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("ECG" OR " EKG") AND "Interpretation"

M S Al-Karadi, A J Wilkinson, J Caldwell, P Langley
Major cardiac organisations recommend U wave abnormalities should be reported during ECG interpretation. However, U waves cannot be measured in patients with atrial fibrillation (AF) due to the obscuring fibrillatory wave. The aim was to validate a U wave measurement algorithm for AF patients. Multi-beat averaging was applied to ECGs of 25 patients during paroxysms of AF and the presence of U waves compared to those from the same patients during sinus rhythm (SR). In a further database of 10 long-term AF recordings, the number of beats for effective U wave extraction by the algorithm was calculated...
August 9, 2018: Scientific Reports
Elena Skornyakov, Shobhan Gaddameedhi, Gemma M Paech, Amy R Sparrow, Brieann C Satterfield, Nita L Shattuck, Matthew E Layton, Ilia Karatsoreos, Hans P A VAN Dongen
Shift work leads to adverse health outcomes including increased risk of cardiovascular disease. Heart rate (HR) and heart rate variability (HRV) are measures of cardiac autonomic activity and markers of cardiovascular disease and mortality. To investigate the effects of shift work on cardiac autonomic activity, we assessed the influence of simulated night work on HR and HRV, and dissociated the direct effects of circadian misalignment from those of sleep displacement and altered physical activity patterns. A total of 29 subjects each participated in one of two in-laboratory, simulated shift work studies...
August 8, 2018: Industrial Health
Tomas Teijeiro, Constantino Antonio García, Daniel Castro, Paulo Felix
OBJECTIVE: This work aims at providing a new method for the automatic detection of atrial fibrillation, other arrhythmia and noise on short single lead ECG signals, emphasizing the importance of the interpretability of the classification results. APPROACH: A morphological and rhythm description of the cardiac behavior is obtained by a knowledge-based interpretation of the signal using the Construe abductive framework. Then, a set of meaningful features are extracted for each individual heartbeat and as a summary of the full record...
August 3, 2018: Physiological Measurement
Annemarijn Sm Steijlen, Kaspar Mb Jansen, Armagan Albayrak, Derk O Verschure, Diederik F Van Wijk
BACKGROUND: Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide. Early diagnosis is of pivotal importance for patients with cardiac arrhythmias and ischemia to minimize the consequences like strokes and myocardial infarctions. The chance of capturing signals of arrhythmias or ischemia is substantially high when a 12-lead electrocardiogram (ECG) can be recorded at the moment when a patient experiences the symptoms. However, until now, available diagnostic systems (Holter monitors and other wearable ECG sensors) have not enabled patients to record a reliable 12-lead ECG at home...
July 30, 2018: JMIR MHealth and UHealth
Harry G Mond
Modern cardiac pacing systems have sophisticated software to document, evaluate and record intrinsic and paced rhythms as well as correct pacing abnormalities and rhythm disturbances by applying algorithms, which are generally company specific. To the cardiologist and technologist, these algorithms may be difficult to interpret on both the 12-lead electrocardiograph (ECG) and Holter ambulatory monitoring recordings, which are usually performed because of patient symptoms or physician concern. The tracings may appear bewildering and mimic pacemaker malfunction, thus leading to unnecessary tests or even surgery...
July 18, 2018: Heart, Lung & Circulation
Peter W Macfarlane
The electrocardiogram (ECG) remains the most commonly used test in medical practice and as such requires to be interpreted with due care and attention to detail. The ECG changes rapidly from birth through childhood with age differences clearly related to increasing QRS voltages and a widening QRS complex. The only sex difference at this age is a slightly longer QRS duration in boys than girls.In adulthood, sex differences in QRS voltage are maximum in the under 40 age group and tend to minimise with advancing age...
2018: Advances in Experimental Medicine and Biology
Manish Sharma, Ru San Tan, U Rajendra Acharya
Myocardial infarction (MI), also referred to as heart attack, occurs when there is an interruption of blood flow to parts of the heart, due to the acute rupture of atherosclerotic plaque, which leads to damage of heart muscle. The heart muscle damage produces changes in the recorded surface electrocardiogram (ECG). The identification of MI by visual inspection of the ECG requires expert interpretation, and is difficult as the ECG signal changes associated with MI can be short in duration and low in magnitude...
