Proceedings of the 5th International Workshop on Wearable and Implantable Body Sensor Networks, in conjunction with
The 5th International Summer School and Symposium on Medical Devices and Biosensors
The Chinese University of Hong Kong, HKSAR, China. Jun 1-3, 2008
Wireless ECG Plaster for Body Sensor Network
M Cassim Munshi, Xiaoyuan Xu, Xiaodan Zou, Edward Soetiono, Chang Sheng Teo, and Yong Lian
Abstract—Miniaturization of electrocardiograph (ECG)
monitoring devices has received much attention due to the
growing emphasis on healthcare. In this paper, we present a
wearable wireless ECG monitoring device, ECG Plaster. A
description of design considerations with regards to the con-
stituents of the device is provided, together with its implemen-
tation on a small size board measuring 55 by 23 mm, to ensure
wearability.
I. INTRODUCTION
E MPHASIS on individual health and well-being in recent
years has triggered the mass insurgence of numerous
healthcare products into the healthcare market. The electro-
cardiograph (ECG) has unrivalled importance, amongst sen-
sory devices, in its ability to monitor heartbeat irregularities,
which in turn, gives insights into the individual’s physio-
logical condition. Most ECG devices at present are not
wearable and expensive, and thus are used in hospitals,
rather than the home where monitoring can be more conven-
ient. Miniaturization of such devices is therefore necessary,
as this ensures simpler, more extensive and prolonged heart-
beat monitoring. Among these downscaled versions are the
wearable devices operating on batteries, forming wireless
nodes positioned on various ECG measurement sites on the
human body, thus constituting a body sensor network
(BSN). Such a system allows real-time in-depth monitoring.
As its mobility feature operates on limited battery power,
a wearable ECG sensor node calls for low power consump-
tion. Other requirements include having a small form factor,
providing reliable communications, and, to the end users’
perspective, ease of use. Various attempts have been re-
ported to address these requirements. In [1], non-contact
Quasar’s sensors were employed to pick up ECG potentials
on different body sites. The analog-to-digital (A/D) conver-
sion and wireless communication to the base station were
carried out on a miniature Eco board. Although the Eco ar-
chitecture is compact, it is evident that analog signals from
different pickup sites may need to travel through long wires
before reaching the quantizer. This increases the likelihood
of the signal being corrupted by noise and other forms of
interference. This problem was rectified in [2] where the
A/D conversion was integrated into the sensor node. Unfor-
tunately, the sensor requires external battery packs to pro-
vide sufficient power. Consequently, cumbersome external
Manuscript received February 1, 2008. This work was supported by the
Embedded and Hybrid System (EHS) programme under the Agency for
Science, Technology and Research (A*STAR) from grants 052-118-0057
and 052-118-0060.
The authors are with the Department of Electrical & Computer Engi-
neering, the National University of Singapore, 119260, Singapore. ({cas-
sim, xiaodan, elexxy, eleliany}@nus.edu.sg)
978-1-4244-2253-1/08/$25 ©2008 IEEE
Authorized licensed use limited to: University of Leeds. Downloaded on August 17,2010 at 08:15:12 UTC from IEEE Xplore. Restrictions apply.
wiring is used, and this inflicts discomfort onto patients.
In this paper, a prototype of fully integrated wearable
ECG plaster that resolves the above issues is presented. The
system level design is described in Section II. The imple-
mentation of each module is detailed in Section III. Section
IV covers the plans for future development and optimiza-
tion.
II. SYSTEM DESIGN
A. Design Considerations & Specifications
In addition to the essential functions that traditional ECG
equipment provides, a wireless ECG plaster has to incorpo-
rate portability without compromising performance. This
translates to the following design considerations:
- The sensor interface must be able to pick up sub-millivolt
level ECG signals from closely spaced electrodes, and apply
bandwidth conditioning and data quantization locally. A low
noise front-end amplifier with sufficient gain and built-in
filtering function is thereby required.
- The collected ECG data needs to be preprocessed before
transmission or storage, and this suggests the use of an on-
board microcontroller. The preprocessing is necessary in
order to minimize the power consumption as the wireless
transceiver dissipates large amounts of power. With the pre-
processing, the device only needs to transmit ECG data
when abnormal ECG signals are detected. This helps to re-
duce the transmission time significantly resulting consider-
able power saving.
- Wireless transmission and local storage are both determin-
ing factors for portability and versatility in a BSN system.
- To ensure stable and continuous operations under the sup-
ply of the onboard low profile battery, the power figure of
the overall system needs to be well confined. A power man-
agement plug-in (either in hardware or software) is a bonus.
- As a wearable medical device meant for continuous health
monitoring, the wireless ECG plaster should be small in
size, and cause minimal discomfort to patients.
- For the ease of use, a fully integrated, “plug-and-play” type
of design that requires few or no external wirings is pre-
ferred.
- The device should use compatible hardware accessories
(e.g. electrode pieces) as those used in commercial ECG
machines.
B. System Architecture
Taking into consideration of above requirements, the sys-
tem architecture for ECG plaster is proposed as shown in
Fig. 1. It contains four blocks, i.e. front-end data acquisition
circuits, digital signal processing and storage, wireless trans-
310
ceiver, and power management system. ECG signals from
the chest area, collected by the on-board electrodes, are fil-
tered and amplified by the low noise front-end amplifier to
reach the desired dynamic range. This analog signal is then
fed into the 12-bit analog to digital converter (ADC) for
quantization. The digitized data are passed to microcontrol-
ler for pre-processing or storage. The microcontroller trig-
gers wireless transceiver if there are abnormal QRS detected
in ECG signals. The power management system optimizes
the power utilization by putting un-used circuits into sleep
mode.
Battery
Power Management
the contradiction that the narrow bandwidth amplifier results
in low driving capability, which has direct impact on the S/H
circuit followed the front-end amplifier. The immediate ef-
fect is on the accuracy of tracking error [7]. To solve this
problem, the proposed front-end amplifier comprises two
stages. The first stage takes care of signal amplification with
low input-referred noise, while the second stage is a low
gain buffer that serves as a driving circuit for the S/H circuit
of ADC, as depicted in Fig. 2.
To prevent the DC component in the ECG signal from
saturating the amplifier, a high pass function with very low
cutoff frequency is preferred to integrate into the front-end
amplifier [8]. This is realized by transistors M1~M4 config-
ured as pseudo-resistors that provide huge resistance values.

