INT. J. BIOAUTOMATION, 2019, 23(1), 61-70 doi: 10.7546/ijba.2019.23.1.

61-70

Continuously Tested and Used QRS Detection

Algorithm: Free Access to the MATLAB Code
Ivan Dotsinsky*, Todor Stoyanov

Bulgarian Academy of Sciences

Institute of Biophysics and Biomedical Engineering
Acad. Georgi Bonchev Str., bl. 105, Sofia, Bulgaria
E-mails: iadoc34@gmail.com, tstoyanov72@gmail.com
*
Corresponding author

Received: May 14, 2018 Accepted: October 01, 2018

Published: March 31, 2019

Abstract: Each ECG analysis begins with the detection of the QRS complex, which is the most
distinguishable wave for initial investigation. Long ago we published an algorithm for
ventricular beats (VB) detection in single ECG lead. The classification of normal QRS
complexes is based on the slope, the amplitude and the width of the ECG waves.
Other criteria recognize ventricular ectopic beats (EB) by presence of biphasic beats and
separate premature EB from the already detected QRS complexes. The aim of this paper is to
place the MATLAB program of our algorithm at disposal to the readers (supplementary
MATLAB codes) looking forward to more successful ECG investigations.

Keywords: Ventricular beat detection, QRS detection, Ectopic beat detection.

Introduction
Each automated as well as manual ECG analysis comprises the next main stages: onset and
offset detection of the waveforms; measurement of their amplitudes, widths, intervals and
interrelationships; comparison between the extracted values and statistically created datasets of
criteria to classify the found ECG morphology as normal or pathological heart activity. To be
successful, the ECG analysis begins with the detection of the QRS complex, which is the most
distinguishable wave for initial investigation.

One of the first software algorithms for QRS detection has been published by Caceres and
Dreifus in the early 1970 [9]. The differentiated ECG signal was divided into short intervals
where the absolute maximums higher than a dynamic threshold were assumed to belong to QRS
complexes. Nowadays the number of the elaborated, tested and reported QRS algorithms is
enormous that proves implicitly the impossibility to build an ideal QRS detector covering all
the variety of shapes encountered in practice.

Generally, each QRS detection algorithm includes two parts: preprocessing and decision rule.
The preprocessing is aimed to suppress the disturbances accompanying the ECG signals
acquisition, such as power line interference (PLI), drift, tremor and artefacts due to bad
electrode-to-skin contact (Nenova and Iliev [20], Bhoi et al. [8], Razavi and Mohammadi [22]).
Here the processing parameters are selected rather to enhance the difference between the QRS
complex and the other waveforms than to keep the informative ECG features.

The decision rules are highly varied. The commonly used algorithms interpret features extracted
from first or second derivative of the ECG signal (Köhler et al. [17], Arzeno et al. [5]).
As an example, Hamilton and Tompkins [14] reported a first derivative based squaring function

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for QRS detection. The last two decades have been proposed algorithms designed by filter
banks (Alfonso et al. [2]), wavelet transforms (Sumathi and Sanavullah [25], Sasikala and
Wahidabanu [24], Benali et al. [6]); artificial networks (Abibullaev and Seo [1]); Hilbert
transform (Benitez et al. [7]; Sahoo [23]); feature extraction (Paoletti and Marchesi [21],
Harikumar and Shivappriya [15]).

Kohler et al. [17] investigate the QRS complexes counting the number of high amplitude zero
crossings per segment in ECG signals, which are preliminary subjected to linear phase band
pass filtration to suppress the P- and T-waves together with the noise oscillations around the
zero line.

Kim and Shin [16] developed algorithm based on some spatiotemporal characteristic.
The power spectrum components of the ECG signal are currently assessed and the maximum
energy level within the 5÷25 Hz frequency band during a short time interval is accepted to
belong to QRS complex.

The Christov’s QRS detector [10] takes in consideration signals from one or more
simultaneously recorded channels. The signals are differentiated and their absolute values are
summed and compare to threshold with three components: adaptive slew-rate, correction
depending on the presence of high-frequency noise and criterion supporting the detection of
low amplitude QRS complexes. In another study [11] Christov reports new modifications of
the combined threshold method. The test carried out with the AHA database recordings
impresses with the obtained very high statistical indices.

