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Designing of a single arm single lead ECG system for wet and dry electrode: A
comparison with traditional system

Article  in  Biomedical Engineering Applications Basis and Communications · June 2016

DOI: 10.4015/S1016237216500216

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Biomedical Engineering: Applications, Basis and Communications, Vol. 28, No. 3 (2016) 1650021 (10 pages)
DOI: 10.4015/S1016237216500216

DESIGNING OF A SINGLE ARM SINGLE LEAD ECG

SYSTEM FOR WET AND DRY ELECTRODE:
A COMPARISON WITH TRADITIONAL SYSTEM

Gautham A* and Karthik Raj V

Department of Biomedical Engineering
SRM University, Chennai, India
*[email protected]

Accepted 9 June 2016

Published 24 June 2016

ABSTRACT
Electrocardiography is a non-invasive medical diagnostic procedure used to record the electrical activity of the heart as
a waveform. An electrocardiogram (ECG) can be utilized to evaluate the electrical activity of the heart, also the rate
and regularity of the heart beat and other related diagnoses. ECG systems have evolved along since its invention and
researches are going on continuously to decrease the complexity of ECG systems. This paper discusses the designing of
a single arm single lead ECG system to acquire ECG signals from areas of left arm alone. The proposed system uses pre-
gelled disposable surface electrodes and dry copper electrodes. The single arm approach in ECG acquisition reduces the
complexity of the system to a greater extent and also improves the ease of use and patient comfort. The paper discusses
the various designing aspects and the working of the single arm single lead ECG system. A hardware only approach has
been used here in the design of the ECG system. ECGs were obtained from 10 healthy subjects using the proposed
system, which were compared along with ECG acquired from a commercially used system. The obtained ECG had
morphological features similar to a normal ECG waveform. The results of the comparison were very promising and all
the values recorded were in the normal range of values for the respective parameters in comparison.

Keywords: Electrocardiogram; Single lead; Hardware; Left arm; Wet electrode; Dry electrode.

INTRODUCTION T wave and a U wave as shown in Fig. 1. The rela-

tionship between the di®erent sections composing the
An electrocardiograph is a medical device which can be waveform can be used to determine heart rate as well as
used to obtain the electrical activity of heart. The recorded distinguish various cardiac arrhythmias. The 12 lead
visual output of the electrocardiograph is called an elec- ECG system is the most popular method of ECG ac-
trocardiogram (ECG). ECGs are mostly used to assess quisition, which uses 10 electrodes to acquire all the 12
heart rhythm, to diagnose poor blood °ow to heart muscles lead ECG information namely lead 1, lead 2, lead 3,
(ischemia) and to diagnose heart abnormalities.1 ECGs are AVR, AVL, AVF, V1-V6.2 Therefore, arises a need for
obtained by measuring electrical potentials between vari- developing a new system with reduced number of elec-
ous parts of the body. Di®erent types of electrodes like pre- trodes, less complexity and increased ease of use.
gelled electrodes, clip electrodes, bulb electrodes and ¯lm ECG gives information about the working of the
electrodes are commonly used for the purpose of obtaining heart and thus has always been worthwhile to
electrical activity from various parts of the body. researchers. Research has been going on since the advent
A typical ECG tracing of a normal heartbeat (or of the ECG machines. Augustus Desir
e Waller was the
cardiac cycle) consists of a P wave, a QRS complex, a ¯rst to discover that the electrical activity of the human

*Corresponding author: Gautham A, M.Tech Biomedical Engineering, Department of Biomedical Engineering, SRM University,
Kattankulathur, Kancheepuram District, Tamil Nadu 603203, India.

1650021-1
Gautham A. & Karthik Raj V.

Fig. 2 General block diagram of single arm single lead ECG system.

