This paper proposes a method of detecting heart
blocks by visual analysis of overlapping ECG recordings of individual cardiac cycles. The cardiac cycles from the ECG of a subject are extracted using Continuous Wavelet Transform
based QRS complex detection technique and each cardiac cycle is
plotted over the previous one allowing one to visually and hence, quickly analyze the correlation between the recorded cardiac cycles and perceive the degree of randomness of the normally
quasi- periodic ECG signal without the use of lassifiers

© All Rights Reserved

Als PDF, TXT **herunterladen** oder online auf Scribd lesen

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This paper proposes a method of detecting heart
blocks by visual analysis of overlapping ECG recordings of individual cardiac cycles. The cardiac cycles from the ECG of a subject are extracted using Continuous Wavelet Transform
based QRS complex detection technique and each cardiac cycle is
plotted over the previous one allowing one to visually and hence, quickly analyze the correlation between the recorded cardiac cycles and perceive the degree of randomness of the normally
quasi- periodic ECG signal without the use of lassifiers

© All Rights Reserved

Als PDF, TXT **herunterladen** oder online auf Scribd lesen

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Detection of Heart Blocks by Cardiac Cycle Extraction

using Time- Scale Analysis

A. Mukherjee

Department of Electronics & Communications Engineering

University of Engineering & Management, Jaipur, India

anandar upmukher j ee@gmai l . com

Abstract This paper proposes a method of detecting heart

blocks by visual analysis of overlapping ECG recordings of

individual cardiac cycles. The cardiac cycles from the ECG of a

subject are extracted using Continuous Wavelet Transform

based QRS complex detection technique and each cardiac cycle is

plotted over the previous one allowing one to visually and hence,

quickly analyze the correlation between the recorded cardiac

cycles and perceive the degree of randomness of the normally

quasi- periodic ECG signal without the use of classifiers.

Keywords Electrocardiogram, Continuous Wavelet

Transform, QRS Complex Detection, Cardiac Cycle Extraction,

Heart Blocks.

I. INTRODUCTION

Cardiology has evolved to its present state mainly due to

the various signal processing techniques applied in

conjunction with the biological concepts. Presently, whatever

we know of the cardiac functions is mostly due to the

biological signal processing technique called

electrocardiography (ECG). ECG is a two dimensional

representation of the cardiac potentials plotted with respect to

time. The ECG signal is quasi- periodic as it is a combined

function of different waves, each wave signifying the

functioning of a particular part of the human heart. The ECG

wave for a single cardiac cycle is divided into three categories

viz.: P, QRS and T (fig. 1). These waves occur after regular

intervals of time. Deviation of the ECG waves or their time

intervals from the regular pattern signifies problems in the

heart. The detection of this deviation is the essence of ECG.

The P wave represents atrial repolarization and depolarization.

The QRS wave represents ventricular repolarization and the T

wave represents ventricular depolarization. The time taken for

the complete generation of a normal P wave is about 80ms to

100ms. The QRS wave duration is approximately 120ms wide.

Any ambiguity in these intervals can broadly identify most of

the cardiac diseases; further analysis of the wave morphology

can even pinpoint the location and cause of the cardiac

abnormality.

Increasing cases of cardiac diseases around the world is of

major concern and requires immediate attention, therefore the

detection and diagnosis of these diseases is important. The

huge amount of data generated every day is too much for

humans to analyze alone, hence automated analysis of these

signals is very crucial. The first step in the analysis of ECG

signals is the removal of noise from the recorded signals. The

noise in ECG signals is mainly due to power line interference

which is in the range of 50Hz to 60Hz; other noises are

motion artifacts due to electrode and skin interface, muscle

noise and noise from other electrical equipment near the ECG

machine. The second stage is the detection of the R- peak or

the QRS complex. The P and T waves are detected with

respect to the R- peak. The later stages may include analysis

of the wave time intervals such as PR interval, RR interval,

ST interval, etc. The final stages mostly include the use of

classifiers to automatically segregate the detected signals into

various categories.

The automated detection of cardiac cycles by analyzing

ECG recordings has reached an advanced stage with the

emergence of a lot of powerful and robust algorithms and

tools. These algorithms are mostly based on Time- frequency

analysis of the ECG signals, more specifically, the discrete

wavelet transform (DWT) [1] [2] [3]. This paper proposes a

method of extracting all the cardiac cycles individually from

ECG recordings containing multiple cardiac cycles and

Fig. 1: An ECG representation of a single cardiac cycle showing all

the waves and intervals.

