Remote Heartbeat Monitoring System for Cardiovascular Patients Toyeeb A. M usliudeen Abdulkarim A. Oloyede Nasir Faruk Departmnet of Departmnet of Electronics, Univeristy Departmnet of TelecommunicationScience University of York, UK TelecommunicationScience University of Ilorin aao500@york.ac.uk of Ilorin musliudeentoyeeb@gmail.com Faruk.n@unilorin.edu.ng Timothy K. Oyun Departmnet of Ibraheem Katibi Lukman A. Olawoyin Departmnet of TelecommunicationScience University Cardiology Unit, Department of TelecommunicationScience University of Ilorin M edicine of Ilorin University of Ilorin iakatibi@unilorin.edu.ng lolawoyin@unilorin.edu.ng Abstract— The rise in Cardiovascular disease (CVD) cases the HR at rest is the number of occurrence of the beat of the is alarming, as it’s become the world’s major disease heart in the sitting condition, when lying down or when the contributing to almost 50% of noncommunicable disease. The nerve is calm. This is set within the range of 60 to 100 beats need to have real time access of the patient’s heart condition per minute (b m) [3]. However, the HR of an athlete and an (heartbeat) is necessary in proper management and treatment active adult is slower than that of a resting or stationary of CVDs. However, the lack of manpower and adequate person [4]. The normal HR for a baby (less than one year of funding hinder the deployment of heart beat monitors in age) is higher and this is expected to be around 120 to 160 considerable number of hospitals in developing countries. In bpm and that of an healthy child is expected to be around 75 this paper, we present design and implementation of energy to 110 bpm [5]. efficient and cost-effective remote heartbeat monitoring system. The implementation consists of pulse sensor, Arduino Over the years, there have been different methods of UNO, HC-05 Bluetooth module and 9v battery. The measuring heartbeat. However as technology advances, the ATMega328 microprocessor of the Arduino is programmed in methods involved is also advancing. The conventional C language with the use of the library function "Pulse Sensor manual method of taking the heart pulse has advanced into Playground" of the Arduino, while the end terminal electronic methods [6]. Two of the most common types of application is programmed with java via processing. A front the electronic methods are the electrical method end application was developed and used to display the pulse (electrocardiography) and the optical method (photo data. The de vice constructed operates smoothly, based on the sampled BPM data collected from 5 adults. The design is quite plethysmography). The electrical method uses the voltage efficient as it successfully connects the pulse sensor remotely to extracted fro m placing a strap of electrode pads on the body, the frontend application. It also relays the BPM value to the while that of the optical method uses light as its source of terminal device in real time. data [7]. The optical method of the pulse sensor involves the process of placing the fingertip between the infrared Keywords—heartbeat monitor, Cardiovascular, energy transmitter and a photodiode sensor. As blood flows through efficiency Arduino, Bluetooth the vein, it absorbs the infrared light which is in turn captured by the photodiode sensor. Afterwards, the intensity of the reflected light captured by the photodiode sensor I. INT RODUCTION (LDR) y ields the blood pulse value [8]. The pulse value is Card iovascular disease (CVD) is a condition involving the then further displayed via a display terminal for access by a blood vessels, either narrowing or co mplete blockage of the cardiologist or medical practitioner. blood vessels, resulting to heart attack. So me examp les of The need to have real time access of the patient’s heart this disease include the heart failure, heart attack, coronary condition (heart beat) is necessary in proper management and artery diseases, stroke and many others [1]. treatment of CVD. Heart beat monitoring systems is commonly used to measure the heartbeat of patients. The global rise in CVDs cases has become the topic issue However, lack of manpower and adequate funding hinder the and burden as its currently the world’s major disease deployment of the devices in considerable number of contributing to almost 50% of non-commun icable disease hospitals in developing countries. Moreover, power supply [2]. This has surpasses the communicable d iseases. The is another big issue to sustain the running of these devices global death as the result of CVDs currently stood at 17.3 within