This dissertation is directed towards improving the state of art cardiac monitoring methods and automatic diagnosis of cardiac anomalies through modern engineering approaches such as adaptive signal processing, and machine learning methods. The dissertation will describe the invention and associated methods of a cardiac rhythm monitor dubbed the Integrated Vectorcardiogram (iVCG). In addition, novel machine learning approaches are discussed to improve diagnoses and prediction accuracy of cardiac diseases. It is estimated that around 17 million people in the world die from cardiac related events each year. It has also been shown that many of such deaths can be averted with long-term continuous monitoring and actuation. Hence, there is a growing need for better cardiac monitoring solutions. Leveraging the improvements in computational power, communication bandwidth, energy efficiency and electronic chip size in recent years, the Integrated Vectorcardiogram (iVCG) was invented as an answer to this problem. The iVCG is a miniaturized, integrated version of the Vectorcardiogram that was invented in the 1930s. The Vectorcardiogram provides full diagnostic quality cardiac information equivalent to that of the gold standard, 12-lead ECG, which is restricted to in-office use due to its bulky, obtrusive form. With the iVCG, it is possible to provide continuous, long-term, full diagnostic quality information, while being portable and unobtrusive to the patient. Moreover, it is possible to leverage this ‘Big Data’ and create machine learning algorithms to deliver better patient outcomes in the form of patient specific machine diagnosis and timely alerts. First, we present a proof-of-concept investigation for a miniaturized vectorcardiogram, the iVCG system for ambulatory on-body applications that continuously monitors the electrical activity of the heart in three dimensions. We investigate the minimum distance between a pair of leads in the X, Y and Z axes such that the signals are distinguishable from the noise. The target dimensions for our prototype iVCG are 3x3x2 cm and based on our experimental results we show that it is possible to achieve these dimensions. Following this, we present a solution to the problem of transforming the three VCG component signals to the familiar 12-lead ECG for the convenience of cardiologists. The least squares (LS) method is employed on the VCG signals and the reference (training) 12-lead ECG to obtain a 12x3 transformation matrix to generate the real-time ECG signals from the VCG signals. The iVCG is portable and worn on the chest of the patient and although a physician or trained technician will initially install it in the appropriate position, it is prone to subsequent rotation and displacement errors introduced by the patient placement of the device. We characterize these errors and present a software solution to correct the effect of the errors on the iVCG signals. We also describe the design of machine learning methods to improve automatic diagnosis and prediction of various heart conditions. Methods very similar to the ones described in this dissertation can be used on the long term, full diagnostic quality ‘Big Data’ such that the iVCG will be able to provide further insights into the health of patients. The iVCG system is potentially breakthrough and disruptive technology allowing long term and continuous remote monitoring of patient’s electrical heart activity. The implications are profound and include 1) providing a less expensive device compared to the 12-lead ECG system (the “gold standard”); 2) providing continuous, remote tele-monitoring of patients; 3) the replacement of current Holter shortterm monitoring system; 4) Improved and economic ICU cardiac monitoring; 5) The ability for patients to be sent home earlier from a hospital since physicians will have continuous remote monitoring of the patients.

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Support of many different services, approximately 1000x increase of current data rates, ultra-reliability, low latency and energy/cost efficiency are among the demands from upcoming 5G standard. In order to meet them, researchers investigate various potential technologies involving different network layers and discuss their trade-offs for possible 5G scenarios. Waveform design is a critical part of these efforts and various alternatives have been heavily discussed over the last few years. Besides that, wireless technology is expected to be deployed in many critical applications including the ones involving with daily life activities, health-care and vehicular traffic. Therefore, security of wireless systems is also crucial for a reliable and confidential deployment. In order to achieve these goals in future wireless systems, physical layer (PHY) algorithms play a vital role not only in waveform design but also for improving security. In this dissertation, we draft the ongoing activities in PHY in terms of waveform design and security for providing spectrally efficient and reliable services considering various scenarios, and present our algorithms in this direction. Regarding the waveform design, orthogonal frequency division multiplexing (OFDM) is mostly considered as the base scheme since it is the dominant technology in many existing standards and is also considered for 5G new radio. We specifically propose two approaches for the improvement of OFDM in terms of out-of-band emission and peak to average power ratio. We also present how the requirements of different 5G RAN scenarios reflect on waveform parameters and explore the motivations behind designing advanced frames that include multiple waveforms with different parameters, referred to as numerologies by the 3GPP community, as well as the problems that arise with such coexistence. On the security aspect, we firstly consider broadband communication scenarios and propose practical security approaches that suppress the cyclic features of OFDM and single carrier-frequency domain equalization based waveforms and remove their vulnerability to the eavesdropping attacks. Additionally, an authentication mechanism in PHY is presented for wireless implantable medical devices. Thus, we address the security issues for two critical wireless communication scenarios in PHY to contribute a confidential and reliable deployment of wireless technologies in the near future.

