JURNAL NASIONAL (10 )

JURNAL 1

MONITORING EKG 3 CHANNEL BERBASIS PERSONAL KOMPUTER

(Atfirul Aziz, Dewa Gede Hari Wisana, Endro Yulianto)
Jurusan Teknik Elektromedik Politeknik Kesehatan Surabaya
Jln. Pucang Jajar Timur No. 10 Surabaya
ABSTRAK

Penderita penyakit jantung koroner memerlukan pemantauan berlanjut dengan memantau

aktifitas sehari-hari dan memonitoring aktifitas listrik jantung menggunakan alat monitoring
EKG. Monitoring EKG dapat menampilkan aktifitas listrik jantung dengan memanfaatkan
axis jantung berdasarkan kelainan yang timbul pada lead I, II, dan III. Oleh karena itu,
penting dirancangknya Monitoring EKG 3 Channel Berbasis PC untuk memudahkan dalam
mengidentifikasi suatu penyakit dan kelainan jantung. Metode penelitian yang digunakan
adalah pre eksperimental design jenis “after only design” karena hanya menambahkan jumlah
channel yang digunakan untuk mendapatkan interpretasi jantung berdasarkan axis jantung.
Diharapkan hasil penelitian ini dapat bermanfaat bagi user dan memudahkan dalam
mendiagnosa penyakit jantung kororner. Hasil penelitian sebelumnya ditemukan masalah
grafik yang ditampilkan tidak stabil dan naik turun, untuk itu dalam penelitian selanjutnya
dapat lebih stabil dan dapat memanfaatkan axis jantung untuk mempermudah diagnosa
penyakit. Berdasarkan hasil penelitian yang dialakukan telah dibuat alat “Monitoring EKG 3
Channel Berbasis PC” dengan nilai error 3,33% dimana masih dalam nilai toleransi karena
batas toleransi 5%. Dalam perancangan alat masih diperlunya pengembangan dan
peningkatan mutu dan kualitas sinyal yang dihasilkan.

Kesimpulan
Secara menyeluruh penelitian ini dapat menyimpulkan bahwa:
1. Hasil pengukuran dengan alat pembanding ternyata terdapat nilai error yang terpaut jauh
dari nilai ambang toleransi.
Saran
Berikut ini adalah beberapa saran yang dapat dipertimbangkan untuk penyempurnaan
penelitian lebih lanjut :
1. Mengurangi nilai error pada sensor kebisingan dengan menggunakan sensor yang lebih
sensitive.
2. Menampilkan grafik untuk mengetahui tinggi rendah gelombang pada suara.

JURNAL 2

“CENTRAL PATIEN MONITOR (Monitoring EKG dan BPM)”

Syarifudin Abdilah, Dr. Ir. H. BambangGuruh I, AIM, MM, Torib Hamzah,S.pd,M.pd

Jurusan Teknik Elektromedik Politeknik Kesehatan Kementrian Kesehatan Surabaya

ABSTRAK

Central Patien monitor adalah alat yang digunakan untuk memonitoring keadaan dari
beberapa pasien. Electrocardiogram (ECG) adalah pemantauan untuk mendeteksi kelainan
jantung dengan mengukur aktivitas listrik yang dihasilkan oleh jantung. Beberapa pasien
memerlukan pemantauan berlanjut dengan memantau aktifitas sehari-hari dan memonitoring
aktifitas listrik jantung menggunakan alat monitoring. Oleh karena itu, penting dirancangknya
alat Central pasien monitor Berbasis PC untuk memudahkan dalam memantau beberapa
keadaanbeberapa pasien . Monitoring dilakukan dengan menempelkan elektroda pada lead II.
Sinyal EKG disadap rangkaian instrumentasi dan pengkondisi sinyal analog untuk menghasil
kansinyal EKG yang diolah mikrokontroller. Display berupa Personal Computer(PC) untuk
menampil kansinyal EKG dan jumlah heart rate. Berdasarkan hasil pengujian dan pengukuran
terhadap phantom EKG, heart rate hasil pembacaan modul memiliki selisi paling sedikit
terhadap alat EKG dengan dengan nilai error tidak melebihi ±5%. Setelah melakukan proses
perencanaan, percobaan, pembuatan modul, dan pengujian serta pendataan dapat disimpulkan
bahwa alat “Non Invasive Pacemaker (Monitoring)” dapat digunakan dan sesuai
perencanaan.
Kesimpulan
Berdasarkan hasil pembahasan dan tujuan pembuatan modul dapat disimpulkan bahwa :
1. Dapat dibuat alat Central pasien monitor yang menanpilkan sinyal ECG menggunakan
rangkaian pengolah sinyal jantung.
2. Dapat dibuat rangkaian minimum system microcontroller Atmega328.
3 Dapat dibuat software untukmenampilkan sinyal pada Personal Computer (PC) Dapat
dibuat software pemrograman mikrokontroller pada pemrograman untuk tampilan hasil grafik
sinyal ECG.
4 Saat pasien dalam kondisi tenang sinyal ECG yang ditampilkan di display bisa stabil, akan
tetapi saat pasien bergerak ditemukan sinyal ECG yang naik turun dari titik referensi awal.
5 Sinyal yang naik turun disebabkan oleh pergerakan pada subyek atau elektroda yang kurang
kontak dengan kulit.
6 Sinyal yang naik turun menyebabkan mikro tidak bias melakukan pengolahan data untuk
menampilkan nilai HR.

Saran
1. Menggunakan USB-HUB yang lebih bagus.
2. Pengolahan sinyal pada display untuk menstabilkan sinyal yang naik turun titik
referensinya.
3. Melakukan penambahan penyimpanan keseluruhan data.

JURNAL 3

ELEKTROKARDIOGRAF (ECG) dan PHOTOPLETHYSMOGRAF (PPG) BERBASIS PC

Aisyah Taqiyyatun Ni’mah, Torib Hamzah,m.Pd, Sumber,S.ST,MT

Jurusan Teknik Elektromedik Politeknik Kesehatan Kementrian Kesehatan Surabaya

ABSTRAK

Elektrokardiograf (ECG) adalah perekam sinyal jantung manusia dengan keluaran sinyal
pada monitor atau dapat di print out dalam bentuk grafik. Cara kerja alat ECG dalam
mengidentifikasi sinyal jantung manusia dilakukan dengan cara menempelkan elektroda pada
dada, tangan, dan kaki manusia. Photoplethysmograph (PPG) merupakan suatu instrumen
yang digunakan untuk mengukur perubahan volume darah di dalam suatu organ
menggunakan sensor optik. Informasi dari kedua sinyal tersebut akan di proses oleh
mikrokontroller. Pengolahan data untuk bisa ditampilkan pada display penulis menggunakan
software Delphi 7.Proses pemantauan pada alat ini dilakukan secara wireless, sehingga dokter
dapat memantau jumlah denyut jantung pasiennya langsung melalui PC dengan
menggunakan Bluetooth. Berdasarkan hasil pengukuran ada 5 orang pasien dengan
pengukuran sebanyak 5 kali pada setiap pasien dengan pembanding Patient Monitor,
didapatkan selisih nilai prosentase eror tidak melebihi 5%.

Kesimpulan
Secara menyeluruh penelitian ini dapat disimpulkan sebagai berikut :
Hasil pengukuran EGG terhadap kalibrator dengan menggunakan phantom ECG didapat nilai
eror paling kecil 0% dan yang paling besar 0,66%
a. Setting media 30 BPM memiliki nilai eror 0,66%
b. Setting media 60 BPM memiliki nilai eror 0,33%
c. Setting media 120 BPM memiliki nilai eror 0%
d. Setting media 180 BPM memiliki nilai eror 0,44%
e. Setting media 240 BPM memiliki nilai eror 0,33
Pengukuran ECG pada responden dengan menggunakan pembanding patient monitor
memiliki nilai eror paling kecil 0% dan yang paling besar 3,06%
a. Pasien 1 memiliki nilai eror 3,06%
b. Pasien 2 memiliki nilai eror 2,05%
c. Pasien 1 memiliki nilai eror 0%
d. Pasien 1 memiliki nilai eror 1,06%
e. Pasien 1 memiliki nilai eror 2,20%
Pengukuran PPG pada responden dengan menggunakan pembanding patient monitor
memiliki nilai eror paling kecil 1,33% dan yang paling besar 3,42%
a. Pasien 1 memiliki nilai eror 2,92%
b. Pasien 2 memiliki nilai eror 1,38%
c. Pasien 1 memiliki nilai eror 3,42%
d. Pasien 1 memiliki nilai eror 2,24%
e. Pasien 1 memiliki nilai eror 2,24%
- Eror pada modul tidak melebihi toleransi yaitu 5%
- Sensor finger menggunakan Pulse sensor
- Saat pasien dalam kondisi tenang sinyal ECG dan PPG akan stabil , akan tetapi saat pasien
bergerak sinyal ECG dan PPG akan naik turun .

Saran
Pengembangan penelitian ini dapat dilakukan pada :
1. Menggunakan sensor finger selain pulse sensor , atau sensor yang lebih stabil.
2. Dilengkapi hasil analisa terhadap sinyal ECG dan PPG yang ditampilkan pada monitor,
saat ini peneliti hanya menampilkan nilai BPM.
3. Melakukan penambahan penyimpanan keseluruhan data.
4. Melakukan penyadapan 12 lead untuk dimonitor oleh modul. Saat ini peneliti hanya
memonitor 1 lead saja, tepatnya pada lead 2.
5. Untuk pihak kampus, diharapkan menambahkan PATIENT MONITOR Karena penulis
menggunakan patient monitor sebagai pembanding.

JURNAL 4

Sistem Monitoring Elektrokardiografi Berbasis Aplikasi Android

Theo Wiranadi Hendrata, Achmad Arifin, dan Nada Fitrieyatul Hikmah
Jurusan Teknik Elektro, Fakultas Teknologi Industri, Institut Teknologi Sepuluh Nopember
(ITS) Jl. Arief Rahman Hakim, Surabaya 60111

Satu dari sepuluh kematian di dunia disebabkan oleh penyakit jantung. Hal ini menjadikan
serangan jantung peringkat pertama penyebab kematian di dunia tiap tahunnya. Aktivitas
fisik yang berat dan kondisi jantung yang tidak dipantau menyebabkan jantung mengalami
kekurangan oksigen, sehingga akhirnya memicu serangan jantung. Terlebih, tanda tanda
serangan jantung harus dikenali dan ditangani dengan segera, atau dapat dipastikan akan
terjadi kerusakan permanen pada otot jantung yang bila berlangsung lama dipastikan akan
berujung pada kematian. Peran pemantauan kondisi jantung ini dapat dilakukan dengan
memantau sinyal jantung menggunakan elektrokardiogram Oleh karena itu dibutuhkan
adanya sistem monitoring elektrokadiografi berbasis android. Alat ini berupa
elektrokardiogram portabel yang terintegrasi dengan perangkat smartphone. Alat ini bekerja
dengan menangkap sinyal jantung melalui elektroda, kemudian diamplifikasi dan difilter, dan
diolah di mikrokontroler untuk memperoleh parameter irama jantung sebagai tanda kelelahan
jantung. Sinyal tersebut lalu dikirimkan melalui komunikasi bluetooth ke perangkat android.
Dari sana dapat diperoleh detak jantung dan zona detak jantung secara spesifik. Dari data
tersebut, ketika terdeteksi kelelahan dari irama jantung akan muncul peringatan pada aplikasi
perangkat pengguna. Teknik Pan-Tompkins digunakan untuk deteksi segmen QRS dan
interval RR untuk detak jantung, Pada aplikasi android, apabila detak jantung melebihi 80%
dari detak jantung maksimal maka akan timbul peringatan dengan harapan penggunanya
dapat beristirahat sejenak agar terhindar dari risiko serangan jantung. Tujuan jangka panjang
dari alat ini adalah dapat meningkatkan kewaspadaan penggunanya akan kesehatan jantung
dan menurunkan tingkat mortalitas yang disebabkan oleh penyakit jantung.

