ECG sonification to support the diagnosis and monitoring of myocardial infarction

Abstract

This paper presents the design and evaluation of four sonification methods to support monitoring and diagnosis in Electrocardiography (ECG). In particular we focus on an ECG abnormality called ST-elevation which is an important indicator of a myocardial infarction. Since myocardial infarction represents a life-threatening condition it is of essential value to detect an ST-elevation as early as possible. As part of the evaluated sound designs, we propose two novel sonifications: (i) Polarity sonification, a continuous parameter-mapping sonification using a formant synthesizer and (ii) Stethoscope sonification, a combination of the ECG signal and a stethoscope recording. The other two designs, (iii) the water ambience sonification and the (iv) morph sonification, were presented in our previous work about ECG sonification (Aldana Blanco AL, Steffen G, Thomas H (2016) In: Proceedings of Interactive Sonification Workshop (ISon). Bielefeld, Germany). The study evaluates three components across the proposed sonifications (1) detection performance, meaning if participants are able to detect a transition from healthy to unhealthy states, (2) classification accuracy, that evaluates if participants can accurately classify the severity of the pathology, and (3) aesthetics and usability (pleasantness, informativeness and long-term listening). The study results show that the polarity design had the highest accuracy rates in the detection task whereas the stethoscope sonification obtained the better score in the classification assignment. Concerning aesthetics, the water ambience sonification was regarded as the most pleasant. Furthermore, we found a significant difference between sound/music experts and non-experts in terms of the error rates obtained in the detection task using the morph sonification and also in the classification task using the stethoscope sonification. Overall, the group of experts obtained lower error rates than the group of non-experts, which means that further training could improve accuracy rates and, particularly for designs that rely mainly on pitch variations, additional training is needed in the non-experts group.

Application Value of Remote ECG Monitoring in Early Diagnosis of PCI for Acute Myocardial Infarction

“…Aldana Blanco et al [ 31 ] introduced a new electrocardiogram (ECG) sonification method for myocardial infarction (MI) monitoring and diagnosis processes in healthcare systems. Polarity sonification is a parameter-mapping method that format synthesizer to get related information for the mapping process.…”

An Embodied Sonification Model for Sit-to-Stand Transfers

“…Future studies will investigate whether patients with varied degrees of cognitive impairment can perceive and comprehend the sounds—particularly in the case of augmented feedback applications (Sigrist et al, 2012 ; Morone et al, 2021 ). It is also possible that these salient entities (e.g., bell sounds) cause unacceptable levels of alarm fatigue (Cvach, 2012 ) and sonic disturbance in clinical monitoring contexts (Roodaki et al, 2017 ; Aldana Blanco et al, 2020 ).…”

“…Due to the versatility of modern sound synthesis platforms, it is now possible to build flexible and complex real-time auditory displays (Supper, 2015 ; Kantan et al, 2021 ). Of particular interest is the sonification of biological signals, which has been explored for rehabilitation (Guerra et al, 2020 ; Linnhoff et al, 2020 ), diagnostics (Ballora et al, 2004 ; Danna et al, 2013 ; Gionfrida and Roginska, 2017 ; Aldana Blanco et al, 2020 ) and monitoring (Aldana Blanco et al, 2020 ). In this study, we focused on sonifying the ubiquitous movement of rising from a chair—the sit-to-stand (STS) transfer .…”

“…Interactive musical sonification can motivate, monitor and modify movement (particularly beat-synchronized rhythmic motion) (Maes et al, 2016 ), and allows comparable motor performance to non-musical sonification (Bergstrom et al, 2013 ). In some recent studies, metaphorical and musical sonification designs have been found to be advantageous, both in terms of information conveyance and aesthetic values (Antle et al, 2009 ; Danna et al, 2015 ; Roodaki et al, 2017 ; Aldana Blanco et al, 2020 ). In the STS sonification model proposed by Newbold et al ( 2015 ), the central idea was that of using melodic phrases to represent STS movement phases within a pre-calibrated range of motion (“exercise space”) , with the pitch structure of the melody providing information of spatiotemporal progression within the phase.…”

Auditory displays and auditory user interfaces: art, design, science, and research

“…Aldana Blanco, Grautoff, and Hermann studied sonification possibilities for the support, monitoring, and diagnosis of myocardial infarction [1]. Four sonification designs were proposed and subjectively evaluated based on different criteria, including detection performance, classification accuracy, and aesthetics.…”