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Hirai K, Sakano N, Oozawa S, Ousaka D, Kuroko Y, Kasahara S. Initial trial of three‑lead wearable electrocardiogram monitoring in a full marathon. J Cardiol Cases 2024; 30:24-28. [PMID: 39007048 PMCID: PMC11245758 DOI: 10.1016/j.jccase.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/18/2024] [Accepted: 03/27/2024] [Indexed: 07/16/2024] Open
Abstract
Sudden cardiac arrest during exercise can occur without prior warning signs at rest, highlighting the importance of monitoring for its prevention. To detect the signs of ischemic heart disease, including coronary artery anomalies, ST changes must be detected using three‑lead electrocardiograms (ECGs) corresponding to each region of the three coronary artery branches. We conducted ECG monitoring of five runners during a marathon using a wearable three‑lead ECG device (e-skin ECG; Xenoma Inc., Tokyo, Japan). Data without noise or artifacts were successfully collected for one of five runners during the entire marathon. Within the initial hour of the marathon, poor electrode adhesion to the skin hindered the data collection for the remaining four runners, which resulted in significantly decreased acquisition rate compared with the first hour (86.7 ± 13.4 % to 37.3 ± 36.9 %, p = 0.028). Couplets of premature ventricular contractions with clear ECG waveforms in the three leads were detected in one runner during the marathon. Further device improvements are necessary to enable marathon runners to obtain ECGs efficiently without affecting their performance. This study also demonstrated the potential applications of three‑lead wearable ECG monitoring for other short-duration sports and remote home-based cardiac rehabilitation. Learning objective This is an initial trial of a three‑lead wearable electrocardiogram (ECG) monitoring device during a full marathon. ECG data were obtained with low noise and artifacts during the first hour of the marathon; however, the data acquisition rate decreased in the middle and late stages owing to poor electrode adhesion. This study demonstrated the possibility of applying wearable ECG monitoring during short-term exercise and cardiac rehabilitation to detect warning signs and prevent sudden cardiac arrest.
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Affiliation(s)
- Kenta Hirai
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Noriko Sakano
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Susumu Oozawa
- Department of Clinical Safety, Okayama University Hospital, Okayama, Japan
| | - Daiki Ousaka
- Department of Pharmacology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Yosuke Kuroko
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
| | - Shingo Kasahara
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan
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Kumar A, Kumar M, Mahapatra RP, Bhattacharya P, Le TTH, Verma S, Mohiuddin K. Flamingo-Optimization-Based Deep Convolutional Neural Network for IoT-Based Arrhythmia Classification. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23094353. [PMID: 37177564 PMCID: PMC10181507 DOI: 10.3390/s23094353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 05/15/2023]
Abstract
Cardiac arrhythmia is a deadly disease that threatens the lives of millions of people, which shows the need for earlier detection and classification. An abnormal signal in the heart causing arrhythmia can be detected at an earlier stage when the health data from the patient are monitored using IoT technology. Arrhythmias may suddenly lead to death and the classification of arrhythmias is considered a complicated process. In this research, an effective classification model for the classification of heart disease is developed using flamingo optimization. Initially, the ECG signal from the heart is collected and then it is subjected to the preprocessing stage; to detect and control the electrical activity of the heart, the electrocardiogram (ECG) is used. The input signals collected using IoT nodes are collectively presented in the base station for the classification using flamingo-optimization-based deep convolutional networks, which effectively predict the disease. With the aid of communication technologies and the contribution of IoT, medical professionals can easily monitor the health condition of patients. The performance is analyzed in terms of accuracy, sensitivity, and specificity.
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Affiliation(s)
- Ashwani Kumar
- Department of Computer Science and Engineering, Faculty of Engineering and Technology, SRM Institute of Science and Technology, NCR Campus, Ghaziabad 201204, India
| | - Mohit Kumar
- MIT Art, Design and Technology University, Pune 412201, India
| | - Rajendra Prasad Mahapatra
- Department of Computer Science and Engineering, Faculty of Engineering and Technology, SRM Institute of Science and Technology, NCR Campus, Ghaziabad 201204, India
| | - Pronaya Bhattacharya
- Department of Computer Science and Engineering, Amity School of Engineering and Technology, Research and Innovation Cell, Amity University, Kolkata 700135, India
| | - Thi-Thu-Huong Le
- Blockchain Platform Research Center, Pusan National University, Busan 609735, Republic of Korea
| | - Sahil Verma
- Faculty of Computer Science and Engineering, Uttaranchal University University, Dehradun 248007, India
| | - Khalid Mohiuddin
- Faculty of Information Systems, King Khalid University, Abha 62529, Saudi Arabia
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Tabaeeian RA, Hajrahimi B, Khoshfetrat A. A systematic review of telemedicine systems use barriers: primary health care providers' perspective. JOURNAL OF SCIENCE AND TECHNOLOGY POLICY MANAGEMENT 2022. [DOI: 10.1108/jstpm-07-2021-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose
The purpose of this review paper was identifying barriers to the use of telemedicine systems in primary health-care individual level among professionals.
