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Watching out for heart health



Fast and fatal.

That’s how Boris Golosarsky, an internist from New Hampshire, views the symptoms related to heart-rate variability. Even a seasoned marathoner with an iron constitution can suffer a heart attack out of the blue if there are discrepancies in the timing of the heart.


Golosarsky estimates about 400,000 heart attacks every year in the United States can be tied back to heart-rate variability. But his hypothesis hasn’t received widespread support in the medical community. That’s why he’s spent years developing a patent for a heart-rate variability watch that can track any adverse changes to the heart’s rhythm.


Golosarsky’s practice is close to Boston, a city densely packed with some of the finest higher education institutions in the country. He considered soliciting help from one of the local colleges to produce a prototype watch to bring to market. But when he wanted results, he didn’t bother with any of the prestigious schools in his backyard. He turned to the University of North Florida — and gained a plethora of resources and like-minded thinking. “Not everyone thinks the way I do in the medical field,” said Golosarsky, a physician with decades of experience in both America and Russia. “So I’m trying to help them see what I see. UNF helped me do that.”


Golosarsky handed over his prized research to a trio of UNF electrical engineering students who spent the better part of the last fall semester creating a heart-rate variability watch based on the doctor’s patent — all on a budget of a couple hundred dollars. Seniors Kevin Nguyen and Evan Stanley and junior John Gonzalez spent dozens of class hours fine tuning the watch’s design and functionality. It uses nine different formulas derived from Golosarsky’s research and measures a user’s natural heart rhythm via a chest strap transmitter synced to the watches receiver and remotely sets off an alarm for a patient’s care provider or the paramedics if it strays outside the comfort zones. It also allows users to sync their cell phones to make emergency calls or send text messages to chosen physicians in case of heart-rate turbulence. “It’s some pretty interesting stuff,” Nguyen said. “Most students don’t think they’ll be working on a class project that one day could be manufactured to help people. It’s kind of crazy if you think about it.”


Heart-Rate Variability importance

The watch sprung from the mind of Golosarsky, who devoted decades to studying the startling phenomenon of heart-rate variability contributing to unexpected heart attacks. Golosarsky said most medical experts and casual adherents to healthy living believe that plaque in the arteries and cholesterol are the most pressing heart-related concerns.


They’re partly right. He said a number of heart attacks happen in perfectly health hearts because of ventricular fibrillation, or a disconnect between the electrical and mechanical functions of the heart. He said a sudden abnormal heart rhythm, also known as an arrhythmia, could be fatal if left untreated for more than a few minutes. The more variability, the greater the likelihood of death.           


“It’s the result of instability in the heart, and the heart is a machine, like anything else,” Golosarsky said. “It’s like in a car. You can have the perfect engine, but if there’s an issue with the gas and brake pedal and the timing is wrong, it will break down like anything else.”


Golosarsky started focusing on heart-rate variability in the mid-’80s while he was still living in the USSR, now Russia. He reviewed dozens of cases involving sudden cardiac deaths and realized that cholesterol was only an ancillary issue for most of the deaths. It clicked for him when he started reading stress-assessment tests that were performed on cosmonauts in the mid-’60s. The candidates who had the greatest swings in heart-rate variability were most likely to suffer catastrophic cardiac events. “HRV (heart-rate variability) is not just an approach to see how the heart works, it’s a measure of how the entire parasympathetic and sympathetic systems act,” he said. “It speaks to the whole body, and you can make assumptions about the whole body's well being based on the HRV.”


Golosarsky’s focus on bringing heart-rate variability to the forefront of the national cardiac health conversation has been driving him for the past two decades. He came up with patents and a rough prototype of a device that could track variability, but he wanted to find a way to alert paramedics if a myocardial infarction was imminent. The only thing missing was some additional design and functionality help. That’s what brought him to Colorado, and that’s what put him on UNF’s radar.


An Education Connection

Dr. Gerry Merckel, an associate dean and professor in UNF’s College of Computing, Engineering and Construction, has attended multiple conferences for the Institute of Electrical and Electronics Engineers. He expected the June 2010 conference in Colorado to be much the same — lots of speeches, some networking and a few banquet-style dinners. And then he heard Golosarsky’s distinctive voice slice through the conference crowd.


Merckel said he only had to listen to a few seconds of the Russian doctor’s presentation to realize his passion for his work was contagious. The internist regaled the conference crowd with his life’s research and Merckel was captivated by the other man’s dedication to his craft. And when he heard about the untapped potential tied to heart-rate variability, he immediately started brainstorming ways to transfer that over to UNF. “It seemed like something way outside of the norm,” Merckel said. “Most of the discussions I had heard during the conference were pretty dry for someone like me, who was looking for a way to relate some of it back to college students,” he said. “But Boris [Golosarsky] cut through that.”


