Cardiac Disorder Detection Application and ANT+ Technology

Ikram Nedjai Merrouche

, Amina Makhlouf

, Nadia Saadia

and Amar Ramdane-Cherif

LRPE Laboratory, University of Science and Technology Houari Boumediene, Algiers, Algeria

LISV Laboratory, University of Versailles-Saint-Quentin-en-Yvelines, Versailles, France

Keywords: Heart Trouble Detection, Elderly People, Mobile Phones, ANT+ Technology, Android Application.

Abstract: The problems caused by the occurrence of a heart disorder are great threats to the elderly. With the evolution

of new mobile technologies and data transmission, the smartphone has become an ideal platform for the

development of applications that can monitoring the person in order to be able to provide assistance if

necessary. In order to transmit the real-time data of a cardiac sensor placed on the person to a smartphone, a

communication medium is required which consumes preferably the least battery possible. In this article we

use a new technology called ANT + that promises a very good rate of wireless transmission with low power

consumption. We present a system that offers the doctor or the person in charge of the security of the elderly

the possibility of recording different data concerning the person monitored. This data is used in a cardiac

disorder detection algorithm, and allow our system to match any type of profile. In addition, we are

implementing an Android application, which monitors real-time heartbeat transmitted from a belt using ANT

+ technology, and detects any heart problems.

1 INTRODUCTION

The environment in which we live evolves rapidly.

Several countries in the world are facing the same

health problems due to various factors such as: aging

of the population, rapid urbanization, etc. Currently a

leading global causes of death is due to non-

communicable diseases (cardiovascular diseases,

diabetes, cancer, etc.) who have taken the magnitude

of infectious diseases.

Cardiovascular diseases (CVD) include a number

of disorders affecting the heart and blood vessels such

as: coronary heart disease (heart attack); High blood

pressure (increase in blood pressure); cerebrovascular

diseases (stroke). Cardiovascular disease is the

leading cause of death in the world: it dies every year

more people because of cardiovascular disease than

any other cause. The WHO (World Health

Organization) estimates that 17.5 million deaths from

cardiovascular disease are responsible for 31% of the

world's total mortality. Among these deaths, she

estimates that 7.4 million are due to coronary heart

disease and 6.7 million to a stroke (WHO, 2016).

These dangerous cardiac disorders occur mostly

suddenly, and early monitoring of people at risk, such

as the elderly, reduces the dangers that these

cardiovascular diseases can cause to their health.

A rapid aging of the population is observed

around the world (World Health Organization, 2015),

and the prevalence of cardiovascular disease

increases with age. A cardiac disorder, for example,

can cause falls which are also considered a major risk

of trauma or death in the elderly.

Mobile technologies are becoming more and more

popular on the market. The smartphone serves as a

central device of informatics and communication in

the lives of peoples. Such a trend is inevitable in the

real world because of the phenomenal growth in

recent years of new intelligent devices, which is

expected to continue (GfK, 2015).

These phones integrate different sensors (Lane, et

al., 2010) (Milette and Stroud, 2012), and can also

communicate with other sensors that are external and

that allow new applications in various fields such as

health. The communication between the smartphones

and the external sensors, is done through

communication protocols generally wireless such as

Bluetooth for example.

To provide monitoring services to seniors, there is

a list of technical objectives and challenges (real-time

monitoring, help service, etc.). In order to better meet

the objectives, we encounter a list of theoretical and

practical challenges, such as peripheral integration,

data acquisition and real-time data exchange. All this

Merrouche, I., Makhlouf, A., Saadia, N. and Ramdane-Cherif, A.

Cardiac Disorder Detection Application and ANT+ Technology.

DOI: 10.5220/0006530202950300

In Proceedings of the 10th International Conference on Agents and Artiﬁcial Intelligence (ICAART 2018) - Volume 2, pages 295-300

ISBN: 978-989-758-275-2

295

with the least energy consumption possible.

A new 2.4GHz protocol called ANT + has

recently become famous due to its low battery

consumption (Thisisant, 2017). Its range is 30 meters

(m) and the battery lasts up to 3 years compared to

Bluetooth Low Energy (BLE) with 1 years (Khssibi,

et al., 2013).

