Advance Wireless ECG monitoring system

CHAPTER 1
INTRODUCTON
Electrocardiogram (ECG) consists of graphical recording of electrical activity of the heart over
time. It is most recognized bio-signal, it is commonly used for diagnosis of some heart diseases
by analysis of the signal. An electrocardiogram (ECG) is a medical test that checks for problems
with the electrical activity of heart.
Cardiovascular diseases and abnormalities changes the ECG wave shape and time period of the
QRS complex each portion of the ECG waveform carries information that is relevant to the
clinician in arriving at a proper diagnosis. The real time bio-signal signal taken from a patient is
generally get corrupted by external noise, hence need of a proper noise free ECG signal. A signal
acquisition system have number of stages, including signal acquisition though electrode,
instrumentation amplifier, noise filtering, band limiting the signal and processing for the
extraction of information.

Fig.1 Schematics of Normal ECG Waveform

Simple ECG waveform shown in Fig.1 It is a combination of P, T, U wave, and a QRS complex.
The complete with respect to time waveform is called an electrocardiogram (ECG) with labels P,
Q, R, S, and T indicating its different features.

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It is not only used in a clinical environment but also applied to the Personal Healthcare scenario.
In this application field, medical devices are intended to be used in the domestic environment
and can communicate wirelessly .In most of the bio-signal monitoring wireless devices the
distance from the node to base station is limited due to Bluetooth technology, this disadvantage
of the previous system is overcome by this system as we are using GSM GPRS 3G technology.
The work conducted, concentrate on designing a system that is functional and reduces wired
links to a minimum and attempts to prove the feasibility of completely wireless ECG.Further
advancement to this system is to interface number of node to capture different bio-signal from
body wirelessly and to send to distribution network, which are controlled by a data management
centre .
Work conducted here has been valuable in creating circuitry that can get an ECG signal, and
ARM controller based software that would digitizes the signal. An important benefit of this
system includes monitoring patients from home remotely, minimizes the hospital admission costs
and gives patients the freedom to move around. In our system, wireless ECG monitoring system
uses a three electrode After detection of the bio-signal, the system amplifies and filters ECG
signal simultaneously by means of a signal conditioning circuitry. The data are converted into
digital form using a 10-bit ADC through ARM controller LPC2148. This reads and store ECG
data in memory is then sends to Tx pin connected to GSM module serially. The signal is finally
transmitted to an appropriate server at receiver side; the port on server side is open for the
incoming data which actually listing to the data.

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CHAPTER 2
LITERATURE SURVEY
This paper focuses on the development of a portable real-time system for analysis of ECG
signals of a patient and also provides algorithms and techniques for buffering and analyzing the
digitized signals. These methods are used for detecting sections of the ECG waveform like the Pwave and QRS complex, for primary diagnosis of heart disease of home-cared patients. The use
of monitoring and analyzing ECG signals system at home can provide preliminary informative
details of home-cared patients by using PDA/PC and this system simultaneously alert the doctor
of any emergencies. This paper mainly focused on a development platform for real-time analysis
of ECG signals and also provides a capability for real time software to analysis of ECG signal.
Costas S. Iliopoulos AND Spiros Michalakopoulos IN [3], they describe A Combinatorial Model
for ECG Interpretation.in this paper they represent a new approach that is a combinatorial model
for analyzing and interpreting an electrocardiogram (ECG). This model detects a QRS peak or
QRS complex and also provides an online algorithm, which is worked with
space as well as time efficient. A Combinatorial Model for ECG Interpretation model provides
advantages like small memory requirements and interpreting large amounts of pre-recorded ECG
data. This paper provides steps for monitoring system, which is to be able to analyze the heart
rate and rhythm disturbances. Steps are; QRS Detection Problem, Parameters and Conditions,
Algorithm Outline and Pseudo-code, Discussion on the Space Complexity. Borromeo S,
Rodriguez-Sanchez C, Machado F, Hernandez-Tamames JA and de la Prieta R. in [4], describe
new concepts of Reconfigurable, Wearable, and Wireless ECG System. They develop bio-signal
acquisition devices to be easily integrated into the clinical routine. In this paper, they present a
new A Reconfigurable, Wearable, Wireless ECG System for Electrocardiogram (ECG)
acquisition as well as its processing, and wireless transmission provides less noise in ECG
signals like Power line interference, Electrode contact noise, Baseline wandering and ECG
amplitude due to respiration Instrumentation noise generated by electronic devices used in signal
processing, and other less significant noise resource. This model provides less Size and power
consumption, which provides mobility and comfort to the patient. They designed a modular
hardware system, which is composed of three layers that can be plugged/unplugged:
communication layer, processing layer and sensor layer and also developed
we also present a general purpose end-user application developed for mobile phones or Personal
Digital Assistant devices (PDAs), and an autonomous platform based on a Field-Programmable
Gate Array (FPGA) for developing and debugging. Sagar Pujari, Patrick O. Bobbie, Chaudary
Zeeshan Arif, Hema Chaudhari , in [5], they describe an Electrocardiogram (EKG) Data
Acquisition and Wireless Transmission System. In this paper, they present a development
platform of an EKG sensor, which are capable for transmitting EKG signals via wireless
technology such as Bluetooth, GPRS, GSM or Wi-Fi to a PC or set-top box. They used 802.11b
to demonstrate the working of the sensor, which makes EKG data easy to obtain, and effective.
This system provides heart patients home based monitoring facility as well as it also provides
patient mobility in hospital premises to efficiently monitor EKG which is not possible due to
wires etc. Also provides doctors central monitor system facility instead of visiting each room and
checking the respective monitors. Patrick O. Bobbie, Chaitanya Deosthale and Walter Thain in
[7] describe Telemedicine system, which is a Mote-Based Data Acquisition System for Real
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Time Health Monitoring. In this paper they develop an integrated sensor-based, wireless-enabled
ECG device using analog/digital signal acquisition circuitry and a TCP-enabled interface to log,
analyze and monitor home based heart patients. This system provides flexibility and mobility of
the patients. They construct ECG device/board using analog electronics,which is obtaining,
amplifying and filtering the captured signals. This ECG device/board is interfaced with wireless
sensors, which are mounted on MicaZs-RF enabled micro-processor nodes, which provide the
wireless platform.MDA300CA sensors are used for signal acquisition and MPR2400 is used
to transmit the signals in the unlicensed 2.4GHz ISM band.