Merckel said he approached Golosarsky after the conference with a deal. His students would make the heart-rate variability watch with Bluetooth functionality, completely free-of-charge. All the doctor needed to do was allow them to work off his patent. Golosarsky was initially taken aback. “I didn’t think colleges did anything like this for free,” Golosarsky said. “But there was Dr. Merckel, offering up his college’s services. I didn’t expect anything like that to happen.”


The UNF partnership was an unexpected turn and Golosarsky willingly handed over his patent and research. The result, he said, speaks for itself. “I needed just a little help, not much,” he said. “I needed someone who could help in the manufacturing. And they did it.”


Replicating the Work World

Dr. Il-Seop Shin, an electrical engineering professor and project advisor, said neither the students nor the University received compensation for the project. It was solely for class credit and to prepare the students for the real-world rigors of working with a business client. “The product development experience is the reward for them,” he said.


Shin, a visiting professor from the University of Massachusetts Amherst, said it was quite the coup for UNF to get to work on a project with a potentially national profile like the heart-rate variability watch. The University has been strategically building up its research and manufacturing portfolio with the Connect Program.


It is a new internship-like initiative by the College of Computing, Engineering and Construction that transforms UNF students into a development team working at the request of business professionals. It’s a major student resume booster, Shin said. And it gets them ready for dealing with collaborative work environments when they graduate.


Another team of Connect Program students produced an inexpensive debate timer for a political party representative late last year. “This program is a good example of what UNF does well,” Shin said. “The students were able to devote their time to it, and I could be there to advise if they ran into any problems. It’s a very hands-on, collaborative environment here, and that helps in making a better product.”


Hands-on Learning

Gonzalez, the student who handled project manager duty throughout much of the design process, said the watch operates as a first-alert system for heart patients, but the technology can be used to establish a baseline heart rate or perform other basic heart-related measurements. The students modified the Golosarsky algorithms so they could enter them into a programmable Texas Instruments watch along with a Bluetooth receiver to transmit emergency signals to paramedics or contact the patient’s doctor if heart-rate variability swings into a dangerous zone. And it’s not the first of its kind to offer up these measurements. Many different watches measure heart rhythms, and a few others track variability. The difference comes in the watch’s ability to communicate with paramedics or medical professionals in the case of a cardiac event.


Nguyen toiled over the watch’s functionality for weeks. He whittled the watch’s stock features down to the bare essentials and plugged in Golosarsky’s formulas. It was tedious work at first making sure the receiver picked up the correct measurements and transmitted them back properly. But the work was validated when they tested the watch and it ran to perfection. “It was a good feeling to see it send that emergency alert out,” he said. “If that were on the market, it would be able to maybe save someone’s life in that situation.”


Stanley echoed his colleague’s sentiments. “It doesn’t even matter if Dr. Golosarsky sells it in the future,” he said. “I just enjoyed knowing that something I worked on in college could help people later on down the road.”


Looking Forward

The students’ work culminated in early February with a visit from Golosarsky. The internist had been in constant communication with his college production crew, and he flew down for a final in-person inspection. “He got to see his research in a physical form, so he seemed very enthusiastic,” Stanley said. “That made working on it more meaningful for me, especially getting to the idea that it wasn’t just academic. He talked to us about how he wanted to use it in the real world. That was a pretty big deal.”


Golosarsky said he envisions having an HRV monitor for every hospital patient —not just those with high-risk heart problems. The only issue is convenience. Most patients wouldn’t be happy wearing a chest strap or a watch everywhere they go.


In time, the technology will grow smaller and more feasible for more patients. And Golosarsky said he hopes his focus on heart-rate variably in the medical community will gain more support.


The project definitely changed the perceptions of the student development team. “The work made me start looking at places that I hadn't considered before,” Stanley said. “I hadn’t thought of medical engineering as a field where I could get a job and still do the work I wanted. The possibility of being an electrical engineer for a field other than distribution or computing — the thought didn’t really cross my mind. But now I know, I can get into other fields with my experience.”


Nguyen said the project has a prominent position on his resume.


“It’s nice to have something like this under my belt where I did programming, designing and the paperwork that goes along with that,” he said. “It hopefully shows that we can do the work in a corporate environment after we graduate.


A Seal of Approval

The next step for the watch isn’t quite clear, Golosarsky said. But he said he would like to find a way to manufacture the prototype and get it into hospitals and medical offices as soon as possible. And he credits the trio of UNF students for their work in making his patent come to life. “They are really bright guys, really sharp college students,” Golosarsky said.


And he would know. His office is based near Boston proper, which is loaded with renowned research institutes. “I’d put UNF up against any of them,” Golosarsky said. “I don’t think I could go into Harvard and have them do the quality of work in the amount of time I needed it that the UNF students did. The school, the students and my experience, were top-notch.”