Heart Failure (HF) diagnosis, subsequent admissions, and possible readmissions present challenges for health systems worldwide. An increasing number of patients within an ageing population are surviving cardiac conditions which can leave them with residual heart function impairment. Follow-up visits of either confirmed HF sufferers or HF high-risk patients could be reduced through the implementation of Point-of-Care (PoC) measurement of N-terminal pro-B-type natriuretic peptide (NT-proBNP), an inactive signal portion of the active hormone BNP that is released in response to cardiac wall stretch. Serial measurements of NT-proBNP concentration may serve to indicate progress/deterioration of HF sufferers which in turn indicates the quality of the interventions designed to treat HF. We present an integrated PoC solution that involves the user-friendly, low volume sampling of blood directly into a single-use sampling key with an integral NT-proBNP biomarker detection strip operating on a lateral flow immunoassay principle. When inserted into a corresponding portable electronic reader it forms an integrated detection and measurement platform that wirelessly communicates measurements (Wi-Fi) for cloud-based reporting, trending and data analysis. The system provides a practical, inexpensive support tool for HF management by informing those involved in clinical decision-making with necessary biomarker data. The PoC NT-proBNP measurement compares well against alternative technologies based on image analysis.
The impedance cardiogram algorithm is a significant marker of circulatory collapse. Automated defibrillators with an integrated impedance cardiogram could improve emergency care by lay persons, enabling rapid and appropriate initiation of external cardiac massage.
This paper proposes a new method of rapidly deriving the transfer matrix for the boundary element method (BEM) forward problem from a tailored female torso geometry in the clinical setting. The method allows rapid calculation of epicardial potentials (EP) from body surface potentials (BSP). The use of EPs in previous studies has been shown to improve the successful detection of the life-threatening cardiac condition--acute myocardial infarction. The MRI scanning of a cardiac patient in the clinical setting is not practical and other methods are required to accurately deduce torso geometries for calculation of the transfer matrix. The new method allows the noninvasive calculation of tailored torso geometries from a standard female torso and five measurements taken from the body surface of a patient. This scaling of the torso has been successfully validated by carrying out EP calculations on 40 scaled torsos and ten female subjects. It utilizes the BEM in the calculation of the transfer matrix as the BEM depends only upon the topology of the surfaces of the torso and the heart, the former can now be accurately deduced, leaving only the latter geometry as an unknown.
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