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. 2022 Sep;27(5):e12993.
doi: 10.1111/anec.12993. Epub 2022 Jul 29.

A universal, high-performance ECG signal processing engine to reduce clinical burden

Austin Gibbs  1 , Matthew Fitzpatrick  2 , Mark Lilburn  2 , Holly Easlea  2 , Jonathan Francey  2 , Rebecca Funston  2 , Jordan Diven  2 , Stacey Murray  2 , Oliver G J Mitchell  1 , Adrian Condon  2 , Andrew R J Mitchell  1 , Benjamin Sanchez  3 , David Steinhaus  4
Affiliations

A universal, high-performance ECG signal processing engine to reduce clinical burden

Austin Gibbs et al. Ann Noninvasive Electrocardiol. 2022 Sep.

Abstract

Background: Electrocardiogram (ECG) signal conditioning is a vital step in the ECG signal processing chain that ensures effective noise removal and accurate feature extraction.

Objective: This study evaluates the performance of the FDA 510 (k) cleared HeartKey Signal Conditioning and QRS peak detection algorithms on a range of annotated public and proprietary ECG databases (HeartKey is a UK Registered Trademark of B-Secur Ltd).

Methods: Seven hundred fifty-one raw ECG files from a broad range of use cases were individually passed through the HeartKey signal processing engine. The algorithms include several advanced filtering steps to enable significant noise removal and accurate identification of the QRS complex. QRS detection statistics were generated against the annotated ECG files.

Results: HeartKey displayed robust performance across 14 ECG databases (seven public, seven proprietary), covering a range of healthy and unhealthy patient data, wet and dry electrode types, various lead configurations, hardware sources, and stationary/ambulatory recordings from clinical and non-clinical settings. Over the NSR, MIT-BIH, AHA, and MIT-AF public databases, average QRS Se and PPV values of 98.90% and 99.08% were achieved. Adaptable performance (Se 93.26%, PPV 90.53%) was similarly observed on the challenging NST database. Crucially, HeartKey's performance effectively translated to the dry electrode space, with an average QRS Se of 99.22% and PPV of 99.00% observed over eight dry electrode databases representing various use cases, including two challenging motion-based collection protocols.

Conclusion: HeartKey demonstrated robust signal conditioning and QRS detection performance across the broad range of tested ECG signals. It should be emphasized that in no way have the algorithms been altered or trained to optimize performance on a given database, meaning that HeartKey is potentially a universal solution capable of maintaining a high level of performance across a broad range of clinical and everyday use cases.

Keywords: ECG; QRS detection; artifact removal; noise filtering; signal conditioning; signal processing.

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Conflict of interest statement

Dr. Austin Gibbs is Lab Director, The Allan Lab, Jersey General Hospital, and is a Consultant to B‐Secur, Ltd (e‐mail: austin@theallanlab.com). Matthew Fitzpatrick (corresponding author) is Scientific Writer, B‐Secur, Ltd (e‐mail: matthew.fitzpatrick@b-secur.com, postal address: B‐Secur. Belfast Ltd, Catalyst Science Park, Belfast, Northern Ireland). Mark Lilburn is Technical Project Manager, B‐Secur, Ltd (e‐mail: mark.lilburn@b-secur.com). Holly Easlea is Data Research Manager, B‐Secur, Ltd (e‐mail: holly.easlea@b-secur.com). Jonathan Francey is Head of Algorithm Development, B‐Secur, Ltd (e‐mail: jonathan.francey@b-secur.com). Jordan Diven is Validation Team Leader, B‐Secur, Ltd (e‐mail: jordan.diven@b-secur.com). Jordan Diven is Validation Team Leader, B‐Secur, Ltd (e‐mail: jordan.diven@b-secur.com). Stacey Murray is Clinical Research Engineer, B‐Secur, Ltd (e‐mail: stacey.murray@b-secur.com). Oliver GJ Mitchell is a Medical Student, The Allan Lab, Jersey General Hospital (e‐mail: mitchogj@gmail.com). Adrian Condon serves as Chief Technology Officer at B‐ Secur, Ltd (e‐mail: acondon@b-secur.com). Dr. Andrew RJ Mitchell is Consultant Cardiologist & Head of Research, The Allan Lab, Jersey General Hospital and is a Consultant to B‐Secur, Ltd (e‐mail: andy@theallanlab.com). Dr. Benjamin Sanchez is Assistant Professor of Electrical and Computer Engineering, University of Utah (e‐mail: benjamin.sanchez@utah.edu). Dr David Steinhaus is a Cardiac Electrophysiologist and Consultant (e‐mail: dmsteinhaus@gmail.com). Dr. Austin Gibbs, Dr. Benjamin Sanchez, Dr. Andrew RJ. Mitchell and Dr. David Steinhaus serve as Scientific Advisors to The Board of B‐Secur, Ltd.

Figures

FIGURE 1
FIGURE 1
Flow of ECG data through HeartKey algorithm(s)
FIGURE 2
FIGURE 2
Overview of data from wet electrode databases
FIGURE 3
FIGURE 3
Overview of data from dry electrode databases
See this image and copyright information in PMC

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