title: Performance of a real-time dicrotic notch detection and prediction algorithm in arrhythmic human aortic pressure signals.
abstract: A novel algorithm for real-time detection and prediction of the dicrotic notch from aortic pressure waves was evaluated in arrhythmic aortic pressure signals from heart failure patients. A simplified model of the arterial tree was used to calculate real-time aortic flow from aortic pressure. The dicrotic notch was detected at the first negative dip from the calculated flow, prediction of the notch was performed using a percentage of the decreasing flow. The performance of the real-time dicrotic notch detection algorithm (RTDND) was evaluated during severe arrhythmia from aortic pressure signals of 12 patients. The RTDND was able to detect the dicrotic notch in 98.1%. No false positive dicrotic notch identifications were observed. Prediction of the dicrotic notch was tested at 40%, 20%, and 0% of the decreasing calculated aortic flow. The mean time-delays to the notch were 68 +/- 14 ms, 55 +/- 12 ms, and 43 +/- 8 ms, respectively. Given these small variability, intra-beat prediction of the dicrotic notch may be used for real-time intra-aortic balloon counterpulsation inflation timing.
authors.affiliation: Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Donelli
authors.forename: Jos R C
authors.initials: JR
authors.lastname: Jansen
authors.forename: Bas
authors.initials: B
authors.lastname: Hoeksel
authors.forename: Paolo
authors.initials: P
authors.lastname: Pedeferri
authors.forename: Ramzi
authors.initials: R
authors.lastname: Hanania
authors.forename: Jan
authors.initials: J
authors.lastname: Bovelander
authors.forename: Francesco
authors.initials: F
authors.lastname: Maisano
authors.forename: Alessandro
authors.initials: A
authors.lastname: Castiglioni
authors.forename: Alfieri
authors.initials: A
authors.lastname: Ottavio
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Schreuder
mesh_terms: D000368:Aged; D000465:Algorithms; D001013:Aorta, Thoracic; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D001794:Blood Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012815:Signal Processing, Computer-Assisted