Estimation accuracy of P wave and QRS complex occurrence times in the ECG: The accuracy for simplified theoretical and computer simulated waveforms

One of the main points of interest in the study of the dynamic behaviour of ECG time intervals is the accuracy with which characteristic moments can be estimated in the various waveform segments such as the P wave or QRS complex. In this study, the error involved in such estimation is regarded as due to the superposition of various types of disturbances (noise, hum and fluctuations in amplitude and symmetry) on a supposedly ideal ECG waveform. The effect of these disturbances on estimation accuracy is investigated for three estimation methods (peak estimation, double level estimation and matched filter estimation) by two different approaches; one based on use of a highly simplified theoretical model permitting the derivation of mathematical expressions for the estimation error, and one involving computer-aided simulation of ECG waveforms, based on real ECG data, with various types of disturbances on the basis of recorded ECG data. Both approaches indicate that noise and hum make the main contribution to estimation error, and that matched filter estimation is likely to give best estimation accuracy for both P waves and QRS complexes.     

Denoising and R-Peak Detection of Electrocardiogram Signal Based on EMD and Improved Approximate Envelope

The electrocardiogram (ECG ) signal is prone to various high and low frequency noises, including baseline wandering and power-line interference, which become the source of errors in QRS and in other extracted features. This paper presents a new ECG signal-processing approach based on empirical mode decomposition (EMD) and an improved approximate envelope method. To reduce the number of the initial intrinsic mode functions (IMFs), a Butterworth lowpass filter is used to eliminate high frequency noises before the EMD. To correct baseline wandering and to eliminate low frequency noises, the two last-order IMFs are abandoned. An improved approximate envelope is proposed and applied after the Hilbert transform to enhance the energy of QRS complexes and to suppress unwanted P/T waves and noises. Then, an algorithm based on the slope threshold is used for R-peak detection. The proposed denoising and R-peak detection algorithm are validated using the MIT-BIH Arrhythmia Database. The simulation results show that the proposed method can effectively eliminate the Gaussian noise, baseline wander, and power-line interference added to the ECG signal. The method can also function reliably even under poor signal quality and with long P and T peaks. The QRS detector has an average sensitivity of Se=99.94 % and a positive predictivity of +P=99.87 % over the first lead of the MIT-BIH Arrhythmia Database.     

A comparison of the noise sensitivity of nine QRS detectionalgorithms

The noise sensitivities for nine different QRS detection algorithms were measured for a normal, single-channel lead II, synthesized ECG corrupted with five different types of synthesized noise. The noise types were electromyographic interference, 60 Hz powerline interference, baseline drift due to respiration, abrupt baseline shift, and a composite noise constructed from all of the other noise types. The percentage of QRS complexes detected, the number of false positives, and the detection delay were measured. None of the algorithms were able to detect all QRS complexes without any false positives for all of the noise types at the highest noise level. Algorithms based on amplitude and slope had the highest performance for EMG-corrupted ECG. An algorithm using a digital filter had the best performance for the composite noise corrupted data.     

A wavelet-based ECG delineator: evaluation on standard databases

In this paper, we developed and evaluated a robust single-lead electrocardiogram (ECG) delineation system based on the wavelet transform (WT). In a first step, QRS complexes are detected. Then, each QRS is delineated by detecting and identifying the peaks of the individual waves, as well as the complex onset and end. Finally, the determination of P and T wave peaks, onsets and ends is performed. We evaluated the algorithm on several manually annotated databases, such as MIT-BIH Arrhythmia, QT, European ST-T and CSE databases, developed for validation purposes. The QRS detector obtained a sensitivity of Se = 99.66% and a positive predictivity of P+ = 99.56% over the first lead of the validation databases (more than 980,000 beats), while for the well-known MIT-BIH Arrhythmia Database, Se and P+ over 99.8% were attained. As for the delineation of the ECG waves, the mean and standard deviation of the differences between the automatic and manual annotations were computed. The mean error obtained with the WT approach was found not to exceed one sampling interval, while the standard deviations were around the accepted tolerances between expert physicians, outperforming the results of other well known algorithms, especially in determining the end of T wave.     

Neural-network-based adaptive matched filtering for QRS detection

We have developed an adaptive matched filtering algorithm based upon an artificial neural network (ANN) for QRS detection. We use an ANN adaptive whitening filter to model the lower frequencies of the ECG which are inherently nonlinear and nonstationary. The residual signal which contains mostly higher frequency QRS complex energy is then passed through a linear matched filter to detect the location of the QRS complex. We developed an algorithm to adaptively update the matched filter template from the detected QRS complex in the ECG signal itself so that the template can be customized to an individual subject. This ANN whitening filter is very effective at removing the time-varying, nonlinear noise characteristic of ECG signals. Using this novel approach, the detection rate for a very noisy patient record in the MIT/BIH arrhythmia database is 99.5%, which compares favorably to the 97.5% obtained using a linear adaptive whitening filter and the 96.5% achieved with a bandpass filtering method.     

