2013 8th International Workshop on Systems, Signal Processing and their Applications (WoSSPA)
AN ECG INTELLIGENT MONITORING SYSTEM WITH MSP430
MICROCONTROLLER
Yan Zhang, Yi Tian, Zhaobin Wang, Yide Ma, Yurun Ma
School of Information Science and Engineering
Lanzhou University
Lanzhou, China
ABSTRACT
This work presents a novel easy-to-use, portable, low-
power, real-time, and autoalarm electrocardiogram
(ECG) intelligent diagnosis system on MSP430
microcontroller. The real-time ECG signal is acquired at
V1 lead and instantaneously amplified and filtered on
front end circuit, and then, the signal is converted from
analog ECG signal to digital value and filtered with
Cohen Daubechies Feauveau 9/7 wavelet. Also, the ECG
waveform is displayed on LCD and the real-time
calculated heart rate is displayed on segment LCD,
refreshed every 4 seconds. The buzzer alarms and the
alarm message with the position information of the
patient are sent to the doctors or relatives immediately,
once an abnormal ECG is detected. A real-time R-wave
detection algorithm based on integral projection function
has been implemented, which is specially designed to be
adaptive against the most common sources of noise and
interference present and baseline wandering when
acquiring the ECG. The system can identify premature
ventricular contractions(PVC), which are very important
for the subjects who are being monitored. Experimental
results show the R-wave detection accuracy of the
proposed system is 98.8% and the PVC detection and
identification of the proposed system is 92.1%.
1. INTRODUCTION
Cadiovascular diseases (CVDs) are the leading causes
of death and disability worldwide. An estimated 17
million people died from CVDs in 2008. Over 3 million
of these deaths occurred before the age of 60. Based on
current trends, by 2030, almost 23.6 million people will
die from CVDs. The percentage of premature deaths from
CVDs ranges from 4% in high-income countries to 42%
in low-income countries, leading to growing inequalities
in the occurrence and outcome of CVDs between
countries and populations. Over 80% of CVD deaths take
place in low-income and middle-income countries [1].
The incorporation of information and communication
technologies into the fields of health and social care is
already a worldwide phenomenon, but the skyrocketing
978-1-4673-5540-7/13/$31.00 ©2013 IEEE
costs of healthcare and the shortage of the telehealth will
become a big issue all over the world, especially in the
developing country. Some home-care, community-care,
and residential-care models were executed successfully to
assist the patients in the pursuit of better healthcare and
high quality of life in some developed country, such as
UK [2]. Rapid developments in information and
communication technologies have made it possible to
tackle the problems mentioned earlier in the developing
country. Telehealth enables the patients to live
independently and to get acute care more efficiently and
to provide a changing society with an improved quality of
life and medical services.
Eectrocardiogram (ECG) is the most important
indicator among all the body parameters and can be easily
recorded using the noninvasive electrodes attached to the
body. The ECG monitor is widely used for detecting and
diagnosing ECG to prevent CVDs in time or avoid
irreparable damages or death. Nowadays, a variety of
ECG monitoring systems, ECG monitoring equipments
used in hospitals are too expensive for individuals and
families and couldn’t be used for homecare and telehealth
care. Holter monitor (often simply "Holter" or
occasionally ambulatory electrocardiography device),
which named for physicist Norman J. Holter who
invented telemetric cardiac monitoring in 1949[3], is a
portable device for continuously monitoring various
electrical activity of CVDs system for at least 24 hours
(often for two weeks at a time) [3], Holter only records
and stores the ECG data for a long time without any
analysis [3]. Most of the available ECG monitors only
provide acquisition of the ECG signal, the diagnosis
results are analyzed from a specialist or expert system
later, they don’t provide a real-time and auto diagnosis or
need in the prevention of CVDs [4][5][6]. Often, the
cardiac pathologies may be hide for a long time and
develop into the vital diseases later, so it is necessary to
keep the continuous monitoring of these patients. Once
the ECG signal shows an irregular activity of the heart,
timely diagnosis are made and alarm message are sent to
the doctors or relatives for a prompt intervention. The
ECG monitors tend to be small, so that they can be used
in domestic or other non-clinical environments. It is
critical to reduce clinical costs. Typically, the low power
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characteristic of the system is the other key focus.
