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Measurement 147 (2019) 106384

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Measurement
journal homepage: www.elsevier.com/locate/measurement

A study on ECG signal characterization and practical implementation of


some ECG characterization techniques
Ahilan Appathurai a,⇑, J. Jerusalin Carol b, C. Raja c, S.N. Kumar d, Ashy V. Daniel b,
A. Jasmine Gnana Malar e, A. Lenin Fred b, Sujatha Krishnamoorthy f
a
Department of ECE, Infant Jesus College of Engineering, Tuticorin, India
b
Department of CSE, Mar Ephraem College of Engineering and Technology, Marthandam, India
c
Department of ECE, Koneru Lakshmaiah Education Foundation, Vaddeswaram, A.P., India
d
Department of ECE, Mar Ephraem College of Engineering and Technology, Marthandam, India
e
Department of EEE, Arunachala College of Engineering for Women, Nagercoil, India
f
Department of CSE, Wenzhou Kean University, China

a r t i c l e i n f o a b s t r a c t

Article history: The role of ECG is pivotal in medical field for the analysis of cardiac physiology and abnormalities. The
Received 11 October 2018 interpretation of ECG signal is performed by signal processing algorithms for diagnosis of cardiac dis-
Received in revised form 27 December 2018 eases. This work analyses filtering approaches, component extraction, classification and compression
Accepted 17 February 2019
algorithms for the ECG signal. The portable ECG systems are also analysed; results and discussion com-
Available online 27 May 2019
prises of IIR notch filter for the removal of power line interference, hybrid wavelet filter for removal of
baseline wander, FFT algorithm for R peak detection and hybrid filtering approach for the detection of
Keywords:
P, QRS and T components. The outcome of this research work is an aid for researchers developing novel
Cardiac disease
Power line interference
algorithms in ECG filtering, segmentation and classification. The algorithms are developed in Matlab
ECG 2015b and tested on fantasia database data sets.
Filtering Ó 2019 Elsevier Ltd. All rights reserved.
Fourier transform
Wavelet transform

1. Introduction ment [4]. The electromagnetic interference degrades the signal


and affects the minute features in the signal; PLI is also induced
Today cardiac diseases are the root of cause of death in the due to variation in electrode impedance and stray current through
world [1]. The role of ECG is vital in the analysis of cardiac physi- the cables and equipment.
ology [2,3].The Electrocardiogram (ECG) records the electrical The digital notch filters and adaptive filters are widely used for
activity of heart; the amplitude of signal is low ranging from 0.4 the elimination of power line interference, however in [5], subtrac-
to 3 mv. The low magnitude value of ECG stress the importance tion method was employed. The digital filter was applied in the lin-
of appropriate filtering approach before further processing for bio- ear segments of ECG signal for the removal of interferences and is
logical analysis. The surface electrodes (Ag/AgCl) are widely used subtracted from the input signal, where ever non-linear segments
for the acquisition of ECG signals and three lead configurations are observed. The source of EMI coupling is of mainly two types;
are there; bipolar, unipolar and augmented unipolar. The source capacitive and inductive [6]. The capacitive coupling is due to the
of noise in ECG signals are baseline wander (also termed as low fre- presence of capacitance between the circuits and inductive cou-
quency noise), power line interference, muscle noise and electro- pling is due to the inductance between the conductors. The PLI is
magnetic interference from other equipment. The frequency of mainly contributed by inductive coupling; proper shielding, avoid-
ECG signal ranges from 0.5 Hz to 100 Hz and artifacts play promi- ing loose connection in wires and appropriate placement of elec-
nent role analysis of ECG signals. The ECG signal is normally trodes can minimize the PLI. The patient movements, dirt in lead
depicted with the letters P,Q, R,S and T. The P and T represent wires/electrodes and changes in electrode skin impedance causes
the low frequency components and QRS complex represents the baseline wander [7,8]. The effect of baseline wander is dominant
high frequency components. The EMI is the main source of power in holter monitoring, online monitoring in moving vehicle (ambu-
line interference (PLI) in the connecting cables of ECG and equip- lance) and exercise ECG. The frequency of baseline wander is less
than 1.0 Hz and varies during exercise. The burst noise is also
⇑ Corresponding author. observed in ECG signal and it can be modelled as additive white

https://doi.org/10.1016/j.measurement.2019.02.040
0263-2241/Ó 2019 Elsevier Ltd. All rights reserved.
2 A. Appathurai et al. / Measurement 147 (2019) 106384

