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Jou
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Com
p
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g
(
I
JE
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Vol.
15
,
No.
1
,
F
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br
ua
r
y
20
25
,
pp.
243
~
251
I
S
S
N:
2088
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8708
,
DO
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.
11591/i
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K
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w
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d
s
:
B
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c
ha
nics
C
a
r
diovas
c
ular
E
ndoc
a
r
dial
pr
e
s
s
ur
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P
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is
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S
e
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s
Th
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s
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s
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n
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ces
s
a
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t
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c
l
e
u
n
d
e
r
t
h
e
CC
B
Y
-
SA
l
i
ce
n
s
e.
C
or
r
e
s
pon
din
g
A
u
th
or
:
Nida
l
T
ur
a
b
De
pa
r
tm
e
nt
of
Ne
twor
ks
a
nd
C
ybe
r
S
e
c
ur
it
y
,
F
a
c
ult
y
of
I
nf
o
r
mation
T
e
c
hnology
,
Al
-
Ahliyya
Amma
n
Unive
r
s
it
y
Amman
19328,
J
or
da
n
E
mail:
n
.
tur
a
b@a
mm
a
nu.
e
du
.
jo
1.
I
NT
RODU
C
T
I
ON
I
t
is
wide
ly
a
c
knowle
dge
d
that
c
a
r
diovas
c
ular
d
i
s
e
a
s
e
(
C
VD
)
a
nd
it
s
potential
c
ompl
ica
ti
ons
a
r
e
a
mong
the
lea
ding
c
a
us
e
s
of
de
a
th
wor
ldwide
[
1]
.
T
his
f
igur
e
is
p
r
ojec
ted
to
incr
e
a
s
e
a
nnua
ll
y
unti
l
i
t
r
e
a
c
he
s
23.
6
mi
ll
ion
by
2030
[
2
]
.
T
he
ter
m
“
c
a
r
diovas
c
ular
dis
or
de
r
s
”
is
us
e
d
to
de
s
c
r
ibe
a
g
r
oup
of
a
bnor
mal
s
ympt
oms
[
3]
,
[
4
]
.
All
of
thes
e
c
ondit
ions
a
r
e
not
or
ious
f
or
the
de
va
s
tating
tol
l
they
take
on
human
li
f
e
a
nd
he
a
lt
h,
a
nd
young
a
dult
s
ha
ve
take
n
c
e
nter
s
tage
i
n
r
e
c
e
nt
ye
a
r
s
[
5]
,
[
6]
.
T
his
is
be
c
a
us
e
li
f
e
s
tyl
e
f
a
c
tor
s
li
ke
be
ing
ove
r
we
ight
,
e
a
ti
ng
poo
r
ly,
a
r
e
major
c
on
tr
ibut
or
s
to
the
de
ve
lopm
e
nt
of
c
a
r
diovas
c
ular
dis
e
a
s
e
.
P
r
e
ve
nti
ng
mos
t
de
a
ths
f
r
om
c
a
r
diovas
c
ular
dis
e
a
s
e
r
e
quir
e
s
e
a
r
ly
obs
e
r
va
ti
on,
whic
h
c
a
n
lea
d
t
o
ti
mely
int
e
r
ve
nti
ons
li
ke
im
pr
ove
d
medic
a
ti
on
a
dmi
nis
tr
a
ti
on
a
nd
he
a
lt
h
c
a
r
e
de
li
ve
r
y
[
6]
–
[
9
]
.
He
a
r
t
dis
e
a
s
e
tr
e
a
tm
e
nt
today
is
a
long
-
ter
m
pr
oc
e
s
s
,
but
r
e
gul
a
r
c
he
c
k
-
ups
c
a
n
s
igni
f
ica
ntl
y
r
e
duc
e
the
li
ke
li
h
ood
that
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
S
N
:
2088
-
8708
I
nt
J
E
lec
&
C
omp
E
ng
,
Vol
.
15
,
No.
1
,
F
e
br
ua
r
y
20
25
:
243
-
251
244
s
ympt
oms
will
r
e
tur
n.
C
VD
c
a
n
be
a
c
c
ur
a
tely
identif
ied
by
a
va
r
iety
of
im
a
ging
tec
hniques
us
e
d
in
c
li
nica
l
s
e
tt
ings
,
a
r
ter
iogr
a
phy,
c
omput
e
d
tom
og
r
a
phy
(
C
T
)
,
a
nd
other
s
[
10
]
–
[
13]
.
T
he
r
e
f
or
e
,
to
thi
s
da
y
,
a
major
ba
r
r
ier
to
pr
o
mot
in
g
indi
vidualize
d
he
a
lt
h
c
a
r
e
s
ys
tems
ha
s
be
e
n
the
lac
k
of
inexpe
ns
ive.
I
mp
r
ove
ments
in
the
a
c
c
ur
a
c
y
a
nd
c
onve
nienc
e
of
pr
e
s
s
ur
e
s
e
ns
or
s
de
s
igned
f
or
us
e
in
we
a
r
a
ble
de
vice
s
ha
ve
be
e
n
notable
ove
r
the
pa
s
t
f
e
w
de
c
a
de
s
.
T
e
c
hnology
a
dva
nc
e
ments
ha
ve
a
ll
ow
e
d
thes
e
s
e
ns
or
s
to
be
us
e
d
in
a
non
-
invas
ive,
24/7
c
a
pa
c
it
y
f
or
moni
tor
ing
[
14]
,
[
15]
.
Us
ing
thes
e
bi
omedic
a
l
indi
c
a
tor
s
f
or
a
c
c
ur
a
te
c
a
r
diovas
c
ular
c
ondit
ion
a
s
s
e
s
s
ment
pa
v
e
s
the
wa
y
f
or
a
pe
r
s
ona
li
z
e
d
h
e
a
lt
hc
a
r
e
s
ys
tem
with
im
pr
ove
d
he
a
lt
h
outcome
s
,
e
a
s
e
of
us
e
,
qua
li
ty,
a
nd
c
os
t
that
is
e
s
s
e
nti
a
l
f
or
r
e
duc
ing
the
incide
nc
e
a
nd
mor
talit
y
r
a
tes
a
s
s
oc
iate
d
with
C
VD
[
11]
,
[
13]
.
A
gr
e
a
t
de
a
l
of
r
e
s
e
a
r
c
h
ha
s
be
e
n
done
on
biom
e
c
ha
nica
l
de
vice
s
f
or
de
tec
ti
ng
[
12]
to
c
oll
e
c
t
phys
iol
ogica
l
da
ta
r
e
late
d
to
the
he
a
r
t.
I
n
f
or
mation
r
e
f
lec
ti
ve
c
a
n
be
obtaine
d
dir
e
c
tl
y
thr
ough
b
iom
e
c
ha
nica
l
methods
by
a
tt
a
c
hing
[
16]
.
B
e
c
a
us
e
of
thi
s
,
pr
e
s
s
ur
e
wa
ve
s
c
a
n
be
r
e
f
lec
ted
wi
thi
n
the
va
s
c
ular
s
y
s
tem.
T
o
top
it
a
ll
o
f
f
,
they
a
r
e
s
igni
f
ica
ntl
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mor
e
e
f
f
icie
nt
be
c
a
us
e
they
ope
r
a
te
on
a
powe
r
r
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nge
that
typi
c
a
ll
y
f
a
ll
s
be
twe
e
n
na
nowa
tt
s
a
nd
mi
c
r
owa
tt
s
.
M
or
e
ove
r
,
a
ddit
ional
inf
or
mation
a
bout
the
pa
ti
e
nt
c
a
n
be
inf
e
r
r
e
d
f
r
om
thi
s
r
e
lations
hip,
whic
h
a
ids
in
the
d
iagnos
is
of
c
a
r
diovas
c
ular
dis
e
a
s
e
s
[
11]
,
[
17]
.
T
his
a
r
ti
c
le
dis
c
us
s
e
s
ne
w
he
a
r
t
a
nd
lung
mec
ha
nica
l
s
e
ns
or
s
.
T
he
f
ir
s
t
s
e
c
ti
on
de
s
c
r
ibes
f
ou
r
popular
mec
ha
nica
l
s
e
ns
or
s
a
nd
their
f
unc
ti
ona
li
ty.
Ne
xt,
vit
a
l
s
ign
tr
a
c
king
methods
a
nd
c
a
r
dio
va
s
c
ular
s
ys
tem
phys
io
-
mec
ha
ni
c
a
l
f
e
a
tur
e
s
a
r
e
dis
c
us
s
e
d.
E
ne
r
gy
-
wis
e
,
s
witching
f
r
om
ba
tt
e
r
y
-
powe
r
e
d
to
s
e
lf
-
powe
r
e
d
s
e
n
s
or
s
a
r
e
c
ons
ider
e
d.
T
he
s
e
s
s
ion
c
onc
ludes
with
a
br
ief
ove
r
view
of
incr
e
a
s
e
d
c
a
r
dio
va
s
c
ular
s
ys
tem
moni
tor
ing.
T
he
pu
r
pos
e
is
to
s
a
f
e
gua
r
d
c
a
r
diovas
c
ular
he
a
lt
h.
2.
B
I
OME
CHAN
I
CA
L
F
UN
CT
I
ON
I
N
T
HE
CA
RD
I
OVASCUL
AR
S
YST
E
M
T
he
biom
e
c
ha
nica
l
f
unc
ti
on
in
the
c
a
r
diovas
c
ular
s
ys
tem
invol
ve
s
the
mec
ha
nica
l
f
or
c
e
s
a
nd
pr
inciples
that
r
e
gulate
the
he
a
r
t
a
nd
blood
ve
s
s
e
ls
,
e
ns
ur
ing
e
f
f
icie
nt
blood
c
ir
c
ulation
thr
oughout
t
he
body.
T
his
include
s
the
dyna
mi
c
s
of
blood
f
low
(
he
mo
dyna
mi
c
s
)
,
whe
r
e
the
he
a
r
t
ge
ne
r
a
tes
the
f
or
c
e
n
e
e
de
d
to
pr
ope
l
blood
,
a
nd
the
blood
ve
s
s
e
ls
,
pa
r
ti
c
ular
ly
a
r
ter
ies
,
mana
ge
the
pr
e
s
s
ur
e
a
nd
r
e
s
is
tanc
e
.
T
he
e
las
ti
c
it
y
a
nd
s
tr
e
ngth
o
f
thes
e
ve
s
s
e
ls
a
r
e
c
r
uc
ial
f
or
with
s
tanding
a
nd
a
da
pti
ng
to
the
c
onti
nuous
mec
ha
ni
c
a
l
load.
