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https://www.readbyqxmd.com/read/28719515/anaesthetic-management-of-patients-with-myopathies
#1
Mark Schieren, Jerome Defosse, Andreas Böhmer, Frank Wappler, Mark U Gerbershagen
: The anaesthetic management of patients with myopathies is challenging. Considering the low incidence and heterogeneity of these disorders, most anaesthetists are unfamiliar with key symptoms, associated co-morbidities and implications for anaesthesia. The pre-anaesthetic assessment aims at the detection of potentially undiagnosed myopathic patients and, in case of known or suspected muscular disease, on the quantification of disease progression. Ancillary testing (e.g. echocardiography, ECG, lung function testing etc...
July 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28668906/a-current-approach-to-heart-failure-in-duchenne-muscular-dystrophy
#2
REVIEW
Domenico D'Amario, Antonio Amodeo, Rachele Adorisio, Francesco Danilo Tiziano, Antonio Maria Leone, Gianluigi Perri, Piergiorgio Bruno, Massimo Massetti, Alessandra Ferlini, Marika Pane, Giampaolo Niccoli, Italo Porto, Gianluca A D'Angelo, Josip Anđelo Borovac, Eugenio Mercuri, Filippo Crea
Duchenne muscular dystrophy (DMD) is a genetic, progressive neuromuscular condition that is marked by the long-term muscle deterioration with significant implications of pulmonary and cardiac dysfunction. As such, end-stage heart failure (HF) in DMD is increasingly becoming the main cause of death in this population. The early detection of cardiomyopathy is often challenging, due to a long subclinical phase of ventricular dysfunction and difficulties in assessment of cardiovascular symptomatology in these patients who usually loose ambulation during the early adolescence...
July 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28667170/isolated-cardiac-sarcoidosis-masquerading-as-right-ventricular-outflow-tract-ventricular-tachycardia
#3
Auras R Atreya, Mitkumar Patel, Senthil K Sivalingam, Mathias L Stoenescu
A 67-year-old man with coronary artery disease (CAD) and left anterior descending artery (LAD) stent presented with symptomatic monomorphic ventricular tachycardia (VT) at a rate of 190 bpm requiring cardioversion. ECG showed left bundle branch block pattern and inferior axis, suggestive of a right ventricular outflow tract (RVOT) focus rather than left ventricular scar due to LAD territory myocardial infarction (MI). Echocardiography showed normal wall motion. Angiography revealed a patent mid-LAD stent. Cardiac MRI with delayed postcontrast sequence revealed several regions of hyperenhancement abnormality within the basal portion of the interventricular septum...
June 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28649031/noise-detection-on-ecg-based-on-agglomerative-clustering-of-morphological-features
#4
João Rodrigues, David Belo, Hugo Gamboa
Biosignals are usually contaminated with artifacts from limb movements, muscular contraction or electrical interference. Many algorithms of the literature, such as threshold methods and adaptive filters, focus on detecting these noisy patterns. This study introduces a novel method for noise and artifact detection in electrocardiogram based on time series clustering. The algorithm starts with the extraction of features that best characterize the shape and behaviour of the signal over time and groups its samples in separated clusters by means of an agglomerative clustering approach...
June 15, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28648668/catheter-ablation-in-patients-with-pleomorphic-idiopathic-premature-ventricular-complexes
#5
Seth H Sheldon, Rakesh Latchamsetty, Fred Morady, Frank Bogun
BACKGROUND: Premature ventricular complexes (PVCs) often originate from multiple locations. OBJECTIVE: The goals of this study were to assess characteristics of patients with pleomorphic, idiopathic PVCs and to determine the impact of pleomorphic PVCs on outcomes. METHODS: Records were collected from 153 consecutive patients referred for ablation of PVCs. Patients with structural heart disease (n = 34) or inadequate ambulatory electrocardiographic data (n = 19) were excluded...
