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European Journal of Pediatrics Aug 2014Cardiac arrhythmias are very frequent in fetuses and newborns. The prognosis depends on the nature of the arrhythmias but is most often either spontaneously benign or... (Review)
Review
UNLABELLED
Cardiac arrhythmias are very frequent in fetuses and newborns. The prognosis depends on the nature of the arrhythmias but is most often either spontaneously benign or following short-term medication administration. A correct diagnosis is essential for both management and prognosis. It is based on echocardiography during the fetal period and mainly on history, physical exam, and electrocardiogram after birth, but other modalities are available to record transient arrhythmic events. Irregular rhythms are mostly benign and rarely require therapy. In most fetuses and infants, tachyarrhythmias resolve spontaneously or require short-term administration of antiarrhythmics. Approximately one third of these may recur later on, especially during adolescence. Persistent bradyarrhythmias might require pacemaker implantation when associated with failure to thrive or with risk of sudden death.
CONCLUSION
Arrhythmias in fetuses and infants are very common and mostly benign. History, physical exam, and recording of the arrhythmia are essential to make a correct diagnosis and establish an appropriate management for the rare potentially harmful arrhythmias.
Topics: Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Echocardiography; Electrocardiography; Female; Fetus; Heart Rate; Humans; Infant, Newborn; Pregnancy; Treatment Outcome; Ultrasonography, Prenatal
PubMed: 24740881
DOI: 10.1007/s00431-014-2316-4 -
Journal of Medical Systems Mar 2016Heart rate is an important clinical measure that is often used in pathological diagnosis and prognosis. Valid detection of irregular heartbeats is crucial in the...
Heart rate is an important clinical measure that is often used in pathological diagnosis and prognosis. Valid detection of irregular heartbeats is crucial in the clinical practice. We propose an artificial neural network using the calculated pulse rate to detect irregular interbeats. The proposed system measures the calculated pulse rate to determine an "irregular interbeat on" or "irregular interbeat off" event. If an irregular interbeat is detected, the proposed system produces a danger warning, which is helpful for clinicians. If a non-irregular interbeat is detected, the proposed system displays the calculated pulse rate. We include a flow chart of the proposed software. In an experiment, we measure the calculated pulse rates and achieve an error percentage of < 3% in 20 participants with a wide age range. When we use the calculated pulse rates to detect irregular interbeats, we find such irregular interbeats in eight participants.
Topics: Arrhythmias, Cardiac; Heart Rate; Humans; Infrared Rays; Monitoring, Physiologic; Neural Networks, Computer; Pulse; Signal Processing, Computer-Assisted; Software Design
PubMed: 26643078
DOI: 10.1007/s10916-015-0409-x -
Journal of the American College of... Mar 2008
Topics: Atrial Fibrillation; Genetic Predisposition to Disease; Heart Rate; Humans; Risk Factors
PubMed: 18342227
DOI: 10.1016/j.jacc.2007.12.011 -
Annual International Conference of the... 2009We developed an arrhythmic pulse detection algorithm from photoplethysmography (PPG) measured in daily life using a wearable PPG sensor, in order to provide a simpler...
We developed an arrhythmic pulse detection algorithm from photoplethysmography (PPG) measured in daily life using a wearable PPG sensor, in order to provide a simpler device than a Holter electrocardiograph (ECG). However, PPG is very sensitive to artifacts in daily life, e.g. body movement. First, we analyzed the correlation between the ECG and the PPG measured at the same time when the arrhythmic heartbeat occurred in daily life. Using the correlation characteristics, we developed a detection algorithm of the arrhythmic pulse to distinguish the artifacts ascribable to body movement and evaluated its accuracy. The algorithm detects pulse-to-pulse interval (PPI) and pulse amplitude by a beat to distinguish between irregular PPI by arrhythmic pulse and that by the artifact.