the time span needed to monitor patients with CVDs. million deaths per year, th is number however, is expected to Furthermore, the economic pressure and realities has pushed grow even higher by the year 2030 [2]. most of the healthcare industries to seek for new and cost effective paradigms that could provide health care service to Hence, detecting this disease is essential and one of early people. Therefore in this paper, a user friendly, portable, cost step is to examine for irregular heartbeat pattern in a patient. and energy efficient heart beat monitoring system that could The rate at which the heart beats could be used as a basis for be used to remotely (via wireless medium), access the beat detecting the condition of the heart of a patient. The heartrate rates or HR of patients with CVD is developed. The device (HR) varies in accordance to the age, activity and the allows for remote monitoring of a patient which is often condition of a person. The HR for a healthy adult, defined as required as the doctor to patent ratio in Africa can be as low Copyright © 2019 for this paper by its authors. Use permitted under Creative Commons License Attribution 4.0 International (CC BY 4.0) IREHI 2018 : 2nd IEEE International Rural and Elderly Health Informatics Conference as 1:50000 [9].The device also provide a short range wireless allow free mobility of the patient while his / her health technology for sending the captured HR to a remote terminal. parameters being monitored. A wireless sensor is to be used The remote terminal would be able to display the HR of in monitoring the health parameters such as the HR, and different patients from time to time. connectivity is made to mobile application via bluetooth. In [19], the authors proposed a system for people in rural II. RELAT ED WORKS areas due to their inaccessibility to doctors and other medical There are two major types of devices used in monitoring practitioners that would monitor their health parameters the heartrate. These include the electrical methods which (such as the heart rate). It was as well proposed in [19], a bi- requires placing a large strap of device on the body while the analysis hierarchical method. The first layer been an optical method doesn’t require anything of such and can be integration with android phone that stores data at SQLite, effectively used as compared to the electrical method [10]. analyzes the data and then send a text based emergency short The development of low cost heart rate measuring device can message to the health practitioners. After receiving the be achieved through the use of optical technology where message, the medical practitioner then analyzes the data LDR and LED are used in sensing the pulses [11]. The received. amplifier circuit amplifies the pulse signal, and then filters it through a band pass filter. The microcontroller receives the III. DESIGN AND IMPLEMENTATION amplified and filtered pulse signal, and then process es the The components used in carrying out the full analog signal. Afterwards, it then counts the HR and displays it on the LCD display [12], [13]. implementation of this work are presented. The components can be sub-divided into two: Hard ware co mponents (Pulse In [14], optical technology was employed to design a sensor, Arduino UNO and Bluetooth module) and Software microcontroller-based HR monitor via fingertip sensor was components (Arduino IDE (Integrated development presented. Optical technology was employed by the device in Environ ment) and Processing). detecting blood that flows through the fingers, and in the process offers great advantage of handiness, usability and A. Pulse Sensor portability over the tape-based recording system. The This is an Arduino based plug-and-play sensor for taking Discrete Fourier Transform was applied in analyzing the the rate at which the heart beats. It is majorly used by electrocardiography (ECG) signals in order to derive the HR developers, athletes, students, for easy incorporation of real measurement. In the research work, the performance of the time data of the amplifier and noise cancellation circuits HR monitoring device was taken in co mparison with the which aid its ability to produce a reliable pulse reading easily ECG signal represented on an oscilloscope and the manual and quickly [20] [21]. A picture of the front and back view of pulse measurement of the heartbeat. this device is shown in figure 1. In [15], a co mpliance tracking mechanism (called CHF Tel-Assurance) was imp lemented [15]. Patients were monitored with the aid of technology