BLUETOOTH PORTABLE DEVICE AND MATLAB-BASED GUI FOR ECG SIGNAL ACQUISITION AND ANALISYS Noureddine BELGACEM* , Said

ASSOUS** , Fethi BEREKSI-REGUIG* Biomedical Engineering Laboratory Abou Bekr Belkaid University, BP 230 Tlemcen, 13000 Algeria, Email : ne belgacem@mail.univ-tlemcen.dz ** Ultrasound Research Laboratory, University of Leicester, University Road, LE1 7RH, Leicester, U.K sa251@leicester.ac.uk
ABSTRACT Various ECG instruments have addressed a wide variety of clinical and technical issues. However, there is still scope for improvement in them particularly in the area of their susceptibility to noise, lack of universal connectivity and off-line processing. In emergency situations, real-time health parameter is crucial. According to the American Heart Association [1], treatment of a patient experiencing ventricular brillation within the rst 12 minutes of cardiac arrest brings a survival rate of 48%-75%. The survival rate drops to 2%-4% after 12 minutes have gone. This paper illustrates a low-cost method for realtime acquisition of ECG signal for storage and processing using a Matlab R -based Graphical User Interface (GUI). This costly effective design can be interesting for the third world medical device industry to develop such device locally instead of buying the technology with high cost from the western contries. The ECG device is wirelessly connected to a smart phone or a computer using IEEE 802.15.1 based radio protocol. It includes an analog system and a Bluetooth transceiver, exible and stretchable for comfortable continuous cardiac monitoring. The Matlab R based GUI is designed to perform real-time analysis on the ECG data to compute the different waves features and display the same on the GUI along with the ECG signal plot. 1. INTRODUCTION ECG system is an ideal instrument for patient monitoring and supervision. An extensive range of human physiological conditions can be inferred from the PQRST parameters (Figure (1)) obtained from an ECG recording instrument. Although ECG instruments were quite bulky, miniaturization in recent years has enabled development of wearable versions that collect and process ECG data [2, 3]. Looking at the recent trends in bio-medical applications, a major advancement can be noted in health monitoring devices. This ranges from simple and portable Holter instruments to sophisticated and costly implantable gadgets. Processing and analysis are then performed on recorded data. Systems with multiple sensors have too many wires between the sensors and the monitoring device, which limit the patients activity and comfort level. Available systems also lack universal connectivity of interfacing to any output display device through common communication ports.
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Fig. 1. Normal ECG Signal.[4]

2. MATERIALS AND METHODS A prototype ECG system has been developed that consists of front-end amplier, microcontroller and a wireless transceiver for transmitting the data to the Laptop (Figure (2)). The real-time acquired ECG signal is displayed and analysed using in-house software developed under Matlab R . The output ECG system related noise is removed using real-time software digital lters.

Fig. 2. The overall hardware system.

2.1. ECG Acquisition The objective of this kit is to acquire the analog ECG signal in digitised format for storage and further processing and analysis. This is achieved by a standalone embedded system-based hardware acquisition unit synchronised with Matlab R software for automatic data storage. The

hardware acquisition unit consists of a microcontroller, Bluetooth transmitter and a low-power multisensor frontend acquisition system with on-board ADC called CARDIC (p/n AuM441Cx) which is an integrated circuit developed mainly for the acquisition of electrocardiographic signals [5]. This single chip permits the implementation of ECG systems with up to twelve leads. CARDIC is a low-power multisensor front-end acquisition system with on-board ADC (12bit@83KS/s) and serial interface communication protocol. It contains a fully congurable multi-channel ECG block, front-end channels for blood pressure and body temperature signal processing, analog channel for battery level monitoring and the possibility of direct access to the input of internal ADC through dedicated pins. The microcontroller converts the CARDIC output into a Bluetooth transmitter for delivery to the Laptop. The functional block diagram of the CARDIC is shown in Figure (3).

