Zoltán GERMÁN-SALLÓ

SUMMARY OF PHD THESIS
APPLICATIONS OF WAVELET ANALYSIS
IN ECG SIGNAL PROCESSING
Supervisor
Professor Dr-Eng Mária IMECS
TECHNICAL UNIVERSITY OF CLUJ-NAPOCA
2005
2
Acknowledgements
I would like to express my gratitude to my supervisor Professor Mária Imecs for the opportunity of
doing this work and for her supervision and advice during the elaboration of this thesis.
Many thanks to my friend and colleague, Professor László Dávid for scientific guidance, also to
members of the Electrical Engineering Department from “Petru Maior” University Tg-Mureş
especially assistant engineers Katalin György and Adrian Gligor for their many valuable remarks.
Without their help I could not have finished this work.
I am grateful to Professor Radu Ciupa, Technical Univesity of Cluj-Napoca, Professor Alexandru
Sălceanu, “Gheorghe Asachi” Technical University of Iaşi, Professor Iuliu Székely, “Transilvania”
University of Braşov, the official reviewers of this thesis, for their comments and suggestions to the
manuscript.
I am grateful to Medical Physicist, Márta Germán-Salló, my wife, for expert guidance and
collaboration regarding the medical aspects of this work.
Many thanks to Mrs. Rodica Brad, Mrs. Dorina Baraian from the Doctoral Office of Technical
University Cluj-Napoca, their work helped me in solving the administrative problems.
Last, but not least, I wish to thank my family and my parents for their love, patience and
understanding provided during these years, for their great support in difficult moments. Their
contribution was crucial in achieving this professional level.
Zoltán Germán-Salló
Sept 28, 2005
3
Contents
SYMBOLS, NOTATIONS, ABBREVIATIONS
Notations
1 INTRODUCTION 1
2 THE ECG SIGNAL. PARAMETERS. INTERPRETATIONS 5
2.1 The Electrocardiogram 5
2.1.1 Introduction 5
2.1.2 Theory and electrical bases 6
2.2 The standard 12-lead derivation system 7
2.3 Rhythmic excitations of the heart. Waves and durations 10
2.3.1 The P wave 12
2.3.2 The P-R interval 12
2.3.3 The QRS complex 12
2.3.4 The S-T segment 12
2.3.5 The T wave 12
2.3.6 The U wave 13
2.4 The main features of the ECG signal 13
2.4.1 Normal sinus rhythm 13
2.4.2 Arrhythmias 14
2.4.2.1 Introduction 14
2.4.2.2 Atrial arrhythmias 14
2.4.2.3 Ventricular arrhythmias 16
2.4.3 Heart rate variability (HRV) 17
2.4.3.1 Definitions. Notations 17
2.4.3.2 The measure of heart rate variability 18
2.5 Disturbances in electrocardiograms 20
2.6 Concluzions 21
2.7 References 22
3 THE WAVELET ANALYSIS 23
3.1 Short history 23
3.2 From Fourier to Gabor expansion 24
3.3 Theoretical issues 29
3.3.1 Introduction 29
3.3.2 The Continous Wavelet transform 29
3.3.3 The properties of wavelet functions 33
3.3.4 The Discrete Wavelet Transformation 34
3.3.5 Multiresolution analysis and The Calculation of wavelet transform 36
3.3.5.1 Multiresolution analysis 36
3.3.5.2 The Fast wavelet Transform 37
3.3.6 Wavelet functions for analysis and synthesis 39
3.3.7 Wavelet packet analysis 42
3.4 Conclusions 42
3.5 References 43
4
4 WAVELET ANALYSIS BASED ECG SIGNAL PROCESSING METHODS
AND PROCEDURES
45
4.1 Short history, actual trends, perspectives 45
4.2 Materials and methods 47
4.2.1 The ECG signal base 47
4.2.2 The proposed procedure 48
4.2.3 The choice of wavelet function 40
4.2.4 Conclusions and own results obtained
4.3 ECG preprocessing 54
4.3.1 The proposed procedure 54
4.3.2 Fundamental operations in ECG signal preprocessing 55
4.3.3 Wavelet Transform based filtering 60
4.3.3.1 Denoising 60
4.3.3.2 Baseline wander removal 68
4.3.3.3 Experimental own results in preprocessing 71
4.3.4 Conclusions 76
4.4 ECG signal parameter extraction 77
4.4.1 Introduction 77
4.4.2 The proposed algorithm 81
4.4.2.1 QRS complex detection 87
4.4.2.2 T wave detection 88
4.4.2.3 P wave detection 89
4.4.2.4 Parameter extraction 91
4.4.3 Heart rate variability analysis 93
4.4.4 Own experimental results in ECG parameter extraction 95
4.4.5 Conclusions 100
4.5 Softcomputing methods applied in ECG signal processing 101
4.5.1 Introduction 101
4.5.2 Automated arrhythmia detection algorithm 102
4.5.3 Fuzzy interpreter 103
4.5.4 The use of artificial neural networks in ECG signal analysis 110
4.5.4.1 Artificial neural networks for filtering ECG signals 110
4.5.4.2 Wavelet function synthesis with artificial neural networks 114
4.5.5 Conclusions and own results 119
4.6 References 120
5 AUTHOR’S CONTRIBUTIONS IN ECG SIGNAL PROCESSING AND
GENERAL CONCLUSIONS
118
5.1 Author’s contributions 118
5.2 General conclusions 120
6 GLOBAL REFERENCES 121
5
Chapter1. Introduction
Electrocardiograms (ECGs) are signals that originate from the action of the human heart. The ECG is the
graphical representation of the potential difference between two points on the body surface, versus time. Its historical
development has resulted in a tool for clinical diagnosis, the 12-lead electrocardogram. Each heartbeat is a complex of
distinct cardiological events, represented by distinct features in the ECG waveform. ECG recordings are examined by a
physician who visually checks features of the signal and estimates the most important parameters of the signal. Using
this expertise the physician judges the status of a patient. Therefore the recognition and analysis of the ECG signals is a
very important task. This could be difficult, because the size and form of these signals may change eventually and can
be noised. Many tools, methods and algorithms from signal processing theory have been proposed, described and
implemented. All of them were developed under Matlab, using Signal processing and Wavelet Toolboxes.
In the first chapter are presented the most important notations, abbreviations and symbols used in this work.
The motivation and structure of this work are also discussed in this chapter.
In the second chapter the ECG signal is introduced through its most important (from a digital signal processing
point of view) parameters: waves, durations and intervals.
The third chapter briefly introduces the theory of wavelet transform (WT) as a young branch of applied
mathematics extensively developed in the last ten years and shows a few promising applications in signal processing.
The fourth chapter presents the whole ECG signal processing procedure proposed by the author from
preprocessing to parameter interpretation. The proposed algorithms provide preprocessing (filtering, denoising, baseline
wander removal), parameter extractions (the most important processing phase) and softcomputing methods for
interpretation and more accurate analysis. Each of these algorithms is presented, tested and evaluated on special created
signal databases, which form a non-officially standard in the ECG processing research field.
The fifth chapter contains the author’s contributions and the general conclusions.
Chapter2. THE ECG SIGNAL
The electrocardiogram is a time-varying signal that measures the electrical activity (on the surface of the
human body) of the heart. The standard parameters of the ECG waveform are the P wave, the QRS complex and the T
wave. But most of the information lies around the R peak. Additionally a small U wave ( with an uncertain origin) is
ocassionally present. The cardiac cycle begins with the P wave, which corresponds to the period of atrial depolarization
in the heart. This is followed by the QRS complex, which is usually the most relevant (recognizable) feature of an ECG
waveform. The T wave follows the QRS complex and corresponds to the period of ventricular repolarization. The end
point of the T wave represents the end of the cardiac cycle (presuming the absence of U wave). The durations (time
between the onset and offset) of particular parameters of the ECG (referred as an time interval) is of great importance
since it provides a measure of the state of the heart and can show the presence of certain cardiological conditions. In
practice, interval measurements, wave interpretations are carried out manually by ECG specialists.
Chapter 3. THE WAVELET ANALYSIS
Over the past ten years, wavelet transform has been used as a powerful tool for image data compression, noise
reduction and feature extraction of a signal. Wavelets provide efficient localization in both time and frequency (or
scale)..To analyze any finite energy signal ( ) ( ) R t f
2
L ∈ , the continous wavelet transform (CWT) is a decomposition
of the signal as a combination of a set of basis function, obtained by means of dilation and translation of a single
prototype wavelet function ( ) t ψ called mother wavelet. The continouos wavelet transform ( )( ) τ
ψ
, s f W of the signal
( ) ( ) R L
2
∈ t f is defined as:
( )( ) ( ) dt
s
t
s
t f s f W ⋅ 




