Development and clinical study of mobile 12-lead electrocardiography based on cloud computing for cardiac emergency.

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Fujita, Hideo; Uchimura, Yuji; Waki, Kayo; Omae, Koji; Takeuchi, Ichiro; Ohe, Kazuhiko

2013-01-01

To improve emergency services for accurate diagnosis of cardiac emergency, we developed a low-cost new mobile electrocardiography system "Cloud Cardiology®" based upon cloud computing for prehospital diagnosis. This comprises a compact 12-lead ECG unit equipped with Bluetooth and Android Smartphone with an application for transmission. Cloud server enables us to share ECG simultaneously inside and outside the hospital. We evaluated the clinical effectiveness by conducting a clinical trial with historical comparison to evaluate this system in a rapid response car in the real emergency service settings. We found that this system has an ability to shorten the onset to balloon time of patients with acute myocardial infarction, resulting in better clinical outcome. Here we propose that cloud-computing based simultaneous data sharing could be powerful solution for emergency service for cardiology, along with its significant clinical outcome.

FPGA-based electrocardiography (ECG signal analysis system using least-square linear phase finite impulse response (FIR filter

Directory of Open Access Journals (Sweden)

Mohamed G. Egila

2016-12-01

Full Text Available This paper presents a proposed design for analyzing electrocardiography (ECG signals. This methodology employs highpass least-square linear phase Finite Impulse Response (FIR filtering technique to filter out the baseline wander noise embedded in the input ECG signal to the system. Discrete Wavelet Transform (DWT was utilized as a feature extraction methodology to extract the reduced feature set from the input ECG signal. The design uses back propagation neural network classifier to classify the input ECG signal. The system is implemented on Xilinx 3AN-XC3S700AN Field Programming Gate Array (FPGA board. A system simulation has been done. The design is compared with some other designs achieving total accuracy of 97.8%, and achieving reduction in utilizing resources on FPGA implementation.

Noninvasive diagnostic test choices for the evaluation of coronary artery disease in women: a multivariate comparison of cardiac fluoroscopy, exercise electrocardiography and exercise thallium myocardial perfusion scintigraphy

International Nuclear Information System (INIS)

Hung, J.; Chaitman, B.R.; Lam, J.; Lesperance, J.; Dupras, G.; Fines, P.; Bourassa, M.G.

1984-01-01

Several diagnostic noninvasive tests to detect coronary and multivessel coronary disease are available for women. However, all are imperfect and it is not yet clear whether one particular test provides substantially more information than others. The aim of this study was to evaluate clinical findings, exercise electrocardiography, exercise thallium myocardial scintigraphy and cardiac fluoroscopy in 92 symptomatic women without previous infarction and determine which tests were most useful in determining the presence of coronary disease and its severity. Univariate analysis revealed two clinical, eight exercise electrocardiographic, seven myocardial scintigraphic and seven fluoroscopic variables predictive of coronary or multivessel disease with 70% or greater stenosis. The multivariate discriminant function analysis selected a reversible thallium defect, coronary calcification and character of chest pain syndrome as the variables most predictive of presence or absence of coronary disease. The ranked order of variables most predictive of multivessel disease were cardiac fluoroscopy score, thallium score and extent of ST segment depression in 14 electrocardiographic leads. Each provided statistically significant information to the model. The estimate of predictive accuracy was 89% for coronary disease and 97% for multivessel coronary disease. The results suggest that cardiac fluoroscopy or thallium scintigraphy provide significantly more diagnostic information than exercise electrocardiography in women over a wide range of clinical patient subsets

Comparison of electron beam computed tomography and exercise electrocardiography in detecting coronary artery disease in the elderly

International Nuclear Information System (INIS)

Inoue, Shinji; Mitsunami, Kenichi; Kinoshita, Masahiko

1998-01-01

Although exercise electrocardiography (ECG) is a useful noninvasive screening test for coronary artery disease (CAD), one prerequisite for ECG screening is that patient be able to exercise enough to evoke myocardial ischemia. Thus, exercise ECG may not be suitable for, some elderly people with CAD who cannot exercise enough. We compared electron beam Computed Tomography (EBCT) with exercise ECG for detecting CAD in 196 patients (mean age, 58.4±12.5 (standard deviation)) who had undergone coronary angiography. Using the angiographic findings as the ''gold standard'', we found that the sensitivity, specificity, positive predictive value, and negative predictive value were 88%, 77%, 89%, and 77%, respectively, for EBCT, and 66%, 72%, 83%, and 52%, respectively, for exercise ECG. Although the results were similar when the subjects were divided into different age groups, the negative predictive value for exercise ECG, among older patients was very low. These findings suggest that EBCT is superior to exercise ECG in detecting CAD in the elderly. (author)

Exercise thallium-201 scintigraphy and prognosis in typical angina pectoris and negative exercise electrocardiography

International Nuclear Information System (INIS)

Bairey, C.N.; Rozanski, A.; Maddahi, J.; Resser, K.J.; Berman, D.S.

1989-01-01

Patients with a history of typical angina but negative exercise electrocardiography represent a subgroup with an intermediate likelihood of having coronary artery disease and future cardiac events. A retrospective study of the prognostic utility of stress-redistribution thallium-201 scintigraphy was performed in 190 such patients. A second group of 203 patients with typical angina and a positive exercise electrocardiogram were analyzed for comparative scintigraphic purposes. The cardiac event rate for the 144 negative exercise electrocardiogram patients with normal thallium results was 5 vs 15% in the 46 patients with abnormal thallium results (p = 0.01). These patients were further stratified into high (14 to 18%), intermediate (9%) and low (less than 2%) risk groups for future cardiac events based on combining the thallium results with the percentage of maximal predicted heart rate achieved. A multivariate analysis revealed that an abnormal thallium result was the only significant correlate of future cardiac events. Mechanisms responsible for the discordant finding of a negative exercise electrocardiogram in patients with typical angina include (1) false-positive angina symptomatology in low prevalence coronary artery disease groups in whom the thallium test is negative, and (2) electrocardiographically silent ischemia in patients in whom the thallium test is positive. These findings reveal that thallium stress-redistribution scintigraphy can be used to stratify 1-year prognosis in this subgroup of patients with typical angina and negative exercise electrocardiograms

Effects of electrocardiography contamination and comparison of ECG removal methods on upper trapezius electromyography recordings.

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Marker, Ryan J; Maluf, Katrina S

2014-12-01

Electromyography (EMG) recordings from the trapezius are often contaminated by the electrocardiography (ECG) signal, making it difficult to distinguish low-level muscle activity from muscular rest. This study investigates the influence of ECG contamination on EMG amplitude and frequency estimations in the upper trapezius during muscular rest and low-level contractions. A new method of ECG contamination removal, filtered template subtraction (FTS), is described and compared to 30 Hz high-pass filter (HPF) and averaged template subtraction (ATS) methods. FTS creates a unique template of each ECG artifact using a low-pass filtered copy of the contaminated signal, which is subtracted from contaminated periods in the original signal. ECG contamination results in an over-estimation of EMG amplitude during rest in the upper trapezius, with negligible effects on amplitude and frequency estimations during low-intensity isometric contractions. FTS and HPF successfully removed ECG contamination from periods of muscular rest, yet introduced errors during muscle contraction. Conversely, ATS failed to fully remove ECG contamination during muscular rest, yet did not introduce errors during muscle contraction. The relative advantages and disadvantages of different ECG contamination removal methods should be considered in the context of the specific motor tasks that require analysis. Copyright © 2014 Elsevier Ltd. All rights reserved.

