Intellewave Theoretical Review and Clinical Use

There is well known that decreasing of Parasympathetic activity directly correspond with the damage of Parasympathetic receptors after any pathology. As result, the goal of Autonomic Function testing is to recognize the stage of pathological developments by assessments of the level of Parasympathetic activity.
Assessment of Sympathetic Nervous system activity clinically makes sense to see the stress level and acute of some problems for instance; acute or infarct of the myocardium, acute of intoxication and others. A decrease of Sympathetic activity in most of the cases related to degenerative joint diseases for elderly people and beta-blockers overdosage. But clinical issues of different Sympathetic activities level can exist only in case of pathological decreasing of Parasympathetic function. In case of positive Parasympathetic activity different Sympathetic level make sense only as a normal physiological activity.
Another aspect of Autonomic Function testing based on Heart Rate Variability analysis is Risk Stratification of Sudden Cardiac Arrest. It's the most effective if combined with appropriate clinical and/or ECG evidence like T-wave alternate, but sometimes even without it.

Quantitative Assessment of ANS based on heart rate variability analysis has been the subject of intensive research for the past four decades. Currently, multiple facets of its theoretical and practical value encourage numerous cutting-edge investigational studies in both basic and clinical research. However, for many years this method has remained the privilege of research laboratories and was not accessible to medical practitioners, and only recently was recognized for its effectiveness in clinical use by the FDA, AAMI, ANSI, a number of health organizations and insurance companies.

Intellewave technology is unique in its ability to automatically differentiate between Sympathetic and Parasympathetic influences on R-R intervals variability regulation mechanisms by using the proprietary patented method based on Artificial Intelligence theory. Such of method did not require any other source of information than R-R intervals variability.

Hence, we included here an overview of theoretical and practical aspects of ANS assessment based on HRV, provided by courtesy of Alexander Riftine, Ph.D., a distinguished investigator recognized worldwide for his contribution in heart rate variability research.

This theoretical overview covers results of Dr. Riftine’s multiple investigational projects, uses statistical data accumulated over the period of 35 years, and incorporates findings of other published research studies in Heart Rate Variability analysis and ANS assessment. To illustrate typical cases of ANS reaction to controlled exercises, the author selected results from patients tested with Intellewave system, as this system is currently on the U.S. medical market.

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The new method and quantitative assessment of the relationship between sympathetic and parasympathetic activities level based on spectral analysis of R-R intervals variability.

 

Traditionally, doctors and physiologists around the world imaged relationship between sympathetic and parasympathetic activities level as a system as one dimension.

This image mentions the case where SNS going up PSNS going down or opposite PSNS going up and SNS going down: WHICH IS NOT TRUE. Simple case very well-known is degenerative joint diseases, in such of the case all autonomic nervous centers is degenerative as result SNS as well as PSNS simultaneously going down. Opposite case imagines an athlete waiting to start, in such of the case, PSNS activity must be on a high level since athlete must be totally relaxed because if he is under stress his PSNS decreased and he will never start on time. But sympatho-adrenergic function must be also on a high level, to be able immediately to start on time, in their case both branches of ANS -  PSNS and SNS must be simultaneously on a high level of activity. This case also contradicts the traditional image of SNS /PSNS as a system of one dimension. As result by definition, the image of autonomic nervous system function must be the system of 2-dimension, but until now there was no existing method to quantitate assessment of the level of activity SNS / PSNS in such of the system of 2-dimension. Because it’s required method for full automatic calculation level of activity SNS and PSNS independently. Until now doctors that work in these fields can provide the indirect assessment of the level activity of SNS / PSNS based on clinical and laboratory data. By Intellewave system, we receive first practical and fully automatic system for quantitative assessment of the Autonomic Nervous system based on spectral analysis of RR interval variability derived from ECG data stream only. See USA Patent N 7,826,892 B2 at November 2, 2010.

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