and were reviewed on a weekly basis by a mu ltidisciplinary team. So me of the team members fro m the cardiac rehabilitation telemetry, and home care research units. The goals of the team were to make provision for an improved patient result, hospitalization, and readmission rates. The core approach was to allow patients to be the co-handler of how their heart system behaves via user education on usable technology. The core approach In [16] was to allow patients to be the co-handler of how their heart system behaves via user Fig 1. Front view and back view diagram of a pulse sensor [27] education on usable technology. In this article, seventy-four (74) heart failure patients were enrolled in the ECG B. Arduino UNO monitoring and telephone follow-up program. In response, patients are capable of sending their respective ECG data The Arduino UNO is an ATmega328P integrated circuit fro m their mobile telephone to a remote receiving terminal open source microcontroller board. It has seven power pin, where the data could be accessed by a heart care and Eighteen (18) input / output digital pins of which Twelve professional. The patients were evaluated and responded to, (12) are dedicated to digital PMW and Six (6) analogue based on the ECG data that the patient must have sent to the input. It also has a reset button, USB connector, and a power remote consultant. jack as shown in Fig 2. The components that make up the controller are designed in such a way to perform the Bodmas et al [17] tried to establish the feasibility and functions of a microcontroller., All that is needed is to potency of remote monitoring and management of the connect it to a power source (such as a 3V or 5V battery or to chronic heart failure. Patients were assessed by tele- computer via USB cable) to start the device. The Arduino monitoring for HR, blood pressure, weight and arterial UNO has been embedded with an inbuilt boot loader to saturation of oxygen. Patient's satisfaction, safety and quality upload a new program to the board of the Arduino. However, of life based on the implementation of these approaches were the boot loader can be bypassed thereby controlling the evaluated for humanistic outcome. microcontroller with the use of the In-Circuit Signal Also, According to S.A Moraru, Szakacs, and L. perniu Programming (ICSP) header [22, 23] in [18], the proposition of the authors was based on having a device that is wearable on the patient’s body which will Fig 2 Arduino UNO with ATmega328p Microprocessor [28] C. Bluetooth Module (HC-05) Bluetooth module was used to interface with an Arduino Fig 4. Arduino IDE board in order to transmit the data fro m the Arduino board to a Bluetooth-enabled terminal such as a PC [24]. The Bluetooth module used in this work is Bluetooth module HC-05 which can either be set to master or slave. The E. Processing module has Seven (7) p ins, namely; KEY, VCC, GND, Processing is an open source developing agent tool for TXD, RXD and STATE as shown in figure 3. These are writing an application program which in turn can be used in ONLY Six pins and not Seven. Among all the just mentioned the same or other computer [26]. Its usefulness in this project pins, the needed ones for this project are; the VCC which the is when the computer is needed to communicate with the voltage source from the Arduino is connected to, the GND Arduino. In this project, the processing software is used to that is connected to the Arduino ground pin, the RXD that program java based computer application, named remote receives data fro m the Arduino transmitting serial, and the heart rate monitor, to display the reading and pulse wave of TXD which transmits the received serial data from the the sensor on the computer. What it does is that it creates an Arduino to the end terminal [25]. environment that accepts data fro m the Arduino via the Bluetooth module and displays it on the application created fro m this processing environment. IV. IMPLEMENTATION AND RESULT S This work is implemented using cost effective and energy efficient method. The schematic design used for the implementation of the wo rk is shown in fig. 5 while the flow chart is shown in figure 6. The simplicity of the method can be seen from the flo w and block d iagram. Patients Sensing Arduino Remote Pulse and Uno Monitor Readin +Bluetooth Te rminal g module Fig 3. Fromt and Back view of HC-05 Bluetooth module [29] D. Arduino IDE Fig 5: Block Diagram of Design The Arduino integrated development environment is an environment in which an Arduino board can be The project was first