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International Journal of Cardiology.... Dec 2021Atrial Fibrillation (AFib) is the most common arrhythmia, associated with considerable morbidity and mortality. It affects 8% population and its incidence rises with...
BACKGROUND AND OBJECTIVES
Atrial Fibrillation (AFib) is the most common arrhythmia, associated with considerable morbidity and mortality. It affects 8% population and its incidence rises with age. The consequences of untreated or poorly treated Afib are grave, therefore, appropriate management of this condition should occupy high priority.
DISCUSSION
AFib clinic provides a prompt, well-organized, and conclusive approach to managing affected patients. The essence of such a set-up lays in providing frequent monitoring to the patient in well-equipped centres with specialized doctors and trained staff. Worldwide AFib clinics have shown evidence of morbidity, mortality, and cost-benefits.
CONCLUSION
In developing countries such as Pakistan with less budget granted to health care, specialized AFib clinics could save cost, besides providing better health care outcomes to the patients. It is crucial to establish such focused AFib care centres urgently.
PubMed: 34988557
DOI: 10.1016/j.ijcrp.2021.200119 -
Biomedical Optics Express Apr 2020With the popularity of smart phones, non-contact video-based vital sign monitoring using a camera has gained increased attention over recent years. Especially, imaging...
With the popularity of smart phones, non-contact video-based vital sign monitoring using a camera has gained increased attention over recent years. Especially, imaging photoplethysmography (IPPG), a technique for extracting pulse waves from videos, conduces to monitor physiological information on a daily basis, including heart rate, respiration rate, blood oxygen saturation, and so on. The main challenge for accurate pulse wave extraction from facial videos is that the facial color intensity change due to cardiovascular activities is subtle and is often badly disturbed by noise, such as illumination variation, facial expression changes, and head movements. Even a tiny interference could bring a big obstacle for pulse wave extraction and reduce the accuracy of the calculated vital signs. In recent years, many novel approaches have been proposed to eliminate noise such as filter banks, adaptive filters, Distance-PPG, and machine learning, but these methods mainly focus on heart rate detection and neglect the retention of useful details of pulse wave. For example, the pulse wave extracted by the filter bank method has no dicrotic wave and approaching sine wave, but dicrotic waves are essential for calculating vital signs like blood viscosity and blood pressure. Therefore, a new framework is proposed to achieve accurate pulse wave extraction that contains mainly two steps: 1) preprocessing procedure to remove baseline offset and high frequency random noise; and 2) a self-adaptive singular spectrum analysis algorithm to obtain cyclical components and remove aperiodic irregular noise. Experimental results show that the proposed method can extract detail-preserved pulse waves from facial videos under realistic situations and outperforms state-of-the-art methods in terms of detail-preserving and real time heart rate estimation. Furthermore, the pulse wave extracted by our approach enabled the non-contact estimation of atrial fibrillation, heart rate variability, blood pressure, as well as other physiological indices that require standard pulse wave.
PubMed: 32341854
DOI: 10.1364/BOE.380646 -
The American Journal of Cardiology Oct 2019A man without cardiac symptoms was found to have a slow irregular pulse, and an electrocardiogram revealed sinus bradycardia with escape-capture bigeminy. He was taking...
A man without cardiac symptoms was found to have a slow irregular pulse, and an electrocardiogram revealed sinus bradycardia with escape-capture bigeminy. He was taking verapamil, clonidine, and hydralazine for hypertension. The verapamil was discontinued; he returned to normal sinus rhythm and was discharged on the second hospital day.
Topics: Calcium Channel Blockers; Electrocardiography; Heart Rate; Humans; Hypertension; Male; Middle Aged; Sick Sinus Syndrome; Verapamil
PubMed: 31443901
DOI: 10.1016/j.amjcard.2019.06.034 -
Physiological Measurement Mar 2023Assessment of heartbeat dynamics provides a promising framework for non-invasive monitoring of cardiovascular and autonomic states. Nevertheless, the non-specificity of...
