Exploring the Feasibility of Remote Cardiac Auscultation Using Earphones

The elderly over 65 accounts for 80% of COVID deaths in the United States. In response to the pandemic, the federal, state governments, and commercial insurers are promoting video visits, through which the elderly can access specialists at home over the Internet, without the risk of COVID exposure. However, the current video visit practice barely relies on video observation and talking. The specialist could not assess the patient's health conditions by performing auscultations.

This paper tries to address this key missing component in video visits by proposing Asclepius, a hardware-software solution that turns the patient's earphones into a stethoscope, allowing the specialist to hear the patient's fine-grained heart sound (i.e., PCG signals) in video visits. To achieve this goal, we contribute a low-cost plug-in peripheral that repurposes the earphone's speaker into a microphone and uses it to capture the patient's minute PCG signals from her ear canal. As the PCG signals suffer from strong attenuation and multi-path effects when propagating from the heart to ear canals, we then propose efficient signal processing algorithms coupled with a data-driven approach to de-reverberate and further correct the amplitude and frequency distortion in raw PCG receptions. We implement Asclepius on a 2-layer PCB board and follow the IRB protocol to evaluate its performance with 30 volunteers. Our extensive experiments show that Asclepius can effectively recover Phonocardiogram (PCG) signals with different types of earphones. The objective blind testing and subjective interview with five cardiologists further confirm the clinical efficacy and efficiency of our system. PCG signal samples, benchmark results, and cardiologist interviews can be found at: https://asclepius-system.github.io/