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Cohen, R. J.

Publications and source records attributed to Cohen, R. J..

50 records · Page 3

Beat to beat variability in cardiovascular variables: noise or music?

Cardiovascular variables such as heart rate, arterial blood pressure, stroke volume and the shape of electrocardiographic complexes all fluctuate on a beat to beat basis. These fluctuations have traditionally been ignored or, at best, treated as noise to be averaged out. The variability in cardiovascular signals reflects the homeodynamic interplay between perturbations to cardiovascular function and the dynamic response of the cardiovascular regulatory systems. Modern signal processing techniques provide a means of analyzing beat to beat fluctuations in cardiovascular signals, so as to permit a quantitative, noninvasive or minimally invasive method of assessing closed loop hemodynamic regulation and cardiac electrical stability. This method promises to provide a new approach to the clinical diagnosis and management of alterations in cardiovascular regulation and stability.

Non-NASA Center

Analysis of long term heart rate variability: methods, 1/f scaling and implications

The use of spectral techniques to quantify short term heart rate fluctuations on the order of seconds to minutes has helped define the autonomic contributions to beat-to-beat control of heart rate. We used similar techniques to quantify the entire spectrum (0.00003-1.0 Hz) of heart rate variability during 24 hour ambulatory ECG monitoring. The ECG from standard Holter monitor recordings from normal subjects was sampled with the use of a phase locked loop, and a heart rate time series was constructed at 3 Hz. Frequency analysis of the heart rate signal was performed after a nonlinear filtering algorithm was used to eliminate artifacts. A power spectrum of the entire 24 hour record revealed power that was inversely proportional to frequency, 1/f, over 4 decades from 0.00003 to 0.1 Hz (period approximately 10 hours to 10 seconds). Displaying consecutive spectra calculated at 5 minute intervals revealed marked variability in the peaks at all frequencies throughout the 24 hours, probably accounting for the lack of distinct peaks in the spectra of the entire records.

Non-NASA Center

Variability in surface ECG morphology: signal or noise?

Using data collected from canine models of acute myocardial ischemia, we investigated two issues of major relevance to electrocardiographic signal averaging: ECG epoch alignment, and the spectral characteristics of the beat-to-beat variability in ECG morphology. With initial digitization rates of 1 kHz, an iterative a posteriori matched filtering alignment scheme, and linear interpolation, we demonstrated that there is sufficient information in the body surface ECG to merit alignment to a precision of 0.1 msecs. Applying this technique to align QRS complexes and atrial pacing artifacts independently, we demonstrated that the conduction delay from atrial stimulus to ventricular activation may be so variable as to preclude using atrial pacing as an alignment mechanism, and that this variability in conduction time be modulated at the frequency of respiration and at a much lower frequency (0.02-0.03Hz). Using a multidimensional spectral technique, we investigated the beat-to-beat variability in ECG morphology, demonstrating that the frequency spectrum of ECG morphological variation reveals a readily discernable modulation at the frequency of respiration. In addition, this technique detects a subtle beat-to-beat alternation in surface ECG morphology which accompanies transient coronary artery occlusion. We conclude that physiologically important information may be stored in the variability in the surface electrocardiogram, and that this information is lost by conventional averaging techniques.

NASA Discipline Cardiopulmonary

On the precision of automated activation time estimation

We examined how the assignment of local activation times in epicardial and endocardial electrograms is affected by sampling rate, ambient signal-to-noise ratio, and sinx/x waveform interpolation. Algorithms used for the estimation of fiducial point locations included dV/dtmax, and a matched filter detection algorithm. Test signals included epicardial and endocardial electrograms overlying both normal and infarcted regions of dog myocardium. Signal-to-noise levels were adjusted by combining known data sets with white noise "colored" to match the spectral characteristics of experimentally recorded noise. For typical signal-to-noise ratios and sampling rates, the template-matching algorithm provided the greatest precision in reproducibly estimating fiducial point location, and sinx/x interpolation allowed for an additional significant improvement. With few restrictions, combining these two techniques may allow for use of digitization rates below the Nyquist rate without significant loss of precision.

