@article{MarwanWesselMeyerfeldtetal.2002, author = {Marwan, Norbert and Wessel, Niels and Meyerfeldt, Udo and Schirdewan, Alexander and Kurths, J{\"u}rgen}, title = {Recurrence-plot-based measures of complexity and its application to heart-rate-variability data}, year = {2002}, abstract = {The knowledge of transitions between regular, laminar or chaotic behavior is essential to understand the underlying mechanisms behind complex systems. While several linear approaches are often insufficient to describe such processes, there are several nonlinear methods which however require rather long time observations. To overcome these difficulties, we propose measures of complexity based on vertical structures in recurrence plots and apply them to the logistic map as well as to heart rate variability data. For the logistic map these measures enable us not only to detect transitions between chaotic and periodic states, but also to identify laminar states, i.e. chaos-chaos transitions. The traditional recurrence quantification analysis fails to detect the latter transitions. Applying our new measures to the heart rate variability data, we are able to detect and quantify the laminar phases before a life-threatening cardiac arrhythmia occurs thereby facilitating a prediction of such an event. Our findings could be of importance for the therapy of malignant cardiac arrhythmias.}, language = {en} } @article{WesselSchwarzSaparinetal.2002, author = {Wessel, Niels and Schwarz, Udo and Saparin, Peter and Kurths, J{\"u}rgen}, title = {Symbolic dynamics for medical data analysis}, isbn = {3-936142-09-2}, year = {2002}, abstract = {Observational data of natural systems, as measured in medical measurements are typically quite different from those obtained in laboratories. Due to the peculiarities of these data, wellknown characteristics, such as power spectra or fractal dimension, often do not provide a suitable description. To study such data, we present here some measures of complexity, which are basing on symbolic dynamics. Firstly, a motivation for using symbolic dynamics and measures of complexity in data analysis based on the logistic map is given and next, two applications to medical data are shown. We demonstrate that symbolic dynamics is a useful tool for the risk assessment of patients after myocardial infarction as well as for the evaluation of th e architecture of human cancellous bone.}, language = {en} } @article{WesselMarwanMeyerfeldtetal.2001, author = {Wessel, Niels and Marwan, Norbert and Meyerfeldt, Udo and Schirdewan, Alexander and Kurths, J{\"u}rgen}, title = {Recurrence quantification analysis to characterise the heart rate variability before the onset of ventricular tachycardia}, year = {2001}, abstract = {Ventricular tachycardia or fibrillation (VT) as fatal cardiac arrhythmias are the main factors triggering sudden cardiac death. The objective of this recurrence quantification analysis approach is to find early signs of sustained VT in patients with an implanted cardioverter-defibrillator (ICD). These devices are able to safeguard patients by returning their hearts to a normal rhythm via strong defibrillatory shocks; additionally, they are able to store at least 1000 beat-to-beat intervals immediately before the onset of a life-threatening arrhythmia. We study the}, language = {en} } @article{WesselVossKurthsetal.2000, author = {Wessel, Niels and Voss, Andreas and Kurths, J{\"u}rgen and Schirdewan, Alexander and Hnatkova, Katarina and Malik, Marek}, title = {Evaluation of renormalised entropy for risk stratification using heart rate variability data}, year = {2000}, abstract = {Standard time and frequency parameters of heart rate variability (HRV) describe only linear and periodic behaviour, whereas more complex relationships cannot be recognised. A method that may be capable of assessing more complex properties is the non-linear measure of 'renormalised entropy.' A new concept of the method, RE(AR), has been developed, based on a non-linear renormalisation of autoregressive spectral distributions. To test the hypothesis that renormalised entropy may improve the result of high-risk stratification after myocardial infarction, it is applied to a clinical pilot study (41 subjects) and to prospective data of the St George's Hospital post- infarction database (572 patients). The study shows that the new RE(AR) method is more reproducible and more stable in time than a previously introduced method (p<0.001). Moreover, the results of the study confirm the hypothesis that on average, the survivors have negative values of RE(AR) (-0.11+/-0.18), whereas the non-survivors have positive values (0.03+/-0.22, p<0.01). Further, the study shows that the combination of an HRV triangular index and RE(AR) leads to a better prediction of sudden arrhythmic death than standard measurements of HRV. In summary, the new RE(AR) method is an independent measure in HRV analysis that may be suitable for risk stratification in patients after myocardial infarction.}, language = {en} } @article{WesselZiehmannKurthsetal.2000, author = {Wessel, Niels and Ziehmann, Christine and Kurths, J{\"u}rgen and Meyerfeldt, Udo and Schirdewan, Alexander and Voss, Andreas}, title = {Short-term forecasting of life-threatening cardiac arrhythmias based on symbolic dynamics and finite-time growth rates}, year = {2000}, abstract = {Ventricular tachycardia or fibrillation (VT-VF) as fatal cardiac arrhythmias are the main factors triggering sudden cardiac death. The objective of this study is to find early signs of sustained VT-VF in patients with an implanted cardioverter-defibrillator (ICD). These devices are able to safeguard patients by returning their hearts to a normal rhythm via strong defibrillatory shocks; additionally, they store the 1000 beat-to-beat intervals immediately before the onset of a life-threatening arrhythmia. We study these 1000 beat-to-beat intervals of 17 chronic heart failure ICD patients before the onset of a life-threatening arrhythmia and at a control time, i.e., without a VT-VF event. To characterize these rather short data sets, we calculate heart rate variability parameters from the time and frequency domain, from symbolic dynamics as well as the finite-time growth rates. We find that neither the time nor the frequency domain parameters show significant differences between the VT-VF and the control time series. However, two parameters from symbolic dynamics as well as the finite-time growth rates discriminate significantly both groups. These findings could be of importance in algorithms for next generation ICD's to improve the diagnostics and therapy of VT-VF.