Removal of ECG interference from surface respiratory electromyography

The signal to noise ratio (SNR) of surface respiratory electromyography signal is very low. Indeed EMG signal is contaminated by different types of noise especially the cardiac artefact ECG. This article explores the problem of removing ECG artefact from respiratory EMG signal. The new method uses an adaptive structure with an electrocardyographic ECG reference signal carried out by wavelet decomposition. The proposed algorithm requires only one channel to both estimating the adaptive filter input reference noise and the respiratory EMG signal. This new technique demonstrates how two steps will be combined: the first step decomposes the signal with forward discrete wavelet transform into sub-bands to get the wavelet coefficients. Then, an improved soft thresholding function was applied. And the ECG input reference signal is reconstructed with the transformed coefficients whereas, the second uses an adaptive filter especially the LMS one to remove the ECG signal. After trying statistical as well as mathematical analysis, the complete investigation ensures that all details and steps make proof that our rigorous method is appropriate. Compared to the results obtained using previous techniques, the results achieved using the new algorithm show a significant improvement in the efficiency of the ECG rejection.     

Segmentation of cardiac sound signals by removing murmurs using constrained tunable-Q wavelet transform

The automatic segmentation of cardiac sound signals into heart beat cycles is generally required for the diagnosis of heart valve disorders. In this paper, a new method for segmentation of the cardiac sound signals using tunable-Q wavelet transform (TQWT) has been presented. The murmurs from cardiac sound signals are removed by suitably constraining TQWT based decomposition and reconstruction. The Q-factor, redundancy parameter and number of stages of decomposition of the TQWT are adapted to the desired statistical properties of the murmur-free reconstructed cardiac sound signals. The envelope based on cardiac sound characteristic waveform (CSCW) is extracted after the removal of low energy components from the reconstructed cardiac sound signals. Then the heart beat cycles are derived from the original cardiac sound signals by mapping the required timing information of CSCW which is obtained using established methods. The experimental results are included in order to show the effectiveness of the proposed method for segmentation of cardiac sound signals in comparison with other existing methods for various clinical cases.     

Grammatic representation of beat sequences for fuzzy arrhythmia diagnosis

The final stage of a system for automatic monitoring of cardiac arrhythmias is the diagnosis of the rhythm or arrhythmia present in the patient during the monitoring process. In this paper we approach the detection process by means of the analysis of the electrocardiographic signal (ECG) on a surface lead produced by those arrhythmias which can be recognized by identifying specific beat sequences and taking into account contextual information, mainly rhythm information. We have developed a diagnosis process for arrhythmias which uses a fuzzy classification of beats according to their etiology or focus of origin. The process we describe permits a more adequate consideration by the user of the arrhythmias diagnosed by the system, mainly in those cases in which the information derived from ECG analysis is not determinant.     

High resolution ECG analysis by an improved signal averaging method and comparison with a beat-to-beat approach

The aim of this paper is to describe the analysis of a high resolution ECG recorded from the body surface. Standard signal averaging techniques are improved by using a new time delay estimation method which leads to a better alignment accuracy of P and T waves. A second method uses adaptive identification to achieve a beat by beat fine ECG estimation. Information provided by the two methods allows a better interpretation of low and very low level signals.     

K-means algorithm for the detection and delineation of QRS-complexes in Electrocardiogram

Electrocardiogram (ECG) is an important bioelectrical signal used to asses the cardiac state of a patient. It consists of a recurrent wave sequence of P-wave, QRS-complex and T-wave associated with each beat. The QRS-complex is the prominent feature of the ECG. This paper presents a simple method using K-means clustering algorithm for the detection of QRS-complexes in ECG signal. Digital filters are used to remove the power line interference and baseline wander present in the ECG signal. K-means algorithm is used to classify QRS and non-QRS-region in the ECG signal. The performance of the algorithm is validated using dataset-3 of the CSE multi-lead measurement library. Detection rate of 98.66% is obtained. The percentage of false positive and false negative is 1.14% and 1.34% respectively. The mean and standard deviation of the errors between automatic and manual annotations is calculated to validate the delineation performance of the algorithm. The onsets and offsets of the detected QRS-complexes are found well within the tolerance limits as specified by the CSE library.     