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The presented work considers a CDMA-based Wireless Body Area Network (WBAN) where multiple biosensors communicate simultaneously to a central node in an asynchronous fashion. The asynchronous nature of the WBAN introduces Multiple Access Interference (MAI). To combat this problem, presented is a methodology that uses a set of cyclically orthogonal spreading codes extracted from the Walsh-Hadamard matrix. When using the Cyclic Orthogonal Walsh-Hadamard Codes (COWHC) as spreading codes in the CDMA-based WBAN, the cyclic orthogonality property helps mitigate MAI amongst the on-body sensors. Presented is an ideal communication system that is most effective at mitigating MAI in proactive WBANs. The work illustrates the system optimality and effectiveness at mitigating MAI by studying the sensitivity to packet-loss through simulating the link Bit Error Rate (BER) performance. It is shown that the proposed design with COWHC, a Rayleigh flat-fading channel, BPSK modulation and a conventional receiver produce optimum MAI mitigation.

The presented work considers a CDMA-based Wireless Body Area Network (WBAN) where multiple biosensors communicate simultaneously to a central node in an asynchronous fashion. The asynchronous nature of the WBAN introduces Multiple Access Interference (MAI). To combat this problem, presented is a methodology that uses a set of cyclically orthogonal spreading codes extracted from the Walsh-Hadamard matrix. When using the Cyclic Orthogonal Walsh-Hadamard Codes (COWHC) as spreading codes in the CDMA-based WBAN, the cyclic orthogonality property helps mitigate MAI amongst the on-body sensors. Presented is an ideal communication system that is most effective at mitigating MAI in proactive WBANs. The work illustrates the system optimality and effectiveness at mitigating MAI by studying the sensitivity to packet-loss through simulating the link Bit Error Rate (BER) performance. It is shown that the proposed design with COWHC, a Rayleigh flat-fading channel, BPSK modulation and a conventional receiver produce optimum MAI mitigation.

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[ES] La población mundial en países desarrollados está envejeciendo y con ello existe un aumento de enfermedades en gran medida causadas por la edad. Las nuevas tecnologías médicas pueden ayudar a detectar, diagnosticar y tratar estas enfermedades y con ello ahorrar dinero, tiempo y recursos de los sistemas sanitarios. Las tecnologías inalámbricas implantables han abierto un nuevo panorama para la próxima generación de tecnologías médicas. Frecuencias como la Ultra Wide-Band (UWB) de 3.1 a 10.6 GHz están siendo consideradas para la nueva generación de dispositivos inalámbricos para dentro del cuerpo humano. Las características como el reducido tamaño de las antenas, la baja potencia de transmisión y la alta velocidad de datos son las más buscadas en este tipo de dispositivos. El problema surge porque el cuerpo humano depende de la frecuencia de modo que a mayores frecuencias, mayores son las pérdidas por propagación. Conociendo el canal de transmisión se puede solventar el problema de las altas pérdidas. Esta tesis tiene como objetivo caracterizar el canal de radio frecuencia (RF) para la nueva generación de dispositivos médicos implantables. Para caracterizar el canal se han empleado tres diferentes metodologías: simulaciones numéricas, medidas en phantom y experimentos en animales vivos. Las medidas en phantom fueron realizadas en un nuevo sistema de medidas expresamente disen¿ados para medidas de dentro a fuera del cuerpo humano en la banda de frecuencias UWB. Además, se utilizó un novedoso recipiente con dos capas de phantom imitando la zona gastrointestinal del cuerpo. Estos phantoms fueron creados para este tipo de medidas y son extremadamente precisos a las frecuencias UWB. Para los experimentos en animales se utilizaron cerdos y se intentó reproducir en ellos las medidas previamente realizadas en phantom. Las simulaciones software se realizaron con la intención de replicar ambas metodologías. Una vez realizados los experimentos se realizó un extensivo estudio del canal en dominio frecuencial y temporal. Mas en detalle, se compararon las antenas usadas en la recepción y transmisión, el efecto de la grasa en el canal, la formas del recipiente contenedor de phantom y las componentesmulticamino. Como resultado se ha propuesto un modelo de propagación del canal para la banda baja de las frecuencias UWB (3.1 -5.1 GHz) para la zona gastrointestinal del cuerpo humano. Este modelo de propagación ha sido validado utilizando las tres metodologías previamente descritas y comparada con otros estudios existentes en literatura. Finalmente, se midió el canal de propagación para una determinada aplicación a bajas frecuencias con señales UWB. También se realizaron medidas del canal de propagación en la zona cardíaca del cuerpo humano desde un punto de vista de seguridad de datos. Los resultados obtenidos en esta tesis confirman los beneficios que tendría la utilización de frecuencias UWB para las futuras generaciones de dispositivos médicos implantables. / [CA] La població mundial a països desenvolupats està envellint-se i enfrontant-se a un augment d'infermetats principalment causades per la edat. Les noves