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Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal
    of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com
                       Vol. 3, Issue 2, March -April 2013, pp.327-332
      Cardiac Arrhythmia Detection By ECG Feature Extraction
  Rameshwari S Mane1, A N Cheeran2, Vaibhav D Awandekar3 and Priya
                               Rani4
                          1,4
                                M. Tech. Student (Electronics), VJTI, Mumbai, Maharashtra
                                    2
                                      Associate Professor, VJTI, Mumbai, Maharashtra
                                  3
                                    A3 RMT Pvt. Ltd. SINE, IIT Mumbai, Maharashtra


ABSTRACT
         Electrocardiogram (ECG) is a non-                    the wavelet decomposition. These coefficients are
invasive technique used as a primary diagnostic               fed to the back-propagation neural network which
tool for detecting cardiovascular diseases. One of            classifies the arrhythmias, [8] presents the
the important cardiovascular diseases is cardiac              classification of cardiac arrhythmia based on the
arrhythmia.        Computer-assisted         cardiac          signal variation characteristic of each beat type.
arrhythmia detection and classification can play              Using the principal component analysis estimation,
a significant role in the management of cardiac               the detection selects the class by searching the
disorders. This paper presents an algorithm                   minimal norm of the error vector obtained by basis
developed using Python 2.6 simulation tool for                of each type, Autoregressive modeling (AR) has
the detection of cardiac arrhythmias e.g.                     been applied to ECG signals and the AR coefficients
premature ventricular contracture (PVC), right                have been used for classification into arrhythmias in
bundle branch block (R or RBBB) and left                      [4], and in [9] the estimation of instantaneous
bundle branch block (L or LBBB) by extracting                 frequency (IF) of an ECG signal is used as a method
various features and vital intervals (i.e. RR, QRS,           for carrying out detection of cardiac disorder. Based
etc) from the ECG waveform. The proposed                      on IF estimates, a classifier has been designed to
method was tested over the MIT-BIH                            differentiate a diseased signal from a normal one.
Arrhythmias Database.                                         This paper presents a method for the recognition of
                                                              various categories of cardiac arrhythmias based on
Keywords - Cardiac Arrhythmia, ECG, left bundle               their characteristics features extracted from ECG
branch block (L or LBBB), premature ventricular               signals. For PVC beat detection RR interval ratio
contracture (PVC), right bundle branch block (R or            and energy of beat is calculated. Dominant (slurred)
RBBB).                                                        or notched (M-shaped) R wave, dominant (slurred) S
                                                              wave, QRS duration and direction of T wave are
1. INTRODUCTION                                               used for the detection of LBBB and RBBB.
           An ECG is a graphic representation of the          The rest of this paper is organized as follows:
electrical activity of the heart muscle. ECG is the           Section 2, presents the ECG signal processing.
main diagnostic approach for cardiac rhythm                   Section 3 describes the detection of arrhythmia.
evaluation. Cardiac arrhythmia is the disturbance in          Finally, the section 4 & 5 summarizes the result &
the regular rhythmic activity of the heart. Different         conclusion of this work.
characteristics such as shapes, interval and
amplitudes of ECG reflect different arrhythmias.              2. ECG SIGNAL PROCESSING
Arrhythmia may be caused by irregular firing                           The proposed method includes processing
patterns from the SA node or due to abnormal                  and parameter calculation of ECG and then detection
activity from other parts of the heart and indicates a        of cardiac arrhythmia using an algorithm developed
serious problem that may lead to stroke or sudden             in Python 2.6 simulation tool. The algorithm is
cardiac death. The vital and weight bearing types of          tested over MIT-BIH Arrhythmia database.
arrhythmia are ventricular tachycardia ventricular
fibrillation, premature ventricular contracture (PVC),        2.1 ECG Denoising
right bundle branch block (R or RBBB) and left                         ECG signals are usually corrupted by
bundle branch block (L or LBBB).                              several noises like 50 Hz power line interferences,
           In the past few years, a lot of research has       baseline wander and electro mayogram (EMG).
been carried out on the automatic classification of           Therefore, the signal needs to be preprocessed
ECG. These attempted to characterize arrhythmia               before applying any detection algorithm. Wavelet
using various features, including waveform shape              denoising and S- Golay Filter is used for removal of
features i.e. using ECG morphology and heartbeat              baseline wander and high frequency noise. ECG
interval [3], in [2] a set of discrete wavelet transform      unfiltered data is passed through baseline wandering
(DWT) coefficient, which contain the maximum                  removal function, followed by wavelet based high
information about the arrhythmia, is selected from            frequency noise removal. The data is then smoothed


