Electrocardiographic Monitoring Research Articles

The Effect of Electromagnetic Interference Produced by Smartphones Using 5G Network on Patients With Permanent Pacemakers (EMS5G‐PPM Study)

Background: The safety of new‐generation mobile phones using 5G networks in patients with modern‐generation pacemakers has not been studied.Objectives: This study aimed to compare the risk of electromagnetic interference (EMI) generated by a new‐generation mobile phone with 5G networks when positioned at the pacemaker pocket or the contralateral ear and assess the incidence of EMI with telemetry interrogation in patients with permanent pacemakers.Methods: We enrolled 489 patients with pacemakers from three different manufacturers. The pacemaker mode was programmed for overdrive pacing and sensing mode if an intrinsic rhythm was present. A smartphone (Samsung S21 + 5G) was placed directly over the pulse generator and right ear. The phone was tested under standby mode, 5G internet connection, and incoming and outgoing calls for each location. Real‐time electrocardiography (ECG) monitoring and patient symptoms were recorded to determine the occurrence of EMI. The possibility of EMI with interrogation telemetry was also investigated.Results: A total of 4824 tests were performed on 489 patients. Most pacemakers were dual‐chamber (82%) or magnetic resonance imaging (MRI)‐compatible systems (83%). EMI was not detected with both mobile phone positions. Interference with telemetry was demonstrated in 11.5% of patients. Almost all incidences of interference (98.2%) occurred during incoming calls. Single‐chamber pacemakers, non‐MRI‐compatible systems, older pulse generators, older leads, and unipolar settings were significantly related to a higher incidence of interference with interrogation telemetry.Conclusions: The risk of EMI between modern smartphones with 5G networks and pacemakers is low. Nevertheless, interference with the interrogation telemetry may still occur.

Cold atmospheric plasma deposition of antibacterial polypyrrole-silver nanocomposites on wearable electronics for prolonged performance.

Wearable electronics have become integral for monitoring physiological parameters in diverse applications, particularly in medical and military fields. e-Textiles, featuring integrated conductive threads or fabrics, offer seamless integration and comfort for prolonged contact with the body. Despite their potential, the biofouling of textile-based electrode systems by skin microbes remains a significant challenge, limiting their operational lifespan. Recent studies have highlighted the efficacy of conductive nanocomposites with antibacterial agents, such as silver nanoparticles (AgNPs), in addressing biofouling concerns. However, implementing such systems on 3D fibrous structures and textile surfaces often proves complex and inefficient. To overcome these challenges, we explored cold atmospheric plasma (CAP)-based in situ polymerization for the direct deposition of functional conductive polypyrrole-silver (PPy-Ag) nanocomposites onto conductive textile surfaces. For this process, a customized CAP deposition system was engineered, enabling precise material deposition through robotic control of the plasma jet. This process achieved direct, conformal attachment onto textile fibrous structures, ensuring uniform distribution of conductive polypyrrole and silver in the form of AgNPs throughout the polymer polypyrrole matrix without compromising fabric flexibility and breathability, which was validated through different surface electron microscopy and chemical analysis (e.g., EDX, FTIR, Raman, and XRD). Systematic studies with various precursor mixtures identified an optimized PPy-Ag composition that demonstrated stable antibacterial properties and biocompatibility against common skin microbes and epithelial cells. Systematic studies with various precursor mixtures identified an optimized PPy-Ag composition, with the precursor mixture containing 96 wt% pyrrole and 4 wt% AgNO3 weight ratios as the optimal surface coating process, demonstrating stable antibacterial properties and biocompatibility against common skin microbes and epithelial cells respectively. As a proof of concept, the nanocomposite coating was applied to conductive carbon fabric surfaces as dry electrodes in a wearable garment for continues electrocardiography (ECG) monitoring over 10 days. Results revealed a significantly longer performance of the dry electrodes as comparable to standard gel-based Ag/AgCl electrodes (1 day) while providing less noise in ECG signal measurements from the subject, showcasing the potential of this technology for practical wearable applications. Envisioned as a groundbreaking solution, this technology opens new avenues for the scalable and effective integration of functional conductive circuits and sensors into everyday garments, ensuring prolonged and efficient performance in wearable electronics.

