Revisiting QRS detection methodologies for portable, wearable, battery-operated, and wireless ECG systems

Cardiovascular diseases are the number one cause of death worldwide. Currently, portable battery-operated systems such as mobile phones with wireless ECG sensors have the potential to be used in continuous cardiac function assessment that can be easily integrated into daily life. These portable point-of-care diagnostic systems can therefore help unveil and treat cardiovascular diseases. The basis for ECG analysis is a robust detection of the prominent QRS complex, as well as other ECG signal characteristics. However, it is not clear from the literature which ECG analysis algorithms are suited for an implementation on a mobile device. We investigate current QRS detection algorithms based on three assessment criteria: 1) robustness to noise, 2) parameter choice, and 3) numerical efficiency, in order to target a universal fast-robust detector. Furthermore, existing QRS detection algorithms may provide an acceptable solution only on small segments of ECG signals, within a certain amplitude range, or amid particular types of arrhythmia and/or noise. These issues are discussed in the context of a comparison with the most conventional algorithms, followed by future recommendations for developing reliable QRS detection schemes suitable for implementation on battery-operated mobile devices.Mohamed Elgendi, Björn Eskofier, Socrates Dokos, Derek Abbot

Robust QRS Detection Using Combination of Three Independent Methods

QRS detection is a fundamental step in ECG analysis. Although there are many algorithms reporting results close to 100%, this problem is still not resolved. The reported numbers are influenced by the quality of the detector, the quality of annotations and also by the chosen method of testing. In this study, we proposed and properly tested robust QRS detection algorithm based on a combination of three independent principles. For enhancement of QRS complexes there were developed three independent approaches based on continuous wavelet transform, Stockwell transform and phasor transform which are followed by individual adaptive thresholding. Each method produces candidates for QRS complexes which are further processed by cluster analysis resulting in final QRS positions. The proposed detection algorithm was tested on three complete standard ECG databases: MIT-BIH Arrhythmia Database, European ST-T Database and QT Database without any change in algorithm setting. We utilized complete data from mentioned databases including all provided leads and used original (not adjusted) reference positions of QRS complexes. Summarized detection accuracy for all three databases was expressed by sensitivity 99.16% and positive predictive value 98.99%