This master thesis deals with QRS complex detection and ECG delineation. The theoretical part of this work describes wavelet transform, some of QRS detection approaches and some of ECG delineation approaches. For algorithm realization in Matlab is used redundant dyadic discrete wavelet transform. Algorithm is designed for experimental electrocardiograms of isolated rabbit hearts and it is evaluated through manually determined references.

This dissertation deals with QRS complex detection and ECG delineation. The theoretical part of the work describes basics of electrocardiography, QRS detection approaches, ECG delineation approaches, the standard CSE database and the wavelet transform theory. The practical part of the work describes designed methods of QRS complex detection and ECG delineation. The designed methods are based on a continuous wavelet transform, appropriate scales, appropriate mother wavelet, cluster analysis and leads transformation. The introduced algorithms were evaluated on the standard CSE database. The obtained results are better, than directly comparable results of other methods and accomplished given database criteria. The robustness of designed algorithms was successfully tested on CSE database signals modified by compression and filtering. The proposed ECG delineation algorithm was successfully used as a tool for evaluation of diagnostic distortion of ECG signals modified by compression.

Abstract Cardiovascular diseases are the leading cause of death in developed countries. Approximately 50% of these events are due to sudden cardiac death (SCD) and often without preceding diagnosis of cardiac disease. Many risk factors for cardiac events have been identified and prevention strategies have improved markedly. The aim of this thesis was to evaluate the usability of the 12-lead electrocardiogram (ECG) to predict cardiac events. The study population consisted of 10,904 middle-aged general population subjects with ECG recordings between the years 1966–1972 with a long follow-up (30±11 years). The first part of the thesis (I) focused on the prevalence and prognostic significance of fragmented QRS complex (fQRS). The prevalence of fQRS was 19.7%. Fragmented QRS complex did not predict mortality in subjects with no history of cardiac disease. Among subjects with underlying cardiac disease and lateral fQRS, the risk of cardiac death was 2.5-fold (P=0.001) and the risk of SCD was almost 3-fold (P=0.004). Other major electrocardiographic abnormalities were assessed in subjects without known cardiac disease for the risk of cardiac death, SCD and hospitalization due to coronary artery disease (II, III). Abnormal ECG was moderately associated with cardiac death after 10 and 30 years of follow-up (hazard ratio 1.7, P=0.009; hazard ratio 1.3, P>0.001, respectively) (II). The risk of hospitalization was not associated with abnormal ECG findings. Abnormal ECG moderately predicted SCD during 10 and 30 years of follow-up (hazard ratio 1.6, P=0.052; hazard ratio 1.3, P=0.007) (III). The risk of SCD was 3-fold when ≥2 ECG abnormalities were present. In conclusion, lateral fQRS in middle-aged subjects with underlying cardiac disease was associated with increased risk of death. Certain abnormal ECG findings associated with the risk of non-arrhythmic cardiac mortality and arrhythmic death. The risk of arrhythmic mortality was substantially elevated when multiple ECG abnormalities were present in middle-aged population. / Tiivistelmä Sydänsairaudet ovat yleisin kuolinsyy kehittyneissä maissa. Noin 50 % näistä kuolemista aiheutuu äkillisestä sydänpysähdyksestä, suuri osa ilman aiempaa tietoa sairaudesta. Useita sydänsairauksien riskitekijöitä on tunnistettu ja ennaltaehkäisy on kehittynyt merkittävästi. Väitöstutkimuksen tavoitteena on tutkia 12-kytkentäisen sydänsähkökäyrän (EKG) käyttökelpoisuutta sydänsairauksien ilmenemisen ennustamisessa. Tutkimusväestöön kuului 10,904 keski-ikäistä suomalaista henkilöä. Aineisto kerättiin vuosina 1966-1972 ja seuranta-aika oli 30 (±11) vuotta. Ensimmäisessä osajulkaisussa (I) tutkimme QRS-kompleksin fragmentaation vallitsevuutta ja sen vaikutusta ennusteeseen väestössä. Fragmentoituneen QRS-kompleksin esiintyvyys oli 19.7 %. Fragmentoitunut QRS-kompleksi ei lisännyt kuolemanriskiä henkilöillä, joilla ei ollut sydänsairautta. Henkilöillä, joilla oli todettu sydänsairaus, lateraalinen fQRS lisäsi sydänperäistä kuolleisuutta 2.5-kertaiseksi (P=0.001) ja rytmihäiriöperäistä kuolleisuutta 3-kertaiseksi (P=0.004). Tutkimme muiden poikkeavien EKG-löydösten ennustearvoa kuolleisuuteen ja sairaalahoidon tarpeeseen sepelvaltimokohtauksen vuoksi (II, III). Poikkeavien EKG-muutosten esiintymiseen liittyi lisääntyneen sydänperäisen kuoleman riski sekä 10 vuoden (riskitiheyssuhde 1.7, P=0.009) että 30 vuoden seurannassa (riskitiheyssuhde 1.3, P>0.001) (II). Poikkeavat EKG-muutokset eivät ennustaneet sairaalahoitojaksoja. Poikkeava EKG ennusti rytmihäiriöperäisen kuoleman riskiä sekä 10 vuoden (riskitiheyssuhde 1.6, P=0.052) että 30 vuoden seurannassa (riskitiheyssuhde 1.3, P=0.007) (III). Äkkikuoleman riski oli 3-kertainen henkilöillä, joilla todettiin ≥ 2 EKG-poikkeavuutta. Tutkimuksen yhteenvetona voidaan todeta, että fQRS lateraalisissa kytkennöissä lisäsi sydänperäisen kuoleman riskiä henkilöillä, joilla on todettu sydänsairaus. Tiettyihin poikkeaviin EKG-muutoksiin liittyi lisääntynyt ei-rytmihäiriöperäisen ja rytmihäiriöperäisen kuoleman riski. Useiden tutkittujen EKG-muutosten ilmentyminen samanaikaisesti lisäsi merkittävästi rytmihäiriöperäisen kuoleman riskiä keski-ikäisessä väestössä.