 −
⋅ ⋅ =

+∞
∞ −
τ
ψ τ
ψ
1
,
(1)
where, we have used ψ to denote the complex conjugate of ψ . The function ( ) R
2
L ∈ ψ is an oscillatory function
with zero mean. Since the scale factor s is proportional to the inverse of the frequency ω , the value ( )( )
0 0

ψ
s f W
exhibits the frequency content of ( ) t f in a frequency interval centered around
1
0 0

= s ω at the time interval centered
around
0
τ = t . The continous wavelet transform maps a signal of one independent variable t of two independent
variables τ , s . The scale factor and/or the translation parameter can be discretized. The usual choice is to follow a
dyadic grid ( )
k j j
s
,
,τ on the time-scale plane with
j
j
s 2 = and
j
k j
k 2
,
⋅ = τ The transform is then called the dyadic
discrete wavelet transform:
( )( ) ( ) ( ) > =< t t f k f W
k j
j j
,
, 2 , 2 ψ
ψ
(2)
where > • • < , denotes the inner product in ( ) R L
2
. The dyadic sampling is a very natural choice for computers.
6
We can construct functions :
( )
( )
2
Z ∈
)
`
¹
¹
´
¦
|
|

|

\
⋅ −
=
k j
j
j
j
k j
k t
t
,
,
2
2
2
1
ψ ψ
(3)
to form an orthonormal basis for signal representations. The decomposition process can be iterated, with successive
approximations being decomposed in turn, so that one signal is broken down into many lower resolution components.
For discrete-time signals, the dyadic discrete wavelet transform (DWT) is equivalent, according to Mallat’s algorithm
to an octave filter bank, and can be implemented as a cascade of identical cells (low-pas and high-pass finite impulse
response (FIR) filters) as illustrated in figure 1.
Fig.1 Wavelet decomposition tree
These filters split the signal’s bandwidth to half. Using downsamplers after each filter, the redundancy of the signal
representation can be removed. This is called the wavelet decomposition tree.
CHAPTER 4. ECG SIGNAL PROCESSING
This thesis focuses on three main topics in the field of ECG processing: preprocessing, parameter extraction
(recognition of waveforms, durations and segments computation) and application of softcomputing methods on
parameters (results) already obtained. The whole processing procedure is focused on three topics presented below
(figure 2):
fig. 2 The main topics
All these steps were performed using wavelet analysis and its benefits. One of most important task was the choice of the
wavelet function. A comprehensive comparative study was performed to achieve this goal. For processing were used
signals from Physionet databases, such as MIT-BIH or Q-T databases. In the preprocessing phase were proposed new
methods in denoising and baseline wander removal. The proposed denoising algorithm is performed as a choice of one
from two already existing procedures, based on the estimated noise level(using Stein’s Unbiased Estimate of Risk or
Donoho’s fixed thresholding). The baseline wandering removal was carried out by identifying the low or the lowest
frequency (large scale) components in the ECG signal. The typical baseline variation means 15 percent of peak-to-peak
ECG amplitude variation of 0.15 to 0.3 Hz. The proposed algorithms were evaluated on test signals (known signal with
added noise), performances were calculated following the obtained gain in signal to noise ratio. The results obtained in
the preprocessing (mostly denoising) phase with these proposed wavelet transform based algorithms are very promising
and sligthly better than others. The main advantage of these algorithms is that they can be applied again to the already
filtered signal and correlated with the following procedures. In the parameter extraction stage, the main ECG signal
features are identified, following the algorithm presented below. The steps are:
• The ECG signal data for analysis is selected (its length is 60 s (meaning 7680 at128 Hz sampling rate).
• A 4-th level wavelet decomposition is performed, using biorthogonal wavelet functions
PREPROCESSING
• Decimation/interpolation
• Denoising
• Baseline wander removal
PARAMETER EXTRACTION
• Identification of waves, segments
• Extragerea parametrilor
• Heart rate variability analysis
SOFTCOMPUTING
• Arrhythmia detection algorithm
• Fuzzy interpreter
• ANN application in wavelet function synthesis
7
• Determination of the R wave location (as local maxima) on first level approximation (first scale). An adaptive
threshold is used (related to the maximum and mean values of the signal), to find the points over this value. After
that, the R peaks are selected and stored in a parameter data vector.
• R-R intervals detection as R-R distances
• Detection of Q, S points as local minimum points before and after R wave. The area of the QRS complex can be
calculated from the Q-S duration and the value of the R peak
• Elimination of the QRS complex from the signal to obtain the other parameters.
• Detection of the T wave location (as new local maxima ) (scales3,4) (the same procedure as for R peak
detection).The T peak value and the Q-T distances will be stored in a parameter data vector
• Elimination of the T wave from the signal
• Determination of the P wave location (as the remained maxima) (scales 3,4) and S-T segments durations
The main parameters, after waves detections are calculated as follows:
1 ... 1 ,
1
− = − =
+
N i R R T
i i RR
;
Q S QRS
T T T − = ;
set on set off T
T T T
− −
− = ;
set on set off P
P P T
− −
− = (4)
set on Q PQ
P T T

