A Novel Adaptive Noise Elimination Algorithm in Long RR Interval Sequences for Heart Rate Variability Analysis.

As heart rate variability (HRV) studies become more and more prevalent in clinical practice, one of the most common and significant causes of errors is associated with distorted RR interval (RRI) data acquisition. The nature of such artifacts can be both mechanical as well as software based. Various currently used noise elimination in RRI sequences methods use filtering algorithms that eliminate artifacts without taking into account the fact that the whole RRI sequence time cannot be shortened or lengthened. Keeping that in mind, we aimed to develop an artifacts elimination algorithm suited to long-term (hours or days) sequences that does not affect the overall structure of the RRI sequence and does not alter the duration of data registration. An original adaptive smart time series step-by-step analysis and statistical verification methods were used. The adaptive algorithm was designed to maximize the reconstruction of the heart-rate structure and is suitable for use, especially in polygraphy. The authors submit the scheme and program for use.

Monopolar electrocautery use in minimally invasive urosurgery: Case report of ectopic ureter management in a bitch.

Background: Ureteral ectopy is a congenital anomaly, affecting young dogs, predominantly bitches. The main complication of the disease is urinary incontinence, which leads to low life quality for both animals and their owners. However, only two less invasive surgical management options are reported. Laser ablation is quite popular, while monopolar electrocautery use is very rare. Case Description: A 3-month and 1-week-old, 1.7 kg female Poodle was admitted to the Vetamicus clinic with severe urinary incontinence and moisture-associated dermatitis. After diagnosing intramural ectopy type during computed tomography scan and video cystoscopy, a search for surgical management options began. We proceeded with the monopolar cauterization technique, where a semirigid Karl Storz monopolar coagulating ball electrode is used to cut a mucous membrane partition between the ureter and urinary bladder. No complications occurred during or after the surgery. Ureter successfully healed and full continence was achieved together with sporadically using phenylpropanolamine syrup. Conclusion: The present case indicates that monopolar electrocautery use in intramural ectopy type management and possibly other urinary tract pathologies might be strongly beneficial.

Daily Heart Rate Variability Indices in Subjects with and Without Metabolic Syndrome Before and After the Elimination of the Influence of Day-Time Physical Activity.

Background and Objectives: The available research shows conflicting data on the heart rate variability (HRV) in metabolic syndrome (MetS) subjects. The discrepancy suggests a methodical shortcoming: due to the influence of physical activity, the standard measuring of HRV at rest is not comparable with HRV assessment based on 24h Holter monitoring, which is preferred because of its comprehensiveness. To obtain a more reliable measure and to clarify to what extent HRV is altered in MetS, we assessed a 24h HRV before and after the elimination of the influence of physical activity. Materials and Methods: We investigated 69 metabolic syndrome (MetS) and 37 control subjects, aged 50-55. In all subjects, 24h monitoring of electrocardiogram, blood pressure, and actigraphy profiles were conducted. To eliminate the influence of day-time physical activity on RR intervals (RRI), a linear polynomial autoregressive model with exogenous terms (ARX) was used. Standard spectral RRI analysis was performed. Results: Subjects with MetS had blunted HRV; the diurnal SDNN index was reliably lower in the MetS group than in control subjects. The elimination of the influence of physical activity did not reveal a significant HRV change in long-term indices (SDNN, SDANN, and SD2), whilst adjacent RRI values (RMSSD, pNN50, and SD1) and SDNN index significantly increased (p < 0.001). An increase in the latter indices highlighted the HRV difference between the MetS and control groups; a significant (p < 0.001) decrease of all short-term HRV variables was found in the MetS group (p < 0.01), and low-frequency spectral components were less pronounced in the MetS group. Conclusion: The application of a polynomial autoregressive model in 24h HRV assessment allowed for the exclusion of the influence of physical activity and revealed that MetS is associated with blunted HRV, which reflects mitigated parasympathetic tone.