AR identification and spectral estimate applied to the R-R interval measurements

The methods of identification and spectral estimate are applied to the tachogram, i.e. the time series constituted by the cycle-by-cycle R-R interval durations measured on the ECG signal from cardiological patients in ambulatory rehabilitation training after episodes of myocardial infarction or ischemic disease. The Batch Least Squares Method is applied to identify the series as an AR process of 5th order. The whiteness test and Rissanen's optimization criterion are also fulfilled. The clinical information is in this way highly compressed in the pole diagram and in the Maximum Entropy Spectrum (MES) estimated on the basis of the AR coefficients. The experimental results in a restricted set of patients confirm the feasibility of new instrumentation design criteria for non-conventional R-R intervals parametrisation, successive diagnostic classification and beat prediction. Finally, some preliminary considerations about the capabilities of the introduced methods put into evidence the role of computerized techniques in recognizing the fundamental patterns of physiopathological heart rate variability, which the usual conventional methods of ECG analysis are not able to detect in a reliable way.     

A lead dependent ischemic episodes detection strategy using Hermite functions

In this work a new strategy for automatic detection of ischemic episodes is proposed. A new measure for ST deviation based on the time–frequency analysis of the ECG and the use of a reduced set of Hermite basis functions for T wave and QRS complex morphology characterization, are the key points of the proposed methodology.Usually, ischemia manifests itself in the ECG signal by ST segment deviation or by QRS complex and T wave changes in morphology. These effects might occur simultaneously. Time–frequency methods are especially adequate for the detection of small transient characteristics hidden in the ECG, such as ST segment alterations. A Wigner–Ville transform-based approach is proposed to estimate the ST shift. To characterize the alterations in the T wave and the QRS morphologies, each cardiac beat is described by expansions in Hermite functions. These demonstrated to be suitable to capture the most relevant morphologic characteristics of the signal. A lead dependent neural network classifier considers, as inputs, the ST segment deviation and the Hermite expansion coefficients. The ability of the proposed method in ischemia episodes detection is evaluated using the European Society of Cardiology ST–T database. A sensitivity of 96.7% and a positive predictivity of 96.2% reveal the capacity of the proposed strategy to perform ischemic episodes identification.     

正常人体表心电图形态的逐拍变化

心电图的各种波形是众多心肌细胞动作电位在体表的综合效应。建立了对体表心电图的形态进行逐拍分析的硬件及软件系统。对５８例健康人体表心电图进行了采集和分析,得到了正常人体表心电图中Ｐ波,ＱＲＳ波,及Ｔ波的形态差异图,并进行了频谱及时域瞬态分析,从而展示了心肌电活动在体表心电图中的逐拍变化现象,体表心电图逐拍形态变化反映了心房肌和心室肌电活动的时变特征。     

Machine Learning Approach to Detect Cardiac Arrhythmias in ECG Signals: A Survey

Cardiac arrhythmia is a condition when the heart rate is irregular either the beat is too slow or too fast. It occurs due to improper electrical impulses that coordinates the heart beats. Sudden cardiac death may occurs due to some dangerous arrhythmias conditions. Hence the main objective of the electrocardiogram (ECG) analysis is to detect the life-threatening arrhythmias accurately for appropriate treatment in order to save life. Since the last decades, several methods were reported for automatic ECG beat classifications. In this work, we present a systematic review of the current state-of-the-art methods used to detect cardiac arrhythmia using on ECG signals. It includes the signal decomposition, feature extraction and machine learning approaches used for automatic detection and decision making process. The articles covers the pre-processing, detection of QRS complex, feature extraction and classification of ECG beats. Based on the past studies, it is understood that the automated approach using computer-aided decision making process is highly required for real-time detection of cardiac arrhythmias. The advantages and limitations of different methods are discussed and also the future scopes is highlighted in the process of effective detection of cardiac arrhythmias. This study could be beneficial for researchers to analyze the existing state-of-art techniques used in detection of arrhythmia conditions.     