In this thesis we suggest a technique for detecting pulses by signal processing of a raw ECG signal registered from 4 electrodes located on the left upper arm. The signal processing is performed in Matlab and consists of normalization, lowpass filtering, highpass filtering, derivation, squaring and a moving average window to reduce interference. The technology is capable of extracting periods between heartbeats after an implemented detection algorithm. The thesis also includes reflections on the types of interferences that may affect an electrical development equipment and also methods of how major parts of the interference can be reduced by different shields. Before the technique is applied in a final product, further tests may need to be performed during the monitoring of a person's pulse. Finally, we believe that our development of pulse detection is the beginning of a new technology that in the future can save lives. / I den här rapporten föreslår vi en teknik för att detektera pulser med hjälp av att signalbehandla en rå EKG-signal registrerad från 4 elektroder placerade på vänster överarm. En signalbehandling utförd i Matlab som bland annat består av normering, lågpassfiltrering, högpassfiltrering, derivering, kvadrering samt ett glidande medelvärdesfönster för att reducera störningar. Tekniken är kapabel till att utvinna tider mellan hjärtslag efter en implementerad detekteringsalgoritm. Rapporten innefattar även reflektioner kring vilka typer av störningar som kan påverka en elektrisk utvecklingsutrustning samt metoder för hur större delar av störningarna kan reduceras med hjälp av olika skärmningar. Innan tekniken appliceras i en slutlig produkt kan ytterligare tester behöva utföras under monitorering av en persons puls. Slutligen anser vi att våran utveckling av pulsdetektion är en början på en ny teknik för att kunna rädda liv.

Electrocardiography (ECG) is the most important noninvasive tool used for diagnosing heart diseases. An ECG interpretation program can help the physician state the diagnosis correctly and take the corrective action. Detection of the QRS complexes from the ECG signal is usually the first step for an interpretation tool. The main goal in this thesis was to develop robust and high performance QRS detection algorithms, and using the results of the QRS detection step, to classify these beats according to their different pathologies. In order to evaluate the performances, these algorithms were tested and compared in Massachusetts Institute of Technology Beth Israel Hospital (MIT-BIH) database, which was developed for research in cardiac electrophysiology. In this thesis, four promising QRS detection methods were taken from literature and implemented: a derivative based method (Method I), a digital filter based method (Method II), Tompkin&rsquo / s method that utilizes the morphological features of the ECG signal (Method III) and a neural network based QRS detection method (Method IV). Overall sensitivity and positive predictivity values above 99% are achieved with each method, which are compatible with the results reported in literature. Method III has the best overall performance among the others with a sensitivity of 99.93% and a positive predictivity of 100.00%. Based on the detected QRS complexes, some features were extracted and classification of some beat types were performed. In order to classify the detected beats, three methods were taken from literature and implemented in this thesis: a Kth nearest neighbor rule based method (Method I), a neural network based method (Method II) and a rule based method (Method III). Overall results of Method I and Method II have sensitivity values above 92.96%. These findings are also compatible with those reported in the related literature. The classification made by the rule based approach, Method III, did not coincide well with the annotations provided in the MIT-BIH database. The best results were achieved by Method II with the overall sensitivity value of 95.24%.