                                                                                                    327 | P a g e
Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal
    of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com
                       Vol. 3, Issue 2, March -April 2013, pp.327-332
further using S-Golay filter. All the modules are         over the time interval n1 ≤ n ≤ n2 is defined as
implemented and simulated in python.                            n2
                                                          E   | x[n] |2 .The energy of ECG signal is
2.2. ECG Parameter Calculation                                  n1
          The purpose of the feature extraction           calculated for each beat and RR interval ratio is also
process is to select and retain relevant information      calculated. The threshold for energy is taken as 65%
from original signal. The Feature Extraction stage        of maximum energy and for ratio 70% of maximum
extracts diagnostic information from the ECG signal.      ratio value. If RR interval ratio and energy is less
In order to detect the peaks, specific details of the     than threshold PVC beat is detected. Figure 1 shows
signal are selected. The detection of R peak is the       the detection of PVC bigeminy and couplet. In
first step of feature extraction. R peak is detected by   Figure 2 PVC trigeminy is detected.
using Pan-Tompkins algorithm [1].
          The intervals QRS, PR and QT are
calculated by searching for corresponding onset and
offset points in the wave. The separate logic was
implemented for identifying P-onset, Q and S points,
once R-peak was located using Pan-Tompkins
algorithm. The window is selected around R-wave
and the minimum of the points within this window
are declared as Q and S points. In the differentiated
signal ECGDER, a window of 155 ms is defined
starting 225 ms before R-peak position. In this
window, we search for maximum and minimum
signal value. The P-wave peak is assumed to occur
at the zero-crossings between maximum and
minimum values within the selected window. Once           Figure 1.Detection of PVC Bigeminy and couplet
P-wave peak is found, we proceed to locate
waveform boundary-P-wave onset. Similarly T wave
peak is obtained by changing the window size.

3. DETECTION OF ARRHYTHMIA
3.1 Detection of PVC
          A premature ventricular contraction (PVC),
also known as a premature ventricular complex,
ventricular premature contraction (or complex or
complexes) (VPC), is a relatively common event
where the heartbeat is initiated by the heart
ventricles rather than by the sinoatrial node, the
normal heartbeat initiator.
ECG Characteristics of PVC patient
1. Broad QRS complex (≥ 120 ms) with abnormal             Figure 2.Detection of PVC Trigeminy
morphology.
2. Premature — i.e. occurs earlier than would be          3.2. Detection of LBBB
expected for the next sinus impulse.                               Normally the septum is activated from left
3. Discordant ST segment and T wave changes.              to right, producing small Q waves in the lateral
There are five different types Of PVC, first              leads. In LBBB, the normal direction of septal
Bigeminy every other beat is a PVC, second                depolarisation is reversed (becomes right to left), as
Trigeminy every third beat is a PVC, third                the impulse spreads first to the RV via the right
Quadrigeminy every fourth beat is a PVC, forth            bundle branch and then to the LV via the septum.
Couplet two consecutive PVCs and last Triplet three       This sequence of activation extends the QRS
consecutive PVCs.                                         duration to > 120 ms and eliminates the normal
The main characteristic of PVCs is its premature          septal Q waves in the lateral leads. As the ventricles
occurrence. This characteristic is measured by            are activated sequentially (right, then left) rather
relating the RR interval lengths of heart cycles          than simultaneously, this produces a broad or
adjacent to the PVC. In case of a PVC, these lengths      notched (‗M‘-shaped) R wave in the lateral leads [6]
should be notoriously different .The method for           [11].
classifying the abnormal complexes from the normal        ECG Characteristics LBBB patient:
ones is based on the concepts of RR interval ratio of     1. QRS duration greater than or equal to 120 ms in
detected R peaks and energy analysis of ECG signal        adults
[7]. The total energy in a discrete time signal x[n]

                                                                                                 328 | P a g e
Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal
    of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com
                       Vol. 3, Issue 2, March -April 2013, pp.327-332
2. Broad notched or slurred R wave in leads I, aVL,
V5, and V6 and an occasional RS pattern in V5 and
V6 attributed to displaced transition of QRS
complex.
3. Absent q waves in leads I, V5, and V6, but in the
lead aVL, a narrow q wave may be present in the
absence of myocardial pathology.
4. T wave usually opposite in direction to QRS.
5. Dominant S wave in V1
Two leads lead V6 and lead V1 are mainly
considered for detection of LBBB.