ANT + has a very good theoretical transmission

rate which assists at 1 Mbps, making this protocol

more appropriate for low bandwidth wireless

personal area networks. The wireless device sensors

are applied together in a group to provide general

services.

Cardiac monitoring is the subject of several

studies. Some only aimed at monitored heart rate

(Agarwal, et al. 2016), and other monitored and also

detected certain heart trouble. Knowing that cardiac

arrest is one of the most dangerous cardiac disorders,

several developed systems aim to detect them

(Dicardiology, 2017) (Magar, M. U. S. M., and

Shinde, U. B. 2016). Nevertheless, the detection of

other disorders such as tachycardia, bradycardia or

arrhythmia is just as important. Because it allows the

doctor or supervisor to anticipate more important

problems.

In this article we propose a monitoring system for

the elderly. The system is based on the new ANT +

technology, to monitor continuously and in real time

the state of the person. The monitoring allows to

detect the eventual cases of cardiac disorder

(Tachycardia, Bradycardia and Cardiac arrest). The

use of ANT + technology makes it possible to have a

system with a long autonomy of energy and therefore

a long period of monitoring without interruption.

In Chapter II, we discuss ANT + technology,

followed by technological implementation in Chapter

III. Chapter IV deals with experimental results, and

future work can be found in Chapter V.

2 ANT+ TECHNOLOGY

ANT + is a wireless sensor network technology,

designed to enable communication between self-

powered devices in an expandable network

environment, to facilitate the collection, automatic

transfer and tracking of sensor data to monitor all

personal information on the well-being. This ability

to transfer data between sensors is a feature based on

the ANT (Advanced and adaptive Network

Technology) protocol.

ANT is a wireless protocol at ultra-low power

(ULP) felt that is responsible for sending information

wirelessly from one device to another device, in

robust and flexible way (Thisisant, 2017). With

millions of nodes deployed, ANT is ideally suited to

all network topologies of low data rate sensors in

Personal Area Networks (PANs) well suited to sports,

fitness, wellness applications and home health care.

In addition, ANT is a convenient solution for local

area networks (LAN) in homes and industrial

automation applications. A convenient wireless

protocol 2.4GHz and embedded system solution,

ANT still has the opportunity to break into complex

network topologies and communication methods,

thereby reducing costs and power. It is capable of

being powered by a coin pile, working for several

years.

ANT + is said to be compact, with a small stack

size; Extensible, supporting complex network

topologies; Flexible, supporting ad hoc network

reconfiguration; Concentrated, not being a standard

development organization; And proved, because of

the millions of knots delivered worldwide.

ANT + is a set of mutually agreed definitions for

what the information sent on ANT represents. These

definitions are called device profiles and are usually

linked to a specific use case.

ANT + files are currently available for different

devices: Heart Rate Monitor, Fitness equipment

device, Bicycle power, Multi sport speed &Distance,

Weight scale, Blood pressure, geocache, etc.

This is a fairly recent technology and most of the

products available on the market focus on sport and

efficiency, instead of health and wellness. This has

resulted in more research (Mehmood and Culmone,

2015) (Belchior, et al., 2012) being done on this

technology and on the benefits it offers. In our

research we take advantage of this technology and its

application to health services.

3 BACKGROUND

As part of a study of the literature on the subject, we

have found some systems that use ANT + technology

for the purpose of providing assistance to people.

The system developed by (Priyadharshni, et

al.,2016 ) aims to monitor real-time and remote heart

rate, temperature and position of a patient. Its main

design is the follow-up of the heart attack during the

duct. In order to send help and stopped the car through

a controller.

The system uses ANT + and Bluetooth technology

for data transmission. Nevertheless, the ECG for a

normal state is set between 70bpm (beat per minute)

and 80bpm. Knowing that heart rate standards differ

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from one person to another, the interval set in this

study may not match all of the targeted user profiles.

Another study has also focused on the use of ANT

+ technology for data transmission. Legido created a

system that interacts with the patient (Lagido, 2013).

The patient uses devices such as a blood pressure

monitor and a scale to measure certain values (blood

pressure, heart rate, weight, etc.) when he wants it

during the day. These values are then sent to the

Smartphone and to a medical entity via the internet.