− = ;
set on PR
P R T

− = ; Q T T
set off QT
− =

;
S set off ST
T T T − =

(5)
This algorithm leads us to determine the main parameters of an ECG signals. Were used signals contained normal sinus
rhythms and signals with abnormalities in order to find the main parameters. The used databases were: MIT-BIH atrial
fibrillation database (afdb), MIT-BIH Supraventricular Arrhythmia Database (svdb), MIT-BIH Arrhythmia Database
(mitdb), MIT-BIH Normal Sinus Rhythm Database (nsrdb). Over 100 signals were used. The evaluation of this
procedures was carried out using the following indicators:
Sensitivity:
FN TP
TP
S
+
= Positive predictibility:
FP TP
TP
P
+
= (6)
where TP is the number of true positive detection, FN stands for the number of false negative misdetections and FP is
the number of false positive misdetections. The results obtained were compared manually by the author (around 60
beats/signal in the self-created database) and the number of misdetection was noted and the indicators calculated (as
13,14 relations).
Table 1
Action taken S [%] P [%]
R peak detection > 99,2 > 99,6
T wave detection > 99,4 > 99,5
P wave detection > 98,6 > 98,7
The obtained parameters can lead to detect various dieseases. A fuzzy interpreter was set up to detect arrhythmias. The
inputs are from previously determined parameters (three beats considered):
( )
3 2 1
3
1
3
QRS QRS QRS QRS
T T T T + + = ;








+ + =
3 2 1
3
1 1 1
3
1
RR RR RR
HRV ;
( ) ( ) ( ) [ ]
2
3
2
2
2
1
2
3
1
RR RR RR RR RR RR
RR
− + − + − = σ ;
( ) ( ) ( ) [ ]
2
3
2
2
2
1
2
3
1
QRS QRS QRS QRS QRS QRS QRS
T T T T T T − + − + − = σ
The structure of the system and the results are below:
Table 2
Arrhythmia type Nr. events Correctly detected
events
[ ] % 100
det
events of number total
events ected correctly
Sinus tachycardia 135 123 91.11
Sinus bradycardia 43 37 86.04
Ventricular complexes 78 69 88.46
Application of artificial neural networks in filtering processes are also presented, proposed, evaluated in different forms.
The structure of such a filter is presented on figure 3.
fig. 3 The proposed filter structure
8
Signal filtering can be regarded as a kind of approximation with noise suppression. For a robust estimation, the output
not only approaches the signal value, but also suppresses the noise distortion. Distributed Approximation Functionals
(DAFs), which can be constructed as a window modulated interpolating shell, were also introduces and presented a a
powerful grid for numerically solving partial differential equations are also proposed for ECG signal processing.
The Hermite-type DAF wavelet is given by:
( )

=






σ ⋅ π
⋅ 





− ⋅








σ
− ⋅
σ
= σ δ
2
0
2
2
2
2 ! 2
1
4
1
2
exp
1
M
n
n
n
M
x
H
n
x
x
(7)
The function
n
H
2
is the Hermite polynomial of even order n 2 . The predominant advantage of the Hermite
polynomial approximation is higher-order derivative preservation. This is given by:
( )
( ) ( ) ( )







> − −
=
=
=
− −
1 : , 1 2 2
1 : , 2
0 : , 1
2 1
n if x H n x xH
n if x
n if
x H
n n
n
fig. 4 Hermite function DAF 1 , 4 = σ = n and 1 , 6 = σ = n
Theorethical analysis and an application show that the approach is extremly stable and and efficient for ECG signal
processing
To increase the detection algorithms performance an artificial neural network based wavelet function synthesizer is
proposed, starting from an arbitrary discretized sequence, from which the reconstruction and decomposition filters can
be obtained, as illustrated in figure 5. The structure is illustrated on figure 3
' S