3.2.1. Processing of lead V6
Lead V6 is processed for detection of dominant
(slurred) or notched (M-shaped) R wave, QRS
duration and direction of T wave.
         The dominant R wave is detected by            Figure 4.Dominent Rwave in LBBB
checking each point between Q and S is greater than
minimum value of S point for every beat.                3.2.2. Processing of lead V1
QS6[i] >smin                                            Lead V1 is processed for detection of dominant
         QRS duration is calculated by taking          (slurred) S wave, QRS duration and direction of T
difference between S point and Q point and then         wave.
averaging the difference. It should be greater than             The dominant S wave is detected by
120 ms.                                                 checking each point between Q and S is less than
QRS>120                                                 minimum value of S point for every beat.
         To detect M-shaped R wave array of points     QS1[i] <smin
between Q and R is obtained for every beat. If the              QRS duration is calculated by taking
difference between every point and previous point is    difference between S point and Q point and then
greater than zero it is normal R wave else notched R    averaging the difference. It should be greater than
wave.                                                   120 ms.
QR6[i]-QR6[i-1]<0                                       QRS1>120
         If the average value of T peak is less than           If tiny R wave is present then Rwave i.e
zero then direction of T wave is opposite to QRS        duration between Q and R and Swave i.e. duration
complex of lead V6.                                     between R and S is obtained. For dominant S wave
Avg(T peak6)<0                                          Rwave duration is less than Swave.
M-shaped and dominant Rwave is shown in Figure 3        Swave>Rwave
and 4.                                                          If the average value of T peak is greater
                                                        than zero then direction of T wave is opposite to
                                                        QRS complex of lead V1.
                                                        Avg(T peak1)>0
                                                        Figure 5 and 6 shows dominant Swave and Swave
                                                        with tiny Rwave in LBBB.




Figure 3.M-shaped Rwave in LBBB




                                                        Figure 5.Dominent Swave in LBBB



                                                                                            329 | P a g e
Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal
    of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com
                       Vol. 3, Issue 2, March -April 2013, pp.327-332
                                                          Figure 7 and 8 shows dominant Swave in RBBB.




Figure 6.Dominent Swave with tiny Rwave in LBBB
                                                          Figure 7.Dominent Swave in RBBB
3.3. Detection of RBBB
          In RBBB, activation of the right ventricle is
delayed as depolarisation has to spread across the
septum from the left ventricle. The left ventricle is
activated normally, meaning that the early part of the
QRS complex is unchanged. The delayed right
ventricular activation produces a secondary R wave
(R‘) in the right precordial leads (V1-3) and a wide,
slurred S wave in the lateral leads [6] [11].
ECG Characteristics RBBB
1. QRS duration greater than or equal to 120 ms in
adults
2. RSR‘ pattern in V1-3 (‗M-shaped‘ QRS complex)
3. S wave of greater duration than R wave in the                Figure 8.Dominent Swave in RBBB
lateral leads (I, aVL, V5-6)
Two leads lead V6 and lead V1 are mainly                  3.3.2. Processing of lead V1
considered for detection of LBBB.                         Lead V1 is processed for detection of dominant
                                                          (slurred) or notched (M-shaped) R wave, QRS
3.3.1. Processing of lead V6                              duration and direction of T wave.
Lead V6 is processed for detection of dominant                     The dominant R wave is detected by
(slurred) S wave, QRS duration and direction of T         checking each point between Q and S is greater than
wave.                                                     minimum value of S point for every beat.
         Rwave i.e duration between Q point and          QS1[i] >smin
point of intersection of signal with isoelectric line              QRS duration is calculated by taking
and Swave i.e. duration between point of                  difference between S point and Q point and then
intersection of signal with isoelectric line and S        averaging the difference. It should be greater than
point is obtained. For dominant S wave Rwave              120 ms.
duration is less than Swave.                              QRS1>120
Swave>Rwave                                                        The notched R wave is detected by
         QRS duration is calculated by taking            detecting number of zero crossing between Q and S
difference between S point and Q point and then           point. If it is greater than 3 R wave is notched [5].
averaging the difference. It should be greater than       No. of zero crossing between Q and S >3
120 ms.                                                            If the average value of T peak is less than
QRS>120                                                   zero then it is T wave inversion.
         If the average value of T peak is greater       Avg(T peak1)<0
than zero then there is no T wave inversion.              In Figure 9 dominant Rwave is shown. Figure 10
Avg(T peak6)>0                                            gives notched Rwave in RBBB.