Electrical Injury-induced Atrial Fibrillation

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia with significant morbidity and mortality risks. Electrical shocks can elicit adverse cardiac effects, including arrhythmias, although AF following electrical injuries remains relatively rare. We present the case of a 45-year-old man who developed AF after accidentally touching a live cable carrying 220 volts during home construction. The patient exhibited palpitations and shortness of breath and was admitted to the emergency department. Electrocardiographic monitoring confirmed AF with an irregular heart rate of 106 bpm. Echocardiographic examination revealed AF with normal ejection fraction. Successful pharmacological cardioversion using digoxin restored normal sinus rhythm within 6 h. The mechanisms underlying AF after electrical injury are not fully understood, but they likely involve arrhythmogenic foci formation and alterations in cardiac ion channels. Prompt diagnosis and management are crucial, with digoxin proving effective in this case. AF is a rare but clinically significant occurrence following low-voltage electrical shocks. Early diagnosis and appropriate management are essential in resolving the arrhythmia and optimizing patient outcomes. Further research is needed to understand the mechanisms and risk factors associated with this rare occurrence and explore long-term outcomes and potential complications.

Relationship between dust allergen sensitization and cardiac autonomic function in patients with chronic obstructive pulmonary disease.

Cardiac autonomic function predicts cardiovascular disease risk. The aim of this study was to investigate the relationship between sensitization to dust allergens and cardiac autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD), and to provide new ideas for the prevention of cardiovascular complications in these patients. Immunoassays for sensitization to cats/dogs, cockroaches and dust mites were performed in 840 patients with COPD. Indicators of heart rate variability in these patients were used to assess cardiac autonomic function, including standard deviation of normal-to-normal intervals (SDNN), root-mean square of successive differences between normal-to-normal intervals (RMSSD), low-frequency power (LF), high-frequency power (HF), and LF/HF ratios, which were obtained based on ambulatory electrocardiographic monitoring data. The relationship between sensitization to these dust allergens and heart rate variability was explored using multivariate logistic regression. The multivariate analyses showed that sensitization to total allergens was associated with reduced levels of SDNN, RMSSD, LF and HF and with increased levels of the LF/HF ratio in the patients with COPD (p < .05). Dust allergen sensitization may be associated with cardiac autonomic dysfunction in patients with COPD. Whether desensitization can prevent cardiovascular complications in these patients should be further explored.

Registered nurses' knowledge and interpretation of ECG rhythms: A cross-sectional study.

Electrocardiographic (ECG) monitoring and recording are seen as the most commonly used non-invasive diagnostic tool to identify cardiac arrhythmia and myocardial damage in the clinical setting. There is an expectation that critical care nurses are ideally trained to interpret abnormalities and morphology in the ECG more proficiently than nurses from general ward areas. However, the ability to interpret and recognise ECG abnormalities is dependent on which critical care area nurses are currently working in and their level of experience. The aim of this study was to investigate registered nurses' knowledge in being able to identify and interpret select electrocardiographic rhythms. This was a cross-sectional study that evaluated registered nurses' knowledge of electrocardiogram rhythm identification and interpretation. A convenience sample of 105 registered nurses currently enrolled in a 2-year Master's programme leading to critical care specialism and advanced practice nurse award were recruited. A 20-item multiple choice questionnaire that provided examples of electrocardiogram rhythm (n=14) abnormalities and rhythm abnormalities caused by electrolyte disturbances (n=6) RESULTS: The study included registered nurses from critical care and general ward areas. The overall results were poor with only 55% of questions answered correctly. Coronary care nurses scored the highest in identifying ECG rhythms (12/20 ± 1.58; p < .001). When ECG abnormalities associated with electrolyte imbalances were analysed, both groups were unable to identify the effects of hypokalaemia and hypomagnesaemia effectively (p = .748). Length of time as a registered nurse (r = -0.304, p = .002) and length of time in current work environment were weakly correlated (r = -0.328, p = .001). Having a critical care background showed a positive relationship with nursing knowledge of ECG rhythm identification (r = 0.614, p < .001). The results of this study demonstrate that nurses have a poor knowledge of ECG rhythm identification and interpretation, a consistent finding from other work. A possible solution is a revamp of education and training associated with ECG recognition and morphology. Monitoring and assessing ECG morphology provide important details about cardio-electroconductive stability, especially with fluctuations in serum electrolyte levels seen in critical illness or trauma. For this, critical nurses must improve their proficiency through education/training or internal quality improvement activities in detecting abnormalities associated with ECG changes beyond those most easily recognizable rhythms such as atrial fibrillation or ventricular tachycardia.

