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One of the crucial steps in assessing hemodynamic parameters using impedance cardiography (ICG) is the detection of the characteristic points in the dZ/dt ICG complex, especially the X point. The most often estimated parameters from the ICG complex are stroke volume and cardiac output, for which is required the left ventricular pre-ejection time. Unfortunately, for beat-to-beat calculations, the accuracy of detection is affected by the variability of the ICG complex subtypes. Thus, in this work, we aim to create a predictive model that can predict the missing points and decrease the previous work percentages of missing points to support the detection of ICG characteristic points and the extraction of hemodynamic parameters according to several existing subtypes. Thus, a time-series non-linear autoregressive model with exogenous inputs (NARX) feedback neural network approach was implemented to forecast the missing ICG points according to the different existing subtypes. The NARX was trained on two different datasets with an open-loop mode to ensure that the network is fed with correct feedback inputs. Once the training is satisfactory, the loop can be closed for multi-step prediction tests and simulation. The results show that we can predict the missing characteristic points in all the complexes with a success rate ranging between 75% and 88% in the evaluated datasets. Previously, without the NARX predictive model, the successful detection rate was 21%–30% for the same datasets. Thus, this work indicates a promising method and an accuracy increase in the detection of X, Y, O, and Z points for both datasets.

The rise of interest in wearable sensing of bioelectrical signals conducted via smart textile systems over the past decades has resulted in many investigations on how to develop and evaluate such systems. All measurements of bioelectrical signals are done by way of electrodes. The most critical parameter for an electrode is the skin-electrode impedance. A common method for measuring skin-electrode impedance is the two-lead method, but it has limitations because it relies on assumptions of symmetries of the body impedance in different parts of the body as well as of the skin-electrode impedances. To address this, in this paper we present an easy-to-use and reliable three-lead in vivo method as a more accurate alternative. We aim to show that the in vivo three-lead method overcomes all such limitations. We aim at raising the awareness regarding the possibility to characterize textile electrodes using a correct, accurate and robust method rather than limited and sometimes inadequate and uninformative methods. The three-lead in vivo method eliminates the effect of body impedance as well as all other contact impedances during measurements. The method is direct and measures only the skin-electrode impedance. This method is suitable for characterization of skin-electrode interface of textile electrodes intended for both bioelectrical signals as well as for electrostimulation of the human body. We foresee that the utilization of the three-lead in vivo method has the potential to impact the further development of wearable sensing by enabling more accurate and reliable measurement of bioelectrical signals.

The development of smart wearable solutions for monitoring daily life health status is increasingly popular, with chest straps and wristbands being predominant. This study introduces a novel sensorized T-shirt design with textile electrodes connected via a knitting technique to a Movesense device. We aimed to investigate the impact of stationary and movement actions on electrocardiography (ECG) and heart rate (HR) measurements using our sensorized T-shirt. Various activities of daily living (ADLs), including sitting, standing, walking, and mopping, were evaluated by comparing our T-shirt with a commercial chest strap. Our findings demonstrate measurement equivalence across ADLs, regardless of the sensing approach. By comparing ECG and HR measurements, we gained valuable insights into the influence of physical activity on sensorized T-shirt development for monitoring. Notably, the ECG signals exhibited remarkable similarity between our sensorized T-shirt and the chest strap, with closely aligned HR distributions during both stationary and movement actions. The average mean absolute percentage error was below 3%, affirming the agreement between the two solutions. These findings underscore the robustness and accuracy of our sensorized T-shirt in monitoring ECG and HR during diverse ADLs, emphasizing the significance of considering physical activity in cardiovascular monitoring research and the development of personal health applications.

The development of smart wearable solutions for monitoring daily life health status is increasingly popular, with chest straps and wristbands being predominant. This study introduces a novel sensorized T-shirt design with textile electrodes connected via a knitting technique to a Movesense device. We aimed to investigate the impact of stationary and movement actions on electrocardiography (ECG) and heart rate (HR) measurements using our sensorized T-shirt. Various activities of daily living (ADLs), including sitting, standing, walking, and mopping, were evaluated by comparing our T-shirt with a commercial chest strap. Our findings demonstrate measurement equivalence across ADLs, regardless of the sensing approach. By comparing ECG and HR measurements, we gained valuable insights into the influence of physical activity on sensorized T-shirt development for monitoring. Notably, the ECG signals exhibited remarkable similarity between our sensorized T-shirt and the chest strap, with closely aligned HR distributions during both stationary and movement actions. The average mean absolute percentage error was below 3%, affirming the agreement between the two solutions. These findings underscore the robustness and accuracy of our sensorized T-shirt in monitoring ECG and HR during diverse ADLs, emphasizing the significance of considering physical activity in cardiovascular monitoring research and the development of personal health applications.

Finansiär: Sparbanksstiftelsen Sjuhärad

In impedance cardiography (ICG), the detection of dZ/dt signal (ICG) characteristic points, especially the X point, is a crucial step for the calculation of hemodynamic parameters such as stroke volume (SV) and cardiac output (CO). Unfortunately, for beat-to-beat calculations, the accuracy of the detection is affected by the variability of the ICG complex subtypes. Thus, in this work, automated classification of ICG complexes is proposed to support the detection of ICG characteristic points and the extraction of hemodynamic parameters according to several existing subtypes. A novel pattern recognition artificial neural network (PRANN) approach was implemented, and a divide-and-conquer strategy was used to identify the five different waveforms of the ICG complex waveform with output nodes no greater than 3. The PRANN was trained, tested and validated using a dataset from four volunteers from a measurement of eight electrodes. Once the training was satisfactory, the deployed network was validated on two other datasets that were completely different from the training dataset. As an additional performance validation of the PRANN, each dataset included four volunteers for a total of eight volunteers. The results show an average accuracy of 96% in classifying ICG complex subtypes with only a decrease in the accuracy to 83 and 80% on the validation datasets. This work indicates that the PRANN is a promising method for automated classification of ICG subtypes, facilitating the investigation of the extraction of hemodynamic parameters from beat-to-beat dZ/dt complexes.

Impedance cardiography (ICG) was discovered nearly half a century ago, being proposed as noninvasive monitoring method for estimation of several hemodynamics parameter. Despite of nearly 5 decades of clinical research and use there is still certain controversy about its performance when estimating Left Ventricular Ejection Time (LVET). This work present a comparison between using the different ICG subtype waveform and the ensemble averaged (EA) method to calculate the LVET. The ICG has been recorded from four volunteers, and the LVET parameter has been calculated using the two approaches. The result shows that each volunteer have different percentage of subtypes, and the mean relative error between the two approaches for estimation of LVET varied between 0.62 to 2.9% with an average mean absolute percentage error of 18,02% ranging between 13.82 to 18.42%.