Experiences with Pulse Arrival Time as Surrogate for Systolic Blood Pressure

Muehlsteff, Jens; Kelm, Malte; Meyer, Christian

doi:10.1515/bmt-2013-4125

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…In particular, it has been demonstrated that a pertinent relation of PAT measures with systolic BP can be observed shortly before syncope, when PAT starts to steadily increase [ 23 ]. This might explain the predictive power of PAT to detect critical events related to BP regulation failures based on this simple and easy measure [ 28 ]. After having investigated a wide range of male and female patients (age: 18–80 years) with and without various cardiovascular diseases, we found that PAT changes preceding syncope appear to be relatively homogenous.…”

Section: Syncope Predictionmentioning

confidence: 99%

Wearable Sensors in Syncope Management

et al. 2015

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Syncope is a common disorder with a lifetime prevalence of about 40%. Implantable cardiac electronic devices, including implantable loop recorders (ILR) and implantable cardioverter-defibrillators (ICD), are well established in syncope management. However, despite the successful use of ILR and ICD, diagnosis and therapy still remain challenging in many patients due to the complex hemodynamic interplay of cardiac and vascular adaptations during impending syncopes. Wearable sensors might overcome some limitations, including misdiagnosis and inappropriate defibrillator shocks, because a variety of physiological measures can now be easily acquired by a single non-invasive device at high signal quality. In neurally-mediated syncope (NMS), which is the most common cause of syncope, advanced signal processing methodologies paved the way to develop devices for early syncope detection. In contrast to the relatively benign NMS, in arrhythmia-related syncopes immediate therapeutical intervention, predominantly by electrical defibrillation, is often mandatory. However, in patients with a transient risk of arrhythmia-related syncope, limitations of ICD therapy might outweigh their potential therapeutic benefits. In this context the wearable cardioverter-defibrillator offers alternative therapeutical options for some high-risk patients. Herein, we review recent evidence demonstrating that wearable sensors might be useful to overcome some limitations of implantable devices in syncope management.

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Section: Syncope Predictionmentioning

confidence: 99%

Wearable Sensors in Syncope Management

et al. 2015

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“…Therefore, a monitoring system for syncope management must provide at least the following two Jens parameters: 1) a measure of pulse rate including reliable detection of pulse presence and 2) a measure of SBP trend or -preferably -even classify normal blood pressure (BP) vs. hypotension in terms of absolute SBP. In previous work the feasibility of using the pulse arrival time (PAT), estimated as a time delay between an electrocardiogram (ECG) and a peripheral photoplethysmogram (PPG), has been demonstrated for early detection of hypotensive events in patients with NMS [4][5]. However, a PPG signal obtained, e.g., at the finger tip is known to be sensitive to hydrostatic effects.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of pulse presence and pulse strength assessment during head-up tilt table testing using an accelerometer located at the carotid artery

Muehlsteff

Dellimore

Aarts

et al. 2014

2014 36th Annual International Conference of the IEEE Engineering in Medicine and Biology Society

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Neurally mediated syncope (NMS) is a disorder of the autonomic regulation of postural tone, which is characterized by hypotension and/or bradycardia, resulting in cerebral hypo-perfusion and finally in a sudden loss of consciousness. Prediction of an impending NMS requires detection of pulse presence to derive heart rate (HR) as well as to assess the pulse strength (PS) related to systolic blood pressure (SBP) preferably from a single body location only. This paper analyses the basic feasibility of using a single accelerometer positioned above the common carotid artery to assess pulse strength and pulse rate towards NMS prediction. A physical model has been investigated to gain insights into expected signal morphologies and potential feature candidates vs. hemodynamic parameters such as SBP, pulse pressure (PP) and PR relevant for NMS detection. Model results are compared with first measurements obtained in a head-up tilt table test (HUTT) from a patient during impending syncope. We show that an accelerometer positioned at the carotid artery is a potential approach offering a valuable tool in syncope management.

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Experiences with Pulse Arrival Time as Surrogate for Systolic Blood Pressure

Cited by 2 publications

References 11 publications

Wearable Sensors in Syncope Management

Wearable Sensors in Syncope Management

Feasibility of pulse presence and pulse strength assessment during head-up tilt table testing using an accelerometer located at the carotid artery

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