An ultra-low power (ULP) bandage-type ECG sensor for efficient cardiac disease management.

This paper proposed an ultra-low power bandage-type ECG sensor (the size: 76 × 34 × 3 (mm(3)) and the power consumption: 1 mW) which allows for a continuous and real-time monitoring of a user's ECG signals over 24h during daily activities. For its compact size and lower power consumption, we designed the analog front-end, the SRP (Samsung Reconfigurable Processor) based DSP of 30 uW/MHz, and the ULP wireless RF of 1 nJ/bit. Also, to tackle motion artifacts(MA), a MA monitoring technique based on the HCP (Half-cell Potential) is proposed which resulted in the high correlation between the MA and the HCP, the correlation coefficient of 0.75 ± 0.18. To assess its feasibility and validity as a wearable health monitor, we performed the comparison of two ECG signals recorded form it and a conventional Holter device. As a result, the performance of the former is a little lower as compared with the latter, although showing no statistical significant difference (the quality of the signal: 94.3% vs 99.4%; the accuracy of arrhythmia detection: 93.7% vs 98.7%). With those results, it has been confirmed that it can be used as a wearable health monitor due to its comfortability, its long operation lifetime and the good quality of the measured ECG signal.

Exercise amount calculation using a wearable half-cell potential sensor for mobile aerobic exercise management.

The obesity has grown to concerning proportions in recent years, and it causes heart disease, type 2 diabetes, breast cancer, and colon cancer. To get healthy weight, commercial wearable devices with a accelerometer have been released to help users to quantitatively manage calories. However, an accelerometer has disadvantages: large power consumption and expensive price. We suggested a new method to measure the exercise amount using a HCP sensor. We performed an experiment to compare accuracies of exercise amount estimation using a HCP sensor with using an accelerometer with five subjects, and the accuracy of the HCP sensor was comparable to it of the accelerometer. Since a HCP sensor has lower power consumption and cheaper price than an accelerometer, wearable sensor can be smaller and cheaper than current commercial devices.

Motion artifact reduction in electrocardiogram using adaptive filtering based on half cell potential monitoring.

The electrocardiogram (ECG) is the main measurement parameter for effectively diagnosing chronic disease and guiding cardio-fitness therapy. ECGs contaminated by noise or artifacts disrupt the normal functioning of the automatic analysis algorithm. The objective of this study is to evaluate a method of measuring the HCP variation in motion artifacts through direct monitoring. The proposed wearable sensing device has two channels. One channel is used to measure the ECG through a differential amplifier. The other is for monitoring motion artifacts using the modified electrode and the same differential amplifier. Noise reduction was performed using adaptive filtering, based on a reference signal highly correlated with it. Direct measurement of HCP variations can eliminate the need for additional sensors.

A PD control-based QRS detection algorithm for wearable ECG applications.

We present a QRS detection algorithm for wearable ECG applications using a proportional-derivative (PD) control. ECG data of arrhythmia have irregular intervals and magnitudes of QRS waves that impede correct QRS detection. To resolve the problem, PD control is applied to avoid missing a small QRS wave followed from a large QRS wave and to avoid falsely detecting noise as QRS waves when an interval between two adjacent QRS waves is large (e.g. bradycardia, pause, and arioventricular block). ECG data was obtained from 78 patients with various cardiovascular diseases and tested for the performance evaluation of the proposed algorithm. The overall sensitivity and positive predictive value were 99.28% and 99.26%, respectively. The proposed algorithm has low computational complexity, so that it can be suitable to apply mobile ECG monitoring system in real time.

Effect of pressurization methods on the accuracy of wrist blood pressure measurement.

In developing a wrist blood pressure monitor of high and reliable accuracy, the effect of different pressurization methods on the accuracy of blood pressure measurement at the wrist using oscillometry is investigated in this paper. 30 volunteers are recruited and blood pressure readings are taken with three different methods of pressurizing the wrist. It was found that measurement of mean arterial pressure (MAP) is more accurate when the wrist is locally compressed directly over the radial artery (-2.6 ± 11.4 mmHg) or with a region of surrounding tissue (10.3 ± 6.0 mmHg) than when the whole wrist is compressed by a conventional, constricting cuff (-11.4 ± 16.4 mmHg). Characteristics of accuracy, however, differ between the two local pressurization methods. While a square airbag that compresses the wrist directly over the radial artery may measure the most accurate MAP on average, the range of errors among individuals is large. Contrarily, measurements taken by pressurizing a region over the radial artery with a bladder are least affected by individual variability. In order to measure blood pressure accurately at the wrist while unbiased by the population-based algorithmic compensation to ensure accuracy among different individuals, therefore, the use of local pressurization method may be the most appropriate.

