CASE
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Arrhythmia and Sudden Death Syndrome Detection Hybrid Network based Telemedicine System

Increasing number of heart patients and swelling statistics of mortality rate due to cardiac problems demand an efficient system pertinent to cardiac care at every level of health centre. One of the tools of cardiac monitoring is electrocardiography commonly known as ECG. Dilemma is that despite the installation of hundreds of ECG machines in hospitals and clinics throughout the country, patients with severe arrhythmic abnormalities are often misdiagnosed or mistreated. This usually happens in rural areas due to unavailability of expert cardiologists at the ECG monitoring station. No doubt cardiologists cannot be present at every ECG station but in this era of sophisticated Communication & Information Technology, ECG from patients with cardiac risk can be provided to experts at Cardiac Centers in Central Hospitals. Further to this, there is a dearth of high resolution ECG machines. The analysis from a high resolution ECG can help in diagnosis of sudden death phenomena in potential patients of Cardiac Arrest.

The project proposes to develop a prototype system to demonstrate geographically distributed installation of network enabled ECG recording and analysis stations with normal and High Resolution digital ECG machines capable of self diagnosing a patient for different arrhythmic abnormalities as well as early detection of risks associated with fatal arrhythmias which can lead to sudden cardiac death. The system will provide 24/7 ECG recording and analysis facility with universal connectivity through dialup, Ethernet, GPRS, Radio and Satellite for connection to the central server located in the Cardiac Control Center (CCC) of a Central Hospital. Here the expert cardiologists will receive ECG data and profile of patients with severe arrhythmic abnormalities and suggest treatment in real time. Offline storage capability is also proposed for later analysis in case a cardiologist is not on duty. The ECG record and the patient profile would be stored at the server and a database for patients and their cardiac history would be managed for future reference as well as for off-line analysis and data-mining. This database would be connected to the National Repository of Cardiac Research which could be accessed by R&D organizations worldwide.

The Self Diagnostic component of the system is the automatic recognition of current status of ECG. This depends upon real-time signal acquisition, signal processing and correct event classification. Running state of the art signal processing algorithm, this prototype would have the capability of automatic diagnosis of ECG arrhythmias with very high degree of certainty as well as provide self diagnosis in case of emergencies. Another distinguishing feature of this system is risk stratification of life-threatening arrhythmic abnormalities by analyzing patterns and trends in the recorded ECG. It is important to highlight that project will explore different implementation methodologies to craft an economic solution in terms of highly efficient arrhythmia detection algorithms, real time ECG monitoring, Database Management and Cost. The proposal will develop a prototype system and shall elaborate the cost and facilities required for producing this system serially for clinics and hospitals around the country. This would benefit thousands of heart patients who are unable to get proper medical treatment due to lack of cardiologists and long delays of appointment issues with the specialists as they would get an expert opinion in real-time. This is the kind of work which has never been done so comprehensively even internationally and thus has a enormous research scope and market potential. Therefore, funding is sorted to design this prototype system demonstrating the effectiveness of the algorithm and its implementation & deployment in actual scenarios while keeping the Bill of Material (BOM) cost relatively low for cost effective serial production.