scholarly journals Single-Lead ECG Recordings Including Einthoven and Wilson Leads by a Smartwatch: A New Era of Patient Directed Early ECG Differential Diagnosis of Cardiac Diseases?

Sensors ◽  
2019 ◽  
Vol 19 (20) ◽  
pp. 4377 ◽  
Author(s):  
Alexander Samol ◽  
Kristina Bischof ◽  
Blerim Luani ◽  
Dan Pascut ◽  
Marcus Wiemer ◽  
...  
Keyword(s):  
Index Finger ◽  
Intercostal Space ◽  
Left Index Finger ◽  
Signal Quality ◽  
Cardiac Diseases ◽  
Lower Abdomen ◽  
Anterior Myocardial Infarction ◽  
Left Hand ◽  
Good Signal ◽  
The Right

Background: Smartwatches that are able to record a bipolar ECG and Einthoven leads were recently described. Nevertheless, for detection of ischemia or other cardiac diseases more leads are required, especially Wilson’s chest leads. Objectives: Feasibility study of six single-lead smartwatch (Apple Watch Series 4) ECG recordings including Einthoven (I, II, III) and Wilson-like pseudo-unipolar chest leads (Wr, Wm, Wl). Methods: In 50 healthy subjects (16 males; age: 36 ± 11 years, mean ± SD) without known cardiac disorders, a standard 12-lead ECG and a six single-lead ECG using an Apple Watch Series 4 were performed under resting conditions. Recording of Einthoven I was performed with the watch on the left wrist and the right index finger on the crown, Einthoven II was recorded with the watch on the left lower abdomen and the right index finger on the crown, Einthoven III was recorded with the watch on the left lower abdomen and the left index finger on the crown. Wilson-like chest leads were recorded corresponding to the locations of V1 (Wr), V4 (Wm) and V6 (Wl) in the standard 12-lead ECG. Wr was recorded in the fourth intercostal space right parasternal, Wm was recorded in the fifth intercostal space on the midclavicular line, and Wl was recorded in the fifth intercostal space in left midaxillary line. For all Wilson-like chest lead recordings, the smartwatch was placed on the described three locations on the chest, the right index finger was placed on the crown and the left hand encompassed the right wrist. Both hands and forearms also had contact to the chest. Three experienced cardiologists were independently asked to allocate three bipolar limb smartwatch ECGs to Einthoven I–III leads, and three smartwatch Wilson-like chest ECGs (Wr, Wm, Wl) to V1, V4 and V6 in the standard 12-lead ECG for each subject. Results: All 300 smartwatch ECGs showed a signal quality useable for diagnostics with 281 ECGs of good signal quality (143 limb lead ECGs (95%), 138 chest lead ECGs (92%). Nineteen ECGs had a moderate signal quality (7 limb lead ECGs (5%), 12 chest lead ECGs (8%)). One-hundred percent of all Einthoven and 92% of all Wilson-like smartwatch ECGs were allocated correctly to corresponding leads from 12-lead ECG. Forty-six subjects (92%) were assigned correctly by all cardiologists. Allocation errors were due to similar morphologies and amplitudes in at least two of the three recorded Wilson-like leads. Despite recording with a bipolar smartwatch device, morphology of all six leads was identical to standard 12-lead ECG. In two patients with acute anterior myocardial infarction, all three cardiologists recognized the ST-elevations in Wilson-like leads and assumed an occluded left anterior descending coronary artery correctly. Conclusion: Consecutive recording of six single-lead ECGs including Einthoven and Wilson-like leads by a smartwatch is feasible with good ECG signal quality. Thus, this simulated six-lead smartwatch ECG may be useable for the detection of cardiac diseases necessitating more than one ECG lead like myocardial ischemia or more complex cardia arrhythmias.

scholarly journals Recording of Bipolar Multichannel ECGs by a Smartwatch: Modern ECG Diagnostic 100 Years after Einthoven

Sensors ◽  
2019 ◽  
Vol 19 (13) ◽  
pp. 2894 ◽  
Author(s):  
Alexander Samol ◽  
Kristina Bischoff ◽  
Blerim Luani ◽  
Dan Pascut ◽  
Marcus Wiemer ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Index Finger ◽  
Left Index Finger ◽  
Signal Quality ◽  
Lower Abdomen ◽  
Left Wrist ◽  
Cardiac Disorders ◽  
The Right ◽  
Erroneous Assignment ◽  
Repolarization Abnormalities