ε
S
S
W W
fig. 5 A wavelet function synthesizer learning structure
The functions obtained gave better results in a decomposition-reconstruction from approximation coefficients procedure
than existing functions.
Chapter 5. AUTHOR’S CONTRIBUTIONS AND GENERAL CONCLUSIONS
The proposed tasks concerning the three topics (preprocessing, parameter extraction and application of
softcomputing methods) were accomplished with relatively good results With the multiscale feature of WT's various
morphologies are excited better at different scales. From these scales various segments and time widths as signal
parameters can be determined more accurately. The procedures proposed in this work can be used by a specialist as tool
for a parallel investigations, applied off-line. These cannot replace the physiscians activity in detecting various cardiac
diseases. The most important contributions of the author are:
• A new denoising algorithm proposed (as a specific combination of two already existing procedures) based on
estimated noise
• A new procedure proposed to remove baseline wander, using wavelet transform to detect and extract low frequency
components
• A comprehensive comparative study to choose the best wavelet function for ECG signal processing purposes, using
self-synthesized test signals and decomposition-reconstruction error as a criterion
Σ
DWT
IDWT
( ) ε Z
9
• A complete procedure to extract ECG signal parameters, searching on different decompositions for different waves,
using mostly approximation coefficients and succesive applications of the same kind of algorithms (peak detection,
wave identification, onset and offset points detection)
• An artificial neural network based filtering method, using Distributed Approximation Function (DAF) wavelet
• An algorithm to automated detection of arrhythmias, which basically follows the standard medical physicians
procedure
• Implementation of the automated arrhythmia detection algorithm into a fuzzy system
• A fuzzy interpreter for a qualitative analysis of already extracted parameters in order to detect arrhythmias or
certain trends to them
• A new method to synthesize a wavelet function from a random or existing sequence of certain length, satisfying the
given mathematical conditions
REFERENCES (selected)
Books
[C_Ald96] Aldroubi, A., Unser, M.: Wavelets in Medicine and Biology. CRC Press New York 1996
[C_Ant74] Antalóczy, Z.: Electrocardiographia az orvosi gyakorlatban. Medicina Könyvkiadó Budapest
1974
[C_Ger02_1] Germán-Salló, Z., Buksa Á. : Electronică medicală. Curs. Pentru uzul studenţilor.
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Maior” Tg-Mureş, 2002
[C_Mal01] Mallat, S.: A wavelet tour of signal processing Academic Press London 2001
[C_Math00] The MathWorks Inc.: Signal Processing Toolbox. For Use with Matlab. User’s Guide. The
MathWorks Inc 2000
Articles
[A_Alm03] Almeida, R., Martinez, J.P., Olmos, S., Rocha, A.P., Laguna, P: Automatic Delineationof T and
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Electrocardiology University of Rochester, Rochester, New York USA 1999
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Universităţii "Politehnica" din Timişoara, Seria Electronică şi Telecomunicaţii, Tom 50(64),
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[I_MONASH] Efficient features for ANN based ECG signal classifiers :
http://www.eng.monash.edu.au/ieee/ieeebio1993/p130.htm
11
CURRICULUM VITAE
Personal details
Surname: GERMÁN-SALLÓ
Name: Zoltán
Date of birth: July 1
st
.1961
Address: Victor Babeş str. 13/4, RO-540095 Tg-Mureş
Phone : Office: +40-265-233212 Home: +40-265-214474
E-mail: zgerman@upm.ro,
Languages: English: advanced, French: advanced, German:conversational
Academic Experience
1997-2005 PHD student, at the Dept. of Electrical Drives and Robots, Technical
University of Cluj-Napoca, Supervisor Prof. Maria IMECS.
1981-1986 Degree in Electrical Engineering at the Polytechnical Institute of Cluj,
Specialisation: Electronics and Telecommunications.
Research Field
Digital signal processing, Electronic devices and circuits, Signal theory, Bioengineering
Work experience
Since 1996 lecturer at “Petru Maior” University Tg-Mureş, Department of
Electrical Engineering
1993-1993 assistant engineer at “Petru Maior” University Tg-Mureş, Department of
Electrical Engineering
1986-1992 Research engineer at “Electromureş” Tg-Mureş
Scientific experience
Since 1993 - Team member in 4 research projects – at the “Petru Maior” University
of Tg-Mures
1998 April-June participant in TEMPUS JEP 11243 Programme at IUT Bordeaux
2002-2004 participant in 100671-CP-1-2002-1-FR-MINERVA-MPP Programme :
“Emerge: Educational network structure for dissemination of real
laboratory experiments to support engineering education”(local
coordinator)
Teaching experience Electronic devices and circuits, Signal theory, Data transmission,
Medical electronics

Last. Technical Univesity of Cluj-Napoca. Many thanks to Mrs. Mrs. Professor Iuliu Székely. I am grateful to Medical Physicist. for expert guidance and collaboration regarding the medical aspects of this work. “Transilvania” University of Braşov. Dorina Baraian from the Doctoral Office of Technical University Cluj-Napoca. for their comments and suggestions to the manuscript.Acknowledgements I would like to express my gratitude to my supervisor Professor Mária Imecs for the opportunity of doing this work and for her supervision and advice during the elaboration of this thesis. their work helped me in solving the administrative problems. Márta Germán-Salló. but not least. “Gheorghe Asachi” Technical University of Iaşi. my wife. I am grateful to Professor Radu Ciupa. also to members of the Electrical Engineering Department from “Petru Maior” University Tg-Mureş especially assistant engineers Katalin György and Adrian Gligor for their many valuable remarks. Many thanks to my friend and colleague. Their contribution was crucial in achieving this professional level. Zoltán Germán-Salló Sept 28. for their great support in difficult moments. the official reviewers of this thesis. Without their help I could not have finished this work. patience and understanding provided during these years. Rodica Brad. 2005 2 . Professor Alexandru Sălceanu. I wish to thank my family and my parents for their love. Professor László Dávid for scientific guidance.

