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https://www.readbyqxmd.com/read/29336652/detection-of-stemi-using-prehospital-serial-12-lead-electrocardiograms
#1
Alain Tanguay, Johann Lebon, Lorraine Lau, Denise Hébert, François Bégin
OBJECTIVE: Repeated or serial 12-lead electrocardiograms (ECGs) in the prehospital setting may improve management of patients with subtle ST-segment elevation (STE) or with a ST-segment elevation myocardial infarction (STEMI) that evolves over time. However, there is a minimal amount of scientific evidence available to support the clinical utility of this method. Our objective was to evaluate the use of serial 12-lead ECGs to detect STEMI in patients during transport in a Canadian emergency medical services (EMS) jurisdiction...
January 16, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29333788/enhancement-of-standard-ecgs-by-a-new-method-for-multi-cycle-superimposition-and-summation
#2
Aharon Frimerman, Simcha Meisel, Avraham Shotan, David S Blondheim
BACKGROUND: Since the introduction of the electrocardiogram (ECG) in 1902, the fundamentals of ECG data acquisition, display, and interpretation in the clinical arena have not changed much. OBJECTIVES: To present a new method to enhance and improve acquisition, analysis, and display of the standard ECG. METHODS: We performed ECG enhancement by superimposition and summation of multiple standard ECG cycles of each lead, by temporal alignment to peak R wave and voltage alignment to an improved baseline, at the T-P segment...
January 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29322817/endovascular-coil-embolization-and-stenting-for-the-treatment-of-iatrogenic-right-internal-mammary-artery-injury-a-case-report
#3
Zhen Jiang, JinXiu Yang, XingXiang Wang
A 54-year-old Chinese woman presented with a 10-year history of repeated paroxysmal palpitations. She was diagnosed with paroxysmal supraventricular tachycardia by 12-lead electrocardiogram and was advised to undergo catheter-based radiofrequency ablation. During the procedure, a rare complication occurred that was diagnosed as a right internal mammary artery penetrating injury. After appropriate emergency treatment with arterial embolization and membrane-covered stent implantation, the patient was out of immediate danger of haemorrhaging...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29317971/transcatheter-closure-versus-repeat-surgery-for-the-treatment-of-postoperative-left-to-right-shunts-a-single-center-15-year-experience
#4
Xinghua Gu, Qiuwang Zhang, Hourong Sun, Jianchun Fei, Xiquan Zhang, Michael J Kutryk
Background: Repeat surgery and the percutaneous approach (transcatheter closure (TCC)) have been used for the management of postoperative left-to-right shunts. In this study, we described our 15 years of experience in treating postoperative left-to-right shunts with these two approaches. Methods: From February 2002 to February 2017, 50 patients with residual left-to-right shunts, following cardiac surgery, were treated using TCC or repeat surgery. Clinical examination, standard 12-lead electrocardiography, chest X-ray, and a transthoracic echocardiogram were performed before hospital discharge and at all follow-ups...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29317399/effect-of-a-single-dose-of-i-v-ondansetron-on-qtc-interval-in-emergency-department-patients
#5
Kai Li, Kathy Vo, Byron K Lee, Newton Addo, Zlatan Coralic
PURPOSE: Results of a study to determine whether i.v. administration of a single dose of 4 mg of ondansetron was associated with QT interval prolongation in emergency department (ED) patients are reported. METHODS: In a prospective observational study conducted at an urban academic medical center ED, a convenience sample of adult ED patients treated with ondansetron 4 mg i.v. were enrolled. A 12-lead electrocardiogram (ECG) was obtained immediately before and 5 minutes after ondansetron administration...
