A wearable real-time telemonitoring electrocardiogram device compared with traditional Holter monitoring

Arrhythmias are very common in the healthy populations as well as patients with cardiovascular diseases.Among them,atrial fibrillation(AF)and malignant ventricular arrhythmias are usually associated with some clinical events.Early diagnosis of arrhythmias,particularly AF and ventricular arrhythmias,is very important for the treatment and prognosis of patients.Holter is a gold standard commonly recommended for noninvasive detection of paroxysmal arrhythmia.However,it has some shortcomings such as fixed detection timings,delayed report and inability of remote real-time detection.To deal with such problems,we designed and applied a new wearable 72-hour triple-lead H3-electrocardiogram(ECG)device with a remote cloud-based ECG platform and an expertsupporting system.In this study,31 patients were recruited and 24-hour synchronous ECG data by H3-ECG and Holter were recorded.In the H3-ECG group,ECG signals were transmitted using remote real-time modes,and confirmed reports were made by doctors in the remote expert-supporting system,while the traditional modes and detection systems were used in the Holter group.The results showed no significant differences between the two groups in 24-hour total heart rate(HR),averaged HR,maximum HR,minimum HR,premature atrial complexes(PACs)and premature ventricular complexes(PVCs)(P>0.05).The sensitivity and specificity of capture and remote automatic cardiac events detection of PACs,PVCs,and AF by H3-ECG were 93%and 99%,98%and 99%,94%and 98%,respectively.Therefore,the long-term limb triple-lead H3-ECG device can be utilized for domiciliary ECG self-monitoring and remote management of patients with common arrhythmia under medical supervision.

Evaluation of Pencil Lead Based Electrodes for Electrocardiogram Monitoring in Hot Spring

Electrocardiogram(ECG)electrodes are conductive pads applied to the skin to measure cardiac activity.Ag/AgCl electrodes are the commercial product which widely used to obtain ECGs.When monitoring the ECG in a hot spring,Ag/AgCl electrodes must be waterproofed;however,this is time-consuming,and the adhesive may tear the skin on removal.For solving the problem,we developed the carbon pencil lead(CPL)electrodes for use in hot springs.Both CPL and Ag/AgCl electrodes were connected to ECG100C’s cables.The Performance was evaluated in three conditions as following:hot spring water with and without bubble,and in cold water.In each environment,the procedure was followed by three different protocols that are recording from the dry condition,hot spring water immersion with and without movement,post hot spring water condition.Under dry and wet conditions,both electrodes can obtain the waveform of the ECG signal in which all PQRST waves were identifiable.Nevertheless,the signal quality of both types of electrodes was different in water immersion with and without movement.The overall morphology obtained by Ag/AgCl electrodes was unstable higher than that of CPL electrodes in immersion without movement condition.The CPL electrodes provided better ECG waveform quality compared to Ag/AgCl electrodes in which the ECG signal had high waveforms distortion in water immersion with movement condition.

Medium to long term prognoses in children with premature ventricular contractions: Follow-up analysis of 106 cases

Background Premature ventricular contractions （PVCs） are frequently seen in children. However, there are less systematic and longer following-up studies examining the prognosis of PVCs in children. The aim of this study was to evaluate the medium to long term prognosis of PVCs in childhood and whether there is a differential prognosis in different primary diseases of PVCs. Methods This study reviewed the data of 106 pediatric patients （49F/57M, 7.5 _ 3.8 years） seen at the Affiliated Hospital of Qingdao University with the diagnosis of PVCs between 1999 and 2005. Data on demographics, clinical presentation, laboratory tests, and echocardiograms of patients were extracted from the available clinical records. Results A total of 35 （33.0%） children presented with PVCs due to myocarditis, 7（6.6%） due to cardiomyopathies, 7（6.6%） due to mitral valve prolapse （MVP）, 10（9.4%） due to operation for congenital heart disease （O-CHD）, 16（15.2%） due to left ventricular false tendons （LVFT）, and 31（29.2%） due to unknown cause. Holter did not show PVCs during follow-up period in 100% of myocarditis patients, 57% of cardiomyopathy patients, 71% of MVP patients, 60% of O-CHD patients, 88% of LVFT patients, 87% of unknown cause patients. The PVCs disappeared in 93% of patients who did not use anti-arrhythmic drugs and in 76% of patients who used anti- arrhythmic drugs. There was no a significant difference in prognosis between myocardial nutrition combined with intravenous injection of immunoglobulin （IVIG） group and propafenone group. Conclusions PVCs caused by different primary diseases has a favorable prognosis in children. Usually, the PVCs will reduce even disappear during follow-up. The patients with PVCs due to myocarditis should be preferred use myocardial nutrient combined with IVIG.