Electrocardiography may be a useful tool in the diagnosis of early mild canine heartworm disease

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Edward M. Onyango

2011-01-01

Full Text Available This study was carried out to determine the usefulness of standard electrocardiography for the diagnosis of early canine heartworm disease. Baseline electrocardiograms were recorded in 12 dogs. Thirty artificial Dirofilaria immitis worms were inserted in the pulmonary artery of each dog. New electrocardiograms were recorded on days 1-4, 7, 14, 21, 28 and 35 after insertion of worms. A significant attenuation of amplitude of Q wave in lead I was recorded on days 1-4, 7, 14, 21, 28 and 35; of R wave in lead II on days 21, 28 and 35; and of S wave in lead aVR on days 7, 14, 21, 28 and 35. Duration of the QRS complex in lead AVF was significantly prolonged on day 14. In 41.6% of the dogs, right axis deviation was recorded. These results suggest that for a dog whose normal baseline standard electrocardiogram is known, a comparison of the QRS complex of the baseline with those of subsequent standard electrocardiograms may suggest early canine heartworm disease when there is an attenuation of amplitude of Q wave in lead I, R wave in lead II and S wave in lead aVR. An additional indication can be right axis deviation.

Myocardial imaging with 201Tl at rest and during exercise. Comparison with coronary arteriography and resting and stress electrocardiography

International Nuclear Information System (INIS)

Ritchie, J.L.; Trobaugh, G.B.; Hamilton, G.W.; Gould, K.L.; Narahara, K.A.; Murray, J.A.; Williams, D.L.

1977-01-01

Myocardial imaging with intravenous thallium-201 ( 201 Tl) was performed at rest and following maximal treadmill exercise in 101 patients with suspected coronary artery disease. Results were interpreted from Polaroid scintiphotos by three independent observers with complete interobserver agreement in 79%. Of 25 patients with no or insignificant coronary artery disease ( 201 Tl image defect, one (4%) had an exercise 201 Tl defect, none had an ECG Q wave, and four (16%) had exercise ST-segment depression. Among 76 patients with coronary artery disease (greater than or equal to 50% diameter stenosis), 58 (76%) had a defect on either the rest or exercise 201 Tl image. The proportion of patients with an exercise image defect (50/76, 66%) was greater than the proportion with exercise ST depression alone (34/76, 45%; P 201 Tl is easily accomplished with readily available imaging equipment. The image data enhanced the diagnostic sensitivity of stress electrocardiography, and provided spatial identification of the abnormal segment(s) of myocardium

Detection of exercise induced ischemia in the asymptomatic recent post myocardial infarction patient: comparison of stress electrocardiography and radionuclide angiography

International Nuclear Information System (INIS)

Jengo, J.A.; Brizendine, M.; Dykstra, L.; Sweet, J.; Bruno, M.; Garcia, A.

1982-01-01

The purpose of this study was to compare the techniques of low level stress electrocardiography and radionuclide angiographic wall motion analysis for the detection of new areas of myocardial ischemia in the asymptomatic recent post-myocardial infarction patient. The protocol consisted of obtaining a resting, RAO upright first pass radionuclide angiocardiogram using 15 mCi of 99m technetium-DTPA. The study suggests that assessment of segmental wall motion during low level stress can detect areas of myocardium at high risk either intermixed with or in addition to recently infarcted areas in the asymptomatic post-infarction patient, which are not detected by ECG. This high risk subset of patients can then be observed or treated in a more vigorous manner. This technique allows for not only the identification of additional areas of myocardium at jeopardy but also provides information regarding the severity of ischemic dysfunction, an important prognostic and therapeutic factor

Interoperability in digital electrocardiography: harmonization of ISO/IEEE x73-PHD and SCP-ECG.

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Trigo, Jesús D; Chiarugi, Franco; Alesanco, Alvaro; Martínez-Espronceda, Miguel; Serrano, Luis; Chronaki, Catherine E; Escayola, Javier; Martínez, Ignacio; García, José

2010-11-01

The ISO/IEEE 11073 (x73) family of standards is a reference frame for medical device interoperability. A draft for an ECG device specialization (ISO/IEEE 11073-10406-d02) has already been presented to the Personal Health Device (PHD) Working Group, and the Standard Communications Protocol for Computer-Assisted ElectroCardioGraphy (SCP-ECG) Standard for short-term diagnostic ECGs (EN1064:2005+A1:2007) has recently been approved as part of the x73 family (ISO 11073-91064:2009). These factors suggest the coordinated use of these two standards in foreseeable telecardiology environments, and hence the need to harmonize them. Such harmonization is the subject of this paper. Thus, a mapping of the mandatory attributes defined in the second draft of the ISO/IEEE 11073-10406-d02 and the minimum SCP-ECG fields is presented, and various other capabilities of the SCP-ECG Standard (such as the messaging part) are also analyzed from an x73-PHD point of view. As a result, this paper addresses and analyzes the implications of some inconsistencies in the coordinated use of these two standards. Finally, a proof-of-concept implementation of the draft x73-PHD ECG device specialization is presented, along with the conversion from x73-PHD to SCP-ECG. This paper, therefore, provides recommendations for future implementations of telecardiology systems that are compliant with both x73-PHD and SCP-ECG.

The use of non-invasive fetal electrocardiography in diagnosing second-degree fetal atrioventricular block.

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Lakhno, Igor; Behar, Joachim A; Oster, Julien; Shulgin, Vyacheslav; Ostras, Oleksii; Andreotti, Fernando

2017-01-01

Complete atrioventricular block in fetuses is known to be mostly associated with autoimmune disease and can be irreversible if no steroids treatment is provided. Conventional methods used in clinical practice for diagnosing fetal arrhythmia are limited since they do not reflect the primary electrophysiological conduction processes that take place in the myocardium. The non-invasive fetal electrocardiogram has the potential to better support fetal arrhythmias diagnosis through the continuous analysis of the beat to beat variation of the fetal heart rate and morphological analysis of the PQRST complex. We present two retrospective case reports on which atrioventricular block diagnosis could have been supported by the non-invasive fetal electrocardiogram. The two cases comprised a 22-year-old pregnant woman with the gestational age of 31 weeks and a 25-year-old pregnant woman with the gestational age of 41 weeks. Both women were admitted to the Department of Maternal and Fetal Medicine at the Kyiv and Kharkiv municipal perinatal clinics. Patients were observed using standard fetal monitoring methods as well as the non-invasive fetal electrocardiogram. The non-invasive fetal electrocardiographic recordings were analyzed retrospectively, where it is possible to identify the presence of the atrioventricular block. This study demonstrates, for the first time, the feasibility of the non-invasive fetal electrocardiogram as a supplementary method to diagnose of the fetal atrioventricular block. Combined with current fetal monitoring techniques, non-invasive fetal electrocardiography could support clinical decisions.

Utility of Electrocardiography (ECG)-Gated Computed Tomography (CT) for Preoperative Evaluations of Thymic Epithelial Tumors.

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Ozawa, Yoshiyuki; Hara, Masaki; Nakagawa, Motoo; Shibamoto, Yuta

2016-01-01

Preoperative evaluation of invasion to the adjacent organs is important for the thymic epithelial tumors on CT. The purpose of our study was to evaluate the utility of electrocardiography (ECG)-gated CT for assessing thymic epithelial tumors with regard to the motion artifacts produced and the preoperative diagnostic accuracy of the technique. Forty thymic epithelial tumors (36 thymomas and 4 thymic carcinomas) were examined with ECG-gated contrast-enhanced CT using a dual source scanner. The scan delay after the contrast media injection was 30 s for the non-ECG-gated CT and 100 s for the ECG-gated CT. Two radiologists blindly evaluated both the non-ECG-gated and ECG-gated CT images for motion artifacts and determined whether the tumors had invaded adjacent structures (mediastinal fat, superior vena cava, brachiocephalic veins, aorta, pulmonary artery, pericardium, or lungs) on each image. Motion artifacts were evaluated using a 3-grade scale. Surgical and pathological findings were used as a reference standard for tumor invasion. Motion artifacts were significantly reduced for all structures by ECG gating ( p =0.0089 for the lungs and p ECG-gated CT and ECG-gated CT demonstrated 79% and 95% accuracy, respectively, during assessments of pericardial invasion ( p =0.03). ECG-gated CT reduced the severity of motion artifacts and might be useful for preoperative assessment whether thymic epithelial tumors have invaded adjacent structures.

