Monitoring of Cardiovascular and Neurological Diseases Using Wearable Devices

In this thesis, I focus on monitoring of patients suffering from cardiovascular and neurological diseases through the use of wearable devices. The main diseases considered in this thesis are atrial fibrillation (AF), myocardial infarction (MI), and epilepsy. The proposed methods for the detection of the considered cardiovascular diseases use ECG as the main biosignal, whereas the main biosignal used for detecting epileptic seizures is EEG.

Firstly, I propose a hierarchical heart-rhythm classification method for AF detection from a single lead ECG recording. The proposed method is based on the features that capture the morphology of important ECG signal segments, along with heart-rate oscillations and time and frequency domain features of the ECG signal. Furthermore, the classification scheme used in this method incorporates two different classifiers: a multiclass classifier and a random forest classifier, resulting in an F1 score of 78.95% for AF detection.

Secondly, I address the problem of early detection and prevention of MI by introducing a real-time event-driven classification technique that uses a hierarchical classifier with multiple levels. The main goal of this technique is to maintain a high classification accuracy while reducing the complexity of the classification algorithm. The reduction in computational complexity, in turn, results in a longer battery life, which is an important factor for wearable devices. The proposed technique is validated on a public database and ported on a real-life wearable device. The experimental evaluation of the proposed technique on MI data shows that this scheme reduces the energy consumption by a factor of 2.60, with no significant loss in classification performance.

The third chapter of this thesis is split into two parts and it focuses on epilepsy. In the first part, I present a real-time method for personalized epileptic seizure detection that uses EEG signals acquired from two electrode pairs: F7T3, and F8T4. The proposed method reaches a sensitivity of 90.98% and specificity of 92.10% on the database used in this study. Furthermore, this method is ported on a pair of eyeglasses in which the used electrodes are embedded and hidden in the temples, allowing for 2.71 days of operation on a single battery charge. This method overcomes the lack of portability and the effect of social stigma of EEG caps, which are used as a gold standard technique for epilepsy detection.

Since the main pitfall of epilepsy detection algorithms is the unacceptably high number of false alarms, in the last part of my thesis, I propose an interpretable patient-specific approach to false alarm reduction for epilepsy detection. This approach is based on similarly occurring morphological EEG signal patterns (seizure signature) that occur frequently during seizures. The proposed approach has been experimentally validated on more than 5500 hours of long-term EEG recordings, resulting in a high classification performance with no false positive alarms. The high degree of interpretability of this method can help physicians discover seizures faster, as well as it can be used to improve data labeling quality in publicly available databases, which confirms its applicability for long-term seizure monitoring.

Real-time classification technique for early detection and prevention of myocardial infarction on wearable devices

Amir Aminifar, David Atienza Alonso, Dionisije Sopic

Continuous monitoring of patients suffering from cardiovascular diseases and, in particular, myocardial infarction (MI) places a considerable burden on health-care systems and government budgets. The rise of wearable devices alleviates this burden, allowing for long-term patient monitoring in ambulatory settings. One of the major challenges in this area is to design ultra-low energy wearable devices for long-term monitoring of patients’ vital signs. In this work, we present a real-time event-driven classification technique, based on support vector machines (SVM) and statistical outlier detection. The main goal of this technique is to maintain a high classification accuracy while reducing the complexity of the classification algorithm. This technique leads to a reduction in energy consumption and thus battery lifetime extension. We validate our approach on a well-established and complete myocardial infarction (MI) database (Physiobank, PTB Diagnostic ECG database [1]). Our experimental evaluation demonstrates that our real-time classification scheme outperforms the existing approaches in terms of energy consumption and battery lifetime by a factor of 3, while maintaining the classification accuracy at a medically-acceptable level of 90%.

IEEE2017

Adaptive wake and sleep detection for wearable systems

Walter Karlen

Sleep problems and disorders have a serious impact on human health and wellbeing. The rising costs for treating sleep-related chronic diseases in industrialized countries demands efficient prevention. Low-cost, wearable sleep / wake detection systems which give feedback on the wearer's "sleep performance" are a promising approach to reduce the risk of developing serious sleep disorders and fatigue. Not all bio-medical signals that are useful for sleep / wake discrimination can be easily recorded with wearable systems. Sensors often need to be placed in an obtrusive location on the body or cannot be efficiently embedded into a wearable frame. Furthermore, wearable systems have limited computational and energetic resources, which restrict the choice of sensors and algorithms for online processing and classification. Since wearable systems are used outside the laboratory, the recorded signals tend to be corrupted with additional noise that influences the precision of classification algorithms. In this thesis we present the research on a wearable sleep / wake classifier system that relies on cardiorespiratory (ECG and respiratory effort) and activity recordings and that works autonomously with minimal user interaction. This research included the selection of optimal signals and sensors, the development of a custom-tailored hardware demonstrator with embedded classification algorithms, and the realization of experiments in real-world environments for the customization and validation of the system. The processing and classification of the signals were based on Fourier transformations and artificial neural networks that are efficiently implementable into digital signal controllers. Literature analysis and empiric measurements revealed that cardiorespiratory signals are more promising for a wearable sleep / wake classification than clinically used signals such as brain potentials. The experiments conducted during this thesis showed that inter-subject differences within the recorded physiological signals make it difficult to design a sleep / wake classification model that can generalize to a group of subjects. This problem was addressed in two ways: First by adding features from another signal to the classifier, that is, measuring the behavioral quiescence during sleep using accelerometers. Conducted research on different feature extraction methods from accelerometer data showed that this data generalizes well for distinct subjects in the study group. In addition, research on user-adaptation methods was conducted. Behavioral sleep and wake measures, notably the measurement of reactivity and activity, were developed to build up a priori knowledge that was used to adapt the classification algorithm automatically to new situations. This thesis demonstrates the design and development of a low-cost, wearable hardware and embedded software for on-line sleep / wake discrimination. The proposed automatic user-adaptive classifier is advantageous compared to previously suggested classification methods that generalize over multiple subjects, because it can take changes in the wearer's physiology and sleep / wake behavior into account without adjustment from a human expert. The results of this thesis contribute to the development of smart, wearable, bio-physiological monitoring systems which require a high degree of autonomy and have only low computational resources available. We believe that the proposed sleep / wake classification system is a first promising step toward a context-aware system for sleep management, sleep disorder prevention, and reduction of fatigue.

EPFL2009

Real-Time Event-Driven Classification Technique for Early Detection and Prevention of Myocardial Infarction on Wearable Systems

Amir Aminifar, David Atienza Alonso, Dionisije Sopic

A considerable portion of government health-care spending is allocated to the continuous monitoring of patients suffering from cardiovascular diseases, particularly myocardial infarction (MI). Wearable devices present a cost-effective means of monitoring patients’ vital signs in ambulatory settings. A major challenge is to design such ultra-low energy devices for long-term patient monitoring. In this paper, we present a real-time event-driven classification technique based on the random forest classification scheme, which uses a confidence-related decision-making process. The main goal of this technique is to maintain a high classification accuracy while reducing the complexity of the classification algorithm. We validate our approach on a well-established and complete MI database (Physiobank, PTB Diagnostic ECG database [1]). Our experimental evaluation demonstrates that our real-time classification scheme outperforms the existing approaches in terms of energy consumption and battery lifetime by a factor of 2.60, with no classification quality loss.

2018

Adaptive wake and sleep detection for wearable systems

Walter Karlen

EPFL2009