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https://www.readbyqxmd.com/read/29351655/establishing-diagnostic-reference-levels-for-cardiac-computed-tomography-angiography-in-saudi-arabia
#1
Ali B Alhailiy, Peter L Kench, Mark F McEntee, Patrick C Brennan, Elaine A Ryan
Cardiac computed tomography angiography (CCTA) is a commonly used diagnostic imaging tool for cardiovascular disease. Despite constant improvements to imaging technologies, the radiation dose to patients remains a concern when using this procedure. Diagnostic reference levels (DRLs) are used as a trigger to identify and alert individual facilities that are using high doses during CT. This study aims to assess patient radiation dose and establish new national DRLs (NDRL) associated with CCTA in Saudi clinical practices...
January 17, 2018: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29337892/improving-remote-health-monitoring-a-low-complexity-ecg-compression-approach
#2
Mohamed Elgendi, Abdulla Al-Ali, Amr Mohamed, Rabab Ward
Recent advances in mobile technology have created a shift towards using battery-driven devices in remote monitoring settings and smart homes. Clinicians are carrying out diagnostic and screening procedures based on the electrocardiogram (ECG) signals collected remotely for outpatients who need continuous monitoring. High-speed transmission and analysis of large recorded ECG signals are essential, especially with the increased use of battery-powered devices. Exploring low-power alternative compression methodologies that have high efficiency and that enable ECG signal collection, transmission, and analysis in a smart home or remote location is required...
January 16, 2018: Diagnostics
https://www.readbyqxmd.com/read/29333788/enhancement-of-standard-ecgs-by-a-new-method-for-multi-cycle-superimposition-and-summation
#3
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/29326113/acute-heart-failure-with-new-onset-continuous-murmur-in-a-26-year-old-man
#4
Yi-Chen Wang, Chen-Wei Huang, Ting-Wei Lin
CLINICAL INTRODUCTION: A 26-year-old man with an unremarkable medical history sensed a momentary retrosternal 'pop' followed by overwhelming dyspnoea, without reporting any prodromal symptoms. At the emergency department, he had a significant tachycardia (170 bpm) and an extreme low diastolic blood pressure (<30 mm Hg). A loud, harsh and continuous murmur could be maximally auscultated at the right lower sternal border. ECG revealed global ST depression with ST elevation in lead aVR...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29314105/ambulatory-diagnostic-ecg-monitoring-for-syncope-and-collapse-an-assessment-of-clinical-practice-in-the-united-states
#5
David G Benditt, Wayne O Adkisson, Richard Sutton, Robin K Mears, Scott Sakaguchi
INTRODUCTION: Diagnostic ambulatory ECG (AECG) monitoring is widely used for evaluating syncope and collapse, and practice guidelines provide recommendations regarding optimal AECG device selection. However, whether physicians utilize AECGs in accordance with the pertinent guidelines is unclear. This study assessed utilization of AECG monitoring systems for syncope and collapse diagnosis by physicians in the United States. METHODS AND RESULTS: A quantitative survey was undertaken of physicians comprising multiple specialties (Emergency Room, n = 35; Primary care, n = 35; Hospitalists, n = 30; Neurologists, n = 30; non-implanting, n = 34 and implanting-Cardiologists, n = 35)...
January 4, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29306269/sealone-safety-and-efficacy-of-coronary-computed-tomography-angiography-with-low-dose-in-patients-visiting-emergency-room-trial-study-protocol-for-a-randomized-controlled-trial
#6
Joonghee Kim, Joon-Won Kang, Kyuseok Kim, Sang Il Choi, Eun Ju Chun, Yeo Goon Kim, Won Young Kim, Dong Woo Seo, Jonghwan Shin, Huijai Lee, Kwang-Nam Jin, Soyeon Ahn, Seung Sik Hwang, Kwang Pyo Kim, Ru-Bi Jeong, Sang Ook Ha, Byungho Choi, Chang-Hwan Yoon, Jung-Won Suh, Hack-Lyoung Kim, Ju Kyoung Kim, Sujin Jang, Ji Seon Seo
OBJECTIVE: Chest pain is one of the most common complaints in the emergency department (ED). Cardiac computed tomography angiography (CCTA) is a frequently used tool for the early triage of patients with low- to intermediate-risk acute chest pain. We present a study protocol for a multicenter prospective randomized controlled clinical trial testing the hypothesis that a low-dose CCTA protocol using prospective electrocardiogram (ECG)-triggering and limited-scan range can provide sufficient diagnostic safety for early triage of patients with acute chest pain...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29305703/cardiac-ischemia-insights-from-computational-models
#7
REVIEW
Axel Loewe, Eike Moritz Wülfers, Gunnar Seemann
BACKGROUND: Complementary to clinical and experimental studies, computational cardiac modeling serves to obtain a comprehensive understanding of the cardiovascular system in order to analyze dysfunction, evaluate existing, and develop novel treatment strategies. OBJECTIVES: We describe the basics of multiscale computational modeling of cardiac electrophysiology from the molecular ion channel to the whole body scale. By modeling cardiac ischemia, we illustrate how in silico experiments can contribute to our understanding of how the pathophysiological mechanisms translate into changes observed in diagnostic tools such as the electrocardiogram (ECG)...