Effects of negative T wave in electrocardiography on prognosis of post-myocardial infarction patients

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Reza Karbasi-Afshar

2013-03-01

Full Text Available BACKGROUND: Negative T (NT wave in electrocardiography (ECG is one of the important factors in determining short- and long-term outcomes in patients with acute myocardial infarction (MI. In this study, we compared clinical and paraclinical findings in post-MI patients according to presence or absence of NT wave. METHODS: A cross-sectional study was conducted on patients with acute ST elevation MI who presented to Shahid Modares Hospital (Tehran, Iran during 2009-10. After undergoing streptokinase therapy, demographic characteristics and ECG and exercise test findings of the subjects were compared based on the presence or absence of NT wave. RESULTS: Overall, 116 patients including 69 cases with NT wave (NT group and 47 cases without NT wave (PT group were enrolled (mean age: 53.7 ± 7.1 vs. 54.1 ± 6.8 years old. Mortality rate during the first five days was 13% in the NT group and 29% in the PT group (P < 0.05. Ejection fraction values of the NT group were significantly higher than the PT group (P = 0.005. However, left ventricular end-diastolic diameter of the NT group was significantly less than the PT group (P = 0.005. Moreover, ST segment depression was significantly less frequent in the NT group compared to the PT group. CONCLUSION: Patients with ST elevation MI accompanying with NT wave in ECG versus have better prognosis and myocardial function than similar patients without NT wave. Therefore, invasive procedures should be recommended for patients without NT wave.   Keywords: Echocardiography, Exercise Test, Myocardial Infarction, Negative T Wave, Echocardiography

Comparison of Left Ventricular Hypertrophy by Electrocardiography and Echocardiography in Children Using Analytics Tool.

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Tague, Lauren; Wiggs, Justin; Li, Qianxi; McCarter, Robert; Sherwin, Elizabeth; Weinberg, Jacqueline; Sable, Craig

2018-05-17

Left ventricular hypertrophy (LVH) is a common finding on pediatric electrocardiography (ECG) leading to many referrals for echocardiography (echo). This study utilizes a novel analytics tool that combines ECG and echo databases to evaluate ECG as a screening tool for LVH. SQL Server 2012 data warehouse incorporated ECG and echo databases for all patients from a single institution from 2006 to 2016. Customized queries identified patients 0-18 years old with LVH on ECG and an echo performed within 24 h. Using data visualization (Tableau) and analytic (Stata 14) software, ECG and echo findings were compared. Of 437,699 encounters, 4637 met inclusion criteria. ECG had high sensitivity (≥ 90%) but poor specificity (43%), and low positive predictive value (< 20%) for echo abnormalities. ECG performed only 11-22% better than chance (AROC = 0.50). 83% of subjects with LVH on ECG had normal left ventricle (LV) structure and size on echo. African-Americans with LVH were least likely to have an abnormal echo. There was a low correlation between V 6 R on ECG and echo-derived Z score of left ventricle diastolic diameter (r = 0.14) and LV mass index (r = 0.24). The data analytics client was able to mine a database of ECG and echo reports, comparing LVH by ECG and LV measurements and qualitative findings by echo, identifying an abnormal LV by echo in only 17% of cases with LVH on ECG. This novel tool is useful for rapid data mining for both clinical and research endeavors.

Inter-Rater Reliability and Downstream Financial Implications of Electrocardiography Screening in Young Athletes.

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Dhutia, Harshil; Malhotra, Aneil; Yeo, Tee Joo; Ster, Irina Chis; Gabus, Vincent; Steriotis, Alexandros; Dores, Helder; Mellor, Greg; García-Corrales, Carmen; Ensam, Bode; Jayalapan, Viknesh; Ezzat, Vivienne Anne; Finocchiaro, Gherardo; Gati, Sabiha; Papadakis, Michael; Tome-Esteban, Maria; Sharma, Sanjay

2017-08-01

Preparticipation screening for cardiovascular disease in young athletes with electrocardiography is endorsed by the European Society of Cardiology and several major sporting organizations. One of the concerns of the ECG as a screening test in young athletes relates to the potential for variation in interpretation. We investigated the degree of variation in ECG interpretation in athletes and its financial impact among cardiologists of differing experience. Eight cardiologists (4 with experience in screening athletes) each reported 400 ECGs of consecutively screened young athletes according to the 2010 European Society of Cardiology recommendations, Seattle criteria, and refined criteria. Cohen κ coefficient was used to calculate interobserver reliability. Cardiologists proposed secondary investigations after ECG interpretation, the costs of which were based on the UK National Health Service tariffs. Inexperienced cardiologists were more likely to classify an ECG as abnormal compared with experienced cardiologists (odds ratio, 1.44; 95% confidence interval, 1.03-2.02). Modification of ECG interpretation criteria improved interobserver reliability for categorizing an ECG as abnormal from poor (2010 European Society of Cardiology recommendations; κ=0.15) to moderate (refined criteria; κ=0.41) among inexperienced cardiologists; however, interobserver reliability was moderate for all 3 criteria among experienced cardiologists (κ=0.40-0.53). Inexperienced cardiologists were more likely to refer athletes for further evaluation compared with experienced cardiologists (odds ratio, 4.74; 95% confidence interval, 3.50-6.43) with poorer interobserver reliability (κ=0.22 versus κ=0.47). Interobserver reliability for secondary investigations after ECG interpretation ranged from poor to fair among inexperienced cardiologists (κ=0.15-0.30) and fair to moderate among experienced cardiologists (κ=0.21-0.46). The cost of cardiovascular evaluation per athlete was $175 (95

Localization of coronary artery disease with exercise electrocardiography: correlation with thallium-201 myocardial perfusion scanning

International Nuclear Information System (INIS)

Dunn, R.F.; Freedman, B.; Bailey, I.K.; Uren, R.F.; Kelly, D.T.

1981-01-01

In 61 patients with single vessel coronary artery disease (70 percent or greater obstruction of luminal diameter in only one vessel) and no previous myocardial infarction, the sites of ischemic changes on 12 lead exercise electrocardiography and on thallium-201 myocardial perfusion scanning were related to the obstructed coronary artery. The site of exercise-induced S-T segment depression did not identify which coronary artery was obstructed. In the 37 patients with left anterior descending coronary artery disease S-T depression was most often seen in the inferior leads and leads V4 to V6, and in the 18 patients with right coronary artery disease and in the 6 patients with left circumflex artery disease S-T depression was most often seen in leads V5 and V6. Although S-T segment elevation was uncommon in most leads, it occurred in lead V1 or a VL, or both, in 51 percent of the patients with left anterior descending coronary artery disease. A reversible anterior defect on exercise thallium scanning correlated with left anterior descending coronary artery disease (probability [p] less than 0.0001) and a reversible inferior thallium defect correlated with right coronary or left circumflex artery disease (p less than 0.0001). In patients with single vessel disease, the site of S-T segment depression does not identify the obstructed coronary artery; S-T segment elevation in lead V1 or aVL, or both, identifies left anterior descending coronary artery disease; and the site of reversible perfusion defect on thallium scanning identifies the site of myocardial ischemia and the obstructed coronary artery

High-risk angina patient: identification by clinical features, hospital course, electrocardiography, and technetium-99m stannous pyrophosphate scintigraphy

International Nuclear Information System (INIS)

Olson, H.G.; Lyons, K.P.; Aronow, W.S.; Stinson, P.J.; Kuperus, J.; Waters, H.J.