Factors affecting the accuracy of volume-oscillometric blood pressure measurement during partial pressurization of the wrist.

We compared the volume-oscillometric responses of the airbag pressure sensor and the contact force sensor across and along the radial artery on the wrist during partial pressurization by an airbag. Because of the anatomic structure and non-uniform pressurization pressure distribution, elongated and shifted oscillometric pressure waveform envelope variations are observed. For the contact force sensors directly above the radial artery, S-shaped pressurization curves can be seen possibly due to temporal softening of the radial artery stiffness at near zero transmural pressure. These differences in the shape of oscillometric envelope as well as pressurization curve may be the leading factors for inaccuracies of volume-oscillometric blood pressure measurement by partial pressurization method using an airbag.

Statistical approach to quantify the presence of phase coupling using the bispectrum.

The bispectrum is a method to detect the presence of phase coupling between different components in a signal. The traditional way to quantify phase coupling is by means of the bicoherence index, which is essentially a normalized bispectrum. The major drawback of the bicoherence index (BCI) is that determination of significant phase coupling becomes compromised with noise and low coupling strength. To overcome this limitation, a statistical approach that combines the bispectrum with a surrogate data method to determine the statistical significance of the phase coupling is introduced. Our method does not rely on the use of the BCI, where the normalization procedure of the BCI is the major culprit in its poor specificity. We demonstrate the accuracy of the proposed approach using simulation examples that are designed to test its robustness against noise contamination as well as varying levels of phase coupling. Our results show that the proposed approach outperforms the bicoherence index in both sensitivity and specificity and provides an unbiased and statistical approach to determining the presence of quadratic phase coupling. Application of this new method to renal hemodynamic data was applied to renal stop flow pressure data obtained from normotensive (N = 7) and hypertensive (N = 7) rats. We found significant nonlinear interactions in both strains of rats with a greater magnitude of coupling and smaller number of interaction peaks in normotensive rats than hypertensive rats.

Gravimetric method for in vitro calibration of skin hydration measurements.

A novel method for in vitro calibration of skin hydration measurements is presented. The method combines gravimetric and electrical measurements and reveals an exponential dependency of measured electrical susceptance to absolute water content in the epidermal stratum corneum. The results also show that absorption of water into the stratum corneum exhibits three different phases with significant differences in absorption time constant. These phases probably correspond to bound, loosely bound, and bulk water.

Fat thickness measurement using optical technique with miniaturized chip LEDs: a preliminary human study.

In this study, we present the possibility of the fat thickness measurement using the miniaturized chip LEDs sensor module for the twelve healthy women. The newly developed sensor module consisted of four different source-detector distances. The measurement sites are the five parts of biceps, triceps, upper abdomen, front thigh, and calf and the range of fat thickness is from 3.5 mm to 39.0 mm. The fitting curve for each measurement sites is separately obtained. We obtained the correlation coefficient of 0.932 compared with the fat thickness of CT measurement for biceps site. For the three measurement sites of biceps, front thigh, and calf of twelve persons and namely 36 data points, the mean absolute difference thickness and % error for the measured thickness compared with that of reference CT thickness are 1.08 mm and 11.49%, respectively. Based on this preliminary experiment, it is confirmed that the fat thickness measurement is possible with proper curve fitting procedure using slope analysis.

Autonomic nervous nonlinear interactions lead to frequency modulation between low- and high-frequency bands of the heart rate variability spectrum.

