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심박수 적응형 심박 조율 알고리즘 설계 및 평가: 시뮬레이션 연구

Design and Evaluation of Blending Algorithm for Rate Adaptive Pace: Simulation Study

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In this study, we designed a blending algorithm for rate adaptive pacing for cardiac pacemaker. Generally, rate adaptive pacing (RAP) is applied to patients whose heart rate does not rise during exercise for chronotropic incompetence (CI) patient. It is very important to develop an algorithm for RAP that can be properly applied to CI patients. In order to design an RAP algorithm we used dual sensors. Firstly, we designed a bio-signal measurement system based on the dual sensors, which are accelerometer and respiratory system. Secondly, we conducted treadmill test for the simulation experiment while using 3-lead ECG as reference. Finally, we designed a blending algorithm based on activation state of the dual sensors. The proposed blending algorithm was subdivided into three sections based on the accelerometer signal, which are rapidly increased section (W1), hardly changed section (W2), and decreased section (W3). Each weight is set aside for each section. To evaluate this algorithm, ten healthy adult males were participated. The correlation and Root Mean Square Error between the proposed algorithm and the reference were compared, and shown to be r=0.88 and 2.82 bpm, respectively. These results show that the proposed blending algorithm of dual sensors enables proper tracking of the heart rate during exercise. Also, it shows the possibility that the proposed blending algorithm can be applied to improve quality of life of the chronotropic incompetence patient.

Abstract

In this study, we designed a blending algorithm for rate adaptive pacing for cardiac pacemaker. Generally, rate adaptive pacing (RAP) is applied to patients whose heart rate does not rise during exercise for chronotropic incompetence (CI) patient. It is very important to develop an algorithm for RAP that can be properly applied to CI patients. In order to design an RAP algorithm we used dual sensors. Firstly, we designed a bio-signal measurement system based on the dual sensors, which are accelerometer and respiratory system. Secondly, we conducted treadmill test for the simulation experiment while using 3-lead ECG as reference. Finally, we designed a blending algorithm based on activation state of the dual sensors. The proposed blending algorithm was subdivided into three sections based on the accelerometer signal, which are rapidly increased section (W1), hardly changed section (W2), and decreased section (W3). Each weight is set aside for each section. To evaluate this algorithm, ten healthy adult males were participated. The correlation and Root Mean Square Error between the proposed algorithm and the reference were compared, and shown to be r=0.88 and 2.82 bpm, respectively. These results show that the proposed blending algorithm of dual sensors enables proper tracking of the heart rate during exercise. Also, it shows the possibility that the proposed blending algorithm can be applied to improve quality of life of the chronotropic incompetence patient.

참고문헌 (13)

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  3. C. W. Israel, "Current status of dual-sensor pacemaker systems for correction of chronotropic incompetence", American Journal of Cardiology, 2, pp.86~94 (2000)
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  8. J. L. Bonnet, "Evaluation of a dual sensor rate responsive pacing system based on a new concept", PACE Pacing Clin Electrophysiol, 21(11), pp.2198~2203 (1998)
  9. M. Matula, "Activity controlled cardiac pacemakers during stairwalking : a comparison of accelerometer with vibration guided devices and with sinus rate", PACE Pacing Clin Electrophysiol, 19, pp.1036~1041 (1996)
  10. Y. Cao, "Assessment of adaptive rate response provided by accelerometer, minute ventilation and dual sensor compared with normal sinus rhythm during exercise : a self-controlled study in chronotropically competent subjects", Chin Med J, 128(1), pp.25~31 (2015)
  11. A. N. Suike, "Comparison of the normal sinus node with seven types of rate responsive pacemaker during everyday activity", Br Heart J, 64(1), pp.25~31 (1990)
  12. E. Alt., "The basis for activity controlled rate variable cardiac pacemakers : an analysis of mechanical forces on the human body induced by exercise and environment", PACE, 12, pp.1667~1680 (1989)
  13. J. Clementy, "Clinical significance of multiple sensor options : rate response optimization, sensor blending, and trending", American journal of Cardiology, 83(11), pp.166~171 (1999)

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