Initial Investigation of Athletes’ Electrocardiograms Acquired by Wearable Sensors during the Pre-exercise Phase

Aim: The aim of this study is to support large-scale prevention programs fighting sport-related sudden cardiac death by providing a set of electrocardiographic features representing a starting point in the development of normal reference values for the pre-exercise phase. Background: In people with underlying, often unknown, cardiovascular abnormalities, increased cardiovascular load during exercise can trigger sport-related sudden cardiac death. Prevention remains the only weapon to contrast sport-related sudden cardiac death. So far, no reference values have been proposed for electrocardiograms of athletes acquired with wearable sensors in the pre-exercise phase, consisting of the few minutes immediately before the beginning of the training session. Objective: To perform an initial investigation of athletes’ electrocardiograms acquired by wearable sensors during the pre-exercise phase. Methods: The analyzed electrocardiograms, acquired through BioHarness 3.0 by Zephyr, belong to 51 athletes (Sport Database and Cycling Database of the Cardiovascular Bioengineering Lab of the Università Politecnica delle Marche, Italy). Preliminary values consist of interquartile ranges of six electrocardiographic features which are heart rate, heart-rate variability, QRS duration, ST level, QT interval, and corrected QT interval. Results: For athletes 35 years old or younger, preliminary values were [72;91]bpm, [26;47]ms, [85;104]ms, [-0.08;0.08]mm, [326;364]ms and [378;422]ms, respectively. For athletes older than 35 years old, preliminary values were [71;94]bpm, [16;65]ms, [85;100]ms, [-0.11;0.07]mm, [330;368]ms and [394;414]ms, respectively. Conclusion: Availability of preliminary reference values could help identify those athletes who, due to electrocardiographic features out of normal ranges, are more likely to develop cardiac complications that may lead to sport-related sudden cardiac death.

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Effects of amiodarone on the circadian rhythm and power spectral changes of heart rate and QT interval: Significance for the control of sudden cardiac death

American Heart Journal ◽

10.1016/0002-8703(94)90584-3 ◽

1994 ◽

Vol 128 (5) ◽

pp. 884-891 ◽

Cited By ~ 21

Author(s):

Michael Antimisiaris ◽

Jonnalagedda S.M. Sarma ◽

Mary P. Schoenbaum ◽

Param P. Sharma ◽

K. Venkataraman ◽

...

Keyword(s):

Heart Rate ◽

Circadian Rhythm ◽

Sudden Cardiac Death ◽

Qt Interval ◽

Cardiac Death ◽

Spectral Changes ◽

Power Spectral

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Secondary risk factors of sudden cardiac death and genes of arterial hypertension

HERALD of North-Western State Medical University named after I I Mechnikov ◽

10.17816/mechnikov34642 ◽

2020 ◽

Vol 12 (3) ◽

pp. 27-34

Author(s):

Vasilii A. Kachnov ◽

Vadim V. Tyrenko ◽

Svetlana N. Kolyubaeva ◽

Lilia A. Myakoshina ◽

Alexandra S. Buntovskaya

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Sudden Cardiac Death ◽

Arterial Hypertension ◽

Qt Interval ◽

Cardiac Death ◽

Risk Variant ◽

Corrected Qt Interval ◽

Increased Risk ◽

Heterozygous Variant

Purpose. To study the influence of polymorphisms of arterial hypertension genes and their various combinations on individual risk factors of sudden cardiac death. Materials and methods. 319 young people from 18 to 24 years of age who are entering military service by conscription were examined. The survey identified 69 individuals with signs of increased risk of sudden cardiac death after being examined for secondary risk factors of sudden cardiac death and taken a blood test to determine the polymorphisms of the genes AGT 521 CT, GNB3 825 CT, CYP11B2 344 CT, NOS3 786 TC. Results. The greatest influence on the severity of secondary risk factors was exerted by the following variants of a combination of gene polymorphisms: AGT 521 CT and NOS3 786 TC in the individuals with a heterozygous risk variant, both genes showed a significant increase in the duration of the corrected QT interval, heart rate, and a decrease in heart rate variability. AGT 521 CT and CYP11B2 344 CT homozygous risk variant of the CYP11B2 344 CT and the heterozygous risk variant AGT 521 CT is associated with a longer duration of the corrected QT interval, and the heterozygous risk variant for both genes is associated with higher heart rate values. AGT 521 CT and GNB3 825 CT combination of a homozygous risk variant of the gene GNB3 825 CT and the heterozygous variant of the gene AGT 521 CT is associated with the greatest effect on a heart rate. Conclusions. The presence of a homozygous risk variant of the gene NOS3 786 TC, a heterozygous risk variant of the gene GNB3 825 CT is prognostically unfavorable for its effect on the severity of secondary risk factors for sudden cardiac death. The combination of the heterozygous variant AGT 521 CT with a heterozygous variant of NOS3 786 TC and a homozygous risk variant by the gene CYP11B2 344 CT and the heterozygous risk variant AGT 521 CT are also the most unfavorable in terms of its effect on secondary risk factors for sudden cardiac death. Secondary risk factors of sudden cardiac death are influenced by both individual polymorphisms of genes of arterial hypertension, and their various combinations.