Aims: Feasibility study of accurate three lead ECG recording (Einthoven I, II and III) using an Apple Watch Series 4. Methods: In 50 healthy subjects (18 male; age: 40 ± 12 years) without known cardiac disorders, a 12-lead ECG and three bipolar ECGs, corresponding to Einthoven leads I, II and III were recorded using an Apple Watch Series 4. Einthoven I was recorded with the watch on the left wrist and the right index finger on the crown, Einthoven II with the watch on the left lower abdomen and the right index finger on the crown, Eindhoven III with the watch on the left lower abdomen and the left index finger on the crown. Four experienced cardiologists were independently asked to assign the watch ECGs to Einthoven leads from 12-lead ECG for each subject. Results: All watch ECGs showed an adequate signal quality with 134 ECGs of good (89%) and 16 of moderate signal quality (11%). Ninety-one percent of all watch ECGs were assigned correctly to corresponding leads from 12-lead ECG. Thirty-nine subjects (78%) were assigned correctly by all cardiologists. All assignment errors occurred in patients with similar morphologies and amplitudes in at least two of the three recorded leads. Erroneous assignment of all watch ECGs to leads from standard ECG occurred in no patient. Conclusion: Recording of Einthoven leads I-III by a smartwatch is accurate and highly comparable to standard ECG. This might contribute to an earlier detection of cardiac disorders, which are associated with repolarization abnormalities or arrhythmias.

scholarly journals Feasibility and Reliability of SmartWatch to Obtain 3-Lead Electrocardiogram Recordings

Sensors ◽  
2020 ◽  
Vol 20 (18) ◽  
pp. 5074
Author(s):  
Amirali Behzadi ◽  
Alireza Sepehri Shamloo ◽  
Konstantinos Mouratis ◽  
Gerhard Hindricks ◽  
Arash Arya ◽  
...  
Keyword(s):  
Data Analysis ◽  
Large Study ◽  
Index Finger ◽  
Left Index Finger ◽  
Spearman Correlation ◽  
Lower Abdomen ◽  
Left Wrist ◽  
The Right ◽  
Ecg Leads ◽  
Electrocardiogram Ecg

Some of the recently released smartwatch products feature a single-lead electrocardiogram (ECG) recording capability. The reliability of obtaining 3-lead ECG with smartwatches is yet to be confirmed in a large study. This study aimed to assess the feasibility and reliability of smartwatch to obtain 3-lead ECG recordings, the classical Einthoven ECG leads I-III compared to standard ECG. To record lead I, the watch was worn on the left wrist and the right index finger was placed on the digital crown for 30 s. For lead II, the watch was placed on the lower abdomen and the right index finger was placed on the digital crown for 30 s. For lead III, the same process was repeated with the left index finger. Spearman correlation and Bland-Altman tests were used for data analysis. A total of 300 smartwatch ECG tracings were successfully obtained. ECG waves’ characteristics of all three leads obtained from the smartwatch had a similar duration, amplitude, and polarity compared to standard ECG. The results of this study suggested that the examined smartwatch (Apple Watch Series 4) could obtain 3-lead ECG tracings, including Einthoven leads I, II, and III by placing the smartwatch on the described positions.

scholarly journals Response preparation involves a release of intracortical inhibition in task-irrelevant muscles

2020 ◽  
Author(s):  
Isaac N. Gomez ◽  
Kara Ormiston ◽  
Ian Greenhouse
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Index Finger ◽  
Intracortical Inhibition ◽  
Left Index Finger ◽  
Task Condition ◽  
Response Preparation ◽  
Action Preparation ◽  
The Right ◽  
Task Irrelevant

AbstractAction preparation involves widespread modulation of motor system excitability, but the precise mechanisms are unknown. In this study, we investigated whether intracortical inhibition changes in task-irrelevant muscle representations during action preparation. We used transcranial magnetic stimulation (TMS) combined with electromyography in healthy human adults to measure motor evoked potentials (MEPs) and cortical silent periods (CSPs) in task-irrelevant muscles during the preparatory period of simple delayed response tasks. In Experiment 1, participants responded with the left-index finger in one task condition and the right-index finger in another task condition, while MEPs and CSPs were measured from the contralateral non-responding and tonically contracted index finger. During Experiment 2, participants responded with the right pinky finger while MEPs and CSPs were measured from the tonically contracted left-index finger. In both experiments, MEPs and CSPs were compared between the task preparatory period and a resting intertrial baseline. The CSP duration during response preparation decreased from baseline in every case. A laterality difference was also observed in Experiment 1, with a greater CSP reduction during the preparation of left finger responses compared to right finger responses. MEP amplitudes showed no modulation during movement preparation in any of the three response conditions. These findings indicate cortical inhibition associated with task-irrelevant muscles is transiently released during action preparation and implicate a novel mechanism for the controlled and coordinated release of motor cortex inhibition.New & NoteworthyIn this study we observed the first evidence of a release of intracortical inhibition in task-irrelevant muscle representations during response preparation. We applied transcranial magnetic stimulation to elicit cortical silent periods in task-irrelevant muscles during response preparation and observed a consistent decrease in the silent period duration relative to a resting baseline. These findings address the question of whether cortical mechanisms underlie widespread modulation in motor excitability during response preparation.