                                                                                                330 | P a g e
Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal
    of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com
                       Vol. 3, Issue 2, March -April 2013, pp.327-332
                                                          positive is that tests positive for a condition and is
                                                          positive (i.e; have the condition). False positive is
                                                          that tests positive but is negative. False negative is
                                                          that tests negative but is positive. Similarly
                                                          specificity and sensitivity are calculated for LBBB
                                                          and RBBB. The final result of detection is provided
                                                          in Table1.
                                                          Arrhythmia Sensitivity               Specificity
                                                          PVC            96.15%                 92.59%
                                                          LBBB           91.66%                 95.65%

                                                          RBBB           96.15%                 96.15%


Figure 9.Dominant Rwave in RBBB                           Table 1.Result of classification

                                                          5. CONCLUSION
                                                                    This paper presents an efficient and simple
                                                          detection algorithm based on feature extraction of
                                                          ECG signal. The efficiency of detection depends on
                                                          the proper extraction of P-Q-R-S and T points for
                                                          ECG signal. The overall specificity above 92% and
                                                          sensitivity above 91% is obtained, which is
                                                          satisfactorily high considering simplicity. Because of
                                                          its simplicity it can be a better choice in clinical field
                                                          of cardiac arrhythmia detection. The efficiency can
                                                          be further improved by using higher order statistics
                                                          and support vector machine.

                                                          REFERENCES
                                                          Journal Papers:
Figure 10.Notched Rwave in RBBB                             [1]   J. Pan, W. J. Tompkins,―A real time QRS
                                                                  detection algorithm,‖ IEEE Transactions on
4. RESULT                                                         Biomed. Eng., Vol. 32, 230– 236,1985.
         The applicability and efficiency of this           [2]   G.K. Prasad et al.,―Classification of ECG
algorithm has been tested using ECG signals from                  arrhythmias using multiresolution analysis
MIT-BIH database which is developed with the aim                  and neural networks‖, IEEE Tencon , Vol.
to be benchmarking references for automated                       1, 227-231,2003.
analysis of ECG [10]. The MIT-BIH arrhythmia                [3]    D.C. Philip et al., "Automatic classification
database contains 48 records (each 30 minutes long)               of heartbeats using ECG morphology and
with a sampling frequency of 360 Hz among which                   heartbeat      interval     features,"    IEEE
32 records exemplifies PVC beats. Data of length                  Transactions on Biomed. Eng., Vol. 51, No.
7.778sec is taken from PVC records and tested. Two                7, 1196-1206,2004.
parameters - sensitivity and specificity are calculated     [4]   D.F. Ge et al.,―Cardiac arrhythmia
to evaluate the detection performance. Sensitivity                classification       using       autoregressive
measures the accuracy in detecting PVC beats                      modeling‖,Biomed. Eng. Online, Vol. 1, No.
whereas specificity depicts performance in rejecting              5, 1-12, 2002.
normal beats as non-PVC beats. These two                    [5]   Hong Yan Luo, ―Automatic analysis of the
parameters are calculated using the following                     high      frequency        electrocardiogram‖,
equations:                                                        International Conference of the IEEE
                                                                  Engineering in Medicine and Biology
                                                                  Society Vol. 9, No. 1, 23-34, 1998.