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CHAPTER 3
BLOCK DIAGRAM
The sampling and conversion of ECG signal is done by LPC 2148 microcontroller. LPC2148 is
32 bit ARM7TDMI controller with 32 KB of internal flash memory. It is tiny size and power
consumption of LPC2148 is suitable for this application as miniaturization is our requirement .It
have 10 bit ADC. The conversion time of 10 bit ADC is up to 2.44s which uses successive
approximation technique. The LPC2148 microcontrollers provides Serial communications
interfaces ranging from a USB 2.0 Full-speed device, multiple UARTs, SPI, SSP to I2C-bus and
on-chip SRAM of 8 Kb up to 40 Kb. The LPC2148 microcontroller contains 128-bit wide
memory interface and a unique accelerator architecture, which provides 32-bit code execution at
the maximum clock rate. It provides two 32-bit timers/external event counters with four captures
and four compare channels each, PWM unit with six outputs and watchdog. The LPC2148
microcontroller provides low power real-time clock with independent power and also provides
Multiple serial interfaces: two UARTs (16C550), two Fast I2C-bus (400 Kbit/s). The signal
captures by the electrode from body of patient are amplified up to 3V. ADC uses the internal
clock source which is programmable to scale this clock up 4.5 MHz for accurate conversion of
analog signal to digital data requires 11 clock pulses .

Fig. 2 System Functional Block Diagram

As maximum frequency of ECG signal is up to 160 Hz thus sampling frequency for ADC
selected is 500Hz. This converted data is stored in internal flash memory temporarily and
transmitted using the GSM 3G module. At receiver this data is received and it is decoded to get
original ECG signal on PC using dot net application.

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CHAPTER 4
Need for Wireless In-Home ECG Monitoring
When a patient is in a hospital, they are surrounded with near constant care. This includes nurses
and machines to monitor the patients health. If a problem arises, it can be detected and
appropriate action can be taken in a timely manner. When a patient leaves the hospital, the
availability of health monitoring can drop dramatically. While at home, the patient will not have
the same level of care as they did at the hospital. The patients own knowledge of their condition
is required to help them diagnose themselves and determine when they are not feeling well.
Machines exist to assist with self-monitoring, such as blood pressure and pulse oximetry devices,
but it is up to the patient to determine the results. Due to this, a patient is not as likely to know
the subtle negative effects that are happening to them. Another potential issue is that the doctor
responsible for the patient has no personal touch with the patient while they are away from the
hospital. Visibility to the patients health is limited to return visits or phone call. Due to the
limited monitoring methods while at home, problems that can occur might not be detected until
the patient has been affected adversely. These problems create a need for better in-home
monitoring. A system that could allow for a doctor to view data on a patient remotely can
increase the likely hood of detecting declining health before it becomes a serious issue. The work
in this thesis concentrates on a design to help address the need for better in-home monitoring.
Since the patient is at home and not confined to a single room as in a hospital, a wireless solution
is most beneficial to the patient by allowing more freedom and range of motion. An ECG
expresses the activity of the heart as an electrical signal throughout the 4 cardiac cycle and can
visually depict a state of condition for the patient through a graph created from the ECG.
Therefore, it serves as the main vital to be monitored by the wireless system.