Clinical trials of a dual-sensor diagnostic pacemaker

The results of clinical trials of a dual-sensor diagnostic pacemaker are described. The system monitors and records intraventricular electrical and pressure waveforms using a special lead incorporating bipolar electrodes together with a piezoelectric pressure transducer. The recorded waveforms, which are shown in conjunction with Holter recordings made simultaneously, demonstrate the value of pressure measurements and illustrate several cardiac events, including an ECG pause, bradycardia, a pressure pause, ectopic beats and tachycardia. The pacing function of the device is shown and capture is demonstrated.     

Fluorescence polarization: a novel indicator of cardiomyocyte contraction

The changes measured in intracellular fluorescein fluorescence polarization (IFFP) are used as a new tool for tracing cytoplasmic effects during contractile cycles of cardiac myocytes (1-2-day-old rat hearts), in addition to the established Ca(2+) monitoring and/or videometric methods of tracking cell-shortening. This novel method was found to be non-intrusive to the contraction cycles. The decay of the transient IFFP signal (from 0.220+/-0.01 to 0.170+/-0.013) seems to be closely related to the extended phase of contractile activation. This fact was further supported when Ca(2+) exchanger inhibitor was introduced and significantly decreased (90%) the rate of beats of contraction and IFFP, but not the Ca(2+) beat rate changes. This result suggests that the IFFP indicator is probably associated with the physiological activation, rather than with Ca(2+) alterations. The IFFP measure monitors the average of effective changes in the micro-viscosity of the cytoplasm protein matrix, associated with cellular activation.     

Discrete-wavelet-transform-based noise removal and feature extraction for ECG signals

Nowadays, doctors use electrocardiogram (ECG) to diagnose heart diseases commonly. However, some nonideal effects are often distributed in ECG. Discrete wavelet transform (DWT) is efficient for nonstationary signal analysis. In this paper, the Symlets sym5 is chosen as the wavelet function to decompose recorded ECG signals for noise removal. Soft-thresholding method is then applied for feature detection. To detect ECG features, R peak of each heart beat is first detected, and the onset and offset of the QRS complex are then detected. Finally, the signal is reconstructed to remove high frequency interferences and applied with adaptive searching window and threshold to detect P and T waves. We use the MIT-BIH arrhythmia database for algorithm verification. For noise reduction, the SNR improvement is achieved at least 10 dB at SNR 5 dB, and most of the improvement SNR are better than other methods at least 1 dB at different SNR. When applying to the real portable ECG device, all R peaks can be detected when patients walk, run, or move at the speed below 9 km/h. The performance of delineation on database shows in our algorithm can achieve high sensitivity in detecting ECG features. The QRS detector attains a sensitivity over 99.94%, while detectors of P and T waves achieve 99.75% and 99.7%, respectively.     

Control of the ciliary beat by cyclic nucleotides in intact cortical sheets from Paramecium

The locomotor behavior of Paramecium depends on the ciliary beat direction and beat frequency. Changes in the ciliary beat are controlled by a signal transduction mechanism that follows changes in the membrane potential. These events take place in cilia covered with a ciliary membrane. To determine the effects of second messengers in the cilia, cortical sheets were used with intact ciliary membrane as a half-closed system in which each cilium is covered with a ciliary membrane with an opening to the cell body. Cyclic nucleotides and their derivatives applied from an opening to the cell body affected the ciliary beat. cAMP and 8-Br-cAMP increased the beat frequency and the efficiency of propulsion and acted antagonistically to the action of Ca(2+). cGMP and 8-Br-cGMP increased the efficiency of propulsion accompanying clear metachronal waves but decreased the beat frequency. These results indicate that the cyclic nucleotides affect target proteins in the ciliary axonemes surrounded by the ciliary membrane without a membrane potential and increase the efficiency of propulsion of the ciliary beat. In vitro phosphorylation of isolated ciliary axonemes in the presence of cyclic nucleotides and their derivatives revealed that the action of cAMP was correlated with the phosphorylation of 29-kDa and 65-kDa proteins and that the action of cGMP was correlated with the phosphorylation of a 42-kDa protein.     

