Technical Note

Two-electrode low supply voltage electrocardiogram signal amplier

D. Dobrev
Centre of Biomedical Engineering, Bulgarian Academy of Sciences, Soa, Bulgaria

AbstractPortable biomedical instrumentation has become an important part of diagnostic and treatment instrumentation, including telemedicine applications. Lowvoltage and low-power design tendencies prevail. Modern battery cell voltages in the range of 33.6 V require appropriate circuit solutions. A two-electrode biopotential amplier design is presented, with a high common-mode rejection ratio (CMRR), high input voltage tolerance and standard rst-order high-pass characteristic. Most of these features are due to a high-gain rst stage design. The circuit makes use of passive components of popular values and tolerances. Powered by a single 3 V source, the amplier tolerates 1 V common mode voltage, 50 mA common mode current and 2 V input DC voltage, and its worst-case CMRR is 60 dB. The amplier is intended for use in various applications, such as Holter-type monitors, debrillators, ECG monitors, biotelemetry devices etc. KeywordsECG amplier, Biopotential amplier, Low supply voltage amplier, AC coupled amplier
Med. Biol. Eng. Comput., 2004, 42, 272276

1 Introduction A MODERN tendency in patient diagnosis and treatment involves the use of personalised portable biomedical instrumentation. In addition to well-known Holter-type ambulatory recorders of electrocardiogram (ECG) and blood pressure signals, various telemedicine applications require instruments of improved design, compatible with modern microcomputers and microcontrollers. Low voltage and low power are among the most important requirements for such instrumentation. Present-day rechargeable or non-rechargeable 3.6 V or 3 V battery voltages need adequate biopotential ampliers. High performance should be obtained in spite of the low supply voltage limitation, especially concerning electrode polarisation voltage and common-mode input voltage tolerance. The most widely used circuits for biosignal ampliers are based on the three-operational-amplier conguration, or instrumentation amplier, followed by an additional AC-coupled stage (NEUMANN, 1998). Usually, the classical amplier gain is split between the instrumentation amplier and the stage after the high-pass decoupling lter. The rst stage gain is set to low values, because of the electrode polarisation potentials. Their voltage difference can reach up to about 200 mV, depending on various factors (electrode metal, conductive gel, patient skin etc.), and appears as an input signal DC component (NEUMAN, 1995).

The main performance characteristics of ECG ampliers can be summarised as follows:

 frequency band at 3 dB from 0.05 to 100 Hz, with rst-order high-pass lter  tolerance of DC input voltage (of level depending on the type of electrode) without input stage saturation  overall gain in the range 2001000 (4660 dB), with a maximum input signal of about 5 mV without output stage saturation  differential input impedance >5 MO in the entire frequency band  common mode rejection ratio (CMRR) >60 dB  for a two-electrode amplier, the inputs should tolerate at least 3 mA common mode current per input, without saturation of the input stage.

Correspondence should be addressed to Dr Dobromir Dobrev; email: ikdas@argo.bas.bg Paper received 7 April 2003 and in nal form 11 November 2003

MBEC online number: 20043858

# IFMBE: 2004

The last requirement corresponds to interference level, which commonly occurs in a hospital room environment, according to our previous experience (DOBREV and DASKALOV, 2002; DOBREV, 2002). Even with a battery-supplied amplier, input common mode currents can often reach 1.5 mA per input. The idea of setting high gain in the rst amplier stage is well known. It allows a high CMRR to be obtained easily. The simplest solution is to add a capacitor in series with the gainsetting resistor of the differential amplier (MCCLELLAN, 1981; PALLAS-ARENY and WEBSTER, 1993), but its value can be inconveniently high, depending on the high-pass cutoff frequency. A version of this circuit, having the same disadvantage, was patented by CHEE (2002). In addition, as the rst stage is a differential follower, any DC input voltage is amplied by the second stage. An old solution, using differential high-pass lters at the inputs, has been reconsidered by BURKE and GLEESON (2000). The circuit needs a reference electrode, otherwise the input stage would be saturated even by very
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small common mode currents. Bootstrapped input stages also suffer from saturation by relatively low input voltages (THAKOR and WEBSTER, 1980). SPINELLI and MAYOSKY (2000) proposed the use of optocouplers in photovoltaic mode and an integrator, included in a negative feedback loop, for input DC voltage compensation and high-pass ltering. The optocoupler transfer characteristics are non-linear, and there is a wide variation between specimens of the current-to-current transfer ratio (about twice). This leads to low accuracy of the high-pass cutoff frequency. In a similar design, JORGOVANOVIC et al. (2001) used differential-to-differential ampliers instead of optocouplers. The circuit is unacceptable for low-power systems, as these types of amplier, designed for high-frequency operation, consume large amounts of current (20 mA or more). These and other inconveniences of existing solutions stimulated us to try and develop a low-voltage, low-power, twoelectrode amplier, satisfying the above requirements.