imp lemented using a breadboard to be programmed. A written program or code is called able to determine any problem with any of the co mponents SKETCH [23]. In this work, the Arduino IDE is used as and while putting the components together. an environment in which the Arduino UNO program is As shown in figure 8, a set of LEDs are connected on the written, compiled and uploaded on the Arduino board as circuit board. A resistor of 200Ω is used in regulating the depicted in figure 4. input voltage of the LED to prevent it fro m burning because of high input voltage to the LED. Furthermore, the schematic b lock d iagram is also shown in figure 7. It can be seen from this diagram that the patient’s pulse rate is measured, analyzed and then wirelessly relayed to a distance-dependent remote terminal. The value of the resister was determined using the equation below 1.0 Where; R is the value of the unknown resistor Vs is the supply voltage power used in powering the circuit in our case the value is as this is the output voltage from the Arduino Vf is the forward voltage required to power the LED in our case the value is If is the forward current required for the LED to operate and in our case, this is The work was imp lemented by connecting the anode (+ve part) of the LED to the Arduino PIN while the cathode (-ve part) is grounded on the circuit board. The female pin connector is also attached to the circuit board wh ich contains the ground port, voltage port, analog port and Bluetooth module port. The prototype produced is as shown in Fig 9 below with a s mall electrical junction box wh ich contains all the components (Arduino UNO, circu it board and a 9V DC battery). To test the device, there is need to ensure that the Fig 6: Flow chat for Implementation Bluetooth module HC-05 is paired with the end terminal. The module must then be attached to a specific computer port on the end terminal device as shown in Figure 10 below; After attaching a port to the HC-05 Bluetooth module, the HRM application can then be launched as shown in Fig 11. Fig 7: Block diagram of the remote heart rate monitoring system. Fig 9: Prototype remote Heartrate Monitor System It can be seen at Fig 10 that once the application is launched, all available ports on the terminal device are shown. Once the appropriate computer port is selected, the pulse data will be received on the selected port. On the terminal device where this project is implemented, the HC- Fig 8 Project implementation on Printed Circuit Board (PCB). 05 Bluetooth module was attached to computer port 21 for the recipient of the pulse data in real time as shown in Fig 12 and 13. Fig13: Pulse sensor taken for one person The terminal application displays the pulse rate in bit per minute (BPM ) and the pattern of individual heartbeat. Fig 10: Port allocation to HC-05 Bluetooth module Fig 14. Average BPM TABLE 1: HEART RATE VARIABILITY OF 5 PATIENT; BEFORE, DURING AND AFTER EXERCISE Fig 11: Port selection on the terminal device Patient before Excersie During Excersie After Excersie ID (BPM ) (BPM ) (BPM ) 1 2 Avg 1 2 Avg 1 2 Avg Patient 1 72 74 73 94 108 101 67 64 66 Patient 2 69 64 67 80 98 89 62 58 60 Patient 3 74 77 76 100 105 103 58 54 56 Patient 4 65 66 66 95 105 100 60 55 58 Patient 5 80 89 85 98 108 103 63 66 65 The HR monitor device successfully connects remotely to the front-end computer-based application via a short-range Bluetooth connection. The front-end application displays the BPM value of the individual that has the pulse sensor placed on his or her body, majorly on the index finger. It was observed that the front-end application displays high BPM value, usually above 150, on startup. Accurate BPM is recorded when the monitored individual is fully settled and Fig 12: Pu lse sensor taken for two people calm for some minutes. Furthermore, when the accurate BPM value is displayed, just as that in the Figure Fig what, the value mostly varies with difference of five. That is, when the displayed BPM value is 83, it might keep showing values fro m 83 to 88. It must also be noted that the configured band [13] K. Y. Sham, and P. L.-K. Wong, "Fitness monitoring device having an rate (rate of data transmission) is 9,600 at both heart rate electronic pedometer and a wireless heart rate monitor," Google Patents, 1999. monitor and the front-end application, based on the HC-05 [14] A. Bhat, S. Dhoble, and K. Rewatkar, “Microcontroller Based Heart Bluetooth recommendation. Rate Monitor using Fingertip Sensors.” [15] D. Knox, and L. 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