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Top1. Introduction
Telemedicine has been used for many years in order to improve health care provision or for patient monitoring. Several issues such as the computational capability, size of the devices, power efficiency and cost were limiting the availability of devices and services to a few special cases (Kyriacou, Pattichis, Pattichis, Panayides, & Pitsillides, 2007; Nugent et al., 2006). However, recent advancements in communications and computer systems including smart hand-held devices and sensing technology help us to develop health monitoring systems that are more efficient, much smaller and at lower cost.
Along this way, numerous systems have been presented until today. The main goal of these systems is the continuous and seamless monitoring of patients based on portable sensors and devices. Detailed surveys and several examples of such systems are presented in National Institute of Information and Communications Technology Japan (2009), Hao and Foster (2008), Gatzoulis and Iakovidis (2007), Muler, Schweizer, Helms, et al. (2010), and Pantelopoulos and Bourbakis (2010). The term Body Area Network or Body Sensor Network has been widely introduced in these papers. This term refers to the concept that the human body that is monitored is part of an area network, which might be a sensor ad-hoc network; the resource management of these networks has been recently studied by Wang et al. [2010]. Monitoring of adults with chronic heart failure has been an issue examined through many research projects, examples of which are presented in papers (Muler, Schweizer, Helms, et al., 2010; Kleinpell & Avitall, 2005; Polisena, Tran, Cimon, et al., 2010). Furthermore, monitoring of children with chronic diseases has also been proposed in Bergman, Sharek, Ekegren, Thyne, Mayer, and Saunders (2008) where telemedicine is applied in order to help children with asthma.
In this study, we will focus on the continuous monitoring of children with suspected cardiac arrhythmias. In order to evaluate the size and severity of the problem; arrhythmia is one of the most difficult problems in cardiology both in terms of diagnosis and management. The problem is particularly pronounced in pediatric cardiology because of the variety of etiologies and the difficulty that the children are having in trying to communicate their symptoms. For example in the case of hypertrophic cardiomyopathy, it is known that children are at higher risk for arrhythmias and sudden death than adults. In most of the cases an ECG tracing is required and this is sufficient for an accurate diagnosis, whereas in some cases, a more sophisticated modality is required (Kyriacou, Pattichis, Pattichis, Panayides, & Pitsillides, 2007; Moreira et al., 2006).
As an example a relatively recently recognized rare form of cardiomyopathy, the Isolated Noncompaction of the Left Ventricle (NCLV), which is a rare form of cardiomyopathy, poses new challenges. A subset of patients with this disease is especially prone to arrhythmia and sudden death. It is not always possible to estimate the risk of each patient with the available test modalities even if genetic testing is included. Current testing with the holter monitor has proved insufficient because it is limited to 24 or 48 hours of recording during which the patient may be asymptomatic. We care for a group of such children, some of whom are at imminent risk of sudden death (Moreira et al., 2006; Stollberger & Finsterer, 2004).