Protecting Athletes From Sudden Cardiac Death

JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 11/2006; 296(13):1648-50. DOI: 10.1001/jama.296.13.1648
Source: PubMed

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    • "This condition becomes progressively worse affecting the metabolic activity of the heart muscles. Over a period of time, the heart muscles become weak and may lead to heart failure and causing arrhythmias [4]. Even more, often the deposited plaques erode or rupture resulting into thrombus formation restricting the flow of blood to the heart muscles thereby increasing the risk of sudden cardiac death. "
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    ABSTRACT: Coronary artery disease (CAD) is the narrowing of coronary arteries leading to inadequate supply of nutrients and oxygen to the heart muscles. Over time, the condition can weaken the heart muscles and may lead to heart failure, arrhythmias and even sudden cardiac death. Hence, the early diagnosis of CAD can save life and prevent the risk of stroke. Electrocardiogram (ECG) depicts the state of the heart and can be used to detect the CAD. Small changes in the ECG signal indicate a particular disease. It is very difficult to decipher these minute changes in the ECG signal, as it is prone to artifacts and noise. Hence, we detect the R peaks from the ECG and use heart rate signals for our analysis. The manual inspection of the heart rate signals is time consuming, taxing and prone to errors due to fatigue. Hence, a decision support system independent of human intervention can yield accurate repeatable results. In this paper, we present a new method for diagnosis of CAD using tunable-Q wavelet transform (TQWT) based features extracted from heart rate signals. The heart rate signals are decomposed into various sub-bands using TQWT for better diagnostic feature extraction. The nonlinear feature called centered correntropy is computed on decomposed detail sub-band. Then the principal component analysis (PCA) is performed on these CC to transform the number of features. These clinically significant features are subjected to least squares support vector machine (LS-SVM) with different kernel functions for automated diagnosis. The experimental results demonstrate highest classification accuracy, sensitivity, specificity and Matthews correlation coefficient of for Q-factor =24 using Morlet wavelet kernel function with optimized kernel and regularization parameters. Also, we have developed a novel CAD Risk index using significant features to discriminate the two classes using a single number. Our proposed methodology is more suitable in classification of normal and CAD heart rate signals and can aid the clinicians while screening the CAD patients.
    No preview · Article · Jul 2015 · Knowledge-Based Systems
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    • "The greatest challenge in such events is the limited staircase space where participants must compete (Fig. 1) making it difficult for staff to monitor the event on foot and to aid in emergencies . In addition, public and charity competitions in many countries do not usually require health checks prior to events, therefore increasing the risk for cardiac-related injuries [5] [6] [7] [8] [9] [10] [11] [12] [13] and other injury types [14] [15] [16] [17] [18]. Furthermore, this particular sport is open to individuals of all ages, some having hearing impairments which may cause additional difficulties in communicating during an emergency. "
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    ABSTRACT: Using mobile wireless technology to monitor ECG in participants of mass events and sports taking place in difficult-to-access location could both prevent and easier detect arrhythmias as well as provide real-time monitoring for any type of injury. We assessed the effectiveness of mobile wireless monitoring technology and IT in detecting possible emergencies during a skyscraper race. We attached specially designed wireless surveillance biopatches on 120 individuals participating to monitor their continuous ECG and location during a skyscraper run-up race at Taipei 101 building, Taiwan. The outcomes of interest were detection of abnormal heartbeats and QRS waves indicative of possible cardiac problems and the exact location of participants during the occurrence of emergencies. The devices accurately sent over 50 warnings to our monitoring platform when both, danger limits were reached by competitors (<60 or >195 beats per minute) or competitors stopped moving, proving very effective in quickly detecting abnormities and alerting staff of possible emergencies at exact locations. This efficient and inexpensive monitoring method can also prevent arrhythmias in unscreened competitors, the danger of collision among staff and competitors, and preserves oxygen by eliminating additional on-foot monitoring staff. Additionally, it could have multipurpose usage, especially during disasters and accidents occurring in difficult-to-access locations, in military exercises and personal monitoring. Copyright © 2015. Published by Elsevier Ireland Ltd.
    Full-text · Article · May 2015 · Computer methods and programs in biomedicine
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    • "In proposals for added testing, the need to avoid harm to donors is crucial but often neglected. For instance, the quoted proposal to use electrocardiography (ECG) as a simple and cheap means to find donors at risk of transmitting HCM to their offspring (Maron et al., 2009)) does not even discuss the possibility that such testing may lead to false-positive results (Thompson and Levine, 2006;Siffroi et al., 2010). Donors excluded because of a false-positive HCM test may lose confidence in their own health without good reason and may wrongly be led to adapt their lives for fear of provoking life-threatening cardiac events. "
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    ABSTRACT: This Task Force document explores the ethical issues involved in the debate about the scope of genetic screening of gamete donors. Calls for expanded donor screening arise against the background of both occasional findings of serious but rare genetic conditions in donors or donor offspring that were not detected through present screening procedures and the advent of new genomic technologies promising affordable testing of donors for a wide range of conditions. Ethical principles require that all stakeholders' interests are taken into account, including those of candidate donors. The message of the profession should be that avoiding all risks is impossible and that testing should remain proportional.
    Full-text · Article · May 2014 · Human Reproduction
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