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a
r
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h
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m
ite
d
a
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n
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o
f
i
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or
m
a
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on on
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ect
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o
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ear
s
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y
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a
m
i
cs
[
1
0
]
.
I
n
t
h
e
r
ecen
t
p
as
t
,
co
n
s
i
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er
ab
l
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o
w
t
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d
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ch
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t
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xp
l
o
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g t
he
b
eh
a
v
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m
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t
e
m
f
r
o
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en
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[1
0
]
-
[
1
6
]
.
T
o
r
em
o
v
e t
h
e i
n
t
er
f
er
en
ce
w
i
t
h
o
u
t
d
et
er
i
o
r
at
i
n
g
t
h
e o
r
i
g
i
n
al
s
i
g
n
al
i
s
n
o
t
a
n
eas
y
t
as
k
d
u
e
t
o
no
nl
i
ne
a
r
s
i
gna
l
d
yna
m
i
c
s
.
T
hi
s
c
a
n b
e
o
ve
r
c
o
m
e
b
y
us
i
n
g t
he
m
o
d
i
f
i
e
d
v
a
r
i
a
t
i
on
a
l
m
ode
de
c
om
pos
i
t
i
o
n
a
n
d
p
o
w
er
l
i
n
e i
n
t
er
f
er
e
n
ce i
s
r
e
m
o
v
ed
s
at
i
s
f
act
o
r
i
l
y
[
1
7
]
.
T
h
e s
y
s
t
e
m
p
er
f
o
r
m
an
ce
f
o
r
d
i
a
g
n
o
s
i
s
o
f
co
r
o
n
ar
y
h
ear
t
d
i
s
ea
s
e
w
a
s
i
m
p
r
o
v
ed
b
y
u
s
i
n
g
h
y
b
r
i
d
s
y
s
t
e
m
o
f
t
i
er
ed
m
u
l
t
i
v
ar
i
at
e a
n
al
y
s
i
s
a
n
d
ar
t
i
f
i
ci
al
n
e
u
r
al
ne
t
w
o
r
k a
nd
ach
i
e
v
e
d a
n
a
c
c
ur
a
c
y
o
f
86.
3%
[
18]
.
S
t
i
l
l
p
r
o
c
e
s
si
n
g
o
f
E
CG
s
i
g
n
a
l
n
e
e
ds
a
l
ot
of
i
m
pr
ov
e
m
e
nt
,
m
o
s
t
o
f
al
l
acc
u
r
at
e d
et
ect
i
o
n
o
f
Q
R
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co
m
p
l
e
x
.
I
n
t
h
i
s
r
es
ear
ch
p
ap
er
,
a
n
o
v
el
co
m
p
u
t
i
n
g
m
et
h
o
d
h
as
b
een
de
v
i
s
e
d ba
s
e
d on
w
i
n
do
w
i
n
g
m
e
c
h
a
n
i
s
m
t
o v
e
r
i
f
y
pe
a
k
pos
itio
n
c
o
m
b
in
e
d
w
it
h
w
a
v
e
le
t b
a
s
e
d
d
e
-
no
i
s
i
ng f
o
r
r
eal
t
i
m
e Q
R
S
d
et
ect
i
o
n
.
2.
M
E
T
HOD
OL
OG
Y
I
n t
hi
s
w
o
r
k
R
-
p
ea
k
h
as
b
een
d
et
ect
ed
f
r
o
m
M
I
T
B
I
H
A
r
r
h
y
t
h
m
i
a
d
at
a b
as
e.
T
o
car
r
y
o
u
t
t
h
i
s
t
a
s
k
,
r
a
w
E
C
G
i
s
f
ir
s
t
f
ilte
r
e
d
b
y
u
s
in
g
t
h
ir
d
o
r
d
e
r
S
a
v
itz
k
y
g
o
la
y
f
ilte
r
a
n
d
t
he
n p
r
e
-
p
r
o
ces
s
ed
b
y
a
w
a
v
el
et
b
as
ed
d
en
o
i
s
i
n
g
i
n
a r
eal
-
t
i
m
e
f
as
h
i
o
n
t
o
m
i
n
i
m
i
ze t
h
e
u
n
d
ef
i
n
ed
n
o
i
s
e l
ev
e
l
.
