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ISSN: 2278 – 1323
                         International Journal of Advanced Research in Computer Engineering & Technology
                                                                             Volume 1, Issue 4, June 2012




    Doctor friendly software for HRV Analysis
                                  N.D.Thakur, M.S.Sankhe, Dr.K.D.Desai



Abstract- This paper discusses about the development         time interval between consecutive R peaks
of HRV analysis software using VB and MATLAB                 resulting from sinus node depolarisation) and
easy to be used and understand by the doctors. The           RMSSD (root-mean square of the difference
developed software provides user friendly GUI which          between two adjacent R-R intervals)[2],[3].
provides the doctors with HRV display along with
time domain and frequency domain parameters
                                                             Depending on the length of the analysed ECG
calculated from HRV. The system provides time                recording, which may vary from a few minutes to
domain measures like heart rate in BPM for every             24 hours, and the choice of the time domain
minute of recording, average heart rate over the             measure, both short-term and long-term HRV can
recording period of 5 minutes, mean NN interval,             be quantified and characterised. While time domain
variance in NN intervals and SDNN. The system also           measures help in assessing the magnitude of the
provides frequency domain measures based on short            temporal variations in the autonomically modulated
term spectral analysis like total power (0.00 to 0.4         cardiac rhythm, the frequency domain analysis
Hz), LF (0.00 to 0.04 Hz), MF (0.04 to 0.15 Hz) and          provides the spectral composition of these
HF (0.15 to 0.40 Hz) power in ms2 . The peak power in
each frequency band along with the corresponding
                                                             variations [4], [5]. The underlying assumption
frequency is also indicated. To minimize the effect of       behind the traditional frequency domain HRV
total power fluctuations the MF and HF are also              analysis is the „time invariance‟ or „stationarity‟ of
calculated in normalized units. The sympatho vagal           the signal, i.e., the individual spectral components
balance (MF/HF) which indicates the influence of two         do not change over the duration of signal
branches of autonomic nervous system on HRV is               acquisition. Through the use of computationally
also indicated for each patient samples. All the above       efficient algorithms such as Fast-Fourier Transform
the parameters provides the doctor an insight in to          (FFT), the HRV signal is decomposed into its
the state of the heart of the patient.                       individual spectral components and their
Index Terms— ANS, BPM, ECG, HRV, HRVPS,
                                                             intensities, using Power Spectral Density (PSD)
SDNN.                                                        analysis. These spectral components are then
                                                             grouped into three distinct bands [2], [4], [5]: low
                I. INTRODUCTION                              frequency (LF), mid frequency (MF) and high
                                                             frequency (HF). The cumulative spectral power in
The variation in the time period separating                  the MF and HF bands and the ratio of these spectral
consecutive heartbeats has come to be                        powers (MF/HF) has demonstrable physiological
conventionally described as heart rate variability           relevance in healthy and disease states. Changes in
(HRV). These inter-beat intervals can be measured            the MF band spectral power (0.04– 0.15Hz ) reflect
conveniently as the time separation between the R            a combination of sympathetic and parasympathetic
peaks of adjacent QRS complexes in a continuous              ANS outflow variations, while changes in the HF
electrocardiogram       (ECG)      recording.    The         band spectral power (0.15–0.40Hz) reflect vagal
sympathetic and parasympathetic branches of the              modulation of cardiac activity. The MF/HF power
autonomic nervous system (ANS) regulate the                  ratio is used as an index for assessing sympatho-
activity of the sinoatrial node, the cardiac                 vagal balance.
pacemaker [1]. The beat-to-beat variation in heart           The time domain and frequency domain measures
rate therefore reflects the time varying influence of        and methods described above were initially
the ANS and its components, on cardiac function.             developed and further refined to meet automation
Over the last 25 years, HRV analysis has                     needs and to keep pace with the evolution in
established itself as a non-invasive research and            processing capabilities offered by the most current
clinical tool for indirectly investigating both              computer and microprocessor technology available.
cardiac and autonomic system function in both                One such quantum refinement addresses the time
health and disease [2]. The current methodologies            varying characteristics of the autonomic influence
used to analyse HRV are based largely on linear              on cardiac activity and the transient changes in
techniques to analyse „past‟ and „present‟                   heart rate response to these regulatory influences.
electrocardiogram data in time and frequency                 Through the use of advanced signal processing
domains. For conventional time domain analysis,              algorithms such as short-time Fourier transform,
the variability in the R-R interval time series              joint time-frequency distributions and wavelets, the
derived from an ECG recording is statistically               dynamic spectral properties of HRV have been
summarised       using     conveniently    calculated        investigated during transient episodes characteristic
measures such as SDNN (standard deviation of                 of various physiological and clinical states.

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                                        All Rights Reserved © 2012 IJARCET
ISSN: 2278 – 1323
                         International Journal of Advanced Research in Computer Engineering & Technology
                                                                             Volume 1, Issue 4, June 2012



A further level of sophistication was provided to             A. Heart Rate Response in Supine and Standing
HRV researchers through the use of complimentary              Positions
analysis techniques that addressed the non-linear
complexities and deterministic nature of the control          Under resting conditions, beat-to-beat variation in
system regulating cardiac activity. These non-linear          the duration of the R-R interval of the EGG in
methods include chaotic analysis, information                 healthy subjects exhibits periodic variation. The
domain measures such as approximate entropy,                  change from horizontal to vertical position brings
detrended fluctuation analysis and heart rate                 about the influence of gravity on circulation. The
turbulence analysis. All of the above mentioned               test is easily performed by asking the subject to lie
methods for analysing HRV are important in their              quietly on a couch for at least five minutes, then
own      right    and    have     provided   unique           stand up unaided as quickly as possible, and remain
physiologically relevant information about cardiac            standing thereafter for at least one minute. After
rhythm and its regulation. It is only through                 standing, there is an immediate increase in heart
widespread use and validation of these existing               rate (HR), and then a subsequent decrease is
methods and continued development of more                     observed in normal people. The increase in HR is
advanced techniques that combine engineering and              mediated by the vagal nerves, since it is abolished
mathematical concepts with biology and medicine               by atropine and not by propranolol. The decrease in
that the true potential of HRV analysis be realised           HR is due to a vagal reflex caused by a
and its clinical relevance fully understood.                  sympathetically mediated vasoconstriction. The
                                                              increase in the HR is quantified by measuring the
       II. VARIATIONS IN HEART RATE                           maximum increase during the first 15 seconds
                                                              compared to the HR in the supine position. The
Under steady state conditions, the specific                   decrease in HR is quantified by measuring the RR
oscillations of the heart rate reflect the beat-to-beat       interval ratio in the 15 and 30 seconds after
autonomic control of SA node activity. The SA                 standing (RR max / RR min) [8]. Unfortunately
node, which is the dominant pacemaker of the                  different values for this ratio are used as standards
heart, is enervated by both sympathetic and                   by several investigators.
parasympathetic nerves. Sympathetic nerve activity
increases the heart rate, while parasympathetic               B. HR Response to Deep Breathing
nerve activity slows it [1]. Clinically measured
variations of the heart rate have shown modulations           Under resting conditions, beat-to-beat variation in
at low, medium and high frequency [6]. These                  duration of the R-R interval of the ECG from
oscillations are of cardiovascular origin and are             healthy subjects exhibits periodic variation, which
pseudo periodical. They repeat themselves in time,            is referred to as respiratory sinus arrhythmia
with a period which oscillates around a certain               (RSA). The origin of the Respiratory sinus
mean value even when no rhythm disturbances are               arrhythmia (RSA) is still not clear. It is generally
present. These oscillations are now recognized as             agreed that it is mainly mediated by the
physiological rhythms, representing neuro cardiac             parasympathetic nervous system, since atropine
regulation of blood pressure and heart rate [7].              greatly reduces its degree [6]. The sympathetic
     Changes in blood pressure in normal healthy              nervous system has a minor role to play in RSA,
persons show spontaneous oscillations of the heart            since blocking it with propranolol leads to a slight
rate in a narrow around 0.1 Hz known as the                   reduction of the RSA, which is more evident in
Traube-Hering-Mayer (THM) waves. It has been                  standing than in the supine position. There is still
established that these HR oscillatory waves are               no consensus on the method or on the way the
generated by the blood pressure control system that           response is quantified or on the limits of the
causes switching on-off of the baroreceptor reflex            reference values.
[6]. The frequency oscillations of the heart rate             In most tests, RSA is measured when the subject
(HR) reflect neuroregulatory activity [6]. In this            lies quietly and breathes deeply at a rate of six
context, the heart rate variation power spectrum              breaths per minute; this rate produces maximum
(HRVPS) has been studied [8], and provides a                  variations in HR [7]. In most studies, RSA is
noninvasive measure of the autonomic nervous                  quantified as the mean difference between the
system function. Studies have documented the                  maximum and minimum HR during consecutive
repeatability of HR power density at rest and its             deep breaths, which can be expressed either in
alterations due to mental loading, orthostatic stress,        beats per minute (BPM) or in seconds. Another
forced respiration, post-myocardial infarct as well           way of expressing RSA is by the mean value of the
as following heart transplant, to help autonomic              ratio of the six longest RR intervals to the six
tone [6, 7].                                                  shortest intervals.