Ischemia episode detection in ECG using kernel density estimation, support vector machine and feature selection

ABSTRACT: BACKGROUND: Myocardial ischemia can be developed into more serious diseases. Early Detection of the ischemic syndrome inelectrocardiogram (ECG) more accurately and automatically can prevent it from developing into a catastrophicdisease. To this end, we propose a new method, which employs wavelets and simple feature selection. METHODS: For training and testing, the European ST-T database is used, which is comprised of 367 ischemic ST episodes in90 records. We first remove baseline wandering, and detect time positions of QRS complexes by a method basedon the discrete wavelet transform. Next, for each heart beat, we extract three features which can be used fordifferentiating ST episodes from normal: 1) the area between QRS offset and T-peak points, 2) the normalizedand signed sum from QRS offset to effective zero voltage point, and 3) the slope from QRS onset to offset point.We average the feature values for successive five beats to reduce effects of outliers. Finally we apply classifiersto those features. RESULTS: We evaluated the algorithm by kernel density estimation (KDE) and support vector machine (SVM) methods.Sensitivity and specificity for KDE were 0.939 and 0.912, respectively. The KDE classifier detects 349 ischemicST episodes out of total 367 ST episodes. Sensitivity and specificity of SVM were 0.941 and 0.923, respectively.The SVM classifier detects 355 ischemic ST episodes. CONCLUSIONS: We proposed a new method for detecting ischemia in ECG. It contains signal processing techniques of removingbaseline wandering and detecting time positions of QRS complexes by discrete wavelet transform, and featureextraction from morphology of ECG waveforms explicitly. It was shown that the number of selected featureswere sufficient to discriminate ischemic ST episodes from the normal ones. We also showed how the proposedKDE classifier can automatically select kernel bandwidths, meaning that the algorithm does not require anynumerical values of the parameters to be supplied in advance. In the case of the SVM classifier, one has to selecta single parameter.     

ECG Data Compression Using Modified Run Length Encoding of Wavelet Coefficients for Holter Monitoring

ObjectiveIn cardiac patient-care, compression of long-term ECG data is essential to minimize the data storage requirement and transmission cost. Hence, this paper presents a novel electrocardiogram data compression technique which utilizes modified run-length encoding of wavelet coefficients.MethodFirst, wavelet transform is applied to the ECG data which decomposes it and packs maximum energy to less number of transform coefficients. The wavelet transform coefficients are quantized using dead-zone quantization. It discards small valued coefficients lying in the dead-zone interval while other coefficients are kept at the formulated quantized output interval. Among all the quantized coefficients, an average value is assigned to those coefficients for which energy packing efficiency is less than 99.99%. The obtained coefficients are encoded using modified run-length coding. It offers higher compression ratio than conventional run-length coding without any loss of information.ResultsCompression performance of the proposed technique is evaluated using different ECG records taken from the MIT-BIH arrhythmia database. The average compression performance in terms of compression ratio, percent root mean square difference, normalized percent mean square difference, and signal to noise ratio are 17.18, 3.92, 6.36, and 28.27 dB respectively for 48 ECG records.ConclusionThe compression results obtained by the proposed technique is better than techniques recently introduced by others. The proposed technique can be utilized for compression of ECG records of Holter monitoring.     

A generating model of realistic synthetic heart sounds for performance assessment of phonocardiogram processing algorithms

A new model which is capable of generating realistic synthetic phonocardiogram (PCG) signals is introduced based on three coupled ordinary differential equations. The new PCG model takes into account the respiratory frequency, the heart rate variability and the time splitting of first and second heart sounds. This time splitting occurs with each cardiac cycle and varies with inhalation and exhalation. Clinical PCG statistics and the close temporal relationship between events in ECG and PCG are used to deduce values of PCG model parameters.In comparison with published PCG models, the proposed model allows a larger number of known PCG features to be taken into consideration. Moreover it is able to generate both normal and abnormal realistic synthetic heart sounds. Results show that these synthetic PCG signals have the closest features to those of a conventional heart sound in both time and frequency domains. Additionally, a sound quality test carried out by eight cardiologists demonstrates that the proposed model outperforms the existing models.This new PCG model is promising and useful in assessing signal processing techniques which are developed to help clinical diagnosis based on PCG.     

