proposed for precise detection of QRS complex with ‘sym2’ mother wavelet. The stationary wavelet transform is a systematic mathematical tool to decompose the signal without downsampling using scale analysis and provides high detection of QRS complex and accurate localization of signal components. In the proposed method four level of decomposition is applied and the initial thresholding value is computed by the maximum amplitude of scale one at level four in SWT coefficients without the zero-crossing amplitude detection method. The multi-layered dynamic thresholding method has been applied to detect the true R-peak values and locate the QRS complex in the ECG signal. Results. For evaluation of results, the presented methodology is assessed on MIT-BIH, QTDB, and Noise stress test databases. In MIT-BIH, the sensitivity = 99.88%, positive predictivity = 99.93%, accuracy = 99.80% and detection error rate = 0.18% is achieved. In NSTD database, sensitivity = 97.46%, positive predictivity = 94.20%, accuracy = 91.95% and detection error rate = 8.47% and in QTDB, sensitivity = 99.95%, positive predictivity = 99.90%, accuracy = 99.71% and detection error rate = 0.16% is executed. Conclusion. In the presented proposed methodology, the computation complexity is low and exhibits a simple technique rather than an empirical approach. The proposed technique corroborates the performance for the detection of QRS complex with improved accuracy.

Implementation of Optimized Low Pass Filter for ECG filtering using Verilog

Electrocardiogram is a standard method used for the diagnosis of heart related disease. QRS complex plays an important role in Electrocardiogram signal processing since it is the prominent feature of Electrocardiogram signal. One of the important modules in the QRS detection algorithm is filtering. Electrocardiogram signal is processed to filter out unwanted signal through digital filtering. The main objective of this paper is to compare the resource utilization of hardware realization consumed between Direct Form I structure and Direct Form II structure. In this work, Infinite Impulse Response low pass filter to remove high frequency noise is designed with a passband frequency and stopband frequency of 5 and 25 Hz respectively. The designed filter is verified using Matlab Filter Design Analysis tool and realized in hardware using Verilog. Both the results show that the unwanted signals in the raw ECG signal are attenuated through the designed filter. The resource utilization result shows improvement with optimized Direct Form II implementation. The amount of look up tables, flip flop and digital signal processing used with Direct Form II structure shows a reduction to 0.26%, 0.12% and 2.50% respectively compared to 1.17%, 0.20%, 2.92% of utilization with Direct Form I structure.

QRS Detection in Electrocardiogram Signal of Exercise Physical Activity

Accurate estimation of heart beats from electrocardiogram (ECG) signals during exercise activity is a very challenging problem. Unlike standard ECG, the signals recorded during exercise activity can affect the accuracy of QRS detection due to the noises and artifacts arise from body movements activity. However, most of the studies on QRS detection often used clean and standard data for the evaluations and assumed to reflect the overall performance of detectors. In addition, there are not many methods that evaluated using real ECG signal in their studies especially during the exercise activity. Therefore, this study was undertaken to access and evaluated the performance of QRS detection algorithms on the real ECG signal data. Three well-known QRS detection algorithms were re-implemented in this study. The ECG signal recorded under realistic movement conditions and can serving as a realistic data to assess the performance of QRS detection is used. The performance of the algorithm in real ECG signal data in sitting, walking, and jogging was then presented. The results show the algorithms capable to detect the QRS in ECG signal of exercise activity.

A Stochastic Resonance Electrocardiogram Enhancement Algorithm for Robust QRS Detection.

This study presents a new QRS detection algorithm making use of the background noise that is inevitably present in electrocardiogram (ECG) recordings. The algorithm suppresses noise, enhances the QRS-waves, and applies a threshold for QRS detection. Noise suppression and QRS enhancement are performed by a band-pass filter stage followed by a nonlinear stage based on the interaction of a particle inside an underdamped monostable potential well. The nonlinear stage maximizes the output when there is a QRS-wave and minimizes the output otherwise. One of the instruments that the nonlinear stage uses to enhance the QRS-waves is stochastic resonance, where the output is maximized for a non-zero intensity background noise. In terms of QRS-wave detection F1 score, which ranges from 98.87% to 99.99% on four major benchmarking databases (MIT-BIH Arrhythmia, QT, European ST-T, and MIT-BIH Noise Stress Test), the algorithm outperforms all existing ECG processing algorithms. The study, for the first time, demonstrates QRS-enhancement by facilitating stochastic resonance while suppressing in-band noise of ECG signals. Detecting QRS-waves as the ECG data streams, having a complexity of O(n), and not requiring any training data make the algorithm convenient for real-time ECG monitoring applications with limited computational resources.

