Real-time cardiac monitoring through the development of a smart holter to detect pathologies through an expert algorithm (Preprint)

BACKGROUND Constant monitoring of the heart’s state is essential for the early detection of pathologies. In the past, this analysis could only be carried out in hospitals, using sophisticated equipment handled by qualified staff. Today there is a wide range of portable monitoring devices (Holters) on the market but with a set of drawbacks (low number of leads supported and their low signal quality among others) that make it difficult to consider them as a viable replacement for the equipment used in medical practice OBJECTIVE This article describes the process of designing and implementing a Smart Holter able to record up to six leads at the same time, providing a signal quality comparable to the equipment used in medical practice, but with the dimensions, consumption and ease of use of portable devices. We also describe the workings of the expert algorithm for detecting cardiac anomalies in real time monitoring, which is embedded in the device itself, and which is capable of detecting tachycardia, bradycardia, ischemia and atrial fibrillation episodes with a high success rate. METHODS The hardware developed, performs the acquisition of 6 leads simultaneously, with a signal quality comparable to that of equipment used in medical practice. Each of the signals are processed by the algorithm described in this paper. This algorithm decomposes each lead into each heartbeat and extracts each of the segments that compose it (QRS complex) as well as a series of additional parameters. Based on the duration, amplitude and different thresholds, the system is able to detect with a high success rate, the existence of a certain cardiac pathology. RESULTS Performance evaluation shows the capacity of the Smart Holter devised to offer a high quality signal that combined with an embedded expert algorithm is capable of detecting tachycardia, bradycardia, ischemia and atrial fibrillation episodes in real time with a high success rate. CONCLUSIONS Development presented in this paper offers better characteristics, because it resolves a wide range of drawbacks inherent in that type of portable medical equipment, mainly in terms of signal quality. One aspect to highlight is the improvement in noise immunity of the equipment. Although it is not possible to compensate large artefacts produced while playing sports, which still remains a challenge for current monitoring systems, an important step has been taken in the right direction to achieve even greater attenuation in the future, through the use of dynamic filtering systems controlled digitally, unlike the systems currently present on the market.

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Methods for the Quantification of Salivary Cortisol and of a-amylase in Biosensors and Portable Devices

Revista de Chimie ◽

10.37358/rc.17.12.5994 ◽

2018 ◽

Vol 68 (12) ◽

pp. 2857-2859

Author(s):

Cristina Mihaela Ghiciuc ◽

Andreea Silvana Szalontay ◽

Luminita Radulescu ◽

Sebastian Cozma ◽

Catalina Elena Lupusoru ◽

...

Keyword(s):

Real Time ◽

Medical Practice ◽

Salivary Cortisol ◽

Clinical Studies ◽

Large Scale ◽

Psychological Research ◽

Portable Devices ◽

Salivary Amylase ◽

Specificity And Sensitivity

There is an increasing interest in the analysis of salivary biomarkers for medical practice. The objective of this article was to identify the specificity and sensitivity of quantification methods used in biosensors or portable devices for the determination of salivary cortisol and salivary a-amylase. There are no biosensors and portable devices for salivary amylase and cortisol that are used on a large scale in clinical studies. These devices would be useful in assessing more real-time psychological research in the future.

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Recurrences in the Blanking Period and 12-Month Success Rate by Continuous Cardiac Monitoring After Cryoablation of Paroxysmal and Non-Paroxysmal Atrial Fibrillation

Journal of Cardiovascular Electrophysiology ◽

10.1111/jce.13190 ◽

2017 ◽

Vol 28 (6) ◽

pp. 625-633 ◽

Cited By ~ 9

Author(s):

PAOLO PIERAGNOLI ◽

ALESSANDRO PAOLETTI PERINI ◽

GIUSEPPE RICCIARDI ◽

LUCA CHECCHI ◽

ANDREA GIOMI ◽

...

Keyword(s):

Atrial Fibrillation ◽

Success Rate ◽

Paroxysmal Atrial Fibrillation ◽

Cardiac Monitoring

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Real-Time WebRTC based Mobile Surveillance System

International Journal of Engineering and Management Research ◽

10.31033/ijemr.11.3.4 ◽

2021 ◽

Vol 11 (3) ◽

Author(s):

Alistair Baretto ◽

Noel Pudussery ◽

Veerasai Subramaniam ◽

Amroz Siddiqui

Keyword(s):

