Development of Advanced Holter Monitor with
Extended Recording and Episode Detection
                        Domain: Healthcare
                     IMPRINT Project Code: 6849
                                Team
                                Dr. Goutam Saha, IIT Kharagpur
                                Dr. Anirban Mukherjee, IIT Kharagpur
                                Dr. Samit Ari, NIT Rourkela
                                Dr. Nitish Naik, AIIMS New Delhi
                                Dr. Harikrishnan S. Pillai, SCTIMST, Trivandrum
     The document is meant only for expert reviewers of IMPRINT-India.
  It may contain intellectual property matters which is yet to be protected.
                    This is not to be put in public domain.
                                                                                    Private &
                                                                                   Confidential
                           Project Timeline
Date of sanction letter: 29/11/2016
Receipt of MHRD grant (1st year): 02/03/2017
Receipt of ICMR grant (1st year): 05/10/2017
Project staff recruitment: Allam Jaya Prakash on 13-07-2017 (NITR)
(completed: 3 round of Advt.#) Supratim Manna on 04-09-2017 (IITKGP)
                               Sudestna Nahak on 30-01-2018 (IITKGP)
 #Not   getting project staff in spite of repeated advertisements created some difficulty.
                                                           Private &
                  Problem Addressed                       Confidential
                                            Issue with:
                                            • Off-line processing
                                            • Missing of some of the
                                              arrhythmia burden
                                            • Computation of heart
                                              rate variability
                                            • Missing important
                                              episodes
                                            • Expensive
                                            • Proprietary
                                            • Incorporation of
                                              advanced signal
                                              processing & pattern
                                              recognition tech.
                         Holter Monitor     • Real-time analysis &
‘Jeff’ Holter of 1962                         use of result
                         currently in use
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                      Objectives
To develop and evaluate
(i) an Advanced Holter Monitor for extended period and
     episode detection and
(ii) wireless transmission of ECG signal from the wearable
     prototype to a remote device/ monitor.
   The aim is to couple the wearable external device to a
   mobile device which can serve as a computing and display
   unit for episodes of interest or serve as a vehicle to connect
   to a server that can take higher computational load.
                                      Private &
Work done                            Confidential
      •   From human body the ECG signal
          will go to the DSP through sensors.
      •   After processing the ECG data,
          those data will be sent to an
          android application via wireless
          communication (via bluetooth).
      •   For data acquisition we are using
          TMS320F2812 DSP. It is 150 MHz
          processor with an internal 16
          channel 12-bit ADC.
      •   The Serial Peripheral Interface (SPI)
          will be used to store data in an
          external memory (microSD card).
      •   A Serial Communication Interface
          (SCI) will be used for bluetooth
          communication with an android
          device.
                                                                       Private &
                      Work done                                       Confidential
Interfacing android application for wireless transmission of ECG signal
                                          • We are using HC-05
                                             bluetooth module for the
                                             communication between
                                             the android application
                                             and the TMS320F2812
                                             processor.
                                          • In the android application
                                             interface we can see that
                                             HC-05 bluetooth module is
                                             available for
                                             communication and it is
                                             already paired with the
                                             processor.
                                                                             Private &
                                Work done                                   Confidential
Real time plotting of the data obtained from three
                                                     •   By using “Connect” and
              different ADC channel
                                                         “Disconnect” button we can
                                                         communicate with bluetooth.
                                                     •   By using ‘Start Stream” button
                                                         we can control when we want
                                                         to start the plotting.
                                                     •   By using “Auto Scroll X” button
                                                         we can scroll the X-axis.
                                                     •   By using “Lock X axis” button
                                                         we can lock the scrolling of X-
                                                         axis.
                                                     •   By using “F” and “S” button we
                                                         can choose different
                                                         combinations of ADC channels
                                                         for data plotting.
                                                     ❖   By using “All” button we can
                                                         see the plot of all ADC
                                                         channels.
