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Irrera F, Gumiero A, Zampogna A, Boscari F, Avogaro A, Gazzanti Pugliese di Cotrone MA, Patera M, Della Torre L, Picozzi N, Suppa A. Multisensor Integrated Platform Based on MEMS Charge Variation Sensing Technology for Biopotential Acquisition. SENSORS (BASEL, SWITZERLAND) 2024; 24:1554. [PMID: 38475089 DOI: 10.3390/s24051554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
We propose a new methodology for long-term biopotential recording based on an MEMS multisensor integrated platform featuring a commercial electrostatic charge-transfer sensor. This family of sensors was originally intended for presence tracking in the automotive industry, so the existing setup was engineered for the acquisition of electrocardiograms, electroencephalograms, electrooculograms, and electromyography, designing a dedicated front-end and writing proper firmware for the specific application. Systematic tests on controls and nocturnal acquisitions from patients in a domestic environment will be discussed in detail. The excellent results indicate that this technology can provide a low-power, unexplored solution to biopotential acquisition. The technological breakthrough is in that it enables adding this type of functionality to existing MEMS boards at near-zero additional power consumption. For these reasons, it opens up additional possibilities for wearable sensors and strengthens the role of MEMS technology in medical wearables for the long-term synchronous acquisition of a wide range of signals.
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Affiliation(s)
- Fernanda Irrera
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Alessandro Zampogna
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Angelo Avogaro
- Department of Medicine, University of Padua, 35122 Padua, Italy
| | | | - Martina Patera
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | | | | | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Neuromed, 86077 Pozzilli, Italy
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Boszko M, Osak G, Żurawska N, Skoczylas K, Krzowski B, Wróblewski G, Maciejewski A, Sobiech J, Ostrowski S, Grabowski M, Kołtowski Ł. Assessment of a new KoMaWo electrode-patch configuration accuracy and review of the literature. J Electrocardiol 2022; 75:82-87. [PMID: 35918203 DOI: 10.1016/j.jelectrocard.2022.07.004] [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: 03/06/2022] [Revised: 07/06/2022] [Accepted: 07/13/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Standard 12‑lead electrocardiogram (ECG) is a basic element of routine everyday clinical practice. Traditional cardiac monitoring devices are associated with considerable limitations. Adhesive patches, novel digital solutions, may become a useful diagnostic tool for several cardiovascular diseases. MATERIALS AND METHODS We propose a new variation of ECG electrodes positioning called KoMaWo. 15 consecutive patients presenting with ST segment deviations due to coronary artery disease were enrolled. The accuracy and utility of the new configuration was assessed and compared with the Mason-Likar configuration, as well as with a standard 12‑lead ECG recording. The scans were blinded and interpreted by two independent cardiologists. RESULTS There were no statistically significant differences in morphology, as well as in the duration of individual waves, complexes, segments, and intervals between the scans obtained using all three methods. In a subgroup analysis, with regard to age, body mass and left ventricle ejection fraction (LVEF), KoMaWo was non-inferior to standard ECG with a 0.2 mm margin. DISCUSSION The role of traditional cardiac monitoring devices is recognized as the gold standard of patient management. However, certain limitations should be considered. Adhesive patches are light-weight, well-tolerated and do not interfere with daily activities of patients. These novel devices allow for extended monitoring, facilitating increased diagnostic accuracy, regarding cardiac arrhythmias. CONCLUSIONS The KoMaWo configuration is not inferior to standard electrode placement, nor to Mason-Likar configuration, including its ability to capture ST segment deviations. Adhesive patches may become a valid alternative for traditional cardiac monitoring methods.
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Affiliation(s)
- Maria Boszko
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Gabriela Osak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Natalia Żurawska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Kamila Skoczylas
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Bartosz Krzowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
| | - Grzegorz Wróblewski
- Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Adrian Maciejewski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Judyta Sobiech
- Faculty of Physics, Warsaw University of Technology, Warsaw, Poland
| | - Szymon Ostrowski
- Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, Warsaw, Poland
| | - Marcin Grabowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Kołtowski
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
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Chang RK. Resting 12‑lead ECG tests performed by patients at home amid the COVID-19 pandemic — Results from the first 1000 patients. J Electrocardiol 2022; 73:108-112. [PMID: 35803062 PMCID: PMC9250819 DOI: 10.1016/j.jelectrocard.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/23/2022] [Accepted: 06/20/2022] [Indexed: 12/21/2022]
Abstract
Background There were surges in the demand for telehealth and home care in the COVID-19 pandemic. A new home ECG testing model was developed and used in the real-world clinical practice. Methods Since June 2020, QT Medical, Inc. (Diamond Bard, California) has been providing home ECG testing service by mail. Upon receiving the order from a clinician, an ECG testing kit was sent to the patient by mail. The kit included an ECG recorder, a prepositioned electrode strip of proper size for the patient (determined by the ordering clinician), printed instructions for performing the test, and a return envelope. We reviewed and analyzed the de-identified administrative dataset of the first 1000 ECG tests ordered by 37 medical practices. Results Of the 1000 patients served by this mail delivery home ECG testing service, 77.3% were female and 22.7% were male. Their ages ranged from 1 year old to 96 years old, mean 49.5 ± 13.4 years (median 52). 92.9% patients completed their tests with clinical quality ECGs uploaded to their ordering clinician's online accounts. Of those who did not complete the tests, the main reason was they “no longer needed the test”. Failure to complete the test due to technical issues was 1.4%. Only one patient had to repeat the test due to inadequate ECG quality as judged by the ordering physician. The median turnaround time, from the kit being mailed out to the recorder being returned, was 10 days. Overall, 2.2% of the ECG devices were lost in shipping or unreturned by patients. Conclusion Of the first 1000 patients who had their ECG tests at homes, it was found that this home ECG testing platform and care model could be reliably used by patients with no training to acquire clinical grade ECG. The current study proved that medical standard, resting 12‑lead ECG can be performed by the majority of patients at home.
