A Remote Cardiac Rhythm Monitoring System for Detecting Episodes of Atrial Fibrillation

2017 ◽  
Vol 51 (3) ◽  
pp. 189-194 ◽  
Author(s):  
Tr. T. Nguyen ◽  
Z. M. Yuldashev ◽  
E. V. Sadykova
Keyword(s):  
Atrial Fibrillation ◽  
Monitoring System ◽  
Cardiac Rhythm ◽  
Rhythm Monitoring

scholarly journals Automatic Mobile Health Arrhythmia Monitoring for the Detection of Atrial Fibrillation: Prospective Feasibility, Accuracy, and User Experience Study

10.2196/29933 ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. e29933
Author(s):  
Onni E Santala ◽  
Jari Halonen ◽  
Susanna Martikainen ◽  
Helena Jäntti ◽  
Tuomas T Rissanen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mobile Phone ◽  
Monitoring System ◽  
Sensitivity And Specificity ◽  
User Experience ◽  
Mobile Health ◽  
Visual Interpretation ◽  
Arrhythmia Detection ◽  
Mobile Phone Application ◽  
Rhythm Monitoring

Background Atrial fibrillation (AF) is the most common tachyarrhythmia and associated with a risk of stroke. The detection and diagnosis of AF represent a major clinical challenge due to AF’s asymptomatic and intermittent nature. Novel consumer-grade mobile health (mHealth) products with automatic arrhythmia detection could be an option for long-term electrocardiogram (ECG)-based rhythm monitoring and AF detection. Objective We evaluated the feasibility and accuracy of a wearable automated mHealth arrhythmia monitoring system, including a consumer-grade, single-lead heart rate belt ECG device (heart belt), a mobile phone application, and a cloud service with an artificial intelligence (AI) arrhythmia detection algorithm for AF detection. The specific aim of this proof-of-concept study was to test the feasibility of the entire sequence of operations from ECG recording to AI arrhythmia analysis and ultimately to final AF detection. Methods Patients (n=159) with an AF (n=73) or sinus rhythm (n=86) were recruited from the emergency department. A single-lead heart belt ECG was recorded for 24 hours. Simultaneously registered 3-lead ECGs (Holter) served as the gold standard for the final rhythm diagnostics and as a reference device in a user experience survey with patients over 65 years of age (high-risk group). Results The heart belt provided a high-quality ECG recording for visual interpretation resulting in 100% accuracy, sensitivity, and specificity of AF detection. The accuracy of AF detection with the automatic AI arrhythmia detection from the heart belt ECG recording was also high (97.5%), and the sensitivity and specificity were 100% and 95.4%, respectively. The correlation between the automatic estimated AF burden and the true AF burden from Holter recording was >0.99 with a mean burden error of 0.05 (SD 0.26) hours. The heart belt demonstrated good user experience and did not significantly interfere with the patient’s daily activities. The patients preferred the heart belt over Holter ECG for rhythm monitoring (85/110, 77% heart belt vs 77/109, 71% Holter, P=.049). Conclusions A consumer-grade, single-lead ECG heart belt provided good-quality ECG for rhythm diagnosis. The mHealth arrhythmia monitoring system, consisting of heart-belt ECG, a mobile phone application, and an automated AF detection achieved AF detection with high accuracy, sensitivity, and specificity. In addition, the mHealth arrhythmia monitoring system showed good user experience. Trial Registration ClinicalTrials.gov NCT03507335; https://clinicaltrials.gov/ct2/show/NCT03507335

scholarly journals Recurrence rate of atrial fibrillation after the first clinical episode: A prospective evaluation using continuous cardiac rhythm monitoring

2018 ◽  
Vol 41 (5) ◽  
pp. 594-600 ◽  
Author(s):  
Emmanuel N. Simantirakis ◽  
Panteleimon E. Papakonstantinou ◽  
Emmanuel Kanoupakis ◽  
Gregory I. Chlouverakis ◽  
Stylianos Tzeis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Recurrence Rate ◽  
Cardiac Rhythm ◽  
Prospective Evaluation ◽  
Clinical Episode ◽  
Rhythm Monitoring

Abstract 25: Paroxysmal Atrial Fibrillation is Common in Patients With Defined Etiology for Stroke: Prolonged Monitoring of Cardiac Rhythm for Detection of Atrial Fibrillation After a Cerebral Ischemic Event (PEAACE) Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Esseddeeg M Ghrooda ◽  
Peter Dobrowolski ◽  
Ghazala Basir ◽  
Ibrahim Yaseen ◽  
Nazim khan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Cardiac Rhythm ◽  
Previous History ◽  
Cryptogenic Stroke ◽  
Predictive Score ◽  
Stroke Patients ◽  
Similar Frequency ◽  
Stroke Team ◽  
Rhythm Monitoring