R
-
p
e
a
k
is
th
e
n
de
t
e
c
t
e
d f
r
o
m
de
n
oi
s
e
d
s
ig
n
a
l a
f
te
r
w
a
v
e
le
t d
e
n
o
is
i
n
g
.
W
in
d
o
w
in
g
m
e
c
h
a
n
i
s
m
i
s
a
ls
o
a
p
p
lie
d
f
o
r
f
in
d
in
g
t
h
e
m
is
s
i
n
g
R
-
p
eak
s
i
f
t
he
r
e i
s
a
n
y
.
D
es
cr
i
p
t
i
v
e d
at
a d
et
ai
l
i
n
g
o
f
t
h
e
ab
o
v
e d
i
s
c
u
s
s
ed
s
i
g
n
al
p
r
o
ces
s
i
n
g
s
t
ag
e
s
ar
e
m
e
n
t
i
o
n
ed
i
n
f
o
llo
w
in
g
s
e
c
t
io
n
s
.
2.
1.
D
a
t
a
b
a
s
e D
es
cri
p
t
i
o
n
T
h
e d
at
ab
as
e o
f
M
I
T
-
B
I
H
A
r
r
hy
t
hm
i
a
i
s
i
n
c
or
por
a
t
e
d i
n
t
hi
s
w
or
k f
or
t
h
e
a
n
a
l
y
s
i
s
o
f
E
C
G
s
i
gn
a
l
.
B
e
t
h
I
s
r
a
e
l
H
os
pi
t
a
l
A
r
r
hy
t
hm
i
a
L
a
bor
a
t
or
y
obt
a
i
n
e
d a
s
e
t
of
ov
e
r
4000
l
on
g
-
t
e
r
m
H
o
l
t
e
r
r
e
c
o
r
d
i
ngs
i
n t
he
e
r
a
of
1975 a
n
d 1979.
T
o obt
a
i
n
t
h
e
s
e
r
e
c
or
di
n
gs
,
m
a
i
n
l
y
t
h
e i
n
p
at
i
e
n
t
s
w
er
e a
n
al
y
s
ed
.
T
h
er
e ar
e 2
3
r
eco
r
d
s
i
n
t
h
i
s
da
t
a
ba
s
e
(
r
a
ng
e
s
f
r
o
m
100 t
o 12
4 i
n
c
l
us
i
v
e
w
i
t
h
s
o
m
e
m
i
s
s
i
n
g num
be
r
s
da
t
a
)
c
hos
e
n
a
r
bi
t
r
a
r
i
l
y
f
r
o
m
t
h
i
s
s
e
t
,
a
n
d 25 r
e
c
or
ds
(
r
a
n
g
e
s
f
r
o
m
200 t
o 234 i
n
c
l
u
s
i
v
e
,
a
g
a
i
n
w
i
t
h
s
o
m
e
num
be
r
s
m
i
s
s
i
n
g
)
s
e
l
ect
ed
f
r
o
m
t
h
e
s
a
m
e
s
e
t
t
o
i
n
cl
u
d
e a
v
ar
i
et
y
o
f
r
ar
e b
u
t
cl
i
n
i
cal
l
y
i
m
p
o
r
t
an
t
p
h
en
o
m
e
n
a t
h
at
w
o
u
l
d
n
o
t
b
e
w
el
l
-
r
e
pr
e
s
e
n
t
e
d by
a
s
m
a
l
l
r
a
n
dom
s
a
m
pl
e
of
H
ol
t
e
r
r
e
c
or
di
ng
s
.
