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Class of 2016 Abstract / Objectives: This study assessed the feasibility of using a hand-held single lead ECG device to collect readable electrocardiograms (ECGs) in a community setting among the general population. Next, the goal was to determine if QT intervals could be measured from the collected ECGs. Additionally, this study was designed to examine if patients who had a prolonged QT interval were taking medications that are associated with an increased risk of prolonged QT interval. Methods: This prospective pilot study involved collecting ECGs via an AliveCor hand-held device at community health fairs. ECGs were evaluated for usefulness and QT intervals were measured if possible. Results: Forty-eight subjects participated in this pilot study. Forty-five viable ECGs were recorded using the hand-held device. Of the 45 ECGs, 38 were of sufficient quality to measure the QT interval and calculate QTc interval. There were no prolonged QT intervals observed in this study. Conclusions: The hand-held device recorded sufficient information to extract QT intervals for the majority of subjects. Due to the lack of prolonged QTc intervals, there was insufficient data to determine if this device could be utilized in the detection of QT prolongation due to medication use.

Orientador: Ivanil Sebastião Bonatti / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Eletrica e de Computação / Made available in DSpace on 2018-08-12T20:20:55Z (GMT). No. of bitstreams: 1 Agulhari_CristianoMarcos_M.pdf: 901688 bytes, checksum: 97ec8feb4ee297c319c80463616a7391 (MD5) Previous issue date: 2009 / Resumo: A principal contribuição desta dissertação é a proposta de dois métodos de compressão de eletrocardiogramas (ECGs). O primeiro método, chamado Run Length Encoding Adaptativo (RLEA), é baseado nas transformadas wavelet e consiste basicamente em utilizar uma função wavelet, obtida pela resolução de um problema de otimização, que se ajuste ao sinal a ser comprimido. O problema de otimização torna-se irrestrito com a parametrização dos coeficientes do filtro escala, que definem unicamente uma função wavelet. Após a resolução do problema de otimização é aplicado o procedimento de decomposição wavelet no sinal e os coeficientes de representação mais significativos são retidos, sendo que o número de coeficientes retidos é determinado de forma a satisfazer uma medida de distorção pré-especificada. Os coeficientes retidos são então quantizados e compactados, assim como o bitmap que indica as posições dos coeficientes retidos. A quantização é feita de forma adaptativa, utilizando diferentes números de bits de quantização para os diferentes subespaços de decomposição considerados. Tanto os valores dos coeficientes retidos quanto o bitmap são codificados utilizando uma variante do método Run Length Encoding. O segundo método proposto nesta dissertação, chamado Zero Padding Singular Values Decomposition (ZPSVD), consiste em primeiramente detectar os batimentos, equalizá-los pela inserção de zeros (zero padding) e então aplicar a decomposição SVD para obter tanto a base quanto os coeficientes de representação dos batimentos. Alguns componentes da base são retidos e então comprimidos utilizando os mesmos procedimentos aplicados aos coeficientes de decomposição do ECG no método RLEA, enquanto que os coeficientes de projeção dos batimentos nessa base são quantizados utilizando um procedimento de quantização adaptativa. Os dois métodos de compressão propostos são comparados com diversos outros métodos existentes na literatura por meio de experimentos numéricos / Abstract: The main contribution of the present thesis is the proposition of two electrocardiogram (ECG) compression methods. The first method, called Run Length Encoding Adaptativo (RLEA), is based on wavelet transforms and consists of using a wavelet function, obtained by the resolution of an optimization problem, which fits to the signal to be compressed. The optimization problem becomes unconstrained with the parametrization of the coefficients of the scaling filter, that define uniquely a wavelet function. After the resolution of the optimization problem, the wavelet decomposition procedure is applied to the signal and the most significant coefficients of representation are retained, being the number of retained coefficients determined in order to satisfty a pre-specified distortion measure. The retained coefficients are quantized and compressed, likewise the bitmap that informs the positions of the retained coefficients. The quantization is performed in an adaptive way, using different numbers of bits for the different decomposition subspaces considered. Both the values of the retained coefficients