Dictionary-based Monitoring of Premature Ventricular Contractions: An Ultra-Low-Cost Point-of-Care Service

While cardiovascular diseases (CVDs) are prevalent across economic strata, the economically disadvantaged population is disproportionately affected due to the high cost of traditional CVD management. Accordingly, developing an ultra-low-cost alternative, affordable even to groups at the bottom of the economic pyramid, has emerged as a societal imperative. Against this backdrop, we propose an inexpensive yet accurate home-based electrocardiogram(ECG) monitoring service. Specifically, we seek to provide point-of-care monitoring of premature ventricular contractions (PVCs), high frequency of which could indicate the onset of potentially fatal arrhythmia. Note that a traditional telecardiology system acquires the ECG, transmits it to a professional diagnostic centre without processing, and nearly achieves the diagnostic accuracy of a bedside setup, albeit at high bandwidth cost. In this context, we aim at reducing cost without significantly sacrificing reliability. To this end, we develop a dictionary-based algorithm that detects with high sensitivity the anomalous beats only which are then transmitted. We further compress those transmitted beats using class-specific dictionaries subject to suitable reconstruction/diagnostic fidelity. Such a scheme would not only reduce the overall bandwidth requirement, but also localising anomalous beats, thereby reducing physicians' burden. Finally, using Monte Carlo cross validation on MIT/BIH arrhythmia database, we evaluate the performance of the proposed system. In particular, with a sensitivity target of at most one undetected PVC in one hundred beats, and a percentage root mean squared difference less than 9% (a clinically acceptable level of fidelity), we achieved about 99.15% reduction in bandwidth cost, equivalent to 118-fold savings over traditional telecardiology.