International Conference on Communication and Signal Processing, April 3-5, 2014, India

TBC Algorithm to Detect R-Peak and HRV

Analysis for Ischemia Heart Disease
Akash Kumar Bhoi, Karma Sonam Sherpa, Sushant Konar

Abstract- Heart Rate Variability (HRV) analysis is the

ability to assess overall cardiac health and the state of the
autonomic nervous system (ANS), responsible for regulating
cardiac activity. ST-change due to ischemia and their HRV
analysis have not been well discussed in the previous works.
The proposed simple and time efficient TBC algorithm has
been tested in four sets of standard databases with selected
patients data having ischemic conditions (i.e.MIT-BIH
Normal-Sinus Rhythm Database (NSRDB), European ST-T
Database (EDB), MIT-BIH ST Change Database (STDB) &
Long-Term ST Database (LTSTDB))for the detection of R-peak
& HRV analysis. The pre-processing is done by MAF and DWT
to remove the baseline drift and noise induced in the ECG
signal. The mean/average of HR is calculated for each set of
databases and in case of EDB it is of 57 BPM (subjected to
bradycardia). The Probability with normal distribution is
analyzed by comparing the NSRDB data with the ischemic data
sets. The performance of this algorithm is found to be 98.5%.

The association between mortality and total, ULF, and

VLF power remained significant and strong, whereas, LF
and HF power were only moderately strongly associated
with mortality. The tendency for VLF power to be more
strongly associated with arrhythmic death than with all-cause
or cardiac death was still evident after adjusting for the five
covariates. Adding measures of HRV to previously known
predictors of risk after myocardial infarction identifies small
subgroups with a 2.5-year mortality risk of approximately
50% (Circulation 1992;85:164-171) [12].Heart rate
variability (HRV) is widely used for quantifying neural
cardiac control, [1] and low variability is particularly
predictive of death in patients after myocardial infarction
[10]. Reduced short-term LFP during controlled breathing is
a powerful predictor of sudden death in patients with CHF
that is independent of many other variables [11].

Index Terms- Biomedical signal processing, Medical signal

detection, Electrocardiography, Diseases, Databases.

Reduced HRV has been shown to be a predictor of

mortality after myocardial infarction [3, 4] although others
have shown that the information in HRV relevant to acute
myocardial infarction survival is fully contained in the mean
heart rate[5].
Heart rate variability analysis has become
an important tool in cardiology, because its measurements
are non-invasive and easy to perform, have relatively good
reproducibility and provide prognostic information on
patients with heart disease. HRV has proved to be a valuable
tool to investigate the sympathetic and parasympathetic
function of the ANS, especially in diabetic and
postinfarction patients[13].In the field of psycho-physiology,
HRV is related to emotional arousal and high-frequency
(HF) activity has been found to decrease under conditions of
acute time pressure and emotional strain[6] and elevated
state anxiety[7], presumably related to focused attention and
motor inhibition. HRV has been shown to be reduced in
individuals reporting a greater frequency and duration of
daily worry[8]. In individuals with post-traumatic stress
disorder (PTSD), HRV and its HF component is reduced
compared to controls whilst the low-frequency (LF)
component is elevated. Furthermore, unlike controls, PTSD
patients demonstrated no LF or HF reactivity to recalling a
traumatic event[9]. Both HR and ischemia at higher HRs
contribute to VCG ST elevation. Established ST ischemia
detection concerning HR levels is suboptimal, and further
attention to the effects of HR on ST segments is needed
toimprove electrocardiographic ischemia criteria [14]. TimeFrequency Method based Heart Rate Variability Analysis of
Ischemic and Heart Rate Related ST-segment Deviation was
described by Wang Xing et al. [15]. The variability of the

I.

INTRODUCTION

Heart Rate Variability (HRV) is the physiological

phenomenon of variation in the time interval between
heartbeats. It is measured by the variation in the beat-to-beat
interval i.e. "cycle length variability", "RR variability" and
"heart period variability".

Akash Kumar Bhoi is with the Applied Electronics & Instrumentation

Engineering Department, Sikkim Manipal Institute of Technology (SMIT),
India (email: akash730@gmail.com)
Karma Sonam Sherpa is with the Electrical &Electronics Engineering
Department, Sikkim Manipal Institute of Technology (SMIT), India (email:
karmasherpa23@gmail.com)
Sushant Konar is with the Applied Electronics & Instrumentation
Engineering Department, Sikkim Manipal Institute of Technology (SMIT),
India (email: sushantkonar91@gmail.com)

978-1-4799-3357-0
Adhiparasakthi Engineering College, Melmaruvathur
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heart beat measured from RR intervals during the exercise

stress test [16]. Andreas Voss et al. in [17]; long-and short
term HRV indices from frequency domain and particularly
from nonlinear dynamics revealed high univariate
significances (p<0.01) discriminating between IHFLR and
IHFHR.The heart rate is calculated using the extracted features
of the ECG signal and calculated HR value can be analysed for
the detection of various cardiovascular abnormalities [26].
In this paper a simple Threshold Beat Counting (TBC)
algorithm is proposed for the analysis of HRV for different
sets of ischemic Patients signals. The presented work
mostly focused on the efficient way of detection of R-peak
by this method and the HR calculation for ischemic signals.
This algorithm is performed on the selected signals from
standard databases (i.e.MIT-BIH NSRDB, MIT-BIH STDB,
EDBand LTSTDB). The MAA and DWT achieved good
results for baseline wanders & noise removal during preprocessing of signals.
II.

