Relationships between the electrocardiogram and phonocardiogram: potential for improved heart monitoring

Improvements in current heart monitoring techniques could reduce the number of heart attacks and resulting deaths. The potential for using time intervals measured between waveforms of the electrocardiogram (ECG), phonocardiogram (PCG), and peripheral blood flow pulse (PP) for heart monitoring was studied. The waveform locations identified in the simultaneously recorded signals included the R- and T-wave peaks of the ECG, the first (S1) and second (S2) sounds of the PCG, and the systolic peak of the PP. The signals were found to be highly consistent from one cardiac cycle to the next. Further, the time intervals measured between the different signals were stable with time. Strong relationships were found between the intervals R to T and R to S2 and the R to R interval. In contrast, R to PP and R to S1 correlated poorly with the R to R but strongly with each other. Additional differences between the measured intervals were revealed by studying changes due to exercise and different body positions. The relationships between the measured intervals were found to be independent of PCG recording location. This study demonstrates the feasibility and potential of using the electrical-contractile indices of heart function for monitoring heart patients. Design of a computer-based monitor using the techniques specified in this study is discussed along with relative strengths and weaknesses of such a system.