July 23, 2018: Computers in Biology and Medicine
Jörg Täubel, Georg Ferber, Sara Fernandes, A John Camm
Understanding the physiological fluctuations in the corrected QT (QTc) interval is important to accurately interpret the variations in drug-induced prolongation. The present study aimed to define the time course of the effect of moxifloxacin on the QT interval to understand the duration of the responses to moxifloxacin. This retrospective analysis was performed on data taken from a thorough QT 4-way crossover study with 40 subjects. Each period consisted of a baseline electrocardiogram (ECG) day (day -1) and a treatment day (day 1)...
July 24, 2018: Journal of Clinical Pharmacology
Maria J Brosnan
Regular exercise training results in structural and electrical cardiac adaptations which are reflected in the resting 12-lead electrocardiograph (ECG), thus an athlete's ECG can be quite different to that of a sedentary person of the same age, gender and ethnicity. This has been recognised as an issue in the setting of pre-participation ECG screening of athletes in whom false positive findings are commonplace when using normative ECG values derived from sedentary populations. As such, athlete ECG interpretation guidelines have been devised and modified several times over the past decade, with the ultimate goal of reducing the number of athletes undergoing unnecessary secondary investigations to exclude cardiac pathology whilst maintaining the sensitivity of the ECG in detecting cardiac diseases associated with sudden cardiac death (SCD)...
September 2018: Heart, Lung & Circulation
Aruna Ramesh, Kenneth A LaBresh, Rhea Begeman, Bentley Bobrow, Teri Campbell, Nayanjeet Chaudhury, Marcia Edison, Timothy B Erickson, John D Manning, Bellur S Prabhakar, Pavitra Kotini-Shah, Naresh Shetty, Pamela A Williams, Terry Vanden Hoek
Background: A system of care designed to measure and improve process measures such as symptom recognition, emergency response, and hospital care has the potential to reduce mortality and improve quality of life for patients with ST-elevation myocardial infarction (STEMI). Objective: To document the methodology and rationale for the implementation and impact measurement of the Heart Rescue India project on STEMI morbidity and mortality in Bangalore, India. Study Design: A hub and spoke STEMI system of care comprised of two interventional, hub hospitals and five spoke hospitals will build and deploy a dedicated emergency response and transport system covering a 10 Km...
June 2018: Contemporary Clinical Trials Communications
Philip A Warrick, Masun Nabhan Homsi
OBJECTIVE: Atrial fibrillation (AF) is a common type of heart rhythm abnormality caused by a problem with the heart's electrical system. Early detection of this disease has important implications for stroke prevention and management. Our objective is to construct an intelligent tool that assists cardiologists in identifying automatically cardiac arrhythmias and noise in electrocardiogram (ECG) recordings. APPROACH: Our base deep classifier combined a Convolutional Neural Network (CNNs) and a sequence of Long Short-Term Memory (LSTM) units, with pooling, dropout and normalization techniques to improve their accuracy...
July 16, 2018: Physiological Measurement
Anna L Beale, Mallaury V Julliard, Philippe Maziarski, Jean-Luc Ziltener, Haran Burri, Philippe Meyer
OBJECTIVES: To categorize ECG findings into normal, borderline or abnormal in a team of professional elite cyclists according to the 2017 international recommendations. DESIGN: A cross-sectional study was performed. METHODS: Twelve-lead ECGs collected between 2012 and 2015 as part of an annual routine examination for a team of professional elite cyclists were analysed, and findings classified as normal, borderline or abnormal according to the 2017 recommendations...
July 5, 2018: Journal of Science and Medicine in Sport
Michael J Hermelin, Jordan M Prutkin
There is debate over the use of the electrocardiogram (ECG) to screen athletes for disorders associated with sudden cardiac death, but if screening is completed, accurate ECG interpretation is important. Recently, there has been recognition of a normal black athlete repolarization pattern which includes J-point elevation, convex ST-segment elevation, and T-wave inversions in leads V1 to V4 occurring in 5-15% of black athletes. This pattern must be differentiated from T-wave inversions that are associated with hypertrophic cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy...
July 2018: Journal of Electrocardiology
Nathan R Riding, Jonathan A Drezner
To assess the accuracy of interpreting the athlete's ECG both pre and post a series of online training modules among a range of healthcare professionals. 10 512 healthcare professionals from 138 different nations commenced the online course. These were primarily doctors (43%), nurses (18.4%) and other healthcare professionals (3.9%). The users came from 102 different specialities, with General Practice/Family Medicine (24.5%), Cardiology (10.6%), Emergency Medicine (8.7%) and Sports Medicine (6.6%) predominating...