                                                                                                              258
                                         All Rights Reserved © 2012 IJARCET
ISSN: 2278 – 1323
                        International Journal of Advanced Research in Computer Engineering & Technology
                                                                            Volume 1, Issue 4, June 2012



         III. RR INTERVAL DETECTOR                          out high frequency noise. The two stage ECG
                                                            amplifier is included to provide an overall gain of
For HRV analysis we require an ECG recorder and             1000 to obtain an ECG signal up to 2 volt
RR interval detector as an analog front end. This
                                                            amplitude. At the output of an ECG amplifier we
section discusses about one such design developed
for the RR interval data acquisition.                       get a clear undistorted analog ECG waveform
In this system the clamp electrodes are used to             which is then sent to ADC in data acquisition
measure the ionic potentials generated at the limbs.        system (DAS).The ECG signal is also applied to an
Fig. 1 shows the physical appearance of these               optoisolator which provides patient isolation along
clamp electrodes. Clamp Electrodes enable quick,            with isolated synchronised pulses corresponding to
secure and reliable ECG leads. Intricate and often          the R waves in ECG. These pulses are sent to the
painful fixing of ECG electrodes is a thing of the
                                                            counter in the DAS which measures the duration
past with clamp electrodes. The large contact area
of the Clamp Electrode guarantees secure ECG                between consecutive R waves and sends this data to
leads. All that has to be done is to apply some             the computer through the serial port. These pulses
medesign Electrode Spray and open and close the             are also applied to trigger input of monostable
clamp. Clamp Electrodes are also easily fixed in            multivibrator which produces a pulse of 429 ms
emergency situations and are easy to clean. The             width for each R wave in ECG. The output of
gentle pressure makes the electrode difficult to            monostable mutivibrator is used to drive an LED
detect for the patient. Staffs do not have to fiddle
                                                            which acts a beat indicator. The DAS consists of
with tightening straps and the ECG is easy to
handle. The Clamp Electrode is easily and quickly           microcontroller PIC 18F2550 and serial port driver
fixed to arms or legs and no tightening strap is            MAX 232.It was found that the estimation accuracy
necessary. One Set contains Clamp Electrodes in             is mainly determined by the noise and hum
red, yellow, green and black. It is Suitable for            interference. The morphology changes of the P-
adults as well as children. They are made from              wave influences the wave form occurrence time
antistatic plastic with a silver/silver chloride
                                                            estimation. Theoretically, it should be P to P
electrode. The Clamp is made from plastic with
surgical steel contact.                                     interval file, but due to the difficulties associated
                                                            with automated recognition of P waves, the R wave
                                                            is chosen. The R-R interval file contains
                                                            information in both the time and frequency domain.
                                                            Hence both time and frequency domain analyses
                                                            can be used to evaluate heart rate variability. It is
                                                            necessary to look carefully to the wave-form
                                                            morphology before estimating it for HRV
                                                            measurement.       Therefore     lead     L1    ECG
                                                            configuration is selected, which has high amplitude
                                                            of QRS wave for measuring R-R interval. The R-R
         Fig. 1: ECG clamp electrodes.                      interval file is used to get instantaneous heart rate
                                                            (HR), as HR is the reciprocal of an R-R interval.
Fig. 2 shows the block schematic of an analog ECG
amplifier cum R-peak detector circuit, which
                                                             ECG pre           Voltage          Low pass        ECG
converts the ECG signal into R-peak pulses. These
                                                             amplifier         Follower         Filter          Amplifier
pulses are further processed by the microcontroller
and programming software on the computer to plot
the instantaneous HRV plot. The HRV program
also calculates time domain measures like heart                  RR Interval               Isolated Sync        Optical
rate, mean NN and SDNN. It performs spectral                     File acquisition          Pulse output         Isolator
analysis to plot the graph of HRVPS and calculates
the different parameters from HRVPS.
The signal obtained from the clamp electrodes is
                                                                                                                 Beat
connected to the ECG preamplifier which is built                                                               Indicator
by making use of AD620 and AD705 ICs.It
provides a low amplitude distorted ECG waveform.
                                                                            Fig. 2: R peak detector.
The voltage follower is included for impedance
matching and to avoid the loading effect. The low
pass filter having cut off frequency of 16 Hz filters

                                                                                                            259
                                       All Rights Reserved © 2012 IJARCET
ISSN: 2278 – 1323
                        International Journal of Advanced Research in Computer Engineering & Technology
                                                                            Volume 1, Issue 4, June 2012



     IV. SOFTWARE FOR HRV ANALYSIS                          The software developed for this application will
                                                            display the information in various screens. The
The software for the system is developed in VB              Startup Screen will appear as soon as the user starts
which provides user friendly graphical interfaces to        the application. This screen shows up the Various
the doctors along with the database to store patient        Tabs which the user of the HRV Analysis Software
information and history. The R-R waves coming               can access. The four main tabs supported are:
from the R peak detector will be recorded for 5             1) Setup Tab,
minutes for each patient and then sent to the               2) Patient Interaction Tab,
computer by DAS              through     the serial         3) Analysis Tab and
communication port. The analog ECG signal                   4) Storage Tab.
coming from ECG recorder is sampled at the rate             Each of these tabs allows for specific functionality
of 8 Hz by the microcontroller and then sent to the         to be accessed of the software, the details are as
computer using serial communication port. The VB            below:
software then provides the display of both the ECG
signal and HRV signal on the GUI. The software              A. Setup
then makes use of MATLAB to calculate the time
domain measures like heart rate in BPM, average             This Tab has a Port setting frame which allows
heart rate for 5 minutes, mean NN, variance of NN           basic port access with Port selection by means of
and SDNN.The power spectrum will be then                    the list box which presents a list of available ports.
plotted using FFT. The power spectrum plot depicts          Open & Close Port functionality is supported;
power in ms2 versus Frequency in Hertz. From the            when the port is open there is a GREEN LED
power spectrum following parameters are                     symbol which turns RED when the port is closed.
calculated:                                                 The selected port is also listed on screen.
Power under Low frequency range (0.00 to 0.04Hz)            The status of Sampling is also presented is it
Power under Mid frequency range (0.04 to 0.15Hz)            stopped? or currently active. If active then the time
Power under High frequency range(0.15 to 0.40Hz)            passed after start of sampling is listed.
Sympatho Vagal balance ratio which is the ratio of          A Simulate signal check box is provided which
mid to high frequency powers. The logical flow              allows the ECG microcontroller Hardware to
chart for the system operation is as given in fig. 3.       simulate some Waveforms so that the
                                                            communication between PC and the ECG
                                                            Hardware and the Graph presentation of the Data
                                                            Received can be tested/ Verified.
                    Patient
                                                            The Next frame in this Tab is the Serial Data Frame
                                                            which shows the Data communication by
                                                            presenting the packets exchanged between the PC
                                                            and ECG Hardware. The outgoing Data from the
                                                            PC is presented in blue colour and Incoming
           Beat to beat RR recording                        responses or Data Packets are presented in Red.
                  in hardware                               Note that most Command buttons except the Stop
                                                            sampling and Exit Application are Disabled, this
                                                            ensures that User cannot open or close port while
                                                            sampling is in progress. The Test Hardware button
                                                            provided in the software allows the user to test the
                                                            ECG recorder for the connection. The Next button
            HRV Analysis software                           provided in this tab allows the user to go to the next
                                                            tab in the software which is the patient interaction
             Set up Module                                 tab with graph frame to display the incoming ECG
                                                            or HRV signal.
             Patient Interaction
              Module                                        B. Patient Interaction

