Wrist and Arm Sensing Technologies for Cardiac Arrhythmias Detection in Long Term Monitoring ( WASTCArD )

Proposed ConceptFor patient comfort and convenience, it would be advantageous to develop an ECG recording system technique for a body surface location which is remote from the heart (eg. on the wrist or lower arm). Extensive experience (e.g. with SHL TeleMedicine Ltd.) has shown that, if at all possible, it is best to use dry electrodes as patients will either lose the gel or the gel-electrode interface impedance degrades. Although it is technologically challenging and requires a multidisciplinary joint effort, the proposed project will investigate the feasibility of this concept and will develop the potential solutions, in order to approach the important clinical need stated above. This proposed concept would allow continuous, non-invasive cardiac monitoring using ¿adjacent¿ ECG electrodes conveniently placed on one of the arms, thus no surgical procedure would be required. The challenges of this approach lie in the difficulty of detecting an adequate cardiac signal due to the low amplitude and excessive muscle artefact in these so called ¿far field ECG¿ locations.The problem of reliable cardiac signal detection against a background of excessive electrical noise circumstances has been approached using several methods. Our research group has developed various low-amplitude electrocardiographic signal recovery techniques. This platform of knowledge and experience will be combined with more recent ECG denoising techniques to approach the aforementioned far-field ECG recovery problem. Of particular interest in solving the ECG denoising problem in this project is the development of suitable software applications based on smart filtering techniques, the empirical mode decomposition (EMD) and the wavelet assessed moving-averaging method.