Actually, the QRS detection represents a special case of ventricular beat (VB) recognition
(Christov [10]), which is followed by discrimination between normal sinus beats (NB) and
ectopic beats (EB) (Millet et al. [18], Dotsinsky and Stoyanov [13], Tanev [27]). This process
is the first step of both morphological and rhythm analysis. Epochs of sinus QRS complexes
are investigated for assessment of the heart rate variation (HRV). The EB are divided in
different types according to their shape and/or time of occurrence that is used further for rhythm
disorders discovery.

Tanev [27] describes very fast off-line procedure for accurate QRS detection in long term ECG
Holter recordings, followed by classification of the complexes in normal and ectopic beats. The
analysis of a 24 hour epoch needs no more than 7-8 min.

The efficiency of VB detection algorithms is usually tested with ECG signals taken from
internationally recognized databases, e.g., the AHA database, the MIT-BIH arrhythmia
database, the diagnostic PhysioNet database, etc. Generally, the performance of the algorithms
is assessed by calculating the true positive (TP), the true negative (TN), the false positive (FP)
and the false negative (FN) detections within the examined recording.
Then some indices are evaluated, for example the sensitivity Se = TP/(TP+FN) and the
specificity Sp = TN/(TN+FP), (Altman and Bland [4]); the positive and negative predictive
values PPV = TP/(TP+FP) and NPV = TN/(TN+FN), thus giving objective rating of the
algorithms accuracy.

As a rule, the TP, TN, FP and FN values are obtained by counting the coincidences between
the recognized and the annotated beats inside the used database. Because of the enormous data
array they have to be checked automatically.

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The annotations have varying positions towards the complexes, e.g., in the AHA database they
are mostly near to the onset of the R wave. Suppappola and Sun [26] advised the users to define
themselves the interval that includes the ventricular beats or to set default borders at
10 ms before and 140 ms after the annotated locations. Dotsinsky and Stoyanov [13], as well
as Christov [10] use specially designed software, which inserts windows surrounding the
marked complexes by 60 ms. The algorithm published by Tanev [27] allows deviation of
±30 ms between the classified beats and the corresponding annotations.

Most of the published methods for QRS detection demonstrate very high performance values
typically more than 95%.

There are numerous papers with extremely scientific contributions. Usually the theoretical
approaches are perfectly carried out, the details are correctly revealed, and the results obtained
are convincingly illustrated by tables and figures. However, a few of the reported studies may
be easily implemented in similar investigations since usually no programs or extracted parts of
them are available to the readers.

Long ago we published an algorithm for VB detection in single ECG lead (Dotsinsky and
Stoyanov [13]). The normal QRS classification is based on the slope, the amplitude and the
width of the ECG waves. Other criteria recognize ventricular EB by presence of biphasic beats
and separate premature EB from already detected QRS complexes. Finally, sinus beats (NB)
and all ectopic beats (EB) are discriminated in two categories. The algorithm was tested in
MATLAB environment by the entire AHA [3] and MIT-BIH [19] databases demonstrating
99.04% sensitivity and 99.62% specificity, but more important is that it was shared with closed
friends thus proving high efficiency in practice.

Aim of the this paper

We would like to place the MATLAB program (used version 7.0.0.19920 (R14)) of our
algorithm at disposal to the readers looking forward to more successful ECG investigations.

Brief description of the algorithm

Preprocessing
Comb filter with first zero at 50 Hz (60 Hz) is applied to eliminate the power-line interference,
followed by low-pas filtration with cut-off approximately at 40 Hz. The baseline drift is
suppressed using first order high-pass filter with cut-off at 2 Hz.

QRS detection
The algorithm for ventricular beat detection (Dotsinsky and Stoyanov [13]) improves
previously developed method for QRS detection (Dotsinsky [12]). Two identical in sign
differences between the ongoing sample Si and the adjacent samples Sin and Si+n are currently
calculated, where n is usually equal to the number of samples within the interference period.
The positions of the ongoing samples Si either coincide with or are very near to peaks of the
investigated ECG signal. The absolute SUM of the differences

SUM = 2Si  Si n  Si n for sign(S i Si n )  sign(Si  Si n )

is compared to appropriate adaptive threshold AT. QRS candidates are marked each time when
SUM > AT. Fig. 1 shows three QT intervals with difficult for detection QRS complexes.

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Fig. 1 Discrimination between different in shape QRS complexes and their T-waves

Nevertheless, the different SUM values ensure efficient discrimination between QRS and
T-waves. For better illustration of the principle based on high amplitude, steep edges and sharp
peak evaluation, the wave peaks are assumed to coincide with samples. Another sample
distribution over the QRS complex can be seen in Fig. 2a.

