An algorithm for heart rate extraction from acoustic recordings at the neck

Heart rate is an important physiological parameter to assess the cardiac condition of an individual and is traditionally determined by attaching multiple electrodes on the chest of a subject to record the electrical activity of the heart. The installation and handling complexities of such systems does not prove feasible for a user to undergo a long-term monitoring in the home settings. A small-sized, battery-operated wearable monitoring device is placed on the suprasternal notch at neck to record acoustic signals containing information about breathing and cardiac sounds. The heart sounds obtained are heavily corrupted by the respiratory cycles and other external artifacts. This paper presents a novel algorithm for reliably extracting the heart rate from such acoustic recordings, keeping in mind the constraints posed by the wearable technology. The methodology constructs the Hilbert energy envelope of the signal by calculating its instantaneous characteristics to segment and classify a cardiac cycle into S1 and S2 sounds using their timing characteristics. The algorithm is tested on a dataset consisting of 13 subjects with an approximate data length of 75 hours and achieves an accuracy of 94.34%, an RMS error of 3.96 bpm and a correlation coefficient of 0.93 with reference to a commercial device in use

Algorithm for heart rate extraction in a novel wearable acoustic sensor.

Phonocardiography is a widely used method of listening to the heart sounds and indicating the presence of cardiac abnormalities. Each heart cycle consists of two major sounds - S1 and S2 - that can be used to determine the heart rate. The conventional method of acoustic signal acquisition involves placing the sound sensor at the chest where this sound is most audible. Presented is a novel algorithm for the detection of S1 and S2 heart sounds and the use of them to extract the heart rate from signals acquired by a small sensor placed at the neck. This algorithm achieves an accuracy of 90.73 and 90.69%, with respect to heart rate value provided by two commercial devices, evaluated on more than 38 h of data acquired from ten different subjects during sleep in a pilot clinical study. This is the largest dataset for acoustic heart sound classification and heart rate extraction in the literature to date. The algorithm in this study used signals from a sensor designed to monitor breathing. This shows that the same sensor and signal can be used to monitor both breathing and heart rate, making it highly useful for long-term wearable vital signs monitoring

Acoustic sensing as a novel approach for cardiovascular monitoring at the wrist

Cardiovascular diseases are the number one cause of deaths globally. An increased cardiovascular risk can be detected by a regular monitoring of the vital signs including the heart rate, the heart rate variability (HRV) and the blood pressure. For a user to undergo continuous vital sign monitoring, wearable systems prove to be very useful as the device can be integrated into the user's lifestyle without affecting the daily activities. However, the main challenge associated with the monitoring of these cardiovascular parameters is the requirement of different sensing mechanisms at different measurement sites. There is not a single wearable device that can provide sufficient physiological information to track the vital signs from a single site on the body. This thesis proposes a novel concept of using acoustic sensing over the radial artery to extract cardiac parameters for vital sign monitoring. A wearable system consisting of a microphone is designed to allow the detection of the heart sounds together with the pulse wave, an attribute not possible with existing wrist-based sensing methods. Methods: The acoustic signals recorded from the radial artery are a continuous reflection of the instantaneous cardiac activity. These signals are studied and characterised using different algorithms to extract cardiovascular parameters. The validity of the proposed principle is firstly demonstrated using a novel algorithm to extract the heart rate from these signals. The algorithm utilises the power spectral analysis of the acoustic pulse signal to detect the S1 sounds and additionally, the K-means method to remove motion artifacts for an accurate heartbeat detection. The HRV in the short-term acoustic recordings is found by extracting the S1 events using the relative information between the short- and long-term energies of the signal. The S1 events are localised using three different characteristic points and the best representation is found by comparing the instantaneous heart rate profiles. The possibility of measuring the blood pressure using the wearable device is shown by recording the acoustic signal under the influence of external pressure applied on the arterial branch. The temporal and spectral characteristics of the acoustic signal are utilised to extract the feature signals and obtain a relationship with the systolic blood pressure (SBP) and diastolic blood pressure (DBP) respectively. Results: This thesis proposes three different algorithms to find the heart rate, the HRV and the SBP/ DBP readings from the acoustic signals recorded at the wrist. The results obtained by each algorithm are as follows: 1. The heart rate algorithm is validated on a dataset consisting of 12 subjects with a data length of 6 hours. The results demonstrate an accuracy of 98.78%, mean absolute error of 0.28 bpm, limits of agreement between -1.68 and 1.69 bpm, and a correlation coefficient of 0.998 with reference to a state-of-the-art PPG-based commercial device. A high statistical agreement between the heart rate obtained from the acoustic signal and the photoplethysmography (PPG) signal is observed. 2. The HRV algorithm is validated on the short-term acoustic signals of 5-minutes duration recorded from each of the 12 subjects. A comparison is established with the simultaneously recorded electrocardiography (ECG) and PPG signals respectively. The instantaneous heart rate for all the subjects combined together achieves an accuracy of 98.50% and 98.96% with respect to the ECG and PPG signals respectively. The results for the time-domain and frequency-domain HRV parameters also demonstrate high statistical agreement with the ECG and PPG signals respectively. 3. The algorithm proposed for the SBP/ DBP determination is validated on 104 acoustic signals recorded from 40 adult subjects. The experimental outputs when compared with the reference arm- and wrist-based monitors produce a mean error of less than 2 mmHg and a standard deviation of error around 6 mmHg. Based on these results, this thesis shows the potential of this new sensing modality to be used as an alternative, or to complement existing methods, for the continuous monitoring of heart rate and HRV, and spot measurement of the blood pressure at the wrist.Open Acces

