Data-driven methods for analyzing ballistocardiograms in longitudinal cardiovascular monitoring

Cardiovascular disease (CVD) is the leading cause of death in the US; about 48% of American adults have one or more types of CVD. The importance of continuous monitoring of the older population, for early detection of changes in health conditions, has been shown in the literature, as the key to a successful clinical intervention. We have been investigating environmentally-embedded in-home networks of non-invasive sensing modalities. This dissertation concentrates on the signal processing techniques required for the robust extraction of morphological features from the ballistocardiographs (BCG), and machine learning approaches to utilize these features in non-invasive monitoring of cardiovascular conditions. At first, enhancements in the time domain detection of the cardiac cycle are addressed due to its importance in the estimation of heart rate variability (HRV) and sleep stages. The proposed enhancements in the energy-based algorithm for BCG beat detection have shown at least 50% improvement in the root mean square error (RMSE) of the beat to beat heart rate estimations compared to the reference estimations from the electrocardiogram (ECG) R to R intervals. These results are still subject to some errors, primarily due to the contamination of noise and motion artifacts caused by floor vibration, unconstrained subject movements, or even the respiratory activities. Aging, diseases, breathing, and sleep disorders can also affect the quality of estimation as they slightly modify the morphology of the BCG waveform.Includes bibliographical reference

BioWatch: Estimation of Heart and Breathing Rates from Wrist Motions

Continued developments of sensor technology including hardware miniaturization and increased sensitivity have enabled the development of less intrusive methods to monitor physiological parameters during daily life. In this work, we present methods to recover cardiac and respiratory parameters using accelerometer and gyroscope sensors on the wrist. We demonstrate accurate measurements in a controlled laboratory study where participants (n = 12) held three different positions (standing up, sitting down and lying down) under relaxed and aroused conditions. In particular, we show it is possible to achieve a mean absolute error of 1.27 beats per minute (STD: 3.37) for heart rate and 0.38 breaths per minute (STD: 1.19) for breathing rate when comparing performance with FDA-cleared sensors. Furthermore, we show comparable performance with a state-of-the-art wrist-worn heart rate monitor, and when monitoring heart rate of three individuals during two consecutive nights of in-situ sleep measurements.National Science Foundation (U.S.) (CCF-1029585)Samsung (Firm). Think Tank TeamMIT Media Lab Consortiu

Physiological Information Analysis Using Unobtrusive Sensors: BCG from Load-Cell Based Infants' Bed and ECG from Patch Electrode

