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ECG interpretation

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https://www.readbyqxmd.com/read/28529261/clinical-implications-of-electrocardiograms-for-patients-with-type-a-acute-aortic-dissection
#1
Masami Kosuge, Kazuo Kimura, Keiji Uchida, Munetaka Masuda, Kouichi Tamura
Type A acute aortic dissection (AAD) is a serious cardiovascular emergency requiring urgent surgery. Timely accurate diagnosis is essential, but often challenging, because of the wide spectrum of clinical presentations. In patients with type A AAD, chest pain is the most common symptom; furthermore, ischemic ST-T changes such as ST-segment elevation or depression or negative T waves are frequently observed on presentation ECG. These clinical presentations of type A AAD are difficult to differentiate from those of acute coronary syndrome (ACS), which could lead to delayed diagnosis and treatment of type A AAD or misdiagnosis of ACS followed by inappropriate treatment...
May 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28528431/rapid-rest-stress-regadenoson-ungated-perfusion-cmr-for-detection-of-coronary-artery-disease-in-patients-with-atrial-fibrillation
#2
Erik T Bieging, I Haider, G Adluru, L Chang, P Suksaranjit, D Likhite, A Shaaban, L Jensen, B D Wilson, C J McGann, E DiBella
Cardiovascular magnetic resonance (CMR) perfusion has been established as a useful imaging modality for the detection of coronary artery disease (CAD). However, there are several limitations when applying standard, ECG-gated stress/rest perfusion CMR to patients with atrial fibrillation (AF). In this study we investigate an approach with no ECG gating and a rapid rest/stress perfusion protocol to determine its accuracy for detection of CAD in patients with AF. 26 patients with AF underwent a rapid rest/regadenoson stress CMR perfusion imaging protocol, and all patients had X-ray coronary angiography...
May 20, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28495249/heart-rate-variability-to-monitor-performance-in-elite-athletes-criticalities-and-avoidable-pitfalls
#3
Daniela Lucini, Ilaria Marchetti, Antonio Spataro, Mara Malacarne, Manuela Benzi, Stefano Tamorri, Roberto Sala, Massimo Pagani
BACKGROUND: Spectral analysis of Heart Rate Variability (HRV) is a simple, non-invasive technique that is widely used in sport to assess sympatho-vagal regulation of the heart. Its employment is increasing partly due to the rising usage of wearable devices. However data acquisition using these devices may be suboptimal because they cannot discriminate between sinus and non-sinus beats and do not record any data regarding respiratory frequency. This information is mandatory for a correct clinical interpretation...
May 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28495230/electrocardiogram-voltage-discordance-interpretation-of-low-qrs-voltage-only-in-the-precordial-leads
#4
Diana H Kim, Ralph J Verdino
OBJECTIVES: To define clinical correlates of low voltage isolated to precordial leads on the surface electrocardiogram (ECG). INTRODUCTION: Low voltage (V) on the ECG is defined as QRS V<5mm in all limb leads and <10mm in all precordial leads. The diagnostic use of ECGs with low voltage isolated to the precordial leads with normal limb lead voltages is unclear. METHODS: Twelve-lead ECGs with QRS V>5mm in one or more limb leads and <10mm in all precordial leads were collected...
April 28, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28479090/electrocardiogram-training-for-residents-a-curriculum-based-on-facebook-and-twitter
#5
Stanley S Liu, Sammy Zakaria, Dhananjay Vaidya, Mukta C Srivastava
BACKGROUND: We studied whether social media applications can serve as effective educational tools for teaching electrocardiogram (ECG) interpretation to medical residents. METHODS: 39 emergency, family, and internal medicine residents participated in the 33-week "ECG of the Week" curriculum via Facebook and Twitter. ECG skill was assessed before and after the study with a 10-ECG quiz. Outcomes of interest included predictors of participant response rates and post-study quiz performance...
