Algorithm for Premature Ventricular Contraction Detection from a Subcutaneous Electrocardiogram Signal

Cardiac arrhythmias occur when the normal pattern of electrical signals in the heart breaks down. A premature ventricular contraction (PVC) is a common type of arrhythmia that occurs when a heartbeat originates from an ectopic focus within the ventricles rather than from the sinus node in the right atrium. This and other arrhythmias are often diagnosed with the help of an electrocardiogram, or ECG, which records the electrical activity of the heart using electrodes placed on the skin. In an ECG signal, a PVC is characterized by both timing and morphological differences from a normal sinus beat. An implantable cardiac monitor (ICM) is a device used to help physicians diagnose and monitor infrequent cardiac arrhythmias that may not be observed during an ECG recording performed during a normal clinic visit. These devices are implanted under the skin of the chest and simply monitor and record the electrical activity of the heart. The recorded signal is referred to as a subcutaneous electrocardiogram, or SECG. This thesis proposes and tests a novel algorithm that uses an SECG signal to perform PVC detection and is suitable for implementation within an implantable cardiac monitoring device. The proposed algorithm uses a combination of morphological and timing criteria to identify PVCs in near real time. Current commercially-available ICMs do not provide a PVC detection feature, so the proposed algorithm could help provide physicians with valuable additional diagnostic information about a clinically-significant arrhythmia