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Eng. & Tech. Journal,Vol.27, No.

7, 2009

Remote ECG Signal Monitoring Via Internet

Dr. Saleh M. Al-Qaraawy* ,Hamid Mousa Hasan* & Maher Faik Esmaile*

Received on:15/10/2008
Accepted on: 22 / 1 /2009

Abstract
In this paper the Internet was used as a media for transmission an ECG (Electro-
Cardio-gram) signal from a patient directly to a remotely reside doctor or consultant who
will respond via the same media directly. The ECG signal (at patient side) has been
compressed in a manner to achieve low bandwidth requirement by using Matlab
capabilities. Also, at consultant side the original signal is reconstructed using the same
capabilities of Matlab. The Internet works as the center of communication between the
two sides. A database was used to store the patient information which can be handled
easily by consultant. Respecting the internet no more than a simple rented web site was
required as a file storage shared between the consultant and patient. The results show
that the received signal at the doctor side after reconstruction had the complete and
compatible to the signal used for diagnosis.

Keywords: ECG Monitoring , Via Internet, FTP



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1. Introduction
Recently, many systems has signals from mobile or homebound
been developed or proposed using the patients, combines GPS ( Global
Internet as a backbone for Positioning System) location data, and
communication, because of it's transmits both to a remote station for
availability over local and wide area. display and monitoring. Fensli, R, et
There are several published literature al.[2] in 2005 published a paper about
and papers about advanced remote New wireless technology for Tele-
monitoring, Kathy J. Liszka, et al.[1] in home-care , that gives new possibilities
2004 described a real time remote for monitoring of vital parameters with
arrhythmia monitoring system wearable biomedical sensors, and give
developed at NASA collects ECG the patient the freedom to be mobile and

* Control and Systems Department, University of Technology/Baghdad

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Eng. & Tech. Journal, Vol.27, No.7, 2009 Remote ECG Signal Monitoring Via Internet

still be under monitoring. Mohammed Moreover, the implementation of such a


Al-Rousan, et. al. [3] in 2006 published system can be regarded low cost
an article presents a remote healthcare compared to others like those in [6,7].
patient monitoring system, called
Virtual Eye (VI) that utilizes the world 2 .The Overall Proposed System
wide web infrastructure to monitor, Description
collect, analyses and record patients The proposed system consists of three
health status. M. Blount, et. al.[4] in parts which are:-
2007 described a Personal Care
Connects (PCC), that had been designed a. The patient part.
to facilitate the remote monitoring of b. The consultant part.
patients. Malcolm Clark, et. Al.[5] in c. The Internet server part.
2007 published a paper which describes
the impact of a Remote Patient These three parts are communicated
Monitoring (RPM), the system allows with each other through the Internet as a
vital signs to be transmitted to a central transmission media. Figure (1) shows
server, the medical professional may these parts.
then observe the data and provide
advice to the staff on optimum
management.. Most of the previous
2.1 Patient Part
In this part the Microsoft Internet
works has been severed from the
Explorer (IE) acts as the user interface
problem which is its need for a public
IP address. In this research we through which the patient can
communicate to both the Internet server
investigated the ability to reduce the
and the Matlab software, The
complexity required, and hence
connection to Matlab software is done
reducing the cost, to acquire and
through the automation server
transmit the ECG signal via Internet. In
commands available in VBscript [8] .
general there are two parts in the project
accompanying this research, first one is i) ECG circuit .
the design and implementation of This circuit consists an instrument
simple Holter device benefited from the amplifier (IA-AD524) then its output
digital processing provided by signal enters two first order high pass
MATLAB software like( acquisition, filters the first one cutoff frequency is at
filtering, compression, etc.) . The 0.05 Hz and the second at 0.5 Hz. The
second one is the web part which is right leg technique is used in this circuit
required for communicating the ECG to reduce the noise, where the negative
signal via Internet, This part also being source (-9) volts is connected to the
simple and not expansive due to using right led of the patient through 44K
the FTP( file transfer protocol) which is resistance, after passing through a
provided simply by the server which buffer that is designed with OP-741.
hosts the rented web site. Comparing to
other methods which are expensive ii) Matlab software at the
because of using host with public IP or patient part .
Virtual private Network(VPN). The Matlab script file, which
consists many Matlab functions, is used
In this research, the need of a public to get the patient ECG signal then
IP address is not necessary, since only a processes this signal to produce the
public Internet server is used. This will polynomial coefficient which is then
make the system very easy to stored in a file to be transmitted to
implement any where without requiring Internet server, the whole process can
a special server with public IP.

