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Patrick E. McSharry Gari D. Clifford
Department of Engineering Science Harvard-MIT Division of Health Sciences & Technology
University of Oxford Rm E25-505, 45 Carleton St., Cambridge MA 02142, US
Parks Road, Oxford OX1 3PJ, UK email: gari@mit.edu
email: patrick@mcsharry.net
ABSTRACT in the literature and those that are now freely available on
ECGSYN, a dynamical model that faithfully reproduces the Internet [10], it remains extremely difficult to evaluate
the main features of the human electrocardiogram (ECG), and contrast their performance. The recent proliferation of
including heart rate variability (HRV), RR intervals and QT biomedical databases, such as Physiobank [10], provides a
intervals is presented. Details of the underlying algorithm common setting for comparing techniques and approaches.
and an open-source software implementation in Matlab, C While this availability of real biomedical recordings has
and Java are described. An example of how this model and will continue to advance the pace of research, the lack
facilitates comparisons of signal processing techniques is of internationally agreed upon benchmarks means that it is
provided. impossible to compare competing signal processing tech-
niques. The definition of such benchmarks is hindered by
KEY WORDS the fact that the true underlying dynamics of a real ECG
Electrocardiogram, ECG, RR intervals, HRV, model can never be known. This void in the field of biomedical
research calls for a gold standard, where an ECG with well-
1 Introduction understood dynamics and known characteristics is made
freely available.
The field of biomedical signal processing has given rise to The model presented here, known as ECGSYN (syn-
a number of techniques for assisting physicians with their thetic electrocardiogram), is motivated by the need to eval-
everyday tasks of diagnosing and monitoring medical dis- uate and quantify the performance of the above signal pro-
orders. Analysis of the electrocardiogram (ECG) provides cessing techniques on ECG signals with known character-
a quantitative description of the heart’s electrical activity istics. While the Physionet web-site [10] already contains
and is routinely used in hospitals as a tool for identifying a synthetic ECG generator [11], this is not intended to be
cardiac disorders. highly realistic. The model and its underlying algorithm
A large variety of signal processing techniques have described in detail in this paper is capable of producing ex-
been employed for filtering the raw ECG signal prior to fea- tremely realistic ECG signals with complete flexibility over
ture extraction and diagnosis of medical disorders. A typ- the choice of parameters that govern the structure of these
ical ECG is invariably corrupted by (i) electrical interfer- ECG signals in both the temporal and spectral domains. In
ence from surrounding equipment (e.g. effect of the elec- addition the average morphology of the ECG may be spec-
trical mains supply), (ii) measurement (or electrode con- ified. In order to facilitate the use of ECGSYN, software
tact) noise, (iii) electromyographic (muscle contraction), has been made freely available as both Matlab and C code
1
(iv) movement artefacts, (v) baseline drift and respiratory . Furthermore users can operate ECGSYN over the Inter-
artefacts and (vi) instrumentation noise (such as artefacts net using a Java applet, which provides a means of simu-
from the analogue to digital conversion process) [1]. lating and downloading an ECG signal with characteristics
Many techniques may be utilised for filtering and re- selected from a graphical user interface.
moving noise from the raw ECG signal, such as wavelet
decomposition [2], Principal Component Analysis (PCA) 2 Background
[3], Independent Component Analysis (ICA) [4], nonlinear
noise reduction [5] and traditional Wiener methods. The The average heart rate is calculated by first measuring
ECG forms the basis of a wide range of medical studies, the time interval, denoted RR interval, between two con-
including the investigation of heart rate variability, respi- secutive R peaks (Fig. 1), taking the average recipro-
ration and QT dispersion [6]. The utility of these medical cal of this value over a fixed window (usually 15, 30 or
indicators relies on signal processing techniques for detect- 60 seconds) and then scaling to units of beats per minute
ing R-peaks [7], deriving heart rate and respiratory rate [8], (bpm). A time series of RR intervals is often referred to
and measuring QT-intervals [9].
Despite the numerous techniques that may be found 1 www.physionet.org/physiotools/ecgsyn
1.5
RR Tachogram RR Tachogram ECG Morphology
RR interval spectral parameters temporal parameters parameters
R R
1 Random
number seed
s(t) [Volts]
RR Tachogram
0.5 T T sampled at f int
P P
3 Method
The dynamical model, ECGSYN, employed for generating
the synthetic ECG is composed of two parts. Firstly, an
as an RR tachogram and the variation in this time series internal time series with internal sampling frequency
is governed by the balance between the sympathetic (fight is produced to incorporate a specific mean heart rate, stan-
and flight) and parasympathetic (rest and digest) branches dard deviation and spectral characteristics corresponding to
of the central nervous system, known as the sympatho- a real RR tachogram. Secondly, the average morphology
vagal balance. In general, innervation of the fast acting of the ECG is produced by specifying the locations and
parasympathetic branch decreases heart rate whereas the heights of the peaks that occur during each heart beat. A
(more slowly acting) sympathetic branch increases heart flow chart of the processes in ECGSYN for producing the
rate. This RR tachogram can therefore be used to estimate ECG is shown in Fig. 2.