4 The S-T segment 2.2 Atrial arrhythmias 2.3.3.1 Introduction 3.2.1 Multiresolution analysis 3.5.3.Contents SYMBOLS.4 The main features of the ECG signal 2.1 Definitions.2 The Continous Wavelet transform 3.3 Rhythmic excitations of the heart.3. NOTATIONS.6 Concluzions 2.3. ABBREVIATIONS Notations 1 INTRODUCTION 2 THE ECG SIGNAL.1 Normal sinus rhythm 2.5 Multiresolution analysis and The Calculation of wavelet transform 3.5 References 1 5 5 5 6 7 10 12 12 12 12 12 13 13 13 14 14 14 16 17 17 18 20 21 22 23 23 24 29 29 29 33 34 36 36 37 39 42 42 43 3 .7 References 3 THE WAVELET ANALYSIS 3.3.2.3.2 Arrhythmias 2.1.3 Theoretical issues 3.4. INTERPRETATIONS 2.2 The standard 12-lead derivation system 2.7 Wavelet packet analysis 3.1 Introduction 2.4.3.3.3.3.3 Heart rate variability (HRV) 2.2 From Fourier to Gabor expansion 3.4 The Discrete Wavelet Transformation 3.2 The measure of heart rate variability 2.5.3.1 Short history 3.1 Introduction 2.4.1 The Electrocardiogram 2.4.6 Wavelet functions for analysis and synthesis 3.4.3 The properties of wavelet functions 3.4.2 The P-R interval 2.3 The QRS complex 2.4.5 The T wave 2.4. PARAMETERS.4 Conclusions 3.3.3.6 The U wave 2.3.5 Disturbances in electrocardiograms 2.1. Notations 2.2 The Fast wavelet Transform 3. Waves and durations 2.3 Ventricular arrhythmias 2.3.3.2.2 Theory and electrical bases 2.1 The P wave 2.

3 Experimental own results in preprocessing 4.3.2.6 References 5 AUTHOR’S CONTRIBUTIONS IN ECG SIGNAL PROCESSING AND GENERAL CONCLUSIONS 5.1 Introduction 4.5 Conclusions and own results 4.2 The proposed procedure 4.2.2.4 Parameter extraction 4.5.4.4.4.2 General conclusions 6 GLOBAL REFERENCES 45 45 47 47 48 40 54 54 55 60 60 68 71 76 77 77 81 87 88 89 91 93 95 100 101 101 102 103 110 110 114 119 120 118 118 120 121 4 .3.3.3.4.5.1 The ECG signal base 4.4.3 The choice of wavelet function 4.2 T wave detection 4.1 Author’s contributions 5.3.4.2 Wavelet function synthesis with artificial neural networks 4.2. actual trends.4 ECG signal parameter extraction 4.3.4.5.1 Introduction 4.2 The proposed algorithm 4.1 Denoising 4.3. perspectives 4.3.5.3.4 Conclusions 4.4.2 Materials and methods 4.3 P wave detection 4.4 WAVELET ANALYSIS BASED ECG SIGNAL PROCESSING METHODS AND PROCEDURES 4.3 Heart rate variability analysis 4.2.1 QRS complex detection 4.4.3 Wavelet Transform based filtering 4.5.4 Own experimental results in ECG parameter extraction 4.3.4.2 Automated arrhythmia detection algorithm 4.3 Fuzzy interpreter 4.4 Conclusions and own results obtained 4.5 Softcomputing methods applied in ECG signal processing 4.5 Conclusions 4.5.1 Artificial neural networks for filtering ECG signals 4.4 The use of artificial neural networks in ECG signal analysis 4.1 The proposed procedure 4.2.2 Baseline wander removal 4.2.3 ECG preprocessing 4.5.1 Short history.2 Fundamental operations in ECG signal preprocessing 4.2.4.

parameter extractions (the most important processing phase) and softcomputing methods for interpretation and more accurate analysis.• > denotes the inner product in L2 (R ) . the QRS complex and the T wave. In the first chapter are presented the most important notations. τ ) of the signal f (t ) ∈ L2 (R ) is defined as: ( ) where. described and implemented. which is usually the most relevant (recognizable) feature of an ECG waveform. The proposed algorithms provide preprocessing (filtering. The usual choice is to follow a j j dyadic grid (s j .ψ j . because the size and form of these signals may change eventually and can be noised. The durations (time between the onset and offset) of particular parameters of the ECG (referred as an time interval) is of great importance since it provides a measure of the state of the heart and can show the presence of certain cardiological conditions. Many tools. using Signal processing and Wavelet Toolboxes. represented by distinct features in the ECG waveform. τ . The standard parameters of the ECG waveform are the P wave. k 2 j =< f (t ). Wavelets provide efficient localization in both time and frequency (or 2 scale). Therefore the recognition and analysis of the ECG signals is a very important task. The end point of the T wave represents the end of the cardiac cycle (presuming the absence of U wave). This could be difficult. In the second chapter the ECG signal is introduced through its most important (from a digital signal processing point of view) parameters: waves. Each of these algorithms is presented. The fourth chapter presents the whole ECG signal processing procedure proposed by the author from preprocessing to parameter interpretation. durations and intervals.k ) on the time-scale plane with s j = 2 and τ j . Since the scale factor s is proportional to the inverse of the frequency ω . Chapter2. The fifth chapter contains the author’s contributions and the general conclusions. The continouos wavelet transform Wψ f (s.To analyze any finite energy signal f (t ) ∈ L (R ) . the continous wavelet transform (CWT) is a decomposition of the signal as a combination of a set of basis function.τ ) = ∫ f (t ) ⋅ ψ −∞ +∞ 1 ψ  t −τ  ⋅ψ   ⋅ dt s  s  (1) to denote the complex conjugate of discrete wavelet transform: where < •. Introduction Electrocardiograms (ECGs) are signals that originate from the action of the human heart. Additionally a small U wave ( with an uncertain origin) is ocassionally present. interval measurements. we have used ψ . This is followed by the QRS complex. τ j . the 12-lead electrocardogram. All of them were developed under Matlab. In practice. The function ψ ∈ L2 (R ) is an oscillatory function with zero mean. which form a non-officially standard in the ECG processing research field. tested and evaluated on special created signal databases. The dyadic sampling is a very natural choice for computers.Chapter1. baseline wander removal). obtained by means of dilation and translation of a single prototype wavelet function ψ (t ) called mother wavelet.. the value (Wψ f )(s 0 . The ECG is the graphical representation of the potential difference between two points on the body surface. The third chapter briefly introduces the theory of wavelet transform (WT) as a young branch of applied mathematics extensively developed in the last ten years and shows a few promising applications in signal processing. which corresponds to the period of atrial depolarization in the heart. noise reduction and feature extraction of a signal. The continous wavelet transform maps a signal of one independent variable t of two independent variables s. Using this expertise the physician judges the status of a patient. THE WAVELET ANALYSIS Over the past ten years. wave interpretations are carried out manually by ECG specialists. methods and algorithms from signal processing theory have been proposed.k = k ⋅ 2 The transform is then called the dyadic (W f )(s. Its historical development has resulted in a tool for clinical diagnosis. The cardiac cycle begins with the P wave. 5 (W f )(2 ψ j . ECG recordings are examined by a physician who visually checks features of the signal and estimates the most important parameters of the signal. But most of the information lies around the R peak. denoising. THE ECG SIGNAL The electrocardiogram is a time-varying signal that measures the electrical activity (on the surface of the human body) of the heart. versus time.k (t ) > ) (2) . abbreviations and symbols used in this work. The motivation and structure of this work are also discussed in this chapter. The T wave follows the QRS complex and corresponds to the period of ventricular repolarization. Each heartbeat is a complex of distinct cardiological events. Chapter 3. wavelet transform has been used as a powerful tool for image data compression. The scale factor and/or the translation parameter can be discretized. τ 0 ) −1 exhibits the frequency content of f (t ) in a frequency interval centered around ω 0 = s 0 at the time interval centered around t = τ 0 .

