This diploma thesis deals with the topic of the ECG quality evaluation. The theoretical part of the thesis contains an overview of the methods, which were studied and an explanation of the basic principles connected with the quality evaluation of the ECG signals. The practical part deals with the implementation of three selected methods, one of which is the continuous evaluation of signal quality by means of SNR (signal to noise ratio) calculation. The results of these methods are further discussed and compared.

This thesis deals with issues of automatic quality estimation of ECG signals. The main aim of this thesis is to implement own algorithm for classifying ECG signals into three classes of quality. Theoretical part of the thesis contains mostly description of recording electrical activity of the heart, anatomy and physiology of the heart, electrocardiography, different types of ECG signals interference and two of the chosen methods for quality estimation. Implementation of the chosen methods is presented in the practical part. Result of this thesis are two implemented algorithms, which are based on methods described in the theoretical part. The first of two is based on detection of R-waves, validation of physiological assumptions and the subsequent calculation of the correlation coefficient between adaptive template and interfered signal. Second is based on calculation of a continuous SNR value over time, which is then thresholded. The robustness of the methods was verified on the three specified real ECG signals, which are all available on UBMI including annotation of specific signal parts. Those 24-hour long signals were recorded by Holter monitor, which is described in the theoretical part of the thesis. Achieved results of individual methods, including their comparison with annotation and statistical evaluation are presented in the conclusion of this thesis.

The thesis provides an analysis of the ECG signal, focusing on the possible types of interference occuring in the signal. These types of interference are closely examined and their realization in the MATLAB programming environment is characterized. The SPIHT algorithm is introduced and the possibilities of its use are discussed. Futher, the application of this algorithm to the ECG signal containing individual types of interference generated by means of the designed interference generator is described and the impact of the SPIHT algorithm on the specific types of signal interference is analyzed. Finally, the obtained results are evaluated.

International Telemetering Conference Proceedings / October 18-21, 2004 / Town & Country Resort, San Diego, California / The Electrocardiograph (EKG or ECG) measures electrical changes of tissue surrounding the heart to create a time-based representation of the physical operation of the heart. The purpose of this paper is to explore the future of ECG telemetry systems and how they are used in health care. The initial goal is to develop an inexpensive, efficient, and robust real-time ECG telemetry system. The future goal is to create a wireless network of miniature body sensors capable of measuring ECG data and other vital signs.

Electrocardiography (ECG or EKG) is the process of recording the electrical activity of the heart over a period of time using electrodes placed on a patient’s body. These electrodes detect the tiny electrical changes on the skin that arise from the heart muscle depolarizing during each heartbeat. [1] It is necessary for the diagnosis and prompt initiation of therapy in patients with acute coronary syndromes (ACS) and is the most accurate means of diagnosing conduction disturbances and arrhythmias. [2]ECG is an irreplaceable diagnostic method in clinical practice. It offers great diagnostic value at minimal costs while being a relatively quick, painless and noninvasive process. The quality of the resulting graph is depending on the accurate placement of the electrodes on the patients' body and that the patient lies absolutely still to avoid any muscle contractions which may lead to distortions of the graph.The interpretation of ECGs is a highly complex topic which requires lots of training and experience. Although there has been plenty of research on the topic of automated interpretation and pattern recognition of ECGs by computer algorithms and neural networks, a reliable interpretation of complex ECGs cannot be guaranteed as of today. While the trend seems to favor automated ECG interpretation, a clear prediction when these technologies have saturated the market cannot be given. One reason for this, similar to autonomous vehicles, is the issue of where liability can be found when an incorrect diagnosis leads to harming of a patient. For the foreseeable future we will most likely rely on the skill and experience of humans to interpret ECGs. [1] https://en.wikipedia.org/wiki/Electrocardiography [2] The British Journal of Primary Care Nursing: Taking an ECG: Getting the best possible recording

Pasinaudojant Henkelio matricomis tiriamas elektrokardiogramos ir jos parametrų kompleksiškumas. Po to, elektrokardiogramos fragmentai aprašomi eksponenčių baigtine sume. Taip pat pasiūlytas algoritmas, kaip pasinaudojant koreliacija dvylika standartinių derivacijų pakeisti trimis laisvai pasirenkamomis. / The method how to reinstate standard ECG lead by means of correlation and by three freely chosen ECG leads is suggested in this work. Next method is to evaluate complexity, to analyze, how many components are needed to record ECG and ECG parameters. Also we try to describe ECG fragment using exponential sum.

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The semestral thesis describes ECG signal compression methods designed to modify the data for transmission via communication channels. The thesis contains an introduction to Ethernet and explanation of communication in the network. The transport protocols TCP and UDP are discussed in more detail. In the practical part of the thesis was created two separate applications. The first application in the sender's computer opens a text file with the ECG signal. Loaded ECG signal is filtered by cascade of filters to eliminate interference. The resulting signal is displayed. A part of the application is the R wave detection, calculating the length of RR interval and heart rate. The application also allows to compress an ECG signal. ECG signal is sent via Ethernet network via UDP protocol for individual samples. Applications in the recipient's computer receives signal samples from the network. Recieved compressed data is reconstructed. The resulting ECG signal is displayed and there are again detected R waves, the length of RR intervals and sampling frequency are calculated.

