Removal of power-line interference from the ECG: a review of the subtraction procedure

BACKGROUND: Modern biomedical amplifiers have a very high common mode rejection ratio. Nevertheless, recordings are often contaminated by residual power-line interference. Traditional analogue and digital filters are known to suppress ECG components near to the power-line frequency. Different types of digital notch filters are widely used despite their inherent contradiction: tolerable signal distortion needs a narrow frequency band, which leads to ineffective filtering in cases of larger frequency deviation of the interference. Adaptive filtering introduces unacceptable transient response time, especially after steep and large QRS complexes. Other available techniques such as Fourier transform do not work in real time. The subtraction procedure is found to cope better with this problem. METHOD: The subtraction procedure was developed some two decades ago, and almost totally eliminates power-line interference from the ECG signal. This procedure does not affect the signal frequency components around the interfering frequency. Digital filtering is applied on linear segments of the signal to remove the interference components. These interference components are stored and further subtracted from the signal wherever non-linear segments are encountered. RESULTS: Modifications of the subtraction procedure have been used in thousands of ECG instruments and computer-aided systems. Other work has extended this procedure to almost all possible cases of sampling rate and interference frequency variation. Improved structure of the on-line procedure has worked successfully regardless of the multiplicity between the sampling rate and the interference frequency. Such flexibility is due to the use of specific filter modules. CONCLUSION: The subtraction procedure has largely proved advantageous over other methods for power-line interference cancellation in ECG signals

Ventricular beat detection in single channel electrocardiograms

BACKGROUND: Detection of QRS complexes and other types of ventricular beats is a basic component of ECG analysis. Many algorithms have been proposed and used because of the waves' shape diversity. Detection in a single channel ECG is important for several applications, such as in defibrillators and specialized monitors. METHODS: The developed heuristic algorithm for ventricular beat detection includes two main criteria. The first of them is based on steep edges and sharp peaks evaluation and classifies normal QRS complexes in real time. The second criterion identifies ectopic beats by occurrence of biphasic wave. It is modified to work with a delay of one RR interval in case of long RR intervals. Other algorithm branches classify already detected QRS complexes as ectopic beats if a set of wave parameters is encountered or the ratio of latest two RR intervals RR(i-1)/RR(i )is less than 1:2.5. RESULTS: The algorithm was tested with the AHA and MIT-BIH databases. A sensitivity of 99.04% and a specificity of 99.62% were obtained in detection of 542014 beats. CONCLUSION: The algorithm copes successfully with different complicated cases of single channel ventricular beat detection. It is aimed to simulate to some extent the experience of the cardiologist, rather than to rely on mathematical approaches adopted from the theory of signal analysis. The algorithm is open to improvement, especially in the part concerning the discrimination between normal QRS complexes and ectopic beats

Public access defibrillation: Suppression of 16.7 Hz interference generated by the power supply of the railway systems

BACKGROUND: A specific problem using the public access defibrillators (PADs) arises at the railway stations. Some countries as Germany, Austria, Switzerland, Norway and Sweden are using AC railroad net power-supply system with rated 16.7 Hz frequency modulated from 15.69 Hz to 17.36 Hz. The power supply frequency contaminates the electrocardiogram (ECG). It is difficult to be suppressed or eliminated due to the fact that it considerably overlaps the frequency spectra of the ECG. The interference impedes the automated decision of the PADs whether a patient should be (or should not be) shocked. The aim of this study is the suppression of the 16.7 Hz interference generated by the power supply of the railway systems. METHODS: Software solution using adaptive filtering method was proposed for 16.7 Hz interference suppression. The optimal performance of the filter is achieved, embedding a reference channel in the PADs to record the interference. The method was tested with ECGs from AHA database. RESULTS: The method was tested with patients of normal sinus rhythms, symptoms of tachycardia and ventricular fibrillation. Simulated interference with frequency modulation from 15.69 Hz to 17.36 Hz changing at a rate of 2% per second was added to the ECGs, and then processed by the suggested adaptive filtering. The method totally suppresses the noise with no visible distortions of the original signals. CONCLUSION: The proposed adaptive filter for noise suppression generated by the power supply of the railway systems has a simple structure requiring a low level of computational resources, but a good reference signal as well

Biphasic pulses enhance bleomycin efficacy in a spontaneous canine genital tumor model of chemoresistance: Sticker sarcoma

Sticker's sarcoma (also known as transmissible venereal tumor) is a horizontally transmitted neoplasm of the dog, that is passed with coitus. It is a locally aggressive tumor with a low tendency to metastatic spread. The most common locations are the genitals, the nose, the perianal area. Standard treatment consists with chemotherapy with vincristine, however other therapies such as, cryotherapy, immunotherapy or, in selected cases, radiation therapy, have been reported. In this article we describe the outcome of a small cohort of canine patients, with chemotherapy resistant transmissible venereal tumor (TVT), treated with bleomycin selectively driven by trains of biphasic pulses (electrochemotherapy). Three canine patients, with refractory TVT, entered the study and received two sessions of ECT under sedation. The pets had local injection of bleomycin at the concentration of 1.5 mg/ml and five minutes after the chemotherapy, trains of 8 biphasic electric pulses lasting 50 + 50 μs each, with 1 ms interpulse intervals, were delivered by means of modified caliper or, for difficult districts, through paired needle electrode. All the patients responded to the treatment and are still in remission at different times. Electrochemotherapy appears as a safe and efficacious modality for the treatment of TVT and warrants further investigations