1,721,010 research outputs found
Atrial fibrillation screening with photo-plethysmography through a smartphone camera
No full textAims This cross-sectional study was set up to assess the feasibility of mass screening for atrial fibrillation (AF) with only the use of a smartphone. Methods and results A local newspaper published an article, allowing to subscribe for a 7-day screening period to detect AF. Screening was performed through an application that uses photo-plethysmography (PPG) technology by exploiting a smartphone camera. Participants received instructions on how to perform correct measurements twice daily, with notifications pushed through the application's software. In case of heart rhythm irregularities, raw PPG signals underwent secondary offline analysis to confirm a final diagnosis. From 12328 readers who voluntarily signed up for screening (49 +/- 14 years; 58% men), 120446 unique PPG traces were obtained. Photo-plethysmography signal quality was adequate for analysis in 92% of cases. Possible AF was detected in 136 individuals (1.1%). They were older (P<0.001), more frequently men (P<0.001), and had higher body mass index (P=0.004). In addition, participants who strictly adhered to the recommended screening frequency (i.e. twice daily) were more often diagnosed with possible AF (1.9% vs. 1.0% in individuals who did not adhere; P = 0.008). Symptoms of palpitations, confusion, and shortness of breath were more frequent in case of AF (P<0.001). The cumulative diagnostic yield for possible AF increased from 0.4% with a single heart rhythm assessment to 1.4% with screening during the entire 7-day screening period. Conclusion Mass screening for AF using only a smartphone with dedicated application based on PPG technology is feasible and attractive because of its low cost and logistic requirements.Qompium N.V. provided free use of the FibriCheckVR algorithm for every study participant during the 7-day study period. The local newspaper Het Belang van Limburg published a free article to inform its readers on this
smartphone-based algorithm and encourage people to participate in the screening programme
REVISITING DIASTOLIC FILLING TIME AS MECHANISTIC INSIGHT FOR RESPONSE TO CARDIAC RESYNCHRONIZATION THERAPY
No full textIncreasing diastolic filling time as mechanistic insight for response to cardiac resynchronization therapy
No full textCardiac resynchronization therapy with or without defibrillator: experience from a high-volume Belgian implantation centre
No full textObjective: Cardiac resynchronization therapy (CRT) is an important treatment modality for heart failure with reduced ejection fraction and ventricular conduction delay. Considering limited health care budgets in an aging population, adding a defibrillator function to CRT remains a matter of debate. Our aim was to describe the experience of a high-volume Belgian implantation centre with CRT/without defibrillator (CRT-D/P). Methods and results: Consecutive CRT patients (n=221), implanted between October 2008 and April 2011 in Ziekenhuis Oost-Limburg (Genk) were reviewed. From 209 primo-implantations, 74 CRT-D and 98 CRT-P patients with complete follow-up inside the centre, were analysed. Despite differences in baseline characteristics, both groups demonstrated similar reverse left ventricular remodelling, improvement in New York Heart Association functional class and maximal aerobic capacity. During mean follow-up 18 +/- 9 months, 21 patients died and 83 spent a total of 1200 days in hospital. Annual mortality was 8% and equal among the groups. The mode of death differed between CRT-D (predominantly pump failure) and CRT-P patients (pump failure, comorbidity and sudden death). The yearly population attributable risk of malignant ventricular arrhythmia was 8.16% in CRT-D and 1.38% in CRT-P patients. Conclusions: With current guidelines applied to the Belgian reimbursement criteria and at physicians' discretion, patient selection for CRT-D/CRT-P was appropriate, with similar reverse remodelling, functional capacity improvement and good clinical outcome in both groups. High-risk patients for malignant ventricular arrhythmia were more likely to receive CRT-D, although the yearly attributable risk remained 1.38% in CRT-P patient
Asymptomatic episodes of device-registered atrial tachyarrhythmia are not associated with worse cardiac resynchronization therapy response
No full textTo assess the influence of device-registered episodes of atrial tachyarrhythmia (AT) on the response to cardiac resynchronization therapy (CRT). Consecutive CRT patients without history of atrial fibrillation (AF; n = 118) were followed prospectively. AT was defined as a device-registered episode of atrial rate > 190 b.p.m. for a parts per thousand yen30 s. Episodes of electrocardiographically documented AF, accompanied by symptoms, or need for cardioversion, were classified as clinical AF. During mean follow-up of 26 +/- 9 months, 39 patients (33%) had a parts per thousand yen1 episode of asymptomatic device-registered AT. Twenty-one patients (18%) developed clinical AF of whom seven had previously experienced episodes of asymptomatic device-registered AT. Patients with asymptomatic AT or AF had a higher body mass index, but otherwise similar baseline characteristics, compared with the subjects without AT. Reverse remodelling after CRT was similar among the groups. While clinical AF was significantly associated with the composite endpoint of all-cause mortality or unplanned hospital admission (hazard ratio = 2.43, 95% confidence interval: 1.40-4.24), this correlation was not observed in patients with asymptomatic device-registered AT (P value = 0.540). Episodes of asymptomatic device-registered AT are frequent in CRT patients, but are not associated with impaired reverse remodelling. In contrast to clinical AF, such episodes are not associated with worse clinical outcome.Limburg Clinical Research Program UHasselt-ZOL-Jessa by foundation Limburg Sterk Merk, Hasselt University; Ziekenhuis Oost-Limburg; Jessa Hospita
MADIT-ICD benefit score aids in selecting implantable cardioverter-defibrillator in cardiac resynchronisation therapy
No full textComparative evaluation of digital consumer devices for atrial fibrillation detection: a validation study
No full textBackground: Consumer-oriented digital devices, such as smartphones and smartwatches, have gained prominence for their ability to conduct heart rhythm analysis, specifically in detecting atrial fibrillation (AF) through proprietary algorithms using electrocardiography (ECG) and/or photoplethysmography (PPG)-based digital recordings. Despite numerous individual validation studies, a direct inter-device comparison of their performance remains elusive.
