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      Design of a Wearable 12-Lead Noncontact Electrocardiogram Monitoring System

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          Abstract

          A standard 12-lead electrocardiogram (ECG) is an important tool in the diagnosis of heart diseases. Here, Ag/AgCl electrodes with conductive gels are usually used in a 12-lead ECG system to access biopotentials. However, using Ag/AgCl electrodes with conductive gels might be inconvenient in a prehospital setting. In previous studies, several dry electrodes have been developed to improve this issue. However, these dry electrodes have contact with the skin directly, and they might be still unsuitable for patients with wounds. In this study, a wearable 12-lead electrocardiogram monitoring system was proposed to improve the above issue. Here, novel noncontact electrodes were also designed to access biopotentials without contact with the skin directly. Moreover, by using the mechanical design, this system allows the user to easily wear and take off the device and to adjust the locations of the noncontact electrodes. The experimental results showed that the proposed system could exactly provide a good ECG signal quality even while walking and could detect the ECG features of the patients with myocardial ischemia, installation pacemaker, and ventricular premature contraction.

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          Most cited references29

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          Dry-contact and noncontact biopotential electrodes: methodological review.

          Recent demand and interest in wireless, mobile-based healthcare has driven significant interest towards developing alternative biopotential electrodes for patient physiological monitoring. The conventional wet adhesive Ag/AgCl electrodes used almost universally in clinical applications today provide an excellent signal but are cumbersome and irritating for mobile use. While electrodes that operate without gels, adhesives and even skin contact have been known for many decades, they have yet to achieve any acceptance for medical use. In addition, detailed knowledge and comparisons between different electrodes are not well known in the literature. In this paper, we explore the use of dry/noncontact electrodes for clinical use by first explaining the electrical models for dry, insulated and noncontact electrodes and show the performance limits, along with measured data. The theory and data show that the common practice of minimizing electrode resistance may not always be necessary and actually lead to increased noise depending on coupling capacitance. Theoretical analysis is followed by an extensive review of the latest dry electrode developments in the literature. The paper concludes with highlighting some of the novel systems that dry electrode technology has enabled for cardiac and neural monitoring followed by a discussion of the current challenges and a roadmap going forward.
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            A direct comparison of wet, dry and insulating bioelectric recording electrodes.

            Alternatives to conventional wet electrode types are keenly sought for biomedical use and physiological research, especially when prolonged recording of biosignals is demanded. This paper describes a quantitative comparison of three types of bioelectrode (wet, dry and insulating) based on tests involving electrode impedance, static interference and motion artefact induced by various means. Data were collected simultaneously, and in the same physical environment for all electrode types. Results indicate that in many situations the performance of dry and insulating electrodes compares favourably with wet electrodes. The influence of non-stationary electric fields on shielded dry and insulating electrode types was compared to wet types. It was observed that interference experienced by dry and insulating electrode types was 40 dB and 34 dB less than that experienced by wet electrode types. Similarly, the effect of motion artefact on dry and insulating electrodes was compared to wet types. Artefact levels for dry and insulating electrodes were significantly higher than those for wet types at the beginning of trials conducted. By the end of the trial periods artefact levels for dry and insulating types were lower than wet electrodes by an average of 8.2 dB and 6.8 dB respectively. The reservations expressed in other studies regarding the viability of dry and insulating electrodes for reliable sensing of biosignals are not supported by the work described here.
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              Novel dry polymer foam electrodes for long-term EEG measurement.

              A novel dry foam-based electrode for long-term EEG measurement was proposed in this study. In general, the conventional wet electrodes are most frequently used for EEG measurement. However, they require skin preparation and conduction gels to reduce the skin-electrode contact impedance. The aforementioned procedures when wet electrodes were used usually make trouble to users easily. In order to overcome the aforesaid issues, a novel dry foam electrode, fabricated by electrically conductive polymer foam covered by a conductive fabric, was proposed. By using conductive fabric, which provides partly polarizable electric characteristic, our dry foam electrode exhibits both polarization and conductivity, and can be used to measure biopotentials without skin preparation and conduction gel. In addition, the foam substrate of our dry electrode allows a high geometric conformity between the electrode and irregular scalp surface to maintain low skin-electrode interface impedance, even under motion. The experimental results presented that the dry foam electrode performs better for long-term EEG measurement, and is practicable for daily life applications. © 2011 IEEE
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                Author and article information

                Journal
                Sensors (Basel)
                Sensors (Basel)
                sensors
                Sensors (Basel, Switzerland)
                MDPI
                1424-8220
                28 March 2019
                April 2019
                : 19
                : 7
                : 1509
                Affiliations
                [1 ]Department of Emergency Medicine, Chi Mei Medical Center, Tainan 710, Taiwan; nych2525@ 123456gmail.com
                [2 ]Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
                [3 ]Department of Computer Science and Information Engineering, National Taipei University, New Taipei 23741, Taiwan; bslin@ 123456mail.ntpu.edu.tw
                [4 ]Institute of Imaging and Biomedical Photonics, National Chiao Tung University, Tainan 711, Taiwan; nctukeyiho@ 123456gmail.com
                Author notes
                [* ]Correspondence: borshyhlin@ 123456gmail.com ; Tel.: +886-6-3032121-57835
                Author information
                https://orcid.org/0000-0003-0498-3190
                https://orcid.org/0000-0002-8653-2571
                Article
                sensors-19-01509
                10.3390/s19071509
                6480574
                30925752
                60ed10e2-1bad-4c21-b68b-212abe644cd4
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 19 February 2019
                : 25 March 2019
                Categories
                Article

                Biomedical engineering
                electrocardiogram,conductive gels,noncontact electrode,myocardial ischemia,pacemaker,ventricular premature contraction

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