Currently, the majority of ECG systems have simple
monitoring and alarming function, they often implement
no first aid, and are not portable [4][5][6]. ECG
monitoring systems based on the MSP430 MCU such as
references [7][8][9] can’t analyze and alarm when
emergency occurs. In order to overcome all these
drawbacks mentioned above, the authors proposed the
ECG intelligent monitoring systems based on the
MSP430 MCU. MSP430 Microcontroller is a series of
mixed signal processors made by the U.S. Texas
Instruments (TI) [10]. It is chosen as the core of the
system which has lower power consumption advantage
than other MCUs. The supply voltage of it is controlled
flexibly and uniquely. Also, it is applied to the portable
instruments. The ultra-low power consumption feature of
the whole system in hardware and software programming
helps to reduce the costs. The system has high anti-
interference ability and the remarkable feature is the real-
time fast data processing. The overall system flowchart of
the system is shown in Fig.1.
Fig.1 The system flowchart of the proposed ECG intelligent
monitoring system.
2. HARDWARE DESIGN
A block schematic of the system is shown in Fig.2. The
system is divided into the following three parts:
Fig.2 The block diagram of system
Front end circuit: The ECG signal is detected from V1
lead, then amplified and filtered in this part.
Microcontroller unit (MCU): MSP430 microcontroller
is 16-bit, RISC-based and mixed-signal processors
designed specifically for ultra-low-power applications
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[10]. This part consists of the A/D converter, the digital
filter, the R-wave detection and heart rate calculation
module, and the diagnosis module.
Peripheral components: This part is composed of dot
matrix LCD display, segment LCD display, buzzer,
matrix keyboard module, GSM/WCDMA module, and
GPS module.
2.1. Front end circuit
A one point (V1 lead) of ECG were sensed by using
bandage type sensors, and the measured ECG data are
collected and transmitted by a fabric inductor coupling.
The front end circuit integrates a preamplifying circuit
and a low-pass filter and amplifier circuit into a small,
lightweight system. The analog front end circuit employs
two consecutive stages to amplify and filter the Lead V1
ECG signal which is detected by ECG electrodes which
seek to the level of ADC converter. The differential
amplifying circuit is implemented using the low-power
instrumentation amplifier INA331[11] with the gain set to
250. A negative feedback circuit which use a low-power
OPA2336[12] Op Amp, designed for low-powered
applications, is fitted here by which the output can be
decreased or increased on REF of the INA331. The right-
leg drive circuit is designed to reduce common-mode
noise with another OPA2336 Op Amp. After it, a second-
order low-pass Butterworth filter with a cutoff frequency
of 100 Hz by using the third low-power OPA2336 Op
Amp are chosen for the system to eliminate the EMG
noise. The measured common-mode-rejection-ratio
(CMRR) of the circuit was about 82 dB.
2.2. Microcontrol unit(MCU)
A high-performace12-bit analog-to-digital converter
embedded on the microcontroller(MSP430F2618), the
ADC12 module, is used to convert the ECG signal
coming from the front end circuit. The principle of
ADC12 module is shown in Fig.3. The ECG signal is
sampled at 512Hz and the ADC12 module works at
single-channel, single-conversion mode. The internal
2.5V is chose as voltage reference. The results of the
conversation are sent to RAM through the channel of
DMA0 controlled by the DMA controller without CPU
intervention. DMA controller can reduce system power
consumption by allowing the CPU to remain in
LPM3(low-power mode 3) mode without having to
awaken to move data to the specified RAM address, the
working current is less than 0.6 μA. The system can
reduce the consumption accordingly. The system is
expected to perform up to approximately 5 ECG cycles
every 4 seconds, which is enough for the arrhythmia
diagnosis purpose(see Section 3.3 3rd paragraph, the
PVC logic judge method need at least 3 continuous QRS
complex ). All the analysis operations are done with the
current 515μA. The ultra-low-power design reduces
power consumption.

