A Novel Real-Time Intelligent Tele Cardiology System Using Wireless Technology to Detect Cardiac Abnormalities

This study presents a novel wireless, ambulatory,real- time, and auto alarm intelligent telecardiology system to improve healthcare for cardiovascular disease, which is one of the most prevalent and costly health problems in the world.This system consists of a lightweight and power-saving wireless ECG device equipped with a built-in automatic warning expert system. A temperature sensor is fixed to the user2019;s body, which senses temperature in the body, and delivers it to the ECG device. This device is connected to a microcontroller and ubiquitous real-time display platform. The acquired ECG signals which are transmitted to the microcontroller is then, processed by the expert system in order to detect the abnormality. An alert signal is sent to the remote database server, which can be accessed by an Internet browser, once an abnormal ECG is detected. The current version of the expert system can identify five types of abnormal cardiac rhythms in real-time, including sinus tachycardia, sinus bradycardia, wide QRS complex, atrial fibrillation (AF), and cardiac asystole, which is very important for both the subjects who are being monitored and the healthcare personnel tracking cardiac-rhythm disorders. The proposed system also activates an emergency medical alarm system when problems occur. We believe that in the future a business-card-like ECG device, accompanied with a Personal Computer, can make universal cardiac protection service possible

The Utilization of Telehealth/ Telemedicine In Cardiology In Rural Areas

Introduction: Telecardiology has been defined as a way of practicing cardiology through the utilization of telecommunications and a more cost-effective way to deliver cardiac care. As a subset of telemedicine, telecardiology has functioned to bring providers to underserved communities through technological mechanisms. Rural regions have turned to telemedicine and tapped into a network of clinical institutions exchanging practitioners and patients to emphasize value-based instead of volume-based care. Methodology: The methodology of this qualitative study was a literature review having used mixed methodologies. Five electronic databases and government websites were utilized, and one semi-structured interview with an expert in cardiology was conducted. There were 34 sources referenced in the literature review. Results: The research demonstrated how the utilization of telecardiology has increased access to care in isolated rural areas via resources such as smartphone apps and outreach sites. Additionally, it was found that the use of non-invasive, wearable technology and other modern communication technologies presented a more cost-effective and efficient solution to expensive health care facilities, while allowing patients to remain comfortable in their home environments. Discussion/ Conclusion: Telecardiology technology has shown to have positive impacts on access to care, the delivery process of care, and financial burdens of care for patients living in rural settings. Through telecardiology services, patients in rural areas have had higher frequencies of interaction with their cardiologist/healthcare provider

Arrhythmia Evaluation in Wearable ECG Devices

This study evaluates four databases from PhysioNet: The American Heart Association database (AHADB), Creighton University Ventricular Tachyarrhythmia database (CUDB), MIT-BIH Arrhythmia database (MITDB), and MIT-BIH Noise Stress Test database (NSTDB). The ANSI/AAMI EC57:2012 is used for the evaluation of the algorithms for the supraventricular ectopic beat (SVEB), ventricular ectopic beat (VEB), atrial fibrillation (AF), and ventricular fibrillation (VF) via the evaluation of the sensitivity, positive predictivity and false positive rate. Sample entropy, fast Fourier transform (FFT), and multilayer perceptron neural network with backpropagation training algorithm are selected for the integrated detection algorithms. For this study, the result for SVEB has some improvements compared to a previous study that also utilized ANSI/AAMI EC57. In further, VEB sensitivity and positive predictivity gross evaluations have greater than 80%, except for the positive predictivity of the NSTDB database. For AF gross evaluation of MITDB database, the results show very good classification, excluding the episode sensitivity. In advanced, for VF gross evaluation, the episode sensitivity and positive predictivity for the AHADB, MITDB, and CUDB, have greater than 80%, except for MITDB episode positive predictivity, which is 75%. The achieved results show that the proposed integrated SVEB, VEB, AF, and VF detection algorithm has an accurate classification according to ANSI/AAMI EC57:2012. In conclusion, the proposed integrated detection algorithm can achieve good accuracy in comparison with other previous studies. Furthermore, more advanced algorithms and hardware devices should be performed in future for arrhythmia detection and evaluation.Cal-Comp Electronics & Communications Co., Ltd.; Kinpo Electronics, Inc. New Taipei City, Taiwan. Innovation Center for Big Data and Digital Convergence; Yuan Ze University, Taiwan

Autonomous network selection strategy for telecardiology application in heterogeneous wireless networks

Existing telecardiology systems are mostly relying on a high bandwidth wireless technology. However, in developing countries, the coverage of high bandwidth wireless network is still imperfect. Thus, the existing telecardiology systems are unable to guarantee users are always connected to the healthcare service provider at anywhere. To overcome this issue, an autonomous network selection strategy for telecardiology application in heterogeneous wireless networks is proposed. This strategy is aware of user velocity, network quality, and telecardiology service setting (e.g. image, vital signs, ECG, etc.). It performs handover from one network to another without disruption to the link. The simulation results show that the proposed strategy outperforms conventional bandwidth-based strategy in term of handover rate, ping-pong effect and handover failure. It has successfully reduced the handover rate up to 97%, eliminated the ping-pong effect and handover failure in both high and low speed scenarios

