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Study of Phase Synchronization in Multimodal
Cardiovascular Signals using Recurrence Plots
1
Rangaprakash. D,
2
T. Srinivas
1,2
Dept. of ECE, Indian Institute of Science, Bangalore, India
Abstract
Many biological systems are inherently nonlinear and in this paper,
we propose a novel application of a nonlinear measure based on
recurrences to study synchronization in cardiovascular system using
multimodal signals. Phase synchronization between two signals
has been characterized by using a nonlinear measure, Correlation
between Probabilities of Recurrence (CPR), and in this work, its
utility in studying synchronization in cardiovascular system has
been studied. Synchronization using CPR of multimodal signals,
viz. electrocardiogram and arterial blood pressure signals, showed
clear differences in results obtained for normal and abnormal
cases. The concept of running CPR has been introduced and its
utility in detecting life threatening condition in a cardiac care
unit is demonstrated. While most of the previous studies have
either employed linear models or nonlinear parametric models,
this paper uses a nonparametric nonlinear model and shows its
utility in studying synchronization in the cardiovascular system
using electrocardiogram and arterial blood pressure signals.
Keywords
Multimodal Cardiovascular Signals, Nonlinear Dynamics,
Recurrence Plots, Phase Synchronization, Correlation Between
Probabilities of Recurrence
I. Introduction
Heart problems are a leading cause of death and hence early
detection and subsequent treatment are essential. Automatic
detection of cardiovascular problems in the Cardiac Care Unit
(CCU) can effciently help in prompt attention and treatment,
thus saving lives. Physiological observations of records of
Electrocardiogram(ECG), Arterial Blood Pressure(ABP) etc.
are routinely acquired in a typical CCU and these data are not
usually processed together. The information fusion to produce a
meaningful interpretation for the decision making process is left to
the experience of the attending cardiologist whose responsibility
goes as far to collect, organize and interpret massive data in order
to construct an appropriate mental image of the pathophysiological
state of the patient. Thus automated analysis becomes important
particularly in view of the fact that a large number of patients
have proven or suspected ventricular failure and close computer
monitoring of their cardiovascular system can detect disturbances
thus avoiding life-threatening complications or sudden cardiac
death.
In hospitals doctors make diagnoses on the basis of information
collected from different sources, effectively fusing the information
to form the decision. Information fusion refers to the combination
of data originating from multiple sources and is used to improve
decision tasks. In a similar way a multimodal system uses
information from more than one type of data source. For example,
patient status detection may occur based on fusion, processing
and analysis of ECG and ABP data. Using multimodal data can
improve diagnosis. The advantages of multimodal over unimodal
analysis are that multimodal analysis reduces the number of false
negatives and also the total number of critical states detected are
increased. In this paper, cardiovascular signals like ECG and ABP
have been considered together for signal processing so as to enable
us to generate intelligent alarms in a CCU environment.
Multivariate time series analysis has been of interest since last
few decades and it has been applied to biomedical signals also
[1-2]. Literature contains analysis of interaction between several
channels of EEG as also between cardio-respiratory signals in
different experimental conditions [3-5]. Studies using linear
parameters like correlation and coherence in EEG and ECG signals
have established that there are alterations in these parameters
during various physiological conditions [6-7].
Biomedical signals investigated in this paper are a record of
electrical potentials obtained from the cardiovascular system.
These signals refect the conditions of the cardiovascular system
and hence a close analysis of these signals provides information
about them. Since biomedical signals are complex and random
looking they can be analyzed as output of a stochastic process,
i.e. system driven by unknown input and based on this approach
several linear models have also been developed. However, one
limitation of this approach is that it bears little or no consideration
to the nonlinear processes that generates the signal. Another
limitation is that the models developed for these sophisticated
biological systems do not represent the biological system to any
reasonable extent. Hence, there is a need to analyze these signals
with a different perceptive. In this work, we are concerned mainly
in applying a nonlinear technique for the analysis of multimodal
cardiovascular signals.
