A Review of Atrial Fibrillation Detection Methods as a Service

Atrial Fibrillation (AF) is a common heart arrhythmia that often goes undetected, and even if it is detected, managing the condition may be challenging. In this paper, we review how the RR interval and Electrocardiogram (ECG) signals, incorporated into a monitoring system, can be useful to track AF events. Were such an automated system to be implemented, it could be used to help manage AF and thereby reduce patient morbidity and mortality. The main impetus behind the idea of developing a service is that a greater data volume analyzed can lead to better patient outcomes. Based on the literature review, which we present herein, we introduce the methods that can be used to detect AF efficiently and automatically via the RR interval and ECG signals. A cardiovascular disease monitoring service that incorporates one or multiple of these detection methods could extend event observation to all times, and could therefore become useful to establish any AF occurrence. The development of an automated and efficient method that monitors AF in real time would likely become a key component for meeting public health goals regarding the reduction of fatalities caused by the disease. Yet, at present, significant technological and regulatory obstacles remain, which prevent the development of any proposed system. Establishment of the scientific foundation for monitoring is important to provide effective service to patients and healthcare professionals

Book review of applied medical image processing: A basic course

This article is a review of the book: 'Applied Medical Image Processing: A Basic Course', by Wolfgang Birkfellner, which is published by CRC Press. Basic information that should be helpful in deciding whether to read the book and whether to use it as a course textbook is presented. This includes an introduction, the suitability of the book for use in coursework, its coverage of medical imaging and image processing, discussion and conclusions, and an appendix with a relevant computer program for extracting medical images

Model of unidirectional block formation leading to reentrant ventricular tachycardia in the infarct border zone of postinfarction canine hearts

AbstractBackgroundWhen the infarct border zone is stimulated prematurely, a unidirectional block line (UBL) can form and lead to double-loop (figure-of-eight) reentrant ventricular tachycardia (VT) with a central isthmus. The isthmus is composed of an entrance, center, and exit. It was hypothesized that for certain stimulus site locations and coupling intervals, the UBL would coincide with the isthmus entrance boundary, where infarct border zone thickness changes from thin-to-thick in the travel direction of the premature stimulus wavefront.MethodA quantitative model was developed to describe how thin-to-thick changes in the border zone result in critically convex wavefront curvature leading to conduction block, which is dependent upon coupling interval. The model was tested in 12 retrospectively analyzed postinfarction canine experiments. Electrical activation was mapped for premature stimulation and for the first reentrant VT cycle. The relationship of functional conduction block forming during premature stimulation to functional block during reentrant VT was quantified.ResultsFor an appropriately placed stimulus, in accord with model predictions: 1. The UBL and reentrant VT isthmus lateral boundaries overlapped (error: 4.8±5.7mm). 2. The UBL leading edge coincided with the distal isthmus where the center-entrance boundary would be expected to occur. 3. The mean coupling interval was 164.6±11.0ms during premature stimulation and 190.7±20.4ms during the first reentrant VT cycle, in accord with model calculations, which resulted in critically convex wavefront curvature and functional conduction block, respectively, at the location of the isthmus entrance boundary and at the lateral isthmus edges.DiscussionReentrant VT onset following premature stimulation can be explained by the presence of critically convex wavefront curvature and unidirectional block at the isthmus entrance boundary when the premature stimulation interval is sufficiently short. The double-loop reentrant circuit pattern is a consequence of wavefront bifurcation around this UBL followed by coalescence, and then impulse propagation through the isthmus. The wavefront is blocked from propagating laterally away from the isthmus by sharp increases in border zone thickness, which results in critically convex wavefront curvature at VT cycle lengths

Application of a new Structural Joint Inversion Approach to Teleseismic and Gravity Data from Mt.Vesuvius, Italy

