Electrocardiographic Signal Processing Applications in Telemedicine

Electrocardiographic Signal Processing Applications in Telemedicine

Adrian Brezulianu, Iulian Ciocoiu, Monica Fira
DOI: 10.4018/978-1-61520-670-4.ch010
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The chapter focuses on telecardiology, as a significant example of telemedicine applications. Essential elements regarding the benefits and importance of telemedicine are presented first, followed by the introduction of specific telecardiology terminology, theoretical grounds, and existing practical applications. In the final part of the chapter new practical approaches are outlined, mainly related to modern signal processing tools such as wavelet analysis and neural networks.
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Telemedicine: History, Advantages, Obstacles And Applications

History of Telemedicine

The idea of performing medical examinations and evaluations using telecommunication networks is not new. Shortly after the invention of the telephone, attempts were made to transmit heart and lung sounds to a trained expert who could assess the state of the organs. However, poor transmission systems made the attempts a failure. We list below some of the historic landmarks across the evolution of telemedicine:

  • 1906 - ECG Transmission: ECG transmission over telephone lines in 1906 made by the “father of electrocardiography”, Einthoven

  • 1920s - Help for ships: During this time, radios were used to link physicians standing at shore stations to assist ships at sea that had medical emergencies

  • 1955 - Telepsychiatry: Nebraska Psychiatric Institute was one of the first facilities in USA to have closed-circuit television in 1955. In 1971 the Nebraska Medical Center was linked with the Omaha Veterans Administration Hospital and VA facilities in two other towns.

  • 1967- Massachusetts General Hospital: This station was established in 1967 to provide occupational health services to airport employees and to deliver emergency care and medical attention to travelers

  • 1970s - Satellite telemedicine via ATS-6 satellites: Paramedics in remote Alaskan and Canadian villages were linked with hospitals in distant towns or cities

An important role in the early development of telemedicine was played by the National Aeronautics and Space Administration (NASA). NASA's efforts in telemedicine began in the early 1960’s when humans began flying in space. NASA has been a pioneer in telemedicine research and applications. Since the first days of suborbital flight, telemedicine has been transformed by the increasing complexity of space operations. NASA have started in telemedicine applications field by monitoring physiological parameters of astronauts sent into space (telemetry) and parameters of the cabin and external environments. These first efforts and the development of satellite communication led to the development of telemedicine as well as developing various equipment used in health care today.

Another universally recognized promoter of telemedicine is the U.S. Defense Department that is interested in new remote medicine developments, due of combat missions that are taking place mainly at distance from the national territory.

Key Terms in this Chapter

Telecardiology: Telecardiology is the practice of cardiology which utilizes telecommunications, and as such is a new alternate and cost-effective means of providing cardiac care.

Classifi cation: Automated classification tools such as decision trees have been shown to be very effective for distinguishing and characterizing very large volumes of data. They assign items to one of a set of predefined classes of objects based on a set of observed features. Classifiers can be learned automatically from a set of examples through supervised learning. Classification rules are rules that discriminate between different partitions of a database based on various attributes within the database. The partitions of the database are based on an attribute called the classification label.

ECG Signal: The electrocardiogram (ECG) is the recording on the body surface of the electrical activity of the heart.

Databases: A structured repository for data, consisting of a collection of data and their associated data model, and usually stored on a computer system. The existence of a regular and formal indexing structure permits rapid retrieval of individual elements of the database.

Artificial Intelligence: Artificial intelligence (AI) is the mimicking of human thought and cognitive processes to solve complex problems automatically. AI uses techniques for writing computer code to represent and manipulate knowledge. Different techniques mimic the different ways that people think and reason. AI applications can be either stand-alone software, such as decision support software, or embedded within larger software or hardware systems.

Automated ECG Analysis: Consists of a series of procedures that can be used in order for useful clinical information to produced that will help the physician to reach a diagnosis faster and safer concerning the path physiological condition of the patient’s heart.

Compression: Use of a mathematical algorithm to reduce the size of data, audio, or video transmissions for greater speed or use of lower bandwidths.

Telemedicine: Telemedicine is thought of as long-distance clinical health care, including practitioner-to-patient meetings, practitioner-to-practitioner discussions and exchange of clinical information via technology.

Telehealth: Telehealth relates to the use of telecommunication equipment and computing technology to support long-distance clinical health care, patient and professional health-related education, public health concerns and health care administration.

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