Objective: To evaluate and compare the ability of digital consumer devices to discriminate between sinus rhythm and AF.
Methods: Patients exhibiting sinus rhythm or AF were consecutively enrolled from the cardiology outpatient clinic. They were instructed to perform heart rhythm measurements, using a handheld six-lead ECG device, a smartwatch-derived single-lead ECG, and two PPG-based smartphone applications in a random sequence, with continuous gold standard 12-lead ECG reference monitoring. Only one confirmed measurement per patient for each digital device was included in the analysis.
Results: Overall, 122 patients were included (age 69 [61-77] years, 63.9% male, 25% with AF). The sensitivity, specificity, accuracy, Cramer's V, and AUROC of the used devices, compared with a reference 12-lead ECG, were comparable and are presented in Table 1. Cohen's kappa demonstrated a near-perfect intra-device algorithm agreement between the first and second measurements with sufficient quality. Remarkably, smartphone PPG app (A) yielded significantly fewer inconclusive tracings compared to the other digital devices (p 5 .002). Nevertheless, participants preferred the use of a smartwatch form factor to monitor their heart rhythm.
Conclusion: The discrimination between sinus rhythm and AF using digital consumer devices based on ECG or PPG was highly accurate, with no discernible variations across the examined devices
Comparative evaluation of digital consumer devices for atrial fibrillation detection: a validation study
No full textBackground: Consumer-oriented digital devices, such as smartphones and smartwatches, have gained prominence for their ability to conduct heart rhythm analysis, specifically in detecting atrial fibrillation (AF) through proprietary algorithms using electrocardiography (ECG) and/or photoplethysmography (PPG)-based digital recordings. Despite numerous individual validation studies, a direct inter-device comparison of their performance remains elusive.
Objective: To evaluate and compare the ability of digital consumer devices to discriminate between sinus rhythm and AF.
Methods: Patients exhibiting sinus rhythm or AF were consecutively enrolled from the cardiology outpatient clinic. They were instructed to perform heart rhythm measurements, using a handheld six-lead ECG device, a smartwatch-derived single-lead ECG, and two PPG-based smartphone applications in a random sequence, with continuous gold standard 12-lead ECG reference monitoring. Only one confirmed measurement per patient for each digital device was included in the analysis.
Results: Overall, 122 patients were included (age 69 [61-77] years, 63.9% male, 25% with AF). The sensitivity, specificity, accuracy, Cramer's V, and AUROC of the used devices, compared with a reference 12-lead ECG, were comparable and are presented in Table 1. Cohen's kappa demonstrated a near-perfect intra-device algorithm agreement between the first and second measurements with sufficient quality. Remarkably, smartphone PPG app (A) yielded significantly fewer inconclusive tracings compared to the other digital devices (p 5 .002). Nevertheless, participants preferred the use of a smartwatch form factor to monitor their heart rhythm.
Conclusion: The discrimination between sinus rhythm and AF using digital consumer devices based on ECG or PPG was highly accurate, with no discernible variations across the examined devices
Cardiac resynchronization therapy with or without defibrillator: experience from a high-volume Belgian implantation centre
No full textObjective: Cardiac resynchronization therapy (CRT) is an important treatment modality for heart failure with reduced ejection fraction and ventricular conduction delay. Considering limited health care budgets in an aging population, adding a defibrillator function to CRT remains a matter of debate. Our aim was to describe the experience of a high-volume Belgian implantation centre with CRT/without defibrillator (CRT-D/P). Methods and results: Consecutive CRT patients (n=221), implanted between October 2008 and April 2011 in Ziekenhuis Oost-Limburg (Genk) were reviewed. From 209 primo-implantations, 74 CRT-D and 98 CRT-P patients with complete follow-up inside the centre, were analysed. Despite differences in baseline characteristics, both groups demonstrated similar reverse left ventricular remodelling, improvement in New York Heart Association functional class and maximal aerobic capacity. During mean follow-up 18 +/- 9 months, 21 patients died and 83 spent a total of 1200 days in hospital. Annual mortality was 8% and equal among the groups. The mode of death differed between CRT-D (predominantly pump failure) and CRT-P patients (pump failure, comorbidity and sudden death). The yearly population attributable risk of malignant ventricular arrhythmia was 8.16% in CRT-D and 1.38% in CRT-P patients. Conclusions: With current guidelines applied to the Belgian reimbursement criteria and at physicians' discretion, patient selection for CRT-D/CRT-P was appropriate, with similar reverse remodelling, functional capacity improvement and good clinical outcome in both groups. High-risk patients for malignant ventricular arrhythmia were more likely to receive CRT-D, although the yearly attributable risk remained 1.38% in CRT-P patient
Cardiac resynchronization therapy with or without defibrillator: experience from a high-volume Belgian implantation centre
No full textBackground: Cardiac resynchronization therapy (CRT) is an important treatment modality for heart failure with reduced ejection fraction and ventricular conduction delay. With stringent reimbursement criteria in an aging population, adding a defibrilator function to CRT remains a matter of debate. Our aim was to describe the experience of a high-volume Belgian implantation centre with CRT with/without defibrilator (CRT-D/P). Methods: Consecutive CRT patients (n=221), implanted between October 2008 and April 2011 in Ziekenhuis Oost-Limburg (Genk), were screened. From 209 primo-implantations, 74 CRTD and 98 CRTP patients with complete follow up inside the centre were analysed. Results: Despite differences in baseline characteristics, both groups demonstrated similar reverse left ventricular remodelling, improvement in New York Heart Association functional class and maximal aerobic capacity
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