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Chen Z, Ono N, Chen W, Tamura T, Altaf-Ul-Amin MD, Kanaya S, Huang M. The feasibility of predicting impending malignant ventricular arrhythmias by using nonlinear features of short heartbeat intervals. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 205:106102. [PMID: 33933712 DOI: 10.1016/j.cmpb.2021.106102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Malignant ventricular arrhythmias (MAs) occur unpredictably and lead to emergencies. A new approach that uses a timely tracking device e.g., photoplethysmogram (PPG) solely to predict MAs would be irreplaceably valuable and it is natural to expect the approach can predict the occurrence as early as possible. METHOD We assumed that with an appropriate metric based on signal complexity, the heartbeat interval time series (HbIs) can be used to manifest the intrinsic characteristics of the period immediately precedes the MAs (preMAs). The approach first characterizes the patterns of preMAs by a new complexity metric (the refined composite multi-scale entropy). The MAs detector is then constructed by checking the discriminability of the MAs against the sinus rhythm and other prevalent arrhythmias (atrial fibrillation and premature ventricular contraction) of three machine-learning models (SVM, Random Forest, and XGboost). RESULTS Two specifications are of interest: the length of the HbIs needed to delineate the preMAs patterns sufficiently (lspec) and how long before the occurrence of MAs will the HbIs manifest specific patterns that are distinct enough to predict the impending MAs (tspec). Our experimental results confirmed the best performance came from a Random-Forest model with an average precision of 99.99% and recall of 88.98% using a HbIs of 800 heartbeats (the lspec), 108 seconds (the tspec) before the occurrence of MAs. CONCLUSION By experimental validation of the unique pattern of the preMAs in HbIs and using it in the machine learning model, we showed the high possibility of MAs prediction in a broader circumstance, which may cover daily healthcare using the alternative sensor in HbIs monitoring. Therefore, this research is theoretically and practically significant in cardiac arrest prevention.
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Affiliation(s)
- Zheng Chen
- Graduate School of Science and Technology, Nara Insitute of Science and Technology, Japan
| | - Naoaki Ono
- Graduate School of Science and Technology, Nara Insitute of Science and Technology, Japan; Data Science Center, Nara Insitute of Science and Technology, Japan
| | - Wei Chen
- Center for Intelligent Medical Electronics, Department of Electronic Engineering, School of Information Science and Technology, Fudan University, Shanghai 200433, China
| | - Toshiyo Tamura
- Institute for Healthcare Robotics, Waseda university, Japan
| | - M D Altaf-Ul-Amin
- Graduate School of Science and Technology, Nara Insitute of Science and Technology, Japan
| | - Shigehiko Kanaya
- Graduate School of Science and Technology, Nara Insitute of Science and Technology, Japan; Data Science Center, Nara Insitute of Science and Technology, Japan
| | - Ming Huang
- Graduate School of Science and Technology, Nara Insitute of Science and Technology, Japan.
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Parsi A, Byrne D, Glavin M, Jones E. Heart rate variability feature selection method for automated prediction of sudden cardiac death. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2020.102310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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3
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Mitchell KJ, Schwarzwald CC. Heart rate variability analysis in horses for the diagnosis of arrhythmias. Vet J 2020; 268:105590. [PMID: 33468305 DOI: 10.1016/j.tvjl.2020.105590] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 11/29/2020] [Accepted: 11/30/2020] [Indexed: 12/16/2022]
Abstract
Heart rate variability (HRV) analysis has been performed on ECG-derived data sets for more than 170 years but is currently undergoing a rapid evolution, thanks to the expansion of the human and veterinary medical technology sector. Traditional HRV analysis was initially performed to identify changes in vago-sympathetic balance, while the most recent focus has expanded to include the use of complex computer algorithms, neural networks and machine learning technology to identify cardiac arrhythmias, particularly atrial fibrillation (AF). Some of these techniques have recently been translated for use in the field of equine cardiology, with particular focus on improving the diagnosis of arrhythmias both at rest and during exercise. This review focuses on understanding the basic HRV variables and important factors to consider when collecting data for use in HRV analysis. In addition, the use of HRV analysis for the diagnosis of arrhythmias is discussed from human, small animal and equine perspectives. Finally, the future of HRV analysis is briefly introduced, including an overview of future developments in this rapidly expanding and exciting field.