Kesimpulan
Berdasarkan perancangan, pengujian, dan analisa sistem dapat ditarik beberapa kesimpulan
dari tugas akhir ini.
Pertama, penguatan instrumentasi menggunakan AD620 dengan diatur penguatan 1000 kali
untuk memperbesar sinyal jantung yang memiliki orde milivolt. Rangkaian filter dengan orde
2 dan topologi Sallen-Key digunakan untuk meredam noise, oleh karena itu digunakan high
pass filter dengan frekuensi cutoff 0,1Hz, low pass filter dengan frekuensi cutoff 80Hz, dan
band stop filter dengan frekuensi cutoff 51,9Hz. Agar dapat diproses secara digital sinyal
dinaikkan ke polaritas positif dengan memberi tegangan offset melalui rangkaian penjumlah
tak membalik. Ketika sinyal jantung memasuki mikrokontroler, sinyal dikonversi menjadi
digital dengan resolusi 8 bit, dan frekuensi sampling 1kHz. Pemrosesan sinyal membutuhkan
waktu 132μs atau 12,2% dari waktu total sehingga pehitungan dapat dilakukan dengan real-
time. Untuk mendeteksi segmen QRS kompleks dapat digunakan band pass filter, dan
teorema PanTompkins untuk memperoleh RR interval. Setelah itu dikomputasikan hingga
menemukan detak jantung penggunanya. Data dikirim dengan bluetooth dengan jarak
konektivitas 5 meter tanpa halangan. Pada aplikasi smartphone peringatan dapat dilakukan
dengan aplikasi, dimana apabila detak jantung melebihi 80% dari detak jantung maksimal
maka akan timbul peringatan. Berdasarkan hasil pengujian dapat disimpulkan bahwa sistem
dapat bekerja dengan baik sesuai dengan rancangan. Hasil pembacaan irama jantung sesuai
dengan teorema dengan eror rata rata 5 persen, hanya terjadi false positive ketika ada distorsi
pada sinyal. Terakhir, alat ini dapat digunakan selama 11,5 jam dari tegangan penuhnya,
dengan konsumsi daya total 173,6 miliwatt.
JURNAL 5

Sistem Monitoring Detak Jantung dan Suhu Tubuh Menggunakan Arduino Monitoring
System Heartbeat and Body Temperature Using Arduino
Tan Suryani Sollu1, Alamsyah2, Muhammad Bachtiar3, Ardi Amir4, Benyamin Bontong5
Jurusan Teknik Elektro Fakultas Teknik Universitas Tadulako
Jurusan Teknik Sipil Fakultas Teknik Universitas Tadulako
Jl. Soekarno Hatta Km.9, Tondo, Mantikulore, Kota Palu, 94118, 0451 – 422611

Pemeriksaan detak jantung dan suhu tubuh merupakan parameter tanda vital yang mendasar
bagi paramedis dalam menentukan kondisi fisik pasien. Pemeriksaan detak jantung dan suhu
tubuh dilakukan oleh petugas medis umumnya menggunakan elektrokardiogram dan
termometer. Penggunaan kedua alat ini masih memiliki kelemahan karena selalu dilakukan
berulang-ulang dan membutuhkan konsentrasi untuk mendapatkan nilai yang akurat. Metode
ini niscaya akan menimbulkan beberapa masalah, seperti waktu yang dibutuhkan oleh tenaga
medis cukup lama dalam menentukan diagnosis, menambah beban staf medis dalam
melakukan pemeriksaan, dan meningkatkan biaya yang harus dikeluarkan oleh pihak
pengelola dalam menyediakan peralatan medis. Sensor yang digunakan dalam penelitian ini
terdiri dari sensor AD8232 sebagai sensor detak jantung yang diubah dalam bentuk denyut
per menit (bpm) dan sensor DS18b20 sebagai pendeteksi suhu tubuh dalam derajat celcius
(0C). Penelitian ini bersifat fundamental dan bermanfaat dalam mengurangi beban tenaga
medis, mencegah terjadinya kesalahan diagnostik terutama dalam pemeriksaan detak jantung
dan suhu tubuh. Hasil dari desain yang diusulkan menunjukkan bahwa pendeteksi detak
jantung dan sensor suhu tubuh bekerja dengan baik.

Kesimpulan
Berdasarkan hasil pengujian yang telah dilakukan, maka ditarik kesimpulan sebagai berikut:
1. Penggunaan sensor board AD8232 dan DS18b20 bekerja dengan baik berdasarkan hasil
pengukuran sumber tegangan yang dihasilkan.
2. Hasil pengambilan data detak jantung pada 5 orang laki-laki berada antara 64 – 88 bpm
dan suhu tubuh berada antara 36,13– 36,93 0C. Hal ini menunjukkan bahwa kondisi
detak jantung dan suhu normal 5 orang laki-laki adalah normal. 3.
3. Modul arduino yang digunakan sebagai pengolah data sensor dari analog menjadi digital
berfungsi dengan baik. Hal ini dapat ditunjukkan dari hasil yang ditampilkan pada LCD
dan komputer server. 4.
4. Pengukuran data detak jantung dan suhu tubuh yang tidak akurat disebabkan oleh
pengaruh peletakan sensor yang tidak tepat.

Saran

Penelitian lebih lanjut akan melengkapi data semua usia dan ditambahkan sensor tekanan
darah, sehingga sistem rancangan yang akan dibangun terdiri dari deteksi detak jantung, suhu
tubuh dan tekanan darah. Untuk menampilkan antar muka yang menarik dapat dilengkapi
dengan pembuatan data base vital sign.

JURNAL 6

ALAT PENGUKUR SUHU BADAN DAN DETAK JANTUNG PORTABLE

Abstrak:

Menjaga kesehatan merupakan hal yang sangat penting bagi kehidupan. Kesehatan tubuh
perlu diperhatikan bagi semua orang, terutama adalah kesehatan jantung. Jantung merupakan
salah satu organ penting yang dimiliki oleh manusia yang berfungsi memompa darah ke
seluruh. Detak jantung beats per menit (bpm) ini merupakan parameter untuk menunjukkan
kondisi jantung. Selain jantung, yang harus diperhatikan adalah suhu badan. Perubahan suhu
badan sangat erat kaitannya dengan produksi panas yang berlebihan, untuk mengetahui suhu
badan diperlukan alat untuk mengukurnya. Dalam kehidupan sehari-hari untuk mengukur
suhu badan dan detak jantung harus menggunakan 2 alat ukur sehingga cukup menyulitkan,
maka perlu adanya suatu alat yang dapat mengukur suhu badan dan detak jantung secara
bersamaan. Alat ukur suhu badan dan detak jantung dirancang berbasis mikrokontroler AT-
Mega328 menggunakan sensor DS18B20 sebagai pengukur suhu dan pulse sensor untuk
mendeteksi detak jantung. Data detak jantung dan suhu tubuh ditampilkan pada LCD 16x2
dan data pengukuran disimpan pada memori mikro SD. Penelitian ini bertujuan untuk
memudahkan dalam mengetahui suhu badan dan frekuensi detak jantung per menit. Selisih
rata-rata antara DS18B20 dengan termometer digital adalah sebesar 0,71%. Pengukuran detak
jantung menggunakan pulse sensor dan beat per minute tensimeter selisihnya sebesar 2,64%.
Alasan dibuat/diteliti:

Untuk memudahkan dalam mengetahui suhu badan dan frekuensi detak jantung per menit
secara bersamaan dengan menggunakan satu alat ukur.

Metodelogi:

Perancangan alat ukur ini menggunakan masukan suhu badan, dan detak jantung yang
diperoleh dari perubahan volume darah pada ujung jari. Tahapan yang dilakukan dalam
perancangan sistem ini adalah melakukan perancangan perangkat lunak yaitu membuat
program untuk membaca data sensor dan mengolah data sensor menjadi parameter derajat
celcius dan beat per minute yang ditampilkan pada LCD dan disimpan pada memori. Tahapan
selanjutnya adalah perancangan perangkat keras yang terdiri dari sensor suhu, sensor detak
jantung, mikrokontroler AT-Mega 328, LCD 16x2, dan modul SD card sehingga menjadi
suatu rangkaian yang saling terhubung. Kemudian setelah perangkat keras dirangkai
dilakukan upload program yang telah dibuat ke dalam mikrokontroler AT-Mega 328.

Hasil, Kesimpulan, Akurasi:

1. Pengukuran suhu badan dan detak jantung dapat menggunakan sensor suhu DS18B20
sebagai pengukur suhu badan dan pulse sensor sebagai pengukur detak jantung per
menit (BPM).
2. Penyimpanan data hasil pengukuran ke memori mikro SD dapat menggunakan modul
micro SD card, kemudian data hasil pengukuran dapat dicetak.
3. Metode pengukuran suhu badan pada sistem ini dengan mengubah besaran panas
menjadi data digital dengan memanfaatkan sensor DS18B20, dan pengukuran detak
jantung dengan memanfaatkan pulse sensor unutk mendeteksi perubahan volume
darah pada ujung jari akibat jantung yang memompa darah.
4. Pada pengujian alat pengukur suhu badan dan detak jantung portable di dapatkan rata-
rata error sebesar 0,71% untuk suhu badan dan 2,64% untuk detak jantung per menit
(BPM).
JURNAL 7

SUHU TUBUH: HOMEOSTASIS DAN EFEK TERHADAP KINERJA TUBUH

MANUSIA

Abstrak:

Suhu tubuh didefinisikan sebagai salah satu tanda vital yang menggambarkan status
kesehatan seseorang. Dibandingkan dengan primata lainnya, manusia mempunyai
kemampuan yang lebih besar untuk mentolerer suhu tinggi oleh karena banyaknya kelenjar
keringat, dan kulitnya hanya ditumbuhi oleh rambut halus. Di dalam tubuh energi panas
dihasilkan oleh jaringan aktif terutama dalam otot, kemudian juga dalam alat keringat, lemak,
tulang, jaringan ikat, serta saraf. Energi panas yang dihasilkan didistribusikan ke seluruh
tubuh melalui sirkulasi darah, namun suhu bagian-bagian tubuh tidak merata. Terdapat
perbedaan yang cukup besar (sekitar 4°C) antara suhu inti dan suhu permukaan tubuh.6,7
Sistem termoregulator tubuh harus dapat mencapai dua gradien suhu yang sesuai, yaitu: 1)
antara suhu inti dengan suhu per-mukaan, 2) antara suhu permukaan dengan suhu lingkungan.
Dari keduanya, gradien suhu inti dengan suhu permukaan adalah yang terpenting untuk
kelangsungan fungsi tubuh yang optimal. Pemahaman tentang besaran suhu dan pengaruhnya
terhadap mekanisme homeostatis tubuh melalui pendekatan hukum-hukum fisika setidaknya
memberi kontribusi yang berarti pada bidang ilmu klinis terapan.