Fig.3 ADC12 Module
2.3. Peripheral components
Peripheral components consist of dot matrix LCD,
segment LCD, matrix keyboard, GPS, GSM/WCDMA,
and Buzzer. In the system Matrix keyboard is employed
to set telephone number. Buzzer is used to issue the alarm.
The dot matrix LCD and the segment LCD are adopted to
display different data. For instance, the wave shape of the
ECG is shown with the dot matrix LCD. The segment
LCD displays the heart rate.
Fig.4 LCD Operation Flowchart
The dot matrix LCD screen LM240160GCW we used
can show 240×160 dot matrix data, so all the wave shape
of ECG signal monitored in 4 seconds can be displayed.
The software flowchart of LCD display is shown in Fig.4.
A useful innovation in the LCD module of the system is
frame by frame display. This enables the time of data
displayed each frame to be precisely controlled by the
time of sampling, regardless of the display speed of the
LCD screen. The adjustable display backlighting
controlled by the manual pushbutton is designed to reduce
electricity consumption of the dot matrix LCD. The
information of the system and the hints of the operating of
matrix keyboard can be showed on the LCD screen by
communicating with GT23L32S4W with SPI protocol. It
provides the doctor a way to examine the ECG signal
when making a visit to the patient and user to check the
electrodes.
The segment LCD we used to display the real-time
heart rate has one LCD driver BU9796FS with a lower
operating voltage range, 200 bit memory space and the
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standard 2-ware I2C communications. The calculated
heart rate is refreshed every 4 seconds, the same to the
ECG waveform refreshing rate.
In this user-oriented system, users may input the phone
number they need to the system with the matrix keyboard
as user interface, this capability enables users choose the
one who do the first aid easily. The phone number then is
written into the flash memory in case of the lost after
power off. The users can choose whether modify the
phone number or not, and input the phone number
conveniently when the system power on.
When the heart attack occur, the precise location of the
patient can be achieved by our Global Positioning System
(GPS) module, it detects the latitude and longitude of the
patient and then the format of the location information is
converted to the standard format which can be used for
searching the location on Google Map on Internet. The
GPS module communicates with the MCU in UART
mode of the USCI_A2 and the location information is
added to the message which can be sent to the one who
give the first aid.
GSM/WCDMA module allows two tasks to be
performed: send English message including the heart rate,
diagnostic symptom and the location information of the
patient to alarm; send Chinese message including what
mentioned above to alarm. We use the EM310
GSM/WCDMA module made in HuaWei Company to
communicate with the MCU in UART mode of the
USCI_A1.
In order to prevent the patient movement and other
factors that affect a false detection after initialization and
the too-frequent alarming messages, we designed the state
machine of the system ensure that messages are sent every
7 minutes roughly. Fig.5 provides an illustration of a state
machine of an alarming message sending process when
the patient diagnosed PVC. For example, the system starts
in S0 state in normal circumstances, when the patient has
PVC, the state transfers to S1. S1 state and S2 state are
wait states that prevent the misdiagnosis. Then the state
transfers to S3 state once the confirmation is obtained.
English message or Chinese message is sent to alarm.
After sending the message, the state will be in S4 state for
7 minutes then go back to the S0 state. This ensures
messages are sent every 7 minutes roughly.
Fig.5 State Machine Of PVC
 3. SOFTWARE DESIGN multiply accumulate operations. After decimal integer
computation and results correction, we use it to complete
the wavelet filtering and reconstruction for high speed of
3.1. CDF9/7 Wavelet Filter data processing.
Fig.6 shows the Wavelet Filtering and Reconstruction
The CDF9/7 wavelet filter, a lifting algorithm of of the measured ECG signal. The blue line represents the
biorthogonal wavelet construction which proposed by I ECG waveform coming from the ADC12 module while
Daubechies and W Sweldens in 1998[13], was used as the red one represents the corresponding waveform after
digital filter to denoise in the system. wavelet filtering and reconstruction by the hardware
When use the majority of other wavelets, FFT multiplier, indicating that high-frequency noise is
transform must be done which include convolution eliminated effectively.