Prediction of ECG fiducial parameters from PPG signals for the analysis of cardiovascular diseases: A novel Gaussian process regression-based approach

PurposeCardiologists use 12-lead electrocardiograph (ECG) and prolonged continuous Holter monitoring to detect abnormalities in heart rhythm, which could diagnose or hint at different cardiac diseases. However, the availability of a costly ECG machine and the expertise to interpret ECG is suboptimal in our country. The current state of the art proposes mitigating the cost and easy diagnosis by physicians with the use of low cost photoplethysmograph (PPG), which will deliver ECG information in terms of ECG fiducial parameters. MethodsThe MIMIC-III matched paired datasets of PPG/Lead-II ECG signals with the six classes (right bundle branch block (RBBB), hypertension (HYPER), arrhythmia-atrial fibrillation (ARYTH-ATRFAB), dilated cardiomyopathy (DCM), complete heart block (CHB) and NORMAL) associated cardiovascular diseases (CVDs) syndromes of 30 patients with 5 minutes duration each were taken from Physionet. The proposed work tested by predicting ECG fiducial parameters (P, Q, R, S and T) through Gaussian process regression(GPR)-based predictor by using the PPG fiducial parameters with a training and testing ratio of 70:30. The performance was analyzed by different performance evaluation parameters e.g., RMSE, rRMSE, etc. ResultsAlthough the shape of the ECG may differ in various ways from that of the normal ECG, the methodology can predict the ECG fiducials from PPG for a variety of CVD patients with a performance accuracy of 95–99% by evaluating through seven performance metrics. ConclusionThe ECG fiducial parameters can be used to analyze CVDs captured from a low-cost, handy, skin-compatible continuous and non-invasive optical recording device well known as a PPG sensor.

Successful high-resolution three-dimensional electroanatomical mapping and radiofrequency catheter ablation of a posteroseptal accessory pathway in a dog using CARTO 3

A one-year-and-seven-month-old, 28 kg, male castrated crossbreed dog was presented for supraventricular tachycardia causing recurrent episodes of anorexia and lethargy. Sotalol (2.2 mg/kg q12 h) reduced the frequency of symptomatic episodes but did not provide full relief. Three-dimensional electroanatomical mapping was performed at the Ghent University Small Animal Teaching hospital using the CARTO 3. Right atrial activation mapping identified the earliest atrial activation right posteroseptal, near the tricuspid annulus. Fast retrograde ventriculoatrial conduction during tachycardia and extrastimulus testing confirmed the presence of a concealed right posteroseptal accessory pathway. Six radiofrequency catheter ablation applications were delivered, and tachycardia remained uninducible. The dog recovered well from the procedure. Sotalol was stopped three weeks later, and no more clinical signs were noted by the owner. Repeated 24-hour electrocardiography monitoring on day one and at one, three, and 12 months after the procedure showed no recurrence of tachycardia.

Electrochemical Properties of PEDOT:PSS/Graphene Conductive Layers in Artificial Sweat.

