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Bong J, Yasin O, Vaidya VR, Park J, Attia ZI, Padmanabhan D, Cho SJ, Asirvatham R, Schneider N, Lee J, Kim EM, Friedman PA, Ma Z. Injectable Flexible Subcutaneous Electrode Array Technology for Electrocardiogram Monitoring Device. ACS Biomater Sci Eng 2019; 6:2652-2658. [DOI: 10.1021/acsbiomaterials.9b01102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Jihye Bong
- Department of Electrical and Computer Engineering, University of Wisconsin−Madison, Madison, Wisconsin 53706, United States
| | - Omar Yasin
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, United States
| | - Vaibhav R. Vaidya
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, United States
| | - Jeongpil Park
- Department of Electrical and Computer Engineering, University of Wisconsin−Madison, Madison, Wisconsin 53706, United States
| | - Zachi I. Attia
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, United States
| | - Deepak Padmanabhan
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, United States
| | - Sang June Cho
- Department of Electrical and Computer Engineering, University of Wisconsin−Madison, Madison, Wisconsin 53706, United States
| | - Roshini Asirvatham
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, United States
| | - Noah Schneider
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, United States
| | - Juhwan Lee
- Department of Electrical and Computer Engineering, University of Wisconsin−Madison, Madison, Wisconsin 53706, United States
| | - Eun Mee Kim
- Department of Emergency Medical Technology, Korea Nazarene University, Cheonan 31172, South Korea
| | - Paul A. Friedman
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, United States
| | - Zhenqiang Ma
- Department of Electrical and Computer Engineering, University of Wisconsin−Madison, Madison, Wisconsin 53706, United States
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Hopenfeld B, John MS, Fischell TA, Johnson SR. A statistically based acute ischemia detection algorithm suitable for an implantable device. Ann Biomed Eng 2012; 40:2627-38. [PMID: 22739698 DOI: 10.1007/s10439-012-0612-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 06/19/2012] [Indexed: 10/28/2022]
Abstract
This study investigates the performance of a new statistically driven acute ischemia detection algorithm that can process data from two bipolar cutaneous or subcutaneous leads. During a start-up phase, the algorithm processes electrocardiogram signals to determine a normal range of ST-segment deviation as a function of heart rate. The algorithm then generates upper and lower ST-deviation thresholds based on the dispersion of the baseline ST-deviation data. After the start-up phase, persistent ST-deviation that is beyond either the upper or lower thresholds results in detection of acute ischemia. To test the algorithm, we performed long-term (10 day) Holter monitoring in a control group of 14 subjects. We also performed Holter monitoring during balloon angioplasty, and for 2 days after surgery, in 30 subjects who underwent elective percutaneous coronary interventions ("PCI"). We determined the percentage of balloon inflations the algorithm detected without producing false positive detections within the control group 10-day daily life data. The algorithm detected 17/17 LAD occlusions, 7/8 LCX occlusions, and 8/9 RCA occlusions. Our results suggest that automatically generated, subject-specific, heart-rate dependent ST-deviation thresholds can detect PCI induced myocardial ischemia without resulting in false positive detections in a small control group.
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Affiliation(s)
- Bruce Hopenfeld
- Angel Medical Systems, 1163 Shrewsbury Avenue, Shrewsbury, NJ 07702, USA.
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BELLARDINE BLACK CARISSAL, STROMBERG KURT, VAN BALEN GEORGETTEPLEMPER, GHANEM RAJAN, BREEDVELD ROBERTW, TIELEMAN ROBERTG. Is Surface ECG a Useful Surrogate for Subcutaneous ECG? PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2010; 33:135-45. [DOI: 10.1111/j.1540-8159.2009.02616.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wireless and inductively powered implant for measuring electrocardiogram. Med Biol Eng Comput 2007; 45:1163-74. [PMID: 17929070 DOI: 10.1007/s11517-007-0264-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Accepted: 09/11/2007] [Indexed: 10/22/2022]
Abstract
The development of an active implantable device for measuring electrocardiogram (ECG) is presented. The study is a part of a project which aims at developing implantable ECG instrumentation with wireless data and power transfer ( http://www.ele.tut.fi/tule ). The developed implant presented here has all the measurement electronics as well as power and data communication instrumentation included. The implant itself contains no battery, while power for the implant is transferred electromagnetically from an external reader device. The results of testing the implant attached on the body surface and in vitro in a water container are also presented. The developed system was also successfully tested in in vivo measurements, which were conducted on four cows with an implantation time of 24 h. The in vivo testing of implant in cows was conducted by a veterinarian in supervised conditions under approved animal experiment licence.
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Riistama J, Vaisanen J, Heinisuo S, Lekkala J, Kaihilahti J. Evaluation of an implantable ECG monitoring device in vitro and in vivo. ACTA ACUST UNITED AC 2007; 2007:5704-7. [DOI: 10.1109/iembs.2007.4353641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Väisänen J, Hyttinen J, Malmivuo J. Finite difference and lead field methods in designing implantable ECG monitor. Med Biol Eng Comput 2006; 44:857-64. [PMID: 17031715 DOI: 10.1007/s11517-006-0092-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2005] [Accepted: 06/28/2006] [Indexed: 11/24/2022]
Abstract
To minimize time-consuming and expensive in vitro and in vivo testing, information regarding the effects of implantation and the implants on measurements should be available during the designing of active implantable devices measuring bioelectric signals such as electrocardiograms (ECG). Modeling offers a fairly inexpensive and effective means of studying and demonstrating the effects of implantation on ECG measurements prior to any in vivo tests, and can thus provide the designer with valuable information. Finite difference model (FDM) and lead field approaches offer straightforward and effective modeling methods supporting the designing of active implantable ECG devices. The present study demonstrates such methods in developing and studying ECG implants. They were applied in demonstrating the effects of implant dimensions and of electrode implantation on the measurement sensitivity of the ECG device. The results of the simulations indicated that the interelectrode distance is the factor of the implant design determining the lead sensitivity. Other parameters related implant dimensions and shape have minor effect on the morphology of the ECG or on the average sensitivity of the measurement. This is shown for example when the interelectrode distance was reduced to 1/3 of original the average lead sensitivity decreased by 69.1% while larger relative changes in other dimensions produced clearly smaller changes. It was also observed here that implanting the electrodes deeper under the skin has major effects on the local sensitivities in heart muscle and thus affect to the morphology of the ECG. The study indicated also that non-conducting medium (i.e. implant insulated body) between the electrodes increases the sensitivity on heart muscle compared to cases where only electrodes are implanted.
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Affiliation(s)
- Juho Väisänen
- Ragnar Granit Institute, Tampere University of Technology, P.O. Box 692, 33101, Tampere, Finland.
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