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Deep neural networks (DNNs) are increasingly important in the medical diagnosis of electrocardiogram (ECG) signals. However, research has shown that DNNs are highly vulnerable to adversarial examples, which can be created by carefully crafted perturbations. This vulnerability can lead to potential medical accidents. This poses new challenges for the application of DNNs in the medical diagnosis of ECG signals. This paper proposes a novel network Channel Activation Suppression with Lipschitz Constraints Net (CASLCNet), which employs the Channel-wise Activation Suppressing (CAS) strategy to dynamically adjust the contribution of different channels to the class prediction and uses the 1-Lipschitz's ℓ∞ distance network as a robust classifier to reduce the impact of adversarial perturbations on the model itself in order to increase the adversarial robustness of the model. The experimental results demonstrate that CASLCNet achieves A C C r o b u s t scores of 91.03% and 83.01% when subjected to PGD attacks on the MIT-BIH and CPSC2018 datasets, respectively, which proves that the proposed method in this paper enhances the model's adversarial robustness while maintaining a high accuracy rate. [ABSTRACT FROM AUTHOR]

The 12-lead electrocardiogram (ECG) is crucial in assessing patient decisions. However, portable ECG devices capable of acquiring a complete 12-lead ECG are scarce. For the first time, a deep learning-based method is proposed to reconstruct the 12-lead ECG from Frank leads (VX, VY, and VZ) or EASI leads (VES, VAS, and VAI). The innovative ECG reconstruction network called M2Eformer is composed of a 2D-ECGblock and a ProbDecoder module. The 2D-ECGblock module adaptively segments EASI leads into multi-periods based on frequency energy, transforming the 1D time series into a 2D tensor representing within-cycle and between-cycle variations. The ProbDecoder module aims to extract Probsparse self-attention and achieve one-step output for the target leads. Experimental results from comparing recorded and reconstructed 12-lead ECG using Frank leads indicate that M2Eformer outperforms traditional ECG reconstruction methods on a public database. In this study, a self-constructed database (10 healthy individuals + 15 patients) was utilized for the clinical diagnostic validation of ECG reconstructed from EASI leads. Subsequently, both the ECG reconstructed using EASI and the recorded 12-lead ECG were subjected to a double-blind diagnostic experiment conducted by three cardiologists. The overall diagnostic consensus among three cardiology experts, reaching a rate of 96%, indicates the significant utility of EASI-reconstructed 12-lead ECG in facilitating the diagnosis of cardiac conditions. [ABSTRACT FROM AUTHOR]

In the rapidly evolving landscape of continuous electrocardiogram (ECG) monitoring systems, there is a heightened demand for non-invasive sensors capable of measuring ECGs and detecting heart rate variability (HRV) in diverse populations, ranging from cardiovascular patients to sports enthusiasts. Challenges like device accuracy, patient privacy, signal noise, and long-term safety impede the use of wearable devices in clinical practice. This scoping review aims to assess the performance and safety of novel multi-channel, sensor-based biopotential wearable devices in adults. A comprehensive search strategy was employed on four databases, resulting in 143 records and the inclusion of 12 relevant studies. Most studies focused on healthy adult subjects (n = 6), with some examining controlled groups with atrial fibrillation (AF) (n = 3), long QT syndrome (n = 1), and sleep apnea (n = 1). The investigated bio-sensor devices included chest-worn belts (n = 2), wrist bands (n = 2), adhesive chest strips (n = 2), and wearable textile smart clothes (n = 4). The primary objective of the included studies was to evaluate device performance in terms of accuracy, signal quality, comparability, and visual assessment of ECGs. Safety findings, reported in five articles, indicated no major side effects for long-term/continuous monitoring, with only minor instances of skin irritation. Looking forward, there are ample opportunities to enhance and test these technologies across various physical activity intensities and clinical conditions. [ABSTRACT FROM AUTHOR]