tecnologies mèdiques poden ajudar a detectar, diagnosticar i tractar aquestes malalties, estalviant diners, temps i recursos sanitaris. Els dispositius implantables sense fils han generat un nou panorama per a les noves generacions de dispositius mèdics. Les freqüències com la banda de UWB estan sent considerades per a les futures tecnologies implantables. La reduïda grandària de les antenes, la baixa potència de transmissió i les altes velocitats de dades son característiques buscades per als dispositius implantables. Per contra, els éssers humans depenen de la freqüència en el sentit que a majors freqüències, majors les pèrdues per propagació quan el senyal travessa el cos humà d'interior a exterior. Per solventar aquestes pèrdues el canal de propagació s'ha d'entendre i conèixer de la millor manera possible. Aquesta tesi doctoral te com a objectiu caracteritzar el canal de radio freqüència (RF) per a la nova generació de dispositius mèdics implantables. S'han emprat tres metodologies diferents per a realitzar aquesta caracterització: simulacions software, mesures amb fantomes i experiments amb animals vius. Els experiments amb fantomes es van realitzar a un sistema de mesures dissenyat expressament per a les transmissions de dins a fora del cos humà a les freqüències UWB. També es van utilitzar un contenidor per als fantomes de dues capes, imitant l'area gastrointestinal dels humans. Per als experiments a animals es van emprar porcs, replicant els experiments al laboratori en fantomes de la forma més semblant possible. Les simulacions software foren dissenyades per a imitar les experiments amb fantomes i animals. Després dels experiments el canal de propagació es va investigar exhaustivament des del domini freqüèncial i temporal. S'ha observat com les antenes en transmissió i recepció afecten al senyal, la influència de la grassa, la forma del contenidor de fantoma i les possibles contribucions multicamí. Finalment es proposa un nou model de propagació per a les baixes freqüències UWB (3.1 a 5.1 GHz) per a la zona GI del cos humà. El model es va validar utilitzant les tres metodologies abans esmentades i també foren comparades amb model ja existents a la literature. Finalment des d'un punt de vista aplicat, el canal es va avaluar per al senyal UWB a baixes freqüències (60 MHz). A més a més, per a la nova generació de marcapassos sense fil es va investigar el canal des d'un punt de vista de seguretat de dades. Els resultats obtinguts a aquesta tesi confirmen els avantatges d'emprar la banda de freqüències UWB per a la nova generació de dispositius médics implantables. / [EN] The current global population in developed countries is becoming older and facing an increase in diseases mainly caused by age. New medical technologies can help to detect, diagnose and treat illness, saving money, time, and resources of physicians. Wireless in-body devices opened a new scenario for the next generation of medical devices. Frequencies like the Ultra Wide-band (UWB) frequency band (3.1 - 10.6 GHz) are being considered for the next generation of in-body wireless devices. The small size of the antennas, the low power transmission, and the higher data rate are desirable characteristics for in-body devices. However, the human body is frequency ependent, which means higher losses of the radio frequency (RF) signal from in- to out-side the body as the frequency increases. To overcome this, the propagation channel has to be understood and known as much possible to process the signal accordingly. This dissertation aims to characterize the (RF) channel for the future of in-body medical devices. Three different methodologies have been used to characterize the channel: numerical simulations, phantom measurements, and living animals experiments. The phantom measurements were performed in a novel testbed designed for the purpose of in-body measurements at the UWB frequency band. Moreover, multi-layer high accurate phantoms mimicking the gastrointesintal (GI) area were employed. The animal experiments were conducted in living pigs, replicating in the fairest way as possible the phantom measurement campaigns. Lastly, the software simulations were designed to replicate the experimental measurements. An in-depth and detail analysis of the channel was performed in both, frequency and time domain. Concretely, the performance of the receiving and transmitting antennas, the effect of the fat, the shape of the phantom container, and the multipath components were evaluated. Finally, a novel path loss model was obtained for the low UWB frequency band (3.1 - 5.1 GHz) at GI scenarios. The model was validated using the three methodologies and compared with previous models in literature. Finally, from a practical case point of view, the channel was also evaluated for UWB signals at lower frequencies (60 MHz) for the GI area. In addition, for the next generation of leadless pacemakers the security link between the heart and an external device was also evaluated. The results obtained in this dissertation reaffirm the benefits of using the UWB frequency band for the next generation of wireless in-body medical devices. / Pérez Simbor, S. (2019). In-body to On-body Experimental UWB Channel Characterization for the Human Gastrointestinal Area [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/133034