Kesimpulan:

Suhu tubuh didefinisikan sebagai salah satu tanda vital yang menggambarkan status
kesehatan seseorang. Energi panas dihasil-kan di dalam tubuh kemudian didistribusi-kan ke
seluruh tubuh melalui sirkulasi da-rah, namun suhu bagian-bagian tubuh tidak merata. Sistem
termoregulator tubuh harus dapat mencapai dua gradien suhu yang sesuai, yaitu: a) antara
suhu inti dengan suhu permukaan, b) antara suhu permukaan dengan suhu lingkungan. Dari
keduanya, gradien suhu inti dengan suhu permukaan adalah yang terpenting untuk
kelangsungan fungsi tubuh yang optimal.
JURNAL 8

RANCANG BANGUN ALAT UKUR DETAK JANTUNG DAN SUHU TUBUH

MANUSIA BERBASIS MIKROKONTROLER ATMEGA16

Abstrak:

Detak jantung dan suhu tubuh merupakan dua parameter penting yang digunakan oleh
paramedis untuk mengetahui kondisi kesehatan fisik maupun kondisi mental seseorang.
Karena bila detak jantung atau suhu tubuh tidak normal maka perlu dilakukan upaya
selanjutnya agar tidak terjadi hal-hal yang tidak diinginkan. Seperti diketahui penyakit
jantung merupakan salah satu penyebab kematian tertinggi didunia, sedangkan suhu tubuh
dapat mengindikasikan sesuatu dalam tubuh, misalnya : terjadi radang, infeksi, strees dan lain
sebagainya.
Stetoskop dan termometer air raksa, dua alat ini diketahui merupakan alat yang biasa
digunakan untuk mengukur detak jantung dan suhu tubuh. Kedua alat ini memang sederhana
dan mudah dibawa, tetapi memiliki kekurangan yang sangat mendasar dalam ilmu
kedokteran. Kekurangan itu, antara lain : membutuhkan waktu yang cukup lama karena harus
dilakukan secara berulang ulang untuk mencapai hasil yang tepat, keakuratanya relatif rendah
karena membutuhkan konsentrasi untuk menghitung detak jantung dan pengelihatan dari
sudut pandang yang tepat untuk mengetahui hasilnya

Alasan dibuat/diteliti:

Untuk mengembangkan dan merancang alat ukur detak jantung dan suhu tubuh karena
terdapat kekurangan yaitu membutuhkan waktu yang cukup lama karena harus dilakukan
secara berulang ulang untuk mencapai hasil yang tepat, keakuratanya relatif rendah karena
membutuhkan konsentrasi untuk menghitung detak jantung dan pengelihatan dari sudut
pandang yang tepat untuk mengetahui hasilnya.

Kesimpulan:

1. Berdasarkan hasil pengujian alat, jika ada perbedaan antara hasil pengukuran dengan alat
dengan detak jantung dan suhu tubuh normal atau pengujian secara manual, hal ini bisa
disebabkan pada perbedaan kondisi, aktifitas dan penempatan sensor yang tidak tepat.
2. Alat yang dibuat sangat sensitif dengan pergerakan dan suara. Usahakan lakukan
pengujian ditempat yang tenang
JURNAL 9

RANCANG BANGUN SISTEM SIMULASI PEMERIKSAAN SUHU TUBUH PADA

VITAL SIGN SIMULATOR UNTUK PELATIHAN KETERAMPILAN MEDIK
MAHASISWA KEDOKTERAN

Abstrak:

Keterampilan klinik merupakan kompetensi yang harus dikuasai oleh mahasiswa

kedokteran/calon dokter. Pemeriksaan tanda vital memiliki nilai kompetensi 4 atau harus
mampu dilakukan secara mandiri oleh calon dokter. Untuk mewujudkannya, dilakukan
pelatihan keterampilan pemeriksaan tanda vital dan suhu tubuh merupakan salah satu aspek
yang perlu diperhatikan oleh calon dokter. Oleh karena itu perlu dikembangkan simulator
suhu tubuh berbasis simulasi pasien berupa jaket/kaos menset yang dilengkapi “sistem
pintar”. Dengan demikian mahasiswa kedokteran dapat berlatih pengukuran tanda vital
dengan tetap mengintegrasikan komunikasi dan profesionalisme. Pada penelitian ini, dibuat
rancang bangun simulator suhu yang mampu mensimulasikan suhu tubuh manusia pada
rentang suhu 37oC – 42oC menggunakan mikrokontroller AVR ATMega16 dengan sensor
suhu LM35 dan aktuator pemanas berupa high power led 3W. Sensor suhu LM35 digunakan
sebagai feedback suhu dari aktuator pemanas dan memberikan informasi kepada
mikrokontroller untuk melakukan kendali terhadap aktuator pemanas tersebut. Data yang
ditampilkan di Liquid Crystal Display (LCD) berupa data ADC, data suhu, dan timer/waktu
(detik). Dari penelitian ini, dihasilkan rancang bangun alat simulasi suhu yang mampu
mensimulasikan suhu tubuh antara 37oC – 42oC. Simulator ini mempunyai akurasi 98,7%.
JURNAL 10

MONITORING DUA PARAMETER DATA MEDIK PASIEN (SUHU TUBUH DAN

DETAK JANTUNG) BERBASIS ARDUINO NIRKABEL

Abstrak:

Sebagaimana kita ketahui bahwa kemajuan teknologi telah memberikan dampak positif
dalam peningkatan kesehatan masyarakat. Untuk meningkatkan pelayanan pada masyarakat
perlu adanya dukungan dari berbagai pihak pada rumah sakit, misalnya kecepatan dan
keakuratan dalam menangani pasien. Dalam hal meningkatkan pelayanan kesehatan dengan
semakin pesat perkembangan ilmu dan teknologi, banyak bermunculan alat-alat kesehatan
yang berfungsi sebagai prasarana dalam kesehatan. Salah satu alat kesehatan itu adalah
monitoring data medic pasien meliputi suhu tubuh dan detak jantung dengan alat control
arduino. Penelitian ini bertujuan untuk merancang alat monitoring data medik pasien secara
nirkabel, atau dapat dilihat langsung pada jarak yang jauh sekalipun dan data pasien yang
sudah terekam dapat disimpan secara otomatis.

Kesimpulan:

Dengan adanya program alat bantu monitoring ini baik berupa hardware maupun software
para dokter dan tenaga medis dapat mengetahui dengan cepat dan tepat rate jantung dan suhu
tubuh pada tiap pasien.

1. Dengan adanya fasilitas tampilan grafik pada rate jantung dan suhu tubuh untuk setiap
pasien para dokter maupun tenaga medis dapat melihat setiap perubahan pada keadaan
pasien setiap waktu dengan cepat.
2. Program ini bisa menampilkan data dari perangkat keras dan nilai yang di tampilkan
sesuai dengan data yang sebenarnya.
3. Sistem program ini dilengkapi dengan fasilitas ganti username, penambahan data pasien
maupun dokter dan dilengkapi dengan fasilitas laporan.
4. Arduino Uno dapat digunakan sebagai media pemrosesan data yang dikirim oleh sensor
detak jantung dan sensor suhu serta EthernetShield dapat digunakan sebagai media
pengiriman data dari Arduino Uno ke web.
5. Untuk menampilkan informasi yang telah diproses oleh arduino dan dikirimkan oleh
EthernetShield melalui router Informasi yang ditampilkan kemudian disimpan dan
dikirim ke server untuk ditampilkan melalui web interface.
Untuk menyimpan informasi dari beberapa sensor ke dalam database sebagai rekam medik
pasien, dapat menggunakan pemrograman php yang telah diintegrasikan dengan SQLite
sebagai database.
JURNAL INTERNASIONAL (20)

JURNAL 1

A REVIEW PAPER ON ANALYSIS OF ELECTROCARDIOGRAPH (ECG) SIGNAL

FOR THE DETECTION OF ARRHYTHMIA ABNORMALITIES
Anand Kumar Joshi1, Arun Tomar2, Mangesh Tomar3
PG Student [ICE], Dept. of Electrical Engineering, Maharana Pratap College of Technology
Gwalior, Madhya Pradesh, India1
Assistant Professor, Dept. of Electrical Engineering, Maharana Pratap College of Technology
Gwalior, Madhya Pradesh, India2
Assistant Professor, Dept. of Electrical Engineering, IITM Gwalior, Madhya Pradesh, India3
ABSTRACT - ECG conveys information regarding the electrical function of the heart, by
altering the shape of its constituent waves, namely the P, QRS, and T waves. ECG Feature
Extraction plays a significant role in diagnosing most of the cardiac diseases. One cardiac
cycle in an ECG signal consists of the P-QRS-T waves. This feature extraction scheme
determines the amplitudes and interval in the ECG signal for subsequent analysis. The
amplitude and interval of P-QRS-T segment determine the function of heart. Cardiac
Arrhythmia shows a condition of abnormal electrical activity in the heart which is a threat to
humans. The aim of this paper presents analyses cardiac disease in Electrocardiogram (ECG)
Signals for Cardiac Arrhythmia using analysis of resulting ECG normal & abnormal wave
forms. This paper presents a method to analyze electrocardiogram (ECG) signal, extract the
features, for the classification of heart beats according to different arrhythmia. Cardiac
arrhythmia which are found are Tachycardia, Bradycardia, Supra ventricular Tachycardia,
Incomplete Bundle Branch Block, Bundle Branch Block, Ventricular Tachycardia, hence
abnormalities of heart may cause sudden cardiac arrest or cause damage of heart. The early
detection of arrhythmia is very important for the cardiac patients. Electrocardiogram (ECG)
feature extraction system has been developed and evaluated based on the multi-resolution
wavelet transform.
 Makalah Ulasan tentang Analisis Sinyal Elektrokardiograf (EKG) untuk Deteksi Kelainan
Aritmia
Anand Kumar Joshi1, Arun Tomar2, Mangesh Tomar3
Mahasiswa PG [ICE],
Departemen Teknik Listrik, Sekolah Tinggi Teknologi Maharana Pratap Gwalior, Madhya
Pradesh, India1
Asisten Profesor, Jurusan Teknik Listrik, Sekolah Tinggi Teknologi Gwalior Maharana
Pratap, Madhya Pradesh, India2
Asisten Profesor, Departemen Teknik Listrik, IITM Gwalior, Madhya Pradesh, India3

ABSTRAK - EKG menyampaikan informasi mengenai fungsi listrik jantung, dengan

mengubah bentuk gelombang penyusunnya, yaitu gelombang P, QRS, dan T. Ekstraksi Fitur
EKG berperan penting dalam mendiagnosis sebagian besar penyakit jantung. Satu siklus
jantung dalam sinyal EKG terdiri dari gelombang P-QRS-T. Skema ekstraksi fitur ini
menentukan amplitudo dan interval dalam sinyal EKG untuk analisis selanjutnya. Amplitudo
dan interval segmen P-QRS-T menentukan fungsi jantung. Aritmia Jantung menunjukkan
kondisi aktivitas kelistrikan abnormal di jantung yang merupakan ancaman bagi manusia.
Tujuan dari makalah ini menyajikan analisis penyakit jantung dalam Sinyal
Elektrokardiogram (EKG) untuk Aritmia Jantung dengan menggunakan analisis bentuk
gelombang normal & abnormal EKG yang dihasilkan. Makalah ini menyajikan metode untuk
menganalisis sinyal elektrokardiogram (EKG), mengekstraksi fitur, untuk klasifikasi detak
jantung menurut aritmia yang berbeda. Aritmia jantung yang ditemukan adalah Takikardia,
Bradikardia, Supra ventrikel Takikardia, Blok Cabang Bundel Tidak Lengkap, Blok Cabang
Bundel, Takikardia Ventrikel, sehingga kelainan jantung dapat menyebabkan henti jantung
mendadak atau menyebabkan kerusakan jantung. Deteksi dini aritmia sangat penting bagi
pasien jantung. Sistem ekstraksi fitur Elektrokardiogram (EKG) telah dikembangkan dan
dievaluasi berdasarkan transformasi wavelet multi-resolusi.