In this paper, a beat-based autoencoder is proposed for mapping photoplethysmography (PPG) to a single-lead electrocardiogram (single-lead ECG) signal. The main limiting factors represented in uncleaned data, subject dependency, and erroneous beat segmentation are regarded. The dataset is cleaned by a two-stage clustering approach. Rather than complete single–lead ECG signal reconstruction, a beat-based PPG-to-single-lead-ECG (PPG2ECG) conversion is introduced for providing a simple lightweight model that meets the computational capabilities of wearable devices. In addition, peak-to-peak segmentation is employed for alleviating errors in PPG onset detection. Furthermore, subject-dependent training is highlighted as a critical factor in training procedures because most existing work includes different beats/signals from the same subject's record in both training and testing sets. So, we provide a completely subject-independent model where the testing subjects' records are hidden in the training stage entirely, i.e., a subject record appears once either in the training or testing set, but testing beats/signals belong to records that never appear in the training set. The proposed deep learning model is designed for providing efficient feature extraction that attains high reconstruction quality over subject-independent scenarios. The achieved performance is about 0.92 for the correlation coefficient and 0.0086 for the mean square error for the dataset extracted/cleaned from the MIMIC II dataset. [ABSTRACT FROM AUTHOR]

The wireless capture of analog differential signals from fully passive (battery-less) sensors is technically challenging but it can allow for the seamless capture of differential biosignals such as an electrocardiogram (ECG). This paper presents a novel design for the wireless capture of analog differential signals using a novel conjugate coil pair for a wireless resistive analog passive (WRAP) ECG sensor. Furthermore, we integrate this sensor with a new type of dry electrode, namely conductive polymer polypyrrole (PPy)-coated patterned vertical carbon nanotube (pvCNT) electrodes. The proposed circuit uses dual-gate depletion-mode MOSFETs to convert the differential biopotential signals to correlated drain-source resistance changes and the conjugate coil wirelessly transmits the differences of the two input signals. The circuit rejects (17.24 dB) common mode signals and passing only differential signals. We have integrated this novel design with our previously reported PPy-coated pvCNT dry ECG electrodes, fabricated on a stainless steel substrate with a diameter of 10 mm, which provided a zero-power (battery-less) ECG capture system for long duration monitoring. The scanner transmits an RF carrier signal at 8.37 MHz. The proposed ECG WRAP sensor uses only two complementary biopotential amplifier circuits, each of which has a single-depletion MOSFET. The amplitude-modulated RF signal is envelope-detected, filtered, amplified, and transmitted to a computer for signal processing. ECG signals are collected using this WRAP sensor and compared with a commercial counterpart. Due to the battery-less nature of the ECG WRAP sensor, it has the potential to be a body-worn electronic circuit patch with dry pvCNT electrodes that stably operate for a long period of time. [ABSTRACT FROM AUTHOR]

With the growing incidence of cardiovascular disease (CVD) in recent decades, the demand for out-of-hospital real-time ECG monitoring is increasing day by day, which promotes the research and development of portable ECG monitoring equipment. At present, two main categories of ECG monitoring devices are "limb lead ECG recording devices" and "chest lead ECG recording devices", which both require at least two electrodes. The former needs to complete the detection by means of a two-hand lap joint. This will seriously affect the normal activities of users. The electrodes used by the latter also need to be kept at a certain distance, usually more than 10 cm, to ensure the accuracy of the detection results. Decreasing the electrode spacing of the existing ECG detection equipment or reducing the area required for detection will be more conducive to improving the integration of the out-of-hospital portable ECG technologies. Therefore, a single-position ECG system based on charge induction is proposed to realize ECG detection on the surface of the human body with only one electrode with a diameter of less than 2 cm. Firstly, the ECG waveform detected in a single location is simulated by analyzing the electrophysiological activities of the human heart on the human body surface with COMSOL Multiphysics 5.4 software. Then, the hardware circuit design of the system and the host computer are developed and the test is performed. Finally, experiments for static and dynamic ECG monitoring are carried out and the heart rate correlation coefficients are 0.9698 and 0.9802, respectively, which proves the reliability and data accuracy of the system. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVD) represent a serious health problem worldwide, of which atrial fibrillation (AF) is one of the most common conditions. Early and timely diagnosis of CVD is essential for successful treatment. When implemented in the healthcare system this can ease the existing socio-economic burden on health institutions and government. Therefore, developing technologies and tools to diagnose CVD in a timely way and detect AF is an important research topic. ECG monitoring patches allowing ambulatory patient monitoring over several days represent a novel technology, while we witness a significant proliferation of ECG monitoring patches on the market and in the research labs, their performance over a long period of time is not fully characterized. This paper analyzes the signal quality of ECG signals obtained using a single-lead ECG patch featuring self-adhesive dry electrode technology collected from six cardiac patients for 5 days. In particular, we provide insights into signal quality degradation over time, while changes in the average ECG quality per day were present, these changes were not statistically significant. It was observed that the quality was higher during the nights, confirming the link with motion artifacts. These results can improve CVD diagnosis and AF detection in real-world scenarios. [ABSTRACT FROM AUTHOR]