and the bitmap are encoded using a modi- fied version of the Run Length Encoding technique. The second method proposed in this dissertation, called Zero Padding Singular Values Decomposition (ZPSVD), consists of detecting the beat pulses of the ECG, equalizing the pulses by inserting zeros (zero padding), and finally applying the SVD to obtain both the basis and the coefficients of representation of the beat pulses. Some components of the basis are retained and then compressed using the same procedures applied to the coefficients of decomposition of the ECG in the RLEA method, while the coefficients of projection of the beat pulses in the basis are quantized using an adaptive quantization procedure. Both proposed compression methods are compared to other techniques by means of numerical experiments / Mestrado / Telecomunicações e Telemática / Mestre em Engenharia Elétrica

LIMA, M. A. Sistema remoto para análise automática de ECGs nos padrões HL7 AECG e DICOM-ECG. 2017. 78 f. Dissertação (Mestrado em Engenharia de Teleinformática)–Centro de Tecnologia, Universidade Federal do Ceará, Fortaleza, 2017. / Submitted by Marlene Sousa (mmarlene@ufc.br) on 2017-09-25T17:22:14Z No. of bitstreams: 1 2017_dis_malima.pdf: 1997199 bytes, checksum: 6819aa354bd4c431de68f3bd5aca3b39 (MD5) / Approved for entry into archive by Marlene Sousa (mmarlene@ufc.br) on 2017-09-25T17:23:17Z (GMT) No. of bitstreams: 1 2017_dis_malima.pdf: 1997199 bytes, checksum: 6819aa354bd4c431de68f3bd5aca3b39 (MD5) / Made available in DSpace on 2017-09-25T17:23:17Z (GMT). No. of bitstreams: 1 2017_dis_malima.pdf: 1997199 bytes, checksum: 6819aa354bd4c431de68f3bd5aca3b39 (MD5) Previous issue date: 2017 / According to the World Health Organization, about 17.5 million people die each year from cardiovascular disease. The early diagnosis and treatment is crucial to reduce this high number of deaths from cardiovascular diseases. Due to the importance of the electrocardiogram (ECG) analysis, which represents one of the main tests for the detection of these cardiovascular diseases, in the present dissertation is proposed a remote system for automatic ECGs analysis based on webservices that can substantially assist the doctor, using the extracted ECGs information, with the purpose to generate reports. Hence, a Middleware is proposed to abstract the complexities and to facilitate the construction of tools that allow the ECGs automatic analysis. The proposed architecture consists on a server which provides the computational algorithms to identify the main waves present in ECGs such as QRS complex, P and T waves, and support the open standards of HL7 aECG and DICOM-ECG. In order to validate the proposed Middleware and contribute to the medical community, especially the Walter Cantídio University Hospital, a Web application for remotely accessible ECG report was developed. The proposed solution was tested using the database MITDB to simulate the patients of the system and produce the results presented in this dissertation. The proposed solution met the established requirements which makes the proposed solution viable financially and technically. / De acordo com a Organização Mundial da Saúde (OMS), cerca de 17,5 milhões de pessoas morrem todos os anos vítimas de doenças cardiovasculares. O diagnóstico e tratamento precoce às pessoas com doenças cardiovasculares é fundamental para reduzir este número elevado de óbitos. Devido à importância da análise de Eletrocardiograma (ECG), que representa um dos principais exames para detecção destas doenças cardiovasculares, na presente dissertação é proposto um sistema remoto para análise automática de Eletrocardiograma (ECG)s baseado em Web services que pode auxiliar substancialmente o médico especialista, a partir de informações extraídas de ECGs, na emissão de laudos. Neste sentido, propõe-se um Middleware para abstrair as complexidades e facilitar a construção de ferramentas que permitam a análise automática de ECGs. Na arquitetura proposta, um servidor disponibiliza os algoritmos computacionais para identificação das principais ondas presentes nos ECGs tais como complexo QRS, ondas P e T, e suporte aos padrões abertos de exames HL7 aECG e DICOM-ECG. Para validar o Middleware proposto e contribuir com a comunidade médica, em especial do Hospital Universitário Walter Cantídio, desenvolve-se uma aplicação Web para geração de laudos de ECGs acessível remotamente. Testes foram realizados com a solução proposta, utilizando-se a base de dados MIT-BIH Arrhythmia Database (MITDB) para simular os pacientes do sistema e produzir os resultados apresentados nesta dissertação. A solução proposta atendeu aos requisitos estabelecidos e representa uma solução viável, financeiramente e tecnicamente.

