Anti-motion artifact is one of the most important properties of ambulatory ECG monitoring equipment. At present, there is a lack of standardized means to test the performance of anti-motion artifact. ECG simulator and special conductive leather are used to build the simulator, it is used to simulate human skin, to generate ECG signal input for the ECG monitoring equipment attached to it. The mechanical arm and fixed support are used to build a motion simulation system to fix the conductive leather. The mechanical arm is programmed to simulate various motion states of the human body, so that the ECG monitoring equipment can produce corresponding motion artifacts. The collected ECG signals are read wirelessly, observed, analyzed and compared, and the anti-motion artifact performance of ECG monitoring equipment is evaluated. The test results show that by artificially creating the small difference between the two groups of ambulatory ECG monitoring equipment, the system can accurately test the interference signals introduced under the conditions of controlled movement such as tension and torsion, and compare the advantages and disadvantages. The research shows that the test system can provide convenient and accurate verification means for the research of optimizing anti-motion interference.
Humans ; Artifacts ; Signal Processing, Computer-Assisted ; Electrocardiography, Ambulatory/methods* ; Electrocardiography ; Motion

As a novel technology, wearable physiological parameter monitoring technology represents the future of monitoring technology. However, there are still many problems in the application of this kind of technology. In this paper, a pilot study was conducted to evaluate the quality of electrocardiogram (ECG) signals of the wearable physiological monitoring system (SensEcho-5B). Firstly, an evaluation algorithm of ECG signal quality was developed based on template matching method, which was used for automatic and quantitative evaluation of ECG signals. The algorithm performance was tested on a randomly selected 100 h dataset of ECG signals from 100 subjects (15 healthy subjects and 85 patients with cardiovascular diseases). On this basis, 24-hour ECG data of 30 subjects (7 healthy subjects and 23 patients with cardiovascular diseases) were collected synchronously by SensEcho-5B and ECG Holter. The evaluation algorithm was used to evaluate the quality of ECG signals recorded synchronously by the two systems. Algorithm validation results: sensitivity was 100%, specificity was 99.51%, and accuracy was 99.99%. Results of controlled test of 30 subjects: the median (Q1, Q3) of ECG signal detected by SensEcho-5B with poor signal quality time was 8.93 (0.84, 32.53) minutes, and the median (Q1, Q3) of ECG signal detected by Holter with poor signal quality time was 14.75 (4.39, 35.98) minutes (Rank sum test,
Algorithms ; Electrocardiography ; Electrocardiography, Ambulatory ; Humans ; Pilot Projects ; Signal Processing, Computer-Assisted ; Wearable Electronic Devices

Aiming at the ECG performance indicators in the YY 0885-2013 "Medical electrical equipment Part 2: Particular requirements for the safety including essential performance of ambulatory electrocardiographic systems", the traditional detection methods are time-consuming and the test results are greatly affected by human factors. In this paper, an automated detection method is proposed. A set of automatic detection software for ECG performance is designed and developed based on a single-channel ECG recorder, and an automated detection system is set up in combination with standard testing equipment. And then, the MSA tool is used to analyze the repeatability and stability of the detection system, and the results show that the detection system is acceptable, and it can improve detection efficiency.
Electricity ; Electrocardiography ; Electrocardiography, Ambulatory ; Humans ; Software

The amplifier is easy to saturation because of polarization voltage in ambulatory ECG acquisition. The traditional way is using analog high-pass filter to eliminate, but the output tends to have a residue. If upgrading high-pass filter cutoff frequency, it will lead to low frequency distortion of ECG signals. In this paper, a Savitzky-Golay (SG) smoothing filter has been designed by combining the single edge point and the polynomial order , which can fit the polarization voltage components of ECG signals, filter useful components and get drift-free ECG signals by using the subtraction algorithm. The results of ECG filtering experiment verify the feasibility of the SG smoothing filter, and show the filtered ECG signal without any losses of useful components.
Algorithms ; Amplifiers, Electronic ; Electrocardiography, Ambulatory ; methods ; Humans ; Signal Processing, Computer-Assisted