¯lters and ampli¯ers with necessary gain parameters to

Fig. 1 A typical ECG waveform. e®ectively obtain the ECG from positions on the left
arm. The obtained ECG waveform will be visualized
heart could be recorded by the capillary electrometer using a digital storage oscilloscope (DSO) or using a NI
without opening the chest to expose the heart.3 He was ELVIS and LabVIEW software. The general block dia-
the ¯rst to record the electrical activity of the human gram of the single arm single lead ECG system is shown
heart in 1887. Dissatis¯ed with this model, Einthoven in Fig. 2.
created a string galvanometer in 1903 which further lead
the way to the evolution of ECG systems.4 Recent
researches have shown the practical possibility of Block Diagram
obtaining ECG from various positions of a body includ-
The detailed block diagram of the single arm single lead
ing arm region.5,6 Dry electrode technology is an emerg-
ECG system has been shown in Fig. 3. The block dia-
ing area that can be associated with the single arm ECG
gram constitutes the basic supporting circuitry that is
acquisition. Dry electrodes7–9 can be e®ectively used to
needed to make the single arm ECG system work. The
implement low cost single arm ECG system. Researchers
gains of each sub circuit have been depicted in Fig. 3.
have been working on dry electrode technology in ECG
systems10,11 but those are not very economic. Most of the
research works using dry electrodes for ECG acquisitions Circuit Architecture
incorporated the use of digital ¯ltering techniques in
denoising and obtaining a clean ECG waveform. Voltage follower
This paper describes about the designing of a single A voltage follower also called a unity-gain ampli¯er or a
arm single lead ECG system. The single arm single lead bu®er ampli¯er is an op-amp circuit which has a voltage
ECG system uses the lead 2 con¯guration from the 12 lead gain of 1. The voltage follower e®ectively eliminates any
ECG system to obtain ECG from the left arm. Further to impedance mismatch at the input. Here the inputs
reduce the complexity, the acquisition is done from areas positive (þÞ and negative (
) are fed through respective
of the left arm. Pre-gelled disposable type surface elec- voltage followers. The outputs of the voltage followers
trodes and dry copper electrodes are used to acquire the are fed to their respective inputs at the next stage. The
body electric potentials. Studies have shown that ECG circuit for a voltage follower is shown in Fig. 4.
can be acquired from various positions on the left arm.12,13
ECG waveform tends to vary with the type of electrode
being used and the position of acquisition. This paper will Instrumentation ampli¯er
enumerate in detail about the various designing aspects of Biosignal or the signals that are acquired from the body
a single arm single lead ECG system. usually are very weak and has low frequency and low
signal strength, a preampli¯er helps in obtaining a clear
biosignal by removing common mode noises and ampli-
MATERIALS AND METHODOLOGY ¯cation with di®erent gain as set by the user needs. An
The methodology used in the designing of the single arm AD 620 instrumentation ampli¯er has been used here
single lead ECG system is the incorporation of active for the purpose of a preampli¯er. The inputs to the

1650021-2
 Designing of a Single Arm Single Lead ECG System for Wet and Dry Electrode

Fig. 3 Detailed block diagram of single arm single lead ECG system.

instrumentation ampli¯er are given from the output of High pass ¯lter
voltage follower at the previous stage, represented in
A high-pass ¯lter only allows frequencies above its cuto®
Fig. 5 as V2. The required gain (G) here is þ100,
frequency to pass through it. The high-pass ¯lter serves
49:400 the circuit by removing baseline wander and blocking
G¼1þ : ð1Þ
Rg noises due to motion artifacts.14 The input to the high-
pass ¯lter is obtained from the instrumentation ampli¯er
The required gain (G) here is þ100. Therefore from output, represented in Fig. 6 as V3. A second order ac-
Eq. (1), we get Rg ¼ 498:98   500 . tive Butterworth high pass ¯lter has been used in the
circuit, with cuto® frequency at 2 Hz.
The gain of a second order Butterworth high pass
¯lter is given as Av ¼ 1:586.
R2
Av ¼ 1 þ : ð2Þ
R1
From Eq. (2), assuming R1 ¼ 22 K, we get R2 as
13 K. The cuto® frequency of the Butterworth high
pass ¯lter is given as Eq. (3)
1
Fig. 4 Circuit diagram for voltage follower. Fc ¼ pffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi : ð3Þ
2
R3 R4 C 1 C 2

Fig. 5 Circuit diagram for instrumentation ampli¯er. Fig. 6 Circuit diagram of second order Butterworth high pass ¯lter.