July 4, 2018: Heart: Official Journal of the British Cardiac Society
Herbert Löllgen, Dieter Leyk
BACKGROUND: Bicycle and treadmill exercise tests are used in sports medicine and occupational medicine to detect latent disease, to monitor treatment, and to measure patients' physical performance ability and reserve. In this review, we describe the indications, contraindications, and manner of performance of these tests, along with the variables tested, criteria for evaluation, (sub)maximal stress, and the factors that affect these tests, including age, sex, and medications. METHODS: This review is based on pertinent articles retrieved by a selective literature search and on the ergometry guidelines of four medical specialty societies...
June 15, 2018: Deutsches Ärzteblatt International
Nicholas M Mohr, Tracy Young, Karisa K Harland, Brian Skow, Amy Wittrock, Amanda Bell, Marcia M Ward
BACKGROUND: Meeting time goals for patients with time-sensitive conditions can be challenging in rural emergency departments (EDs), and adopting policies is critical. ED-based telemedicine has been proposed to improve quality and timeliness of care in rural EDs. INTRODUCTION: The objective of this study was to test the hypothesis that diagnostic testing in telemedicine-supplemented ED care for patients with myocardial infarction (MI) and stroke would be faster than nontelemedicine care in rural EDs...
June 29, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Sarah Blissett, Matthew Sibbald, Ellen Kok, Jeroen van Merrienboer
Accurate self-regulation of performance is important for trainees. Trainees rely on cues to make monitoring judgments to self-regulate their performance. Ideally, cues and monitoring judgements accurately reflect performance, as measured by cue diagnosticity (the ability of a cue to predict performance) and monitoring accuracy (the ability of a monitoring judgement to predict performance). However, this process is far from perfect, emphasizing the need for more accurate cues and monitoring judgements. Perhaps the mental effort of a task could be a cue used to inform certainty judgements...
June 9, 2018: Advances in Health Sciences Education: Theory and Practice
Per Olofsson, Håkan Norén, Ann Carlsson, Karl G Rosén
INTRODUCTION: The intrapartum cardiotocography (CTG) classification system by FIGO in 2015 (FIGO2015) was introduced to simplify CTG interpretation, but it is not harmonized with the fetal ECG ST analysis (STAN) algorithm from 2007 (STAN2007), which is based on the FIGO CTG system from 1987. The study aimed to determine time courses and sensitivity between the systems in classifying CTG + ST events to indicate metabolic acidosis at birth. MATERIAL AND METHODS: Forty-four cases with umbilical cord artery metabolic acidosis were retrieved from a European multicenter database...
June 26, 2018: Journal of Maternal-fetal & Neonatal Medicine
E Fotiadou, J O E H van Laar, S G Oei, R Vullings
Extraction of a clean fetal electrocardiogram (ECG) from non-invasive abdominal recordings is one of the biggest challenges in fetal monitoring. An ECG allows for the interpretation of the electrical heart activity beyond the heart rate and heart rate variability. However, the low signal quality of the fetal ECG hinders the morphological analysis of its waveform in clinical practice. The time-sequenced adaptive filter has been proposed for performing optimal time-varying filtering of non-stationary signals having a recurring statistical character...
June 25, 2018: Medical & Biological Engineering & Computing
Elizabeth V Saarel, Suzanne Granger, Jonathan R Kaltman, L LuAnn Minich, Martin Tristani-Firouzi, Jeffrey J Kim, Kathleen Ash, Sabrina S Tsao, Charles I Berul, Elizabeth A Stephenson, David G Gamboa, Felicia Trachtenberg, Peter Fischbach, Victoria L Vetter, Richard J Czosek, Tiffanie R Johnson, Jack C Salerno, Nicole B Cain, Robert H Pass, Ilana Zeltser, Eric S Silver, Joshua R Kovach, Mark E Alexander
BACKGROUND: Interpretation of pediatric ECGs is limited by lack of accurate sex- and race-specific normal reference values obtained with modern technology for all ages. We sought to obtain contemporary digital ECG measurements in healthy children from North America, to evaluate the effects of sex and race, and to compare our results to commonly used published datasets. METHODS: Digital ECGs (12-lead) were retrospectively collected for children ≤18 years old with normal echocardiograms at 19 centers in the Pediatric Heart Network...
July 2018: Circulation. Arrhythmia and Electrophysiology
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