Electrodes based on PEDOT:PSS are gaining increasing importance as conductive electrodes and functional layers in various sensors and biosensors due to their easy processing and biocompatibility. This study investigates PEDOT:PSS/graphene layers deposited via spray coating on flexible PET substrates. The layers are characterized in terms of their morphology, roughness (via AFM and SEM), and electrochemical properties in artificial sweat using electrochemical impedance spectroscopy (EIS) and cyclic voltammetry (CV). The layers exhibit dominant capacitive behavior at low frequencies, with cut-off frequencies determined for thicker layers at 1 kHz. The equivalent circuit used to fit the EIS data reveals a resistance of about three orders of magnitude higher inside the layer compared to the charge transfer resistance at the solid/liquid interface. The capacitance values determined from the CV curves range from 54.3 to 122.0 mF m-2. After 500 CV cycles in a potential window of 1 V (from -0.3 to 0.7 V), capacitance retention for most layers is around 94%, with minimal surface changes being observed in the layers. The results suggest practical applications for PEDOT:PSS/graphene layers, both for high-frequency impedance measurements related to the functioning of individual organs and systems, such as impedance electrocardiography, impedance plethysmography, and respiratory monitoring, and as capacitive electrodes in the low-frequency range, realized as layered PEDOT:PSS/graphene conductive structures for biosignal recording.

Left ventricular longitudinal strain in patients with undifferentiated connective tissue disease and arrhythmia

Aim. To evaluate the left ventricular longitudinal strain in patients with arrhythmia and undifferentiated connective tissue disease (UCTD).Material and methods. This cross-sectional comparative study included young patients with arrhythmia and UCTD (43 men and 84 women; mean age, 30,82±8,17 years (group 1, n=127)). The control group included volunteers with single phenotypic characteristics of UCTD, comparable in age and sex (9 men and 21 women, mean age, 34,13±6,87 years (group 2, n=30)). A standard clinical examination, 72-hour electrocardiographic monitoring, and speckle-tracking echocardiography were performed.Results. Patients of group 1 were characterized by lower global systolic longitudinal myocardial strain compared to the control group: -22,96% [-24,56%; -21,50%] in group 1 vs -24,73% [-25,25%; -23,84%] in group 2 (p=0,016). A local decrease in longitudinal myocardial strain (in two or more segments) was noted in 62,2% of patients in group 1 and 13,3% of patients in group 2 (p=0,025). In group 1, a relationship was revealed between class I premature ventricular contractions (PVCs) and a longitudinal strain decrease in the medial anterior (r1=0,253, p=0,004) and apical anterior (r1=0,253, p=0,004) segments, as well as between class V PVCs and strain decrease in the basal lower (r1=0,215, p=0,021) and middle anterior (r1=0,211, p=0,023) segments. In addition, there was a moderate correlation between mitral valve prolapse (MVP) and a decrease in longitudinal systolic strain in the basal inferolateral (r1=0,405, p=0,041) and basal anterior (r1=0,519, p=0,003) segments.Conclusion. Local decrease in left ventricular longitudinal systolic strain in association with arrhythmia and MVP in patients with UCTD makes it possible to recommend speckle-tracking echocardiography for early non-invasive assessment of myocardial remodeling in this cohort of patients.