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Eng. & Tech. Journal, Vol.27, No.7, 2009 Remote ECG Signal Monitoring Via Internet

be shown in figure (2), and a summary These filters were implemented


of them is given bellow:- using Matlab software.
1. Signal enters to PC from
microphone of sound card, using 4. Recognize if the abnormality has
microphone jack . occurred, Since there are standard
2. Use Matlab to get the signal & measurements for ECG signal that
convert it to vector, By using the determine the correct interval and
following Matlab commands: amplitude.
AI = aloginput('winsound');
start(AI) 5. Treat the resulting signal
trigger(AI) mathematically to get polynomial
data = getdata(AI); equation, calculate the coefficients of
Process the converted signal with SW the polynomial equation for each 40
notch filter, the notch filter is a second- elements of the ECG data vector by
order (IIR) filter designed to suppress using the matlab command (polyfit),
the 50Hz interference this filter has a The polynomial generated is a 6th
noch frequency of 50Hz and -3dB width order has the following form:-
10Hz, the transfer function of this filter
is:-

The deference equation of this filter iii) Connecting Patient's part to


has been implemented using matlab Internet Server.
software . The patient part communicates
3. Process the output signal from the with the Internet server using
previous step with software (SW) HTTP(Hyper Text Transport
digital Butterworth filter in 4 steps Protocols) protocol used by the
two for low pass filter and two for Internet Explorer( IE) to get the
high pass filter , The low pass filter patient page, but the compressed ECG
has cutoff frequency at 50Hz and has data will be transferred to the Internet
the following transfer function:- server using FTP (File Transfer
Protocol), which has the following
advantages:-
- It is fast than HTTP in this type of
applications.
The high pass filter has cutoff -It is a secure protocol by using
requency at 0.5Hz and has the authentication.
following transfer function:-

-It is essentially designed for file by using the Automation commands


transferring. available in VBscrip .
2.2 Consultant part ii) Matlab software for
i) In this part the Microsoft consultant part.
Internet Explorer (IE) is also used as In this part the reconstruction of
the interface between the consultant the original signal is done by Matlab
and both the Internet server and the script file consists many functions
Matlab software. The Matlab software carried upon the received data from the
is installed in both the patient and patient part, the diagram shown in
consultant clients. The interaction figure(3) summarizes this process.
between the (IE) and Matlab is done These function can be summarized as:-

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Eng. & Tech. Journal, Vol.27, No.7, 2009 Remote ECG Signal Monitoring Via Internet

The consultant part retrieves the


1. Download the files of the ECG data from the Internet server
patient in sequence, All patient files Using FTP and sends the responses to
are downloaded one after the other the Internet server using FTP too, but
from the specified directory within the consultant Page is retrieved using
the web site at the server. HTTP protocol used by the (IE), as
2. Check if new information is described in figure (1).
found, this means there is a change
with patient files if not no action has 2.3 Internet Server Part
been taken . Here, a general purpose Internet
3. Reconstruct & plot the server with HTTP and FTP services is
polynomials equation, this means provided, the data files as well as the
regenerating the 40 data vector for interfacing pages are reside in this
each 7 elements(p6..p0)which is the server at a leased site, No additional
coefficients of the 6th order work is required more than using the
polynomial, using Matlab command site as a meeting point for the patient
(polyval). part and the consultant part.
4. Send the reply to the patient,
according to the current patient
information the doctor will send a 3.Results:-
reply. The obtained results can be
5. Insert the notes of doctor in demonstrated in the figures (4-13),
Access database, the notes of the figure (4) is the original ECG signal and
doctor will be inserted into a figure (5) is the ECG obtained from the
database which was constructed polynomial parameters ( i.e the
using Access database in this compressed signal), the other figures
database there are two tables, one demonstrate the web part.
includes patients personal
information like :- 4.Conclusions:
A continuous monitoring of the
( name, sex, age, family history, ECG signal and the patient's current
diabetes, blood pressure, others) heart activity are necessary for people
suffering from the cardiac diseases. In
The second table contains the this we describe an internet based
doctor notes and date of that notes remote real time Holter ECG
there is a table for each patient see monitoring system which characterized
figures(11,12) . by the following features:-
iii)Consultant connection with
Internet server.
1. we use simple hardware consists of an 2. The MATLAB was used for local
ECG preamplifier ( 1000 gain) , a signal analysis then using the
high pass filter ( to remove noise MATLAB capabilities to transmit and
artifacts ), and a digital Notch and receive files using FTP over the
Butterworth filters that were built internet so only a website was rented
with Matlab. The signal was entered in a size of 250 KB which leads to a
using the "microphone" jack built in great reduction in the cost.
the sound card of a PC to minimize 3. Ther eliability of the communications
the electronic circuits that led to in this system is good because of
reduce the cost and power using the Internet as a communication
consumption. medium , since the Internet has the
ability to communicate in case of