Gaussian noise [9]. Some of the types of burst noise are electrode suitable for other applications like pulse oximetry and respiratory
pop noise [10], electrode motion artifact, electro surgical noise signal extraction. The digital FIR equiripple notch filter was found
and instrumentation noise [11] etc. The ECG is used to assist imag- to be efficient for the power line interference; FDA tool in MATLAB
ing modality such as SPECT for the analysis of myocardial perfusion was used for the design and doesn’t require any reference signal for
and left ventricular function simultaneously [12]. The CT coronary processing [28]. The extended kalman filter was found to be profi-
angiography (CTCA) and ECG-gated myocardial perfusion SPECT is cient for the filtering of low SNR ECG signals especially the fetal
used for the diagnosis of ischemic heart disease [12]. signals and was tested on synthetic ECG signal constructed from
The long short term memory network and CNN was coupled nonlinear dynamic model [29].
together for the classification of ECG signals, diagnostic accuracy The extended kalman filter was found to be proficient in the
of 99.85% was obtained [13]. The discrete cosine transform with extraction of ECG signal from noisy data. The restoration modal
KNN classifier was found to be efficient for the cardiac diseases is based on the combination of extended kalman filter and dynamic
analysis, the coefficients selection was done by Locality Preserving model of synthetic ECG signal [30]. An adaptive recurrent filter was
Projection (LPP) technique, DCT performance was better than Dis- employed for the filtering of ECG signals for the analysis of
crete Wavelet Transform (DWT) and Empirical Mode Decomposi- Arrhythmia problems [31]. In adaptive recurrent filter, the coeffi-
tion (EMD) [14].The deep convolution neural network was found cients are adaptable so that the impulse response of the desired
to be efficient in the classification of normal and abnormal heart signal is obtained. It minimizes the mean square error between
rhythms [15]. The variational mode decomposition technique the noisy ECG input and reference pulse. The reference pulse is
was found to be efficient for the characterization of cardiac positioned in the beginning of QRS complex. The morphology of
arrhythmias, the transform domain analysis can detect the closely the ECG signal components changes during arrhythmia and can
space frequencies [16]. In [17], a detailed study has been per- detect the ectopic beats, detection of P waves in conduction blocks,
formed on the segmentation algorithms for the extraction of fidu- detection of atrial fibrillation and monitoring the performance of
cial points on the ECG signal. The algorithms that relies on NI pacemaker. The kalman filter with adaptive noise covariance esti-
LABVIEW software was used for the characterization and classifica- mation was proposed for the filtering of ECG signals, the increase
tion of ECG signals [18]. The machine learning clustering algo- in SNR with preservation of morphological variations was observed
rithms with markers were found to be efficient for the detection [32].
of ECG phenotypes in hypertrophic cardiomyopathy [19]. The The moving average filter is a type of FIR filter that is applied to
wavelet packet decomposition with extracted nonlinear features a set of data samples by generating a mean of different samples on
was found to be robust in the characterization of cardiac diseases the full data set [33].
[20]. The flexible analytic wavelet transform with least square The expression for moving average of samples is expressed as
SVM was found to be efficient for the classification of coronary follows
artery diseases [21]. The ECG signals were found to be effective
xðn  2Þ þ xðn  1Þ þ xðnÞ þ xðn þ 1Þ þ xðn þ 2Þ
as a biometric trait for IOT applications [22]. xðnÞ ¼
5
In this work, the widely used filtering and analysis techniques
for the ECG are discussed initially; some of the hardware where xðnÞ is the original signal.
approaches for the implementation of ECG system are also dis- The ECG signals acquired during MRI scans were severely
cussed. Results and discussion depicts IIR notch filter for the reduc- affected by noise; nonlinear filters are employed for the restoration
tion of power line interference, hybrid wavelet domain filter for the of ECG signal [34]. The adaptive filter based on dynamic structure
elimination of baseline wander, fast fourier transform algorithm was proposed for the filtering of ECG EMG and EEG signals. Effi-
for R peak detection and hybrid filtering approach for P, QRS and cient results were produced when compared with the classical
T wave detection and finally conclusions are drawn. adaptive filter [35]. The fast fourier transform filtering along with
artificial neural network was found to be efficient for the detection
of cardiac diseases [36].
2. Related works The steps in the fourier transform filtering of ECG signal is as
follows
2.1. ECG filtering approaches The Discrete Fourier Transform (DFT) of noisy ECG signal e(n)
into n sample points is as follows
The adaptive band pass filter was found to be efficient for the X
N1
detection of QRS complex and tested on 24 h MIT/BIH arrhythmia Y ðkÞ ¼ eðnÞW nk
N ; 0  k  N1
database [23]. The band pass filter eliminates false spurious signals n¼0

