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Ecg challenges

Jyh-Ming Jimmy Juang, Minoru Horie
In 1992, the Brugada syndrome (BrS) was recognized as a disease responsible for sudden cardiac death, characterized by a right bundle-branch block with ST segment elevation in the leads V1 and V2. This syndrome is highly associated with sudden cardiac death, especially in young males. BrS is currently diagnosed in patients with ST-segment elevation showing type 1 morphology ≥ 2 mm in ≥1 leads among the right precordial leads V1 or V2 positioned in the 2nd, 3rd, or 4th intercostal space, and occurring either spontaneously or after a provocative drug test by the intravenous administration of Class I antiarrhythmic drugs...
October 2016: Journal of Arrhythmia
Kristin McLeod, Samuel Wall, Ida Skrinde Leren, Jørg Saberniak, Kristina Hermann Haugaa
BACKGROUND: Altered right ventricular structure is an important feature of Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), but is challenging to quantify objectively. The aim of this study was to go beyond ventricular volumes and diameters and to explore if the shape of the right and left ventricles could be assessed and related to clinical measures. We used quantifiable computational methods to automatically identify and analyse malformations in ARVC patients from Cardiovascular Magnetic Resonance (CMR) images...
October 14, 2016: Journal of Cardiovascular Magnetic Resonance
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
M P Turuk, A P Dhande
The exponential augmentation of information and communication technologies has appreciably shifted panorama of Health Information System (HIS), drawing keen interests of the researchers to address the challenges in protecting the medical data. Digital Watermarking therefore gained wide popularity as an entrusted measure to ensure the security. Literature reports wide assortment of imaging approaches for digital watermarking; however its perspectives in the HIS have received meager attention, especially in the reversible watermarking context...
December 2016: Journal of Medical Systems
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
Fiona Brigid McDonald, Kumaran Chandrasekharan, Richard J A Wilson, Shabih U Hasan
Maternal cigarette smoke (CS) exposure exhibits a strong epidemiological association with Sudden Infant Death Syndrome but other environmental stressors, including infection, hyperthermia and hypoxia have also been postulated as important risk factors. This study examines if maternal CS exposure causes maladaptations within homeostatic control networks by influencing the response to lipopolysaccharide, heat stress and/or hypoxia in neonatal rats. Pregnant dams were exposed to CS or parallel sham treatments daily for the length of gestation...
October 12, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Azhar Mohamed Nomair, Mona Mohamed Kamal ElDeeb, Dalia Aly Maharem
INTRODUCTION: Over the past three decades, the number of people with diabetes mellitus (DM) has more than doubled globally, making it one of the most important public health challenges to all nations. Aldose reductase (AR) is a rate-limiting enzyme in the polyol pathway, which has been implicated in the pathogenesis of diabetic microvascular complications; however, the association of the AR gene with diabetic macrovascular complications has rarely been investigated. AIM: The study aimed to identify the possible association between C(-106) T polymorphism of the AR gene and diabetic macroangiopathy in a cohort of Egyptian patients with type 2 DM...
September 2016: Indian Journal of Endocrinology and Metabolism
Alan Kennedy, Dewar D Finlay, Daniel Guldenring, Raymond R Bond, Kieran Moran, James McLaughlin
Automated detection of AF from the electrocardiogram (ECG) still remains a challenge. In this study, we investigated two multivariate-based classification techniques, Random Forests (RF) and k-nearest neighbor (k-nn), for improved automated detection of AF from the ECG. We have compiled a new database from ECG data taken from existing sources. R-R intervals were then analyzed using four previously described R-R irregularity measurements: (1) the coefficient of sample entropy (CoSEn), (2) the coefficient of variance (CV), (3) root mean square of the successive differences (RMSSD), and (4) median absolute deviation (MAD)...