Clinical outcome of idiopathic juvenile ventricular arrhythmias in 25 dogs

Introduction/ObjectivesJuvenile ventricular arrhythmias in the absence of structural heart disease have been characterized in a small number of canine breeds with limited long-term follow up. The objective of this study was to describe the clinical outcome of dogs with JVA presenting to a university teaching hospital. Animals, materials, methodsTwenty five dogs, less than two years old with idiopathic ventricular arrhythmias were retrospectively identified via a medical record search. Young dogs with ventricular arrhythmias were excluded if they had structural heart disease, systemic illness, or an abnormal troponin (if performed). Electrocardiographic and Holter monitor data was evaluated for arrhythmia frequency and complexity at the time of diagnosis and over time. Long-term follow up was achieved through client and primary veterinarian contact. ResultsBreeds included German Shepherd (eight), Boxer (four), Great Dane (three), mixed breed (two) and one each of the following: Anatolian Shepherd, French Bulldog, golden retriever, Great Pyrenees, Labrador retriever, Shiloh Shepherd, miniature Poodle and Siberian Husky. The average age at diagnosis was 7.9 months (range, 2–22 months). The overall median survival was 10.96 years (range, 1.75–15.66 years). There was an average reduction in the number of ventricular beats by 86.7 % per year (P value −0.0257) based on Holter data. ConclusionIn most cases, idiopathic juvenile ventricular arrhythmias had a favorable long-term prognosis with reduced ectopy over time in this case series. Juvenile ventricular arrhythmias remains a diagnosis of exclusion but can be considered in a broader range of dog breeds than previously described.

Continuous Electrocardiographic Monitoring for 24 Hours Before Death in Patients with Terminal Cancer.

Purposeless physiological monitoring at the end-of-life is not recommended. However, studies on how families feel regarding the death of patients with terminal cancer without continuous electrocardiographic monitoring (CEM) are lacking. To explore the impact on the quality of care and the feelings and psychological distress experienced by families when CEM is not used during the 24 hours preceding a patient's death. In this multicenter cross-sectional, self-report questionnaires were distributed to 1087 bereaved families at Japanese specialized palliative care units in 2018. Out of 671 responses, 394 valid responses were analyzed. Families of nonmonitored patients (NM-group) accounted for 79.2%, while those with bedside electrocardiogram monitoring (MB-group) and remote nurse station monitoring (MC-group) comprised 11.9% and 8.9%, respectively. In the NM-group, 85.5% expressed satisfaction without CEM, which was more than 10% lower than other groups. While 14% in the NM-group desired patient monitoring, families who received adequate explanations about CEM had lower proportions compared to the MB-group (P = .021). Univariate analyses showed no significant differences in evaluations of the quality of care and families' psychological distress (mean scores of Overall Care Satisfaction, Care Evaluation Scale, Good Death Inventory, Brief Grief Questionnaires) across all groups. While the majority of NM-group were satisfied with their patient's care without CEM, the proportion of dissatisfied families was higher than in other groups. Although not using CEM is not a major hindrance to end-of-life care for patients with terminal cancer, providing sufficient explanations may be important for satisfactory care.

Telemedicine technologies and remote electrocardiographic monitoring. Reality and prospects. Functionalist perspective. Part 1

The article presents the methods and their options of telemedicine and remote electrocardiographic (ECG) monitoring. The purpose of the work is to acquaint general practitioners, functional diagnostics physicians and healthcare organizers with the prospects and possible difficulties in introducing digital technologies into everyday practice. The state of the problem today in the world and in our country is shown. The review is made in two parts. In the first part, general methods of remote monitoring of indicators of the human body are described. In the second part, the remote transmission of the cardiogram, the possibilities and prospects of remote ECG monitoring are presented.

Influence of the Apelinergic System on Conduction Disorders in Patients after Myocardial Infarction.

There is a growing body of evidence for an important role of the apelinergic system in the modulation of cardiovascular homeostasis. The aim of our study was to (1) examine the relationship between apelin serum concentration at index myocardial infarction (MI) and atrioventricular conduction disorders (AVCDs) at 12-month follow-up, and (2) investigate the association between initial apelin concentration and the novel marker of post-MI scar (Q/QRS ratio) at follow-up. In 84 patients with MI with complete revascularization, apelin peptide serum concentrations for apelin-13, apelin-17, elabela (ELA) and apelin receptor (APJ) were measured on day one of hospitalization; at 12-month follow-up, 54 of them underwent thorough examination that included 12-lead electrocardiography (ECG), Holter ECG monitoring and echocardiography. The mean age was 58.9 years. At 12-month follow-up, AVCDs were diagnosed in 21.4% of subjects, with AV first-degree block in 16.7% and sinoatrial arrest in 3.7%. ELA serum concentration at index MI correlated positively with the occurrence of AVCD (p = 0.003) and heart rate (p = 0.005) at 12-month follow-up. The apelin-13 serum concentration at index MI correlated negatively with the Q/QRS ratio. The apelin peptide concentration during an acute phase of MI impacts the development of AVCD and the value of Q/QRS ratio in MI survivors.