1650021-3
Gautham A. & Karthik Raj V.

Assuming R3 ¼ R4 and C1 ¼ C2 , Eq. (3) becomes

1
FC ¼ : ð4Þ
2
R3 C1
In Eq. (4), required Fc ¼ 2 Hz. Therefore, C1 ¼ C2 ¼
10 F, R3 ¼ R4 ¼ 8 K.

Low pass ¯lter

A low pass ¯lter allows only frequencies below its cuto®
frequency to pass through it. The low pass ¯lter serves
the circuit by limiting the frequency of the circuit by
45 Hz, and thereby preventing any other noises being
added to the signal of interest. Usually the standard Fig. 7 Circuit diagram of second order Butterworth low pass ¯lter.
clinical bandwidth for the 12-lead clinical ECG is
0.05 Hz to 100 Hz whereas the monitoring system
applications use a bandwidth of 0.5–50 Hz.15 Many of Assuming R2 ¼ R3 and C1 ¼ C2 , Eq. (6) becomes
the research papers12,16,17 use di®erent bandwidths for 1
ECG which is relevant and suitable for their studies. For Fh ¼ : ð7Þ
2
R2 C1
the high pass ¯lter, the cut-o® frequency is ¯xed at 2 Hz
so as to reduce baseline wandering and motion artifacts. In Eq. (7), required Fh ¼ 45 Hz. Therefore C1 ¼ C2 ¼
So this system designed here is for monitoring applica- 0:1 F, R2 ¼ R3 ¼ 35:37 K  36 K.
tions only. Three second order active Butterworth low
pass ¯lters have been cascaded in the circuit to get an
e®ective sixth order low pass ¯lter. An additional second Notch ¯lter
order ¯lter is added optional to the circuit to obtain an
A notch ¯lter is a type of band stop ¯lter with a very
e®ective eighth order ¯lter which can be used during
steep notch at a particular frequency. It is used to at-
acquisition at noisy environments. Even though we are
tenuate or eliminate particular frequency, generally
¯xing the cuto® frequency for low pass ¯lter as 45 Hz, it
50 Hz. Notch ¯lter eliminates the most common problem
will allow some frequencies above 45 Hz to pass through
of power line interferences from the signal of interest.
it since it is not an ideal low pass ¯lter and also
This ¯lter is an optional one if the power line inter-
depending upon the component tolerance values, it will
ferences comes into picture. In our circuit, a twin-T
vary. For that reason, later part of the circuit, there is an
notch circuit has been used. The input to the notch ¯lter
optional notch ¯lter with cut-o® frequency 50 Hz which
is given from the output of the e®ective sixth order low
is placed to remove the power line interference if it comes
pass ¯lter. The twin-T ¯lters output is fed to a unity
into picture. The input to the ¯rst low pass ¯lter is fed
gain ampli¯er. The output of sixth order low pass ¯lter
from the output of high pass ¯lter from the previous
represented in Fig. 8 as V5* is fed as the input to the
stage, represented in Fig. 7 as V4. The output of the ¯rst
notch ¯lter.
low pass ¯lter is shown in Fig. 7 as V5. The e®ective
output of the sixth order low pass ¯lter (output at the
end of third low pass ¯lter) is represented as V5*.
The gain of a second order Butterworth low pass
¯lter is given as Af ¼ 1:586.
Rf
Af ¼ 1 þ : ð5Þ
R1

From Eq. (5), assuming R1 ¼ 22 K we get Rf as 13 K.