1981-01-01

We evaluated 193 consecutive unstable angina patients by clinical features, hospital course and electrocardiography. All patients were managed medically. Of the 193 patients, 150 (78%) had a technetium-99m pyrophosphate (Tc-PYP) myocardial scintigram after hospitalization. Of these, 49 (33%) had positive scintigrams. At a follow-up of 24.9 +- 10.8 months after hospitalization, 16 of 49 patients (33%) with positive scintigrams died from cardiac causes, compared with six of 101 patients (6%) with negative scintigrams (p < 0.001). Of 49 patients with positive scintigrams, 11 (22%) had had nonfatal myocardial infarction at follow-up, compared with seven of 101 patients (7%) with negative scintigrams (p < 0.01). Age, duration of clinical coronary artery disease, continuing angina during hospitalization, ischemic ECG, cardiomegaly and a history of heart failure also correlated with cardiac death at follow-up. Ischemic ECG and a history of angina with a crescendo pattern also correlated with nonfatal infarction at follow-up. Patients with continuing angina, an ischemic ECG and a positive scintigram constituted a high-risk unstable angina subgroup, with a survival rate of 58% at 6 months, 47% at 12 months and 42% at 24 and 36 months. We conclude that the assessment of clinical features, hospital course, ECG and Tc-PYP scintigraphy may be useful in identifying high-risk unstable angina patients

High-risk angina patient. Identification by clinical features, hospital course, electrocardiography and technetium-99m stannous pyrophosphate scintigraphy

International Nuclear Information System (INIS)

Olson, H.G.; Lyons, K.P.; Aronow, W.S.; Stinson, P.J.; Kuperus, J.; Waters, H.J.

1981-01-01

We evaluated 193 consecutive unstable angina patients by clinical features, hospital course and electrocardiography. All patients were managed medically. Of the 193 patients, 150 (78%) had a technetium-99m pyrophosphate (Tc-PYP) myocardial scintigram after hospitalization. Of these, 49 (33%) had positive scintigrams. At a follow-up of 24.9 +/- 10.8 months after hospitalization, 16 of 49 patients (33%) with positive scintigrams died from cardiac causes, compared with six of 101 patients (6%) with negative scintigrams (p less than 0.001). Of 49 patients with positive scintigrams, 11 (22%) had had nonfatal myocardial infarction at follow-up, compared with seven of 101 patients (7%) with negative scintigrams (p less than 0.01). Age, duration of clinical coronary artery disease, continuing angina during hospitalization, ischemic ECG, cardiomegaly and a history of heart failure also correlated with cardiac death at follow-up. Ischemic ECG and a history of angina with a crescendo pattern also correlated with nonfatal infarction at follow-up. Patients with continuing angina, an ischemic ECG and a positive scintigram constituted a high-risk unstable angina subgroup with a survival rate of 58% at 6 months, 47% at 12 months and 42% at 24 and 36 months. We conclude that the assessment of clinical features, hospital course, ECG and Tc-PYP scintigraphy may be useful in identifying high-risk unstable angina patients

The role of electrocardiography in evaluation of severity of chronic obstructive pulmonary disease in daily clinical practice.

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Aktürk, Faruk; Bıyık, İsmail; Kocaş, Cüneyt; Ertürk, Mehmet; Yalçın, Ahmet Arif; Savaş, Ayfer Utku; Kuzer, Firuzan Pınar; Uzun, Fatih; Yıldırım, Aydın; Uslu, Nevzat; Çuhadaroğlu, Çağlar

2013-01-01

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of chronic morbidity and mortality. Bronchial obstruction and increased pulmonary vascular resistance impairs right atrial functions. In this study, we aimed to investigate the effect of bronchial obstruction on p wave axis in patients with COPD and usefulness of electrocardiography (ECG) in the evaluation of the severity of COPD. Ninety five patients (64 male and 31 female) included to the study. Patients were in sinus rhythm, with normal ejection fraction and heart chamber sizes. Their respiratory function tests and 12 lead electrocardiograms were obtained at same day. Correlations with severity of COPD and ECG findings including p wave axis, p wave duration, QRS axis, QRS duration were studied. The mean age was 58 ± 12 years. Their mean p wave axis was 62 ± 18 degrees. In this study, p wave axis has demonstrated significant positive correlations with stages of COPD and QRS axis but significant negative correlations with FEV1, FEF, BMI and QRS duration. P wave axis increases with increasing stages of COPD. Verticalization of the frontal p wave axis may be an early finding of worsening of COPD before occurrences of other ECG changes of hypertrophy and enlargement of right heart chambers such as p pulmonale. Verticalization of the frontal p wave axis reflecting right atrial electrical activity and right heart strain may be a useful parameter for quick estimation of the severity of COPD in an out-patient cared.

Non-contact detection of myocardium's mechanical activity by ultrawideband RF-radar and interpretation applying electrocardiography.

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Thiel, F; Kreiseler, D; Seifert, F

2009-11-01

can potentially be used to support standard electrocardiography (ECG) analysis by complementary information where sole ECG analysis fails, e.g., electromechanical dissociation.

Non-contact detection of myocardium's mechanical activity by ultrawideband RF-radar and interpretation applying electrocardiography

Science.gov (United States)

Thiel, F.; Kreiseler, D.; Seifert, F.

2009-11-01

can potentially be used to support standard electrocardiography (ECG) analysis by complementary information where sole ECG analysis fails, e.g., electromechanical dissociation.

Study design and rationale for biomedical shirt-based electrocardiography monitoring in relevant clinical situations: ECG-shirt study.

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Balsam, Paweł; Lodziński, Piotr; Tymińska, Agata; Ozierański, Krzysztof; Januszkiewicz, Łukasz; Główczyńska, Renata; Wesołowska, Katarzyna; Peller, Michał; Pietrzak, Radosław; Książczyk, Tomasz; Borodzicz, Sonia; Kołtowski, Łukasz; Borkowski, Mariusz; Werner, Bożena; Opolski, Grzegorz; Grabowski, Marcin

2018-01-01

Today, the main challenge for researchers is to develop new technologies which may help to improve the diagnoses of cardiovascular disease (CVD), thereby reducing healthcare costs and improving the quality of life for patients. This study aims to show the utility of biomedical shirt-based electrocardiography (ECG) monitoring of patients with CVD in different clinical situations using the Nuubo® ECG (nECG) system. An investigator-initiated, multicenter, prospective observational study was carried out in a cardiology (adult and pediatric) and cardiac rehabilitation wards. ECG monitoring was used with the biomedical shirt in the following four independent groups of patients: 1) 30 patients after pulmonary vein isolation (PVI), 2) 30 cardiac resynchronization therapy (CRT) recipients, 3) 120 patients during cardiac rehabilitation after myocardial infarction, and 4) 40 pediatric patients with supraventricular tachycardia (SVT) before electrophysiology study. Approval for all study groups was obtained from the institutional review board. The biomedical shirt captures the electrocardiographic signal via textile electrodes integrated into a garment. The software allows the visualization and analysis of data such as ECG, heart rate, arrhythmia detecting algorithm and relative position of the body is captured by an electronic device. The major advantages of the nECG system are continuous ECG monitoring during daily activities, high quality of ECG recordings, as well as assurance of a proper adherence due to adequate comfort while wearing the shirt. There are only a few studies that have examined wearable systems, especially in pediatric populations. This study is registered in ClinicalTrials.gov: Identifier NCT03068169. (Cardiol J 2018; 25, 1: 52-59).

Continuous stroke unit electrocardiographic monitoring versus 24-hour Holter electrocardiography for detection of paroxysmal atrial fibrillation after stroke.