Objective: To monitor fetal health and growth, fetal heart rate is a critical indicator. The non-invasive fetal electrocardiogram is a widely employed measurement for fetal heart rate estimation, which is extracted from the electrodes placed on the surface of the maternal abdomen. The qualities of the fetal ECG recordings, however, are frequently affected by the noises from various interference sources. In general, the fetal heart rate estimates are unreliable when low-quality fetal ECG signals are used for fetal heart rate estimation, which makes accurate fetal heart rate estimation a challenging task. So, the signal quality assessment for the fetal ECG records is an essential step before fetal heart rate estimation. In other words, some low-quality fetal ECG signal segments are supposed to be detected and removed by utilizing signal quality assessment, so as to improve the accuracy of fetal heart rate estimation. A few supervised learning-based fetal ECG signal quality assessment approaches have been introduced and shown to accurately classify high- and low-quality fetal ECG signal segments, but large fetal ECG datasets with quality annotation are required in these methods. Yet, the labeled fetal ECG datasets are limited. Proposed methods: An unsupervised learning-based multi-level fetal ECG signal quality assessment approach is proposed in this paper for identifying three levels of fetal ECG signal quality. We extracted some features associated with signal quality, including entropy-based features, statistical features, and ECG signal quality indices. Additionally, an autoencoder-based feature is calculated, which is related to the reconstruction error of the spectrograms generated from fetal ECG signal segments. The high-, medium-, and low-quality fetal ECG signal segments are classified by inputting these features into a self-organizing map. Main results: The experimental results showed that our proposal achieved a weighted average F1-score of 90% in three-level fetal ECG signal quality classification. Moreover, with the acceptable removal of detected low-quality signal segments, the errors of fetal heart rate estimation were reduced to a certain extent. [ABSTRACT FROM AUTHOR]

Simple Summary: Electrocardiography is a method used to understand equine cardiovascular health and fitness. While electrocardiograms (ECGs) are essential, the devices typically utilized are limited by their reliance on adhesive electrodes. Therefore, the aim of this study was to compare ECG quality obtained using a smart textile band to the standard adhesive electrodes. ECGs were recorded simultaneously using both electrode types in stalled horses. We did not observe any significant differences in ECG signal quality, the degree of motion artifacts, or the output of heart rate. These results indicate that smart textile electrodes are a reliable alternative to adhesive electrodes for ECG data collection in horses at rest. Electrocardiography (ECG) is an essential tool in assessing equine health and fitness. However, standard ECG devices are expensive and rely on the use of adhesive electrodes, which may become detached and are associated with reduced ECG quality over time. Smart textile electrodes composed of stainless-steel fibers have previously been shown to be a suitable alternative in horses at rest and during exercise. The objective of this study was to compare ECG quality using a smart textile girth band knit with silver and carbon yarns to standard adhesive silver/silver chloride (Ag/AgCl) electrodes. Simultaneous three-lead ECGs were recorded using a smart textile band and Ag/AgCl electrodes in 22 healthy, mixed-breed horses that were unrestrained in stalls. ECGs were compared using the following quality metrics: Kurtosis (k) value, Kurtosis signal quality index (kSQI), percentage of motion artifacts (%MA), peak signal amplitude, and heart rate (HR). Two-way ANOVA with Tukey's multiple comparison tests was conducted to compare each metric. No significant differences were found in any of the assessed metrics between the smart textile band and Ag/AgCl electrodes, with the exception of peak amplitude. Kurtosis and kSQI values were excellent for both methods (textile mean k = 21.8 ± 6.1, median kSQI = 0.98 [0.92–1.0]; Ag/AgCl k = 21.2 ± 7.6, kSQI = 0.99 [0.97–1.0]) with <0.5% (<1 min) of the recording being corrupted by MAs for both. This study demonstrates that smart textiles are a practical and reliable alternative to the standard electrodes typically used in ECG monitoring of horses. [ABSTRACT FROM AUTHOR]