January 9, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29316995/prehospital-modified-heart-score-predictive-of-30-day-adverse-cardiac-events
#6
Jason P Stopyra, William S Harper, Tyson J Higgins, Julia V Prokesova, James E Winslow, Robert D Nelson, Roy L Alson, Christopher A Davis, Gregory B Russell, Chadwick D Miller, Simon A Mahler
Introduction The History, Electrocardiogram (ECG), Age, Risk Factors, and Troponin (HEART) score is a decision aid designed to risk stratify emergency department (ED) patients with acute chest pain. It has been validated for ED use, but it has yet to be evaluated in a prehospital setting. Hypothesis A prehospital modified HEART score can predict major adverse cardiac events (MACE) among undifferentiated chest pain patients transported to the ED. METHODS: A retrospective cohort study of patients with chest pain transported by two county-based Emergency Medical Service (EMS) agencies to a tertiary care center was conducted...
January 10, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29313583/termination-of-ventricular-tachycardia-by-anti-tachycardia-pacing-an-uncommon-diagnosis-on-12-lead-surface-ecg
#7
Vaibhav M Dedhia
No abstract text is available yet for this article.
September 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29310809/relation-of-overall-and-abdominal-adiposity-with-electrocardiogram-parameters-of-subclinical-cardiovascular-disease-in-individuals-aged-45-to-65-years-from-the-netherlands-epidemiology-of-obesity-study
#8
Theodora W Elffers, Renée de Mutsert, Hildo J Lamb, Arie C Maan, Peter W Macfarlane, Ko Willems van Dijk, Frits R Rosendaal, J Wouter Jukema, Stella Trompet
Overall and abdominal obesity are well-established risk factors for cardiometabolic disease. However, associations of overall and abdominal adiposity with electrocardiographic (ECG) markers of subclinical cardiovascular disease (CVD) have not yet been fully elucidated. Therefore, we investigated these associations in a population without preexisting CVD. We performed cross-sectional analyses in the Netherlands Epidemiology of Obesity Study. Body mass index (BMI), total body fat, and waist circumference were assessed in all participants, and abdominal subcutaneous adipose tissue and visceral adipose tissue (by magnetic resonance imaging) were assessed in a random subgroup...
December 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29308607/electrocardiogram-ecg-patterns-of-left-anterior-fascicular-block-and-conduction-impairment-in-ventricular-myocardium-a-whole-heart-model-based-simulation-study
#9
Yuan Gao, Ling Xia, Ying-Lan Gong, Ding-Chang Zheng
Left anterior fascicular block (LAFB) is a heart disease identifiable from an abnormal electrocardiogram (ECG). It has been reported that LAFB is associated with an increased risk of heart failure. Non-specific intraventricular conduction delay due to the lesions of the conduction bundles and slow cell to cell conduction has also been considered as another cause of heart failure. Since the location and mechanism of conduction delay have notable variability between individual patients, we hypothesized that the impaired conduction in the ventricular myocardium may lead to abnormal ECGs similar to LAFB ECG patterns...
2018: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/29306455/small-and-large-vessel-disease-in-persons-with-unrecognized-compared-to-recognized-myocardial-infarction-the-troms%C3%A3-study-2007-2008
#10
Andrea Milde Øhrn, Henrik Schirmer, Therese von Hanno, Ellisiv B Mathiesen, Kjell Arne Arntzen, Geir Bertelsen, Inger Njølstad, Maja-Lisa Løchen, Tom Wilsgaard, C Noel Bairey Merz, Haakon Lindekleiv
BACKGROUND: Unrecognized myocardial infarction (MI) is a frequent condition with unknown underlying reason. We hypothesized the lack of recognition of MI is related to pathophysiology, specifically differences in underlying small and large vessel disease. METHODS: 6128 participants were examined with retinal photography, ultrasound of the carotid artery and a 12‑lead electrocardiography (ECG). Small vessel disease was defined as narrower retinal arterioles and/or wider retinal venules measured on retinal photographs...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29298860/pre-hospital-detection-of-acute-ischemic-stroke-secondary-to-emergent-large-vessel-occlusion-lessons-learned-from-electrocardiogram-and-acute-myocardial-infarction
#11
REVIEW
Alexander G Chartrain, Christopher Paul Kellner, J Mocco
Currently, there is no device capable of detecting acute ischemic stroke (AIS) secondary to emergent large vessel occlusion (ELVO) in the pre-hospital setting. The inability to reliably identify patients that would benefit from primary treatment with endovascular thrombectomy remains an important limitation to optimizing emergency medical services (EMS) triage models and time-to-treatment. Several clinical grading scales that rely solely on clinical examination have been proposed and have demonstrated only moderate predictive ability for ELVO...