Assessment of heartbeat dynamics provides a promising framework for non-invasive monitoring of cardiovascular and autonomic states. Nevertheless, the non-specificity of such measurements among clinical populations and healthy conditions associated with different autonomic states severely limits their applicability and exploitation in naturalistic conditions. This limitation arises especially when pathological or postural change-related sympathetic hyperactivity is compared to autonomic changes across age and experimental conditions. In this frame, we investigate the intrinsic irregularity and complexity of cardiac sympathetic and vagal activity series in different populations, which are associated with different cardiac autonomic dynamics. Sample entropy, fuzzy entropy, and distribution entropy are calculated on the recently proposed sympathetic and parasympathetic activity indices (SAI and PAI) series, which are derived from publicly available heartbeat series of congestive heart failure patients, elderly and young subjects watching a movie in the supine position, and healthy subjects undergoing slow postural changes. Results show statistically significant differences between pathological/old subjects and young subjects in the resting state and during slow tilt, with interesting trends in SAI- and PAI-related entropy values. Moreover, while CHF patients and healthy subjects in upright position show the higher cardiac sympathetic activity, elderly and young subjects in resting state showed higher vagal activity. We conclude that quantification of intrinsic cardiac complexity from sympathetic and vagal dynamics may provide new physiology insights and improve on the non-specificity of heartbeat-derived biomarkers.
Topics: Humans; Aged; Autonomic Nervous System; Vagus Nerve; Heart; Cardiovascular System; Heart Rate
PubMed: 36787644
DOI: 10.1088/1361-6579/acbc07 -
Communications Biology Mar 2021Heart rhythm assessment is indispensable in diagnosis and management of many cardiac conditions and to study heart rate variability in healthy individuals. We present a... (Comparative Study)
Comparative Study
Heart rhythm assessment is indispensable in diagnosis and management of many cardiac conditions and to study heart rate variability in healthy individuals. We present a proof-of-concept system for acquiring individual heart beats using smart speakers in a fully contact-free manner. Our algorithms transform the smart speaker into a short-range active sonar system and measure heart rate and inter-beat intervals (R-R intervals) for both regular and irregular rhythms. The smart speaker emits inaudible 18-22 kHz sound and receives echoes reflected from the human body that encode sub-mm displacements due to heart beats. We conducted a clinical study with both healthy participants and hospitalized cardiac patients with diverse structural and arrhythmic cardiac abnormalities including atrial fibrillation, flutter and congestive heart failure. Compared to electrocardiogram (ECG) data, our system computed R-R intervals for healthy participants with a median error of 28 ms over 12,280 heart beats and a correlation coefficient of 0.929. For hospitalized cardiac patients, the median error was 30 ms over 5639 heart beats with a correlation coefficient of 0.901. The increasing adoption of smart speakers in hospitals and homes may provide a means to realize the potential of our non-contact cardiac rhythm monitoring system for monitoring of contagious or quarantined patients, skin sensitive patients and in telemedicine settings.
Topics: Acoustics; Aged; Algorithms; Arrhythmias, Cardiac; Case-Control Studies; Electrocardiography; Equipment Design; Female; Heart Failure; Heart Rate; Hospitalization; Humans; Male; Middle Aged; Predictive Value of Tests; Proof of Concept Study; Prospective Studies; Reproducibility of Results; Signal Processing, Computer-Assisted; Telemedicine; Time Factors; Transducers; Wireless Technology
PubMed: 33750897
DOI: 10.1038/s42003-021-01824-9 -
Chaos (Woodbury, N.Y.) Apr 2021The idealization of neuronal pulses as δ-spikes is a convenient approach in neuroscience but can sometimes lead to erroneous conclusions. We investigate the effect of a...
The idealization of neuronal pulses as δ-spikes is a convenient approach in neuroscience but can sometimes lead to erroneous conclusions. We investigate the effect of a finite pulse width on the dynamics of balanced neuronal networks. In particular, we study two populations of identical excitatory and inhibitory neurons in a random network of phase oscillators coupled through exponential pulses with different widths. We consider three coupling functions inspired by leaky integrate-and-fire neurons with delay and type I phase-response curves. By exploring the role of the pulse widths for different coupling strengths, we find a robust collective irregular dynamics, which collapses onto a fully synchronous regime if the inhibitory pulses are sufficiently wider than the excitatory ones. The transition to synchrony is accompanied by hysteretic phenomena (i.e., the co-existence of collective irregular and synchronous dynamics). Our numerical results are supported by a detailed scaling and stability analysis of the fully synchronous solution. A conjectured first-order phase transition emerging for δ-spikes is smoothed out for finite-width pulses.
