A Fast Multimodal Ectopic Beat Detection Method Applied for Blood Pressure Estimation Based on Pulse Wave Velocity Measurements in Wearable Sensors.

Automatic detection of ectopic beats has become a thoroughly researched topic, with literature providing manifold proposals typically incorporating morphological analysis of the electrocardiogram (ECG). Although being well understood, its utilization is often neglected, especially in practical monitoring situations like online evaluation of signals acquired in wearable sensors. Continuous blood pressure estimation based on pulse wave velocity considerations is a prominent example, which depends on careful fiducial point extraction and is therefore seriously affected during periods of increased occurring extrasystoles. In the scope of this work, a novel ectopic beat discriminator with low computational complexity has been developed, which takes advantage of multimodal features derived from ECG and pulse wave relating measurements, thereby providing additional information on the underlying cardiac activity. Moreover, the blood pressure estimations' vulnerability towards ectopic beats is closely examined on records drawn from the Physionet database as well as signals recorded in a small field study conducted in a geriatric facility for the elderly. It turns out that a reliable extrasystole identification is essential to unsupervised blood pressure estimation, having a significant impact on the overall accuracy. The proposed method further convinces by its applicability to battery driven hardware systems with limited processing power and is a favorable choice when access to multimodal signal features is given anyway.

Multi-modal signal acquisition using a synchronized wireless body sensor network in geriatric patients.

Wearable home-monitoring devices acquiring various biosignals such as the electrocardiogram, photoplethysmogram, electromyogram, respirational activity and movements have become popular in many fields of research, medical diagnostics and commercial applications. Especially ambulatory settings introduce still unsolved challenges to the development of sensor hardware and smart signal processing approaches. This work gives a detailed insight into a novel wireless body sensor network and addresses critical aspects such as signal quality, synchronicity among multiple devices as well as the system's overall capabilities and limitations in cardiovascular monitoring. An early sign of typical cardiovascular diseases is often shown by disturbed autonomic regulations such as orthostatic intolerance. In that context, blood pressure measurements play an important role to observe abnormalities like hypo- or hypertensions. Non-invasive and unobtrusive blood pressure monitoring still poses a significant challenge, promoting alternative approaches including pulse wave velocity considerations. In the scope of this work, the presented hardware is applied to demonstrate the continuous extraction of multi modal parameters like pulse arrival time within a preliminary clinical study. A Schellong test to diagnose orthostatic hypotension which is typically based on blood pressure cuff measurements has been conducted, serving as an application that might significantly benefit from novel multi-modal measurement principles. It is further shown that the system's synchronicity is as precise as 30 µs and that the integrated analog preprocessing circuits and additional accelerometer data provide significant advantages in ambulatory measurement environments.

Improved signal quality indication for photoplethysmographic signals incorporating motion artifact detection.

Wearable monitoring systems have gained tremendous popularity in the health-care industry, opening new possibilities in diagnostic routines and medical treatments. Numerous hardware systems have been presented since, which allow for continuous acquisition of various biosignals like the ECG, PPG, EMG or EEG and which are suited for ambulatory settings. Unfortunately, these flexible systems are liable to motion artifacts and especially photoplethysmographic signals are seriously distorted when the patient is not at rest. A lot of work has been done to reduce artifacts and noise, ranging from simple filtering methods to very complex statistical approaches. With regard to the PPG, certain quality indices have been proposed to evaluate the signal conditions. As movements are the primary source of signal disturbances, the relation between the output of a signal quality estimator and acceleration data captured directly on the PPG sensor is focused in this work. It will be shown that typical motions can be detected on-line, thereby providing additional information which will significantly improve signal quality assessments.

Online learning algorithms for principal component analysis applied on single-lead ECGs.

This article evaluates several adaptive approaches to solve the principal component analysis (PCA) problem applied on single-lead ECGs. Recent studies have shown that the principal components can indicate morphologically or environmentally induced changes in the ECG signal and can be used to extract other vital information such as respiratory activity. Special interest is focused on the convergence behavior of the selected gradient algorithms, which is a major criterion for the usability of the gained results. As the right choice of learning rates is very data dependant and subject to movement artifacts, a new measurement system was designed, which uses acceleration data to improve the performance of the online algorithms. As the results of PCA seem very promising, we propose to apply a single-channel independent component analysis (SCICA) as a second step, which is investigated in this paper as well.