Mohamed Elgendi

On the Analysis of Fingertip Photoplethysmogram Signals

Photoplethysmography (PPG) is used to estimate the skin blood flow using infrared light. Researchers from different domains of science have become increasingly interested in PPG because of its advantages as non-invasive, inexpensive, and convenient diagnostic tool. Traditionally, it measures the oxygen saturation, blood pressure, cardiac output, and for assessing autonomic functions. Moreover, PPG is a promising technique for early screening of various atherosclerotic pathologies and could be helpful for regular GP-assessment but a full understanding of the diagnostic value of the different features is still lacking. Recent studies emphasise the potential information embedded in the PPG waveform signal and it deserves further attention for its possible applications beyond pulse oximetry and heart-rate calculation. Therefore, this overview discusses different types of artifact added to PPG signal, characteristic features of PPG waveform, and existing indexes to evaluate for diagnoses.

Revisiting QRS detection methodologies for portable, wearable, battery-operated, and wireless ECG systems

Cardiovascular diseases are the number one cause of death worldwide. Currently, portable battery-operated systems such as mobile phones with wireless ECG sensors have the potential to be used in continuous cardiac function assessment that can be easily integrated into daily life. These portable point-of-care diagnostic systems can therefore help unveil and treat cardiovascular diseases. The basis for ECG analysis is a robust detection of the prominent QRS complex, as well as other ECG signal characteristics. However, it is not clear from the literature which ECG analysis algorithms are suited for an implementation on a mobile device. We investigate current QRS detection algorithms based on three assessment criteria: 1) robustness to noise, 2) parameter choice, and 3) numerical efficiency, in order to target a universal fast-robust detector. Furthermore, existing QRS detection algorithms may provide an acceptable solution only on small segments of ECG signals, within a certain amplitude range, or amid particular types of arrhythmia and/or noise. These issues are discussed in the context of a comparison with the most conventional algorithms, followed by future recommendations for developing reliable QRS detection schemes suitable for implementation on battery-operated mobile devices.

Fast QRS detection with an optimized knowledge-based method: evaluation on 11 standard ECG databases.

The current state-of-the-art in automatic QRS detection methods show high robustness and almost negligible error rates. In return, the methods are usually based on machine-learning approaches that require sufficient computational resources. However, simple-fast methods can also achieve high detection rates. There is a need to develop numerically efficient algorithms to accommodate the new trend towards battery-driven ECG devices and to analyze long-term recorded signals in a time-efficient manner. A typical QRS detection method has been reduced to a basic approach consisting of two moving averages that are calibrated by a knowledge base using only two parameters. In contrast to high-accuracy methods, the proposed method can be easily implemented in a digital filter design.

Systolic peak detection in acceleration photoplethysmograms measured from emergency responders in tropical conditions.

Photoplethysmogram (PPG) monitoring is not only essential for critically ill patients in hospitals or at home, but also for those undergoing exercise testing. However, processing PPG signals measured after exercise is challenging, especially if the environment is hot and humid. In this paper, we propose a novel algorithm that can detect systolic peaks under challenging conditions, as in the case of emergency responders in tropical conditions. Accurate systolic-peak detection is an important first step for the analysis of heart rate variability. Algorithms based on local maxima-minima, first-derivative, and slope sum are evaluated, and a new algorithm is introduced to improve the detection rate. With 40 healthy subjects, the new algorithm demonstrates the highest overall detection accuracy (99.84% sensitivity, 99.89% positive predictivity). Existing algorithms, such as Billauers, Lis and Zongs, have comparable although lower accuracy. However, the proposed algorithm presents an advantage for real-time applications by avoiding human intervention in threshold determination. For best performance, we show that a combination of two event-related moving averages with an offset threshold has an advantage in detecting systolic peaks, even in heat-stressed PPG signals.

Detection of a and b waves in the acceleration photoplethysmogram

BackgroundAnalyzing acceleration photoplethysmogram (APG) signals measured after exercise is challenging. In this paper, a novel algorithm that can detect a waves and consequently b waves under these conditions is proposed. Accurate a and b wave detection is an important first step for the assessment of arterial stiffness and other cardiovascular parameters.MethodsNine algorithms based on fixed thresholding are compared, and a new algorithm is introduced to improve the detection rate using a testing set of heat stressed APG signals containing a total of 1,540 heart beats.ResultsThe new a detection algorithm demonstrates the highest overall detection accuracy—99.78% sensitivity, 100% positive predictivity—over signals that suffer from 1) non-stationary effects, 2) irregular heartbeats, and 3) low amplitude waves. In addition, the proposed b detection algorithm achieved an overall sensitivity of 99.78% and a positive predictivity of 99.95%.ConclusionsThe proposed algorithm presents an advantage for real-time applications by avoiding human intervention in threshold determination.