Indications are that autonomic under-arousal exists in children with ADHD. Published results are, however, controversial and few studies examine the relationship between the autonomic nervous system and focussed attention. In line with the indications of sympathetic under-arousal, patients with the disorder are treated with sympathomimetic stimulants such as Ritalin (methylphenidate). Since these medications stimulate the sympathetic nervous system, they possess the potential to influence cardiac function. The aims of this study were a) to assess autonomic nervous system functioning in 20 children with ADHD, as compared to controls, and to examine the effects of focussed attention and sympathomimetic medication on this system, b) to investigate cardiac functioning in 20 children with ADHD, as compared to controls, and to examine the effects of sympathomimetic medication on this system and c) to assess EEG functioning in children with ADHD, as compared to controls, and to examine the effects of sympathomimetic medication on this functioning. Children with ADHD were tested while they were stimulant-free and during a period in which they were on stimulant medication, while controls were tested once. Autonomic nervous system activity of the children was assessed at baseline and during focussed attention by means of heart rate variability (HRV) and skin conductivity. Attention was evoked by means of a program on the BioGraph Infiniti biofeedback apparatus, which is used specifically to train ADHD individuals to increase their attentive abilities. HRV was determined by time-domain, frequency-domain and Poincaré analysis of RR interval data. Skin conductivity was determined by BioGraph Infiniti biofeedback apparatus. Cardiac functioning of the children was assessed at baseline by means of blood pressure recordings and electrocardiograms (ECGs). Blood pressure was measured by means of a stethoscope and mercurial sphygmomanometer. ECGs were obtained by means of a Schiller CardioLaptop AT-110 ECG recorder using the standard 12-lead cable positioning for a resting ECG and parameters measured included HR, RR, QT, JT, QTc, JTc, QTd, JTd, QTcd and JTcd. EEG values were determined at baseline and during focussed attention by means of BioGraph Infiniti biofeedback apparatus. EEG values measured in this study included theta/beta ratios, theta/SMR ratios and thalpha, low alpha and high alpha power. The main findings of this study are that: <ul> <li>Stimulant-free ADHD children show a parasympathetic dominance of the sympathovagal balance relative to controls.</li> <li>Methylphenidate usage shifts the autonomic balance of children with ADHD towards normal levels; however a normal autonomic balance is not reached.</li> <li>Stimulant-free ADHD children exhibit a shift in the sympathovagal balance towards the sympathetic nervous system from baseline to focussed attention; however, methylphenidate abolishes this shift.</li> <li>Methylphenidate usage does not, in general, cause QTc or JTc prolongation but it may cause QTc or JTc prolongation in susceptible individuals.</li> <li>Children with ADHD can not be differentiated from normal children on the basis of theta/beta ratios, theta/SMR ratios or alpha power.</li> <li>Methylphenidate increases the level of centering in children with ADHD.</li> <li>Stimulant-free ADHD children display an alpha block from baseline to focussed attention; however, methylphenidate abolishes this alpha block.</li></ul> Copyright / Dissertation (MSc)--University of Pretoria, 2009. / Physiology / unrestricted

La modélisation du vivant, en particulier la modélisation de l'activité cardiaque, est devenue un défi scientifique majeur. Le but de cette thématique est de mieux comprendre les phénomènes physiologiques et donc d'apporter des solutions à des problèmes cliniques. Nous nous intéressons dans cette thèse à la modélisation et à l'étude numérique de l'activité électrique du cœur, en particulier l'étude des électrocardiogrammes (ECGs). L'onde électrique dans le cœur est gouvernée par un système d'équations de réaction-diffusion appelé modèle bidomaine ce système est couplé à une EDO représentant l'activité cellulaire. Afin simuler des ECGs, nous tenons en compte la propagation de l'onde électrique dans le thorax qui est décrite par une équation de diffusion. Nous commençons par une démonstrer l'existence d'une solution faible du système couplé cœur-thorax pour une classe de modèles ioniques phénoménologiques. Nous prouvons ensuite l'unicité de cette solution sous certaines conditions. Le plus grand apport de cette thèse est l'étude et la simulation numérique du couplage électrique cœur-thorax. Les résultats de simulations sont représentés à l'aide des ECGs. Dans une première partie, nous produisons des simulations pour un cas normal et pour des cas pathologiques (blocs de branche gauche et droit et des arhythmies). Nous étudions également l'impact de certaines hypothèses de modélisation sur les ECGs (couplage faible, utilisation du modèle monodomaine, isotropie, homogénéité cellulaire, comportement résistance-condensateur du péricarde,. . . ). Nous étudions à la fin de cette partie la sensibilité des ECGs par apport aux paramètres du modèle. En deuxième partie, nous effectuons l'analyse numérique de schémas du premier ordre en temps découplant les calculs du potentiel d'action et du potentiel extérieur. Puis, nous combinons ces schémas en temps avec un traîtement explicite du type Robin-Robin des conditions de couplage entre le cœur et le thorax. Nous proposons une analyse de stabilité de ces schémas et nous illustrons les résultats avec des simulations numériques d'ECGs. La dernière partie est consacrée à trois applications. Nous commençons par l'estimation de certains paramètres du modèle (conductivité du thorax et paramètres ioniques). Dans la deuxième application, qui est d'originie industrielle, nous utilisons des méthodes d'apprentissage statistique pour reconstruire des ECGs à partir de mesures ('électrogrammes). Enfin, nous présentons des simulations électro-mécaniques du coeur sur une géométrie réelle dans diverses situations physiologiques et pathologiques. Les indicateurs cliniques, électriques et mécaniques, calculés à partir de ces simulations sont très similaires à ceux observés en réalité.

