Simultaneous recording of arterial blood pressure, heart rate and ST segment in the ambulant patient: a new system

  • A. B. Davies
  • P. M. M. Cashman
  • V. Bala Subramanian
  • E. B. Raftery
Article
  • 24 Downloads

Abstract

A system developed for the accurate and simultaneous recording of blood pressure, heart rate and ST segment level in the unrestricted patient is described, with laboratory validation and experience of its clinical use. The recording system uses a brachial artery cannula, a transducer/perfusion unit and a miniature f.m.e.c.g. tape recorder (Oxford Medilog Mark II), one channel of which is modified to enable the recording of a blood pressure signal. Data are initially presented as analogue trend charts, with further detailed analysis being carried out by an automated digital system with interactive software enabling data editing and averaging. Laboratory evaluation demonstrated that the modified blood pressure channel had a satisfactory frequency response, linearity, signal-tonoise ratio, and temperature stability. Battery depletion produced a consistent increase in gain which could be compensated by repeated calibration throughout the period of recording. The system has been found to be reliable when used for recording periods of up to 24 h on patients with ischaemic heart disease.

Keywords

Ambulatory monitoring Blood pressure Data analysis E.c.g. Ischaemic heart disease ST segment Tape recording 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Bala Subramanian, V., Davies, A. B., Bowles, M. J. andRaftery, E. B. (1981)Ambulatory ST segment monitoring with frequency-modulated tape recorders—a review. Proceeding 4th International Symposium on Ambulatory Monitoring, Academic Press, 1982, 52–76.Google Scholar
  2. Bala Subramanian, V., Lahiri, A., Green, H. L., Stott, F. D. andRaftery, E. B. (1980) Ambulatory ST segment monitoring: problems, pitfalls, solutions and clinical applications.Br. Heart. J.,44, 419–425.Google Scholar
  3. Bala Subramanian, V., Raftery, E. B. andStott, F. D. (1979) Myocardial ischaemia in patients with frequent angina pectoris.Br. Med. J.,1, 198.Google Scholar
  4. Berson, A. S. andPipberger, H. V. (1966) The low frequency response of electrocardiographs, a frequent source of recording errors.Am. Heart J.,71, 779–789.CrossRefGoogle Scholar
  5. Bleifer, S. B. (1976) Clinical applications of Holter continuous electrocardiography.Postgrad. Med. J.,52 (Suppl. 7), 60–65.Google Scholar
  6. Bragg-Remschel, D. A., Anderson, C. M. andWinkle, R. A. (1982) Frequency response characteristics of ambulatory ECG monitoring systems and their implications for ST segment analysis.Am. Heart J.,103, 20–31.CrossRefGoogle Scholar
  7. Cashman, P. M. M., Stott, F. D. andMillar Craig, M. W. (1979) Hybrid system for fast data reduction of long-term blood-pressure recordings.Med. & Biol. Eng. & Comput.,17, 629–635.Google Scholar
  8. Corday, E., Bazika, V., Lang, T-W., Pappelbaum, S., Gold, H. andBernstein, H. (1965) Detection of phantom arrhythmias and evanescent electrocardiographic abnormalities.J. Amer. Med. Assoc.,193, 79–83.Google Scholar
  9. Davies, A. B. (1982) Simultaneous recording of arterial blood pressure, ST segment and heart rate during exercise and environmental stress in ambulant patients with severe angina. M.D. Thesis, London University.Google Scholar
  10. De Looy, A. E. (1973) Socially acceptable measurement of energy expenditure in man. Ph.D. Thesis, London University, 115–166.Google Scholar
  11. Geddes, L. A. (1970)The direct and indirect measurement of blood pressure. Year Book Medical Publ., Chicago, 46.Google Scholar
  12. Goldberg, A. D., Raftery, E. B. andGreen, H. L. (1976) The Oxford continuous blood pressure recordertechnical and clinical evaluation.Postgrad. Med. J.,52 (Suppl. 7), 104–109.Google Scholar
  13. Hinkle, L. E., Meyer, J., Stevens, M. andCarver, S. T. (1967) Limitations and advantages of the Holter-Avionics instruments.Circulation,36, 752–765.Google Scholar
  14. Holter, N. J. (1961) New method for heart studies.Science,134, 1214–1220.Google Scholar
  15. Krasnow, A. Z. andBloomfield, D. K. (1976) Artefacts in portable electrocardiographic monitoring.Am. Heart J.,91, 349–357.Google Scholar
  16. Littler, W. A., Honour, A. J., Sleight, P. andStott, F. D. (1973) Direct arterial pressure and the electrocardiogram in unrestricted patients with angina pectoris.Circulation,48, 125–134.Google Scholar
  17. Millar Craig, M. W., Hawes, D. andWhittington, J. (1978) New system for recording ambulatory blood pressure in man.Med. & Biol. Eng. & Comput.,16, 727–731.Google Scholar
  18. Norland, C. C. andSemler, H. J. (1964) Angina pectoris and arrhythmias monitored by telemetry.J. Amer. Med. Assoc.,190, 115–118.Google Scholar
  19. Robinson, B. F. (1967) Relation of heart rate and systolic blood pressure to the onset of pain in angina pectoris.Circulation,35, 1073–1083.Google Scholar
  20. Selwyn, A. P., Fox, K., Eves, M., Oakley, D., Dargie, H. andShillingford, J. (1978) Myocardial ischaemia in patients with frequent angina pectoris,Br. Med. J.,2, 1594–1596.CrossRefGoogle Scholar
  21. Stern, S. andTzivoni, D. (1972) The reliability of the Holter-Avionics system in reproducing the ST-T segment.Am. Heart J.,84, 427–428.CrossRefGoogle Scholar

Copyright information

© IFMBE 1983

Authors and Affiliations

  • A. B. Davies
    • 1
    • 2
  • P. M. M. Cashman
    • 1
    • 2
  • V. Bala Subramanian
    • 1
    • 2
  • E. B. Raftery
    • 1
    • 2
  1. 1.The Department of CardiologyNorthwick Park Hospital & Clinical Research CentreHarrowEngland
  2. 2.Divisions of Bioengring and Clinical SciencesNorthwick Park Hospital & Clinical Research CentreHarrowEngland

Personalised recommendations