A WEARABLE DEVICE USING CLOTH BASED NANOSENSOR TECHNOLOGY DEMONSTRATES MORE PROLONGED CHANGES IN CARDIAC AND RESPIRATORY PHYSIOLOGY FOLLOWING NOCTURNAL AROUSALS IN HEART FAILURE PATIENTS WITH HOSPITALIZATION EVENTS

Abstract

Nocturnal symptoms such as Paroxysmal Nocturnal Dyspnea (PND) events are common in Heart Failure (HF) patients. However, the changes in cardiac and respiratory physiology leading up to and in recovery after a waking event (WE) has not been presented thus far with fine granularity in HF patients. A wearable device was used to collect multi-parametric data for 12 hrs—per day over 90 days following discharge from a HF-related hospitalization (HFE). With a WE defined as a postural transition from lateral or supine to sitting between 12 AM and 4 AM, a total of 370 WE were detected across three patients, including 238 WE in a patient (Age 58, M, ischemic, NYHA 4, LVEF 65%) who had a HFE on day 65 and 132 control WE in 2 patients (Age 74 & 61, M, ischemic, NYHA 3, LVEF <25% 30%) with no HFE within 90 days. For each WE, respiration rate, heart rate, and relative tidal volume were extracted for a 2-hour window centered on the time of the WE. Ensemble averages were computed for the normalized data windows across 238 events (HFE) and 132 events (no HFE) (Figure). Recovery time was defined as time to recover to within 10% of the baseline following a WE. The recovery times for heart rate, respiratory rate, and relative tidal volume were 33%, 44%, and 100% longer, respectively, for the patient with a HFE compared to patients with no HFE. Nocturnal arousals in a HF patient with a HFE are associated with more prolonged changes in cardiac and respiratory physiology as compared to more stable HF patients. This early observation provides justification for further study to confirm its utility in monitoring HF patients.