operation, it needs considerable calculation time. Taking
the hardware application convenient advantage into
account, the CDF9/7 wavelet filter are superior in terms
of computation amount, memory space, complexity to
other wavelet filters because the calculation is in time
domain. The situ calculation can be achieved in the
computing process and the operation process only
includes simple multiplication and addition. Also it can
avoid delay processing. It is optimal for reducing muscle
noise, baseline wander and motion artifacts while
retaining the ECG waveform characteristics. x2l is the Fig.6 Wavelet Filtering And Reconstruction Of Measured ECG
even point and x2l+1 is the odd point of the input signal, Signal
so sl and dl are the wavelet coefficients. The factorization
leads to the wavelet coefficients:
3.2. R-wave Detection and Heart Rate Calculation
­ sl (0) x2l (1)
° (0)
°dl x2l 1
A new real-time R-wave detection algorithm based on
° (1)
d
° l d l
(0)
 D ( sl (0)  sl 1(0) ) integral projection function is designed and tested with
°s (1)
sl  E (dl (1)  d l 1(1) )
(0)
° l good results [14]. The algorithm is used for detection with
® (2)
°dl dl (1)  J ( sl (1)  sl 1(1) ) the advantage of low possession of hardware resources,
° s (2) s (1)  G (d (2)  d (2) ) high detection accuracy, and high running speed.
° l l l l 1
° s ] s (2) The determination of threshold is the difficulty in this
° l l
algorithm. The ECG signal is different from men to men,
°¯dl dl (2) ]
even the waveform of same person at different period of
The CDF9/7 lifting coefficients, 10 valid figures was time is not stable. Therefore, the threshold with dynamic
kept. They are as follows: adaptability is developed in the algorithm. Otherwise it
­ D 1.586134342
will create the false alarms of R-wave and lead to
°E 0.05298011854
°° diagnostic errors.
® J 0.8829110762 (2) The algorithm consists of four consecutive stages, these
° G 0.4435068522
° stages are, in order, RR interval (the time of two adjacent
°¯ ] 1.149604398 heartbeats) estimation and segment selection, extreme
The algorithm performs decomposition, filter, and detection, threshold determination, and R-wave detection
reconstruction procedures. The wavelet decomposition [14]. The maximum found in an RR interval includes the
coefficients are obtained through odd-even separation, peak of R[14]. The points and amplitude segment
interpolation prediction and updating. Because the noise histogram depending on the distribution of maximum
signal is not continuous in the time domain and usually points is produced. There is no extreme value distribution
high-frequency, the noise corresponds to most of the between the R-wave peak and the adjacent non-R-wave
small coefficients in high-frequency after wavelet peak which represents a relatively smooth curve. The
transforming. The ECG signal is decomposed to three- extreme points that distribute after the zero distribution
layer wavelet, then the threshold is used to find the high- may be the R-wave according the set of thresholds[14].
frequency signal in each layer, then the coefficients less Since the integral projection function and its curve change
than the threshold each layer are removed. Finally, after with the ECG signal, the thresholds are automatically
reconstruction layer by layer we obtain the filtered ECG adjusted to float over the noise in the algorithm [14]. The
signal. algorithm has real-time adaptive property and it only
The hardware multiplier is a 16-bit peripheral which needs a small size memory.
support 16 bit multiplication connected to CPU through When the continuous 4 seconds’ R-peaks’ number is
the internal bus, its activities do not interface with the obtained, the heart rate is calculated through 4 seconds
CPU activities. It supports unsigned multiply, signed divided by the R-peaks’ number. According to the system
multiply, unsigned multiply accumulate and signed

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data refreshing rate, it is calculated every 4 seconds and 4. EXPERIMENTAL RESULTS
displayed on the segment LCD screen.