Andnöd är en av de vanligaste kontaktorsakerna inom ambulanssjukvården. Det finns flera olika bakomliggande diagnoser till upplevelsen av andnöd, både kardiella och icke kardiella tillstånd. Dyspné definieras som en subjektiv upplevelse av andningsbesvär. Andnöd och dyspné är därför att betrakta som synonyma begrepp. Andnöd kan ge upphov till obehag och lidande för patienten, oavsett om det är ett livshotande- eller icke livshotande tillstånd. Det är av vikt att behandlingsriktlinjerna följs upp och att bedömningen dokumenteras för att ambulanssjuksköterskan skall kunna utvärdera patientens vårdbehov. Bristande bedömning medför en patientsäkerhetsrisk och kan bidra till ett ökat lidande för patienten. Syftet med studien är att undersöka ambulanssjuksköterskans följsamhet till behandlingsriktlinjerna för patienter som erhåller sökorsak dyspné (ESS 4). Studien är en retroperspektiv journalgranskningsstudie med kvantitativ jämförande design och slumpmässigt obundet urval. Trehundra journaler har granskats som påvisar en äldre patientgrupp med en medianålder på 80 år med hög samsjuklighet. Följsamheten till behandlingsriktlinjer är låg när det gäller de riktade undersökningarna EKG (54%) och lungauskultation (62%). Vitalparametrar bedöms i 86% av fallen oavsett kön. Följsamheten till behandlingsriktlinjer och bedömning av samtliga vitalparametrar för patienter med andnöd är bristfällig. Fler studier efterfrågas beträffande följsamheten till behandlingsriktlinjer för att öka patientsäkerheten och synliggöra en sårbar patientgrupp. Med stöd i föreliggande resultat och i linje med tidigare studier rekommenderas för bedömning av patienter som söker ambulanssjukvård för andnöd: Öka följsamheten till behandlingsriktlinjerna; Förbättra dokumentationen av utförda bedömningar och Ökad kunskap om åldrandet.

MAIDA ASANI Asani M. Granskning av svar från arbetsprov gällande ischemi och arytmi. Examensarbete i Biomedicinsk laboratorievetenskap 15 högskolepoäng. Malmö Universitet: Fakulteten för hälsa och samhälle, institutionen för biomedicinsk vetenskap, 2020. Den vanligaste dödsorsaken i Sverige bland män och kvinnor är hjärtkärlsjukdomar. Många upplever inga symtom i vila men i samband med ansträngning eller stress kan besvären uppkomma. Elektrokardiografi (EKG) innebär att elektriska impulser från hjärtat registreras med hjälp av elektroder placerade på bröstkorgen och extremiteterna. Ett arbetsprov, som är EKG-registrering under arbete, kan göras för att påvisa eller utesluta sjukdomar som ger symtom under arbete. Ischemi och arytmi är vanliga frågeställningar för patienter som utför arbetsprov. Syftet med studien var att undersöka andelen undersökningar som bekräftar remissfrågeställnigen samt att undersöka hur många som rekommenderas vidare undersökning. Studien utfördes retrospektivt på klinisk fysiologi och nuklearmedicin på Lunds universitetssjukhus genom granskning av remisser och remissvar i Sectra RIS. Studien inkluderade 219 patienter varav 164 hade frågeställning ischemi, 32 hade frågeställning arytmi och 23 patienter hade både ischemi och arytmi som frågeställning. Studien visade att en liten del av patienter med ischemifrågeställning fick ett icke-konklusivt svar och rekommenderades vidare undersökning. Majoriteten fick dock konklusivt negativt svar. Gällande patienter med arytmifrågeställning visade studien att alla fick ett konklusivt svar, dock är även dessa övergripande negativa. För patienter med kombinerad frågeställning visade studien liknande svar som för de patienter med endast en frågeställning. Nyckelord: Arbetsprov, arytmi, EKG, ischemi, sensitivitet. / MAIDA ASANI Asani M. Reviewing answers of exercise test regarding ischemia and arrhythmias. Degree project in Biomedical Science, 15 Credit Points. Malmö University: Faculty of Health and Society, Department of Biomedical Science, 2020. The most common cause of death among men and women in Sweden are cardiovascular diseases. When at rest, many do not experience any symptoms, however, associated with stress or exertion the symptoms can arise. Electrocardiography (ECG) is recording of the electrical impulses from the heart using electrodes placed on the chest and extremities. Exercise in combination with ECG, also called exercise test, can be done to exclude or detect diseases that give symptoms during exercise. Ischemia and arrhythmias are both common diseases to be diagnosed with an exercise test. The purpose of this study was to investigate the percentage of examinations that confirms the referral question. This was a retrospective study performed at the Department of Clinical Physiology and Nuclear Medicine at Skåne University Hospital in Lund. The study was executed by reviewing referrals and responses to the tests in Sectra RIS. The study included 219 patients, of whom 164 had a question of ischemia, 32 of arrhythmia and 23 patients had both. Regarding patients with a question of ischemia the study showed that only a small proportion received a non-conclusive answer. These patients were recommended to do further investigation. The majority of the patients that where given conclusive answers got negative results. For patients with a question of arrhythmia the study showed that all of the patients received conclusive answers which where all negative. Regarding the group of patients with both questions, the study showed similar results to those patients that only had one of the given questions. Keywords: Arrhythmias, ECG, exercise test, ischemia, sensitivity.