Detection of hemodynamic adaptations during impending syncope: implementation of a robust algorithm based on pulse arrival time measurements only.

Syncopes are a major public health concern since they can cause severe injuries e.g. by associated falls. We previously demonstrated the feasibility of syncope prediction based on the pulse arrival time (PAT) analysis. Importantly, algorithms for early detection of impending syncope need to be robust against measurement noise, in particular photoplethysmography (PPG) artifacts, causing false detection. We introduce in this work an algorithm concept to deal with artifacts as well as to detect the onset of syncope based on tracking of relative PAT changes only. Our method has been shown useful to improve detection performance for measurements during impending syncope in patients undergoing head-up tilt table testing which might improve syncope prediction.