Fog Computing in Medical Internet-of-Things: Architecture, Implementation, and Applications

In the era when the market segment of Internet of Things (IoT) tops the chart in various business reports, it is apparently envisioned that the field of medicine expects to gain a large benefit from the explosion of wearables and internet-connected sensors that surround us to acquire and communicate unprecedented data on symptoms, medication, food intake, and daily-life activities impacting one's health and wellness. However, IoT-driven healthcare would have to overcome many barriers, such as: 1) There is an increasing demand for data storage on cloud servers where the analysis of the medical big data becomes increasingly complex, 2) The data, when communicated, are vulnerable to security and privacy issues, 3) The communication of the continuously collected data is not only costly but also energy hungry, 4) Operating and maintaining the sensors directly from the cloud servers are non-trial tasks. This book chapter defined Fog Computing in the context of medical IoT. Conceptually, Fog Computing is a service-oriented intermediate layer in IoT, providing the interfaces between the sensors and cloud servers for facilitating connectivity, data transfer, and queryable local database. The centerpiece of Fog computing is a low-power, intelligent, wireless, embedded computing node that carries out signal conditioning and data analytics on raw data collected from wearables or other medical sensors and offers efficient means to serve telehealth interventions. We implemented and tested an fog computing system using the Intel Edison and Raspberry Pi that allows acquisition, computing, storage and communication of the various medical data such as pathological speech data of individuals with speech disorders, Phonocardiogram (PCG) signal for heart rate estimation, and Electrocardiogram (ECG)-based Q, R, S detection.Comment: 29 pages, 30 figures, 5 tables. Keywords: Big Data, Body Area Network, Body Sensor Network, Edge Computing, Fog Computing, Medical Cyberphysical Systems, Medical Internet-of-Things, Telecare, Tele-treatment, Wearable Devices, Chapter in Handbook of Large-Scale Distributed Computing in Smart Healthcare (2017), Springe

Acoustic sensing as a novel wearable approach for cardiac monitoring at the wrist

This paper introduces the concept of using acoustic sensing over the radial artery to extract cardiac parameters for continuous vital sign monitoring. It proposes a novel measurement principle that allows detection of the heart sounds together with the pulse wave, an attribute not possible with existing photoplethysmography (PPG)-based methods for monitoring at wrist. The validity of the proposed principle is demonstrated using a new miniature, battery-operated wearable device to sense the acoustic signals and a novel algorithm to extract the heart rate from these signals. The algorithm utilizes the power spectral analysis of the acoustic pulse signal to detect the S1 sounds and additionally, the K-means method to remove motion artifacts for an accurate heartbeat detection. It has been validated on a dataset consisting of 12 subjects with a data length of 6 hours. The results demonstrate an accuracy of 98.78\%, mean absolute error of 0.28 bpm, limits of agreement between -1.68 and 1.69 bpm, and a correlation coefficient of 0.998 with reference to a state-of-the-art PPG-based commercial device. The results in this proof of concept study demonstrate the potential of this new sensing modality to be used as an alternative, or to complement existing methods, for continuous monitoring of heart rate at wrist