}, language = {en} } @article{RiedlvanLeeuwenSuhrbieretal.2009, author = {Riedl, Maik and van Leeuwen, Peter Jan and Suhrbier, Alexander and Malberg, Hagen and Groenemeyer, Dietrich and Kurths, J{\"u}rgen and Wessel, Niels}, title = {Testing foetal-maternal heart rate synchronization via model-based analyses}, issn = {1364-503X}, doi = {10.1098/rsta.2008.0277}, year = {2009}, abstract = {The investigation of foetal reaction to internal and external conditions and stimuli is an important tool in the characterization of the developing neural integration of the foetus. An interesting example of this is the study of the interrelationship between the foetal and the maternal heart rate. Recent studies have shown a certain likelihood of occasional heart rate synchronization between mother and foetus. In the case of respiratory-induced heart rate changes, the comparison with maternal surrogates suggests that the evidence for detected synchronization is largely statistical and does not result from physiological interaction. Rather, they simply reflect a stochastic, temporary stability of two independent oscillators with time-variant frequencies. We reanalysed three datasets from that study for a more local consideration. Epochs of assumed synchronization associated with short-term regulation of the foetal heart rate were selected and compared with synchronization resulting from white noise instead of the foetal signal. Using data-driven modelling analysis, it was possible to identify the consistent influence of the heartbeat duration of maternal beats preceding the foetal beats during epochs of synchronization. These maternal beats occurred approximately one maternal respiratory cycle prior to the affected foetal beat. A similar effect could not be found in the epochs without synchronization. Simulations based on the fitted models led to a higher likelihood of synchronization in the data segments with assumed foetal-maternal interaction than in the segment without such assumed interaction. We conclude that the data-driven model-based analysis can be a useful tool for the identification of synchronization.}, language = {en} } @article{RetzlaffBauernschmittMalbergetal.2009, author = {Retzlaff, Beatrice and Bauernschmitt, Robert and Malberg, Hagen and Brockmann, Gernot and Uhl, Christian and Lange, Ruediger and Kurths, J{\"u}rgen and Bretthauer, Georg and Wessel, Niels}, title = {Depression of cardiovascular autonomic function is more pronounced after mitral valve surgery : evidence for direct trauma}, issn = {1364-503X}, doi = {10.1098/rsta.2008.0272}, year = {2009}, abstract = {The analysis of baroreflex sensitivity (BRS) and heart rate variability (HRV) leads to additional insights into patients' prognosis after cardiovascular events. The following study was performed to assess the differences in the post-operative recovery of autonomic regulation after mitral valve (MV) and aortic valve (AV) surgery with a heart lung machine. Among the 43 consecutive male patients enrolled in a prospective study, 26 underwent isolated AV surgery and 17 isolated MV surgery. Blood pressure as well as ECG signals were recorded the day before, 24 hours after and one week after surgery. BRS was calculated according to the dual sequence method, and HRV was calculated using standard linear as well as nonlinear parameters. There were no major differences between the two groups in the pre-operative values. At 24 hours a comparable depression of HRV and BRS in both groups was observed, while at 7 days there was partial recovery in AV patients, which was absent in MV patients: p(AV versus MV) < 0.001. While the response of the autonomic system to surgery is similar in AV and MV patients, there is obviously a decreased ability to recover in MV patients, probably attributed to traumatic lesions of the autonomic nervous system by opening the atria. Ongoing research is required for further clarification of the pathophysiology of this phenomenon and to establish strategies to restore autonomic function.}, language = {en} } @article{WesselRiedlKurths2009, author = {Wessel, Niels and Riedl, Maik and Kurths, J{\"u}rgen}, title = {Is the normal heart rate "chaotic" due to respiration?}, issn = {1054-1500}, doi = {10.1063/1.3133128}, year = {2009}, abstract = {The incidence of cardiovascular diseases increases with the growth of the human population and an aging society, leading to very high expenses in the public health system. Therefore, it is challenging to develop sophisticated methods in order to improve medical diagnostics. The question whether the normal heart rate is chaotic or not is an attempt to elucidate the underlying mechanisms of cardiovascular dynamics and therefore a highly controversial topical challenge. In this contribution we demonstrate that linear and nonlinear parameters allow us to separate completely the data sets of the three groups provided for this controversial topic in nonlinear dynamics. The question whether these time series are chaotic or not cannot be answered satisfactorily without investigating the underlying mechanisms leading to them. We give an example of the dominant influence of respiration on heart beat dynamics, which shows that observed fluctuations can be mostly explained by respiratory modulations of heart rate and blood pressure (coefficient of determination: 96\%). Therefore, we recommend reformulating the following initial question: "Is the normal heart rate chaotic?" We rather ask the following: " Is the normal heart rate 'chaotic' due to respiration?"}, language = {en} } @article{PortaDiRienzoWesseletal.2009, author = {Porta, Alberto and Di Rienzo, Marco and Wessel, Niels and Kurths, J{\"u}rgen}, title = {Addressing the complexity of cardiovascular regulation}, issn = {1364-503X}, doi = {10.1098/rsta.2008.0292}, year = {2009}, language = {en} }