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Affiliation(s)
- Katharyn J Mitchell
- Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich, 8057, Switzerland.
| | - Colin C Schwarzwald
- Equine Department, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich, 8057, Switzerland
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Martinez-Alanis M, Bojorges-Valdez E, Wessel N, Lerma C. Prediction of Sudden Cardiac Death Risk with a Support Vector Machine Based on Heart Rate Variability and Heartprint Indices. SENSORS 2020; 20:s20195483. [PMID: 32992675 PMCID: PMC7582608 DOI: 10.3390/s20195483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/11/2020] [Accepted: 09/22/2020] [Indexed: 11/16/2022]
Abstract
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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Affiliation(s)
- Marisol Martinez-Alanis
- Facultad de Ingeniería, Universidad Anáhuac México, Huixquilucan 52786, Estado de Mexico, Mexico;
| | - Erik Bojorges-Valdez
- Departamento de Estudios en Ingeniería para la Innovación, Universidad Iberoamericana Ciudad de México, Ciudad de México 01219, Mexico;
| | - Niels Wessel
- Department of Physics, Humboldt-Universität zu Berlin, 10099 Berlin, Germany;
| | - Claudia Lerma
- Departamento de Instrumentación Electromecánica, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México 14089, Mexico
- Correspondence: ; Tel.: +52-55-5573-2911 (ext. 26202)
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Parsi A, O'Loughlin D, Glavin M, Jones E. Heart Rate Variability Analysis to Predict Onset of Ventricular Tachyarrhythmias in Implantable Cardioverter Defibrillators. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:6770-6775. [PMID: 31947395 DOI: 10.1109/embc.2019.8857911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Implantable cardioverter defibrillators (ICDs) are commonly used in patients at high risk of sudden cardiac death (SCD) to help prevent and treat life-threatening arrhythmia. Up to 80% of cases of sudden cardiac death are caused by ventricular tachyarrhythmias (VTA) and the accurate prediction of VTA in patients with ICDs can help prevent SCD. Early prediction allows tiered and less invasive therapies to be used to help prevent VTA which are more easily tolerated by the patient and are less battery intensive. In this work, a comparative study of three types of frequency domain features (spectral, bispectrum, and Fourier-Bessel) for VTA prediction is presented based on heart rate variability (HRV) signals between one and five minutes prior to known SCD. Using Fourier-Bessel features and a standard classification approach resulted in the best performance of 87.5% accuracy, 89.3% sensitivity and 85.7% specificity. These results suggest that Fourier-Bessel features are a promising approach for SCD prediction, and that new feature development can help improve both the sensitivity and specificity of SCD prediction in ICDs.
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Parsi A, O'Loughlin D, Glavin M, Jones E. Prediction of Sudden Cardiac Death in Implantable Cardioverter Defibrillators: A Review and Comparative Study of Heart Rate Variability Features. IEEE Rev Biomed Eng 2019; 13:5-16. [PMID: 31021774 DOI: 10.1109/rbme.2019.2912313] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Over the last four decades, implantable cardioverter defibrillators (ICDs) have been widely deployed to reduce sudden cardiac death (SCD) risk in patients with a history of life-threatening arrhythmia. By continuous monitoring of the heart rate, ICDs can use decision algorithms to distinguish normal cardiac sinus rhythm or supra-ventricular tachycardia from abnormal cardiac rhythms like ventricular tachycardia and ventricular fibrillation and deliver appropriate therapy such as an electrical stimulus. Despite the success of ICDs, more research is still needed, particularly in decision-making algorithms. Because of low specificity in practical devices, patients with ICDs still receive inappropriate shocks, which may lead to inadvertent mortality and reduction of quality of life. At the same time, higher sensitivity can lead to the use of newer tiered therapies. The purpose of this study is to review the literature on common signal features used in detection algorithms for abnormal cardiac sinus rhythm, as well as reviewing datasets used for algorithm development in previous studies. More than 50 different features to address heart rate changes before SCD have been reviewed and general methodology on this area proposed based on variety of studies on ICDs functionality. A comparative study on the prediction performance of these features, using a common database, is also presented. By combining these features with a support vector machine classifier, achieved results have compared well with other studies.
