Is One Lead Registered ECG Able to Reflect the Whole Picture of the Main Electrocardiographic Parameters Characteristic for Healthy Patients As Well As for Myocardial Ischemia Ones?
Electrocardiograms (ECG) remain the main noninvasive tool that cardiologists use first for examining CAD in clinical practice. Since the invention of cardiograph, the cardiologists following the original Eindhoven construction traditionally have been using 12 lead electrodes kit for registering ECGs. However, together with development of telemedicine the one lead electrode ECG registering is in high demand. The heart, being a selfsustained oscillatory system could be possibly analyzed through studying the Fourier spectrum features of the ECG registered by any of the 12 conventional leads, which remind electricity consumer’s lines going from a central generating power station – the heart. So far, any lead as any electrical line may contain the overwhelming heart dynamic characteristics by analogy with the parameters of the central electric generator.
The ECG features analysis in a patient born in 1946 led to repeated statement of misdiagnosis, particularly of myocardial infarction. About 2,500 patients’s ECGshave been analyzed for the three-year period of the patient’s observation. A Fourier analysis of the spectra of the ECGs of the patient 2506 allowed to assume that there exists an additional leading center in his myocardium, with a variable start phase of the myocardium relative to the phase of the fundamental frequency of contractions of the myocardium. Experimental confirmation of this hypothesis is in particular; found in the patient jump-like transition from synchronous phase daily changes in the function dynamics of the P wave width and the PQ segment to the antiphase ones, which reflects the change in the conditions for triggering the process of myocardial contraction. As a result, the coupling of the two leading frequencies of the myocardium, with a variable phase shift of the triggering, can be expressed both in the extra systoles appearance as well as in unusual cardio cycles not coinciding in the form and phase of cardio cycles of a single ECG. Cluster analysis of the entire set of collected patient’s ECGs in the similarity of their forms revealed 18 separate clusters of similarity. While cluster analysis of the ECG samples in other 4857 patients in most cases led to the identification of only one cluster characteristic for a certain patient’s ECG form. Mathematical modeling of the proposed hypothesis about the presence of more than one leading center of myocardial triggering which resulted in getting model patterns of split ECGs, qualitatively corresponding to the split forms of ECGs observed in the studied patient, confirmed its validity.
The mass application of mobile cardiographs already leads to both explosive quantitative growth of the number of patients available for ECG study, registered daily outside the hospital (Big DATA in cardiology), and to the emergence of new qualitative opportunities for the study of long-term oscillatory processes (weeks, months, years) of the dynamics of the individual state of the Cardiovascular system of any patient.
The article demonstrates that new opportunities of long - term continuous monitoring of the Cardiov ascular system state of patients ' mass allow to reveal the regularities (DATA MINING) of Cardiovascular system dynamics, leading to the hypothesis of the existence of an adequate Cardiovascular system model as a distributed nonlinearself - oscillating system of the FPU recurrence model class . The presence of a meaningful mathematical model of Cardiovascular system within the framework of the FPU auto – recurrence , as a refinement of the traditional model of studying black box, further allows us to offer new computational methods for ECG analysis and prediction of Cardiovascular system dynamics for a refined diagnosis and evaluation of the effectiveness of the treatment.
Continua Health Alliance is a non-profit, open industry organization of healthcare and technology companies joining together in collaboration to improve the quality of personal healthcare. With more than 200members companies around the world, Continua is dedicated to establishing a system of interoperable personal connected health solutions with the knowledge that extending those solutions into the home fosters independence, empowers individuals and provides the opportunity for truly personalized health and wellness management. When you look at complete list of Continua Certified TM http://www.continuaalliance.org/node/77, you cannot find any ECG device (at the time of writing), but need ECG asa useful screening tool for a variety of cardiac abnormalities. We decided to build the prototype of 3-5-lead ECG with Bluetooth LE and USB interface. The firmware of the device was developed according the ISO/EEE 11073-10406:2011 and this device as a agent can communicate with any manager device on Personal Area Network. The filters of the device (50/60 Hz , low and high pass) are programmable and can be remotely configured. The signals from electrodes can be routed to doctor computer's screen for online diagnostic, can be save in EHR system or sent to special computer with LabView for ECG signal processing with different algorithms. This prototype could be used as a X73 agent for other consumer medical applications.
Two versions of the mathematical model that detect different glycemia cases using heart rate variability (HRV) values taking into account the patient age have been developed and evaluated. HRV and glucose data have been obtained from 128 patients with type 2 diabetes mellitus (T2DM). Based on the evaluation results, the fundamental possibility of developing a non-invasive glycemia monitoring system based on one of the model variants has been confirmed. To increase the accuracy of the model, it is necessary to conduct a similar study involving patients without annotated type 2 diabetes.
This prototype development explains the challenges encountered during the ISO/IEEE 11073 standard implementation process. The complexity of the standard and the consequent heavy requirements, which have not encouraged software engineers to adopt the standard. The developing complexity evaluation drives us to propose two possible implementation strategies that cover almost all possible use cases and eases handling the standard by non-expert users. The first one is focused on medical devices (MD) and proposes a low-memory and low-processor usage technique. It is based on message patterns that allow simple functions to generate ISO/IEEE 11073 messages and to process them easily. MD act as X73 agent. Second one is focused on more powerful device X73 manager, which do not have the MDs' memory and processor usage constraints. The protocol between Agent and Manager is point-to-point and we can distribute the functionality between devices.
Developed both implementation X73 Agent and Manager will cut developing time for applications based on ISO/EEE 11073.
A form for an unbiased estimate of the coefficient of determination of a linear regression model is obtained. It is calculated by using a sample from a multivariate normal distribution. This estimate is proposed as an alternative criterion for a choice of regression factors.
This proceedings publication is a compilation of selected contributions from the “Third International Conference on the Dynamics of Information Systems” which took place at the University of Florida, Gainesville, February 16–18, 2011. The purpose of this conference was to bring together scientists and engineers from industry, government, and academia in order to exchange new discoveries and results in a broad range of topics relevant to the theory and practice of dynamics of information systems. Dynamics of Information Systems: Mathematical Foundation presents state-of-the art research and is intended for graduate students and researchers interested in some of the most recent discoveries in information theory and dynamical systems. Scientists in other disciplines may also benefit from the applications of new developments to their own area of study.