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. 2023 May 30;2(4):187-195.
doi: 10.1016/j.cjcpc.2023.05.007. eCollection 2023 Aug.

Textile-based Wearable to Monitor Heart Activity in Paediatric Population: A Pilot Study

Nasim Montazeri Ghahjaverstan  1   2 , Diana Balmer-Minnes  3 , Behrad Taghibeyglou  1   2 , Bastien Moineau  4 , Gabriela Chaves  4 , Milad Alizadeh-Meghrazi  4 , Barbara Cifra  3 , Aamir Jeewa  3 , Azadeh Yadollahi  1   2
Affiliations

Textile-based Wearable to Monitor Heart Activity in Paediatric Population: A Pilot Study

Nasim Montazeri Ghahjaverstan et al. CJC Pediatr Congenit Heart Dis. .

Abstract
in English, French

Background: Cardiac monitoring for children with heart disease still employs common clinical techniques that require visits to hospital either in an ambulatory or inpatient setting. Frequent cardiac monitoring, such as heart rate monitoring, can limit children's physical activity and quality of life. The main objective of this study is to evaluate the performance of a textile-based device (SKIIN) in measuring heart rate (HR) in different tasks: lying down, sitting, standing, exercising, and cooling down.

Methods: Twenty participants including healthy children and children with heart disease were included in this study. The difference between the HRs recorded by the SKIIN was compared with a reference electrocardiogram collection by normalized root mean squared error. Participants completed a questionnaire on their experience wearing the textile device with additional parental feedback on the textile device collected.

Results: Participants had the median age of 14 years (range: 10-17 years), with body mass index 23.1 ± 3.8 kg/m2 and body surface area 1.70 ± 0.25 m2. The HR recorded by SKIIN and reference system significantly changes between tasks (P < 0.001), while not significantly different from each other (P > 0.05). The normalized root mean squared error was 3.8% ± 3.0% and 3.6% ± 3.7% for healthy and the heart disease groups, respectively. All participants found the textile device non-irritating and easy to wear.

Conclusions: This study provides proof of concept that HR can be robustly and conveniently monitored by smart textiles, with similar accuracy to standard-of-care devices.

Contexte: Encore aujourd’hui, la surveillance cardiaque chez les enfants atteints de cardiopathie repose sur des techniques cliniques courantes qui doivent être réalisées à l’hôpital, en soins ambulatoires ou en contexte d’hospitalisation. Chez les enfants, la surveillance cardiaque répétée, comme c’est le cas pour la fréquence cardiaque (FC), peut limiter leurs activités physiques et leur qualité de vie. La présente étude évalue principalement la performance d’un dispositif textile (SKIIN) dans la mesure de la FC pendant différentes tâches : en position couchée, en position assise, en position debout, pendant l’activité physique et pendant le retour au calme.

Méthodologie: Vingt participants, y compris des enfants en santé et des enfants présentant une cardiopathie, ont été inclus dans l’étude. La différence entre la FC enregistrée par le dispositif SKIIN et la FC mesurée par une électrocardiographie (ECG) de référence a été comparée à l’aide de la racine de l’erreur quadratique moyenne normalisée (REQMN). Les participants ont rempli un questionnaire sur leur expérience avec le dispositif textile, et les commentaires des parents sur ce dispositif ont été recueillis.

Résultats: Les participants avaient un âge médian de 14 ans [10-17 ans], un indice de masse corporelle de 23,1 ± 3,8 kg/m2 et une surface corporelle de 1,70 ± 0,25 m2. La FC enregistrée par le système SKIIN et le système de référence variait significativement d’une tâche à l’autre (p < 0,001), mais il n’y avait pas de différence significative entre les deux systèmes (p > 0,05). La REQMN était de 3,8 ± 3,0 % pour le groupe en santé et de 3,6 ± 3,7 % pour le groupe présentant une cardiopathie. Tous les participants ont trouvé que le dispositif textile ne causait pas d’irritation et qu’il était facile à porter.

Conclusions: Cette étude démontre que les textiles intelligents permettent de surveiller la FC de façon fiable et pratique, avec une exactitude semblable à celle des dispositifs de référence.

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Figures

Figure 1
Figure 1
(A) The SKIIN device with conductive textile sensors integrated in the base textile stretch band, (B) a participant wearing the SKIIN band and recording textile-based ECG via a smart device that receives the data from the pod, and using a specifically developed application traces the data and transfers them to a secure cloud-based memory. (C) The pod that is inserted to the charger, and (D) spatial location of the textile sensors, fastening mechanism, and the pod that includes the computing and data transferring modules. ECG, electrocardiogram; RLD, The right leg drive (the body bias).
Figure 2
Figure 2
The schematic overview of the study protocol. ECG, electrocardiogram.
Figure 3
Figure 3
(A) The overview of the data analysis, (B) an example trace of segmenting reference ECG, and (C) an example of processing to extract R peaks from noisy ECG. ECG, electrocardiogram.
Figure 4
Figure 4
Sample trace of (A) the reference ECG and (B) smart textile ECG along with the detected R peaks. The solid signals are recorded ECGs and the thick grey signals are the reconstructed ECGs by the wavelet technique. The cross signs mark R peaks. ECG, electrocardiogram.
Figure 5
Figure 5
Comparing extracted heart rate from the SKIIN textile device with the reference heart rate during an experiment.
Figure 6
Figure 6
Average heart rate in different states of the experiment extracted from reference ECG compared with 3 different channels of the textile device for (A) heart disease and (B) healthy groups. ∗P value <0.001. There is no significant difference between the average heart rate from Reference and from the SKIIN device channels. ECG, electrocardiogram.
Figure 7
Figure 7
Bland-Altman plots for comparing the average heart rate measured via a textile device with the reference measurement in different channels for (A) supine, (B) sitting, (C) standing, (D) exercise, and (E) resting. Each point is the average heart rate over the full task.
See this image and copyright information in PMC

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