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16 pages, 1890 KiB

Open AccessArticle

A Sliding Scale Signal Quality Metric of Photoplethysmography Applicable to Measuring Heart Rate across Clinical Contexts with Chest Mounting as a Case Study

by Marnie K. McLean, R. Glenn Weaver, Abbi Lane, Michal T. Smith, Hannah Parker, Ben Stone, Jonas McAninch, David W. Matolak, Sarah Burkart, M. V. S. Chandrashekhar and Bridget Armstrong

Sensors 2023, 23(7), 3429; https://doi.org/10.3390/s23073429 - 24 Mar 2023

Cited by 1 | Viewed by 2451

Abstract

Photoplethysmography (PPG) signal quality as a proxy for accuracy in heart rate (HR) measurement is useful in various public health contexts, ranging from short-term clinical diagnostics to free-living health behavior surveillance studies that inform public health policy. Each context has a different tolerance [...] Read more.

Photoplethysmography (PPG) signal quality as a proxy for accuracy in heart rate (HR) measurement is useful in various public health contexts, ranging from short-term clinical diagnostics to free-living health behavior surveillance studies that inform public health policy. Each context has a different tolerance for acceptable signal quality, and it is reductive to expect a single threshold to meet the needs across all contexts. In this study, we propose two different metrics as sliding scales of PPG signal quality and assess their association with accuracy of HR measures compared to a ground truth electrocardiogram (ECG) measurement. Methods: We used two publicly available PPG datasets (BUT PPG and Troika) to test if our signal quality metrics could identify poor signal quality compared to gold standard visual inspection. To aid interpretation of the sliding scale metrics, we used ROC curves and Kappa values to calculate guideline cut points and evaluate agreement, respectively. We then used the Troika dataset and an original dataset of PPG data collected from the chest to examine the association between continuous metrics of signal quality and HR accuracy. PPG-based HR estimates were compared with reference HR estimates using the mean absolute error (MAE) and the root-mean-square error (RMSE). Point biserial correlations were used to examine the association between binary signal quality and HR error metrics (MAE and RMSE). Results: ROC analysis from the BUT PPG data revealed that the AUC was 0.758 (95% CI 0.624 to 0.892) for signal quality metrics of STD-width and 0.741 (95% CI 0.589 to 0.883) for self-consistency. There was a significant correlation between criterion poor signal quality and signal quality metrics in both Troika and originally collected data. Signal quality was highly correlated with HR accuracy (MAE and RMSE, respectively) between PPG and ground truth ECG. Conclusion: This proof-of-concept work demonstrates an effective approach for assessing signal quality and demonstrates the effect of poor signal quality on HR measurement. Our continuous signal quality metrics allow estimations of uncertainties in other emergent metrics, such as energy expenditure that relies on multiple independent biometrics. This open-source approach increases the availability and applicability of our work in public health settings. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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27 pages, 1396 KiB

Open AccessArticle

Heart Rate Variability Based Estimation of Maximal Oxygen Uptake in Athletes Using Supervised Regression Models

by Vaishali Balakarthikeyan, Rohan Jais, Sricharan Vijayarangan, Preejith Sreelatha Premkumar and Mohanasankar Sivaprakasam

Sensors 2023, 23(6), 3251; https://doi.org/10.3390/s23063251 - 20 Mar 2023

Cited by 1 | Viewed by 3029

Abstract

Wearable Heart Rate monitors are used in sports to provide physiological insights into athletes’ well-being and performance. Their unobtrusive nature and ability to provide reliable heart rate measurements facilitate the estimation of cardiorespiratory fitness of athletes, as quantified by maximum consumption of oxygen [...] Read more.

Wearable Heart Rate monitors are used in sports to provide physiological insights into athletes’ well-being and performance. Their unobtrusive nature and ability to provide reliable heart rate measurements facilitate the estimation of cardiorespiratory fitness of athletes, as quantified by maximum consumption of oxygen uptake. Previous studies have employed data-driven models which use heart rate information to estimate the cardiorespiratory fitness of athletes. This signifies the physiological relevance of heart rate and heart rate variability for the estimation of maximal oxygen uptake. In this work, the heart rate variability features that were extracted from both exercise and recovery segments were fed to three different Machine Learning models to estimate maximal oxygen uptake of 856 athletes performing Graded Exercise Testing. A total of 101 features from exercise and 30 features from recovery segments were given as input to three feature selection methods to avoid overfitting of the models and to obtain relevant features. This resulted in the increase of model’s accuracy by 5.7% for exercise and 4.3% for recovery. Further, post-modelling analysis was performed to remove the deviant points in two cases, initially in both training and testing and then only in training set, using k-Nearest Neighbour. In the former case, the removal of deviant points led to a reduction of 19.3% and 18.0% in overall estimation error for exercise and recovery, respectively. In the latter case, which mimicked the real-world scenario, the average R value of the models was observed to be 0.72 and 0.70 for exercise and recovery, respectively. From the above experimental approach, the utility of heart rate variability to estimate maximal oxygen uptake of large population of athletes was validated. Additionally, the proposed work contributes to the utility of cardiorespiratory fitness assessment of athletes through wearable heart rate monitors. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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11 pages, 5618 KiB

