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ECG interpretation

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https://www.readbyqxmd.com/read/29779529/inhibition-and-restoration-of-crt-pacing-what-is-the-mechanism
#1
Andrzej Ząbek, Barbara Małecka, Maciej Dębski, Krzysztof Boczar, Katarzyna Holcman, Mateusz Ulman, Jacek Lelakowski
The electrocardiogram (ECG) interpretation in patients with cardiac resynchronization therapy (CRT) may be challenging. The difficulty increases if not well-known pacemaker algorithm is turned on. We show a T-wave protection algorithm (LVTP) in a patient with CRT. Accelerated sinus rhythm and intermittent oversensing in left ventricular channel resulted in loss of CRT pacing. The restoration of biventricular pacing occurred when atrial rate decreased. We provide detailed descriptions of the electrocardiogram and intracardiac electrogram...
May 2018: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29759909/the-predictive-value-of-arteriogenic-erectile-dysfunction-for-coronary-artery-disease-in-men
#2
Sherif Salah Azab, Hossam El Din Hosni, Taha A El Far, Nashaat Nabil Ismail, Yasser K El Bakdady, Ahmed F Mohamed
BACKGROUND: Erectile dysfunction (ED) is assumed to be connected with vascular disease caused by endothelial dysfunction, and characterized by the incapability of the smooth muscle cells lining the arterioles to relax, therefore, inhibit vasodilatation. AIM: To assess the predictive value of arteriogenic ED for coronary artery disease in men above the age of 40 years. METHODS: 75 Patients reporting arteriogenic ED and 25 men with normal erectile function were enrolled in the study...
May 11, 2018: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29747948/automated-quantification-of-mitral-valve-geometry-on-multi-slice-computed-tomography-in-patients-with-dilated-cardiomyopathy-implications-for-transcatheter-mitral-valve-replacement
#3
Tom Banks, Orod Razeghi, Ioannis Ntalas, Waqar Aziz, Jonathan M Behar, Rebecca Preston, Brian Campbell, Simon Redwood, Bernard Prendergast, Steven Niederer, Ronak Rajani
OBJECTIVES: The primary aim of this study was to quantify the dimensions and geometry of the mitral valve complex in patients with dilated cardiomyopathy and significant mitral regurgitation. The secondary aim was to evaluate the validity of an automated segmentation algorithm for assessment of the mitral valve compared to manual assessment on computed tomography. BACKGROUND: Transcatheter mitral valve replacement (TMVR) is an evolving technique which relies heavily on the lengthy evaluation of cardiac computed tomography (CT) datasets...
April 21, 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29738675/the-role-of-technology-and-telemetry-medicine-in-the-initial-management-of-a-st-segment-elevated-myocardial-infarction-in-a-rural-emergency-department
#4
Michael L Hood
CONTEXT: The 12-lead electrocardiogram (ECG) is an integral part of the diagnostic tools available for recognising a patient who is experiencing an ST-segment elevated myocardial infarction (STEMI). Consequently, a great emphasis is placed on the rapid acquisition and expert interpretation of the 12-lead ECG so that the appropriate reperfusion management might be commenced to optimise patient outcomes by preventing further damage to the myocardium. With the advancement of telemetric and diagnostic abilities of the modern ECG machine, the role of frontline rural emergency clinicians is as important as ever...
May 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29736398/educational-software-applied-in-teaching-electrocardiogram-a-systematic-review
#5
REVIEW
Paulo A I Pontes, Rafael O Chaves, Roberto C Castro, Érica F de Souza, Marcos C R Seruffo, Carlos R L Francês
Background: The electrocardiogram (ECG) is the most used diagnostic tool in medicine; in this sense, it is essential that medical undergraduates learn how to interpret it correctly while they are still on training. Naturally, they go through classic learning (e.g., lectures and speeches). However, they are not often efficiently trained in analyzing ECG results. In this regard, methodologies such as other educational support tools in medical practice, such as educational software, should be considered a valuable approach for medical training purposes...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29724738/gender-disparities-in-first-medical-contact-and-delay-in-st-elevation-myocardial-infarction-a-prospective-multicentre-swedish-survey-study
#6
Sofia Sederholm Lawesson, Rose-Marie Isaksson, Maria Ericsson, Karin Ängerud, Ingela Thylén
OBJECTIVES: Compare gender disparities in ST-elevation myocardial infarction (STEMI) regarding first medical contact (FMC) and prehospital delay times and explore factors associated with prehospital delay in men and women separately. DESIGN: Cross-sectional study based on medical records and a validated questionnaire. Eligible patients were enrolled within 24 hours after admittance to hospital. SETTING: Patients were included from November 2012 to January 2014 from five Swedish hospitals with catheterisation facilities 24/7...
May 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29714427/electrocardiograms-a-guide-to-rhythm-recognition-for-emergency-nurses
#7
Anthony McGrath, Michael Sampson
Electrocardiogram (ECG) is one of the most commonly performed investigations in emergency departments (EDs), and is an extremely useful adjunct that guides diagnosis, prognosis and treatment. In most cases nurses are the first healthcare professional to assess patients and record an ECG, yet anecdotal evidence suggests that few emergency nurses review, interpret and act on ECG findings. Research suggests this may be due to lack of confidence in, or knowledge about, interpretation of results, often because of inadequate training...
