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Meet the challenge of high-pass filter and ST-segment requirements with a DC-coupled digital electrocardiogram amplifier.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Abächerli, Roger Schmid, Hans-Jakob
Description	Country affiliation: Switzerland Author Affiliation: Abächerli R ( SCHILLER AG, Biomed. Research and Signal Processing, Altgasse 68, Baar, Switzerland. roger.abaecherli@schiller.ch)
Abstract	BACKGROUND: The high-pass filter (HPF) in an electrocardiogram (ECG) amplifier can distort the ST segment required for ischemia interpretation. Therefore, the current standards and guidelines require -3 dB for monitoring and -0.9 dB for diagnostic purposes at 0.67 Hz. In addition, a minimal reaction to a rectangular pulse of 300 microV has to be proven. We raise the question of why the design of a DC-coupled digital ECG amplifier is reasonable when today the AC-coupled digital ECG amplifier including a 0.05-Hz HPF works so well, meets all required standards, and is already safe. We make the hypothesis that a digital DC-coupled ECG amplifier can as well meet the requirements and guarantee the same safety levels at the same time provide a higher degree of freedom for future improvements of the ECG signal quality. METHODS: Firstly, a historical research of the origin of the 0.05-Hz requirement has been made. Secondly, triangular pulses simulating unipolar QRS complexes have been passed through a digital filter to get qualitative results of the HPF response. And finally, to quantitatively describe the filter response, corresponding test requirement signals have been passed through a digital filter to simulate the HPF behavior, therefore understanding the reasons for the required tests. RESULTS: The oldest reference found to the 0.05-Hz filter dates from 1937. At that time, DC-coupled analogue ECG amplifiers were used. The simulation of the AC-coupled ECG amplifier with a first-order analogue HPF shows that the rectangular 300-microV pulse is a phase requirement and more restrictive than the frequency requirements. The phase requirement in fact corresponds to the requirement of a 0.05-Hz first-order analogue HPF (-3 dB) even if -0.9 dB at 0.67 Hz is required. The DC-coupled ECG amplifier (without an analogue HPF and during online and off-line acquisition) fulfils the phase and frequency requirements, just as the digital AC-coupled ECG amplifier does. CONCLUSIONS: An AC-coupled ECG amplifier based on a first-order analogue HPF must have a maximum cutoff frequency of 0.05 Hz or requires a phase equalizer causing a delay of the acquired ECG. Because the desired delay during online acquisition should be short, the solution is practical but could be improved. Not the frequency cutoff of the HPF but the phase distortion of such a filter should be discussed. The DC-coupled ECG amplifier is as safe as the AC-coupled ECG amplifier; but it provides a higher degree of freedom for future filter designs certainly improving the ECG signal quality, while the safety can be guaranteed. Furthermore, the DC-coupled ECG amplifier allows investigation of the HPF, which is not easily possible when an AC-coupled ECG amplifier including the HPF is to be investigated.
File Format	HTM / HTML
ISSN	00220736
Issue Number	6
Volume Number	42
e-ISSN	15328430
Journal	Journal of Electrocardiology
Language	English
Publisher	Elsevier
Publisher Date	2009-11-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Cardiology Amplifiers, Electronic Analog-digital Conversion Electrocardiography Instrumentation Signal Processing, Computer-assisted Computer-aided Design Equipment Design Equipment Failure Analysis Reproducibility Of Results Sensitivity And Specificity Journal Article
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine

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