A Novel Pocket Intelligent One Lead ECG Monitor Based on Fingers Touching

Shi Zhang, Jinshuan Zhao, Lihuang She, and Guohua Wang School of Information Science and Engineering, Northeastern University, Shenyang, Peoples Republic of China

AbstractIn this paper, a Pocket Intelligent ECG One Lead Monitor (PIEOLM) is present, which can be used for detecting human Electrocardiogram (ECG). Advanced RISC Machines (ARM) as well as instrument amplier, electrodes, Universal Serial Bus (USB) and Secure Digital Memory Card (SD) technologies are adopted in hardware design. In software frame, digital lter, correcting baseline drift, detecting R wave and cardiac arrhythmia analysis are used for ECG rendering. Users simply touch the electrodes by two ngers, his/her ECG tracing and heart rate is displayed alive on LCD. The heart rate is displayed with beep sound and LED ashing. The PIEOLM also can storage and transport data to PC through USB cable. An antitype of this device has been nally accomplished and will be put into the clinical environment. The results of the experiment show that this PIEOLM is clinically approbated, accurate in its estimation, easy-to use and light-weight.

I. I NTRODUCTION Cardiac disease is one of the most dangerous threats to human health. Moreover, due to the problem of aging of population is getting worse and worse, the number of cardiac deaths is sustained increasing. In nowadays medical conditions, there are a variety of means of diagnosing heart disease, such as Auscultation, Echocardiography, Color Doppler Ultrasound, ECG/EKG, Magnetic Resonance Imaging (MRI), Left Ventriculography (LVG), Computerized tomography (CT), Coronary angiography. Among these measures, ECG diagnosis has the advantages of convenience, precision and low-cost, and therefore ECG diagnosis has been widely used nowadays. Whereas, some arrhythmias (fast, slow, or irregular heartbeat), which have the abnormal symptoms, may occur only once in a while, or may occur only under certain conditions, such as strain. These kinds of arrhythmias are very difcult to capture by ECG tracing which is only checked in hospital or only runs for a few minutes at the normal condition. As it can not check the heart disease conveniently and betimes, a pocket ECG monitor device which can monitor arrhythmias at once and give different alarms would be very helpful. Since Norman Jeff Holter developed a new way to record ambulatory ECG in 1957, the Holter monitor has been developed both in hardware and software. With the rapidly development of the information technology, there are some ECG monitor products using technologies such as Internet solutions [1], Bluetooth [2], cellular phones [3], and wireless local area networks(WLAN) [4]. But there are problems of them as follows: (1) High cost. (2) High power consumption. (3) Cant detect the ECG tracing

conveniently without the electrode on chest. (4) Taking much time to detect ECG trace. To solve these problems presented above, we have developed an original Pocket Intelligent ECG Monitor and will be experimented in the clinical environment in the Clinical Hospital of China Medical University. Users just simply touch the PIEOLM by two ngers through two iron square pads, his/her ECG and heart rate are scrolling alive on the LCD screen. This monitor can quickly show the ECG trace and heart rate, and it is able to record, store and display diagnose standard one-lead ECG too. Meanwhile, this device contains intelligent self-adaptive data processing and decision-making techniques, which can generate different levels of alarms and transport the ECG data on PC through the USB cable. While analysis the ECG data, doctors can quickly make sure the kind of the disease. II. H ARDWARE FRAME The design of the Hardware should be high anti-jamming, low-power, high precision and low cost. The Hardware Frame is shown in Fig. 1. We use a high common mode reject ratio (CMRR) instrument amplier to measure ECG signals. While design the digital circuit, we choose a microcontroller based on ARM architecture, which was used to receive, record, display and analysis the ECG signals with SD, USB cable and LCD connected.

Fig. 1.

Hardware architecture of monitor

A. Sample electrode In this design, no wire is used to simple the ECG signals from the chest of human. Two square electrodes, which are provided on either side of the LCD to serve as right and left hands touch electrodes, are on the top layer of the double sided PCB. While using the PIEOLM, users can simply use both hands by placing thumb ngers of each hand on the square pads. Then the ECG signal is sampled to the later amplier. B. Front-end amplier To measure the ECG, there are two methods: one is using amplier ICs, the other is using ASIC. In this paper, we choose amplier ICs. It is the product of Analog Devices Inc. The rst step of the ECG amplier circuit is an instrument amplier, which has high CMRR for eliminating the common mode noise. As human skin contact the ECG electrode, which may create a small DC voltage offset, an integrator is used for compensating this DC offset by feedback it to the reference pin of the instrument amplier. Because the ECG signal of human is very small (in 0.5-5 mV range). The amplication of the rst amplier step is set to 6, while the second amplier step is set to 200, so the total amplication of the circuit is about 1000. Through the amplication and adding a reference voltage to the output, the voltage of ECG signal is right in the range for the analog to digital converter (ADC). The nal output of ECG amplier is connected the ADC. The instrument amplier and operation amplier are lower power and the entire circuit current consumption is less than 1 mA. C. Microcontroller Sorts of microcontrollers can be used in ECG monitor, from 8-bit to 32-bit microcontroller, as well as DSP. In this design, we choose an ARM based microcontroller called STM32F103xx, which is the production of STMicroelectronics. The STM32F103xx performance line family incorporates the high-performance ARM R CortexTM -M3 32-bit RISC core operating at a 72 MHz frequency [5]. It contains high-speed embedded memories: ash memory up to 256 Kbytes and SRAM up to 48 Kbytes. This device offers three 12-bit ADCs, as well as standard and advanced communication interfaces: two I2Cs, three SPIs, two I2Ss, one SDIO, ve USARTs, an USB and a CAN. The STM32F103xx operates in the 2.0 to 3.6 V power range. A comprehensive set of power-saving mode allows the design of low-power applications. And the price of this kind of ARM microcontroller is as low as the normal Single Chip Microcomputer. By using this microcontroller, we can sample the analogy signal at the rate 1000/sec, storage the data in SD, display the ECG tracing on the LCD and translate the data to PC via USB cable. There is no doubt that it makes the hardware powerful, low cost and stable. III. S OFTWARE FRAME In design of this ECG monitor, software is the soul of the whole system. The structure of software consists of three layers which can be seen in Fig. 2. The device driver layer

is connected to the hardware, and the application layer is presented to users. The application layer has two parts, which are the application of front ECG data processing and the fast algorithm for R wave detection.

