Optimized Electrode Locations for Wearable Single-Lead ECG Monitoring Devices: A Case Study Using WFEES Modules Based on the LANS Method

Zhu, Huaiyu; Pan, Yun; Wu, Fan; Huan, Ruohong

doi:10.3390/s19204458

Cited by 14 publications

(9 citation statements)

References 25 publications

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“…In this study, the MC-100 was patched 45° from the inter-nipple line to record lead II signals at the precordium. This position conformed to the optimal position for wearable single-lead ECG devices [ 23 ]. Detailed specifications of MC-100 are described in Table 1 .…”

Section: Methodsmentioning

confidence: 65%

Validation of Adhesive Single-Lead ECG Device Compared with Holter Monitoring among Non-Atrial Fibrillation Patients

Kwon

Lee

Choi

et al. 2021

Sensors

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There are few reports on head-to-head comparisons of electrocardiogram (ECG) monitoring between adhesive single-lead and Holter devices for arrhythmias other than atrial fibrillation (AF). This study aimed to compare 24 h ECG monitoring between the two devices in patients with general arrhythmia. Twenty-nine non-AF patients with a workup of pre-diagnosed arrhythmias or suspicious arrhythmic episodes were evaluated. Each participant wore both devices simultaneously, and the cardiac rhythm was monitored for 24 h. Selective ECG parameters were compared between the two devices. Two cardiologists independently compared the diagnoses of each device. The two most frequent monitoring indications were workup of premature atrial contractions (41.4%) and suspicious arrhythmia-related symptoms (37.9%). The single-lead device had a higher noise burden than the Holter device (0.04 ± 0.05% vs. 0.01 ± 0.01%, p = 0.024). The number of total QRS complexes, ventricular ectopic beats, and supraventricular ectopic beats showed an excellent degree of agreement between the two devices (intraclass correlation coefficients = 0.991, 1.000, and 0.987, respectively). In addition, the minimum/average/maximum heart rates showed an excellent degree of agreement. The two cardiologists made coherent diagnoses for all 29 participants using both monitoring methods. In conclusion, the single-lead adhesive device could be an acceptable alternative for ambulatory ECG monitoring in patients with general arrhythmia.

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Section: Methodsmentioning

confidence: 65%

Validation of Adhesive Single-Lead ECG Device Compared with Holter Monitoring among Non-Atrial Fibrillation Patients

Kwon

Lee

Choi

et al. 2021

Sensors

View full text Add to dashboard Cite

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“…Since certain arrhythmias attack occasionally and transiently, these patients were requested to wear the CarePatch™ ECG patch continuously for as long as possible within 7 days (the patch is cleared for 7-day continuous ECG monitoring). The device collected the wearable non-standard lead ECG signals at the recommended electrode location [ 32 ] as shown in Figure 2 . The sample rate of the ECG signals is 256 Hz, and the resolution is 12-bit.…”

Section: Methodsmentioning

confidence: 99%

Robust Heartbeat Classification for Wearable Single-Lead ECG via Extreme Gradient Boosting

Zhu

Zhao

Pan

et al. 2021

Sensors

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Wearable electrocardiogram (ECG) monitoring devices have enabled everyday ECG collection in our daily lives. However, the condition of ECG signal acquisition using wearable devices varies and wearable ECG signals could be interfered with by severe noises, resulting in great challenges of computer-aided automated ECG analysis, especially for single-lead ECG signals without spare channels as references. There remains room for improvement of the beat-level single-lead ECG diagnosis regarding accuracy and efficiency. In this paper, we propose new morphological features of heartbeats for an extreme gradient boosting-based beat-level ECG analysis method to carry out the five-class heartbeat classification according to the Association for the Advancement of Medical Instrumentation standard. The MIT-BIH Arrhythmia Database (MITDB) and a self-collected wearable single-lead ECG dataset are used for performance evaluation in the static and wearable ECG monitoring conditions, respectively. The results show that our method outperforms other state-of-the-art models with an accuracy of 99.14% on the MITDB and maintains robustness with an accuracy of 98.68% in the wearable single-lead ECG analysis.