12-bit Micro ZigBee

ADC
Controller Radio

Input from
Amplifier Micro SD
Probes

Data Digital Data

Acquisition Processing/ Transceiver Fig. 2. Schematic diagram of front-end amplifier.
Storage

Most of the information present in ECG signals fall below

Fig. 1. System architecture of the Wireless ECG Plaster. 300 Hz, which relaxes the speed requirement of ADC. The
power-efficient capacitive successive approximation register
The data rate for ECG signals is low, and this mitigates (SAR) structure (Fig. 3) in this case makes an ideal candi-
the need for wasteful continuous wireless transmission, es- date. To conserve switching power, 1 V VDD is used across
pecially for a power hungry wireless module. The data is the quantizer. The ECG signal out of the front-end amplifier
thus buffered locally and transmitted intermittently. This is sampled through the bootstrapped switch and held in the
necessitates the use of a micro-SD module interfaced to the capacitive DAC. The SAR logic then resolves this input
ZigBee node for temporary storage. In addition, the micro- level bit by bit. The driving clock is provided by the local
SD module allows for several other operating modes such as 32.768 kHz crystal oscillator, which features both low jitter
long-term local recording which consumes very little power. level and low power consumption.
The microcontroller coordinates the use of such operating
modes and modular power management.
C. Front-end Chip Design
ECG signal characteristics pose great challenges to the
front-end amplifier design. Several low power biomedical
signal acquisition front-end circuits were proposed in the
past [3-6]. Most of these circuits dissipate power ranging
from a few microwatts to tens of microwatts. We have pro-
Fig. 3. Schematic diagram of ADC.
posed an energy efficient biomedical signal acquisition
front-end architecture that optimizes the power consumption
A front-end chip is designed with a low noise amplifier, a
and meets all requirements for wearable ECG devices. Tra-
band-pass filter with corner frequencies at 0.052Hz and
ditionally, the bio-signal acquisition frond-end circuits con-
200Hz, a 12-bit ADC sampled at 1 KS/s. The chip die photo
tain a low noise amplifier, a sample and hold (S/H) circuit,
is shown in Fig.4. Table 1 listed the measurement results.
and a successive approximation ADC. The bandwidth of
The core of overall chip consumes only 1.1µW from a 1-V
low noise amplifier is designed in such a way that it encom-
supply voltage. The level converters are included in the chip
passes the frequency range of the ECG signal, which is from
to allow the front-end chip interfacing with transceiver.
sub 1 hertz to several hundred hertz. However, this leads to