Design/methodology/approach
This study used Scopus and PubMed databases for scientific records identification. A systematic review of the literature structured by PRISMA guidelines was conducted on 37 included papers published between 2009 and 2019. A qualitative approach was used to synthesize insights into using telemedicine by primary care professionals.
Findings
Three barriers were identified and classified: system quality, data quality and service quality barriers. System complexity in terms of usability, system unreliability, security and privacy concerns, lack of integration and inflexibility of systems-in-use are related to system quality. Data quality barriers are data inaccuracy, data timeliness issues, data conciseness concerns and lack of data uniqueness. Finally, service reliability concerns, lack of technical support and lack of user training have been categorized as service quality barriers.
Originality/value
This review identified and mapped emerging themes of barriers to the use of telemedicine systems. This paper also through a new conceptualization of telemedicine use from perspectives of the primary care professionals contributes to informatics literature and system usage practices.
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Yamane T, Hirano K, Hirai K, Ousaka D, Sakano N, Morita M, Oozawa S, Kasahara S. Trial of Sportswear Type ECG Sensor Device for Cardiac Safety Management during Marathon Running. ADVANCED BIOMEDICAL ENGINEERING 2022. [DOI: 10.14326/abe.11.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Takahiro Yamane
- Department of Biomedical Informatics, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University
| | - Kazuya Hirano
- Department of Biomedical Informatics, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University
| | - Kenta Hirai
- Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
| | - Daiki Ousaka
- Department of Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
| | - Noriko Sakano
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
| | - Mizuki Morita
- Department of Biomedical Informatics, Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University
| | - Susumu Oozawa
- Department of Clinical Safety, Okayama University Hospital
| | - Shingo Kasahara
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science
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Hamada S, Sasaki K, Kito H, Tooyama Y, Ihara K, Aoyagi E, Ichimura N, Tohda S, Sasano T. Effect of the recording condition on the quality of a single-lead electrocardiogram. Heart Vessels 2021; 37:1010-1026. [PMID: 34854951 DOI: 10.1007/s00380-021-01991-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 11/12/2021] [Indexed: 11/26/2022]
Abstract
Although many wearable single-lead electrocardiogram (ECG) monitoring devices have been developed, information regarding their ECG quality is limited. This study aimed to evaluate the quality of single-lead ECG in healthy subjects under various conditions (body positions and motions) and in patients with arrhythmias, to estimate requirements for automatic analysis, and to identify a way to improve ECG quality by changing the type and placement of electrodes. A single-lead ECG transmitter was placed on the sternum with a pair of electrodes, and ECG was simultaneously recorded with a conventional Holter ECG in 12 healthy subjects under various conditions and 35 patients with arrhythmias. Subjects with arrhythmias were divided into sinus rhythm (SR) and atrial fibrillation (AF) groups. ECG quality was assessed by calculating the sensitivity and positive predictive value (PPV) of the visual detection of QRS complexes (vQRS), automatic detection of QRS complexes (aQRS), and visual detection of P waves (vP). Accuracy was defined as a 100% sensitivity and PPV. We also measured the amplitude of the baseline, P wave, and QRS complex, and calculated the signal-to-noise ratio (SNR). We then focused on aQRS and estimated thresholds to obtain an accurate aQRS in more than 95% of the data. Finally, we sought to improve ECG quality by changing electrode placement using offset-type electrodes in 10 healthy subjects. The single-lead ECG provided 100% accuracy for vQRS, 87% for aQRS, and 74% for vP in healthy subjects under various conditions. Failure for accurate detection occurred in several motions in which the baseline amplitude was increased or in subjects with low QRS or P amplitude, resulting in low SNR. The single-lead ECG provided 97% accuracy for vQRS, 80% for aQRS in patients with arrhythmias, and 95% accuracy for vP in the SR group. The AF group showed higher baseline amplitude than the SR group (0.08 mV vs. 0.02 mV, P < 0.01) but no significant difference in accuracy for aQRS (79% vs. 81%, P = 1.00). The thresholds to obtain an accurate aQRS were a QRS amplitude > 0.42 mV and a baseline amplitude < 0.20 mV. The QRS amplitude was significantly influenced by electrode placement and body position (P < 0.01 for both, two-way analysis of variance), and the maximum reduction by changing body position was estimated as 30% compared to the sitting posture. The QRS amplitude significantly increased when the inter-electrode distance was extended vertically (1.51 mV for vertical extension vs. 0.93 mV for control, P < 0.01). The single-lead ECG provided at least 97% accuracy for vQRS, 80% for aQRS, and 74% for vP. To obtain stable aQRS in any body positions, a QRS amplitude > 0.60 mV and a baseline amplitude < 0.20 mV were required in the sitting posture considering the reduction induced by changing body position. Vertical extension of the inter-electrode distance increased the QRS amplitude.