Here a, b and c, d are the two differential amplier inputs, and Ad is the gain. The high-pass cutoff frequency is dened by the time constant 2R3C. The detailed circuit is shown in Fig. 1b. The input stage consists of operational ampliers A1, A2, A3 and A4. A1 and A2 are the main gain stages, and A3 and A4 are unity gain buffers. As the non-inverting input voltages of A3 and A4 are equal to their respective output voltages, resistors R2 and R3 are virtually in parallel. Therefore the ratio of the currents in R2 and R3 is IR2=IR3 R3=R2. The current in R1 is the sum of the currents in R2 and R3: IR1 IR2 IR3 (1 R3=R2)IR3. As mentioned above, the resistors R3 and C form a rst-order low-pass lter, and the AC component on C decreases with 6 dB Oct1 and becomes practically zero for the operating frequency band. The A1 and A2 ampliers take one-half of the differential input AC signal each. The input DC component is ltered by C and appears at the A3 and A4 outputs. The second stage is a unity gain four input adder=subtractor stage. It implements (1), where Ad is as follows: Ad 1 R1 R2 kR3 with R3 4R2 , Ad 1 R1 R2

2 Amplier circuit concept The simplied amplier circuit is shown in Fig. 1a. The general principle is that the input signal is buffered (two buffers marked 1) and AC decoupled by the capacitor C and the resistors R3. The second stage consists of two differential ampliers Ad. Each of them amplies half of the differential input signal. By summing, the output signal is obtained as Vout Ad (Va Vb Vc Vd ) s2R3 C (V VinN ) Ad 1 s2R3 C inP

Another solution for the second stage could be by two differential channel analogue-to-digital converters (ADCs), producing a digitised Vout, ready for microcomputer processing. When 5 V supply voltage is available, it is possible to obtain Vout by two difference ampliers in a microchip, such as INA2134, for example. The rst stage has unity common mode voltage gain. The second stage has unity differential mode voltage gain. The minimum CMRR can be calculated as Ad14 Ad5 A 1 d Acm14 Acm5 1 4d=(1 R4 =2R4 ) 1:5 (2) Ad 4d where d is the tolerance of the R4 resistors used. If Ad 1000 and d 1%, the theoretically computed minimum CMRR (assuming ideal operational ampliers) is 91.5 dB, taking opposite signs for the resistor tolerances. With Ad 200, CMRR becomes 77.5 dB. Taking into account real operational ampliers (with CMRRmin 75 dB) and with Ad 200, the real minimum CMRR is 60.3 dB. A very important parameter is the operational ampliers input offset voltage, especially concerning A3 and A4. The A1 and A2 offsets do not contribute to error, as they are added to the input signal DC component, which is cancelled by the capacitor C. The maximum output voltage error due to the operational ampliers input offset voltage is   R1 Voomax (VioA3 max VioA4 max ) 1 R2 CMRR 3VioA5 max $ 2Ad VioA3;4 max Here Viomax are the maximum offset voltages of the corresponding operational ampliers. When selecting operational ampliers, the following should be respected: A3, A4 and A5 to be low input offset voltage and high CMRR types; A1 and A2 to be of high open-loop gain, high CMRR and high gain-bandwidth product.

(1)

3 Bodyamplier interface As mentioned above, for a two-electrode amplier, the inputs should tolerate input common mode currents of at least 3 mA per input. If the supply voltage is only 3 V, this cannot be done using passive components, resistors and capacitors. The only solution
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Fig. 1

Basic amplier circuit concept. (a) Simplied and (b) detailed circuits

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Fig. 3 Practical amplier circuit

consideration. With R7 C4 (R1 k R2 k R3)C2 % R2C2, the highfrequency zero in the amplier transfer function is cancelled Ad (s) Vout 1 sC3 2R3 VInP VInN 1 sC4 R7 1 sC3 2R3   R1 1 sC2 (R1 kR2 kR3 ) 1 1 sC2 R1 R2 kR3