Open AccessArticle

Laser-Induced Graphene for Heartbeat Monitoring with HeartPy Analysis

by Teodora Vićentić, Milena Rašljić Rafajilović, Stefan D. Ilić, Bojana Koteska, Ana Madevska Bogdanova, Igor A. Pašti, Fedor Lehocki and Marko Spasenović

Sensors 2022, 22(17), 6326; https://doi.org/10.3390/s22176326 - 23 Aug 2022

Cited by 13 | Viewed by 3315

Abstract

The HeartPy Python toolkit for analysis of noisy signals from heart rate measurements is an excellent tool to use in conjunction with novel wearable sensors. Nevertheless, most of the work to date has focused on applying the toolkit to data measured with commercially [...] Read more.

The HeartPy Python toolkit for analysis of noisy signals from heart rate measurements is an excellent tool to use in conjunction with novel wearable sensors. Nevertheless, most of the work to date has focused on applying the toolkit to data measured with commercially available sensors. We demonstrate the application of the HeartPy functions to data obtained with a novel graphene-based heartbeat sensor. We produce the sensor by laser-inducing graphene on a flexible polyimide substrate. Both graphene on the polyimide substrate and graphene transferred onto a PDMS substrate show piezoresistive behavior that can be utilized to measure human heartbeat by registering median cubital vein motion during blood pumping. We process electrical resistance data from the graphene sensor using HeartPy and demonstrate extraction of several heartbeat parameters, in agreement with measurements taken with independent reference sensors. We compare the quality of the heartbeat signal from graphene on different substrates, demonstrating that in all cases the device yields results consistent with reference sensors. Our work is a first demonstration of successful application of HeartPy to analysis of data from a sensor in development. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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16 pages, 4092 KiB

Open AccessEditor’s ChoiceArticle

The Movesense Medical Sensor Chest Belt Device as Single Channel ECG for RR Interval Detection and HRV Analysis during Resting State and Incremental Exercise: A Cross-Sectional Validation Study

by Bruce Rogers, Marcelle Schaffarczyk, Martina Clauß, Laurent Mourot and Thomas Gronwald

Sensors 2022, 22(5), 2032; https://doi.org/10.3390/s22052032 - 5 Mar 2022

Cited by 23 | Viewed by 7067

Abstract

The value of heart rate variability (HRV) in the fields of health, disease, and exercise science has been established through numerous investigations. The typical mobile-based HRV device simply records interbeat intervals, without differentiation between noise or arrythmia as can be done with an [...] Read more.

The value of heart rate variability (HRV) in the fields of health, disease, and exercise science has been established through numerous investigations. The typical mobile-based HRV device simply records interbeat intervals, without differentiation between noise or arrythmia as can be done with an electrocardiogram (ECG). The intent of this report is to validate a new single channel ECG device, the Movesense Medical sensor, against a conventional 12 channel ECG. A heterogeneous group of 21 participants performed an incremental cycling ramp to failure with measurements of HRV, before (PRE), during (EX), and after (POST). Results showed excellent correlations between devices for linear indexes with Pearson’s r between 0.98 to 1.0 for meanRR, SDNN, RMSSD, and 0.95 to 0.97 for the non-linear index DFA a1 during PRE, EX, and POST. There was no significant difference in device specific meanRR during PRE and POST. Bland–Altman analysis showed high agreement between devices (PRE and POST: meanRR bias of 0.0 and 0.4 ms, LOA of 1.9 to −1.8 ms and 2.3 to −1.5; EX: meanRR bias of 11.2 to 6.0 ms; LOA of 29.8 to −7.4 ms during low intensity exercise and 8.5 to 3.5 ms during high intensity exercise). The Movesense Medical device can be used in lieu of a reference ECG for the calculation of HRV with the potential to differentiate noise from atrial fibrillation and represents a significant advance in both a HR and HRV recording device in a chest belt form factor for lab-based or remote field-application. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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24 pages, 11078 KiB

