Chung-Dann Kan
Current Position
Vice Dean, Education Affairs, College of Medicine
Professor and Visiting Staff, Cardiovascular Surgery
National Cheng Kung University Hospital
Access Session

Topic: Development and application of wearable monitoring device for hemodialysis access


End-stage renal disease (ESRD) has become a global issue and a considerable strain on Taiwan's  healthcare system. For decades, researchers have been developing wearables to monitor and track hemodynamically significant dialysis access stenosis. Develop cutting-edge wearables for assessing and monitoring dialysis access stenosis that is hemodynamically severe. Particularly at high frequencies and in specific locations, the sound becomes more intense as the area is reduced. On the other hand, it is hypothesized that significant local stenosis increases vascular resistance and slows blood flow through the graft or fistula, hence decreasing vascular sound.
While phonoangiography (PAG) is successful at detecting DOS at an early stage, it can be difficult to distinguish between severe stenosis and near-total occlusion. Photoplethysmography (PPG) detectors can detect lower blood flow due by arteriovenous access (AVA) stenosis; however, this reduction in blood flow may not appear for up to 80% of the stenosis, making it problematic to employ PPG for early diagnosis of AVA stenosis. Several areas of cardiovascular medicine, including heart failure, electrophysiology, valvular heart disease, and coronary artery disease, are increasingly adopting machine learning algorithms. By automating cardiac measurements, AI systems can improve clinical judgment and diagnostic capabilities for heart failure. On a large scale, ML is used to uncover latent heart issues in diagnostic data. Combining PAG, PPG, and an artificial intelligence (AI) wearable medical device for the early and precise diagnosis of AVA stenosis in ESRD patients is encouraging as the partnership between researchers and physicians continues to improve.

Keywords: phonoangiography (PAG), Photoplethysmography (PPG), Smart Wearable Medical device