Utility of a Smartphone Based System (cvrPhone) to Predict Short-term Arrhythmia Susceptibility

Sohn, Kwanghyun; Dalvin, Steven P.; Merchant, Faisal M.; Kulkarni, Kanchan; Sana, Furrukh; Abohashem, Shady; Singh, Jagmeet P.; Heist, E. Kevin; Owen, Chris; Isselbacher, Eric M.; Armoundas, Antonis A.

doi:10.1038/s41598-019-50487-4

Cited by 16 publications

(6 citation statements)

References 24 publications

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“…In this paper, we introduce a wireless, smartphone-based, continuous SpO2 monitoring system that aims to supplement cvrPhone, a medical-grade, smartphone-based cardiac and respiratory monitoring platform [ 6 , 7 , 8 ]. To avoid an invasive measurement directly from a blood sample, we have researched and developed a PPG-based estimation approach.…”

Section: Discussionmentioning

confidence: 99%

“…SpO2 monitoring is an important vital sign in evaluating and monitoring the cardio-pulmonary function of both in-hospital and out-of-hospital patients [2][3][4]. As the average age of the US population increases and chronic conditions are becoming more prevalent, there is a need to improve the effectiveness of disease prevention, to enhance access to healthcare, and to sustain healthy independent living [5][6][7][8]. Mobile health technologies are expected to function Figure 1.…”

Section: Introductionmentioning

confidence: 99%

“…SpO2 monitoring is an important vital sign in evaluating and monitoring the cardio-pulmonary function of both in-hospital and out-of-hospital patients [ 2 , 3 , 4 ]. As the average age of the US population increases and chronic conditions are becoming more prevalent, there is a need to improve the effectiveness of disease prevention, to enhance access to healthcare, and to sustain healthy independent living [ 5 , 6 , 7 , 8 ]. Mobile health technologies are expected to function not only as monitoring devices, but also as essential components in the delivery of healthcare to those with chronic diseases [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ], especially in under-served populations.…”

Section: Introductionmentioning

confidence: 99%

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Design Implementation and Evaluation of a Mobile Continuous Blood Oxygen Saturation Monitoring System

Zhang

Arney

Goldman

et al. 2020

Sensors

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Objective: In this study, we built a mobile continuous Blood Oxygen Saturation (SpO2) monitor, and for the first time, explored key design principles towards daily applications. Methods: We firstly built a customized wearable computer that can sense two-channel photoplethysmogram (PPG) signals, and transmit the signals wirelessly to smartphone. Afterwards, we explored many SpO2 model building principles, focusing on linear/nonlinear models, different PPG parameter calculation methods, and different finger types. Moreover, we further compared PPG sensor placement principles by comparing different hand configurations and different finger configurations. Finally, a dataset collected from eleven human subjects was used to evaluate the mobile health monitor and explore all of the above design principles. Results: The experimental results show that the root mean square error of the SpO2 estimation is only 1.8, indicating the effectiveness of the system. Conclusion: These results indicate the effectiveness of the customized mobile SpO2 monitor and the selected design principles. Significance: This research is expected to facilitate the continuous SpO2 monitoring of patients with clinical indications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Design Implementation and Evaluation of a Mobile Continuous Blood Oxygen Saturation Monitoring System

Zhang

Arney

Goldman

et al. 2020

Sensors

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“…We have previously demonstrated the ability of microvolt TWA to predict short- (Weiss et al, 2011;Merchant and Armoundas, 2012;Merchant et al, 2013bMerchant et al, , 2020 and long-term (Merchant et al, , 2015Sohn et al, 2019) susceptibility to ventricular tachy-arrhythmias and sudden cardiac death, using an algorithm based on the spectral method (Smith et al, 1988;Merchant and Armoundas, 2012;Merchant et al, , 2013bMerchant et al, , 2015Sohn et al, 2019). Briefly, the alternans voltage was used as a direct measure of the presence of alternans and calculated based on the amplitude of the power spectrum at the alternans frequency (0.5 cycles/beat) (Armoundas et al, 2013;Sayadi et al, 2013;Merchant et al, 2014Merchant et al, , 2020.…”

