Wave Detection in Acceleration Plethysmogram

OBJECTIVES Acceleration plethysmogram (APG) obtained from the second derivative of photoplethysmography (PPG) is used to predict risk factors for atherosclerosis with age. This technique is promising for early screening of atherosclerotic pathologies. However, extraction of the wave indices of APG signals measured from the fingertip is challenging. In this paper, the development of a wave detection algorithm including a preamplifier based on a microcontroller that can detect the a, b, c, and d wave indices is proposed. METHODS The 4(th) order derivative of a PPG under real measurements of an APG waveform was introduced to clearly separate the components of the waveform, and to improve the rate of successful wave detection. A preamplifier with a Sallen-Key low pass filter and a wave detection algorithm with programmable gain control, mathematical differentials, and a digital IIR notch filter were designed. RESULTS The frequency response of the digital IIR filter was evaluated, and a pulse train consisting of a specific area in which the wave indices existed was generated. The programmable gain control maintained a constant APG amplitude at the output for varying PPG amplitudes. For 164 subjects, the mean values and standard deviation of the a wave index corresponding to the magnitude of the APG signal were 1,106.45 and ±47.75, respectively. CONCLUSIONS We conclude that the proposed algorithm and preamplifier designed to extract the wave indices of an APG in real-time are useful for evaluating vascular aging in the cardiovascular system in a simple healthcare device.