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Focus on ECGs

Giacomo Veronese, Federico Germini, Stella Ingrassia, Ombretta Cutuli, Valeria Donati, Luca Bonacchini, Maura Marcucci, Andrea Fabbri
BACKGROUND: Electrocardiogram (ECG) interpretation is widely performed by emergency physicians. We aimed to determine the accuracy of interpretation of potential ST-segment elevation myocardial infarction (STEMI) ECGs by emergency physicians. METHODS: Thirty-six ECGs resulted in putative STEMI diagnoses were selected. Participants were asked to focus on whether or not the ECG in question met the diagnostic criteria for an acutely blocked coronary artery causing a STEMI...
October 19, 2016: Acute Cardiac Care
Nicole Kurhanewicz, Rachel McIntosh-Kastrinsky, Haiyan Tong, Allen Ledbetter, Leon Walsh, Aimen Farraj, Mehdi Hazari
Short-term exposure to ambient air pollution is linked with adverse cardiovascular effects. While previous research focused primarily on particulate matter-induced responses, gaseous air pollutants also contribute to cause short-term cardiovascular effects. Mechanisms underlying such effects have not been adequately described, however the immediate nature of the response suggests involvement of irritant neural activation and downstream autonomic dysfunction. Thus, this study examines the role of TRPA1, an irritant sensory receptor found in the airways, in the cardiac response of mice to acrolein and ozone...
October 13, 2016: Toxicology and Applied Pharmacology
Ming Dai, Xueliang Xiao, Xin Chen, Haoming Lin, Wanqing Wu, Siping Chen
With the increasing aging population as well as health concerns, chronic heart disease has become the focus of public attention. A comfortable, low-powered, and wearable electrocardiogram (ECG) system for continuously monitoring the elderly's ECG signals over several hours is important for preventing cardiovascular diseases. Traditional ECG monitoring apparatus is often inconvenient to carry, has many electrodes to attach to the chest, and has a high-power consumption. There is also a challenge to design an electrocardiograph that satisfies requirements such as comfort, confinement, and compactness...
October 14, 2016: Australasian Physical & Engineering Sciences in Medicine
Quan Ding, Yong Bai, Yusuf Bugra Erol, Rebeca Salas-Boni, Xiaorong Zhang, Xiao Hu
QRS peak detection is a challenging problem when ECG signal is corrupted. However, additional physiological signals may also provide information about the QRS position. In this study, we focus on a unique benchmark provided by PhysioNet/Computing in Cardiology Challenge 2014 and Physiological Measurement focus issue: robust detection of heart beats in multimodal data, which aimed to explore robust methods for QRS detection in multimodal physiological signals. A dataset of 200 training and 210 testing records are used, where the testing records are hidden for evaluating the performance only...
October 13, 2016: Physiological Measurement
Syed Anas Imtiaz, James Mardell, Siavash Saremi-Yarahmadi, Esther Rodriguez-Villegas
Continuous patient monitoring systems acquire enormous amounts of data that is either manually analysed by doctors or automatically processed using intelligent algorithms. Sections of data acquired over long period of time can be corrupted with artefacts due to patient movement, sensor placement and interference from other sources. Owing to the large volume of data these artefacts need to be automatically identified so that the analysis systems and doctors are aware of them while making medical diagnosis. Three important factors are explored that must be considered and quantified for the design and evaluation of automatic artefact identification algorithms: signal quality, interpretation quality and computational complexity...
September 2016: Healthcare Technology Letters
Desheng Zhai, Yan Lang, Gaopan Dong, Yijun Liu, Xin Wang, Dushuang Zhou, Taizhen Cui, Yuxin Yang, Wenxi Zhang, Ying Zhao, Ruiling Zhang
Antipsychotic use is reported to be associated with a higher risk of sudden cardiac death and new users are especially susceptible to that risk. In this study, we focused on the ability of antipsychotics to prolong the QTc interval at the earliest stages of antipsychotic use. We employed a retrospective cohort study design in a naturalistic setting where having three ECG measurements over time (at baseline and after drug exposure) in antipsychotic-naïve, first-episode schizophrenia (FES) inpatients. The results revealed, in this relatively homogeneous, drug naïve FES patient sample, that QTc intervals were statistically significantly prolongated after a relatively short term (2-4weeks) of antipsychotic treatments, compared with baseline...