CONCLUSION
This research aims to design an ECG analysis system that will measure the rate and regularity
of heartbeats. This system need a good quality and accurate of analysis output to make sure
the result of the heart problem are correct. Basically the goals of this research as follows.
1. To determine the viability of ECG signal and characterization of ECG waveform in
classifying the heart disease problem.
2. To implement an analysis system for ECG signals using Discrete Wavelet
Transform (DWT) and Adaptive Neural Inference System (ANIS) as a Neural classifier.
3. To evaluate the performance of ECG analysis using DWT and ANIS that can allow for
more accurate diagnoses in classifying the heart disease.
4. To analyze the ECG signal waveform in classifying Normal, Arrhythmia, of ECG signals

KESIMPULAN

Penelitian ini bertujuan untuk merancang sistem analisis EKG yang akan mengukur laju dan
keteraturan detak jantung. Sistem ini membutuhkan kualitas yang baik dan hasil analisis yang
akurat untuk memastikan hasil dari masalah jantung benar. Pada dasarnya tujuan penelitian
ini sebagai berikut.
1. Untuk menentukan kelayakan sinyal EKG dan karakterisasi bentuk gelombang EKG dalam
mengklasifikasikan masalah penyakit jantung.
2. Untuk menerapkan sistem analisis untuk sinyal EKG menggunakan Discrete Wavelet
Transform (DWT) dan Adaptive Neural Inference System (ANIS) sebagai pengklasifikasi
Saraf.
3. Untuk mengevaluasi kinerja analisis EKG menggunakan DWT dan ANIS yang dapat
memungkinkan diagnosis yang lebih akurat dalam mengklasifikasikan penyakit jantung.
4. Untuk menganalisis bentuk gelombang sinyal EKG dalam mengklasifikasikan sinyal EKG,
Normal, Aritmia
JURNAL 2

ECG-VIEW II, A FREELY ACCESSIBLE ELECTROCARDIOGRAM DATABASE

Young-Gun Kim1☯, Dahye Shin1☯, Man Young Park2, Sukhoon Lee1¤, Min Seok
Jeon1,3, Dukyong Yoon1*, Rae Woong Park1,3*

1 Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South

Korea, 2 Mibyeong Research Center, Korea Institute of Oriental Medicine, Daejeon, Korea, 3
Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon,
South Korea

Abstract

The Electrocardiogram Vigilance with Electronic data Warehouse II (ECG-ViEW II) is a

large, single-center database comprising numeric parameter data of the surface
electrocardiograms of all patients who underwent testing from 1 June 1994 to 31 July 2013.
The electrocardiographic data include the test date, clinical department, RR interval, PR
interval, QRS duration, QT interval, QTc interval, P axis, QRS axis, and T axis. These data
are connected with patient age, sex, ethnicity, comorbidities, age-adjusted Charlson
comorbidity index, prescribed drugs, and electrolyte levels. This longitudinal observational
database contains 979,273 electrocardiograms from 461,178 patients over a 19-year study
period. This database can provide an opportunity to study electrocardiographic changes
caused by medications, disease, or other demographic variables.

Abstrak

Kewaspadaan Elektrokardiogram dengan Data Elektronik Gudang II (ECG-VIEW II) adalah

basis data besar, pusat tunggal yang terdiri dari data parameter numerik elektrokardiogram
permukaan dari semua pasien yang menjalani pengujian dari 1 Juni 1994 hingga 31 Juli 2013.
Data elektrokardiografi meliputi tanggal tes, departemen klinis, interval RR, interval PR,
durasi QRS, interval QT, interval QTc, sumbu P, sumbu QRS, dan sumbu T. Data ini
terhubung dengan usia pasien, jenis kelamin, etnis, komorbiditas, indeks komorbiditas
Charlson yang disesuaikan usia, obat yang diresepkan, dan kadar elektrolit. Basis data
pengamatan longitudinal ini mengandung 979.273 elektrokardiogram dari 461.178 pasien
selama periode studi 19 tahun. Database ini dapat memberikan kesempatan untuk
mempelajari perubahan elektrokardiografi yang disebabkan oleh obat, penyakit, atau variabel
demografis lainnya.

Conclusion The ECG-ViEW II database, described in this article, is a freely accessible

electrocardiogram database. This database has integrated all numeric parameters of
electrocardiogram, patient demographics, diagnosis data and drug prescription data. We
believe that the ECG-ViEW II database will be an excellent data source for research scientists
who study electrophysiological effect of diseases or drug prescription.

Kesimpulan Basis data ECG-VIEW II, yang dijelaskan dalam artikel ini, adalah basis data
elektrokardiogram yang dapat diakses secara bebas. Basis data ini telah mengintegrasikan
semua parameter numerik elektrokardiogram, demografi pasien, data diagnosis, dan data
resep obat. Kami percaya bahwa basis data ECG-VIEW II akan menjadi sumber data yang
sangat baik bagi para ilmuwan penelitian yang mempelajari efek elektrofisiologis dari
penyakit atau resep obat.

JURNAL 3

ECG SIGNAL PROCESSING METHOD AND HEART FREQUENCY DETECTION

METHOD

Abstract - Digital signal processing and data analysis are methods that are often used in
biomedical engineering research. This paper explains the use of digital signal filters on an
electrocardiogram (ECG). The designed filter is focused on removing the 50 Hz frequency
supply network and inhaling muscle artifacts. In addition, this paper contains descriptions of
three heart rate frequency detection algorithms from ECG. The algorithm is based on
statistical and differential mathematical methods. All methods are compared to the stress test
measurement. All the methods described are suitable for subsequent simple implementations
to the microprocessor for real-time signal processing and analysis.

The designed digital filter and the heart rate frequency algorithm are very simple. Filters have
small orders. Saves computing time, but is very effective for processing ECG signals. This is
the reason why this algorithm can be easily implemented into microprocessor units. Based on
the application of computational algorithms for digitally filtered ECG signals obtained during
stress tests, it can be said that differential computational methods are better for implementing
real-time processing. (Parák and Havlík, 2011)

METODE PENGOLAHAN SINYAL EKG DAN METODE DETEKSI FREKUENSI

JANTUNG
Abstrak - Pemrosesan sinyal digital dan analisis data adalah metode yang sering
digunakan dalam penelitian teknik biomedis. Makalah ini menjelaskan pemanfaatan filter
sinyal digital pada elektrokardiogram (EKG). Filter yang dirancang difokuskan untuk
menghilangkan jaringan suplai frekuensi 50 Hz dan menghirup artefak otot. Selain itu,
makalah ini berisi deskripsi dari tiga algoritma deteksi frekuensi denyut jantung dari EKG.
Algoritma didasarkan pada metode matematika statistik dan diferensial. Semua metode
dibandingkan pada pengukuran stress test. Semua metode yang dijelaskan cocok untuk
implementasi sederhana berikutnya ke mikroprosesor untuk pemrosesan dan analisis sinyal
waktu-nyata.

Filter digital yang dirancang dan algoritma frekuensi detak jantung sangat sederhana.
Filter memiliki pesanan kecil. Menghemat waktu komputasi, tetapi sangat efektif untuk
memproses sinyal EKG. Ini adalah alasan mengapa algoritma ini dapat dengan mudah
diimplementasikan ke unit mikroprosesor. Berdasarkan penerapan algoritma komputasi untuk
sinyal EKG yang disaring secara digital yang diperoleh selama stress test, dapat dikatakan
bahwa metode komputasi diferensial lebih baik untuk implementasi pemrosesan real-time.
(Parák and Havlík, 2011)
JURNAL 4

AUTOMATIC PATIENT ECG PROFILE AND INTERPRETATION FOR DETECTION,

TRACKING AND DISEASE DISCOVERY

Abstract - An electrocardiogram or ECG has been used for more than 100 years and remains
the most widely performed diagnostic test for characterization of heart structure and electrical
activity. Remarkably, the current approach to ECG interpretation automatically comes from
heuristics that were designed more than 40 years ago. textbfObjective: We hypothesize that
parallel advances in computing power, innovations in machine learning algorithms, and the
availability of large-scale digital ECG data will allow expanding ECG utilities beyond current
limitations, while at the same time maintaining interpretability, attributes that remain
important for decision making medical.

Conclusion: Modern AI methods can expand 12-lead ECGs into quantitative and diagnostic
applications beyond current use. In addition, careful selection of machine learning algorithms
achieves the goals of automation and accuracy without reducing transparency that is so
fundamental to clinical care and scientific discovery. (Tison et al., 2018)

Profil EKG Pasien Otomatis dan Interpretasi untuk Deteksi, Pelacakan, dan Penemuan
Penyakit

Abstrak- Elektrokardiogram atau EKG telah digunakan selama lebih dari 100 tahun dan tetap
menjadi tes diagnostik yang paling banyak dilakukan untuk karakterisasi struktur jantung dan
aktivitas listrik. Hebatnya, pendekatan saat ini untuk interpretasi EKG otomatis berasal dari
heuristik yang dirancang lebih dari 40 tahun yang lalu. textbfObjective: Kami berhipotesis
bahwa kemajuan paralel dalam daya komputasi, inovasi dalam algoritma pembelajaran
mesin, dan ketersediaan data EKG digital berskala besar akan memungkinkan memperluas
utilitas EKG di luar keterbatasan saat ini, sementara pada saat yang sama menjaga
interpretabilitas, atribut yang tetap penting untuk pengambilan keputusan medis.

Kesimpulan: Metode AI modern dapat memperluas EKG 12-lead ke aplikasi kuantitatif dan
diagnostik di luar penggunaan saat ini. Selain itu, pemilihan algoritma pembelajaran mesin
yang cermat mencapai tujuan otomatisasi dan akurasi tanpa mengurangi transparansi yang
begitu mendasar bagi perawatan klinis dan penemuan ilmiah. (Tison et al., 2018)

JURNAL 5

RAW ECG SIGNAL PROCESSING AND COMPLEX QRS DETECTION

Abstract— Introduction of data from an electrocardiogram (ECG) is an important area of

biomedical signal processing. Real-time identification of ECG signals is closely related to the
classification of patient diagnoses, examined for the purpose of diagnosis of cardiac status. In
our paper, we analyze suitable algorithms for extracting QRS complexes from raw ECG data.
This algorithm will be implemented in the ECG SYS software (electrocardiogram system).
This system will function as a decision support tool for doctors and especially for
cardiologists. The ECG decision support system will work with machine learning algorithms
to detect various diagnoses and anomalies in heart function. This paper is devoted to
processing raw ECG data and detection of QRS complexes.
In this paper, it is demonstrated the use of two selected algorithms suitable for the detection
of QRS complexes. The first is an online ECG QRS wave detector. This algorithm uses state-
machine logic to determine the different peaks in the ECG. This is based on averaging and
adaptive limits that fluctuate with respect to noise and signal. This algorithm also has the
ability to deal with noise with high pass filtering and base line wandering with low pass. The
second algorithm, the Pan Tompkins implementation of the ECG and QRS detectors uses
band filters and derivate filters. The algorithm is used with Normal ECG signals and
Arrhythmic ECG signals. To be able to detect QRS complexes and other parameters from
raw ECG signals, it is important to design and develop a system for ECG processing. This
system will function as a decision support tool for doctors and especially cardiologists. The
ECG support decision system will work with machine learning algorithms to detect various
diagnoses and anomalies in heart function. But this is not the only thing
area of use for the system. This can also be used as a complementary tool in health
monitoring systems that are far more complex in hospitals, retirement homes and places
where people must be monitored because of the dangerous environment. Future work will
focus on extracting other ECG parameters, for example T and Q waves. Detection of the QRS
complex is one of the phases in ECG SYS. These parameters as well as the QRS complex are
important for complex E-Health systems for people with special care needs (monitoring heart
rate, monitoring ECG signals, etc.) The final system will be used for recognition of ECG
patterns to automatically reveal patient status. heart disease. Pattern recognition will be
executed using machine learning methods. (Peterkova and Stremy, 2015)