generated due to various interferences; the algorithm was devel- Y (K) is the amplitude of ECG signal and the time series compo-
oped in Z80 assembly language with an accuracy of 99.3%. In nent h(t) is windowed with the window function to obtain the
[24], different digital filtering approaches for ECG signals were ana- resultant spectrum as follows
lyzed. The wavelet domain wiener filter generates efficient filtering Z 1
results for the real time data from 192 cases obtained from 8 chan- Eðf Þ ¼ eðt Þei2pft dt
nels comprising of normal and pathological signals [25]. The two 1
stage filtering based on time frequency approach improves the The DFT of noisy ECG signal e½kT  in terms of the generalized
denoising; the selection of wavelet basis function is vital, short gaussian function is as follows
length for the detection of QRS complex and medium length for
h mi X N1  
the detection of P and T sections of ECG signal. The wavelet trans- K þ m 2p22 m2 i2pmj
Y k; ¼ E e n e N
form detects the QRS complex accurately; db3 wavelet generates NT NT
n¼0
good results and sym wavelet generates poor results [26]. m
The wavelet filtering approach was efficient for long term anal- where E HT is fourier transform of frequency domain noisy ECG
ysis of ECG signal, computation complexity is low. The notch filter signal.
was found to be efficient for the noise generated due to power line The Undecimated Wavelet Transform (UWT) based on Daube-
interferences and high pass filter (DC notch filter) was proposed for chies (D6) wavelet efficiently filters the ECG signal and the algo-
baseline removal [27]. The simplicity in the filter design makes it rithm was developed in Lab View software [37]. The wavelet
A. Appathurai et al. / Measurement 147 (2019) 106384 3