Embedded QRS complex detection based on ECG signal strength and trend

Cardiovascular diseases (CVD) are among the most fatal diseases and its mitigation is a huge challenge in healthcare. Electrocardiography (ECG) remains the most commonly used method and device for the visualization and analysis cardiac rhythm. QRS complex detection has been extensively used for this purpose. Recently, several PC based QRS detection algorithms were proposed wherein the QRS complex is detected from previously stored ECG signals. However, with the expansion of personalized medicine backed by advances in the field of wearable medical devices, it is imperative to have an algorithm that is robust, accurate, real-time, and computationally efficient for low resource microcontroller units (MCU). In this paper, a novel embedded QRS complex detection algorithm based on the ECG signal strength and its trend is presented. The algorithm is based on a simulated capacitor threshold that captures the signal strength two other thresholds based on the signal trend to find the position of the R-peak. Subsequently, the location of the end of the R-peak and the tangent to the ECG curve are used to find the onset of the QRS complex. The algorithm obtained average F1 scores of 99.75%, 99.84%, 97.39%, and 86.63% on the MIT-BIH Arrhythmia, MIT-BIH Normal Sinus, the MIT-BIH Noise Stress Test, and the 2014 PhysioNet/CinC Challenge databases respectively. Average run-times for the processing of a single data point were 3.38μs, and 383μs when the algorithm was running respectively on an ESP32-WROOM-32 MCU @240MHz and an Arduino Nano MCU @16MHz. This algorithm has a great potential in the field of wearable medical devices and remote monitoring systems.

Verification and comparison of MIT-BIH arrhythmia database based on number of beats

&lt;span lang="EN-US"&gt;The ECG signal processing methods are tested and evaluated based on many databases. The most ECG database used for many researchers is the MIT-BIH arrhythmia database. The QRS-detection algorithms are essential for ECG analyses to detect the beats for the ECG signal. There is no standard number of beats for this database that are used from numerous researches. Different beat numbers are calculated for the researchers depending on the difference in understanding the annotation file. In this paper, the beat numbers for existing methods are studied and compared to find the correct beat number that should be used. We propose a simple function to standardize the beats number for any ECG PhysioNet database to improve the waveform database toolbox (WFDB) for the MATLAB program. This function is based on the annotation's description from the databases and can be added to the Toolbox. The function is removed the non-beats annotation without any errors. The results show a high percentage of 71% from the reviewed methods used an incorrect number of beats for this database.&lt;/span&gt;

A novel adaptive multilevel thresholding based algorithm for QRS detection

The heart is the single most important organ of the human body. By studying the ECG signal any abnormalities in the heart’s tempo can be identified. The QRS complex is the most prominent feature of an ECG signal. However, the detection of this feature is hampered by the presence of high and low-frequency noises in the ECG signal and abrupt changes in the signal’s morphology. This paper presents a new method of QRS detection using advanced adaptive multilevel thresholding (AAMT) with selective statistical false peak elimination (SSFPE). Firstly, a band-pass filter is used to filter out most of the unwanted noise and interference to aid the detection operation. Then, AAMT is applied to the entire ECG record to find the location and amplitudes of the pseudo peaks. Next, SSFPE is employed to eliminate false peaks resulting from electromyogram (EMG) and any other high-frequency noise that has not been eliminated in the filtering stage. Finally, after most of the peaks are correctly identified a search back stage is included to find any low amplitude true peaks that might have been missed in the peak detection stage. The proposed method is tested on the MIT-BIH arrhythmia and Fantasia databases and shows high accuracy in detection compared to many state-of-the-art QRS detection methods. The method yields high sensitivity, positive predictivity, and a low detection error rate of 99.85%, 99.91%, and 0.25%, respectively, for the MIT-BIH arrhythmia and 99.98%, 99.90%, and 0.12%, respectively for the Fantasia database.