Open AccessArticle

Information Retrieval from Photoplethysmographic Sensors: A Comprehensive Comparison of Practical Interpolation and Breath-Extraction Techniques at Different Sampling Rates

by Pierluigi Reali, Riccardo Lolatto, Stefania Coelli, Gabriella Tartaglia and Anna Maria Bianchi

Sensors 2022, 22(4), 1428; https://doi.org/10.3390/s22041428 - 13 Feb 2022

Cited by 7 | Viewed by 3298

Abstract

The increasingly widespread diffusion of wearable devices makes possible the continuous monitoring of vital signs, such as heart rate (HR), heart rate variability (HRV), and breath signal. However, these devices usually do not record the “gold-standard” signals, namely the electrocardiography (ECG) and respiratory [...] Read more.

The increasingly widespread diffusion of wearable devices makes possible the continuous monitoring of vital signs, such as heart rate (HR), heart rate variability (HRV), and breath signal. However, these devices usually do not record the “gold-standard” signals, namely the electrocardiography (ECG) and respiratory activity, but a single photoplethysmographic (PPG) signal, which can be exploited to estimate HR and respiratory activity. In addition, these devices employ low sampling rates to limit power consumption. Hence, proper methods should be adopted to compensate for the resulting increased discretization error, while diverse breath-extraction algorithms may be differently sensitive to PPG sampling rate. Here, we assessed the efficacy of parabola interpolation, cubic-spline, and linear regression methods to improve the accuracy of the inter-beat intervals (IBIs) extracted from PPG sampled at decreasing rates from 64 to 8 Hz. PPG-derived IBIs and HRV indices were compared with those extracted from a standard ECG. In addition, breath signals extracted from PPG using three different techniques were compared with the gold-standard signal from a thoracic belt. Signals were recorded from eight healthy volunteers during an experimental protocol comprising sitting and standing postures and a controlled respiration task. Parabola and cubic-spline interpolation significantly increased IBIs accuracy at 32, 16, and 8 Hz sampling rates. Concerning breath signal extraction, the method holding higher accuracy was based on PPG bandpass filtering. Our results support the efficacy of parabola and spline interpolations to improve the accuracy of the IBIs obtained from low-sampling rate PPG signals, and also indicate a robust method for breath signal extraction. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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12 pages, 10595 KiB

Open AccessArticle

Invisible ECG for High Throughput Screening in eSports

by Aline Santos Silva, Miguel Velhote Correia and Hugo Plácido Silva

Sensors 2021, 21(22), 7601; https://doi.org/10.3390/s21227601 - 16 Nov 2021

Cited by 8 | Viewed by 3457

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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15 pages, 1119 KiB

Open AccessArticle

Multi-Headed Conv-LSTM Network for Heart Rate Estimation during Daily Living Activities

by Michał Wilkosz and Agnieszka Szczęsna

Sensors 2021, 21(15), 5212; https://doi.org/10.3390/s21155212 - 31 Jul 2021

Cited by 13 | Viewed by 3440

Abstract

Non-invasive photoplethysmography (PPG) technology was developed to track heart rate during physical activity under free-living conditions. Automated analysis of PPG has made it useful in both clinical and non-clinical applications. Because of their generalization capabilities, deep learning methods can be a major direction [...] Read more.

Non-invasive photoplethysmography (PPG) technology was developed to track heart rate during physical activity under free-living conditions. Automated analysis of PPG has made it useful in both clinical and non-clinical applications. Because of their generalization capabilities, deep learning methods can be a major direction in the search for a heart rate estimation solution based on signals from wearable devices. A novel multi-headed convolutional neural network model enriched with long short-term memory cells (MH Conv-LSTM DeepPPG) was proposed for the estimation of heart rate based on signals measured by a wrist-worn wearable device, such as PPG and acceleration signals. For the PPG-DaLiA dataset, the proposed solution improves the performance of previously proposed methods. An experimental approach was used to develop the final network architecture. The average mean absolute error (MAE) of the final solution was 6.28 bpm and Pearson’s correlation coefficient between the estimated and true heart rate values was 0.85. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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13 pages, 3883 KiB

Open AccessArticle

Bed-Based Ballistocardiography: Dataset and Ability to Track Cardiovascular Parameters

by Charles Carlson, Vanessa-Rose Turpin, Ahmad Suliman, Carl Ade, Steve Warren and David E. Thompson

Sensors 2021, 21(1), 156; https://doi.org/10.3390/s21010156 - 29 Dec 2020

Cited by 29 | Viewed by 8812

Abstract

Background: The goal of this work was to create a sharable dataset of heart-driven signals, including ballistocardiograms (BCGs) and time-aligned electrocardiograms (ECGs), photoplethysmograms (PPGs), and blood pressure waveforms. Methods: A custom, bed-based ballistocardiographic system is described in detail. Affiliated cardiopulmonary signals are acquired [...] Read more.