Additi
ona
ll
y,
the
he
a
r
t's
a
bil
it
y
to
c
ont
r
a
c
t
a
n
d
r
e
lax
e
f
f
e
c
ti
ve
ly
is
e
s
s
e
nti
a
l
f
or
maintainin
g
pr
ope
r
c
ir
c
ulation,
while
the
s
tr
uc
tur
a
l
in
tegr
it
y
of
the
va
s
c
ular
wa
ll
s
is
vit
a
l
f
or
r
e
s
ponding
to
the
mec
ha
nica
l
s
tr
e
s
s
e
s
of
blood
f
low
.
Unde
r
s
tanding
thes
e
bio
mec
ha
nica
l
f
unc
ti
ons
is
ke
y
to
a
ddr
e
s
s
ing
c
a
r
diovas
c
ular
he
a
lt
h
a
nd
de
ve
lopi
ng
e
f
f
e
c
ti
ve
medic
a
l
int
e
r
ve
nti
ons
[
18]
–
[
20]
.
I
t
is
no
r
mally
pe
r
c
e
ived
a
s
a
pr
e
s
s
ur
e
wa
ve
s
.
T
he
two
mos
t
p
r
omi
ne
nt
f
e
a
tur
e
s
o
f
a
puls
e
wa
v
e
a
r
e
i
ts
pe
a
k
a
nd
it
s
tr
ough.
As
s
hown
by
the
a
s
c
e
nding
br
a
nc
h,
the
a
r
ter
y
s
we
ll
s
dr
a
matica
ll
y
du
r
ing
ve
nt
r
i
c
ular
s
ys
tol
e
,
while
dur
ing
ve
ntr
icula
r
dias
tol
e
it
c
ontr
a
c
ts
.
3.
S
E
NSI
NG
CA
RD
I
AC
AC
T
I
VI
T
Y:
T
HE
B
ASI
C
CONC
E
P
T
M
e
c
ha
nica
l
methods
f
or
moni
tor
ing
c
a
r
d
iovas
c
ular
phys
iol
ogica
l
pa
r
a
mete
r
s
typi
c
a
ll
y
e
mpl
oy
s
tr
e
tcha
ble
s
e
ns
or
s
li
ke
s
tr
a
in
s
e
ns
or
s
a
nd
p
r
e
s
s
ur
e
s
e
ns
or
s
,
e
it
he
r
im
plante
d
o
r
wor
n
by
the
pa
ti
e
nt.
F
igur
e
1
(
s
e
e
in
Appe
ndix)
de
picts
the
va
r
ious
ba
s
ic
s
e
ns
ing
tec
hniques
us
e
d
by
thes
e
de
vic
e
s
.
T
he
s
e
include
piez
or
e
s
is
ti
ve
,
piez
oe
lec
tr
ic,
t
r
iboele
c
tr
ic,
a
nd
c
a
p
a
c
it
ive.
T
he
piez
or
e
s
is
ti
ve
s
e
ns
or
is
ba
s
e
d
on
the
pr
inciple
of
the
piez
or
e
s
is
ti
ve
e
f
f
e
c
t.
T
he
piez
or
e
s
is
ti
ve
e
f
f
e
c
t
de
s
c
r
ibes
how
the
output
e
lec
tr
ica
l
im
puls
e
c
ha
nge
s
whe
n
the
pr
e
s
s
ur
e
on
a
mate
r
ial
that
r
e
s
is
ts
e
lec
tr
icity
c
ha
nge
s
.
Alter
a
ti
ons
to
buil
dings
’
e
lec
tr
ica
l
r
e
s
is
tanc
e
due
to
higher
pr
e
s
s
ur
e
a
c
ti
ng
on
diele
c
tr
ic
mate
r
ials
a
r
e
a
nother
method
of
de
tec
ti
on.
T
he
r
e
s
is
tanc
e
of
piez
or
e
s
is
ti
ve
im
pa
c
t
s
e
ns
or
s
is
a
lt
e
r
e
d
whe
n
a
n
e
xter
na
l
f
or
c
e
de
f
or
ms
the
diele
c
tr
ic
mate
r
ial
[
21]
–
[
2
5]
.
4.
M
ONI
T
ORI
NG
OF
CA
RD
I
OVASCUL
AR
P
H
YSI
OL
OG
I
CA
L
M
E
ASURE
M
E
NT
S
Although
the
phys
iol
ogy
of
the
he
a
r
t
a
nd
blood
ve
s
s
e
ls
i
s
c
ompl
e
x,
their
pr
im
a
r
y
pur
pos
e
is
c
lea
r
:
to
c
a
r
r
y
oxyge
n
-
r
ich
blood
to
the
body
’
s
vit
a
l
or
ga
n
s
a
nd
ti
s
s
ue
s
.
T
he
he
a
r
t's
f
unc
ti
on
a
s
a
pump
is
c
r
uc
ial
to
thi
s
pr
oc
e
dur
e
.
T
he
te
r
m
“
c
a
r
diac
c
yc
le
”
is
us
e
d
to
de
s
c
r
ibe
the
e
nti
r
e
s
e
que
nc
e
of
e
ve
nts
that
tak
e
s
plac
e
be
twe
e
n
the
be
ginni
ng
of
one
ve
ntr
icula
r
s
ys
tol
e
a
nd
the
be
ginni
ng
of
the
ne
xt.
S
o
,
it
i
s
im
po
r
tant
to
ke
e
p
a
n
e
ye
on
your
blood
pr
e
s
s
ur
e
,
your
he
a
r
t
r
a
te,
a
nd
other
biom
e
c
ha
nica
l
pr
oc
e
s
s
e
s
ha
pp
e
ning
in
your
c
a
r
diovas
c
ular
s
ys
tem
[
26]
,
[
27]
.
4.
1.
B
lood
p
r
e
s
s
u
r
e
High
blood
pr
e
s
s
ur
e
ha
s
s
e
r
ious
c
on
s
e
que
nc
e
s
f
or
the
c
a
r
diovas
c
ular
s
ys
tem.
S
ince
blood
is
a
tur
bulent,
vis
c
ous
f
lui
d
in
the
a
or
ta's
f
lexible
c
a
pil
l
a
r
ies
,
mos
t
of
the
e
ne
r
gy
tr
a
ns
f
e
r
oc
c
ur
s
in
the
wa
ll
s
of
the
ve
s
s
e
l
s
[
28]
,
[
29]
.
B
oth
va
s
oc
ons
tr
iction
a
nd
dias
tol
e
,
whic
h
a
f
f
e
c
t
blood
volum
e
,
inf
luenc
e
the
pr
e
s
s
ur
e
Evaluation Warning : The document was created with Spire.PDF for Python.
I
nt
J
E
lec
&
C
omp
E
ng
I
S
S
N:
2088
-
8708
N
ar
r
ati
v
e
r
e
v
ie
w
of
the
li
ter
atur
e
:
appli
c
ati
on
of
me
c
hanical
s
e
lf
pow
e
r
e
d
s
e
n
s
or
s
…
(
Ham
z
a
A
bu
Ow
ida
)
245
puls
a
ti
ons
withi
n
the
ve
s
s
e
ls
.
Aus
c
ult
a
tor
y
a
nd
o
s
c
il
lom
e
tr
ic
pr
oc
e
dur
e
s
a
r
e
the
s
tanda
r
d
in
c
li
nic
a
l
blood
pr
e
s
s
ur
e
mea
s
ur
e
ment.
T
wo
methods
[
18
]
,
[
19]
e
xis
t
f
or
mea
s
ur
ing
a
bs
olut
e
a
ir
pr
e
s
s
ur
e
,
bo
th
o
f
whic
h
invol
ve
inf
lating
a
c
uf
f
with
a
c
omp
r
e
s
s
or
a
nd
m
onit
or
ing
the
r
e
s
ult
ing
ga
s
pr
e
s
s
ur
e
with
a
pr
e
s
s
ur
e
ga
uge
.
As
s
umi
ng
that
the
pr
e
s
s
ur
e
mea
s
ur
e
d
a
t
the
b
r
a
c
hi
a
l
a
r
ter
y
a
c
c
ur
a
tely
r
e
f
lec
ts
the
pr
e
s
s
ur
e
a
t
the
a
o
r
t
ic
va
lve,
a
ll
that
is
ne
e
de
d
to
obtain
a
pe
r
s
on's
a
ve
r
a
ge
blood
pr
e
s
s
ur
e
(
B
P
)
r
e
a
ding
is
a
blood
pr
e
s
s
ur
e
c
uf
f
mea
s
ur
e
ment.
I
t
c
a
n't
be
mea
s
ur
e
d
in
r
e
a
l
ti
me
de
s
pit
e
be
ing
s
im
ple
to
us
e
a
nd
low
-
maintena
nc
e
.
S
ince
r
e
a
l
-
ti
me
moni
tor
ing
of
blood
p
r
e
s
s
ur
e
is
now
pos
s
ibl
e
,
the
mos
t
a
c
c
ur
a
te
method
o
f
mea
s
ur
ing
blood
pr
e
s
s
ur
e
is
to
inj
e
c
t
a
pr
e
s
s
ur
e
s
e
ns
or
int
o
the
a
or
t
a
[
28]
.
N
o
ne
th
e
l
e
s
s
,
th
is
met
ho
d
c
a
n
't
b
e
us
e
d
f
o
r
lo
n
g
-
te
r
m
m
o
ni
to
r
in
g
be
c
a
us
e
o
f
h
ow
in
va
s
ive
i
t
is
.
T
h
e
c
u
f
f
les
s
tec
hn
i
que
[
29
]
,
w
hi
c
h
us
e
s
a
m
e
c
h
a
n
ica
l
s
e
ns
o
r
,
a
ll
ows
t
he
pa
ti
e
n
t
m
o
r
e
f
r
e
e
do
m
of
m
ove
me
nt
.
A
tr
iboele
c
tr
ic
de
tec
tor
wa
s
de
ve
loped
by
F
a
ng
e
t
al
.
[
30]
us
ing
a
f
unc
ti
ona
ll
y
r
e
s
il
ient
texti
le
mate
r
ial.
T
his
mate
r
ial
is
li
ghtwe
ight
a
nd
c
a
n
t
r
a
ns
f
e
r
e
lec
tr
ica
l
e
ne
r
gy
f
r
om
s
mall
s
kin
de
f
o
r
mations
induce
d
by
a
r
ter
y
puls
e
s
.
I
n
both
a
c
ti
ve
a
nd
pe
r
s
pir
ing
s
tate
s
,
thi
s
a
ll
ows
f
or
the
moni
to
r
ing
of
puls
e
wa
ve
f
or
ms
in
r
e
a
l
-
ti
me
a
t
a
low
c
os
t
with
a
high
de
g
r
e
e
of
r
e
s
olut
ion.
Us
ing
a
r
outi
ne
blood
pr
e
s
s
ur
e
ga
uge
,
th
e
textil
e
tr
iboele
c
tr
ic
s
e
ns
or
s
uppor
ted
by
mac
hine
lea
r
ning
a
lgor
it
hms
wa
s
put
th
r
ough
it
s
pa
c
e
s
.