nÃo hà / A tarefa mais importante em processamento de sinais de eletrocardiograma (ECG) à a determinaÃÃo exata do complexo de QRS, em particular, a detecÃÃo dos picos de onda R atravÃs de sistemas e anÃlises computadorizadas. à essencial, especialmente, para uma medida correta da variabilidade do ritmo cardÃaco (HRV). Um grande obstÃculo a ser superado para uma detecÃÃo confiÃvel à a sensibilidade do eletrocardiograma a diversas fontes de distÃrbio, tais como, a interferÃncia à rede elÃtrica, os artefatos do movimento, flutuaÃÃo da linha base e o ruÃdo dos mÃsculos. Este trabalho utiliza as propriedades matemÃticas da transformaÃÃo de Hilbert sobre wavelets para desenvolver um novo algoritmo capaz de diferenciar as ondas R das demais (P, Q, S, T e U) e facilitar a detecÃÃo dos complexos QRS. Uma taxa de detecÃÃo do complexo QRS de 99,92% à alcanÃada para a base de dados de arritmias do MIT-BIH. A tolerÃncia a ruÃdo do mÃtodo proposto foi tambÃm testada usando os registros padrÃo da base de dados MIT-BIH Noise Stress Test. A taxa da detecÃÃo do detector ficou aproximadamente 99,35% mesmo para as relaÃÃes sinal-ruÃdo (SNR) tÃo baixo quanto 6dB. / The most important task in the ECG signal processing is the accurate determina-tion of QRS complex, in particular, accurate detection of the R wave peaks, is essential in computer-based ECG analysis especially for a correct measurement of Heart Rate Variability (HRV). A great hurdle to be overcome in reliable detection is the sensibility of the electrocar-diogram to several disturbance sources such as powering source interference, movement arti-facts, baseline wandering and muscle noise. This study uses the Hilbert Transform pairs of wavelet bases for QRS detection. From the properties of these mathematical tools it was pos-sible to develop an algorithm which is able to differentiate the R waves from the others (P, Q, S, T and U waves).The performance of the algorithm was verified using the records MIT-BIH arrhythmia and normal databases. A QRS detection rate of 99.92% was achieved against MIT-BIH arrhythmia database. The noise tolerance of the proposed method was also tested using standard records from the MIT-BIH Noise Stress Test Database. The detection rate of the detector remains about 99.35% even for signal-to-noise ratios (SNR) as low as 6dB.

Requirement engineering (RE) is an important phase in any project. Both functional and non-functional requirements are required to be elicited. Quality requirements (QRs) are usually catered at the end of software development process. Along with functional requirements, non-functional (QRs) also need to be handled and implemented through a structural way. It is observed that most organizations do not have proper management for quality requirements in their project life cycles. Especially if we consider the case of market driven requirement engineering (MDRE), it is a dire need to handle those QRs along with the functional requirement using a structural way. In this study we investigate Requirements Abstraction Model (RAM), which is basically designed for MDRE and is the case of continuous RE. The purpose was to analyze RAM specifications, which could be able to provide an effective way of manage QRs. RAM also deals with the specification of QRs, so it was required to investigate that how effective RAM can handle the creation of QRs.

