A Novel Point-of-Care Smartphone Based System for Monitoring the Cardiac and Respiratory Systems.

• Type of Material: Article
• Authors: Kwanghyun Sohn, Massachusetts General Hospital; Faisal Merchant, Emory University; Omid Sayadi, Massachusetts General Hospital; Dheeraj Puppala, Massachusetts General Hospital; Rajiv Doddamani, Massachusetts General Hospital; Ashish Sahani, Massachusetts General Hospital; Jagmeet P. Singh, Massachusetts General Hospital; E. Kevin Heist, Massachusetts General Hospital; Eric M. Isselbacher, Massachusetts General Hospital; Antonis A. Armoundas, Massachusetts Institute of Technology
• Language: English
• Date: 2017-03-22
• Publisher: Nature Publishing Group: Open Access Journals - Option C
• Publication Version: Final Published Version
• Copyright Statement: © 2017, The Author(s)
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/srep44946
• Title of Journal or Parent Work: Scientific Reports
• ISSN: 2045-2322
• Volume: 7
• Start Page: 44946
• End Page: 44946
• Grant/Funding Information: 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).; 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, the Kenneth M. Rosen Fellowship in Cardiac Pacing and Electrophysiology (#13-FA-32-HRS) from the Heart Rhythm Society and a Founders Affiliate Post-doctoral Fellowship (#15POST22690003) from the AHA.
• Keywords: Myocardial infarction; Respiratory signs and symptoms
• Research Categories: Engineering, Biomedical; Health Sciences, Medicine and Surgery

Abstract

Cardio-respiratory monitoring is one of the most demanding areas in the rapidly growing, mobile-device, based health care delivery. We developed a 12-lead smartphone-based electrocardiogram (ECG) acquisition and monitoring system (called "cvrPhone"), and an application to assess underlying ischemia, and estimate the respiration rate (RR) and tidal volume (TV) from analysis of electrocardiographic (ECG) signals only. During in-vivo swine studies (n = 6), 12-lead ECG signals were recorded at baseline and following coronary artery occlusion. Ischemic indices calculated from each lead showed statistically significant (p < 0.05) increase within 2 min of occlusion compared to baseline. Following myocardial infarction, spontaneous ventricular tachycardia episodes (n = 3) were preceded by significant (p < 0.05) increase of the ischemic index ~1-4 min prior to the onset of the tachy-arrhythmias. In order to assess the respiratory status during apnea, the mechanical ventilator was paused for up to 2 min during normal breathing. We observed that the RR and TV estimation algorithms detected apnea within 7.9 ± 1.1 sec and 5.5 ± 2.2 sec, respectively, while the estimated RR and TV values were 0 breaths/min and less than 100 ml, respectively. In conclusion, the cvrPhone can be used to detect myocardial ischemia and periods of respiratory apnea using a readily available mobile platform.