Exercise ECG System Using Elliptical Training Equipment and Bluetooth Technology

Stasys Korsakas, Gediminas Jarusevicius, Alfonsas Vainoras, Rimtautas Ruseckas, Liudas Gargasas

Institute of Cardiology, Kaunas Medical University, Kaunas, Lithuania

Correspondence: S Korsakas, Institute of Cardiology, Kaunas Medical University, Sukileliu 17, LT-3007 Kaunas, Lithuania.
E-mail: stakor@medi.lt, phone +370 37 792515, fax +370 37 302872

1.  Introduction

The recent developments in the area of vital signals provide a market opportunity for the “smart” system capable to measure, analyse and predict future events in the human functional state, select the training program and use it in the monitoring of exercise process. Basically, exercise combined with ECG and other parameters monitoring is practised in two distinct areas: it is used for diagnostic purposes in clinical setting [Viik et al., 1998] and for increasing training efficiency in sport medicine and rehabilitation [Katzel et al., 1998]. Normally, the equipments of exercise system: a bicycle ergometer, ECG recorder and PC are interconnected by the wires. However, a bicycle ergometer and net of wires are not convenient for patients during diagnostic procedures and training processes. The using of elliptical training equipments and wireless technology are the new stage in developing exercise systems. The aim of the study was to develop and to test the exercise system for human functional state integrated evaluation using elliptical training equipment and wireless Bluetooth technology (Lifetrack).

2.  Methods

A new version of the exercise system Lifetrack was based on the integrative model of human organism response to physical activity [Vainoras et al., 2000]. The human organism integrated evaluation consists of working periphery (muscles), supplying system (heart) and regulatory system, including interaction between them. The system Lifetrack architecture was developed according of the integrative model requirements (Fig. 1).

Figure 1. Block diagram of Lifetrack system.       

The system hardware consists of 12 ECG lead recorder [Kardiosignalas, 2000], blood pressure monitor [Seinex, 2001], elliptical training equipment ELLIPSE-PRO [Korsakas, 2001], PDA (iPAQ H3970) and PC with Bluetooth (MSI PC2PC) module. The software was developed for Windows CE and Windows 2000 and it allows:

• Preparation of exercise plan, it automatic fulfilment and management of all equipments;
• Displaying ECG, HR and ST during all testing time and input 12 lead ECG to PC;
• Measurement of ECG parameters, evaluation parameters changes in average or separate cardio cycles and representation them in two-dimensional (2D) or three-dimensional (3D) trends,
• The integrated evaluation of patient functional state and the document output.

3.  Results

The system Lifetrack was tested on 204 healthy persons and patients with hypertension and coronary artery diseases (CAD). 50 persons were additionally examined using echocardiography and angiography techniques. They were divided into 3 groups: healthy – 14, patients with hypertension – 23 and patients with CAD (narrowing of coronary artery >60%) – 13. For 14 healthy persons the exercise test was terminated after achieving the submaximal HR. The changes of ECG or blood pressure (BP) were not established during all process. For 23 patients with hypertension before exercise test systolic BP was 148±28 mmHg and diastolic BP - 89±12 mmHg. During exercise (max load) systolic BP increased till 182±12 mmHg and diastolic BP - 109±9 mmHg (p<0.05). It confirmed hypertension for all 23 patients. The results of CAD detection is showed in Fig. 2. For 2 patients the exercise test was terminated not achieving the submaximal HR and pathological ST changes through severe angina.

4.  Discussion and Conclusions

The developed exercise system using elliptical training equipment and wireless Bluetooth technology is more convenient for physicians and for patients (the examination of patient with elliptical equipment is more physiological, during examination the patient felt more little paint of legs).

The results of clinical investigation permit to conclude that system Lifetrack could be used for human integrative functional state evaluation and for diagnostic of hypertension and coronary artery diseases. Especially the system Lifetrack is useful for selection of patients for coronary angiography.

References

Katzel L.J., Fleg J.L., Busly-Whitehead M.J., Sorkin J.D., Becker L.C., Lokatta E.G. and Goldberg A.P. Exercise-induced silent myocardial ischemia in master athletes. Am. J.Cardiol., 81:.261-5, 1998.

Korsakas S., Vainoras A., Jarusevicius G., Gargasas L. Using the training equipment Ellipse-Pro for human functional state evaluation. In proceedings of International Conference of the Biomedical Engineering, 2001, 65-68.

Vainoras A., Baciuliene K. Human functional model application for evaluation effects of local physical activity. In proceedings of International Conference of the Biomedical Engineering, 2000, 129-132.

Viik J., Lehtinen R., Turjanmaa V., Niemelak and Malmivuo J. Correct utilization of exercise electrocardiographic leads in differentiation of men with coronary artery disease from patients with a low likelihood of coronary artery disease using peak exercise ST-segment depression. Am.J.Cardiol., 81:.964-9, 1998.

Portable Computerized Electrocardiograph "Kaunas". www.kardiosignalas.lt Kaunas, 2000.

24 hours ambulatory blood pressure monitor SE-25M/P. www.seinex.com London, 2001.