October 7, 2016: Schizophrenia Research
Robert M Lester, Joy Olbertz
hERG assays and thorough ECG trials have been mandated since 2005 to evaluate the QT interval and potential proarrhythmic risk of new chemical entities. The high cost of these studies and the shortcomings inherent in these binary and limited approaches to drug evaluation have prompted regulators to search for more cost effective and mechanistic paradigms to assess drug liability as exemplified by the CiPA initiative and the exposure response ICH E14(R3) guidance document. Areas Covered: This review profiles the changing regulatory landscape as it pertains to early drug development and outlines the analyses that can be performed to characterize preclinical and early clinical cardiovascular risk...
October 10, 2016: Expert Review of Clinical Pharmacology
Luca Iozzia, Luca Cerina, Luca Mainardi
In this paper, classical time- and frequency-domain variability indexes obtained by pulse rate variability (PRV) series extracted from video-photoplethysmography signals (vPPG) were compared with heart rate variability (HRV) parameters extracted from ECG signals. The study focuses on the analysis of the changes observed during a rest-to-stand manoeuvre (a mild sympathetic stimulus) performed on 60 young, normal subjects (age: [Formula: see text] years). The objective is to evaluate if video-derived PRV indexes may replace HRV in the assessment of autonomic responses to external stimulation...
September 28, 2016: Physiological Measurement
Gianfranco Piccirillo, Federica Moscucci, Claudia Fiorucci, Claudia Di Iorio, Fabiola Mastropietri, Damiano Magrì
To seek possible differences in short-period temporal RR interval, P-wave and PR interval dispersion and spectral coherence in patients with a head-up tilt test positive for vasovagal syncope with or without prolonged asystole, severe symptoms and at high risk of trauma. We retrospectively reviewed 5 min ECG and blood pressure recordings obtained at baseline, at rest and during head-up tilt in 40 patients diagnosed as having recurrent vasovagal syncope confirmed at a head-up tilt test. We analysed autoregressive spectral power for all the ECG-derived variables, focusing on temporal P-wave and PR interval dispersion indexes as well as their spectral coherence calculated on the same 5 min recordings at rest and during tilt...
September 28, 2016: Physiological Measurement
I Dierickx, S Van Hooland, K Tomsin, D Vanercke, W Cools, H Fransen, W Gyselaers
INTRODUCTION: Studying the venous compartment may add valuable information on background mechanisms and (patho)physiology of the cardiovascular system in normal pregnancies and pregnancies complicated by preeclampsia. Every component of the venous pulse wave is reflecting a specific stage of the cardiac cycle in the right atrium, and can be recognized in the neck veins, the hepatic and the renal veins. Previous studies have demonstrated the repeatability and reproducibility of venous Doppler sonography and venous pulse transit time in renal interlobar and hepatic veins...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Samy A Abdelghani, Todd M Rosenthal, Daniel P Morin
BACKGROUND: Heart disease is a major cause of death in industrialized nations, with approximately 50% of these deaths attributable to sudden cardiac arrest. If patients at high risk for sudden cardiac arrest can be identified, their odds of surviving fatal arrhythmias can be significantly improved through prophylactic implantable cardioverter defibrillator placement. This review summarizes the current knowledge pertaining to surface electrocardiogram (ECG) predictors of sudden cardiac arrest...
2016: Ochsner Journal
Caterina Rizzo, Francesco Monitillo, Massimo Iacoviello
The 12-lead electrocardiogram (ECG) is still the most used tool in cardiology clinical practice. Considering its easy accessibility, low cost and the information that it provides, it remains the starting point for diagnosis and prognosis. More specifically, its ability to detect prognostic markers for sudden cardiac death due to arrhythmias by identifying specific patterns that express electrical disturbances of the heart muscle, which may predispose to malignant arrhythmias, is universally recognized. Alterations in the ventricular repolarization process, identifiable on a 12-lead ECG, play a role in the genesis of ventricular arrhythmias in different cardiac diseases...
August 26, 2016: World Journal of Cardiology
Beáta Bodócsi, István Koncz, Zsigmond Hum, Orsolya Serfőző, József Pap-Szekeres, István Szabó
Chest pain is a common symptom in patients who visit Emergency Departments. The main task is to exclude life-threatening diseases such as acute coronary syndrome, pulmonary embolization and dissection of thoracic aorta. The authors present the history of a patient, who had an intense chest pain for 7 hours. In accordance with the diagnostic algorithm of chest pain, ECG, blood collection, chest X-ray and chest computed tomography angiography were performed. Acute coronary syndrome, pulmonary embolization and dissection of the thoracic aorta were excluded, however, chest computed tomography CT revealed a huge hiatal hernia as an incidental finding...