Fig. 2: Overlapping, singular cardiac cycle ECG for an arrhythmic

heart with no heart block.

12

International Journal of Emerging Trends in Signal Processing

ISSN(2319-9784) IJETSP , Volume 1 , Issue 3 March 2013

http://ijetsp.info/article/IJETSPV1I302.pdf

overlapping them to visually compare and detect

abnormalities in the heart using Continuous Wavelet

Transforms (CWT). A normal heart will have regular time

intervals and regular wave morphology; when overlapped,

almost all of the cardiac cycles will form a regular wave

boundary not deviating much from each other (fig.2). A heart

with cardiac abnormalities will produce an output which has

no clear wave boundaries and is random and garbled (fig.3);

higher the randomness in the pattern, higher is the degree of

heart abnormality, indicating the absence of regular rhythms.

A. ECG Intervals

The normal ECG wave intervals of a healthy person have

the following characteristics: a PR interval lying within 120ms

to 200ms time interval, a QRS complex of duration less than

120ms and a QT interval lying between 400ms to 440ms.

Long PR intervals are generally associated with heart blocks

and fascicular blocks [4] [5]; QRS complexes with longer

duration are associated with bundle branch blocks and long

QT intervals are generally associated with myocardial

infarction or myocardial disease. Long QT intervals are

sometimes due to the effect of certain drugs such as sotalol

and amiodarone [4].

B. Wavelet Transform

Traditional signal processing techniques such as Fourier

Transform is able to detect the frequencies present in a time

domain signal; its major drawback lies in the fact that it

cannot localize the positions of occurrence of these

frequencies, thus, the need for Wavelet Transform. Wavelet

Transform is effective in localizing a signal in both time and

frequency domain. It consists of two major operations of time

shifting and dilation [6]. In time shifting operation, an

analyzing wavelet of fixed window length called the mother

wavelet is convoluted with the time- domain signal for the

signal length of 0 toL

[6]. The analyzing window is shifted

along the time axis and again convolved with the time domain

signal for the next window length from L to L 2 . This process

is repeated until the whole range of the signal has been

analyzed. The second operation of dilation repeats the above

time shifting process with a reduced window length. The

reduction in window length is also called scaling. The scale is

directly proportional to the inverse of frequency. Larger the

window length, higher is the probability of detecting changes

in low frequency signals and smaller window length detects

changes in signals of higher frequencies with greater

probability. The range of scales and the type of analyzing

wavelet, also called the wavelet family, is generally based on

the users discretion and the type of signal to be analyzed. The

CWT of a continuous square integrable function ) (t x at a scale

0 > a and a translational value or window lengthb is given by:

= dt

a

b t

t x

a

b a X

) (

1

) , (

(1)

Where ) (t is continuous in both time and frequency

domain and is also known as the mother wavelet, which is

responsible for generating dilated copies of itself based on the

value of scalesa . The dilated versions of the mother wavelet

are known as daughter wavelets. The transformed signal is

generally plotted in a 2D plot called a scalogram plot. A

scalogram plot has scales on one axis and time on the other.

The values of coefficients are represented in colored spectrum

with violet having the lowest value and red having the highest

value (fig. 4).

C. Database

The work for this paper is done on the freely available

MIT- BIH Arrhythmia database (mitdb). This database

contains dual channel, long term ECG recordings of patients

from mixed age groups and both genders. The patients

medical history is provided with the database along with the

analysis and diagnosis of the ECG signals by a specialist. The

signals are sampled at a sampling rate of 360 samples per

second with 11 bit resolution over a 10 millivolt range [7] [8].

Fig. 3: Overlapping, singular cardiac cycle ECG for an arrhythmic

heart with block.

Fig. 4: A time domain ECG signal and its corresponding scalogram

plot.

13

International Journal of Emerging Trends in Signal Processing

ISSN(2319-9784) IJETSP , Volume 1 , Issue 3 March 2013

http://ijetsp.info/article/IJETSPV1I302.pdf

II. METHODOLOGY

The signals from the MIT-BIH Arrhythmia database is

analysed by CWT using Symlet6 family of wavelets for a

scale range of 1 to 130. The Symlet 6 wavelet closely

resembles a normal ECG pattern and hence, provides greater

accuracy in detection of abnormalities in ECG signals using

CWT [9]. The wavelet coefficients generated are used for

locating the start and end of individual QRS complexes in the

ECG signal [10].