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Rizos, Timolaos; Güntner, Janina; Jenetzky, Ekkehart; Marquardt, Lars; Reichardt, Christine; Becker, Rüdiger; Reinhardt, Roland; Hepp, Thomas; Kirchhof, Paulus; Aleynichenko, Elena; Ringleb, Peter; Hacke, Werner; Veltkamp, Roland

2012-10-01

Cardioembolism in paroxysmal atrial fibrillation (pxAF) is a frequent cause of ischemic stroke. Sensitive detection of pxAF after stroke is crucial for adequate secondary stroke prevention; the optimal diagnostic modality to detect pxAF on stroke units is unknown. We compared 24-hour Holter electrocardiography (ECG) with continuous stroke unit ECG monitoring (CEM) for pxAF detection. Patients with acute ischemic stroke or transient ischemic attack were prospectively enrolled. After a 12-channel ECG on admission, all patients received 24-hour Holter ECG and CEM. Additionally, ECG monitoring data underwent automated analysis using dedicated software to identify pxAF. Patients with a history of atrial fibrillation or with atrial fibrillation on the admission ECG were excluded. Four hundred ninety-six patients (median age, 69 years; 61.5% male) fulfilled all inclusion criteria (ischemic stroke: 80.4%; transient ischemic attack: 19.6%). Median stroke unit stay lasted 88.8 hours (interquartile range, 65.0-122.0). ECG data for automated CEM analysis were available for a median time of 64.0 hours (43.0-89.8). Paroxysmal AF was documented in 41 of 496 patients (8.3%). Of these, Holter detected pxAF in 34.1%; CEM in 65.9%; and automated CEM in 92.7%. CEM and automated CEM detected significantly more patients with pxAF than Holter (Pstroke on stroke units compared with 24-hour Holter ECG. The comparative usefulness of prolonged or repetitive Holter ECG recordings requires further evaluation.

High-resolution electrocardiography in the diagnosis of arrhythmogenic right ventricular cardiomyopathy in Boxer dogs Eletrocardiografia de alta resolução no diagnóstico da cardiomiopatia arritmogênica do ventrículo direito em cães da raça Boxer

Directory of Open Access Journals (Sweden)

Evandro Zacché Pereira

2013-06-01

Full Text Available To evaluate the reliability of high-resolution electrocardiography in the diagnosis of arrhythmogenic right ventricular cardiomyopathy in Boxers, 20 dogs with no structural cardiac alterations at echocardiographic examination were grouped on the basis of frequency of ventricular arrhythmias, evaluated by 24-hour ambulatory ECG, and undergoing a high-resolution electrocardiography. High frequency QRS duration, duration of terminal QRS complex less than 40µV (LAS40 and root mean square voltage of the terminal 40 milliseconds of the QRS complex (RMS40 were measured. Differences in high-resolution ECG variables were not observed between groups. Therefore, the results of this investigation suggest that high-resolution electrocardiography is not a useful method for the diagnosis of arrhythmogenic right ventricular cardiomyopathy in Boxers without detectable myocardial alterations or systolic dysfunction.Com o objetivo de avaliar a importância da eletrocardiografia de alta resolução no diagnóstico da cardiomiopatia arritmogênica do ventrículo direito do Boxer, 20 cães sem evidências de doença cardíaca estrutural à avaliação ecodopplercardiográfica foram agrupados de acordo com a frequência de arritmias ventriculares, avaliadas pela eletrocardiografia ambulatorial de 24 horas, e submetidos ao exame eletrocardiográfico de alta resolução. Duração do complexo QRS filtrado, duração dos sinais de baixa amplitude (menor que 40µV dos últimos 40 milissegundos do complexo QRS e raiz quadrada média da voltagem ao quadrado dos últimos 40 milissegundos do complexo QRS (RMS40 foram as variáveis avaliadas. Não foram observadas diferenças significativas entre os grupos em relação às variáveis estudadas. Sendo assim, os resultados do presente estudo sugerem que a eletrocardiografia de alta resolução não é uma ferramenta útil no auxílio diagnóstico da cardiomiopatia arritmogênica do ventrículo direito dos cães da raça Boxer

Comparative study of thallium-201 single-photon emission computed tomography and electrocardiography in Duchenne and other types of muscular dystrophy

International Nuclear Information System (INIS)

Yamamoto, S.; Matsushima, H.; Suzuki, A.; Sotobata, I.; Indo, T.; Matsuoka, Y.

1988-01-01

Single-photon emission computed tomography (SPECT) using thallium-201 was compared with 12-lead electrocardiography (ECG) in patients with Duchenne (29), facioscapulohumeral (7), limb-girdle (6) and myotonic (5) dystrophies, by dividing the left ventricular (LV) wall into 5 segments. SPECT showed thallium defects (37 patients, mostly in the posteroapical wall), malrotation (23), apical aneurysm (5) and dilatation (7). ECG showed abnormal QRS (36 patients), particularly as a posterolateral pattern (13). Both methods of assessment were normal in only 7 patients. The Duchenne type frequently showed both a thallium defect (particularly in the posteroapical wall) and an abnormal QRS (predominantly in the posterolateral wall); the 3 other types showed abnormalities over the 5 LV wall segments in both tests. The percent of agreement between the 2 tests was 64, 66, 70, 72 and 72 for the lateral, apical, anteroseptal, posterior and inferior walls, respectively. The 2 tests were discordant in 31% of the LV wall, with SPECT (+) but ECG (-) in 21% (mostly in the apicoinferior wall) and SPECT (-) but ECG (+) in 10% (mostly in the lateral wall). Some patients showed large SPECT hypoperfusion despite minimal electrocardiographic changes. ECG thus appeared to underestimate LV fibrosis and to reflect posteroapical rather than posterolateral dystrophy in its posterolateral QRS pattern. In this disease, extensive SPECT hypoperfusion was also shown, irrespective of clinical subtype and skeletal involvement

The application of root mean square electrocardiography (RMS ECG) for the detection of acquired and congenital long QT syndrome.

Science.gov (United States)

Lux, Robert L; Sower, Christopher Todd; Allen, Nancy; Etheridge, Susan P; Tristani-Firouzi, Martin; Saarel, Elizabeth V

2014-01-01

Precise measurement of the QT interval is often hampered by difficulty determining the end of the low amplitude T wave. Root mean square electrocardiography (RMS ECG) provides a novel alternative measure of ventricular repolarization. Experimental data have shown that the interval between the RMS ECG QRS and T wave peaks (RTPK) closely reflects the mean ventricular action potential duration while the RMS T wave width (TW) tracks the dispersion of repolarization timing. Here, we tested the precision of RMS ECG to assess ventricular repolarization in humans in the setting of drug-induced and congenital Long QT Syndrome (LQTS). RMS ECG signals were derived from high-resolution 24 hour Holter monitor recordings from 68 subjects after receiving placebo and moxifloxacin and from standard 12 lead ECGs obtained in 97 subjects with LQTS and 97 age- and sex-matched controls. RTPK, QTRMS and RMS TW intervals were automatically measured using custom software and compared to traditional QT measures using lead II. All measures of repolarization were prolonged during moxifloxacin administration and in LQTS subjects, but the variance of RMS intervals was significantly smaller than traditional lead II measurements. TW was prolonged during moxifloxacin and in subjects with LQT-2, but not LQT-1 or LQT-3. These data validate the application of RMS ECG for the detection of drug-induced and congenital LQTS. RMS ECG measurements are more precise than the current standard of care lead II measurements.