The extraction of pulse rate variability(PRV) in daily life is often affected by exercise and blood perfusion. Therefore, this paper proposes a method of detecting pulse signal and extracting PRV in post-ear, which could improve the accuracy and stability of PRV in daily life. First, the post-ear pulse signal detection system suitable for daily use was developed, which can transmit data to an Android phone by Bluetooth for daily PRV extraction. Then, according to the state of daily life, nine experiments were designed under the situation of static, motion, chewing, and talking states, respectively. Based on the results of these experiments, synchronous data acquisition of the single-lead electrocardiogram (ECG) signal and the pulse signal collected by the commercial pulse sensor on the finger were compared with the post-auricular pulse signal. According to the results of signal wave, amplitude and frequency-amplitude characteristic, the post-ear pulse signal was significantly steady and had more information than finger pulse signal in the traditional way. The PRV extracted from post-ear pulse signal has high accuracy, and the accuracy of the nine experiments is higher than 98.000%. The method of PRV extraction from post-ear has the characteristics of high accuracy, good stability and easy use in daily life, which can provide new ideas and ways for accurate extraction of PRV under unsupervised conditions.
Ear ; Electrocardiography, Ambulatory ; Fingers ; Heart Rate ; Humans ; Monitoring, Ambulatory ; Motion ; Pulse

BACKGROUND/AIMS: Many systems including the cardiovascular system (ischemic heart diseases, heart failure, and hypertension) may act as comorbidities that can be seen during the course of chronic obstructive pulmonary disease (COPD). Comorbidities affect the severity and prognosis of COPD negatively. Nearly 25% of patients with COPD die due to cardiovascular diseases. In this study, we aimed to evaluate the relationship between the blood pressure, inflammation, hypoxia, hypercapnia, and the severity of airway obstruction. METHODS: We included 75 COPD patients in the study with 45 control cases. We evaluated age, sex, body mass index, smoking history, C-reactive protein levels, 24-hour ambulatory blood pressure Holter monitoring, arterial blood gas, and respiratory function tests of the patient and the control groups. RESULTS: In COPD patients, the night time systolic, diastolic blood pressures and pulse per minute and the mean blood pressures readings were significantly elevated compared to the control group (p < 0.05). In the correlation analysis, night time systolic pressure was associated with all the parameters except forced expiratory volume in 1 second (FEV₁%). Diastolic blood pressure was associated with pH and HCO₃ levels. The mean night time, day time pulse pressures and 24-hour pulse per minute values were also associated with all the parameters except FEV₁%. CONCLUSIONS: In this study we found that parameters of systolic and diastolic blood pressures and pulse pressures were significantly elevated in COPD patients compared to the control groups. Blood pressure was associated blood gas parameters and inflammation parameters in COPD patients. This, in turn, may cause understanding of the pathophysiology of COPD and its complications.
Airway Obstruction ; Anoxia ; Blood Pressure* ; Body Mass Index ; C-Reactive Protein ; Cardiovascular Diseases ; Cardiovascular System ; Comorbidity ; Electrocardiography, Ambulatory ; Forced Expiratory Volume ; Heart Diseases ; Heart Failure ; Humans ; Hydrogen-Ion Concentration ; Hypercapnia ; Inflammation* ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Reading ; Respiratory Function Tests ; Smoke ; Smoking ; Spirometry*

A 34-year-old man presented to the outpatient clinic with syncope for 1 minute when he was working. He had no past medical and family history of sudden cardiac death. Electrocardiography (ECG) showed no remarkable findings. Follow-up ECG different from initial ECG was changed to type 1 Brugada ECG pattern. As time goes by, follow-up ECG was changed to type 2 Brugada ECG pattern. Although cause of syncope was assessed as Brugada syndrome, we performed coronary angiography to rule out ischemic heart disease. Coronary angiogram showed significant stenosis in the left main coronary artery (LMCA). Percutaneous coronary intervention with sirolimus-eluting stent was done at LMCA. He has been followed up for 1 year without any events. This is the first case of LMCA as syncope with Brugada type ECG in a young patient and it gives us the lesson that ischemic heart disease should be considered as the cause of syncope with Brugada type ECG.
Adult ; Ambulatory Care Facilities ; Brugada Syndrome ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Death, Sudden, Cardiac ; Electrocardiography ; Follow-Up Studies ; Humans ; Myocardial Ischemia ; Percutaneous Coronary Intervention ; Stents ; Syncope