The initial value of AT is set to 0.2 mV (Dotsinsky and Stoyanov [13]). Except for occurrence
of very low peak amplitude, the threshold after each QRS detection becomes equal to 0.7 SUM.
It does not change for 200 ms to skip high-amplitude T-waves, decreasing further linearly in
accordance with different laws until and after the end of the first second.

A true beat candidate is expected to appear after a delay called DIST that is related to the
expected QT interval duration of the ongoing RR interval. Each beat candidate located to the
latest detected QRS complex nearer than DIST is ignored if its SUM is less than that of the latest
complex. Otherwise, the latest complex is discarded assuming it is a lower amplitude
component of the new candidate.

Further, the maximum value Vmax inside the interval of 120 ms around the candidate is found.
Its position is entered in buffer normal beats if Vmax > 80 µV and the number of zero crossings
N < 8. The first requirement allows the detection of low amplitude QRS complexes; the second
one is aimed to suppress electromyographic artifacts and other high frequency disturbances.

Ectopic beats detection

Another algorithm branch investigates ventricular EBs. It is activated 120 ms after each
detected QRS complex looking for biphasic wave consisting of three consecutive crossing of
thresholds with alternative polarity W1÷W3. Then the peaks A1 and A2 inside the thresholds are
located and their amplitudes as well as the intervals W1-W2 and A1-A2 (see Fig. 2b) are checked
for conformity with several criteria for EB identification. They are additionally aimed to cope
with either previously detected QRS complexes with low amplitude or encountered EBs with
sharp peak, after which the signal remains long time near to the zero line.

If the criteria are not met, W1 is discarded, while W2 and W3 are marked as W1 and W2.
They form the next two waves together with a new crossing W3. This cycle is repeated until EB
is detected. Its position is saved in buffer ectopic beats. Besides, it is entered in buffer
suspicious beats for additional analysis. The reason is that two consecutive VBs may occur at
distance shorter than DIST in case of long RR intervals, which include burst of EBs or EB
followed by compensatory pause.

Analogously, deviations of the QRS width and/or its maximum peak-to-peak amplitude may
erroneously classify normal QRS complex as ectopic beat. That is why other algorithm branch
compares the parameters of the currently detected QRS complexes with the corresponding
parameters of a template QRSe created during the first 12 detected beats to distribute the

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suspicious or erroneous beats in the true buffers. Among the used parameters are the maximum
positive and negative amplitudes, their peak-to-peak amplitudes and the number of zero
crossings.

Fig. 2a. Discovery of typical QRS complex Fig. 2b. Investigation of ectopic beats

MATLAB codes
Two MATLAB codes for VB detection are available in compressed format at
http://www.biomed.bas.bg/bioautomation/2019/vol_23.1/files/23.1_06.zip
together with associated ECG signals.

They are structured in two directories: version1 and version2. You can download every one of
them and run the corresponding VB1.m or VB2.m code from archive 23.1_06.zip:
Free access to QRS detection code/version1/VB1.m
Free access to QRS detection code/version2/VB2.m

Our original MATLAB program discussed in the publication (Dotsinsky and Stoyanov [13])
was adapted to work with all ECG recordings from AHA and MIT-BIH databases, representing
a lot of files of many Mbytes that have to be open in a complicated manner, specifically for the
MIT-BIH database.

Therefore we compiled the file VB1.m to operate with several selected recordings, which are
quite enough to discover the algorithm potential. The file execution starts with question about
the database to be used. A click on the button AHA gives access to 8 recordings.
Four recordings are available if the reader chooses the button MIT-BIH but not before selecting
one of the two channels replying to a second question. The code entitled %epoch length
(enclosed inside 174th and 186th lines) defines either the entire ECG file or its selected part to
be opened, analyzed and displayed. The results are shown in sequence of figures, which include
two curves, the non-used lead and the original processed and analyzed lead together with the
marked normal and ectopic beats. In a lot of cases the correct recognition may be visually
confirmed by the accompanying lead.

Below are presented results of ventricular beat detection obtained with VB1.m. Figs. 3 and 4
show the recognized normal QRS complexes and ectopic beats in epochs taken from the
recordings AHA A7006D1 and MIT­BIH 212D2. Please, pay attention to the signal displayed
in Fig. 4, where all QRS complexes are correctly detected regardless of the abrupt waveform
change after the 251th s.