Object Detection ◽

Real Time ◽

Deep Neural Networks ◽

Ease Of Use ◽

Problem Statement ◽

Wide Range ◽

Technological Growth ◽

Computationally Intensive ◽

Processing Techniques ◽

Opening Up

The rapid growth that has taken place in Computer Vision has been instrumental in driving the advancement of Image processing techniques and drawing inferences from them. Combined with the enormous capabilities that Deep Neural networks bring to the table, computers can be efficiently trained to automate the tasks and yield accurate and robust results quickly thus optimizing the process. Technological growth has enabled us to bring such computationally intensive tasks to lighter and lower-end mobile devices thus opening up a wide range of possibilities. WebRTC-the open-source web standard enables us to send multimedia-based data from peer to peer paving the way for Real-time Communication over the Web. With this project, we aim to build on one such opportunity that can enable us to perform custom object detection through an android based application installed on our mobile phones. Therefore, our problem statement is to be able to capture real-time feeds, perform custom object detection, generate inference results, and appropriately send intruder alerts when needed. To implement this, we propose a mobile-based over-the-cloud solution that can capitalize on the enormous and encouraging features of the YOLO algorithm and incorporate the functionalities of OpenCV’s DNN module for providing us with fast and correct inferences. Coupled with a good and intuitive UI, we can ensure ease of use of our application.

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Abstract WP222: Comparison of Two Methods of External Prolonged Cardiac Monitoring for the Detection of Atrial Fibrillation: Cardiophone - satellite Real Time Device vs Sorin (Automated Software) for the Peaace Study

Stroke ◽

10.1161/str.47.suppl_1.wp222 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Herbert Manosalva ◽

Saad Hasan ◽

Arif Pervez ◽

Askar Mohammad ◽

Dulara Hussain ◽

...

Keyword(s):

Atrial Fibrillation ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Real Time ◽

Heart Rhythm ◽

Cardiac Monitoring ◽

Real Time Monitoring ◽

Prolonged Monitoring ◽

Stroke Type ◽

Automated Software

Introduction: Recent evidence has shown that prolonged cardiac monitoring is superior to 24 hour Holter for detection of atrial fibrillation (AF). We compared two methods of prolonged monitoring in patients with acute ischemic stroke and TIAs. Objective: Comparison of the Cardiophone and Sorin monitor for detection of AF. Method: In the first part of the study (PEAACE I; 2011-2013), we used the spiderflash (Sorin, Italy) for up to 21 days of monitoring. In the second part (PEAACE II; 2013-2015), Cardiophone with real time monitoring of the heart rhythm for 14 days was used. Results: 102 patients in PEAACE I, (Mean age 72 +/-, 48.8% male) were compared to 120 patients in PEAACE II (Mean age 73 +/-, 70% male). Stroke type was “undetermined (cryptogenic) 92% and 91% in the two studies respectively. In PEAACE I, AF was detected in 43 out of 102 subjects (42%) (72% <30 seconds, 28% >30 seconds) with detection of 75% in the first week, 23% in the second, and 2% in the last week. In PEAACE II, 20 out of 120 subjects (17%) (70% <30 seconds, 30% >30 seconds) had AF, with 55% of detection in the first week, 45% in the second one (χ2 p=0.001). In PEAACE II, the results were available faster, within 2 days compared to 21 days in PEAACE I (χ2 p<0.0005). In PEAACE II, 90% of the patients received anticoagulation (93% of participants with A Fib <30 seconds, 83% with >30 seconds) compared to 77% in PEAACE I (68% with AF <30 seconds and 100% with AF >30 seconds) (χ2 p=0.021). Conclusion: There were significant differences noted in the rates of detection with the two techniques. Real-time monitoring resulted in recording of fewer events but lead to earlier initiation of treatment. All patients with >30 seconds of AF were anticoagulated whereas fewer patients with less than 30 seconds of AF were anticoagulated.

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The efficacy of synchronized direct current shock in reverting long standing persistent atrial fibrillation in to sinus rhythm. What help to achieve high success rate?

Journal of the Faculty of Medicine Baghdad ◽

10.32007/jfacmedbagdad.6311820 ◽

2021 ◽

Vol 63 (1) ◽

pp. 1-7

Author(s):

AMAR Talib AL-HAMDI ◽

Azad J. Ali

Keyword(s):