January 5, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29302124/extracorporeal-life-support-as-a-rescue-measure-for-managing-life-threatening-arrythmia-and-brugada-syndrome
#8
Asaad G Beshish, Allison Weinberg, Waseem Ostwani, Gabe E Owens
We describe the use of extracorporeal cardiopulmonary resuscitation (E-CPR) to transiently stabilize a 3-month-old patient who presented with ventricular tachyarrhythmias leading to spontaneous cardiac arrest. The patient required 4 days of extracorporeal life support (ECLS) where he was diagnosed with probable Brugada syndrome (BS). The patient was discharged home in stable condition after implantable cardioverter defibrillator placement. This case highlights the importance of early transfer to extracorporeal membrane oxygenation (ECMO) center in the setting of unexplained cardiac arrhythmia in a pediatric patient...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29284918/telemedicine-in-cardiology-perspectives-in-bosnia-and-herzegovina
#9
REVIEW
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
https://www.readbyqxmd.com/read/29278352/impact-of-diagnostic-ecg-to-wire-delay-in-stemi-patients-treated-with-primary-pci-a-danami-3-substudy
#10
Lars Nepper-Christensen, Jacob Lønborg, Dan Eik Høfsten, Kiril Aleksov Ahtarovski, Kasper Kyhl, Christoffer Göransson, Lars Køber, Steffen Helqvist, Frants Pedersen, Henning Kelbæk, Niels Vejlstrup, Lene Holmvang, Thomas Engstrøm
AIMS: We evaluated the impact of delay from diagnostic pre-hospital electrocardiogram (ECG) to wiring of the infarct related vessel (ECG-to-wire) >120 minutes on cardiovascular magnetic resonance (CMR) markers of reperfusion success and clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS: We included 1492 patients in the analyses of clinical outcome. CMR was performed in 748 patients to evaluate infarct size and myocardial salvage...
December 26, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29277471/retrospective-evaluation-of-notched-qrs-complexes-in-dogs-85-cases
#11
R L Winter, R M Bates
INTRODUCTION: Notched QRS complexes on electrocardiography (ECG) have been described in veterinary and human reports, but little is known about this finding in veterinary patients. Therefore, the objectives of this study were to describe the signalment and cardiac disease diagnosis in dogs with notched QRS complexes, as well as to describe the specific leads and number of leads with notched QRS complexes on ECG. ANIMALS: Eighty-five dogs with notched QRS complexes of normal duration in at least one ECG lead...
December 22, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/29276924/-myocardial-hypoenhancement-on-multidetector-computed-tomography-in-patients-with-non-st-elevation-acute-coronary-syndrome
#12
M Y Ruda, N A Barysheva, I N Merkulova, M S Shabanova, M A Shariya, S A Gaman, T S Sukhinina, T N Veselova
The purpose of our study was analysis of myocardial hypoenhancement areas (MHAs) found by multidetector computed tomography (MDCT) in patients with non-ST elevation acute coronary syndrome (NSTEACS) and comparison of these findings with results of standard methods of diagnostics of myocardial infarction and ischemia [electrocardiography (ECG) and echocardiography (ECHO)]. METHODS: MHAs were found in 18 of 21 patients with non-ST segment elevation myocardial infarction (NSTEMI) (85.7%) and only in 3 of 22 patients with unstable angina (UA) (13...
October 2017: Kardiologiia
https://www.readbyqxmd.com/read/29275393/unusual-case-of-anxiety-trichloroethylene-neurotoxicity
#13
Joshua Au Yeung
I present an uncommon case of recurrent, intractable anxiety that was presented acutely and slowly evolved into a chronic debilitating condition. A young previously fit and healthy 24-year-old patient presents with somewhat atypical symptoms of anxiety. Full medical work-up including examination, blood, ECG electrocardiogram, electroencephalogram and CT of the head was unremarkable. When the history was explored in detail, it was revealed he worked in the navy and was exposed to a neurotoxic solvent, trichloroethylene...
December 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29274604/interictal-cardiac-repolarization-abnormalities-in-people-with-epilepsy
#14
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/29248334/diagnostic-accuracy-of-a-new-high-sensitivity-troponin-i-assay-and-five-accelerated-diagnostic-pathways-for-ruling-out-acute-myocardial-infarction-and-acute-coronary-syndrome
#15
Jaimi H Greenslade, Edward W Carlton, Christopher Van Hise, Elizabeth Cho, Tracey Hawkins, William A Parsonage, Jillian Tate, Jacobus Ungerer, Louise Cullen
STUDY OBJECTIVE: This diagnostic accuracy study describes the performance of 5 accelerated chest pain pathways, calculated with the new Beckman's Access high-sensitivity troponin I assay. METHODS: High-sensitivity troponin I was measured with presentation and 2-hour blood samples in 1,811 patients who presented to an emergency department (ED) in Australia. Patients were classified as being at low risk according to 5 rules: modified accelerated diagnostic protocol to assess patients with chest pain symptoms using troponin as the only biomarker (m-ADAPT), the Emergency Department Assessment of Chest Pain Score (EDACS) pathway, the History, ECG, Age, Risk Factors, and Troponin (HEART) pathway, the No Objective Testing Rule, and the new Vancouver Chest Pain Rule...