Background: The goal of this work was to create a sharable dataset of heart-driven signals, including ballistocardiograms (BCGs) and time-aligned electrocardiograms (ECGs), photoplethysmograms (PPGs), and blood pressure waveforms. Methods: A custom, bed-based ballistocardiographic system is described in detail. Affiliated cardiopulmonary signals are acquired using a GE Datex CardioCap 5 patient monitor (which collects ECG and PPG data) and a Finapres Medical Systems Finometer PRO (which provides continuous reconstructed brachial artery pressure waveforms and derived cardiovascular parameters). Results: Data were collected from 40 participants, 4 of whom had been or were currently diagnosed with a heart condition at the time they enrolled in the study. An investigation revealed that features extracted from a BCG could be used to track changes in systolic blood pressure (Pearson correlation coefficient of 0.54 +/− 0.15), dP/dt_max (Pearson correlation coefficient of 0.51 +/− 0.18), and stroke volume (Pearson correlation coefficient of 0.54 +/− 0.17). Conclusion: A collection of synchronized, heart-driven signals, including BCGs, ECGs, PPGs, and blood pressure waveforms, was acquired and made publicly available. An initial study indicated that bed-based ballistocardiography can be used to track beat-to-beat changes in systolic blood pressure and stroke volume. Significance: To the best of the authors’ knowledge, no other database that includes time-aligned ECG, PPG, BCG, and continuous blood pressure data is available to the public. This dataset could be used by other researchers for algorithm testing and development in this fast-growing field of health assessment, without requiring these individuals to invest considerable time and resources into hardware development and data collection. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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14 pages, 2892 KiB

Open AccessArticle

Platform for Analysis and Labeling of Medical Time Series

by Andrejs Fedjajevs, Willemijn Groenendaal, Carlos Agell and Evelien Hermeling

Sensors 2020, 20(24), 7302; https://doi.org/10.3390/s20247302 - 19 Dec 2020

Cited by 7 | Viewed by 5283

Abstract

Reliable and diverse labeled reference data are essential for the development of high-quality processing algorithms for medical signals, such as electrocardiogram (ECG) and photoplethysmogram (PPG). Here, we present the Platform for Analysis and Labeling of Medical time Series (PALMS) designed in Python. Its [...] Read more.

Reliable and diverse labeled reference data are essential for the development of high-quality processing algorithms for medical signals, such as electrocardiogram (ECG) and photoplethysmogram (PPG). Here, we present the Platform for Analysis and Labeling of Medical time Series (PALMS) designed in Python. Its graphical user interface (GUI) facilitates three main types of manual annotations—(1) fiducials, e.g., R-peaks of ECG; (2) events with an adjustable duration, e.g., arrhythmic episodes; and (3) signal quality, e.g., data parts corrupted by motion artifacts. All annotations can be attributed to the same signal simultaneously in an ergonomic and user-friendly manner. Configuration for different data and annotation types is straightforward and flexible in order to use a wide range of data sources and to address many different use cases. Above all, configuration of PALMS allows plugging-in existing algorithms to display outcomes of automated processing, such as automatic R-peak detection, and to manually correct them where needed. This enables fast annotation and can be used to further improve algorithms. The GUI is currently complemented by ECG and PPG algorithms that detect characteristic points with high accuracy. The ECG algorithm reached 99% on the MIT/BIH arrhythmia database. The PPG algorithm was validated on two public databases with an F1-score above 98%. The GUI and optional algorithms result in an advanced software tool that allows the creation of diverse reference sets for existing datasets. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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Review

Jump to: Research, Other

29 pages, 964 KiB

Open AccessReview

An Overview of the Sensors for Heart Rate Monitoring Used in Extramural Applications

by Alessandra Galli, Roel J. H. Montree, Shuhao Que, Elisabetta Peri and Rik Vullings

Sensors 2022, 22(11), 4035; https://doi.org/10.3390/s22114035 - 26 May 2022

Cited by 25 | Viewed by 11035

Abstract

This work presents an overview of the main strategies that have been proposed for non-invasive monitoring of heart rate (HR) in extramural and home settings. We discuss three categories of sensing according to what physiological effect is used to measure the pulsatile activity [...] Read more.

