We have developed a real-time algorithm for detection of the QRS complexes of ECG signals. It reliably recognizes QRS complexes based upon digital analyses of slope, amplitude, and width. A special digital bandpass filter reduces false detections caused by the various types of interference present in ECG signals. This filtering permits use of low thresholds, thereby increasing detection sensitivity. The algorithm automatically adjusts thresholds and parameters periodically to adapt to such ECG changes as QRS morphology and heart rate. For the standard 24 h MIT/BIH arrhythmia database, this algorithm correctly detects 99.3 percent of the QRS complexes.

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A Real-Time QRS Detection Algorithm

An overview of the self-organizing map algorithm, on which the papers in this issue are based, is presented in this article.

The Self-Organizing Map

Kubios HRV - Heart rate variability analysis software

The COVID-19 pandemic caused by infection with SARS-CoV-2 has led to more than 200,000 deaths worldwide. Several studies have now established that the hyperinflammatory response induced by SARS-CoV-2 is a major cause of disease severity and death in infected patients. Macrophages are a population of innate immune cells that sense and respond to microbial threats by producing inflammatory molecules that eliminate pathogens and promote tissue repair. However, a dysregulated macrophage response can be damaging to the host, as is seen in the macrophage activation syndrome induced by severe infections, including in infections with the related virus SARS-CoV. Here we describe the potentially pathological roles of macrophages during SARS-CoV-2 infection and discuss ongoing and prospective therapeutic strategies to modulate macrophage activation in patients with COVID-19.

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Pathological inflammation in patients with COVID-19: a key role for monocytes and macrophages.

t. This paper surveys some of the work our group has done in electrical impedance tomography.

Electrical Impedance Tomography

We have investigated the quantitative effects of a number of common elements of QRS detection rules using the MIT/BIH arrhythmia database. A previously developed linear and nonlinear filtering scheme was used to provide input to the QRS detector decision section. We used the filtering to preprocess the database. This yielded a set of event vectors produced from QRS complexes and noise. After this preprocessing, we tested different decision rules on the event vectors. This step was carried out at processing speeds up to 100 times faster than real time. The role of the decision rule section is to discriminate the QRS events from the noise events. We started by optimizing a simple decision rule. Then we developed a progressively more complex decision process for QRS detection by adding new detection rules. We implemented and tested a final real-time QRS detection algorithm, using the optimized decision rule process. The resulting QRS detection algorithm has a sensitivity of 99.69 percent and positive predictivity of 99.77 percent when evaluated with the MIT/BIH arrhythmia database.

Quantitative Investigation of QRS Detection Rules Using the MIT/BIH Arrhythmia Database

Sensory substitution systems provide their users with environmental information through a human sensory channel (eye, ear, or skin) different from that normally used or with the information processed in some useful way. The authors review the methods used to present visual, auditory, and modified tactile information to the skin and discuss present and potential future applications of sensory substitution, including tactile vision substitution (TVS), tactile auditory substitution, and remote tactile sensing or feedback (teletouch). The relevant sensory physiology of the skin, including the mechanisms of normal touch and the mechanisms and sensations associated with electrical stimulation of the skin using surface electrodes (electrotactile, or electrocutaneous, stimulation), is reviewed. The information-processing ability of the tactile sense and its relevance to sensory substitution is briefly summarized. The limitations of current tactile display technologies are discussed, and areas requiring further research for sensory substitution systems to become more practical are suggested. >

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Electrotactile and vibrotactile displays for sensory substitution systems

The authors have designed a multirate digital signal processing algorithm to detect heartbeats in the electrocardiogram (ECG). The algorithm incorporates a filter bank (FB) which decomposes the ECG into subbands with uniform frequency bandwidths. The FB-based algorithm enables independent time and frequency analysis to be performed on a signal. Features computed from a set of the subbands and a heuristic detection strategy are used to fuse decisions from multiple one-channel beat detection algorithms. The overall beat detection algorithm has a sensitivity of 99.59% and a positive predictivity of 99.56% against the MIT/BIH database. Furthermore this is a real-time algorithm since its beat detection latency is minimal. The FB-based beat detection algorithm also inherently lends itself to a computationally efficient structure since the detection logic operates at the subband rate. The FB-based structure is potentially useful for performing multiple ECG processing tasks using one set of preprocessing filters.

ECG beat detection using filter banks

Presents a "mixture-of-experts" (MOE) approach to develop customized electrocardiogram (EGG) beat classifier in an effort to further improve the performance of ECG processing and to offer individualized health care. A small customized classifier is developed based on brief, patient-specific ECG data. It is then combined with a global classifier, which is tuned to a large ECG database of many patients, to form a MOE classifier structure. Tested with MIT/BIH arrhythmia database, the authors observe significant performance enhancement using this approach.

/pdf/a-patient-adaptable-ecg-beat-classifier-using-a-mixture-of-4hcnrmk2in.pdf

Willis J. Tompkins

Papers

A Real-Time QRS Detection Algorithm

Quantitative Investigation of QRS Detection Rules Using the MIT/BIH Arrhythmia Database

Electrotactile and vibrotactile displays for sensory substitution systems

ECG beat detection using filter banks

A patient-adaptable ECG beat classifier using a mixture of experts approach