June 22, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28610987/tracking-interlead-heterogeneity-of-r-and-t-wave-morphology-to-disclose-latent-risk-for-sudden-cardiac-death
#6
Richard L Verrier, Heikki Huikuri
Sudden cardiac death (SCD) due primarily to ventricular fibrillation claims 1.5 million lives worldwide each year. In 45%-50% of cases, it is the first manifestation of underlying heart disease. Traditional risk factors including smoking, hypertension, age, sex, as well as depressed left ventricular ejection fraction lack sufficient sensitivity and specificity to forewarn of impending life-threatening arrhythmias. There has been a decades-long search for electrocardiographic (ECG) markers of SCD risk. Several interval-based indices such as QT dispersion and Tpeak-Tend interval held initial promise but ultimately yielded mixed results...
June 10, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28608915/abc-om-pediatrisk-ekg-tolkning
#7
Caroline Fransson, Stefan Johansson, Cecilia Halvorsen
The ABC of paediatric ECG interpretation In paediatric patients, ECG is used as a tool for investigation of arrhythmias, chest pain, syncope, intoxications and congenital heart abnormalities. Paediatric ECGs differ significantly from adult ECGs, and change gradually during childhood, largely because of the changes that start with the transition of foetal circulation at birth. This evolution is most prominent during the first year of life, but it is not until the late adolescent years that the ECG corresponds to that of adults...
June 9, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28559848/efficient-fetal-maternal-ecg-signal-separation-from-two-channel-maternal-abdominal-ecg-via-diffusion-based-channel-selection
#8
Ruilin Li, Martin G Frasch, Hau-Tieng Wu
There is a need for affordable, widely deployable maternal-fetal ECG monitors to improve maternal and fetal health during pregnancy and delivery. Based on the diffusion-based channel selection, here we present the mathematical formalism and clinical validation of an algorithm capable of accurate separation of maternal and fetal ECG from a two channel signal acquired over maternal abdomen. The proposed algorithm is the first algorithm, to the best of the authors' knowledge, focusing on the fetal ECG analysis based on two channel maternal abdominal ECG signal, and we apply it to two publicly available databases, the PhysioNet non-invasive fECG database (adfecgdb) and the 2013 PhysioNet/Computing in Cardiology Challenge (CinC2013), to validate the algorithm...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28552121/research-and-improvement-of-ecg-compression-algorithm-based-on-ezw
#9
Ziran Peng, Guojun Wang, Huabin Jiang, Shuangwu Meng
Embedded zerotree wavelet (EZW) is an efficient compression method that has advantages in coding, but its multilayer structure information coding reduces signal compression ratio. This paper studies the optimization of the EZW compression algorithm and aims to improve it. First, we used lifting wavelet transformation to process electrocardiograph (ECG) signals, focusing on the lifting algorithm. Second, we utilized the EZW compression coding algorithm, through the ECG information decomposition to determine the feature detection value...
July 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28548234/catheter-ablation-of-atrial-flutter-a-survey-focusing-on-post-ablation-oral-anticoagulation-management-and-ecg-monitoring
#10
Philipp Attanasio, Tabea Budde, Philipp Lacour, Abdul Shokor Parwani, Burkert Pieske, Florian Blaschke, Wilhelm Haverkamp, Leif-Hendrik Boldt, Martin Huemer
BACKGROUND: A considerable amount of patients with typical atrial flutter develop atrial fibrillation after cavotricuspid isthmus (CTI) ablation. No uniform recommendations are available to guide anticoagulation regimes or electrocardiogram (ECG) monitoring strategies after this procedure. METHODS: We conducted a web-based survey in electrophysiology (EP) centers in Germany, Switzerland, and Austria. Responses were received from 47 centers. The survey was designed to investigate variations in management of the following: ablation strategy, oral anticoagulation (OAC) management, and ECG monitoring after successful CTI ablation...
May 26, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28546676/mental-stress-neurophysiology-and-its-regulation-by-sudarshan-kriya-yoga
#11
Sushil Chandra, Amit Kumar Jaiswal, Ram Singh, Devendra Jha, Alok Prakash Mittal
AIM: The present study focuses on analyzing the effects of Sudarshan Kriya yoga (SKY) on EEG as well as ECG signals for stress regulation. To envision the regulation of stress Determination Test (DT) has been used. We have chosen a control group for contriving a cogent comparison that could be corroborated using statistical tests. SUBJECTS AND METHODS: A total of 20 subjects were taken in the study, of which 10 were allotted to a control group. Electroencephalograph was taken during a DT task, before and after SKY the sky session with 30 days of SKY session given to the experimental group...
