The poor quality of wireless electrocardiography (ECG) recordings can lead to misdiagnosis and waste of medical resources. This study presents an interpretation of Lempel-Ziv (LZ) complexity in terms of ECG quality assessment, and verifies its performance on real ECG signals. Firstly, LZ complexities for typical signals, namely high-frequency (HF) noise, low-frequency (LF) noise, power-line (PL) noise, impulse (IM) noise, clean artificial ECG signals, and ECG signals with various types of noise added (ECG plus HF, LF, PL, and IM noise, respectively) were analyzed. Then, the effects of noise, signal length, and signal-to-noise ratio (SNR) on the LZ complexity of ECG signals were analyzed. The simulation results show that LZ complexity for HF noise was obviously different from those for PL and LF noise. The LZ value can be used to determine the presence of HF noise. ECG plus HF noise had the highest LZ values. Other types of noise had low LZ values. Signal lengths of over 40 s had only a small effect on LZ values. The LZ values for ECG plus all types of noise increased monotonically with decreasing SNR except for LF and PL noise. For the test of real ECG signals plus three types of noise, namely muscle artefacts (MAs), baseline wander (BW), and electrode motion (EM) artefacts, LZ complexity varied obviously with increasing MA but not for BW and EM noise. This study demonstrates that LZ complexity is sensitive to noise level (especially for HF noise) and can thus be a valuable reference index for the assessment of ECG signal quality.
Keywords: Electrocardiography (ECG); Lempel–Ziv (LZ) complexity; Signal quality assessment; Signal-to-noise ratio (SNR).