the effect of both these branches. A spectral analysis of the The spectral characteristics of the RR tachogram, in-
RR tachogram is usually divided into two main frequency cluding both RSA and Mayer waves, are replicated by spec-
bands, known as the low-frequency (LF) band (0.04 to 0.15 ifying a bi-modal spectrum composed of the sum of two
Hz) and high-frequency (HF) band (0.15 to 0.4 Hz) [12]. Gaussian functions,
Sympathetic tone is believed to affect the LF component
!
whereas both sympathetic and parasympathetic activity in-
"
fluence the HF component [6]. The ratio of the power con-
(1)
tained in the LF and HF components has been used as a
measure of the sympathovagal balance [6, 12]. with means " and standard deviations " . Power in
the LF and HF bands are given by and respectively
!
whereas the variance equals the total area ,
The structure of the power spectrum of the RR yielding an LF/HF ratio of $# .
'&$
tachogram tends to vary from person to person with a num- A time series % with power spectrum is gen-
ber of spectral peaks associated with particular biological erated by taking the inverse Fourier transform of a sequence
mechanisms [13, 14]. While the correspondence between of complex numbers with amplitudes and phases
(
these mechanisms and the positions of spectral peaks are which are randomly distributed between 0 and . By mul-
strongly debated, there are two peaks which usually ap- tiplying this time series by an appropriate scaling constant
pear in most subjects. These are due to Respiratory Sinus and adding an offset value, the resulting time series can be
Arrhythmia (RSA) [15, 16] caused by parasympathetic ac- given any required mean and standard deviation. Different
tivity which is synchronous with the respiratory cycle and realisations of the random phases may be specified by vary-
Mayer waves caused by oscillations in the blood pressure ing the seed of the random number '&$
s(t) [Volts]
0.5
0
x
−0.5
0 1 2 3 4 5 6 7 8 9 10
(b)
T 1
P
s(t) [Volts]
0.5
Q 0
S
y
−0.5
0 1 2 3 4 5 6 7 8 9 10
(c)
1
s(t) [Volts]
0.5
−0.5
0 1 2 3 4 5 6 7 8 9 10
n d n d
beled by its peaks and troughs, P, Q, R, S and T, as shown 1aJpjq;o rEs . This particular angular frequency, , is
in Fig. 1. This quasi-periodicity can be reproduced by con- used to specify the dynamics until the angle , reaches
structing a dynamical model containing an attracting limit ,/ again, whereby a complete revolution (one heart beat)
cycle; each heart beat corresponds 'to one revolution around has taken
&Ydut
place.
v&Yd !
For 'the
&Yde
PQRST-waveform in the + -direction. A series of five an- beat time series, % , can be used to generate an ECG with
gles, ( ,- , ,. , ,/ , ,0 , ,1 ), are used to specify the extrema associated RR intervals that have6zthe '&$
, *>" and is the angular velocity of the trajec- size of the integration. The final output ECG signal is then
tory as it moves around the limit cycle. The coefficients B 9 down-sampled to if by a factor to
G
govern the magnitude of the peaks whereas the 9 define the generate anECG at the requested sampling frequency. For
width (time duration) of each peak. Baseline wander may simplicity, is taken as an integer multiple of .
be introduced by coupling the baseline value +YI in (2) to the The size of the mean heart rate affects the shape of
Z&$
\[^]`_'Xa ( &$
pressed by the time series % with power spectrum conduction velocity across the ventricles increases together
given by (1), this can then be used to drive the dynami- with an augmented heart rate. The time for ventricular de-
cal model (2) so that the resulting RR intervals
time , with angle , , / , the time ifying the width of the exponentials in (2) and also the po-
interval % is used to calculate an angular frequency sitions of the angles , 3 . This Sis
achieved by using a heart
` S
`
2 This auxiliary time axis is used to calculate the values of fcg for con- rate dependent factor # where is the
secutive RR intervals whereas the time axis for the ECG signal is sampled mean heart rate expressed in units of bpm (see Table 1).
around the limit cycle in the hji4kZlSm -plane. Operation of ECGSYN, composed of the spectral
0.51
Table 1. Morphological
3
parameters
`
of the ECG model with
modulation factor #EW . 0.5
0.49
Index (i) P Q R S T
Time (secs) -0.2
-0.05 0 0.053 0.3 0.48
3 3
LF/HF ratio
, 9 (radians) 0
B 9 0.47
1.2 3 -5.03 30.03 -7.53 0.753
G 9
0.25 0.1 0.1 0.1 0.4 0.46
0.45
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lead ECGs,” Computers in Cardiology, vol. 12, pp. 1998.
113–116, 1985. [21] S. Abboud and O. Barnea, “Errors due to sampling
[9] P. Davey, “A new physiological method for heart rate frequency of electrocardiogram in spectral analysis of
correction of the QT interval,” Heart, vol. 82, pp. heart rate signals with low variability,” Computers in
183–186, 1999. Cardiology, vol. 22, pp. 461–463, September 1995.