April 22, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28475022/hybrid-ecg-gated-versus-non-gated-512-slice-ct-angiography-of-the-aorta-and-coronary-artery-image-quality-and-effect-of-a-motion-correction-algorithm
#6
Ji Won Lee, Chang Won Kim, Geewon Lee, Han Cheol Lee, Sang-Pil Kim, Bum Sung Choi, Yeon Joo Jeong
Background Using the hybrid electrocardiogram (ECG)-gated computed tomography (CT) technique, assessment of entire aorta, coronary arteries, and aortic valve can be possible using single-bolus contrast administration within a single acquisition. Purpose To compare the image quality of hybrid ECG-gated and non-gated CT angiography of the aorta and evaluate the effect of a motion correction algorithm (MCA) on coronary artery image quality in a hybrid ECG-gated aorta CT group. Material and Methods In total, 104 patients (76 men; mean age = 65...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28465689/reversible-inferolateral-st-segment-elevation-associated-with-small-bowel-obstruction
#7
Ankit Upadhyay, Sudheer Chauhan, Umair Jangda, Vipul Bodar, Ahmed Al-Chalabi
ST-segment elevation is an important and alarming electrocardiographic sign that necessitates immediate attention but does not always indicate that the primary pathology is cardiac in origin. It needs to be interpreted in the clinical context as several pathological conditions involving especially gastrointestinal tract may lead to delayed diagnosis and treatment as well as complications from invasive unnecessary interventions. We present two patients, a 64-year-old male and a 71-year-old female, who were admitted to the emergency room of a community-based hospital with similar complaints of worsening epigastric abdominal pain and were diagnosed later with small bowel obstruction...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28457177/high-sensitivity-cardiac-troponin-assays-from-improved-analytical-performance-to-enhanced-risk-stratification
#8
Marek Kozinski, Magdalena Krintus, Jacek Kubica, Grazyna Sypniewska
Implementation of cardiac troponin (cTn) assays has revolutionized the diagnosis, risk stratification, triage and management of patients with suspected myocardial infarction (MI). The Universal Definition of MI brought about a shift in the diagnostics of MI, from an approach primarily based on electrocardiography (ECG) to one primarily based on biomarkers. Currently, detection of a rise and/or fall in concentration or activity of myocardial necrosis biomarkers, preferentially cTns, with at least one value above the 99th percentile upper reference limit (URL), is the essential component for the diagnosis of MI...
May 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28455103/transcranial-doppler-ultrasonography-in-the-assessment-of-neurovascular-coupling-responses-to-cognitive-examination-in-healthy-controls-a-feasibility-study
#9
C A L Williams, R B Panerai, T G Robinson, V J Haunton
BACKGROUND: We tested the hypothesis that paradigms from the Addenbrooke's Cognitive Examination (ACE-III), including those that had not been studied using TCD previously (novel) versus those which had been (established), would elicit changes in CBF velocity (CBFv). NEW METHOD: Healthy subjects were studied with bilateral transcranial Doppler (TCD), beat-to-beat blood pressure (Finapres), continuous electrocardiogram (ECG), and end-tidal CO2 (nasal capnography)...
April 26, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28403965/understanding-fetal-physiology-and-second-line-monitoring-during-labor
#10
REVIEW
C Garabedian, J De Jonckheere, L Butruille, P Deruelle, L Storme, V Houfflin-Debarge
Cardiotocography (CTG) is a technique used to monitor intrapartum fetal condition and is one of the most common obstetric procedures. Second line methods of fetal monitoring have been developed in an attempt to reduce unnecessary interventions due to continuous cardiotocography and to better identify fetuses at risk of intrapartum asphyxia. The acid-base balance of the fetus is evaluated by fetal blood scalp samples, the modification of the myocardial oxygenation by the fetal ECG ST-segment analysis (STAN) and the autonomic nervous system by the power spectral analysis of the fetal heart variability...