                                                            Books:
                                                            [6]  A. Bayés de Luna (2009), Basic
                                                                 Electrocardiography Normal  And
                                                                 Abnormal ECG Patterns, Blackwell
                                                                 Publishers.
         Where, TP, FP, FN denote for true positive,
false positive and false negative respectively. True

                                                                                                   331 | P a g e
Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal
   of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com
                      Vol. 3, Issue 2, March -April 2013, pp.327-332
Proceedings Papers:
[7]   Awadhesh Pachauri et al., ―Wavelet and
      Energy Based Approach for PVC
      Detection‖,International Conference on
      Emerging Trends in Electronic and
      Photonic Devices & Systems, 2009, pp.
      258-261.
[8]   Chusak Thanawattano and Surapol Tan-a-
      ram, ―Cardiac Arrhythmia Detection based
      on Signal Variation Characteristic‖
      International Conference on BioMedical
      Engineering and Informatics, 2008, pp.
      367-370
[9]   Asim Dilawer Bakhshi et al.,―Cardiac
      Arrhythmia Detection Using Instantaneous
      Frequency Estimation of ECG Signals‖,
      International Conference on Information
      and Emerging Technologies (ICIET), 2010,
      pp. 1-5.

Websites:
[10]. http://www.physionet.org/mitdb

[11]. www.ahajournals.org/




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  • 1. Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com Vol. 3, Issue 2, March -April 2013, pp.327-332 Cardiac Arrhythmia Detection By ECG Feature Extraction Rameshwari S Mane1, A N Cheeran2, Vaibhav D Awandekar3 and Priya Rani4 1,4 M. Tech. Student (Electronics), VJTI, Mumbai, Maharashtra 2 Associate Professor, VJTI, Mumbai, Maharashtra 3 A3 RMT Pvt. Ltd. SINE, IIT Mumbai, Maharashtra ABSTRACT Electrocardiogram (ECG) is a non- the wavelet decomposition. These coefficients are invasive technique used as a primary diagnostic fed to the back-propagation neural network which tool for detecting cardiovascular diseases. One of classifies the arrhythmias, [8] presents the the important cardiovascular diseases is cardiac classification of cardiac arrhythmia based on the arrhythmia. Computer-assisted cardiac signal variation characteristic of each beat type. arrhythmia detection and classification can play Using the principal component analysis estimation, a significant role in the management of cardiac the detection selects the class by searching the disorders. This paper presents an algorithm minimal norm of the error vector obtained by basis developed using Python 2.6 simulation tool for of each type, Autoregressive modeling (AR) has the detection of cardiac arrhythmias e.g. been applied to ECG signals and the AR coefficients premature ventricular contracture (PVC), right have been used for classification into arrhythmias in bundle branch block (R or RBBB) and left [4], and in [9] the estimation of instantaneous bundle branch block (L or LBBB) by extracting frequency (IF) of an ECG signal is used as a method various features and vital intervals (i.e. RR, QRS, for carrying out detection of cardiac disorder. Based etc) from the ECG waveform. The proposed on IF estimates, a classifier has been designed to method was tested over the MIT-BIH differentiate a diseased signal from a normal one. Arrhythmias Database. This paper presents a method for the recognition of various categories of cardiac arrhythmias based on Keywords - Cardiac Arrhythmia, ECG, left bundle their characteristics features extracted from ECG branch block (L or LBBB), premature ventricular signals. For PVC beat detection RR interval ratio contracture (PVC), right bundle branch block (R or and energy of beat is calculated. Dominant (slurred) RBBB). or notched (M-shaped) R wave, dominant (slurred) S wave, QRS duration and direction of T wave are 1. INTRODUCTION used for the detection of LBBB and RBBB. An ECG is a graphic representation of the The rest of this paper is organized as follows: electrical activity of the heart muscle. ECG is the Section 2, presents the ECG signal processing. main diagnostic approach for cardiac rhythm Section 3 describes the detection of arrhythmia. evaluation. Cardiac arrhythmia is the disturbance in Finally, the section 4 & 5 summarizes the result & the regular rhythmic activity of the heart. Different conclusion of this work. characteristics such as shapes, interval and amplitudes of ECG reflect different arrhythmias. 