Journal
COMPUTERS IN BIOLOGY AND MEDICINE
Volume 116, Issue -, Pages -Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.compbiomed.2019.103540
Keywords
Wearable devices; Mobile health; Smart health; Entropy; Embedded algorithms; Cardiac arrhythmias; Cardiac rhythm monitoring
Categories
Funding
- Provincia Autonoma di Trento, Industrial Project Ri.Car.Do
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Background: Due to the growing epidemic of atrial fibrillation (AF), new strategies for AF screening, diagnosis, and monitoring are required. Wearable devices with on-board AF detection algorithms may improve early diagnosis and therapy outcomes. In this work, we implemented optimized algorithms for AF detection on a wearable ECG monitoring device and assessed their performance. Methods: The signal processing framework was composed of two main modules: 1) a QRS detector based on a fmite state machine, and 2) an AF detector based on the Shannon entropy of the symbolic word series obtained from the instantaneous heart rate. The AF detector was optimized off-line by tuning its parameters to reduce the computational burden while preserving detection accuracy. On-board performance was assessed in terms of detection accuracy, memory usage, and computation time. Results: The on-board implementation of the QRS detector produced an overall accuracy of 99% on the MIT-BIH Arrhythmia Database, with memory usage = 672 bytes, and computation time <= 90 mu s. The on-board implementation of the optimized AF algorithm gave an overall accuracy of 98.1% (versus 98.3% of the original version) on the MIT-BIH AF Database, with increased sensitivity (99.2% versus 98.5%) and decreased specificity (97.3% versus 98.2%), memory usage = 4648 bytes, and computation time <= 75 mu s (consistent with real-time detection). Conclusions: This study demonstrated the feasibility of real-time AF detection on a wearable ECG device. It constitutes a promising step towards the development of novel ECG monitoring systems to tackle the growing AF epidemic.
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