E
a
c
h
o
f
t
h
e
48 r
e
c
or
ds
i
s
s
l
i
g
ht
l
y
o
v
e
r
30
m
i
nut
e
s
l
o
n
g.
T
he
f
i
r
s
t
gr
o
up
i
s
i
nt
e
nd
e
d
t
o
s
er
v
e as
a r
e
p
r
es
en
t
at
i
v
e s
a
m
p
l
e o
f
t
h
e v
ar
i
et
y
o
f
w
av
ef
o
r
m
s
a
n
d
ar
t
ef
act
t
h
at
an
ar
r
h
y
t
h
m
i
a d
et
ect
o
r
m
i
g
h
t
en
co
u
n
t
er
i
n
r
o
u
t
i
n
e cl
i
n
i
cal
u
s
e.
A
n
ar
b
i
t
r
ar
y
n
u
m
b
er
s
w
er
e u
s
ed
f
o
r
t
ap
es
s
el
ect
i
o
n
,
a
n
d
t
h
en
t
o
s
el
ect
t
h
e
m
f
o
r
a s
eg
m
e
n
t
o
f
h
al
f
-
ho
ur
.
I
f
ne
i
t
he
r
o
f
t
he
t
w
o
E
C
G
s
i
gna
l
s
w
e
r
e
o
f
ad
eq
u
at
e q
u
al
i
t
y
f
o
r
an
al
y
s
i
s
b
y
m
a
n
u
al
ex
p
er
t
i
s
e ar
e ex
c
l
u
d
ed
i
n
t
h
i
s
ap
p
r
o
ach
.
T
h
e
s
eco
n
d
g
r
o
u
p
h
ad
ch
o
s
en
t
h
e r
eco
r
d
s
t
o
i
n
cl
u
d
e
co
m
p
l
i
cat
ed
s
u
p
r
av
en
t
r
i
c
u
l
ar
,
j
u
n
ct
i
o
n
al
an
d
v
en
t
r
i
c
u
l
ar
ar
r
h
y
t
h
m
i
as
a
n
d
m
aj
o
r
ab
n
o
r
m
al
i
t
i
es
i
n
co
n
d
u
c
t
i
o
n
.
M
o
s
t
l
y
,
t
h
es
e r
eco
r
d
s
w
er
e s
el
ect
ed
b
ecau
s
e
of
Q
R
S
m
or
ph
ol
ogy
v
a
r
i
a
t
i
on,
r
hy
t
hm
f
e
a
t
u
r
e
s
or
qu
a
l
i
t
y
of
s
i
gn
a
l
m
i
g
h
t
be
e
x
pe
c
t
e
d t
o pr
e
s
e
n
t
di
f
f
i
c
u
l
t
y
t
o
ar
r
h
y
t
h
m
i
a d
et
ect
o
r
s
i
n
a s
i
g
n
i
f
i
ca
n
t
m
a
n
n
er
;
an
d
co
n
s
i
d
er
a
b
l
e n
o
t
o
r
i
et
y
h
a
v
e r
eco
r
d
ed
b
y
d
at
ab
as
e a
n
al
y
s
er
.
T
h
e
s
t
u
d
y
w
a
s
c
on
du
c
t
e
d on
25 m
e
n
a
g
e
d 32 t
o 89 y
e
a
r
s
,
a
n
d 22
w
o
m
e
n
a
g
e
d 23 t
o 89
y
e
a
r
s
.
(
R
e
c
or
ds
201
an
d
2
0
2
o
b
t
ai
n
ed
f
r
o
m
t
h
e
s
a
m
e
m
a
l
e s
u
b
j
ect
)
.
2.
2.
E
C
G
L
e
ad
C
on
f
i
gu
r
at
i
on
T
h
e el
ect
r
o
d
es
ar
e
t
o
b
e
p
l
ace
d
o
n
ch
es
t
f
o
r
g
et
t
i
n
g
t
h
e u
p
p
e
r
s
ig
n
a
l
w
h
ic
h
is
a
m
o
d
i
f
ie
d
li
m
b
le
a
d
I
I
(
M
L
I
I
)
.