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 battery, are placed on a 1-mm thick PCB measuring 55 mm
TABLE I
SPECIFICATIONS OF DATA ACQUISITION CHIP by 23 mm, as shown in Fig. 5. Prioritizing size require-
ments, components are chosen and placed such that the
Parameter Typical Reading empty area on the board remains as small as possible. A tiny
Core Voltage 1V chip antenna operating in the 2.4 GHz band is placed at the
I/O Voltage 3V
edge of the board to minimize losses due to absorption of
Core Current 1.1 µA
RF energy from the inner metallization planes. Its balun and
3 dB Bandwidth 0.052 Hz ~ 200 Hz
matching network circuitry provides a matched 50-ohm im-
Mid-band Gain 45.5 dB
Input Referred Noise 2.1 µVrms (0.05 Hz ~ 200 Hz)
pedance, while 0603 package size RLC components are
Amplifier THD < 1% @ full output swing mainly used. Decoupling capacitors are placed as closely as
CMRR > 67 dB possible to the power inputs to stabilize supply voltage lev-
ADC Resolution 12 bits els, and a small pushbutton switch is included for manual
ADC Sampling Rate 1 KS/s resetting of the CC2430. Moreover, power control is pro-
ADC DNL < ±1.5 LSB vided by a Power MOSFET switch which ensures that while
ADC INL < ±1.5 LSB the CC2430 is being downloaded with firmware, no power
Package 44-pin QFN is being supplied to the ECG chip. While the CC2430 has an
internal voltage regulator, the ECG chip adopts an external
voltage regulator to provide desired voltage levels to its core
modules. DC power for the entire system is drawn from a
rechargeable 100-mAh Lithium Polymer battery measuring
11.0 by 28.7 mm, providing 3.7 V under normal operating
conditions. In addition, the two on-board electrodes used are
compatible with present ECG monitoring applications.
Debugging the firmware of CC2430 is carried out through
an external evaluation board which interfaces with the IO
ports via a FPC connector, located on the bottom side of the
board. As mentioned, the power MOSFET switch automati-
cally turns off the power to the ECG chip while the CC2430
is being debugged.

Fig.4 Front-end chip die photo
D. MCU and RF Transceiver
Prioritizing low power operation, the CC2430 ZigBee
Transceiver from TI is selected as the wireless channel to
transmit ECG signals to a host device. The transceiver con-
sumes only 27 mA with the data rate of 250kbps, and uses
very few inexpensive external components. Furthermore it
integrates an 8051 microcontroller making it ideal for the
ECG plaster. Its other features include 8 kB of RAM and
128 kB of flash memory. Having 21 pins across 3 ports, the
transceiver is able to accommodate the 12 data bits from the
ECG sensor in parallel, as well as one strobe bit. In serial
mode, data is read through only one of these pins, together
with a strobe pin and a clock signal from the ECG sensor. In
both modes, 6 of the remaining pins transfer data to and
from the micro SD card, for storage purposes.
B. Firmware Development
With the use of a 3rd party IDE software, the IAR Embed-
ded Workbench, and CC2430 Zigbee Development tools,
the firmware is downloaded onto the module. At present, the
CC2430 microcontroller is tasked to read parallel ECG data
placed on its port pins, and transmit wirelessly at 2.4 GHz to
a host device. The current consumption for continuous
transmission is measured at 29 mA, resulting in the continu-
ous operation for more than 3 hours before the battery runs
out. It is expected that when transmission is done with
packets instead of continuously, the power consumption can
be reduced, thus increasing operation time. This is because a
large portion of the power is being consumed by the RF part
of the wireless module, and packet transmission allows for
this part to be switched off in the durations between succes-
sive packet transmissions. This is especially the case since
data arrives to the CC2430 MCU at 12kbps, but the 802.15.4
standard, observed by Zigbee, dictates data transmission
wirelessly at 250 kbps.

