Monitoring the Heartbeat of ECG Technology

By: Mark Josewski

Electrocardiography (ECG or EKG) is a transthoracic interpretation of the

electrical activity of the heart over time captured and externally recorded by skin
electrodes. It is a noninvasive recording produced by an electrocardiographic
device.

The ECG works mostly by detecting and amplifying the tiny electrical changes on
the skin that are caused when the heart muscle "depolarizes" during each heart
beat. At rest, each heart muscle cell has a charge across its outer wall, or cell
membrane. Reducing this charge towards zero is called de-polarization, which
activates the mechanisms in the cell that cause it to contract. During each
heartbeat a healthy heart will have an orderly progression of a wave of
depolarization that is triggered by the cells in the sinoatrial node, spreads out
through the atrium, passes through "intrinsic conduction pathways" and then
spreads all over the ventricles. This is detected as tiny rises and falls in the
voltage between two electrodes placed on either side of the heart which is
displayed as a wavy line either on a screen or on paper. This display indicates
the overall rhythm of the heart and weaknesses in different parts of the heart
muscle.

An analog signal such as an ECG can be digitized and then processed by

standard digital signal processing techniques. When two signals are recorded
from the same source, these techniques can be used to examine the
relationships between the signals and infer information about the source. This
type of analysis allows a complex system emitting signals to be modeled as
mathematical functions, where one signal is treated as the input and the other
the output of the system. The functions represent a virtual or idealized system
that embodies the relationship between the two signals, and is used to examine
the relationship as a meaningful component of the more complex system.

The system modeled by such a function could be a series of cardiac cycles, a

flow of blood from chamber to chamber, or a depolarization and repolarization
cycle from one part of the heart to another part of the heart. An ECG plot is the
summation of all of the complex periodic electrical activity throughout a cardiac
cycle of a human heart, and can be broken down into discernible components in
a systems analysis approach.
Heart Cycle:

First, the atriums become depolarized (stimulated by primary impulse from the
Sinoatrial Node). Depolarization is the main cause for atrium contractions. This
phase corresponds to P wave on the ECG. Next, the depolarization wave is
conducted by an inter-nodal and passes to the AV node. That action is followed
by small break, which is caused by stopping the impulse in AV node. The reason
for this is that the ventricle is preparing for action. The period that shows these
two parts of the heart cycle is the PQ segment of the ECG. Lastly, the
depolarization wave comes to the ventricles and pushes them into contraction,
QRS complex, relaxation of ventricles and T wave. While the ventricles contract,
the atriums relax. That is the whole heart cycle.

ECG Construction:

ECG signal consists of: P wave, QRS complex and T wave. P wave shows us
the activation of atriums (depolarization). QRS complex shows us the ventricles
action (depolarization). T wave is a diagram of repolarization of ventricle muscle
cells, coming back into stable stage for another contraction.
Collecting the ECG Cycle:

Probes located on the skin collect the ECG signal. The signal is then amplified,
antialiased and read by an analog to digital converter (ADC). The quality of the
ECG signal depends on the probe’s location. Using multiple probes in different
positions can help generate different ECG signals. Two samples will be taken
sequentially; a third will be sampled consecutively. The front-end ADC’s
maximum required sampling is 800KHz, and the common sampling frequency of
an ECG signal is ~500Hz because each sample occurs ever 1/512 second, so
there is sample reserve to perform time-multiplexed sampling. The ADC’s
resolution could be 10-12 bits, enough to accurately capture the ECG signal.
A sampled ECG signal is stored using a double buffering technique - one buffer
for storage, a second buffer for data processing. After signal processing, filtering,
detection of abnormalities and optional data compression functions are
performed. An ECG monitor commonly uses four filters:
Notch 50/60 Hz for AC coupled noise
Band stop 35 Hz, the muscle interference
High pass 0.1 Hz, drift compensation
Low pass 250Hz, upper boundary

Assuming the maximum ECG frequency is three beats per second and three-
channel processing has a sampling frequency of 500Hz, 1500 samples per
second and 9 pulses detected per second process are required. About 3 MIPS
will be necessary for a basic ECG evaluation, keeping a reserve for time scaling
of reference vectors.