Cardiac sympathetic and parasympathetic neural activities have been found to interact with each other to efficiently regulate the heart rate and maintain homeostasis. Quantitative and noninvasive methods used to detect the presence of interactions have been lacking, however. This may be because interactions among autonomic nervous systems are nonlinear and nonstationary. The goal of this work was to identify nonlinear interactions between the sympathetic and parasympathetic nervous systems in the form of frequency and amplitude modulations in human heart rate data. To this end, wavelet analysis was performed, followed by frequency analysis of the resultant wavelet decomposed signals in several frequency brackets defined as very low frequency (f < 0.04 Hz), low frequency (LF; 0.04-0.15 Hz), and high frequency (HF; 0.15-0.4 Hz). Our analysis suggests that the HF band is significantly modulated by the LF band in the heart rate data obtained in both supine and upright body positions. The strength of modulations is stronger in the upright than supine position, which is consistent with elevated sympathetic nervous activities in the upright position. Furthermore, significantly stronger frequency modulation than in the control condition was also observed with the cold pressor test. The results with the cold pressor test, as well as the body position experiments, further demonstrate that the frequency modulation between LF and HF is most likely due to sympathetic and parasympathetic nervous interactions during sympathetic activations. The modulation phenomenon suggests that the parasympathetic nervous system is frequency modulated by the sympathetic nervous system. In this study, there was no evidence of amplitude modulation among these frequencies.

Evaluation of chip LED sensor module for fat thickness measurement using tissue phantoms.

We tested the feasibility of noninvasive fat thickness measurements by using a diffuse optical method with variable source-detector pairs. A light source module composed of 770 nm low-power chip LEDs and a photodetector were used in this study. The tissue phantoms are composed of a fat and a muscle layer made with gels with appropriate absorption/scattering coefficients. The fat thickness was varied from several to 30 mm. Based on this preliminary study, it is concluded that the noninvasive fat thickness measurement is possible with proper curve fitting procedure.

The preliminary study on the clinical application of the WHAM (Wearable Heart Activity Monitor).

In this paper, we investigated the validity of the WHAM (wearable heart activity monitor) in the clinical applications, which has been implemented as a wearable ambulatory device for continuously and long-term monitoring user's cardiac conditions. To this end, using the WHAM and the conventional Holter monitor the ECG signals over 24 hours were recorded during daily activities. The signal from the WHAM was compared with that from the conventional Holter monitor in terms of the readability of the signal, the quality of the signal, and the accuracy of arrhythmia detection. The performance of the WHAM was a little lower as compared with the conventional Holter monitor, although showing no significant difference (the readability of the signal: 97.2% vs 99.3%; the quality of the signal: 0.97 vs 0.98; the accuracy of arrhythmia detection: 96.2% vs 98.1%). From these results, it is likely that the WHAM shows the performance enough to be used in the clinical application as a wearable ambulatory monitoring device.

Estimation of activity energy expenditure: accelerometer approach.

A novel algorithm estimating the calorie expenditure during physical activities is introduced. The physical activity is quantified by the integration of the accelerometer signals obtained from the 3D accelerometer fixed at the waist level of the human body. Simultaneous measurements of activity and calorie expenditure using 3D accelerometer and gas analyzer show the activity calorie expenditure increases as the activity increases with different rates depending on the type of activities (e.g., walking, running) as well as the physical characteristics of the subjects (e.g., gender, age, mass, and height). Based on the experimental data gathered from 94 subjects, we suggest a new algorithm estimating the activity calorie expenditure dependent on the demographic data of the subjects and the types of the activity.

WHAM: A novel, wearable heart activity monitor based on Laplacian potential mapping.

In this paper, a novel, wearable cardiac monitor (hereafter called WHAM) is proposed which allows a continuous and real-time monitoring of user's cardiac conditions. The proposed device is composed of 3 main components: a disposable electrode, a controller, and personal gateway (e.g., cellular phone, PDA, and smart phone etc.). The ECG signal is recorded according to the surface Laplacian of the body surface potential. We investigated the feasibility of WHAM as a wearable ambulatory device for continuously and on-line monitoring a user's cardiac conditions. To this end, the ECG signals recorded with WHAM were compared with those obtained by Wilson's unipolar chest leads, that is, v1 to v6. As a result, the ECG signals recorded with WHAM showed the similar morphology to Wilson's unipolar chest leads (v1 to v6) with the exception of P and T waves, although there is a difference between amplitudes of both signals. Also, it is shown that the R-peaks are accurately detected by the algorithm at the accuracy of more than 99% for the ECG signals of WHAM recorded during resting and walking. From these results, it is found that the WHAM shows enough feasibility and has advantages as a wearable ambulatory monitoring device in that the hardware is miniaturized enough small to integrate on a small region, thereby no wire leads need.