New approaches to study the behavior of complex biological
systems based on nonlinear dynamics have come to the scenario
of current research recently. This approach is becoming important
as more and more problems from different felds such as physical,
chemical and life sciences have been more satisfactorily studied
after putting them in the context of nonlinear dynamics.
Especially in biological and life sciences, important components
of physiological systems have been modeled as a set of coupled
nonlinear dynamical oscillators [8].
The appearance of synchronized phenomena in nonlinear and
chaotic systems is rather universal but not trivial. Coupling takes
place when two or more systems synchronize some characteristic
of their respective motions, due to an interaction between the
systems or to a common external interaction. The study of coupled
systems has been made earlier with the analysis of synchronization
of nonlinear periodic systems. Well known examples are the
synchronization of two pendulum clocks that hang on the same
beam and the synchronized fashing of frefies. But the research
of chaotic synchronization began much later [9], where it was
shown that two chaotic systems can become completely coupled,
i.e. their time evolution becomes identical. In [10] the notion of
complete synchronization of chaotic systems was generalized,
allowing the non identity between the coupled systems. And
some time later, researchers considered a rather weak degree
of synchronization between chaotic oscillators, of which their
associated phases become locked, whereas their amplitudes
remain almost uncorrelated [9]. Hence, they called this kind of
synchronization, phase synchronization.
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Not only laboratory experiments have demonstrated phase
synchronization of chaotic oscillators such as electronic circuits
but also natural systems can exhibit phase synchronization.
Cooperative behavior of coupled complex systems has recently
attracted considerable interest from theoreticians as well as
experimentalists, since synchronization and related phenomena
have been observed not only in physical systems , but also in
many biological systems. For example, the dynamics of the cardio
respiratory system and the electroencephalographic activity of
patients display synchronization features. In such systems it is
important to detect synchronized states. This is made more diffcult
since the systems under study can no longer be assumed to be
stationary. In recent years, a lot of work is being done in the
area of time series analysis techniques to study the dynamics of
biomedical systems [11] with attendant diagnostic applications.
For studying their interactions we have employed the method
of phase synchronization using recurrences. The nonparametric
nature of the recurrence based technique makes them widely
applicable.
The aim of this paper is to study interaction between cardiovascular
signals by means of recurrence based nonlinear methods under
various experimental conditions. In view of the fact that
cardiovascular signals exhibit nonlinear characteristics, the use
of nonlinear approach to study the synchronization is preferred
over the linear methods such as correlation and coherence. While
these nonlinear methods deal with nonlinear dependencies, most
nonlinear methods require suffciently long stationary time series
and hence ,in this paper, we employ recurrence based techniques
which are applicable for the case where stationarity holds only for
short observation time. It has been shown that this measure can
effectively distinguish between normal and abnormal conditions
which has potential applications in cardiac care.
II. Materials and Methods
A. Multimodal Cardiac Database
We have considered multimodal records of ECG and ABP signals
of a subject in CCU. These records are obtained from MIT database
[12] and they contain both normal and abnormal segments. The
abnormality corresponds to the case of Pre-Ventricular Contraction
(PVC) of the heart, which is an indicator of a possible myocardial
infarction about to happen. The data comprises of parallel record of
ECG and ABP, sampled at 512 Hz. Most part of the signals looks
like normal ones with abnormality (PVC) appearing towards the
end. RP is obtained using the following parameters: D=5, d=20,
=0.5. These values of D and d are popularly used in literature [13].
is derived using the procedure outlined earlier in this paper.
B. Nonlinear Dynamical Analysis
A simple nonlinear deterministic system, which is very sensitive
to initial conditions, can generate outputs that are very complex.