             Analysis Module                               This Tab has a Graph frame which is used to
                                                            display HRV or ECG waveform while it is being
             Storage Module                                sampled by the Microcontroller hardware system.
                                                            The Show ECG and Show HRV buttons are
                                                            provided to select the waveform to be displayed.
                                                            The default waveform displayed is HRV
  Fig. 3: Logical flow chart for system operation.          waveform. The name of the waveform displayed is
                                                            also shown in this tab along with the corresponding
                                                            waveform. The microcontroller sends the data to

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                                       All Rights Reserved © 2012 IJARCET
ISSN: 2278 – 1323
                        International Journal of Advanced Research in Computer Engineering & Technology
                                                                            Volume 1, Issue 4, June 2012



the PC in three channel format. The first channel           corresponding peak power frequency. The MF and
indicates ECG units, the second channel indicates           HF powers are also displayed in normalised units
Whether RR interval is detected or not? When RR             which reduce the effect of changes in total power
interval is detected it sends 1 else 0. The third           on these components. The sympatho vagal balance
channel indicates the value of detected RR interval.        which is the ratio of MF to HF power and indicates
Since we have used 8 Hz sampling rate for ECG               the influence of the two branches of autonomic
signal there will be eight values consecutively             nervous system on HRV is also displayed in this
displayed in the ECG channel corresponding to one           frame. The MATLAB program developed for the
value in RR interval. All these three channel values        analysis tab is given below.
are also displayed in this tab along with the graph.
This Tab also has the Sampling time section                 % delete old output and Processing had done flag.
indicating the current sampling time lapsed or              dos 'del HRVParmOut.txt'
sampling stopped status. Using the Setup and                dos 'del HRVPPSD.txt'
Patient Interaction tab the user can Setup the Port         dos 'del HRVPSD.bmp'
and interact with the Patient by Starting or                dos 'del HRVDone.txt'
Stopping sampling. Also Testing Hardware                    dos 'del HRVFFT.txt'
connectivity or Quitting Application Command                dos 'del HRVFFT.bmp'
Buttons are available. There are Previous and Next
Navigation keys available for moving between the            % Read Input from File
four Tabs, when the user is on First (Setup) Tab the        NNSamples = dlmread ('HRVInput.txt');
Previous key is disabled and when the user reaches           sprintf ('Read in %d samples‟,
the Last (Storage) tab the Next key is disabled. In          length (NNSamples))
case of Clicking the Test / Start /Stop /Start with         Sample Count = length (NNSamples);
Simulate selected Command buttons the                       Sum (1) =0;
corresponding packets are sent by the PC over               for j=2: SampleCount
serial port hardware and the incoming packets are              Sum (j) =Sum (j-1) +NNSamples (j-1);
populated in to the Serial Data Frame in RED                end
colour. Also the data from packets is decoded and            Mins=round (Sum (Sample Count)/60000);
saved in a data File named – HRV_FILE.txt.                  if Mins >5
                                                               Mins = 5
C. Analysis                                                 end
                                                             for M=1: Mins
This Tab has a Save file button which allow the                Detect (Sum>60000*M) =1;
User to Save Patients Data and Calculations for the            BPMIndex=find (Detect==1);
purpose of later use. Also the Load file button can            BPM (M) =BPMIndex (1)-1;
be used to reload a saved file back into HRV                   clear Detect BPMIndex
software. This tab supports the Analysis based on           end
Time and frequency domain, which allows the user            BPM
to Select and evaluate specific HRV parameters for           for M=Mins: 1:2
Analysis. The Process HRV button in this tab calls                BPM (M) =BPM (M)-BPM (M-1);
the MATLAB program named process PSD.m to                   end
calculate the time and frequency domain                      AVGBPM5=mean (BPM);
parameters based on the acquired or loaded RR                MeanNN=mean (NNSamples);
interval file. This Tab also has a Graph frame              VarNN=var (NNSamples);
which displays HRV power spectrum for the                   STDNN=std (NNSamples);
patient.
The next frame in this tab is Time domain                   % Compute FFT
measures which displays the time of recording, the          FreqCount=256;
number of NN samples in the loaded RR interval              FFTNN = fft (NNSamples, FreqCount);
file, heart rate in BPM for every minute of
recording, average heart rate over a recording               % Output post process
period of 5 minutes, mean NN value in ms,                   Pyy = FFTNN.* conj (FFTNN) / FreqCount;
variance of NN values in ms and SDNN value in               f = (0 :( FreqCount/2)-1)/FreqCount;
ms.                                                          figure
It also has frequency domain measures frame                 plot (f (1 :( FreqCount/2)), FFTNN (1 :
which displays the values of various components             (FreqCount/2)))
obtained from short term spectral analysis of HRV            set (get (gca,'Title'),'FontName','FixedWidth')
for 5 minutes. The values displayed are total power         set(get (gca,'Title'),'FontWeight','Bold')
in ms2, LF power, MF power and HF power in ms2,             set (get (gca,'xlabel'),'FontName','FixedWidth')
along with the peak power in each band and the              set (get (gca,'xlabel'),'FontWeight','Bold')

                                                                                                               261
                                       All Rights Reserved © 2012 IJARCET
ISSN: 2278 – 1323
                         International Journal of Advanced Research in Computer Engineering & Technology
                                                                             Volume 1, Issue 4, June 2012



set (get (gca,'ylabel'),'FontName','FixedWidth')             % HF band
set (get (gca,'ylabel'),'FontWeight','Bold')                 Max1=find (PSDHF==max (PSDHF));
title ('FFT Samples')                                        HFPeakf = fHF (Max1 (1));
xlabel ('frequency (Hz)')                                    PsumHF =sum (PSDHF);
 Print -dbmp256 'HRVFFT.bmp'                                 PeakP= [max (PSDLF),
close (1)                                                    max (PSDMF), max (PSDHF)]
 dlmwrite ('HRVFFT.txt', FFTNN)                              Power= [PSDsum, PsumLF, PsumMF, PsumHF]
Pyy (Pyy==max (Pyy)) =0;                                     PeakF= [LFPeakf, MFPeakf, HFPeakf]
 figure
plot (f (1:FreqCount/2),Pyy(1:FreqCount/2))                   % write Freq & Time Domain Parameters
title ('PSD Frequency content')                              OutputVar=[PeakP,Power,PeakF,Mins,SampleCou
 set(get(gca,'Title'),'FontName','FixedWidth')               nt,MeanNN,VarNN,STDNN,AVGBPM5,BPM];
set (get(gca,'Title'),'FontWeight','Bold')                   dlmwrite ('HRVParmOut.txt', OutputVar);
set (get(gca,'xlabel'),'FontName','FixedWidth')               True1=1;
set (get(gca,'xlabel'),'FontWeight','Bold')                  dlmwrite ('HRVDone.txt', True1);
set (get(gca,'ylabel'),'FontName','FixedWidth')
set (get(gca,'ylabel'),'FontWeight','Bold')                   % go back
 xlabel ('frequency (Hz)')                                   exit
ylabel ('Power ms^2');
 print -dbmp256 'HRVPSD.bmp'                                  D. Storage
close (1)
 dlmwrite ('HRVPSD.txt', Pyy)                                This Tab again has a Save file button which allow
                                                             the User to Save Patients Data and Calculations for
% process for band selection                                 purpose of later use. Similarly the Load file button
LFMax = 0.04                                                 can be used to reload a saved file back into HRV
MFMax = 0.15                                                 software. The Clear record button is used to delete
HFMax = 0.4                                                  the previous saved record of the patient. This tab
 for j=1:length (f)                                          supports the Patient Information like Name,
   if f (j)<=LFMax                                           Address and Other Contact details etc. to be feed in
      fLF (j) =f (j);                                        or reviewed along with Doctors Contact
      PSDLF (j) = Pyy (j);                                   Information. The file is saved in text format which
   else                                                      contains the RR interval information over a
      if f (j)<=MFMax                                        recording period. The path for saving of file can
          fMF (j) =f(j);                                     also be selected from this tab.
          PSDMF (j) =Pyy (j);                                The figures 4 to 7 indicate the various conditions in
      else                                                   these developed tabs.
          if f (j)<=HFMax
             fHF (j) =f (j);
             PSDHF (j) =Pyy (j);
          end
      end
   end
end

