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  1. Transform -- Digital Filters -- FIR -- Low Pass -- Line Frequency (60Hz) & Filter entire waveform
  2. eSelect Systole: Analysis -- Hemodynamic -- ABP classifier for BP data
  3. Make SC none for all except BPM
  • Focus on blood pressure
  • Find discrepancies in data
    1. Analysis -- Find Cycle -- Events -- start event: start with Diastole, end with Systole located on Blood Pressure (Channel number 5) -- Find all cycles
    2. Use BPM channel to find any problems
    3. Fixing with markers: flag and zap

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  1. Respiration: low pass filter
  2. ECG
    1. Event -- clear option for biphasic (channel 9), remove positive/negative
    2. Negative QRS peaks:
      1. Remove qrs: clear -- are of type QRS peak -- defined ECG
      2. Analysis -- find cycle -- max threshold 0.25 mV (this may vary depending on hight of the peak) 
      3. Go to Selection -- -0.1 left edge -- 0.1 right edge current peak
      4. Go to Output -- Events -- Max: ECG, QRS peak (Under Hemodynamic -- ECG complex) Channel 9
        1. Click output
    3. Can also go to measurements and display
    4. Misses too many markers -- change BPM selection to none, change to another one
    5. Same step as before: Repeat steps for Analysis -- Find Cycle -- Events
    6. Output: Display measurement values as channels in graph
    7. Maximum: ECG, QRS peak
    8. For ECG: Remove label biphasic with icon right of < > -- clear, select channel 9
    9. For regular peaks: place QRS peaks -- make sure everything has the marker
  3. Analysis -- HRV/RSA -- HRA time series markers for respiration and heart rate -- Text Only
    1. Use flag inspire start expire start
    2. Look for a clear hump to place the markers
    3. Push marker closer to base of the hump for inspire start marker
    4. Selection alt key to move marker
    5. Check for humps that covary with peak from ECG, don’t place respiration marker for these instances
    6. Use the BPM channel with inspire and inspire start to double check the breathing rate. 
    7. Check the RSA (bpm HR channel) by comparing the inspire to inspire respiration cycle (channel).
    8. When placing inspire markers, only place at the lowest point on the respiration channel, and expire start on the highest, being cautious of intermediary bumps in OSA where we will NOT place the markers.



Data Analysis:


  1. HRV: open excel template

Figure 1

    1. Analysis -- HRV/RSA 

-1.Time domain; 2./5. Frequency Domain 3. RR point care -- take SD1,2,3 values and copy into excel -- text to columns 4. Use for excel sheet, save the values

- Multi-epoch HRV - Statistical/Multi-epoch HRV and RSA: Focus areas, spreadsheet, ECG channel

    1. Analysis -- Hemodynamics -- Choose option 5 for ECG interval: choose excel spreadsheet only -- copy and paste values onto excel (ECG) (figure 2)



Figure 2



































    1. Edit -- clipboard -- copy event summary -- then just paste into excel (no data sheet will pop up)

Figure 3


    1. Analysis -- Hemodynamics -- Choose option 6 for cardiac output: choose excel spreadsheet only -- copy and paste values onto excel (Channel 5 Blood Pressure) (figure 2), check baseline for male/female
    2. Choose arterial blood pressure from figure 2: Analysis -- Hemodynamics for Arterial Blood pressure (figure 4)
    3. Baroreflex sequence analysis, from figure 2 (analysis/hemo); Analyze focus areas only

Figure 4

    1. Baroreflex slope analysis from figure 2: copy all three sections, change range for ascending and descending if necessary
    2. Analysis — Electromyography — EMG frequency and power analysis (30 seconds, channel 11) — copy only the values onto analysis data sheet
    3. Electromyography — root mean square by selecting rest (focus area)
      1. Measurement channel (RMS EMG): Delta, Area, Slope, Mean, and Stddev — copy clipboard (right) 
    4. Electrodermal   — option 1, 3
    5. After locate SCRs: Measurement preset — turn off first two, even count (10) — EDA , mean Stddev from phasic EDA
    6. Skin temperature: just mean and Stddev and copy clipboard
    7. Analysis-> epoch analysis

Add: mean and std dev of skin temp, evt count of EDA, mean and std dev of phasic EDA, mean and std dev of RMS EMG.


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Severity OSA Analysis

  1. Mild OSA AHI 5-15
  2. Moderate OSA 15
  3. Severe OSA >15

Macey 2013


HR:

  1. Valsalva Ratio
  2. Tachycardia ratio
  3. Time to recovery
  4. Time to peak


Valsalva:

Why look at autonomic challenge

  • Challenges tell us how they function during rest or during the autonomic challenge
  • During wakeful periods
  • Problems in sympathetic activation
    • Want to know what’s happening brain
    • First what’s happening in physiological signals
    • I’m looking at just heart rate: oSA vs control
    • See if response varies
    • Problem in muscle tone -- problem with nerves controlling muscles
    • MRI measures BOLD: blood oxygen level -- oxygen binding in blood
  • Make sure to include why we care -treatment 



PVT preventricular contraction

Premature ventricular contraction

https://www.mayoclinic.org/diseases-conditions/premature-ventricular-contractions/symptoms-causes/syc-20376757

https://ecgwaves.com/topic/premature-ventricular-contractions-complex-beats-ecg/

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