METHODOLOGY

This is really a challenging move to implement this

method for calculating heart rate from Ischemic Patients
databases.The proposed work is basically divided into three
parts; generating an ischemic database, Pre-processing i.e.
baseline drift & noise removal and HR calculation by
detecting R-peak (Fig.1.).

The algorithm accomplishes a moving average by taking

two or more of these data points from the acquired
waveform, adding them, dividing their sum by the total
number of data points added, replacing the first data point of
the waveform with the average just computed, and repeating
the steps with the second, third, and so on data points until
the end of the data is reached. The result (Fig.2.) is a second
or generated waveform consisting of the averaged data and
having the same number of points as the original waveform
[21].
This equation can be further generalized. The moving
average of a waveform can be calculated as:
(

( ) = 1/s

y(n)

(1)

where, a = averaged value n = data point position,s =

smoothing factor and y = actual data point value.

The span must be odd.

The data point to be smoothed must be at the center

of the span.

The span is adjusted for data points that cannot

accommodate the specified number of neighbors on
either side.

The end points are not smoothed because a span

cannot be defined[22].
C. Noise Cancellation by Discrete wavelet transform
The discrete wavelet transform (DWT) uses filter banks
for the construction of the multi-resolution time-frequency
plane.
Filter banks

Fig.1. Block diagram of the proposed methodology.

A. Formation of Database
Data were taken from Physiobank [18], which maintains a
large online repository of various physiological signals,
including ECG signals. The databases used from Physiobank
were the European ST-T Database (EDB) [19]; MIT-BIH ST
Change Database, Long-Term ST Database and MIT-BIH
Normal-Sinus Rhythm Database were taken for comparison
&evaluation purpose [20]. Bipolar leads &signals with
positive polarity of QRS complex are selected. Total 67 data
were collected and implemented with the proposed
algorithm.
B. Baseline Drift Removal by Moving Average Filter
It can be used as a low-pass filter to attenuate the noise
inherent in many types of waveforms, or as a high-pass filter
to eliminate a drifting baseline from a higher frequency
signal. The procedure used by the algorithm to determine the
amount of filtering involves the use of a smoothing factor.

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A filter bank consists of filters which separate a signal into

frequency bands [24]. A discrete time signal x(k) enters the
analysis bank and is filtered by the filters L(z) and H(z)
which separate the frequency content of the input signal in
frequency bands of equal width. The filters L (z) and H (z)
are therefore respectively a low-pass and a high-pass filter.
The output of the filters each contains half the frequency
content, but an equal amount of samples as the input signal.
The two outputs together contain the same frequency content
as the input signal; however the amount of data is doubled.
Therefore, down sampling by a factor two, denoted by 2, is
applied to the outputs of the filters in the analysis bank [23].
Reconstruction of the original signal is possible using the
synthesis filter bank [24]. In the synthesis bank the signals
are up sampled (2) and passed through the filters L'(z) and
H'(z)
[2].
The
implemented
soft
&
hard
thresholdingisperformed using ddencmp & wdencmp
function for 1D ECG signal using db4 wavelet. The

performance is evaluated in the following section (i.e. result

& analysis).
D. Threshold Beat Counting (TBC) Algorithm
The proposed thresholding based beat counting is simple
and efficient algorithm which is briefly described below;
Step 1: Determining the threshold value (T) of the ECG
signal:
of the ECG Signal.
Step2:

R-Peak detection of ECG signal:

(Let, x= sample value of R-peak)
Then, detect x, if
x 1 < > + 1 &x >

Step 3: Heart Rate Calculation:

(a)Duration = Length ofECG signal/Sampling Rate
(b) HR or BPM= No. of R-Peaks Detected/
Duration

TABLE I describes the HR which are calculated by TBC

algorithm for the standard databases.
TABLE I
CALCULATED HR OF SELECTED SUBJECTS FROM NRSDB AND
STDB
NRSDB