May 2017: International Journal of Yoga
https://www.readbyqxmd.com/read/28544933/cardiotoxic-effect-of-levofloxacin-and-ciprofloxacin-in-rats-with-without-acute-myocardial-infarction-impact-on-cardiac-rhythm-and-cardiac-expression-of-kv4-3-kv1-2-and-nav1-5-channels
#12
Ahmed M Abdelrady, Sawsan A Zaitone, Noha E Farag, Manal S Fawzy, Yasser M Moustafa
Prolongation of QT interval is possible with fluoroquinolones, yet the underlying contributing factors have not been elucidated. Two widely used fluoroquinolone drugs were at the focus of this study in rats with/without acute myocardial dysfunction (AMI) induced by isoproterenol. The effects of levofloxacin and ciprofloxacin on the cardiac mRNA expression of rat Kv4.3, Kv1.2 and Nav1.5 mRNAs were determined. Administration of the two antibiotics produced dose-dependent changes in ECG parameters that were more prominent in rats with AMI than healthy rats; this was accompanied by elevations in serum lactate dehydrogenase and creatine kinase-MB...
August 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28534810/non-invasive-fetal-monitoring-a-maternal-surface-ecg-electrode-placement-based-novel-approach-for-optimization-of-adaptive-filter-control-parameters-using-the-lms-and-rls-algorithms
#13
Radek Martinek, Radana Kahankova, Homer Nazeran, Jaromir Konecny, Janusz Jezewski, Petr Janku, Petr Bilik, Jan Zidek, Jan Nedoma, Marcel Fajkus
This paper is focused on the design, implementation and verification of a novel method for the optimization of the control parameters (such as step size μ and filter order N) of LMS and RLS adaptive filters used for noninvasive fetal monitoring. The optimization algorithm is driven by considering the ECG electrode positions on the maternal body surface in improving the performance of these adaptive filters. The main criterion for optimal parameter selection was the Signal-to-Noise Ratio (SNR). We conducted experiments using signals supplied by the latest version of our LabVIEW-Based Multi-Channel Non-Invasive Abdominal Maternal-Fetal Electrocardiogram Signal Generator, which provides the flexibility and capability of modeling the principal distribution of maternal/fetal ECGs in the human body...
May 19, 2017: Sensors
https://www.readbyqxmd.com/read/28534205/outflow-tract-ventricular-arrhythmias-electrocardiographic-features-in-relation-to-mapping-and-ablation
#14
REVIEW
Deepak Padmanabhan, Alan Sugrue, Prakriti Gaba, Samuel J Asirvatham
Ventricular arrhythmia arising from the outflow tracts can manifest itself as frequent premature ventricular complexes (PVCs), salvos of ventricular tachycardia (VT), and/or sustained VT. It is amenable to management with medication and catheter ablation without need for an intracardiac defibrillator. The electrocardiogram (ECG) is a crucial tool in the management of these patients as it is can help localize the site of origin, thereby helping guide the electrophysiologist. An appreciation of the unique anatomy of the outflow tracts as well as their relationships with the surrounding structures is essential in interpreting the ECG...
May 22, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28527890/mechano-electric-coupling-heterogeneity-in-repolarization-and-the-electrocardiographic-t-wave
#15
REVIEW
V M F Meijborg, C N W Belterman, J M T de Bakker, R Coronel, C E Conrath
Stretch influences repolarization by mechano-electric coupling (MEC) and contributes to arrhythmogenesis. Although there is an abundance of research on electrophysiological effects of MEC, it is still unclear how MEC translates to the ECG. We aim to provide an overview of the MEC research focused on the ECG and the underlying changes in electrophysiology. In addition, we present new data on the effect of left ventricular pressure on the electrocardiographic T-wave. We show that an increase in left ventricular pressure leads to prolonged QT-intervals with increased amplitudes of the STT-segment...
