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6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME Engineering & Technology (IJECET) ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep - Oct (2010), pp. 33-43 IAEME IAEME, http://www.iaeme.com/ijecet.html
IJECET
ABSTRACT:
This paper contains brief introduction of the conduction of the heart, its periodicity and stability for the normal sinus rhythm. Any disorder in the cardiac rhythm may cause heart failure .In this classification of different cardiac disease like ventricular and super ventricular fibrillation [SVF], arterial flutter/Fibrillation [AF], ventricular fibrillation, [VF], Premature ventricular contraction [PVC], is chemia, Mayocardial Infraction [MI] etc. is covered This work presents the approach followed for the assessment of cardiac arrhythmias, with clinical relevance for heart failure prevention. The results figures are produced for the detection of the arrhythmia using Pan Tompkins algorithm .MIT BHI database is use for the detection of arrhythmia and the verified with the physionet.org ATM.
INTRODUCTION:
More than 35 % of all deaths in Asia are due to cardiovascular disease (CVD) and more than 20% of all asian citizens suffer from a chronic CVD, such as myocardial infarction, arrhythmias and congestive heart failure. Despite the advances in the treatment of heart failure (HF), it is observed that the mortality rate continues to be high. Now a days, close to 40% of deaths in HF are thought to occur suddenly. The principal cause of mortality in HF is not absolutely clear, but the presence of cardiac arrhythmias suggests a reserved prognosis. Atrial fibrillation (AF) and ventricular tachyarrhythmia (VA) are the most significant rhythm disturbances found in ventricular dysfunction (decompensation) both in terms of the number of patients affected and the associated mortality and morbidity
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International Journal of Electronics and Communication Engineering & Technology (IJECET), ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME
Although several cardiac arrhythmias classification methods have been proposed, it is observed that usually they focus on one specific problem, i.e. AF, PVC, VT or VF detection, and only few methods consider the problem of ECG analysis as a global/integrated procedure.
Figure 1 The anatomy of the heart A cardiac cycle takes around 1 second, which can be divided into four phases: contraction phase, ejection phase, resting phase, and lling phase. The resting and falling phase is called diastole; the pumping phase (contraction and ejection) is called systole. The atria systole is followed by ventricular systole, and then ventricular diastole.
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International Journal of Electronics and Communication Engineering & Technology (IJECET), ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME
Figure 2 (Left) The conduction system of the heart; (Right) Different waveforms representing action potentials from each of the specialized cells found in the heart; (Bottom) normal scalar ECG.
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International Journal of Electronics and Communication Engineering & Technology (IJECET), ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME
Figure 3 Phases of the action potential of a cardiac muscle The initial depolarization is due to Na+inow through rapid opening of Na+ channels. The plateau phase is produced by more slowly Ca2+ in flow, and the repolarisation is due to net K+ out flow. The waveforms of action potential observed in representative cells of different cardiac tissues show different characteristics, as we can see in Figure 2 (right part). For example, cells within the SA node are called primary pacemaker, which do not have a constant resting potential. Instead, they generate regular, spontaneous action potentials. The depolarizing current is carried primarily by relatively slow, inward Ca2+ currents instead of by fast Na+ currents. The bottom trace of Figure 2 also shows the sum of electrical activity of all the cardiac muscle, which is the Electrocardiogram (ECG).
4. ECG MEASUREMENTS
The most commonly used clinical ECG-system is the 12-lead ECG system, providing different views of the same electrical activity within the heart in a threedimensional view.
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International Journal of Electronics and Communication Engineering & Technology (IJECET), ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME
Figure 4 (A) First-degree AV block; (B) Second-degree AV block; (C) Third-degree AV block.
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International Journal of Electronics and Communication Engineering & Technology (IJECET), ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME
2. Bundle Branch: Block Disturbance of conduction in a branch of the bundle of His. If the two bundle-branches are blocked simultaneously, the activation from the atria to the ventricles is completely prohibited. Bizarrely shaped QRS complexes of abnormally long duration occur on the ECG.
5.2 ISCHEMIA
Ischemia is an inadequate flow of blood to the cardiac muscle caused by occlusion of coronary arteries. It is most likely to occur when the heart demands extra oxygen. Ischemia can present symptoms ranging from mild chest discomfort on exertion to the crushing chest pain of an infraction. Changes in the resting potential and in the repolarisation of the muscle cells occur, which is mostly seen as changes in the ST: either ST elevation (transmural ischemia) or ST depression (sub end cordial ischemia).
5.3 ARRHYTHMIAS
The rhythm of the heart is normally generated and regulated by pacemaker cells within the SA node. The SA nodal pacemaker activity controls the rhythm of the atria and ventricles. Normal heart rhythm is very regular, with minimal fluctuation. When this rhythm becomes irregular, too fast (tachycardia) or too slow (bradycardia), or the frequency of the atrial and ventricular beats are different, we call it an arrhythmia. In another word, arrhythmias are pathological changes in cardiac impulse generation or conduction that can be visualized by ECG[3]. Depending on the severity of the arrhythmia, patients may experience shortness of breath, fainting, fatigue, heart failure symptoms, chest pain or cardiac arrest. Basically, the most common arrhythmias can be classified as supraventricular (above the ventricles) and ventricular arrhythmias.