Elektrokardiografi, EKG är den mest använda kardiovaskulära undersökningen för studering av hjärtats funktion, patologi i hjärtats retledningssystem och rytm. För att registrera och undersöka hjärtats elektriska aktivitet, används de standardiserade 12-avledningssystemet (12-SL) med distal placering av extremitetsavledningarna på underarmar och underben. På grund av muskelstörningar som kan förekomma under bland annat ett arbetsprov, är 12-SL inte alltid optimalt. Därför har andra modifierade system för elektrodplacering av extremitetselektroderna som Mason- Likar och Lund-avledningssystemet, ersatt med en omplacering proximalt på överarmar och höftkam. Tidigare studier har visat en förändring i EKG-registreringen som kan leda till falska patologier eller missvisande av det befintliga patologierna. Studier har även visat en förändring i EKG-registreringar som kan uppkomma vid olika kroppspositioner. Syftet med denna studie var därför att studera den potentiella skillnaden som uppstår mellan 12-SL och en proximal omplacering enligt Lund-systemet med en kroppspositionsändring. Studien inkluderade 31 deltagare remitterade till ett ordinärt arbetsprov, där en registrering skedde vid distal- och proximal koppling samt med patienten i sittande läge. Utifrån erhållna EKG-registreringar jämfördes R-vågsamplituden, QRS-durationen samt PQ tiden. Studien visade en statistisk signifikant skillnad i alla extremitetsavledningar vid en förflyttning av elektroderna för R-vågamplituden samt för avledning V5 och –aVL vid ändring av kroppsposition. Ingen signifikant förändring kunde observeras för PQ-tiden och QRS-durationen. / Electrocardiography, ECG is the most used cardiovascular method to study cardiac function, pathology of the heart's retinal system and rhythm. To record and investigate the electrical activity of the heart, the standard 12-lead system (12-SL) with distal placement of the limb leads on the forearms and lower legs are commonly used. Due to muscular artifact that can occur in connection with exercise ECGs, 12-SL is not always optimal for use. Therefore, other systems such as Mason-Likar and the Lund-system have replaced with a proximal repositioning of the limb electrodes. Previous studies have shown a change in ECG registration that can lead to false pathology and alarms when modifying the standardized 12-lead system. Previous studies have also shown a possible change in ECG-registrations that can occur with a different body positions. The purpose of this research was to study the potential change that arises between 12-SL and a proximal relocation according to the Lund system with a difference in a body position. The study included 31 participants referred to the regular work test, where a registration was made at distal and proximal connection as well as with the patient in a sitting position. Based on the obtained ECG, the R- wave amplitudes, QRS- durations and PQ- intervals was measured and compared. Results showed a statistically significant difference in all limb leads at and displacements of the electrodes for the R-wave amplitude as well as for the V5 and -aVL with a different body position. No significant change was observers for the PQ- time and QRS- duration.

Elektrokardiografi är en medicinsk teknik som används för att registrera hjärtats elektriska aktivitet. QRS-tiden avspeglar hur snabbt kammarmuskulaturen depolariseras. QRS-tiden mäts från början av Q-vågen till slutet av S-vågen och har ett normalt värde som ligger på <120 millisekunder (ms) hos vuxna. Ett breddökat QRS-komplex (>120 ms) kan uppstå på grund av defekta retledningsbanor som vänstersidigt skänkelblock/högersidigt skänkelblock då kammarnas depolarisation sker långsammare. QRS-tiden kan även förlängas vid användning av vissa antiarytmiska läkemedel som Tambocor. Många studier har visat att Tambocor kan medföra en viss QRS-breddökning vid fysisk ansträngning. QRS-breddökning är en avgörande prognostisk markör för Tambocor-utsättning eller dosjustering då en förlängd QRS-tid kan leda till livshotande arytmier såsom ventrikelflimmer. I studien utfördes QRS-mätningar på friska patienter, patienter med Tambocor-behandling och patienter med vänstersidigt/högersidigt skänkelblock. Syftet med studien var att undersöka om QRS-tiden i vila och maxbelastning vid arbetsprov skiljer sig statistiskt och kliniskt åt när mätning sker med två olika metoder. QRS-mätning med båda metoderna utfördes digitalt via ECView program. Metod 1 baserade på att välja ett QRS-komplex som ser bredast ut och har bra teknisk kvalitet för att kunna mäta på. Metod 2 baserade på att mäta på avledningen som har tidigast Q och på avledningen som har senast S. Resultatet visade en stark positiv korrelation mellan metoderna både i vila och vid maxbelastning. One sample T test visade att metod 2 ger signifikant högre värde än metod 1. Bland-Altman diagram visade en god överenstämmelse mellan metoderna. Resultatet visade även att det kliniska beslutet för medicinutsättning/dosjustering hade påverkats hos två patienter med Tambocor-behandling beroende på vilken metod som används. Slutsatsen är att metoderna skiljer sig signifikant åt och fler studier behövs för att bekräfta om skillnaden är klinisk signifikant

The aim of this thesis is to analyse high-frequency ECG to detect some heart diseases. This is performed with averaging of selected QRS complexes for each lead of the signal; these are thenfilteredin range 500-1 000 Hz. After that the envelope of the signal is done and here the peaks are detected. Based on mutual positions of this peaks, it is possible to detectwhat kind od signal we treat.