A Simultaneous ECG-PCG Acquisition System with Real-Time Burst-Adaptive Noise Cancellation

Cardiac auscultation is an essential clinical skill, requiring excellent hearing to distinguish subtle differences in timing and pitch of heart sounds. However, diagnosing solely from these sounds is often challenging due to interference from surrounding noise, and the information may be limited. Most of the existing solutions that adaptively cancel external noise are either non-real-time or computationally intensive, making them unsuitable for implementation in a portable system. This work proposes an end-to-end system with a real-time adaptive noise cancellation pipeline integrated into a device that simultaneously acquires electrocardiogram (ECG) and phonocardiogram (PCG) signals. We employ a burst adaptive normalized least mean square algorithm that adjusts its adaptation in response to high-energy, non-stationary hospital noise. The algorithm's performance was initially assessed using datasets with artificially induced noise. Subsequently, the complete end-to-end system was validated using real-world hospital recordings captured with the dual-modality device. For PCG and ECG signals recorded from the device in noisy hospital settings, the proposed system achieved signal-to-noise ratio improvements of 37.01 dB and 30.32 dB, respectively. Furthermore, complexity analysis confirms the pipeline's suitability for embedded implementation. These results demonstrate the system's effectiveness in enabling reliable and accessible cardiac screening in noisy hospital environments typical of resource-constrained settings.