PEMROSESAN SINYAL EKG MENTAH DAN DETEKSI QRS KOMPLEKS

Abstrak— Pengenalan data dari elektrokardiogram (EKG) adalah area penting dari
pemrosesan sinyal biomedis. Identifikasi sinyal EKG secara real time berkaitan erat dengan
klasifikasi diagnosis pasien, diperiksa untuk tujuan diagnosis status jantung. Dalam makalah
kami, kami menganalisis aloritma yang cocok untuk ekstraksi kompleks QRS dari data EKG
mentah. Algoritma ini akan diimplementasikan dalam perangkat lunak ECG SYS (sistem
elektrokardiogram). Sistem ini akan berfungsi sebagai alat pendukung keputusan untuk para
dokter dan terutama untuk para ahli jantung. Sistem keputusan dukungan ECG akan bekerja
dengan algoritma pembelajaran mesin untuk mendeteksi berbagai diagnosa dan anomali
dalam fungsi jantung. Makalah ini dikhususkan untuk memproses data EKG mentah dan
deteksi kompleks QRS.
Dalam tulisan ini, ditunjukkan penggunaan dua algoritma terpilih yang cocok untuk
deteksi kompleks QRS. Yang pertama adalah detektor gelombang ECG QRS online.
Algoritma ini menggunakan logika state-machine untuk menentukan puncak yang berbeda
dalam EKG. Ini didasarkan pada rata-rata dan batas adaptif yang berfluktuasi sehubungan
dengan kebisingan dan sinyal. Algoritma ini juga memiliki kemampuan untuk menghadapi
kebisingan dengan pemfilteran lulus tinggi dan pengembaraan garis dasar dengan lulus
rendah. Algoritma kedua, implementasi Pan Tompkins dari ECG dan detektor QRS
menggunakan filter band dan filter derivate. Algoritma digunakan dengan sinyal EKG
Normal dan sinyal EKG Aritmia. Untuk dapat mendeteksi kompleks QRS dan parameter
lainnya dari sinyal EKG mentah, penting untuk merancang dan mengembangkan sistem
untuk pemrosesan EKG. Sistem ini akan berfungsi sebagai alat pendukung keputusan untuk
dokter dan terutama ahli jantung. Sistem keputusan dukungan EKG akan bekerja dengan
algoritma pembelajaran mesin untuk mendeteksi berbagai diagnosa dan anomali dalam fungsi
jantung. Namun ini bukan satu-satunya
 area penggunaan untuk sistem tersebut. Ini dapat juga digunakan sebagai alat
pelengkap dalam sistem pemantauan kesehatan yang jauh lebih kompleks di rumah sakit,
rumah pensiun dan tempat-tempat di mana orang harus dipantau karena lingkungan yang
berbahaya. Pekerjaan masa depan akan difokuskan pada ekstraksi pada parameter EKG
lainnya, misalnya gelombang T dan Q. Deteksi kompleks QRS adalah salah satu fase dalam
ECG SYS. Parameter-parameter ini serta kompleks QRS penting untuk sistem E-Health
kompleks untuk orang-orang dengan kebutuhan perawatan khusus (memantau detak jantung,
memantau sinyal EKG, dll.) Sistem terakhir akan digunakan untuk pengenalan pola EKG
untuk secara otomatis mengungkapkan status pasien. penyakit jantung. Pengenalan pola akan
dieksekusi dengan menggunakan metode pembelajaran mesin. (Peterkova and Stremy, 2015)

JURNAL 6

RANCANG BANGUN PENGONTROLAN SUHU PADA SLEEPINGBAGSEBAGAI

TINDAKAN PENCEGAHAN PADA PENDERITA HIPOTERMIA

Abstrak:

The advent of climbing in Indonesia can not be denied by the jump in number of climbers
every year. Climbing is widely done in September through December where the moon
presents its natural beauty to its maximum. But during the month, the Mountains had very
cold temperatures due to the extremely high rainfall. Where very high rain rains cause some
risks, especially those related to the health of climbers such as colds, injuries from power
(heart, and muscle) and hypothermia. This condition often attacks climbers who do not
carry complete climbing equipment, are exposed to rain and lack of calorie or other
consumption. Based on that background, this study is designed to design. Temperature
Control on Sleepingbag as a Relief Action on Hypothermia Patients. In this research
the writer uses two components namely bracelet and sleeping bag. The bracelet acts as a
transformation to get data from the body which is an object then sent to the sleeepingbag that
serves to warm the body of hypothermia based on the inputs obtained from the bracelet.
Thesis research is intended to design and implement temperature controlling on sleepingbag
as a precautionary measure for hypothermia that often occurs in mountainous areas as well as
for the development of domestic industry in the field of medical devices.
The results of this study indicate that the bracelet system and sleeping bag system work
according to the human body condition. The bracelet system will tell the data obtained from
the sensor through the LCD display, when the pulse sensor gets the body data less than 60
then the lcd will show that you are detected hypothermia. Then the user will press the button
to trim data to sleepingbag to process the data with fuzzy method. Where if the body
temperature is less than 35⁰C and the sleep sleeping bag is less than 28 then the sleeping bag
system will unveil the heating output in the form of full nickel wire according to the rule
made in matlab.

Kesimpulan:
Pada sistem ini penggunaan sensor pulse bertujuan untuk mendeteksi detak jantung pada
seorang pendaki. Sensor ini diracang pada sarung tangan yang diletakan dibagian
ujung sarung tangan, sensor ini terhubung dengan mikrokontroler arduino nano. Sensor
mlx90614esf bertujuan untuk mendeteksi suhu tubuh sseorang pendaki. Sensor ini
dirancang pada sleeping bag yang diletakan pada tempat kotak penyimpanan modul
mikrokontroler, sensor ini terhubung dengan mikrokontroler arduino nano. Kedua
sensor tersebut akan diproses pada arduino nano dan mendapatkan otuput berupa
monitoring di lcd. Cara menghubungkan sistem gelang dan sistem sleepingbag yaitu
dengan memonitoring sistem gelang dimana ketika output sistem mengluarkan data
bahwa pengguna terdeteksi hipotermiah maka tombol akan ditekan untuk mengrimkan
data ke sleepingbag. Setelah mengirimkan data kesleepingbag maka sistem sleepingbag
akan aktif dan bekerja sesasuai metode yang digunakan.sistem sleepingbag dapat menguji
dengan metode fuzzy yang disimpulkan nilai sensor suhu tubuh, sensor suhu ruangan dan
PWM pada sistem sleepingbagyang ditampilkan melalui LCD 16x2 mendapat
perbandingan antara sensor suhu tubuh, sensor suhu ruangan dan nilai PWM sesuai dengan
rule yang telah dibuat melalui aplikasi dimatlab. Sebagai contoh jika nilai suhu tubuh
36.01°C (normal)dan suhu ruangan 28,94°C (normal)maka keluaran pwm adalah 122
yang berarti sesuai dengan hasil nilai PWM pada rule yang telah ditentukan. Dari hasil diatas
seluruh data yang ada pada pengujian keseluruhan sesuai dengan kondisi rule
metode fuzzy mamdani dengan infusi MIN-MAX yang sudah ditentukan yang
dimana sistem mendapatkan nilai untuk menghasilkan stabilisasi.
JURNAL 7

ECG MONITOR WITH HEART RATE VARIABILITY AND TEMPERATURE FOR USE
IN ANESTHESIOLOGY: FRONT-END BASED ON DSP

Abstrak:

The correct evaluation of the anesthetic state is an essential issue to avoid morbi-mortality in
a surgical patient. Recent studies proved that the anesthesia analgesic aspect may be
evaluated through the analysis of the heart rhythm variability. This work describes hardware
and software design of an ECG, HRV and temperature monitor frontend, based on low cost
DSP. It is able to show the patient’s ECG signal, to compute and show the tachogram, and to
show two different body temperatures. With cost similar to that of a conventional ECG
monitor, this equipment is able to provide more information to the anesthesiologist.

Hasil, Kesimpulan, Akurasi:

JURNAL 8

EFFICIENT SKIN TEMPERATURE SENSOR AND STABLE GEL-LESS STICKY ECG

SENSOR FOR A WEARABLE FLEXIBLE HEALTHCARE PATCH

Abstrak:

Wearable, flexible healthcare devices, which can monitor health data to predict and diagnose
disease in advance, benefit society. Toward this future, various flexible and stretchable
sensors as well as other components are demonstrated by arranging materials, structures, and
processes. Although there are many sensor demonstrations, the fundamental characteristics
such as the dependence of a temperature sensor on film thickness and the impact of adhesive
for an electrocardiogram (ECG) sensor are yet to be explored in detail. In this study, the
effect of film thickness for skin temperature measurements, adhesive force, and reliability of
gel-less ECG sensors as well as an integrated real-time demonstration is reported. Depending
on the ambient conditions, film thickness strongly affects the precision of skin temperature
measurements, resulting in a thin flexible film suitable for a temperature sensor in wearable
device applications. Furthermore, by arranging the material composition, stable gel-less
sticky ECG electrodes are realized. Finally, real-time simultaneous skin temperature and
ECG signal recordings are demonstrated by attaching an optimized device onto a volunteer’s
chest.

Hasil, Kesimpulan, Akurasi:

In summary, we studied the influence of film thickness on the temperature monitoring of skin
and gel-less adhesive conductive electrode for ECG recording. This systematic study reveals
that the PET film thickness causes a large temperature difference, which depends on the
ambient temperature. The results suggest that a thin-layer flexible sensor sheet is suitable for
a wearable skin temperature-sensing device compared to other conventional bulk-based
temperature sensors. For a gel-less sticky ECG sensor, the material composite concentration
of CNT, PEIE, and PDMS strongly influence the impedance between skin and the sensor.
However, optimizing the composition yielded a relatively reliable and stable gel-less ECG
sensor. We integrated an ECG sensor and a temperature sensor to monitor health condition
change based on ECG signal and skin temperature to monitor dehydration and heat stroke
applications as the simple flexible sensor system. By adding extra flexible sensors/actuators
to detect chemical contents in body and to deliver drug with data processing system, for
example, the further potential application can be realized widely for healthcare devices. In
addition, by collecting a lot of data about the health conditions, big data platform for health
monitoring may be available to diagnose disease. Although many other obstacles must be
addressed to realize practical healthcare patches, the fundamental properties reported here are
a step in that direction.
JURNAL 9

REMOTE MONITORING SYSTEM OF ECG AND BODY TEMPERATURE SIGNALS

Abstrak:

The paper presents a remote monitoring system for electrocardiographic and temperature
signals. The system consists of a hardware module for acquisition, a Bluetooth transmission
module and finally a displaying module (PC or mobile devices). Information is sent via IP
(GPRS or WiFi) to a database server containing clinical data, which can be accessed through
a web application. The system was assessed by testing different patients with the support of a
medical doctor, obtaining a positive performance.

Alasan dibuat/diteliti:

Hasil, Kesimpulan, Akurasi:

Jurnal 10

DIGITAL SENSOR FOR MINIATURE MEDICAL THERMOMETER, AND BODY

TEMPERATURE MONITOR

Abstrak:

A thermometer is disclosed that utilizes a thermistor as a temperature sensor, to control the

period and duty cycle of a multivibrator circuit. A second circuit, controlled by a
microcontroller, measures both the charge and discharge times of the oscillation. From the
ratio of these parameters, a precise indication of temperature can be obtained that is
independent of temperature variations within the active components and the charging
capacitor of the multivibrator circuit. The method is also independent of the value of the
charging capacitor. Furthermore, by measuring the same ratio when a fixed resistor is
substituted for the thermistor, a cell constant can be derived. The cell constant is used to
calibrate the non-ideal response of the multivibrator circuit, thus providing a more accurate
measurement of temper.

JURNAL 11

PREDICTIVE IMPLICATION OF INITIAL ELECTROCARDIOGRAM AND CREATINE

KINASE FOR LEFT VENTRICULAR EJECTION

Fraction in Patients with Acute ST-Elevation Myocardial Infarction Saeed Nourian*,

Mohammad Reza Beyranvand, Zeinedin Kheiry, Ali Ali Asgari and Mohamad Asadpour
Piranfar Tehran Heart Center, Teheran, Iran *Corresponding author: Saeed Nourian, Tehran
Heart Center, Poursina St., Ghods St., Keshavarz Blvd, Teheran, Iran, Tel: +98218802 9600;
Fax: 98(21)8885 2654; E-mail: Sd.nourian@yahoo.com Rec Date: Sep 05, 2016, Acc Date:
Oct 27, 2016, Pub Date: Oct 30, 2016 Citation: Nourian S, Beyranvand MR, Kheiry Z, et al.
Predictive Implication of Initial Electrocardiogram and Creatine Kinase for Left Ventricular
Ejection Fraction in Patients with Acute ST-Elevation Myocardial Infarction. Interv Cardiol J
2016, 2:3.