% Find Total Power
PSDsum =sum (Pyy);

% Find Max power in each band

% LF band
Max1=find (PSDLF==max (PSDLF));
LFPeakf = fLF (Max1 (1));
PsumLF =sum (PSDLF);

% MF band
Max1=find (PSDMF==max (PSDMF));
MFPeakf = fMF (Max1 (1));
PsumMF =sum (PSDMF);




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                                        All Rights Reserved © 2012 IJARCET
ISSN: 2278 – 1323
International Journal of Advanced Research in Computer Engineering & Technology
                                                    Volume 1, Issue 4, June 2012




Fig. 4: The Setup tab with com 1 port open and sampling started.




   Fig. 5: Patient interaction tab with patient HRV displayed.

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               All Rights Reserved © 2012 IJARCET
ISSN: 2278 – 1323
   International Journal of Advanced Research in Computer Engineering & Technology
                                                       Volume 1, Issue 4, June 2012




Fig. 6: Analysis tab with HRVPS, Time & Frequency domain measures.




             Fig. 7: Storage tab to store the patient data.
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                 All Rights Reserved © 2012 IJARCET
ISSN: 2278 – 1323
                        International Journal of Advanced Research in Computer Engineering & Technology
                                                                            Volume 1, Issue 4, June 2012

                   V. RESULTS

The fig.8 (a) and 8(b) presented below indicates the
HRV graph and HRV power spectrum obtained for
patient with MIT_BIH Arrhythmia. While fig. 9(a)
and 9(b) indicates the HRV and HRVPS obtained
for patient with normal heart rate variations. Both
the results are obtained from the RR interval
samples recorded over a period of 5 minutes.
Looking at the very nature of the HRV graph the
doctor can very easily and primarily differentiate
between the normal and abnormal heart rate
variations. The software also provides HRVPS and
various time domain and frequency domain
parameters calculated from HRV which further
helps the doctor for detail diagnosis.
                                                                 Fig. 9(a): HRV for patient with normal Heart.
                                                            .




    Fig. 8 (a): HRV for patient with MIT_BIH                    Fig. 9(b): HRVPS for patient with normal Heart.
                   Arrhythmia.
                                                                             VI. CONCLUSION

                                                            Heart rate variability analysis is increasingly
                                                            becoming an important tool in cardiology, because
                                                            it constitutes a non-invasive and convenient method
                                                            to diagnose cardiac patients. It can provide
                                                            measures of sympathetic and parasympathetic
                                                            function of the autonomic nervous system.
                                                            HRV has considerable potential to assess the role
                                                            of autonomic nervous system fluctuations in
                                                            normal healthy individuals and in patients with
                                                            various cardiovascular and noncardiovascular
                                                            disorders. HRV studies enhance our understanding
                                                            of physiological phenomena, the actions of
                                                            medications, and disease mechanisms. The
                                                            developed software for HRV system is user
                                                            friendly and would provide an economical and
                                                            efficient solution to the doctors for the assessment
   Fig.8 (b): HRVPS for patient with MIT_BIH                of risk in cardiovascular disorders; assessment of
                  Arrhythmia.                               physical fitness; documentation of benefit for
                                                            cardiac, chiropractic, or orthopaedic rehabilitation.
                                                                                                            265
                                       All Rights Reserved © 2012 IJARCET
ISSN: 2278 – 1323
                             International Journal of Advanced Research in Computer Engineering & Technology
                                                                                 Volume 1, Issue 4, June 2012

                                                                     working as Associate Professor in Electronics Department at
                       REFERENCES                                    Mukesh Patel School of Technology Management and
                                                                     Engineering, SVKM‟S NMIMS University, Mumbai. He is life
[1] Leslie Cromwell, Fred J. Weibell, Erich A. Pfeiffer,             member of Indian Society of Technical education (ISTE). His
“Biomedical Instrumentation and Measurements”, Prentice –            areas of interests are Biomedical Electronics, Electronics Circuit
Hall of India Private ltd.Second edition, pp. 92,292 (1980).         analysis & Design and Neural Network & Fuzzy Systems. He
[2] Task Force of the European Society of Cardiology and the         has 05 papers in National / International Conferences and
North American Society of Pacing and Electrophysiology               Journals to his credit.
“Heart rate variability. Standards of measurement, physiological
interpretation, and clinical use.”1996 Mar; 17(3), pp. 354-381.
                                                                                          Dr. K.D. Desai has received B.E. in
[3] Drs Tarun Chandra, Donovan B Yeates and Lid B Wong
                                                                                          Electrical Engineering from V.J.T.I.,
“Heart Rate Variability Analysis – Current and Future Trends”
Business briefing Global healthcare 2003, pp.1-5                                          Mumbai University in 1970, M.E. in
[4] Pomeranz M, Macaulay RJB, Caudill MA, Kutz I, Adam D,                                 Electrical Engineering (Computer Science
Gordon D, Kilborn KM, Barger AC, Shannon DC, Cohen RJ,                                    Specialization) from V.J.T.I., Mumbai
Benson M. “Assessment of autonomic function in humans by                                  University in 1985 and Ph.D. in
heart rate spectral analysis”. Am J Physiol. 1985; 248:H151-                              Technology from V.J.T.I., Mumbai
H153.                                                                University in 1995. He has more than 25 years of experience in
 [5] Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R,
                                                                     teaching & 13 years of experience in Industry. He is currently
Pizzinelli P, Sandrone G, Malfatto G, Dell'Orto S, Piccaluga E,
Turiel M, Baselli G, Cerutti S, Malliani A. “Power spectral          working as Director and Principal at K.C.college of Engineering
analysis of heart rate and arterial pressure variabilities as a      Thane, Mumbai University. His areas of interests are
marker of sympathovagal interaction in man and conscious             Biomedical Electronics, Telecommunication & Industrial
dog”. Circ Res. 1986; pp. 59:178-193.                                LASER Applications. He has 09 papers in National /
[6] Issam El Mugamar, K.D. Desai, Sulatan Abdul Ali,                 International Conferences and Journals to his credit. Currently
Mohammed Saeed, Amin Fikree, S.D. Bhagwat: “Computerized             he is guiding two Ph.D. students at MPSTME, SVKM‟S
Reliable Detection of Diabetic Autonomic Neuropathy”, Proc.
                                                                     NMIMS University.
Of International Conference on Recent Advances in Biomedical
Engineering – 94, Hyderabad, India (1994), pp.321-325.
[7]. Fallen, E.L., D. Nandogopal, S. Connonlly and D.N. Ghista,
“How reproducible is the power spectrum of heart rate
variability in health subjects?” Proceedings of International
Symposium on Neural and Cardiovascular Mechanisms,
Bologna, Italy (May, 1985), pp.41-45.
[8].Kamath, D.N. Ghista, E.L. Fallen, D. Fitchett, D. Miller and
R. McKelvie, “Heart rate variability power spectrogram as
potential noninvasive signature of cardiac regulatory system
response, mechanisms, and disorders”, in Heart and Vessels,pp.
3, 33-41 (1987).
[9].Kamalakar Desai, Dhanjoo N. Ghista,Issam Jaha El
Mugamex,Rajendra Acharya U Michael Towsey, Sultan Abdul
Ali,Mohammed Saeed, M. Amin Fikri,”DAN detection by HRV
power spectral analysis”, pp. 3-14 (2010).
[10] Noel Jerke “The complete reference Visual Basic 6”.First
edition 22nd reprint 2005, pp.187-247.