Atrial Fibrillation ◽

Body Weight ◽

Sinus Rhythm ◽

Success Rate ◽

Direct Current ◽

Antiarrhythmic Drugs ◽

Persistent Atrial Fibrillation ◽

High Success Rate ◽

Reversion Rate ◽

Case Series Study

Background: Atrial fibrillation is the most frequent cardiac arrhythmia encountered in general medicine and cardiology practice. Synchronized direct current shock is a known safe and effective procedure to revert long standing persistent atrial fibrillation into sinus rhythm. Patients and Methods: Patients with long-standing atrial fibrillation who were seen at the author’s private clinic and Al-Hassani Heart Center in Sulaimanya from April 2018 to December 2020 were chosen for rhythm control subjected to synchronized direct current cardioversion under heavy sedation applying a modified anterolateral paddles position with 200J and 300J successively according to the reversion dose required. Objectives: The Objective of current study was to assess the efficacy of synchronized direct current shock in reverting long-standing persistent atrial fibrillation into sinus rhythm and recognizing factors that help in achieving high success rate. Results: In this case series study 61 patients were included thirty-one males 30 females The success rate was 89%. Even patients with atrial fibrillation duration more than 2 years showed a success rate of 84%. The recurrence rate of atrial fibrillation was 30% within a follow up period of one month to 2 years. The modified paddles position has helped in achieving high reversion rate where success increased from 62% to 85% and failure rate decreased from 38% to 15%. The shock dose needed for reversion ranged from 200J to 300 J. There was no correlation between the needed dose for reversion and body weight where patients with body weight of 71-80kg, more than 80% reverted with 200J. Pre shock antiarrhythmic drugs did not facilitate the conversion, the reversion rate in patients with or without antiarrhythmic drugs were 85% and 82% successively. No per procedure complications were seen. Conclusion: Electrical cardioversion of atrial fibrillation with modified paddles position is a safe, effective and smooth procedure with significantly high success rate and very low incidence of complications even with very long-standing atrial fibrillation.

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Smartphone Application with Wireless Cardiac Monitoring Device to Analyze Real-Time ECG Using Modified Pan Tompkins Algorithm

10.1101/260034 ◽

2018 ◽

Author(s):

Usama Pervaiz ◽

Saed Khawaldeh ◽

Tajwar Abrar Aleef ◽

Vu Hoang Minh

Keyword(s):

Heart Rate ◽

Real Time ◽

Low Cost ◽

Smartphone Application ◽

Ease Of Use ◽

Cardiac Monitoring ◽

Health History ◽

Heart Patients ◽

History Of ◽

Care Assistance

Heart patients are constantly at risk of a heart failure, therefore, it is crucial to track their vitals. There is also a dire need to make a single platform which has patients and doctors on board, provides health-care assistance remotely, and have a low-cost and accessible solution that would cater large masses, both in terms of its buying accessibility as well as its ease of use. We are bringing a one stop solution, with a wearable device which monitors Electrocardiogram (ECG) and consequently measure heart rate. The wearable wireless device have an application compatibility on Smartphone which allows real time monitoring of ECG as well as it gives various post processing options, in which heart rate would be measured using modified Pan-Tompkins Algorithm and kept overtime for maintaining health history of the patient.

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Abstract WP229: Prolonged Monitoring of Cardiac Rhythm With Wireless Cardiophone for Real Time Detection of Atrial Fibrillation After a Cerebral Ischemic Event (PEAACE II Study) The Edmonton Alberta Experience

Stroke ◽

10.1161/str.47.suppl_1.wp229 ◽

2016 ◽

Vol 47 (suppl_1) ◽

Author(s):

Saad Hasan ◽

Herbert Manosalva ◽

Arif Pervez ◽

Askar Mohammad ◽

Dulara Hussain ◽

...

Keyword(s):

Atrial Fibrillation ◽

Medical Treatment ◽

Real Time ◽

Heart Rhythm ◽

Primary Objective ◽

Care Physician ◽

Cardiac Monitoring ◽

Chi Square ◽

Hospital Patients ◽

The Difference

Introduction: Atrial fibrillation (AF) is a leading cause of preventable stroke and can be prevented with anticoagulants. Prolonged cardiac monitoring can lead to better detection of AF. Real time cardiac monitoring may lead to earlier diagnosis and treatment. Objective: Primary objective is to detect AF using wireless cardiophone for 14 days in stroke patients. Secondary objective is to determine the reduction of time of AF diagnosis resulting in a prompt change in clinical management. Method: This was a Cohort/Prospective study at the Univesity of Alberta Hospital. Patients ≥40 years of age (without known AF on ECG/Holter) who had an ischemic stroke or TIA within ≤90 days were eligible. The signals from cardiophone were analyzed in real time at Canadian cardiac center in Windsor, Ontario. The incidence and time of onset of AF and change in medical treatment (anti-coagulation) was recorded. Results: Out of 120 patients, 118 completed monitoring for more than 48 hours. Twenty out of these 118 subjects (≈ 17 %) were shown positive for AF. When compared with the incidence of 5% reported in historical controls wearing 24 hour holter, the difference was significant (chi square p=0.004). Fourteen out of 20 AF subjects (70%)had AF duration of < 30 seconds, while 6/20 (30%) had a duration of >30 seconds. Mean time from onset of arrhythmia to report was ≈48 hours; shorter than the time for report with Holter (≈10 days in Alberta). Ninety percent of AF positive subjects were started on anti-coagulation therapies. Conclusion: Prolonged cardiac monitoring for 14 days increased the detection of AF approximately 3 fold as compared to 24 hour Holter. Cardiophone device allowed feasible real time monitoring of heart rhythm and faster reporting time (within 48 hours) that lead to prompt change in medical treatment by the health care physician.

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