(4)

Fig. 2

Amplier with bidirectional current sources connected to inputs

is common mode input impedance reduction by voltagecontrolled current sources (DOBREV and DASKALOV, 2002) using negative shunt-shunt feedback. Such a circuit is shown in Fig. 2. It makes use of the rst stage circuit shown above. In addition, two bidirectional current sources are connected to the amplier inputs. Thus frequencydependent differential and frequency-independent common mode input impedances are obtained. If the current source transconductance is gm, it can be seen (Fig. 2) that Zcm 1 2gm Zd 2 (1 s2R3 C) gm (3)

Inserting C5 capacitors ensures the circuit stability. The input impedances are implemented by two bidirectional modied Howland voltage controlled current sources (VCCSs), described in DOBREV and DASKALOV (2002). The VCCS transconductance can be chosen in the range of 1=201=100 kO. Thus a high VCCS output minimum resistance is ensured for a given resistor tolerance and signal frequency band. The corresponding input impedance (3) differential and common mode resistive components including the input RF lters are   1 2(R5 kR6 R7 ) % 84 kO Rd 2 gm R7 (1=gm R7 ) (R5 kR6 R7 ) % 21 kO Rcm 2 2 In the signal frequency band, Zd also has an inductive component (3) Ld 4R3 C 461:6 MO61 mF6(R5 kR6 ) % 205 kH gm

Here Zcm and Zd are the common-mode and differential input impedances, respectively. Zcm has only resistive character, whereas Zd has resistive (2=gm) and inductive (4R3C=gm) components. Controlling the amplier differential input impedance yields an advantage: the polarisation potentials effect is automatically balanced. Owing to the low resistive value of the differential input impedance, they recharge and tend to equalise each other.

The simulated Ad, differential Zd and common mode Zcm input impedances for this amplier (circuit of Fig. 3) are shown in Fig. 4. The frequency band is 0.05100 Hz, as is usual for ECG ampliers. The circuit tolerates up to 50 mA common mode

4 Practical amplier circuit The two-electrode amplier design was implemented in a practical circuit shown in Fig. 3. It is powered by a single 3 V supply voltage. Several operational ampliers types can be used, e.g. MCP607, OPA2336 or similar. Because of the input common mode voltage range, the signal ground is set to onethird of the supply voltage (U4B). The diodes D1D4 prevent latch up of the circuit. The inputs are RF noise-protected by the RC networks R7, C4. Its value was derived from the following
274

Fig. 4

Simulated gain, differential Zd and common mode Zcm input impedances of practical amplier circuit. (u u) Ad, dB; (s s) Zd O; (, ,) Zcm, O

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currents and up to about 2 V DC differential signal. The current consumption is 150 mA (0.45 mW) at 3 V supply voltage.

5 Multichannel ground free circuit Multichannel ampliers can be built according to the design described above, as shown in Fig. 5. One of the electrodes (REF) is buffered and is common for all channels. The same electrode is connected to a current source transconductance reciprocal resistor to signal ground (or half of the ADC reference). The remaining channels have VCCSs connected to their inputs. Each VCCS is driven by the difference between signal ground (or half of the ADC reference) and a ltered DC component input voltage. Each channel amplies the voltage difference between its input, referenced to the common electrode REF. Thus a pseudo-differential multichannel system is achieved. The output signal can be directly obtained by ADC or referenced to the circuit common point by differential ampliers. The amplied differential voltage between input 1 and REF is V (1a ) V (1b ) V (REF) The REF electrode common for all channels is usually connected to the left leg. Setting the current source transconductance depends on the number of channels, and it can be selected slightly lower than for the single-channel amplier, for example in the range of 1=5001=100 kO. signal from the proposed amplier output is displayed. Standard stick-on disposable ECG electrodes were used, two for the ECG channel and two for the tested amplier, at 5 cm distance from each other on the arms, plus a third one for the ECG unit, which required a reference electrode. The two signals were identical, except for a small difference in channel sensitivities. Lowamplitude electromyogram signals can be observed in both traces. The measured CMRR was 60 dB, using 1 Vpp 50 Hz common mode voltage. The measurements were extended for the frequency range of 3129 Hz, yielding the same value. In addition, this value includes common mode input voltage and input current simultaneously, owing to the low common mode input impedance (21 kO). The common mode input current was 48 mApp. Eliminating the two current sources at the amplier inputs produced CMRR 66 dB. Obviously, the price for the common mode input impedance reduction (which prevents saturation by a high level of common mode noise) was the loss of 6 dB CMRR, mainly owing to non-ideal resistor matching in the current sources. The following advantages of this circuit should be pointed out: (i) the overall gain is ensured by the rst stage; thus a high CMRR is obtained without the use of high-precision resistors in the second stage (ii) additional input buffers are avoided by connecting the low frequency determining RC network to the inverting inputs of op amp pair which amplies the input signal (iii) implementing different common mode and differential mode input impedances achieves two goals: improved tolerance to input common mode currents, thus avoiding saturation even with low supply voltage; low resistive differential impedance component, helping to minimize and equalize electrode polarisation potentials difference (iv) low supply current and power consumption: 150 mA, 0.45 mW (v) acceptable input common mode currents (<50 mA) and input DC differential voltage (2 V)
AcknowledgmentsThe author thanks Professor I. K. Daskalov
*EK53R, Hellige

