Design and evaluation of a novel approach to invisible electrocardiography (ECG) in sanitary facilities using polymeric electrodes

Abstract

Multiple wearable devices for cardiovascular self-monitoring have been proposed over the years, with growing evidence showing their effectiveness in the detection of pathologies that would otherwise be unnoticed through standard routine exams. In particular, Electrocardiography (ECG) has been an important tool for such purpose. However, wearables have known limitations, chief among which are the need for a voluntary action so that the ECG trace can be taken, battery lifetime, and abandonment. To effectively address these, novel solutions are needed, which has recently paved the way for "invisible" (aka "off-the-person") sensing approaches. In this article we describe the design and experimental evaluation of a system for invisible ECG monitoring at home. For this purpose, a new sensor design was proposed, novel materials have been explored, and a proof-of-concept data collection system was created in the form of a toilet seat, enabling ECG measurements as an extension of the regular use of sanitary facilities, without requiring body-worn devices. In order to evaluate the proposed approach, measurements were performed using our system and a gold standard equipment, involving 10 healthy subjects. For the acquisition of the ECG signals on the toilet seat, polymeric electrodes with different textures were produced and tested. According to the results obtained, some of the textures did not allow the acquisition of signals in all users. However, a pyramidal texture showed the best results in relation to heart rate and ECG waveform morphology. For a texture that has shown 0% signal loss, the mean heart rate difference between the reference and experimental device was - 1.778 ± 4.654 Beats per minute (BPM); in terms of ECG waveform, the best cases present a Pearson correlation coefficient above 0.99.

Figure 1

Electrode textures considered for the implementation of our approach.

Figure 2

Prototype of the toilet seat, highlighting the electrodes positioning. A1: Flat texture; A2: Sinusoidal texture; A3: Trapezoidal texture; A4: Pyramidal texture.

Figure 3

Experimental setup. A1: Flat texture; A2: Sinusoidal texture; A3: Trapezoidal texture; A4: Pyramidal texture.

Figure 4

Example of raw and filtered data.

Figure 5

DFA and Poincaré plots for REF, A4, and A2 electrodes.

Figure 6

Normal heartbeat waveforms and outliers removed after the decision criteria.

Figure 7

Proposed final electrode texture for deployment and example heartbeat waveform obtained for one participant with the final electrode comparatively with the best performing texture (A4) used in our work (“Electrode texture”).