Observation of electrocardiograms through tap water

Measurement of electrocardiograms in a bath through tap water utilizing capacitive coupling electrodes placed outside the bathtub wall

BACKGROUND

Taking a bath sometimes poses a risk for subjects with chronic cardiopulmonary disorders, due to the thermal effect and water pressure on his/her body. The ECG measurement would be helpful for the early recognition of abnormal cardiac beats and respiratory conditions. This paper describes a new attempt to improve on previous bathtub ECG measurement techniques that had electrodes placed inside the bathtub that were intrusive to the subjects' bathing experience. This study is concerned with the initial development of a method to measure an electrocardiogram (ECG) through tap water without conscious awareness of the presence of electrodes that are placed outside the bathtub wall.

METHODS

A configuration of capacitive coupling electrodes placed outside the bathtub was designed so that the electrodes could be hidden. The capacitive coupling was made from the electrodes to the water through the bathtub wall. Two electrodes with an active shielding amplifier covered further by an electromagnetic shield were fixed to the outside surface of the bathtub wall, near the bather's right scapula and left foot. The potential difference between these two electrodes, similar to the bipolar lead-II ECG, was amplified to obtain raw signals inclusive of ECG/QRS components. Respiration intervals were also derived from ECG/RR intervals. Comparison experiments between this bathtub method and conventional direct methods with spot-electrodes and a chest-band sensor were made using 10 healthy male volunteers (22.2 ± 0.98 years).

RESULTS

The ECG signal was detectable through tap water as well as water with differing conductivity resulting from mixing bathwater additives with the water. ECG signals and respiration curves derived from ECG/RR intervals were successfully obtained in all subjects. The intervals of the ECG/RR and respiration obtained by the bathtub system and by the direct method were respectively agreed well with each other.

CONCLUSION

The ECG signal, in particular ECG/QRS components, were successfully detected utilizing capacitive coupling electrodes placed outside the bathtub wall. Also, the ECG/RR and respiration intervals were determined with reasonable accuracy as compared with the conventional direct methods.

Smart sensing of cardiovascular physiological information from soles without direct skin contact

This study proposes the development of a smart sensing measurement system using a mat-type sensor in order to obtain sole-electrocardiogram data from soles and toe-photoplethysmogram data from toes. In addition, the proposed measurement system can calculate pulse wave velocity from sole-ECG and toe-PPG. The subjective experiments revealed that the developed system can measure these parameters even when socks are being worn. Moreover, simultaneous measurements of systolic blood pressure and PWV determined by the developed system indicate a strong correlation was found between SBP and PWV. Therefore, this system can detect cardiovascular diseases or symptoms of common diseases and suggests the possibility to estimate the temporal changes in SBP without required compression using cuffs.

Smart health monitoring systems: an overview of design and modeling

Health monitoring systems have rapidly evolved during the past two decades and have the potential to change the way health care is currently delivered. Although smart health monitoring systems automate patient monitoring tasks and, thereby improve the patient workflow management, their efficiency in clinical settings is still debatable. This paper presents a review of smart health monitoring systems and an overview of their design and modeling. Furthermore, a critical analysis of the efficiency, clinical acceptability, strategies and recommendations on improving current health monitoring systems will be presented. The main aim is to review current state of the art monitoring systems and to perform extensive and an in-depth analysis of the findings in the area of smart health monitoring systems. In order to achieve this, over fifty different monitoring systems have been selected, categorized, classified and compared. Finally, major advances in the system design level have been discussed, current issues facing health care providers, as well as the potential challenges to health monitoring field will be identified and compared to other similar systems.

Development of a network system combined with ambulatory and non-conscious physiological measurements for supporting challenged kids - a new proposal of a gait monitoring system for use in rehabilitation

Various physiological measurement techniques have been developed to support healthcare and daily living of adult including elderly. However, in light of the rapid growth of the declining birth rate, promotion in care and life support for children are not enough. Especially in rehabilitation for disabled children, i.e., challenged kids, it is important for therapist to evaluate the efficacy of rehabilitation and the health condition. Share of these information with educational, welfare, and government institutions are also needed for accurate life support. Therefore, the quantitative data of the activities and daily health status are helpful. From these viewpoints, we are developing a new network system for monitoring the activities and the health status of children using ambulatory and non-conscious physiological measurements as well as data browse at anytime and anywhere. Firstly, we propose a wearable gait monitoring system to support evaluation for the efficacy of rehabilitation. In this study, the present system can successfully detect the characteristics of postural changes in children with disorder of movement, demonstrating its usefulness and availability to the evaluation for the effect of the brace attached to the subject's lower limb.

