• International Journal of Advanced Culture Technology
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• 제11권2호
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• pp.310-314
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• 2023

In this paper, we show that the limitations of Holter monitoring and Wearable Electrocardiogarphy Devices and their arrhythmia detection. Sudden death caused by cardiovascular disease, often referred to as the "silent killer" due to its unpredictable nature, is a major health concern. Electrocardiography (ECG) is a basic diagnostic tool for detecting heart disease, but its limitations make it difficult to detect arrhythmia, a significant indicator of an irregular heart state. To address this limitation, a long-term continuous ECG recording device has been developed, Holter ECG device and wearable device. A significant number of studies have focused on the differences between Holter monitoring and wearable devices. The Holter tests were useful for detecting regularly occurring arrhythmias, whereas wearable patches were better at detecting random and infrequent arrhythmias. Wearable patches were effective in detecting episodes of arrhythmia and myocardial ischemia. Despite the concern, wearable devices had less signal loss than Holter monitoring and patients also preferred wearable devices over Holter monitoring due to convenience. These results could mean that the wearable devices can perfectly replace the Holter test.

• 한국임상수의학회지
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• 제28권1호
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• pp.128-132
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• 2011

Holter monitoring has been recognized as an useful noninvasive instrument for monitoring the cardiac electrical activity over 24 to 48 hours. Because the surface electrocardiogram (ECG) is recorded only for several seconds to minutes, it often misses or underestimates the underlying arrhythmia. The surface ECG is also easily influenced by depolarization potentials from skeletal muscle by the movement of patient (especially muscle tremor). However, holter monitoring is less affected by such factors. There has been no precedential report in veterinary medicine applying digital holter monitor with unipolar precordial chest lead using 4 electrodes. This article describes its clinical indications, equipment and technical application method in dogs.

• Journal of Chest Surgery
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• 제57권2호
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• pp.205-212
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• 2024

Background: Postoperative atrial fibrillation (A-fib) is a serious complication of cardiac surgery that is associated with increased mortality and morbidity. Traditional 24-hour Holter monitors have limitations, which have prompted the development of innovative wearable electrocardiogram (ECG) monitoring devices. This study assessed a patch-type wearable ECG device (MobiCARE-MC100) for monitoring A-fib in patients undergoing cardiac surgery and compared it with 24-hour Holter ECG monitoring. Methods: This was a single-center, prospective, investigator-initiated cohort study that included 39 patients who underwent cardiac surgery between July 2021 and June 2022. Patients underwent simultaneous monitoring with both conventional Holter and patchtype ECG devices for 24 hours. The Holter device was then removed, and patch-type monitoring continued for an additional 48 hours, to determine whether extended monitoring provided benefits in the detection of A-fib. Results: This 72-hour ECG monitoring study included 39 patients, with an average age of 62.2 years, comprising 29 men (74.4%) and 10 women (25.6%). In the initial 24 hours, both monitoring techniques identified the same number of paroxysmal A-fib in 7 out of 39 patients. After 24 hours of monitoring, during the additional 48-hour assessment using the patch-type ECG device, an increase in A-fib burden (9%→38%) was observed in 1 patient. Most patients reported no significant discomfort while using the MobiCARE device. Conclusion: In patients who underwent cardiac surgery, the mobiCARE device demonstrated diagnostic accuracy comparable to that of the conventional Holter monitoring system.

• 한국한의학연구원논문집
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• 제14권1호
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• pp.85-89
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• 2008

This study is to investigate cardiotonic effect of acupuncture on heart rate variability(HRV) analyzed by a nonlinear way(DFA, Detrended Fluctuation Analysis). It was designed as a randomized, single-blind, waiting list-controlled, cross-over study. We assessed heart rate and R-R intervals in Circadian electrocardiography with a Holter monitoring device for twelve hospitalized participants. The compatible analytical program, Zymed, was used for generating the signals of R-R intervals from 24 hour-ECG. In DFA analysis, we produced DFA alpha 1, alpha 2 parameters according to the process of Cygwin module of Linux server. We tested if there was any difference between HRV parameters using SPSS, a statistical package. There was no difference between acupuncture and no treatment group in DFA alpha 2 parameter {95% Confidence Interval (-)0.058 - 0.037, P = .565}. Two group all showed large intra-individual variations. Consequently, acupuncture treatment did not modulate the complexity of HRV in a DFA analysis. This study can be a rationale for acupuncture's properties on cardiovascular and autonomic systems.

• ETRI Journal
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• 제29권4호
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• pp.530-532
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• 2007

This paper presents a simple method to implement a complete on-line portable wireless holter including an electrocardiogram (ECG) monitoring, processing, and communication protocol. The proposed algorithm significantly reduces the hardware resources of threshold estimation for ECG compression, using the standard deviation updated with each new input signal sample. The new method achieves superior performance in terms of hardware complexity, channel occupation and memory requirements, while keeping the ECG quality at a clinically acceptable level.

