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Lingawi S, Hutton J, Khalili M, Shadgan B, Christenson J, Grunau B, Kuo C. Cardiorespiratory Sensors and Their Implications for Out-of-Hospital Cardiac Arrest Detection: A Systematic Review. Ann Biomed Eng 2024; 52:1136-1158. [PMID: 38358559 DOI: 10.1007/s10439-024-03442-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/03/2024] [Indexed: 02/16/2024]
Abstract
Out-of-hospital cardiac arrest (OHCA) is a major health problem, with a poor survival rate of 2-11%. For the roughly 75% of OHCAs that are unwitnessed, survival is approximately 2-4.4%, as there are no bystanders present to provide life-saving interventions and alert Emergency Medical Services. Sensor technologies may reduce the number of unwitnessed OHCAs through automated detection of OHCA-associated physiological changes. However, no technologies are widely available for OHCA detection. This review identifies research and commercial technologies developed for cardiopulmonary monitoring that may be best suited for use in the context of OHCA, and provides recommendations for technology development, testing, and implementation. We conducted a systematic review of published studies along with a search of grey literature to identify technologies that were able to provide cardiopulmonary monitoring, and could be used to detect OHCA. We searched MEDLINE, EMBASE, Web of Science, and Engineering Village using MeSH keywords. Following inclusion, we summarized trends and findings from included studies. Our searches retrieved 6945 unique publications between January, 1950 and May, 2023. 90 studies met the inclusion criteria. In addition, our grey literature search identified 26 commercial technologies. Among included technologies, 52% utilized electrocardiography (ECG) and 40% utilized photoplethysmography (PPG) sensors. Most wearable devices were multi-modal (59%), utilizing more than one sensor simultaneously. Most included devices were wearable technologies (84%), with chest patches (22%), wrist-worn devices (18%), and garments (14%) being the most prevalent. ECG and PPG sensors are heavily utilized in devices for cardiopulmonary monitoring that could be adapted to OHCA detection. Developers seeking to rapidly develop methods for OHCA detection should focus on using ECG- and/or PPG-based multimodal systems as these are most prevalent in existing devices. However, novel sensor technology development could overcome limitations in existing sensors and could serve as potential additions to or replacements for ECG- and PPG-based devices.
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Affiliation(s)
- Saud Lingawi
- British Columbia Resuscitation Research Collaborative, Vancouver, BC, Canada.
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada.
- Centre for Aging SMART, University of British Columbia, 2635 Laurel St., Vancouver, BC, V5Z 1M9, Canada.
| | - Jacob Hutton
- British Columbia Resuscitation Research Collaborative, Vancouver, BC, Canada
- British Columbia Emergency Health Services, Vancouver, Canada
- Department of Emergency Medicine, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
- Centre for Advancing Health Outcomes, University of British Columbia, Vancouver, BC, Canada
| | - Mahsa Khalili
- British Columbia Resuscitation Research Collaborative, Vancouver, BC, Canada
- Centre for Aging SMART, University of British Columbia, 2635 Laurel St., Vancouver, BC, V5Z 1M9, Canada
- Department of Emergency Medicine, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
- Centre for Advancing Health Outcomes, University of British Columbia, Vancouver, BC, Canada
| | - Babak Shadgan
- British Columbia Resuscitation Research Collaborative, Vancouver, BC, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
- Department of Orthopedic Surgery, University of British Columbia, Vancouver, BC, Canada
- International Collaboration on Repair Discoveries, Vancouver, BC, Canada
| | - Jim Christenson
- British Columbia Resuscitation Research Collaborative, Vancouver, BC, Canada
- British Columbia Emergency Health Services, Vancouver, Canada
- Department of Emergency Medicine, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
- Centre for Advancing Health Outcomes, University of British Columbia, Vancouver, BC, Canada
| | - Brian Grunau
- British Columbia Resuscitation Research Collaborative, Vancouver, BC, Canada
- British Columbia Emergency Health Services, Vancouver, Canada
- Department of Emergency Medicine, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
- Centre for Advancing Health Outcomes, University of British Columbia, Vancouver, BC, Canada
| | - Calvin Kuo
- British Columbia Resuscitation Research Collaborative, Vancouver, BC, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
- Centre for Aging SMART, University of British Columbia, 2635 Laurel St., Vancouver, BC, V5Z 1M9, Canada
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Sanjo K, Hebiguchi K, Tang C, Rashed EA, Kodera S, Togo H, Hirata A. Sensitivity of Electrocardiogram on Electrode-Pair Locations for Wearable Devices: Computational Analysis of Amplitude and Waveform Distortion. BIOSENSORS 2024; 14:153. [PMID: 38534260 DOI: 10.3390/bios14030153] [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: 03/11/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
An electrocardiogram (ECG) is used to observe the electrical activity of the heart via electrodes on the body surface. Recently, an ECG with fewer electrodes, such as a bipolar ECG in which two electrodes are attached to the chest, has been employed as wearable devices. However, the effect of different geometrical factors and electrode-pair locations on the amplitude and waveform of ECG signals remains unclear. In this study, we computationally evaluated the effects of body morphology, heart size and orientation, and electrode misalignment on ECG signals for 48 scenarios using 35 bipolar electrode pairs (1680 waveforms) with a dynamic time warping (DTW) algorithm. It was observed that the physique of the human body model predominantly affected the amplitude and waveform of the ECG signals. A multivariate analysis indicated that the heart-electrode distance and the solid angle of the heart from the electrode characterized the amplitude and waveform of the ECG signals, respectively. Furthermore, the electrode locations for less individual variability and less waveform distortion were close to the location of electrodes V2 and V3 in the standard 12-lead. These findings will facilitate the placement of ECG electrodes and interpretation of the measured ECG signals for wearable devices.