To verify the performances of the system, twenty health
3.3. Arrhythmia Diagnosis Algorithm people with different ages were tested using the system.
The results of test of healthy subjects showed that the
The clinician is guided by a period of observation of system is of relatively high intelligence, high speed and
the ECG waveform in accordance with the relevant operated reliability. The real-time ECG signal waveform
experience to determine the patient's condition. To and heart rate of a healthy people are shown in Fig.9.
analyze the ECG signal and make a diagnosis in
intelligent diagnosis of cardiac arrhythmia, we mainly do
the logic judgment according to the doctor's clinical
experience to identify arrhythmias of patients. The ECG
automatic analysis system is shown in Fig.7.

Fig.9 Real-time ECG Signal Waveform Of Healthy People and

Real-time Heart Rate Of Healthy People
Fig.7 ECG Automatic Analysis System
We have carried out a lot of simulation experiments in
Automatic detection of the ECG parameters and the the system design and algorithm validation process which
ECG diagnostic classification are particularly important. show that the system has a good R-wave detection results.
Since the time-domain characteristics extraction approach The MIT/BIH Arrhythmia Database studied by the BIH
of the ECG signal is consistent with the diagnostic habits Arrhythmia Laboratory is used to evaluate the algorithm.
of clinicians and the approach has a small amount of It contains two-channel ambulatory ECG recordings of 48
arithmetic operations compared with the frequency- half-hour from 47 subjects. Sampling frequency of these
domain characteristics extraction approach, it is suitable recordings is 360 Hz, the sampling accuracy is 11bit [15].
for portable ECG instrument. The ECG parameters in The database has about 109,933 heart beats that hand-
time-domain include average heart rate, RR interval and marked the diagnosis remarks independently by at least
adjacent RR interval difference and so on. In this paperˈ two ECG experts or more. Fig.10 shows the results for the
the actual measured average heart rate is represented as R-wave detection algorithm tested for the MIT/BIH
Rate, the actual measured RR interval difference is Arrhythmia Database Nos.105, the normal ECG signal.
represented as HRV. The PVC logic judge method is Fig.11 shows the results for the R-wave detection
shown as follows: algorithm tested for the MIT/BIH Arrhythmia Database
HRV (i ) ! 0.12s & &HRV (i  1) ! 0.12s & &HRV (i  2) ! 0.12s Nos.119, the premature ventricular contractions (PVC)
ECG signal.
When the continuous three HRVs are all above 0.12s,
the patient is diagnosed PVC according to the doctors’
diagnostic experiences. The HRV are the key
characteristic parameter in the method.
To verify the accuracy of the judge method of system
we need compare the estimated parameters with those of
the identified reference model: Rate is compared with
the reference rate value or HRV is compared with the
ventricular arrhythmias reference HRV value. Some
arrhythmia signals with clear comments are used to do
the algorithm correctness verification. The standard
Fig.10 R-wave detection result for the MIT/BIH Arrhythmia
MIT-BIH Arrhythmia Database [15] is used as the test Database Nos.105
object to evaluate our algorithm. The algorithm
evaluation process is shown in Fig.8.

Fig.8 Arrhythmia Evaluation Flow Chart Fig.11 R-wave detection result for the MIT/BIH Arrhythmia
Database Nos.119

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 Table ĉ shows the R-wave detection results of the 6. ACKNOWLEDGMENT
recordings from the MIT/BIH database. Out of the 19166
beats used for evaluation, the algorithm responded with This work is jointly supported by National Natural
an accuracy of 98.8%. FP, a false positive, represents a Science Foundation of China (No.61175012& 61201421),
false beat detection; FN, a false negative, occurs when the Natural Science Foundation of Gansu Province (No.
algorithm fails to detect a true beat (actual R-wave). 1208RJZA265), Specialized Research Fund for the
Doctoral Program of Higher Education of China
TABLE I (No.20110211110026). The authors express the sincere
R-WAVE TEST RESULT thanks to all the volunteers in performing the
Data Total FP FN Failed Failed
(No.) (No. (Beats) (Beats) Detection Detection
experimental experiments.
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