September 2016: Orvosi Hetilap
Shu-Li Guo, Li-Na Han, Hong-Wei Liu, Quan-Jin Si, De-Feng Kong, Fu-Su Guo
Remote ECG monitoring systems are becoming commonplace medical devices for remote heart monitoring. In recent years, remote ECG monitoring systems have been applied in the monitoring of various kinds of heart diseases, and the quality of the transmission and reception of the ECG signals during remote process kept advancing. However, there remains accompanying challenges. This report focuses on the three components of the remote ECG monitoring system: patient (the end user), the doctor workstation, and the remote server, reviewing and evaluating the imminent challenges on the wearable systems, packet loss in remote transmission, portable ECG monitoring system, patient ECG data collection system, and ECG signals transmission including real-time processing ST segment, R wave, RR interval and QRS wave, etc...
September 2016: Journal of Geriatric Cardiology: JGC
Sylvère Störmann, Melanie Stankiewicz, Patricia Raes, Christina Berchtold, Yvonne Kosanke, Gabrielle Illes, Peter Loose, Matthias W Angstwurm
INTRODUCTION: The clinical examination and other practical clinical skills are fundamental to guide diagnosis and therapy. The teaching of such practical skills has gained significance through legislative changes and adjustments of the curricula of medical schools in Germany. We sought to find out how well final year undergraduate medical students master practical clinical skills. METHODS: We conducted a formative 4-station objective structured clinical examination (OSCE) focused on practical clinical skills during the final year of undergraduate medical education...
2016: GMS Journal for Medical Education
Tyler H Harris, Jeffrey G Gossett
Care of adults with coronary artery disease focuses on troponins to rapidly move patients to catheterization. Troponins are increasingly drawn in children, but emergent catheterization may not be indicted. We sought to establish etiologies of troponin elevation and ascertain the yield of diagnostic tests, in this population. Retrospective review of patients from January 1, 2002, to December 31, 2011, who had any elevated troponin during the study period. Patients were excluded for recent cardiac surgery, "significant" congenital heart disease, if they were neonates in the NICU or were on ECMO...
August 29, 2016: Pediatric Cardiology
Jose Vicente, Norman Stockbridge, David G Strauss
Fourteen drugs were removed from the market worldwide because their potential to cause torsade de pointes (torsade), a potentially fatal ventricular arrhythmia. The observation that most drugs that cause torsade block the potassium channel encoded by the human ether-à-go-go related gene (hERG) and prolong the heart rate corrected QT interval (QTc) on the ECG, led to a focus on screening new drugs for their potential to block the hERG potassium channel and prolong QTc. This has been a successful strategy keeping torsadogenic drugs off the market, but has resulted in drugs being dropped from development, sometimes inappropriately...
July 28, 2016: Journal of Electrocardiology
Yoshihiro Tsuji, Naoki Suzuki, Yasumasa Hitomi, Toshiko Yoshida, Yuko Mizuno-Matsumoto
BACKGROUND: Few studies have focused on the imbalance of the autonomic nervous system in ultrafiltration rate (UFR) subjects without blood pressure variation during maintenance hemodialysis (HD), although the role of autonomic nervous system activation during HD has been proposed to be an important factor for the maintenance of blood pressure. METHODS: Variations over time in autonomic nervous activity due to differences in UFR were evaluated by measuring heart rate variability (HRV) and approximate entropy (ApEn) in 35 HD patients without blood pressure variations during HD session...
August 1, 2016: Clinical and Experimental Nephrology
Adrián Colomer Granero, Félix Fuentes-Hurtado, Valery Naranjo Ornedo, Jaime Guixeres Provinciale, Jose M Ausín, Mariano Alcañiz Raya
This work focuses on finding the most discriminatory or representative features that allow to classify commercials according to negative, neutral and positive effectiveness based on the Ace Score index. For this purpose, an experiment involving forty-seven participants was carried out. In this experiment electroencephalography (EEG), electrocardiography (ECG), Galvanic Skin Response (GSR) and respiration data were acquired while subjects were watching a 30-min audiovisual content. This content was composed by a submarine documentary and nine commercials (one of them the ad under evaluation)...
2016: Frontiers in Computational Neuroscience
Vijay Srinivas Agneeswaran, Joydeb Mukherjee, Ashutosh Gupta, Pranay Tonpay, Jayati Tiwari, Nitin Agarwal
It is time for the healthcare industry to move from the era of "analyzing our health history" to the age of "managing the future of our health." In this article, we illustrate the importance of real-time analytics across the healthcare industry by providing a generic mechanism to reengineer traditional analytics expressed in the R programming language into Storm-based real-time analytics code. This is a powerful abstraction, since most data scientists use R to write the analytics and are not clear on how to make the data work in real-time and on high-velocity data...
September 2013: Big Data
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