                      Nirmal D. Thakur has received B.E. in
                      Industrial Electronics Engineering from
                      Amravati University in 2002, M.B.A. in
                      Human resources management from
                      IGNOU in 2011, and M.Tech. in
                      Electronics Engineering from NMIMS
                      University, Mumbai in 2012. He has
more than 8 years of experience in teaching. He is currently
working as Lecturer in Electronics Department at Shreeram
Polytechnic Airoli, NaviMumbai. He is life member of Indian
Society of Technical education (ISTE). His areas of interest are
Biomedical Electronics, Industrial Automation, Process Control
and Instrumentation. He has 05 papers in National/International
Conferences and Journals to his credit.

                     Manoj S. Sankhe has received B.E .in
                     Electronics Engineering from Pune
                     University in 1996, M.E. in Digital
                     Electronics from Amravati University in
                     2002, and is currently pursuing Ph.D.
                     from NMIMS University, Mumbai. He
                     has more than 15 years of experience in
teaching & 1.5 years of experience in industry. He is currently

                                                                                                                                 266
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  • 1. ISSN: 2278 – 1323 International Journal of Advanced Research in Computer Engineering & Technology Volume 1, Issue 4, June 2012 Doctor friendly software for HRV Analysis N.D.Thakur, M.S.Sankhe, Dr.K.D.Desai Abstract- This paper discusses about the development time interval between consecutive R peaks of HRV analysis software using VB and MATLAB resulting from sinus node depolarisation) and easy to be used and understand by the doctors. The RMSSD (root-mean square of the difference developed software provides user friendly GUI which between two adjacent R-R intervals)[2],[3]. provides the doctors with HRV display along with time domain and frequency domain parameters Depending on the length of the analysed ECG calculated from HRV. The system provides time recording, which may vary from a few minutes to domain measures like heart rate in BPM for every 24 hours, and the choice of the time domain minute of recording, average heart rate over the measure, both short-term and long-term HRV can recording period of 5 minutes, mean NN interval, be quantified and characterised. While time domain variance in NN intervals and SDNN. The system also measures help in assessing the magnitude of the provides frequency domain measures based on short temporal variations in the autonomically modulated term spectral analysis like total power (0.00 to 0.4 cardiac rhythm, the frequency domain analysis Hz), LF (0.00 to 0.04 Hz), MF (0.04 to 0.15 Hz) and provides the spectral composition of these HF (0.15 to 0.40 Hz) power in ms2 . The peak power in each frequency band along with the corresponding variations [4], [5]. The underlying assumption frequency is also indicated. To minimize the effect of behind the traditional frequency domain HRV total power fluctuations the MF and HF are also analysis is the „time invariance‟ or „stationarity‟ of calculated in normalized units. The sympatho vagal the signal, i.e., the individual spectral components balance (MF/HF) which indicates the influence of two do not change over the duration of signal branches of autonomic nervous system on HRV is acquisition. Through the use of computationally also indicated for each patient samples. All the above efficient algorithms such as Fast-Fourier Transform the parameters provides the doctor an insight in to (FFT), the HRV signal is decomposed into its the state of the heart of the patient. individual spectral components and their Index Terms— ANS, BPM, ECG, HRV, HRVPS, intensities, using Power Spectral Density (PSD) SDNN. analysis. These spectral components are then grouped into three distinct bands [2], [4], [5]: low I. INTRODUCTION frequency (LF), mid frequency (MF) and high frequency (HF). The cumulative spectral power in The variation in the time period separating the MF and HF bands and the ratio of these spectral consecutive heartbeats has come to be powers (MF/HF) has demonstrable physiological conventionally described as heart rate variability relevance in healthy and disease states. Changes in (HRV). These inter-beat intervals can be measured the MF band spectral power (0.04– 0.15Hz ) reflect conveniently as the time separation between the R a combination of sympathetic and parasympathetic peaks of adjacent QRS complexes in a continuous ANS outflow variations, while changes in the HF electrocardiogram (ECG) recording. The band spectral power (0.15–0.40Hz) reflect vagal sympathetic and parasympathetic branches of the modulation of cardiac activity. The MF/HF power autonomic nervous system (ANS) regulate the ratio is used as an index for assessing sympatho- activity of the sinoatrial node, the cardiac vagal balance. pacemaker [1]. The beat-to-beat variation in heart The time domain and frequency domain measures rate therefore reflects the time varying influence of and methods described above were initially the ANS and its components, on cardiac function. developed and further refined to meet automation Over the last 25 years, HRV analysis has needs and to keep pace with the evolution in established itself as a non-invasive research and processing capabilities offered by the most current clinical tool for indirectly investigating both computer and microprocessor technology available. cardiac and autonomic system function in both One such quantum refinement addresses the time health and disease [2]. The current methodologies varying characteristics of the autonomic influence used to analyse HRV are based largely on linear on cardiac activity and the transient changes in techniques to analyse „past‟ and „present‟ heart rate response to these regulatory influences. electrocardiogram data in time and frequency Through the use of advanced signal processing domains. For conventional time domain analysis, algorithms such as short-time Fourier transform, the variability in the R-R interval time series joint time-frequency distributions and wavelets, the derived from an ECG recording is statistically dynamic spectral properties of HRV have been summarised using conveniently calculated investigated during transient episodes characteristic measures such as SDNN (standard deviation of of various physiological and clinical states. 257 All Rights Reserved © 2012 IJARCET
  • 2. ISSN: 2278 – 1323 International Journal of Advanced Research in Computer Engineering & Technology Volume 1, Issue 4, June 2012 A further level of sophistication was provided to A. Heart Rate Response in Supine and Standing HRV researchers through the use of complimentary Positions analysis techniques that addressed the non-linear complexities and deterministic nature of the control Under resting conditions, beat-to-beat variation in system regulating cardiac activity. These non-linear the duration of the R-R interval of the EGG in methods include chaotic analysis, information healthy subjects exhibits periodic variation. The domain measures such as approximate entropy, change from horizontal to vertical position brings detrended fluctuation analysis and heart rate about the influence of gravity on circulation. The turbulence analysis. All of the above mentioned test is easily performed by asking the subject to lie methods for analysing HRV are important in their quietly on a couch for at least five minutes, then own right and have provided unique stand up unaided as quickly as possible, and remain physiologically relevant information about cardiac standing thereafter for at least one minute. After rhythm and its regulation. It is only through standing, there is an immediate increase in heart widespread use and validation of these existing rate (HR), and then a subsequent decrease is methods and continued development of more observed in normal people. The increase in HR is advanced techniques that combine engineering and mediated by the vagal nerves, since it is abolished mathematical concepts with biology and medicine by atropine and not by propranolol. The decrease in that the true potential of HRV analysis be realised HR is due to a vagal reflex caused by a and its clinical relevance fully understood. sympathetically mediated vasoconstriction. The