2. ECG SIGNAL PROCESSING Arrhythmia may be caused by irregular firing The proposed method includes processing patterns from the SA node or due to abnormal and parameter calculation of ECG and then detection activity from other parts of the heart and indicates a of cardiac arrhythmia using an algorithm developed serious problem that may lead to stroke or sudden in Python 2.6 simulation tool. The algorithm is cardiac death. The vital and weight bearing types of tested over MIT-BIH Arrhythmia database. arrhythmia are ventricular tachycardia ventricular fibrillation, premature ventricular contracture (PVC), 2.1 ECG Denoising right bundle branch block (R or RBBB) and left ECG signals are usually corrupted by bundle branch block (L or LBBB). several noises like 50 Hz power line interferences, In the past few years, a lot of research has baseline wander and electro mayogram (EMG). been carried out on the automatic classification of Therefore, the signal needs to be preprocessed ECG. These attempted to characterize arrhythmia before applying any detection algorithm. Wavelet using various features, including waveform shape denoising and S- Golay Filter is used for removal of features i.e. using ECG morphology and heartbeat baseline wander and high frequency noise. ECG interval [3], in [2] a set of discrete wavelet transform unfiltered data is passed through baseline wandering (DWT) coefficient, which contain the maximum removal function, followed by wavelet based high information about the arrhythmia, is selected from frequency noise removal. The data is then smoothed 327 | P a g e
  • 2. Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com Vol. 3, Issue 2, March -April 2013, pp.327-332 further using S-Golay filter. All the modules are over the time interval n1 ≤ n ≤ n2 is defined as implemented and simulated in python. n2 E   | x[n] |2 .The energy of ECG signal is 2.2. ECG Parameter Calculation n1 The purpose of the feature extraction calculated for each beat and RR interval ratio is also process is to select and retain relevant information calculated. The threshold for energy is taken as 65% from original signal. The Feature Extraction stage of maximum energy and for ratio 70% of maximum extracts diagnostic information from the ECG signal. ratio value. If RR interval ratio and energy is less In order to detect the peaks, specific details of the than threshold PVC beat is detected. Figure 1 shows signal are selected. The detection of R peak is the the detection of PVC bigeminy and couplet. In first step of feature extraction. R peak is detected by Figure 2 PVC trigeminy is detected. using Pan-Tompkins algorithm [1]. The intervals QRS, PR and QT are calculated by searching for corresponding onset and offset points in the wave. The separate logic was implemented for identifying P-onset, Q and S points, once R-peak was located using Pan-Tompkins algorithm. The window is selected around R-wave and the minimum of the points within this window are declared as Q and S points. In the differentiated signal ECGDER, a window of 155 ms is defined starting 225 ms before R-peak position. In this window, we search for maximum and minimum signal value. The P-wave peak is assumed to occur at the zero-crossings between maximum and minimum values within the selected window. Once Figure 1.Detection of PVC Bigeminy and couplet P-wave peak is found, we proceed to locate waveform boundary-P-wave onset. Similarly T wave peak is obtained by changing the window size. 3. DETECTION OF ARRHYTHMIA 3.1 Detection of PVC A premature ventricular contraction (PVC), also known as a premature ventricular complex, ventricular premature contraction (or complex or complexes) (VPC), is a relatively common event where the heartbeat is initiated by the heart ventricles rather than by the sinoatrial node, the normal heartbeat initiator. ECG Characteristics of PVC patient 1. Broad QRS complex (≥ 120 ms) with abnormal Figure 2.Detection of PVC Trigeminy morphology. 2. Premature — i.e. occurs earlier than would be 3.2. Detection of LBBB expected for the next sinus impulse. Normally the septum is activated from left 3. Discordant ST segment and T wave changes. to right, producing small Q waves in the lateral There are five different types Of PVC, first leads. In LBBB, the normal direction of septal Bigeminy every other beat is a PVC, second depolarisation is reversed (becomes right to left), as Trigeminy every third beat is a PVC, third the impulse spreads first to the RV via the right Quadrigeminy every fourth beat is a PVC, forth bundle branch and then to the LV via the septum. Couplet two consecutive PVCs and last Triplet three This sequence of activation extends the QRS consecutive