Electrocardiogram (ECG) detection is a routine and effective cardiac problem detection project. Traditional electrocardiogram detection has limitations in cardiac arrhythmia and other heart disease detection and diagnosis, such as effectiveness, real-time and so on. Based on the advanced mobile networking and wearable design concept, this paper designs and implements a dynamic ECG real-time monitoring system with low power embedded system and Bluetooth 4.0 wireless communication. Its main functions include 24-hour dynamic ECG signal real-time acquisition, processing, wireless communication, display and storage, real-time analysis of typical arrhythmia, recording and alarm, professional doctors real-time reading and diagnosis, dynamic ECG sharing and cloud platform automatic analysis and diagnosis. Both the physiological signal generator and the actual patient's wear test showed that the design and function of the wearable dynamic ECG real-time monitoring terminal based on the mobile networking could meet and apply to the patients with cardiac monitoring needs in the house, hospital, nursing home, outdoor and many other places.
Electrocardiography ; Electrocardiography, Ambulatory ; Humans ; Internet ; Signal Processing, Computer-Assisted ; Wearable Electronic Devices

BACKGROUND: Polymorphic premature ventricular complexes (PVCs) are very common, appearing most frequently in patients with hypertension, obesity, sleep apnea, and structural heart disease. Sympathetic hyperactivity plays a critical role in the development, maintenance, and aggravation of ventricular arrhythmias. Endurance exercise training clearly lowers sympathetic activity in sympatho-excitatory disease states and may be tolerated by patients with chronic kidney disease (CKD). METHODS: We assessed 40 CKD patients with hypertension with polymorphic PVCs. Patients underwent a complete medical history and physical examination. We evaluated the effectiveness of β blocker only or β blocker + exercise during 12 months of follow-up regarding the changes of the numbers of PVCs and mean heart rate (HR) by 24-hour-Holter. RESULTS: We observed in the β blocker group a significant decrease in the number of polymorphic PVCs from baseline 36,515 ± 3,518 to 3, 6, 9 and 12 months of follow-up, 28,314 ± 2,938, 23,709 ± 1,846, 22,564 ± 1,673, and 22,725 ± 1,415, respectively (P < 0.001). In the β blocker + exercise group a significant decrease in the number of polymorphic PVCs also occurred from baseline 36,091 ± 3,327 to 3, 6, 9 and 12 months of follow-up, 29,252 ± 3,211, 20,948 ± 2,386, 14,238 ± 3,338, and 6,225 ± 2,319, respectively (P < 0.001). Comparisons between the two groups at the same time point showed differences from the sixth month onwards: the 6th (Δ = −2,761, P = 0.045), 9th (Δ = −8,325, P < 0.001) and 12th (Δ = −16,500, P < 0.001) months. There was an improvement during the 12 months of follow-up vs. baseline, after the β blocker or β blocker + exercise in mean 24-hour HR Holter monitoring, creatinine values, eGFR, and ACR. CONCLUSION: Polymorphic PVCs may be modifiable by physical activity in CKD patients with hypertension without structural heart disease.
Arrhythmias, Cardiac ; Creatinine ; Electrocardiography, Ambulatory ; Follow-Up Studies ; Heart Diseases ; Heart Rate ; Humans ; Hypertension ; Motor Activity* ; Obesity ; Physical Examination ; Renal Insufficiency, Chronic* ; Sleep Apnea Syndromes ; Ventricular Premature Complexes*

Rivaroxaban is a new oral anticoagulant used for the prevention of stroke in patients with atrial fibrillation. Hemorrhagic pericarditis is known to occur with rivaroxaban; however, only a few case reports in the literature describe such events. Recently, we experienced hemorrhagic pericarditis that treated with rivaroxaban for anticoagulation of newly diagnosed, non valvular AF patients with pacemaker. An 83 year old male with permanent pacemaker receiving rivaroxaban 20 mg daily once for 3 months presented at our emergency department complaining of exertional dyspnea. ECG showed intermittent atrial pacing failure and echocardiography showed large amount of pericardial effusion. After urgent pericardiocentesis, which resulted in removal of 500cc bloody fluid, there was an immediate and dramatic improvement in the patient's clinical state. He was discharged without anticoagulation therapy due to concern for further bleeding. This case highlight the potential for bleeding complications associated with novel anticoagulants. Rivaroxaban is being used with increasing frequently in outpatient care. However, no available laboratory test specifically measures the anticoagulant effect of rivaroxaban. Also, in the events of serious bleeding, no specific antidotes, reversal agents were available. Clinicians should be aware of the possibility of hemopericardium in patients treated with anticoagulants, including rivaroxaban who presented with cardiomegaly.
Ambulatory Care ; Anticoagulants ; Antidotes ; Atrial Fibrillation* ; Cardiomegaly ; Dyspnea ; Echocardiography ; Electrocardiography ; Emergency Service, Hospital ; Hemorrhage ; Humans ; Male ; Pericardial Effusion ; Pericardiocentesis ; Pericarditis* ; Rivaroxaban* ; Stroke