*Article* **ECG Measurement Uncertainty Based on Monte Carlo Approach: An Effective Analysis for a Successful Cardiac Health Monitoring System**

**Jackson Henrique Braga da Silva 1, Paulo Cesar Cortez 1, Senthil K. Jagatheesaperumal <sup>2</sup> and Victor Hugo C. de Albuquerque 1,\***


**Abstract:** Measurement uncertainty is one of the widespread concepts applied in scientific works, particularly to estimate the accuracy of measurement results and to evaluate the conformity of products and processes. In this work, we propose a methodology to analyze the performance of measurement systems existing in the design phases, based on a probabilistic approach, by applying the Monte Carlo method (MCM). With this approach, it is feasible to identify the dominant contributing factors of imprecision in the evaluated system. In the design phase, this information can be used to identify where the most effective attention is required to improve the performance of equipment. This methodology was applied over a simulated electrocardiogram (ECG), for which a measurement uncertainty of the order of 3.54% of the measured value was estimated, with a confidence level of 95%. For this simulation, the ECG computational model was categorized into two modules: the preamplifier and the final stage. The outcomes of the analysis show that the preamplifier module had a greater influence on the measurement results over the final stage module, which indicates that interventions in the first module would promote more significant performance improvements in the system. Finally, it was identified that the main source of ECG measurement uncertainty is related to the measurand, focused towards the objective of better characterization of the metrological behavior of the measurements in the ECG.

**Keywords:** Measurement uncertainty; Monte Carlo method; ECG; Cardiac health