• 대한의용생체공학회:의공학회지
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• 제19권3호
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• pp.251-260
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• 1998

홀터 심전계는 심장 이상으로 인한 급사 위험이 있는 환자를 위한 비관혈인 진단 장비이다. 본 연구에서는 일상생활 중에 심전도 데이터를 획득할 수 있도록 원칩 마이크로프로세서와 대용량메모리인 플레쉬 메모리(flash memory) 카드를 이용하여 2채널의 홀터 심전계를 설계하였다. 시스템 하드웨어는 크게 원칩 마이크로프로세서(68HC11E9)의 아날로그 심전도 처리회로, 플레쉬 메모리 카드로 구성하였다. 아날로그 심전도 처리회로는 250,500,1000의 이득을 갖는 증폭기와 0.05-100Hz의 대역폭을 갖는 대역통과 필터, 호흡으로 인한 기저선의 이동을 제거하기 위한 auto-balancing 회로와 포화-보정회로를 사용하였다. 심전도 신호는 240샘플/초 샘플링하여 A/D 변환하였다. 심전도는 필터링 및 전처리 과정을 통하여 특징점인 Q-R-T파를 검출하고, 이를 근거로 템플리트 생성, ST레벨, 심박수, QT간격 측정과 부정맥을 검출하였다. 또한 장시간동안의 심전도 데이터와 측정된 진단파라미터를 저장하기 위해 실시간 압축 알고리즘인 MFan과 delta modulation 방법을 이용하여 데이터를 압축, 저장하였다. 20M 바이트 용량의 플레쉬 메모리 카드에 기록된 데이터는 PC의 DOS나 Windows 환경의 ambulatory monitoring 분석시스템과 쉽게 인터페이스가 가능하도록 FFS(Flash File System)의 호환 가능한 SBF(Symetric Block format)포맷으로 저장하여 분석시스템에서 데이터 처리 및 관리할 수 있게 하였다.

• 융합신호처리학회논문지
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• 제23권2호
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• pp.62-69
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• 2022

의료현장에서는 최근 디지털 헬스케어의 중요성이 대두되면서, 다양한 형태의 생체신호 측정 관련 연구가 활발히 진행되고 있다. 생체신호 중 가장 중요한 신호로 심전도를 들 수 있으며, 특히 부정맥 환자에 있어 심전도 신호의 연속 모니터링은 매우 중요하다. 부정맥은 동결절(sinus node), 동빈맥(sinus tachycardia), 심방조기수축(atrial premature beat, APB), 심실세동 (ventricular fibrillation) 등으로 그 발병원에 따른 형태가 다양하며, 발병 이후의 예후가 좋지 않으므로 일상 중 연속 모니터링은 부정맥의 조기 진단과 치료방향 설정에서 매우 중요하다. 부정맥 환자의 심전도 신호는 매우 불안정하며, 부정맥을 자동 검출하기 위한 주요 특징점으로 작용하는 정확한 R-peak 포인트의 검출이 어렵다. 본 연구에서는 연속 측정하는 홀터 심전도 모니터링 기기와 분석용 소프트웨어를 개발하였으며, 부정맥 데이터베이스를 통해 심전도 신호의 R-peak 효용성을 확인하였다. 향후 연구에서는 다양한 발병원인으로 인한 부정맥의 형태적 구분 및 예측을 위한 알고리즘과 임상 데이터에 근거한 유효성 검증에 관한 추가 연구가 필요하다.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2006년도 춘계학술대회
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• pp.141-141
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• 2006

• Journal of Chest Surgery
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• 제47권1호
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• pp.1-5
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• 2014

Background: Recently, a hybrid surgical-electrophysiological (EP) approach for confirming ablation lines in patients with atrial fibrillation (AF) was suggested. The aim of this approach was to overcome the limitations of current surgery- and catheter-based techniques to yield better outcomes. Methods: Ten consecutive patients with AF underwent total thoracoscopic ablation (TTA) following transvenous catheter EP ablation (residual gap and cavotricuspid isthmus [CTI] ablation). Holter monitoring was performed 6 months postoperatively. Results: Ten patients (90% with persistent AF) underwent successful hybrid procedures, and there was no in-hospital mortality. An EP study was performed in 8 patients and showed that successful antral ablation in all pulmonary veins was achieved in 7 of them. The median follow-up duration was 7.63 months (range, 6.7 to 11.6 months). Nine patients underwent Holter monitoring 6 months postoperatively, and the results indicated an underlying sinus rhythm without AF, atrial flutter, or atrial tachycardia lasting more than 30 seconds in all of the patients. There was no recurrence of AF during follow-up. Conclusion: A hybrid approach that consists of TTA followed by transvenous catheter EP ablation (residual gap and CTI ablation) yielded excellent outcomes in our patient population. A hybrid approach should be considered in patients with a high risk of AF recurrence.

• 대한전기학회:학술대회논문집
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• 대한전기학회 1986년도 하계학술대회논문집
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• pp.192-197
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• 1986

The device that we are developing is a microprocessor-based, portable arrhythmia monitor that ultimately will need processing algorithm similar to those found now in monitoring systems in the cardiac care unit of today's hospital. Our initial goal is to replace the functions of the Holter tape recorder, the current device of choice for determining if an ambulatory patient has potential heart disease.