transform has inevitable role in ECG signal filtering and compres- for the determination of respiration rate from single channel ECG
sion [38]. signal [43]. The physioNet data base signals are used and require
The continuous wavelet transform of the function h(x) is as only R wave detection. The ECG characteristic components are
follows extracted by multi scale morphological derivative (MMD)
Z 1 transform-based singularity detector; better results are produced
W w ðs; sÞ ¼ hðxÞws;s ðxÞdx when compared with the wavelet transform-based and adaptive
1
thresholding-based techniques [44].
where The ECG signal recording help for the prediction of defibrillation
1 x  s
in patients with ventricular fibrillation (VF) [45]. The irregularity
ws;s ðxÞ ¼ pffiffi w nature is observed in ECG signals of VF cases that depicts the chao-
s s
tic nature of working of heart. The online ECG signal recording was
The discrete wavelet transform of the function is expressed in performed with the defibrillation by monophasic defibrillator. The
the same form continuous wavelet transform except that DWT principal component analysis (PCA) is found to be effective for the
uses scale and position in powers of 2 as follows baseline wander removal of ECG signal; Independent Component
! Analysis (ICA) was found to be better than PCA in the abnormality
1 x  kso soj detection, hybrid combination of ICA and PCA was better in the
wj;k ðxÞ ¼ qffiffiffiffi w
soj soj removal of artifacts [46]. The image form of ECG was proficient
for the accurate determination of periodicity; pixel dithering
The value of s and s ares ¼ 2 j , s ¼ k  2 j and ðj; kÞ 2 Z 2 as shown increases the thickness of R peaks, when trace is scanned or ren-
in the equation. dered in videos [47]. The pixel thickness information was utilized
in the estimation of periodicity; accuracy was good for bradycardia
2.2. ECG characterization approaches and tachycardia detection. The feed forward back propagation neu-
ral network was employed for the detection of poor ECG signals,
The classical feature extraction technique (mean, variance, fre- preprocessing was performed by wavelet domain filter [48]. The
quency, energy) was used for the classification of ECG signals for Daubechies wavelet was found to be efficient in the filtering of
the diagnosis of arrhythmias [39]. The efficiency of classification ECG signal; T-wave abnormality can be analyzed without the need
was performed by Anova statistical tool and computation com- for T-wave end point identification. A detailed study has been per-
plexity was low. Apart from the cardiac activity, respiratory rate formed on the acquisition and challenges in the analysis of fetal
monitoring and ventricular triggering can also be determined and ECG signals in [49]. The nonlinear filtering approach based on
continuous monitoring is required for the patients in postoperative multi resolution wavelet filter effective filters the ECG signal effec-
care unit [40]. The synthetic ECG signal was generated by a novel tively on signals from MIT-BIH database [50]. The data mining
dynamic model based on differential equation that aids for the sta- clustering and classification algorithms based on weka system
tistical analysis of clinical ECG signals [41]. The morphological was used for the analysis of ECG signals [51]. The ECG signal has
parameters of ECG signal are user defined with respiratory sinus its role in security authentication in biometrics system; the ECG
arrhythmia at the high frequencies (HFs) and Mayer waves at the signal is also a signature like finger print and retina and is unique
low frequencies (LFs) together with the LF/HF ratio are also incor- for each individual [52]. The MIT/BIH Arrhythmia database was
porated in the model. The hidden semi markov model efficiently used and correlation coefficient was used for identification. In
segments the ECG signal into its constituent parts [42]. The proba- [53], a detailed study on ECG feature extraction techniques based
bilistic approach was proficient when compared with the classical on fuzzy logic, Artificial Neural Networks (ANN), Genetic Algo-
threshold based methods. The higher order statistics are employed rithm(GA), Support Vector Machines (SVM) are analyzed.

Fig. 1. First and second column represents the input and IIR notch filtering output corresponding to the ECG data set O1.txt and O2.txt.
4 A. Appathurai et al. / Measurement 147 (2019) 106384

The empirical mode decomposition algorithm was used for the Neural Network (ANN), Support Vector Machine (SVM), Linear Dis-
detection of arrhythmia in ECG signals [54]. The algorithm was val- criminant Analysis (LDA), Kth Nearest Neighbor (KNN) and Hidden
idated on MIT-BIH data base and EMD algorithm decomposes sig- Markov Model (HMM). The wavelet transform was employed for
nal into finite number of Intrinsic Mode functions (IMFs) and band filtering of ECG signal and the compression is performed by SPIHT
pass butter worth filter was used for filtering the components. The algorithm [57]. Efficient results are produced on MIT-BIH
neural network based ECG signal analysis accuracy relies on the polysomnographic and MIT-BIH arrhythmia database. The wavelet
training employed. The features like amplitudes, durations, gradi- based watermarking and compression scheme for ECG signal
ents, polarity are extracted and normalized within the range from reduces the storage capacity and improves the security in the
0 to 1 [55]. The training accuracy is 85.7%, validation accuracy is transmission [58]. The role of compression algorithms is vital in
71.4% and the testing accuracy is 71.4%. In [56], a detailed analysis teleradiology for data transmission. The adaptive difference pulse
has been made on the ECG morphology analysis using Artificial code modulation generates efficient results than DPCM [59]. The

Fig. 2. First and second column represents the input and IIR notch filtering output corresponding to the ECG data set O3.txt and O4.txt.