Introduction: Atrial fibrillation (AF) related cardioembolic stroke accounts for over 20% of ischemic stroke. Recent reports using prolonged cardiac rhythm monitoring (PCRM) in cryptogenic stroke reveal paroxysmal AF (PAF) in an additional 20% of patients. We report our findings with PCRM in patients with and without cryptogenic stroke patients in whom an initial 24-h Holter was negative. Methods: Patients admitted to the stroke service with no previous history of AF and no AF on Holter monitoring were enrolled for 3 weeks of PCRM. We used a PAF predictive score to determine the risk of the arrhythmia. All studies were interpreted by the stroke team prior to final review by the cardiologist. Results: Between Sept 2012 and June 2013, 96 patients were evaluated. Over all PAF was diagnoses in 37.5 % of patients. PAF was diagnosed in 32% of patients with cryptogenic stroke and 36 % of patients where an additional etiology may account for the stroke diagnosis. The AF prediction score was not useful in the recognition of patients that were more likely to be at risk for AF. 96 of 98 recordings were correctly identified by the stroke team prior to final diagnosis by the cardiologist. Interpretation: PAF is more common in stroke patients than was previously suspected. It occurs with similar frequency in patients with and without cryptogenic stroke. Our data strongly supports the need for prolonged cardiac rhythm monitoring in all stroke patients to diagnose this important preventable cause of ischemic stroke.

scholarly journals Detection of Paroxysmal Atrial Fibrillation in Stroke/Tia Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Muhib Khan ◽  
Daniel J. Miller
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Cardiac Rhythm ◽  
Genetic Factors ◽  
Arrhythmia Detection ◽  
Ischemic Attack ◽  
Event Definition ◽  
Possible Cause ◽  
Rhythm Monitoring

One-third of stroke and transient ischemic attack (TIA) are cryptogenic, and paroxysmal atrial fibrillation (PAF) has been suggested as a possible cause for these cryptogenic strokes. Multiple studies have recently evaluated long-term cardiac rhythm monitoring with good yield for PAF. The duration of monitoring varies between studies as well as the qualifying event definition. Moreover, the clinical significance of very brief atrial fibrillation events is unclear in the literature. This paper provides an overview of current advances in the detection of paroxysmal atrial fibrillation, the clinical and genetic factors predictive of arrhythmia detection, and the therapeutic dilemma concerning this approach.

scholarly journals Blood Biomarkers of Heart Failure and Hypercoagulation to Identify Atrial Fibrillation–Related Stroke

Stroke ◽  
2019 ◽  
Vol 50 (8) ◽  
pp. 2223-2226 ◽  
Author(s):  
Markus Kneihsl ◽  
Thomas Gattringer ◽  
Egbert Bisping ◽  
Daniel Scherr ◽  
Reinhard Raggam ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cardiac Rhythm ◽  
Blood Biomarkers ◽  
Stroke Patients ◽  
At Iii ◽  
D Dimer ◽  
Rhythm Monitoring

Background and Purpose— Occult atrial fibrillation (AF) causes a relevant proportion of initially cryptogenic stroke (CS), but prolonged rhythm monitoring is difficult to apply to all such patients. We hypothesized that blood biomarkers indicating heart failure (NT-proBNP [N-terminal pro-brain natriuretic peptide]) and hypercoagulability (D-dimer, AT-III [antithrombin-III]) were associated with AF-related stroke and could serve to predict the likelihood of AF detection in CS patients early on. Methods— Over a 1-year period, we prospectively applied a defined etiologic work-up to all ischemic stroke patients admitted to our stroke unit. If no clear stroke cause was detected (CS), patients underwent extended in-hospital cardiac rhythm monitoring (≥72 hours). Blood to determine biomarker levels was drawn within 24 hours after admission. Results— Of 429 patients, 103 had AF-related stroke. Compared with noncardiac stroke patients (n=171), they had higher NT-proBNP (1867 versus 263 pg/ml) and D-dimer levels (1.1 versus 0.6 µg/ml), and lower AT-III concentration (89% versus 94%). NT-proBNP ≥505 pg/ml distinguished AF-related from noncardiac stroke with a sensitivity of 93% and a specificity of 72%. D-dimer and AT-III cutoffs had lower sensitivities (61% and 53%) and specificities (58% and 69%) for AF-related stroke. Of all initially 143 CS patients, 14 were diagnosed with AF during in-hospital monitoring. The preidentified NT-proBNP cutoff ≥505 pg/ml correctly predicted AF in 12 of them (86%, negative predictive value: 98%), while D-dimer and AT-III cutoffs were noncontributory. Conclusions— This study supports the association of NT-proBNP and to a lesser extent of hypercoagulation markers with AF-related stroke. NT-proBNP seems helpful in selecting CS patients for immediate extended cardiac rhythm monitoring to detect occult AF whereby levels <505 pg/ml seem to have a high-negative predictive value.

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