Semester: ICTE4 Aalborg University Copenhagen A.C. Meyers Vænge 15 2450 København SV Title: Semester Coordinator: Henning System for Reducing the Risk of Mortality due to Ischemic Olesen Heart Disease among the Elderly Secretary: Maiken Keller Project Period: 1 February 2017 – 30 June 2017 Semester Theme: Abstract: Master Thesis The world’s population is currently experiencing a trend towards ageing. People now live longer than Supervisor(s): ever before and it is expected that by 2050 one out of every five people will be at least 60-years-old. Per Lynggaard Respectively, of all age groups senior citizens experience the highest mortality rates. Among the global leading causes of death, the foremost is Project group no.: Ischemic Heart Disease. The focus of the current 4SER 4.8 Thesis is to develop a system – hereafter referred to as Vixi - that would aid in reducing the risk of death due to the aforementioned ailment. In order to do so, Members research is conducted into the nature of Ischemic (do not write CPR.nr.): Heart Disease, specifically the exact conditions that can lead to a fatal outcome, along with their Michaela Mihaylova Mihaylova pathology, as well as the technologies that can detect them. From the discovered diagnostic tools, the non- invasive ones are extracted so as to be applied within the service – these are preferred because the Vixi is intended for continuous daily monitoring. The Vixi system is based on the utilization of the following two devices: the smartwatch and the wearable ECG. The data gathered via their various sensors serves as input for Vixi’s main algorithm. The aforementioned algorithm is designed by the author; it can interpret sensor and user input in order to determine at any given moment whether its user is experiencing an ischemia-induced cardiac event that can lead to a fatal outcome. Additionally, within the current report a proposal for the accompanying system architecture is also provided. Pages: 82 Finished: 8 June 2017 When uploading this document to Digital Exam each group member confirms that all have participated equally in the project work and that they collectively are responsible for the content of the project report. Furthermore each group member is liable for that there is no plagiarism in the report. Table of Contents 1 Introduction ................................................................................................................................................................ 1 1.1 Background ....................................................................................................................................................... 1 1.2 Motivation .......................................................................................................................................................... 1 2 Problem Formulation ............................................................................................................................................. 3 2.1 Research Question .......................................................................................................................................... 3 2.2 Objectives ........................................................................................................................................................... 3 2.3 Delimitations .................................................................................................................................................... 4 3 Methodology ............................................................................................................................................................... 5 3.1 Qualitative and Quantitative Research .................................................................................................. 5 3.2 Primary and Secondary Research ............................................................................................................ 5 4 Ischemic Heart Disease .......................................................................................................................................... 7 4.1 Overview of the Human Vascular System ............................................................................................. 7 4.2 Ischemic Heart Disease ............................................................................................................................. 10 4.2.1 Angina ..................................................................................................................................................... 10 4.2.2 Acute Myocardial Infarction .......................................................................................................... 11 4.2.3 Sudden Cardiac Death ...................................................................................................................... 13 4.3 Overview of Ischemic Heart Disease and Accompanying Symptoms .................................... 14 5 State of The Art ....................................................................................................................................................... 16 5.1 Positioning Methods ................................................................................................................................... 16 5.1.1 Global Navigation Satellite Systems ........................................................................................... 16 5.1.2 NLOS Positioning Methods ............................................................................................................. 17 5.1.3 Indoor Positioning Methods .......................................................................................................... 19 5.2 Measuring an Electrocardiogram and Heart Rate .......................................................................... 20 5.2.1 Measuring an Electrocardiogram ................................................................................................ 20 5.2.2 Measuring Heart Rate ....................................................................................................................... 22 5.3 Fall Detection ................................................................................................................................................. 23 5.3.1 Existing Solutions ............................................................................................................................... 23 5.4 Smartwatch Capabilities ........................................................................................................................... 28 6 Analysis ...................................................................................................................................................................... 31 6.1 Integration of parameters to be measured Within the Intended devices ............................ 31 6.1.1 Detecting Alarming Pulse Patterns through a PPG .............................................................. 31 6.1.2 Diagnosing an AMI through an ECG ............................................................................................ 32 6.1.3 Vixi Devices and the User ................................................................................................................ 34 6.2 Elderly Survey ............................................................................................................................................... 34 6.2.1 Hypotheses ........................................................................................................................................... 35 i 6.2.2 Contents and Results from the Survey ...................................................................................... 35 6.2.3 Revised Hypotheses .......................................................................................................................... 45 6.3 Expert Interview .......................................................................................................................................... 48 6.4 Scenarios ......................................................................................................................................................... 50 6.5 System Context Diagram ........................................................................................................................... 52 6.6 Use Cases ......................................................................................................................................................... 53 6.7 Requirements Specification ..................................................................................................................... 56 6.7.1 Functional Requirements ............................................................................................................... 57 6.7.2 Nonfunctional Requirements ........................................................................................................ 58 7 Design and Implementation .............................................................................................................................. 60 7.1 System Architecture ................................................................................................................................... 60 7.2 Algorithm for Detecting a Critical Event ............................................................................................ 63 7.2.1 Fall Detection Algorithm ................................................................................................................