This work presents an overview of the main strategies that have been proposed for non-invasive monitoring of heart rate (HR) in extramural and home settings. We discuss three categories of sensing according to what physiological effect is used to measure the pulsatile activity of the heart, and we focus on an illustrative sensing modality for each of them. Therefore, electrocardiography, photoplethysmography, and mechanocardiography are presented as illustrative modalities to sense electrical activity, mechanical activity, and the peripheral effect of heart activity. In this paper, we describe the physical principles underlying the three categories and the characteristics of the different types of sensors that belong to each class, and we touch upon the most used software strategies that are currently adopted to effectively and reliably extract HR. In addition, we investigate the strengths and weaknesses of each category linked to the different applications in order to provide the reader with guidelines for selecting the most suitable solution according to the requirements and constraints of the application. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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31 pages, 2169 KiB

Open AccessEditor’s ChoiceReview

A Comprehensive Review of Techniques for Processing and Analyzing Fetal Heart Rate Signals

by Alfonso Maria Ponsiglione, Carlo Cosentino, Giuseppe Cesarelli, Francesco Amato and Maria Romano

Sensors 2021, 21(18), 6136; https://doi.org/10.3390/s21186136 - 13 Sep 2021

Cited by 75 | Viewed by 6503

Abstract

The availability of standardized guidelines regarding the use of electronic fetal monitoring (EFM) in clinical practice has not effectively helped to solve the main drawbacks of fetal heart rate (FHR) surveillance methodology, which still presents inter- and intra-observer variability as well as uncertainty [...] Read more.

The availability of standardized guidelines regarding the use of electronic fetal monitoring (EFM) in clinical practice has not effectively helped to solve the main drawbacks of fetal heart rate (FHR) surveillance methodology, which still presents inter- and intra-observer variability as well as uncertainty in the classification of unreassuring or risky FHR recordings. Given the clinical relevance of the interpretation of FHR traces as well as the role of FHR as a marker of fetal wellbeing autonomous nervous system development, many different approaches for computerized processing and analysis of FHR patterns have been proposed in the literature. The objective of this review is to describe the techniques, methodologies, and algorithms proposed in this field so far, reporting their main achievements and discussing the value they brought to the scientific and clinical community. The review explores the following two main approaches to the processing and analysis of FHR signals: traditional (or linear) methodologies, namely, time and frequency domain analysis, and less conventional (or nonlinear) techniques. In this scenario, the emerging role and the opportunities offered by Artificial Intelligence tools, representing the future direction of EFM, are also discussed with a specific focus on the use of Artificial Neural Networks, whose application to the analysis of accelerations in FHR signals is also examined in a case study conducted by the authors. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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Other

Jump to: Research, Review

12 pages, 3627 KiB

Open AccessLetter

A Wireless High-Sensitivity Fetal Heart Sound Monitoring System

by Jianjun Wei, Zhenyuan Wang and Xinpeng Xing

Sensors 2021, 21(1), 193; https://doi.org/10.3390/s21010193 - 30 Dec 2020

Cited by 19 | Viewed by 7380

Abstract

In certain cases, the condition of the fetus can be revealed by the fetal heart sound. However, when the sound is detected, it is mixed with noise from the external environment as well as internal disturbances. Our exclusive sensor, which was constructed of [...] Read more.

In certain cases, the condition of the fetus can be revealed by the fetal heart sound. However, when the sound is detected, it is mixed with noise from the external environment as well as internal disturbances. Our exclusive sensor, which was constructed of copper with an enclosed cavity, was designed to prevent external noise. In the sensor, a polyvinylidene fluoride (PVDF) piezoelectric film, with a frequency range covering that of the fetal heart sound, was adopted to convert the sound into an electrical signal. The adaptive support vector regression (SVR) algorithm was proposed to reduce internal disturbance. The weighted-index average algorithm with deviation correction was proposed to calculate the fetal heart rate. The fetal heart sound data were weighted automatically in the window and the weight was modified with an exponent between windows. The experiments show that the adaptive SVR algorithm was superior to empirical mode decomposition (EMD), the self-adaptive least square method (LSM), and wavelet transform. The weighted-index average algorithm weakens fetal heart rate jumps and the results are consistent with reality. Full article

(This article belongs to the Special Issue Sensors for Heart Rate Monitoring)

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