May 1, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29708085/weekly-checks-improve-real-time-prehospital-ecg-transmission-in-suspected-stemi
#8
Nicole T D'Arcy, Nichole Bosson, Amy H Kaji, Quang T Bui, William J French, Joseph L Thomas, Yvonne Elizarraraz, Natalia Gonzalez, Jose Garcia, James T Niemann
IntroductionField identification of ST-elevation myocardial infarction (STEMI) and advanced hospital notification decreases first-medical-contact-to-balloon (FMC2B) time. A recent study in this system found that electrocardiogram (ECG) transmission following a STEMI alert was frequently unsuccessful.HypothesisInstituting weekly test ECG transmissions from paramedic units to the hospital would increase successful transmission of ECGs and decrease FMC2B and door-to-balloon (D2B) times. METHODS: This was a natural experiment of consecutive patients with field-identified STEMI transported to a single percutaneous coronary intervention (PCI)-capable hospital in a regional STEMI system before and after implementation of scheduled test ECG transmissions...
April 30, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29693306/pacing-spikes-following-qrs-complexes-what-is-the-mechanism
#9
Andrzej Ząbek, Barbara Małecka, Ewa Nowosielska-Ząbek, Maciej Dębski, Krzysztof Boczar, Jacek Lelakowski
The electrocardiogram (ECG) interpretation in patients with implantable cardioverter defibrillator (ICD) is often a puzzling problem. The difficulty of the device function evaluation further increases in the presence of unfamiliar timing cycles and additional functions. Authors present a special function of a Biotronik ICD devices called the thoracic impedance monitoring, and demonstrate its behavior in a patient with sinus rhythm, ventricular ectopic beats, and ventricular tachycardia episode. This report shows unexceptional occurrence of tricky ECG finding in patient with Biotronik ICD...
April 25, 2018: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29680808/large-q-and-s-waves-in-lead-iii-on-the-electrocardiogram-distinguish-patients-with-hypertrophic-cardiomyopathy-from-athletes
#10
Alvin S Chen, Rachel E Bent, Matthew Wheeler, Joshua W Knowles, Francois Haddad, Victor Froelicher, Euan Ashley, Marco V Perez
OBJECTIVE: To identify electrocardiographic findings, especially deep Q and S waves in lead III, that differentiate athletes from patients with hypertrophic cardiomyopathy (HCM). METHODS: Digital ECGs of athletes and patients with HCM followed at the Stanford Center for Inherited Cardiovascular Disease were studied retrospectively. All patients with HCM had an echocardiogram performed. A multivariable logistic regression model was used to calculate ORs for various demographic and ECG characteristics...
April 21, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29676061/use-of-fragmented-qrs-in-prognosticating-clinical-deterioration-and-mortality-in-pulmonary-embolism-a-meta-analysis
#11
REVIEW
Amro Qaddoura, Geneviève C Digby, Conrad Kabali, Piotr Kukla, Gary Tse, Benedict Glover, Adrian M Baranchuk
BACKGROUND: Fragmented QRS (fQRS) on electrocardiography is potentially valuable in prognosticating acute pulmonary embolism (PE). ECG is one of the first tests performed in the emergency department, quickly interpretable, noninvasive, inexpensive, and available in remote areas. We aimed to review fQRS's role in PE prognostication. METHODS: We searched MEDLINE, EMBASE, Google Scholar, Web of Science, abstracts, conference proceedings, and reference lists until October 2017...
April 19, 2018: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29658201/enhancement-of-standard-ecgs-by-a-new-method-for-multi-cycle-superimposition-and-summation
#12
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/29623770/atypical-presentation-of-acute-coronary-syndrome-acs-a-case-report
#13
Axel Van Damme, Philippe Vanderheeren, Tine De Backer, Françine Desimpel
Case A 45-year-old man presented at the emergency department (ED) with stomach pain since eight days. The patient was not worried about his symptoms and requested only pain relief. The emergency physician requested a consult of the gastroenterologist. Clinical examination was unremarkable. However, 12-lead ECG and ischemic markers were suggestive of acute coronary syndrome (ACS) which led to admission at the cardiology department. Despite delayed presentation, the patient was still referred for urgent coronary angiogram after receiving heparin, ticagrelor and acetylsalicylic acid because of persistent pain...
April 6, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29622596/risk-stratifying-chest-pain-patients-in-the-emergency-department-using-heart-grace-and-timi-scores-with-a-single-contemporary-troponin-result-to-predict-major-adverse-cardiac-events
#14
Peter D W Reaney, Hamish I Elliott, Awsan Noman, Jamie G Cooper
BACKGROUND: The majority of patients presenting to the ED with cardiac sounding chest pain have a non-diagnostic ECG and the problem of differentiating those suffering an acute coronary syndrome from those without is familiar to all ED clinical staff. To stratify risk in these patients, specific scores have been developed. Recent work has focused on incorporating newer high-sensitivity cardiac troponin (hs-cTn) assays; however, issues regarding performance and availability of these assays remain...
