. De-plus, Il nécessite aussi une sonde nasale qui mesure le flux d'air, une ceinture abdominale pour mesurer les mouvements thoraciques liésliésà l'effort respiratoire et la saturation sanguine en oxygène pour scruter la respiration. Enfin, il comprend l'´ electrocardiogramme (ECG) pour la mesure de la fréquence cardiaque et la détection des arrythmies. Typiquement, une nuit de sommeil est nécessaire, voire deux nuits d'enregistrement sont nécessaires avant d'´ etablir un diagnostic plus ou moins fiable

. Dans-cette-optique, des mesures, sur une nuit, basées sur l'oxymétrie et le flux aérien ontétéétudiéesontété ontétéétudiées. L'investigation du signal ECGàECGà partir d'enregistrements de longue durée (Holter) a aussí eté menée pour la détection de l'apnée obstructive

L. Possibilité-de-détecter-lesépisodeslesépisodes-d-'apnée and . Obstructive, AOS) en utilisant l'ECG est basée sur (a) les changements connus des intervalles RR suivant que la fréquence de battements cardiaques augmente et diminue en réponse de l'apnée et (b) les changement de l'amplitude du complexe QRS par la modulation de l'ECG par la respiration. En complément de ces approches qui ont fourni des résultats de détection de l'apnée encourageants [132], nous avons voulu explorer une possible influence de l'apnée sur la forme du signal ECG etparticulì erement l'onde P

P. Classement-de-forme-des-ondes and . Dans-la-littérature, la classification morphologique des ondes-P a déjàdéjàété abordée [126] ,[133]. Les méthodes proposées font appeì a des modèles ou paramètres de l'onde P. Même si ces approches fournissent des résultats probants, elles ne comparent pas

. Dans-cette-section, CISA (moyenne et distance) coupléè a l'algorithme des nuées dynamiques (k-means) [59] pour construire un outil de classement de forme de l'onde P. La méthode sera utilisée pour effectuer deux types de classement. Le premier que nous définissons comme " macro-classement " a pour objectif de classer les formes d'ondes P prototypes extraites de 163 segments d'ECGéchantillonnésàECGéchantillonnésECGéchantillonnésà 128 Hz. Ces segments concernent 2 minutes chacun et proviennent de 7 patients souffrants d'AOS. (a) La respiration, le classement CISA et la saturation O2 pour le premier segmentétudiésegmentétudié

. Au-contraire, P2 semblent difficilesàdifficilesà détecter par l'approche. Cela est principalement dû aux faibles différences de forme des signaux avec les signaux sains. Pour cette classe, la stratégie 2 fait mieux que lapremì ere (6/10 bien classés contre 6/14) De la même ma-nì ere pour les enregistrements sains, les résultats de la seconde approche sont meilleurs

. Etude, exercice, le système nerveux sympathique devient actif chez les personnes saines Cette activation a pour effet d'augmenter le rythme cardiaque et de diminuer la durée de l'onde P [134]. Cette information peut aideràaiderà mieux détecter certaines pathologies comme la fibrillation auriculaire [134]. En plus de la durée de l'onde P, l'analyse de forme est pertinente et liée directementàdirectementà l'activitéactivitéélectrique des oreillettes comme décrit précédemment. L'´ etude présente s'intéressè a décrire l'influence de l'effort sur la forme de l'onde P ` a travers l'analyse de lois d'´ evolution de forme en exercice et en récupération. Pour effectuer cette tâche, nous utiliserons une méthode de recalage de courbes : l'approche SMR décrite en chapitre théorique, Cette permet de lier les ondes P ` a travers des transformations temporelles non linéaires. Sous une hypothèse de structure commune, elle permet un suivi de forme précis suivant l'´ evolution d'unétatunétat

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