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AHA A7006D1.DAT

[mV]
2

-2
60 61 62 63 64 65 66 67 68 69 70

upper trace (green) - the accompanying lead, lower trace (black) - the analyzed lead

4
[mV]

-2
70 71 72 73 74 75 76 77 78 79 80

normal QRS complexes are marked by *, ectopic beats by o

4
[mV]

-2
80 81 82 83 84 85 86 87 88 89 90
[s]

Fig. 3

MIT-BIH 212D2.DAT

4
[mV]

240 241 242 243 244 245 246 247 248 249 250

upper trace (green) - the accompanying lead, lower trace (black) - the analyzed lead

4
[mV]

250 251 252 253 254 255 256 257 258 259 260

normal QRS complexes are marked by *, ectopic beats by o

4
[mV]

260 261 262 263 264 265 266 267 268 269 270
[s]

Fig. 4

The second file VB2.m simplifies the algorithm implementation working with the
AHA/AHA6003d1 and MIT­BIH/203d1 recordings, which are preliminary opened and
secondary saved in a format suitable for analysis of reader’s files. Here the %epoch length
definition is inside 98th and 110th lines. The results of the investigated signals are demonstrated
in Figs. 5 and 6.

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AHA/A6003d1

[mV]
0

-2
90 91 92 93 94 95 96 97 98 99 100

2
[mV]

-2
100 101 102 103 104 105 106 107 108 109 110

normal QRS complexes are marked by * ectopic beats by o

2
[mV]

-2
110 111 112 113 114 115 116 117 118 119 120
[s]

Fig. 5

MIT-BIH/203d1

1
[mV]

-1

-2
150 151 152 153 154 155 156 157 158 159 160

1
[mV]

-1

-2
160 161 162 163 164 165 166 167 168 169 170

normal QRS complexes are marked by * ectopic beats by o

1
[mV]

-1

-2
170 171 172 173 174 175 176 177 178 179 180
[s]

Fig. 6

More detail can be found in the attached MATLAB codes provided with comments.

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Conclusion
We hope this paper may support the investigators in developing of complex ECG signal
analyses. The shared algorithm was tested with the entire AHA and MIT-BIH databases
demonstrating 99.04% sensitivity and 99.62% specificity.

The number of the attached to the first VB1.m version recordings is limited to save the space.
Still, we think they demonstrate quite enough the algorithm power, although the discrimination
between normal and ectopic beats can be improved. The reader can easily add other recordings
from the mentioned databases if necessary. The presence of the accompanying leads may
confirm the detection and classification considerations.

The two recorders attached to the second VB2.m version simplify the opening of files saved in
a wide accepted mode.

References
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Prof. Ivan Dotsinsky, MScEE, Ph.D., D.Sci.

E-mail: iadoc34@gmail.com

Ivan Dotsinsky obtained his M.Sc. degree from the Faculty of

Electrical Engineering, Technical University of Sofia. His Ph.D.
thesis was on the statistical assessment of the reliability of electrical
and electronic circuitry. In 1987 he obtained the Dr.Eng.Sci. degree
on Instrumentation of Electrocardiology. Since 1989, he has been a
Professor in Biomedical Engineering. Since 1994, he is a Professor
with the Centre of Biomedical Engineering and the Institute of
Biophysics and Biomedical Engineering, Bulgarian Academy of
Sciences. His interests are mainly in the field of acquisition,
preprocessing, analysis and recording of biomedical signals.

Senior. Assist. Prof. Todor Stoyanov, Ph.D.

E-mail: tstoyanov72@gmail.com

Todor Stoyanov graduated as M.Sc. from the Faculty of Electronics,

Technical University of Sofia, in 1999. Since then he is with the Centre
of Biomedical Engineering and the Institute of Biophysics and
Biomedical Engineering, Bulgarian Academy of Sciences. He is
Senior. Assist. Prof. since 2002. He obtained Ph.D. degree in 2005 on
computer aided processing and analysis of electrocardiograms.
His interests are in developing embedded systems for biomedical
signal analysis.

© 2019 by the authors. Licensee Institute of Biophysics and Biomedical Engineering,

Bulgarian Academy of Sciences. This article is an open access article distributed under the
terms and conditions of the Creative Commons Attribution (CC BY) license
(http://creativecommons.org/licenses/by/4.0/).

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