Automatic segmentation of the second cardiac sound by using wavelets and hidden Markov models.

This paper is concerned with the segmentation of the second heart sound (S2) of the phonocardiogram (PCG), in its two acoustic events, aortic (A2) and pulmonary (P2) components. The aortic valve (A2) usually closes before the pulmonary valve (P2) and the delay between these two events is known as 'split' and is typically less than 30 miliseconds. S2 splitting, reverse splitting or reverse occurrence of components A2 and P2 are the most important aspects regarding cardiac diagnosis carried out by the analysis of S2 cardiac sound. An automatic technique, based on discrete wavelet transform and hidden Markov models, is proposed in this paper to segment S2, to estimate de order of occurrence of A2 and P2 and finally to estimate the delay between these two components (split). A discrete density hidden Markov model (DDHMM) is used for phonocardiogram segmentation while embedded continuous density hidden Markov models are used for acoustic models, which allows segmenting S2. Experimental results were evaluated on data collected from five different subjects, using CardioLab system and a Dash family patient monitor. The ECG leads I, II and III and an electronic stethoscope signal were sampled at 977 samples per second.