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CHAPTER 5
HARDWARE SYSTEM
The system comprises of two part transmitter (the ECG signal acquisition and processing
Hardware) and monitoring application receiver .
The hardware system of bio signal conditioning circuit:
5.1 - Instrumentation amplifier to amplify the raw ECG bio-signal.
5.2- High pass filter to remove the DC offset.
5.3 - Low pass filter to remove high frequency noise.
5.4 - Notch filter is used to remove the 50Hz power line interference.
Fig. 3 shows the actual hardware system implemented.

Fig.3 Hardware Implementation

5.1- Instrumentation Amplifier

An IC 8220 instrumentation amplifier is used to amplify the ECG signal. The AD8220 IA was
selected due to high CMRR with low effect from RFI, adjustable gain up to 1000 and very l
input bias current .

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Fig. 4 Instrumentation Amplifier

High gain is achievable with AD 8220 but to avoid o/p voltage saturation the gain set to 12 .The
typical ECG signal amplitude is 1mv with the gain of 12 signal is amplified to 13mv
The amplification block consists of the amplifying circuit necessary to start producing a usable
ECG signal. The ECG signal is the difference in potential between the positive and negative
electrode. The main operation of the instrumentation amplifier is to take two differential inputs,
obtain the difference between them and amplify the signal according to a specified gain. Another
feature that makes the instrumentation amplifier necessary is that it rejects most common mode
noise. This is known as the common mode rejection ratio (CMRR).
1.5.2- High Pass Filter (HPF)
After amplification it passes through the active high pass filter (HPF) to remove DC offset
voltage developed between the electrodes. This active HPF uses the OP07D op-amp. The gain
with HPF is 2. Fig.5 shows circuit connection. Typical ECG signal have frequency range of 0.05
Hz to 100 Hz [8] thus the cute off frequency Fc of 0.05 Hz is chosen C is 10 f
1.5.3- Second order Active LPF
After passing signal through HPF the ECG bio signal is passes through the LPF to remove the
high frequency noise, the cut off frequency chosen is 160 HZ. Fig.6 shows the active LPF circuit.
The first filter is 1st order active low pass filter and second filter is active 2nd order low pass
filter.
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Fig. 5 Active 3rd order Low Pass Filter

1.5.4- Notch Filter

The notch filter is used in biomedical instrumentation to suppress 50Hz power line interference
[8]. A twin T notch filter is used remove the 50Hz noise. Fig.7 shows the twin T notch filter
circuit. The RC filter with op-amp MCP6217 used. Also the MCP 6271 provides high input
impedance and low output impedance [12].

Fig.6 Twin T Notch Filter

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CHAPTER 6
ECG signal testing using designed system
The designed system is tested on human body. The system is connected with body by using three
electrodes

Fig.7 Filter Output

The signal is capture by electrode & passed through the Instrumentation Amplifier HPF LPF and
then band reject filter (Notch Filter) figure shows output at each stage of signal conditioning. In
figure the initial instrumentation amplifier gain with gain is 12 only. Observe the ECG voltage
level no significant ECG wave form is observed. The output of high pass filter shows same peak
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of ECG signal with high frequency noise, thus noise is removed by LPF .We get more cleaner
waveform from the LPF. The consecutive band reject filter removes the 50Hz power line noise.
The PQRST peaks are thus now more distinguishes from final wave form it is confirm that ECG
monitoring circuit works properly. Fig.8 shows output of the all filters on DSO. Final ECG
waveform at output of the Twin T Notch Filter is shown in Fig. 9 this bio signal is digitized and
transmitted.

Fig.8 Analog Output Of System

This analog output of the filter get digitized by the ARM microcontroller and transmitted through
wireless, at receiver get waveform which is reconstructed using Dot Net application on the PC ia
as shown in fig.10 reconstructed waveform is identical to transmitted ECG waveform.

