ECG compression for Holter monitoring

Abstract

Cardiologists can gain useful insight into a patient's condition when they are able to correlate the patent's symptoms and activities. For this purpose, a Holter Monitor is often used - a portable electrocardiogram (ECG) recorder worn by the patient for a period of 24-72 hours. Preferably, the monitor is not cumbersome to the patient and thus it should be designed to be as small and light as possible; however, the storage requirements for such a long signal are very large and can significantly increase the recorder's size and cost, and so signal compression is often employed. At the same time, the decompressed signal must contain enough detail for the cardiologist to be able to identify irregularities. "Lossy" compressors may obscure such details, where a "lossless" compressor preserves the signal exactly as captured.The purpose of this thesis is to develop a platform upon which a Holter Monitor can be built, including a hardware-assisted lossless compression method in order to avoid the signal quality penalties of a lossy algorithm. The objective of this thesis is to develop and implement a low-complexity lossless ECG encoding algorithm capable of at least a 2:1 compression ratio in an embedded system for use in a Holter Monitor. Different lossless compression techniques were evaluated in terms of coding efficiency as well as suitability for ECG waveform application, random access within the signal and complexity of the decoding operation. For the reduction of the physical circuit size, a System On a Programmable Chip (SOPC) design was utilized. A coder based on a library of linear predictors and Rice coding was chosen and found to give a compression ratio of at least 2:1 and as high as 3:1 on real-world signals tested while having a low decoder complexity and fast random access to arbitrary parts of the signal. In the hardware-assisted implementation, the speed of encoding was a factor of between four and five faster than a software encoder running on the same CPU while allowing the CPU to perform other tasks during the encoding process.