Assessment of Radiation Protection in Hand-Shielding Products With Mini C-Arm Fluoroscopy

Hand ◽  
2019 ◽  
pp. 155894471986593 ◽  
Author(s):  
Matthew B. Cantlon ◽  
Asif M. Ilyas
Keyword(s):  
Radiation Exposure ◽  
Index Finger ◽  
Proximal Phalanx ◽  
Left Index Finger ◽  
Surgical Glove ◽  
Thermoluminescent Dosimeters ◽  
Intraoperative Fluoroscopy ◽  
The Mean ◽  
The Right ◽  
Free Metal

Background: Previous studies have highlighted the particular risk of radiation exposure to the surgeon’s hands with intraoperative fluoroscopy. Although evidence exists that shielding equipment for the hands reduces exposure, the extent of protection is not well understood. Therefore, we set out to determine the degree to which radiation exposure to the surgeon’s hands is decreased with hand-shielding products. Methods: An anthropomorphic model was positioned to simulate a surgeon sitting at a hand table. Thermoluminescent dosimeters were placed on the proximal phalanx of each index finger. The right index finger dosimeter was covered with a standard polyisoprene surgical glove (control arm), whereas the left index finger dosimeter was covered with commercially available hand-shielding products (study arm): lead-free metal-oxide gloves, leaded gloves, and radiation-attenuating cream. Mini fluoroscope position, configuration, and settings were standardized. The model was scanned for 15 continuous minutes in each test run, and each comparative arm was run 3 times. Results: The mean radiation dose absorbed by the control and variable dosimeters across all tests was 44.8 mrem (range, 30-54) and 18.6 mrem (range, 14-26), respectively. Each hand-shielding product resulted in statistically lower radiation exposure than a single polyisoprene surgical glove. Conclusions: The mean radiation exposure to the hands was significantly decreased when protected by radiation-attenuating options. Each product individually resulted in a statistically significant decrease in hand exposure compared with the control. We recommend that in addition to efforts to decrease radiation exposure, surgeons consider routine use of hand-shielding products when using mini c-arm fluoroscopy.

Music Affects Learning of a Braille-Like Task by Sighted Subjects

1989 ◽  
Vol 69 (3-1) ◽  
pp. 923-929
Author(s):  
Robert F. Kennison ◽  
Richard A. Mcfarland
Keyword(s):  
College Students ◽  
Sensory Input ◽  
Index Finger ◽  
Practical Importance ◽  
Left Index Finger ◽  
Interhemispheric Competition ◽  
Male College ◽  
The Right ◽  
The Brain ◽  
Male College Students

24 consistently right-handed male college students felt sets of four Braille symbols with either the right or the left index finger and identified by touch alone which two of the four symbols in each set were identical. During the task music was played to either the right ear, the left ear, both ears, or neither ear. Significantly fewer errors were made when the music was in the ear contralateral to whichever hand performed the task. The ipsilateral, binaural, and no-music groups did not differ significantly from each other. It is suggested that monaural music to the ear contralateral to the engaged hand led to reduced interhemispheric competition acting on the hemisphere controlling the hand. Such a facilitating effect may be of practical importance in tasks during which one hemisphere receives the bulk of the task-related sensory input and/or processes the final order from the brain to the task-related muscles.

scholarly journals Investigation of the relationship of the morphometric measurements of the hands and fingers with the personality traits of leadership

2019 ◽  
Vol 8 (1) ◽  
pp. 5
Author(s):  
Seda Sertel Meyvaci ◽  
Rengin Kosif ◽  
Murat Diramali ◽  
Tugce Baki
Keyword(s):  
Personality Traits ◽  
Index Finger ◽  
Charismatic Leadership ◽  
Distal Phalanx ◽  
Anthropometric Measurements ◽  
Leadership Frames ◽  
Left Hand ◽  
Leadership Frame ◽  
The Right ◽  
The Relationship

Background: The hand is a functionally critical organ at the distal end of the upper extremity. Also, the creases in the hands and the digital flexion creases on the fingers are the important external anatomical landmarks.Objectives: There are no studies found in the literature, linking solely the leadership personality traits with the anthropometric measurements of the hand.Methods: This descriptive study was to investigate the relationship between the 44 anthropometric measurements about hand, and the leadership personality traits in young adults from both genders.Results: When the leadership frames were compared by the scores, human resource leadership scores were significantly higher in the females. The charismatic leadership frame scores positively correlated with the parameters in males; including the breadth of the right hand, the breadth of the left hand, the index finger length of the left hand, and the distal phalanx length of the index finger on the left hand. The transformational leadership score was positively correlated with the left hand width and with the distal phalanx of the index finger on the left hand. In females, it was found out that the frames of human leadership and charismatic leadership correlated negatively with the length of the right thumb.Conclusions: According to the results of our study, we concluded that the breadth of the hand and the measurements of the thumb and the index fingers can provide opinion on leadership personality traits.  