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Sharma E, Arunachalam K, Di M, Chu A, Maan A. PVCs, PVC-Induced Cardiomyopathy, and the Role of Catheter Ablation. Crit Pathw Cardiol 2017; 16:76-80. [PMID: 28509708 DOI: 10.1097/hpc.0000000000000106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Premature ventricular contractions (PVCs) are common arrhythmias noticed in the clinical setting because of premature depolarization of the ventricular myocytes. Although often thought to be reflective of underlying disease rather than intrinsically harmful, PVCs have recently been linked with worse outcomes in patients without significant cardiac disease. Long-term exposure to a high PVC burden can lead to the development of PVC-induced cardiomyopathy. The pathogenesis of this condition is poorly understood at the current time. Many studies have suggested that catheter ablation of these PVCs may result in reversal of the PVC-induced cardiomyopathy. This article will go over the natural history of PVCs and PVC-induced cardiomyopathy, as well as review the current literature on the role of catheter ablation in treating PVC-induced cardiomyopathy.
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Affiliation(s)
- Esseim Sharma
- From The Warren Alpert Medical School of Brown University, Providence, RI
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Martínez-Alanis M, Ruiz-Velasco S, Lerma C. Quantitative analysis of ventricular ectopic beats in short-term RR interval recordings to predict imminent ventricular tachyarrhythmia. Int J Cardiol 2016; 225:226-233. [DOI: 10.1016/j.ijcard.2016.09.117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 09/27/2016] [Accepted: 09/29/2016] [Indexed: 10/20/2022]
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Nenadovic V, Perez Velazquez JL, Hutchison JS. Phase synchronization in electroencephalographic recordings prognosticates outcome in paediatric coma. PLoS One 2014; 9:e94942. [PMID: 24752289 PMCID: PMC3994059 DOI: 10.1371/journal.pone.0094942] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 03/21/2014] [Indexed: 02/06/2023] Open
Abstract
Brain injury from trauma, cardiac arrest or stroke is the most important cause of death and acquired disability in the paediatric population. Due to the lifetime impact of brain injury, there is a need for methods to stratify patient risk and ultimately predict outcome. Early prognosis is fundamental to the implementation of interventions to improve recovery, but no clinical model as yet exists. Healthy physiology is associated with a relative high variability of physiologic signals in organ systems. This was first evaluated in heart rate variability research. Brain variability can be quantified through electroencephalographic (EEG) phase synchrony. We hypothesised that variability in brain signals from EEG recordings would correlate with patient outcome after brain injury. Lower variability in EEG phase synchronization, would be associated with poor patient prognosis. A retrospective study, spanning 10 years (2000-2010) analysed the scalp EEGs of children aged 1 month to 17 years in coma (Glasgow Coma Scale, GCS, <8) admitted to the paediatric critical care unit (PCCU) following brain injury from TBI, cardiac arrest or stroke. Phase synchrony of the EEGs was evaluated using the Hilbert transform and the variability of the phase synchrony calculated. Outcome was evaluated using the 6 point Paediatric Performance Category Score (PCPC) based on chart review at the time of hospital discharge. Outcome was dichotomized to good outcome (PCPC score 1 to 3) and poor outcome (PCPC score 4 to 6). Children who had a poor outcome following brain injury secondary to cardiac arrest, TBI or stroke, had a higher magnitude of synchrony (R index), a lower spatial complexity of the synchrony patterns and a lower temporal variability of the synchrony index values at 15 Hz when compared to those patients with a good outcome.