NASA Discipline Cardiopulmonary

Nonlinear dynamics in cardiac conduction

Electrical conduction in the heart shows many phenomena familiar from nonlinear dynamics. Among these phenomena are multiple basins of attraction, phase locking, and perhaps period-doubling bifurcations and chaos. We describe a simple cellular-automation model of electrical conduction which simulates normal conduction patterns in the heart as well as a wide range of disturbances of heart rhythm. In addition, we review the application of percolation theory to the analysis of the development of complex, self-sustaining conduction patterns.

NASA Discipline Cardiopulmonary

Narrow polarized components in the OH 1612-MHz maser emission from supergiant OH-IR sources

High-resolution (300 Hz) OH 1612-MHz spectra of the supergiant OH-IR sources VY CMa, VX Sgr, IRC 10420, and NML Cyg are presented. Linewidths as small as 550 Hz (0.1 km/s) are found for narrow components in the spectra. The present results are consistent with current models for maser line-narrowing and for the physical properties in the OH maser regions. A significant degree of circular polarization is noted in many of the narrow components. The circular polarization suggests the presence of magnetic fields of about 1 mG in the circumstellar envelopes which would be strong enough to influence the outflow from the stars, and which may explain asymmetries found in the circumstellar envelopes.

Cohen, R. J.

Signal averaging technique for noninvasive recording of late potentials in patients with coronary artery disease

An advanced non invasive signal averaging technique was used to detect late potentials in two groups of patients: Group A (24 patients) with coronary artery disease (CAD) and without sustained ventricular tachycardia (VT) and Group B (8 patients) with CAD and sustained VT. Recorded analog data were digitized and aligned using a cross correlation function with fast Fourier transform schema, averaged and band pass filtered between 60 and 200 Hz with a non-recursive digital filter. Averaged filtered waveforms were analyzed by computer program for 3 parameters: (1) filtered QRS (fQRS) duration (2) interval between the peak of the R wave peak and the end of fQRS (R-LP) (3) RMS value of last 40 msec of fQRS (RMS). Significant change was found between Groups A and B in fQRS (101 -/+ 13 msec vs 123 -/+ 15 msec; p < .0005) and in R-LP vs 52 -/+ 11 msec vs 71-/+18 msec, p <.002). We conclude that (1) the use of a cross correlation triggering method and non-recursive digital filter enables a reliable recording of late potentials from the body surface; (2) fQRS and R-LP durations are sensitive indicators of CAD patients susceptible to VT.

NASA Discipline Cardiopulmonary

Computer simulation of fibrillation threshold measurements and electrophysiologic testing procedures

A finite element model of cardiac conduction was used to simulate two experimental protocols: 1) fibrillation threshold measurements and 2) clinical electrophysiologic (EP) testing procedures. The model consisted of a cylindrical lattice whose properties were determined by four parameters: element length, conduction velocity, mean refractory period, and standard deviation of refractory periods. Different stimulation patterns were applied to the lattice under a given set of lattice parameter values and the response of the model was observed through a simulated electrocardiogram. The studies confirm that the model can account for observations made in experimental fibrillation threshold measurements and in clinical EP testing protocols.

NASA Discipline Cardiopulmonary

Application of non-linear dynamics to the characterization of cardiac electrical instability

Beat-to-beat alternation in the morphology of the ECG has been previously observed in hearts susceptible to fibrillation. In addition, fibrillation has been characterized by some as a chaotic state. Period doubling phenomena, such as alternation, and the onset of chaos have been connected by non-linear dynamical systems theory. In this paper, we describe the use of a technique from nonlinear dynamics theory, the construction of a first return nap, to assess the susceptibility to fibrillation threshhold in canine experiments.