For such systems, called dynamical systems, evolution from
some initial state is dictated by a set of ordinary differential
equations.
dx
1
/dt = f
1
(x
1
,x
2
,.x
n
)
dx
2
/dt = f
2
(x
1
,x
2
,.x
n
)
(1)
dx
n
/dt = f
n
(x
1
,x
2
,.x
n
)
where y(t) = (x
1
(t), x
2
(t),., x
n
(t))
T
is the state of the system
at time t, and F = (f
1
, f
2
, , f
n
)
T
: R
N
, is called a vector feld. The
dynamical system (Eq. 1) is nonlinear if F is nonlinear.
The solution to Eq. 1 for a given initial condition is called fow

t
(y
0
) and it indicates the position of the initial condition of y
0
after
time t. The state space of system (Eq. 1) is a coordinate system
with coordinates x
1
, x
2
,., x
n
and the set of points {
t
(y
0
)} in
the state space can be plotted as a function of time resulting in
the state space trajectory of the system [14].
Chaos is the unpredictable long time behavior of a deterministic
dynamical system which is highly sensitivity to initial conditions.
In case of chaotic systems, it is observed that the systems trajectory
starting from a specifc initial condition in state space is different
from another trajectory starting from a slightly different initial
condition. In a chaotic system, these two trajectories will soon
start to diverge.
Since biomedical signals are complex and random looking, it could
be generated by a chaotic system. In our work biomedical signals
are analyzed as chaotic signals rather than stochastic signals
particularly in view of new developments in nonlinear dynamics.
Since these signals are generated by complex biomedical systems
like heart, the number of state variables required to defne these
systems are not small and hence the number of points to be
considered becomes very large. In order to overcome this problem,
we have used recurrence plots for analyzing the biomedical signal.
Recurrence plots come under the category of nonlinear dynamical
techniques and it can be effectively applied to biomedical signals
for extracting useful information from them.
C. Recurrence Plots
In natural systems ,there will not be access to all the state variables
of the system and hence the method of Takens is employed [15].
In this method the mapping of a discrete signal x into phase space
is made as follows. Given a signal with N
s
terms, x
1
,x
2
,x
3
,
x
i
,x
Ns
is mapped into phase space by constructing vectors y
i
of
dimension D with lag d defned as
(2)
D 1, d 1, i=1 to N
s
, k=i mod N
s
-(D-1)d
This is called embedding the signal in phase space of dimension
D with lag d. The trajectory of the signal in D dimensional phase
space is given by the variable y and it completely represents the
original state space topologically thus preserving all its properties.
Two points yi and yj in phase space, corresponding to time instants
i and j, can come close to each other and then we say a recurrence
has occurred. Recurrence are preserved by phase space thus
enabling further analysis on such a trajectory.
Eckmann et al. [16] have introduced a tool called Recurrence Plot
(RP) which facilitates the visualization of recurrences in phase
space. This visualization is usually done by projection into two or
three dimensional sub-spaces. However, the D-dimensional phase
space trajectory can be investigated through a two-dimensional
representation of its recurrences and this is done by using an NN
matrix whose elements take values 0 or 1. Each element of the
matrix is mapped to a unit black or white pixel at the corresponding
location of 1 and 0 representing the presence and absence of
recurrences respectively. Thus we calculate an NN matrix
(3)
where ||.|| is a norm, is the recurrence threshold and ( ) is the
Heaviside step function forcing R
i,j
to be either 0 or 1. Euclidean
norm has been used throughout this work.
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It should be noted that RP is a convenient tool to graphically view
recurring patterns and non-stationarity in time series. Recurring
patterns are among the most important features of natural systems
and hence RPs have been applied to a wide range of scientifc
studies including the study of various biological systems. One of
the major reasons for the popularity of RPs is due to the fact that
the structures of RPs are visually appealing and they may reveal
patterns in the data not evident from examination of the time series.
The use of the distance-matrix formalization permits the utilization
of any kind of data and hence very useful for applications where
the data could be non-stationary, or nonlinear. RP provides a global
picture of dependence in a signal, not readily available to many
approaches.
