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

Srinivas Kuntamalla, Ram Gopal Reddy Lekkala
Currently, heartbeat intervals required for the analysis of heart rate variability (HRV) are derived from electrocardiogram (ECG). Many investigators have explored the possibility of using photoplethysmography (PPG), for the analysis of HRV. However, all these studies are based on statistical approach and have used the correlation coefficient for the comparison of HRV data obtained using ECG and PPG, which is inappropriate as the causal relationship between the R-peaks in ECG and the systolic peaks in PPG is well known in physiology...
October 16, 2018: Journal of Medical Engineering & Technology
Agnieszka Świerkosz, Piotr Augustyniak
Watermarking is currently investigated as an efficient and safe method of embedding additional patient or environment-related data into the electrocardiogram. This paper presents experimental work on the assessment of the loss of ECG (electrocardiogram signal) diagnostic quality from the industrial standard EN60601-2-25:2015 point of view. We implemented an original time-frequency watermarking technique with an adaptive beat-to-beat lead-independent data container design. We tested six wavelets, six coding bit depth values (including the automatic noise-dependent one) and two types of watermark content to find the conditions that are necessary for watermarked ECG to maintain the compliance with International Electrotechnical Commission (IEC) requirements for interpretation performance...
October 11, 2018: Sensors
Ching-Hui Sia, Devinder Singh, Joshua Ping-Yun Loh
Stress (Takotsubo) cardiomyopathy (SC) is a cardiomyopathy characterised by transient myocardial dysfunction, commonly triggered by a surge in catecholamine. Electrocardiographic features may mimic other conditions, such as myocardial infarction. We presented two cases of SC and reviewed the electrocardiographic features of this disease entity.
September 2018: Singapore Medical Journal
Théa Venet, Vincent Pichot, David Charier, Aurélien Scalabre, Hugues Patural
BACKGROUND: General anesthesia dramatically decreases the activity of the autonomic nervous system. Most of the hypnotic agents used to induce anesthesia inhibit sympathetic cardiovascular regulation and baroreflex control in a dose-dependent manner, lowering cardiac adaptability during the operation. The consequence of this effect in children during and after surgery has never been studied to date. AIM: The aim of this study was to follow the variations in autonomic cardiac indices in children younger than 8 years old after general anesthesia (6-24 hours) in programmed surgery...
October 2018: Paediatric Anaesthesia
Haris M Haqqani, Francis E Marchlinski
The 12-lead electrocardiograph (ECG) is of critical importance both in the diagnosis of wide complex tachycardia and in the further classification, characterisation and management of ventricular arrhythmias. With its diligent application and interpretation, remarkable precision can be achieved in the localisation of the site of origin of ventricular arrhythmias and this may have major implications in the care of these patients. This review discusses the technical, anatomic and mechanistic basis of ECG interpretation in ventricular arrhythmias...
September 24, 2018: Heart, Lung & Circulation
Flavio D'Ascenzi, Francesca Anselmi, Beatrice Berti, Elena Capitani, Chiara Chiti, Andrea Franchini, Francesca Graziano, Stefano Nistri, Marta Focardi, Massimo Capitani, Domenico Corrado, Marco Bonifazi, Sergio Mondillo
BACKGROUND: T-wave inversion (TWI) is rare in athlete's heart but is a common manifestation in cardiomyopathies. Although TWI has been extensively investigated in adult athletes, the ability of this ECG pattern to distinguish between a physiological variant and a developing heart muscle disease in children is controversial. The aim of this longitudinal study was to establish the prevalence, changes and clinical significance of TWI in a large cohort of pre-adolescent athletes. METHODS: 2227 children (mean age 12...
September 21, 2018: International Journal of Cardiology
Shiv Gandhi, Miranda Lin, Sharon R Smith, Jesse J Sturm
Background: Electrocardiograms (ECGs) are ordered in the pediatric emergency room for a wide variety of chief complaints. Objectives: Criteria are lacking as to when physicians should obtain ECGs. This study uses a large retrospective cohort of 880 pediatric emergency department (ED) patients to highlight objective criteria including significant medical history and specific vital sign abnormalities to guide clinicians as to which patients might have an abnormal ECG...