Fig. 3. First and second column represents the input and IIR notch filtering output corresponding to the ECG data set Y1.txt and Y2.txt.
A. Appathurai et al. / Measurement 147 (2019) 106384 5

compression plays vita role in the transmission of ECG signal for was done by quadratic discriminant function (QDF) and multilayer
telemedicine application [60]. A novel compression scheme termed perceptron (MLP). The band pass filter was used for the removal of
as compressive sensing reconstruct the signal in the receiver side noise and for feature extraction; discrete wavelet transform is
with few samples. Prior to compression, the signal is transformed employed [62]. The machine learning SVM algorithm was used
into wavelet domain and validated on MIT-BIH Arrhythmia for the classification and validated on MIT-BIH Arrhythmia Data-
Database. base. The artital fibrillation is the root cause of arrhythmia causing
The preprocessing was performed by FIR least squares filter; death in adults. The feature extraction was performed by Auto
feature extraction was performed by autoregressive (AR) and mul- regressive (AR) model and classification was done by kernel Sup-
tivariate autoregressive (MVAR) models [61]. The classification port Vector Machine (KSVM) and K- Nearest Neighbor (KNN)

Fig. 4. First and second column represents the input and IIR notch filtering output corresponding to the ECG data set Y3.txt and Y4.txt.

Fig. 5. Hybrid filtering result (Wavelet domain + Average filter) corresponding to the ECG data set O1.txt and Y1.txt.
6 A. Appathurai et al. / Measurement 147 (2019) 106384

Fig. 6. Wavelet decomposition (d1, d2, a1, a2) corresponding to the ECG data O1.txt.

Fig. 7. Wavelet decomposition (d3, d4, a3, a4) corresponding to the ECG data O1.txt.
A. Appathurai et al. / Measurement 147 (2019) 106384 7

[63]. The KNN with burg’s technique generates good classification phological and transform based features for ECG signals [65]. The
accuracy. In [64], two algorithms are proposed for the detection of Pan Tompkins algorithm was used for the detection of R peaks;
QRS complex. The first algorithm is based on averaging and adap- walsh hadmard transform generates zero distortion. The KNN clas-
tive threshold uses the state logic to determine the different peaks sifier generates good classification accuracy and was validated on
of the signal. The feature extraction comprises of statistical, mor- MIT-BIH arrhythmias database. The discrete wavelet transform

Fig. 8. Wavelet decomposition (d1, d2, a1, a2) corresponding to the ECG data Y1.txt.

Fig. 9. Wavelet decomposition (d3, d4, a3, a4) corresponding to the ECG data Y2.txt.
8 A. Appathurai et al. / Measurement 147 (2019) 106384

Fig. 10. FFT filtering and R peak detection of sample 1.

Fig. 11. FFT filtering and R peak detection of sample 2.