This system allows to provide assistance to the

elderly if the measures sent are not good. However,

surveillance is not real-time and non-stop, it depends

on the patient and when he decides to use the devices.

Our system not only provides continuous, real-

time heart rate monitoring. But also the advantage of

being intended for any type of profile. And this,

avoiding to use fixed thresholds. Rather, by offering

the medical entity in charge of the care, the possibility

of recording the exact cardiac standards that

correspond to the patient monitored.

4 TECHNOLOGICAL

IMPEMENTATION

4.1 Hardware

The prototype application uses the heart rate monitor

(Geonaute Digital Coded), a small, lightweight sensor

with built-in power supply to the chest. It utilizes the

conductive strap to calculate heart rate. The monitor

is powered by a coin battery that provides a usage

time of several years. It uses ANT + technology to

transmit the strap signal to the application. Once a

connection is established with an Android device, the

monitor will broadcast the data continuously, which

will be displayed in BTM (Beat per Minute).

4.2 Software

This application is designed on the Android software

stack produced by Google. Android is an open source

framework designed for mobile devices such as smart

phones and tablet computers. It packages an operating

system, middleware, and key programs (Android

developers. 2017). The Android service development

kit provides libraries needed to interface with the

hardware at a high level and make/deploy Android

applications (Hoog, 2011).

Application are written in Java and data concerning

localizations and configuration of the client is

synchronized with a server application. The server is

written in PHP, run on Apache server and uses a

MySQL database to store persistent data. The GSM

or WIFI connection is used following their

availability. We choose this platform as it is the most

widespread (Statista, 2016), and is supported by a

large community of developers and also to its

compatibility with other Android devices.

4.3 Heart Disorder Detection

Pulse measurement can be used to assess heart rate

regulation in a simple manner, ie heart rate (beats of

the heart per minute) and pulsation amplitude.

Assessment of the general condition of a person is

used to monitor the course of a cardiac disease, to

prevent and / or detect a complication (rhythm

disorder). Without proven heart disease can still

remove some anomalies in the frequency outside the

norms. (Bauer et al. 2008)

▪ Bradycardia: Decreased heart rate.

▪ Tachycardia: Acceleration of the heart rate.

▪ Cardiac arrest: no pulse.

There are heart rate standards for a person in good

health. Nevertheless these standards can not be used

in the development of an algorithm that aims to

monitor and detect cardiac disorders. Especially as

these generally occur in people with some health

problem or older people. After various research and

the opinion of several cardiologist doctors, one came

to the conclusion that for these types of person there

were no fixed standards and the thresholds can vary

from one individual to another. And so tried to set

them by ourselves in our algorithm was an error that

will generate several false positives, and that will

cause our application can not be used by any type of

user profile.

The solution offered by our system is to allow the

doctor or the person in charge of patient safety to

enter the standards, and thus the minimum and

maximum heart rate (Hmin and Hmax) specific to the

patient. These two thresholds will be stored in a

database with the rest of the patient profile

information. And used later in the detection of

possible cardiac disorders (Tachycardia, Bradycardia,

and cardiac arrest). For tachycardia, for example if

BPM (i) <Hmax and BPM (i + 1)> Hmax the system

starts a small timer, if a T = t the beats are always

greater than Hmax then a cardiac disorder

(tachycardia) is detected.

The detection of recurrent tachycardia and

bradycardia allows the overseer to anticipate other

more important health problems.

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297

4.4 Data Base

A database is a device for storing a set of information

in a structured manner. The databases for Android are

provided using SQLite (Owens and Allen, 2010). The

advantage of SQLite is that it is a very compact

DBMS and therefore very efficient for embedded

applications.

SQLite does not require a server to run, which

means that it runs in the same process as the

application. Therefore, a massive operation launched

in the database will have visible consequences on the

performance of your application. Thus, we had to

know how to master its implementation so as not to

penalize the rest of our execution.

For our application we have created a database to

record user profiles with several information (Name,

date of birth, max and min heart rate, etc.) (Figure1).

Figure 1: Screenshot profile information.

Some of these data such as minimum heart rate

and maximum heart rate are used in algorithms for the

detection of various disorders such as tachycardia or

bradycardia.