Tesis por compendio / [ES] La fibrilación auricular (FA) es la arritmia cardíaca más común. A pesar de la gran popularidad de la ablación con catéter (AC) como tratamiento principal, todavía hay margen de mejora. Aunque las venas pulmonares (VPs) son los principales focos de FA, muchos sitios pueden contribuir a su propagación, formando el sustrato de la FA (SFA). El mapeo preciso del SFA y el registro de la modificación del SFA, como marcador positivo después de AC, son fundamentales. Los electrocardiogramas (ECG) y los electrogramas (EGM) se reclutan para este propósito. Los EGM se utilizan para detectar candidatos de AC como áreas que provocan o perpetúan la FA. Por lo tanto, el análisis de EGM es una parte indispensable de AC. Con la capacidad de observar las aurículas globalmente, la principal aplicación de los ECG es evaluar la modificación del SFA analizando las ondas f o P. A pesar del extenso análisis de cualquiera de los tipos de registro, existen algunas brechas. La AC no-VP aumenta el tiempo en quirófano, provocando mayores riesgos y costos. En cuanto al análisis de la modificación del SFA, se utilizan varios umbrales para definir una onda P prolongada. El principal objetivo de la presente Tesis es contribuir al esfuerzo de análisis de SFA y de modificación de SFA. Para ello, la presente Tesis se desarrolló bajo dos hipótesis principales. Que la calidad de la información extraída durante el SFA y el análisis de modificación del SFA se puede mejorar mediante la introducción de pasos innovadores. Además, la combinación de análisis de ECG y EGM puede aumentar la resolución del mapeo y revelar nueva información sobre los mecanismos de FA. Para cumplir con el objetivo principal, el análisis se divide en 4 partes, conformando los 4 capítulos del Compendio de articulos. En primer lugar, se reclutó la dimensión de correlación de grano grueso (DCGG). DCGG localizó de manera confiable EGM complejos y la clasificación por tipos de FA arrojó una precisión del 84 %. Luego, se adoptó un análisis alternativo de la onda P, estudiando por separado su primera y su segunda parte, correspondientes a la aurícula derecha (AD) e izquierda (AI). Los resultados indicaron LA como la principal fuente de modificación del SFA y subrayaron la importancia de estudiar partes integrales de ECG. Los hallazgos de este estudio también sugieren la implementación de partes integrales de ondas P como un posible alivio de las discrepancias en los umbrales de ondas P para definir el tejido fibrótico. Posteriormente, se estudió el efecto diferente del aislamiento de la VP izquierda (AVPI) y derecha (AVPD) sobre la modificación del SFA. AVPI fue la parte crítica, siendo la fuente exclusiva de acortamiento de onda P. El análisis de los registros durante la AC también permitió una observación más cercana de las fluctuaciones de la variabilidad de la frecuencia cardíaca (VFC) a lo largo del procedimiento de CA, lo que reveló información sobre el efecto de la energía de radiofrecuencia (RF) en el tejido auricular. La última parte se centró en el seno coronario (SC), una estructura fundamental en el mapeo de FA para aumentar la resolución de la información. Se definieron los canales más y menos robustos durante el ritmo sinusal (RS) y se investigó la utilidad de SC en la evaluación de la modificación del SFA. Aunque CS no proporcionó una imagen global de la alteración del SFA, pudo registrar con mayor sensibilidad las fluctuaciones en la respuesta auricular durante la AC. Los hallazgos presentados en esta Tesis Doctoral ofrecen una perspectiva alternativa sobre la modificación del SFA y contribuyen al esfuerzo general sobre el mapeo de FA y la evaluación del sustrato posterior a la CAAC, abriendo futuras líneas de investigación hacia una resolución más alta y un mapeo más eficiente de los mecanismos desencadenantes de la FA. / [CA] La fibril·lació auricular (FA) és l'arítmia cardíaca més comú. Tot i la gran popularitat de l'ablació amb catèter (AC) com a tractament principal, encara hi ha marge de millora. Tot i que les venes pulmonars (VPs) són els principals focus de FA, molts llocs poden contribuir a la seva propagació, formant el substrat de la FA (SFA). El mapatge precís de l'SFA i el registre de la modificació de l'SFA, com a marcador positiu després d'AC, són fonamentals. Els electrocardiogrames (ECG) i els electrogrames (EGM) es recluten per a aquest propòsit. Els EGM es fan servir per detectar candidats d'AC com a àrees que provoquen o perpetuen la FA. Per tant, lanàlisi dEGM és una part indispensable