Development of a ubiquitous healthcare monitoring system combined with non-conscious and ambulatory physiological measurements and its application to medical care

The demand for ubiquitous healthcare monitoring has been increasingly raised for prevention of lifestyle-related diseases, acute life support or chronic therapies for inpatients and/or outpatients having chronic disorder and home medical care. From these view points, we developed a non-conscious healthcare monitoring system without any attachment of biological sensors and operations of devices, and an ambulatory postural changes and activities monitoring system. Furthermore in this study, in order to investigate those applicability to the ubiquitous healthcare monitoring, we have developed a new healthcare monitoring system combined with the non-conscious and the ambulatory measurements developed by us. In patients with chronic cardiovascular disease or stroke, the daily health conditions such as pulse, respiration, activities and so on, could be continuously measured in the hospital, the rehabilitation room and subject's own home, using the present system. The results demonstrated that the system appears useful for the ubiquitous healthcare monitoring not only at medical facility, but also during daily living at home.

A fully automated health-care monitoring at home without attachment of any biological sensors and its clinical evaluation

Daily monitoring of health condition is important for an effective scheme for early diagnosis, treatment and prevention of lifestyle-related diseases such as adiposis, diabetes, cardiovascular diseases and other diseases. Commercially available devices for health care monitoring at home are cumbersome in terms of self-attachment of biological sensors and self-operation of the devices. From this viewpoint, we have been developing a non-conscious physiological monitor installed in a bath, a lavatory, and a bed for home health care and evaluated its measurement accuracy by simultaneous recordings of a biological sensors directly attached to the body surface. In order to investigate its applicability to health condition monitoring, we have further developed a new monitoring system which can automatically monitor and store the health condition data. In this study, by evaluation on 3 patients with cardiac infarct or sleep apnea syndrome, patients' health condition such as body and excretion weight in the toilet and apnea and hypopnea during sleeping were successfully monitored, indicating that the system appears useful for monitoring the health condition during daily living.

Development of a fully automated network system for long-term health-care monitoring at home

Daily monitoring of health condition at home is very important not only as an effective scheme for early diagnosis and treatment of cardiovascular and other diseases, but also for prevention and control of such diseases. From this point of view, we have developed a prototype room for fully automated monitoring of various vital signs. From the results of preliminary experiments using this room, it was confirmed that (1) ECG and respiration during bathing, (2) excretion weight and blood pressure, and (3) respiration and cardiac beat during sleep could be monitored with reasonable accuracy by the sensor system installed in bathtub, toilet and bed, respectively.

Capacitive sensing of electrocardiographic potential through cloth from the dorsal surface of the body in a supine position: a preliminary study

A method for obtaining electrocardiographic potential through thin cloth inserted between the measuring electrodes and the skin of a subject's dorsal surface when lying supine has been proposed. The method is based on capacitive coupling involving the electrode, the cloth, and the skin. Examination of a pilot device which employed the method revealed the following: (1) In spite of the gain attenuation in the high frequency region, the proposed method was considered useful for monitoring electrogardiogram (ECG) for nondiagnostic purpose. (2) The method was able to yield a stable ECG from a subject at rest for at least 7 h, and there was no significant adverse effect of long-term measurement on the quality of the signal obtained. (3) Electrode area was the factor that had most influence on the signal, compared with other factors such as cloth thickness and coupling pressure, but could be reduced to 10 cm2 for heart rate detection. (4) Input capacitance of the device was assumed to be the dominant factor for the gain attenuation in the high frequency region, and should be reduced with a view to diagnostic use. Although there is still room for improvement in terms of practical use, the proposed method appears promising for application to bedding as a noninvasive and awareness-free method for ECG monitoring.

