Unsupervised ensembling of multiple software sensors: a new approach for electrocardiogram-derived respiration using one or two channels

While several electrocardiogram-derived respiratory (EDR) algorithms have been proposed to extract breathing activity from a single-channel ECG signal, conclusively identifying a superior technique is challenging. We propose viewing each EDR algorithm as a {\em software sensor} that records the breathing activity from the ECG signal, and ensembling those software sensors to achieve a higher quality EDR signal. We refer to the output of the proposed ensembling algorithm as the {\em ensembled EDR}. We test the algorithm on a large scale database of 116 whole-night polysomnograms and compare the ensembled EDR signal with four respiratory signals recorded from four different hardware sensors. The proposed algorithm consistently improves upon other algorithms, and we envision its clinical value and its application in future healthcare

A comparative study of ECG-derived respiration in ambulatory monitoring using the single-lead ECG

Cardiorespiratory monitoring is crucial for the diagnosis and management of multiple conditions such as stress and sleep disorders. Therefore, the development of ambulatory systems providing continuous, comfortable, and inexpensive means for monitoring represents an important research topic. Several techniques have been proposed in the literature to derive respiratory information from the ECG signal. Ten methods to compute single-lead ECG-derived respiration (EDR) were compared under multiple conditions, including different recording systems, baseline wander, normal and abnormal breathing patterns, changes in breathing rate, noise, and artifacts. Respiratory rates, wave morphology, and cardiorespiratory information were derived from the ECG and compared to those extracted from a reference respiratory signal. Three datasets were considered for analysis, involving a total 59 482 one-min, single-lead ECG segments recorded from 156 subjects. The results indicate that the methods based on QRS slopes outperform the other methods. This result is particularly interesting since simplicity is crucial for the development of ECG-based ambulatory systems

A Morphological Approach To Identify Respiratory Phases Of Seismocardiogram

Respiration affects the cardiovascular system significantly and the morphology of signals relevant to the heart changes with respiration. Such changes have been used to extract respiration signal from electrocardiogram (ECG). It is also shown that accelerometers placed on the body can be used to extract respiration signals. It has been demonstrated that the signal morphology for seismocardiogram, the lower frequency band of chest accelerations, is different between inhale and exhale. For instance, systolic time intervals (STI), which provide a quantitative estimation of left ventricular performance, vary between inhale and exhale phases. In other words, heart beats happening in exhale phase are different compared to those in inhale phase. Thus, our main goal in this thesis is investigating feasibility of finding an automatic morphological based method to identify respiratory phases of heart cycles. In this thesis, forty signal recordings from twenty subjects were used. In each recording, the reference respiratory belt signal, three dimensional (3D) chest acceleration signals, and electrocardiogram signals were recorded. The first stage was is choosing a proper estimated respiratory signal. The second stage, was the automatic respiratory phase detection of heart cycles using the selected estimated respiratory signal. The result shows that among estimated respiratory signals, accelerometer-derived respiration (ADR), in z-direction, has a potential m to identify respiratory phase of heart cycles with total accuracy of about 77%

Multimodal Signal Processing for Diagnosis of Cardiorespiratory Disorders

This thesis addresses the use of multimodal signal processing to develop algorithms for the automated processing of two cardiorespiratory disorders. The aim of the first application of this thesis was to reduce false alarm rate in an intensive care unit. The goal was to detect five critical arrhythmias using processing of multimodal signals including photoplethysmography, arterial blood pressure, Lead II and augmented right arm electrocardiogram (ECG). A hierarchical approach was used to process the signals as well as a custom signal processing technique for each arrhythmia type. Sleep disorders are a prevalent health issue, currently costly and inconvenient to diagnose, as they normally require an overnight hospital stay by the patient. In the second application of this project, we designed automated signal processing algorithms for the diagnosis of sleep apnoea with a main focus on the ECG signal processing. We estimated the ECG-derived respiratory (EDR) signal using different methods: QRS-complex area, principal component analysis (PCA) and kernel PCA. We proposed two algorithms (segmented PCA and approximated PCA) for EDR estimation to enable applying the PCA method to overnight recordings and rectify the computational issues and memory requirement. We compared the EDR information against the chest respiratory effort signals. The performance was evaluated using three automated machine learning algorithms of linear discriminant analysis (LDA), extreme learning machine (ELM) and support vector machine (SVM) on two databases: the MIT PhysioNet database and the St. Vincent’s database. The results showed that the QRS area method for EDR estimation combined with the LDA classifier was the highest performing method and the EDR signals contain respiratory information useful for discriminating sleep apnoea. As a final step, heart rate variability (HRV) and cardiopulmonary coupling (CPC) features were extracted and combined with the EDR features and temporal optimisation techniques were applied. The cross-validation results of the minute-by-minute apnoea classification achieved an accuracy of 89%, a sensitivity of 90%, a specificity of 88%, and an AUC of 0.95 which is comparable to the best results reported in the literature

