The rate at which our heart beats, is a dynamical process enabling adaptive changes according to the demands of our body. These variations in heart rate are widely studied in so-called heart rate variability (HRV) analyses, as they contain much information about the activity of our autonomic nervous system. Variability in the heart rate arises from several processes, such as thermoregulation, hormones, arterial blood pressure, respiration, etc. One of the main short-term modulators of the heart rate is respiration. This phenomenon is called respiratory sinus arrhythmia (RSA) and comprises the rhythmic fluctuation of the heart rate at respiratory frequency. It has also widely been used as an index of vagal outflow. However, this has been widely debated as some studies have shown that the magnitude of RSA changes with respiratory rate and the depth of breathing, independently of parasympathetic activity. ...

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 ...

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 ...

The fact that a third of a human life is spent in a bed indicates the essential character of sleep. While some people might opt voluntarily for sleep deprivation, others don’t get to choose. Their healthy pattern of sleep is disrupted due to sleep disorders such as sleep apnea, insomnia and restless legs syndrome. Most clinical diagnoses revolve around complaints of excessive daytime sleepiness. People usually wait quite long however before contacting professional help, and might only do so when complaints have gone from minor to serious. It can be argued that people with minor complaints will have negligible compliance to rather obtrusive therapies, and should not be treated with pharmaceuticals. However, cognitive and behavioral therapy has proven its effectiveness for clinically diagnosed patients in different domains, and might thus also enhance the quality of life for people with minor ...

Epilepsy is one of the most common neurological disorders, which affects almost 1% of the population worldwide. Anti-epileptic drugs provide adequate treatment for about 70% of epilepsy patients. The remaining 30% of the patients continue to have seizures, which drastically affects their quality of life. In order to obtain efficacy measures of therapeutic interventions for these patients, an objective way to count and document seizures is needed. However, in an outpatient setting, one of the major problems is that seizure diaries kept by patients are unreliable. Automated seizure detection systems could help to objectively quantify seizures. Those detection systems are typically based on full scalp Electroencephalography (EEG). In an outpatient setting, full scalp EEG is of limited use because patients will not tolerate wearing a full EEG cap for long time periods during daily life. There is a need for ...

Computer vision-based analysis of human facial video provides information regarding to expression, diseases symptoms, and physiological parameters such as heartbeat rate, blood pressure and respiratory rate. It also provides a convenient source of heartbeat signal to be used in biometrics and forensics. This thesis is a collection of works done in five themes in the realm of computer vision-based facial image analysis: Monitoring elderly patients at private homes, Face quality assessment, Measurement of physiological parameters, Contact-free heartbeat biometrics, and Decision support system for healthcare. The work related to monitoring elderly patients at private homes includes a detailed survey and review of the monitoring technologies relevant to older patients living at home by discussing previous reviews and relevant taxonomies, different scenarios for home monitoring solutions for older patients, sensing and data acquisition techniques, data processing and analysis techniques, available datasets for ...

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 ...

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 ...

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 ...

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 ...

The first part of the presented work is focused on measuring of QT intervals. QT interval can be an indicator of the cardiovascular health of the patient and detect any potential abnormalities. The QT interval is measured from the onset of the QRS complex to the end of the T wave. However, measurements for the end of the T wave are often highly subjective and the corresponding verification is difficult. Here we propose two methods of QT interval measuring – wavelet based and template matching method. Methods are compared with each other and tested on standard QT database. The second part of the presented work is focused on modelling of arrhythmias using McSharry’s model followed with classification using an artificial neural network. The proposed method uses pre-processing of signals with Linear Approximation Distance Thresholding method and Line Segment Clustering method ...

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 ...

Accurate detection of ischemic patterns in ECG is important for correct diagnosis of myocardial ischemia or infarct and further treatment of the patients. Therefore, this research area is highly topical for the past few decades. The thesis introduces the results of comprehensive study on rabbit isolated heart, where many various aspects of ECG acquisition, processing and analysis have been addressed. Particularly, effects of ischemia, increased left ventricular mass and voltage-sensitive dye di-4-ANEPPS on heart electrical activity were evaluated by analysis of various ECG and VCG parameters. The impact of the last two phenomena (frequent in animal studies) on electrocardiographic ischemia manifestations and detection was described quantitatively. Various approaches for ischemia detection via advanced supervised classification tools and feature selection methods were proposed and evaluated by cross-validation technique considering such important aspects as electrode placement, features and classification models used, definition ...

Over the last decade there has been an increasing interest in solutions for the continuous monitoring of health status with wireless, and in particular, wearable devices that provide remote analysis of physiological data. The use of wireless technologies have introduced new problems such as the transmission of a huge amount of data within the constraint of limited battery life devices. The design of an accurate and energy efficient telemonitoring system can be achieved by reducing the amount of data that should be transmitted, which is still a challenging task on devices with both computational and energy constraints. Furthermore, it is not sufficient merely to collect and transmit data, and algorithms that provide real-time analysis are needed. In this thesis, we address the problems of compression and analysis of physiological data using the emerging frameworks of Compressive Sensing (CS) and sparse ...

Acutely-ill hospitalised patients are at risk of clinical deteriorations in health leading to adverse events such as cardiac arrests. Deteriorations are currently detected by manually measuring physiological parameters every 4-6 hours. Consequently, deteriorations can remain unrecognised between assessments, delaying clinical intervention. It may be possible to provide earlier detection of deteriorations by using wearable sensors for continuous physiological monitoring. Respiratory rate (RR) is not commonly monitored by wearable sensors, despite being a sensitive marker of deteriorations. This thesis presents investigations to identify an algorithm suitable for estimating RR from two signals commonly acquired by wearable sensors: the electrocardiogram (ECG) and photoplethysmogram (PPG). A suitable algorithm was then used to estimate RRs retrospectively from a physiological dataset acquired from acutely-ill patients to assess the potential utility of wearable sensors for detecting deteriorations. Existing RR algorithms were identi ed through a systematic ...