Signal Quality Analysis of Single-Arm Electrocardiography

The number of people experiencing mental stress or emotional dysfunction has increased since the onset of the COVID-19 pandemic, as many individuals have had to adapt their daily lives. Numerous studies have demonstrated that mental health disorders can pose a risk for certain diseases, and they are also closely associated with the problem of mental workload. Now, wearable devices and mobile health applications are being utilized to monitor and assess individuals' mental health conditions on a daily basis using heart rate variability (HRV), typically measured by the R-to-R wave interval (RRI) of an electrocardiogram (ECG). However, portable or wearable ECG devices generally require two electrodes to perform bipolar limb leads, such as the Einthoven triangle. This study aims to develop a single-arm ECG measurement method, with lead I ECG serving as the gold standard. We conducted static and dynamic experiments to analyze the morphological performance and signal-to-noise ratio (SNR) of the single-arm ECG. Three morphological features were defined, RRI, the duration of the QRS complex wave, and the amplitude of the R wave. Thirty subjects participated in this study. The results indicated that RRI exhibited the highest cross-correlation (R = 0.9942) between the single-arm ECG and lead I ECG, while the duration of the QRS complex wave showed the weakest cross-correlation (R = 0.2201). The best SNR obtained was 26.1 ± 5.9 dB during the resting experiment, whereas the worst SNR was 12.5 ± 5.1 dB during the raising and lowering of the arm along the z-axis. This single-arm ECG measurement method offers easier operation compared to traditional ECG measurement techniques, making it applicable for HRV measurement and the detection of an irregular RRI.