Evaluation of ambulatory ECG sensors for a clinical trial on outpatient cardiac rehabilitation

The objective of this paper is to investigate an R wave extraction function of the ECG signals from different sensors and electrodes used in an ICT-based home care cardiac rehabilitation (CR) program called the Care Assessment Platform (CAP). The CAP's focus is to provide patients an alternative option to undertake CR program at home to improve the uptake of CR programs that is currently underutilised. The CAP uses ambulatory monitoring devices to collect physiological data such as Heart Rate (HR) for a home setting. In this study we evaluated the performance of HR measurement by testing two ECG sensors and four different brands of electrodes intended for ambulatory use. ECG noise levels and error rates of R-wave extractions were analyzed under different test conditions, activities, and combinations of sensors and electrodes. The results display that the textile electrodes can have better performance than the conventional Ag/AgCl gel based electrodes and the R wave detection error rates for walking activity, the major exercise for the CR patients, are generally lower than 0.6% for all the tested textile electrodes. The study demonstrates that all the tested electrodes and sensors can obtain sufficient ECG signals for heart rate and heart rate variability studies in the CAP. It also indicates that the textile electrodes may outperform the conventional Ag/AgCl gel electrodes in particular to applications of the CR study.