May 17, 2017: Progress in Biophysics and Molecular Biology
https://www.readbyqxmd.com/read/28509783/the-evaluation-of-adolescent-chest-pain-a-screening-ecg-or-psc-17
#16
Patricia E Acra, María T Pérez
PURPOSE OF REVIEW: The present review offers an update on entities presenting as chest pain in the adolescent population. It discusses recently proposed tools and shared mental models used in primary and urgent care settings to evaluate chest pain, and their focus on identifying life-threatening processes. We consider whether the current practice may be improved by accounting for the increasingly recognized non-life-threatening causes of adolescent chest pain. RECENT FINDINGS: The present experiences and behaviors of adolescents have added new causes of chest pain to the work-up of this disquieting chief complaint...
August 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28496929/management-of-patients-with-atrial-fibrillation-focus-on-treatment-options
#17
REVIEW
Pawel Matusik, Jacek Lelakowski, Barbara Malecka, Jacek Bednarek, Remigiusz Noworolski
Atrial fibrillation (AF) is leading cardiac arrhythmia with important clinical implications. Its diagnosis is usually made on the basis on 12-lead ECG or 24-hour Holter monitoring. More and more clinical evidence supports diagnostic use of cardiac event recorders and cardiovascular implantable electronic devices (CIED). Treatment options in patients with atrial fibrillation are extensive and are based on chosen rhythm and/or rate control strategy. The use and selected contraindications to AF related pharmacotherapy, including anticoagulants are shown...
October 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/28458554/patient-characteristics-associated-with-false-arrhythmia-alarms-in-intensive-care
#18
Patricia R Harris, Jessica K Zègre-Hemsey, Daniel Schindler, Yong Bai, Michele M Pelter, Xiao Hu
INTRODUCTION: A high rate of false arrhythmia alarms in the intensive care unit (ICU) leads to alarm fatigue, the condition of desensitization and potentially inappropriate silencing of alarms due to frequent invalid and nonactionable alarms, often referred to as false alarms. OBJECTIVE: The aim of this study was to identify patient characteristics, such as gender, age, body mass index, and diagnosis associated with frequent false arrhythmia alarms in the ICU. METHODS: This descriptive, observational study prospectively enrolled patients who were consecutively admitted to one of five adult ICUs (77 beds) at an urban medical center over a period of 31 days in 2013...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28457177/high-sensitivity-cardiac-troponin-assays-from-improved-analytical-performance-to-enhanced-risk-stratification
#19
Marek Kozinski, Magdalena Krintus, Jacek Kubica, Grazyna Sypniewska
Implementation of cardiac troponin (cTn) assays has revolutionized the diagnosis, risk stratification, triage and management of patients with suspected myocardial infarction (MI). The Universal Definition of MI brought about a shift in the diagnostics of MI, from an approach primarily based on electrocardiography (ECG) to one primarily based on biomarkers. Currently, detection of a rise and/or fall in concentration or activity of myocardial necrosis biomarkers, preferentially cTns, with at least one value above the 99th percentile upper reference limit (URL), is the essential component for the diagnosis of MI...
May 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28451686/data-requirements-for-the-correct-identification-of-medication-errors-and-adverse-drug-events-in-patients-presenting-at-an-emergency-department
#20
Bettina Plank-Kiegele, Thomas Bürkle, Fabian Müller, Andrius Patapovas, Anja Sonst, Barbara Pfistermeister, Harald Dormann, Renke Maas
BACKGROUND: Adverse drug events (ADE) involving or not involving medication errors (ME) are common, but frequently remain undetected as such. Presently, the majority of available clinical decision support systems (CDSS) relies mostly on coded medication data for the generation of drug alerts. It was the aim of our study to identify the key types of data required for the adequate detection and classification of adverse drug events (ADE) and medication errors (ME) in patients presenting at an emergency department (ED)...
April 28, 2017: Methods of Information in Medicine
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