increase in the HR is quantified by measuring the II. VARIATIONS IN HEART RATE maximum increase during the first 15 seconds compared to the HR in the supine position. The Under steady state conditions, the specific decrease in HR is quantified by measuring the RR oscillations of the heart rate reflect the beat-to-beat interval ratio in the 15 and 30 seconds after autonomic control of SA node activity. The SA standing (RR max / RR min) [8]. Unfortunately node, which is the dominant pacemaker of the different values for this ratio are used as standards heart, is enervated by both sympathetic and by several investigators. parasympathetic nerves. Sympathetic nerve activity increases the heart rate, while parasympathetic B. HR Response to Deep Breathing nerve activity slows it [1]. Clinically measured variations of the heart rate have shown modulations Under resting conditions, beat-to-beat variation in at low, medium and high frequency [6]. These duration of the R-R interval of the ECG from oscillations are of cardiovascular origin and are healthy subjects exhibits periodic variation, which pseudo periodical. They repeat themselves in time, is referred to as respiratory sinus arrhythmia with a period which oscillates around a certain (RSA). The origin of the Respiratory sinus mean value even when no rhythm disturbances are arrhythmia (RSA) is still not clear. It is generally present. These oscillations are now recognized as agreed that it is mainly mediated by the physiological rhythms, representing neuro cardiac parasympathetic nervous system, since atropine regulation of blood pressure and heart rate [7]. greatly reduces its degree [6]. The sympathetic Changes in blood pressure in normal healthy nervous system has a minor role to play in RSA, persons show spontaneous oscillations of the heart since blocking it with propranolol leads to a slight rate in a narrow around 0.1 Hz known as the reduction of the RSA, which is more evident in Traube-Hering-Mayer (THM) waves. It has been standing than in the supine position. There is still established that these HR oscillatory waves are no consensus on the method or on the way the generated by the blood pressure control system that response is quantified or on the limits of the causes switching on-off of the baroreceptor reflex reference values. [6]. The frequency oscillations of the heart rate In most tests, RSA is measured when the subject (HR) reflect neuroregulatory activity [6]. In this lies quietly and breathes deeply at a rate of six context, the heart rate variation power spectrum breaths per minute; this rate produces maximum (HRVPS) has been studied [8], and provides a variations in HR [7]. In most studies, RSA is noninvasive measure of the autonomic nervous quantified as the mean difference between the system function. Studies have documented the maximum and minimum HR during consecutive repeatability of HR power density at rest and its deep breaths, which can be expressed either in alterations due to mental loading, orthostatic stress, beats per minute (BPM) or in seconds. Another forced respiration, post-myocardial infarct as well way of expressing RSA is by the mean value of the as following heart transplant, to help autonomic ratio of the six longest RR intervals to the six tone [6, 7]. shortest intervals. 258 All Rights Reserved © 2012 IJARCET
  • 3. ISSN: 2278 – 1323 International Journal of Advanced Research in Computer Engineering & Technology Volume 1, Issue 4, June 2012 III. RR INTERVAL DETECTOR out high frequency noise. The two stage ECG amplifier is included to provide an overall gain of For HRV analysis we require an ECG recorder and 1000 to obtain an ECG signal up to 2 volt RR interval detector as an analog front end. This amplitude. At the output of an ECG amplifier we section discusses about one such design developed for the RR interval data acquisition. get a clear undistorted analog ECG waveform In this system the clamp electrodes are used to which is then sent to ADC in data acquisition measure the ionic potentials generated at the limbs. system (DAS).The ECG signal is also applied to an Fig. 1 shows the physical appearance of these optoisolator which provides patient isolation along clamp electrodes. Clamp Electrodes enable quick, with isolated synchronised pulses corresponding to secure and reliable ECG leads. Intricate and often the R waves in ECG. These pulses are sent to the painful fixing of ECG electrodes is a thing of the counter in the DAS which measures the duration past with clamp electrodes. The large contact area of the Clamp Electrode guarantees secure ECG between consecutive R waves and sends this data to leads. All that has to be done is to apply some the computer through the serial port. These pulses medesign Electrode Spray and open and close the are also applied to trigger input of monostable clamp. Clamp Electrodes are also easily fixed in multivibrator which produces a pulse of 429 ms emergency situations and are easy to clean. The width for each R wave in ECG. The output of gentle pressure makes the electrode difficult to monostable mutivibrator is used to drive an LED detect for the patient. Staffs do not have to fiddle which acts a beat indicator. The DAS consists of with tightening straps and the ECG is easy to handle. The Clamp Electrode is easily and quickly microcontroller PIC 18F2550 and serial port driver fixed to arms or legs and no tightening strap is MAX 232.It was found that the estimation accuracy necessary. One Set contains Clamp Electrodes in is mainly determined by the noise and hum red, yellow, green and black. It is Suitable for interference. The morphology changes of the P- adults as well as children. They are made from wave influences the wave form occurrence time antistatic plastic with a silver/silver chloride estimation. Theoretically, it should be P to P electrode. The Clamp is made from plastic with surgical steel contact. interval file, but due to the difficulties associated with automated recognition of P waves, the R wave is chosen. The R-R interval file contains information in both the time and frequency domain. Hence both time and frequency domain analyses can be used to evaluate heart rate variability. It is necessary to look carefully to the wave-form morphology before estimating it for HRV measurement. Therefore lead L1 ECG configuration is selected, which has high amplitude of QRS wave for measuring R-R interval. The R-R Fig. 1: ECG clamp electrodes. interval file is used to get instantaneous heart rate (HR), as HR is the reciprocal of an R-R interval. Fig. 2 shows the block schematic of an analog ECG amplifier cum R-peak detector circuit, which ECG pre Voltage Low pass ECG converts the ECG signal into R-peak pulses. These amplifier Follower Filter Amplifier pulses are further processed by the microcontroller and programming software on the computer to plot the instantaneous HRV plot. The HRV program also calculates time domain measures like heart RR Interval Isolated Sync Optical rate, mean NN and SDNN. It performs spectral File acquisition Pulse output Isolator analysis to plot the graph of HRVPS and calculates the different parameters from HRVPS. The signal obtained from the clamp electrodes is Beat connected to the ECG preamplifier which is built Indicator by making use of AD620 and AD705 ICs.It provides a low amplitude distorted ECG waveform. Fig. 2: R peak detector. The voltage follower is included for impedance matching and to avoid the loading effect. The low pass filter having cut off frequency of 16 Hz filters 259 All Rights Reserved © 2012 IJARCET