PVCs. duration to > 120 ms and eliminates the normal The main characteristic of PVCs is its premature septal Q waves in the lateral leads. As the ventricles occurrence. This characteristic is measured by are activated sequentially (right, then left) rather relating the RR interval lengths of heart cycles than simultaneously, this produces a broad or adjacent to the PVC. In case of a PVC, these lengths notched (‗M‘-shaped) R wave in the lateral leads [6] should be notoriously different .The method for [11]. classifying the abnormal complexes from the normal ECG Characteristics LBBB patient: ones is based on the concepts of RR interval ratio of 1. QRS duration greater than or equal to 120 ms in detected R peaks and energy analysis of ECG signal adults [7]. The total energy in a discrete time signal x[n] 328 | P a g e
  • 3. Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com Vol. 3, Issue 2, March -April 2013, pp.327-332 2. Broad notched or slurred R wave in leads I, aVL, V5, and V6 and an occasional RS pattern in V5 and V6 attributed to displaced transition of QRS complex. 3. Absent q waves in leads I, V5, and V6, but in the lead aVL, a narrow q wave may be present in the absence of myocardial pathology. 4. T wave usually opposite in direction to QRS. 5. Dominant S wave in V1 Two leads lead V6 and lead V1 are mainly considered for detection of LBBB. 3.2.1. Processing of lead V6 Lead V6 is processed for detection of dominant (slurred) or notched (M-shaped) R wave, QRS duration and direction of T wave.  The dominant R wave is detected by Figure 4.Dominent Rwave in LBBB checking each point between Q and S is greater than minimum value of S point for every beat. 3.2.2. Processing of lead V1 QS6[i] >smin Lead V1 is processed for detection of dominant  QRS duration is calculated by taking (slurred) S wave, QRS duration and direction of T difference between S point and Q point and then wave. averaging the difference. It should be greater than  The dominant S wave is detected by 120 ms. checking each point between Q and S is less than QRS>120 minimum value of S point for every beat.  To detect M-shaped R wave array of points QS1[i] <smin between Q and R is obtained for every beat. If the  QRS duration is calculated by taking difference between every point and previous point is difference between S point and Q point and then greater than zero it is normal R wave else notched R averaging the difference. It should be greater than wave. 120 ms. QR6[i]-QR6[i-1]<0 QRS1>120  If the average value of T peak is less than  If tiny R wave is present then Rwave i.e zero then direction of T wave is opposite to QRS duration between Q and R and Swave i.e. duration complex of lead V6. between R and S is obtained. For dominant S wave Avg(T peak6)<0 Rwave duration is less than Swave. M-shaped and dominant Rwave is shown in Figure 3 Swave>Rwave and 4.  If the average value of T peak is greater than zero then direction of T wave is opposite to QRS complex of lead V1. Avg(T peak1)>0 Figure 5 and 6 shows dominant Swave and Swave with tiny Rwave in LBBB. Figure 3.M-shaped Rwave in LBBB Figure 5.Dominent Swave in LBBB 329 | P a g e
  • 4. Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com Vol. 3, Issue 2, March -April 2013, pp.327-332 Figure 7 and 8 shows dominant Swave in RBBB. Figure 6.Dominent Swave with tiny Rwave in LBBB Figure 7.Dominent Swave in RBBB 3.3. Detection of RBBB In RBBB, activation of the right ventricle is delayed as depolarisation has to spread across the septum from the left ventricle. The left ventricle is activated normally, meaning that the early part of the QRS complex is unchanged. The delayed right ventricular activation produces a secondary R wave (R‘) in the right precordial leads (V1-3) and a wide, slurred S wave in the lateral leads [6] [11]. ECG Characteristics RBBB 1. QRS duration greater than or equal to 120 ms in adults 2. RSR‘ pattern in V1-3 (‗M-shaped‘ QRS complex) 3. S wave of greater duration than R wave in the Figure 8.Dominent Swave in RBBB lateral leads (I, aVL, V5-6) Two leads lead V6 and lead V1 are mainly 3.3.2. Processing of lead V1 considered for detection of LBBB. Lead V1 is processed for detection of dominant (slurred) or notched (M-shaped) R wave, QRS 3.3.1. Processing of lead V6 duration and direction of T wave. Lead V6 is processed for detection of dominant  The dominant R wave is detected by (slurred) S wave, QRS duration and direction of T checking each point between Q and S is greater than wave. minimum value of S point for every beat.  