W
h
i
l
e a
m
o
d
i
f
i
ed
l
ea
d
V
1
(
o
ccas
i
o
n
al
l
y
V
2
o
r
V
5
,
an
d
i
n
o
n
e i
n
s
t
a
n
ce V
4
)
;
i
n
l
o
w
er
s
i
g
n
al
s
.
I
n
t
h
i
s
cas
e al
s
o
,
t
h
e el
ect
r
o
d
es
ar
e p
l
aced
o
n
t
h
e
ch
e
s
t
.
B
I
H
A
r
r
h
y
t
h
m
i
a
L
ab
o
r
at
o
r
y
i
s
u
s
i
n
g
t
h
i
s
co
n
f
i
g
u
r
at
i
o
n
on
r
eg
u
l
ar
b
as
i
s
.
I
n
t
h
e u
p
p
er
s
i
g
n
al
s
i
n
d
i
cat
i
o
n
s
ar
e g
e
n
er
al
l
y
p
r
o
m
i
n
en
t
w
h
en
Q
R
S
co
m
p
l
e
x
i
s
n
o
r
m
al
.
M
ea
n
car
d
i
ac el
ect
r
i
cal
ax
i
s
a
n
d
t
h
e
l
ead
ax
i
s
m
a
y
b
e n
ear
l
y
o
r
t
h
o
g
o
n
al
f
o
r
t
h
e
l
o
w
er
s
i
g
n
al
,
h
o
w
e
v
er
(
i
.
e.
,
n
o
r
m
a
l
b
eat
s
ar
e u
s
u
al
l
y
b
i
p
h
a
s
i
c an
d
m
a
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In
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r
o
ach
f
o
r
R
-
P
eak
D
et
ect
i
o
n
i
n
E
l
ect
r
o
car
d
i
o
g
r
am
(
E
C
G
)
S
i
g
n
al
,
”
I
n
t
e
r
n
at
i
on
al
j
our
n
al
of
adv
a
nc
e
E
l
e
c
t
r
i
c
al
an
d
E
l
e
c
t
r
oni
c
s
E
ngi
ne
e
r
i
ng
, p
p
.
2
278
-
89
48
,
201
5
.
[
1
2]
M.
I
.
O
wi
s
,
et
a
l
.
,
“
S
t
udy
of
f
e
a
t
ur
e
s
ba
s
e
d o
n n
onl
i
ne
a
r
dy
na
m
i
c
a
l
m
ode
l
i
ng
i
n E
C
G
a
r
r
hy
t
h
m
i
a
d
et
ect
i
o
n
an
d
cl
as
s
i
fi
cat
i
o
n
,
”
I
E
E
E
T
r
ans
ac
t
i
o
n
s
on B
i
om
e
di
c
al
E
ngi
ne
e
r
i
ng
,
v
o
l
/is
s
u
e
:
4
9(
7)
, p
p
.
7
33
-
73
6
,
20
02
.
[
1
3]
J
.
F
e
ll,
e
t
a
l.
,
“
N
on
l
i
ne
a
r
a
na
l
y
s
i
s
of
c
ont
i
nuo
us
E
C
G
dur
i
n
g
s
l
eep
I
I
.
D
y
n
a
m
i
cal
m
eas
u
r
e
s
,
”
Bio
lo
g
ic
a
l
C
yb
er
n
et
i
cs
,
vo
l
.
82
,
p
p.
48
5
-
4
91
,
20
00
.
[
1
4]
R.
B
.
G
ov
i
nda
n,
e
t
a
l.
,
“
O
n t
he
e
v
i
de
nc
e
of
de
t
e
r
m
i
ni
s
t
i
c
c
ha
os
i
n E
C
G
:
s
ur
r
og
a
t
e an
d
p
r
ed
i
ct
ab
i
l
i
t
y
an
al
y
s
i
s
,
”
C
haos
,
v
o
l/is
s
u
e
:
8(
2)
,
pp.