Remote ECG Monitoring System via Internet

Electrocardiography (ECG) is a non-invasive diagnostic tool that records the electrical activity of the heart. It is a valuable tool for diagnosing a variety of heart conditions, including arrhythmias, heart failure, and myocardial infarction. This review paper explores the landscape of Real-time Electrocardiogram (ECG) Monitoring Systems via the Internet, analyzing advancements, challenges, and future prospects in this domain. The study investigates the integration of ECG monitoring systems with internet connectivity, enabling real- time data transmission and analysis for remote healthcare applications. Examining the utilization of IoT frameworks, particularly Raspberry Pi and Arduino, the review elucidates their role in establishing connectivity and data transmission protocols. It assesses the impact of IoT-enabled ECG systems on enhancing patient care, enabling telemedicine, and improving healthcare accessibility. Keywords— Internet of Things (IoT), Raspberry Pi R3, Arduino UNO, Remote Monitoring, Electrocardigraphy (ECG), Internet connected Medical Devices, Remote Healthcare

Prevalence of Subclinical Atrial Fibrillation in Heart Failure With Preserved Ejection Fraction

BackgroundAtrial fibrillation (AF) is common in patients with heart failure with preserved ejection fraction (HFpEF) and is associated with poorer clinical outcomes. The prevalence of subclinical AF in patients with HFpEF remains unknown. ObjectivesThe aim of this study was to determine whether subclinical AF was more prevalent in individuals with HFpEF than in individuals without histories of heart failure (HF). MethodsPatients with HFpEF with no prior diagnoses of AF were screened for subclinical AF, and the prevalence of subclinical AF was compared with that among control subjects without HF drawn from MESA (Multi-Ethnic Study of Atherosclerosis) who underwent the same electrocardiographic monitoring. Multivariable logistic regression was used to adjust for demographic and clinical comorbidities. ResultsNinety patients with HFpEF and 1,230 MESA participants were included. Patients with HFpEF were younger (median age 69 years [Q1-Q3: 63-76 years] vs 72 years [Q1-Q3: 66-80 years]; P = 0.02), more obese (median body mass index 36 kg/m2 [Q1-Q3: 30-45 kg/m2] vs 27 kg/m2 [Q1-Q3: 24-30 kg/m2]; P < 0.001), and more likely to have diabetes (34% vs 21%; P = 0.01). The prevalence of subclinical AF was 8.9% in patients with HFpEF and 4.1% in non-HF participants. After multivariable adjustment for age, sex, race, body mass index, diabetes, smoking, and total analyzable time on electrocardiographic monitor, there was a significantly higher odds of subclinical AF in patients with HFpEF compared with MESA (OR: 3.01; 95% CI: 1.13-7.99; P = 0.03). ConclusionsPatients with HFpEF had a higher prevalence of subclinical AF than participants without HF from a community-based study. Screening for atrial arrhythmias may be appropriate among patients with HFpEF for timely initiation of thromboembolic prophylaxis and may identify individuals at greater risk for clinical decompensation.