Alignment methods for averaging of high-resolution cardiac signals:a comparative study of performance

Accurate signal estimation by means of coherent averaging techniques needs temporal alignment methods. A known low-pass filtering effect is yielded when alignment errors are present. This is very critical in the estimation of low-level high-frequency potentials in high-resolution ECG analysis. A comparative study of the performance of three alignment methods (the double-level method, a new time-delay estimation method based on normalized integrals, and matched filtering) is presented in this paper. A real signal and additive random noise for several signal-to-noise ratios (SNR's) are selected to make an ensemble of computer-simulated beats. The relation between the standard deviation of temporal misalignment versus SNR is discussed. A second study with real ECG signals is also presented. Several morphologies of QRS and P waves are tested. The results are in agreement with the computer simulation study. Nevertheless, the power spectrum of the noise process can affect the results. Matched filter estimation has been tested in the presence of power line interference (50 Hz), with poor results. An application of the three alignment methods as a function of the SNR is proposed. The new time-delay estimation method has been observed to be robust, even in the presence of nonwhite noise.     

一种基于Hilbert变换的R波检测算法

基于希尔波特(Hilbert)变换性质和自适应阈值检测原理,本文提出一种新的心电信号R检测算法。该方法经MIT-BIH心电数据库数据验证,可有效降低基线漂移和高频噪声的干扰,克服高大P波和T波的影响,准确检测率在99．84%以上,算法简单,实时性好。     

基于平稳和连续小波变换融合算法的心电信号P,T波检测

P, T波的检测在临床上是心血管疾病诊断的重要依据。由于其波形能量低、形态复杂,极易受到噪声干扰,导致现有检测算法精度仍有待提高。该文提出平稳和连续小波变换融合算法检测P, T波,利用连续小波变换的多尺度信息,获取心电图(ECG)信号中P, T波主要成分,融合其平稳小波对P, T波候选段进行平滑处理,消除波形中锯齿状毛刺对峰值点检测的影响,最后对P, T波过零点进行时移修正,保证过零点还原到原始信号过程中能够准确对应其峰值点,从而提高P, T波检测精度。该文算法在MIT-BIH arrhythmic数据库上进行验证,最终P波的误差率、敏感度、正确预测度达到：0.23%, 99.85%, 99.90%;T波的误差率、敏感度、正确预测度达到0.27%, 99.85%, 99.87%。     

基于平稳和连续小波变换融合算法的心电信号P,T波检测

P, T波的检测在临床上是心血管疾病诊断的重要依据。由于其波形能量低、形态复杂,极易受到噪声干扰,导致现有检测算法精度仍有待提高。该文提出平稳和连续小波变换融合算法检测P, T波,利用连续小波变换的多尺度信息,获取心电图(ECG)信号中P, T波主要成分,融合其平稳小波对P, T波候选段进行平滑处理,消除波形中锯齿状毛刺对峰值点检测的影响,最后对P, T波过零点进行时移修正,保证过零点还原到原始信号过程中能够准确对应其峰值点,从而提高P, T波检测精度。该文算法在MIT-BIH arrhythmic数据库上进行验证,最终P波的误差率、敏感度、正确预测度达到：0.23%, 99.85%, 99.90%;T波的误差率、敏感度、正确预测度达到0.27%, 99.85%, 99.87%。     

How Many Leads Are Necessary for a Reliable Reconstruction of Surface Potentials During Atrial Fibrillation?

In this study, we aimed at determining how many leads are necessary for accurately reconstructing ECG potentials during atrial fibrillation (AF) on the body surface. Although the standard ECG is appropriate for the detection of this arrhythmia, its accuracy for extracting other diagnostic features or constructing surface potential maps may not be optimal. We evaluated the suitability of the standard ECG in AF and proposed a new lead system for improving the information content of AF signals in limited lead systems. We made use of 64-lead body surface potential mapping recordings of 17 patients during AF and 18 healthy subjects. Lead selection was performed by making use of a lead selection algorithm proposed by Lux, and error curves were calculated for increasing number of selected leads for QRS complexes and P waves from healthy subjects and AF signals. From our results, at least 23 leads are needed in order to have the same degree of accuracy in the derivation of AF waves as the 12-lead ECG for a normal QRS complex (25% error). The 12-lead ECG allows a reconstruction of surface potentials with 53% error. If a limited lead set is to be chosen, a repositioning of only four electrodes from the standard ECG reduces reconstruction error in 11%. This repositioning of electrodes may include more right anterior electrodes and one posterior electrode.     

