Abstract
Background and Objective:Frequent ectopic beats in patients under hemodialysis may be associated with the occurrence of life-threatening arrhythmias. However, data regarding the prognostic significance of ectopic beats are limited due to the lack of accessible technology for long-term monitoring. This study aims to investigate the feasibility to assess the ectopic burden from continuously acquired wrist photoplethysmogram (PPG). Methods:The performance of two PPG-based ectopic beat detectors operating on the pulse-to-pulse basis was investigated against the reference ectopic beats detected from the electrocardiogram using 41 24-h recordings obtained from hemodialysis patients under uncontrolled conditions. The estimation accuracy of an average daily ectopic burden and the detection performance of high-risk ectopic burden (≥30 beats/h) were also compared to the reference electrocardiogram. Results:The sensitivity and positive predictive value of 68.1% and 59.5%, respectively, were reached by the better-performing PPG-based ectopic beat detector. A PPG-based average daily ectopic burden was estimated with a median error of 3 beats/h. Sensitivity of 82.7% and specificity of 89.8% were achieved when identifying high-risk ectopic burden in 1-h segments with at least 75% of acceptable-quality PPG. Conclusion:The study demonstrates the potential of the wrist PPG to monitor ectopic burden in an outpatient setting and identify patients eligible for early antiarrhythmic treatment.
Published Version
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