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Affiliation(s)
- Vera Nenadovic
- Division of Neurology Sick Kids, Toronto, Ontario, Canada
- Brain and Mental Health, Toronto, Ontario, Canada
| | - Jose Luis Perez Velazquez
- Brain and Mental Health, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - James Saunders Hutchison
- Division of Neurology Sick Kids, Toronto, Ontario, Canada
- Brain and Mental Health, Toronto, Ontario, Canada
- Department of Critical Care Medicine Sick Kids, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
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Lerma C, Gorelick A, Ghanem RN, Glass L, Huikuri HV. Patterns of ectopy leading to increased risk of fatal or near-fatal cardiac arrhythmia in patients with depressed left ventricular function after an acute myocardial infarction. ACTA ACUST UNITED AC 2013; 15:1304-12. [DOI: 10.1093/europace/eus415] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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11
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Shields KN, Cavallari JM, Hunt MJO, Lazo M, Molina M, Molina L, Holguin F. Traffic-related air pollution exposures and changes in heart rate variability in Mexico City: a panel study. Environ Health 2013; 12:7. [PMID: 23327098 PMCID: PMC3639920 DOI: 10.1186/1476-069x-12-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 12/10/2012] [Indexed: 05/09/2023]
Abstract
BACKGROUND While air pollution exposures have been linked to cardiovascular outcomes, the contribution from acute gas and particle traffic-related pollutants remains unclear. Using a panel study design with repeated measures, we examined associations between personal exposures to traffic-related air pollutants in Mexico City and changes in heart rate variability (HRV) in a population of researchers aged 22 to 56 years. METHODS Participants were monitored for approximately 9.5 hours for eight days while operating a mobile laboratory van designed to characterize traffic pollutants while driving in traffic and "chasing" diesel buses. We examined the association between HRV parameters (standard deviation of normal-to-normal intervals (SDNN), power in high frequency (HF) and low frequency (LF), and the LF/HF ratio) and the 5-minute maximum (or average in the case of PM(2.5)) and 30-, 60-, and 90-minute moving averages of air pollutants (PM(2.5), O(3), CO, CO(2), NO(2), NO(x), and formaldehyde) using single- and two-pollutant linear mixed-effects models. RESULTS Short-term exposure to traffic-related emissions was associated with statistically significant acute changes in HRV. Gaseous pollutants - particularly ozone - were associated with reductions in time and frequency domain components (α = 0.05), while significant positive associations were observed between PM(2.5) and SDNN, HF, and LF. For ozone and formaldehyde, negative associations typically increased in magnitude and significance with increasing averaging periods. The associations for CO, CO(2), NO(2), and NO(x) were similar with statistically significant associations observed for SDNN, but not HF or LF. In contrast, PM(2.5) increased these HRV parameters. CONCLUSIONS Results revealed an association between traffic-related PM exposures and acute changes in HRV in a middle-aged population when PM exposures were relatively low (14 μg/m(3)) and demonstrate heterogeneity in the effects of different pollutants, with declines in HRV - especially HF - with ozone and formaldehyde exposures, and increases in HRV with PM(2.5) exposure. Given that exposure to traffic-related emissions is associated with increased risk of cardiovascular morbidity and mortality, understanding the mechanisms by which traffic-related emissions can cause cardiovascular disease has significant public health relevance.
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Affiliation(s)
- Kyra Naumoff Shields
- Department of Environmental and Occupational Health, University of Pittsburgh, Bridgeside Point I, 100 Technology Drive, Suite 350, Pittsburgh, PA, 15219, USA
| | - Jennifer M Cavallari
- Division of Occupational and Environmental Medicine, University of Connecticut Health Center, 270 Farmington Ave., The Exchange, Suite 262, Farmington, Ct. 06032-6210, USA
| | - Megan J Olson Hunt
- Department of Biostatistics, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA, 15261, USA
| | - Mariana Lazo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, Maryland, 21205, USA
| | - Mario Molina
- Department of Chemistry and Biochemistry, University of San Diego, Science & Technology 374, 5998 Alcala Park, San Diego, CA, 92110, USA
| | - Luisa Molina
- Department of Earth, Atmospheric and Planetary Sciences Cambridge, Massachusetts Institute of Technology, MA 02139, 9500 Gilman Dr., MCO332, La Jolla, CA, 92093-0332, USA
| | - Fernando Holguin
- Montefiore Hospital, University of Pittsburgh Medical Center, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA
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In vivo human left-to-right ventricular differences in rate adaptation transiently increase pro-arrhythmic risk following rate acceleration. PLoS One 2012; 7:e52234. [PMID: 23284948 PMCID: PMC3527395 DOI: 10.1371/journal.pone.0052234] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 11/13/2012] [Indexed: 11/19/2022] Open
Abstract
Left-to-right ventricular (LV/RV) differences in repolarization have been implicated in lethal arrhythmias in animal models. Our goal is to quantify LV/RV differences in action potential duration (APD) and APD rate adaptation and their contribution to arrhythmogenic substrates in the in vivo human heart using combined in vivo and in silico studies. Electrograms were acquired from 10 LV and 10 RV endocardial sites in 15 patients with normal ventricles. APD and APD adaptation were measured during an increase in heart rate. Analysis of in vivo electrograms revealed longer APD in LV than RV (207.8 ± 21.5 vs 196.7 ± 20.1 ms; P<0.05), and slower APD adaptation in LV than RV (time constant τ(s) =47.0 ± 14.3 vs 35.6 ± 6.5 s; P<0.05). Following rate acceleration, LV/RV APD dispersion experienced an increase of up to 91% in 12 patients, showing a strong correlation (r(2) =0.90) with both initial dispersion and LV/RV difference in slow adaptation. Pro-arrhythmic implications of measured LV/RV functional differences were studied using in silico simulations. Results show that LV/RV APD and APD adaptation heterogeneities promote unidirectional block following rate acceleration, albeit being insufficient for establishment of reentry in normal hearts. However, in the presence of an ischemic region at the LV/RV junction, LV/RV heterogeneity in APD and APD rate adaptation promotes reentrant activity and its degeneration into fibrillatory activity. Our results suggest that LV/RV heterogeneities in APD adaptation cause a transient increase in APD dispersion in the human ventricles following rate acceleration, which promotes unidirectional block and wave-break at the LV/RV junction, and may potentiate the arrhythmogenic substrate, particularly in patients with ischemic heart disease.
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A classification scheme for ventricular arrhythmias using wavelets analysis. Med Biol Eng Comput 2012; 51:153-64. [DOI: 10.1007/s11517-012-0980-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 10/15/2012] [Indexed: 10/27/2022]
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Cardiovascular side-effects of antipsychotic drugs: The role of the autonomic nervous system. Pharmacol Ther 2012; 135:113-22. [DOI: 10.1016/j.pharmthera.2012.04.003] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 04/08/2012] [Indexed: 01/27/2023]
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Nonlinear dynamics of heart rate variability in response to orthostatism and hemodialysis in chronic renal failure patients: recurrence analysis approach. Med Eng Phys 2012; 35:178-87. [PMID: 22647839 DOI: 10.1016/j.medengphy.2012.04.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 04/24/2012] [Accepted: 04/28/2012] [Indexed: 11/20/2022]
Abstract
We studied the response of heart rate variability to hemodialysis and orthostatism using traditional linear indexes and 9 recurrence quantification analysis indexes to reveal changes in the heart rate dynamics. Twenty healthy subjects and 19 chronic renal failure patients treated with hemodialysis thrice a week were included. Five-minute heart rate variability time series were obtained during supine position (clinostatism) and orthostatism from each participant; recordings in renal patients were repeated after hemodialysis. Linear indexes were consistent with sympathetic predominance in response to orthostatism in the control group. Renal patients before hemodialysis showed increased sympathetic predominance in clinostatism, with further increase in orthostatism and hemodialysis. In response to orthostatism, 4 recurrence indexes changed in the control group, while in renal patients any of them changed before hemodialysis and 1 changed after hemodialysis. In clinostatism, renal patients (both before and after hemodialysis) had higher laminarity, trapping time, and recurrence time than the control group. Recurrence indexes showed that the heart rate dynamics in renal patients are different from healthy subjects, suggesting loss of access to some regulatory conditions. These findings are consistent with reports of sympathetic stimulation induced by hemodialysis and active standing.
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Bhushan M, Asirvatham SJ. The conundrum of ventricular arrhythmia and cardiomyopathy: Which abnormality came first? Curr Heart Fail Rep 2009; 6:7-13. [DOI: 10.1007/s11897-009-0003-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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