III. DESIGN OF ECG PLASTER.

A. Hardware Development
Surface mount components, CC2430 RF Transceiver, the
ECG Chip, electrodes, SD Card slot, and Lithium Polymer

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(a). Top view
(b) Bottom view
Fig. 5. The top and bottom views of the wireless ECG
module
IV. FUTURE WORK
Power saving remains the primary objective, and this
cause is aided by the used of a micro SD Card. Data being
read from the ECG Chip can be written to the SD Card for
temporary buffering, before transmission as a single packet,
and as mentioned, the RF part can be switched off to save
power. Measurements have been made to indicate that the
RF part consumes 18 mA in continuous transmission at 250
kbps. Since the ECG data samples arrive at the MCU at 12
kbps, an estimate would be that the RF part needs to be
turned on about 5% of the time, since this is when the packet
transmission takes place. It is expected that the RF part can
consume as low as 1 mA, averaged over the entire monitor-
ing duration, and thus the overall current consumption can
be as low as 12 mA. This scheme is being investigated at
present.
The device might also work on another operating mode,
one which does not make use of the RF portion. Here, data
is simply collected and written to the micro SD Card for
storage. Such a scheme greatly increases the battery operat-
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ing time and is intended when the immediate retrieval of
ECG data is not required.
V. CONCLUSION
A wearable ECG plaster that is suitable for BSN applica-
tions and compatible with most commercial ECG products is
designed and implemented. By integrating the differential
electrode sockets, signal acquisition front-end, microcontrol-
ler, micro-SD card, ZigBee transmitter and LiPo battery
onto the same miniaturized PCB, the device offers mobility
and most of the essential functions in ECG monitoring with
hardly any noticeable discomfort to users. Benefitting from
the state-of-the-art low power circuit techniques and the
system level power management, the ECG plaster provides
multiple operation modes and promises long battery life.
Future optimization in system firmware can make further
use of such advantage to achieve even better power effi-
ciency.
REFERENCES
[1] C. Park, P. H. Chou, Y. Bai, R. Matthews and A. Hibbs, “An Ultra-
Wearable, Wireless, Low Power ECG Monitoring System,” Proceed-
ings of IEEE International Conference on biomedical circuits and sys-
tems (BioCAS’06), Nov. 2006, London, UK.
[2] T. J. Sullivan, S. R. Deiss and G. Cauwenberghs, “A Low-Noise, Non-
Contact EEG/ECG Sensor,” Proceedings of IEEE International con-
ference on biomedical circuits and systems (BioCAS’07), Nov. 2007,
Montreal, Canada.
[3] H. Wu, Y. P. Xu, “A 1V 2.3µW Biomedical Signal Acquisition IC,”
Proceedings of the 2006 IEEE International Solid-State Circuit Con-
ference, Feb. 2006, 119-128.
[4] M. Yin and M. Ghovanloo, “A Low-Noise Preamplifier with Adjust-
able Gain and Bandwidth for Biopotential Recording Applications,”
Proceedings of IEEE International Symposium on Circuits and Sys-
tems, pp. 321-324, May 2007.
[5] W. Wattanapanitch, M. Fee and R. Sarpeshkar, “An Energy-Efficient
Micropower Neural Recording Amplifier,” IEEE Transactions on
Biomedical Circuits and Systems, vol.1, no.2, June 2007.
[6] T. Denison, K. Consoer, W. Santa, A. Avestruz, J. Cooley and
A. Kelly, “A 2 μW 100 nV/rtHz Chopper-Stabilized Instru-
mentation Amplifier for Chronic Measurement of Neural Field
Potentials,” IEEE J. Solid-State Circuits, vol.42, no.12,
pp.2934-2945, Dec. 2007.
[7] X.D. Zou, X.Y. Xu, Y. Lian, and Y.J. Zheng, “A Low Power Sensor
Interface IC for Wearable Wireless Biomedical Devices,” Proceedings
of 2nd International Conference on Body Area Net-
works(BodyNets’07), Jun. 2007, Florence, Italy.
[8] R.R. Harrison and C. Charles, “A Low-Power Low-Noise CMOS
Amplifier for Neural Recording Applications.” IEEE J. Solid-State
Circuits, vol.38, pp.958-965, June 2003.