The Ear-ECG provides a continuous Lead I electrocardiogram (ECG) by measuring the potential difference related to heart activity through the use of electrodes that can be embedded within earphones. The significant increase in wearability and comfort afforded by Ear-ECG is often accompanied by a corresponding degradation in signal quality -a common obstacle that is shared by the majority of wearable technologies. We aim to resolve this issue by introducing a Deep Matched Filter (Deep-MF) for the highly accurate detection of R-peaks in wearable ECG, thus enhancing the utility of Ear-ECG in real-world scenarios. The Deep-MF consists of an encoder stage (trained as part of an encoder-decoder module to reproduce ground truth ECG), and an R-peak classifier stage. Through its operation as a Matched Filter, the encoder section searches for matches with an ECG template pattern in the input signal, prior to filtering the matches with the subsequent convolutional layers and selecting peaks corresponding to true ECG matches. The so condensed latent representation of R-peak information is then fed into a simple R-peak classifier, of which the output provides precise R-peak locations. The proposed Deep Matched Filter is evaluated using leave-one-subject-out cross validation over 36 subjects with an age range of 18-75, with the Deep-MF outperforming existing algorithms for R-peak detection in noisy ECG. The proposed Deep-MF is bench marked against a ground truth ECG in the form of either chest-ECG or arm-ECG, and both R-peak recall and R-peak precision is calculated. The Deep-MF achieves a median R-peak recall of 94.9% and a median precision of 91.2% across subjects when evaluated with leave-one-subject-out cross validation. Moreover, when evaluated across a range of thresholds, the Deep-MF achieves an area under the curve (AUC) value of 0.97. The interpretability of Deep-MF as a Matched Filter is further strengthened by the analysis of its response to partial initialisation with an ECG template. We demonstrate that the Deep Matched Filter algorithm not only retains the initialised ECG kernel structure during the training process, but also amplifies portions of the ECG which it deems most valuable -namely the P wave, and each aspect of the QRS complex. Overall, the Deep Matched Filter serves as a valuable step forward for the real-world functionality of Ear-ECG and, through its explainable operation, the acceptance of deep learning models in e-health.
Wearable technologies are envisaged to provide critical support to future healthcare systems. Hearables - devices worn in the ear - are of particular interest due to their ability to provide health monitoring in an efficient, reliable and unobtrusive way. Despite the considerable potential of these devices, the ECG signal that can be acquired through a hearable device worn on a single ear is still relatively unexplored. Biophysics modelling of ECG volume conduction was used to establish principles behind the single ear ECG signal, and measurements of cardiac rhythms from 10 subjects were found to be in good correspondence with simulated equivalents. Additionally, the viability of the single ear ECG in real-world environments was determined through one hour duration measurements during a simulated driving task on 5 subjects. Results demonstrated that the single ear ECG resembles the Lead I signal, the most widely used ECG signal in the identification of heart conditions such as myocardial infarction and atrial fibrillation, and was robust against real-world measurement noise, even after prolonged measurements. This study conclusively demonstrates that hearables can enable continuous monitoring of vital signs in an unobtrusive and seamless way, with the potential for reliable identification and management of heart conditions such as myocardial infarction and atrial fibrillation.
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