Experience of treating congenital complete atrioventricular block with epicardial pacemaker in infants and young children: a retrospective study

BackgroundThis article summarizes the treatment experience for congenital complete atrioventricular block (CCAVB) in newborns and infants, and discusses the necessity and feasibility of treating CCAVB with permanent pacemaker implantation in this population.MethodsIn this study, the clinical data and follow-up results of nine children admitted at our center with CCAVB from January 2005 to March 2023 were retrospectively analyzed. Among them, two children received early implantation of permanent pacemakers (within 1 year of age), two children received non-early implantation (1 year or older), and the remaining five children received no pacemaker implantation. CCAVB diagnosis was confirmed by clinical symptoms and clinical examinations, including electrocardiography and echocardiography before surgery. After surgery, the pacing and sensing functions of the pacemaker were observed using electrocardiography, echocardiography, and pacing threshold monitoring. A comprehensive assessment of the treatment efficacy was conducted, encompassing improvements in clinical symptoms, growth and development, as well as the absence of any additional potential complications. The children who did not receive pacemaker implantation were followed up.ResultsAmong the four children who successfully received pacemaker implantation, one child who received non-early implantation died. For the remaining three children, the threshold level, amplitude, impedance, and minute ventilation sensor function of the pacemaker were good during the follow-up period, with a heart rate at the pacing rate. The growth and development of the aforementioned patients who received pacemaker implantation demonstrated adherence to the percentile curve, and their motor and cognitive development remained unaffected. However, among the children who did not undergo pacemaker implantation, two experienced death, while three were lost to follow-up, thereby limiting the evaluation of their long-term outcomes.ConclusionsEarly implantation of an epicardial pacemaker at an early stage in newborns and infants diagnosed with CCAVB can significantly improve clinical symptoms without affecting their growth and development. These data are in line with current literature and suggest that early implantation of an epicardial pacemaker in newborns and infants diagnosed with CCAVB but further studies are needed.

Association Between Left Ventricular Scar and Ventricular Ectopy in People Living With and Without HIV

BackgroundPeople living with HIV (PLWH) have greater risk for arrhythmic sudden death and heart failure than people without HIV (PWOH), though risk identifiers remain understudied. Higher ventricular ectopy (VE) burden reflects increased arrhythmic susceptibility and cardiomyopathy risk. ObjectivesThe purpose of this study was to test if myocardial scar measured by late gadolinium-enhancement cardiovascular magnetic resonance (LGE-CMR) associates with VE by ambulatory electrocardiographic monitoring among PLWH and PWOH with risk factors for HIV, and if the association differs by HIV. MethodsParticipants from 3 cohorts of PLWH and PWOH underwent electrocardiographic monitoring (median wear time 8.3 days) and CMR. Using multivariable regression, we assessed: 1) associations between scar metrics and VE, adjusting for demographics, HIV serostatus, substance use, cardiovascular risk factors, and left ventricular (LV) function/structure; and 2) effect measure modification by HIV. ResultsOf 329 participants (median age 55 years, 30% women, 62% PLWH), 109 had LGE (62% PLWH). Ischemic or major nonischemic pattern LGE was associated with high VE burden (adjusted OR: 2.32, P = 0.004) and more PVCs/day (141% higher, P < 0.001). Among people with LGE, greater scar mass correlated with more PVCs/day (P = 0.028). Associations persisted after adjustment for LV function/structure and when excluding PLWH with HIV viremia and showed no effect measure modification by HIV. ConclusionsIschemic or major nonischemic pattern LGE and greater scar mass correlated with higher VE burden, independently of LV structure/function, HIV serostatus, and HIV viremia. The findings highlight specific scar characteristics common to PLWH and PWOH with risk factors for HIV that may portend higher risk for arrhythmias and heart failure.

Sensorized T-Shirt with Intarsia-Knitted Conductive Textile Integrated Interconnections: Performance Assessment of Cardiac Measurements during Daily Living Activities.

