IoT and fog computing-based monitoring system for cardiovascular patients with automatic ECG classification using deep neural networks

[EN] Telemedicine and all types of monitoring systems have proven to be a useful and low-cost tool with a high level of applicability in cardiology. The objective of this work is to present an IoT-based monitoring system for cardiovascular patients. The system sends the ECG signal to a Fog layer service by using the LoRa communication protocol. Also, it includes an AI algorithm based on deep learning for the detection of Atrial Fibrillation and other heart rhythms. The automatic detection of arrhythmias can be complementary to the diagnosis made by the physician, achieving a better clinical vision that improves therapeutic decision making. The performance of the proposed system is evaluated on a dataset of 8.528 short single-lead ECG records using two merge MobileNet networks that classify data with an accuracy of 90% for atrial fibrillation.This work was partly supported by the Spanish Government (RTI2018-095390-B-C31), Universitat Politecnica de Valencia Research Grant PAID-10-19. S.G-O has been funded by grant PDBCEx COLDOC 679, scholarship programme from COLCIENCIAS (Administrative Department of Science, Technology and Innovation of Colombia).Rincón-Arango, JA.; Guerra-Ojeda, S.; Carrascosa Casamayor, C.; Julian, V. (2020). IoT and fog computing-based monitoring system for cardiovascular patients with automatic ECG classification using deep neural networks. Sensors. 20(24):1-19. https://doi.org/10.3390/s20247353119202

Efficient and secured wireless monitoring systems for detection of cardiovascular diseases

Cardiovascular Disease (CVD) is the number one killer for modern era. Majority of the deaths associated with CVD can entirely be prevented if the CVD struck person is treated with urgency. This thesis is our effort in minimizing the delay associated with existing tele-cardiology application. We harnessed the computational power of modern day mobile phones to detect abnormality in Electrocardiogram (ECG). If abnormality is detected, our innovative ECG compression algorithm running on the patient's mobile phone compresses and encrypts the ECG signal and then performs efficient transmission towards the doctors or hospital services. According to the literature, we have achieved the highest possible compression ratio of 20.06 (95% compression) on ECG signal, without any loss of information. Our 3 layer permutation cipher based ECG encoding mechanism can raise the security strength substantially higher than conventional AES or DES algorithms. If in near future, a grid of supercomputers can compare a trillion trillion trillion (1036) combinations of one ECG segment (comprising 500 ECG samples) per second for ECG morphology matching, it will take approximately 9.333 X 10970 years to enumerate all the combinations. After receiving the compressed ECG packets the doctor's mobile phone or the hospital server authenticates the patient using our proposed set of ECG biometric based authentication mechanisms. Once authenticated, the patients are diagnosed with our faster ECG diagnosis algorithms. In a nutshell, this thesis contains a set of algorithms that can save a CVD affected patient's life by harnessing the power of mobile computation and wireless communication

Application of Handheld Tele-ECG for Health Care Delivery in Rural India

Telemonitoring is a medical practice that involves remotely monitoring patients who are not at the same location as the health care provider. The purpose of our study was to use handheld tele-electrocardiogram (ECG) developed by Bhabha Atomic Research Center (BARC) to identify heart conditions in the rural underserved population where the doctor-patient ratio is low and access to health care is difficult. The objective of our study was clinical validation of handheld tele-ECG as a screening tool for evaluation of cardiac diseases in the rural population. ECG was obtained in 450 individuals (mean age 31.49 ± 20.058) residing in the periphery of Chandigarh, India, from April 2011 to March 2013, using the handheld tele-ECG machine. The data were then transmitted to physicians in Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, for their expert opinion. ECG was interpreted as normal in 70% individuals. Left ventricular hypertrophy (9.3%) was the commonest abnormality followed closely by old myocardial infarction (5.3%). Patient satisfaction was reported to be ~95%. Thus, it can be safely concluded that tele-ECG is a portable, cost-effective, and convenient tool for diagnosis and monitoring of heart diseases and thus improves quality and accessibility, especially in rural areas

Telemedicine

Telemedicine is a rapidly evolving field as new technologies are implemented for example for the development of wireless sensors, quality data transmission. Using the Internet applications such as counseling, clinical consultation support and home care monitoring and management are more and more realized, which improves access to high level medical care in underserved areas. The 23 chapters of this book present manifold examples of telemedicine treating both theoretical and practical foundations and application scenarios

