Effectiveness of a handheld remote ECG monitor

This present study deals with designing a real-time remote handheld ECG monitoring system and evaluating its potential usefulness in early detection of heart conduction problems. The raw ECG recordings were sent by the handheld monitor (client) to a remote server, which performed an on-line ECG analysis and sent the results back to the client. Real-time feedback provided to the client included display of ECG, results of ECG analysis and alarms (if required). The objective of this work was to determine its effectiveness in real-time identification of particular pattern preceding ventricular fibrillation. The remote server identified the occurrence of QRS complex and premature ventricular contractions and monitored ECG for ventricular tachycardia and variations in heart rate variability indices. The sensitivity and specificity of the QRS detection to ECG recordings from MIT-Arrhythmia database were 99.34% and 99.31%, respectively. Similarly these parameters of the premature ventricular contraction detection were 87.5% and 91.67%, respectively. The time between alarm and the onset of ventricular fibrillation was measured on ECG recordings where premature ventricular contractions were found to lead to ventricular fibrillation. The remote monitor was able to successfully identify the onset on ventricular fibrillation. Early detection could contribute to better response to an emergency intervention. HRV indices sensitive to the differences between normal and subjects with congestive heart failure were monitored in real-time. They were heart rate, statistical index RMSSD, total spectral power, high frequency power and the ratio of low frequency to high frequency power (LFP:HFP). The effectiveness of HRV indices was tested on an ECG recording of a sleep study subject, who experienced cardiac arrhythmia. Cyclic changes observed in total spectral power prior to onset of cardiac arrhythmia could be attributed to REM sleep cycles. No other conclusive change in HRV indices was observed. The monitor's usefulness in predicting long-term prognosis of post-MI subjects was tested on ECG recordings from two subjects made immediately after conclusion of cardiac arrhythmia and during a follow-up visit. Both showed higher RMSSD, total spectral power and LFP:HFP ratio. Personalizing the monitor for each patient further improves its accuracy in measurement of various parameters.