Digital fractional order operators for R-wave detection in electrocardiogram signal

In this study, we present an effective R-wave detection method in the QRS complex of the electrocardiogram (ECG) based on digital differentiation and integration of fractional order. The detection algorithm is performed in two steps. The pre-processing step is based on a fractional order digital band-pass filter whose fractional order is obtained by maximising the signal to noise ratio of the ECG signal, followed by a five points differentiator of fractional order 1.5 then the squaring transformation and the smoothing are used to generate peaks corresponding to the ECG parts with high slopes. The detection step is a new and simple strategy which is also based on fractional order operators for the localisation of the R waves. The MIT/BIH arrhythmia database is used to test the effectiveness of the proposed method. The algorithm has provided very good performance and has achieved about 99.86% of the detection rate for the standard database. The results obtained are presented, discussed and compared to the most recent and efficient R-wave detection algorithms.     

基于形态滤波的心电信号基线矫正算法

基线矫正是心电(ECG)信号预处理中的一个重要步骤.本文提出了一个基于形态滤波的ECG信号基线矫正算法.首先,对原始输入ECG信号进行基于相同结构元素的形态开闭-闭开滤波,抑制其中的QRS波群;然后,采用两个不同宽度的结构元素,对去除QRS波群后的ECG信号进行广义形态开-闭滤波,分离出基线漂移信号;最后,用原始ECG信号减去估计出的基漂信号,得到经过基线矫正的ECG信号.仿真实验与实际应用结果表明,本文方法不仅可以有效去除ECG信号中的基漂干扰,而且较好地保持了ECG信号的原有特征形态,处理效果明显优于以往算法.     

小波变换在心电信号处理中的应用

在心脏病诊断过程中,心电信号的检测是重要的环节,然而心电信号的噪声很强,为了能够较好地滤除信号中的噪声,对信号的特点进行准确标定,利用基于小波变换的阈值去噪算法和基于小波的模极大值-极小值的算法进行心电信号的处理.采用MIT/BIH中的数据进行仿真调试验证,实验结果表明,被引入的几种噪声能被很好地去除,而且心电信号能较完整地保留下来,特征点能被准确地检测到,从而提高了诊断心脏等疾病的诊断效率.     

Applications of adaptive filtering to ECG analysis: noisecancellation and arrhythmia detection

Several adaptive filter structures are proposed for noise cancellation and arrhythmia detection. The adaptive filter essentially minimizes the mean-squared error between a primary input, which is the noisy ECG, and a reference input, which is either noise that is correlated in some way with the noise in the primary input or a signal that is correlated only with ECG in the primary input. Different filter structures are presented to eliminate the diverse forms of noise: baseline wander, 60 Hz power line interference, muscle noise, and motion artifact. An adaptive recurrent filter structure is proposed for acquiring the impulse response of the normal QRS complex. The primary input of the filter is the ECG signal to be analyzed, while the reference input is an impulse train coincident with the QRS complexes. This method is applied to several arrhythmia detection problems: detection of P-waves, premature ventricular complexes, and recognition of conduction block, atrial fibrillation, and paced rhythm.     

Using wavelet transform and fuzzy neural network for VPC detection from the Holter ECG

A novel method for detecting ventricular premature contraction (VPC) from the Holter system is proposed using wavelet transform (WT) and fuzzy neural network (FNN). The basic ideal and major advantage of this method is to reuse information that is used during QRS detection, a necessary step for most ECG classification algorithm, for VPC detection. To reduce the influence of different artifacts, the filter bank property of quadratic spline WT is explored. The QRS duration in scale three and the area under the QRS complex in scale four are selected as the characteristic features. It is found that the R wave amplitude has a marked influence on the computation of proposed characteristic features. Thus, it is necessary to normalize these features. This normalization process can reduce the effect of alternating R wave amplitude and achieve reliable VPC detection. After normalization and excluding the left bundle branch block beats, the accuracies for VPC classification using FNN is 99.79%. Features that are extracted using quadratic spline wavelet were used successfully by previous investigators for QRS detection. In this study, using the same wavelet, it is demonstrated that the proposed feature extraction method from different WT scales can effectively eliminate the influence of high and low-frequency noise and achieve reliable VPC classification. The two primary advantages of using same wavelet for QRS detection and VPC classification are less computation and less complexity during actual implementation.     