In the above D, d and should be chosen properly. The D value
should be selected such that it is high enough to capture all state
variables but avoiding too high a value to limit computational
time. D can be determined experimentally on a case by case basis.
However specifc value of D for EEG are universally accepted
which has been used in this paper. Similarly the value of d has been
chosen based on the one used in literature [17-18]. To choose the
value of threshold , we perform the calculations at the smallest
, say 0.1, and then increase it in steps of, say, 0.1, to get a plot
of number of recurrences versus . We select the threshold by
considering the value where the percentage of recurring points
begins to rise sharply off the noise foor. In our work, proper
value of for EEG signal has been chosen by the procedure as
described above.
D. Recurrence Quantification Analysis
Quantifcation measures have been derived from RPs even for data
sets with short length [19-21] and they have been obtained using a
technique termed recurrence quantifcation analysis (RQA). They
quantify systematically the different structures found in RP [22]
and they have become very popular with numerous applications.
Several works describe the use of RP as a tool for detecting changes
in system dynamics and RQA has been effectively used to quantify
the changing dynamics of various systems.
It may be observed that RQA has the advantage of independence
from constraining assumptions and limitations plaguing other
analyses. There is no need to pre-condition the data since recurrence
structures are simply tallied within the signal (or between
signals). Also it is not constrained by signal non-stationary and
transients. Hence RQA has proven to be ideally suited for the
study of numerous real-world systems encompassing a multitude
of disciplines. In addition, RQA is model free and it can also deal
with signals from nonlinear systems of any nature. Thus this tool
is particularly suitable for analysis of physiological signals which
depict nonlinearity and non-stationarity. Hence, it is very suitable
for revealing changes in the dynamics of cardiovascular system.
Considering these advantages, RQA is continuously being applied
to various practical situations. Cross RQA (CRQA) is a subset
of RQA in which two signals are simultaneously considered for
obtaining certain measures. In this work we consider its application
to cardiovascular system and study its changing dynamics using
multimodal cardiovascular signals .
E. Correlation Between Probabilities of Recurrence for
Two Signals
The case of R(i,j)=1 with j=i+ corresponds to the trajectory that
returns to the neighborhood of i after a delay . Considering such
occurrences for all (i, i+),one can get an estimate of the probability
P() of the system returning to a pre-defned state after a delay
. Then one can estimate the probability P() that each of the
samples of the trajectory returns to its own neighborhood after
samples delay as
(4)
P() has found application in the estimation of the dynamical
invariants of the system by means of recurrences in phase space
[23] and has found applications to geophysical data [24]. However,
this function do not seem to have been applied for the analysis of
multimodal cardiovascular signals.
The probability of recurrence, P() of two signals has been used
in the detection of Phase synchronization (PS) between any two
signals [25]. We can quantify the degree of phase synchronization
by looking at the coincidence of the positions of the maxima of P()
for both signals. In fact, we can derive from that a measure called
Correlation coeffcient between Probabilities of Recurrence (CPR)
[25]. Evaluation of degree of phase synchronization between two
cardiovascular signals may be made by computing the correlation
coeffcient between probabilities of recurrence P
1
() and P
2
() for
the signals 1 and 2 respectively. This is given by
(5)
where m
1
and m
2
are the mean, and
1
and
2
are the standard
deviations of P
1
() and P
2
() respectively. The value of ranges
from
e
to
m
where
e
is the value of for which P()=1/e. The
value of
m
is usually chosen to be half the length of the longer
signal.
The degree of phase synchronization between two signals is given
by CPR. The probability of recurrences has peaks for some delay
and CPR ~ 1 if two signals are in perfect PS. In contrast, the
peaks of the probability of recurrences do not coincide when the
signals are not in PS and CPR will then have a low value. In this
paper, the defnition of CPR has been extended to study the overall
synchrony of multimodal cardiovascular signals.
