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# International Journal of Biological and Life Sciences 7:1 2011

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A Combinatorial Model for ECG Interpretation
Costas S. Iliopoulos∗ , Spiros Michalakopoulos∗∗
algorithm reads the signals and from the differences between consecutive electrical potentials builds sequences of characters, as shown in Figure 2. String algorithms have proven to be efﬁcient and useful for solving many molecular biology related problems [15], [16]. Pattern matching techniques used could have similar applications in biomedicine, for example for efﬁcient algorithms on electroencephalographic (EEG) data, as for ECGs. In this paper, the model’s practicality is illustrated on an implementation of automated QRS detection. Tests were performed on all the records in the MIT-BIH Arrhythmia database and the results reafﬁrmed the belief that the model is worth investigating further. Possible applications of the method include more complex ECG analysis tasks, such as automatic heartbeat classiﬁcation for which accurate algorithms are still required [17]. The rest of the paper is organized as follows. Next, in Section II, some deﬁnitions are presented as they relate to the problem and the algorithm, both of which are described in Section III. The implementation and experimental results are discussed in Section IV. Finally, Section V describes other applications of the model, extensions to the algorithm and the conclusions. II. D EFINITIONS A signal s is a k-tuple (t, pM LII , pV 1 , ...), where t is the time in seconds and pE is the electrical potential at lead E in millivolts. When the signal read is from a single lead, it is represented as a pair, a 2-tuple, (t, p). A sequence of signals s1 , s2 , . . . , sn is a sequence of pairs, (t1 , p1 ), (t2 , p2 ), . . ., (tn , pn ). The readings are taken at regular time intervals, the sample rate σ . Note that σ = ti+1 − ti = ti − ti−1 , for all i ∈ [2, n − 1]. For example, in the MIT-BIH Arrhythmia database, 360 samples are taken per second, i.e. the sample rate σ = 1000/360 ms. ˆ and Σ the following alphabets: Let Σ ˆ = {−−, −, 0, +, ++} Σ Σ = {C −− , C − , C 0 , C + , C ++ } and A the set of non-trivial pairs: A = {(+, 0), (−, 0), (++, +), (−−, −)} Note that trivial pairs are (0, 0), (+, +), .... The rate of change is the difference between the potentials of two consecutive signals. Thus, at position i, the rate of change is pi − pi−1 . A gradual rate increase is depicted as C + , a sharp rate increase as C ++ and gradual and sharp decreases equivalently as C − and C −− . A negligible or zero rate change is C 0 .

Abstract—A new, combinatorial model for analyzing and interpreting an electrocardiogram (ECG) is presented. An application of the model is QRS peak detection. This is demonstrated with an online algorithm, which is shown to be space as well as time efﬁcient. Experimental results on the MIT-BIH Arrhythmia database show that this novel approach is promising. Further uses for this approach are discussed, such as taking advantage of its small memory requirements and interpreting large amounts of pre-recorded ECG data. Keywords—Combinatorics, ECG analysis, MIT-BIH Arrhythmia Database, QRS Detection, String Algorithms