Transparent authentication: Utilising heart rate for user authentication

There has been exponential growth in the use of wearable technologies in the last decade with smart watches having a large share of the market. Smart watches were primarily used for health and fitness purposes but recent years have seen a rise in their deployment in other areas. Recent smart watches are fitted with sensors with enhanced functionality and capabilities. For example, some function as standalone device with the ability to create activity logs and transmit data to a secondary device. The capability has contributed to their increased usage in recent years with researchers focusing on their potential. This paper explores the ability to extract physiological data from smart watch technology to achieve user authentication. The approach is suitable not only because of the capacity for data capture but also easy connectivity with other devices - principally the Smartphone. For the purpose of this study, heart rate data is captured and extracted from 30 subjects continually over an hour. While security is the ultimate goal, usability should also be key consideration. Most bioelectrical signals like heart rate are non-stationary time-dependent signals therefore Discrete Wavelet Transform (DWT) is employed. DWT decomposes the bioelectrical signal into n level sub-bands of detail coefficients and approximation coefficients. Biorthogonal Wavelet (bior 4.4) is applied to extract features from the four levels of detail coefficents. Ten statistical features are extracted from each level of the coffecient sub-band. Classification of each sub-band levels are done using a Feedforward neural Network (FF-NN). The 1 st , 2 nd , 3 rd and 4 th levels had an Equal Error Rate (EER) of 17.20%, 18.17%, 20.93% and 21.83% respectively. To improve the EER, fusion of the four level sub-band is applied at the feature level. The proposed fusion showed an improved result over the initial result with an EER of 11.25% As a one-off authentication decision, an 11% EER is not ideal, its use on a continuous basis makes this more than feasible in practice

Monitoring Cardiovascular Physiology using Bio-compatible AlN Piezoelectric Skin Sensors

Arterial pulse waves contain a wealth of parameters indicative of cardiovascular disease. As such, monitoring them continuously and unobtrusively can provide health professionals with a steady stream of cardiovascular health indices, allowing for the development of efficient, individualized treatments and early cardiovascular disease diagnosis solutions. Blood pulsations in superficial arteries cause skin surface deformations, typically undetectable to the human eye; therefore, Microelectromechanical systems (MEMS) can be used to measure these deformations and thus create unobtrusive pulse wave monitoring devices. Miniaturized ultrathin and flexible Aluminium Nitride (AlN) piezoelectric MEMS are highly sensitive to minute mechanical deformations, making them suitable for detecting the skin deformations caused by cardiac events and consequently providing multiple biomarkers useful for monitoring cardiovascular health and assessing cardiovascular disease risk. Conventional wearable continuous pulse wave monitoring solutions are typically large and based on technologies limiting their versatility. Therefore, we propose the adoption of 29.5 μm-thick biocompatible, skin-conforming devices on piezoelectric AlN to create versatile, multipurpose arterial pulse wave monitoring devices. In our initial trials, the devices are placed over arteries along the wrist (radial artery), neck (carotid artery), and suprasternal notch (on the chest wall and close to the ascending aorta). We also leverage the mechano-acoustic properties of the device to detect heart muscle vibrations corresponding to heart sounds S1 and S2 from the suprasternal notch measurement site. Finally, we characterize the piezoelectric device outputs observed with the cardiac cycle events using synchronized electrocardiogram (ECG) reference signals and provide information on heart rate, breathing rate, and heart sounds. The extracted parameters strongly agree with reference values as illustrated by minimum Pearson correlation coefficients (r) of 0.81 for pulse rate and 0.95 for breathing rate

Characterization and processing of novel neck photoplethysmography signals for cardiorespiratory monitoring

