The respiratory sinus arrhythmia (RSA) is a form of cardiorespiratory coupling in which the heart rate accelerates during inhalation and decelerates during exhalation. Its quantification has been suggested as a tool to assess different diseases and conditions. However, whilst the potential of the RSA estimation as a diagnostic tool is shown in research works, its use in clinical practice and mobile applications is rather limited. This can be attributed to the lack of understanding of the mechanisms generating the RSA. To try to explain the RSA, studies are done using noninvasive signals, namely, respiration and heart rate variability (HRV), which are combined using different algorithms. Nevertheless, the algorithms are not standardized, making it difficult to draw solid conclusions from these studies. Therefore, the first aim of this thesis was to develop a framework to evaluate algorithms for RSA estimation. To ...

This research focuses on the development of algorithms to extract diagnostic information from the ECG signal, which can be used to improve automatic detection systems and home monitoring solutions. In the first part of this work, a generically applicable algorithm for model selection in kernel principal component analysis is presented, which was inspired by the derivation of respiratory information from the ECG signal. This method not only solves a problem in biomedical signal processing, but more importantly offers a solution to a long-standing problem in the field of machine learning. Next, a methodology to quantify the level of contamination in a segment of ECG is proposed. This level is used to detect artifacts, and to improve the performance of different classifiers, by removing these artifacts from the training set. Furthermore, an evaluation of three different methodologies to compute the ECG-derived ...

Cardiovascular diseases are a growing problem in today’s society. The World Health Organization (WHO) reported that these diseases make up about 30% of total global deaths and that heart diseases have no geographic, gender or socioeconomic boundaries. Therefore, detecting cardiac irregularities early-stage and a correct treatment are very important. However, this requires a good physiological understanding of the cardiovascular system. The heart is stimulated electrically by the brain via the autonomic nervous system, where sympathetic and vagal pathways are always interacting and modulating heart rate. Continuous monitoring of the heart activity is obtained by means of an ElectroCardioGram (ECG). Studying the fluctuations of heart beat intervals over time reveals a lot of information and is called heart rate variability (HRV) analysis. A reduction of HRV has been reported in several cardiological and noncardiological diseases. Moreover, HRV also has a prognostic ...

Advances in wearable electrocardiogram (ECG) monitoring devices have allowed for new cardiovascular applications to emerge beyond diagnostics, such as stress and fatigue detection, athletic performance assessment, sleep disorder characterization, mood recognition, activity surveillance, biometrics, and fitness tracking, to name a few. Such devices, however, are prone to artifacts, particularly due to movement, thus hampering heart rate and heart rate variability measurement and posing a serious threat to cardiac monitoring applications. To address these issues, this thesis proposes the use of a spectro-temporal signal representation called “modulation spectrum”, which is shown to accurately separate cardiac and noise components from the ECG signals, thus opening doors for noise-robust ECG signal processing tools and applications. First, an innovative ECG quality index based on the modulation spectral signal representation is proposed. The representation quantifies the rate-of-change of ECG spectral components, which are shown to ...

Work-related musculoskeletal disorders are a growing problem in todays society. These musculoskeletal disorders are caused by, amongst others, repetitive movements and mental stress. Stress is defined as the mismatch between a perceived demand and the perceived capacities to meet this demand. Although stress has a subjective origin, several physiological manifestations (e.g. cardiovascular and muscular) occur during periods of perceived stress. New insight and algorithms to extract information, related to stress are beneficial. Therefore, two series of stress experiments are executed in a laboratory environment, where subjects underwent different tasks inducing physical strain, mental stress and a combination of both. In this manuscript, new and modified algorithms for electromyography signals are presented that improve the individual analysis of electromyography signals. A first algorithm removes the interference of the electrical activity of the heart on singlechannel electromyography measurements. This interference signal is ...

The electrocardiogram or ECG is a relatively easy-to-record signal that contains an enormous amount of potentially useful information. It is currently mostly being used for screening purposes. For example, pre-participation cardiovascular screening of young athletes has been endorsed by both scientific organisations and sporting governing bodies. A typical cardiac examination is taken in a hospital environment and lasts 10 seconds. This is often sufficient to detect major pathologies, yet this small sample size of the heart’s functioning can be deceptive when used to evaluate one’s general condition. A solution for this problem is to monitor the patient outside of the hospital, during a longer period of time. Due to the extension of the analysis period, the detection rate of cardiac events can be highly increased, compared to the cardiac exam in the hospital. However, it also increases the likelihood of ...

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice, and one of the main causes of ictus and strokes. Despite the advances in the comprehension of its mechanisms, its thorough characterization and the quantification of its effects on the human heart are still an open issue. In particular, the choice of the most appropriate therapy is frequently a hard task. Radiofrequency catheter ablation (CA) is becoming one of the most popular solutions for the treatment of the disease. Yet, very little is known about its impact on heart substrate during AF, thus leading to an inaccurate selection of positive responders to therapy and a low success rate; hence, the need for advanced signal processing tools able to quantify AF impact on heart substrate and assess the effectiveness of the CA therapy in an objective and ...

Monitoring of vital signs is a key tool in medical diagnostics to asses the onset and the evolution of several diseases. Among fundamental vital parameters, such as the hearth rate, blood pressure and body temperature, the Respiratory Rate (RR) plays an important role. For this reason, respiration needs to be carefully monitored in order to detect potential signs or events indicating possible changes of health conditions. Monitoring of the respiration is generally carried out in hospital and clinical environments by the use of expensive devices with several sensors connected to the patient's body. A new research trend, in order to reduce healthcare service costs and make monitoring of vital signs more comfortable, is the development of low-cost systems which may allow remote and contactless monitoring; in such a context, an appealing method is to rely on video processing-based solutions. In ...