            Raw data from 12 channels
                              Private &
Work done                    Confidential
        Computer-aided analysis is
        required for studying long ECG
        records in short time.
        Steps:
        • Pre-processing of the
          acquired ECG signal
        • Determination of R-peak
          location (Pan-Tompkins
          Algorithm)
        • Extraction of the feature
          set from the ECG signal
        • Detection of arrhythmias
          from ECG signal
                                                                                                 Private &
                                                                                                Confidential
                                        Work done
                                                                          Normal (N)
             Pre-processing and        Feature     ECG arrhythmia
ECG data                                                             Atrial fibrillation (AF)
              R-peak detection        extraction    specific model
                                                                        Paced beat (P)
                                                                                                 Training phase
                                                                                                 Testing phase
                              Pre-processing and       Feature             Matching
            ECG data
                               R-peak detection       extraction           algorithm
                                                                        Classification of
                                                                        ECG arrhythmia
      Pre-processing & R-peak detection: Filtering – Differentiation – Squaring – Moving
      Window Integration – Adaptive Thresholding
      Feature Extraction: Dual Tree Complex Wavelet Transform (DTCWT)
      Classifier: Artificial Neural Network (ANN)
                                                                               Private &
                                                                              Confidential
                          Work done
A sample ECG signal           Filtered output
                                                         Detected R-peaks of the ECG signal
Differentiator output   Moving average filtered output
                                                                              Private &
                                                                             Confidential
                               Work done
  Confusion matrix for the Classification results
Class    Confusion matrix      Class    Confusion matrix
                                                                   Database used
                [DWT]                          [DTCWT]
                                                                Physionet
         N       AF      P              N        AF       P
                                                                100 series: Normal
                                                                200 series: Abnormal
 N      65501    850    957     N      65998     642     668    mixed with normal
                                                                segments
 AF     1122    5933    400     AF     976      5920     224    Length of ECG > 30 min
 P      141      541    4297    P       87       54      4838   No. of ECG : 44
                                                        Private &
                     Work done                         Confidential
  Classification performance of DWT and DTCWT based method
 Method      Class              Performance matrix
                      Acc (%)   Sen (%)   Spe (%)    Ppr (%)
              N       96.15     97.32      89.84     98.11
DWT-MLP
              AF      96.35     79.58      98.08     81.01
              P       96.44     86.30      98.18     76.00
              N       97.02     98.05      91.45     98.41
DTCWT-MLP
              AF      97.50     82.56      99.04     89.84
              P       98.58     97.17      98.67     82.98
                                                           Private &
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           Patent / Publication
• Prototype development is still under progress. At its
  completion, patent documentation will be done.
• Manuscript is under preparation.
                                                          Private &
          Project Milestones                             Confidential
                Activity                      Status
Study of ECG data, basic algorithms,        Completed
use of standard database
Development of data acquisition            In progress
system, Development of wireless
module and its incorporation into the
device; Display of acquired signal
Development of ECG analysis software       In progress
Field data collection from developed            -
prototype and analysis of the same
Incorporation of analysis tool as               -
backend software
Testing for real-time diagnosis                 -
     Amount of work completed (estimated): 30 percent
                                                                       Private &
                  Fund Utilization                                    Confidential
              Source of fund                  Amount (Rs. In Lakhs)
                   MHRD                              37.00
                   ICMR                              26.20            Total: 63.2 L
            Expenditure Heads                 Amount (Rs. In Lakhs)
Equipment                                            23.00
Salary                                                4.70
Consumable + Travel + Contingency                     1.90
Institute overhead + NIT Rourkella transfer          12.30
Blocked for NIT Rourkella transfer                    8.20            Total: 50.1 L
                                                                        Private &
                                                                       Confidential
              Thank You
   The document is meant only for expert reviewers of IMPRINT-India.
It may contain intellectual property matters which is yet to be protected.
                  This is not to be put in public domain.