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Affiliation(s)
- Satomi Hamada
- Department of Clinical Laboratory, Tokyo Medical and Dental University (TMDU) Hospital, Tokyo, Japan
| | - Kanae Sasaki
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hotaka Kito
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Yui Tooyama
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Kensuke Ihara
- Department of Bio-Informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Eiko Aoyagi
- Department of Clinical Laboratory, Tokyo Medical and Dental University (TMDU) Hospital, Tokyo, Japan
| | - Naoya Ichimura
- Department of Clinical Laboratory, Tokyo Medical and Dental University (TMDU) Hospital, Tokyo, Japan
| | - Shuji Tohda
- Department of Clinical Laboratory, Tokyo Medical and Dental University (TMDU) Hospital, Tokyo, Japan
| | - Tetsuo Sasano
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Batista E, Moncusi MA, López-Aguilar P, Martínez-Ballesté A, Solanas A. Sensors for Context-Aware Smart Healthcare: A Security Perspective. SENSORS (BASEL, SWITZERLAND) 2021; 21:6886. [PMID: 34696099 PMCID: PMC8537585 DOI: 10.3390/s21206886] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 12/24/2022]
Abstract
The advances in the miniaturisation of electronic devices and the deployment of cheaper and faster data networks have propelled environments augmented with contextual and real-time information, such as smart homes and smart cities. These context-aware environments have opened the door to numerous opportunities for providing added-value, accurate and personalised services to citizens. In particular, smart healthcare, regarded as the natural evolution of electronic health and mobile health, contributes to enhance medical services and people's welfare, while shortening waiting times and decreasing healthcare expenditure. However, the large number, variety and complexity of devices and systems involved in smart health systems involve a number of challenging considerations to be considered, particularly from security and privacy perspectives. To this aim, this article provides a thorough technical review on the deployment of secure smart health services, ranging from the very collection of sensors data (either related to the medical conditions of individuals or to their immediate context), the transmission of these data through wireless communication networks, to the final storage and analysis of such information in the appropriate health information systems. As a result, we provide practitioners with a comprehensive overview of the existing vulnerabilities and solutions in the technical side of smart healthcare.
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Affiliation(s)
- Edgar Batista
- Department of Computer Engineering and Mathematics, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (E.B.); (M.A.M.); (A.M.-B.)
- SIMPPLE S.L., C. Joan Maragall 1A, 43003 Tarragona, Spain
| | - M. Angels Moncusi
- Department of Computer Engineering and Mathematics, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (E.B.); (M.A.M.); (A.M.-B.)
| | - Pablo López-Aguilar
- Anti-Phishing Working Group EU, Av. Diagonal 621–629, 08028 Barcelona, Spain;
| | - Antoni Martínez-Ballesté
- Department of Computer Engineering and Mathematics, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (E.B.); (M.A.M.); (A.M.-B.)
| | - Agusti Solanas
- Department of Computer Engineering and Mathematics, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (E.B.); (M.A.M.); (A.M.-B.)