Rwave i.e duration between Q point and QS1[i] >smin point of intersection of signal with isoelectric line  QRS duration is calculated by taking and Swave i.e. duration between point of difference between S point and Q point and then intersection of signal with isoelectric line and S averaging the difference. It should be greater than point is obtained. For dominant S wave Rwave 120 ms. duration is less than Swave. QRS1>120 Swave>Rwave  The notched R wave is detected by  QRS duration is calculated by taking detecting number of zero crossing between Q and S difference between S point and Q point and then point. If it is greater than 3 R wave is notched [5]. averaging the difference. It should be greater than No. of zero crossing between Q and S >3 120 ms.  If the average value of T peak is less than QRS>120 zero then it is T wave inversion.  If the average value of T peak is greater Avg(T peak1)<0 than zero then there is no T wave inversion. In Figure 9 dominant Rwave is shown. Figure 10 Avg(T peak6)>0 gives notched Rwave in RBBB. 330 | P a g e
  • 5. Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com Vol. 3, Issue 2, March -April 2013, pp.327-332 positive is that tests positive for a condition and is positive (i.e; have the condition). False positive is that tests positive but is negative. False negative is that tests negative but is positive. Similarly specificity and sensitivity are calculated for LBBB and RBBB. The final result of detection is provided in Table1. Arrhythmia Sensitivity Specificity PVC 96.15% 92.59% LBBB 91.66% 95.65% RBBB 96.15% 96.15% Figure 9.Dominant Rwave in RBBB Table 1.Result of classification 5. CONCLUSION This paper presents an efficient and simple detection algorithm based on feature extraction of ECG signal. The efficiency of detection depends on the proper extraction of P-Q-R-S and T points for ECG signal. The overall specificity above 92% and sensitivity above 91% is obtained, which is satisfactorily high considering simplicity. Because of its simplicity it can be a better choice in clinical field of cardiac arrhythmia detection. The efficiency can be further improved by using higher order statistics and support vector machine. REFERENCES Journal Papers: Figure 10.Notched Rwave in RBBB [1] J. Pan, W. J. Tompkins,―A real time QRS detection algorithm,‖ IEEE Transactions on 4. RESULT Biomed. Eng., Vol. 32, 230– 236,1985. The applicability and efficiency of this [2] G.K. Prasad et al.,―Classification of ECG algorithm has been tested using ECG signals from arrhythmias using multiresolution analysis MIT-BIH database which is developed with the aim and neural networks‖, IEEE Tencon , Vol. to be benchmarking references for automated 1, 227-231,2003. analysis of ECG [10]. The MIT-BIH arrhythmia [3] D.C. Philip et al., "Automatic classification database contains 48 records (each 30 minutes long) of heartbeats using ECG morphology and with a sampling frequency of 360 Hz among which heartbeat interval features," IEEE 32 records exemplifies PVC beats. Data of length Transactions on Biomed. Eng., Vol. 51, No. 7.778sec is taken from PVC records and tested. Two 7, 1196-1206,2004. parameters - sensitivity and specificity are calculated [4] D.F. Ge et al.,―Cardiac arrhythmia to evaluate the detection performance. Sensitivity classification using autoregressive measures the accuracy in detecting PVC beats modeling‖,Biomed. Eng. Online, Vol. 1, No. whereas specificity depicts performance in rejecting 5, 1-12, 2002. normal beats as non-PVC beats. These two [5] Hong Yan Luo, ―Automatic analysis of the parameters are calculated using the following high frequency electrocardiogram‖, equations: International Conference of the IEEE Engineering in Medicine and Biology Society Vol. 9, No. 1, 23-34, 1998. Books: [6] A. Bayés de Luna (2009), Basic Electrocardiography Normal And Abnormal ECG Patterns, Blackwell Publishers. Where, TP, FP, FN denote for true positive, false positive and false negative respectively. True 331 | P a g e
  • 6. Rameshwari S Mane, A N Cheeran, Vaibhav D Awandekar, Priya Rani / International Journal of Engineering Research and Applications (IJERA) ISSN: 2248-9622 www.ijera.com Vol. 3, Issue 2, March -April 2013, pp.327-332 Proceedings Papers: [7] Awadhesh Pachauri et al., ―Wavelet and Energy Based Approach for PVC Detection‖,International Conference on Emerging Trends in Electronic and Photonic Devices & Systems, 2009, pp. 258-261. [8] Chusak Thanawattano and Surapol Tan-a- ram, ―Cardiac Arrhythmia Detection based on Signal Variation Characteristic‖ International Conference on BioMedical Engineering and Informatics, 2008, pp. 367-370 [9] Asim Dilawer Bakhshi et al.,―Cardiac Arrhythmia Detection Using Instantaneous Frequency Estimation of ECG Signals‖, International Conference on Information and Emerging Technologies (ICIET), 2010, pp. 1-5. Websites: [10]. http://www.physionet.org/mitdb [11]. www.ahajournals.org/ 332 | P a g e