Network selection mechanism for telecardiology application in high speed environment

The existing network selection schemes biased either to cost or Quality of Service (QoS) are not efficient enough for telecardiology application in high traveling speed environment. Selection of the candidate network that is fulfilling the telecardiology service requirements as well as user preference is a challenging issue. This is because the preference of telecardiology user might change based on the patient health condition. This research proposed a novel Telecardiology-based Handover Decision Making (THODM) mechanism that consists of three closely integrated algorithms: Adaptive Service Adjustment (ASA), Dwelling Time Prediction (DTP) and Patient Health Condition-based Network Evaluation (PHCNE). The ASA algorithm guarantees the quality of telecardiology service when none of the available networks fulfils the service requirements. The DTP algorithm minimizes the probability of handover failure and unnecessary handover to Wireless Local Area Network (WLAN), while optimizing the connection time with WLAN in high traveling speed environment. The PHCNE algorithm evaluates the quality of available networks and selects the best network based on the telecardiology services requirement and the patient health condition. Simulation results show that the proposed THODM mechanism reduced the number of handover failures and unnecessary handovers up to 80.0% and 97.7%, respectively, compared with existing works. The cost of THODM mechanism is 20% and 85.3% lower than the Speed Threshold-based Handover (STHO) and Bandwidth-based Handover (BWHO) schemes, respectively. In terms of throughput, the proposed scheme is up to 75% higher than the STHO scheme and 370% greater than the BWHO scheme. For telecardiology application in high traveling speed environment, the proposed THODM mechanism has better performance than the existing network selection schemes

Yield of diagnosis and risk of stroke with screening strategies for atrial fibrillation: a comprehensive review of current evidence

Atrial fibrillation (AF) is the most prevalent arrhythmia worldwide. The presence of AF is associated with increased risk of systemic thromboembolism, but with the uptake of oral anticoagulant (OAC) and implementation of a holistic and integrated care management, this risk is substantially reduced. The diagnosis of AF requires a 30-s-long electrocardiographic (ECG) trace, irrespective of the presence of symptoms, which may represent the main indication for an ECG tracing. However, almost half patients are asymptomatic at the time of incidental AF diagnosis, with similar risk of stroke of those with clinical AF. This has led to a crucial role of screening for AF, to increase the diagnosis of population at risk of clinical events. The aim of this review is to give a comprehensive overview about the epidemiology of asymptomatic AF, the different screening technologies, the yield of diagnosis in asymptomatic population, and the benefit derived from screening in terms of reduction of clinical adverse events, such as stroke, cardiovascular, and all-cause death. We aim to underline the importance of implementing AF screening programmes and reporting about the debate between scientific societies’ clinical guidelines recommendations and the concerns expressed by the regulatory authorities, which still do not recommend population-wide screening. This review summarizes data on the ongoing trials specifically designed to investigate the benefit of screening in terms of risk of adverse events which will further elucidate the importance of screening in reducing risk of outcomes and influence and inform clinical practice in the next future

ECG Signal Super-resolution by Considering Reconstruction and Cardiac Arrhythmias Classification Loss

With recent advances in deep learning algorithms, computer-assisted healthcare services have rapidly grown, especially for those that combine with mobile devices. Such a combination enables wearable and portable services for continuous measurements and facilitates real-time disease alarm based on physiological signals, e.g., cardiac arrhythmias (CAs) from electrocardiography (ECG). However, long-term and continuous monitoring confronts challenges arising from limitations of batteries, and the transmission bandwidth of devices. Therefore, identifying an effective way to improve ECG data transmission and storage efficiency has become an emerging topic. In this study, we proposed a deep-learning-based ECG signal super-resolution framework (termed ESRNet) to recover compressed ECG signals by considering the joint effect of signal reconstruction and CA classification accuracies. In our experiments, we downsampled the ECG signals from the CPSC 2018 dataset and subsequently evaluated the super-resolution performance by both reconstruction errors and classification accuracies. Experimental results showed that the proposed ESRNet framework can well reconstruct ECG signals from the 10-times compressed ones. Moreover, approximately half of the CA recognition accuracies were maintained within the ECG signals recovered by the ESRNet. The promising results confirm that the proposed ESRNet framework can be suitably used as a front-end process to reconstruct compressed ECG signals in real-world CA recognition scenarios

Wireless sensor node for non-invasive high precision electrocardiographic signal acquisition based on a multi-ring electrode