August 12, 2016: Journal of Electrocardiology
O Nallet, G Gouffran, Y Lavie Badie
Cardiac troponins are the most sensitive and specific markers of myocardial injury. Cardiac troponin elevation are common in many diseases and do not necessarily indicate the presence of a thrombotic acute coronary syndrome. In clinical practice, interpretation of dynamic changes of troponin may be challenging. Troponin evaluation should be performed only if clinically indicated and must be interpreted in the context of clinical presentation, ECG changes, troponin level and kinetic. In the absence of thrombotic acute coronary syndrom, troponin retains a prognostic value...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Srinivasa Prasad, Narayanan Namboodiri, Anees Thajudheen, Gurbhej Singh, Mukund A Prabhu, S P Abhilash, Krishnakumar Mohanan Nair, Aamir Rashid, V K Ajit Kumar, Jaganmohan A Tharakan
BACKGROUND: Many subjects in community have non-type 1 Brugada pattern ECG with atypical symptoms, relevance of which is not clear. Provocative tests to unmask type 1 Brugada pattern in these patients would help in diagnosing Brugada Syndrome. However sensitivity and specificity of provocating drugs are variable. METHODS: We studied 29 patients referred to our institute with clinical presentation suggestive but not diagnostic of Brugada or with non-Type 1 Brugada pattern ECG...
March 2016: Indian Pacing and Electrophysiology Journal
Nil Ozyuncu, Sevinc Akturk, Turkan Seda Tan Kurklu, Cetin Erol
Pheochromocytoma is a rare adrenal gland tumour, usually alerting the physician by causing hypertensive tachycardic attacks. Patients with pheochromocytoma can rarely present with clinical signs similar to acute coronary syndrome. QT interval prolongation and ST segment changes due to pheochromocytoma have also been reported in the literature in a few case reports. We report a patient who had been admitted to the emergency department with chest pain, ischaemic ECG changes and marked QT prolongation. Despite a normal coronary angiogram, we observed that the QT interval and ST segment morphologies had changed during the hospitalisation period...
2016: BMJ Case Reports
A L M J van der Knijff-van Dortmont, M Dirckx, J J Duvekot, J W Roos-Hesselink, A Gonzalez Candel, C D van der Marel, G P Scoones, V F R Adriaens, I J J Dons-Sinke
SCN5A gene mutations can lead to ion channel defects which can cause cardiac conduction disturbances. In the presence of specific ECG characteristics, this mutation is called Brugada syndrome. Many drugs are associated with adverse events, making anesthesia in patients with SCN5A gene mutations or Brugada syndrome challenging. In this case report, we describe a pregnant patient with this mutation who received epidural analgesia using low dose ropivacaine and sufentanil during labour.
2016: Case Reports in Anesthesiology
Patrik Gilje, Sasha Koul, Jakob Hartvig Thomsen, Yvan Devaux, Hans Friberg, Michael Kuiper, Janneke Horn, Niklas Nielsen, Tomasso Pellis, Pascal Stammet, Matthew P Wise, Jesper Kjaergaard, Christian Hassager, David Erlinge
AIM OF THE STUDY: Predicting outcome of unconscious patients after successful resuscitation is challenging and better prognostic markers are highly needed. Ischemic heart disease is a common cause of out-of-hospital cardiac arrest (OHCA). Whether or not high-sensitivity troponin T (hs-TnT) is a prognostic marker among survivors of OHCA with both ischemic and non-ischemic aetiologies remains to be determined. We sought to evaluate the ability of hs-TnT to prognosticate all-cause mortality, death due to cardiovascular causes or multi-organ failure and death due to cerebral causes after OHCA...
October 2016: Resuscitation
Riqing Chen, Yingsong Huang, Jian Wu
BACKGROUND AND OBJECTIVE: P-wave detection is one of the most challenging aspects in electrocardiograms (ECGs) due to its low amplitude, low frequency, and variable waveforms. This work introduces a novel multi-window detection method for P-wave delineation based on the bilateral accumulative area. METHOD: The bilateral accumulative area is calculated by summing the areas covered by the P-wave curve with left and right sliding windows. The onset and offset of a positive P-wave correspond to the local maxima of the area detector...