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Affiliation(s)
- Ruey-Kang Chang
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA; QT Medical, Inc., Diamond Bar, CA, USA.
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Manoni A, Gumiero A, Zampogna A, Ciarlo C, Panetta L, Suppa A, Della Torre L, Irrera F. Long-Term Polygraphic Monitoring through MEMS and Charge Transfer for Low-Power Wearable Applications. SENSORS (BASEL, SWITZERLAND) 2022; 22:2566. [PMID: 35408181 PMCID: PMC9002930 DOI: 10.3390/s22072566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/14/2022] [Accepted: 03/22/2022] [Indexed: 02/01/2023]
Abstract
In this work, we propose a wireless wearable system for the acquisition of multiple biopotentials through charge transfer electrostatic sensors realized in MEMS technology. The system is designed for low power consumption and low invasiveness, and thus candidates for long-time monitoring in free-living conditions, with data recording on an SD or wireless transmission to an external elaborator. Thanks to the wide horizon of applications, research is very active in this field, and in the last few years, some devices have been introduced on the market. The main problem with those devices is that their operation is time-limited, so they do not match the growing demand for long monitoring, which is a must-have feature in diagnosing specific diseases. Furthermore, their versatility is hampered by the fact that they have been designed to record just one type of signal. Using ST-Qvar sensors, we acquired an electrocardiogram trace and single-channel scalp electroencephalogram from the frontal lobes, together with an electrooculogram. Excellent results from all three types of acquisition tests were obtained. The power consumption is very low, demonstrating that, thanks to the MEMS technology, a continuous acquisition is feasible for several days.
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Affiliation(s)
- Alessandro Manoni
- Department of Information Engineering, Electronics, and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy; (C.C.); (L.P.); (F.I.)
| | | | - Alessandro Zampogna
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.Z.); (A.S.)
| | - Chiara Ciarlo
- Department of Information Engineering, Electronics, and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy; (C.C.); (L.P.); (F.I.)
| | - Lorenzo Panetta
- Department of Information Engineering, Electronics, and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy; (C.C.); (L.P.); (F.I.)
| | - Antonio Suppa
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (A.Z.); (A.S.)
- IRCCS Neuromed, 86077 Pozzilli, Italy
| | | | - Fernanda Irrera
- Department of Information Engineering, Electronics, and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy; (C.C.); (L.P.); (F.I.)
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Gurunath P, Chinmay P, Hrishikesh P, Vaijayanti G, Sharada K, Pratap R, Wasim B, Gopi P, Rajeev S, Yash L. Assessment of a widely applicable torso ECG in acute coronary syndrome. Indian Heart J 2021; 73:487-491. [PMID: 34474763 PMCID: PMC8424276 DOI: 10.1016/j.ihj.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/02/2021] [Accepted: 03/23/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The time from symptom onset to arrival at healthcare facility, and door to reperfusion time in treatment of acute coronary syndrome (ACS) can be improved significantly if the patient or the relatives can record a 12-lead ECG at home and transmit it to the physician for prompt interpretation. To make this widely applicable, the 12-lead ECG recording device has to be simple and user friendly. In this regard, torso ECG (T-ECG) electrode positions that are less cumbersome than the conventional ECG (C-ECG) electrode positions are an alternative worthy of consideration. OBJECTIVE and setting: To study the utility of T-ECG versus C-ECG in ACS patients. DESIGN and intervention: We proposed torso electrode positions in which upper limb electrodes were placed in the respective deltopectoral grooves below the lateral end of the clavicle; the right lower limb electrode was placed 2 finger breadths above the umbilicus and the left lower limb electrode, 2 finger breadths to the left of the umbilicus. We then studied the ECGs recorded, to ascertain whether T-ECGs miss or over-diagnose ACS changes. Twelve lead ECGs were recorded by both techniques (C-ECG & T-ECG) in 1361 patientsfrom the coronary care unit & out-patient department of a tertiary care hospital. A total of 1526 sets of ECGs (each set consisting of one C-ECG and one T -ECG) were read by two trained cardiologists independently and in a blinded fashion. There were 457 ECG sets from 342 patients with ACS. Of these, 116 ECG sets from 112 patients of anterior infarction who had changes restricted to precordial leads were excluded. Finally, 341 ECG sets from 230 patients with ACS and 324 sets of patients diagnosed to be normal on C-ECG were considered for the purpose of this study. MAIN RESULTS All 341 ECG sets from the 230 patients of ACS diagnosed by C-ECG were correctly diagnosed by T-ECG (100% sensitivity) and all 324 normal ECGs on C-ECG were also identified as normal on T-ECG (100% specificity). Of the ACS ECGs, ST elevation was seen in 234 ECGs and ST depressions 154 ECGs. The localizations of ST elevation and ST depression were also accurately diagnosed by the T-ECG. CONCLUSION The ECG recorded by our novel proposed torso electrode positions is comparable to a conventional ECG for the diagnosis of ACS.