  • 4. ISSN: 2278 – 1323 International Journal of Advanced Research in Computer Engineering & Technology Volume 1, Issue 4, June 2012 IV. SOFTWARE FOR HRV ANALYSIS The software developed for this application will display the information in various screens. The The software for the system is developed in VB Startup Screen will appear as soon as the user starts which provides user friendly graphical interfaces to the application. This screen shows up the Various the doctors along with the database to store patient Tabs which the user of the HRV Analysis Software information and history. The R-R waves coming can access. The four main tabs supported are: from the R peak detector will be recorded for 5 1) Setup Tab, minutes for each patient and then sent to the 2) Patient Interaction Tab, computer by DAS through the serial 3) Analysis Tab and communication port. The analog ECG signal 4) Storage Tab. coming from ECG recorder is sampled at the rate Each of these tabs allows for specific functionality of 8 Hz by the microcontroller and then sent to the to be accessed of the software, the details are as computer using serial communication port. The VB below: software then provides the display of both the ECG signal and HRV signal on the GUI. The software A. Setup then makes use of MATLAB to calculate the time domain measures like heart rate in BPM, average This Tab has a Port setting frame which allows heart rate for 5 minutes, mean NN, variance of NN basic port access with Port selection by means of and SDNN.The power spectrum will be then the list box which presents a list of available ports. plotted using FFT. The power spectrum plot depicts Open & Close Port functionality is supported; power in ms2 versus Frequency in Hertz. From the when the port is open there is a GREEN LED power spectrum following parameters are symbol which turns RED when the port is closed. calculated: The selected port is also listed on screen. Power under Low frequency range (0.00 to 0.04Hz) The status of Sampling is also presented is it Power under Mid frequency range (0.04 to 0.15Hz) stopped? or currently active. If active then the time Power under High frequency range(0.15 to 0.40Hz) passed after start of sampling is listed. Sympatho Vagal balance ratio which is the ratio of A Simulate signal check box is provided which mid to high frequency powers. The logical flow allows the ECG microcontroller Hardware to chart for the system operation is as given in fig. 3. simulate some Waveforms so that the communication between PC and the ECG Hardware and the Graph presentation of the Data Received can be tested/ Verified. Patient The Next frame in this Tab is the Serial Data Frame which shows the Data communication by presenting the packets exchanged between the PC and ECG Hardware. The outgoing Data from the PC is presented in blue colour and Incoming Beat to beat RR recording responses or Data Packets are presented in Red. in hardware Note that most Command buttons except the Stop sampling and Exit Application are Disabled, this ensures that User cannot open or close port while sampling is in progress. The Test Hardware button provided in the software allows the user to test the ECG recorder for the connection. The Next button HRV Analysis software provided in this tab allows the user to go to the next tab in the software which is the patient interaction  Set up Module tab with graph frame to display the incoming ECG or HRV signal.  Patient Interaction Module B. Patient Interaction  Analysis Module This Tab has a Graph frame which is used to display HRV or ECG waveform while it is being  Storage Module sampled by the Microcontroller hardware system. The Show ECG and Show HRV buttons are provided to select the waveform to be displayed. The default waveform displayed is HRV Fig. 3: Logical flow chart for system operation. waveform. The name of the waveform displayed is also shown in this tab along with the corresponding waveform. The microcontroller sends the data to 260 All Rights Reserved © 2012 IJARCET
  • 5. ISSN: 2278 – 1323 International Journal of Advanced Research in Computer Engineering & Technology Volume 1, Issue 4, June 2012 the PC in three channel format. The first channel corresponding peak power frequency. The MF and indicates ECG units, the second channel indicates HF powers are also displayed in normalised units Whether RR interval is detected or not? When RR which reduce the effect of changes in total power interval is detected it sends 1 else 0. The third on these components. The sympatho vagal balance channel indicates the value of detected RR interval. which is the ratio of MF to HF power and indicates Since we have used 8 Hz sampling rate for ECG the influence of the two branches of autonomic signal there will be eight values consecutively nervous system on HRV is also displayed in this displayed in the ECG channel corresponding to one frame. The MATLAB program developed for the value in RR interval. All these three channel values analysis tab is given below. are also displayed in this tab along with the graph. This Tab also has the Sampling time section % delete old output and Processing had done flag. indicating the current sampling time lapsed or dos 'del HRVParmOut.txt' sampling stopped status. Using the Setup and dos 'del HRVPPSD.txt' Patient Interaction tab the user can Setup the Port dos 'del HRVPSD.bmp' and interact with the Patient by Starting or dos 'del HRVDone.txt' Stopping sampling. Also Testing Hardware dos 'del HRVFFT.txt' connectivity or Quitting Application Command dos 'del HRVFFT.bmp' Buttons are available. There are Previous and Next Navigation keys available for moving between the % Read Input from File four Tabs, when the user is on First (Setup) Tab the NNSamples = dlmread ('HRVInput.txt'); Previous key is disabled and when the user reaches sprintf ('Read in %d samples‟, the Last (Storage) tab the Next key is disabled. In length (NNSamples)) case of Clicking the Test / Start /Stop /Start with Sample Count = length (NNSamples); Simulate selected Command buttons the Sum (1) =0; corresponding packets are sent by the PC over for j=2: SampleCount serial port hardware and the incoming packets are Sum (j) =Sum (j-1) +NNSamples (j-1); populated in to the Serial Data Frame in RED end colour. Also the data from packets is decoded and Mins=round (Sum (Sample Count)/60000); saved in a data File named – HRV_FILE.txt. if Mins >5 Mins = 5 C. Analysis end for M=1: Mins This Tab has a Save file button which allow the Detect (Sum>60000*M) =1; User to Save Patients Data and Calculations for the BPMIndex=find (Detect==1); purpose of later use. Also the Load file button can BPM (M) =BPMIndex (1)-1; be used to reload a saved file back into HRV clear Detect BPMIndex software. This tab supports the Analysis based on end Time and frequency domain, which allows the user BPM to Select and evaluate specific HRV parameters for for M=Mins: 1:2 Analysis. The Process HRV button in this tab calls BPM (M) =BPM (M)-BPM (M-1); the MATLAB program named process PSD.m to end calculate the time and frequency domain AVGBPM5=mean (BPM); parameters based on the acquired or loaded RR MeanNN=mean (NNSamples); interval file. This Tab also has a Graph frame VarNN=var (NNSamples); which displays HRV power spectrum for the STDNN=std (NNSamples); patient. The next frame in this tab is Time domain % Compute FFT measures which displays the time of recording, the FreqCount=256; number of NN samples in the loaded RR interval FFTNN = fft (NNSamples, FreqCount); file, heart rate in BPM for every minute of recording, average heart rate over a recording % Output post process period of 5 minutes, mean NN value in ms, Pyy = FFTNN.* conj (FFTNN) / FreqCount; variance of NN values in ms and SDNN value in f = (0 :( FreqCount/2)-1)/FreqCount; ms. figure It also has frequency domain measures frame plot (f (1 :( FreqCount/2)), FFTNN (1 : which displays the values of various components (FreqCount/2))) obtained from short term spectral analysis of HRV set (get (gca,'Title'),'FontName','FixedWidth') for 5 minutes. The values displayed are total power set(get (gca,'Title'),'FontWeight','Bold') in ms2, LF power, MF power and HF power in ms2, set (get (gca,'xlabel'),'FontName','FixedWidth') along with the peak power in each band and the set (get (gca,'xlabel'),'FontWeight','Bold') 261 All Rights Reserved © 2012 IJARCET