Cancellation of ventricular activity in the ECG: evaluation of novel and existing methods

Due to the much higher amplitude of the electrical activity of the ventricles in the surface electrocardiogram (ECG), its cancellation is crucial for the analysis and characterization of atrial fibrillation. In this paper, two different methods are proposed for this cancellation. The first one is an average beat subtraction type of method. Two sets of templates are created: one set for the ventricular depolarization waves and one for the ventricular repolarization waves. Next, spatial optimization (rotation and amplitude scaling) is applied to the QRS templates. The second method is a single beat method that cancels the ventricular involvement in each cardiac cycle in an independent manner. The estimation and cancellation of the ventricular repolarization is based on the concept of dominant T and U waves. Subsequently, the atrial activities during the ventricular depolarization intervals are estimated by a weighted sum of sinusoids observed in the cleaned up segments. ECG signals generated by a biophysical model as well as clinical ECG signals are used to evaluate the performance of the proposed methods in comparison to two standard ABS-based methods.     

Analysis of ECG from pole-zero models

A complete solution to the fundamental problem of ECG analysis, viz., delineation of the signal into its component waves, is proposed from a system theoretic point of view. The discrete cosine transform of a bell shaped biphasic function is approximated mathematically by a system function with two poles and two zeros, i.e., of order (2, 2). Using this concept as the basis, a pole-zero model of suitable order is derived from the discrete cosine transform (DCT) of the given signal using Steiglitz-McBride method. This model is expanded into a unique set of partial fractions each of order (2, 2), and a biphasic function is recovered from each one of these fractions in the inverse process. Each of the P and T waves usually requires only one biphasic function, while the QRS complex needs two or at most three such fractions. A one-to-one relationship between the pole pattern in the z-plane and component wave pattern in the time signal is established. Results of analysis of continuous strips of ECG show that the delineated component waves are in excellent agreement with the original waves both qualitatively and quantitatively. The method is robust for the analysis of signals with artifacts of various kinds, independent of the sampling rate used, and is free from ad hoc back and forth search procedures.     

Detection of Fetal Heart Rate Through 3-D Phase Space Analysis From Multivariate Abdominal Recordings

A novel three-stage methodology for the detection of fetal heart rate (fHR) from multivariate abdominal ECG recordings is introduced. In the first stage, the maternal R-peaks and fiducial points (maternal QRS onset and offset) are detected, using band-pass filtering and phase space analysis. The maternal fiducial points are used to eliminate the maternal QRS complexes from the abdominal ECG recordings. In the second stage, two denoising procedures are applied to enhance the fetal QRS complexes. The phase space characteristics are employed to identify fetal heart beats not overlapping with the maternal QRSs, which are eliminated in the first stage. The extraction of the fHR is accomplished in the third stage, using a histogram-based technique in order to identify the location of the fetal heart beats that overlap with the maternal QRSs. The methodology is evaluated on simulated multichannel ECG signals, generated by a recently proposed model with various SNRs, and on real signals, recorded from pregnant women in various weeks during gestation. In both cases, the obtained results indicate high performance; in the simulated ECGs, the accuracy ranges from 72.78% to 98.61%, depending on the employed SNR, while in the real recordings, the average accuracy is 95.45%. The proposed methodology is advantageous since it copes with the existence of noise from various sources while it is applicable in multichannel abdominal recordings.      

Estimation of QRS complex power spectra for design of a QRS filter

We present power spectral analysis of ECG waveforms as well as isolated QRS complexes and episodes of noise and artifact. The power spectral analysis shows that the QRS complex could be separated from other interfering signals. A bandpass filter that maximizes the signal (QRS complex)-to-noise (T-waves, 60 Hz, EMG, etc.) ratio would be of use in many ECG monitoring instruments. We calculate the coherence function and, from that, the signal-to-noise ratio. Upon carrying out this analysis on experimentaly obtained ECG data, we observe that a bandpass filter with a center frequency of 17 Hz and a Q of 5 yields the best signal-to-noise ratio.     

Model-based fiducial points extraction for baseline wandered electrocardiograms

A fast algorithm based on the nonlinear dynamical model for the electrocardiogram (ECG) is presented for the precise extraction of the characteristic points of these signals with baseline drift. Using the adaptive bionic wavelet transform, the baseline wander is removed efficiently. In fact by the means of the bionic wavelet transform, the resolution in the time-frequency domain can be adaptively adjusted not only by the signal frequency but also by the signal instantaneous amplitude and its first-order differential, which results in a better baseline wander cancellation. At the next step the parameters of the model are chosen to have the least square error with the original ECG. Determining the precise position of the waveforms of an ECG signal with baseline wander is complicated due to the varying amplitudes of its waveforms, the ambiguous and changing form of the complex and the unknown drift. A model-based approach handles these complications, therefore a method based on this concept has been developed and the fiducial points are accurately detected using the center and spread parameters of Gaussian-functions of the model. Simulation results show that the proposed method has an average sensitivity of 99.58%, average detection accuracy of 99.64%, and specificity of 100%.