Electrocardiography (ECG) is the standard method for assessing the state of the cardiovascular system non-invasively. In the context of magnetic resonance imaging (MRI) the ECG signal is used for cardiac monitoring and triggering, i.e., the acquisition of images synchronized to the cardiac cycle. However, ECG acquisition is impeded by the static and dynamic magnetic fields which alter the measured voltages and may reduce signal-to-noise ratio (SNR), leading to false alarms during cardiac monitoring or to image artifacts during cardiac triggering. A major source of noise is the magnetohydrodynamic (MHD) effect as it is proportional to field strength and represents a key challenge in application of ultra-high-field (UHF) MRI >=7 T. In this work, two approaches for overcoming these limitations are proposed: i) Development of a hardware and software system based on the principal of photoplethysmography imaging (PPGi) as an optical ...

Obstructive sleep apnea (OSA) is the most prevalent sleep related breathing disorder, nevertheless subjects suffering from it often remain undiagnosed due to the cumbersome diagnosis procedure. Moreover, the prevalence of OSA is increasing and a better phenotyping of patients is needed in order to prioritize treatment. The goal of this thesis was to tackle those challenges in OSA diagnosis. Additionally, two main algorithmic contributions which are generally applicable were proposed within this thesis. The binary interval coded scoring algorithm was extended to multilevel problems and novel monotonicity constraints were introduced. Moreover, improvements to the random-forest based feature selection were proposed including the use of the Cohen’s kappa value, patient independent validation, and further feature pruning steered by the correlation between features. These novel methods were applied together with classification and feature selection methods from the literature to improve the OSA ...

This work has, as its objective, the development of non-invasive and low-cost systems for monitoring and automatic diagnosing specific neonatal diseases by means of the analysis of suitable video signals. We focus on monitoring infants potentially at risk of diseases characterized by the presence or absence of rhythmic movements of one or more body parts. Seizures and respiratory diseases are specifically considered, but the approach is general. Seizures are defined as sudden neurological and behavioural alterations. They are age-dependent phenomena and the most common sign of central nervous system dysfunction. Neonatal seizures have onset within the 28th day of life in newborns at term and within the 44th week of conceptional age in preterm infants. Their main causes are hypoxic-ischaemic encephalopathy, intracranial haemorrhage, and sepsis. Studies indicate an incidence rate of neonatal seizures of 2‰ live births, 11‰ for preterm ...

Obstructive sleep apnea (OSA) is among the most prevalent sleep disorders, which is estimated to affect 6 %−19 % of women and 13 %−33 % of men. Besides daytime sleepiness, impaired cognitive functioning and an increased risk for accidents, OSA may lead to obesity, diabetes and cardiovascular diseases (CVD) on the long term. Its prevalence is only expected to rise, as it is linked to aging and excessive body fat. Nevertheless, many patients remain undiagnosed and untreated due to the cumbersome clinical diagnostic procedures. For this, the patient is required to sleep with an extensive set of body attached sensors. In addition, the recordings only provide a single night perspective on the patient in an uncomfortable, and often unknown, environment. Thus, large scale monitoring at home is desired with comfortable sensors, which can stay in place for several nights. To ...

Congenital heart defects are the leading cause of birth defect-related deaths. The fetal electrocardiogram (fECG), which is believed to contain much more information as compared with conventional sonographic methods, can be measured by placing electrodes on the mother’s abdomen. However, it has very low power and is mixed with several sources of noise and interference, including the strong maternal ECG (mECG). In previous studies, several methods have been proposed for the extraction of fECG signals recorded from the maternal body surface. However, these methods require a large number of sensors, and are ineffective with only one or two sensors. In this study, state modeling, statistical and deterministic approaches are proposed for capturing weak traces of fetal cardiac signals. These three methods implement different models of the quasi-periodicity of the cardiac signal. In the first approach, the heart rate and its ...

This thesis focuses on the design of various automatic signal processing algorithms to extract information from physiological signals of preterm infants. Overall, the aim was to improve the neurodevelopmental outcome of the neonate. More specifically, three main research objectives were carried out. The first objective was to describe the maturation of neonates during their stay in the neonatal intensive care unit. The second objective was to assess the stress and pain in premature infants and their impact on the development of neonates. The third objective was to predict developmental disabilities, such as autism. The first part of this thesis presents an extensive overview of various developmental models to describe the maturation of premature infants. Three main strategies were proposed. The first strategy proposed an investigation of EEG connectivity networks. A variety of functional and effective connectivity methods were combined with ...

In numerous signal processing applications one disposes of multiple probes, delivering simultaneously information about one or multiple observed processes. The resulting multidimensional time series are often highly redundant and may contain stochastic contributions. The perception of the useful information becomes therefore very difficult and sometimes impossible. Thus, the major issue of concern of this thesis resides in the development of novel algorithms for the extraction of the salient and characteristic features of multidimensional time series. The proposed algorithms are based on parametric signal processing, namely we assume that the features of the experimental data can be represented efficiently by a specific model. We present a global framework for the selection of a specific model out of the large span of techniques proposed in the literature. For the selection of the model classes we use, in addition to prior knowledge about ...