Fig. 4. Experimental setup consisted of a patient simulator, an ECG acquisition system and a PC. 2.3. Wireless Data Transmission The wireless revolution is creating large numbers of new wireless devices with continuously more stringent requirements: smaller size, weight, higher bandwidth and lower power consumption at low cost. For these systems, onchip integration of RF systems has become a reality. In particular, Bluetooth standard offers important advantages: low cost, low EM interferences [9], reduced power consumption, condentiality of the data, dimensions of the transmitter and it is capable to generate small pico-net of some devices. Also it is a mobile technology, palm computers and cell phones already used it in a great number of wearable devices (e.g. mobile phones wireless headsets). The emerging Zig-Bee standard [10, 11] offers enhanced capabilities especially in term of power consumption, number of connected devices but not so widespread use as Bluetooth technology. To provide Bluetooth we choose BlueSmirf module provided by Sparkfun Electronics [12]. It is a class 1 model that has an approximate range of 100 meters. The asynchronous data from the dsPIC microcontroller are delivered to the BlueSmirf Bluetooth module on the serial port. 2.4. Power consumption One of the limiting factors on the functionality of the telemetry system is the power supply. This is because of the limited battery capacity that might be used. The power consumption in such systems comes mainly from the ampliers and the PIC microcontroller. The power consumption of the patient detection circuit was minimised in the hardware design in a way that all electronic parts used were selected based on supply current rating. The current level of the amplier used was 20 mA for the Cardic circuit. For the PIC microcontroller, power consumption can be minimised by introducing the sleeping mode, but this was not used in this study. In this work, the patient device is powered by rechargeable lithium batteries. Because continuous powering of real-time ECG transmission system

Fig. 3. Functional block diagram of the CARDIC circuit.

2.2. ECG Processing With the increased use of microcontrollers as front-end programmable devices, Personal Computer (PC)-based data acquisition systems have gained immense popularity over the last decade or more. Microcontrollers are the preferred choice in low-cost data acquisition systems due to their low-power, programmable, cheap and high-speed features. The sensor output is amplied before digitisation and nally a microcontroller generates the communication protocol for transmission to a standalone PC. There are many microcontrollers used in ECG monitors, from 8 to 32-bit microcontrollers, as well as DSPs [6, 7, 8]. In this design, we propose the use of dsPIC microcontrollers (dsPIC30F6010), which are able to acquire and process the signals needed in monitoring applications. Owing to the cost-effectiveness of the devices, it is reasonable to embed in one chip if possible. In the system design shown in Figure (4), the speed of computation and memory capacity are considered as the two most important characteristics. Since the dsPIC30F6010 device has these properties, it has been chosen for our design. A patient simulator is used to generate simulated ECG signals.

is difcult, one solution was to use the low battery alarm integrated in the Cardic circuit. When the battery is low the device sends an alarm telling the patient to replace or the battery and recharge it. 3. SOFTWARE DEVELOPMENT 3.1. Microcontroller Software The microcontroller has been programmed to perform the following functions: capture the ECG signal from the ECG ASIC, establish the connection to the Bluetooth transmitter and send the data (Figure (5)). This Bluetooth module allows provides an API for communication through the AT level, freeing the programmer from implementing the complete Bluetooth stack.

Fig. 6. Developed GUI with signal plots and processed ECG features. identication. Single lead ECG waveform analysis includes wave shapes (morphology), spectra and repeatability of the cardiac cycle. Multiple lead processing algorithms utilise additional information from other leads. QRS detection forms the basis of most ECG analysis algorithms, particularly for arrhythmia monitoring. Simple QRS detection algorithms are based on one of the methods like derivative, lter-banks, wavelets, mathematical morphology and correlation. More sophisticated approaches use Hidden Markov Model, syntactic approaches are also used but time-consuming [13, 14, 15]. 3.2.1. Digital Filtering The QRS complex is detected by ltering the raw ECG signal using a low-pass lter, a high pass lter and a differentiator [16]. The difference equations of the low-pass and high-pass lters are respectively : y(nT ) = (1/36)(2y(nT T ) y(nT 2T ) + x(nT ) 2x(nT 6T ) + x(nT 12T )) (1) and y(nT ) = 32x(nT 16T ) [y(nT T ) + x(nT ) x(nT 32T )] (2) The differentiation lter equation is : y(nT ) = (1/8T )[x(nT 2T ) 2x(nT T ) +2x(nT + T ) + x(nT + 2T )] The squaring function equation is : y(nT ) = (x(nT ))2 (4) (3)

Fig. 5. Software assembly code owchart for encoding dsPIC.

3.2. Laptop Software Matlab R is universally accepted as one of the most powerful data processing platform in the academia institutions. Its connectivity with many advanced programming languages (C, Java, VB) and availability of a wide range of toolboxes make it popular among the scientic and research community. The developed Matlab R -based GUI shown in Figure (6) facilitates a user to control the operations on the entire system. This processing software provides a preliminary guide for ECG interpretation based on time-plane analysis and feature extraction from the stored ECG data. This is supplemented by displaying plots of the reconstructed signal and the RR interval plot, which assists in visual inspection of the signal by experts. The starting point of ECG signal processing is accurate determination of R-peaks in the record dataset. A simple derivative based approach is followed for the QRS complex detection. Automated ECG analysis using different techniques has evolved to assist the cardiologists in detecting abnormalities. ECG signal processing principally involves two areas, QRS detection and, ECG classication for disease

where N is the number of samples of the ECG signal. 3.2.2. Peak Detection There are many uses for a reliable QRS detection algorithm in all applications in the area of cardiology monitoring and diagnostics, and therefore it is the most investigated subject. The R Peak detection method is very similar to the real time algorithms in [17, 18]. the owchart is givern in Figure (7).