April 5, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29615448/a-protocol-for-a-prospective-observational-study-using-chest-and-thumb-ecg-transient-ecg-assessment-in-stroke-evaluation-tease-in-sweden
#15
Peter Magnusson, Hirsh Koyi, Gustav Mattsson
INTRODUCTION: Atrial fibrillation (AF) causes ischaemic stroke and based on risk factor evaluation warrants anticoagulation therapy. In stroke survivors, AF is typically detected with short-term ECG monitoring in the stroke unit. Prolonged continuous ECG monitoring requires substantial resources while insertable cardiac monitors are invasive and costly. Chest and thumb ECG could provide an alternative for AF detection poststroke.The primary objective of our study is to assess the incidence of newly diagnosed AF during 28 days of chest and thumb ECG monitoring in cryptogenic stroke...
April 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29611774/examining-physiotherapist-use-of-structured-aerobic-exercise-testing-to-decrease-barriers-to-aerobic-exercise
#16
Evan Foster B Sc, Julia E Fraser, Elizabeth L Inness PhD, Sarah Munce, Louis Biasin, Vivien Poon, Mark Bayley
OBJECTIVE: To determine the frequency of physiotherapist-administered aerobic exercise testing/training, the proportion of physiotherapists who administer this testing/training, and the barriers that currently exist across different practice environments. A secondary objective is to identify the learning needs of physiotherapists for the development of an education curriculum in aerobic exercise testing and training with electrocardiograph (ECG) administration and interpretation. DESIGN: National, cross-sectional survey...
April 3, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29607336/the-effect-of-cardiac-arrhythmias-simulation-software-on-the-nurses-learning-and-professional-development
#17
Leila Bazrafkan, Mehdi Hemmati
Introduction: One of the important tasks of nurses in intensive care unit is interpretation of ECG. The use of training simulator is a new paradigm in the age of computers. This study was performed to evaluate the impact of cardiac arrhythmias simulator software on nurses' learning in the subspecialty Vali-Asr Hospital in 2016. Methods: This study was conducted by quasi-experimental randomized Salomon four group design with the participation of 120 nurses in subspecialty Vali-Asr Hospital in Tehran, Iran in 2016 that were selected purposefully and allocated in 4 groups...
April 2018: Journal of Advances in Medical Education & Professionalism
https://www.readbyqxmd.com/read/29582136/unexplained-cardiac-arrest-a-tale-of-conflicting-interpretations-of-kcnq1-genetic-test-results
#18
Han Chow Chua, Helge Servatius, Babken Asatryan, André Schaller, Claudine Rieubland, Fabian Noti, Jens Seiler, Laurent Roten, Samuel H Baldinger, Hildegard Tanner, Juerg Fuhrer, Andreas Haeberlin, Anna Lam, Stephan A Pless, Argelia Medeiros-Domingo
OBJECTIVE: Unexplained cardiac arrest (UCA) is often the first manifestation of an inherited arrhythmogenic disease. Genetic testing in UCA is challenging due to the complexities of variant interpretation in the absence of supporting cardiac phenotype. We aimed to investigate if a KCNQ1 variant [p.(Pro64_Pro70del)], previously reported as pathogenic, contributes to the long-QT syndrome phenotype, co-segregates with disease or affects KCNQ1 function in vitro. METHODS: DNA was extracted from peripheral blood of a 22-year-old male after resuscitation from UCA...
March 26, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29577914/the-importance-of-the-learning-process-in-st-analysis-interpretation-and-its-impact-in-improving-clinical-and-neonatal-outcomes
#19
Susanna Timonen, Kaisa Holmberg
BACKGROUND: Intrapartum fetal heart rate (FHR) monitoring was introduced with the goal to reduce fetal hypoxia and deaths. However, continuous FHR monitoring has been shown to have a high sensitivity but also a high false positive rate. To improve specificity, adjunctive technologies have been developed to identify fetuses at risk for intrapartum asphyxia. Intensive research on the value of ST-segment analysis of the fetal electrocardiogram (ECG) as an adjunct to standard electronic fetal monitoring (EFM) in lowering the rates of fetal metabolic acidosis and operative deliveries has been ongoing...
March 22, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29567824/serial-troponin-for-early-detection-of-nivolumab-cardiotoxicity-in-advanced-non-small-cell-lung-cancer-patients
#20
Matteo Sarocchi, Francesco Grossi, Eleonora Arboscello, Andrea Bellodi, Carlo Genova, Maria Giovanna Dal Bello, Erika Rijavec, Giulia Barletta, Giovanni Rossi, Federica Biello, Giorgio Ghigliotti, Marco Canepa, Michele Mussap, Claudio Brunelli, Paolo Spallarossa
BACKGROUND: Rare cases of severe myocarditis are reported during treatment with nivolumab. Troponin, a biomarker of cardiac damage, is a key component of the diagnostic workup of many cardiac disorders, including myocarditis. This study investigates the role of troponin to assess cardiac involvement during nivolumab therapy for non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: We evaluated 59 NSCLC patients, analyzing serum samples collected within a translational research study...
March 22, 2018: Oncologist
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