I
t
is
now
po
s
s
ibl
e
to
s
ha
r
e
da
ta
a
nd
c
onduc
t
da
ta
-
dr
iven
c
a
r
diovas
c
ular
diagnos
e
s
be
c
a
u
s
e
to
thi
s
tec
hnology
[
31]
.
A
number
of
c
a
r
diac
a
nd
va
s
c
ular
pa
r
a
mete
r
s
we
r
e
non
-
invas
ively
moni
tor
e
d
by
Xu
e
t
al
.
[
32]
us
ing
s
e
lf
-
powe
r
e
d
ult
r
a
s
e
ns
it
ive
puls
e
s
e
ns
or
s
(
S
UPS
s
)
plac
e
d
a
t
s
e
ve
r
a
l
a
r
ter
ial
puls
e
s
it
e
s
.
B
y
a
na
ly
z
ing
the
int
e
r
va
ls
be
twe
e
n
the
pe
a
ks
of
the
S
UP
S
pu
ls
e
w
a
ve
s
,
they
we
r
e
a
ble
to
de
ter
mi
ne
the
a
r
m
-
f
inger
ti
p
pa
r
ti
a
l
thr
ombopl
a
s
ti
n
ti
me
(
P
T
T
)
.
T
he
pa
ti
e
nt's
he
a
r
t
r
a
t
e
,
puls
e
wa
ve
ve
locity,
a
nd
blood
pr
e
s
s
ur
e
we
r
e
c
ompar
e
d
to
s
tanda
r
d
medic
a
l
e
quipm
e
nt
us
ing
li
ne
a
r
f
it
ti
ng
to
the
a
ve
r
a
ge
va
lue
f
r
om
a
n
e
lec
tr
onic
c
u
f
f
blood
pr
e
s
s
ur
e
moni
tor
.
T
he
ou
tcome
s
we
r
e
c
ons
is
tent.
W
e
a
v
i
ng
p
r
e
s
s
u
r
e
s
e
ns
o
r
s
th
a
t
a
r
e
b
ot
h
f
lex
ib
le
a
nd
s
e
l
f
-
p
owe
r
e
d
we
r
e
d
e
ve
lo
pe
d
[
33
]
.
I
ts
s
e
ns
i
ti
vi
ty
(
4
5
.
7
m
V
P
a
-
1
)
a
n
d
r
e
s
po
ns
e
t
im
e
(
l
e
s
s
th
a
n
5
ms
)
a
r
e
a
ll
be
c
a
us
e
o
f
it
s
e
t
c
h
in
g
P
o
ly
te
t
r
a
f
lu
or
oe
th
yl
e
ne
(
P
T
F
E
)
i
n
to
na
n
ow
i
r
e
s
,
w
hi
c
h
e
na
bl
e
i
t
t
o
f
un
c
t
io
n
w
it
h
a
s
in
gl
e
e
l
e
c
t
r
o
de
.
W
e
ight
a
nd
he
ight
mea
s
ur
e
ments
we
r
e
take
n
f
r
om
pa
r
ti
c
ipants
r
a
nging
in
he
a
lt
h
s
tatus
f
r
om
24
to
82
ye
a
r
s
old
.
T
he
P
T
T
wa
s
f
ound
by
s
ubtr
a
c
ti
ng
the
ti
mes
tamps
of
the
pe
a
ks
in
the
f
inger
ti
p
a
nd
e
a
r
s
ignal,
a
nd
the
B
P
mea
s
ur
e
ment
wa
s
done
in
r
e
a
l
ti
me
us
ing
a
n
upda
ted
ge
ne
ti
c
a
lgor
i
thm
.
Dis
c
r
e
pa
nc
ies
r
a
nging
f
r
o
m
0
.
87
%
to
3
.
65%
we
r
e
r
e
c
or
de
d
be
twe
e
n
W
C
S
P
S
a
nd
a
c
omm
e
r
c
ial
blood
pr
e
s
s
ur
e
c
u
f
f
.
T
he
s
e
thi
ngs
pr
ove
that
a
s
ys
tem
f
or
moni
tor
ing
th
e
he
a
r
t
in
r
e
a
l
ti
me
c
a
n
be
both
e
f
f
e
c
ti
ve
a
nd
a
f
f
or
da
ble.
A
wir
e
les
s
a
r
ter
ial
blood
f
low
moni
tor
that
doe
s
no
t
r
e
quir
e
ba
tt
e
r
ies
wa
s
de
s
c
r
ibed
by
B
a
outr
y
e
t
al
.
[
34]
.
T
he
pr
e
s
s
ur
e
s
e
ns
or
,
onc
e
a
s
s
e
mbl
e
d,
is
e
a
s
y
to
wr
a
p
a
r
ound
a
r
ter
ies
of
va
r
ying
s
ize
s
be
c
a
us
e
to
it
s
li
ghtwe
ight
a
nd
f
lexible
c
ons
tr
uc
ti
on.
I
t
is
pos
s
ibl
e
to
indi
r
e
c
tl
y
a
nd
di
r
e
c
tl
y
moni
to
r
a
r
te
r
ial
blood
f
l
ow
us
ing
f
r
inge
f
ield
c
a
pa
c
it
a
nc
e
tec
hnology,
whic
h
doe
s
not
r
e
qui
r
e
invas
ive
touch.
T
he
s
e
ns
or
mi
ght
be
a
good
opti
on
f
o
r
r
e
duc
ing
va
s
c
ular
da
mage
be
c
a
us
e
of
it
s
low
late
nc
y,
quick
r
e
s
pons
e
,
c
yc
le
s
tabili
ty
,
l
onge
vit
y,
a
nd
s
tr
a
ight
f
or
wa
r
d
,
dis
a
s
s
e
mbl
y
-
f
r
e
e
ins
tallation.
As
pa
r
t
o
f
thei
r
va
s
c
ular
e
lec
tr
onic
s
ys
tem,
He
r
be
r
t
e
t
al
.
[
35
]
de
ve
loped
a
wir
e
les
s
s
tent
s
ys
tem
that
us
e
s
s
of
t
s
e
ns
or
s
.
T
he
s
e
ns
it
ivi
ty
a
nd
r
e
s
pon
s
e
ti
me
of
the
c
a
pa
c
it
ive
s
e
ns
or
s
we
r
e
im
pr
ove
d
by
a
e
r
os
ol
jet
pr
int
ing
a
pa
tt
e
r
ne
d
diele
c
tr
ic
laye
r
a
nd
a
tt
a
c
hing
two
s
tr
e
tchy
c
onne
c
ti
ve
pr
e
s
s
ur
e
s
e
ns
or
s
to
the
s
t
e
nt.
T
he
ga
dge
t
e
na
bles
r
e
a
l
-
ti
me
moni
tor
ing
of
blood
pr
e
s
s
ur
e
,
he
a
r
t
r
a
te,
a
nd
blood
f
low
by
wir
e
l
e
s
s
da
ta
tr
a
ns
mi
s
s
ion
thr
ough
inductive
c
oupli
ng
.
3D
pr
int
i
ng
method
wa
s
de
ve
loped
by
L
i
e
t
al
.
[
36]
that
u
ti
li
z
e
s
a
n
e
lec
tr
ic
f
ield
to
e
xpe
dit
e
the
in
vivo
manu
f
a
c
tur
i
ng
of
polar
ize
d
f
e
r
r
oe
lec
tr
ic
a
r
ti
f
icia
l
a
r
ter
ies
.
W
i
thout
the
ne
e
d
f
or
ba
tt
e
r
ies
,
the
a
r
ter
ies
c
a
n
de
tec
t
obs
t
r
uc
ti
ons
a
nd
take
r
e
a
l
-
ti
me
blood
pr
e
s
s
ur
e
r
e
a
dings
.
A
polyvi
nyli
de
ne
dif
luo
r
ide
(
P
VD
F
)
polym
e
r
matr
ix
c
ombi
ne
d
with
potas
s
ium
s
odium
niobate
(
KN
N)
pa
r
ti
c
les
pr
oduc
e
d
ve
r
y
high
-
qua
li
ty
piez
oe
lec
tr
ic
c
ha
r
a
c
ter
is
ti
c
s
(
d33>
12
pC
N
-
1)
.
B
e
c
a
us
e
of
it
s
3D
pr
int
e
d
s
tr
uc
tur
e
a
nd
s
inus
oidal
pa
tt
e
r
n,
the
f
e
r
r
oe
lec
tr
ic
mate
r
ial
is
a
ble
to
s
e
ns
e
pr
e
s
s
ur
e
with
a
mec
ha
nica
l
modu
lus
of
only
0.
306
mV
mm
Hg
-
1,
R
2>
0.
99
.
o
f
(
11.
25
-
225,
000
mm
Hg)
.
Adva
nc
e
d
pr
e
s
s
ur
e
s
e
ns
or
s
a
ll
ow
f
o
r
t
he
e
a
r
ly
de
tec
ti
on
of
e
ve
n
mi
nute
c
ha
nge
s
in
blood
ve
s
s
e
l
mot
ion,
whic
h
a
ids
in
the
e
a
r
ly
diagnos
is
o
f
pa
r
ti
a
l
oc
c
lus
ions
s
uc
h
a
s
thr
ombos
is
a
nd
de
c
r
e
a
s
e
s
the
li
ke
li
hood
of
i
mpl
a
nt
f
a
il
u
r
e
.
A
piez
oe
lec
tr
ic
thi
n
f
il
m
i
mpl
a
nted
b
lood
pr
e
s
s
ur
e
moni
to
r
wa
s
c
ons
tr
uc
ted
by
C
he
ng
e
t
al
.
[
37]
without
the
ne
e
d
f
or
ba
tt
e
r
ies
.
T
he
outpu
t
volt
a
g
e
of
the
s
e
ns
or
wa
s
pos
it
ively
c
or
r
e
late
d
with
th
e
a
or
ti
c
s
ys
tol
ic
blood
pr
e
s
s
ur
e
(
R
2=
0.
971)
,
a
nd
i
ts
s
e
ns
it
ivi
ty
wa
s
14.
32
mV
mm
Hg
-
1.
Adult
Yor
ks
hir
e
pig
s
ha
d
the
p
olyethylene
ter
e
phthala
te
(
P
E
T
F
)
im
plante
d
s
o
th
a
t
it
c
ould
de
tec
t
the
pr
e
s
e
nc
e
of
hype
r
tens
ion
a
nd
a
c
ti
va
te
a
n
a
lar
m.
T
he
de
ve
lopm
e
nt
of
both
im
plan
ted
a
nd
e
xter
na
l
medic
a
l
de
vice
s
r
e
li
e
s
he
a
vil
y
on
e
lec
tr
omec
ha
nica
l
c
oupli
ng
biopol
ymer
s
.
L
i
a
nd
c
oll
e
a
gue
s
unve
il
e
d
the
wo
r
ld's
f
i
r
s
t
por
table
t
hr
ombus
de
tec
tor
in
2019
[
38]
.