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Exercise heart rate reserve and recovery as risk factors for sudden cardiac death

Progress in Cardiovascular Diseases ◽

10.1016/j.pcad.2021.09.002 ◽

2021 ◽

Author(s):

Sudhir Kurl ◽

Sae Young Jae ◽

Ari Voutilainen ◽

Magnus Hagnäs ◽

Jari A. Laukkanen

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Exercise Heart Rate ◽

Heart Rate Reserve

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Abstract 2140: Infrequent Need for Pacing Following Implantable Cardioverter-Defibrillator Shocks: Analysis of the Sudden Cardiac Death in Heart Failure Trial

Circulation ◽

10.1161/circ.118.suppl_18.s_674 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Jordan M Prutkin ◽

Jeanne E Poole ◽

George Johnson ◽

Jill Anderson ◽

Daniel B Mark ◽

...

Keyword(s):

Heart Failure ◽

Heart Rate ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Nyha Class ◽

Prior History ◽

Baseline Heart Rate ◽

Implantable Cardioverter Defibrillators ◽

Heart Failure Trial ◽

Post Shock

Background: Implantable cardioverter-defibrillators (ICD) are routinely programmed to pace after a shock to prevent possible asystole. In those with no prior history of bradycardia, there is little data regarding the prevalence and characteristics of those who use post-shock pacing (PSP). Methods: We analyzed the occurrence of pacing within the first nine beats after the first successful ICD shock for ventricular tachycardia (VT) or ventricular fibrillation (VF) in the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). All ICDs were single lead with the first PSP delivered at 1400msec and all subsequent stimuli delivered at 1200msec. We excluded patients with pacing during pre-shock rhythms and those who had pacing rates different than the protocol default rate of 50bpm (1200 msec). Results: There were 2521 patients enrolled in SCD-HeFT, of which 811 received an ICD. A total of 153 shock events were examined; 36 (23.5%) had at least one of the first nine beats paced post-shock, though only 4 (2.5%) had greater than 4 out of the 9 beats paced. No subjects needed pacing for all nine beats and only 8 (5.2%) paced for greater than 5 seconds. There were no differences in age, gender, etiology of cardiomyopathy, or NYHA class between those with PSP or not. The prevailing heart rate pre-shock was predictive of PSP; the mean cycle length of the baseline rhythm pre-shock was longer (slower rate) for those who used PSP (735 ± 228msec vs. 624 ± 158msec, P=0.001). More often, VF (vs. VT) was the rhythm shocked in those using PSP (P=0.015). A trend also was seen toward increased frequency of PSP in those receiving 30J shocks (16 of 49) versus ≤20J shocks (20 of 104, P=0.068). Conclusion: Patients infrequently require multiple paced beats post-shock for VT or VF. Patients using PSP have a slower baseline heart rate and are more likely to have VF as the shocked rhythm. While 1 or 2 paced beats out of the first nine occurred occasionally, these patients also had rapid return of their native rhythm for which the hemodynamic contribution of 1 or 2 paced beats is unclear. These data suggest that for most patients receiving a primary prevention ICD programmed for shock-only therapy, the need for PSP is limited. PSP use may reflect convention and the assumption that minor post-shock pauses are detrimental.

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Machine Learning-Based Rapid Prediction of Sudden Cardiac Death (SCD) Using Precise Statistical Features of Heart Rate Variability for Single Lead ECG Signal

Green Computing and Predictive Analytics for Healthcare ◽

10.1201/9780429317224-4 ◽

2020 ◽

pp. 65-80

Author(s):

Prakash Banerjee

Keyword(s):

Machine Learning ◽

Heart Rate ◽

Heart Rate Variability ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Ecg Signal ◽

Statistical Features ◽

Rapid Prediction

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Effects of Marine n-3 Polyunsaturated Fatty Acids on Heart Rate Variability and Heart Rate in Patients on Chronic Dialysis: A Randomized Controlled Trial

Nutrients ◽

10.3390/nu10091313 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1313 ◽

Cited By ~ 6

Author(s):

Jesper Rantanen ◽

Sam Riahi ◽

Martin Johansen ◽

Erik Schmidt ◽

Jeppe Christensen

Keyword(s):