December 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29239051/coronary-and-carotid-atherosclerosis-in-asymptomatic-male-marathon-runners
#16
Christof Burgstahler, Hans Cipowicz, Christoph Thomas, Christoph Schabel, Stefanie Mangold, Dominik Ketelsen, Claus D Claussen, Andreas M Niess, Ilias Tsiflikas
The aim of the study was to evaluate the diagnostic accuracy of carotid ultrasound (CU) to predict coronary atherosclerosis in asymptomatic male marathon runners. A total of 49 male marathon runners older than 45 years(mean age 53.3±7.2 years, range 45-74 years) received CU and cardiac CT angiography(CTA) including calcium scoring(CS). Results of CU and CTA were classified binary: 1. Absence of atherosclerosis and 2. presence of atherosclerosis. The extend of atherosclerosis was not primary end-point of the study...
December 14, 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/29223306/diagnostic-accuracy-of-multi-lead-ecgs-obtained-using-a-pocket-sized-bipolar-handheld-event-recorder
#17
Ani Nigolian, Nicolas Dayal, Haïg Nigolian, Carine Stettler, Haran Burri
BACKGROUND: Handheld ECG event recorders are useful for rhythm monitoring but only record a single lead, which may limit interpretation. We sought to investigate if a multi-lead ECG may be reconstituted using this device, and aimed to evaluate diagnostic accuracy. METHODS: A commercially-available handheld bipolar ECG event recorder was used to reconstruct a 9-lead ECG (leads I, II and III, V1-6). Tracings were analyzed independently by a cardiologist and a fellow...
November 21, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29214181/cardiac-autonomic-neuropathy-why-should-cardiologists-care-about-that
#18
REVIEW
Andrzej Bissinger
Background: Cardiac autonomic neuropathy (CAN) is a frequent but underdiagnosed complication of diabetes mellitus. It has a strong influence on various cardiac disorders including myocardial ischemia and infarction, hypertension, orthostatic hypotonia, heart failure, and arrhythmias. CAN can lead to severe morbidity and mortality and increase the risk of sudden cardiac death. Methods: This review article summarizes the latest evidence regarding the epidemiology, pathogenesis, influence on the cardiovascular system, and diagnostic methods for CAN...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/29207228/-clinical-practice-for-the-diagnosis-of-cardiac-arrhythmias-in-patients-on-renal-replacement-therapy-data-from-a-lombard-survey
#19
Simonetta Genovesi, Elisa Nava, Alice Pasa, Enzo Corghi, Patrizia Ondei, Elisabetta Marta, Antonio Bellasi, Fabio Malberti, Ugo Teatini, Carlo Maria Guastoni, Leonardo Spatola, Maria Carmen Luise, Renza Tiboldo, Silvio Bertoli, Piergiorgio Messa, Maria Doria, Maurizio Gallieni, Mario Cozzolino, Donatella Spotti, Valeria Sala, Elisabetta Sironi, Giuseppe Boriani
Among dialysis patients, 40% of deaths are due to cardiovascular causes, and 60% of cardiac deaths are due to an arrhythmia. The purpose of this survey, carried out with the organizational support of the Lombard Section of the Italian Society of Nephrology, is to evaluate the frequency and mode of use of non-invasive instruments for the diagnosis of cardiac arrhythmias in the dialysis centers of Lombardy. Information on the prevalence and type of cardiac devices at December 1, 2016 in this population was also required...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29205690/refinement-of-detecting-atrial-fibrillation-in-stroke-patients-results-from-the-track-af-study
#20
Florian Reinke, Markus Bettin, Linda Sarah Ross, Simon Kochhäuser, Ilka Kleffner, Martin Ritter, Jens Minnerup, Dirk Dechering, Lars Eckardt, Ralf Dittrich
BACKGROUND: Detection of occult atrial fibrillation (AF) is crucial for optimal secondary prevention in stroke patients. We determined the AF detection rate by implantable cardiac monitor (ICM) compared to the prediction rate of the probability of incident AF by software based analysis of continuously monitored ECG at follow up (Stroke risk analysis=SRA) and propose an optimized AF detection algorithm by combining both tools. METHODS: In a monocentric prospective study we investigated 105 out of 389 patients with cryptogenic stroke despite extensive diagnostic workup with two additional cardiac monitoring tools: (a) 20 month monitoring by ICM and (b) SRA during hospitalization at the Stroke Unit...
December 4, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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