A. QRS Complex Detection

The time domain ECG signal is converted to time- scale

domain using CWT. The position of the maximum coefficient

generated ) (MAX POS is selected as reference. Positions of

other coefficients, ) ( ts coefficien POS , are selected based on

the criteria in (2) below.

if end

ts coefficien POS

else

ts coefficien POS

MAX POS ts coefficien POS if

; 0 ) (

; 1 ) (

) ( 55 . 0 ) (

=

=

(2)

) ( ts coefficien POS forms an array which has unit amplitude

along the time axis whenever QRS complex is encountered,

otherwise it has zero amplitude. To rectify erroneous multiple

detection or multiple detection within a single QRS complex,

a checking operation has been provided based on the

following criteria:

end

CNT PEAK CNT PEAK

i POS i POS while

; 1 _ _

50 ) ( ) 1 (

+ =

> +

(3)

The positions between two detected complexes should be at

least 50 samples which roughly equals to 0.13 seconds, as the

sampling rate of the database is 360 samples per second and

multiple QRS complexes cannot lie within each other. The

start and end positions of the detected QRS complexes are

recorded and stored in two separate arrays, namely

loc START _ and loc END _ respectively. The output of the

above method is shown in fig.5.

B. Estimation of P and T waves

The positions of P and T waves can be approximated by

simple arithmetic operations. The array containing the

location of the start of QRS complexes and the array

containing the locations of the end of the QRS complexes are

element-wise averaged and stored in an array named

loc MEAN _ as shown in (4).

2

) ( _ ) ( _

) ( _

i loc END i loc START

i loc MEAN

+

= (4)

It is known that the PR interval of a normal ECG has a

maximum duration of 0.2 seconds. Since, this method deals

with detection of abnormalities of the ECG signals, a PR

interval of 0.3 second is considered as worst case scenario

value. Similarly, a QT interval value of 0.44 seconds is

considered. The signal is sampled at a rate of 360 samples per

second, which gives a boundary value of 108 samples and 150

samples for PR and QT intervals respectively. Single cardiac

cycles are extracted from the time domain ECG signal based

on the criteria in (5) and (6) below.

Fig. 5: Time- domain ECG signals (blue) with detected QRS

complexes (green) superimposed on it.

MIT- BIH Arrhythmia Database

Continuous Wavelet Transform

Family= symlet6

Scales=1:130

QRS Complex Detection

Estimate location of P and T waves

from sampling rate

Extract single cardiac cycles from

the long term ECG signal

Store each cardiac cycle in an array

Plot all the cardiac cycles, one over

the other.

Fig. 6: Flowchart for extraction of singular cardiac cycles from long

termECG recordings.

14

International Journal of Emerging Trends in Signal Processing

ISSN(2319-9784) IJETSP , Volume 1 , Issue 3 March 2013

http://ijetsp.info/article/IJETSPV1I302.pdf

108 ) ( _ ) ( _ = i loc MEAN i start CC (5)

150 ) ( _ ) ( _ + = i loc MEAN i end CC (6)

The flowchart for the above process is given in fig.6 which

gives an overview of the QRS complex detection and cardiac

cycle extraction process mentioned in this paper.

III. RESULTS

The results of application of the aforementioned method are

shown in figs. 7 to 10. Select records from the MIT-BIH

Arrhythmia database are chosen to test the method. One set

contains arrhythmic patients having no heart blocks and the

other set has arrhythmic patients with major blockage of heart.

The first set contains records 100 and 102. The record ID 100

contains significant instances of atrial premature contraction

(APC) and premature ventricular contraction (PVC). Record

ID 102 contains paced beats and pacemaker fusion beats. The

second set contains records 107 and 111. Record ID 107 has

complete heart blockage and ID 111 has first degree AV block.

The diagnosis is provided along with the database itself. Fig. 7

shows the overlapping cardiac cycles of record ID 100. The

time intervals of the cardiac cycles are more or less same;

hence, a neat boundary is achieved. Fig. 8 shows the

overlapping cardiac cycles of record ID 102. The patients

ECG has elevated ST segments and diminished QRS

complexes, but no heart block. The time intervals of the

patients cardiac cycle are almost the same; hence, again a

clear boundary has been achieved.

The overlapping cardiac cycle plot of record ID 107 is

shown in fig. 9. The patient is suffering from complete heart

block causing the plot to be garbled and with no clear and

uniform boundary. Fig. 10 contains the plot of record ID 111,

suffering from 1

st

degree AV block. Just like the previous

figure, this figure has no clear boundaries due to changes in

the time intervals caused by blocked conduction of the Atrio-

Ventricular (AV) node. This type of block causes a delay in

the completion of some of the cardiac cycles, causing the

normally overlapping and constant intervals to vary from the

regular intervals.