Detection of c, d, and e waves in the acceleration photoplethysmogram

Analyzing the acceleration photoplethysmogram (APG) is becoming increasingly important for diagnosis. However, processing an APG signal is challenging, especially if the goal is to detect its small components (c, d, and e waves). Accurate detection of c, d, and e waves is an important first step for any clinical analysis of APG signals. In this paper, a novel algorithm that can detect c, d, and e waves simultaneously in APG signals of healthy subjects that have low amplitude waves, contain fast rhythm heart beats, and suffer from non-stationary effects was developed. The performance of the proposed method was tested on 27 records collected during rest, resulting in 97.39% sensitivity and 99.82% positive predictivity.

Optimization of EEG frequency bands for improved diagnosis of Alzheimer disease

Many clinical studies have shown that electroencephalograms (EEG) of Alzheimer patients (AD) often have an abnormal power spectrum. In this paper a frequency band analysis of AD EEG signals is presented, with the aim of improving the diagnosis of AD from EEG signals. Relative power in different EEG frequency bands is used as features to distinguish between AD patients and healthy control subjects. Many different frequency bands between 4 and 30Hz are systematically tested, besides the traditional frequency bands, e.g., theta band (4–8Hz). The discriminative power of the resulting spectral features is assessed through statistical tests (Mann-Whitney U test). Moreover, linear discriminant analysis is conducted with those spectral features. The optimized frequency ranges (4–7Hz, 8–15Hz, 19–24Hz) yield substantially better classification performance than the traditional frequency bands (4–8Hz, 8–12Hz, 12–30Hz); the frequency band 4–7Hz is the optimal frequency range for detecting AD, which is similar to the classical theta band. The frequency bands were also optimized as features through leave-one-out crossvalidation, resulting in error-free classification. The optimized frequency bands may improve existing EEG based diagnostic tools for AD. Additional testing on larger AD datasets is required to verify the effectiveness of the proposed approach.

R wave detection using Coiflets wavelets

Accurate detection of QRS complexes is important for ECG signal analysis. In this paper, a generic algorithm using Coiflet wavelets is introduced to improve the detection of QRS complexes in Arrhythmia ECG Signals that suffer from: 1) non-stationary effects, 2) low Signal-to-Noise Ratio, 3) negative QRS polarities, 4) low QRS amplitudes, and 5) ventricular ectopics. The algorithm achieves high detection rates by using a signal-to-noise ratio threshold instead of predetermined static thresholds. The performance of the algorithm was tested on 48 records of the MIT/BIH Arrhythmia Database. It was shown that this adaptive approach results in accurate detection of the QRS complex and that Coiflet1 achieves better detection rate than the other Coiflet wavelets.

Standard Terminologies for Photoplethysmogram Signals

Photoplethysmography is one of the optical techniques has been developed for experimental use in vascular disease. It has several advantages over other traditional experimental approaches. Because of its non-invasive, safe, costeffective and easy-to-use properties, it is considered as a useful diagnostic tool. The further developments in the Photoplethysmograph may replace it among other tools used in the assessment of vascular diseases such as blood test and ultrasound. This overview discusses the different terminologies used for the photoplethysmograph and reveals the research discontinuity among different disciplines. Moreover, it suggests standard terminologies as a resolution for a confusion persisted for more than 50 years.

Diagnosis of Alzheimer's disease from EEG by means of synchrony measures in optimized frequency bands

Several clinical studies have reported that EEG synchrony is affected by Alzheimers disease (AD). In this paper a frequency band analysis of AD EEG signals is presented, with the aim of improving the diagnosis of AD using EEG signals. In this paper, multiple synchrony measures are assessed through statistical tests (Mann-Whitney U test), including correlation, phase synchrony and Granger causality measures . Moreover, linear discriminant analysis (LDA) is conducted with those synchrony measures as features. For the data set at hand, the frequency range (5-6Hz) yields the best accuracy for diagnosing AD, which lies within the classical theta band (4-8Hz). The corresponding classification error is 4.88% for directed transfer function (DTF) Granger causality measure. Interestingly, results show that EEG of AD patients is more synchronous than in healthy subjects within the optimized range 5-6Hz, which is in sharp contrast with the loss of synchrony in AD EEG reported in many earlier studies. This new finding may provide new insights about the neurophysiology of AD. Additional testing on larger AD datasets is required to verify the effectiveness of the proposed approach.