Harald Reiter

Wearable approach for continuous ECG - and activity patient-monitoring

The paper describes an approach to monitor a persons ECG and activity continuously with functional clothing. A belt with integrated electronics has been developed and has proven long-term robustness of all electrical components. A low-power module measures the ECG signal as well as the acceleration (2-axis) and stores data continuously up to two days. A user test has been performed to evaluate the belt according to system performance at different daily-life activities like sleeping, walking and so on. System parameters are ECG-signal quality, system up-time, and ECG-signal coverage during a day.

Medical application and clinical validation for reliable and trustworthy physiological monitoring using functional textiles: Experience from the HeartCycle and MyHeart project

Functional textiles are seen as promising technology to enable healthcare services and medical care outside hospitals due to their ability to integrate textile-based sensing and monitoring technologies into the daily life. In the past much effort has been spent onto basic functional textile research already showing that reliable monitoring solutions can be realized. The challenge remains to find and develop suited medical application and to fulfil the boundary conditions for medical endorsement and exploitation. The HeartCycle vest described in this abstract will serve as an example for a functional textile carefully developed according to the requirements of a specific medical application, its clinical validation, the related certification aspects and the next improvement steps towards exploitation.

HeartCycle: Compliance and effectiveness in HF and CAD closed-loop management

HeartCycle is an integrated project aiming to provide a disease management solution for cardiovascular disease patients. The project develops technologies and services to facilitate the remote management of patients at home and motivate them to be compliant to treatment regimes and to adopt a beneficial lifestyle. HeartCycle aims to develop a personalised care system, integrating care at home with professional care in the hospital embedding health delivery feedback loops both at the professional and patient levels. In this paper an overview of the technological challenges that are under research and development in the HeartCycle project shall be presented and their possible implications on the personalized health concept shall be addressed.

Towards closed-loop personal health systems in cardiology: The HeartCycle approach

HeartCycle is a large-scale EU integrated project aiming to provide a complete disease management solution for cardiovascular disease patients, with emphasis on Heart Failure (HF) and Coronary Artery Disease (CAD) patients. The project develops innovative technologies and services to facilitate remote management of patients at home and motivate them to be compliant to treatment regimes and to adopt a beneficial lifestyle. HeartCycle aims to develop a personalised care system, integrating care at home with professional care in the hospital embedding health delivery feedback loops both at the professional and patient levels. In this paper, we present the three major systems that HeartCycle consists of, namely, the Heart Failure Management system, the Guided Exercise system, and the Assessment system. For each of these systems we summarise the current research and development efforts conducted, as well as the challenges faced towards their embodiment in actual healthcare delivery.

Analysis of sleep and stress profiles from biomedical signal processing in wearable devices

The present paper describes procedures for the evaluation of sleep quality and for stress management based on the analysis of the HRV and respiration signals. The analysis is though for a device aimed to provide support to people who want to develop a healthier lifestyle, with major focus on cardiovascular disease prevention.

Cardiac status assessment with a multi-signal device for improved home-based congestive heart failure management

State-of-the-Art disease management for Congestive Heart Failure (CHF) patients is still based on easy-to-acquire measures such as heart rate (HR), weight and blood pressure (BP). However, these measures respond late to changes of the patient health status and provide limited information to personalize and adapt medication therapy. This paper describes our concept called “Cardiac Status Assessment” we have been investigating within the European project “HeartCycle” towards next-generation home-based disease management of CHF. In our concept we analyze non-invasive surrogate measures of the cardio-vascular function in particular systolic time intervals and pulse wave characteristics to estimate Cardiac Output (CO) and Systemic Vascular Resistance (SVR) both are established clinical measures. We discuss the underlying concept, a developed measurement system and first results.

Early Indication of Decompensated Heart Failure in Patients on Home-Telemonitoring: A Comparison of Prediction Algorithms Based on Daily Weight and Noninvasive Transthoracic Bio-impedance

Background Heart Failure (HF) is a common reason for hospitalization. Admissions might be prevented by early detection of and intervention for decompensation. Conventionally, changes in weight, a possible measure of fluid accumulation, have been used to detect deterioration. Transthoracic impedance may be a more sensitive and accurate measure of fluid accumulation. Objective In this study, we review previously proposed predictive algorithms using body weight and noninvasive transthoracic bio-impedance (NITTI) to predict HF decompensations. Methods We monitored 91 patients with chronic HF for an average of 10 months using a weight scale and a wearable bio-impedance vest. Three algorithms were tested using either simple rule-of-thumb differences (RoT), moving averages (MACD), or cumulative sums (CUSUM). Results Algorithms using NITTI in the 2 weeks preceding decompensation predicted events (P<.001); however, using weight alone did not. Cross-validation showed that NITTI improved sensitivity of all algorithms tested and that trend algorithms provided the best performance for either measurement (Weight-MACD: 33%, NITTI-CUSUM: 60%) in contrast to the simpler rules-of-thumb (Weight-RoT: 20%, NITTI-RoT: 33%) as proposed in HF guidelines. Conclusions NITTI measurements decrease before decompensations, and combined with trend algorithms, improve the detection of HF decompensation over current guideline rules; however, many alerts are not associated with clinically overt decompensation.

HeartCycle: Beyond building demonstrators. A structured approach to develop, implement and validate healthcare innovations in telemonitoring

HeartCycle, running since March 2008, is an European Integrated Project aiming to provide innovations for the next generation of disease management solutions dedicated for cardiovascular disease patients. The appropriate remote management of such patients at home is seen as a promising solution to both, the delivery of innovative healthcare and the containment of future healthcare cost. Major challenges are the detection of negative health status trends in time, the appropriate decision support for professionals to react to such trends and supporting the motivation of patients to be compliant to treatment regimes and to adopt a beneficial lifestyle. In this paper an overview description of the HeartCycle process is presented which is a structured approach to develop, implement and validate healthcare innovations.

HeartCycle: From insights to clinically evaluated ICT solutions for Telehealth

HeartCycle is a large European Integrated Project (IP) and develops technologies and services for Telehealth, which is to remotely monitor and manage patients at home and motivate them to be compliant to treatment regimens and to a beneficial lifestyle. Telehealth allows healthcare professionals to better control the progress of the therapy, detect upcoming adverse events early and react in time with personalized care plan adjustments, leading to prevent relapses, stabilizing the patient and avoid costly hospitalizations.

TakeCare: A home-based sensor system for the management of cardiovascular risk factors Primary prevention by monitoring vital body signs, analysing the data and closing the loop by feedback, coaching, and motivation

Unobtrusive and easy-to-use sensor devices are used for monitoring the health condition of people interested in adopting a healthier lifestyle. The collected data from body sensors and input from questionnaires are analyzed allowing to derive improvement plans and recommendations. With the help of feedback, coaching and motivation a closed-loop system approach is realized optimally supporting people to reach their goals in daily life. The improved self-management has been successfully validated by people with sleep problems. They received tailored TakeCare systems for several weeks to be used in their own homes.