Detection of ventricular premature beats based on the pressure signals of a hemodialysis machine

Autores

Holmer, M; Martinez, JP; Gil, E; Sandberg, F; Olde, B; Sornmo, L

Revista

MEDICAL ENGINEERING & PHYSICS

Año: 2018 Volumen: 51 Páginas: 49-55

Editor:

ELSEVIER SCI LTD

DOI:

10.1016/j.medengphy.2017.11.004

Resumen

Monitoring of ventricular premature beats (VPBs), being abundant in hemodialysis patients, can provide information on cardiovascular instability and electrolyte imbalance. In this paper, we describe a method for VPB detection which explores the signals acquired from the arterial and the venous pressure sensors, located in the extracorporeal blood circuit of a hemodialysis machine. The pressure signals are mainly composed of a pump component and a cardiac component. The cardiac component, severely overshadowed by the pump component, is estimated from the pressure signals using an earlier described iterative method. A set of simple features is extracted, and linear discriminant analysis is performed to classify beats as either normal or ventricular premature. Performance is evaluated on signals from nine hemodialysis treatments, using leave-one-out crossvalidation. The simultaneously recorded and annotated photoplethysmographic signal serves as the reference signal, with a total of 149,686 normal beats and 3574 VPBs. The results show that VPBs can be reliably detected, quantified by a Youden's J statistic of 0.9, for average cardiac pulse pressures exceeding 1 mmHg: for lower pressures, the J statistic drops to 0.55. It is concluded that the cardiac pressure signal is suitable for VPB detection, provided that the average cardiac pulse pressure exceeds 1 mmHg. (C) 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

Palabras clave

Ventricular ; premature ; beats ; Extracorporeal ; pressure ; sensors ; Cardiac ; pressure ; signal ; Fistula ; Hemodialysis ; Linear ; discriminant ; analysis

Afiliación

Holmer, M (Reprint Author), Lund Univ, Dept Biomed Engn, POB 118, Lund, Sweden.
Holmer, M (Reprint Author), Lund Univ, Ctr Integrat Electrocardiol CIEL, POB 118, Lund, Sweden.
Holmer, Mattias; Sandberg, Frida; Sornmo, Leif, Lund Univ, Dept Biomed Engn, POB 118, Lund, Sweden.
Holmer, Mattias; Sandberg, Frida; Sornmo, Leif, Lund Univ, Ctr Integrat Electrocardiol CIEL, POB 118, Lund, Sweden.
Pablo Martinez, Juan; Gil, Eduardo, Univ Zaragoza, Aragon Inst Engn Res I3A, IIS Aragon, Zaragoza, Spain.
Holmer, Mattias; Olde, Bo, Baxter Int Inc, Lund, Sweden.
Pablo Martinez, Juan; Gil, Eduardo, CIBER BBN, Zaragoza, Spain.