A. Appathurai et al. / Measurement 147 (2019) 106384 9

along with run length coding generates efficient results for the when compared with recurrent neural networks and spectrogram
compression of ECG signals applicable for telemedicine applica- learning [70].
tions [66]. A hybrid algorithm comprising of linearization and prin-
cipal component analysis (PCA) was applied for the detection of R 2.3. Portable ECG systems
waves and QRS complex [67]. The local adaptive filter generates
satisfactory results for the denoising of ECG signal [68]. The filter- The ECG monitoring software was developed for smartphone;
ing of ECG signal was performed by rbio3.7 wavelet and for classi- wavelet algorithm was used to detect the QRS complex and can
fication deep convolution neural network was employed [69]. In classify 14 types of arrhythmia disease [72]. A telemonitoring PC
[70], a study has been performed on different feature extraction based system receives the signal by GPRS, process the signal and
and classification techniques for ECG signal. A digital elliptical communicate to the user. The real-world ECG signal data set was
band pass filter was constructed by cascading low pass and high formulated for the wearable computer comprising of different
pass filter for the removal of baseline wander and muscle noise cases [73]. The dataset includes 260 recordings, eight use cases
[67]. For feature extraction, wavelet and 1D local binary pattern for baseline wander, twenty eight use cases for motion artifact
was utilized and classification was performed by extreme learning and 16 use cases for power line interference. The fluctuation char-
machine. The normal and abnormal ECG signal was subjected to acteristics of ECG signal is analyzed in [73], for the non-shockable
feature extraction by Gray level Co-occurrence matrix and for clas- arrhythmias like sinus rhythm, the function has Gaussian charac-
sification; Support Vector Machine (SVM) was employed [71]. A 16 teristics, whereas in the case of shockable, the ventricular fibrilla-
layer 1D convolution neural network can efficiently classify the tion signal depicts an excellent agreement with the Bramwell-
normal and abnormal heart rhythms; the results were superior Holdsworth-Pinton (BHP) probability density function. A portable

Fig. 12. R peak detection plot corresponding to sample 1 and sample 2.

Fig. 13. (a) Original input signal, (b) Low pass filter output, (c) High pass filter (d) Derivative filter.
10 A. Appathurai et al. / Measurement 147 (2019) 106384

ARM processor based ECG system was developed for the real time need reliable ADC [78]. Proper ground to bounce noise mitigation
analysis of ECG signals [74]. For the classification of signals SVM is needed for real time implementation [79]. FPGA based compres-
was employed, the signals are classified into normal, atrial fibrilla- sion helps in real time processing with large volume of ECG data
tion and myocardial ischemia. A six lead ECG acquisition system [80].
with instrumentation amplifier based on CMOS process was pro- A hand held ECG device was proposed for the detection of atrial
posed, second order unity-gain Sallen-Key high pass and low pass fibrillation based on random forest classifier, overall score of 82.6%
filter was used to remove unwanted noise and any DC offset volt- was obtained [81]. A portable micro electro mechanical system
ages [75]. A wearable ECG system was developed for acquisition of (MEMS) was developed for mobile applications that measures the
signals from horses, Stationary Wavelet Movement Artifact Reduc- glucose level and ECG signals for the analysis and transfer of medical
tion (SWMAR) algorithm was proposed for the elimination of data [82]. A portable cardio analyser was proposed for the analysis
motion artifacts [76]. The reliability of the portable ECG monitor- of ECG signal for e-health applications [83]. A wearable ECG device
ing system needs reliable hardware platform for various algorithm was developed for the analysis of cardiac disorders, four machine
implementations [77]. The interfacing part from input to output learning algorithms comprising of support vector machine (SVM),

Fig. 14. (a) Moving average filter output, (b) Filtered ECG signal, (c) Filtered ECG signal with P, QRS and T markings.
A. Appathurai et al. / Measurement 147 (2019) 106384 11

K-nearest neighbour (KNN), naïve Bayes (NB), and logistic regres- for the analysis of cardiac pathophysiology and disorders. The
sion (LR) were used, KNN gives superior accuracy of 65.37% for men- noise filtering has to be carried out before any subsequent process
tal fatigue detection [84]. The wireless ECG system based on zigbee like extraction of P, QRS and T components, classification and com-
was developed for home applications and transfer of patient data to pression. Some of the portable ECG systems and its necessity are
remote places [85]. A real time ECG signal processing software was also described in this work. The outcome of this work will be an
developed for arrhythmia detection on mobile phones; the algo- aid for the researchers working on ECG signal processing for the
rithms used for analysis comprises of moving average, Pan Tomp- development of novel algorithms. The future works will be analysis
kins and Wavelet techniques [86]. The low cost portable ECG and of filtering and classification algorithms for various cardiac dis-
EEG systems were developed for the acquisition of signals and a eases on real time and standard database.
database DREAMER was proposed for the emotion recognition
[87]. A portable wearable device was proposed for the measurement
of heart rate variability; data obtained from Microsoft band (MS
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