This work presents a new modular and low-complexity algorithm for the delineation of the different ECG waves (QRS, P and T peaks, onsets, and end). Involving a reduced number of operations per second and having a small memory footprint, this algorithm is intended to perform real-time delineation on resource-constrained embedded systems. The modular design allows the algorithm to automatically adjust the delineation quality in runtime to a wide range of modes and sampling rates, from a ultralow-power mode when no arrhythmia is detected, in which the ECG is sampled at low frequency, to a complete high-accuracy delineation mode, in which the ECG is sampled at high frequency and all the ECG fiducial points are detected, in the case of arrhythmia. The delineation algorithm has been adjusted using the QT database, providing very high sensitivity and positive predictivity, and validated with the MIT database. The errors in the delineation of all the fiducial points are below the tolerances given by the Common Standards for Electrocardiography Committee in the high-accuracy mode, except for the P wave onset, for which the algorithm is above the agreed tolerances by only a fraction of the sample duration. The computational load for the ultralow-power 8-MHz TI MSP430 series microcontroller ranges from 0.2% to 8.5% according to the mode used.

In the last years, the need for enhancing health and preventing problems with remote monitoring is increasing. A non-invasive low-cost technique for processing bio-signals and monitoring vital parameters, at rest and during physical activity, is the use of wearable PhotoPlethysmoGraphic (PPG) systems. However, in order to detect a relevant vital parameter, such as the heart rate during demanding exercises, motion artifacts must be removed from the signals retrieved. In this paper, we present a fast and easy to implement algorithm to estimate the heart rate value which does not need to reconstruct the noise-free signal nor does it apply adaptive filtering as existing algorithms, thus gaining computational time and stored memory space. The method consists of applying the Fast Fourier Transform on short windows of data and removing motion artifacts relying on single-sided amplitude spectrum analysis of PPG and 3-axis accelerometer signals. The results show that our algorithm manages to remove a wide range of motion artifacts achieving an average absolute error of only 1.27 BPM between the heart rate estimated by the algorithm every second and the ground-truth value. The method was successfully implemented on a wearable PPG device achieving an execution time of 226 ms per second, hence obtaining a battery lifetime of 9.37 days.

It is widely recognized today that there is an alarming rise of lifestyle-induced chronic diseases (e.g., type II diabetes) in our society. Therefore, a strong need exists for cost-effective and non-invasive devices that can measure blood pressure (BP) to monitor, diagnose and follow-up patients at risk, but also healthy population in general. One promising method for arterial BP estimation is to measure a surrogate marker of it, such as, Pulse Transit Time (PTT) and derive pressure values from it. However, current methods for measuring PTT require complex sensing and analysis circuitry and the related medical devices are expensive and inconvenient for the user to wear. In this paper, we present a new smartphone-based method to estimate PTT reliably and subsequently BP from the baseline sensors on smartphones. This new approach involves determining PTT by simultaneously measuring the time the blood leaves the heart, by recording the heart sound using the standard microphone of the phone and the time it reaches the finger, by measuring the pulse wave using the phone's camera. Moreover, we also describe algorithms that can be executed directly on current smartphones to obtain clean and robust heart sound signals and to extract the pulse wave characteristics using smartphones. We also present methods to ensure a synchronous capture of the waveforms, which is essential to obtain reliable PTT values with inexpensive sensors. Our experiments show that the computational overhead of the proposed two-phase processing method is minimum, with the ability to reliably measure the PTT values in a fully accurate (beat-to-beat) fashion using directly state-of-the-art smartphones as medical devices.

This paper presents the system-level architecture of novel ultra-low power wireless body sensor nodes (WBSNs) for real-time cardiac monitoring and analysis, and discusses the main design challenges of this new generation of medical devices. In particular, it highlights first the unsustainable energy cost incurred by the straightforward wireless streaming of raw data to external analysis servers. Then, it introduces the need for new cross-layered design methods (beyond hardware and software boundaries) to enhance the autonomy of WBSNs for ambulatory monitoring. In fact, by embedding more onboard intelligence and exploiting electrocardiogram (ECG) specific knowledge, it is possible to perform real-time compressive sensing, filtering, delineation and classification of heartbeats, while dramatically extending the battery lifetime of cardiac monitoring systems. The paper concludes by showing the results of this new approach to design ultra-low power wearable WBSNs in a real-life platform commercialized by SmartCardia. This wearable system allows a wide range of applications, including multi-lead ECG arrhythmia detection and autonomous sleep monitoring for critical scenarios, such as monitoring of the sleep state of airline pilots.