Or
ga
nic
piez
oe
lec
tr
ic
na
no
f
iber
s
(
OPNs
)
we
r
e
s
ynthes
ize
d
by
c
ombi
ning
P
VD
F
a
nd
KNN
in
a
c
or
e
/s
he
ll
s
tr
uc
tur
e
.
T
he
s
e
na
nof
iber
s
e
xhibi
t
e
nha
nc
e
d
piez
oe
lec
tr
icity,
f
a
ti
gue
r
e
s
is
tanc
e
,
s
tabili
ty,
a
nd
biocompa
ti
bil
it
y
.
I
n
o
r
de
r
to
de
tec
t
a
nd
moni
tor
mi
nu
te
c
ha
nge
s
in
int
r
a
c
e
ll
ular
pr
e
s
s
ur
e
,
a
P
VD
F
/HHE
OPNs
s
of
t
s
e
ns
or
wa
s
de
ve
lop
e
d.
E
xtr
e
mely
s
e
ns
it
ive
a
nd
a
c
c
ur
a
te
moni
t
or
ing
of
mi
c
r
o
-
pr
e
s
s
ur
e
va
r
iations
e
xter
na
l
to
the
c
a
r
diova
s
c
ular
wa
ll
wa
s
pos
s
ibl
e
f
o
ll
owing
p
ig
i
mpl
a
ntati
on.
T
he
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
S
N
:
2088
-
8708
I
nt
J
E
lec
&
C
omp
E
ng
,
Vol
.
15
,
No.
1
,
F
e
br
ua
r
y
20
25
:
243
-
251
246
piez
oe
lec
tr
ic
s
ignal
a
ll
ows
f
or
the
de
tec
ti
on
of
e
l
a
s
ti
c
c
ha
nge
s
,
thr
ombus
,
a
nd
a
tr
ioventr
icula
r
he
a
r
t
block.
As
s
e
s
s
ment
is
f
a
c
il
it
a
ted
by
thes
e
biol
ogica
l
da
ta.
T
his
f
a
c
il
it
a
tes
the
nuc
lea
ti
on
of
-
pha
s
e
polym
e
r
c
ha
ins
a
nd
their
a
li
gnment
.
T
he
incr
e
a
s
e
d
piez
oe
lec
tr
ic
pr
ope
r
ti
e
s
,
biocompa
ti
bil
it
y,
a
nd
s
tab
il
it
y
of
the
de
ve
loped
P
VD
F
/DA
NFs
a
r
e
notew
or
t
hy.
As
a
r
e
s
ult
of
thi
s
s
tudy,
a
n
a
ll
-
f
iber
s
of
t
s
e
ns
or
that
is
both
s
e
ns
it
ive
a
nd
a
c
c
ur
a
te
in
de
tec
ti
ng
d
iaphr
a
gmatic
moveme
nt
a
nd
c
a
r
diac
blood
puls
a
ti
on
ha
s
be
e
n
de
ve
loped.
I
t
c
a
n
im
p
r
ove
tr
e
a
tm
e
nt
by
s
c
r
e
e
ning
f
or
a
nd
diagnos
ing
c
a
r
diovas
c
ular
a
nd
r
e
s
pir
a
tor
y
pr
obl
e
ms
e
a
r
ly
on
[
39]
.
T
we
nty
-
two
bios
e
ns
or
s
E
v
a
luating
potential
opti
ons
T
he
-
C
F
2
gr
oup
on
P
VD
F
a
n
d
the
a
tom
ic
-
pos
it
ion
NH
2
gr
oup
on
DA
a
id
i
n
c
ha
in
a
li
gnment
a
nd
pha
s
e
nuc
lea
ti
on.
T
he
piez
oe
lec
tr
ic
pr
ope
r
ti
e
s
of
P
VD
F
/DA
NFs
a
r
e
e
nha
nc
e
d,
a
nd
they
a
r
e
s
table
.
T
he
r
e
s
ult
s
of
thi
s
s
tudy
include
a
n
a
ll
-
f
iber
s
of
t
s
e
ns
or
that
is
both
s
e
ns
it
ive
a
nd
a
c
c
ur
a
te
e
nough
to
de
tec
t
the
diaph
r
a
gm's
moveme
nt
a
nd
the
he
a
r
t's
b
lood
puls
ing.
S
o
,
it
c
a
n
be
uti
li
z
e
d
f
or
r
is
k
a
s
s
e
s
s
ment
a
nd
diagnos
is
of
r
e
s
pir
a
tor
y
a
nd
c
a
r
diovas
c
ular
dis
e
a
s
e
s
.
W
it
h
the
he
lp
of
tr
iboele
c
tr
ic
na
noge
ne
r
a
tor
s
(
T
E
NG
)
,
s
e
lf
-
s
us
taining
s
tent
s
ha
ve
be
e
n
de
ve
loped.
A
biocompa
ti
ble,
non
-
toxi
c
,
s
e
lf
-
s
e
ns
ing
s
tent
ba
s
e
d
on
c
ompos
it
e
mec
ha
nica
l
meta
mate
r
ials
w
a
s
int
r
oduc
e
d
by
B
a
r
r
i
e
t
al
.
[
40
]
.
T
he
ha
mm
e
r
ing
o
f
the
a
r
ter
y
wa
ll
s
c
ould
powe
r
thi
s
s
tent,
a
ll
owing
it
to
f
unc
ti
on
indepe
nde
ntl
y.
A
c
omm
e
r
c
ial
ba
ll
oon
dil
a
tor
c
a
th
e
ter
c
a
n
be
us
e
d
to
ins
tall
the
s
tent
while
c
ha
nge
s
in
loca
l
he
modynamics
a
r
e
e
va
luate
d
f
or
s
igns
of
a
r
ter
ial
r
e
s
tenos
i
s
or
ti
s
s
ue
ove
r
gr
owth.
T
he
pu
r
pos
e
of
thi
s
de
s
ign
is
only
to
de
mons
tr
a
te
f
e
a
s
ibi
li
ty;
it
s
f
unc
ti
ona
li
ty
a
nd
dur
a
bil
it
y
a
r
e
not
pr
ior
it
ies
.
M
ode
r
n
medic
a
l
s
t
e
nts
c
a
n
incor
por
a
te
a
r
ti
f
icia
l
li
f
e
mec
ha
nis
ms
,
a
nd
th
is
s
hows
how
to
give
s
mar
t
he
a
lt
hc
a
r
e
s
ys
tems
c
ons
ider
a
ble
lee
wa
y
to
do
s
o.
Ouya
ng
e
t
al
.
[
41]
de
s
c
r
ibed
a
pr
e
s
s
ur
e
s
e
ns
or
in
2021
that
us
e
s
the
tr
iboele
c
tr
ic
e
f
f
e
c
t
be
twe
e
n
bioabs
or
ba
ble
mate
r
ials
to
ins
tantly
tr
a
ns
f
or
m
c
ha
nge
s
in
a
mbi
e
nt
pr
e
s
s
ur
e
int
o
e
lec
tr
ica
l
d
a
ta.
T
he
li
ne
a
r
it
y
(
R
2=
0.
993)
,
s
e
ns
it
ivi
ty
(
11
mV
mm
Hg
-
1)
,
a
nd
du
r
a
bil
it
y
(
450,
000
c
yc
les
)
of
thi
s
bioabs
or
ba
ble
tr
iboele
c
tr
ic
s
e
ns
or
(
B
T
S
)
we
r
e
a
bove
a
ve
r
a
ge
.
E
f
f
e
c
ti
ve
ne
s
s
in
identif
ying
a
nomalous
va
s
c
ular
oc
c
l
us
ion
in
big
da
tas
e
ts
is
high
(
59.
54
%
)
.
4.
2.
P
u
ls
e
wave
an
d
c
ar
d
iac
ou
t
p
u
t
T
he
mec
ha
nica
l
pr
e
s
s
ur
e
s
e
n
s
or
c
a
n
de
tec
t
a
nd
p
r
e
c
is
e
ly
r
e
a
d
the
pr
e
s
s
ur
e
s
ignal
of
a
puls
e
wa
ve
be
c
a
us
e
of
it
s
e
xc
e
pti
ona
l
s
e
ns
it
ivi
ty
a
nd
r
e
a
c
ti
on
s
pe
e
d.
M
us
c
les
a
nd
e
las
ti
c
c
onne
c
ti
ve
ti
s
s
ue
c
ome
togethe
r
to
c
r
e
a
te
a
r
ter
ies
.
Dur
ing
e
a
c
h
c
a
r
diac
c
yc
le,
the
v
e
ntr
icle
r
e
gular
ly
c
ont
r
a
c
ts
a
nd
r
e
laxe
s
,
c
a
us
ing
a
puls
e
to
be
tr
a
ns
mi
tt
e
d
[
42]
.
T
he
e
lec
tr
ica
l
a
c
ti
vit
y
o
f
the
he
a
r
t
de
ter
mi
ne
s
the
puls
e
r
a
te,
whic
h
is
e
xpr
e
s
s
e
d
a
s
a
be
a
ts
pe
r
mi
nute
(
bpm
)
.
C
ur
r
e
nt
medic
a
l
we
a
r
a
ble
e
lec
tr
onics
make
s
us
e
o
f
op
ti
c
a
l
a
nd
c
a
pa
c
it
ive
puls
e
pr
e
s
s
ur
e
s
e
n
s
or
s
[
12]
.
P
uls
e
s
e
ns
or
s
that
r
un
on
ba
tt
e
r
ies
c
a
n
be
opti
c
a
l,
piez
or
e
s
is
ti
ve
,
or
c
a
pa
c
it
ive.
P
iez
oe
lec
tr
ic
a
nd
tr
iboele
c
tr
ic
pr
e
s
s
ur
e
s
e
ns
or
s
a
r
e
e
xa
mpl
e
s
of
puls
e
de
tec
tor
s
that
do
not
r
e
quir
e
po
we
r
.
One
s
uc
h
de
vice
that
ke
e
ps
tabs
on
vit
a
ls
in
r
e
a
l
ti
me
is
the
li
quid
c
a
ps
ule
pr
e
s
s
ur
e
s
e
ns
or
s
(
L
C
P
S
)
,
de
ve
loped
by
F
a
n
e
t
al
.
[
43]
.
T
he
l
iqui
d
ins
ide
th
e
c
a
ps
ule
is
c
ontaine
d
by
a
thi
n
,
pe
r
mea
ble
memb
r
a
ne
.
B
y
uti
li
z
ing
P
a
s
c
a
l's
noti
on,
a
p
iez
or
e
s
is
ti
ve
s
e
ns
or
that
wa
s
im
plante
d
wa
s
a
ble
to
r
e
c
e
ive
the
pu
ls
a
ti
on
s
ignal
f
r
om
the
c
a
ps
ule.