ECG SIGNAL PROCESSING This thesis focuses on three main topics in the field of ECG processing: preprocessing. durations and segments computation) and application of softcomputing methods on parameters (results) already obtained. One of most important task was the choice of the wavelet function. the main ECG signal features are identified.k )∈Z 2 (3) Fig. In the parameter extraction stage. The steps are: • The ECG signal data for analysis is selected (its length is 60 s (meaning 7680 at128 Hz sampling rate). the redundancy of the signal representation can be removed. The proposed denoising algorithm is performed as a choice of one from two already existing procedures. • A 4-th level wavelet decomposition is performed. according to Mallat’s algorithm to an octave filter bank. The decomposition process can be iterated. 2 The main topics • • • All these steps were performed using wavelet analysis and its benefits. such as MIT-BIH or Q-T databases. In the preprocessing phase were proposed new methods in denoising and baseline wander removal. The baseline wandering removal was carried out by identifying the low or the lowest frequency (large scale) components in the ECG signal.3 Hz. and can be implemented as a cascade of identical cells (low-pas and high-pass finite impulse response (FIR) filters) as illustrated in figure 1. using biorthogonal wavelet functions 6 .  t − k ⋅2j 1 ψ j . The main advantage of these algorithms is that they can be applied again to the already filtered signal and correlated with the following procedures. This is called the wavelet decomposition tree. segments Extragerea parametrilor Heart rate variability analysis SOFTCOMPUTING Arrhythmia detection algorithm Fuzzy interpreter ANN application in wavelet function synthesis fig. The results obtained in the preprocessing (mostly denoising) phase with these proposed wavelet transform based algorithms are very promising and sligthly better than others.1 Wavelet decomposition tree These filters split the signal’s bandwidth to half. The whole processing procedure is focused on three topics presented below (figure 2): • • • PREPROCESSING Decimation/interpolation Denoising Baseline wander removal • • • PARAMETER EXTRACTION Identification of waves. parameter extraction (recognition of waveforms. CHAPTER 4. For processing were used signals from Physionet databases. performances were calculated following the obtained gain in signal to noise ratio. with successive approximations being decomposed in turn. following the algorithm presented below. the dyadic discrete wavelet transform (DWT) is equivalent. The typical baseline variation means 15 percent of peak-to-peak ECG amplitude variation of 0. Using downsamplers after each filter. For discrete-time signals.15 to 0. so that one signal is broken down into many lower resolution components. based on the estimated noise level(using Stein’s Unbiased Estimate of Risk or Donoho’s fixed thresholding). A comprehensive comparative study was performed to achieve this goal.k (t ) = ψ  j  2j  2      ( j . The proposed algorithms were evaluated on test signals (known signal with added noise).We can construct functions : to form an orthonormal basis for signal representations.

A fuzzy interpreter was set up to detect arrhythmias. fig.4) and S-T segments durations The main parameters. The used databases were: MIT-BIH atrial fibrillation database (afdb). The structure of such a filter is presented on figure 3. TQRS = TS − TQ . After that.4 > 99.14 relations).11 86.7 The obtained parameters can lead to detect various dieseases. TST = Toff − set − TS (5) This algorithm leads us to determine the main parameters of an ECG signals.• Determination of the R wave location (as local maxima) on first level approximation (first scale). the R peaks are selected and stored in a parameter data vector.2 > 99. 3 3 1 2 3  2 2 2 1 2 σ RR = RR1 − RR + RR2 − RR + RR3 − RR .6 > 98.. proposed. Over 100 signals were used. An adaptive threshold is used (related to the maximum and mean values of the signal). events 135 43 78 Correctly detected events 123 37 69 correctly det ected events total number of events 100[%] 91.. The inputs are from previously determined parameters (three beats considered): TP TP + FN Positive predictibility: P= TP TP + FP (6) TQRS 3 = 1 1 1 1  1 TQRS1 + TQRS 2 + TQRS3 . 3 The proposed filter structure 7 . TP = Poff − set − Pon − set (4) TPQ = TQ − Pon − set . • Detection of the T wave location (as new local maxima ) (scales3. The area of the QRS complex can be calculated from the Q-S duration and the value of the R peak • Elimination of the QRS complex from the signal to obtain the other parameters. after waves detections are calculated as follows: TRR = Ri +1 − Ri . TPR = R − Pon − set .N − 1 . MIT-BIH Normal Sinus Rhythm Database (nsrdb). HRV3 =    RR + RR + RR  . TT = Toff − set − Ton − set .46 Application of artificial neural networks in filtering processes are also presented. The evaluation of this procedures was carried out using the following indicators: Sensitivity: S= where TP is the number of true positive detection.6 T wave detection > 99. The results obtained were compared manually by the author (around 60 beats/signal in the self-created database) and the number of misdetection was noted and the indicators calculated (as 13. MIT-BIH Supraventricular Arrhythmia Database (svdb). 3 2 2 2 1 2 σ QRS = TQRS 1 − TQRS + TQRS 2 − TQRS + TQRS 3 − TQRS 3 ( ) [( [( ) ( ) ( ) ( ) ( )] )] The structure of the system and the results are below: Table 2 Arrhythmia type Sinus tachycardia Sinus bradycardia Ventricular complexes Nr. TQT = Toff − set − Q .5 P wave detection > 98. Were used signals contained normal sinus rhythms and signals with abnormalities in order to find the main parameters. FN stands for the number of false negative misdetections and FP is the number of false positive misdetections. evaluated in different forms.04 88. S points as local minimum points before and after R wave.The T peak value and the Q-T distances will be stored in a parameter data vector • Elimination of the T wave from the signal • Determination of the P wave location (as the remained maxima) (scales 3. • R-R intervals detection as R-R distances • Detection of Q. to find the points over this value. Table 1 Action taken S [%] P [%] R peak detection > 99. MIT-BIH Arrhythmia Database (mitdb). i = 1.4) (the same procedure as for R peak detection).