[EN] Concentric ring electrodes (CRE) have been proposed for sensing bioelectrical activity with high spatial resolution. Computational studies have revealed that the CRE dimensions are closely related to the electric dipole depth they can sense, but further experimental confirmation is needed. We aimed to develop and test a wireless multichannel ECG recording system based on a new flexible multi-ring electrode and to check the influence of CRE dimensions on the acquired signals. The system provided high-precision ECG signals by a simple procedure. The bipolar concentric ECG signal amplitude and SNR increase with the CRE¿s outer ring dimension. Differences in the signal morphologies, associated with different sensitivities to the location of the active dipoles, were also obtained in the case of diameters smaller than 34 mm. A system with several wireless sensor nodes developed could be easily used by clinical staff for non-invasive cardiac monitoring and diagnosis with high spatial and temporal resolution.Research supported in part by a grant from the Conselleria d'Educacio, Cultura I Esport, Generalitat Valenciana Conselleria - Spain (GV/2014/029); by a grant from the Universitat Politecnica de Valencia - Spain (SP20120490); and by the Ministry of Economy and Competitiveness - Spain and the European Regional Development Fund (DPI2015-68397-R (MINECO/FEDER)).Ye Lin, Y.; Bueno Barrachina, JM.; Prats-Boluda, G.; Rodríguez De Sanabria Gil, R.; Garcia Casado, FJ. (2017). Wireless sensor node for non-invasive high precision electrocardiographic signal acquisition based on a multi-ring electrode. Measurement. 97:195-202. https://doi.org/10.1016/j.measurement.2016.11.009S1952029

M2M 원격심전도를 위한 스케일러블 코딩 및 링크 적응기법

학위논문 (박사)-- 서울대학교 대학원 : 전기·컴퓨터공학부, 2017. 2. 신현식.Medical telemetry is one of the most demanding applications in recent wearable computing era. Telecardiology, which uses the power of telecommunications for the remote diagnosis and treatment of heart diseases, is one of the key telemetry applications that leverages IoT-based technologies to improve patient care. Based on recent advances in wearable sensors and telecommunication technologies, this thesis proposes a universal platform for wearable daily cardiac monitoring service. First, we propose an adaptive framework for layered representation and transmission of ECG (electrocardiography) data that can accommodate a time-varying wireless channel on cellular networks. The representation, combined with the layer-based earliest deadline first (LB-EDF) scheduler, ensures that the perceptual quality of the reconstructed ECG signal does not degrade abruptly under severe channel conditions and that the available bandwidth is utilized efficiently. Simulation shows that the proposed approach significantly improves the perceptual quality of the ECG signal reconstructed at the remote monitoring station. Then we extend the proposed adaptive framework to support time-critical medical applications. In fact, the use of wireless technologies has been avoided for medical situations that demand instantaneous cardiac monitoring because of their considerable and nondeterministic end-to-end latency. This thesis introduces a universal platform for machine-to-machine (M2M) telecardiology over cellular networks, along with a novel conservative modulation and coding scheme to minimize and stabilize the delay down to 10 ms of ultra-low latency level, incurred during the process of ECG transmission over a wireless medium while maintaining the desired level of ECG pattern quality required for improving the chance of its interpretation. Machine-type communication (MTC) system is adopted for the delivery of patient ECG data to benefit from its inherent reliability, pervasiveness, security, and performance of 4G long term evolution (LTE) technologies with reduced cost and enhanced coverage. Extensive evaluations indicate that the proposed system provides a sufficient level of service for medical-grade instantaneous ECG monitoring in significantly deteriorated channel conditions.1.Introduction 1 1.1 Motivation and Objectives 1 1.2 Research Contributions 6 1.3 Orgranization of Thesis 8 2 Background and Related Works 10 2.1 ECG Generals 10 2.2 Wireless ECG 15 2.3 Wireless Medium for Telecardiology 20 2.3.1 Wireless Personal Area Networks 21 2.3.2 Wireless Local Area Networks 22 2.3.3 Cellular Networks 23 3 Scalable ECG Transmission over Cellular Networks 24 3.1 System Architecture 26 3.2 Scalable Representation of ECG Data 27 3.3 ARQ-Based Error Control Using LB-EDF 30 3.4 Performance of Wireless ECG Transmission 33 4 Conservative Modulation and Coding for Instantaneous ECG Monitoring over LTE MTC 37 4.1 Architecture of Universal M2M ECG Platform 39 4.2 Demand for Instantaneous Monitoring 43 4.3 System Requirements for Instantaneous Monitoring Services 45 4.3.1 Latency Requirements and Analysis 45 4.3.2 Presentation Requirements for Sufficient Clinical Accuracy 53 4.4 System Architecture for Instantaneous Wireless ECG Monitoring using LTE MTC 58 4.4.1 Spatio-Temporal Scalable Media Coding for ECG signal 60 4.4.2 Conservative Modulation and Coding to Provide Extra Protection for Higher Prioritized Scalable Layers 64 4.4.3 System Parameter Analysis 68 4.5 Performance Evaluation 72 4.5.1 Simulation Environment 72 4.5.2 Simulation Results 72 4.5.3 Service Level Adjustment 78 5 Conclusion 79 5.1 Summary 79 5.2 Future Research Directions 83 Bibliography 84 Abstract in Korean 103Docto