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https://www.readbyqxmd.com/read/28870390/how-do-we-balance-the-long-term-health-of-a-patient-with-the-short-term-risk-to-the-physician
#1
Michael B Weinstock, Amal Mattu, Erik P Hess
BACKGROUND: There is a wide variation in practice patterns among emergency medicine physicians; many factors weigh into the medical decision-making process including the health of the patient as well as short-term risk to the physician. OBJECTIVE: The objective of our discussion is to illustrate specific scenarios where medical decisions are focused on the physician's short-term risk, then to propose an approach to shifting the balance to the patient's long-term health...
September 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28854987/-non-st-segment-elevation-acute-coronary-syndrome-recent-developments-in-diagnostics-and-treatment
#2
P Damman, R J de Winter
- This paper covers recent developments in diagnostics and treatment of patients presenting with non-ST segment elevation acute coronary syndrome.- For the diagnostic phase we focus on the role of the clinical presentation, the ECG and biomarkers.- In the acute phase, treatment mainly consists of pharmacological therapy and revascularisation; long-term treatment mainly involves pharmacological therapy, cardiac rehabilitation, and lifestyle changes.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28795416/the-acute-effect-of-beta-guanidinopropionic-acid-versus-creatine-or-placebo-in-healthy-men-abc-trial-a-randomized-controlled-first-in-human-trial
#3
F A Karamat, D L Horjus, Y C Haan, L van der Woude, M C Schaap, I Oudman, G A van Montfrans, R Nieuwland, G S Salomons, J F Clark, L M Brewster
AIM: Increasing evidence indicates that the ATP-generating enzyme creatine kinase (CK) is involved in hypertension. CK rapidly regenerates ATP from creatine phosphate and ADP. Recently, we showed that beta-guanidinopropionic acid (GPA), a kidney-synthesized creatine analogue and competitive CK inhibitor, reduced blood pressure in spontaneously hypertensive rats. To further develop the substance as a potential blood pressure-lowering agent, we assessed the tolerability of a sub-therapeutic GPA dose in healthy men...
August 10, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28775185/frequency-of-exercise-induced-st-t-segment-deviations-and-cardiac-arrhythmias-in-recreational-endurance-athletes-during-a-marathon-race-results-of-the-prospective-observational-berlin-beat-of-running-study
#4
Juliane Herm, Agnieszka Töpper, Alexander Wutzler, Claudia Kunze, Matthias Krüll, Lars Brechtel, Jürgen Lock, Jochen B Fiebach, Peter U Heuschmann, Wilhelm Haverkamp, Matthias Endres, Gerhard Jan Jungehulsing, Karl Georg Haeusler
OBJECTIVES: While regular physical exercise has many health benefits, strenuous physical exercise may have a negative impact on cardiac function. The 'Berlin Beat of Running' study focused on feasibility and diagnostic value of continuous ECG monitoring in recreational endurance athletes during a marathon race. We hypothesised that cardiac arrhythmias and especially atrial fibrillation are frequently found in a cohort of recreational endurance athletes. The main secondary hypothesis was that pathological laboratory findings in these athletes are (in part) associated with cardiac arrhythmias...
August 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28765984/-acute-chest-pain
#5
REVIEW
M Möckel, T Störk
Patients presenting with acute chest pain are a challenge for attending physicians in private practice and specialists for emergency and acute medicine in hospitals because a wide spectrum of diagnoses may be the cause, ranging from acute myocardial infarction (AMI) to harmless muscular tension. The evaluation of patients with acute chest pain follows basic principles independent of the setting: A thorough clinical investigation by the responsible physician including medical history and physical examination, followed by a 12-channel electrocardiogram (ECG) and further focused diagnostics...
August 1, 2017: Der Internist
https://www.readbyqxmd.com/read/28751844/anmco-sit-consensus-document-telemedicine-for-cardiovascular-emergency-networks
#6
Pasquale Caldarola, Michele Massimo Gulizia, Domenico Gabrielli, Marco Sicuro, Luisa De Gennaro, Massimo Giammaria, Niccolò Brenno Grieco, Daniele Grosseto, Roberto Mantovan, Marco Mazzanti, Alberto Menotti, Natale Daniele Brunetti, Silva Severi, Giancarmine Russo, Gian Franco Gensini
Telemedicine has deeply innovated the field of emergency cardiology, particularly the treatment of acute myocardial infarction. The ability to record an ECG in the early prehospital phase, thus avoiding any delay in diagnosing myocardial infarction with direct transfer to the cath-lab for primary angioplasty, has proven to significantly reduce treatment times and mortality. This consensus document aims to analyse the available evidence and organizational models based on a support by telemedicine, focusing on technical requirements, education, and legal aspects...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28719515/anaesthetic-management-of-patients-with-myopathies
#7
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...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28668906/a-current-approach-to-heart-failure-in-duchenne-muscular-dystrophy
#8
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
#9
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
#10
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...
August 1, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28648668/catheter-ablation-in-patients-with-pleomorphic-idiopathic-premature-ventricular-complexes
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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