September 15, 2016: Computers in Biology and Medicine
George S Waits, Elsayed Z Soliman
The paper electrocardiogram (ECG) has been widely used for cardiac assessment for well over a century. ECGs can be obtained quickly and cheaply. For this reason, an ever-growing amount of paper ECG records continue to accumulate, some of which are stored into a paper-only format. Converting paper ECGs into digital form has been proposed as the most efficient means to store and analyze an otherwise cumbersome paper archive. In this article, a literature review was conducted for conversion algorithms, criticisms of said algorithms, applications, and standardization efforts...
September 12, 2016: Journal of Electrocardiology
Peter Seizer, Michaela Rockenstiehl, Suzanne Fateh-Moghadam, Susanne Haen, Ferruh Artunc, Martin R Müller, Azadeh Ebrahimi, Reimer Riessen, Meinrad Gawaz, Falko Fend, Michael Haap
HISTORY AND ADMISSION FINDINGS: A 55-year old man suffers from progressive, distinctive dyspnoea and physical weakness since 5 days. Due to ST-segment changes in the ECG and a positive troponin-test, the primary care physician initiates an hospitalization. INVESTIGATIONS: After admission, the laboratory tests confirm the elevated troponin-values, and show additionally elevated pro-brain-natriuric-peptide-values. The coronary angiography presents a highly reduced left ventricular function, an aortic insufficiency III° and a coronary heart disease...
September 2016: Deutsche Medizinische Wochenschrift
Konstantinos Karatolios, Caroline Rolfes, Hinnerk Wulf, Bernhard Schieffer
Cardiovascular complications, particularly perioperative myocardial infarction (PMI), are major contributors to mortaliyt after noncardiac surgery. PMI often occurs unnoticed without symptoms or ECG changes. Despite ist silent presentation, PMI is associated with increased mortality. The combination of high associated mortality and diagnostic challenges mandates increased awareness of PMI. Perioperative myocardial infarction may result from plaque rupture (PMI type I) or be caused by a myocardial supply-demand imbalance of oxygen without plaque rupture (PMI type II)...
September 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Hau-Tieng Wu, Gregory F Lewis, Maria I Davila, Ingrid Daubechies, Stephen W Porges
BACKGROUND: With recent advances in sensor and computer technologies, the ability to monitor peripheral pulse activity is no longer limited to the laboratory and clinic. Now inexpensive sensors, which interface with smartphones or other computer-based devices, are expanding into the consumer market. When appropriate algorithms are applied, these new technologies enable ambulatory monitoring of dynamic physiological responses outside the clinic in a variety of applications including monitoring fatigue, health, workload, fitness, and rehabilitation...
October 17, 2016: Methods of Information in Medicine
Nima Karimian, Zimu Guo, Mark Tehranipoor, Domenic Forte
Traditional passwords are inadequate as cryptographic keys, as they are easy to forge and are vulnerable to guessing. Human biometrics have been proposed as a promising alternative due to their intrinsic nature. Electrocardiogram (ECG) is an emerging biometric that is extremely difficult to forge and circumvent, but has not yet been heavily investigated for cryptographic key generation. ECG has challenges with respect to immunity to noise, abnormalities, etc. In this paper, we propose a novel key generation approach that extracts keys from real valued ECG features with high reliability and entropy in mind...
September 8, 2016: IEEE Transactions on Bio-medical Engineering
Dimitrios Poulikakos, Marek Malik
Patients on hemodialysis (HD) suffer from high cardiovascular morbidity and mortality due to high rates of coronary artery disease and arrhythmias. Electrocardiography (ECG) is often performed in the dialysis units as part of routine clinical assessment. However, fluid and electrolyte changes have been shown to affect all ECG morphologies and intervals. ECG interpretation thus depends on the time of the recording in relation to the HD session. In addition, arrhythmias during HD are common, and dialysis-related ECG artifacts mimicking arrhythmias have been reported...
July 28, 2016: Journal of Electrocardiology
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