III. Results and Discussion
A. Phase Synchronization Between two Signals of Same
Type
We have considered two cardiovascular signals of same type
(ex. two ECGs) and analyzed phase synchronization between
them, which will also provide insights helpful to understand later
results.
1. Phase Synchronization Between Two ECG Signals
Phase synchronization for ECG signals is presented frst in this
section. The two signals considered are (a) a typical segment of
normal ECG signal of W samples, which acts as a template and (b)
contiguous segments taken from a complete record of ECG signal.
W is chosen as 500 samples. Signal (b) is divided into a number of
non-overlapping frames of W samples. CPR is computed between
signal (a) and each of the frames of signal (b) to obtain a running
CPR (rCPR) signal. The motivation for this analysis is to assess
the degree of synchronization in the cardiac system under normal
and PVC conditions using the CPR parameter when only one
signal is accessible. Results are given in fg. 1 and fg. 2. In fg.
1 is shown PR for two typical segments of normal ECG. Under
normal conditions the two signals are well synchronized leading
to a high value of CPR equal to 0.93. Fig. 2 shows PR for typical
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segments of normal and abnormal (PVC) signals. The two signals
are not well synchronized (CPR=0.03). This could be a potential
indicator of arrhythmia.
In this paper ,the concept of running CPR, which is very useful
in practical applications, has been introduced and then applied
to cardiovascular signals . Here the value of CPR of a long data
is calculated by frst evaluating CPR for each of several smaller
contiguous segments of data . Then the running CPR is obtained
by plotting the values of CPR over these segments of data, i.e. it is
a plot of variation of CPR with time. If we keep a normal segment
as template and continuously obtain the running CPR of the two
signals then we can detect any abnormality in the signal. We have
considered a long record of ECG which shows normal data up to
58850 sample values and then starts changing abruptly (due to
PVCs) due to deteriorating condition of the patient. Fig. 3 shows
the rCPR of this ECG data. It is observed that CPR shows clear
dip at the same time location where PVC abnormality occurs in
the original ECG signal. A simple threshold could easily catch this
difference and raise an alarm. Hence, this method can be used for
real time abnormality detection and has potential applications in
cardiac care. It may be noted that rCPR shows some dips of smaller
amplitude indicating a probable warning for the onset of PVC.
Fig. 1: CPR Between Two Different Segments of ECG During
Normal Condition (CPR=0.93)
Fig. 2: CPR Between Normal and Abnormal (PVC) ECG Segments
(CPR=0.03)
Fig. 3: Running CPR for a Long ECG Data
2. Phase Synchronization Between Two ABP Signals
Next we consider the phase synchronization for ABP signals and
an analysis of rCPR similar to the case of ECG is performed. Fig.
4 shows CPR for two typical segments of normal ABP signal and it
is observed that the two signals are well synchronized (CPR=0.99).
Fig. 5 shows PR for typical normal and abnormal (PVC) segments
and it is seen that the two signals are not so well synchronized
(CPR=0.11).
If we keep a normal segment as template and continuously
obtain the running CPR of the ABP signal then we can detect any
abnormality in real time. We have considered a long record of ABP
signal which shows normal data up to 58850 sample values and
then starts changing abruptly (due to PVCs) due to deteriorating
condition of the patient. Fig.6 shows the rCPR of this ABP data.
It is observed that CPR shows clear dip at the same time location
where PVC abnormality occurs in the original ABP signal. A
simple threshold could easily catch the difference and raise an
alarm. Hence, this method can be used for real time abnormality
detection and hence has potential applications in cardiac care.
However, rCPR of ECG gave a better discrimination. The pre-
warning dips of smaller amplitudes seen in case of rCPR of ECG
is absent in case of rCPR of ABP.