Wireless sensor nodes (WSNs) have recently evolved to include a fair amount of computational power, so that advanced signal processing algorithms can now be embedded even in these extremely low-power platforms. An increasingly successful field of application of WSNs is tele-healthcare, which enables continuous monitoring of subjects, even outside a medical environment. In particular, the design of solutions for automated and remote electrocardiogram (ECG) analysis has attracted considerable research interest in recent years, and different algorithms for delineation of normal and pathological heart rhythms have been proposed. In this paper, some of the most promising techniques for filtering and delineation of ECG signals are explored and comparatively evaluated, describing their implementation on the state-of-the-art IcyHeart WSN. The goal of this paper is to explore the trade-offs implied in the different settings and the impact of design choices for implementing “smart” WSNs dedicated to monitoring ECG bio-signals.

Wireless sensor networks (WNSs) are gradually evolving from a promising technology to a well-established reality in a large set of different domains. In order to fulfill the requirements of the specific scenario, a WSN must provide the right tradeoff between performance and lifetime, which is heavily determined by the network design. However, although the complexity of WSNs is increasing, the design space exploration is often carried out manually without the support of a general analytical methodology. In this paper, we advocate a model-based approach as an efficient and scalable way to explore the energy-performance tradeoffs during the design. In particular, we show that it is possible to define system-level models to describe wide classes of WSNs, providing a quick and accurate network evaluation. As a proof of concept, we propose a general model that describes the main characteristics of a class of WSNs for human health monitoring, and we apply it to a real case study. The results show that the energy-performance estimation error of the model never exceeds 1.74% compared to real data, while the evaluation time is reduced by up to 6 orders of magnitude with respect to an accurate network simulation.

This paper presents a novel method for classification of multi-lead electrocardiogram (ECG) signals. The feature extraction is based on the random projection (RP) concept for dimensionality reduction. Furthermore, the classification is performed by a neuro-fuzzy classifier. Such a model can be easily implemented on portable systems for practical applications in both health monitoring and diagnostic purposes. Moreover, the RP implementation on portable systems is very challenging featuring both energy efficiency and feasibility. The proposed method is tested on a 12-lead ECG database consisting of 20 beats during normal sinus rhythm, 20 beats with myocardial infarction and 20 beats showing cardiomyopathy for 60 different subjects. The experiments give a recognition rate of 100% for a small number of RP coefficients (only 25), i.e. after a considerable dimensionality reduction of the input ECG signal. The results are very promising, not only from the classification performance point of view, but also while targeting a low-complexity feature extraction in terms of computation requirements and memory usage for real-time operation on a wireless wearable sensor platform.

This work is devoted to the evaluation of multilead digital wavelet transform (DWT)-based electrocardiogram (ECG) wave delineation algorithms, which were optimized and ported to a commercial wearable sensor platform. More specifically, we investigate the use of root-mean squared (RMS)-based multilead followed by a single-lead online delineation algorithm, which is based on a state-of-the-art offline single-lead delineator. The algorithmic transformations and software optimizations necessary to enable embedded ECG delineation notwithstanding the limited processing and storage resources of the target platform are described, and the performance of the resulting implementations are analyzed in terms of delineation accuracy, execution time, and memory usage. Interestingly, RMS-based multilead delineation is shown to perform equivalently to the best single-lead delineation for the 2-lead QT database (QTDB), within a fraction of a sample duration of the Common Standards for Electrocardiography (CSE) committee tolerances. Finally, a comprehensive evaluation of the energy consumption entailed by the considered algorithms is proposed, which allows very relevant insights into the dominant energy-draining functionalities and which suggests suitable design guidelines for long-lasting wearable ECG monitoring systems.

Accurate power and performance figures are critical to assess the effective design of possible sensor node architectures in body area networks (BANs) since they operate on limited energy storage. Therefore, accurate power models and simulation tools that can model real-life working conditions need to be developed and validated with real platforms. In this paper we propose a sensor node platform designed for health-care applications and a validated simulation model based on event-driven operating system simulation that can be used to accurately analyze performance and power consumption in BANs composed of multiple nodes. Thus, this model can be employed to tune the node architecture and communication layer for different working conditions, applications and topologies of BANs. In this paper we validate the proposed simulation model on different real-life applications and working conditions. Our results show variations of less than 4% between the presented simulation framework and measurements in the final platforms.