September 2018: Annals of Pediatric Cardiology
K S Cheung, L P Leung, Y C Siu, T C Tsang, M Sh Tsui, C C Tam, R Hw Chan
INTRODUCTION: After ST-segment elevation myocardial infarction (STEMI), it is vital to shorten reperfusion time. This study examined data from a pilot project to shorten the door-to-balloon (D2B) time by using prehospital 12-lead electrocardiogram (ECG). METHODS: Fifteen ambulances equipped with X Series® Monitor/Defibrillator (Zoll Medical Corporation) were deployed to the catchment area of Queen Mary Hospital, Hong Kong, from November 2015 to December 2016. For patients with chest pain, prehospital 12-lead ECG was performed and tele-transmitted to attending physicians at the accident and emergency department for immediate interpretation...
October 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Sakari Syväoja, Tuomas T Rissanen, Pamela Hiltunen, Maaret Castren, Pirjo Mäntylä, Antti Kivelä, Ari Uusaro, Helena Jäntti
BACKGROUND: Recognition of out-of-hospital-cardiac arrests (OHCAs) at emergency medical communication centres is based on questions of OHCA symptoms, resulting in 50-80% accuracy rates. However, OHCAs might be recognized more promptly using 'rhythm-based' recognition, whereby a victim's cardiac rhythm is recorded with mobile phone technology that analyses and transmits recordings to emergency medical communication centres for further interpretation. OBJECTIVE: To examine whether the quality of normal cardiac rhythm and the rhythm with the best prognosis in OHCA, ventricular fibrillation (VF), is sufficient for 'rhythm-based' OHCA recognition when recorded within a mobile phone-sized device...
September 19, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Gavin McClean, Nathan R Riding, Guido Pieles, Victoria Watt, Carmen Adamuz, Sanjay Sharma, Keith P George, David Oxborough, Mathew G Wilson
OBJECTIVE: Historically, electrocardiographic (ECG) interpretation criteria for athletes were only applicable to adults. New international recommendations now account for athletes ≤16 years, but their clinical appropriateness is unknown. We sought to establish the diagnostic accuracy of new international ECG recommendations against the Seattle criteria and 2010 European Society of Cardiology (ESC) recommendations in paediatric athletes using receiver operator curve analysis. Clinical context was calculated using Bayesian analysis...
September 18, 2018: Heart: Official Journal of the British Cardiac Society
Alain Tanguay, Johann Lebon, Eric Brassard, Denise Hébert, François Bégin
BACKGROUND: Prehospital 12‑lead electrocardiogram (ECG) is the most widely used screening tool for recognition of ST-segment elevation myocardial infarction (STEMI). However, prehospital diagnosis of STEMI based solely on ECGs can be challenging. OBJECTIVES: To evaluate the ability of emergency department (ED) physicians to accurately interpret prehospital 12‑lead ECGs from a remote location. METHODS: All suspected prehospital STEMI patients who were transported by EMS and underwent angiography between 2006 and 2014 were included...
September 6, 2018: American Journal of Emergency Medicine
Jana Faganeli Pucer, Matjaž Kukar
BACKGROUND AND OBJECTIVE: Arrhythmias are one of the most common symptoms of cardiac failure. They are usually diagnosed using ECG recordings, particularly long ambulatory recordings (AECG). These recordings are tedious to interpret by humans due to their extent (up to 48 h) and the relative scarcity of arrhythmia events. This makes automated systems for detecting various AECG anomalies indispensable. In this work we present a novel procedure based on topological principles (Morse theory) for detecting arrhythmic beats in AECG...
October 2018: Computer Methods and Programs in Biomedicine
Iman Alikhani, Kai Noponen, Arto Hautala, Tapio Seppänen
Heart rate variability (HRV) is defined as the variation of heart's beat to beat time intervals. Although HRV has been studied for decades, its response to stress tests and off-rest measurements is still open to controversy. In this paper, we studied the influence of motion on HRV throughout different exercise tests, including a maximal running of healthy recreational runners, cycling and walking tests of healthy subjects. In our proposed method, we utilize the motion trajectory (which is known to exist partially in HRV) measured by a three-channel accelerator (ACC) and estimate their share in HRV, derived from a wearable electrocardiography (ECG), in an error correcting problem formulation...
September 5, 2018: Physiological Measurement
Negin Yaghmaie, Mohammad Ali Maddah-Ali, Herbert F Jelinek, Faezeh Marzbanrad
The advent of telehealth applications and remote patient monitoring has led to an increasing need for continuous signal quality monitoring to ensure high diagnostic accuracy of the recordings. Cardiovascular diseases often manifest electrophysiological anomalies, therefore the Electrocardiogram (ECG) is one of the most used signals for diagnostic applications. Various types of noise and artifacts are not uncommon in ECG recordings and assessing the quality of the signal is essential prior to any clinical interpretation...