학위논문 (박사)-- 서울대학교 대학원 : 바이오엔지니어링전공, 2016. 8. 박광석.The aging population, chronic diseases, and infectious diseases are major challenges for our current healthcare system. To address these unmet healthcare needs, especially for the early prediction and treatment of major diseases, acquiring physiological information of different types has emerged as a promising interdisciplinary research area. Unobtrusive sensing techniques are instrumental in constructing a routine health management system, because they can be incorporated in daily life without confining individuals or causing any discomfort. This dissertation is dedicated to summarizing our research on monitoring of cardiorespiratory activities by means of unobtrusive sensing methods. Ballistocardiography and electrocardiography, which record the activity of the cardiorespiratory system with respect to mechanical or electrical characteristics, are both being actively investigated as important physiological signal measurement that provide the information required to monitor human health states. This research was carried out to evaluate the feasibility of new application methods of unobtrusive sensing that not been investigated significantly in previous investigations. We also tried to incorporate improvement essential for bringing these technologies to practical use. Our first device is a non-confining system for monitoring the physiological information of infants using ballistocardiography technology. Techniques to observe continuous biological signals without confinement may be even more important for infants since they could be used effectively to detect respiratory distress and cardiac abnormalities. We also expect to find extensive applications in the field of sleep research for analyzing sleep efficiency and sleep patterns of infants. Specifically, the sleep of infants is closely related to their health, growth, and development. Children who experience abnormal sleep and activity rhythms during their early infantile period are more prone to developing sleep-related disorders in late childhood, which are also more difficult to overcome. Therefore, studying their sleep characteristics is extremely important. Although ballistocardiography technology seems to represent a possible solution to overcome the limitations of conventional physiological signal monitoring, most studies investigating the application of these methods have focused on adults, and few have been focused on infants. To verify the usefulness of ballistocardiogram (BCG)-based physiological measurement in infants, we describe a load-cell based signal monitoring bed and assess an algorithm to estimate heartbeat and respiratory information. Four infants participated in 13 experiments. As a reference signal, electrocardiogram (ECG) and respiration signals were simultaneously measured using a commercial device. The proposed automatic algorithm then selected the optimal sensor from which to estimate the heartbeat and respiratory information. The results from the load-cell sensor signals were compared with those of the reference signals, and the heartbeat and respiratory information were found to have average performance errors of 2.55% and 2.66%, respectively. We believe that our experimental results verify the feasibility of BCG-based measurements in infants. Next, we developed a small, light, ECG monitoring device with enhanced portability and wearability, with software that contains a peak detection algorithm for analyzing heart rate variability (HRV). A mobile ECG monitoring system, which can assess an individuals condition efficiently during daily life activities, could be beneficial for management of their health care. A portable ECG monitoring patch with a minimized electrode array pad, easily attached to a persons chest, was developed. To validate the devices performance and efficacy, signal quality analysis in terms of robustness under motion, and HRV results obtained under stressful conditions were assessed by comparing the developed device with a commercially available ECG device. The R-peak detection results obtained with the device exhibited a sensitivity of 99.29%, a positive predictive value of 100.00%, and an error of 0.71%. The device also exhibited less motional noise than conventional ECG recording, being stable up to a walking speed of 5 km/h. When applied to mental stress analysis, the device evaluated the variation in HRV parameters in the same way as a reference ECG signal, with very little difference. Thus, our portable ECG device with its integrated minimized electrode patch carries promise as a form of ECG measurement technology that can be used for daily health monitoring. There is currently an increased demand for continuous health monitoring systems with unobtrusive sensors. All of the experimental results in this dissertation verify the feasibility of our unobtrusive cardiorespiratory activity monitoring system. We believe that the proposed device and algorithm presented here are essential prerequisites toward substantiating the utility of unobtrusive physiological measurements. We also expect this system can help users better understand their state of health and provide physicians with more reliable data for objective diagnosis.Chapter 1. Introduction 1 1.1. Cardiorespiratory signal and its related physiological information 2 1.1.1. Electrocardiogram 2 1.1.2. Ballistocardiogram 3 1.1.3. Respiration 4 1.1.4. Heart rate and breathing rate 5 1.1.5. Variability analysis of heart and respiratory rate 5 1.2. Unobtrusive sensing methods for continuous physiological monitoring 6 1.3. Outline of the dissertation 9 Chapter 2. Development of sensor device for unobtrusive physiological signal measurement 13 2.1. Unobtrusive BCG measurement device for infants health monitoring 13 2.1.1. Specifications of the device 17 2.1.2. Signal processing in hardware 18 2.1.3. Performance of the device 21 2.2. Unobtrusive ECG measurement device for health monitoring in daily life 25 2.2.1. Specifications of the device 26 2.2.2. Signal processing in hardware 28 2.2.3. Performance of the device 30 Chapter 3. Development of algorithm for physiological information analysis from unobtrusively measured signal 35 3.1. Algorithm for automatically analyzing unobtrusively measured BCG signal 35 3.1.1. Process flow of the algorithm 36 3.1.2. Performance evaluation 47 3.2. Algorithm for automatically analyzing unobtrusively measured ECG signal 57 3.2.1. Process flow of the algorithm 57 3.2.2. Performance evaluation 60 3.3. HRV analysis for processing unobtrusively measured signals 63 3.3.1. Optimum HRV algorithm selection in data missing simulation 64 3.3.2. Stress assessment using HRV parameters 67 Chapter 4. Discussion 71 Chapter 5. Conclusion 79 Reference 81 Abstract in Korean 89 Appendix 93Docto

Robust Algorithms for Unattended Monitoring of Cardiovascular Health

Cardiovascular disease is the leading cause of death in the United States. Tracking daily changes in one’s cardiovascular health can be critical in diagnosing and managing cardiovascular disease, such as heart failure and hypertension. A toilet seat is the ideal device for monitoring parameters relating to a subject’s cardiac health in his or her home, because it is used consistently and requires no change in daily habit. The present work demonstrates the ability to accurately capture clinically relevant ECG metrics, pulse transit time based blood pressures, and other parameters across subjects and physiological states using a toilet seat-based cardiovascular monitoring system, enabled through advanced signal processing algorithms and techniques. The algorithms described herein have been designed for use with noisy physiologic signals measured at non-standard locations. A key component of these algorithms is the classification of signal quality, which allows automatic rejection of noisy segments before feature delineation and interval extractions. The present delineation algorithms have been designed to work on poor quality signals while maintaining the highest possible temporal resolution. When validated on standard databases, the custom QRS delineation algorithm has best-in-class sensitivity and precision, while the photoplethysmogram delineation algorithm has best-in-class temporal resolution. Human subject testing on normative and heart failure subjects is used to evaluate the efficacy of the proposed monitoring system and algorithms. Results show that the accuracy of the measured heart rate and blood pressure are well within the limits of AAMI standards. For the first time, a single device is capable of monitoring long-term trends in these parameters while facilitating daily measurements that are taken at rest, prior to the consumption of food and stimulants, and at consistent times each day. This system has the potential to revolutionize in-home cardiovascular monitoring

Development of a Portable Seat Cushion for the Estimation of Heart Rate Using Ballistocardiography

