Signal processing techniques for cardiovascular monitoring applications using conventional and video-based photoplethysmography

Photoplethysmography (PPG)-based monitoring devices will probably play a decisive role in healthcare environment of the future, which will be preventive, predictive, personalized and participatory. Indeed, this optical technology presents several practical advantages over gold standard methods based on electrocardiography, because PPG wearable devices can be comfortably used for long-term continuous monitoring during daily life activities. Contactless video-based PPG technique, also known as imaging photoplethysmography (iPPG), has also attracted much attention recently. In that case, the cardiac pulse is remotely measured from the subtle skin color changes resulting from the blood circulation, using a simple video camera. PPG/iPPG have a lot of potential for a wide range of cardiovascular applications. Hence, there is a substantial need for signal processing techniques to explore these applications and to improve the reliability of the PPG/iPPG-based parameters. \par A part of the thesis is dedicated to the development of robust processing schemes to estimate heart rate from the PPG/iPPG signals. The proposed approaches were built on adaptive frequency tracking algorithms that were previously developed in our group. These tools, based on adaptive band-pass filters, provide instantaneous frequency estimates of the input signal(s) with a very low time delay, making them suitable for real-time applications. In case of conventional PPG, a prior adaptive noise cancellation step involving the use of accelerometer signals was also necessary to reconstruct clean PPG signals during the regions corrupted by motion artifacts. Regarding iPPG, after comparing different regions of interest on the subject face, we hypothesized that the simultaneous use of different iPPG signal derivation methods (i.e. methods to derive the iPPG time series from the pixel values of the consecutive frames) could be advantageous. Methods to assess signal quality online and to incorporate it into instantaneous frequency estimation were also examined and successfully applied to improve system reliability. \par This thesis also explored different innovative applications involving PPG/iPPG signals. The detection of atrial fibrillation was studied. Novel features derived directly from the PPG waveforms, designed to reflect the morphological changes observed during arrhythmic episodes, were proposed and proven to be successful for atrial fibrillation detection. Arrhythmia detection and robust heart rate estimation approaches were combined in another study aimed at reducing the number of false arrhythmia alarms in the intensive care unit by exploiting signals from independent sources, including PPG. Evaluation on a hidden dataset demonstrated that the number of false alarms was drastically reduced while almost no true alarm was suppressed. Finally, other aspects of the iPPG technology were examined, such as the measurement of pulse rate variability indexes from the iPPG signals and the estimation of respiratory rate from the iPPG interbeat intervals.