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Eng. & Tech. Journal, Vol.27, No.7, 2009 Remote ECG Signal Monitoring Via Internet

connection failure because almost sytemem" , International journal of


(with internet) there are an alternative Electronic Healthcare (IJEH), Vol.
connection to carry the 2,NO.3,2006.
communications. [4]. M.Blout, V.M. Batra, A.N. Capella,
M.r.Ebling, W. f .Jerome, S.M.
Comparing this approach with other martin, M. nidd, M.R. Niemi, S.P.
systems we were pointed to in the Wright, "Remote health-care
survey which are lack of the local monitoring using personal care
analysis and most of them required connect" IBM sysem journal
server with public IP address which is information-based medicine volume
not easy to realize and costly. 46, number 1,2007.
[5]. Malcolm Clarke, Tanja Bratan,
References Sadhana kulkarni, Russell Jones, "
The impacte of remote patient
[1]. Kathy J. Liszka, Michael A. monitoring in managing silent
Mackin, "Keeping a Beat on the myocardial infarction in a
Heart", University of Akron, NASA residential home setting", Brunel
Glenn Research Center, 2004 ( Vol. university, London, Chorleywood
3, No.4) pp.42-49. Health centre, Chorleywood, UK.
[2].Fensli, R., Gunnarson,E.,Gundersen, 2007.
T. "Awearable ECG-recording [6]. Jessica Lambourn, " Portable ECG
system for continous arrhythmia Logger". Department of electrical
monitoring in wireless tele-home- engineering, University of
care situation". Computer-baseed Queensland electrical engineering (
Medical Systems, 2005. biomedical Minor) October 2003.
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Proceedings. 18 IEEE symopsim [7]. Gupta R. P. Varma R. K., "Web
volume, Issue 23-24 Tune 2005 based monitoring of electric power
Pages:407-412. distribution networks". Department
[3]. Mohammad Al-rousan, A.R. Al- of electrical engineering, India
Ali, Armin Eberlein, "Remote institute of technology kanpur.
patient monitering and information [8]. http://www.mathwork.com/help/

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Eng. & Tech. Journal, Vol.27, No.7, 2009 Remote ECG Signal Monitoring Via Internet

Figure(1) The Overall ECG Monitoring System

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Eng. & Tech. Journal, Vol.27, No.7, 2009 Remote ECG Signal Monitoring Via Internet

0.06 volts

0.04

0.02
0

-0.02

-0.04

-0.06
1 1.5 2 2.5 3 3.5 4 4.5 5 sec

Figure (4) ECG original signal

0.06 volts

0.04
0.02
0
-0.02
-0.04

-0.06
1 1.5 2 2.5 3 3.5 4 4.5 5 sec

Figure (5) Manipulated ECG signal

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Eng. & Tech. Journal, Vol.27, No.7, 2009 Remote ECG Signal Monitoring Via Internet

Figure (6):An abnormal signal was detected and ready for send

Figure (7): ECG signal was sent

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Eng. & Tech. Journal, Vol.27, No.7, 2009 Remote ECG Signal Monitoring Via Internet

Figure(8):sending a message

Figure(9):Replay from the Doctor

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Eng. & Tech. Journal, Vol.27, No.7, 2009 Remote ECG Signal Monitoring Via Internet

Figure(10):Finishing The connection

Figure (11):Patient Database

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Eng. & Tech. Journal, Vol.27, No.7, 2009 Remote ECG Signal Monitoring Via Internet

Figure(12):Patient1 database since every patient has its own database

Figure(13):Stored normal ECG Signal Database That is


used in Analysis and detection process

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