Abstract

Aim: Our aim was to determine the clinical, electrocardiographic (ECG) and biochemical
predictors of left ventricular dysfunction in patients with acute ST elevation myocardial
infarction (STEMI).
Methods: Patients with STEMI admitted in Loghman Hakim hospital were studied. The ECG
variables were: ECG rate, ECG rhythm, QRS duration, sum of absolute ST deviation (in all,
inferior and anterior leads), number of leads with ST elevation, maximum ST elevation,
presence of pathological Q waves and location of the infarct. The primary outcome measure
was LVEF ≤ 40%.

Results: A total of 124 patients (91 male, 33 female) were studied. Mean age of the patients
was 59.1 years (SD=12.6). Of these, 52 patients (44.4%) had an LVEF ≤ 40% and
angiography was recommended to 68 patients (54.8%) at the time of discharge. The
multivariate analysis showed an association of LVEF ≤ 40% with prior MI, diabetes,
maximum creatine kinase (CK) levels, the sum of absolute ST deviation in all and inferior
leads.

Conclusions: The initial ECG and CK levels in patients with STEMI may contain valuable
information for risk stratification, determination of prognosis and the subsequent
management plan. The results of this study warrant further studies to define patients who
benefit most from invasive and sophisticated interventions.

Keywords: Myocardial infarction; Electrocardiography; Creatine kinase; Risk assessment;

Prognosis

Conclusions

The initial ECG and CK levels in patients with STEMI may contain valuable information for
risk stratification, determination of prognosis and the subsequent management plan.

IMPLIKASI PREDIKTIF ELEKTROKARDIOGRAM AWAL DAN KINASE CREATINE

UNTUK EJEKSI KIRI VENTRIKULER
Fraksi pada Pasien dengan Infark Miokard Akut ST-Elevasi Saeed Nourian *, Mohammad
Reza Beyranvand, Zeinedin Kheiry, Ali Ali Asgari dan Mohamad Asadpour Piranfar Pusat
Jantung Tehran, Tehran, Iran * Penulis yang sesuai: Saeed Nourian, Tehran Heart Center,
Poursina St. Ghods St., Keshavarz Blvd, Teheran, Iran, Telp: +98218802 9600; Faks: 98 (21)
8885 2654; Alamat email: Sd.nourian@yahoo.com Tanggal Rec: 05 September 2016,
Tanggal Acc: 27 Okt 2016, Pub Date: 30 Okt 2016 Kutipan: Nourian S, Beyranvand MR,
Kheiry Z, et al. Implikasi Prediktif Elektrokardiogram Awal dan Creatine Kinase untuk
Fraksi Ejeksi Ventrikel Kiri pada Pasien dengan Infark Miokard ST-Elevasi Akut. Interv
Cardiol J 2016, 2: 3.
Abstrak
Tujuan: Tujuan kami adalah untuk menentukan prediktor klinis, elektrokardiografi (EKG)
dan biokimiawi dari disfungsi ventrikel kiri pada pasien dengan peningkatan ST akut miokard
infark (STEMI).
Metode: Pasien dengan STEMI yang dirawat di rumah sakit Loghman Hakim dipelajari.
Variabel EKG adalah: laju EKG, irama EKG, durasi QRS, jumlah deviasi ST absolut (dalam
semua, lead inferior dan anterior), jumlah lead dengan elevasi ST, elevasi ST maksimum,
keberadaan gelombang Q patologis dan lokasi infark . Ukuran hasil primer adalah LVEF ≤
40%.
Hasil: Sebanyak 124 pasien (91 laki-laki, 33 perempuan) dipelajari. Usia rata-rata pasien
adalah 59,1 tahun (SD = 12,6). Dari jumlah tersebut, 52 pasien (44,4%) memiliki LVEF ≤
40% dan angiografi direkomendasikan untuk 68 pasien (54,8%) pada saat dipulangkan.
Analisis multivariat menunjukkan hubungan LVEF ≤ 40% dengan tingkat MI, diabetes,
kreatin kinase (CK) maksimum sebelumnya, jumlah deviasi ST absolut dalam semua dan
lead yang lebih rendah.
Kesimpulan: Level EKG dan CK awal pada pasien dengan STEMI dapat berisi informasi
berharga untuk stratifikasi risiko, penentuan prognosis dan rencana manajemen selanjutnya.
Hasil penelitian ini memerlukan penelitian lebih lanjut untuk menentukan pasien yang paling
diuntungkan dari intervensi invasif dan canggih.
Kata kunci: infark miokard; Elektrokardiografi; Creatine kinase; Tugas beresiko; Prognosa
Kesimpulan
Level EKG dan CK awal pada pasien dengan STEMI dapat berisi informasi berharga untuk
stratifikasi risiko, penentuan prognosis dan rencana manajemen selanjutnya.

JURNAL 12

Clasification Of Arrhythmic ECG Data Using Machine Learning Techniques

Abhinav Vishwa, Mohit K. Lal, Sharad Dixit, Dr. Pritish Vardwaj 1Indian Institute of
Information Technology, Allahabad India

Abstract — In this paper we proposed a automated Artificial Neural Network (ANN) based
classification system for cardiac arrhythmia using multi-channel ECG recordings. In this
study, we are mainly interested in producing high confident arrhythmia classification results
to be applicable in diagnostic decision support systems. Neural network model with back
propagation algorithm is used to classify arrhythmia cases into normal and abnormal classes.
Networks models are trained and tested for MIT-BIH arrhythmia. The different structures of
ANN have been trained by mixture of arrhythmic and non arrhythmic data patient. The
classification performance is evaluated using measures; sensitivity, specificity, classification
accuracy, mean squared error (MSE), receiver operating characteristics (ROC) and area under
curve (AUC). Our experimental results gives 96.77% accuracy on MIT-BIH database and
96.21% on database prepared by including NSR database also.

Keywords — ECG arrhythmia, Sensitivity, specificity, accuracy, Arrhythmia classification,

artificial neural networks.

Conclution and Future Scope

This paper proposes an effective automated ANN based system for multi class Cardiac
Arrhythmia classification from ECG signal data. Every ANN has been tested and compared
with the most common traditional ECG analyzers on appropriate databases. Thus, based on
the results, the ANN’s approach is shown to be capable of dealing with the ambiguous nature
of the ECG signal. The crucial role of data pre-processing and post processing comes out,
either for reducing the input space dimension or for more appropriately describing the input
features. It is clear that

the estimated feed forward ANN with error back propagation algorithm operate as an
excellent classifier for given cardiac arrhythmia data set. Therefore our future scope will be
further fine tuning design of MLP and pre-processing of ECG signal data so that
classification results for other classes will be improved and design of MLP model to classify
all 16 arrhythmia classes in one MLP design only. We hope that this system can be further
developed and fine-tuned for practical application.

JURNAL 13

IS ONE LEAD REGISTERED ECG ABLE TO REFLECT THE WHOLE PICTURE OF

THE MAIN ELECTROCARDIOGRAPHIC
Parameters Characteristic for Healthy Patients As Well As for Myocardial Ischemia Ones?
Alexander Shmid, Maxim Novopashin and Andrey Berezin* EC-leasing, Varshavskoye
Shosse, Moscow, Russian Federation *Corresponding author: Andrey Berezin, EC-leasing,
Varshavskoye Shosse, Moscow 113405, Russian Federation, Tel: 89671280467; E-mail:
artparis@mail.ru Received: 28 October 2017; Accepted: 16 November 2017; Published: 27
November 2017 Copyright: © 2017 Shimid A, et al. This is an open-access article distributed
under the terms of the creative Commons attribution License, which permits unrestricted use,
distribution and reproduction in any medium, provided the original author and source are
credited. Citation: Shmid A, Novopashin M, Berezin A (2017) Is One Lead Registered ECG
Able to Reflect the Whole Picture of the Main Electrocardiographic Parameters
Characteristic for Healthy Patients As Well As for Myocardial Ischemia Ones? J Heart
Cardiovasc Res. Vol. 1 No. 3: 110.

Abstract

Electrocardiograms (ECG) remain the main noninvasive tool that cardiologists use first for
examining CAD in clinical practice. Since the invention of cardiograph, the cardiologists
following the original Eindhoven construction traditionally have been using 12 lead
electrodes kit for registering ECGs. However, together with development of telemedicine the
one lead electrode ECG registering is in high demand. The heart, being a selfsustained
oscillatory system could be possibly analyzed through studying the Fourier spectrum features
of the ECG registered by any of the 12 conventional leads, which remind electricity
consumer’s lines going from a central generating power station – the heart. So far, any lead as
any electrical line may contain the overwhelming heart dynamic characteristics by analogy
with the parameters of the central electric generator.

Conclution

The laws of thermos convection proved to be applicable to the description of the ionic current
flowing in the myocardial tissue within the framework of the Lorenz system. Classical
solution of the Lorenz system in the strange attractor form corresponded in the model to the
heart fibrillation mode. It says in favor of universality of distributed dynamic systems
possessing order to chaos mode of functioning. Together with that healthy and some
pathological sates of heart may be possibly manifested in the attractor parameters of coupled
Lorenz systems.
JURNAL 14

A Portable WiFi ECG

1N. A. Abdul-Kadir, 1N. S. Sahar, 2W. H. Chan, 1,3F. K. C. Harun* 1School of Biomedical
Engineering, 2School of Computing, 3School of Electrical Engineering, Faculty of
Engineering, Universiti Teknologi Malaysia, 81310 UTM Johor Bahru, Johor, Malaysia
ashikin.kadir@utm.my, syazwana19@yahoo.com, cwenghowe@utm.my, fauzan@utm.my*

Abstract— The development of information and communication technology has improved

health tele-care by providing more sophisticated analysis software to support a realtime
processing of ECG signals. Moreover, intense research has been devoted to the development
of an affordable and reliable ECG for daily monitoring and outpatient usage. Meanwhile, the
increase in manufacturing of small system module in medical diagnostic equipment for
digital signal processing (DSP) applications can provide affordable ECGs with real-time
processing which is suitable for monitoring and alert system. In this study, a wireless
communication channel of ECG is developed using an ESP8266 WiFi module and an
BMD101 Neurosky bio-signal system-on-a-chip (SoC) device. The SoC is designed with a
powerful DSP structure which has a filter, amplifier, 16-bit analog-digital converter and an
integrated 22.1MHz clock reference signal. The ECG circuit is equipped with single lead of
two inputs of positive and negative. The size of the ECG circuit is as compact as 4.5 cm x 3
cm of length x width and it is a portable device. The performance shows the ECG device was
able to capture the normal sinus rhythm of 60 beatper-minute (bpm) , 80 bpm, 100 bpm and
120 bpm from a patient simulator. The ECG circuit design also able to capture abnormal
sinus rhythm such as atrial fibrillation, ventricular tachycardia, ventricular fibrillation.

Keywords—ECG; monitoring; system-on-a-chip; telecare; WiFi

CONCLUSION In conclusion, the portable ECG Wi-Fi is successfully designed, fabricated,

and assembled on an PCB. The design was abled to capture and save the recorded signals.
For future work is to integrate the ECG device with app on mobile phone. More testing shall
be done in order to ensure the portable ECG device could benefit in healthcare industry.
JURNAL 15

Body Temperature and Electrocardiogram Monitoring Using an SMS-Based Telemedicine

System

Ashraf A Tahat School of Electrical Engineering Princess Sumaya University for

Technology Amman, Jordan tahat@psut.edu.jo

Abstract

A mobile monitoring system utilizing Short Message Service with low-cost hardware
equipment has been developed and implemented to enable transmission of the temperature
and ECG signal of a patient. Communication between a mobile phone client and a remote
smart-phone (or PDA) consultation/server unit is achieved through programming the client
using attention commands (atcommands), and the Protocol Description Unit (PDU) mode.
The experimental setup can be operated for monitoring from anywhere covered by the
Cellular (GSM) service by exchanging SMS messages with the remote mobile device. At the
consultation unit, a dedicated application software is required to manage the follow of SMS
messages from the Mobile and display the temperature and ECG of the patient.