The electrocardiogram (ECG) signal describes the heart's electrical activity, allowing it to detect several health conditions, including cardiac system abnormalities and dysfunctions. Nowadays, most patient medical records are still paper-based, especially those made in past decades. The importance of collecting digitized ECGs is twofold: firstly, all medical applications can be easily implemented with an engineering approach if the ECGs are treated as signals; secondly, paper ECGs can deteriorate over time, therefore a correct evaluation of the patient's clinical evolution is not always guaranteed. The goal of this paper is the realization of an automatic conversion algorithm from paper-based ECGs (images) to digital ECG signals. The algorithm involves a digitization process tested on an image set of 16 subjects, also with pathologies. The quantitative analysis of the digitization method is carried out by evaluating the repeatability and reproducibility of the algorithm. The digitization accuracy is evaluated both on the entire signal and on six ECG time parameters (R-R peak distance, QRS complex duration, QT interval, PQ interval, P-wave duration, and heart rate). Results demonstrate the algorithm efficiency has an average Pearson correlation coefficient of 0.94 and measurement errors of the ECG time parameters are always less than 1 mm. Due to the promising experimental results, the algorithm could be embedded into a graphical interface, becoming a measurement and collection tool for cardiologists. [ABSTRACT FROM AUTHOR]

Approximate entropy (ApEn) is used as a nonlinear measure of heart-rate variability (HRV) in the analysis of ECG time-series recordings. Previous studies have reported that HRV can differentiate between frail and pre-frail people. In this study, EEGs and ECGs were recorded from 38 elderly adults while performing a three-stage cycling routine. Before and after cycling stages, 5-min resting-state EEGs (rs-EEGs) and ECGs were also recorded under the eyes-open condition. Applying the K-mean classifier to pre-exercise rs-ECG ApEn values and body weights revealed nine females with EEG power which was far higher than that of the other subjects in all cycling stages. The breathing of those females was more rapid than that of other subjects and their average heart rate was faster. Those females also presented higher degrees of asymmetry in the alpha and theta bands (stronger power levels in the right frontal electrode), indicating stressful responses during the experiment. It appears that EEG delta activity could be used in conjunction with a very low ECG frequency power as a predictor of bursts in the heart rate to facilitate the monitoring of elderly adults at risk of heart failure. A resting ECG ApEn index in conjunction with the subject's weight or BMI is recommended for screening high-risk candidates prior to exercise interventions. [ABSTRACT FROM AUTHOR]

Nowadays, even with all the tremendous advances in medicine and health protocols, cardiovascular diseases (CVD) continue to be one of the major causes of death. In the present work, we focus on a specific abnormality: ST-segment deviation, which occurs regularly in high-performance athletes and elderly people, serving as a myocardial infarction (MI) indicator. It is usually diagnosed manually by experts, through visual interpretation of the printed electrocardiography (ECG) signal. We propose a methodology to detect ST-segment deviation and quantify its scale up to 1 mV by extracting statistical, point-to-point beat characteristics and signal quality indexes (SQIs) from single-lead ECG. We do so by applying automated machine learning methods to find the best hyperparameter configuration for classification and regression models. For validation of our method, we use the ST-T database from Physionet; the results show that our method obtains 98.30% accuracy in the case of a multiclass problem and 99.87% accuracy in the case of binarization. [ABSTRACT FROM AUTHOR]

