Utility of a Smartphone Based System (cvrPhone) to Predict Short-term Arrhythmia Susceptibility

• Type of Material: Article
• Authors: Kwanghyun Sohn, Massachusetts General Hospital; Steven P. Dalvin, Massachusetts General Hospital; Faisal Merchant, Emory University; Kanchan Kulkarni, Massachusetts General Hospital; Furrukh Sana, Massachusetts General Hospital; Shady Abohashem, Massachusetts General Hospital; Jagmeet P. Singh, Massachusetts General Hospital; E. Kevin Heist, Massachusetts General Hospital; Chris Owen, Massachusetts General Hospital; Eric M. Isselbacher, Massachusetts General Hospital; Antonis A. Armoundas, Massachusetts General Hospital
• Language: English
• Date: 2019-10-10
• Publisher: NATURE PUBLISHING GROUP
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2019
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41598-019-50487-4
• Title of Journal or Parent Work: SCIENTIFIC REPORTS
• Volume: 9
• Issue: 1
• Start Page: 14497
• End Page: 14497
• Grant/Funding Information: The work was supported by a Grand-in-Aid (#15GRNT23070001) from the American Heart Association (AHA), the RICBAC Foundation, NIH grant 1 R01 HL135335-01, 1 R21 HL137870-01 and 1 R21EB026164-01 and a Founders Affiliate Post-doctoral Fellowship (#15POST22690003) from the AHA. This work was conducted with support from Harvard Catalyst, The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award 8UL1TR000170-05 and financial contributions from Harvard University and its affiliated academic health care centers).
• Keywords: Multidisciplinary Sciences; STANDARD; VENTRICULAR TACHYARRHYTHMIAS; LEAD; Science & Technology - Other Topics; HEART; Science & Technology; ELECTRICAL ALTERNANS; DEPOLARIZATION; T-WAVE ALTERNANS
• Research Categories: Biology, Neuroscience; Health Sciences, Medicine and Surgery

Abstract

Repolarization alternans (RA) has been implicated in the pathogenesis of ventricular arrhythmias and sudden cardiac death. We developed a 12-lead, blue-tooth/Smart-Phone (Android) based electrocardiogram (ECG) acquisition and monitoring system (cvrPhone), and an application to estimate RA, in real-time. In in-vivo swine studies (N = 17), 12-lead ECG signals were recorded at baseline and following coronary artery occlusion. RA was estimated using the Fast Fourier Transform (FFT) method using a custom developed algorithm in JAVA. Underlying ischemia was detected using a custom developed ischemic index. RA from each lead showed a significant (p < 0.05) increase within 1 min of occlusion compared to baseline (n = 29). Following myocardial infarction, spontaneous ventricular tachycardia episodes (n = 4) were preceded by significant (p < 0.05) increase of RA prior to the onset of the tachy-arrhythmias. Similarly, the ischemic index exhibited a significant increase following myocardial infarction (p < 0.05) and preceding a tachy-arrhythmic event. In conclusion, RA can be effectively estimated using surface lead electrocardiograms by analyzing beat-to-beat variability in ECG morphology using a smartphone based platform. cvrPhone can be used to detect myocardial ischemia and arrhythmia susceptibility using a user-friendly, clinically acceptable, mobile platform.