A 3-D joint inversion of seismic and gravimetric data is performed to re-investigate the subsurface structure of Mt. Vesuvius (Italy) utilizing an improved joint inversion method. The aim is to derive models of the 3D distribution of velocity and density perturbations that are consistent with both data sets and with local velocity models. Mt. Vesuvius is a strato volcano located within a graben (Campania Plain) formed in Plio-Pleistocene. Campania Plain is bordered by mostly Mesozoic carbonaceous rocks. Mt. Vesuvius is the southernmost and the youngest of a group of Pleistocene volcanoes, three of which (Ischia, Campi Flegrei and Mt. Vesuvius) have erupted in historical times. The most recent eruption of Mt. Vesuvius occurred in 1944 and since then the volcanic activity has been characterized by moderate low magnitude seismicity and low temperature fumaroles at the summit crater. We modified the coupling mechanism between velocity and density models in the JI-3D optimized joint inversion method (Jordan and Achauer, 1999). This method was designed to provide stable and high resolution results and involves iterative optimized parameterization, 3D ray tracing, and the incorporation of a priori information. The coupling of the velocity and density models, vital to the joint inversion, is based on a cross-gradient approach (e.g. Gallardo and Meju, 2004), which has been proven to work very well in a variety of cases involving seismic, magnetic, CSEM, MT and gravity data sets. We implemented the cross-gradient coupling for our 3-D irregular adaptive grid parameterization. In contrast to conventional joint inversion methods this approach encourages structural similarities in the models and does not rely on predefined relationships between velocity and density parameters. As a consequence, the resulting velocity-density relations are not contaminated by a priori assumptions and can be utilized to derive rock physical parameters. We apply this method to data from the TomoVes project (Gasparini et al. 1998), combining seismics and Bouguer gravity and local high resolution velocity models as a priori information. The starting models for the joint inversion are derived by separate inversions of the individual data sets. We show 3D distributions of velocity perturbations and density variations from the joint inversion of teleseismic relative traveltimes and Bouguer anomaly data with the aim of extracting further information about the physical status of the volcano- tectonic system

Review of biomedical signal and image processing

This article is a review of the book “Biomedical Signal and Image Processing” by Kayvan Najarian and Robert Splinter, which is published by CRC Press, Taylor & Francis Group. It will evaluate the contents of the book and discuss its suitability as a textbook, while mentioning highlights of the book, and providing comparison with other textbooks

Review of Biomedical Image Processing

This article is a review of the book: 'Biomedical Image Processing', by Thomas M. Deserno, which is published by Springer-Verlag. Salient information that will be useful to decide whether the book is relevant to topics of interest to the reader, and whether it might be suitable as a course textbook, are presented in the review. This includes information about the book details, a summary, the suitability of the text in course and research work, the framework of the book, its specific content, and conclusions

Measurement and monitoring of electrocardiogram belt tension in premature infants for assessment of respiratory function

Background: Monitoring of the electrocardiogram (ECG) in premature infants with conventional adhesive-backed electrodes can harm their sensitive skin. Use of an electrode belt prevents skin irritation, but the effect of belt pressure on respiratory function is unknown. A strain gauge sensor is described which measures applied belt tension. Method: The device frame was comprised of an aluminum housing and slide to minimize the device weight. Velcro tabs connected housing and slide to opposite tabs located at the electrode belt ends. The slide was connected to a leaf spring, to which were bonded two piezoresistive transducers in a half-bridge circuit configuration. The device was tested for linearity and calibrated. The effect on infant respiratory function of constant belt tension in the normal range (30 g–90 g) was determined. Results: The mechanical response to a step input was second order (f_n = 401 Hz, ζ = 0.08). The relationship between applied tension and output voltage was linear in the range 25–225 gm of applied tension (r² = 0.99). Measured device sensitivity was 2.18 mV/gm tension using a 5 V bridge excitation voltage. When belt tension was increased in the normal range from 30 gm to 90 gm, there was no significant change in heart rate and most respiratory functions during monitoring. At an intermediate level of tension of 50 gm, pulmonary resistance and work of breathing significantly decreased. Conclusion: The mechanical and electrical design of a device for monitoring electrocardiogram electrode belt tension is described. Within the typical range of application tension, cardiovascular and respiratory function are not substantially negatively affected by electrode belt force

