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ECG interpretation

Jonathan Lichtenberger, Kathryn M Meurs, Etienne Côté
Cardiac arrhythmias often are transient and might not be detected using conventional electrocardiographic (ECG) techniques. The adhesive patch monitor (APM) is a single-lead, lightweight, up to 14-day continuous ambulatory ECG monitor. This study aimed to prospectively assess its usability in four boxer dogs considered either to be healthy or to have arrhythmogenic right ventricular cardiomyopathy. Optimal recording was obtained by placing the APM on the left side of the animal's thorax, at the fifth intercostal space, slightly dorsal to the costochondral junction, and oriented either vertically or parallel to the long axis of the heart...
March 20, 2018: Journal of the American Animal Hospital Association
Bradley A Perkins, C Thomas Caskey, Pamila Brar, Eric Dec, David S Karow, Andrew M Kahn, Ying-Chen Claire Hou, Naisha Shah, Debbie Boeldt, Erin Coughlin, Gabby Hands, Victor Lavrenko, James Yu, Andrea Procko, Julia Appis, Anders M Dale, Lining Guo, Thomas J Jönsson, Bryan M Wittmann, Istvan Bartha, Smriti Ramakrishnan, Axel Bernal, James B Brewer, Suzanne Brewerton, William H Biggs, Yaron Turpaz, J Craig Venter
Reducing premature mortality associated with age-related chronic diseases, such as cancer and cardiovascular disease, is an urgent priority. We report early results using genomics in combination with advanced imaging and other clinical testing to proactively screen for age-related chronic disease risk among adults. We enrolled active, symptom-free adults in a study of screening for age-related chronic diseases associated with premature mortality. In addition to personal and family medical history and other clinical testing, we obtained whole-genome sequencing (WGS), noncontrast whole-body MRI, dual-energy X-ray absorptiometry (DXA), global metabolomics, a new blood test for prediabetes (Quantose IR), echocardiography (ECHO), ECG, and cardiac rhythm monitoring to identify age-related chronic disease risks...
March 19, 2018: Proceedings of the National Academy of Sciences of the United States of America
Samantha Noll, Heidi Alvey, Namita Jayaprakash, Aniruddha Paranjpe, Joseph Miller, Michele L Moyer, Richard Nowak
INTRODUCTION: Current AHA/ACC guidelines on the management of ST-elevation myocardial infarction (STEMI) suggest that an ECG is indicated within 10minutes of arrival for patients arriving to the Emergency Department (ED) with symptoms concerning for STEMI. In response, there has been a creep towards performing ECGs more frequently in triage. The objectives of this study were to quantify the number of triage ECGs performed at our institution, assess the proportion of ECGs performed within current hospital guidelines, and evaluate the rate of STEMI detection in triage ECGs...
February 3, 2018: American Journal of Emergency Medicine
Emma L Veale, Adrian J Stewart, Alistair Mathie, Satvinder K Lall, Melanie Rees-Roberts, Vilius Savickas, Sukvinder K Bhamra, Sarah A Corlett
INTRODUCTION: Atrial fibrillation (AF) affects >6% of people aged 65 years or older. Left undetected and untreated, patients may develop significant cardiovascular complications and have a fivefold increased risk of suffering a stroke. For 40% of all sufferers, AF can be asymptomatic. Every year in the UK, £2.2 billion is spent on AF-related strokes, so there is an urgent need to improve early detection of AF. This study aims to determine the feasibility of using trained clinical pharmacists based in general practices, to screen for AF, using pulse palpation and a single-lead ECG device on participants aged 65 years or older, attending influenza vaccination clinics...
March 14, 2018: BMJ Open
Joseph M Bumgarner, Cameron T Lambert, Ayman A Hussein, Daniel J Cantillon, Bryan Baranowski, Kathy Wolski, Bruce D Lindsay, Oussama M Wazni, Khaldoun G Tarakji
BACKGROUND: The Kardia Band (KB) is a novel technology that enables patients to record a rhythm strip using an Apple smartwatch. The band is paired with an app providing automated detection of atrial fibrillation (AF). OBJECTIVES: To examine whether the KB could accurately differentiate sinus rhythm (SR) from AF compared to physician-interpreted 12-lead ECGs and KB recordings. METHODS: Consecutive patients with AF presenting for cardioversion (CV) were enrolled...