49
5
-
5
02
,
19
98
.
[
1
5]
R
.
S
ili
p
o
,
e
t a
l.
,
“
D
yn
a
m
i
c
s
e
x
tr
a
c
tio
n
i
n
m
u
ltiv
a
r
ia
te
b
io
m
e
d
ic
a
l tim
e
s
e
r
ie
s
,
”
B
i
ol
ogi
c
al
C
y
be
r
ne
t
i
c
s
,
vo
l
.
79
,
p
p
.
15
-
27
,
1
998
.
[
1
6]
A
.
C
as
al
eg
g
i
o
an
d
S
.
B
r
a
i
ot
t
a
,
“
E
s
t
i
m
a
t
i
on of
L
y
a
punov
e
x
p
one
nt
s
of
E
C
G
t
i
m
e
s
e
r
i
e
s
—
t
he
i
nfl
ue
nc
e
of
p
ar
am
et
er
s
,
”
C
haos
,
S
ol
i
t
ons
&
F
r
ac
t
al
s
,
v
o
l/
is
s
u
e
:
8(
10)
,
pp
.
15
91
-
15
99
,
1
997
.
[
1
7]
N
.
M
oha
n,
“
M
odi
f
i
e
d
V
a
r
i
a
t
i
ona
l
M
o
de
D
e
c
om
pos
i
t
i
on F
or
P
ow
e
r
L
i
ne
I
nt
e
r
f
e
r
e
nc
e
R
e
m
ova
l
i
n E
C
G
S
i
g
na
l
s
,
”
IJ
E
CE
,
v
ol
/
i
s
s
ue
:
6(
1)
,
2
01
6
.
[
1
8]
W
ih
a
r
to
,
e
t a
l.
,
“
H
y
b
r
id
S
y
s
te
m
o
f
T
ie
r
e
d
M
u
ltiv
a
r
ia
te
A
n
a
l
y
s
is
a
n
d
A
r
tif
ic
ia
l N
e
u
ra
l
N
e
t
w
o
rk
f
o
r Co
ro
n
a
ry
H
e
a
rt
Di
se
a
se
Di
a
g
n
o
si
s
,
”
IJ
E
CE
,
v
ol
/
i
s
s
ue
:
7(
2)
,
2
01
7
.
[
1
9]
w
w
w
.
ph
y
s
i
one
t
.
or
g
[
2
0]
S
.
W
.
C
h
en
,
e
t a
l.
,
“A
r
eal
-
t
i
m
e
Q
R
S
de
t
e
c
t
i
on m
e
t
hod ba
s
e
d o
n m
ov
i
ng
-
a
ve
r
a
gi
n
g i
n
c
o
r
p
o
r
at
i
n
g
w
i
t
h
w
av
el
et
de
noi
s
i
ng
,”
c
om
p
ut
e
r
m
e
t
ho
ds
a
n
d pr
ogr
am
s
i
n B
i
om
ed
i
ci
n
e
, v
o
l
.
82
,
p
p.
18
7
-
1
95
,
20
06
.
[
2
1]
D.
L
.
D
ono
ho
an
d
I.
M
.
J
o
h
n
s
t
o
n
e,
“I
d
eal
s
p
at
i
al
ad
ap
t
at
i
o
n
v
i
a w
a
v
el
et
s
h
r
i
n
k
ag
e
,
”
Bio
m
e
tr
ik
a
,
p
p.
425
-
45
5
,
19
94
.
[
2
2]
S
. J
.
O
r
f
a
ni
di
s
,
“
I
nt
r
o
duc
t
i
on t
o S
i
g
na
l
P
r
oc
e
s
s
i
ng
,
” P
r
en
t
i
ce
-
H
a
l
l
,
E
ng
l
e
w
ood C
l
i
f
f
s
,
N
J
,
1996
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