A Framework for Remote Patient Monitoring to Diagnose the Cardiac Disorders

Electrocardiogram (ECG) is an efficient diagnostic tool to monitor the electrical activity of heart. One of the most vital benefit of using telecommunication technologies in medical field is to provide cardiac health care at a distance. Telecardiology is the most efficient way to provide faster and affordable health care for the cardiac patients located at rural areas. Early detection of cardiac disorders can minimize cardiac death rates. In real time monitoring process, ECG data from a patient usually takes large storage space in the order of gigabytes (GB). Hence, compression of bulky ECG signal is a common requirement for faster transmission of cardiac signals using wireless technologies. Several techniques such as the Fourier transform based methods, wavelet transform based methods, etc., have been reported for compression of ECG data. Though Fourier transform is suitable for analyzing the stationary signals. An improved version, the wavelet transform allows the analysis of non-stationary signal. It provides a uniform resolution for all the scales, however, wavelet transform faces difficulties like uniformly poor resolution due to limited size of the basic wavelet function and it is nonadaptive in nature. A data adaptive method to analyse non-stationary signal is based on empirical mode decomposition (EMD), where the bases are derived from the multivariate data which are nonlinear and non-stationary. A new ECG signal compression technique based on EMD is proposed, in which first EMD technique is applied to decompose the ECG signal into several intrinsic mode functions (IMFs). Next, downsampling, discrete cosine transform (DCT), window filtering and Huffman encoding processes are used sequentially to compress the ECG signal. The compressed ECG is then transmitted as short messageservice (SMS) message using a global system for mobile communications (GSM) modem. First the AT-command ‘+CMGF’ is used to set the SMS to text mode. Next, the GSM modem uses the AT-command ‘+CMGS’ to send a SMS message. The received text SMS messages are transferred to a personal computer (PC) using blue-tooth. All text SMS messages are combined in PC as per the received sequence and fed as data input to decompress the compressed ECG data. The decompression method which is used to reconstruct the original ECG signal consists of Huffman decoding, inverse discrete cosine transform (IDCT) and spline interpolation. The performance of the compression and decompression techniques are evaluated in terms of compression ratio (CR) and percent root mean square difference (PRD) respectively by using both European ST-T database and Massachusetts Institute of Technology-Beth Israel Hospital (MIT-BIH) arrhythmia database. The average values of CR and PRD for selected ECG records of European ST-T database are found to be 23.5:1 and 1.38 respectively. All 48 ECG records of MIT-BIH arrhythmia database are used for comparison purpose and the average values of CR and PRD are found to be 23.74:1 and 1.49 respectively. The reconstructed ECG signal is then used for detection of cardiac disorders like bradycardia, tachycardia and ischemia. The preprocessing stage of the detection technique filters the normalized signal to reduce noise components and detects the QRS-complexes. Next, ECG feature extraction, ischemic beat classification and ischemic episode detection processes are applied sequentially to the filtered ECG by using rule based medical knowledge. The ST-segment and T-wave are the two features generally used for ischemic beat classification. As per the recommendation of ESC (European Society of cardiology) the ischemic episode detection procedure considers minimum 30s duration of signal. The performance of the ischemic episode detection technique is evaluated in terms of sensitivity (Se) and positive predictive accuracy (PPA) by using European ST-T database. This technique achieves an average Se and PPA of 83.08% and 92.42% respectively

Electrocardiogram data collection under network attacks on the MAC platform

Increasing heart disease among human beings needs more precise treatment, which requires monitoring of electrocardiogram (ECG). In many cases, real time monitoring of ECG is needed via wireless or wireline networks. Use of network-connected computers for monitoring proposes can raise security issues, which can be created by viruses, worms, or external agents such as DoS attack traffic. Any alteration of this biomedical signal can lead to wrong diagnosis and wrong treatment. Furthermore, in healthcare industry, HIPAA rules require health information to be kept secure by providing confidentiality, integrity, and availability. This thesis investigates how integrity and availability of remotely monitored ECG signals can be affected silently due to adverse network conditions, hence raising false alarms. In this thesis, components of monitored ECG signals under adverse network conditions are measured and compared against normal ECG signals for detection of different heart diseases

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