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Affiliation(s)
- Parale Gurunath
- Ashwini Cooperative Hospital, R 10, 952 B, Adarsh Nagar SadarBazar, Ashwini Cooperative Hospital, Solapur, 413003, India.
| | - Parale Chinmay
- Ashwini Cooperative Hospital, R 10, 952 B, Adarsh Nagar SadarBazar, Ashwini Cooperative Hospital, Solapur, 413003, India
| | - Parale Hrishikesh
- Ashwini Cooperative Hospital, R 10, 952 B, Adarsh Nagar SadarBazar, Ashwini Cooperative Hospital, Solapur, 413003, India
| | - Gandhi Vaijayanti
- Ashwini Cooperative Hospital, R 10, 952 B, Adarsh Nagar SadarBazar, Ashwini Cooperative Hospital, Solapur, 413003, India
| | - Kolhapure Sharada
- Ashwini Cooperative Hospital, R 10, 952 B, Adarsh Nagar SadarBazar, Ashwini Cooperative Hospital, Solapur, 413003, India
| | - Randive Pratap
- Ashwini Cooperative Hospital, R 10, 952 B, Adarsh Nagar SadarBazar, Ashwini Cooperative Hospital, Solapur, 413003, India
| | - Bennishirur Wasim
- Ashwini Cooperative Hospital, R 10, 952 B, Adarsh Nagar SadarBazar, Ashwini Cooperative Hospital, Solapur, 413003, India
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Roudijk RW, Boonstra MJ, Ruisch J, Kastelein M, van Dam E, Schellenkens M, Loh P, van Dam PM. Feasibility study of a 3D camera to reduce electrode repositioning errors during longitudinal ECG acquisition. J Electrocardiol 2021; 66:69-76. [PMID: 33794386 DOI: 10.1016/j.jelectrocard.2021.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 03/05/2021] [Accepted: 03/21/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Longitudinal monitoring of sometimes subtle waveform changes of the 12‑lead electrocardiogram (ECG) is complicated by patient-specific and technical factors, such as the inaccuracy of electrode repositioning. This feasibility study uses a 3D camera to reduce electrode repositioning errors, reduce ECG waveform variability and enable detailed longitudinal ECG monitoring. METHODS Per subject, three clinical ECGs were obtained during routine clinical follow-up. Additionally, two ECGs were recorded guided by two 3D cameras, which were used to capture the precordial electrode locations and direct electrode repositioning. ECG waveforms and parameters were quantitatively compared between 3D camera guided ECGs and clinical ECGs. Euclidian distances between original and repositioned precordial electrodes from 3D guided ECGs were measured. RESULTS Twenty subjects (mean age 65.1 ± 8.2 years, 35% females) were included. The ECG waveform variation between routine ECGs was significantly higher compared to 3D guided ECGs, for both the QRS complex (correlation coefficient = 0.90 vs 0.98, p < 0.001) and the STT segment (correlation coefficient = 0.88 vs. 0.96, p < 0.001). QTc interval variation was reduced for 3D camera guided ECGs compared to routine clinical ECGs (5.6 ms vs. 9.6 ms, p = 0.030). The median distance between 3D guided repositioned electrodes was 10.0 [6.4-15.2] mm, and did differ between males and females (p = 0.076). CONCLUSIONS 3D guided repositioning of precordial electrodes resulted in, a low repositioning error, higher agreement between waveforms of consecutive ECGs and a reduction of QTc variation. These findings suggest that longitudinal monitoring of disease progression using 12‑lead ECG waveforms is feasible in clinical practice.
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Affiliation(s)
- Robert W Roudijk
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Machteld J Boonstra
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | | | | | | | | | - Peter Loh
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Peter M van Dam
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; ECG Excellence BV, Nieuwerbrug, the Netherlands.
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