Nallathambi Gabriel, Selvaraj Nandakumar, Rajbhandary Paurakh L
Annu Int Conf IEEE Eng Med Biol Soc. 2020 Jul;2020:5012-5015. doi: 10.1109/EMBC44109.2020.9176390.
Accurate assessment of pacemaker function or malfunction is essential to make clinical interpretations on pacemaker therapy and patient symptoms. This article presents an innovative approach for detecting pacemaker pulses at sampling frequency as low as 125Hz. The proposed method is validated in wide range of simulated clinical ECG conditions such as arrhythmia (sinus rhythms, supraventricular rhythms, and AV blocks), pulse amplitudes (100µV to ~3mV), pulse durations (100µs to ~2ms), pacemaker modes and types (fixed-rate or on-demand single chamber, dual chamber, and bi-ventricular pacing), and physiological noise (tremor). The proposed algorithm demonstrates clinically acceptable detection accuracies with sensitivity and PPV of 98.1 ± 4.4 % and 100 %, respectively. In conclusion, the approach is well suited for integration in long-term wearable ECG sensor devices operating at a low sample frequency to monitor pacemaker function.Clinical Relevance- The proposed system enables real-time long-term continuous assessment of the proper functioning of implanted pacemaker and progression of treatment for cardiac conditions using battery-powered wearable ECG monitors.
准确评估起搏器功能正常与否对于对起搏器治疗和患者症状进行临床解读至关重要。本文提出了一种创新方法，可在低至125Hz的采样频率下检测起搏器脉冲。所提出的方法在多种模拟临床心电图条件下得到验证，如心律失常（窦性心律、室上性心律和房室传导阻滞）、脉冲幅度（约100µV至约3mV）、脉冲持续时间（约100µs至约2ms）、起搏器模式和类型（固定频率或按需单腔、双腔和双心室起搏）以及生理噪声（震颤）。所提出的算法显示出临床可接受的检测准确率，灵敏度和阳性预测值分别为98.1±4.4%和100%。总之，该方法非常适合集成到以低采样频率运行的长期可穿戴式心电图传感器设备中，以监测起搏器功能。临床相关性 - 所提出的系统能够使用电池供电的可穿戴式心电图监测器对植入起搏器的正常功能和心脏疾病治疗进展进行实时长期连续评估。
