Abstract

Previous studies have shown that miniaturised accelerometers can be used to monitor cardiac function and automatically detect ischemic events. However, accelerometers cannot differentiate between acceleration due to motion and acceleration due to gravity. Gravity filtering is essential for accurate integration of acceleration to yield velocity and displacement. Heart motion is cyclic and mean acceleration over time is zero. Thus, static gravity filtering is performed by subtracting mean acceleration. However, the heart rotates during the cycle, the gravity component is therefore not constant, resulting in overestimation of motion by static filtering. Accurate motion can be calculated using dynamic gravity filtering by a combined gyro and accelerometer. In an animal model, we investigated whether increased accuracy using dynamic filtering, compared to using static filtering, would enhance the ability to detect ischemia. Additionally, we investigated how well the gyro alone could detect ischemia based on the heart’s rotation. Dynamic filtering tended towards lower sensitivity and specificity, using receiver operating characteristics analysis, for ischemia-detection compared to static filtering (area under the curve (AUC): 0.83 vs 0.93, p = 0.125). The time-varying gravity component indirectly reflects the heart’s rotation. Hence, static filtering has the advantage of indirectly including rotation, which alone demonstrated excellent sensitivity to ischemia (AUC = 0.98).

Highlights

  • Patients undergoing coronary artery bypass graft surgery are at risk of intra- and post-operative re-infarction due to occlusion of the bypass graft anastomoses

  • We hypothesised that the increased accuracy achieved using dynamic gravity compensation would improve the ability to detect ischemia

  • Successful induction of ischemia was confirmed by regional work analysis using left ventricle (LV) pressure and sonomicrometry measurements of myocardial strain

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Summary

Introduction

Patients undergoing coronary artery bypass graft surgery are at risk of intra- and post-operative re-infarction due to occlusion of the bypass graft anastomoses. A miniaturised sensor can be incorporated in the temporary pacemaker leads routinely attached during cardiac surgery In this manner, motion monitoring can be performed during surgery, and in the critical post-operative phase, without adding to the surgical procedure. We have shown that both the static and the time varying gravity component can be estimated and removed using a combined accelerometer and gyro sensor. The gyro measures angular velocity, from which rotation is calculated, and can estimate and remove the gravity vector dynamically for all time points. Using this dynamic gravity compensation method gives a significantly more accurate measurement of cardiac motion[7]. To investigate the underlying differences between these methods, we performed frequency analyses of the motion traces

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