Combined electrocardiography- and respiratory-triggered CT of the lung to reduce respiratory misregistration artifacts between imagining slabs in free-breathing children: Initial experience

International Nuclear Information System (INIS)

Goo, Hyun Woo; Allmendinger, Thomas

2017-01-01

Cardiac and respiratory motion artifacts degrade the image quality of lung CT in free-breathing children. The aim of this study was to evaluate the effect of combined electrocardiography (ECG) and respiratory triggering on respiratory misregistration artifacts on lung CT in free-breathing children. In total, 15 children (median age 19 months, range 6 months–8 years; 7 boys), who underwent free-breathing ECG-triggered lung CT with and without respiratory-triggering were included. A pressure-sensing belt of a respiratory gating system was used to obtain the respiratory signal. The degree of respiratory misregistration artifacts between imaging slabs was graded on a 4-point scale (1, excellent image quality) on coronal and sagittal images and compared between ECG-triggered lung CT studies with and without respiratory triggering. A p value < 0.05 was considered significant. Lung CT with combined ECG and respiratory triggering showed significantly less respiratory misregistration artifacts than lung CT with ECG triggering only (1.1 ± 0.4 vs. 2.2 ± 1.0, p = 0.003). Additional respiratory-triggering reduces respiratory misregistration artifacts on ECG-triggered lung CT in free-breathing children

Combined electrocardiography- and respiratory-triggered CT of the lung to reduce respiratory misregistration artifacts between imagining slabs in free-breathing children: Initial experience

Energy Technology Data Exchange (ETDEWEB)

Goo, Hyun Woo [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Allmendinger, Thomas [Siemens Healthcare, GmbH, Computed Tomography Division, Forchheim (Germany)

2017-09-15

Cardiac and respiratory motion artifacts degrade the image quality of lung CT in free-breathing children. The aim of this study was to evaluate the effect of combined electrocardiography (ECG) and respiratory triggering on respiratory misregistration artifacts on lung CT in free-breathing children. In total, 15 children (median age 19 months, range 6 months–8 years; 7 boys), who underwent free-breathing ECG-triggered lung CT with and without respiratory-triggering were included. A pressure-sensing belt of a respiratory gating system was used to obtain the respiratory signal. The degree of respiratory misregistration artifacts between imaging slabs was graded on a 4-point scale (1, excellent image quality) on coronal and sagittal images and compared between ECG-triggered lung CT studies with and without respiratory triggering. A p value < 0.05 was considered significant. Lung CT with combined ECG and respiratory triggering showed significantly less respiratory misregistration artifacts than lung CT with ECG triggering only (1.1 ± 0.4 vs. 2.2 ± 1.0, p = 0.003). Additional respiratory-triggering reduces respiratory misregistration artifacts on ECG-triggered lung CT in free-breathing children.

Usefulness of electrocardiography-gated dual-source computed tomography for evaluating morphological features of the ventricles in children with complex congenital heart defects

International Nuclear Information System (INIS)

Nakagawa, Motoo; Hara, Masaki; Sakurai, Keita; Asano, Miki; Shibamoto, Yuta; Ohashi, Kazuya

2011-01-01

Improved time resolution using dual-source computed tomography (DSCT) enabled adaptation of electrocardiography (ECG)-gated cardiac CT for children with a high heart rate. In this study, we evaluated the ability of ECG-gated DSCT (ECG-DSCT) to depict the morphological ventricular features in patients with congenital heart disease (CHD). Between August 2006 and March 2010, a total of 66 patients with CHD (aged 1 day to 9 years, median 11 months) were analyzed using ECG-DSCT. The type of anomaly was ventricular septal defect (VSD) in 32 (malaligned type in 20, perimembranous type in 7, supracristal type in 3, muscular type in 2), single ventricle (SV) in 11, and corrected transposition of the great arteries (cTGA) in 3. All patients underwent ECG-DSCT and ultrasonography (US). We evaluated the accuracy of diagnosing the type of VSD. For the cases with SV and cTGA, we evaluated the ability to depict anatomical ventricular features. In all 32 cases of VSD, DSCT could confirm the VSD defects, and the findings were identical to those obtained by US. Anatomical configurations of the SV and cTGA were correctly diagnosed, similar to that on US. Our study suggests that ECG-DSCT can clearly depict the configuration of ventricles. (author)

Thallium-201 myocardial perfusion imaging at rest and during exercise. Comparative sensitivity to electrocardiography in coronary artery disease

International Nuclear Information System (INIS)

Bailey, I.K.; Griffith, L.S.C.; Rouleau, J.; Strauss, H.W.; Pitt, B.

1977-01-01

The sensitivity of myocardial perfusion imaging (MPI) using thallium-201 injected both at rest and during peak exercise was compared to simultaneously recorded 12 lead electrocardiography (ECG) for the detection of transient ischemia in 20 normal subjects and 63 patients with coronary artery disease (CAD). No significant perfusion defects or ECG changes were seen on either the rest or exercise studies in any of the normal subjects. Fifty-six percent of patients with CAD developed new perfusion defects with exercise compared to 38 percent who developed ischemic ST-segment depression (P < 0.02). However, when chest pain and/or ST depression were considered indices of ischemia, the sensitivity of exercise testing and thallium-201 MPI was similar. The increased sensitivity of MPI compared to ST-segment depression on the ECG was due to patients with baseline ECG abnormalities and those who failed to achieve 85 percent of predicted maximum heart rate with exercise. Analysis of the exercise results according to the extent of coronary artery disease revealed a progressive increase in both positive ECGs and MPI with the number of vessels involved. In patients with single vessel disease the MPI was more sensitive than the ECG (P < 0.02). The combination of the rest and exercise ECG, MPI and chest pain during exercise failed to identify 11 percent of patients with CAD. Exercise thallium-201 MPI is a useful adjunct to conventional exercise testing particularly when evaluating patients with abnormal resting ECGs, those who develop ventricular conduction defects or arrhythmias during exercise, and those who fail to achieve their predicted heart rate because of fatigue or breathlessness

Coronary computed tomography angiography using prospective electrocardiography-gated axial scans with 64-detector computed tomography. Evaluation of stair-step artifacts and padding time

International Nuclear Information System (INIS)

Kimura, Fumiko; Umezawa, Tatsuo; Asano, Tomonari; Chihara, Ruri; Nishi, Naoko; Nishimura, Shigeyoshi; Sakai, Fumikazu

2010-01-01

We compared stair-step artifacts and radiation dose between prospective electrocardiography (ECG)-gated coronary computed tomography angiography (prospective CCTA) and retrospective CCTA using 64-detector CT and determined the optimal padding time (PT) for prospective CCTA. We retrospectively evaluated 183 patients [mean heart rate (HR) <65 beats/min, maximum HR instability <5 beats/min] who had undergone CCTA. We scored stair-step artifacts from 1 (severe) to 5 (none) and evaluated the effective dose in 53 patients with retrospective CCTA and 130 with prospective CCTA (PT 200 ms, n=32; PT 50 ms, n=98). Mean artifact scores were 4.3 in both retrospective and prospective CCTAs. However, statistically more arteries scored <3 (nonassessable) on prospective CCTA (P<0.001). Mean scores for prospective CCTA with 200- and 50-ms PT were 4.1 and 4.3, respectively (no significant difference). The radiation dose of prospective CCTA was reduced by 59.1% to 80.7%. Prospective CCTA reduces the radiation dose and allows diagnostic imaging in most cases but shows more nonevaluable artifacts than retrospective CCTA. Use of 50-ms instead of 200-ms PT appears to maintain image quality in patients with a mean HR <65 beats/min and HR instability of <5 beats/min. (author)

Application of iterative reconstruction in prospective electrocardiography-triggered CT coronary angiography

International Nuclear Information System (INIS)