B
e
c
a
us
e
of
thi
s
,
the
a
r
ter
ial
a
li
g
nment
pr
e
c
is
ion
of
the
pr
e
s
s
ur
e
s
e
ns
or
s
ys
tem
wa
s
r
e
duc
e
d
to
8.
5
mm
.
T
he
r
e
is
a
mea
n
c
or
r
e
lation
c
oe
f
f
icie
nt
of
0
.
9944
be
twe
e
n
the
L
C
P
S
-
de
r
ived
a
nd
e
lec
tr
oc
a
r
diogr
a
m
(
E
C
G)
-
de
r
ived
he
a
r
t
r
a
tes
f
o
r
the
11
pe
r
s
ons
who
wor
e
the
de
vice
without
pos
it
ion
c
a
li
br
a
ti
on.
T
he
E
C
G,
pho
topl
e
thys
mogr
a
phy
(
P
P
G)
,
a
nd
L
C
P
S
we
r
e
us
e
d
to
mea
s
ur
e
the
be
a
t
-
to
-
be
a
t
s
ys
tol
ic
a
nd
dias
tol
ic
blood
pr
e
s
s
ur
e
of
the
s
ubjec
t
s
,
whic
h
wa
s
then
li
nke
d
with
the
B
P
r
e
c
or
de
d
by
the
c
uf
f
.
C
ompar
ing
L
C
P
S
+
E
C
G
to
P
P
G+
E
C
G,
the
r
e
s
ult
s
de
mons
tr
a
te
that
bo
th
methods
a
r
e
s
im
il
a
r
ly
de
p
e
nda
ble.
T
his
e
a
s
y
-
to
-
s
e
tup,
low
-
powe
r
(
35
nW
)
L
C
P
S
de
li
ve
r
s
a
high
-
f
idelit
y
e
pider
mal
puls
e
s
ignal
to
th
e
s
e
ns
or
.
One
f
ur
ther
wa
y
to
opti
mi
z
e
puls
e
wa
ve
f
or
ms
is
to
us
e
a
we
a
r
a
ble
pr
e
s
s
ur
e
s
e
ns
or
a
r
r
a
y
to
mea
s
ur
e
the
s
pa
ti
a
l
a
nd
tempor
a
l
c
omponents
o
f
pu
ls
e
wa
ve
s
[
43]
.
T
h
in
s
he
e
ts
of
s
e
ns
it
ive
piez
or
e
s
is
ti
ve
s
e
ns
or
s
we
r
e
manuf
a
c
tur
e
d
us
ing
inkj
e
t
by
B
a
e
k
e
t
al
.
[
44
]
to
c
r
e
a
te
thi
n
-
f
il
m
tr
a
ns
is
tor
(
T
F
T
)
a
r
r
a
ys
.
R
e
duc
e
d
powe
r
c
ons
umpt
ion
(
101
nW
)
a
nd
e
nha
nc
e
d
pr
e
s
s
ur
e
s
e
ns
it
ivi
ty
(
16.
8
kP
a
-
1)
we
r
e
a
c
hieve
d
thr
ough
s
tr
a
tegic
r
e
gulation
of
the
T
F
T
ope
r
a
ti
ng
vo
lt
a
ge
.
A
t
wo
-
dim
e
ns
ional
dis
tr
ibut
ion
of
wr
is
t
puls
e
wa
ve
s
wa
s
c
ons
tr
uc
ted
us
ing
a
100
-
pixel
pr
e
s
s
ur
e
s
e
ns
or
a
r
r
a
y.
A
s
pa
c
e
-
ti
me
puls
e
wa
ve
map
de
mons
tr
a
ti
ng
the
pos
it
ion
de
pe
nde
nc
y
of
puls
e
a
mpl
i
tude
c
a
n
be
ge
ne
r
a
te
d
by
p
r
e
c
is
e
ly
mea
s
ur
ing
the
pr
e
s
s
ur
e
s
ignal
a
n
d
a
r
ter
y
pos
it
ion.
B
e
c
a
us
e
of
thi
s
,
the
a
ugmenta
ti
on
index,
whic
h
e
va
luate
s
a
r
ter
ial
s
ti
f
f
ne
s
s
,
c
a
n
be
c
ompu
ted
with
the
r
ight
a
r
te
r
ial
l
ines
.
F
lexible
a
nd
s
e
ns
it
ive
pr
e
s
s
ur
e
s
e
ns
or
s
we
r
e
de
ve
loped
by
S
u
[
45]
.
T
he
s
e
ns
or
's
pe
r
f
or
manc
e
wa
s
una
f
f
e
c
ted
by
the
s
tr
e
tching.
C
ontour
e
d
piez
oe
lec
tr
ic
s
e
ns
or
s
that
a
r
e
ge
ntl
e
on
the
s
kin
S
pe
c
if
ica
ll
y,
lea
d
z
ir
c
ona
te
ti
tana
te
(
P
Z
T
)
wa
s
uti
li
z
e
d
by
P
a
r
k
e
t
al
.
[
46]
.
A
s
tanda
r
d
metho
d
f
or
f
a
b
r
ica
ti
ng
ti
ny
,
be
nda
ble
e
lec
tr
onics
.
T
he
n,
the
thi
n
P
Z
T
s
ubs
tr
a
te
wa
s
a
f
f
ixed
with
f
inger
e
lec
tr
ode
s
that
we
r
e
f
or
ke
d
with
gold
.
T
he
p
iez
oe
lec
tr
ic
s
e
ns
or
s
e
mbedde
d
in
the
wr
is
tbands
s
e
nd
the
puls
e
va
lues
to
ne
a
r
by
c
e
ll
phone
s
in
a
wir
e
les
s
f
a
s
hion.
Ouya
ng
e
t
al
.
[
47]
de
ve
loped
a
r
e
c
ha
r
ge
a
ble
ult
r
a
s
e
ns
it
ive
puls
e
s
e
ns
or
by
c
ombi
ning
a
polym
e
r
a
nd
na
nos
tr
uc
tur
e
d
meta
ll
ic
c
oppe
r
f
il
m
with
a
n
e
nc
a
ps
ulating
laye
r
o
f
f
lexible
polyd
im
e
thyl
s
il
oxa
ne
(
P
DM
S
)
(
S
UPS
)
[
4
8]
–
[
51]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
nt
J
E
lec
&
C
omp
E
ng
I
S
S
N:
2088
-
8708
N
ar
r
ati
v
e
r
e
v
ie
w
of
the
li
ter
atur
e
:
appli
c
ati
on
of
me
c
hanical
s
e
lf
pow
e
r
e
d
s
e
n
s
or
s
…
(
Ham
z
a
A
bu
Ow
ida
)
247
4.
3.
E
n
d
oc
ar
d
ial
p
r
e
s
s
u
r
e
an
d
h
e
ar
t
r
at
e
De
vice
s
s
uc
h
a
s
de
f
ibr
il
lator
s
,
pa
c
e
make
r
s
,
a
nd
c
a
r
dior
e
s
pir
a
tor
y
t
r
a
iner
s
r
e
duc
e
dis
e
a
s
e
a
nd
de
a
th
by
moni
tor
ing,
r
e
s
tor
ing,
a
nd
c
ontr
oll
ing
c
a
r
diac
f
unc
ti
on
[
13]
,
[
52
]
.
An
im
por
tant
ba
r
o
mete
r
of
c
a
r
diac
pumpi
ng
is
e
ndoc
a
r
dial
pr
e
s
s
ur
e
(
E
P
)
,
whic
h
incl
ude
s
both
ve
ntr
icula
r
a
nd
a
tr
ial
pr
e
s
s
ur
e
s
[
53]
.
I
n
a
de
qua
te
e
xter
na
l
r
e
c
or
de
r
s
f
o
r
c
a
r
diac
c
a
thete
r
s
mi
ght
lea
d
to
c
ompl
ica
ti
ons
dur
ing
s
ur
ge
r
y
a
nd
nonc
ompl
ian
c
e
f
r
om
pa
ti
e
nts
[
54]
.
I
n
pr
a
c
ti
c
a
l
pr
a
c
ti
c
e
,
int
e
r
m
it
tent
E
P
moni
to
r
ing
ha
s
the
potential
to
mi
s
s
s
hor
t
-
li
ve
d
or
quiet
s
ympt
oms
,
lea
ding
to
inco
r
r
e
c
t
pa
ti
e
nt
diagnos
e
s
[
55]
.
Ac
ti
ve
e
ndoc
a
r
dial
moni
to
r
ing
a
nd
other
r
e
a
l
-
ti
me
phys
iol
ogica
l
s
ignal
moni
tor
ing
a
ppli
c
a
ti
ons
will
be
ne
f
it
f
r
om
s
e
lf
-
powe
r
e
d,
powe
r
-
f
r
e
e
s
e
ns
or
s
.
Us
ing
a
n
i
-
NG
s
ys
tem
with
f
lexible
a
nd
s
of
t
na
noge
ne
r
a
tor
s
,
L
i
e
t
al
.
[
56]
e
va
luate
d
the
in
vivo
s
a
f
e
ty
of
a
c
a
r
diac
im
plant.
P
igs
ha
d
i
-
NG
s
,
lea
ds
,
a
nd
r
e
c
e
iver
s
made
of
piez
oe
lec
tr
ic
P
VD
F
im
plante
d
int
o
their
he
a
r
ts
ov
e
r
the
c
our
s
e
of
two
mont
hs
.
T
he
r
e
may
be
a
c
ha
nge
due
to
the
dias
tol
e
P
VD
F
memb
r
a
ne
e
xtens
ion.
I
n
the
e
v
e
nt
of
a
he
a
r
t
a
tt
a
c
k,
the
pe
a
k
-
to
-
pe
a
k
volt
a
ge
(
Vp
p)
o
f
the
i
-
r
a
pid
NG
r
os
e
f
r
om
2.
3
to
4.
5
V
due
to
the
te
mpor
a
r
y
oc
c
lus
ion
of
the
lef
t
a
nter
ior
de
s
c
e
nding
(
L
AD
)
a
r
ter
y.
I
n
or
de
r
to
t
r
a
c
k
phys
iol
ogica
l
a
nd
pa
th
ologi
c
a
l
indi
c
a
tor
s
,
M
a
e
t
al
.
[
57
]
c
r
e
a
ted
a
n
i
mpl
a
nted
tr
iboele
c
tr
ic
a
c
ti
ve
s
e
ns
or
(
iT
E
AS
)
that
is
both
f
lexible
a
nd
s
e
lf
-
powe
r
e
d.
T
he
tr
iboele
c
tr
ic
laye
r
c
a
n
de
tac
h
a
nd
touch
the
he
a
r
t
dur
ing
s
ys
tol
e
a
nd
dias
tol
e
,
c
r
e
a
ti
ng
e
lec
tr
ica
l
s
ignals
thr
ough
c
ontac
t
e
lec
tr
if
ica
ti
on
a
nd
e
lec
tr
os
tatic
induction,
i
f
the
c
a
r
diac
s
e
ns
or
is
im
plante
d
c
or
r
e
c
tl
y.