Fig. 4: CPR Between Two Different Segments of ABP During
Normal Condition (CPR=0.99)
Fig. 5: CPR Between Normal and Abnormal ABP Segments
(CPR=0.11)
Fig. 6: Running CPR for a Long ABP Data
B. Phase Synchronization in Multimodal Cardiac
Signals
The motivation for this analysis is to assess the degree of
synchronization in the cardiac system under normal and PVC
conditions using the CPR parameter when multimodal cardiac
signals (ECG and ABP) are available. Here a template signal
is not required. Both signals are divided into a number of non-
overlapping frames of W (=500) samples. A running CPR (rCPR)
signal is obtained between respective frames of the two signals.
Fig.7a shows CPR for the case of normal ECG and ABP segments.
Under normal conditions the two signals are well synchronized
(CPR=0.76). This value of CPR is lower than the values obtained
for either ECG or ABP individually since we are comparing signals
of two different types. Yet CPR is signifcantly high. Fig.7b shows
PR for the case of abnormal (PVC) ECG and ABP segments. The
two signals are not so well synchronized (CPR=0.15).
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(a)
(b)
Fig. 7: CPR Between ECG and ABP Segments During (a) Normal
Condition (CPR=0.76), (b) Abnormal Condition (CPR=0.15)
We have considered a long parallel record of ECG and ABP which
shows normal data up to 58850 sample values and then starts
changing abruptly (due to PVCs) due to deteriorating condition
of the patient. Fig. 8 shows the rCPR obtained using the two
records. It is observed that CPR shows clear dip at the same time
location where PVC abnormality occurs in the original signals.
A simple threshold could easily catch the difference and raise an
alarm. Hence, this method can be used for real time abnormality
detection and hence has potential applications in cardiac care.
Fig. 8: Running CPR for Parallel Channels of Long ECG and
ABP Signals
Synchronization analysis of ECG and ABP illustrate the use of CPR
for detection of abnormality in the cardiac system. Systems can be
built using this approach for automatic detection of abnormalities
in CCU which can save lives.
IV. Conclusion
In this paper, we have studied phase synchronization in multimodal
biomedical signals using recurrence plot technique. It appears
that the application of phase synchronization in cardiovascular
system using recurrence plots has not been much studied and we
demonstrate here a novel application of recurrence based phase
synchronization technique to cardiovascular data. In order to
assess degree of synchronization in the cardiovascular system,
multimodal data of ECG and ABP with abnormalities has been
considered. The concept of running CPR has been introduced
and the running CPR of only the ECG (or ABP) signal of the
multimodal data is initially considered. CPR between template
of ECG with different segments of ECG shows a wide contrast
between normal (CPR=0.99) and abnormal (CPR=0.01) states.
But this requires the template. Analysis of multimodal signals does
not require the template yet provides a suffcient contrast between
the two states. The effcacy of the synchronization technique in
detecting PVC abnormality has been demonstrated.
In this paper, we have quantifed PS based on recurrences in phase
space and this is relevant for attractors with a rather broadband
power spectrum. Since cardiovascular signals are known to have
broadband spectrum, these techniques are particularly relevant for
such signals. Also this technique, being nonlinear, is particularly
suitable for a cardiovascular system which is inherently nonlinear. It
is suitable for studying phase synchronization in the cardiovascular
system in a data driven way since very few assumptions are made
in this method due to its nonparametric nature . We hope that the
novel application proposed in this paper will stimulate interest in
using recurrence based techniques for many other applications. In
fact, the proposed technique can be applied to many other types
of multichannel biomedical signals for healthcare applications.
It is also hoped that the paper will lead to many other studies on
nonlinear based synchronization resulting in better understanding
of nonlinear aspects in biomedical systems. While most of the
previous studies have either employed linear models or nonlinear
parametric models, this paper uses a nonparametric nonlinear
model and shows its utility in studying synchronization in the
cardiovascular system for multimodal biomedical signals.
V. Acknowledgments
The authors would like to thank Prof.T.V.Ananthapadmanabha
for many useful discussions.
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