Hou Yang; Yu Bing; Guo Qiyong; Wang Yuke; Yu Mei

2013-01-01

Objective: To assess the image quality (IQ) of an iterative reconstruction (IR) technique (iDose"4) from prospective electrocardiography (ECG)-triggered coronary CTA on a 256 MSCT scanner and determine the optimal dose reduction using IR that can provide IQ comparable to filtered back projection (FBP). Methods: Prospectively ECG gated CCTA were performed on 120 patients [76 men, 44 women; age: (53 ± 10) y] using a 256-slice MSCT (Brilliance iCT, Philips Healthcare). The control group (Group A , n = 30) were scanned using the conventional tube output (120 kVp, 210 mAs) and reconstructed using FBP. The other 3 groups were scanned with the same kVp but successively reduced tube output as follows: B (n = 30) : 105 mAs , C (n = 30) : 84 mAs: D (n = 30) : 65 mAs and reconstructed using IR levels of L4 to L6, respectively. All images were reconstructed using the same kernel (XCB). Two radiologists graded IQ in a blinded fashion on a 4-point scale (4-excellent, 3-good, 2-fair and 1-poor). Quantitative measurements of CT values, image noise, Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were obtained in each group. Analysis of variance (ANOVA) was used for comparisons of objective evaluation indices (noise, CNR) and radiation dose (CTDIvol, DLP, ED) between the four groups. The Kruskal-Wallis test was used for comparisons of demographic data and for detection of differences in subjective evaluation of IQ among groups. A level of P < 0.05 was considered statistically significant. A ROC analysis was performed to determine a radiation reduction threshold up to which excellent IQ was maintained. Results: There was no significant differences in objective noise among Groups A (37.4 ± 7.9) HU, B (33.2 ± 7.1) HU, C (35.7 ± 9.8) HU, and D (36.0 ± 6.8) HU (F = 1.48, P = 0.22). There was no significant differences in CNR among Groups A (15.0 ± 2.3), B (16.5 ± 3.6), C (16.3 ± 3.5), and D (15.3 ± 2.8) (F = 1.70, P = 0.17). Group B and C had good and excellent

Usefulness of exercise electrocardiography and thallium scintigraphy in unstable angina pectoris in predicting the extent and severity of coronary artery disease

International Nuclear Information System (INIS)

Freeman, M.R.; Chisholm, R.J.; Armstrong, P.W.

1988-01-01

The safety and efficacy of exercise electrocardiography and thallium scintigraphy early in the course of unstable angina pectoris were assessed 4.6 +/- 1.6 days after admission in 67 patients with unstable angina that stabilized after medical therapy. Coronary arteriography was performed in all patients 5.4 +/- 2.4 days after admission. There was no difference in clinical, exercise or scintigraphic variables between patients with stenoses less than 50% and patients with 1-vessel coronary artery disease (CAD) defined as a diameter stenosis greater than or equal to 50%. Patients with 3-vessel CAD had a significantly shorter exercise duration than patients with less than 50%-diameter narrowing (5.5 +/- 2.2 vs 8.3 +/- 3.3 minutes, respectively), lower exercise heart rate (119 +/- 20 vs 149 +/- 22 beats/min) and systolic blood pressure (156 +/- 29 vs 166 +/- 33 mm Hg), more frequent chest pain (76 vs 20%) and more pronounced ST depression (-1.48 +/- 1.37 vs -0.33 +/- 0.72 mm). In addition, thallium defect size on exercise was greater in the patients with 2-vessel CAD (159 +/- 132 degrees) and 3-vessel CAD (255 +/- 132 degrees) than in patients with no CAD (28 +/- 319 degrees) or 1-vessel CAD (73 +/- 78 degrees), p greater than or equal to 0.05. Multiple regression analysis demonstrated that thallium defect size was the best predictor of extent of CAD, with exercise heart rate and presence of chest pain during exercise also predictive of extent of CAD

[Late arrhythmias in the operated interatrial communication. Analysis of sinus node function and the conduction pathways by His bundle electrocardiography].

Science.gov (United States)

Ramírez, A; Gil, M; Martínez Ríos, M A; Cárdenas, M; Pliego, J; Zamora, C; Mata, L A

1982-01-01

Four hundred patients with atrial septal defect treated surgically were reviewed. Thirty five (8.7%) developed arrhytmias post-surgery which persisted for over a year. Sinus bradycardia was found in 10 patients, nodal rhythm in 21, and atrial fibrilation and flutter in 4 patients. Thirty five per cent of the patients with late arrhythmias developed related symptomatology. In 14 patients the function of the sinus node was studied with electrical stimulation of the atrium and with His registry. The interatrial conduction time, AV node and His Purkinje were analized employing various stimulation frequencies. All the cases studied had normal intra-atrial conduction; the response of the atrio-ventricular node to increasing frequencies was normal, an the intraventricular conduction remained constant. In 8 patients (52%), alterations of the sinus node were found; these consisted of prolonged post-stimulation pauses, Wenckebach's type sinoatrial block and suppression of sinus automatism employing vagal procedures or through electrical stimulation. A patient with severe bradycardia detected by dynamic electrocardiography had to be treated with a permanent pacemaker. We confirm that these arrhytmias are not produced by lesions of the internodal tracts, and that an alteration of the sinus node is frequent without a concomitant lesion of the intraventricular pathway. The lesion to the nutrient artery could be due to trauma and/or surgically induced. The response to anticholinergic drugs was good. Prolonged observation of these patients could increase the morbility of these arrythmias and raise doubts of the surgical indications in cases with moderate hemodynamic repercussion.

Computerized electrocardiography in American pit bull terrier dogsEletrocardiografia computadorizada em cães da raça American pit bull terrier

Directory of Open Access Journals (Sweden)

Mauro José Lahm Cardoso

2013-10-01

Full Text Available Electrocardiography (ECG is an essential examination for evaluation of patient with heart disease is great importance the diagnosis of arrhythmias. The examination can determine source f rhythm and frequency depolarization heart, providing information in clinical status myocardium, since deflections P-QRS-T tracing can be altered by disease or physiological factor. With advancement of computer technology, computerized electrocardiography has been used in human medicine as auxiliary diagnostic method and currently is being increasingly used in veterinary medicine. The objectives this study were to study e computerized electrocardiographic parameters in dogs breed American Pit Bull Terrier, comparing them with patterns species. In present study, we evaluated electrocardiographic examinations 42 dogs the breed American Pit Bull clinically healthy, 22 males and 20 females, aged between 1 and 6 years. Sinus rhythm was observed in 57% of dogs showed sinus rhythm and only 26% were wandering pacemaker. The electrocardiographic values obtained from these dogs computerized ECG were within the normal range of species, except the duration of the P wave which had longer than 0.04 seconds in 24% of dogs. We conclude that the dogs of the breed American Pit Bull Terrier have the same electrocardiographic values obtained in other breeds by the computerized method, except for the increase in P-wave duration. A eletrocardiografia (ECG é um exame essencial para avaliação do paciente com doença cardíaca, sendo de grande importância para o diagnóstico das arritmias. O exame pode determinar a origem do ritmo e a freqüência de despolarização do coração, fornecendo informações do estado clínico do miocárdio, uma vez que as deflexões P-QRS-T do traçado podem ser alteradas por uma enfermidade ou fator fisiológico. Com o avanço da informática, a eletrocardiografia computadorizada tem sido utilizada na medicina humana e veterinária como método de

Comparison of exercise electrocardiography and stress perfusion CMR for the detection of coronary artery disease in women

Directory of Open Access Journals (Sweden)

