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Photoplethysmography use for Assessment of Mechanical Alternans in Human Cardiovascular Disease

Besleaga, Tudor; (2020) Photoplethysmography use for Assessment of Mechanical Alternans in Human Cardiovascular Disease. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

This thesis investigates the feasibility of using photoplethysmography (PPG) as a non-invasive bio-signal to evaluate cardiac risk. It focuses on detecting specific markers of cardiac risk, commonly detected using arterial blood pressure monitoring. Firstly, the PPG technology is evaluated from a theoretical and practical perspective to identify the optimal requirements for assessing cardiac function. Different sensor configurations are designed and evaluated. Secondly, this work examines the ability of PPG to detect arterial drops in blood pressure related to ventricular tachycardia induced syncope in a cohort of 14 patients undergoing VT ablation. The aim is to supplement the internal defibrillator device data towards detecting haemodynamic instability and increasing specificity of defibrillator shock delivery. Secondly, this work evaluates for the first time the detection and quantification of Mechanical alternans (MA) via the PPG, in three conditions: stationary awake, during exercise and stationary during surgery. In total, MA was evaluated in 49 patients. MA is a biomarker associated with mortality in heart failure patients and potentially fatal ventricular arrhythmias, that until now, has only been examined using continuous blood pressure recordings. This work demonstrates that using time-domain and time-frequency domain information, the abovementioned biomarkers can be evaluated using PPG. In contrast to continuous BP monitoring, which is costly and impractical, the PPG (photoplethysmography) technology is non-invasive, widely available, cost effective and already incorporated into pulse oximeters and wearable wellness trackers. I hypnotized that PPG could be used to detect BP variations, thus providing further insights into people’s health status and cardiac risk of sudden death at low cost.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Photoplethysmography use for Assessment of Mechanical Alternans in Human Cardiovascular Disease
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2020. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
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 Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10100901
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