January 3, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29297735/national-assessment-of-quality-programs-in-emergency-medical-services
#12
Michael Redlener, Patrick Olivieri, George T Loo, Kevin Munjal, Michael T Hilton, Katya Trudeau Potkin, Michael Levy, Jeffrey Rabrich, Michael R Gunderson, Sabina A Braithwaite
OBJECTIVE: This study aims to understand the adoption of clinical quality measurement throughout the United States on an EMS agency level, the features of agencies that do participate in quality measurement, and the level of physician involvement. It also aims to barriers to implementing quality improvement initiatives in EMS. METHODS: A 46-question survey was developed to gather agency level data on current quality improvement practices and measurement. The survey was distributed nationally via State EMS Offices to EMS agencies nation-wide using Surveymonkey©...
January 3, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29290418/effect-of-high-intensity-perturbations-during-core-specific-sensorimotor-exercises-on-trunk-muscle-activation
#13
Juliane Mueller, Miralem Hadzic, Hendrik Mugele, Josefine Stoll, Steffen Mueller, Frank Mayer
Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk. However, the influence of high-intensity perturbations on training efficiency is unclear within this context. Sixteen participants (29±2yrs; 175±8cm; 69±13kg) were prepared with a 12-lead bilateral trunk EMG. Warm-up on a dynamometer was followed by maximum voluntary isometric trunk (flex/ext) contraction (MVC). Next, participants performed four conditions for a one-legged stance with hip abduction on a stable surface (HA) repeated randomly on an unstable surface (HAP), on a stable surface with perturbation (HA+P), and on an unstable surface with perturbation (HAP+P)...
December 15, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29287718/noninvasive-clues-for-diagnosing-ventricular-tachycardia-mechanism
#14
REVIEW
Andres Enriquez, Michael Riley, Francis Marchlinski
The electrophysiologic mechanisms responsible for the initiation and maintenance of ventricular tachycardia (VT) include enhanced automaticity, triggered activity and reentry. Differentiating between these three mechanisms can be challenging for the clinician and usually requires an invasive electrophysiology study. Establishing the underlying VT mechanism in a particular patient is helpful to define the optimal therapeutic approach, including the selection of pharmacologic agents or delineation of an ablation strategy...
November 21, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29280520/significance-of-isolated-papillary-muscle-hypertrophy-a-comparison-of-left-ventricular-hypertrophy-diagnosed-using-electrocardiography-vs-echocardiography
#15
Namiko Nomura, Tomoko Tani, Toshiko Konda, Kitae Kim, Takeshi Kitai, Natsumi Nomoto, Naoko Suganuma, Hitomi Nakamura, Toshiaki Sumida, Yoko Fujii, Junichi Kawai, Shuichiro Kaji, Yutaka Furukawa
AIMS: The clinical significance of papillary muscle hypertrophy and its electrocardiography (ECG) findings has not been fully elucidated. This study aimed to investigate the relationship between ECG findings and papillary muscle hypertrophy and to confirm the importance of papillary muscle measurements on transthoracic echocardiography (TTE). METHODS AND RESULTS: Of the 237 consecutive patients who showed left ventricular hypertrophy (LVH) pattern on a 12-lead ECG, TTE data were available for 101 patients...
