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Published on: May 3, 2018
Continuous Monitoring of Changes in Heart Rate during the Periprocedural Course of Carotid Artery Stenting Using a
Kentaro Hirai1, Yasunori Fujimoto1, Yohei Bamba1
1Department of Neurosurgery, Osaka Rosai Hospital.
Insights
Continuous heart rate (HR) monitoring after carotid artery stenting (CAS) using a wearable device showed a prolonged HR decrease. This finding offers new insights into carotid sinus baroreceptor function post-procedure.
Area of Science:
- Cardiology
- Medical Devices
- Physiology
Background:
- Carotid artery stenting (CAS) is a procedure to prevent stroke.
- Heart rate (HR) changes after CAS are not fully understood.
- Continuous monitoring can provide detailed physiological insights.
Purpose of the Study:
- To evaluate periprocedural HR changes during CAS using a wearable device.
- To assess the accuracy of wearable HR monitoring against electrocardiogram (ECG).
- To investigate the duration and pattern of HR changes post-CAS.
Main Methods:
- Prospective observational study.
- Continuous HR monitoring with a wearable device from pre-admission to post-discharge.
- Bland-Altman analysis to compare wearable device HR with ECG during CAS.
- Time-series analysis of HR data.
Main Results:
- A decrease in HR was observed starting on day 1 post-CAS.
- The most significant HR decrease rate was 12.1% on day 4.
- Wearable device HR measurement showed good accuracy (bias -1.12 bpm, precision 3.16 bpm) compared to ECG.
- HR decrease post-CAS persisted longer than previously reported.
Conclusions:
- Continuous wearable HR monitoring is accurate for assessing periprocedural changes.
- HR decrease following CAS may be more prolonged than previously thought.
- Findings suggest sustained effects on carotid sinus baroreceptor physiology.
Abstract:
This prospective observational study will evaluate the change in heart rate (HR) during the periprocedural course of carotid artery stenting (CAS) via continuous monitoring using a wearable device. The participants were recruited from our outpatient clinic between April 2020 and March 2023. They were instructed to continuously wear the device from the last outpatient visit before admission to the first outpatient visit after discharge. The changes in HR of interest throughout the periprocedural course of CAS were assessed. In addition, the Bland-Altman analysis was adopted to compare the HR measurement made by the wearable device during CAS with that made by the electrocardiogram (ECG). A total of 12 patients who underwent CAS were included in the final analysis. The time-series analysis revealed that a percentage change in HR decrease occurred on day 1 following CAS and that the most significant HR decrease rate was 12.1% on day 4 following CAS. In comparing the measurements made by the wearable device and ECG, the Bland-Altman analysis revealed the accuracy of the wearable device with a bias of -1.12 beats per minute (bpm) and a precision of 3.16 bpm. Continuous HR monitoring using the wearable device indicated that the decrease in HR following CAS could persist much longer than previously reported, providing us with unique insights into the physiology of carotid sinus baroreceptors.
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