1. Indigenous software for quantification of autonomic tone Prof. K K Deepak MD, PhD, MNAMS Professor of Physiology kkdeepak@gmail.com All India Institute of Medical Sciences New Delhi 110029 India

2. Autonomic controller PNS SNS High freq. Low freq. Aff. Nvs. ECG Autonomic Control of Function of Heart HRV pattern

3. Respiration Blood Pressure Cardiac Output Renin-Angioten. Thermoregul. Others inputs Autonomic controller PNS SNS High freq. Low freq. Aff. Nvs. ECG Autonomic Control of Function of Heart HRV pattern

4. Cardiovascular pathophysiology Myocardial Infarction Diabetic neuropathy Estimation of vagal tone Neurological disorders Migraine Applied aspect of Cardiac tone (HRV) MSA Assessment of neonatal ANS Hypertension

5. Cardiac Transplant Rejection End organ failure Hypertension Hypertensive Pregnancy Disorders Applied aspect of vascular tone (BPV) Risk factor for stroke / SCD / SIDS Prognosis in CHF

6. Autonomic Tone (HRV) in health and disease Healthy Heart AttackHeart transplant

7. Indigenously Developed HRV Software for the Quantification of Autonomic Tone Objectives Software development for measurement of Heart Rate Variability ( HRV_Soft ) and Blood Pressure Variability ( BPV_Soft ) Offline Data Analysis Online Data Acquisition Done

8. Development & Acquisition Tools Used 1.National Instruments USB-6008 DAQ 2.National Instruments (NI) Labview FDS 8.0 3.NI Measurement and Automation Libraries 1)Colin BP-508 BP Monitor 2)Finapres Ohmeda 2300 BP Monitor 3)DAS port (Nevrokard) 4)Analog ECG from any source

9. Patient DAQ Module (USB Based) Analysis & Storage Signal Source Flow Diagram Blood Pressure ECG HRV_Soft BPV_Soft

10. Main Panel of Indigenously Developed Software (HRV_Soft)

11. Heart Rate Variability

12. Validation of our HRV_Soft & studies carried out We acquired the ECG and BP Signal from the Nevrokard DAS port and FINAPRES simultaneously on our Software and Nevrokard Software. We compared the Time Domain, Frequency Domain & Non Linear Parameters The results were found to be Statistically comparable

13. Testing Model 1 Analysis Analog Signal Acquisition Nevrokard Digitization Analog Signal Acquisition Single patient source (ECG) HRV_Soft

14. Time Domain Parameters N=22

15. FREQUENCY DOMAIN PARAMETERS N=22

16. Testing Model Analysis Analog Signal Acquisition Nevrokard Digitization & Peak detection by our software BPV_SoftHRV_Soft Testing Model 2 Analog Signal Acquisition ( our software) Patient ECG

17. Pearson Correlation Test of HRV parameters obtained from 45 subjects as measured from HRV soft and Neurokard Statistical Parametersr2r2 r p Value (p<0.05) Range0.99951.0000.000 Mean0.99991.0000.000 Median0.88620.9440.000 Variance1.00001.0000.000 VLF%0.85970.9280.000 LF%0.94450.9750.000 HF%0.88550.9410.000 LF(nu)0.84550.9200.000 HF(nu)0.89970.9490.000 SD11.00001.0000.000 SD20.86490.9590.000 SD1/SD20.83940.9570.000

18. One more feature has been developed which can trace the path of Non Linear behavior. This actually analyses the phases of development of Poincare plot.

19. What is being delivered ?

20. Unique features of our software 1.Complete report generation in printable format as shown in fig below. Also all the parameter of time frequency & non-linear analysis are transferred to Excel sheet for maintaining Database 2. Additional Parameters than commercially available software. 3.Poincare tracking feature in poincare plot (Non-linear analysis) allows user to observe point-by-point movement of the plot 4.Provision for deleting artifacts present in the ECG waveform before performing Peak detection. 5.Robust fully automatic peak detection algorithm. 6.USB/Serial port connectivity & Easy to use Graphical User Interface. 7.Flexible & Cost Effective.

21. HRV-Soft BPV-Soft Analog to Digital Converter Any device that can pick ECG signals Any Biological signal: EEG/ EMG/ENG/ Resp/ EGG/ ICG Any device that can record Continuous BP Compatibility with existing systems General compatibility

22. 2007 19962004 2002