Topics: Activities of Daily Living; Algorithms; Arrhythmias, Cardiac; Diagnosis, Computer-Assisted; Equipment Design; Equipment Failure Analysis; Heart Rate; Humans; Monitoring, Ambulatory; Photoplethysmography; Reproducibility of Results; Sensitivity and Specificity; Transducers
PubMed: 19965254
DOI: 10.1109/IEMBS.2009.5335401 -
British Heart Journal Jul 1986The belief that there is total irregularity of the pulse in atrial fibrillation has been re-examined. In a computerised analysis of R-R intervals and pulse volumes,...
The belief that there is total irregularity of the pulse in atrial fibrillation has been re-examined. In a computerised analysis of R-R intervals and pulse volumes, 100-500 (mean 237) consecutive cycles were examined in 74 patients with atrial fibrillation, of whom 36 were on digoxin and 38 were not taking any antiarrhythmic treatment. A Doppler ultrasound technique was used to assess pulse volumes, against which R-R intervals were correlated. Although the sequence of consecutive R-R intervals was random in 52 (70%), patients there was a significant correlation between consecutive intervals in 22 (30%), the correlation coefficient being negative in 11 and positive in 11. In 43 (58%) cases the sequence of consecutive pulse volumes was significantly non-random; 34 (46%) showed pulsus alternans, indicated by a negative correlation between consecutive volumes. The proportion of patients with a non-random sequence of R-R intervals or pulse volumes was the same whether or not they were taking digoxin. Thus patients with atrial fibrillation often have patterns of regularity of the pulse, with the ventricular rhythm being non-random in almost one third and the sequence of pulse volumes being non-random in over a half. Contrary to classic teaching, in many patients with atrial fibrillation the pulse is not irregularly irregular.
Topics: Adult; Aged; Atrial Fibrillation; Digoxin; Electrocardiography; Female; Heart Ventricles; Humans; Male; Middle Aged; Pulse; Time Factors
PubMed: 3730206
DOI: 10.1136/hrt.56.1.4 -
International Journal of Biological... 2017With the fast development of wearable medical device in recent years, it becomes critical to conduct research on continuously measured physiological signals. Entropy is... (Review)
Review
With the fast development of wearable medical device in recent years, it becomes critical to conduct research on continuously measured physiological signals. Entropy is a key metric for quantifying the irregularity and/or complexity contained in human physiological signals. In this review, we focus on exploring how entropy changes in various physiological signals in cardiovascular diseases. Our review concludes that the direction of entropy change relies on the physiological signals under investigation. For heart rate variability and pulse index, the entropy of a healthy person is higher than that of a patient with cardiovascular diseases. For diastolic period variability and diastolic heart sound, the direction of entropy change is reversed. Our conclusion should not only give valuable guidance for further research on the application of entropy in cardiovascular diseases but also provide a foundation for using entropy to analyze the irregularity and/or complexity of physiological signals measured by wearable medical device.
Topics: Animals; Cardiovascular Diseases; Electrocardiography; Entropy; Heart Rate; Humans
PubMed: 29104498
DOI: 10.7150/ijbs.19462 -
Journal of Cardiovascular... Jan 2016Atrial fibrillation (AF) is a common and dangerous rhythm abnormality. Smartphones are increasingly used for mobile health applications by older patients at risk for AF...
BACKGROUND
Atrial fibrillation (AF) is a common and dangerous rhythm abnormality. Smartphones are increasingly used for mobile health applications by older patients at risk for AF and may be useful for AF screening.
OBJECTIVES
To test whether an enhanced smartphone app for AF detection can discriminate between sinus rhythm (SR), AF, premature atrial contractions (PACs), and premature ventricular contractions (PVCs).
METHODS
We analyzed two hundred and nineteen 2-minute pulse recordings from 121 participants with AF (n = 98), PACs (n = 15), or PVCs (n = 15) using an iPhone 4S. We obtained pulsatile time series recordings in 91 participants after successful cardioversion to sinus rhythm from preexisting AF. The PULSE-SMART app conducted pulse analysis using 3 methods (Root Mean Square of Successive RR Differences; Shannon Entropy; Poincare plot). We examined the sensitivity, specificity, and predictive accuracy of the app for AF, PAC, and PVC discrimination from sinus rhythm using the 12-lead EKG or 3-lead telemetry as the gold standard. We also administered a brief usability questionnaire to a subgroup (n = 65) of app users.