IV. CONCLUSION

Figs. 7 and 8 clearly show that the cardiac cycles are being

accurately extracted and all the time intervals within a cardiac

cycle such as the PR interval and the QT interval overlap in

the consecutive plots of the cardiac cycles, forming a single,

clearly cognizable boundary. The plot in Fig.7 has some of the

cardiac cycles with higher wave amplitudes than the other

cardiac cycles but the time intervals overlap perfectly. This

ambiguity in the cardiac amplitudes is due to the presence of

Fig. 7: Overlapped plot of extracted cardiac cycles for record ID 100

indicating absence of cardiac blocks.

Fig. 8: Overlapped plot of extracted cardiac cycles for record ID 102

indicating absence of cardiac blocks.

Fig. 9: Overlapped plot of extracted cardiac cycles for record ID 107

indicating the presence of cardiac blocks.

Fig. 10: Overlapped plot of extracted cardiac cycles for record ID 111

indicating the presence of cardiac blocks.

15

International Journal of Emerging Trends in Signal Processing

ISSN(2319-9784) IJETSP , Volume 1 , Issue 3 March 2013

http://ijetsp.info/article/IJETSPV1I302.pdf

baseline wander noise present in the signal as seen in fig.11.

Figs. 9 and 10 have no single cognizable wave boundary due

to the presence of multiple QRS complexes within the plot

area. Since, the record IDs 107 and 108 suffer from heart

blocks, the plots in fig. 9 and fig. 10 show absence of regular

time intervals, causing the extracted cardiac cycles to deviate

vastly from each other.

This paper proposes a method for quick analysis of the

ECG signals visually and without any numeric calculation of

intervals, so that even a non- specialist can judge the condition

of the heart just by looking at the plot of the cardiac cycles.

However, for specific and detailed diagnosis of the heart, the

involvement of a cardiac specialist is a must.

ACKNOWLEDGMENT

The efforts of Prof. K. K. Ghosh in the Department of

Electronics and Communications Engineering at the Institute

of Engineering and Management, Kolkata and Dr. K. K.

Mukherjee, Inspector General (Medical), ITBP, New Delhi,

India are gratefully acknowledged for their constant guidance

and assistance with my work.

REFERENCES

[1] S.Z. Mahmoodabadi, A. Ahmadian, M.D. Abolhasni, M.Eslami, J .H.

Bidgoli, ECG Feature Extraction based on Multiresolution Wavelet

Transform, Procedings of the 2005 IEEE Engineering in Medicine and

Biology 27

th

Annual Conference, Shanghai, China, Sep 1-4, 2005

[2] A. Pachauri, M. Bhuyan, Robust Detection of R- Wave Using Wavelet

Technique, World Academy of Science, Engineering and Technology

56, 2009, p.901-905.

[3] A. Mukherjee, K.K. Ghosh, An Efficient Wavelet Analysis for ECG

Signal Processing, IEEE Xplore, 2012, DOI:

10.1109/ICIEV.2012.6317419, p.411- 415.

[4] www.ecglibrary.com/norm.htm

[5] Leo Schamroth, An Introduction to Electrocardiography, Oxford

University Press, SBN: 0 19 562790 3

[6] R. Polikar, The Wavelet Tutorial, Part

IV,www.cs.ucf.edu/courses/cap5015/WTpart4.pdf, 2008

[7] Goldberger AL, Amaral LAN, Glass L, Hausdroff J M, Ivanov PCh,

Mark RG, Mietus J E, Moody GB, Peng C-K, Stanley HE, PhysioBank,

PhysioToolkit and PhysioNet: Components of a New Research

Resource for Complex Physiologic Signals. Circulation 101(23):e215-

e220, [Circulation Electronic Pages;

http://circ.ahajournals.org/cgi/content/full/101/23/e215]; 2000 (J une

13).

[8] http://physionet.org/physiobank/database/html/mitdbdir/mitdbdir.htm

[9] A. Mukherjee, S. Chatterjee, k. Chattopadhyay, K. K. Ghosh, A

Comparative Study on the Accuracy of ECG Detection for Arrhythmia

by Different Wavelet Families, IEMIJ MT, Vol.2 No.1, J an. 2012, p.93-

98.

[10] A. Mukherjee, K.K.Ghosh, A Noise Independent Approach to QRS

Complex Detection using CWT, communicated to the International

Conference on Informatics, Electronics and Vision, 2013, Dhaka,

Bangladesh, 2013.

Fig. 11: A time domain plot of the ECG recordings for record ID 100,

showing the presence of baseline wanders in the signal.

16

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