Continuous health monitoring in a vehicle enables the earlier detection of symptoms of cardiovascular diseases. In this work, we designed flexible and thin electrodes made of polyurethane for long-term electrocardiogram (ECG) monitoring while driving. We determined the time for reliable ECG recording to evaluate the effectiveness of the electrodes. We recorded data from 19 subjects under four scenarios: rest, city, highway, and rural. The recording time was five min for rest and 15 min for the other scenarios. The total recording (950 min) is publicly available under a CC BY-ND 4.0 license. We used the simultaneous truth and performance level estimation (STAPLE) algorithm to detect the position of R-waves. Then, we derived the RR intervals to compare the estimated heart rate with the ground truth, which we obtained from ECG electrodes on the chest. We calculated the signal-to-noise ratio (SNR) and averaged it for the different scenarios. Highway had the lowest SNR (−6.69 dB) and rural had the highest (−6.80 dB). The usable time of the steering wheel was 42.46% (city), 46.67% (highway), and 47.72% (rural). This indicates that steering-wheel-based ECG recording is feasible and delivers reliable recordings from about 45.62% of the driving time. In summary, the developed electrodes allow continuous in-vehicle heart rate monitoring, and our publicly available recordings provide the opportunity to apply more sophisticated data analytics. [ABSTRACT FROM AUTHOR]

The development of smart cars with e-health services allows monitoring of the health condition of the driver. Driver comfort is preserved by the use of capacitive electrodes, but the recorded signal is characterized by large artifacts. This paper proposes a method for reducing artifacts from the ECG signal recorded by capacitive electrodes (cECG) in moving subjects. Two dominant artifact types are coarse and slow-changing artifacts. Slow-changing artifacts removal by classical filtering is not feasible as the spectral bands of artifacts and cECG overlap, mostly in the band from 0.5 to 15 Hz. We developed a method for artifact removal, based on estimating the fluctuation around linear trend, for both artifact types, including a condition for determining the presence of coarse artifacts. The method was validated on cECG recorded while driving, with the artifacts predominantly due to the movements, as well as on cECG recorded while lying, where the movements were performed according to a predefined protocol. The proposed method eliminates 96% to 100% of the coarse artifacts, while the slow-changing artifacts are completely reduced for the recorded cECG signals larger than 0.3 V. The obtained results are in accordance with the opinion of medical experts. The method is intended for reliable extraction of cardiovascular parameters to monitor driver fatigue status. [ABSTRACT FROM AUTHOR]

Today's wearable medical devices are becoming popular because of their price and ease of use. Most wearable medical devices allow users to continuously collect and check their health data, such as electrocardiograms (ECG). Therefore, many of these devices have been used to monitor patients with potential heart pathology as they perform their daily activities. However, one major challenge of collecting heart data using mobile ECG is baseline wander and motion artifacts created by the patient's daily activities, resulting in false diagnoses. This paper proposes a new algorithm that automatically removes the baseline wander and suppresses most motion artifacts in mobile ECG recordings. This algorithm clearly shows a significant improvement compared to the conventional noise removal method. Two signal quality metrics are used to compare a reference ECG with its noisy version: correlation coefficients and mean squared error. For both metrics, the experimental results demonstrate that the noisy signal filtered by our algorithm is improved by a factor of ten. [ABSTRACT FROM AUTHOR]

eSports is a rapidly growing industry with increasing investment and large-scale international tournaments offering significant prizes. This has led to an increased focus on individual and team performance with factors such as communication, concentration, and team intelligence identified as important to success. Over a similar period of time, personal physiological monitoring technologies have become commonplace with clinical grade assessment available across a range of parameters that have evidenced utility. The use of physiological data to assess concentration is an area of growing interest in eSports. However, body-worn devices, typically used for physiological data collection, may constitute a distraction and/or discomfort for the subjects. To this end, in this work we devise a novel "invisible" sensing approach, exploring new materials, and proposing a proof-of-concept data collection system in the form of a keyboard armrest and mouse. These enable measurements as an extension of the interaction with the computer. In order to evaluate the proposed approach, measurements were performed using our system and a gold standard device, involving 7 healthy subjects. A particularly advantageous characteristic of our setup is the use of conductive nappa leather, as it preserves the standard look and feel of the keyboard and mouse. According to the results obtained, this approach shows 3–15% signal loss, with a mean difference in heart rate between the reference and experimental device of −1.778 ± 4.654 beats per minute (BPM); in terms of ECG waveform morphology, the best cases show a Pearson correlation coefficient above 0.99. [ABSTRACT FROM AUTHOR]