Section: Estimation Of Repolarization Alternans Burdenmentioning

confidence: 99%

Microvolt T-Wave Alternans Is Modulated by Acute Low-Level Tragus Stimulation in Patients With Ischemic Cardiomyopathy and Heart Failure

et al. 2021

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Aims: Microvolt T-wave alternans (TWA), an oscillation in T-wave morphology of the electrocardiogram (ECG), has been associated with increased susceptibility to ventricular tachy-arrhythmias, while vagus nerve stimulation has shown promising anti-arrhythmic effects in in vivo and ex vivo animal studies. We aimed to examine the effect of non-invasive, acute low-level tragus stimulation (LLTS) on TWA in patients with ischemic cardiomyopathy and heart failure.Methods: 26 patients with ischemic cardiomyopathy (left ventricular ejection fraction <35%) and chronic stable heart failure, previously implanted with an automatic implantable cardioverter defibrillator (ICD) device with an atrial lead (dual chamber ICD or cardiac resynchronization therapy defibrillator), were enrolled in the study. Each patient sequentially received, (1) Sham LLTS (electrode on tragus, but no stimulation delivered) for 5 min; (2) Active LLTS at two different frequencies (5 and 20 Hz, 15 min each); and (3) Active LLTS, during concomitant atrial pacing at 100 bpm at two different frequencies (5 and 20 Hz, 15 min each). LLTS was delivered through a transcutaneous electrical nerve stimulation device (pulse width 200 μs, frequency 5/20 Hz, amplitude 1 mA lower than the discomfort threshold). TWA burden was assessed using continuous ECG monitoring during sham and active LLTS in sinus rhythm, as well as during atrial pacing.Results: Right atrial pacing at 100 bpm led to significantly heightened TWA burden compared to sinus rhythm, with or without LLTS. Acute LLTS at both 5 and 20 Hz, during sinus rhythm led to a significant rise in TWA burden in the precordial leads (p < 0.05).Conclusion: Acute LLTS results in a heart-rate dependent increase in TWA burden.

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“…The use of smartphones is increasingly popular, because the price of the device is getting cheaper and the device itself has good design [17]. In addition, several communication technologies such as bluetooth are used on Colunas et al [18,19,20]; while Lee et al [21] utilizes WIFI technology to transmit messages.…”

Section: Introductionmentioning

confidence: 99%

ECG-based prediction algorithm for imminent malignant ventricular arrhythmias using decision tree

Mandala

Sunar

et al. 2020

PLoS ONE

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Spontaneous prediction of malignant ventricular arrhythmia (MVA) is useful to avoid delay in rescue operations. Recently, researchers have developed several algorithms to predict MVA using various features derived from electrocardiogram (ECG). However, there are several unresolved issues regarding MVA prediction such as the effect of number of ECG features on a prediction remaining unclear, possibility that an alert for occurring MVA may arrive very late and uncertainty in the performance of the algorithm predicting MVA minutes before onset. To overcome the aforementioned problems, this research conducts an in-depth study on the number and types of ECG features that are implemented in a decision tree classifier. In addition, this research also investigates an algorithm's execution time before the occurrence of MVA to minimize delays in warnings for MVA. Lastly, this research aims to study both the sensitivity and specificity of an algorithm to reveal the performance of MVA prediction algorithms from time to time. To strengthen the results of analysis, several classifiers such as support vector machine and naive Bayes are also examined for the purpose of comparison study. There are three phases required to achieve the objectives. The first phase is literature review on existing relevant studies. The second phase deals with design and development of four modules for predicting MVA. Rigorous experiments are performed in the feature selection and classification modules. The results show that eight ECG features with decision tree classifier achieved good prediction performance in terms of execution time and sensitivity. In addition, the results show that the highest percentage for sensitivity and specificity is 95% and 90% respectively, in the fourth 5-minute interval (15.1 minutes-20 minutes) that preceded the onset of an arrhythmia event. Such results imply that the fourth 5-minute interval would be the best time to perform prediction.

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Utility of a Smartphone Based System (cvrPhone) to Predict Short-term Arrhythmia Susceptibility

Cited by 16 publications

References 24 publications

Design Implementation and Evaluation of a Mobile Continuous Blood Oxygen Saturation Monitoring System

Design Implementation and Evaluation of a Mobile Continuous Blood Oxygen Saturation Monitoring System

Microvolt T-Wave Alternans Is Modulated by Acute Low-Level Tragus Stimulation in Patients With Ischemic Cardiomyopathy and Heart Failure

ECG-based prediction algorithm for imminent malignant ventricular arrhythmias using decision tree

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