Fatty Acids ◽

Heart Rate ◽

Heart Rate Variability ◽

Sudden Cardiac Death ◽

Polyunsaturated Fatty Acids ◽

Cardiac Death ◽

Controlled Trial ◽

Chronic Dialysis ◽

Dialysis Vintage ◽

The Mean

Marine n-3 polyunsaturated fatty acids (PUFA) may improve autonomic dysfunction, as indicated by an increase in heart rate variability (HRV) and reduce the risk of sudden cardiac death. Hence, the aim of this study was to investigate the effects of marine n-3 PUFA on 24-h HRV in patients on chronic dialysis, who have a high risk of sudden cardiac death. Between June 2014 and March 2016, 112 patients on chronic dialysis from Denmark were allocated to a daily supplement of 2 g marine n-3 PUFA or control for three months in a randomized, double-blinded, controlled trial. A 48-h Holter monitoring was performed and mean 24-h HRV indices for the two days were available in 85 patients. The mean age was 62.3 years (SD: 14.3) and median dialysis vintage was 1.7 years (IQR: 0.5, 6.4). Within-group and between-group changes in outcome were evaluated by a paired and two sample t-test, respectively. Marine n-3 PUFA did not change the primary endpoint SDNN (SD of all RR-intervals) reflecting overall HRV, but other HRV indices increased and the mean RR-interval increased significantly, corresponding to a decrease in heart rate by 2.5 beats per minute (p = 0.04). In conclusion, marine n-3 PUFA did not change SDNN, but the mean heart rate was significantly reduced and changes in other HRV-indices were also observed, indicating an increase in vagal modulation that might be protective against malignant ventricular arrhythmias.

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Heart rate and metabolic response to competitive squash in veteran players: identification of risk factors for sudden cardiac death

European Heart Journal ◽

10.1093/oxfordjournals.eurheartj.a059415 ◽

1989 ◽

Vol 10 (11) ◽

pp. 1029-1035 ◽

Cited By ~ 5

Author(s):

H. R. BRADY ◽

M. KINIRONS ◽

T. LYNCH ◽

E. M. OHMAN ◽

W. TORMEY ◽

...

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Metabolic Response

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The role of endocarditis in sudden cardiac death: highlighting the value of the autopsy, pathological features and cardiac complications

Cardiovascular Pathology ◽

10.1016/j.carpath.2020.107292 ◽

2021 ◽

Vol 50 ◽

pp. 107292 ◽

Cited By ~ 1

Author(s):

Susanna T.E. Cooper ◽

Joseph D. Westaby ◽

Kathryn J. Griffin ◽

Mary N. Sheppard

Keyword(s):

Sudden Cardiac Death ◽

Cardiac Death ◽

Cardiac Complications ◽

Pathological Features

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Prediction of Sudden Cardiac Death Risk with a Support Vector Machine Based on Heart Rate Variability and Heartprint Indices

Sensors ◽

10.3390/s20195483 ◽

2020 ◽

Vol 20 (19) ◽

pp. 5483

Author(s):

Marisol Martinez-Alanis ◽

Erik Bojorges-Valdez ◽

Niels Wessel ◽

Claudia Lerma

Keyword(s):

Heart Rate ◽

Support Vector Machine ◽

Heart Rate Variability ◽

Sudden Cardiac Death ◽

Cardiac Death ◽

Area Under The Curve ◽

Premature Ventricular Complex ◽

Support Vector ◽

Auc Value ◽

Sudden Cardiac Death Risk

Most methods for sudden cardiac death (SCD) prediction require long-term (24 h) electrocardiogram recordings to measure heart rate variability (HRV) indices or premature ventricular complex indices (with the heartprint method). This work aimed to identify the best combinations of HRV and heartprint indices for predicting SCD based on short-term recordings (1000 heartbeats) through a support vector machine (SVM). Eleven HRV indices and five heartprint indices were measured in 135 pairs of recordings (one before an SCD episode and another without SCD as control). SVMs (defined with a radial basis function kernel with hyperparameter optimization) were trained with this dataset to identify the 13 best combinations of indices systematically. Through 10-fold cross-validation, the best area under the curve (AUC) value as a function of γ (gamma) and cost was identified. The predictive value of the identified combinations had AUCs between 0.80 and 0.86 and accuracies between 80 and 86%. Further SVM performance tests on a different dataset of 68 recordings (33 before SCD and 35 as control) showed AUC = 0.68 and accuracy = 67% for the best combination. The developed SVM may be useful for preventing imminent SCD through early warning based on electrocardiogram (ECG) or heart rate monitoring.

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