TY  - JOUR
A1  - Wessel, Niels
A1  - Voss, Andreas
A1  - Malberg, Hagen
A1  - Ziehmann, Christine
A1  - Voss, Henning U.
A1  - Schirdewan, Alexander
A1  - Meyerfeldt, Udo
A1  - Kurths, Jürgen
T1  - Nonlinear analysis of complex phenomena in cardiological data
N2  - The main intention of this contribution is to discuss different nonlinear approaches to heart rate and blood pressure variability analysis for a better understanding of the cardiovascular regulation. We investigate measures of complexity which are based on symbolic dynamics, renormalised entropy and the finite time growth rates. The dual sequence method to estimate the baroreflex sensitivity and the maximal correlation method to estimate the nonlinear coupling between time series are employed for analysing bivariate data. The latter appears to be a suitable method to estimate the strength of the nonlinear coupling and the coupling direction. Heart rate and blood pressure data from clinical pilot studies and from very large clinical studies are analysed. We demonstrate that parameters from nonlinear dynamics are useful for risk stratification after myocardial infarction, for the prediction of life-threatening cardiac events even in short time series, and for modelling the relationship between heart rate and blood pressure regulation. These findings could be of importance for clinical diagnostics, in algorithms for risk stratification, and for therapeutic and preventive tools of next generation implantable cardioverter defibrillators.
Y1  - 2000
ER  - 
TY  - JOUR
A1  - Wessel, Niels
A1  - Schumann, Agnes
A1  - Wessel, Niels
A1  - Schumann, Agnes
A1  - Schirdewan, Alexander
A1  - Voss, Andreas
A1  - Kurths, Jürgen
T1  - Entropy measures in heart rate variability data
Y1  - 2000
ER  - 
TY  - JOUR
A1  - Wessel, Niels
A1  - Voss, Andreas
A1  - Kurths, Jürgen
A1  - Schirdewan, Alexander
A1  - Hnatkova, Katarina
A1  - Malik, Marek
T1  - Evaluation of renormalised entropy for risk stratification using heart rate variability data
N2  - 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.
Y1  - 2000
ER  - 
TY  - JOUR
A1  - Wessel, Niels
A1  - Ziehmann, Christine
A1  - Kurths, Jürgen
A1  - Meyerfeldt, Udo
A1  - Schirdewan, Alexander
A1  - Voss, Andreas
T1  - Short-term forecasting of life-threatening cardiac arrhythmias based on symbolic dynamics and finite-time growth rates
N2  - 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.
Y1  - 2000
ER  -