The quest for blood pressure markers in photoplethysmography and its applications in digital health.

Introduction: Photoplethysmography (PPG) sensors, capturing optical signals from arterial pulses, are debated for their potential in blood pressure (BP) measurement. This study employed the largest dataset to date of paired PPG and cuff BP readings to explore PPG signals for BP estimation.

Methods: 32,152 European residents (age 55.

Evaluation and optimization of novel extraction algorithms for the automatic detection of atrial activations recorded within the pulmonary veins during atrial fibrillation.

Background And Objective: The automated detection of atrial activations (AAs) recorded from intracardiac electrograms (IEGMs) during atrial fibrillation (AF) is challenging considering their various amplitudes, morphologies and cycle length. Activation time estimation is further complicated by the constant changes in the IEGM active zones in complex and/or fractionated signals. We propose a new method which provides reliable automatic extraction of intracardiac AAs recorded within the pulmonary veins during AF and an accurate estimation of their local activation times.

RMSSD Is More Sensitive to Artifacts Than Frequency-Domain Parameters: Implication in Athletes' Monitoring.

Easy-to-use and accurate heart rate variability (HRV) assessments are essential in athletes' follow-up, but artifacts may lead to erroneous analysis. Artifact detection and correction are the purpose of extensive literature and implemented in dedicated analysis programs. However, the effects of number and/or magnitude of artifacts on various time- or frequency-domain parameters remain unclear.

Effects of COVID-19 lockdown on heart rate variability.

Introduction: Strict lockdown rules were imposed to the French population from 17 March to 11 May 2020, which may result in limited possibilities of physical activity, modified psychological and health states. This report is focused on HRV parameters kinetics before, during and after this lockdown period.

Methods: 95 participants were included in this study (27 women, 68 men, 37 ± 11 years, 176 ± 8 cm, 71 ± 12 kg), who underwent regular orthostatic tests (a 5-minute supine followed by a 5-minute standing recording of heart rate (HR)) on a regular basis before (BSL), during (CFN) and after (RCV) the lockdown.

REWARD: Design, Optimization, and Evaluation of a Real-Time Relative-Energy Wearable R-Peak Detection Algorithm.

Wearable devices are an unobtrusive, cost-effective means of continuous ambulatory monitoring of chronic cardiovascular diseases. However, on these resource-constrained systems, electrocardiogram (ECG) processing algorithms must consume minimal power and memory, yet robustly provide accurate physiological information. This work presents REWARD, the Relative-Energy-based WeArable R-Peak Detection algorithm, which is a novel ECG R-peak detection mechanism based on a nonlinear filtering method called Relative-Energy (Rel-En).

AltitudeOmics: Spontaneous Baroreflex Sensitivity During Acclimatization to 5,260 m: A Comparison of Methods.

Introduction: Baroreflex sensitivity (BRS) is essential to ensure rapid adjustment to variations in blood pressure (BP). Spontaneous baroreflex function can be assessed using continuous recordings of blood pressure. The goal of this study was to compare four methods for BRS quantification [the sequence, Bernardi's (BER), frequency and transfer function methods] to identify the most consistent method across an extreme range of conditions: rest and exercise, in normoxia, hypoxia, hypocapnia, and hypercapnia.

AltitudeOmics: Baroreflex Sensitivity During Acclimatization to 5,260 m.

Baroreflex sensitivity (BRS) is essential to ensure rapid adjustment to variations in blood pressure (BP). Little is known concerning the adaptive responses of BRS during acclimatization to high altitude at rest and during exercise. Twenty-one healthy sea-level residents were tested near sea level (SL, 130 m), the 1st (ALT1) and 16th day (ALT16) at 5,260 m using radial artery catheterization.

Overload blunts baroreflex only in overreached athletes.

Objectives: Heart rate variability (HRV) is commonly used to diagnose overreaching and monitor athletes' responses to training. Baroreflex sensitivity (BRS) is modified by changes in training load and might be another means to detect overreaching. The goal of this study was to assess BRS and HRV changes in two groups of athletes responding either negatively (FOR) or positively (AF) to similar training overload.

Concealed abnormal atrial phenotype in patients with Brugada syndrome and no history of atrial fibrillation.

Objectives: The electrocardiogram (ECG) of patients with BrS in sinus rhythm might reflect intrinsic atrial electrical abnormalities independent from any previous atrial fibrillation (AF). Aim of this study is to investigate the presence of P-wave abnormalities in patients with BrS and no history of AF, and to compare them with those displayed by patients with documented paroxysmal AF and by healthy subjects.

Methods: Continuous 5-min 16-lead ECG recordings in sinus rhythm were obtained from 72 participants: 32 patients with a type 1 Brugada ECG, 20 patients with a history of paroxysmal AF and 20 age-matched healthy subjects.

Acute and chronic changes in baroreflex sensitivity in hypobaric vs. normobaric hypoxia.

Normobaric hypoxia (NH) is used as a surrogate for hypobaric hypoxia (HH). Recent studies reported physiological differences between NH and HH. Baroreflex sensitivity (BRS) decreases at altitude or following intense training.

Minimal Window Duration for Accurate HRV Recording in Athletes.

Heart rate variability (HRV) is non-invasive and commonly used for monitoring responses to training loads, fitness, or overreaching in athletes. Yet, the recording duration for a series of RR-intervals varies from 1 to 15 min in the literature. The aim of the present work was to assess the minimum record duration to obtain reliable HRV results.

A Novel Short-Term Event Extraction Algorithm for Biomedical Signals.

In this paper, we propose a fast novel nonlinear filtering method named Relative-Energy (Rel-En), for robust short-term event extraction from biomedical signals. We developed an algorithm that extracts short- and long-term energies in a signal and provides a coefficient vector with which the signal is multiplied, heightening events of interest. This algorithm is thoroughly assessed on benchmark datasets in three different biomedical applications, namely ECG QRS-complex detection, EEG K-complex detection, and imaging photoplethysmography (iPPG) peak detection.

Usefulness of P-Wave Duration and Morphologic Variability to Identify Patients Prone to Paroxysmal Atrial Fibrillation.

Few data are available on the assessment of P-wave beat-to-beat morphology variability and its ability to identify patients prone to paroxysmal atrial fibrillation (AF) occurrence. Aim of this study was to determine whether electrocardiographic (ECG) parameters resulting from the beat-to-beat analysis of P wave in ECG recorded during sinus rhythm could be indicators of paroxysmal AF susceptibility. ECGs of 76 consecutive patients including 36 patients with history of AF and no overt structural cardiac abnormalities and a control group of 40 healthy patients without history of AF were analyzed.

False arrhythmia alarms reduction in the intensive care unit: a multimodal approach.

The purpose of this study was to develop algorithms to lower the incidence of false arrhythmia alarms in the ICU using information from independent sources, namely electrocardiogram (ECG), arterial blood pressure (ABP) and photoplethysmogram (PPG). Our approach relies on robust adaptive signal processing techniques in order to extract accurate heart rate (HR) values from the different waveforms. Based on the quality of available signals, heart rate was either estimated from pulsatile waveforms using an adaptive frequency tracking algorithm or computed from ECGs using an adaptive mathematical morphology approach.