T
h
r
e
e
da
ys
f
oll
owing
c
he
s
t
c
lo
s
ur
e
,
the
moni
tor
c
onti
nue
d
to
f
unc
ti
on
nor
mally
.
T
he
de
vic
e
is
99%
a
c
c
ur
a
te
in
it
s
mea
s
ur
e
ment
of
he
a
r
t
r
a
te.
R
hythm
a
bnor
malit
ies
s
uc
h
pr
e
matur
e
ve
nt
r
icula
r
be
a
ts
,
ve
ntr
icula
r
tac
hyc
a
r
dia,
a
nd
a
tr
ial
f
ib
r
il
lation
c
a
n
be
identif
ied
in
r
e
a
l
t
im
e
.
T
he
ga
dge
t
wa
s
s
hown
to
be
biocompa
ti
ble
a
nd
r
e
a
dy
f
o
r
c
li
nica
l
us
a
ge
two
we
e
ks
f
oll
owing
im
planta
ti
on
.
I
n
he
a
lt
hc
a
r
e
,
the
s
ugge
s
ted
iT
E
AS
ha
s
the
potential
to
s
e
r
ve
a
s
a
mul
ti
f
unc
ti
ona
l
biol
ogica
l
moni
tor
that
doe
s
not
r
e
quir
e
a
powe
r
s
u
pply.
I
n
he
a
r
t
f
a
il
ur
e
,
whe
n
c
a
r
diac
f
unc
ti
on
de
c
r
e
a
s
e
s
,
it
is
c
r
uc
ial
to
moni
to
r
noninvas
ive
c
ha
nge
s
in
e
lec
tr
oc
a
r
diogr
a
m
(
E
P
)
.
T
he
e
nc
a
ps
ulating
laye
r
's
c
ompatibi
li
ty
with
blood
mea
nt
that
the
a
c
ti
va
ti
on
of
the
c
oa
gulation
c
a
s
c
a
d
e
a
nd
he
mol
ys
is
w
e
r
e
r
e
mot
e
pos
s
ibi
li
ti
e
s
.
B
y
a
ll
owing
f
or
non
-
invas
ive
pr
e
s
s
ur
e
s
e
ns
ing,
c
a
r
diovas
c
ular
dis
e
a
s
e
diagnos
is
,
a
nd
mon
it
or
in
g,
thes
e
a
dva
nc
e
ments
ha
ve
the
potential
to
c
o
mpl
e
tely
tr
a
ns
f
or
m
im
plante
d
he
a
lt
h
moni
to
r
ing
[
58]
,
[
59
]
.
I
n
their
s
tudy,
Ouya
ng
e
t
al
.
[
41
]
us
e
d
a
lar
ge
a
nim
a
l
model
to
s
how
that
a
s
ymbi
oti
c
pa
c
e
make
r
ba
s
e
d
on
im
plante
d
T
E
NG
c
ould
ha
r
ve
s
t
e
ne
r
gy,
s
tor
e
it
,
a
nd
pa
c
e
the
he
a
r
t.
Ope
n
c
ir
c
uit
volt
a
ge
s
of
up
to
65.
2%
a
r
e
pos
s
ibl
e
with
im
plante
d
T
E
NG
s
.
T
he
e
ndoc
a
r
dial
pa
c
ing
ba
r
r
ier
is
0.
377
J
,
whic
h
is
hi
ghe
r
than
the
e
ne
r
gy
e
xtr
a
c
ti
on
of
0
.
495
J
du
r
ing
the
c
a
r
diac
c
yc
le.
I
n
a
ddit
ion
to
tr
e
a
ti
ng
s
inus
a
r
r
hythm
ias
,
s
ymbi
oti
c
pa
c
e
make
r
s
s
lowe
d
the
pr
ogr
e
s
s
ion
of
dis
e
a
s
e
.
T
he
s
e
T
E
NG
s
a
r
e
we
ll
-
s
uit
e
d
f
o
r
us
e
a
s
in
vivo
s
yne
r
gis
ti
c
bios
e
ns
or
s
a
nd
other
diagnos
ti
c
a
nd
ther
a
pe
uti
c
a
ppli
c
a
ti
ons
due
to
their
s
upe
r
c
a
pa
c
it
or
s
,
e
ndur
a
nc
e
,
a
nd
high
c
oe
f
f
icie
nt
of
pe
r
f
or
manc
e
[
60
]
–
[
62]
.
He
r
e
a
r
e
the
pr
os
a
nd
c
ons
of
c
a
pa
c
it
ive,
piez
or
e
s
is
ti
ve
,
a
nd
piez
oe
lec
tr
ic
tr
iboele
c
tr
ic
s
e
ns
or
s
,
a
s
s
hown
in
T
a
b
le
1.
T
a
ble
1.
C
ha
r
a
c
ter
is
ti
c
s
,
be
ne
f
it
s
,
a
nd
dr
a
wba
c
ks
of
piez
oe
lec
tr
ic
e
leme
nts
tr
iboele
c
tr
ic
,
c
onduc
ti
ve
,
a
nd
piez
or
e
s
is
ti
ve
s
e
n
s
or
s
S
e
ns
or
T
ype
B
e
ne
f
it
s
D
r
a
w
ba
c
ks
P
ie
z
oe
le
c
tr
ic
E
xt
e
ns
iv
e
f
r
e
que
nc
y r
e
s
pons
e
E
xt
r
e
me
ly
s
e
ns
it
iv
e
M
in
im
a
li
s
t
de
s
ig
n t
ha
t
ma
xi
mi
z
e
s
e
f
f
ic
ie
nc
y
L
im
it
e
d t
o e
vol
vi
ng s
ig
na
ls
E
mi
s
s
io
n of
c
ur
r
e
nt
f
r
om
e
le
c
tr
ic
a
ppl
ia
nc
e
s
P
ie
z
or
e
s
is
ti
ve
L
a
r
ge
dyna
mi
c
r
a
nge
L
a
yout
a
nd c
ons
tr
uc
ti
on t
ha
t
a
r
e
bot
h s
tr
a
ig
ht
f
or
w
a
r
d
H
ig
h
pr
e
c
is
io
n
a
nd a
c
c
ur
a
c
y
E
r
r
or
s
c
a
us
e
d by e
le
va
te
d t
e
mpe
r
a
tu
r
e
s
I
nt
r
ic
a
te
pr
oduc
ti
on me
th
od
C
a
pa
c
it
iv
e
S
ig
ni
f
ic
a
nt
de
gr
e
e
of
s
te
a
di
ne
s
s
S
upe
r
b dyna
mi
c
r
e
s
pons
e
H
ig
h i
mpe
da
nc
e
P
oor
l
oa
d c
a
pa
c
it
y
T
r
ib
oe
le
c
tr
ic
E
xt
r
e
me
ly
s
e
ns
it
iv
e
L
a
yout
a
nd c
ons
tr
uc
ti
on t
ha
t
a
r
e
bot
h s
tr
a
ig
ht
f
or
w
a
r
d
E
c
onomi
c
a
ll
y vi
a
bl
e
S
ig
na
ls
w
it
h a
hi
gh dyna
mi
c
i
mpe
da
nc
e
onl
y
5.
CONC
L
USI
ON
AN
D
F
UT
UR
E
P
ROS
P
E
CT
I
V
E
S
M
e
c
ha
nica
l
s
e
n
s
or
s
ha
ve
the
potential
to
c
ompl
e
tely
tr
a
ns
f
or
m
the
wa
y
c
a
r
diovas
c
ular
he
a
lt
h
is
a
s
s
e
s
s
e
d
thr
ough
it
s
us
e
.
T
he
s
e
s
e
ns
or
s
of
f
e
r
in
va
luable
ins
ight
s
int
o
c
a
r
diac
f
unc
ti
on
a
nd
he
mo
dyna
mi
c
pa
r
a
mete
r
s
,
pa
ving
the
wa
y
f
or
mor
e
a
c
c
ur
a
te
diagnos
ti
c
s
a
nd
pr
oa
c
ti
ve
mana
ge
ment
of
c
a
r
diovas
c
ular
c
ondit
ions
.
T
he
mec
ha
nica
l
s
e
ns
or
s
hold
s
igni
f
ica
nt
pr
omi
s
e
f
o
r
e
nha
nc
ing
he
a
r
t
-
r
a
te
moni
tor
ing
a
nd
c
a
r
diovas
c
ular
he
a
lt
h
a
s
s
e
s
s
ment.
De
pe
nding
on
the
s
pe
c
if
ic
c
i
r
c
ums
tanc
e
s
a
nd
r
e
quir
e
ments
,
we
a
r
a
ble
s
e
ns
or
s
c
a
n
be
s
e
a
ml
e
s
s
ly
int
e
gr
a
ted
int
o
c
lot
hing
or
a
f
f
ixed
to
the
s
kin
us
ing
a
dhe
s
ive
pa
tche
s
.
T
his
non
-
invas
ive
a
ppr
oa
c
h
of
f
e
r
s
unpa
r
a
ll
e
led
c
onve
nienc
e
a
nd
e
xc
e
ll
e
nt
pa
ti
e
nt
c
ompl
ianc
e
,
making
it
the
pr
e
f
e
r
r
e
d
opti
on
in
many
c
a
s
e
s
.
C
ons
e
que
ntl
y,
we
a
r
a
ble
s
e
n
s
or
s
r
e
pr
e
s
e
nt
the
opti
mal
c
hoice
f
o
r
he
a
r
t
-
r
a
te
mo
nit
or
ing
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
S
N
:
2088
-
8708
I
nt
J
E
lec
&
C
omp
E
ng
,
Vol
.
15
,
No.
1
,
F
e
br
ua
r
y
20
25
:
243
-
251
248
a
nd
c
a
r
diovas
c
ular
a
s
s
e
s
s
ment
due
to
thei
r
e
a
s
e
of
us
e
a
nd
pa
ti
e
nt
-
f
r
iendly
na
tur
e
.
C
onve
r
s
e
ly,
the
p
l
a
c
e
ment
of
im
planta
ble
s
e
ns
or
s
ne
c
e
s
s
it
a
te
s
invas
ive
s
ur
gic
a
l
pr
oc
e
dur
e
s
,
int
r
oduc
ing
inher
e
nt
r
is
ks
a
nd
c
ompl
e
xit
ies
.