Time-frequency investigation of heart rate variability and cardiovascular system modeling of normal and chronic obstructive pulmonary disease (COPD) subjects

A study has been designed to add insight to some questions that have not been fully investigated in the heart rate variability field and the cardiovascular regulation system in normal and Chronic Obstructive Pulmonary Disease (COPD) subjects. It explores the correlations between heart rate variability and cardiovascular regulation, which interact through complex multiple feedback and control loops. This work examines the coupling between heart rate (HR), respiration (RESP), and blood pressure (BP) via closed-loop system identification techniques in order to noninvasively assess the underlying physiology. In the first part of the study, the applications of five different bilinear time-frequency representations are evaluated on modeled HRV test signals, actual electrocardiograms (ECG), BP and RESP signals. Each distribution: the short time Fourier transform (STFT), the smoothed pseudo Wigner-Ville (SPWVD), the ChoiWilliams (CWD), the Bom-Jordan-Cohen (BJC) and wavelet distribution (WL), has unique characteristics which is shown to affect the amount of smoothing and the generation of cross-terms. The CWD and the WL are chosen for further application because of overcoming the drawbacks of other distributions by providing higher resolution in time and frequency while suppressing interferences between the signal components. In the second part of the study, the Morlet, Meyer, Daubechies 4, Mexican Hat and Haar wavelets are used to investigate the heart rate and blood pressure variability from both COPD and normal subjects. The results of wavelet analysis give much more useful information than the Cohen\u27s class representations. Here we are able to quantitatively assess the parasympathetic (HF) and sympatho-vagal balance (LF:HF) changes as a function of time. As a result, COPD subjects breathe faster, have higher blood pressure variability and lower HRV. In the third part of the study, a special class of the exogenous autoregressive (ARX) model is developed as an analytical tool for uncovering the hidden autonomic control processes. Non-parametric relationships between the input and outputs of the ARX model resulting in transfer function estimations of the noise filters and the input filter were used as mechanistic cardiovascular models that have shown to have predictive capabilities for the underlying autonomic nervous system activity of COPD patients. Transfer functions of COPD cardiovascular models have similar DC gains but show a larger lag in phase as compared to the models of normal subjects. Finally, a method of severity classification is presented. This method combines the techniques of principal component analysis (PCA) and cluster analysis (CA) and has been shown to separate the COPD from the normal population with 100% accuracy. It can also classify the COPD population into at risk , mild , moderate and severe stages with 100%, 90%, 88% and 100% accuracy respectively. As a result, cluster and principal component analysis can be used to separate COPD and normal subjects and can be used successfully in COPD severity classification

ECG-derived respiratory rate in atrial fibrillation

Objective: The present study addresses the problem of estimating the respiratory rate from the morphological ECG variations in the presence of atrial fibrillatory waves (f-waves). The significance of performing f-wave suppression before respiratory rate estimation is investigated. Methods: The performance of a novel approach to ECG-derived respiration, named “slope range” (SR) and designed particularly for operation in atrial fibrillation (AF), is compared to that of two well-known methods based on either R-wave angle (RA) or QRS loop rotation angle (LA). A novel rule is proposed for spectral peak selection in respiratory rate estimation. The suppression of f-waves is accomplished using signal- and noise-dependent QRS weighted averaging. The performance evaluation embraces real as well as simulated ECG signals acquired from patients with persistent AF; the estimation error of the respiratory rate is determined for both types of signals. Results: Using real ECG signals and reference respiratory signals, rate estimation without f-wave suppression resulted in a median error of 0.015±0.021 Hz and 0.019±0.025 Hz for SR and RA, respectively, whereas LA with f-wave suppression resulted in 0.034±0.039 Hz. Using simulated signals, the results also demonstrate that f-wave suppression is superfluous for SR and RA, whereas it is essential for LA. Conclusion: The results show that SR offers the best performance as well as computational simplicity since f-wave suppression is not needed. Significance: The respiratory rate can be robustly estimated from the ECG in the presence of AF