Cardiovascular diseases are a leading contributor of health problems all over the world and are the second leading cause of death. They are also the cause of significant economic burden, costing billions of dollars in healthcare every year. With an aging population, the strain on the healthcare system, both in terms of costs and care provision, is expected to worsen. Frequent cardiac assessment can provide essential information towards diagnosis, monitoring, and treatment, which can mitigate symptoms and improve health outcomes for people with conditions such as heart failure. This has led to increasing interest in cardiac assessment at home. Additionally, for some populations like people with limited mobility and older adults, long term vitals monitoring at a clinical setting is not feasible, making at-home monitoring more viable and economical. Most devices available for cardiac monitoring at home are wearables. While wearable technology can be accurate, it requires compliance and maintenance, which is not an ideal solution for all populations. For example, people who are not comfortable using wearables or people with a cognitive impairment may not want or be able to use wearables, which could exclude these user types from at home monitoring. Keeping these factors under consideration, the past decade has seen an increased interest in the development of technologies for Ambient Assisted Living (i.e., smart technologies integrated into a user's environment). These technologies have the potential for ongoing health monitoring in an unobtrusive manner. This thesis presents research into the development of a smart seat cushion for heart rate monitoring. The cushion is able to calculate the heart rate of a person seated on it by acquiring their Ballistocardiogram (BCG). BCG is a cardiovascular signal corresponding to the displacement of the body in response to the heart pumping blood at every heartbeat. The prototype seat cushion has load cells embedded inside it that sense the micromovements of the body and translate it to an electrical signal. An analog signal conditioning circuit amplifies and filters this signal to enhance the components corresponding to BCG before it is converted to digital form. A pilot study was conducted with twenty participants to acquire BCG in real-world scenarios: 1) sitting still, 2) reading, 3) using a computer, 4) watching TV, and 5) having a conversation. Heart rate was calculated using a novel algorithm based on Continuous Wavelet Transform by detecting the largest peaks (referred to as the J-peaks) in the BCG. Excluding three outliers, the algorithm is able to achieve an overall accuracy of 94.6% compared to gold standard Electrocardiography (ECG). This accuracy is observed to be as good as or better than those of existing wearable heart rate monitors. The seat cushion developed in this thesis research can serve as a portable solution for cardiac monitoring and can integrate into an ambient health monitoring system, offering continued monitoring of heart rate while requiring no perceived effort to operate it. Future work includes exploring different sensor configurations, machine learning based approaches for improving J-peaks detection, and real-time monitoring of heart rate

A wearable heart monitor at the ear using ballistocardiogram (BCG) and electrocardiogram (ECG) with a nanowatt ECG heartbeat detection circuit

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2013.Cataloged from PDF version of thesis.Includes bibliographical references (p. 132-137).This work presents a wearable heart monitor at the ear that uses the ballistocardiogram (BCG) and the electrocardiogram (ECG) to extract heart rate, stroke volume, and pre-ejection period (PEP) for the application of continuous heart monitoring. Being a natural anchoring point, the ear is demonstrated as a viable location for the integrated sensing of physiological signals. The source of periodic head movements is identified as a type of BCG, which is measured using an accelerometer. The head BCG's principal peaks (J-waves) are synchronized to heartbeats. Ensemble averaging is used to obtain consistent J-wave amplitudes, which are related to stroke volume. The ECG is sensed locally near the ear using a single-lead configuration. When the BCG and the ECG are used together, an electromechanical duration called the RJ interval can be obtained. Because both head BCG and ECG have low signal-to-noise ratios, cross-correlation is used to statistically extract the RJ interval. The ear-worn device is wirelessly connected to a computer for real time data recording. A clinical test involving hemodynamic maneuvers is performed on 13 subjects. The results demonstrate a linear relationship between the J-wave amplitude and stroke volume, and a linear relationship between the RJ interval and PEP. While the clinical device uses commercial components, a custom integrated circuit for ECG heartbeat detection is designed with the goal of reducing power consumption and device size. With 58nW of power consumption, the ECG circuit replaces the traditional instrumentation amplifier, analog-to-digital converter, and signal processor with a single chip solution. The circuit demonstrates a topology that takes advantage of the ECG's characteristics to extract R-wave timings at the chest and the ear in the presence of baseline drift, muscle artifact, and signal clipping.by David Da He.Ph.D

Continuous Cardiorespiratory Monitoring Using Ballistocardiography From Load Cells Embedded in a Hospital Bed

The objective of this research is to explore signal processing and machine learning techniques to allow continuous monitoring of cardiorespiratory parameters using the ballistocardiogram (BCG) signals recorded with sensors embedded in a hospital bed. First, the heart rate (HR) estimation algorithms were presented. The first is signal processing-based HR estimation with array processing for multi-channel combination. The second uses a deep learning (DL) model that transforms BCG signals into an interpretable triangular waveform, from which heartbeat locations can be estimated. Second part of the work focuses on estimating respiratory rate (RR) and respiratory volume (RV) using the respiration waveforms derived from the low-frequency components of the load cell signals. Lastly, this work presents two models for blood pressure (BP) estimation -- 1) Conventional pulse transit time (PTT)-based model and 2) DL-based model, both using multi-channel BCG and the photoplethysmogram (PPG) signals to extract features. Overall, this work established methods to enable non-invasive and continuous monitoring of standard vital signs utilizing the sensors already embedded in commonly-deployed commercially available hospital beds. Such technologies could potentially improve the continuous assessment of the patients' physiologic state without adding an extra burden on the caregivers.Ph.D