W
hil
e
im
planta
ble
s
e
ns
or
s
may
of
f
e
r
c
e
r
tain
a
dva
ntage
s
in
s
pe
c
if
ic
c
li
nica
l
s
c
e
n
a
r
ios
,
s
uc
h
a
s
c
o
nti
nuous
moni
tor
ing
in
c
r
it
ica
ll
y
il
l
pa
ti
e
nts
o
r
thos
e
with
c
ompl
e
x
c
a
r
diac
c
ondit
ions
,
their
us
e
is
o
f
ten
li
mi
t
e
d
by
the
invas
ivene
s
s
of
the
im
planta
ti
on
p
r
oc
e
s
s
a
nd
a
s
s
oc
iate
d
pa
ti
e
nt
dis
c
omf
or
t,
while
both
we
a
r
a
ble
a
nd
im
planta
ble
s
e
ns
or
s
play
c
r
uc
ial
r
oles
in
c
a
r
diovas
c
ular
he
a
lt
h
moni
tor
ing,
we
a
r
a
ble
s
e
ns
or
s
e
mer
ge
a
s
the
pr
e
f
e
r
r
e
d
opti
on
f
or
he
a
r
t
-
r
a
te
moni
tor
ing
in
man
y
s
it
ua
ti
ons
due
to
their
non
-
invas
ive
na
tur
e
a
nd
s
upe
r
ior
pa
ti
e
nt
a
c
c
e
ptanc
e
.
How
e
ve
r
,
the
s
e
lec
ti
on
of
s
e
ns
or
type
s
hould
be
tailo
r
e
d
to
the
indi
vidual
pa
ti
e
nt'
s
ne
e
ds
,
c
li
nica
l
c
ontext,
a
nd
moni
tor
ing
objec
ti
ve
s
,
e
ns
ur
i
ng
opti
mal
outcome
s
a
nd
pa
ti
e
nt
s
a
ti
s
f
a
c
ti
on.
W
hil
e
im
planta
ble
a
nd
we
a
r
a
ble
pr
e
s
s
ur
e
de
vice
s
may
incur
s
igni
f
ica
nt
c
os
ts
,
their
unpa
r
a
ll
e
led
a
dva
ntage
s
make
them
indi
s
pe
n
s
a
ble
tool
s
,
e
s
pe
c
ially
f
or
de
tec
ti
ng
s
ubtl
e
f
or
c
e
s
withi
n
s
ubc
utane
ous
ti
s
s
ue
.
T
he
p
r
im
a
r
y
c
ha
ll
e
nge
s
li
e
in
e
ns
ur
ing
the
a
c
c
ur
a
c
y
of
mea
s
ur
e
ments
a
nd
maintaining
the
f
unc
ti
o
na
li
ty
of
thes
e
de
vice
s
f
or
long
-
ter
m
diagnos
ti
c
us
e
.
W
hil
e
thes
e
obs
tac
le
s
a
r
e
f
or
mi
da
ble,
they
a
r
e
not
ins
ur
mount
a
ble;
howe
ve
r
,
they
de
mand
c
onc
e
r
ted
e
f
f
or
ts
to
ove
r
c
ome.
Ac
hieving
c
onf
or
mal
c
ontac
t
with
the
s
ur
f
a
c
e
s
of
s
of
t
ti
s
s
ue
s
a
nd
or
ga
ns
r
e
pr
e
s
e
nts
a
c
r
it
ica
l
hu
r
dle
that
mus
t
be
a
ddr
e
s
s
e
d
to
e
nha
nc
e
the
a
da
ptabili
ty
a
nd
c
ytocompa
ti
bil
it
y
o
f
s
e
ns
or
s
.
T
his
ne
c
e
s
s
it
a
te
s
f
ur
ther
a
dva
nc
e
ments
in
s
e
ns
or
tec
hnology
to
e
ns
ur
e
opti
mal
pe
r
f
or
manc
e
a
nd
c
ompatibi
li
ty
with
biol
ogica
l
ti
s
s
ue
s
.
C
ons
e
que
ntl
y,
ther
e
r
e
mains
a
mul
ti
tude
of
obs
tac
les
to
ove
r
c
ome,
a
long
wi
th
a
bunda
nt
oppor
tuni
ti
e
s
f
o
r
gr
owth
a
nd
opti
m
iza
ti
on
in
the
a
ppli
c
a
ti
on
of
biom
e
c
ha
nica
l
s
e
ns
or
s
f
o
r
C
VD
m
onit
or
ing.
De
s
pit
e
the
c
ha
ll
e
nge
s
,
the
potential
be
ne
f
it
s
of
ove
r
c
omi
ng
thes
e
hu
r
dles
a
r
e
im
mens
e
,
with
the
pr
os
pe
c
t
o
f
r
e
volut
ioni
z
ing
C
VD
diagn
os
is
a
nd
mana
ge
ment.
W
it
h
c
onti
nue
d
innovation
a
nd
r
e
s
e
a
r
c
h
e
f
f
or
ts
,
biom
e
c
ha
nica
l
s
e
ns
or
s
hold
the
pr
omi
s
e
of
of
f
e
r
ing
unpr
e
c
e
de
nted
ins
ight
s
int
o
c
a
r
diovas
c
ular
he
a
lt
h,
ther
e
by
a
dva
nc
ing
the
f
o
r
e
f
r
ont
of
medic
a
l
tec
hnology,
a
nd
im
p
r
oving
pa
ti
e
nt
outcome
s
in
c
li
nica
l
s
e
tt
ings
.
T
hus
,
whi
le
the
jou
r
ne
y
a
he
a
d
may
be
c
ha
ll
e
nging,
the
r
e
wa
r
ds
of
ove
r
c
omi
ng
thes
e
obs
tac
les
a
r
e
boundles
s
.
B
y
i
nt
e
g
r
a
t
in
g
e
ne
r
g
y
h
a
r
ve
s
t
in
g
a
nd
c
on
ve
r
s
ion
m
e
c
h
a
n
is
ms
,
we
c
a
n
a
c
tu
a
l
ize
a
s
e
l
f
-
c
h
a
r
g
in
g
d
e
t
e
c
ti
on
s
ys
te
m
,
e
f
f
e
c
t
iv
e
l
y
r
e
duc
in
g
th
e
t
i
me
r
e
qu
i
r
e
d
t
o
r
e
c
ha
r
ge
i
mp
lan
ta
b
le
s
e
ns
o
r
s
.
T
h
is
inn
o
va
t
i
ve
a
pp
r
oa
c
h
e
n
c
o
mp
a
s
s
e
s
b
ot
h
l
ow
-
e
ne
r
gy
s
e
ns
i
ng
a
n
d
s
e
l
f
-
po
we
r
e
d
s
e
ns
i
ng
m
e
t
ho
do
lo
g
ies
,
o
f
f
e
r
in
g
v
e
r
s
a
ti
le
a
ve
nue
s
t
o
a
c
c
om
pl
is
h
t
he
tas
k
a
t
ha
nd
.
T
o
e
na
bl
e
c
on
t
in
uo
us
m
on
i
to
r
in
g
o
f
m
ul
ti
p
le
ph
ys
i
ol
og
ic
a
l
pa
r
a
me
te
r
s
.
C
ol
la
bo
r
a
t
ive
e
f
f
o
r
ts
a
m
on
g
r
e
s
e
a
r
c
he
r
s
f
r
om
d
i
ve
r
s
e
c
ou
nt
r
ies
w
or
l
dw
ide
h
a
ve
s
pe
a
r
he
a
de
d
the
d
e
v
e
l
o
pm
e
nt
o
f
i
mp
la
nta
b
le
a
nd
we
a
r
a
b
le
s
e
ns
o
r
s
.
T
he
s
e
c
o
ll
a
b
o
r
a
ti
ve
e
n
de
a
vo
r
s
un
de
r
s
c
or
e
t
he
gl
ob
a
l
s
i
gn
i
f
ica
nc
e
a
n
d
p
o
ten
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ia
l
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mpa
c
t
o
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t
he
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e
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e
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or
s
a
s
f
u
tu
r
e
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ols
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o
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uo
us
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on
i
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o
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ie
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ti
s
ts
f
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om
va
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io
us
c
o
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ne
r
s
o
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he
gl
ob
e
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ve
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it
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d
t
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r
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xp
e
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.
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P
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1
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to
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249
RE
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RE
NC
E
S
[
1]
S
.
H
e
nki
n
a
nd
M
.
A
.
C
r
e
a
ge
r
,
“
V
a
s
c
ul
a
r
me
di
c
in
e
,”
C
ar
di
ol
ogy
C
li
ni
c
s
,
vol
.
39,
no.
4,
N
ov.
2021,
doi
:
10.1016/S
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21)
00077
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K
.
M
e
ng
e
t
al
.
,
“
W
e
a
r
a
bl
e
pr
e
s
s
ur
e
s
e
ns
or
s
f
or
pul
s
e
w
a
v
e
moni
to
r
in
g,”
A
dv
anc
e
d
M
at
e
r
ia
ls
,
vol
.
34,
no.
21,
M
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y
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22,
doi
:
10.1002/a
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3]
D
.
M
.
D
a
vi
d
s
on,
“
A
n
in
tr
oduc
ti
on
to
c
a
r
di
ova
s
c
ul
a
r
di
s
e
a
s
e
,”
Soc
ia
l
Suppor
t
and
C
a
r
di
ov
as
c
ul
ar
D
i
s
e
as
e
.
S
pr
in
ge
r
U
S
,
B
os
to
n,
M
A
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–
19, 1994, doi:
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1
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4899
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5_1.
[
4]
L
. L
.
L
. Y
e
o a
nd
T
. A
nde
r
s
s
on, “
S
tr
oke
, 6
th
e
di
ti
on pa
th
ophys
io
lo
gy, dia
gnos
is
, a
nd ma
na
ge
me
nt
by J
a
me
s
C
. G
r
ot
ta
,
G
r
e
gor
y W
.
A
lb
e
r
s
,
J
os
e
ph
P
.
B
r
ode
r
ic
k,
S
c
ot
t
E
.
K
a
s
ne
r
,
E
ng
H
.
L
o,
A
.
D
a
vi
d
M
e
nde
lo
w
, R
a
lp
h
L
.
S
a
c
c
o,
a
nd
L
a
w
r
e
nc
e
K
.
S
.
W
ong,”
A
c
ta
N
e
ur
oc
hi
r
ur
gi
c
a
, vol
. 159, no. 1, pp. 111
–
112, J
a
n. 2017, doi:
10.1007/s
00701
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016
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3037
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4.
[
5]
E
.
B
r
a
unw
a
ld
e
t
al
.
,
“
F
or
e
w
or
d,”
C
ar
di
o
-
O
nc
ol
ogy
P
r
ac
ti
c
e
M
anual:
a
C
om
pani
on
to
B
r
aunw
al
d
’
s
H
e
ar
t
D
is
e
as
e
.
E
ls
e
v
ie
r
,
2023, doi:
10.1016/B
978
-
0
-
323
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68135
-
3.00006
-
4.
[
6]
H
.
A
.
O
w
id
a
,
O
.
S
.
M
.
H
e
mi
e
d,
R
.
S
.
A
lk
ha
w
a
ld
e
h,
N
.
F
.
F
.
A
ls
hda
if
a
t,
a
nd
S
.