ECG beat classification using PCA,LDA, ICA and Discrete Wavelet Transform

Electrocardiogram (ECG) is the P-QRS-T wave, representing the cardiac function. The information concealed in the ECG signal is useful in detecting the disease afflicting the heart. It is very difficult to identify the subtle changes in the ECG in time and frequency domains. The Discrete Wavelet Transform (DWT) can provide good time and frequency resolutions and is able to decipher the hidden complexities in the ECG. In this study, five types of beat classes of arrhythmia as recommended by Association for Advancement of Medical Instrumentation (AAMI) were analyzed namely: non-ectopic beats, supra-ventricular ectopic beats, ventricular ectopic beats, fusion betas and unclassifiable and paced beats. Three dimensionality reduction algorithms; Principal Component Analysis (PCA), Linear Discriminant Analysis (LDA) and Independent Component Analysis (ICA) were independently applied on DWT sub bands for dimensionality reduction. These dimensionality reduced features were fed to the Support Vector Machine (SVM), neural network (NN) and probabilistic neural network (PNN) classifiers for automated diagnosis. ICA features in combination with PNN with spread value (σ) of 0.03 performed better than the PCA and LDA. It has yielded an average sensitivity, specificity, positive predictive value (PPV) and accuracy of 99.97%, 99.83%, 99.21% and 99.28% respectively using ten-fold cross validation scheme.     

Effects of electrocardiography contamination and comparison of ECG removal methods on upper trapezius electromyography recordings

Electromyography (EMG) recordings from the trapezius are often contaminated by the electrocardiography (ECG) signal, making it difficult to distinguish low-level muscle activity from muscular rest. This study investigates the influence of ECG contamination on EMG amplitude and frequency estimations in the upper trapezius during muscular rest and low-level contractions. A new method of ECG contamination removal, filtered template subtraction (FTS), is described and compared to 30 Hz high-pass filter (HPF) and averaged template subtraction (ATS) methods. FTS creates a unique template of each ECG artifact using a low-pass filtered copy of the contaminated signal, which is subtracted from contaminated periods in the original signal. ECG contamination results in an over-estimation of EMG amplitude during rest in the upper trapezius, with negligible effects on amplitude and frequency estimations during low-intensity isometric contractions. FTS and HPF successfully removed ECG contamination from periods of muscular rest, yet introduced errors during muscle contraction. Conversely, ATS failed to fully remove ECG contamination during muscular rest, yet did not introduce errors during muscle contraction. The relative advantages and disadvantages of different ECG contamination removal methods should be considered in the context of the specific motor tasks that require analysis.     

Denoising of ECG signals based on noise reduction algorithms in EMD and wavelet domains

This paper presents a new ECG denoising approach based on noise reduction algorithms in empirical mode decomposition (EMD) and discrete wavelet transform (DWT) domains. Unlike the conventional EMD based ECG denoising approaches that neglect a number of initial intrinsic mode functions (IMFs) containing the QRS complex as well as noise, we propose to perform windowing in the EMD domain in order to reduce the noise from the initial IMFs instead of discarding them completely thus preserving the QRS complex and yielding a relatively cleaner ECG signal. The signal thus obtained is transformed in the DWT domain, where an adaptive soft thresholding based noise reduction algorithm is employed considering the advantageous properties of the DWT compared to that of the EMD in preserving the energy in the presence of noise and in reconstructing the original ECG signal with a better time resolution. Extensive simulations are carried out using the MIT-BIH arrythmia database and the performance of the proposed method is evaluated in terms of several standard metrics. The simulation results show that the proposed method is able to reduce noise from the noisy ECG signals more accurately and consistently in comparison to some of the stateof-the-art methods.     

A training whole-heart model for simulating propagation and ECG patterns

The forward problem of electrocardiography describes the spatio-temporal source–field relationship generating the body surface potential (BSP) and, thus, the electrocardiogram (ECG). The paper presents a ventricular and atrial model for simulating cardiac de- and repolarization and the P-, QRS- and T-wave. The atria and the ventricles are coupled, so that electroanatomical function can be simulated at ones. Movement and contraction are not taken into account while an individual geometry, fibre architecture and ECG sensor arrangement including the Wilson central terminal (WCT) as common reference were considered. This in silico whole-heart model can be used for detailed investigations of the nature of the ECG for the normal beat, arrhythmias, ischemia and infarction. In addition, this model was used as a reference tool for developing and testing different electrocardiographic inverse approaches.