Options for Intermittent and Continuous Atrial Fibrillation Monitoring

Chon, Ki ;   Chong, Jowoon

We hypothesize that for intermittent monitoring of atrial fibrillation (AF), our smartphone-based arrhythmia discrimination algorithm with data acquisition approach reliably differentiates between normal sinus rhythm (NSR), atrial fibrillation (AF), premature ventricular contractions (PVCs), and premature atrial contraction (PACs) in a diverse group of patients having these common arrhythmias. We combine Root Mean Square of Successive RR Differences (RMSSD) and Shannon Entropy (ShE) with Poincare plot (or turning point ratio (TPR) method) and pulse rise/fall times to increase the sensitivity of AF discrimination and add new capabilities of PVC and PAC identification. For continuous monitoring of AF, a reusable dry electrodes is needed over the standard Ag/AgCl electrodes which is well known to cause skin irritation when they are used for a prolonged period of time. To overcome the limitation of the Ag/AgCl electrodes, we have recently successfully developed reusable dry bioelectrodes using carbon black powder and polydimethylsiloxane (PDMS). Our carbon-based electrodes are able to provide all morphological waves (PQRST) of ECG signals in both dry and wet environments. Further, in dry environments, unlike most ECG electrodes, our carbon-based electrodes do not require wetting of the electrodes to function properly. This means that they do not require hydrogel, and thus do not expire or dry out. Our carbon electrodes are re-usable, flexible and appear not to degrade with repeated usage, hence, they could maybe be incorporated into a wearable devices for continuous AF monitoring for both dry and wet conditions.