Study on the Stability of CFAEs to Characterize the Atrial Substrate in Atrial Fibrillation

[EN] A variety of indexes has been applied to complex fractionated atrial electrograms (CFAEs) of atrial fibrillation (AF) aimed at characterizing the atrial substrate. However, often the reported results miss the assessment of intra-recording and intra-patient stability of the analyzed data, as well as CFAEs signal quality. This work introduces a study in which Determinism (DET) of Recurrence Quantification Analysis (RQA) and Sample Entropy (SE) have been applied to assess intra-recording and intrapatient stability of 1, 2 and 4 s-length segments CFAEs recorded from patients with paroxysmal and persistent AF using the coefficient of variation (CV). Furthermore, the analyses verified changes introduced by discarding artifacted and noisy CFAE segments. The intra-recording analysis pointed out that discarding segments provoked a significant variation of CV(%) in any segment length both for DET and SE, with deeper decreases for longer segments. Intra-patient stability provided large variations in CV(%) for DET and even bigger for SE at any segment length. In this case discarding segments was useless and CV provided limited variations. Kruskal-Wallis test revealed significant differences in DET and SE values among channels, independently from the discarding process.Research supported by grants DPI2017-83952-C3 from MINECO/AEI/FEDER UE, SBPLY/17/180501/000411 from JCCLM and AICO/2019/036 from GVA.Finotti, E.; Ciaccio, EJ.; Garan, H.; Hornero, F.; Alcaraz, R.; Rieta, JJ. (2020). Study on the Stability of CFAEs to Characterize the Atrial Substrate in Atrial Fibrillation. IEEE. 1-4. https://doi.org/10.22489/CinC.2020.252S1

Community antibiotic prescribing in patients with COVID-19 across three pandemic waves:a population-based study in Scotland, UK

Objectives: This study aims to examine community antibiotic prescribing across a complete geographical area for people with a positive COVID-19 test across three pandemic waves, and to examine health and demographic factors associated with antibiotic prescribing.Design: A population-based study using administrative data.Setting: A complete geographical region within Scotland, UK.Participants: Residents of two National Health Service Scotland health boards with SARS-CoV-2 virus test results from 1 February 2020 to 31 March 2022 (n=184 954). Individuals with a positive test result (n=16 025) had data linked to prescription and hospital admission data ±28 days of the test, general practice data for high-risk comorbidities and demographic data.Outcome measures: The associations between patient factors and the odds of antibiotic prescription in COVID-19 episodes across three pandemic waves from multivariate binary logistic regression.Results: Data included 768 206 tests for 184 954 individuals, identifying 16 240 COVID-19 episodes involving 16 025 individuals. There were 3263 antibiotic prescriptions ±28 days for 2395 episodes. 35.6% of episodes had a prescription only before the test date, 52.3% of episodes after and 12.1% before and after. Antibiotic prescribing reduced over time: 20.4% of episodes in wave 1, 17.7% in wave 2 and 12.0% in wave 3. In multivariate logistic regression, being female (OR 1.31, 95% CI 1.19 to 1.45), older (OR 3.02, 95% CI 2.50 to 3.68 75+ vs <25 years), having a high-risk comorbidity (OR 1.45, 95% CI 1.31 to 1.61), a hospital admission ±28 days of an episode (OR 1.58, 95% CI 1.42 to 1.77) and health board region (OR 1.14, 95% CI 1.03 to 1.25, board B vs A) increased the odds of receiving an antibiotic.Conclusion: Community antibiotic prescriptions in COVID-19 episodes were uncommon in this population and likelihood was associated with patient factors. The reduction over pandemic waves may represent increased knowledge regarding COVID-19 treatment and/or evolving symptomatology