Fig. 2.

Software architecture

A. Front ECG data processing Although the analogy circuit has Low-pass lter and radio frequency interference suppression, there are some other kind of noise in the signal, such as baseline drift, 50Hz powerline interference. As the signal has been seriously interference with these noises, some methods should be taken to remove them. To remove the power line interference noise (50 Hz AC interference at China), the data is rst processed by FIR (Finite Impulse Response) notch digital lter. The trap frequency of the lter is set to 50 Hz, which can remove the frequency noise. In order to speed the ltering process, the xed point process is used in this ltering, instead of oating point process. Meanwhile, an easy and fast way is taken to remove the baseline drift. There are many methods to remove baseline drift, including median ltering, curve-tting, zero-phase IIR ltering, wave-let transform [6], and so on. In this design, a modied median lter is used while considering the operation ability of the microcontroller. By using the modied lter, it removes baseline drift effectively. The ECG data processing can provide clean and accurate data for R wave detecting and original displaying the ECG on LCD. B. Fast algorithm for ECG The PC ECG monitors have the algorithm for detecting arrhythmias and other heart diseases, which may be very complex and heavy computation. But the operation ability of portable ECG monitors microcontroller is limited, some device only simple the ECG signal without algorithm for detecting arrhythmias. In this paper, it includes a fast intelligent algorithm for detecting arrhythmias such as sinus-arrhythmia, ventricular premature beat, sinus bradycardia. A kind of computerized serial ECG analysis method is developed. The algorithm is divided into two parts: (1) R wave peak detection. (2) Heart diseases diagnosis.

The position and direction of R wave peak is an important feature for analyzing an ECG segment. There are multifarious methods for R wave detection. In this design, a combined method is taken, which has the advantages of differentiation techniques and threshold techniques. As shown in Fig. 3. In the rst step, the differentiation technique is used to nd the positions of possible R wave, then, the threshold techniques is used to conrm weather it is really a R wave or noise, nally, the R wave is extracted. As the R wave is detected exactly, the intelligent program can make the diagnosis for every interval of R wave. Any abnormal heart rates will be marked, displayed on the LCD and alarmed through an alarm buzzer.

V. C ONCLUSION A prototype of the device has been produced and tested. User simply touch the PIEOLM by two ngers, it can calculate heart rate accurate, display the ECG on LCD, storage the data in SD, and translate data to PC via USB. It is very conveniently to monitor the users ECG trace and quickly calculate heart rate. As the prototype has not been put into use in the clinical environment yet, no arrhythmias patient has used prototype. So the accuracy rating of detecting arrhythmias should be improved in the clinical environment. VI. ACKNOWLEDGMENT This work was supported by the Open Project Program of the National Laboratory of Pattern Recognition (NLPR). R EFERENCES
[1] A. I. Hernndez, F. Mora, G. Villegas, G. Passariello, and G. Carrault, Real-Time ECG Transmission Via Internet for Nonclinical Applications, IEEE Transactions on Information Technology in Biomedicine, Institute of Electrical and Electronics Engineers, USA, vol. 5, pp. 253257, 2001. [2] J. Andreasson, M. Ekstrom, A. Fard, J. G. Castano, and T. Johnson, Remote System for Patient Monitoring Using Bluetooth, Sensors, Proceedings of IEEE, USA, vol. 1, pp. 304-307, 2002. [3] R. H. Istepanian, B. Woodward, E. Gorilas, and P. A. Balos, Design of mobile telemedicine systems using GSM and IS-54 cellular telephone standards, J Telemed Telecare, Royal Society Of Medicine Press, England, vol. 4, pp. 80-82, 1998. [4] D. L. Rollins, C. R. Killings worth, G. P. Walcott, R. K. Justice, and R. E. Ideker, A Telemetry System for the Study of Spontaneous Cardiac Arrhytmias, IEEE transactions on bio-medical engineering, Institute of Electrical and Electronics Engineers, USA , vol. 47, pp. 887-92, 2000. [5] STMicroelectronics. www.st.com/mcu/. [6] R. von Borries, J. H. Pierluissi, and H. Nazeran, Wavelet TransformBased ECG Baseline Drift Removal for Body Surface Potential Mapping, IEE Engineering in Medicine and Biology Society, Institute of Electrical and Electronics Engineers, USA, 2005.

Fig. 3.

R wave detection

IV. E XPERIMENT AND RESULTS A prototype of this PIEOLM is produced. The ECG signal can be sampled and analyzed in real-time. While using the monitor, the real-time R detection rate is about 95%, and the calculative accuracy rate of heart rate is 90%. When the heart rate has some change, it can be exactly detected and quickly displayed on LCD. The ECG data also can storage in SD and transport the data to PC via USB cable. The result of this prototype is shown at Fig. 4.

Fig. 4.

Experiment result of the prototype