NASA Discipline Cardiopulmonary

Applications of a detailed model of cardiac conduction to ventricular dysrhythmogenesis

In order to study transitions from normal patterns of electrical activity to abnormal patterns, such as ventricular activation, one requires a means to represent the state of myocardial electrical activation in a few parameters. Two parameters are presented here: 1) the net vorticity index (NVI) which is a measure of the net vorticity in a given region, and 2) the wavefront fractionation index (WFI), which is a measure of perturbations in the propagation of the electrical activation through the myocardium. Both parameters are topological measures in that normal propagation is condensed to a zero state, irrespective of smooth changes in wavefront orientation or shape. Several examples are demonstrated using a computer simulation of cardiac conduction. Potential applications to clinical diagnosis using experimentally obtainable data are discussed.

NASA Discipline Cardiopulmonary

Transfer function analysis of the autonomic response to respiratory activity during random interval breathing

We report a new method for the noninvasive characterization of the frequency response of the autonomic nervous system (ANS) in mediating fluctuations in heart rate (HR). The approach entails computation of the transfer function magnitude and phase between instantaneous lung volume and HR. Broad band fluctuations in lung volume were initiated when subjects breathed on cue to a sequence of beeps spaced randomly in time. We studied 10 subjects in both supine and standing positions. The transfer function, averaged among all the subjects, showed systematic differences between the two postures, reflecting the differing frequency responses of the sympathetic and parasympathetic divisions of the ANS.

Non-NASA Center

A new technique to determine the correlation between the QT interval and heart-rate for control and SIDS babies

The ability of the autonomic nervous system to alter the QT interval in response to heart rate changes is essential to cardiovascular control. An accurate way to determine the relation between QT intervals and their corresponding RR intervals is described. A computer algorithm measures the RR intervals using digital filtering and cross-correlating the QRS sections of consecutive waveforms. The QT intervals is calculated by choosing a section of, the ECG that includes the T wave and cross-correlating it with all the consecutive T waves. At least 4000 pairs of QT-RR intervals are computed for each subject and a best fit correlation function determines the relations between the QT and RR intervals. This technique enables to establish a precise correlation between RR and QT in order to distinguish between control and SIDS babies.

Non-NASA Center

A time dependent anatomically detailed model of cardiac conduction

In order to understand the determinants of transitions in cardiac electrical activity from normal patterns to dysrhythmias such as ventricular fibrillation, we are constructing an anatomically and physiologically detailed finite element simulation of myocardial electrical propagation. A healthy human heart embedded in paraffin was sectioned to provide a detailed anatomical substrate for model calculations. The simulation of propagation includes anisotropy in conduction velocity due to fiber orientation as well as gradients in conduction velocities, absolute and relative refractory periods, action potential duration and electrotonic influence of nearest neighbors. The model also includes changes in the behaviour of myocardial tissue as a function of the past local activity. With this model, we can examine the significance of fiber orientation and time dependence of local propagation parameters on dysrhythmogenesis.

Computer Simulation

Subtle alternating electrocardiographic morphology as an indicator of decreased cardiac electrical stability

Observations from finite-element computer models, together with analytic developments based on percolation theory have suggested that subtle fluctuations of ECG morphology might serve as an indicator diminished cardiac electrical stability. With fixed-rate atrial pacing in canines, we have previously observed a pattern of alternation in T wave energy which correlated with cardiac electrical stability. We report here on a series of 20 canine experiments in which cardiac electrical stability (measured via Ventricular Fibrillation Threshold determination) was compared to a non-degenerate, multidimensional measurement of the degree of alternating activity present in the ECG complex morphology. The decrease in cardiac electrical stability brought on by both coronary artery occlusion and systemic hypothermia was consistently accompanied by subtle alternation in ECG morphology, with the absolute degree of alternating activity being significantly (negatively) correlated with cardiac electrical stability.

Ventricular Fibrillation