March 7, 2018: Journal of the American College of Cardiology
Sebastian Polak, Barbara Wiśniowska, Aleksander Mendyk, Adam Pacławski, Jakub Szlęk
Human heart electrophysiology is complex biological phenomenon, which is indirectly assessed by the measured ECG signal. ECG trace is further analyzed to derive interpretable surrogates including QT interval, QRS complex, PR interval, and T wave morphology. QT interval and its modification are the most commonly used surrogates of the drug triggered arrhythmia, but it is known that the QT interval itself is determined by other nondrug related parameters, physiological and pathological. In the current study, we used the computational intelligence algorithms to analyze correlations between various simulated physiological parameters and QT interval...
2018: Computational and Mathematical Methods in Medicine
Sebastian Polak, Klaus Romero, Alexander Berg, Nikunjkumar Patel, Masoud Jamei, David Hermann, Debra Hanna
Cardiotoxicity is among the top drug safety concerns, and is of specific interest in tuberculosis, where this is a known or potential adverse event of current and emerging treatment regimens. As there is a need for a tool, beyond the QT interval, to quantify cardiotoxicity early in drug development, an empirical decision tree based classifier was developed to predict the risk of Torsades de pointes (TdP). The cardiac risk algorithm was developed using pseudo-electrocardiogram (ECG) outputs derived from cardiac myocyte electromechanical model simulations of increasing concentrations of 96 reference compounds which represented a range of clinical TdP risk...
March 8, 2018: Journal of Pharmacokinetics and Pharmacodynamics
Guoliang Li, Ardan M Saguner, Deniz Akdis, Guy H Fontaine
Atrioventricular (AV) block has been extensively studied. However, conduction inside the myocardium in patients with AV block has not been reported. In this study, we aimed to demonstrate the presence of intramyocardial block in patients with AV block. Five consecutive patients with spontaneous high-grade AV block and Torsades de pointes (TdP) were prospectively studied with standard United States Catheter Instruments (USCI) endocardial temporary catheter located at the right ventricle (RV) apex. The morphology of endocardial potentials observed in the basic QRS complexes as well as during episodes of TdP was studied...
March 7, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Iacopo Olivotto, Gherardo Finocchiaro, Niccolò Maurizi, Lia Crotti
Ventricular or supraventricular ectopic beats or atrial fibrillation may be the first presentation of uncommon cardiac disease, both acquired and genetically determined. In some patients, these manifestations can be the first sign of the underlying cardiac disorder. In others, however, they are also important as prognostic indicators, reflecting electrical instability and risk. Most cardiology clinics are busy environments where the implementation of complex diagnostic algorithms is not feasible. However, it is equally impossible to reach a final diagnosis, among the thousands of rare diseases that involve the heart, moving from a first line clinical and instrumental examination...
April 15, 2018: International Journal of Cardiology
David F Miranda, Angie S Lobo, Brooks Walsh, Yader Sandoval, Stephen W Smith
The 12-lead electrocardiogram (ECG) remains the most immediately accessible and widely used initial diagnostic tool for guiding management in patients with suspected myocardial infarction (MI). Although the development of high-sensitivity cardiac troponin assays has improved the rule-in and rule-out and risk stratification of acute MI without ST elevation, the immediate management of the subset of acute MI with acute coronary occlusion depends on integrating clinical presentation and ECG findings. Careful interpretation of the ECG might yield subtle features suggestive of ischemia that might facilitate more rapid triage of patients with subtle acute coronary occlusion or, conversely, in identification of ST-elevation MI mimics (pseudo ST-elevation MI patterns)...
February 2018: Canadian Journal of Cardiology
Srishti Sareen, Mannu Nayyar, Brian Wheeler, Michelle Skelton, Rami N Khouzam
Atrial flutter (AF) is the second most common supraventricular tachyarrhythmia following atrial fibrillation. We present an interesting case of a diagnostic challenge manifested as an electrocardiogram (ECG) recording mimicking AF in a patient with Parkinson's disease (PD). A 72-year-old African-American female with history of PD presented to our Emergency Department with a one day history of chest pain. Her vital signs were within normal limits. Physical exam was remarkable for bilateral resting hand tremors at a frequency of 6-8 hertz and mild cogwheel rigidity in both upper extremities...
January 2018: Annals of Translational Medicine
N M Panhuyzen-Goedkoop, H T Jørstad, J L R M Smeets
Sudden cardiac arrest or death (SCA/SCD) in athletes has a low event rate. Pre-participation or eligibility screening is a widely accepted method of primary prevention of SCA/SCD in athletes. Most European countries and international sports governing bodies perform ECG-inclusive screening. However, implementation of a resting 12-lead ECG in pre-participation or eligibility cardiac screening is still a topic of debate. Recently, the 'International recommendations for electrocardiographic interpretation in athletes' was published in three leading international medical journals...