The development of smart wearable solutions for monitoring daily life health status is increasingly popular, with chest straps and wristbands being predominant. This study introduces a novel sensorized T-shirt design with textile electrodes connected via a knitting technique to a Movesense device. We aimed to investigate the impact of stationary and movement actions on electrocardiography (ECG) and heart rate (HR) measurements using our sensorized T-shirt. Various activities of daily living (ADLs), including sitting, standing, walking, and mopping, were evaluated by comparing our T-shirt with a commercial chest strap. Our findings demonstrate measurement equivalence across ADLs, regardless of the sensing approach. By comparing ECG and HR measurements, we gained valuable insights into the influence of physical activity on sensorized T-shirt development for monitoring. Notably, the ECG signals exhibited remarkable similarity between our sensorized T-shirt and the chest strap, with closely aligned HR distributions during both stationary and movement actions. The average mean absolute percentage error was below 3%, affirming the agreement between the two solutions. These findings underscore the robustness and accuracy of our sensorized T-shirt in monitoring ECG and HR during diverse ADLs, emphasizing the significance of considering physical activity in cardiovascular monitoring research and the development of personal health applications.

Changes in Heart Rate Variability During Low-Frequency Transcutaneous Electrical Nerve Stimulation in Athletes with Acute Musculoskeletal Injury

Background: Pain is a relevant clinical symptom to ask for medical management. Since pain is a subjective sensation, its intensity is difficult to precisely assess. Objectives: The present study aimed to determine whether heart rate variability (HRV) can be a potential parameter to evaluate the pain-relieving effect of low-frequency transcutaneous electrical nerve stimulation (TENS). Methods: Athletes with lower limb musculoskeletal injuries were voluntarily included in the study. Pressure pain thresholds (PPT) was measured immediately after the intervention, and 24 hours after the treatment. Heart rate variability was also determined from electrocardiography (ECG) monitoring throughout the intervention. Results: The HRV of 25 participants revealed that 30 minutes of low-frequency electrical stimulation immediately increased PPT (before = 2.67 ± 0.79; after = 2.92 ± 0.90, P = 0.011). Thirteen participants had more than a 10% increase in PPT after the intervention; nevertheless, three participants had a decrease in PPT. The PPT was returned to the baseline 24 hours after the intervention. Electrocardiography demonstrated that only the frequency domain of low frequency-high frequency (LF/HF) ratio was significantly increased after the intervention (before = 1.454 ± 0.739; after = 1.922 ± 1.378; P = 0.035) but not time-domain HRV. Time-domain HRV significantly decreased during the intervention before returning to the baseline. The correlation between the change in PPT is mostly correlated with LF/HF. Conclusions: Heart rate variability revealed the potential change in sympathovagal balance toward the sympathetic domain during low-frequency TENS intervention. The frequency-domain LF/HF ratio was the most sensitive parameter to be affected by pain.

Evaluation of a smartphone electrocardiograph in healthy foals and comparison to standard base-apex electrocardiography

Smartphone-based technology for ECG recording has recently spread as a complementary tool for electrocardiographic screening and monitoring in adult horses and in other animal species. The present study aimed to assess the feasibility and accuracy of a smartphone-based ECG in healthy foals. This was a prospective observational study (authorization n. 45,865/2016) including 22 foals aged less than 21 days. A reference standard base-apex ECG (rECG) was acquired, and a smartphone ECG (sECG) was recorded immediately after by using a smartphone-based single lead electrocardiograph. All ECG tracings were evaluated in a blind fashion by a single board-certified cardiologist, who judged whether the tracings were acceptable for interpretation and performed ECG measurements and diagnosis. The Spearman correlation coefficient, the Cohen’s k test and the Bland-Altman test were used to assess the agreement between sECG and rECG. All sECG tracings were acceptable for interpretation. All foals showed sinus rhythm on both rRCG and sECG tracings, with perfect agreement in heart rate classification (κ = 0.87; p < 0.001). No clinically relevant differences were found in the assessment of waves and intervals duration. Concerning P wave and QRS complex polarity, the percentage of agreement between rECG and sECG was 78% and 83%, respectively. About ECG tracing quality, rECG and sECG showed a substantial agreement (κ = 0.624; p < 0.001). In conclusion, the smartphone-based ECG device tested in the present study recorded good quality single-lead ECG tracings in foals, reliable for heart rate and ECG measurements, but different polarity of P waves and QRS complexes was found in some foals in comparison to rECG.