dAC. Amb la capacitat d'observar les aurícules globalment, la principal aplicació dels ECG és avaluar la modificació de l'SFA analitzant les ones f o P. Tot i l'extensa anàlisi de qualsevol dels tipus de registre, hi ha algunes bretxes. L'AC no-VP augmenta el temps a quiròfan, provocant majors riscos i costos. Pel que fa a l'anàlisi de la modificació de l'SFA, s'utilitzen diversos llindars per definir una ona P perllongada. L'objectiu principal d'aquesta Tesi és contribuir a l'esforç d'anàlisi de SFA i de modificació de SFA. Per això, aquesta Tesi es va desenvolupar sota dues hipòtesis principals. Que la qualitat de la informació extreta durant el SFA i lanàlisi de modificació de lSFA es pot millorar mitjançant la introducció de passos innovadors. A més, la combinació d'anàlisi d'ECG i EGM pot augmentar la resolució del mapatge i revelar informació nova sobre els mecanismes de FA. Per complir amb l'objectiu principal, l'anàlisi es divideix en 4 parts i es conforma els 4 capítols del Compendi d'articles. En primer lloc, es va reclutar la dimensió de correlació de gra gruixut (DCGG). DCGG va localitzar de manera fiable EGM complexos i la classificació per tipus de FA va donar una precisió del 84%. Després, es va adoptar una anàlisi alternativa de l'ona P, estudiant per separat la primera i la segona part corresponents a l'aurícula dreta (AD) i esquerra (AI). Els resultats van indicar LA com la font principal de modificació de l'SFA i van subratllar la importància d'estudiar parts integrals d'ECG. Les troballes d'aquest estudi també suggereixen la implementació de parts integrals d'ones P com a possible alleugeriment de les discrepàncies als llindars d'ones P per definir el teixit fibròtic. Posteriorment, es va estudiar l'efecte diferent de l'aïllament de la VP esquerra (AVPI) i la dreta (AVPD) sobre la modificació de l'SFA. AVPI va ser la part crítica, sent la font exclusiva d'escurçament d'ona P. L'anàlisi dels registres durant l'AC també va permetre una observació més propera de les fluctuacions de la variabilitat de la freqüència cardíaca (VFC) al llarg del procediment de CA , cosa que va revelar informació sobre l'efecte de l'energia de radiofreqüència (RF) en el teixit auricular. L'última part es va centrar al si coronari (SC), una estructura fonamental al mapeig de FA per augmentar la resolució de la informació. Es van definir els canals més i menys robustos durant el ritme sinusal (RS) i es va investigar la utilitat de SC a l'avaluació de la modificació de l'SFA. Tot i que CS no va proporcionar una imatge global de l'alteració de l'SFA, va poder registrar amb més sensibilitat les fluctuacions a la resposta auricular durant l'AC. Les troballes presentades en aquesta Tesi Doctoral ofereixen una perspectiva alternativa sobre la modificació de l'SFA i contribueixen a l'esforç general sobre el mapeig de FA i l'avaluació del substrat posterior a la CAAC, obrint futures línies de recerca cap a una resolució més alta i un mapeig més eficient dels mecanismes desencadenants de la FA. / [EN] Atrial fibrillation (AF) is the commonest cardiac arrhythmia. Despite the high popularity of catheter ablation (CA) as the main treatment, there is still room for improvement. Time spent in AF affects the AF confrontation and evolution, with 1,15% of paroxysmal AF patients progressing to persistent annually. Therefore, from diagnosis to follow-up, every aspect that contributes to the AF confrontation is of utmost importance. Although pulmonary veins (PVs) are the main AF foci, many sites may contribute to the AF propagation, by triggering or sustaining the AF, forming the AF substrate. Precise AF substrate mapping and recording of the AF substrate modification, as a positive marker after CA sessions, are critical. Electrocardiograms (ECGs) and electrograms (EGMs) are vastly recruited for this purpose. EGMs are used to detect candidate CA targets as areas that provoke or perpetuate AF. Hence, EGMs analysis is an indispensable part of the CA procedure. With the ability to observe the atria globally, ECGs' main application is to assess the AF substrate modification by analyzing f- or P-waves from recordings before and after CA. Despite the extensive analysis on either recording types, some gaps exist. Non-PV CA increases the time in operation room, provoking higher risks and costs. Furthermore, whether non-PV CA is beneficial is under dispute. As for the AF substrate modification analysis, various thresholds are used to define a prolonged P-wave, related with poor CA prognostics. The main