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Bedside arrhythmia monitor

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Research into a real-time arrhythmia detector began at the Biomedical Engineering Center for Clinical Instrumentation at MIT in the early 1970s under professor Roger Mark. One of his students, Paul Scott Schluter, chose this problem for his 1981 PhD thesis. His research focused on the development of an instrument that could improve the diagnosis and treatment of patients with cardiac arrythmias. Specifically, he saw the need for the development of a portable, cost-effective instrument that could monitor a patient’s heart rhythm in real time and provide instant feedback and analysis of that data. The finished product was a self-contained bedside monitor that performed real-time arrhythmia analysis on bed-bound patients and reproduced the arrhythmia pattern on a paper tape. It was easy to use, required little training to use effectively, and was effective in monitoring patients and catching potentially life-threatening cardiac events.

Schluter’s prototype monitor was successfully used clinically in Boston’s Beth Israel Hospital for two years during his doctoral work. After graduating in 1981, he and Roger Mark worked with the Waltham, Massachusetts firm Lifeline Systems to develop the product commercially. Lifeline provided Schluter and Mark funds to further develop the algorithm, and they also updated the front panel to be more user friendly. The system made it to market in February 1984, making it the first commercially available portable arrhythmia monitors.

Crucial to the development of this machine was the development and evaluations of algorithms that could detect and classify cardiac events from a patient’s electrocardiogram in real time. The development (and evaluation) of the algorithms used in the bedside arrythmia monitor was done through the creation of an annotated database of heart rhythm recordings which would later become the basis of the MIT-BIH Arrhythmia Database.

Working with Scott Peterson and George Moody, Schluter was instrumental in designing this database of electrocardiogram readings taken from patients at the Beth Israel Hospital with beat-by-beat annotations from physicians. Originally, the material was used internally at MIT and Beth Israel, and it served as the basis not only for the development of Schluter’s arrythmia algorithms, but also for the instrument’s evaluation. By 1980, however, the MIT-BIH Arrhythmia Database was released to the public. By the time Schluter finished his dissertation work, 14 other institutions had purchased the MIT-BIH database, and it soon became the standard database against which to test arrhythmia detectors, and an important tool for basic research into cardiac dynamics. It also eventually became one of the first databases distributed by PhysioNet, a repository of biomedical data and software maintained by MIT’s Laboratory for Computational Physiology.

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