The cuto® frequency of the Butterworth low pass ¯lter is
given as Eq. (6)
1
Fh ¼ pffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi : ð6Þ
2
R2 R3 C1 C2
Fig. 8 Circuit diagram of twin T notch ¯lter.

1650021-4
 Designing of a Single Arm Single Lead ECG System for Wet and Dry Electrode

For a notch ¯lter, Noise reduction

1 ECG systems usually have too much noise interferences
Fc ¼ : ð8Þ
2
RC which should be eliminated to get a clean ECG wave-
Here Fc ¼ 50 Hz in Eq. (8) and R & C should be selected form output. In the single arm single lead ECG system,
such that R/2 and 2C are also possible resistance and we have used the following methods to reduce the
capacitor values. interferences in ECG signal.
Assuming R ¼ R1 ¼ R2 ¼ 68 K and C ¼ C1 ¼ Electrodes for the acquisition were placed closer to
C2 ¼ 0:047 F we get R=2 ¼ R3 ¼ 34 K and 2C ¼ the shoulder to reduce the EMG noise interference from
C3 ¼ 0:1 F. the arm muscles. Magnetically induced interferences
were removed by twisting the electrode lead wires to-
gether.18–20 And ¯nally the acquisition procedure was
Non-inverting ampli¯er conducted with the subject in sitting position at a re-
The non-inverting ampli¯er is the ¯nal stage ampli¯er. laxed state, which reduces the noise and other inter-
A non-inverting ampli¯er simply ampli¯es the incoming ferences to a great extent.
signal based on the gain value set to it. The non-
inverting ampli¯er here has variable gain since the gain
values needed for wet electrodes and dry electrode are NI ELVIS
di®erent. The output from the notch circuit, represented The National Instruments Educational Laboratory
in Fig. 9 as V6 is fed to the non-inverting terminal of the Virtual Instrumentation Suite (NI ELVIS) is a hands-on
last stage ampli¯er. design and prototyping platform that integrates the 12
The gain of a non-inverting ampli¯er is given in most commonly used instruments including oscilloscope,
Eq. (9). digital multimeter, function generator, bode analyzer,
Rf and more into a compact form factor ideal for the lab or
Acl ¼ 1 þ : ð9Þ classroom. It connects to your PC through USB con-
R1
nection, providing quick and easy acquisition and dis-
The gain for the non-inverting ampli¯er is kept variable play of measurements.
with four values of 11, 101, 151 and 221. Keeping the The supporting circuit needed for the single arm
R1 ¼ 1 K, the value of Rf for the speci¯ed gains single lead ECG system to work properly was ¯rst as-
would be almost equal to 10 K, 100 K, 150 = K and sembled over an NI ELVIS board and interfaced with a
220 K, respectively. laptop for further recording and analysis which is shown
in Fig. 10.
Power supply
The circuit uses a dual power supply ( 9V) to power Biomedical workbench
the circuit for its proper functioning. Two 9 volts battery
The LabVIEW biomedical toolkit is a collection of
were used for this purpose.
ready-to-run applications, utilities and algorithms
designed to simplify the use of LabVIEW software in

Fig. 9 Circuit diagram of non-inverting ampli¯er. Fig. 10 Single arm single lead ECG circuit on NI ELVIS board.

1650021-5
Gautham A. & Karthik Raj V.

physiological DAQ, signal processing and image pro-

cessing. The toolkit includes applications commonly
used in teaching physiology, bioinstrumentation and
biomedical signal processing and provides researchers
with tools to create powerful custom LabVIEW appli-
cations to accelerate their research. Ready-to-run
applications include the Biosignal Data logger and
Player, File Viewer, Biosignal Generator, ECG Feature
Extractor and Heart Rate Variability Analyzer.
The ECG signals were recorded using the signal
logger application from the biomedical toolkit interfaced (A)

with the NI ELVIS board with circuit. The ECG signals

were recorded for a time period of 3 minutes. The
recorded ECG signals were analyzed using the ECG
feature extraction tool from the biomedical tool kit in
LABVIEW for collecting information such as heart rate,
PR internal, QRS width, RR mean and QT interval.