objective of the present Thesis is to contribute to the effort of AF substrate and AF substrate modification analysis. For this purpose, the present Thesis was developed under two main hypotheses. That the information quality extracted during AF substrate and AF substrate modification analysis can be improved by introducing innovative steps. Also, that combining ECG and EGM analysis can augment the mapping resolution and reveal new information regarding AF mechanisms. To accomplish the main objective, the analysis is split in 4 parts, forming the 4 chapters of the Compendium of publications. Firstly, coarse-grained correlation dimension (CGCD) was recruited. CGCD reliably localized highly complex EGMs and classification by AF types yielded 84% accuracy. Then, an alternative P-wave analysis was suggested, studying separately the first and second P-wave parts, corresponding to the right (RA) and left (LA) atrium. The findings indicated LA as the main AF substrate modification source and underlined the importance of studying integral ECG parts. The findings of this study additionally suggest the implementation of integral P-wave parts as a possible alleviation for the discrepancies in P-wave thresholds to define fibrotic tissue. Afterwards, the different effect of left (LPVI) and right pulmonary vein isolation (RPVI) on the AF substrate modification was studied. LPVI was the critical part, being the exclusive source of P-wave shortening. Analysis of recordings during CA also allowed a closer observation of the heart rate variability (HRV) fluctuations throughout the CA procedure, revealing information on the effect of radiofrequency (RF) energy on the atrial tissue. The last part was focused on coronary sinus (CS), a fundamental structure in AF mapping to increase the information resolution. The most and least robust channels during sinus rhythm (SR) were defined and the utility of CS in AF substrate modification evaluation was investigated. Although CS did not provide a global picture of the AF substrate alteration, it was able to record with higher sensitivity the fluctuations in the atrial response during the application of RF energy. The findings presented in this Doctoral Thesis offer an alternative perspective on the AF substrate modification and contribute to the overall effort on AF mapping and post-CA substrate evaluation, opening future lines of research towards a higher resolution and more efficient mapping of the AF drivers. / Vraka, A. (2022). Characterization of the Substrate Modification in Patients Undergoing Catheter Ablation of Atrial Fibrillation [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/191410 / Compendio

<p>The last two decades have shown a boom in the field of wearable sensing technology. Particularly in the consumer industry, growing trends towards personalized health have pushed new devices to report many vital signs, with a demand for high accuracy and reliability. The most common technique used to gather these vitals is photoplethysmography or PPG. PPG devices are ideal for wearable applications as they are simple, power-efficient, and can be implemented on almost any area of the body. Traditionally PPGs were utilized for capturing just heart rate, however, recent advancements in hardware and digital processing have led to other metrics including respiratory rate (RR) and peripheral oxygen saturation (SpO2), to be reported as well. Our research investigates the potential for wearable devices to be used for outpatient apnea monitoring, and particularly the ability to detect opioid misuse resulting in respiratory depression. Ultimately, the long-term goal of this work is to develop a wearable device that can be used in the rehabilitation process to ensure both accountability and safety of the wearer. This document details contributions towards this goal through the design, development, and evaluation of a device called “Kick Ring”. Primarily, we investigate the ability of Kick Ring to record heartrate (HR), RR, and SpO2. Moreover, we show that the device can calculate RR in real time and can provide an immediate indication of abnormal events such as respiratory depression. Finally, we explore a novel method for reporting apnea events through the use of several PPG characteristics. Kick Ring reliably gathers respiratory metrics and offers a combination of features that does not exist in the current wearables space. These advancements will help to move the field forward, and eventually aid in early detection of life-threatening events.</p>