Epilepsy is a neurological disorder causing serious brain seizures that severely affect the patients' quality of life. Sudden unexpected death in epilepsy (SUDEP), for which no evident decease reason is found after post-mortem examination, is a common cause of mortality. The mechanisms leading to SUDEP are uncertain, but, centrally mediated apneic respiratory dysfunction, inducing dangerous hypoxemia, plays a key role. Continuous physiological monitoring appears as the only reliable solution for SUDEP prevention. However, current seizure-detection systems do not show enough sensitivity and present a high number of intolerable false alarms. A wearable system capable of measuring several physiological signals from the same body location, could efficiently overcome these limitations. In this framework, a neck wearable apnea detection device (WADD), sensing airflow through tracheal sounds, was designed. Despite the promising performance, it is still necessary to integrate an oximeter sensor into the system, to measure oxygen saturation in blood (SpO2) from neck photoplethysmography (PPG) signals, and hence, support the apnea detection decision. The neck is a novel PPG measurement site that has not yet been thoroughly explored, due to numerous challenges. This research work aims to characterize neck PPG signals, in order to fully exploit this alternative pulse oximetry location, for precise cardiorespiratory biomarkers monitoring. In this thesis, neck PPG signals were recorded, for the first time in literature, in a series of experiments under different artifacts and respiratory conditions. Morphological and spectral characteristics were analyzed in order to identify potential singularities of the signals. The most common neck PPG artifacts critically corrupting the signal quality, and other breathing states of interest, were thoroughly characterized in terms of the most discriminative features. An algorithm was further developed to differentiate artifacts from clean PPG signals. Both, the proposed characterization and classification model can be useful tools for researchers to denoise neck PPG signals and exploit them in a variety of clinical contexts. In addition to that, it was demonstrated that the neck also offered the possibility, unlike other body parts, to extract the Jugular Venous Pulse (JVP) non-invasively. Overall, the thesis showed how the neck could be an optimum location for multi-modal monitoring in the context of diseases affecting respiration, since it not only allows the sensing of airflow related signals, but also, the breathing frequency component of the PPG appeared more prominent than in the standard finger location. In this context, this property enabled the extraction of relevant features to develop a promising algorithm for apnea detection in near-real time. These findings could be of great importance for SUDEP prevention, facilitating the investigation of the mechanisms and risk factors associated to it, and ultimately reduce epilepsy mortality.Open Acces

Thought on Food: A Systematic Review of Current Approaches and Challenges for Food Intake Detection

Nowadays, individuals have very stressful lifestyles, affecting their nutritional habits. In the early stages of life, teenagers begin to exhibit bad habits and inadequate nutrition. Likewise, other people with dementia, Alzheimer’s disease, or other conditions may not take food or medicine regularly. Therefore, the ability to monitor could be beneficial for them and for the doctors that can analyze the patterns of eating habits and their correlation with overall health. Many sensors help accurately detect food intake episodes, including electrogastrography, cameras, microphones, and inertial sensors. Accurate detection may provide better control to enable healthy nutrition habits. This paper presents a systematic review of the use of technology for food intake detection, focusing on the different sensors and methodologies used. The search was performed with a Natural Language Processing (NLP) framework that helps screen irrelevant studies while following the PRISMA methodology. It automatically searched and filtered the research studies in different databases, including PubMed, Springer, ACM, IEEE Xplore, MDPI, and Elsevier. Then, the manual analysis selected 30 papers based on the results of the framework for further analysis, which support the interest in using sensors for food intake detection and nutrition assessment. The mainly used sensors are cameras, inertial, and acoustic sensors that handle the recognition of food intake episodes with artificial intelligence techniques. This research identifies the most used sensors and data processing methodologies to detect food intake.info:eu-repo/semantics/publishedVersio

Models and Analysis of Vocal Emissions for Biomedical Applications

The International Workshop on Models and Analysis of Vocal Emissions for Biomedical Applications (MAVEBA) came into being in 1999 from the particularly felt need of sharing know-how, objectives and results between areas that until then seemed quite distinct such as bioengineering, medicine and singing. MAVEBA deals with all aspects concerning the study of the human voice with applications ranging from the neonate to the adult and elderly. Over the years the initial issues have grown and spread also in other aspects of research such as occupational voice disorders, neurology, rehabilitation, image and video analysis. MAVEBA takes place every two years always in Firenze, Italy. This edition celebrates twenty years of uninterrupted and succesfully research in the field of voice analysis