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Affiliation(s)
- Kiyoto Sanjo
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Kazuki Hebiguchi
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Cheng Tang
- Faculty of Information Science and Electrical Engineering, Kyushu University, Fukuoka 819-0395, Japan
| | - Essam A Rashed
- Graduate School of Information Science, University of Hyogo, Kobe 650-0047, Japan
| | - Sachiko Kodera
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Hiroyoshi Togo
- NTT Device Innovation Center, NTT Corporation, Atsugi 243-0198, Japan
| | - Akimasa Hirata
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
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Hafid A, Gunnarsson E, Ramos A, Rödby K, Abtahi F, Bamidis PD, Billis A, Papachristou P, Seoane F. Sensorized T-Shirt with Intarsia-Knitted Conductive Textile Integrated Interconnections: Performance Assessment of Cardiac Measurements during Daily Living Activities. SENSORS (BASEL, SWITZERLAND) 2023; 23:9208. [PMID: 38005593 PMCID: PMC10675781 DOI: 10.3390/s23229208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
The development of smart wearable solutions for monitoring daily life health status is increasingly popular, with chest straps and wristbands being predominant. This study introduces a novel sensorized T-shirt design with textile electrodes connected via a knitting technique to a Movesense device. We aimed to investigate the impact of stationary and movement actions on electrocardiography (ECG) and heart rate (HR) measurements using our sensorized T-shirt. Various activities of daily living (ADLs), including sitting, standing, walking, and mopping, were evaluated by comparing our T-shirt with a commercial chest strap. Our findings demonstrate measurement equivalence across ADLs, regardless of the sensing approach. By comparing ECG and HR measurements, we gained valuable insights into the influence of physical activity on sensorized T-shirt development for monitoring. Notably, the ECG signals exhibited remarkable similarity between our sensorized T-shirt and the chest strap, with closely aligned HR distributions during both stationary and movement actions. The average mean absolute percentage error was below 3%, affirming the agreement between the two solutions. These findings underscore the robustness and accuracy of our sensorized T-shirt in monitoring ECG and HR during diverse ADLs, emphasizing the significance of considering physical activity in cardiovascular monitoring research and the development of personal health applications.
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Affiliation(s)
- Abdelakram Hafid
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, 503 32 Borås, Sweden; (E.G.); (A.R.); (K.R.); (F.S.)
- School of Innovation, Design and Engineering, Mälardalen University, 722 20 Västerås, Sweden
| | - Emanuel Gunnarsson
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, 503 32 Borås, Sweden; (E.G.); (A.R.); (K.R.); (F.S.)
| | - Alberto Ramos
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, 503 32 Borås, Sweden; (E.G.); (A.R.); (K.R.); (F.S.)
- UDIT—University of Design, Innovation and Technology, 28016 Madrid, Spain
| | - Kristian Rödby
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, 503 32 Borås, Sweden; (E.G.); (A.R.); (K.R.); (F.S.)
| | - Farhad Abtahi
- Institute for Clinical Science, Intervention and Technology, Karolinska Institutet, 141 83 Stockholm, Sweden;
- Department of Medical Care Technology, Karolinska University Hospital, 141 57 Huddinge, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, 141 57 Huddinge, Sweden
| | - Panagiotis D. Bamidis
- Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (P.D.B.); (A.B.)
| | - Antonis Billis
- Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece; (P.D.B.); (A.B.)
| | - Panagiotis Papachristou
- Academic Primary Health Care Center, Region Stockholm, 104 31 Stockholm, Sweden;
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Stockholm, Sweden
| | - Fernando Seoane
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, 503 32 Borås, Sweden; (E.G.); (A.R.); (K.R.); (F.S.)
- Institute for Clinical Science, Intervention and Technology, Karolinska Institutet, 141 83 Stockholm, Sweden;
- Department of Medical Care Technology, Karolinska University Hospital, 141 57 Huddinge, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, 141 57 Huddinge, Sweden
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