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“…One study reported that the best orientation was diagonally on the chest and the best locations were around the chest electrodes of standard precordial leads V 2 to V 4 for the QRS complex and above the leads V 1 and V 2 for the P wave [34]. Another study reported that the best orientation was diagonally sloping downward to the left and the best location was above leads V 1 -V 4 [35]. However, their diagonal orientation also included an extension of the inter-electrode distance.…”

Section: Optimization Of Recording Condition Of a Single-lead Electrocardiogrammentioning

confidence: 99%

Effect of the recording condition on the quality of a single-lead electrocardiogram

et al. 2021

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Although many wearable single-lead electrocardiogram (ECG) monitoring devices have been developed, information regarding their ECG quality is limited. This study aimed to evaluate the quality of single-lead ECG in healthy subjects under various conditions (body positions and motions) and in patients with arrhythmias, to estimate requirements for automatic analysis, and to identify a way to improve ECG quality by changing the type and placement of electrodes. A single-lead ECG transmitter was placed on the sternum with a pair of electrodes, and ECG was simultaneously recorded with a conventional Holter ECG in 12 healthy subjects under various conditions and 35 patients with arrhythmias. Subjects with arrhythmias were divided into sinus rhythm (SR) and atrial fibrillation (AF) groups. ECG quality was assessed by calculating the sensitivity and positive predictive value (PPV) of the visual detection of QRS complexes (vQRS), automatic detection of QRS complexes (aQRS), and visual detection of P waves (vP). Accuracy was defined as a 100% sensitivity and PPV. We also measured the amplitude of the baseline, P wave, and QRS complex, and calculated the signal-to-noise ratio (SNR). We then focused on aQRS and estimated thresholds to obtain an accurate aQRS in more than 95% of the data. Finally, we sought to improve ECG quality by changing electrode placement using offset-type electrodes in 10 healthy subjects. The single-lead ECG provided 100% accuracy for vQRS, 87% for aQRS, and 74% for vP in healthy subjects under various conditions. Failure for accurate detection occurred in several motions in which the baseline amplitude was increased or in subjects with low QRS or P amplitude, resulting in low SNR. The single-lead ECG provided 97% accuracy for vQRS, 80% for aQRS in patients with arrhythmias, and 95% accuracy for vP in the SR group. The AF group showed higher baseline amplitude than the SR group (0.08 mV vs. 0.02 mV, P < 0.01) but no significant difference in accuracy for aQRS (79% vs. 81%, P = 1.00). The thresholds to obtain an accurate aQRS were a QRS amplitude > 0.42 mV and a baseline amplitude < 0.20 mV. The QRS amplitude was significantly influenced by electrode placement and body position (P < 0.01 for both, two-way analysis of variance), and the maximum reduction by changing body position was estimated as 30% compared to the sitting posture. The QRS amplitude significantly increased when the inter-electrode distance was extended vertically (1.51 mV for vertical extension vs. 0.93 mV for control, P < 0.01). The single-lead ECG provided at least 97% accuracy for vQRS, 80% for aQRS, and 74% for vP. To obtain stable aQRS in any body positions, a QRS amplitude > 0.60 mV and a baseline amplitude < 0.20 mV were required in the sitting posture considering the reduction induced by changing body position. Vertical extension of the inter-electrode distance increased the QRS amplitude.

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Optimized Electrode Locations for Wearable Single-Lead ECG Monitoring Devices: A Case Study Using WFEES Modules Based on the LANS Method

Cited by 14 publications

References 25 publications

Validation of Adhesive Single-Lead ECG Device Compared with Holter Monitoring among Non-Atrial Fibrillation Patients

Validation of Adhesive Single-Lead ECG Device Compared with Holter Monitoring among Non-Atrial Fibrillation Patients

Robust Heartbeat Classification for Wearable Single-Lead ECG via Extreme Gradient Boosting

Effect of the recording condition on the quality of a single-lead electrocardiogram

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