RMS vesta 301i

The vesta 301i (shown in Fig. 11) from recorders and
medicare systems (RMS) India is a three channel ECG (B)
system. The vesta 301i is commercially available and are Fig. 12 Wet and Dry electrodes used in the study. (A) Pre-gelled
used in hospitals and other healthcare organizations. disposable surface electrode and (B) Dry copper electrode used in the
This system can be used for 12 lead simultaneous ac- study.
quisition and real-time ECG monitoring. It also has an
optional PC connectivity with which the ECG acquisi- Electrodes
tion and analysis can be performed on a PC.
For the comparison purpose, the limb lead systems of Two types of electrodes were used in the study. Firstly
the RMS vesta 301i was used. The lead two con¯gura- a pre-gelled disposable surface electrode (shown in
tion from the 12 lead ECG system was used for recording Fig. 12(A)), which had foam back, single use and
the ECG from RMS Vesta 301i system. The ECG was economic. Secondly a dry copper electrode (shown in
acquired from the subjects in sitting position on an up- Fig. 12(B)) which did not need any gel interfaced be-
right chair in relaxed state. The heart rate and other tween the skin. The dry electrode was of rectangular size
ECG parameters compared in the study were analyzed measuring 2:5  2:7 cms.
with the software package of the RMS ECG system
in a PC. Positioning of Electrodes
The single arm single lead ECG system acquires ECG
from areas of the left hand. The lead two con¯guration
from the 12 lead ECG system was taken for the acqui-
sition purpose. Pre-gelled disposable surface electrodes
and dry copper electrodes were used as electrodes.
In the placement of electrodes, the left leg electrode
corresponds to the positive electrode (þ), the right arm
electrode corresponds to the negative electrode (
) and
the reference electrode (REF) corresponds to the ground.
Figure 13 shows the placement con¯gurations of the
electrodes on the left arm. From Fig. 13, RA (
), LL (þÞ
and REF A constitutes the ¯rst placement con¯guration
and RA (
), LL (þÞ and REF B constitutes the second
Fig. 11 RMS vesta 301i ECG system. placement con¯guration of electrodes to obtain ECG.

1650021-6
 Designing of a Single Arm Single Lead ECG System for Wet and Dry Electrode

Fig. 14 Printed circuit board for the single arm single lead ECG
system.

board for the single arm single lead ECG system is

shown in Fig. 14.
ECGs were obtained from each subject for both the
Fig. 13 Positioning of electrodes on left arm. placement con¯gurations of electrode.
The output ECGs of all the subjects had distin-
guishable morphological features of an ECG waveform.
During the acquisition of ECG, the negative electrode The obtained ECG waveforms from all the subjects had
(
) is placed approximately 2 cm away from the armpit well-de¯ned P waves, QRS complexes, ST segments
on the inner biceps and the positive electrode (þ) is which can be seen from Figs. 15–18.
placed diametrically opposite on the outer biceps. The The acquisition procedure was conducted at normal
position of the positive and the negative electrodes are laboratory condition with the subjects in sitting position
kept closer to the shoulder so as to reduce the EMG at rest and relaxed state.
interferences from the arm muscles. The ECG is ac- In the bar chart, the ECG parameters obtained from
quired using the system with two di®erent placements of pre-gelled disposable electrodes with placement con¯g-
electrodes with di®erent positions for the reference uration one and two are represented as WET REF A
electrode (REF). For the ¯rst placement con¯guration, and WET REF B, respectively. Also the ECG para-
the reference electrode (REF A) is placed in the middle meters obtained from dry copper electrodes with place-
part to the elbow and biceps considering centered be- ment con¯guration one and two are represented as DRY
tween positive (þ) and negative electrodes (
), and for REF A and DRY REF B, respectively.
the second placement con¯guration, the reference elec- The ECG parameters taken for the comparison are
trode (REF B) placed in between the positive (þ) and heart rate, PR interval, QRS width, RR mean and QT
negative electrodes (
) with equal distances between interval. The normal ranges for the considered para-
them forming a straight line. meters are 60–90 beats per minute for heart rate, be-
tween 120 and 200 ms for PR interval, less than 120 ms
for QRS width and less than 440 ms for QT interval.
The bar charts of comparison show the values of each
RESULT parameter compared for ECG obtained from pre-gelled
The outputs obtained from the designed single arm disposable electrodes and dry copper electrodes for the
single lead ECG have been enumerated in this section. placement positions discussed in the study along with
The designed system was successfully used to obtain the values obtained from the commercially used RMS
ECGs from the left arm of subjects. ECGs were taken vesta 301i ECG system. It can be very evidently seen
from 10 healthy subjects, all of them in relaxed sitting from the comparison bar charts that the values from the
posture during the acquisition. A total of ten subjects proposed study and the commercial system come in the
were included in the study. The ¯nal printed circuit normal range of corresponding parameters.