Conclution

A low cost mobile patient monitoring system that utilizes Short Messaging Service (SMS)
was designed, developed, and tested. An Infrared temperature sensor was integrated with a
three lead ECG monitor (client unit) on a cellular (mobile) phone platform, which can be
considered as a realtime transmission mode. An application software is required at the
receiving mobile device (consultation unit) to decode the biosignal SMS messages and plot
the ECG and display the body temperature. The new system has a significantly reduced size
and weight, which improves its versatility and mobility. Besides, SMS can be the most
suitable, if not the only, method of data transmission in emergency situations in remote area
where broadband data communications (like GPRS, EDGE … etc.) are not available.
JURNAL 16

Temperature effects on the cardiorespiratory control of American bullfrog tadpoles based on

a non-invasive methodology

Leonardo S. Longhini1 , Lucas A. Zena1,2*, Glauber S. F. da Silva1,2 , Kênia C. Bícego1,2 ,

Luciane H. Gargaglioni1,2* 1Department of Animal Morphology and Physiology, College of
Agricultural and Veterinary Sciences, São Paulo State University, 14884-900, Jaboticabal,
São Paulo, Brazil. 2National Institute of Science and Technology in Comparative Physiology
(INCT Fisiologia Comparada), Brazil.

Abstract-- Temperature effects on cardiac autonomic tonus in amphibian larval stages have
never been investigated. Therefore, we evaluated the effect of different temperatures (15ºC,
25ºC, and 30ºC) on the cardiorespiratory rates and cardiac autonomic tonus of
premetamorphic bullfrog tadpoles, Lithobates catesbeianus. To this end, a non-invasive
method was developed to permit measurements of electrocardiogram (ECG) and buccal
movements (fB; surface electromyography of the buccal floor). For evaluation of autonomic
regulation, intraperitoneal injections of Ringer’s solution (control), atropine (cholinergic
muscarinic antagonist), and sotalol (β-adrenergic antagonist) were performed. Ringer’s
injections did not affect heart rate (fH) and fB across temperatures. Cardiorespiratory
parameters were significantly augmented by temperature [fH (beats.min-1): 15ºC: 24.5 ± 1.0;
25ºC: 54.5 ± 2.0; 30ºC: 75.8 ± 2.8 and fB (movements.min-1): 15ºC: 30.3 ± 1.1; 25ºC: 73.1 ±
4.0; 30ºC: 100.6 ± 3.7]. A predominant vagal tone was observed at 15°C (32.0 ± 3.2%) and
25ºC (27.2 ± 6.7%) relative to the adrenergic tone. At 30°C, the adrenergic tone increased
relative to the lower temperature. In conclusion, the cholinergic and adrenergic tones seem to
be independent of temperature for colder thermal intervals (15-25ºC), while exposure to a
hotter ambient temperature (30°C) seems to be followed by a significant increase in
adrenergic tone and may reflect cardiovascular adjustments made to match oxygen delivery
to demand. Furthermore, while excluding the use of implantable electrodes or cannulae, this
study provides a suitable non-invasive method for investigating cardiorespiratory function
(cardiac and respiratory rates) in water-breathing animals, like the tadpole. Keywords:
Amphibians, cholinergic tone, adrenergic tone, buccal frequency, heart rate.

Conclution
To our knowledge, this is the first study to address a non-invasive methodology for
measuring cardiorespiratory parameters in tadpoles. Based on that, we demonstrated that
premetamorphic bullfrog tadpoles (L. catesbeianus) exhibit a prevailing cholinergic over
adrenergic tones at lowers temperatures, 15 and 25ºC. In contrast, adrenergic tone increases
at 30°C, while cholinergic tone trends toward a decrease and may reflect cardiovascular
adjustments in order to match oxygen delivery to demand across thermal exposures. The
extent to which adrenergic and cholinergic tones modulate fH can vary greatly among species
and developmental stages within species, and is further compounded by the degree of surgical
instrumentation and recovery time (Taylor et al., 2014; Sandblom and Axelsson, 2011;
Journal of Experimental Biology • Accepted manuscript Burggren and Doyle, 1986). Since
the autonomic nervous system is very sensitive to stress and anesthesia (Campbell et al.,
2004), we used a non-invasive methodology, which eliminated the need for implantation of
electrodes and buccal cannula, to evaluate fH and fB in bullfrog tadpoles. Some studies have
already used non-invasive methodologies to measure fish physiological parameters (Altimiras
and Larsen, 2000; Yoshida et al., 2009), but there is no report on amphibians, especially in
the larval stage. In addition, the recorded signals for buccal movements made by the same
electrodes were compared with pressure oscillations recorded by a polyethylene cannula (P-
10) inserted into the buccal cavity and connected to a pressure transducer (Fig. 2), and the
recordings were identical. Thus, we believe the method described here is perfectly suitable
for studies in intact and undisturbed tadpoles and opens the possibility for investigation of
cardiorespiratory physiology in other amphibian species, especially when considering
limitations such as size and number of individuals available. In the present study, the
premetamorphic tadpoles increased fH as temperature increased, as expected. Thermal
acclimation effects on resting fH implicate adjustments in the intrinsic fH and control
systems that modulate fH, such as the sympathetic and parasympathetic nervous system
(Sandblom et al., 2016). Besides the existence of an inverse relationship between vagal and
sympathetic tones across temperature exposures in our tadpoles, the major changes in fH in
the American bullfrog tadpoles are dictated by thermal acute effects on the intrinsic
pacemaker cells, since the fH thermal effect (Q10; thermal interval 15-30°C) of full
autonomic blockaded tadpoles varies very little from that in resting animals (Q10 = 1.92 vs.
Q10 = 2.08, respectively). This suggests that, for short-term acclimation, thermal effects in
American bullfrog tadpoles involve mainly thermal effects on cardiac intrinsic rate, rather
than extrinsic, adjustments. A long-term acclimation (weeks) might reveal compensatory
adjustments in magnitude, such as an increased cholinergic tone, as seen in rainbow trout and
perch (Sandblom et al., 2016; Ekström et al., 2016). Nevertheless, chronic acclimation to
high temperatures may impose additional challenges to study autonomic balance for a
specific developmental phase in tadpoles since increases in temperature reduce the duration
of amphibian metamorphosis (Orizaola and Laurila, 2009). Our data in resting and doubly-
blockaded tadpoles are in agreement with previous studies in adult bullfrogs, demonstrating
that temperature-induced rises in fH are mostly due to intrinsic pacemaker adjustments
(Taylor et al., 2012). Although the drop in the cholinergic tone is not statistically significant,
adrenergic tone increases significantly, and this may indicate that 30°C represents a stressful
condition for the bullfrog tadpoles. It is worth mentioning that we performed some tests at
35°C, but the animals did not withstand the two days of experiments, so we chose to perform
the protocols at 30°C. Journal of Experimental Biology • Accepted manuscript Amphibians
larvae may develop in environments where their adults’ forms spend part or the totally of
their life cycle, experiencing stressful conditions such as predation, desiccation, and
temperature changes. The significance of developmental changes in autonomic tone is
directly linked to maturation of their cardiovascular system and reflex mechanisms involved
in cardiovascular homeostasis. Thus, adjustments in the metabolic and autonomic modulation
would be particularly important for tadpoles species that occupy puddles with little water
volume that undergo intense heating (Katzenberger et al., 2012). In contrast to
premetamorphic tadpoles, full-grown bullfrogs exhibit elevate adrenergic tone that is
virtually independent of temperature (10°C, 20°C, and 30°C; Taylor et al., 2012), and
cholinergic tone that increases slightly from -5% to 10% with increasing temperature (10°C
to 30ºC). Conversely, the cholinergic tone is highly augmented by a 3-day acclimation to a
decreasing temperature (from 25°C to 15°C, then to 5°C) in the aquatic Xenopus leavis,
showing that thermal effects on the fH is attenuated by higher cholinergic tone (Taylor et al.,
1995). Having performed experiments at ~21.5oC in bullfrog tadpoles, Burggren and Doyle
(1986) described an ANS modulation involved in the regulation of fH. According to the
authors, the resting vagal tone appears at stages X-XIV, during which tadpoles already
exhibit lung ventilation. Interestingly, our data suggest that resting parasympathetic
modulation of fH in bullfrog tadpoles appears earlier in their development, since
intraperitoneal injections of atropine increased fH in our animals at stages IV-VII (Fig. 5).
This difference could be related to the methodology used in the first study, since ECG
electrode implantation required surgical procedures done under anesthesia with MS-222,
which may have changed autonomic balance in their tadpoles. Although Burggren and Doyle
(1986) did not report a significant increase in fH by atropine treatment, it is still possible to
observe a slight increase in fH in their tadpoles. The absence of changes in fH may be
justified by prior use of anesthesia and/or a lower experimental temperature as compared to
our study, since no significant increase in fH was observed at 15°C after treatment with
atropine (Fig. 5), aside from the cholinergic tone being higher than adrenergic tone. Tadpoles
use skin, gills and lungs for gas exchange in which their relative role changes through their
development (Burggren and West, 1982). Tadpoles selected in the present study did not
exhibit surfacing behavior for pulmonary gas exchange, suggesting that most of gas exchange
have occurred through their skin and gills. Gill ventilation in tadpoles are directly related to
buccal movements comprising of both buccal and pharyngeal force pumps to produce a
continuous unidirectional flow of water from the mouth and to across the gills. A
highfrequency and low-amplitude activity bursts of motor trigeminal (V), facial (VII) and
vagus Journal of Experimental Biology • Accepted manuscript (X) innervates the
orophaeryngeal muscles, providing the driving force for gill ventilation (reviewed by
Gargaglioni and Milsom, 2007). Temperature may also influence the relative contribution
between gills and skin gas exchange, and the obvious reduction in fB (and sometimes the
occurrence of apneas), at 15°C likely occurs because of a combination of decreased O2
demand and increased O2 availability, since O2 solubility in water increases as temperature
decrease (Dejours, 1981). Therefore, we suggest that a reduced metabolic rate at 15°C
(inferred by a reduced fH and fB) in our tadpoles caused a reduced demand for oxygen,
which could be obtained either by the gill or, more commonly, by the cutaneous route, in
which skin is highly vascularized and has a large surface area-to-body mass ratio (Burggren
and West, 1982). Noteworthy, premetamorphic tadpoles used in the present study exhibited
fB greater then fH at 25°C (fB / fH > 1). Despite temperature changes and decrease or
increase both fB and fH, the relationship between fB and fH was kept slightly constant across
temperatures in which fB was always higher than fH (15°C: 1.24 ± 0.04; 25°C: 1.43 ± 0.06;
30°C: 1.33 ± 0.07). Breathing in water requires great energy expenditure to extract sufficient
oxygen from an environmental medium in which oxygen is limited by its solubility,
especially at high temperature. Therefore, after β-adrenergic blockade, fH decreased while fB
increased as a compensatory response to maintain oxygen homeostasis at 25°C and 30°C. A
contrasting result was observed when muscarinic blockade was performed elevating fH,
while fB remained unchanged at 25°C or increased slightly at 30°C relative to baseline
values. It is not clear why fB was not proportionally reduced while fH increased after
muscarinic blockade; however, a possible explanation may involve temperature effects on
oxygen chemosensitivity preventing reductions in fB when oxygen becomes the limiting
factor in a high metabolic demanding environment. In summary, our data show that the
cholinergic tone originates earlier than previously suggested in the development of American
bullfrog tadpoles. The use of a successfully noninvasive methodology for measuring fH and
fB (and, thus, avoiding the use of anesthetic agents and surgical procedures) was essential to
assess the autonomic tonus in the present study. For the thermal interval between 15°C and
25°C, cholinergic and adrenergic tones are temperatureindependent, while at higher
temperatures (30°C), the cholinergic tone trends toward a decrease and the adrenergic tone
increases. Besides changes in autonomic balance, fH adjustments in tadpoles are mainly
dictated by thermal effects in the intrinsic fH since the Q10 effects on both tadpoles’ resting
and intrinsic (full autonomic blockade) heart rates are very similar (1.92 vs. 2.08). Based on
the methodology developed in the present study, we encourage further Journal of
Experimental Biology •