Unconstrained estimation of HRV indices after removing respiratory influences from heart rate

Objective: This paper proposes an approach to better estimate the sympathovagal balance (SB) and the respiratory sinus arrhythmia (RSA) after separating respiratory influences from the heart rate (HR). Methods: The separation is performed using orthogonal subspace projections and the approach is first tested using simulated HR and respiratory signals with different spectral properties. Then, RSA and SB are estimated during autonomic blockade and stress using the proposed approach and the classical heart rate variability (HRV) analysis. Both real and ECG-derived respiration (EDR) are used and the reliability of the EDR is evaluated. Results: Mean absolute percentage errors lower than 1% were obtained after removing previously known respiratory signals from simulated HR. The proposed indices were able to improve the quantification of SB during autonomic withdrawal. In the stress data, differences ( $p < 0.003 ) among relaxed and stressful phases were found with the proposed approach, using both the real respiration and the EDR, but they disappeared when using the classical HRV. Conclusion: A better assessment of the autonomic nervous system' response to pharmacological blockade and stress can be achieved after removing respiratory influences from HR, and this can be done using either the real respiration or the EDR. Significance: This work can be used to better identify vagal withdrawal and increased sympathetic activation when the classical HRV analysis fails due to the respiratory influences on HR. Furthermore, it can be computed using only the ECG, which is an advantage when developing wearable systems with limited number of sensors

Extraction of respiratory signals from the electrocardiogram and photoplethysmogram: technical and physiological determinants.

OBJECTIVE: Breathing rate (BR) can be estimated by extracting respiratory signals from the electrocardiogram (ECG) or photoplethysmogram (PPG). The extracted respiratory signals may be influenced by several technical and physiological factors. In this study, our aim was to determine how technical and physiological factors influence the quality of respiratory signals. APPROACH: Using a variety of techniques 15 respiratory signals were extracted from the ECG, and 11 from PPG signals collected from 57 healthy subjects. The quality of each respiratory signal was assessed by calculating its correlation with a reference oral-nasal pressure respiratory signal using Pearson's correlation coefficient. MAIN RESULTS: Relevant results informing device design and clinical application were obtained. The results informing device design were: (i) seven out of 11 respiratory signals were of higher quality when extracted from finger PPG compared to ear PPG; (ii) laboratory equipment did not provide higher quality of respiratory signals than a clinical monitor; (iii) the ECG provided higher quality respiratory signals than the PPG; (iv) during downsampling of the ECG and PPG significant reductions in quality were first observed at sampling frequencies of  <250 Hz and  <16 Hz respectively. The results informing clinical application were: (i) frequency modulation-based respiratory signals were generally of lower quality in elderly subjects compared to young subjects; (ii) the qualities of 23 out of 26 respiratory signals were reduced at elevated BRs; (iii) there were no differences associated with gender. SIGNIFICANCE: Recommendations based on the results are provided regarding device designs for BR estimation, and clinical applications. The dataset and code used in this study are publicly available

Self-adjustable domain adaptation in personalized ECG monitoring integrated with IR-UWB radar

To enhance electrocardiogram (ECG) monitoring systems in personalized detections, deep neural networks (DNNs) are applied to overcome individual differences by periodical retraining. As introduced previously [4], DNNs relieve individual differences by fusing ECG with impulse radio ultra-wide band (IR-UWB) radar. However, such DNN-based ECG monitoring system tends to overfit into personal small datasets and is difficult to generalize to newly collected unlabeled data. This paper proposes a self-adjustable domain adaptation (SADA) strategy to prevent from overfitting and exploit unlabeled data. Firstly, this paper enlarges the database of ECG and radar data with actual records acquired from 28 testers and expanded by the data augmentation. Secondly, to utilize unlabeled data, SADA combines self organizing maps with the transfer learning in predicting labels. Thirdly, SADA integrates the one-class classification with domain adaptation algorithms to reduce overfitting. Based on our enlarged database and standard databases, a large dataset of 73200 records and a small one of 1849 records are built up to verify our proposal. Results show SADA\u27s effectiveness in predicting labels and increments in the sensitivity of DNNs by 14.4% compared with existing domain adaptation algorithms