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Fig.9 Reconstructed ECG Waveform

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CHAPTER 7
TEST OF ECG SIGNAL
The purpose of test was to verify that the ECG device could accurately capture normal and
abnormal ECGs using only three leads and that the waveform was noticeably different. This
helps to validate if the device could be useful by medical physicians to spot abnormal ECGs.
Figure 4.5 shows a normal ECG.

Figure 10 Normal ECG

The waveform is shown to be mostly uniform with slight variations in the peaks of the R and S
wave. This is normal as magnitudes of the deflections can differ. An abnormal ECG is primarily
observed through the length or timing of the various components of the waveform. An
abnormal waveform, mitral valve prolapse, is shown in figure 4.6. The heart beats in a regular
rhythm, usually between 60to100 beats per minute .Tracing looking normal .when the heart
beats too slow (as less than 60 bps),as heart rate is too fast (as geater than the 100 beat per sec) .

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Figure 11 Abnormal ECG

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CHAPTER 8
Applications
1.Its used in the domestic environment and can communicate wirelessly.
2. An important benefit of this system includes monitoring patients from home remotely,
minimizes the hospital admission costs and gives patients the freedom to move around.
3. The design of this system leads to flexibility and mobility of the patients
4. It find the cause of unexplained chest pain or pressure .This could be caused by a heart attack.
5. check the health of the heart when other diseases or condition are present this include high
blood pressure ,high cholesterol, blood sugar .
6. The design of the system leads to flexibility and mobility of the patients

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CHAPTER 9
CONCLUSION
With technological advances in communication it is important to use this system for benefit of
the heart patients with this system cabling and remotely access of the patient is possible also
further processing on the ECG signal are possible. In addition other parameter of body like
temperature, pulse oximetry, respiratory data can be monitored. The most important advantages
of this system are flexible excellent functionality. The main part of this system is wirelessly
monitoring using 3G network. So such wireless system allows remotely access of patient &
also patient does not stick to one place (Hospital). The 3G technology allow test data rates & 10
bit ADC gives more accurate digital data equivalent to analog signal. Previous monitoring
system uses the Bluetooth as data transmission technology, so patient has restriction about
distance from the system. In our case as we are using GSM technology as transmission
technology patient has freedom to move.

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CHAPTER 10
FUTURE SCOPE
1.It involve recording of the heart beats of patients.
2.It enables monitoring the functions of heart accurately in very short span of time .
3.It helping in efficient diagnosis and treatment of heart related problems.
4.In addition other parameter of body like temperature, pulse oximetry, respiratory data can
be monitored.

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REFERENCES

[1] Winston De Armas 2010. Design of a Non-intrusive 2 lead ECG System Using the Active
Insulated Electrode. McMaster University.
[2] William Brims 2002 Wireless ECG. Technical Report. University of Queensland at Australia.
[3] Patrick O. Bobbie, Chaintanya Deosthale,Walter Thain, Telemedicine:A Mote-Based Data
Acquisition System For Real Time Health Monitoring. Southern Polytechnic State University.
[4] Aleksandrowicz A., Leonhardt S. 2007 Wireless and Non-contact ECG Measurement Systemthe Aachen Smart Chair. Acta Polytechnica.
[5] Borromeo S., Rodriguez- Sanchez C., Machado F., Hernandez- Tamames J.A., De La Prieta
R.,2007 A Reconfigurable ,Wearable ,Wireless ECG System. Proceedings of the IEEE EMBS
Conference, University of Rey Juan Carlos-28933- Mostoles .Madrid .Spain.
[6] Choo Tien Weay, Foh Chit Horng , Sriskanthan Nadarajah. PC Based ECG Monitoring
System. Nanyang University. Nanyang Avenue, Singapore.
[7] Zarina Md Amin, Suryani Ilias, Zunuwanas Mohamad. ECG Monitoring System Using
Bluetooth Technology. Polytechnic Of Sultan Abdul Salahuddin Abdul Aziz Shah. Shan Alam
Selangor. Malaysia.
[8] Dr. Soni M.K., Dr. Bansal Dipali., " Filtering Techniques For ECG Signal Processing",
International Journal Of Researches In Engineering & Applied Science, 2012.
[9] Ying Bai, Robert Matthews, Andrew Hibbs. An Ultra-Wearable, Wireless, Low Power ECG
Monitoring System. University Of California.
[10] Count L., Kitchin C., A Designer Guide Of Instrumentation Amplifier. 2nd ed., Analog
Devices Inc., Norwood, MA, USA, 2004

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