1650021-7
Gautham A. & Karthik Raj V.

Fig. 15 ECG output from ¯rst placement con¯guration of electrodes using pre-gelled disposable surface electrodes (REF A).

Fig. 16 ECG output from second placement con¯guration of electrodes using pre-gelled disposable surface electrodes (REF B).

Fig. 17 ECG output from ¯rst placement con¯guration of electrodes using dry copper electrodes (REF A).

1650021-8
 Designing of a Single Arm Single Lead ECG System for Wet and Dry Electrode

Fig. 18 ECG output from second placement con¯guration of electrodes using dry copper electrodes (REF B).

100 1200

RR Means (ms)
Heart rate (BPM)

80 1000
60 800
DRY REF B 600 DRY REF B
40 400
DRY REF A DRY REF A
20 200
0 WET REF B 0 WET REF B
subject 1
subject 2
subject 3
subject 4
subject 5
subject 6

subject 9

subject 1
subject 2
subject 3
subject 4
subject 5
subject 6

subject 9
subject 10

subject 10
subject 7
subject 8

subject 7
subject 8
WET REF A WET REF A
RMS RMS

Subjects Subjects

Fig. 19 Comparison bar chart for heart rates. Fig. 22 Comparison bar chart for RR means.

180 500
160
QT Interval (ms)
PR Interval (ms)

140 400
120
100 300 DRY REF B
DRY REF B
80 200
60 DRY REF A DRY REF A
40 100
20 WET REF B WET REF B
0
0
subject 1
subject 2
subject 3
subject 4
subject 5
subject 6

subject 9
subject 10

WET REF A WET REF A

subject 7
subject 8
subject 1
subject 2
subject 3
subject 4
subject 5
subject 6

subject 10
subject 7
subject 8
subject 9

RMS RMS

Subjects
Subjects
Fig. 23 Comparison bar chart for QT intervals.
Fig. 20 Comparison bar chat for PR intervals.

140
QRS WIDTH (ms)

120 DISCUSSIONS
100
80 DRY REF B
60 Stable and clean ECG waveforms were successfully ac-
40 DRY REF A quired using the designed system from 10 subjects on
20
0 WET REF B di®erent placement con¯gurations of electrodes. Precise
subject 1
subject 2
subject 3
subject 4
subject 5
subject 6

subject 9
subject 10
subject 7
subject 8

WET REF A positioning of the electrodes and empirical adjustments

RMS in the positioning of the electrodes during the acquisition
procedure will lead to more accurate ECG waveforms.
Subjects
The comparison of the proposed system to the com-
Fig. 21 Comparison bar chart for QRS widths. mercially used system yielded results in good agreement

1650021-9
 Gautham A. & Karthik Raj V.

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