{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T22:25:52Z","timestamp":1777415152833,"version":"3.51.4"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Multiple wearable devices for cardiovascular self-monitoring have been proposed over the years, with growing evidence showing their effectiveness in the detection of pathologies that would otherwise be unnoticed through standard routine exams. In particular, Electrocardiography (ECG) has been an important tool for such purpose. However, wearables have known limitations, chief among which are the need for a voluntary action so that the ECG trace can be taken, battery lifetime, and abandonment. To effectively address these, novel solutions are needed, which has recently paved the way for \u201cinvisible\u201d (aka \u201coff-the-person\u201d) sensing approaches. In this article we describe the design and experimental evaluation of a system for invisible ECG monitoring at home. For this purpose, a new sensor design was proposed, novel materials have been explored, and a proof-of-concept data collection system was created in the form of a toilet seat, enabling ECG measurements as an extension of the regular use of sanitary facilities, without requiring body-worn devices. In order to evaluate the proposed approach, measurements were performed using our system and a gold standard equipment, involving 10 healthy subjects. For the acquisition of the ECG signals on the toilet seat, polymeric electrodes with different textures were produced and tested. According to the results obtained, some of the textures did not allow the acquisition of signals in all users. However, a pyramidal texture showed the best results in relation to heart rate and ECG waveform morphology. For a texture that has shown 0% signal loss, the mean heart rate difference between the reference and experimental device was \u2212\u00a01.778\u2009\u00b1\u20094.654 Beats per minute (BPM); in terms of ECG waveform, the best cases present a Pearson correlation coefficient above 0.99.<\/jats:p>","DOI":"10.1038\/s41598-021-85697-2","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T16:48:15Z","timestamp":1616086095000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Design and evaluation of a novel approach to invisible electrocardiography (ECG) in sanitary facilities using polymeric electrodes"],"prefix":"10.1038","volume":"11","author":[{"given":"Aline","family":"dos Santos Silva","sequence":"first","affiliation":[]},{"given":"Hugo","family":"Almeida","sequence":"additional","affiliation":[]},{"given":"Hugo Pl\u00e1cido","family":"da Silva","sequence":"additional","affiliation":[]},{"given":"Ant\u00f3nio","family":"Oliveira","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"85697_CR1","unstructured":"World Health Organization. Top 10 causes of death fact sheet (). https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/the-top-10-causes-of-death. Accessed 24 January 2021."},{"key":"85697_CR2","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/s41569-020-0428-2","volume":"18","author":"WJ McKenna","year":"2021","unstructured":"McKenna, W. J. & Judge, D. P. Epidemiology of the inherited cardiomyopathies. Nat. Rev. Cardiol. 18, 22\u201336. https:\/\/doi.org\/10.1038\/s41569-020-0428-2 (2021).","journal-title":"Nat. Rev. Cardiol."},{"key":"85697_CR3","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1007\/s11883-020-00889-x","volume":"22","author":"K Santo","year":"2020","unstructured":"Santo, K. & Redfern, J. Digital health innovations to improve cardiovascular disease care. Curr. Atheroscler. Rep. 22, 71. https:\/\/doi.org\/10.1007\/s11883-020-00889-x (2020).","journal-title":"Curr. Atheroscler. Rep."},{"issue":"21","key":"85697_CR4","doi-asserted-by":"publisher","first-page":"2012","DOI":"10.1161\/CIRCULATIONAHA.114.008723","volume":"132","author":"JD Piette","year":"2015","unstructured":"Piette, J. D. et al. Mobile health devices as tools for worldwide cardiovascular risk reduction and disease management. Circulation 132(21), 2012\u20132027. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.114.008723 (2015).","journal-title":"Circulation"},{"issue":"2","key":"85697_CR5","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1002\/joa3.12035","volume":"34","author":"A Bansal","year":"2018","unstructured":"Bansal, A. & Joshi, R. Portable out-of-hospital electrocardiography: A review of current technologies. J. Arrhythm. 34(2), 129\u2013138. https:\/\/doi.org\/10.1002\/joa3.12035 (2018).","journal-title":"J. Arrhythm."},{"key":"85697_CR6","unstructured":"Apple. Using Apple Watch for Arrhythmia Detection. https:\/\/www.apple.com\/nz\/healthcare\/docs\/site\/Apple_Watch_Arrhythmia_Detection.pdf. Accessed 24 Jan 2021."},{"issue":"23","key":"85697_CR7","doi-asserted-by":"publisher","first-page":"2224","DOI":"10.1093\/eurheartj\/ehaa290","volume":"41","author":"M Drexler","year":"2020","unstructured":"Drexler, M. et al. Apple Watch detecting coronary ischaemia during chest pain episodes or an apple a day may keep myocardial infarction away. Eur. Heart J. 41(23), 2224. https:\/\/doi.org\/10.1093\/eurheartj\/ehaa290 (2020).","journal-title":"Eur. Heart J."},{"issue":"8","key":"85697_CR8","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1161\/CIRCULATIONAHA.119.044126","volume":"141","author":"DR Seshadri","year":"2020","unstructured":"Seshadri, D. R. et al. Accuracy of Apple Watch for detection of atrial fibrillation. Circulation 141(8), 702\u2013703. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.119.044126 (2020).","journal-title":"Circulation"},{"key":"85697_CR9","unstructured":"Fadhil, A. Beyond Technical Motives: Perceived User Behavior in Abandoning Wearable Health & Wellness Trackers. ArXiv abs\/1904.07986 (2019): n. pag."},{"key":"85697_CR10","unstructured":"Silva, H.P. Biomedical sensors as invisible doctors. In Regenerative Design in Digital Practice: A Handbook for the Built Environment (eds. Naboni, E. & Havinga, L.). 322\u2013329. (Eurac Research, 2019)."},{"key":"85697_CR11","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1007\/s12553-015-0098-y","volume":"4","author":"HP Silva","year":"2015","unstructured":"Silva, H. P. et al. Off-the-person electrocardiography: Performance assessment and clinical correlation. 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JMIR mHealth uHealth 7(1), e12419. https:\/\/doi.org\/10.2196\/12419 (2019).","journal-title":"JMIR mHealth uHealth"},{"key":"85697_CR17","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1038\/s41551-020-0534-9","volume":"4","author":"SM Park","year":"2020","unstructured":"Park, S. M. et al. A mountable toilet system for personalized health monitoring via the analysis of excreta. Nat. Biomed. Eng. 4, 624\u2013635. https:\/\/doi.org\/10.1038\/s41551-020-0534-9 (2020).","journal-title":"Nat. Biomed. Eng."},{"key":"85697_CR18","doi-asserted-by":"publisher","unstructured":"Tsuchiyama, K., Kajiwara, A. Accident Detection and Health-Monitoring UWB Sensor in Toilet. In Proc. of the IEEE Topical Conf. on Wireless Sensors and Sensor Networks (WiSNet) 1\u20134. https:\/\/doi.org\/10.1109\/WISNET.2019.8711812. (2019)","DOI":"10.1109\/WISNET.2019.8711812"},{"key":"85697_CR19","doi-asserted-by":"publisher","unstructured":"Huang, J., Yu, S., Syu, H. 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IEEE Pervasive Comput. 13(4), 64\u201371. https:\/\/doi.org\/10.1109\/MPRV.2014.61 (2014).","journal-title":"IEEE Pervasive Comput."},{"key":"85697_CR22","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1049\/htl.2018.5037","volume":"6","author":"D Batista","year":"2019","unstructured":"Batista, D. et al. Benchmarking of the BITalino biomedical toolkit against an established gold standard. Healthc. Technol. Lett. 6, 232\u2013236. https:\/\/doi.org\/10.1049\/htl.2018.5037 (2019).","journal-title":"Healthc. Technol. Lett."},{"key":"85697_CR23","unstructured":"BITalino. Microcontroller Unit (MCU) Block Data Sheet. https:\/\/bitalino.com\/datasheets\/REVOLUTION_MCU_Block_Datasheet.pdf. Accessed 24 Jan 2021."},{"key":"85697_CR24","unstructured":"PIA-Group. BioSPPy\u2014Biosignal Processing in Python. https:\/\/github.com\/PIA-Group\/BioSPPy. Accessed 24 Jan 2021."},{"key":"85697_CR25","doi-asserted-by":"publisher","unstructured":"Louren\u00e7o, A., Silva, H., Carreiras, C. 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