RESULTS
The smartphone-based app demonstrated excellent sensitivity (0.970), specificity (0.935), and accuracy (0.951) for real-time identification of an irregular pulse during AF. The app also showed good accuracy for PAC (0.955) and PVC discrimination (0.960). The vast majority of surveyed app users (83%) reported that it was "useful" and "not complex" to use.
CONCLUSION
A smartphone app can accurately discriminate pulse recordings during AF from sinus rhythm, PACs, and PVCs.
Topics: Aged; Algorithms; Atrial Fibrillation; Atrial Premature Complexes; Attitude to Computers; Diagnosis, Differential; Electrocardiography; Female; Heart Rate; Humans; Male; Middle Aged; Mobile Applications; Patient Satisfaction; Photoplethysmography; Predictive Value of Tests; Prospective Studies; Pulse; Reproducibility of Results; Signal Processing, Computer-Assisted; Smartphone; Surveys and Questionnaires; Telemetry; Ventricular Premature Complexes
PubMed: 26391728
DOI: 10.1111/jce.12842 -
Circulation Aug 2017
Topics: Action Potentials; Administration, Intravenous; Aged; Anti-Arrhythmia Agents; Electrocardiography; Female; Flecainide; Heart Rate; Humans; Sodium Bicarbonate; Tachycardia, Ventricular; Time Factors
PubMed: 28827222
DOI: 10.1161/CIRCULATIONAHA.117.029974 -
PloS One 2022Atrial fibrillation (AF) remain a prevalent undiagnosed condition frequently encountered in primary care.
BACKGROUND
Atrial fibrillation (AF) remain a prevalent undiagnosed condition frequently encountered in primary care.
OBJECTIVE
We aimed to find the parameters that optimize the diagnostic accuracy of pulse palpation to detect AF. We also aimed to create a simple algorithm for selecting which individuals would benefit from pulse palpation and, if positive, receive an ECG to detect AF.
METHODS
Nurses from four Cardiology outpatient clinics palpated 7,844 pulses according to a randomized list of arterial territories and durations of measure and immediately followed by a 12-lead ECG, which we used as the reference standard. We calculated the sensitivity and specificity of the palpation parameters. We also assessed whether diagnostic accuracy depended on the nurse's experience or on a list of clinical factors of the patients. With this information, we estimated the positive predictive values and false omission rates according to very few clinical factors readily available in primary care (age, sex, and diagnosis of heart failure) and used them to create the algorithm.
RESULTS
The parameters associated with the highest diagnostic accuracy were palpation of the radial artery and classifying as irregular those palpations in which the nurse was uncertain about pulse regularity or unable to palpate pulse (sensitivity = 79%; specificity = 86%). Specificity decreased with age. Neither the nurse's experience nor any investigated clinical factor influenced diagnostic accuracy. We provide the algorithm to select the ≥40 years old individuals that would benefit from a pulse palpation screening: a) do nothing in <60 years old individuals without heart failure; b) do ECG in ≥70 years old individuals with heart failure; c) do radial pulse palpation in the remaining individuals and do ECG if the pulse is irregular or you are uncertain about its regularity or unable to palpate it.
CONCLUSIONS
Opportunistic screening for AF using optimal pulse palpation in candidate individuals according to a simple algorithm may have high effectiveness in detecting AF in primary care.
Topics: Adult; Aged; Ambulatory Care Facilities; Atrial Fibrillation; Cardiology; Electrocardiography; Heart Failure; Humans; Mass Screening; Middle Aged; Palpation; Pulse
PubMed: 35446875
DOI: 10.1371/journal.pone.0266955 -
Heart Rhythm Apr 2017
Topics: Aged; Bundle-Branch Block; Electrocardiography; Female; Heart Rate; Humans
PubMed: 28335931
DOI: 10.1016/j.hrthm.2017.01.014