September 5, 2018: Physiological Measurement
Rose Hatala, Jacqueline Gutman, Matthew Lineberry, Marc Triola, Martin Pusic
Learning curves can support a competency-based approach to assessment for learning. When interpreting repeated assessment data displayed as learning curves, a key assessment question is: "How well is each learner learning?" We outline the validity argument and investigation relevant to this question, for a computer-based repeated assessment of competence in electrocardiogram (ECG) interpretation. We developed an on-line ECG learning program based on 292 anonymized ECGs collected from an electronic patient database...
August 31, 2018: Advances in Health Sciences Education: Theory and Practice
Nathan R Riding, Sanjay Sharma, Gavin McClean, Carmen Adamuz, Victoria Watt, Mathew G Wilson
Aims: Black athletes demonstrate an increased prevalence of repolarization anomalies and left ventricular hypertrophy compared to their white counterparts. Recent international recommendations for electrocardiogram (ECG) interpretation in athletes now account for some of these observations, but little attention is given to whether the heart of the black athlete is universal, or whether substantial differences exist according to geographic origin. Our aim was to examine the impact of geographical origin upon the electrical-and structural manifestations of the black athlete's heart...
August 29, 2018: European Heart Journal
Nikhil Ahluwalia, Hariharan Raju
PURPOSE OF REVIEW: Pre-participation athlete screening has led to the referral of asymptomatic athletes with a prolonged QT interval warranting their evaluation for long QT syndrome (LQTS). Establishing a diagnosis of LQTS can be difficult, particularly in asymptomatic athletes presenting with a prolonged QTc < 500 ms. This review examines the evaluatory pathway to ascertain the common pitfalls leading to mis- or overdiagnosis. We discuss the advanced ECG-based tools and consider their application in the diagnostic process...
August 27, 2018: Current Treatment Options in Cardiovascular Medicine
Amila D William, Majd Kanbour, Thomas Callahan, Mandeep Bhargava, Niraj Varma, John Rickard, Walid Saliba, Kathy Wolski, Ayman Hussein, Bruce D Lindsay, Oussama M Wazni, Khaldoun G Tarakji
BACKGROUND: The Kardia Mobile Cardiac Monitor (KMCM) detects atrial fibrillation (AF) via a handheld cardiac rhythm recorder and AF detection algorithm. The algorithm operates within predefined parameters to provide a "normal" or "possible atrial fibrillation detected" interpretation; outside of these parameters, an "unclassified" rhythm is reported. The system has been increasingly used, but its performance has not been independently tested. OBJECTIVE: The objective of this study was to evaluate whether the KMCM system can accurately detect AF...
October 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Mark Lown, Arthur M Yue, Benoy N Shah, Simon J Corbett, George Lewith, Beth Stuart, James Garrard, Michael Brown, Paul Little, Michael Moore
The prevalence of atrial fibrillation (AF) is estimated at more than 3% in the adult population and there has been increased interest in screening for AF. In the SAFETY trial we chose to evaluate if inexpensive, wearable, consumer electrocardiography (ECG) sensing devices (Polar-H7 [PH7] and Firstbeat Bodyguard 2 [BG2]), could be used to detect AF accurately. We undertook a case-control study of 418 participants aged >65 (82 with AF and/or flutter at the study visit and 336 without) attending 3 general practice surgeries in Hampshire, UK for a single screening visit...
July 19, 2018: American Journal of Cardiology
Raymond R Bond, Tomas Novotny, Irena Andrsova, Lumir Koc, Martina Sisakova, Dewar Finlay, Daniel Guldenring, James McLaughlin, Aaron Peace, Victoria McGilligan, Stephen J Leslie, Hui Wang, Marek Malik
INTRODUCTION: Interpretation of the 12‑lead Electrocardiogram (ECG) is normally assisted with an automated diagnosis (AD), which can facilitate an 'automation bias' where interpreters can be anchored. In this paper, we studied, 1) the effect of an incorrect AD on interpretation accuracy and interpreter confidence (a proxy for uncertainty), and 2) whether confidence and other interpreter features can predict interpretation accuracy using machine learning. METHODS: This study analysed 9000 ECG interpretations from cardiology and non-cardiology fellows (CFs and non-CFs)...
August 10, 2018: Journal of Electrocardiology
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