February 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28390652/a-fast-noise-tolerant-ecg-feature-recognition-algorithm-based-on-probabilistic-analysis-of-gradient-discontinuity
#11
Peter A Watterson
PURPOSE: Improvement in real-time electrocardiogram (ECG) interpretation is still needed, especially for QT estimation. This paper proposes a fast algorithm for ECG feature recognition, based on locating turning points in the waveform gradient. METHODS: The algorithm places the fiducial point at the maximal value of a probabilistic decision function, assessing line intervals of best fit before and after the point and the point location relative to R-wave peaks already found...
March 14, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28367010/prehospital-delay-and-time-to-reperfusion-therapy-in-st-elevation-myocardial-infarction
#12
Linsha George, Lakshmi Ramamoorthy, Santhosh Satheesh, Rama Prakasha Saya, D K S Subrahmanyam
BACKGROUND: Despite efforts aimed at reducing the prehospital delay and treatment delay, a considerable proportion of patients with ST elevation myocardial infarction (STEMI) present late and receive the reperfusion therapy after unacceptably long time periods. This study aimed at finding out the patients' decision delay, prehospital delay, door-to-electrocardiography (ECG), door-to-needle, and door-to-primary percutaneous coronary intervention (PCI) times and their determinants among STEMI patients...
April 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28361477/effect-of-patient-positioning-on-the-evaluation-of-myocardial-perfusion-spect
#13
Bertalan Kracskó, Sándor Barna, Orsolya Sántha, Anett Kiss, József Varga, Attila Forgács, Ildikó Garai
BACKGROUND: ECG-gated SPECT myocardial perfusion imaging is usually acquired in supine position. However, some patients are not comfortable in this position for a variety of personal or medical reasons. Our aim was to investigate the effect of patient positioning on quantitative SPECT imaging results using normal supine database. METHODS: 55 patients (mean age 58.5 ± 8.3 years) were enrolled in this prospective study. Each patient had a pair of ECG-gated stress SPECT myocardial perfusion images acquired on two gamma cameras: one in supine position and the other in upright sitting position...
March 30, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28353213/development-and-validation-of-an-automatic-method-to-detect-the-latest-contracting-viable-left-ventricular-segments-to-assist-guide-crt-therapy-from-gated-spect-myocardial-perfusion-imaging
#14
Weihua Zhou, Ningchao Tao, Xiaofeng Hou, Yao Wang, Russell D Folks, David C Cooke, Valeria M Moncayo, Ernest V Garcia, Jiangang Zou
OBJECTIVES: The purpose of this study is to use ECG-gated SPECT MPI to detect the latest contracting viable left ventricular (LV) segments to help guide the LV probe placement used in CRT therapy and to validate segment selection against the visual integration method by experts. METHODS: For each patient, the resting ECG-gated SPECT MPI short-axis images were sampled in 3D to generate a polar map of the perfusion distribution used to determine LV myocardial viability, and to measure LV synchronicity using our phase analysis tool...
March 28, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28351482/fermi-pasta-ulam-auto-recurrence-in-the-description-of-the-electrical-activity-of-the-heart
#15
M A Novopashin, A V Shmid, A A Berezin
The authors proposed and mathematically described model of a new type of the Fermi-Pasta-Ulam recurrence (the FPU auto recurrence) and hypothesized an adequate description of the heart's electrical dynamics within the observed phenomenon. The dynamics of the FPU auto recurrence making appropriate electrical dynamics of the normal functioning of the heart in the form of an electrocardiogram (ECG) was obtained by a computer model study. The model solutions in the form of the FPU auto recurrence - ECG Fourier spectrum were evaluated for resistance to external disturbances in the form of random effects, as well as periodic perturbation at a frequency close to the heart beating rate of about 1Hz...
April 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28347451/the-role-of-computerized-diagnostic-proposals-in-the-interpretation-of-the-12-lead-electrocardiogram-by-cardiology-and-non-cardiology-fellows
#16
Tomas Novotny, Raymond Bond, Irena Andrsova, Lumir Koc, Martina Sisakova, Dewar Finlay, Daniel Guldenring, Jindrich Spinar, Marek Malik
INTRODUCTION: Most contemporary 12-lead electrocardiogram (ECG) devices offer computerized diagnostic proposals. The reliability of these automated diagnoses is limited. It has been suggested that incorrect computer advice can influence physician decision-making. This study analyzed the role of diagnostic proposals in the decision process by a group of fellows of cardiology and other internal medicine subspecialties. MATERIALS AND METHODS: A set of 100 clinical 12-lead ECG tracings was selected covering both normal cases and common abnormalities...
