This paper proposes a generalized Phase Space Reconstruction (PSR) based Cardiovascular Diseases (CVD) classification methodology by exploiting the localized features of the ECG. The proposed methodology first extracts the ECG localized features including PR interval, QRS complex, and QT interval from the continuous ECG waveform using features extraction logic, then the PSR technique is applied to get the phase portraits of all the localized features. Based on the cleanliness and contour of the phase portraits CVD classification will be done. This is first of its kind approach where the localized features of ECG are being taken into considerations unlike the state-of-art approaches, where the entire ECG beats have been considered. The proposed methodology is generic and can be extended to most of the CVD cases. It is verified on the PTBDB and IAFDB databases by taking the CVD including Atrial Fibrillation, Myocardial Infarction, Bundle Branch Block, Cardiomyopathy, Dysrhythmia, and Hypertrophy. The methodology has been tested on 65 patients’ data for the classification of abnormalities in PR interval, QRS complex, and QT interval. Based on the obtained statistical results, to detect the abnormality in PR interval, QRS complex and QT interval the Coefficient Variation (CV) should be greater than or equal to 0.1012, 0.083, 0.082 respectively with individual accuracy levels of 95.3%, 96.9%, and 98.5% respectively. To justify the clinical significance of the proposed methodology, the Confidence Interval (CI), the p-value using ANOVA have been computed. The p-value obtained is less than 0.05, and greater F-statistic values reveal the robust classification of CVD using localized features.
This paper describes a mixed-signal electrocardiogram (ECG) system for personalized and remote cardiac health monitoring. The novelty of this paper is fourfold. First, a low power analog front end with an efficient automatic gain control mechanism, maintaining the input of the ADC to a level rendering optimum SNR and the enhanced recyclic folded cascode opamp used as an integrator for ADC. Second, a novel on-the-fly PQRST boundary detection (BD) methodology is formulated for finding the boundaries in continuous ECG signal. Third, a novel low-complexity ECG feature extraction architecture is designed by reusing the same module present in the proposed BD methodology. Fourth, the system is having the capability to reconfigure the proposed low power ADC for low (8 b) and high (12 b) resolution with the use of the feedback signal obtained from the digital block when it is in processing. The proposed system has been tested and validated on patient's data from PTBDB, CSEDB, and in-house IIT Hyderabad Data Base (IITHDB) and we have achieved an accuracy of 99% upon testing on various normal and abnormal ECG signals. The whole system is implemented in 180-nm technology resulting in 9.47-µW (at 1 MHz) power consumption and occupying 1.74-mm 2 silicon area.
Aims
Approximately 5.7% of potential subcutaneous implantable cardioverter-defibrillator (S-ICD) recipients are ineligible by virtue of their vector morphology, with higher rates of ineligibility observed in some at-risk groups. Mathematical vector rotation is a novel technique that can generate a personalized sensing vector, one with maximal R:T ratio, using electrocardiogram (ECG) signal recorded from the present S-ICD location.
Methods and results
A cohort of S-ICD ineligible patients were identified through ECG screening of ICD patients with no ventricular pacing requirement and their personalized vectors were generated using ECG signal from a Holter monitor. Subcutaneous ICD eligibility in this cohort was then recalculated. In a separate cohort, episodes of arrhythmia were recorded in patients undergoing arrhythmia induction, and arrhythmia detection in standard S-ICD vectors was compared to rotated vectors using an S-ICD simulator. Ninety-two participants (mean age 64.9 ± 2.7 years) underwent screening and 5.4% were found to be S-ICD ineligible. Personalized vector generation increased the R:T ratio in these vectors from 2.21 to 7.21 (4.54–9.88, P < 0.001) increasing the cohort eligibility from 94.6% to 100%. Rotated S-ICD vectors also showed high ventricular fibrillation (VF) detection sensitivity (97.8%), low time to VF detection (6.1 s), and excellent tachycardia discrimination (sensitivity 96%, specificity 88%), with no significant differences between rotated and standard vectors.
Conclusion
In S-ICD ineligible patients, mathematical vector rotation can generate a personalized vector that is associated with a significant increase in R:T ratio, resulting in universal device eligibility in our cohort. Ventricular fibrillation detection efficacy, time to VF detection, and tachycardia discrimination were not affected by vector rotation.
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