Topics: Models, Neurological; Neurons
PubMed: 34251252
DOI: 10.1063/5.0046691 -
International Journal of Molecular... Apr 2022Rare Diseases (RD) are defined by their prevalence in less than 5 in 10,000 of the general population. Considered individually, each RD may seem insignificant, but... (Review)
Review
Rare Diseases (RD) are defined by their prevalence in less than 5 in 10,000 of the general population. Considered individually, each RD may seem insignificant, but together they add up to more than 7000 different diseases. Research in RD is not attractive for pharmaceutical companies since it is unlikely to recover development costs for medicines aimed to small numbers of patients. Since most of these diseases are life threatening, this fact underscores the urgent need for treatments. Drug repurposing consists of identifying new uses for approved drugs outside the scope of the original medical indication. It is an alternative option in drug development and represents a viable and risk-managed strategy to develop for RDs. In 2008, the "off label" therapeutic benefits of propranolol were described in the benign tumor Infantile Hemangioma. Propranolol, initially prescribed for high blood pressure, irregular heart rate, essential tremor, and anxiety, has, in the last decade, shown increasing evidence of its antiangiogenic, pro-apoptotic, vasoconstrictor and anti-inflammatory properties in different RDs, including vascular or oncological pathologies. This review highlights the finished and ongoing trials in which propranolol has arisen as a good repurposing drug for improving the health condition in RDs.
Topics: Adrenergic beta-Antagonists; Drug Repositioning; Humans; Propranolol; Rare Diseases; Vascular Diseases
PubMed: 35457036
DOI: 10.3390/ijms23084217 -
Annals of the New York Academy of... Oct 2019Regular rhythm facilitates audiomotor entrainment and synchronization in motor behavior and vocalizations between individuals. As rhythm entrainment between interacting...
Regular rhythm facilitates audiomotor entrainment and synchronization in motor behavior and vocalizations between individuals. As rhythm entrainment between interacting agents is correlated with higher levels of cooperation and prosocial affiliative behavior, humans can potentially map regular speech rhythm onto higher cooperation and friendliness between interacting individuals. We tested this hypothesis at two rhythmic levels: pulse (recurrent acoustic events) and meter (hierarchical structuring of pulses based on their relative salience). We asked the listeners to make judgments of the hostile or collaborative attitude of two interacting agents who exhibit either regular or irregular pulse (Experiment 1) or meter (Experiment 2). The results confirmed a link between the perception of social affiliation and rhythmicity: evenly distributed pulses (vowel onsets) and consistent grouping of pulses into recurrent hierarchical patterns are more likely to be perceived as cooperation signals. People are more sensitive to regularity at the level of pulse than at the level of meter, and they are more confident when they associate cooperation with isochrony in pulse. The evolutionary origin of this faculty is possibly the need to transmit and perceive coalition information in social groups of human ancestors. We discuss the implications of these findings for the emergence of speech in humans.
Topics: Adolescent; Adult; Female; Humans; Judgment; Language; Male; Multilingualism; Periodicity; Social Behavior; Speech; Speech Perception; Young Adult
PubMed: 31373001
DOI: 10.1111/nyas.14193 -
Cureus Jan 2022Colon carcinoma (CA) is one of the most common cancers worldwide. Cardiac metastasis in CA is quite rare with only a few incidences. These tumors are usually clinically...
Colon carcinoma (CA) is one of the most common cancers worldwide. Cardiac metastasis in CA is quite rare with only a few incidences. These tumors are usually clinically silent and are discovered on autopsy. We present a case of a 62-year-old woman, known diabetic, hypertensive, and hypothyroid patient, who presented with complaints of abdominal distention and obstipation with multiple episodes of vomiting undigested food particles for three days. She had been passing dark tarry stools infrequently for over a month. She complained of a progressive loss of appetite and 5 kg weight loss over a month. Her examination revealed pallor and irregular pulse with a rate of 94/min. She had a distended non-tender abdomen and absent bowel sounds. Contrast-enhanced computed tomography (CECT) abdomen showed circumferential thickening of the descending colon, causing acute stenosis with multiple liver metastases and enlarged pericolic lymph nodes. Serum carcinoembryonic antigen (CEA) was elevated, 55.45 ng/mL. She underwent an emergency exploratory laparotomy with transverse loop colostomy. Histopathology report showed moderately differentiated adenocarcinoma. ECG showed atrial fibrillation and two-dimensional echocardiogram showed right ventricular metastasis. High-resolution computed tomography (HRCT) thorax was done to confirm the diagnosis. The common sites of metastases from colorectal cancer are the lymph nodes, liver, and lungs. When cardiac metastasis occurs, it often presents with features of heart failure. Our patient presented with atrial fibrillation. As the incidence of cardiac metastasis is quite rare, there is no standard established treatment. Certain chemotherapeutic drugs, such as 5-fluorouracil, oxaliplatin, irinotecan (FOLFIRINOX regimen), have been shown to improve cardiac metastases. Due to the extensive spread of primary cancer in our patient, she was planned for palliative chemotherapy; however, the patient expired before initiation of therapy.
PubMed: 35145823
DOI: 10.7759/cureus.21703