May 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28347441/assessment-of-a-personalized-and-distributed-patient-guidance-system
#17
Mor Peleg, Yuval Shahar, Silvana Quaglini, Tom Broens, Roxana Budasu, Nick Fung, Adi Fux, Gema García-Sáez, Ayelet Goldstein, Arturo González-Ferrer, Hermie Hermens, M Elena Hernando, Val Jones, Guy Klebanov, Denis Klimov, Daniel Knoppel, Nekane Larburu, Carlos Marcos, Iñaki Martínez-Sarriegui, Carlo Napolitano, Àngels Pallàs, Angel Palomares, Enea Parimbelli, Belén Pons, Mercedes Rigla, Lucia Sacchi, Erez Shalom, Pnina Soffer, Boris van Schooten
OBJECTIVES: The MobiGuide project aimed to establish a ubiquitous, user-friendly, patient-centered mobile decision-support system for patients and for their care providers, based on the continuous application of clinical guidelines and on semantically integrated electronic health records. Patients would be empowered by the system, which would enable them to lead their normal daily lives in their regular environment, while feeling safe, because their health state would be continuously monitored using mobile sensors and self-reporting of symptoms...
May 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28341306/high-frequency-qrs-analysis-in-the-evaluation-of-chest-pain-in-the-emergency-department
#18
Ori Galante, Guy Amit, Yair Granot, Linda R Davrath, Shimon Abboud, Doron Zahger
OBJECTIVES: High frequency QRS (HFQRS) analysis has been shown to be an accurate marker for myocardial ischemia. Our objective was to test the use of HFQRS in diagnosing ACS in the emergency department. METHODS: 324 patients presenting to the ED with chest pain were enrolled. Resting ECG was recorded and later analyzed by an HFQRS algorithm. Results were compared to the conventional ECG diagnosis by 3 independent interpretations: treating physician, expert cardiologist and an automated computer program...
February 20, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28339578/safe-automatic-one-lead-electrocardiogram-analysis-in-screening-for-atrial-fibrillation
#19
Emma Svennberg, Martin Stridh, Johan Engdahl, Faris Al-Khalili, Leif Friberg, Viveka Frykman, Mårten Rosenqvist
Aims: Screening for atrial fibrillation (AF) using intermittent electrocardiogram (ECG) recordings can identify individuals at risk of AF-related morbidity in particular stroke. We aimed to validate the performance of an AF screening algorithm compared with manual ECG analysis by specially trained nurses and physicians (gold standard) in 30 s intermittent one-lead ECG recordings. Methods: The STROKESTOP study is a mass-screening study for AF using intermittent ECG recordings...
October 6, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339570/frequency-of-different-electrocardiographic-abnormalities-in-a-large-cohort-of-spanish-workers
#20
Jorge Rodríguez-Capitán, Ana Fernández-Meseguer, José Manuel García-Pinilla, Eva Calvo-Bonacho, Manuel Jiménez-Navarro, Teresa García-Margallo, Fernando Cabrera-Bueno, Ignacio Echeverria-Lucotti, Juan José Gómez-Doblas, Eduardo De Teresa-Galván
Aims: Our aim was to describe the electrocardiographic findings of a large sample of Spanish workers from several different employment sectors. Methods and results: Between May 2008 and November 2010, 13 495 consecutive 12-lead resting electrocardiograms (ECGs) were obtained during health examinations of working adults aged 16-74 years in 5 cities in different regions of Spain. Of those, 13 179 ECGs suitable for interpretation were included in this study. All tracings were classified by the same cardiologist, according to the Minnesota Code criteria...
October 6, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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