F
.
A
.
A
buowa
id
a
,
“
I
mpr
ove
d
de
e
p
le
a
r
ni
ng
a
ppr
oa
c
he
s
f
or
C
O
V
I
D
-
19
r
e
c
ogni
ti
on
in
C
T
im
a
ge
s
,”
J
ou
r
n
al
of
T
he
or
e
ti
c
al
and
A
ppl
ie
d
I
nf
or
m
at
io
n
T
e
c
hnol
ogy
,
vol
.
100,
no. 13, pp. 4925
–
4931, 2022.
[
7]
X
.
L
iu
,
P
.
X
io
ng,
L
.
L
i,
M
.
Y
a
ng,
M
.
Y
a
ng,
a
nd
C
.
M
a
o,
“
M
oni
to
r
in
g
c
a
r
di
ova
s
c
ul
a
r
di
s
e
a
s
e
s
e
v
e
r
it
y
us
in
g
ne
a
r
-
in
f
r
a
r
e
d
me
c
ha
nol
umi
ne
s
c
e
nt
ma
te
r
ia
ls
a
s
a
bui
lt
-
in
in
d
ic
a
to
r
,”
M
at
e
r
ia
ls
H
or
iz
ons
,
vol
.
9,
no.
6,
pp.
1658
–
1669,
20
22,
doi
:
10.1039/D2M
H
00320A.
[
8]
P
.
H
.
C
ha
r
lt
on,
P
.
A
.
K
yr
ia
c
ou,
J
.
M
a
nt
,
V
.
M
a
r
oz
a
s
,
P
.
C
how
ie
nc
z
yk,
a
nd
J
.
A
la
s
tr
ue
y,
“
W
e
a
r
a
bl
e
phot
opl
e
th
ys
mogr
a
phy
f
or
c
a
r
di
ova
s
c
ul
a
r
moni
to
r
in
g,”
in
P
r
oc
e
e
di
ngs
of
th
e
I
E
E
E
,
vol
.
110,
no.
3,
pp.
355
–
381,
M
a
r
.
2022,
doi
:
10.1109/J
P
R
O
C
.2022.3149785.
[
9]
L
.
W
a
ng
a
nd
Y
.
Z
ha
n,
“
A
c
on
c
e
pt
ua
l
pe
e
r
r
e
vi
e
w
mode
l
f
or
a
r
X
iv
a
nd
ot
he
r
pr
e
pr
in
t
da
ta
ba
s
e
s
,”
L
e
ar
ne
d
P
ubl
is
hi
ng
,
vol
.
32,
no. 3, pp. 213
–
219, J
ul
. 2019, doi:
10.1002/l
e
a
p.1229.
[
10]
R
. L
. V
e
r
r
ie
r
, B
. D
.
N
e
a
r
in
g, a
nd A
.
D
’
A
vi
la
, “
S
pe
c
tr
um
of
c
li
ni
c
a
l
a
ppl
ic
a
ti
ons
of
i
nt
e
r
le
a
d
E
C
G
he
te
r
oge
ne
it
y a
s
s
e
s
s
me
nt
:
f
r
om
myoc
a
r
di
a
l
is
c
he
mi
a
de
te
c
ti
on
to
s
udde
n
c
a
r
di
a
c
d
e
a
th
r
is
k
s
tr
a
ti
f
ic
a
ti
on,”
A
nnal
s
of
N
oni
nv
a
s
iv
e
E
le
c
t
r
oc
ar
di
ol
ogy
,
vol
.
26,
no. 6, pp. e
12894
–
e
12894, Nov. 2021, d
oi
:
10.1111/a
ne
c
.12894
.
[
11]
H
.
A
bu
O
w
id
a
,
H
.
S
.
M
ig
da
di
,
O
.
S
.
M
oha
m
e
d
H
e
mi
e
d,
N
.
F
.
F
a
nkur
A
ls
hda
if
a
t,
S
.
F
.
A
hma
d
A
buowa
id
a
,
a
nd
R
.
S
.
A
lk
ha
w
a
ld
e
h,
“
D
e
e
p
le
a
r
ni
ng
a
lg
or
it
hms
to
im
pr
ove
C
O
V
I
D
-
19
c
la
s
s
if
ic
a
ti
on
ba
s
e
d
on
C
T
im
a
ge
s
,
”
B
ul
le
ti
n
of
E
le
c
t
r
ic
al
E
ngi
ne
e
r
in
g and I
nf
or
m
at
ic
s
, vol
. 11, no. 5, pp. 2876
–
2885, Oc
t.
2022, doi:
10.11591/ee
i.
v11i
5.3802.
[
12]
L
.
D
a
ghe
r
,
H
.
S
hi
,
Y
.
Z
ha
o,
a
nd
N
.
F
.
M
a
r
r
ouc
he
,
“
W
e
a
r
a
bl
e
s
in
c
a
r
di
ol
ogy:
he
r
e
to
s
ta
y,
”
H
e
a
r
t
R
hy
th
m
,
vol
.
17,
n
o.
5,
pp. 889
–
895, M
a
y 2020, doi:
10.1016/j
.hr
th
m.2020.02.023.
[
13]
E
.
M
.
C
r
oni
n
a
nd
N
.
V
a
r
ma
,
“
R
e
mot
e
moni
to
r
in
g
of
c
a
r
di
ov
a
s
c
ul
a
r
im
pl
a
nt
e
d
e
le
c
tr
oni
c
de
vi
c
e
s
:
a
pa
r
a
di
gm
s
hi
f
t
f
or
th
e
21
s
t
c
e
nt
ur
y,”
E
x
pe
r
t
R
e
v
ie
w
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di
a
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a
s
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di
a
gno
s
is
u
s
in
g
f
e
a
tu
r
e
e
xt
r
a
c
ti
on
a
nd
ma
c
h
in
e
le
a
r
ni
ng
ba
s
e
d
c
la
s
s
if
ic
a
ti
on
w
it
h
in
te
r
ne
t
of
th
in
gs
(
I
oT
)
,”
C
onc
ur
r
e
n
c
y
and
C
om
put
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s
e
d
c
a
r
di
a
c
he
a
lt
hc
a
r
e
s
ys
te
m
f
or
ubi
qui
to
us
he
a
lt
hc
a
r
e
s
e
r
vi
c
e
,
”
in
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I
nt
e
r
nat
io
nal
C
ongr
e
s
s
of
A
dv
anc
e
d
T
e
c
hnol
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E
ngi
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r
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g
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E
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hnol
o
gi
e
s
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f
le
xi
bl
e
pr
e
s
s
ur
e
s
e
ns
or
s
:
ma
te
r
ia
ls
,
mode
li
ng,
de
vi
c
e
s
,
a
n
d
ma
nuf
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g,”
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s
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or
pul
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ve
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to
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A
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e
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ur
e
,”
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lo
od
P
r
e
s
s
ur
e
M
oni
to
r
in
g
in
C
ar
di
ov
a
s
c
ul
ar
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e
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e
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T
he
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ti
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D
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s
ig
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a
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I
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e
gr
a
te
d
lo
w
-
c
os
t
e
le
c
tr
os
pi
nni
ng
de
vi
c
e
f
or
na
nof
ib
r
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s
c
a
f
f
ol
d f
a
br
ic
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a
l
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e
z
oe
le
c
tr
ic
s
e
le
ni
um
na
now
ir
e
s
f
or
w
e
a
r
a
bl
e
s
e
lf
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pow
e
r
e
d
huma
n
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tr
ib
oe
le
c
tr
ic
na
noge
ne
r
a
to
r
vi
a
f
a
c
il
e
va
c
uum
-
a
s
s
is
ta
nt
f
il
tr
a
ti
on
me
th
od
f
o
r
s
e
lf
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e
r
e
d bi
ome
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ni
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T
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z
or
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s
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ve
e
f
f
e
c
t
a
nd
it
s
a
ppl
ic
a
ti
on
s
,”
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e
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ie
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Spr
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nge
r
Se
r
ie
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he
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ic
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ns
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io
s
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or
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e
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ogr
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in
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bl
e
c
a
pa
c
it
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e
s
e
n
s
or
s
:
s
tr
uc
tu
r
e
s
a
nd
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ti
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on
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r
y
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s
s
,
s
e
c
o
nd
e
d
it
i
on
G
r
a
vl
e
e
,
D
a
vi
s
,
K
u
r
us
z
,
U
tl
e
y
,
L
ip
pi
nc
o
t
t
W
i
ll
ia
ms
a
b;
W
il
k
in
s
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20
00
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39
.0
0,
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ge
s
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”
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Su
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18
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20
01
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.1
01
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/S
096
7
-
2
1
09
(
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1
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0
00
05
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to
r
in
g:
r
e
c
e
nt
e
vi
de
nc
e
a
nd
c
li
ni
c
a
l
ph
a
r
ma
c
y
a
ppl
ic
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ti
ons
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”
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har
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ac
ot
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a
py
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T
he
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lo
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e
s
s
ur
e
moni
t
or
in
g:
a
s
ta
te
me
nt
f
r
om
th
e
H
O
P
E
A
s
ia
N
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T
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g
vi
a
a
ma
c
hi
ne
‐
le
a
r
ni
ng‐
a
s
s
is
te
d
te
xt
il
e
tr
ib
oe
le
c
tr
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f
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ur
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f
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ur
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gnos
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ul
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bl
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ir
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s
ba
tt
e
r
yl
e
s
s
va
s
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ul
a
r
e
le
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tr
oni
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s
w
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h
pr
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te
d
s
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t
s
e
ns
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e
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s
e
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ic
ia
l
a
r
te
r
y
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r
om
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r
e
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i
nt
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g
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h
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l
t
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e
r
r
oe
le
c
tr
ic
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y
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nd
ti
s
s
ue
-
ma
tc
hi
ng
modul
u
s
f
or
r
e
a
l
-
ti
me
s
e
ns
in
g
a
nd
o
c
c
lu
s
io
n
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to
r
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g,”
A
dv
anc
e
d
F
unc
ti
onal
M
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le
c
tr
ic
al
E
ngi
ne
e
r
in
g and I
nf
or
m
at
ic
s
, vol
. 12, no. 2, pp. 891
–
901, Apr
. 2023, doi:
10.11591/ee
i.
v12i
2.4310.
[
62]
H
.
A
bu
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.
,
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nc
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im
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gi
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s
c
r
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ni
ng,”
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nt
e
r
nat
i
onal
J
our
nal
of
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le
c
tr
ic
al
and
C
om
put
e
r
E
ngi
ne
e
r
in
g
,
vol
.
14,
no.
2,
p
p
.
2234
–
2241
,
A
pr
.
2024,
doi
:
10.11591/i
je
c
e
.v14i2.pp22
34
-
2241.
Evaluation Warning : The document was created with Spire.PDF for Python.
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Evaluation Warning : The document was created with Spire.PDF for Python.