a doctor in your

log in >

project ECGalert

Alerting of a heart attack with ECG


start date

1 Jan 2016

end date

31 Dec 2017

at a glance

The purpose of this project is to develop a system for early detection and alerting of the onset of a heart attack. The system consists of a wireless and mobile ECG biosensor, a data center, smartphone and web applications, and a remote 24h health care.

The motivation arises from the latest statistics by the Macedonian Institute of Public Health that in 2014 more than 11,000 people died of cardiovascular diseases, amounting to 57.2% of the total mortality rate. Additionally, because of dynamic and stressful lifestyle, recently the age limit for incidences of cardiac arrests has shifted from people aged 65 to people aged 40 or older.

The scientific basis for this project is founded on the fact that a heart attack can be detected at least two hours before its onset, and that a timely medical attention can dramatically reduce the risk of death or serious tissue damage.


Cardiovascular diseases are the leading cause of death globally - they cause more deaths than all other causes together and affect most low- and middle-income countries. In 2014 in Macedonia, a total of 11,270 people died prematurely of diseases of the cardiovascular system, which is 57.2% of the total mortality number1.

Within the cardiovascular diseases, a heart attack is a serious medical emergency, which occurs when blood flow (and oxygen supply) stops to a part of the heart. If impaired blood flow to the heart lasts long enough, it triggers a process called an ischemic cascade - the heart cells die (mainly by necrosis followed by apoptosis) and do not grow back. A timely medical attention, however, may save the patient of premature death, and drastically reduce the risk of serious damage to the heart. Interestingly, studies show that a heart attack may be predicted a couple of hours before its onset by detecting changes in the Electrocardiogram (ECG) of the patient2. This, indeed, is the starting point and the motivation for our innovation, since a quick reaction may save the patient and avoid serious damage of the heart3.

Even though there is much research on the subject of early prediction of heart attacks, still in Macedonia there is no commercialized solution to this problem. With this project, we propose an innovative solution for early warning and quick medical attention in case of a heart attack, by introducing a new product (sensor and smartphone application), and a new service (medical care as a service) to patients with heart disease.

1 Institute of Public Health of Republic of Macedonia, release on the occasion of 29th September - World Heart Day,
2 Lewine H., New test may speed detection of heart attacks, Harvard Health Publications,
3 Leijdekkers, P. and Gay, V. "A self-test to detect a heart attack using a mobile phone and wearable sensors." Computer-Based Medical Systems, 2008. CBMS'08. 21st IEEE International Symposium on. IEEE, 2008.


The system consists of attaching a small portable wireless ECG biosensor on the patient’s body and installing an application on the patient’s smartphone that receives ECG signals from the sensor, passes them to the data center, which in turn, processes them and determines if there’s any abnormal heart activity. In case of a detected onset of a heart attack, doctors are notified by the system and may call the patient with instructions and medical advice. Additionally, 24h medical care service centers are notified by the system to send an ambulance on the location given by the patient’s smartphone. This timely medical attention may save a patient’s life.


Phase 1

Requirements specification & system design

This phase includes 1) detailed analysis of user requirements; 2) analysis of potential ECG biosensors; 3) architecture design of the software solution for the mobile application; and 4) design of the alert system and cloud computing solution for organising a 24h health care.

time frame:
Month 1 - Month 8

Phase 2

Development of smartphone applications

This phase contains research and development of the mobile application under Android and iOS platforms. We plan: 1) development of an application architecture with details on communication in the personal network and WiFi; and 2) application coding and initial testing.

time frame:
Month 9 - Month 16

Phase 3

Development of web application on cloud

This phase is based on research and development of the veb application and cloud computing solution for 24h health care based on early alerting system. We plan: 1) development of a scalable application and hardware cloud computing platform; and 2) coding and testing the web application and services.

time frame:
Month 9 - Month 16

Phase 4

Interface design and testing

This phase consists of interface design (human computer interaction) and front-end programming. The sensors and applications must be intinuitive and easy to use. For this purpose, all applications and sensors will be tested and verified in a real-life testing environment. We plan to collaborate wth cardiovascular clinics and hospitals and introduce the application to prospective end-users (patients).

time frame:
Month 9 - Month 16

Phase 5

Demonstration, sustainability and quality control

This phase includes a demonstration of the realized prototype in real-life environment. In addition, it involves activities to enable sustainability of the developed solution and quality control of the mobile and web applications. We will improve the product and service organisation based on patient’s feedback from the testing and quality control procedure results.

time frame:
Month 17 - Month 24

Phase 6

Validation, verification and initial promotion

This phase realizes the final technology readiness stage prior to market. It includes: validation and verification of the prototype. Concerning marketing, we plan establishing several initial promotion channels and campaigns to raise the patient’s awareness about the product’s existence.

time frame:
Month 17 - Month 24

project team

Innovation Dooel is an IT company that specializes in developing highly adaptable, flexible, and scalable software solutions, aimed at offering a simple and easy way for a company to organize and manage its business. The company was established in 2006 as a spin-off from the Laboratory for New and Innovative Technologies at the University in Skopje. Innovation is the regional leader in the implementation of elections reconciliation; registration of voters and voters list management software for the central election commissions with references in numerous successful projects in the Balkan region including Macedonia, Kosovo, Bosnia and Herzegovina and Albania.