Real-Time, Single-Ear, Wearable ECG Reconstruction, R-Peak Detection, and HR/HRV Monitoring

Biosignal monitoring, in particular heart activity through heart rate (HR) and heart rate variability (HRV) tracking, is vital in enabling continuous, non-invasive tracking of physiological and cognitive states. Recent studies have explored compact, head-worn devices for HR and HRV monitoring to improve usability and reduce stigma. However, this approach is challenged by the current reliance on wet electrodes, which limits usability, the weakness of ear-derived signals, making HR/HRV extraction more complex, and the incompatibility of current algorithms for embedded deployment. This work introduces a single-ear wearable system for real-time ECG (Electrocardiogram) parameter estimation, which directly runs on BioGAP, an energy-efficient device for biosignal acquisition and processing. By combining SoA in-ear electrode technology, an optimized DeepMF algorithm, and BioGAP, our proposed subject-independent approach allows for robust extraction of HR/HRV parameters directly on the device with just 36.7 uJ/inference at comparable performance with respect to the current state-of-the-art architecture, achieving 0.49 bpm and 25.82 ms for HR/HRV mean errors, respectively and an estimated battery life of 36h with a total system power consumption of 7.6 mW. Clinical relevance: The ability to reconstruct ECG signals and extract HR and HRV paves the way for continuous, unobtrusive cardiovascular monitoring with head-worn devices. In particular, the integration of cardiovascular measurements in everyday-use devices (such as earbuds) has potential in continuous at-home monitoring to enable early detection of cardiovascular irregularities.