Heart rate is one of the most important diagnostic bases for cardiovascular disease. This paper introduces a deep autoencoding strategy into feature extraction of electrocardiogram (ECG) signals, and proposes a beat-to-beat heart rate estimation method based on convolution autoencoding and Gaussian mixture clustering. The high-level heartbeat features were first extracted in an unsupervised manner by training the convolutional autoencoder network, and then the adaptive Gaussian mixture clustering was applied to detect the heartbeat locations from the extracted features, and calculated the beat-to-beat heart rate. Compared with the existing heartbeat classification/detection methods, the proposed unsupervised feature learning and heartbeat clustering method does not rely on accurate labeling of each heartbeat location, which could save a lot of time and effort in human annotations. Experimental results demonstrate that the proposed method maintains better accuracy and generalization ability compared with the existing ECG heart rate estimation methods and could be a robust long-time heart rate monitoring solution for wearable ECG devices. [ABSTRACT FROM AUTHOR]

The development and use of wearable devices require high levels of security and have sparked interest in biometric authentication research. Among the available approaches, electrocardiogram (ECG) technology is attracting attention because of its strengths in spoofing. However, morphological changes of ECG, which are affected by physical and psychological factors, can make authentication difficult. In this paper, we propose authentication using non-linear normalization of ECG beats that is robust to changes in ECG waveforms according to heart rate fluctuations in various daily activities. We performed a non-linear normalization method through the analysis of ECG alongside heart rate, evaluating similarities and authenticating the performance of our new method compared to existing methods. Compared with beats before normalization, the average similarity of the proposed method increased 23.7% in the resting state and 43% in the non-resting state. After learning in the resting state, authentication performance reached 99.05% accuracy for the resting state and 88.14% for the non-resting state. The proposed method can be applicable to an ECG-based authentication system under various physiological conditions. [ABSTRACT FROM AUTHOR]

Electrocardiogram (ECG) synchronization is useful to avoid the effects of cardiac motion in medical measurements, and is widely used in standard medical imaging. A number of medical equipment include embedded commercial synchronizers. However, the use of independent synchronization modules is sometimes needed when several non-integrated instruments are used, or in the development of new medical instruments and procedures. We present a simple low-cost ECG synchronizer module based on an Arduino controller board that converts the ECG signal into a transistor-transistor-logic (TTL) one, allowing real-time medical measurements triggered at specific phases of the cardiac cycle. The device and conversion algorithm developed is optimized in vitro using synthetic and human ECG signals, and tested in vivo on three swine specimens. Error rates during the in vivo testing stage remain below the 2% of the cycles in all animals and critical false positives are less than 1%, which is sufficient for most applications. Possible algorithm updates are discussed if its performance needs to be improved. [ABSTRACT FROM AUTHOR]

Electrocardiogram (ECG) signals have been used to monitor and diagnose signs of cardiovascular disease and abnormal signals about the human body. ECG signals are typically characterized by the PR, QRS, QT interval, ST-segment, and heart rate (HR) parameters. ECG devices are widely used for many applications, especially for the elderly. However, ECG signals are often affected by noises from the environment. There are mainly two types of noises that affect the ECG signals: low frequencies from muscle activity and 50/60 Hz from the electrical grid. Removing these noises is important for improving the quality of the ECG signal. A clear ECG signal makes it easy to diagnose cardiovascular problems. ECG signals with high sampling frequency are more accurate. However, the noises in the signal will be more obvious and it will be difficult to remove these noises with filters. We analyzed the symmetrical correlation between the sampling frequency of the signal and the parameters of the signal such as signal to noise ratio (SNR) and signal amplitude. This study will compare characterization of ECG signals performed at different sampling frequencies before and after applying infinite impulse response (IIR) and symmetric finite impulse response (FIR) filters. Therefore, it is critical that the sampling frequency is consistent at the same frequency of the ECG signal for accurate diagnosis. Furthermore, the approach can be also important for the device to help reduce the device's computing power and hardware resources. Our results were tested with the MIT/ BIH database at 360 Hz sampling frequency with 11-bit resolution. We also experimented with the device operating in real-time with a sampling frequency from 100 Hz to 2133 Hz and a 24-bit resolution. The test results show the advantages of the symmetric FIR filter over IIR when applied to the filtering of ECG signals. The study's conclusions can be applied to real-world devices to improve the quality of ECG signals. [ABSTRACT FROM AUTHOR]