5 EVALUATION AND

EXPERIMENTAL RESULT

5.1 Experimental Setup

For reasons of safety, this study was carried out on

two persons of different sex and an average age of 29

years in good physical condition. And the max and

min thresholds used comply with safety

standards. During the tests the cardiac belt was

placed on the chest of the subject. Once the Android

app is running and the profile data for the user

counting the min and max thresholds recorded.

The application checks to see if the belt is

positioned on the person. If yes, a connection is

established and an interface opens automatically

displaying the change of the BPM (Figure 2). The

algorithm for detection of cardiac disorder is then

launched. If a heart trouble is detected, a toast is

displayed for a moment on the application interface.

Figure 2: Flow chart of the execution steps.

5.2 Experimental Result

For the evaluation of our application, we first set the

max and min thresholds and verify the correct

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functioning of the database. Once the data is recorded

they are used in our algorithm of detection of cardiac

disorder.

The Figure 3 shows a screenshot of the cardiac

monitoring interface, where we can see the thresholds

previously recorded in the profile as well as the BTMs

can be seen.

Knowing that a tachycardia is by definition an

acceleration of the heart rhythm, in our case study we

asked the subjects to make a physical effort

Figure 3: Screenshot of cardiac monitoring interface.

As a result, the observed increase in beats was

observed and once the maximum threshold was

exceeded, the Toast appears showing the detection of

a tachycardia (Figure 4).

The tests were performed several times with

different thresholds and the result was that, whenever

the beats are lower or above the set threshold a trouble

is detected after a short time t.

The results obtained during our tests show that the

system instantly detects some cardiac disorders

mainly Tachycardias and Bradycardias.

The detection of cardiac arrest has been included

in the algorithm of our system but the verification of

this part in a real and secure case study is almost

impossible. For now, the detection of the cardiac

disorder is displayed by a Toast (Figure 4), but this

validation is temporary. Services such as alarm

triggering and message sending, for example, will be

added to the application (see the next section for

details).

Figure 4: Screenshot of cardiac monitoring interface at

moment of tachycardia detection.

When the minimum threshold is set at 60 bpm for

example, and the patient beats below this threshold, a

disorder (Bradycardia) is detected. And that either

beats are slightly lower (example 55bpm) or really

lower (example 35bpm). This difference plays a very

important role in the consequence of the disorder on

the health of the patient. For this reason assistance

services will have to be adjusted to the application. In

order to interact with the user and checked his / her

state before sending the emergency services.

Real-time monitoring is very important because if

a disorder is not detected over time more serious

problems can arise. Our system not only aims,

monitored the condition of a person. But also to

provide him help if necessary. In the next section we

can see the main objectives of our system in order to

offer assistance to individuals.

6 FUTURE WORK

Our system provides a solution that can detect certain

cardiac disorders (tachycardia, bradycardia, and

cardiac arrest). Knowing that a severe disorder is

followed in most cases by a fall, we work on a

solution based on the accelerometer of the

smartphone which aims to detect the moments of fall

(Merrouche, et al., 2016)(Makhlouf, et al.,2017). The

fusion of the two algorithms will allow us to create a

Cardiac Disorder Detection Application and ANT+ Technology

299

table that classifies the various disorder and their

severity. This table will then be used in emergency

services.

The flexibility of the platform as well as the

applications of the hardware capacity of the phone

allows this system to be extended in many ways.

Several features such as emergency call, emergency

message, alarm and localization are under

development to be integrated into our application.

7 CONCLUSIONS

In conclusion, we presented an approach to the

detection of certain cardiac disorders using a

smartphone and a cardiac belt based on the ANT +

technology. For detection, we have modeled a system

that provides the ability to capture and record the

maximum and minimum heartbeat thresholds for a

patient who monitors his BTM in real time and

detects different disorders such as tachycardia,

Bradycardia or cardiac arrest.

The modeled system is implemented on an

Android platform, and uses the new ANT +

technology to transmit the heart rate data to our

application installed on the smartphone. The

application we have developed aims to monitor in real

time an elderly person, detected any problems and

provided help if necessary. Overall, the work in this

article provides an example of the great potential for

application of detection technology using mobile

phones for health care.

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