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Accurate QRS detection is an important first step for almost all automatic electrocardiogram (ECG) analyzing systems. However, QRS detection is difficult, not only because of the wide variety of ECG waveforms but also because of the interferences caused by various types of noise. This study proposes an improved QRS complex detection algorithm based on a four-level biorthogonal spline wavelet transform. A noise evaluation method is proposed to quantify the noise amount and to select a lower-noise wavelet detail signal instead of removing high-frequency components in the preprocessing stage. The QRS peaks can be detected by the extremum pairs in the selected wavelet detail signal and the proposed decision rules. The results show the high accuracy of the proposed algorithm, which achieves a 0.25% detection error rate, 99.84% sensitivity, and 99.92% positive prediction value, evaluated using the MIT-BIT arrhythmia database. The proposed algorithm improves the accuracy of QRS detection in comparison with several wavelet-based and non-wavelet-based approaches.

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