Dataset Information

Wearable sensors in syncope management.

ABSTRACT: Syncope is a common disorder with a lifetime prevalence of about 40%. Implantable cardiac electronic devices, including implantable loop recorders (ILR) and implantable cardioverter-defibrillators (ICD), are well established in syncope management. However, despite the successful use of ILR and ICD, diagnosis and therapy still remain challenging in many patients due to the complex hemodynamic interplay of cardiac and vascular adaptations during impending syncopes. Wearable sensors might overcome some limitations, including misdiagnosis and inappropriate defibrillator shocks, because a variety of physiological measures can now be easily acquired by a single non-invasive device at high signal quality. In neurally-mediated syncope (NMS), which is the most common cause of syncope, advanced signal processing methodologies paved the way to develop devices for early syncope detection. In contrast to the relatively benign NMS, in arrhythmia-related syncopes immediate therapeutical intervention, predominantly by electrical defibrillation, is often mandatory. However, in patients with a transient risk of arrhythmia-related syncope, limitations of ICD therapy might outweigh their potential therapeutic benefits. In this context the wearable cardioverter-defibrillator offers alternative therapeutical options for some high-risk patients. Herein, we review recent evidence demonstrating that wearable sensors might be useful to overcome some limitations of implantable devices in syncope management.

SUBMITTER: Meyer C

PROVIDER: S-EPMC4315629 | biostudies-literature | 2015 Jan

REPOSITORIES: biostudies-literature

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Wearable sensors in syncope management.

Meyer Christian C Carvalho Paulo P Brinkmeyer Christoph C Kelm Malte M Couceiro Ricardo R Mühlsteff Jens J

Medical science monitor : international medical journal of experimental and clinical research 20150122

Syncope is a common disorder with a lifetime prevalence of about 40%. Implantable cardiac electronic devices, including implantable loop recorders (ILR) and implantable cardioverter-defibrillators (ICD), are well established in syncope management. However, despite the successful use of ILR and ICD, diagnosis and therapy still remain challenging in many patients due to the complex hemodynamic interplay of cardiac and vascular adaptations during impending syncopes. Wearable sensors might overcome ...[more]

PMID: 25608536

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Project description:Distinct gait characteristics like short steps and shuffling gait are prototypical signs commonly observed in Parkinson's disease. Routinely assessed by observation through clinicians, gait is rated as part of categorical clinical scores. There is an increasing need to provide quantitative measurements of gait, e.g. to provide detailed information about disease progression. Recently, we developed a wearable sensor-based gait analysis system as diagnostic tool that objectively assesses gait parameter in Parkinson's disease without the need of having a specialized gait laboratory. This system consists of inertial sensor units attached laterally to both shoes. The computed target of measures are spatiotemporal gait parameters including stride length and time, stance phase time, heel-strike and toe-off angle, toe clearance, and inter-stride variation from gait sequences. To translate this prototype into medical care, we conducted a cross-sectional study including 190 Parkinson's disease patients and 101 age-matched controls and measured gait characteristics during a 4x10 meter walk at the subjects' preferred speed. To determine intraindividual changes in gait, we monitored the gait characteristics of 63 patients longitudinally. Cross-sectional analysis revealed distinct spatiotemporal gait parameter differences reflecting typical Parkinson's disease gait characteristics including short steps, shuffling gait, and postural instability specific for different disease stages and levels of motor impairment. The longitudinal analysis revealed that gait parameters were sensitive to changes by mirroring the progressive nature of Parkinson's disease and corresponded to physician ratings. Taken together, we successfully show that wearable sensor-based gait analysis reaches clinical applicability providing a high biomechanical resolution for gait impairment in Parkinson's disease. These data demonstrate the feasibility and applicability of objective wearable sensor-based gait measurement in Parkinson's disease reaching high technological readiness levels for both, large scale clinical studies and individual patient care.

Dataset Information

Wearable sensors in syncope management.

Publications

Wearable sensors in syncope management.

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