SUPRAVENTRICULAR ARRHYTHMIAS
1. Sinus Arrhythmias Sinus tachycardia is when the sinus rhythm rises to 100/min or higher, due to physical exercise, stress, emotion, fever or hyperthyroidism. Sinus
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International Journal of Electronics and Communication Engineering & Technology (IJECET), ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME
bradycardia is when the heart rate falls below 60/min, due to the disrupted electrical impulses at the nodes or along the pathways. In both cases the rhythm is regular. Sinus arrhythmias can be physiological and respiration dependent (heart rate is increased during inspiration and decreased during expiration). 2. Paroxysmal Atrial Tachycardia Rapid discharge of impulses from an atrial focus, which triggers the AV node or ventricles to generate ectopic impulses at a rate usually between 160 and 200/min. The P waves are a result of a circular movement in the atria involving the AV node, which leads to a high rate
of activation. The isoelectric baseline may be seen between the T- wave and the next P-wave.
3. Atrial Flutter A very rapid and regular 'mapping' contraction of the atria, beating
at a rate of
activated by every second or every third atrial impulse. In the ECG, the isoelectric interval between the end of T and beginning of P disappears. [Figure 5 (A)]
Figure 5 (A) Atrial flutter; (B) Atrial fibrillation. 1. Atrial Fibrillation A weak and uncoordinated twitching of atria in the baseline at the rate up to 500 beats/min. The ventricular rate is thus rapid and irregular, though the QRS usually appears normal. [Figure 5 (B)]
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International Journal of Electronics and Communication Engineering & Technology (IJECET), ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME
2. Atrial Extra systole Impulses from the SA node stimulates the AV node prematurely. The P wave on the ECG is distorted while the QRS complex remains normal.
VENTRICULAR ARRHYTHMIAS
In ventricular arrhythmias, ventricular activation is not originated from the AV node and usually proceeds in the ventricles in an abnormal way. 1. Premature Ventricular Contraction (PVC) An ectopic pacemaker within the ventricle or specialized conduction system may discharge, generating an extra beat, or extra systole that interrupts the normal rhythm. It is characterized by distorted and widened QRS complexes in the ECG. [Figure 6 (A)] 2. Ventricular Tachycardia A rapid train (100-200/min) of impulses originating from a ventricular focus, usually caused by a slower conduction in the ischemic ventricular muscle, leading to circular activation (re-entry). On the ECG it is characterized by rapid, bizarre and widened QRS. [Figure 6 (B)]
Figure 6 (A) A Premature ventricular contraction; (B) Ventricular tachycardia; (C) Ventricular fibrillation.
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International Journal of Electronics and Communication Engineering & Technology (IJECET), ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME
3. Ventricular Fibrillation when ventricular depolarization occurs chaotically, the ventricles twitch in a very weak and uncoordinated way with no blood pumped from the heart. It is caused by multiple re-entry loops usually involving diseased myocardium, and may lead to loss of consciousness and death within minutes. The ventricular fibrillation may be stopped with an external de fibrillate pulse. On the ECG, it appears to be extremely frequent and uncoordinated and lacks QRS waves.[Figure 6 (C)]
RESULT:
The following record of ecg is processed with the help of MATLAB 7.8 tools The result are shown in the figure [6]. Database Used ECG Record Domain Name : MITBHI : 100 : Physionet.org.
The work is done by using the Pan Tompkin algorithm for the QRS detection. The Figure [6] shows the waveforms for the 5 sec duration.
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International Journal of Electronics and Communication Engineering & Technology (IJECET), ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME
Figure 6: (A) Original and Normalized ECG signal (B) Filterd Squared and Averaged ECG signal; (C) Histogram or calculated RR interval
CONCLUSION:
With the basic knowledge of the conduction system of the heart, how the ECG is originated, and how it looks like under normal condition and in different kinds of heart diseases, we can come back to this scenario. As we know, atrial fibrillation, congestive heart failure, and ventricular flutter or fibrillation are complications of hyperthyroidism. And when ventricular fibrillation occurs, patients may die almost immediately. Ischemia or infarction can also occur without any warning symptoms (silent ischemia or MI). The
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International Journal of Electronics and Communication Engineering & Technology (IJECET), ISSN 0976 6464(Print), ISSN 0976 6472(Online) Volume 1, Number 1, Sep Oct (2010), IAEME
thyroid is a butterfly-shaped endocrine gland located in the base of the neck. had very weak, slow and irregular pulses. It is probably caused by an AV block, or sinus bradycardia. Bradycardia can be developed with aging, coronary artery disease and MI,or hypothyroidism, etc. An artificial pacemaker, an implanted device that consists of a pulse generator and leads sending small electrical impulses to the heart muscle to maintain a suitable heart rate, should be used.
REFERENCES:
1).ELECTROCARDIOGRAM (ECG) SIGNAL PROCESSING LEIF SO RNMO Lund University Sweden 2. Assessment of Arrhythmias for Heart Failure Management J. Henriques, P. Carvalho , M. Harris, M. Antunes1, R. Couceiro, M. Brito, R. Schmidt #Center for Informatics and Systems, University of Coimbr 3.BiomedicalSignal Processing. By RangayanBiomedical Signal Processing.By Tompkin 4. The weighted diagnostic distortion (WDD) measure for ECG signal compression. IEEE Trans. Biomed. Eng. 2000; 47: 14221430. G. J. Balm, 5..Crosscorrelation techniques applied to the electrocardiogram interpretation problem. IEEE Trans. Biomed.Eng. 1967; 14:258262..J. C. Huhta and J. G. Webster, 6.60-Hz interference in electrocardiographyIEEE Trans. Biomed. Eng. 1973; 43:91101.C. D. McManus, D. Neubert, and E. Cramer, 7. Characterization and elimination of AC noise in the electrocardiogram: a comparison of digital filtering methods. Comput. Biomed. Res. 1993; 26:4867. P. S. Hamilton, 8. A comparison of adaptive and non adaptive filters for the reduction of power line interference in the ECG.IEEE Trans. Biomed. Eng. 1996; 43:105109.
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