Biomedical Engineering Theory And

Practice/Biomedical
Instrumentation/Electrocardiography
This chapter should cover the basics of ECG systems from
a design point of view; not from a diagnosis point of view.

Physiological Background
QRS
Complex

ST
Segment

PR

Segment

PR Interval

Q
S

An animation showing how the electrical activity of the heart is

reected on the ECG signal

QT Interval

nal generated from the SA node. This phase appears as

the P-wave on the ECG chart. The electrical signal, originally generated by the SA node, then spreads through
the Atrioventricual (AV) Junction, the bundle of His, and
the Purkinje bers to nally reach and stimulate the ventricles. The spread of the electrical signal through the
ventricles causes ventricular contraction. The phase of
ventricular contraction appears as the characteristic QRS
complex on the ECG chart. Finally, with the relaxation
of the two ventricles, a depolarization signal is generated
and appears as the T-wave on the ECG chart.

Typical ECG signal

The function of the heart is to contract rhythmically and

pump blood to the lungs for oxygenation and then pump
this oxygenated blood into the general circulation. This
perfect rhythm is continuously maintained and signaled
by the spread of electrical signals generated by the heart
pacemaker, the sinoatrial (SA) node. [1] Detecting such
electrical activity of the heart can help identify many heart
disorders. This is the main concept behind using an ECG
(Electrocardiogram), tracing the electrical activity of the
heart.

By measuring and tracing the potential dierence between two points on the outer surface of the body we 2 Design of a Basic ECG Signal Acobtain the simplest ECG chart. Two typical measuring
quisition Module
points between the left arm and the right arm. By dening the two points and setting up the conventional posi- The acquisition of the ECG signal is a rather challengtive direction for measuring the voltage, we create what ing task, as the case with many biological signals. ECG
is called a Lead.
voltage signal is very low in magnitude (few millivolts)
The rst phase of the cardiac muscle activation is the and has relatively low frequency content. The expected
stimulation of the right and left atria by an electrical sig- bandwidth of the signal typically begins from 0.01 Hz and
1

8 FURTHER READING

extends to no more than 150 Hz.

Another challenge in acquiring the ECG signal is the
power-line interference that is often order of magnitudes
greater than the original ECG signal. All this suggests
challenging requirements for the design of the signal acquisition module: It should have minimum loading eect,
it should contain an amplication stage to make the signal
level appropriate for further use, and it should contain a
ltration stage customized to remove the expected noise
and power-line interference that often corrupts the ECG.

Electrode Contact Noise where the electrodes are

not tightly coupled to the patient causing some distortion
Electrosurgical Unit (ESU) interference where
high-frequency signals from the ESU used by surgeons during operation interfere with the ECG

4 Basic Signal Conditioning for the

ECG

In this section, we are NOT going to consider the full design of the ECG signal; rather, we shall focus on a minimal
ECG acquisition module design that would just work.
This section should discuss theoretical signal processing
solutions to the above artifacts

Patient

Dierence Amplier

A VERY simplied block diagram of an ECG amplier. The voltage of the right arm (w.r.t right leg) is subtracted from the voltage
of the left arm (w.r.t right leg) to get the ECG Lead I signal).

As discussed in the physiological background section, an

ECG signal is obtained as the voltage dierence between
two points on the skin. This suggests the need for some
subtraction mechanism. The subtraction could be done
using an electronic Dierence Amplier. This amplier
basically subtracts and amplies the dierence between
two electrical points. For the subtraction to work correctly, the voltage of both electrical points should be measured with respect to a common electrical reference. This
common reference is typically chosen to be the right leg
of the patient.

5 Analog Implementations for the

Signal Conditioning
6 Digital Hardware Implementations for the Signal Conditioning
7 Software Implementations for
the Signal Conditioning
8 Further Reading
Programmable Chip EEG
the OpenEEG Wiki

So, a simplied diagram of a simple ECG acquisition

module would be as shown in the gure.

The thread amplifying biomedical signals: 150 uA

with 16 bit resolution?" has several op-amp suggestions, and mentions that a good, low-noise, lowcost, isolated EMG/EEG amplier is one of the
most demanding analog electronics designs.

How to build your own ECG device

Signal Artifacts

Baseline Wander where the ECG waveform baseline starts to drift up and down in a sinusoidal pattern
following the patient breathing

TI app note Biophysical Monitoring: Electrocardiogram (ECG) Front End has a simple circuit: 390
KOhm resistors in-line with each lead -- one end
touches patient, the other end directly connected to
the instrumentation amp input (or the right-leg drive
amplier output, which has no further protection).
The inst. amp has 2 protection diodes on each input, directly to +power and -power. Also, 39 pF capacitor from each input to analog GND, and 200 pF
between the 2 inputs. The TI publication Information for Medical Applications (2Q 2004) reprints
that circuit, but leaves out the caps and the diodes.

EMG Interference where muscle contraction signals interfere with the ECG.

Some people use 420 Hz sampling rate, 10

bits/sample.

Artifacts that corrupt the raw ECG signal have either

physiological or non-physiological origin. The most dominant artifact is the power-line interference which appears as an sinusoidal wave of frequency 50 Hz (or 60 Hz
in USA). Other artifacts include:[2]
Movement Artifacts due to patient movement,
etc...

3
High-Resolution QRS Detection Algorithm for
Sparsely Sampled ECG Recordings by Timo
Bragge et al. 2004 recommends: the sampling frequency of the ECG should be at least 500 Hz
Low-Power, Low-Voltage IC Choices for ECG
System Requirements by Jon Firth and Paul Errico
says The multiplexed architecture, based on an
old assumption that the converter is by far the
most-expensive front-end component, is prevalent in
todays electrophysiological measurement systems.
However, with the proliferation of sigma-delta converter architectures, converter-per-channel is now
a power- and cost-competitive alternative. It also
gives a typical schematic for both architectures and
suggests some parts.
Is there a Medical Electronics Forum?
Make: Homemade Electrocardiograph ( recommends skin lotion or shampoo as a low-cost electrode gel)

References

Please cite all the references you have used. See the Local
Manual of Style for examples on citations.
[1] Clinical Electrocardiography, a Simplied Approach.
Seventh Edition; Ary L. Goldberger, Mosby-Elsevier,
2006
[2] Takla G, Petre JH, Doyle DJ, Horibe M, Gopakumaran
B. The problem of artifacts in patient monitor data during surgery: a clinical and methodological review. Anesth
Analg. 2006;103(5):1196-204

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