  • 6. ISSN: 2278 – 1323 International Journal of Advanced Research in Computer Engineering & Technology Volume 1, Issue 4, June 2012 set (get (gca,'ylabel'),'FontName','FixedWidth') % HF band set (get (gca,'ylabel'),'FontWeight','Bold') Max1=find (PSDHF==max (PSDHF)); title ('FFT Samples') HFPeakf = fHF (Max1 (1)); xlabel ('frequency (Hz)') PsumHF =sum (PSDHF); Print -dbmp256 'HRVFFT.bmp' PeakP= [max (PSDLF), close (1) max (PSDMF), max (PSDHF)] dlmwrite ('HRVFFT.txt', FFTNN) Power= [PSDsum, PsumLF, PsumMF, PsumHF] Pyy (Pyy==max (Pyy)) =0; PeakF= [LFPeakf, MFPeakf, HFPeakf] figure plot (f (1:FreqCount/2),Pyy(1:FreqCount/2)) % write Freq & Time Domain Parameters title ('PSD Frequency content') OutputVar=[PeakP,Power,PeakF,Mins,SampleCou set(get(gca,'Title'),'FontName','FixedWidth') nt,MeanNN,VarNN,STDNN,AVGBPM5,BPM]; set (get(gca,'Title'),'FontWeight','Bold') dlmwrite ('HRVParmOut.txt', OutputVar); set (get(gca,'xlabel'),'FontName','FixedWidth') True1=1; set (get(gca,'xlabel'),'FontWeight','Bold') dlmwrite ('HRVDone.txt', True1); set (get(gca,'ylabel'),'FontName','FixedWidth') set (get(gca,'ylabel'),'FontWeight','Bold') % go back xlabel ('frequency (Hz)') exit ylabel ('Power ms^2'); print -dbmp256 'HRVPSD.bmp' D. Storage close (1) dlmwrite ('HRVPSD.txt', Pyy) This Tab again has a Save file button which allow the User to Save Patients Data and Calculations for % process for band selection purpose of later use. Similarly the Load file button LFMax = 0.04 can be used to reload a saved file back into HRV MFMax = 0.15 software. The Clear record button is used to delete HFMax = 0.4 the previous saved record of the patient. This tab for j=1:length (f) supports the Patient Information like Name, if f (j)<=LFMax Address and Other Contact details etc. to be feed in fLF (j) =f (j); or reviewed along with Doctors Contact PSDLF (j) = Pyy (j); Information. The file is saved in text format which else contains the RR interval information over a if f (j)<=MFMax recording period. The path for saving of file can fMF (j) =f(j); also be selected from this tab. PSDMF (j) =Pyy (j); The figures 4 to 7 indicate the various conditions in else these developed tabs. if f (j)<=HFMax fHF (j) =f (j); PSDHF (j) =Pyy (j); end end end end % Find Total Power PSDsum =sum (Pyy); % Find Max power in each band % LF band Max1=find (PSDLF==max (PSDLF)); LFPeakf = fLF (Max1 (1)); PsumLF =sum (PSDLF); % MF band Max1=find (PSDMF==max (PSDMF)); MFPeakf = fMF (Max1 (1)); PsumMF =sum (PSDMF); 262 All Rights Reserved © 2012 IJARCET
  • 7. ISSN: 2278 – 1323 International Journal of Advanced Research in Computer Engineering & Technology Volume 1, Issue 4, June 2012 Fig. 4: The Setup tab with com 1 port open and sampling started. Fig. 5: Patient interaction tab with patient HRV displayed. 263 All Rights Reserved © 2012 IJARCET
  • 8. ISSN: 2278 – 1323 International Journal of Advanced Research in Computer Engineering & Technology Volume 1, Issue 4, June 2012 Fig. 6: Analysis tab with HRVPS, Time & Frequency domain measures. Fig. 7: Storage tab to store the patient data. 264 All Rights Reserved © 2012 IJARCET
  • 9. ISSN: 2278 – 1323 International Journal of Advanced Research in Computer Engineering & Technology Volume 1, Issue 4, June 2012 V. RESULTS The fig.8 (a) and 8(b) presented below indicates the HRV graph and HRV power spectrum obtained for patient with MIT_BIH Arrhythmia. While fig. 9(a) and 9(b) indicates the HRV and HRVPS obtained for patient with normal heart rate variations. Both the results are obtained from the RR interval samples recorded over a period of 5 minutes. Looking at the very nature of the HRV graph the doctor can very easily and primarily differentiate between the normal and abnormal heart rate variations. The software also provides HRVPS and various time domain and frequency domain parameters calculated from HRV which further helps the doctor for detail diagnosis. Fig. 9(a): HRV for patient with normal Heart. . Fig. 8 (a): HRV for patient with MIT_BIH Fig. 9(b): HRVPS for patient with normal Heart. Arrhythmia. VI. CONCLUSION Heart rate variability analysis is increasingly becoming an important tool in cardiology, because it constitutes a non-invasive and convenient method to diagnose cardiac patients. It can provide measures of sympathetic and parasympathetic function of the autonomic nervous system. HRV has considerable potential to assess the role of autonomic nervous system fluctuations in normal healthy individuals and in patients with various cardiovascular and noncardiovascular disorders. HRV studies enhance our understanding of physiological phenomena, the actions of medications, and disease mechanisms. The developed software for HRV system is user friendly and would provide an economical and efficient solution to the doctors for the assessment Fig.8 (b): HRVPS for patient with MIT_BIH of risk in cardiovascular disorders; assessment of Arrhythmia. physical fitness; documentation of benefit for cardiac, chiropractic, or orthopaedic rehabilitation. 265 All Rights Reserved © 2012 IJARCET
  • 10. ISSN: 2278 – 1323 International Journal of Advanced Research in Computer Engineering & Technology Volume 1, Issue 4, June 2012 working as Associate Professor in Electronics Department at REFERENCES Mukesh Patel School of Technology Management and Engineering, SVKM‟S NMIMS University, Mumbai. He is life [1] Leslie Cromwell, Fred J. Weibell, Erich A. Pfeiffer, member of Indian Society of Technical education (ISTE). His “Biomedical Instrumentation and Measurements”, Prentice – areas of interests are Biomedical Electronics, Electronics Circuit Hall of India Private ltd.Second edition, pp. 92,292 (1980). analysis & Design and Neural Network & Fuzzy Systems. He [2] Task Force of the European Society of Cardiology and the has 05 papers in National / International Conferences and North American Society of Pacing and Electrophysiology Journals to his credit. “Heart rate variability. Standards of measurement, physiological interpretation, and clinical use.”1996 Mar; 17(3), pp. 354-381. Dr. K.D. Desai has received B.E. in [3] Drs Tarun Chandra, Donovan B Yeates and Lid B Wong Electrical Engineering from V.J.T.I., “Heart Rate Variability Analysis – Current and Future Trends” Business briefing Global healthcare 2003, pp.1-5 Mumbai University in 1970, M.E. in [4] Pomeranz M, Macaulay RJB, Caudill MA, Kutz I, Adam D, Electrical Engineering (Computer Science Gordon D, Kilborn KM, Barger AC, Shannon DC, Cohen RJ, Specialization) from V.J.T.I., Mumbai Benson M. “Assessment of autonomic function in humans by University in 1985 and Ph.D. in heart rate spectral analysis”. Am J Physiol. 1985; 248:H151- Technology from V.J.T.I., Mumbai H153. University in 1995. He has more than 25 years of experience in [5] Pagani M, Lombardi F, Guzzetti S, Rimoldi O, Furlan R, teaching & 13 years of experience in Industry. He is currently Pizzinelli P, Sandrone G, Malfatto G, Dell'Orto S, Piccaluga E, Turiel M, Baselli G, Cerutti S, Malliani A. “Power spectral working as Director and Principal at K.C.college of Engineering analysis of heart rate and arterial pressure variabilities as a Thane, Mumbai University. His areas of interests are marker of sympathovagal interaction in man and conscious Biomedical Electronics, Telecommunication & Industrial dog”. Circ Res. 1986; pp. 59:178-193. LASER Applications. He has 09 papers in National / [6] Issam El Mugamar, K.D. Desai, Sulatan Abdul Ali, International Conferences and Journals to his credit. Currently Mohammed Saeed, Amin Fikree, S.D. Bhagwat: “Computerized he is guiding two Ph.D. students at MPSTME, SVKM‟S Reliable Detection of Diabetic Autonomic Neuropathy”, Proc. NMIMS University. Of International Conference on Recent Advances in Biomedical Engineering – 94, Hyderabad, India (1994), pp.321-325. [7]. Fallen, E.L., D. Nandogopal, S. Connonlly and D.N. Ghista, “How reproducible is the power spectrum of heart rate variability in health subjects?” Proceedings of International Symposium on Neural and Cardiovascular Mechanisms, Bologna, Italy (May, 1985), pp.41-45. [8].Kamath, D.N. Ghista, E.L. Fallen, D. Fitchett, D. Miller and R. McKelvie, “Heart rate variability power spectrogram as potential noninvasive signature of cardiac regulatory system response, mechanisms, and disorders”, in Heart and Vessels,pp. 3, 33-41 (1987). [9].Kamalakar Desai, Dhanjoo N. Ghista,Issam Jaha El Mugamex,Rajendra Acharya U Michael Towsey, Sultan Abdul Ali,Mohammed Saeed, M. Amin Fikri,”DAN detection by HRV power spectral analysis”, pp. 3-14 (2010). [10] Noel Jerke “The complete reference Visual Basic 6”.First edition 22nd reprint 2005, pp.187-247. Nirmal D. Thakur has received B.E. in Industrial Electronics Engineering from Amravati University in 2002, M.B.A. in Human resources management from IGNOU in 2011, and M.Tech. in Electronics Engineering from NMIMS University, Mumbai in 2012. He has more than 8 years of experience in teaching. He is currently working as Lecturer in Electronics Department at Shreeram Polytechnic Airoli, NaviMumbai. He is life member of Indian Society of Technical education (ISTE). His areas of interest are Biomedical Electronics, Industrial Automation, Process Control and Instrumentation. He has 05 papers in National/International Conferences and Journals to his credit. Manoj S. Sankhe has received B.E .in Electronics Engineering from Pune University in 1996, M.E. in Digital Electronics from Amravati University in 2002, and is currently pursuing Ph.D. from NMIMS University, Mumbai. He has more than 15 years of experience in teaching & 1.5 years of experience in industry. He is currently 266 All Rights Reserved © 2012 IJARCET