[2] U. Patel, C. Babbs, A computer based automated telephonic system to monitor patient progress in home setting, Journal of Medical Systems, vol. 16(2), 1992, 101-112. [3] G. Coyle, L. Boydell, L. Brown, Home telecare for the elderly, Journal of Telemedicine and. Telecare, vol. 1, 1995, 183-185. [4] http://cnx.org/ [5] Aurelia Microelectronica, http://www.caen.it [6] J Dong, S Zhang A Portable Intelligent ECG Monitor Based on Wireless Internet and Embedded System Technology, 2008 International Conference on BioMedical Engineering and Informatics. [7] C.Rodriguez, S. Borromeo Wireless ECG based on Bluetooth protocol: design and implementation.. [8] S Arslan, K Kose A Design of DSPIC Based Signal Monitoring and Processing System., Journal of Electrical and Electronics Engineering, Istanbul, number 1, volume 9. 2009. Fig. 7. QRS Complex and P wave detection owchart. 4. CONCLUSION AND RECOMMENDATIONS The wireless ECG system presented in this work was able to detect and transmit the basic elements of the ECG waveform with high quality and efciency. Based on the ndings in this study, the proposed system proved to be effective (in the lab scale) in transmitting ECG signals with high extent of matching between the input/output signals. The two major problems of this design regarding the aspects of powering the system and the optimum number of samples to be transmitted for efcient ECG recording were tackled. The current system has the advantages of low-cost and low power consumption. The system is so exible that with the aid of a Matlab R -based GUI, the operator can enter the time duration needed to monitor the patient in the receiving equipment. Further developments in the near future will be carried on to improve the performance of the system. The use of a parallel transmitter along with a modication in the A/D code in the PIC microcontroller would allow for better output resolution. This is because a serial transmitter has only three pins, two of which are used for I/O data. To reduce power consumption, the sleep mode can be effectively used with the PIC microcontroller. Software functionality via the Matlab R GUI can be boosted by adding several algorithms of diagnostic capabilities, which would check abnormalities in the ECG waveform and thus assist medical staff. As for life-battery, a study could be conducted to experimentally and/or analytically estimate the life of a battery used under this particular systems operating conditions. 5. REFERENCES [1] American Heart Association www.americanheart.org [9] http://www.bluetooth.org [10] Zigbee Alliance, http://www.zigbee.org [11] Paul Frehill, Desmond Chambers. Using Zigbee to Integrate Medical Devices, Proceedings of the 29th Annual International Conference of the IEEE EMBS Cit Internationale, Lyon, France August 23-26, 2007. [12] Sparkfun electronics, http://www.sparkfun.com [13] ANDREAO Rodrigo et al,ECG signal analysis through hidden markov models, R. Andreao, B.Dorizzi, J.Boudy; vol. 53, no8, pp. 1541-1549. IEEE transactions on biomedical engineering. 2006. [14] G. de Lannoy , B. Frenay , M. Verleysen and J. Delbeke; Supervised ECG Delineation Using the Wavelet Transform and Hidden Markov Models, ECIFMBE 2008, IFMBE Proceedings 22, pp. 2225. SpringerVerlag Berlin Heidelberg 2009. [15] Bushra, J.,Olivier, L.,Eric, F.,Ouadi, B.Detection of QRS complex in ECG signal based on classication approach, Image Processing (ICIP), 2010 17th IEEE International Conference on, 26-29 Sept. 2010. [16] Kiing-Ing Wong,Real-time Heart Rate Variability Detection on Sensor Node, SAS 2009 IEEE Sensors Applications Symposium. IEEE 2009. [17] J. Pan and W. J. Tompkins, A Real-Time QRS Detection Algorithm, IEEE Transactions on Biomedical Engineering, Vol 32, No. 3, pp 230-236, 1985. [18] N. Belgacem, Chikh M.A, F.Meghne, F.BereksiReguig; Detection et identication des parametres du signal ECG, Seminaire National sur lAutomatique et les Signaux SNAS 02- 27-28-octobre-2002-AnnabaAlgeria.