A health monitoring system for elderly people living alone

We have developed a health monitoring system for elderly people living alone. We monitored the in-house movements of eight subjects (average age 81 years) by placing infrared sensors in each room of their homes. Because their movements were unrestricted, monitoring could last longer than other forms of monitoring. Continuous monitoring was performed for 80 months in total. We found that each subject had a specific pattern of movements. We estimated their health condition by comparing the duration of stays in specific rooms, such as the lavatory, with previously recorded data. If after analysis an unusual state was detected, we informed the family of the incident. Final decisions should be made by the family members, not automatically by computer software. For example, after contacting the subject or a neighbour by telephone, family members could call for an ambulance or arrange a visit by a doctor or home help. Thus, this system reduced anxiety for both the elderly subjects living alone and their family members.

Unconstrained and non-invasive measurement of heart-beat and respiration periods using a phonocardiographic sensor

With the rapid growth in the number of elderly people in the population, interest in health monitoring is increasing. Therefore the development of an unconstrained and non-invasive vital signs measurement system could be important for monitoring health status at home or in hospitals or nursing facilities. A simple system is proposed for measuring heart-beat and respiration periods for home healthcare. This was achieved with a phonocardiographic (PCG) sensor set on a water-mat or air-mat. The PCG sensor was an acceleration sensor that extracted the vibration of the mat caused by heart-beat and respiration. By calculating an autocorrelation function of the fully rectified sensor output or by local pattern matching between the rectified output and a reference signal (pre-memorised for each subject), the system measured the average and instantaneous periods of both heart-beat and respiration. Results showed that these periods were measured to a similar level of accuracy as for the electrocardiogram and thermistor respiration pickup. The comparative accuracies were within the following ranges: average heartbeat 0.19% to 0.67%, instantaneous heartbeat 0.53% to 1.15%, average respiration 0.51% to 2.17%, and instantaneous respiration 2.51% to 5.20%.

Chronodiagnostic acquisition of recovery speed of heart rate under bathing stress

Cycling on an ergometer is one effective means of measuring cardiovascular function while applying stress on the heart. Bathing in a hot water bath applies a low stress to the heart. The electrocardiograms of a healthy adult male (aged 35 at the start of study) were recorded while taking a hot water bath with no electrode attached to the body over a period of 2 years (376 days over a 762 day period). The recovery speed following the initial overshoot of the heart rate (HR) was observed. The bathtub was designed for the automatic acquisition of ECG data. Immediately after immersion in the tub, the HR reached a peak within 20 s and then exponentially decreased toward the lowest rate in the 120 s of bathing. The initial recovery speed of the HR from the stress of bathing had a specific rhythm in the subject. Spectrum analysis of the speed series indicated that slow recovery speed appeared in cyclic periods of approximately 1 year, 42 days and 17 days. The methodology may provide a chronodiagnostic index of an exercise test for cardiovascular function.

Cardiopulmonary monitoring by textile electrodes without subject-awareness of being monitored

An automated system is developed to monitor cardiopulmonary functions during sleep using electrically conductive textiles. The system obviates the need to attach transducers or electrodes to the body surface, and the subject can follow his or her normal daily routine, wearing regular pajamas to bed. Part of the bed sheet consists of electrically conductive textiles under the positions of the head, torso and legs. Respiratory activity and electrocardiograms of diagnostic quality are observed by means of the electrodes while the subject is sleeping. Respiration is sensed by means of electrical capacitance in/around the thorax. Data acquisition and storage are fully automated; thus, the subject's awareness of being monitored is greatly reduced. This system could detect disorders of cardiopulmonary functions at an early stage, if used daily in the home with the concept of chronodiagnosis.

Monitoring of electrocardiograms in bed without utilizing body surface electrodes

We investigated a system by which an electrocardiogram can be obtained without the individual's awareness. The practice of this concept involves placing the electrodes in a bed set composed of electrically conductive textiles. Electrocardiograms were successfully obtained during sleep. However, during the periods of subject's movement in bed, the waveform became unrecognizable.