JURNAL 17

International criteria for electrocardiographic interpretation in athletes:

consensus statement Jonathan A Drezner,1 Sanjay Sharma,2 Aaron Baggish,3 Michael
Papadakis,2 Mathew G Wilson,4 Jordan M Prutkin,5 Andre La Gerche,6 Michael J
Ackerman,7,8,9,10,11 Mats Borjesson,12,13 Jack C Salerno,14 Irfan M Asif,15 David S
Owens,5 Eugene H Chung,16 Michael S Emery,17 Victor F Froelicher,18 Hein
Heidbuchel,19 Carmen Adamuz,4 Chad A Asplund,20 Gordon Cohen,21,22 Kimberly G
Harmon,1 Joseph C Marek,23 Silvana Molossi,24,25 Josef Niebauer,26 Hank F Pelto,1
Marco V Perez,27 Nathan R Riding,4 Tess Saarel,28,29 Christian M Schmied,30 David M
Shipon,31 Ricardo Stein,32 Victoria L Vetter,33 Antonio Pelliccia,34 Domenico
Corrado35,36,37
ABSTRACT
Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A
variety of mostly hereditary, structural or electrical cardiac disorders are associated with SCD
in young athletes, the majority of which can be identified or suggested by abnormalities on a
resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes,
physicians responsible for the cardiovascular care of athletes should be knowledgeable and
competent in ECG interpretation in athletes. However, in most countries a shortage of
physician expertise limits wider application of the ECG in the care of the athlete. A critical
need exists for physician education in modern ECG interpretation that distinguishes normal
physiological adaptations in athletes from distinctly abnormal findings suggestive of
underlying pathology. Since the original 2010 European Society of Cardiology
recommendations for ECG interpretation in athletes, ECG standards have evolved quickly,
advanced by a growing body of scientific data and investigations that both examine proposed
criteria sets and establish new evidence to guide refinements. On 26–27 February 2015, an
international group of experts in sports cardiology, inherited cardiac disease, and sports
medicine convened in Seattle, Washington (USA), to update contemporary standards for
ECG interpretation in athletes. The objective of the meeting was to define and revise ECG
interpretation standards based on new and emerging research and to develop a clear guide to
the proper evaluation of ECG abnormalities in athletes. This statement represents an
international consensus for ECG interpretation in athletes and provides expert opinion-based
recommendations linking specific ECG abnormalities and the secondary evaluation for
conditions associated with SCD.

Conclusion
Accurate ECG interpretation in athletes requires adequate training and an attention to detail
to distinguish physiological ECG findings from abnormal ECG findings that might indicate
the presence of cardiac pathology. Cardiac adaptation and remodelling from regular athletic
training produce common ECG alterations that could be mistaken as abnormal. Whether
performed for screening or diagnostic purposes, it is critical that physicians responsible for
the cardiovascular care of athletes be guided by ECG interpretation standards that improve
disease detection and limit false-positive results. The international consensus standards
presented on ECG interpretation and the evaluation of ECG abnormalities serve as an
important foundation for improving the quality of cardiovascular care of athletes. As new
scientific data become available, revision of these recommendations may be necessary to
further advance the accuracy of ECG interpretation in the athletic population.

JURNAL 18

The Computerized ECG:

Friend and Foe Harold Smulyan, MD Upstate Medical University, State University of New
York, Syracuse

ABSTRACT

Computerized interpretation of the electrocardiogram (ECG) began in the 1950s when

conversion of its analog signal to digital form became available. Since then, automatic
computer interpretations of the ECG have become routine, even at the point of care, by the
addition of interpretive algorithms to portable ECG carts. Now, more than 100 million
computerized ECG interpretations are recorded yearly in the United States. These
interpretations have contributed to medical care by reducing physician reading time and
accurately interpreting most normal ECGs. But errors do occur. The computer cannot be
held responsible for misinterpretations due to recording errors, such as muscle artifacts or
lead reversal. But, in many abnormal ECGs, the computer makes its own errors—sometimes
critical—in its incorrect detection of arrhythmias, pacemakers, and myocardial infarctions.
These errors require that all computerized state-ments be over-read by trained physicians
who have the advantage of clinical context, unavailable to the computer. Together, the
computer and over-readers now provide the most accurate ECG interpretations available.

2018 Elsevier Inc. All rights reserved. The American Journal of Medicine (2019)
132:153−160

CONCLUSIONS

The physician reader and the computer see the ECG dif-ferently, with advantages and
disadvantages for each. The computer makes routine measurements accurately and quickly,
thus saving physician readers’ time. It does not tire or fatigue after a long day, it is not
distracted by out-side pressures, and its performance continues to improve over time. The
computerized interpretation available with the ECG itself may have influence in clinical
decision making. However, the computer does have difficulty sepa-rating small waves from
artifacts, difficulty in making dis-tinctions between similar ECG findings in different
diseases, and difficulty in dealing with the myriad other combinations that clinical ECGs may
present. Impor-tantly, it also lacks clinical context available only to the reader. These
limitations lead to computer interpretation errors that require over-reading and correction.
But, the computer and reader complement each other and together.

JURNAL 19

ECG Data Compression for a Portable ECG Recorder and Transmitter

Diptee C. Pandhe Instrumentation And Control Cummins College of Engineering for Women
Karvenagar, Pune H. T. Patil Instrumentation And Control Cummins College of Engineering
for Women Karvenagar, Pune

Abstract—The ECG digital signal processing evolved in last decade and the need to store and
transmit ECG signal data is continuously increasing. This paper involves analysis of an
enhanced ECG compression and de-compression method. The method is evaluated on the
basis of different compression and quality parameters like compression ratio (CR), percent
root mean square difference (PRD), Signal to noise ratio (SNR), quality score (QS), etc. The
compression algorithm includes three sequential processing phases: 1. Pre-processing and
classification, 2. Linear transformation, 3. Entropy coding. The compression method is
implemented by deciding a particular signal processing / coding algorithm for each of these
phases. The de-compression technique is the inverse process of compression and it
reconstructs the original signal with negligible loss of information. Finally, the described
method is compared with existing ECG compression algorithms. Index Terms—
Electrocardiogram (ECG), Discrete Cosine Transform (DCT), Digital Wavelet Transform
(DWT), Compression Ratio (CR), Percent Root Mean Square Difference (PRD), Percent
Root Mean Square Difference Normalised (PRDN), Signal to Noise Ratio (SNR), Quality
Score (QS).

CONCLUSION

The paper describes various stages of ECG compression and it tries to enhance and simplify
these stages as compare to existing literature. The frequency response analysis of ECG signal
described in the paper can be used to design proper pre-posing filter. A simple ECG peak
detection method based on characteristics of ECG signal is proposed. The Huffman encoding
algorithm is used for subset of all possible DCT values to achieve better compression. The
described method achieves compression of ECG signal with lower computational complexity
as compared to various complex techniques described IEEE literature. It uses standard digital
processing algorithms. Hence, this method can be easily implemented on embedded systems.
JURNAL 20

Non-Contact Wearable Wireless ECG Systems for Long Term Monitoring

Sumit Majumder, Leon Chen, Ognian Marinov, Member, IEEE, Chih-Hung Chen, Senior
Member, IEEE, Tapas Mondal, and M. Jamal Deen, Fellow, IEEE

Abstract—Electrocardiography (ECG) is the most common and 3 extensively used vital sign
monitoring method in the modern 4 healthcare systems. Different designs of ambulatory ECG
systems 5 were developed as alternatives to the commonly used twelve-lead 6 clinical ECG
systems. These designs primarily focus on 7 portability and user convenience, while
maintaining signal 8 integrity and lowering power consumption. Here, a wireless ECG 9
monitoring system is developed using flexible and dry capacitive 10 electrodes for long-term
monitoring of cardiovascular health. Our 11 capacitive-coupled dry electrodes can measure
ECG signals over a 12 textile-based interface material between the skin and electrodes. 13
The electrodes are connected to a data acquisition system that 14 receives the raw ECG
signals from the electrodes and transmits 15 the data using Bluetooth to a computer. A
software application 16 was developed to process, store and display the ECG signal in real 17
time. ECG measurements were obtained over different types of 18 textile materials and in
presence of body movements. Our 19 experiment results show that the performance of our
ECG system 20 is comparable to other reported ECG monitoring systems. Also, to 21 put this
research into perspective, recent ambulatory ECG 22 monitoring systems, ECG systems-on-
chip, commercial ECG 23 monitoring systems and different state-of-the-art ECG systems 24
are reviewed, compared and critically discussed. 25 26 Index Terms—Capacitive coupling;
flexible electrodes; ECG 27 sensors; wearable ECG sensing system.

CONCLUSIONS 9 10 An Electrocardiography (ECG) monitoring system has been 11

developed to achieve improved signal detection, portability and 12 reduced power
consumption by addressing the trade-offs 13 among size, power requirements, and signal
quality. Recent 14 developments in the ambulatory ECG monitoring systems have 15 been
leaning towards the idea of contactless bio-potential 16 sensing. Since the contactless ECG
monitoring system does not 17 require any direct contact to the skin, it offers better user 18
comfort during prolonged monitoring. The proposed system is 19 capable of measuring the
ECG signal on a biocompatible 20 textile-based interface material such as cotton. The smaller
size 21 of the electrodes also allows for better portability and 22 convenience to the user. The
proposed system does not require 23 a ground electrode. As a result, the single lead ECG can
be 24 measured by using only two electrodes. 25 The proposed ECG electrodes consume
small amount power 26 and can run continuously for 2 weeks from a 3V coin cell 27 battery
that makes the electrode suitable for long-term 28 monitoring. The electrodes are connected
to a portable ECG 29 device that is capable of transmitting signals continuously for 30 24
hours over the Bluetooth platform to a personal computer in 31 real time. Therefore, at
present, the overall continuous run time 32 of the system is limited by the battery life of the
commercial 33 data acquisition and transmission module. As observed from 34 the results of
the experiments, the proposed ECG monitoring 35 system can properly acquire the ECG
signals over the cloth 36 with the QRS complexes, P and T waves being clearly 37
distinguishable, when measured at rest. The proposed system, 38 therefore, can potentially be
used to detect abnormal ECGs by 39 enabling long-term monitoring of cardiac activities. 40
Despite the advances that are being made in ECG monitoring 41 systems, there is still room
for further improvements. In order 42 to reduce the displacement of the electrodes with
motion, the 43 electrodes need to be firmly integrated over the cloth. 44 Furthermore, the
electrostatic coupling of the electrodes to the 45 skin potential can be improved by employing
a dedicated film 46 or membrane materials with increased dielectric permittivity. 47
Conductive polymers or smart textiles can also be used to 48 realize conductive sensing part
of the electrodes, which may 49 offer enhanced flexibility and user comfort. 50
Electrocardiography monitoring systems continue to be a 51 very active area of research and
technology development. So, a 52 critical review and comparison of recent ambulatory ECG
53 monitoring systems and ECG systems-on-chip solutions is 54 presented and discussed.
The major features and performance 55 characteristics of recently published state-of-the-art
ECG 56 systems are compared and described. For long-term 57 monitoring, electrodes
integrated on skin and different types of 58 interface clothing materials are desired.
Therefore, a 59 comparison of the advantages and limitations between the 60 method
proposed in this paper and recent alternatives for ECH 61 sensing systems is presented and
discussed.