scholarly journals Handedness and index finger movements performed on a small touchscreen

2016 ◽  
Vol 115 (2) ◽  
pp. 858-867 ◽  
Author(s):  
Tomoko Aoki ◽  
Gil Rivlis ◽  
Marc H. Schieber
Keyword(s):  
Right Hemisphere ◽  
Index Finger ◽  
Impedance Control ◽  
Tracking Task ◽  
Left Index Finger ◽  
Time Lags ◽  
Left Hand ◽  
Left Handed ◽  
Right Hand ◽  
Hemisphere Specialization

Many studies of right/left differences in motor performance related to handedness have employed tasks that use arm movements or combined arm and hand movements rather than movements of the fingers per se, the well-known exception being rhythmic finger tapping. We therefore explored four simple tasks performed on a small touchscreen with relatively isolated movements of the index finger. Each task revealed a different right/left performance asymmetry. In a step-tracking Target Task, left-handed subjects showed greater accuracy with the index finger of the dominant left hand than with the nondominant right hand. In a Center-Out Task, right-handed subjects produced trajectories with the nondominant left hand that had greater curvature than those produced with the dominant right hand. In a continuous Circle Tracking Task, slips of the nondominant left index finger showed higher jerk than slips of the dominant right index finger. And in a continuous Complex Tracking Task, the nondominant left index finger showed shorter time lags in tracking the relatively unpredictable target than the dominant right index finger. Our findings are broadly consistent with previous studies indicating left hemisphere specialization for dynamic control and predictable situations vs. right hemisphere specialization for impedance control and unpredictable situations, the specialized contributions of the two hemispheres being combined to different degrees in the right vs. left hands of right-handed vs. left-handed individuals.

Shifts in Kinesthesis through Time and after Active and Passive Movement

1975 ◽  
Vol 40 (3) ◽  
pp. 755-761 ◽  
Author(s):  
Brian Craske ◽  
Martin Crawshaw
Keyword(s):  
Shoulder Joint ◽  
Index Finger ◽  
Position Sense ◽  
Passive Movement ◽  
Active Movement ◽  
Final Position ◽  
Left Hand ◽  
Limb Position ◽  
Test Position ◽  
The Right

The position sense of a stationary arm was investigated subsequent to an horizontally adductive movement with axis the shoulder joint. The right arm was the treated arm: it reached a test position actively, using minimal voluntary effort, or passively from each of 10 starting positions. The blindfolded S localized the index finger of the treated arm by attempting to touch it with the index finger of his left hand. The results indicate that subsequent to active movement the final position of a limb is more accurately known than a position resulting from passive movement. A second finding is that concomitant with both forms of limb placement there is a unidirectional drift of perceived limb position over trials.

Cortical Representation of Swallowing: A Modified Dual Task Paradigm

2002 ◽  
Vol 94 (3) ◽  
pp. 1029-1040 ◽  
Author(s):  
Stephanie K. Daniels ◽  
David M. Corey ◽  
Cristen L. Barnes ◽  
Nikki M. Faucheaux ◽  
Daniel H. Priestly ◽  
...  
Keyword(s):  
Dual Task ◽  
Right Hemisphere ◽  
Index Finger ◽  
Finger Tapping ◽  
Left Index Finger ◽  
Cortical Representation ◽  
Word Repetition ◽  
Dual Task Paradigm ◽  
Left And Right ◽  
The Right

It is unclear whether the cortical representation of swallowing is lateralized to the left cerebral hemisphere, right hemisphere, or bilaterally represented. As dysphagia is common in acute stroke, it is important to elucidate swallowing lateralization to facilitate earlier detection of stroke patients who may be at greater risk for dysphagia and aspiration. In this study, a modified dual task paradigm was designed to study laterality of swallowing in a group of 14 healthy, young, right-handed, male adults. The subjects were studied at baseline and with interference. Baseline conditions, performed separately, were continuous swallowing, finger tapping using the right and left index fingers, and word repetition. Interference tasks, including tapping with the right index finger, tapping with the left index finger, and word repetition, were completed with and without swallowing. Finger-tapping rate was measured, and x-ray samples of the swallowing task were taped to measure swallowing rate and volume swallowed. At baseline, the rate of tapping the right index finger was significantly faster than that of the left index finger. There was a significant decline in the tapping rates of both left and right index fingers with swallowing interference. The volume per swallow was significantly reduced during the interfering language task of silent repetition. These results offer partial support for a bilateral representation of swallowing as well as suggest an important left hemispheric contribution to swallowing. However, it cannot be concluded that the left hemisphere is more important than the right, as a comparable right hemisphere task was not studied.

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