Fig. 6 Lead I electrocardiogram of volunteer taken simultaneously by (a) commercial electrocardiograph and (b) the amplier of Fig. 4

6 Results and conclusions A sample recording of an ECG signal acquired using a commercial electrocardiograph* and the proposed ECG amplier is shown in Fig. 6. This type of three-channel electrocardiograph was selected owing to its abilities to record one lead I ECG synchronously with two experimental inputs, where external units can be connected. The trace in Fig. 6a was obtained by the electrocardiograph own amplier (lead I) and, in Fig. 6b, the

Fig. 5 Ground-free multichannel amplier principle

for the useful discussions and help.

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References
BURKE, M. J., and GLEESON, D. T. (2000): A micropower dryelectrode ECG preamplier, IEEE Trans. Biomed. Eng., 47, pp. 155162 CHEE, J. (2002): Low-frequency high gain amplier with high DCoffset voltage tolerance. US patent, US6396343 B2 DOBREV, D. P., and DASKALOV I. K., (2002): Two-electrode biopo, tential amplier with current-driven inputs, Med. Biol. Eng. Comp., 40, pp. 122127 DOBREV, D. P. (2002): Two-electrode biopotential amplier, Med. Biol. Eng. Comp., 40, pp. 546549 JORGOVANOVIC, N., PETROVIC, R., DOSEN, S., and POPOVIC, D. (2001): A novel AC amplier for electrophysiology: active DC suppression with differential to differential amplier in the feedback loop. 23rd Ann. Internat. Conf. IEEE EMBS, CD-ROM, paper 441.pdf MCCLELLAN, A. D. (1981): Extracellular amplier with bootstrapped input stage results in high common-mode rejection, Med. Biol. Eng. Comp., 19, pp. 657658 NEUMAN, M. R. (1998): Biopotential ampliers in WEBSTER, J. G. (Ed.): Medical instrumentation: applications and design, 3rd edn (John Wiley & Sons, New York, 1998), pp. 262264 NEUMAN, M. R. (1995): Biopotential electrodes, in BRONZINO, J. D. (Ed): Biomedical engineering handbook (CRC Press, Boca Raton, 1995), pp. 745757

PALLAS-ARENY, R., and WEBSTER, J. G. (1993): AC instrumentation amplier for bioimpedance measurements, IEEE Trans. Biomed. Eng., 40, pp. 830833 SPINELLI, E. M., and MAYOSKY, M. A. (2000): AC coupled three opamp amplier with active DC suppression, IEEE Trans. Biomed. Eng., 47, pp. 16161619 THAKOR, N., and WEBSTER, J. (1980): Ground-free ECG recording with two electrodes, IEEE Trans. Biomed. Eng., 27, pp. 699704

Authors biography
DOBROMIR DOBREV obtained his MSc in electronic engineering from the Technical University of Soa, in 1994. He specialized in medical electronics, with a diploma thesis on ltering and amplication of biosignals. He has worked in the Institute of Medical Engineering of the Medical Academy as a Research Assistant and, since 1997, has been with the Centre of Biomedical Engineering of the Bulgarian Academy of Sciences. His PhD is in the eld of neonatal monitoring. The study of analogue circuits, including the design, simulation and integration of biosignal ampliers and lters, electrical impedance measurement circuits and transient processes in ampliers, are among his present research interests.

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