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Detecting Mechanical Alternans Utilizing Photoplethysmography

Besleaga, T; Canichella, A; Toschi, N; Demosthenous, A; Lambiase, PD; Orini, M; (2019) Detecting Mechanical Alternans Utilizing Photoplethysmography. In: Dassen, Willem and Heijman, Jordi, (eds.) Proceedings of Computers in Cardiology (CinC) 2018. IEEE Xplore: New York, USA. Green open access

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Abstract

Mechanical alternans (MA) is a biomarker associated with mortality in heart failure patients. Its detection through continuous blood pressure (BP) monitoring is costly and impractical. In this work, we propose the use of photoplethysmography (PPG) as a non-invasive solution for MA detection. Continuous invasive BP and PPG were recorded and analyzed during ventricular pacing in 10 patients. The presence of MA was evaluated in BP and in features characterizing the PPG pulse morphology. Mechanical alternans was defined as an alternation in maximum dP/dt for a duration of 20 consecutive heart beats or more. Mechanical alternans was observed in BP in 5 patients (50%). The PPG-based MA surrogates showing the highest detection accuracy, were the maximum of the first derivative of the PPG pulse (V'M), and the pulse amplitude (A). Both features allow detection of MA positive patients with 100% sensitivity and 100% specificity. The magnitude of MA was correlated between BP and V'M PPG (R=0.92, p<0.001) and between BP and A PPG (R=0.89, p<0.001). In conclusion, MA can be accurately detected noninvasively through the PPG.

Type: Proceedings paper
Title: Detecting Mechanical Alternans Utilizing Photoplethysmography
Event: Computers in Cardiology (CinC) 2018), 23-26 Sept 2018, Maastricht, Netherlands
ISBN: 978-1-7281-0924-4
ISBN-13: 9781728109589
Open access status: An open access version is available from UCL Discovery
DOI: 10.22489/CinC.2018.212
Publisher version: https://doi.org/10.22489/CinC.2018.212
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: biomechanics, blood, blood pressure measurement, blood vessels, diseases, haemodynamics, patient monitoring, photoplethysmography, plethysmography
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Electronic and Electrical Eng
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10079088
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