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首页> 外文会议>33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society >Wireless monitoring of reconstructed 12-lead ECG in atrial fibrillation patients enables differential diagnosis of recurrent arrhythmias
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Wireless monitoring of reconstructed 12-lead ECG in atrial fibrillation patients enables differential diagnosis of recurrent arrhythmias

机译：对心房颤动患者重建的12导联心电图进行无线监测可对复发性心律失常进行鉴别诊断

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Differential diagnosis of symptomatic events in post-ablation atrial fibrillation (AF) patients (pts) is important; in particular, accurate, reliable detection of AF or atrial flutter (AFL) is essential. However, existing remote monitoring devices usually require attached leads and are not suitable for prolonged monitoring; moreover, most do not provide sufficient information to assess atrial activity, since they generally monitor only 1–3 ECG leads and rely on RR interval variability for AF diagnosis. A new hand-held, wireless, symptom-activated event monitor (CardioBip; CB) does not require attached leads and hence can be conveniently used for extended periods. Moreover, CB provides data that enables remote reconstruction of full 12-lead ECG data including atrial signal information. We hypothesized that these CB features would enable accurate remote differential diagnosis of symptomatic arrhythmias in post-ablation AF pts. Methods: 21 pts who underwent catheter ablation for AF were instructed to make a CB transmission (TX) whenever palpitations, lightheadedness, or similar symptoms occurred, and at multiple times daily when asymptomatic, during a 60 day post-ablation time period. CB transmissions (TXs) were analyzed blindly by 2 expert readers, with differences adjudicated by consensus. Results: 7 pts had no symptomatic episodes during the monitoring period. 14 of 21 pts had symptomatic events and made a total of 1699 TX, 164 of which were during symptoms. TX quality was acceptable for rhythm diagnosis and atrial activity in 96%. 118 TX from 10 symptomatic pts showed AF (96 TX from 10 pts) or AFL (22 TX from 3 pts), and 46 TX from 9 pts showed frequent PACs or PVCs. No other arrhythmias were detected. Five pts made symptomatic TX during AF/AFL and also during PACs/PVCs. Conclusions: Use of CB during symptomatic episodes enabled detection and differential diagnosis of symptomatic arrhythmias. The ability of CB to provide accurate reconstruction of 12 L ECGs-- including atrial activity, combined with its ease of use, makes it suitable for long-term surveillance for recurrent AF in post-ablation patients.
机译：消融后房颤（AF）患者（pts）的症状事件的鉴别诊断很重要;特别是，准确，可靠地检测房颤或心房扑动（AFL）至关重要。但是，现有的远程监视设备通常需要连接导线，因此不适合长时间监视。此外，大多数人没有提供足够的信息来评估心房活动，因为它们通常仅监测1-3个ECG导联，并依赖RR间期变异性进行AF诊断。新的手持式无线症状激活事件监视器（CardioBip; CB）不需要连接导线，因此可以方便地长期使用。此外，CB提供的数据可实现包括心房信号信息在内的完整12导联ECG数据的远程重建。我们假设这些CB功能将能够对消融后房颤患者的症状性心律不齐进行准确的远程鉴别诊断。方法：在消融后60天内，每当出现心21，头晕或类似症状时，以及每天无症状时，每天21次接受导管消融的房颤患者均应进行CB传输（TX）。由2位专业读者盲目分析了CB传输（TX），并通过共识确定了差异。结果：7例在监测期间无症状发作。 21例患者中有14例有症状，共计1699 TX，其中164例在症状期间。 TX质量在心律诊断和心房活动方面是可以接受的，占96％。 10例有症状的患者有118 TX显示AF（10例有96 TX）或AFL（3例有22 TX），而9例有46 TX表现为频繁的PAC或PVC。未检测到其他心律失常。在AF / AFL以及PAC / PVC期间，有5位患者进行了有症状的TX。结论：在症状发作期间使用CB可以对症状性心律不齐进行检测和鉴别诊断。 CB提供12 L ECG的准确重建的能力- -- 包括心房活动，加上其易用性，使其适合于长期监测消融后患者的复发性房颤。

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