HR

STDB

lead

HR

lead

HR

16265m

age/
sex
32 M

96

301m

ECG1

60

ECG2

60

16272m

20 F

60

302m

ECG1

60

ECG2

60

16273m

28 F

96

303m

ECG1

114

ECG2

96

16420m
16483m
16539m
16773m
16786m
16795m
17052m
17453m

38 F
42 M
35 F
26 M
32 F
20 F
45 F
32 F

90
96
78
72
72
66
66
78

304m
307m
309m
310m
311m
313m
314m
316m

ECG1
ECG1
ECG1
ECG1
ECG1
ECG1
ECG1
ECG1

54
54
84
90
78
78
60
114

ECG2
ECG2
ECG2
ECG2
ECG2
ECG2

60
72
84
90
96
78

18177m

26 F

108

317m

ECG1

66

18184m

34 F

72

324m

ECG1

66

ECG2

66

325m

ECG1

72

Mean= 80.7

Mean= 74 BPM

The sampling rates of MIT-BIH Normal-sinus rhythm

database (MIT-BIH NRSDB) ECG signals are of 128HZ, for
European ST-T Database (EDB) is of 250 Hz, for MIT-BIH
ST Change Database (STDB) is of 360Hz and 250Hz for
Long-term ST database (LTSTDB).
III.

TABLE II
CALCULATED HR OF SELECTED SUBJECTS FROM EDB
EDB

clinical note :
diagnoses
#Mixed angina

lead

HR

V4

60

e0104

myocardial
nfarction

MLIII

e0105

myocardial
infarction

e0106

#Mixed angina
#2-vessel
disease (LAD,
LCX)
#Mixed angina
#1-vessel
disease (LCX)
myocardial
infarction
#Mixed angina
#1-vessel disease
(LAD)
#Mixed angina
#Mixed angina
#3-vessel disease

e0103

RESULTS & ANALYSIS

The baseline wanders and noise are significantly removed

during the pre-processing steps. The developed TBC
algorithm has been showing promising results in detecting
R-peak & calculating the Heart rate from normal and
ischemic patients data (Fig.2.).

e0107

e0108
e0111

e0112
e0113

lead

HR

72

V4

72

MLIII

54

V4

54

V4

54

V4

54

V4

54

MLIII

54

MLIII

60

V4

60

MLIII
MLIII

36
60

V4

60

Mean = 57 BPM

The NSRDB database includes 13 ECG recording ranging

from 20 to 42 age groups and the mean/average heart rate
calculated is 80 BPM (TABLE I). The STDB database
includes 24 ECG recordings of varying lengths; most of the
recorded signals were during exercise which exhibit transient
ST depression. The last two records i.e.324 & 325exhibit ST
elevation. NRSDB presented in Table. I show mean HR of
74 BPM.

Fig.2. Results for data s20101m of LTSTDB showing HR=66.

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TABLE III
CALCULATED HR OF SELECTED SUBJECTS FROM LTSTDB
LTSTDB
s20011m
s20021m
s20031m

s20041m
s20061m
s20071m
s20081m
s20091m
s20101m

s20111m
s20121m

clinical note :
diagnoses
No coronary
artery disease
Prinzmetal's
angina
Coronary
artery disease,
Previous
myocardial
infarction
Coronary
artery disease
Syncope
Syncope
Pregnant
Palpitations

lead

HR

lead

HR

ML2

66

MV2

66

MLIII
ECG

distribution of normal sinus data vs. the patients (ischemic

conditions) data.
To analyze and discuss the detection performance of this
algorithm, four sets of ECG data coming from LTSTDB,
EDB, MIT-BIH NRSDB &MIT-BIH STDB are calculated
by means of the performance formula defined in [25],
modified in this paper as:

V4
66
66

ECG

66
66

P=
ECG

60

ML2
ML2

84
84

ML2

72

Palpitations
ML2
102
Pregnant
Coronary
ML2
66
artery disease,
Angina,
Hypertension
Coronary
ML2
84
artery disease
3-vessel
ML2
54
coronary
artery disease
Mean= 72 BPM

ECG

54

S ( M + F)
100%
S

where, S is the total number of HR detect (i.e. 67), M is

the number of missing HR detection (i.e. 0), and F is the
number of false detection of HR (i.e. 1, for e0112). The
Performance value P is found to be of 98.5%.
IV.

MV2

(2)

102

24 ECG recordings with the clinical notes are listed from

EDB (TABLE II) to evaluate TBC algorithm where,bipolar
& chest leads ECG signals are selected.The mean HR found
to be 57 BPM which is subjected to bradycardia.16 ECG
data from LTSTDB is derived, most of which belong to
cardiac dysfunctions and the mean HR is calculated as 72
BPM (Table III).

This analysis can help to identify patients at increased risk

for sudden death who could benefit from more aggressive
anti-ischemic therapy. The applied algorithm is tested with
MIT-BIH NSRDB, EDB, MIT-BIH STDBand LTSTDB.
This method is independent of the ST-change effect on the
ECG signal which results in accurate R-peaks detection and
HR calculation. The performance of this algorithm is
calculated as 98.5%. Probability with normal distribution of
NRSDB is compared with the other four ischemic databases.
The further research involves in real-time based beat
detection for all kinds of ischemic and arrhythmic patients
signals.
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Fig.3. Probalility plot with normal distribution of four databases

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This method of computing probability plots (Fig.3.) is that
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