from which the reconstruction and decomposition filters can be obtained. Chapter 5. The Hermite-type DAF wavelet is given by:  2 1 1  x  (7)  ⋅∑−  ⋅ H 2n    4 2π ⋅ n! n =0   2σ   The function H 2 n is the Hermite polynomial of even order 2n . This is given by:  1. The procedures proposed in this work can be used by a specialist as tool for a parallel investigations. if : n > 1   x2 1 δ M ( x σ ) = ⋅ exp − 2  2σ σ  M n fig. 5 A wavelet function synthesizer learning structure The functions obtained gave better results in a decomposition-reconstruction from approximation coefficients procedure than existing functions. applied off-line. σ = 1 Theorethical analysis and an application show that the approach is extremly stable and and efficient for ECG signal processing To increase the detection algorithms performance an artificial neural network based wavelet function synthesizer is proposed. The structure is illustrated on figure 3 S' Σ S ε Z (ε ) DWT WS IDWT W fig. For a robust estimation. using wavelet transform to detect and extract low frequency components • A comprehensive comparative study to choose the best wavelet function for ECG signal processing purposes. The most important contributions of the author are: • A new denoising algorithm proposed (as a specific combination of two already existing procedures) based on estimated noise • A new procedure proposed to remove baseline wander. These cannot replace the physiscians activity in detecting various cardiac diseases. From these scales various segments and time widths as signal parameters can be determined more accurately. using self-synthesized test signals and decomposition-reconstruction error as a criterion 8 .Signal filtering can be regarded as a kind of approximation with noise suppression. 4 Hermite function DAF n = 4. σ = 1 and n = 6. The predominant advantage of the Hermite polynomial approximation is higher-order derivative preservation. starting from an arbitrary discretized sequence. were also introduces and presented a a powerful grid for numerically solving partial differential equations are also proposed for ECG signal processing. but also suppresses the noise distortion. if : n = 0   H n (x ) =  2 x. the output not only approaches the signal value. which can be constructed as a window modulated interpolating shell. AUTHOR’S CONTRIBUTIONS AND GENERAL CONCLUSIONS The proposed tasks concerning the three topics (preprocessing. if : n = 1  2 xH n −1 ( x ) − 2(n − 1)H n −2 ( x ). as illustrated in figure 5. Distributed Approximation Functionals (DAFs). parameter extraction and application of softcomputing methods) were accomplished with relatively good results With the multiscale feature of WT's various morphologies are excited better at different scales.