February 1, 2018: Netherlands Heart Journal
Thomas Lindow, Olle Pahlm
Correct electrode placement - a prerequisite for correct ECG interpretation Different lead misplacements may present with typical ECG changes, which may influence the management of the patient, if not identified and corrected. It is important, both for the ECG technician and for the interpreting physician, to recognize typical patterns of lead misplacement to avoid misinterpretation of the ECG.
January 22, 2018: Läkartidningen
Jen Hong Tan, Yuki Hagiwara, Winnie Pang, Ivy Lim, Shu Lih Oh, Muhammad Adam, Ru San Tan, Ming Chen, U Rajendra Acharya
Coronary artery disease (CAD) is the most common cause of heart disease globally. This is because there is no symptom exhibited in its initial phase until the disease progresses to an advanced stage. The electrocardiogram (ECG) is a widely accessible diagnostic tool to diagnose CAD that captures abnormal activity of the heart. However, it lacks diagnostic sensitivity. One reason is that, it is very challenging to visually interpret the ECG signal due to its very low amplitude. Hence, identification of abnormal ECG morphology by clinicians may be prone to error...
January 2, 2018: Computers in Biology and Medicine
Narges Malakooti, Parvin Bahadoran, Soheyla Ehsanpoor
Background: One of the important goals of clinical education is to promote the level of students' clinical skills. About 50% of the midwifery education is focused on clinical education, which has a great importance in shaping the professional skills of the students. The aim of this study was to determine the ability of students in some practical skills, before internship program in the field, using objective structured clinical examination (OSCE). Materials and Methods: This research was a descriptive cross-sectional study with a single-stage, multivariate prospective design...
January 2018: Iranian Journal of Nursing and Midwifery Research
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
Aurore Lyon, Ana Mincholé, Juan Pablo Martínez, Pablo Laguna, Blanca Rodriguez
Widely developed for clinical screening, electrocardiogram (ECG) recordings capture the cardiac electrical activity from the body surface. ECG analysis can therefore be a crucial first step to help diagnose, understand and predict cardiovascular disorders responsible for 30% of deaths worldwide. Computational techniques, and more specifically machine learning techniques and computational modelling are powerful tools for classification, clustering and simulation, and they have recently been applied to address the analysis of medical data, especially ECG data...
January 2018: Journal of the Royal Society, Interface
Chun-Chieh Chao, Yi-Chun Chen, Chun-Ming Shih, Sen-Kuang Hou, Raghu R Seethala, Imoigele P Aisiku, Chuan-Chin Huang, Peter C Hou, Wei-Fong Kao
BACKGROUND: This retrospective study evaluated the use of a smartphone application to facilitate communication between the emergency physician (EP) and the interventional cardiologist in order to minimize the time to cardiac catheterization laboratory (CCL) activation and time to percutaneous coronary intervention (PCI). METHODS: We retrospectively collected pertinent time-points in the management of patients diagnosed with STEMI in the emergency department and their outcome...
December 26, 2017: Journal of the Chinese Medical Association: JCMA
Nabil Naser, Salih Tandir, Edin Begic
Introduction: Aim of article was to present perspectives of telemedicine in the field of cardiology in Bosnia and Herzegovina. Material and methods: Article has descriptive character and present review of literature. Results: Information technology can have the application in the education of students, starting from basic medical sciences up to clinical subjects. Information technologies are used for ECG analysis, 24h ECG Holter monitoring, which detects different rhythm disorders...
December 2017: Acta Informatica Medica: AIM
Charle André Viljoen, Rob Scott Millar, Mark E Engel, Mary Shelton, Vanessa Burch
INTRODUCTION: Although ECG interpretation is an essential skill in clinical medicine, medical students and residents often lack ECG competence. Novel teaching methods are increasingly being implemented and investigated to improve ECG training. Computer-assisted instruction is one such method under investigation; however, its efficacy in achieving better ECG competence among medical students and residents remains uncertain. METHODS AND ANALYSIS: This article describes the protocol for a systematic review and meta-analysis that will compare the effectiveness of computer-assisted instruction with other teaching methods used for the ECG training of medical students and residents...
December 26, 2017: BMJ Open
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