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Ousaka D, Hirai K, Sakano N, Morita M, Haruna M, Hirano K, Yamane T, Teraoka A, Sanou K, Oozawa S, Kasahara S. Initial evaluation of a novel electrocardiography sensor-embedded fabric wear during a full marathon. Heart Vessels 2021; 37:443-450. [PMID: 34519873 PMCID: PMC8438904 DOI: 10.1007/s00380-021-01939-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/03/2021] [Indexed: 10/27/2022]
Abstract
Sudden cardiac accident (SCA) during a marathon is a concern due to the popularity of the sport. Preventive strategies, such as cardiac screening and deployment of automated external defibrillators have controversial cost-effectiveness. We investigated the feasibility of use of a new electrocardiography (ECG) sensor-embedded fabric wear (SFW) during a marathon as a novel preventive strategy against SCA. Twenty healthy volunteers participated in a full marathon race. They were equipped with a SFW hitoe® with a transmitter connected via Bluetooth to a standard smartphone for continuous ECG recording. All data were stored in a smartphone and used to analyze the data acquisition rate. The adequate data acquisition rate was > 90% in 13, 30-90% in 3, and < 10% in 4 runners. All of 4 runners with poorly recorded data were female. Inadequate data acquisition was significantly associated with the early phase of the race compared with the mid phase (P = 0.007). Except for 3 runners with poor heart rate data, automated software calculation was significantly associated with manual analysis for both the mean (P < 0.001) and maximum (P = 0.014) heart rate. We tested the feasibility of continuously recording cardiac data during a marathon using a new ECG sensor-embedded wearable device. Although data from 65% of runners were adequately recorded, female runners and the early phase of the race tended to have poor data acquisition. Further improvements in device ergonomics and software are necessary to improve ability to detect abnormal ECGs that may precede SCA.
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Affiliation(s)
- Daiki Ousaka
- Department of Pharmacology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, 700-8558, Japan
| | - Kenta Hirai
- Department of Pediatric Cardiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, 700-8558, Japan
| | - Noriko Sakano
- Department of Biomedical Informatics, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama, 700-8558, Japan
| | - Mizuki Morita
- Department of Biomedical Informatics, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama, 700-8558, Japan
| | - Madoka Haruna
- Department of Clinical Laboratory, Okayama University Hospital, Okayama, 700-8558, Japan
| | - Kazuya Hirano
- Department of Biomedical Informatics, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama, 700-8558, Japan
| | - Takahiro Yamane
- Department of Biomedical Informatics, Okayama University Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama, 700-8558, Japan
| | - Akira Teraoka
- Teraoka Memorial Hospital, Hiroshima, 729-3103, Japan
| | | | - Susumu Oozawa
- Department of Clinical Safety, Okayama University Hospital, Okayama, 700-8558, Japan
| | - Shingo Kasahara
- Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, 700-8558, Japan.
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Habibzadeh H, Dinesh K, Shishvan OR, Boggio-Dandry A, Sharma G, Soyata T. A Survey of Healthcare Internet-of-Things (HIoT): A Clinical Perspective. IEEE INTERNET OF THINGS JOURNAL 2020; 7:53-71. [PMID: 33748312 PMCID: PMC7970885 DOI: 10.1109/jiot.2019.2946359] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
In combination with current sociological trends, the maturing development of IoT devices is projected to revolutionize healthcare. A network of body-worn sensors, each with a unique ID, can collect health data that is orders-of-magnitude richer than what is available today from sporadic observations in clinical/hospital environments. When databased, analyzed, and compared against information from other individuals using data analytics, HIoT data enables the personalization and modernization of care with radical improvements in outcomes and reductions in cost. In this paper, we survey existing and emerging technologies that can enable this vision for the future of healthcare, particularly in the clinical practice of healthcare. Three main technology areas underlie the development of this field: (a) sensing, where there is an increased drive for miniaturization and power efficiency; (b) communications, where the enabling factors are ubiquitous connectivity, standardized protocols, and the wide availability of cloud infrastructure, and (c) data analytics and inference, where the availability of large amounts of data and computational resources is revolutionizing algorithms for individualizing inference and actions in health management. Throughout the paper, we use a case study to concretely illustrate the impact of these trends. We conclude our paper with a discussion of the emerging directions, open issues, and challenges.
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Affiliation(s)
- Hadi Habibzadeh
- Department of Electrical and Computer Engineering, SUNY Albany, Albany NY, 12203
| | - Karthik Dinesh
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY 14627
| | - Omid Rajabi Shishvan
- Department of Electrical and Computer Engineering, SUNY Albany, Albany NY, 12203
| | - Andrew Boggio-Dandry
- Department of Electrical and Computer Engineering, SUNY Albany, Albany NY, 12203
| | - Gaurav Sharma
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY 14627
| | - Tolga Soyata
- Department of Electrical and Computer Engineering, SUNY Albany, Albany NY, 12203
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