December 27, 2017: Echocardiography
https://www.readbyqxmd.com/read/29275955/inter-and-intra-observer-variability-of-visual-fragmented-qrs-scoring-in-ischemic-and-non-ischemic-cardiomyopathy
#16
Bert Vandenberk, Tomas Robyns, Griet Goovaerts, Mathias Claeys, Frederik Helsen, Sofie Van Soest, Christophe Garweg, Joris Ector, Sabine Van Huffel, Rik Willems
BACKGROUND: Fragmented QRS (fQRS) on a 12-lead ECG has been linked with adverse outcome. However, the visual scoring of ECGs is prone to inter- and intra-observer variability. METHODS: Five observers, two experienced and three novel, assessed fQRS in 712 digital ECGs, 100 were re-evaluated to assess intra-observer variability. Fleiss and Cohen's Kappa were calculated and compared between subgroups. RESULTS: The inter-observer variability for assessing fQRS in all leads combined was substantial with a Kappa of 0...
December 7, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29275944/electrocardiographic-patterns-and-long-term-training-induced-time-changes-in-2484-elite-football-players
#17
Olivier Huttin, Christine Selton-Suty, Clément Venner, Jean-Baptiste Vilain, Pierre Rochecongar, Etienne Aliot
BACKGROUND: High-level physical training induces cardiac structural and functional changes, including 12-lead electrocardiogram modifications. OBJECTIVES: The purpose of this cross-sectional longitudinal study was to establish a quantitative electrocardiographic profile in highly trained football players. Initial and serial annual electrocardiogram monitoring over subsequent years allowed us to investigate the long-term effects of exercise on cardiac conduction and electrophysiological remodelling...
December 21, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29274604/interictal-cardiac-repolarization-abnormalities-in-people-with-epilepsy
#18
Nirmeen A Kishk, Yasser Sharaf, Asmaa M Ebraheim, Yasser Baghdady, Nelly Alieldin, Ahmed Afify, Ahmed Eldamaty
BACKGROUND AND OBJECTIVE: The occurrence of cardiac electrical abnormalities such as repolarization disorders in patients with epilepsy was previously documented and may, in part, clarify the mechanism of sudden unexpected death in those patients. The aim of this study was to investigate the frequency of cardiac repolarization disorders among patients with epilepsy and whether specific demographic- or disease-related features were associated with their occurrence. SUBJECTS AND METHODS: This cross-sectional study was carried out on 1000 subjects with epilepsy who were compared with age- and sex-matched 2500 subjects without epilepsy...
December 20, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29273234/body-surface-activation-mapping-of-electrical-dyssynchrony-in-cardiac-resynchronization-therapy-patients-potential-for-optimization
#19
Alan J Bank, Ryan M Gage, Antonia E Curtin, Kevin V Burns, Jeffrey M Gillberg, Subham Ghosh
BACKGROUND: Electrical synchronization is likely improved by cardiac resynchronization therapy (CRT), but is difficult to quantify with 12-lead ECG. We aimed to quantify changes in electrical synchrony and potential for optimization with CRT using a body-surface activation mapping (BSAM) system. METHODS: Standard deviation of activation times (SDAT) was calculated in 94 patients using BSAM at baseline CRT (CRTbl), native, and different CRT configurations. RESULTS: SDAT decreased 20% from native to CRTbl (p<0...
December 6, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29262473/-clinical-challenges-in-the-management-of-catecholaminergic-polymorphic-ventricular-tachycardia-in-children
#20
H Y Ge, X M Li, H Jiang, Y Zhang, H J Liu, X C Zheng, M T Li
Objective: Catecholaminergic polymorphic ventricular tachycardia (CPVT) accounts for up to 10%-15% sudden cardiac death (SCD) in the children and young population. This study aimed to assess the current situation and challenges in CPVT clinical diagnosis. Method: A retrospective review included 11 children (7 male patients) at the First Hospital of Tsinghua University clinically diagnosed with CPVT from June 2014 to July 2017. Each patient was evaluated with detailed history, physical examination, resting 12-lead electrocardiogram(ECG), 24-h Holter, exercise stress test, Doppler echocardiography and genetic test...
December 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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