Hospital Bedside Solution:

The requirements for processing, analysis and interface can differ greatly for an
ECG machine. Hospital ECG solutions are more complex in their waveform
analysis capabilities, network and printer interfacing requirements, power
consumption and cost. The front-end operational amplifiers need to be sensitive
yet low noise. The National Semiconductor LMP7718 addresses these needs
with 88MHz operation, a low noise design and 1.8V CMOS inputs. These
precision op-amps can feed a series of Dual Channel 12-bit A/D SAR 50ksps –
200ksps converters such as the National ADC122S021. For higher sampling
rates, National has a pin and function compatible family of devices to support
sampling rates of up to 1MSPS. Also useful in this application are National’s EMI
hardened amplifiers LMV861/2. These amplifiers are well suited for ECG
applications in the harsh RF noise environment of a hospital. The RF immunity of
these devices allows designers to create sensitive yet isolated front ends.
To process all this data a DSP enabled Processor needs to be implemented.
Freescale offers a wide variety of solutions in their ColdFire series of 32-bit
Microcontrollers. This class of ECG units will feature auto-calibration and must
have configurability and flexibility to accommodate from 3-10 probes. A USB,
LAN and Serial or Wireless (802.15.4 or 802.11) interface is often present to
allow for interface flexibility to various printers, remote analysis devices and
networking interfaces. The Freescale MCF5225x (with Ethernet) and MCF5227x
(with LCD Controller) series addresses these processing and interface needs.
They are also equipped to perform digital signal processing using their enhanced
multiply accumulate module (eMAC). This class of ECG solutions is primarily line
powered with a battery backup. An LCD graphical interface is used and can be
touch-screen enabled. The Freescale MCF5227x device provides an LCD
interface onboard and the capability to interface to most popular touchscreens.

Doctors Office/EMT Solution:

These type of ECG solutions need to be rugged, low power and battery enabled.
Medium resolution ADC’s from 10 to12-Bits are typically used. National
Semiconductor has a great selection of front-end devices to address this. The
LMV844 quad CMOS input, Rail-to-Rail I/O operational amplifiers easily hit the
mark. They can be coupled with a series of National ADC122S021 12-Bit Dual,
or ADC102S021 10-bit Dual 200ksps A/D converters. A Freescale MCF51JE
ultra-low powered 32-bit microcontroller can handle the computational and
interface needs with its efficient core and USB connectivity. This microcontroller
can be called upon to handle some of the waveform analysis but typically the
recorded data is sent to a more powerful diagnostic device either wirelessly or via
network or USB interface. These devices require sensitivity control, battery part-
time operation and are designed for rugged use.

Portable Home Use Solution:

The home use ECG solution functions more like a data acquisition device. Lower
resolution 10-bit ADC’s such as the National Semiconductor ADC101S021 single
channel 200ksps, 10-Bit A/D converters fit well here and can be fed by precision
LMP7715 low operational-current Op Amps. National also offers a wide array of
LED drivers delivering flexible feedback indicators. The LM279x series of LED
drivers offer flexible interface options to drive a variety of lighting solutions.
These front-end analog components can be mated to Freescale’s MC9S08L or J
series of 8-bit low-power microcontrollers. These full-featured cost optimized
microcontrollers offer a variety of interface options to meet the needs of a
portable design. ECG solutions in this segment have either fixed LED’s or basic
serial LCD interface options and the ability to upload logged data over a USB
connection. These devices are typically battery powered with rechargeable
supplies. Freescale has you covered in this segment with their MC9S08
offerings.

Summary:

The ECG market is very diverse. The basic principals of collecting the data are
similar, but the means at which the data is analyzed and displayed can be vastly
different. To meet price and performance targets though, a wide variety of ECG
monitoring and analysis devices have to be created. Freescale Semiconductor
and National Semiconductor have strategically aligned their offerings to meet
these differencing market needs. From the low signal interface and signal
conversion path to the audio, power management and clocking functions,
National Semiconductor has the solutions. Freescale Semiconductor addresses
the processing needs by offering 8 to 32-bit Microcontrollers with a wide array of
integrated features. Both suppliers have solutions that can scale from cost
effective and battery powered to high performance hospital grade ECG solutions.

References:

Microcontroller Based ECG and Blood Pressure Simulator, Nivedita Daimiwal, Asmitaa
Wakankar, Dipali Ramdasi and Mrunal Chandratreya
ECG Front-End Design is simplified with MicroConverter, Analog Dialogue 37-11, November
(2003)
Medical Personal Electrocardiogram (ECG) Monitor, Freescale Semiconductor SG2079-2
The Multiphase Functional Cardiogram, A Clinical Overview, Joseph T. Shen, MD, Premier Heart,
LLC