Heart rate monitors (HRMs) are important for measuring heart rate, which can be used as a training parameter for healthy athletes. They indicate stress-related heart rhythm disturbances—recognized as an unexpected increase in heart rate (HR)—which can be life-threatening. Most HRMs confuse arrhythmias with artifacts. This study aimed to assess the usefulness of electrocardiogram (ECG) recordings from sport HRMs for endurance athletes, coaches, and physicians, compared with other basic and hypothetical functions. We conducted three surveys among endurance athletes (76 runners, 14 cyclists, and 10 triathletes), 10 coaches, and 10 sports doctors to obtain information on how important ECG recordings are and what HRM functions should be improved to meet their expectations in the future. The respondents were asked questions regarding use and hypothetical functions, as well as their preference for HRM type (optical/strap). Athletes reported distance, pace, instant HR, and oxygen threshold as being the four most important functions. ECG recording ranked eighth and ninth for momentary and continuous recording, respectively. Coaches placed more importance on ECG recording. Doctors ranked ECG recording the highest. All participants preferred optical HRMs to strap HRMs. Research on the improvement and implementation of HRM functions showed slightly different preferences for athletes compared with coaches and doctors. In cases where arrhythmia was suspected, the value of the HRM's ability to record ECGs during training by athletes and coaches increased. For doctors, this is the most desirable feature in any situation. Considering the expectations of all groups, continuous ECG recording during training will significantly improve the safety of athletes. [ABSTRACT FROM AUTHOR]

Cardiography is an indispensable element of health care. However, the accessibility of at-home cardiac monitoring is limited by device complexity, accuracy, and cost. We have developed a real-time algorithm for heart rate monitoring and beat detection implemented in a custom-built, affordable system. These measurements were processed from seismocardiography (SCG) and gyrocardiography (GCG) signals recorded at the sternum, with concurrent electrocardiography (ECG) used as a reference. Our system demonstrated the feasibility of non-invasive electro-mechanical cardiac monitoring on supine, stationary subjects at a cost of $100, and with the SCG–GCG and ECG algorithms decoupled as standalone measurements. Testing was performed on 25 subjects in the supine position when relaxed, and when recovering from physical exercise, to record 23,984 cardiac cycles at heart rates in the range of 36–140 bpm. The correlation between the two measurements had r2 coefficients of 0.9783 and 0.9982 for normal (averaged) and instantaneous (beat identification) heart rates, respectively. At a sampling frequency of 250 Hz, the average computational time required was 0.088 s per measurement cycle, indicating the maximum refresh rate. A combined SCG and GCG measurement was found to improve accuracy due to fundamentally different noise rejection criteria in the mutually orthogonal signals. The speed, accuracy, and simplicity of our system validated its potential as a real-time, non-invasive, and affordable solution for outpatient cardiac monitoring in situations with negligible motion artifact. [ABSTRACT FROM AUTHOR]

In this paper, we describe and test a new portable device that is able to deliver tactile interoceptive stimulation. The device works by delivering precise interoceptive parasympathetic stimuli to C-tactile afferents connected to the lamina I spinothalamocortical system. In humans, interoceptive stimulation can be used to enhance heart rate variability (HRV). To test the effectiveness of the device in enhancing HRV, 13 subjects were randomly assigned in a single-blind between-subjects design either to the experimental condition or to the control condition. In the experimental condition, subjects received stimulation with the developed device; in the control condition subjects received stimulation with static non-interoceptive pressure. Subjects’ electrocardiograms (ECG) were recorded, with sampling at 1000 Hz for 5 min as a baseline, and then during the stimulations (11 min). Time domain analyses were performed to estimate the short-term vagally mediated component (rMSSD) of HRV. Results indicated that the experimental group showed enhanced rMSSD, compared to the control group. Moreover, frequency domain analyses indicated that high frequency band power, which reflects parasympathetic activity in humans, also appeared to be enhanced in the experimental group compared to control subjects. Conclusions and future challenges for an embodied perspective of rehabilitative medicine are discussed. [ABSTRACT FROM AUTHOR]