: Prelucrarea semnalelor electrofiziologice bazată pe inteligenţă artificială . Theory.Z. Medicina Könyvkiadó Budapest 1974 Germán-Salló. Rochester. Z.R. on Biomedical Engineering.Ph. Z.: Contribution of the Wavelet Analysis to the Non-Invasive Electrocardiology University of Rochester. S. pag. Buletinul Ştiinţific al Universităţii "Politehnica" din Timişoara. 2002 Mallat. Buletinul ştiinţific Universitatea “Petru Maior” Târgu-Mureş vol XVII . 41.V Wickerhauser : Entropy-based algorithms for best basis selection IEEE Trans... onset and offset points detection) An artificial neural network based filtering method. 1995 Mallat. Olmos. M. Vol. L. no. satisfying the given mathematical conditions REFERENCES (selected) Books [C_Ald96] [C_Ant74] [C_Ger02_1] [C_Ger02_2] [C_Mal01] [C_Math00] Aldroubi. A.on Inf. Romania. Universitatea “Petru Maior” Tg-Mureş. International Congress on Computational Bioengineering...P. september 19-21. vol 42. nr. vol. 483-484 Germán-Salló. Rocha. 37. J. pp. Germán-Salló. using Distributed Approximation Function (DAF) wavelet An algorithm to automated detection of arrhythmias. July 1991 9 Articles [A_Alm03] [A_Coi92] [A_Cou99] [A_Dav00] [A_Dav01] [A_Don95] [A_Fri90] [A_Ger03_2] [A_Ger04_1] [A_Ger04_2] [A_Ger04_3] [A_Ger05] [A_Ino98] [A_Li95] [A_Mal91] .: Wavelet Transform based ECG signal analysis. Couderc..: Wavelet transform based characteristic points detection on ECG signals.: M. 3.: Zero crossing of a wavelet transform. Zareba. : Characteristic points detection on ECG signal. Friesen G. 2004 pag 139-145 Germán-Salló Z. Tg-Mureş. : De-Noising by soft-thresholding IEEE Trans.: Wavelets in Medicine and Biology. No. pp. 1990 Germán-Salló. User’s Guide. vol. D. Germán-Salló.W. which basically follows the standard medical physicians procedure Implementation of the automated arrhythmia detection algorithm into a fuzzy system A fuzzy interpreter for a qualitative analysis of already extracted parameters in order to detect arrhythmias or certain trends to them A new method to synthesize a wavelet function from a random or existing sequence of certain length. 1992.: Teoria semnalelor. Z. Robotics AQTR 2004 – THETA 14 Cluj-Napoca. vol. Buksa Á. madrid. Tom 50(64). 2003. using mostly approximation coefficients and succesive applications of the same kind of algorithms (peak detection. Universitatea “Petru Maior” Tg-Mureş. P: Automatic Delineationof T and P waves using Wavelet-based multiscale approach.243-247 Coifman. R. pag. 2004. 713–718. 38. A : Noise reduction method for ECG signals Using the dyadic wavelet transform. IEEE Transactions. A comparison of the noise sensitivity of nine QRS detection algorithms. 2. searching on different decompositions for different waves. Z. May 13-15. Pentru uzul studenţilor. 2002 Germán-Salló. Horváth.4.: Signal Processing Toolbox. R.: Multiresolution analysis in ECG signal processing Proceedings International Conference on Intelligent Engineering Systems INES 2004 Cluj-Napoca. A. New York USA 1999 Dávid L. Buletinul ştiinţific al Universităţii Petru Maior din Tg-Mureş 2000-2001 vol XIIIXIV Dávid. 613–627..: A wavelet tour of signal processing Academic Press London 2001 The MathWorks Inc. Seria Electronică şi Telecomunicaţii. Fascicola 1.. S. Pentru uzul studenţilor.P. Fundamentals. Romania. Laguna.21-28. : Artificial intelligence based biomedical signal processing Health CEEC Conference 15-18 october 2001 Tg-Mureş. Martinez. Curs.: Electrocardiographia az orvosi gyakorlatban. Unser.. 6. Proceedings of International Conference on Automation. E81-A. CRC Press New York 1996 Antalóczy. pp. Z. Detection of ECG characteristic points using wavelet transform. Espana. The MathWorks Inc 2000 Almeida. Scientific Conference with International participation. IEEE Transactions on information theory. C.. 1998 Li. 6-7 november 2003 Germán-Salló. . 1995.: Analiza multirezoluţie în detecţia complexului QRS ale semnaleleor ECG.• • • • • • A complete procedure to extract ECG signal parameters.L. INTER-ING 2003. : Electronică medicală. 37. vol. IEEE Transaction on Biomedical Engineering. on Inf. Quality and Testing. Z. 2004 pag 242-245 Germán-Salló Z. wave identification. Theory. For Use with Matlab. J.1.. IEICE Trans. Romania Donoho. S.. Romania. S. 2005 Inoue H. Curs. Z.

no. 12 Shivannarayana. 1996 PHD theses [T_Cou97] [T_Dub02] [T_Tik99] CD-ROMs [D_Hur96] Internet Resources [I_MITBIH] MIT-BIH databese Distribution Home page : http://ecg.. Laguna. N : Interactive Electrocardiography. M.physionet.. : Analyse quantitative des composantes temps-echelle de l’ECG de haute resolution moyenne pour l’evaluation du risque de tachycardies ventriculaires et de la mort subite aprés un infarctus du myocarde. Tongsak. Novartis Pharmaceuticals Corporation Summit. P.eng.org/ Efficient features for ANN based ECG signal classifiers : [I_MONASH] http://www. CD-ROM. Rocha.167-174 Couderc.. Reddy.4.. IEEE Transactions on Biomedical Engineering. Almeida.P. Olmos.C. P.[A_Mar04] [A_Oka79] [A_Shi99] Martinez. : Biorthogonal Wavelet Transforms for ECG parameters estimation. 26. M.mit. S. : A Wavelet-based ECG delineator: Evaluation on standard databases. 570-561 Okado. D. N. 1999. Universite Lyon 1997 Dubowik. 1979 vol.21.: A digital filter for the QRS complex detection IEEE Transaction on Biomedical Engineering.edu/ [I_PHYSIO] PhysioNet The research resource for complex physiologic signals http://www.htm 10 .P. Institute of computer science. K. Medical engineering and Physics. vol 51. pag. No. Technical University of Lodz 2002 Tikkanen. nr. A.. J.P. New Jersey .. April 2004. University of Oulu 1999 Hurley. pag.: Automated arrhythmia analysis-an expert system for an intensive care unit. R.monash.edu.au/ieee/ieeebio1993/p130. Faculty of Science. J. : Characterization and application of analysis methods for ECG and time interval variability data.

Signal theory. Electronic devices and circuits. Department of Electrical Engineering Research engineer at “Electromureş” Tg-Mureş Scientific experience Since 1993 1998 April-June 2002-2004 Team member in 4 research projects – at the “Petru Maior” University of Tg-Mures participant in TEMPUS JEP 11243 Programme at IUT Bordeaux participant in 100671-CP-1-2002-1-FR-MINERVA-MPP Programme : “Emerge: Educational network structure for dissemination of real laboratory experiments to support engineering education”(local coordinator) Teaching experience Electronic devices and circuits. Medical electronics 11 . Supervisor Prof. of Electrical Drives and Robots.CURRICULUM VITAE Personal details Surname: Name: Date of birth: Address: Phone : E-mail: Languages: GERMÁN-SALLÓ Zoltán July 1st. 13/4. Technical University of Cluj-Napoca. Data transmission. Specialisation: Electronics and Telecommunications. RO-540095 Tg-Mureş Office: +40-265-233212 Home: +40-265-214474 zgerman@upm. Degree in Electrical Engineering at the Polytechnical Institute of Cluj.1961 Victor Babeş str. Department of Electrical Engineering assistant engineer at “Petru Maior” University Tg-Mureş. Research Field Digital signal processing. French: advanced. at the Dept. Maria IMECS.ro. German:conversational Academic Experience 1997-2005 1981-1986 PHD student. Bioengineering Work experience Since 1996 1993-1993 1986-1992 lecturer at “Petru Maior” University Tg-Mureş. Signal theory. English: advanced.

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