Greulich Simon

2012-06-01

Full Text Available Abstract Background Exercise electrocardiography (ECG is frequently used in the work-up of patients with suspected coronary artery disease (CAD, however the accuracy is reduced in women. Cardiovascular magnetic resonance (CMR stress testing can accurately diagnose CAD in women. To date, a direct comparison of CMR to ECG has not been performed. Methods and results We prospectively enrolled 88 consecutive women with chest pain or other symptoms suggestive of CAD. Patients underwent a comprehensive clinical evaluation, exercise ECG, a CMR stress test including perfusion and infarct imaging, and x-ray coronary angiography (CA within 24 hours. CAD was defined as stenosis ≥70% on quantitative analysis of CA. Exercise ECG, CMR and CA was completed in 68 females (age 66.4 ± 8.8 years, number of CAD risk factors 3.5 ± 1.4. The prevalence of CAD on CA was 29%. The Duke treadmill score (DTS in the entire group was −3.0 ± 5.4 and was similar in those with and without CAD (−4.5 ± 5.8 and −2.4 ± 5.1; P = 0.12. Sensitivity, specificity and accuracy for CAD diagnosis was higher for CMR compared with exercise ECG (sensitivities 85% and 50%, P = 0.02, specificities 94% and 73%, P = 0.01, and accuracies 91% and 66%, P = 0.0007, respectively. Even after applying the DTS the accuracy of CMR was higher compared to exercise ECG (area under ROC curve 0.94 ± 0.03 vs 0.56 ± 0.07; P = 0.0001. Conclusions In women with intermediate-to-high risk for CAD who are able to exercise and have interpretable resting ECG, CMR stress perfusion imaging has higher accuracy for the detection of relevant obstruction of the epicardial coronaries when directly compared to exercise ECG.

Paediatrics Electrocardiography

African Journals Online (AJOL)

Prof Ezechukwu

2011-11-28

Nov 28, 2011 ... Right axis deviation- Tetralogy of Fallot, pulmonary atresia, transposition of the great arteries (TGA). Superior axis deviation- Atrioventricular septal defect, tricuspid atresia. QRS Complex. The QRS complex represents ventricular depolarization and the normal duration 0.10 seconds or less. It is meas-.

Diagnostic performance of coronary computed tomography angiography versus exercise electrocardiography for coronary artery disease: a systematic review and meta-analysis.

Science.gov (United States)

Yin, Xinxin; Wang, Jiali; Zheng, Wen; Ma, Jingjing; Hao, Panpan; Chen, Yuguo

2016-07-01

Both coronary computed tomography angiography (CCTA) and exercise electrocardiography (ExECG) are non-invasive testing methods for the evaluation of coronary artery disease (CAD). However, there was controversy on the diagnostic performance of these methods due to the limited data in each single study. Therefore, we performed a meta-analysis to address these issues. We searched PubMed and Embase databases up to May 22, 2015. Two authors identified eligible studies, extracted data and accessed quality. Pooled estimation of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), summary receiver-operating characteristic curve (SROC) and the area under curve (AUC) of CCTA and ExECG for the diagnosis of CAD were calculated using Stata, Meta-Disc and Review Manager statistical software. Seven articles were included. Pooled sensitivity of CCTA and ExECG were 0.98 [95% confidence intervals (CIs): 0.95-0.99] and 0.66 (95% CIs: 0.59-0.72); pooled specificity of CCTA and ExECG were 0.84 (95% CIs: 0.81-0.87) and 0.75 (95% CIs: 0.71-0.79); pooled DOR of CCTA and ExECG were 110.24 (95% CIs: 35.07-346.55) and 6.28 (95% CIs: 2.06-19.13); and AUC of CCTA and ExECG were 0.9950±0.0046 and 0.7727±0.0638, respectively. There is no heterogeneity caused by threshold effect in CCTA or ExECG analysis. The Deeks' test showed no potential publication bias (P=0.17). CCTA has better diagnostic performance than ExECG in the evaluation of CAD, which can provide a better solution for the clinical problem of the diagnosis for CAD.

Clinical significance of normal exercise thallium-201 myocardial scintigraphy in subjects with abnormal exercise electrocardiographic findings

International Nuclear Information System (INIS)

Matsuo, Takeshi; Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei; Chiba, Hiroshi; Mitani, Isao; Saito, Muneyasu; Sumiyoshi, Tetsuya

1988-01-01

The relationship between exercise thallium-201 scintigraphic findings and clinical features (chest pain, risk factors, resting electrocardiography, exercise electrocardiography and prognosis) was studied in the 234 patients with profound ST-segment depression (J 80 ≥ -2 mm) or negative U wave in exercise electrocardiography. We classified these cases into two groups by exercise thallium perfusion; (I) normal thallium-201 perfusion (n = 24), (II) abnormal thallium-201 perfusion (n = 210). The incidence of female in group I was larger than that in group II. In resting electrocardiography, left ventricular hypertrophy was found more frequent in group I. In exercise electrocardiography, most of ST-segment depression in group I revealed up-slope type and a rapid recovery to baseline. Group I had lower incidence of cardiac events (cardiac death, nonfatal myocardial infarction, percutaneous transluminal coronary angioplasty, coronary artery bypass grafting). In conclusion, normal thallium-201 perfusion in exercise thallium-201 scintigraphy was more useful indicator for prognosis, even if the patients had the findings of profound ST-segment depression or negative U wave in exercise electrocardiography. (author)

Electrocardiography-triggered high-resolution CT for reducing cardiac motion artifact. Evaluation of the extent of ground-glass attenuation in patients with idiopathic pulmonary fibrosis

International Nuclear Information System (INIS)

Nishiura, Motoko; Johkoh, Takeshi; Yamamoto, Shuji

2007-01-01

The aim of this study was to evaluate the decreasing of cardiac motion artifact and whether the extent of ground-glass attenuation of idiopathic pulmonary fibrosis (IPF) was accurately assessed by electrocardiography (ECG)-triggered high-resolution computed tomography (HRCT) by 0.5-s/rotation multidetector-row CT (MDCT). ECG-triggered HRCT were scanned at the end-diastolic phase by a MDCT scanner with the following scan parameters; axial four-slice mode, 0.5 mm collimation, 0.5-s/rotation, 120 kVp, 200 mA/rotation, high-frequency algorithm, and half reconstruction. In 42 patients with IPF, both conventional HRCT (ECG gating (-), full reconstruction) and ECG-triggered HRCT were performed at the same levels (10-mm intervals) with the above scan parameters. The correlation between percent diffusion of carbon monoxide of the lung (%DLCO) and the mean extent of ground-glass attenuation on both conventional HRCT and ECG-triggered HRCT was evaluated with the Spearman rank correlation coefficient test. The correlation between %DLCO and the mean extent of ground-glass attenuation on ECG-triggered HRCT (observer A: r=-0.790, P<0.0001; observer B: r=-0.710, P<0.0001) was superior to that on conventional HRCT (observer A: r=-0.395, P<0.05; observer B: r=-0.577, P=0.002) for both observers. ECG-triggered HRCT by 0.5 s/rotation MDCT can reduce the cardiac motion artifact and is useful for evaluating the extent of ground-glass attenuation of IPF. (author)

Evaluation of cardiac autonomic nerves by iodine-123 metaiodobenzylguanidine scintigraphy and ambulatory electrocardiography in patients after arterial switch operations

Energy Technology Data Exchange (ETDEWEB)

Sakurai, Hajime; Maeda, Masanobu; Miyahara, Ken [Shakaihoken Chukyo Hospital, Nagoya (Japan)] [and others

2000-05-01

The autonomic cardiac nerves reach the heart after passing through the vicinity of the aortic root and the pulmonary trunk. The arterial switch operation (ASO) completely transects the ascending aorta and the pulmonary trunk. Therefore, this surgical procedure virtually denerves the heart. Cardiac sympathetic denervation and reinnervation were evaluated in patients after ASO using iodine-123 metaiodobenzylguanidine (MIBG) myocardial scintigraphy and parasympathetic denervation and reinnervation using ambulatory electrocardiography [Holter electrocardiogram (ECG)]. MIBG scintigraphy was performed in 14 patients who underwent ASO (ASO group) and 3 patients who underwent other open heart surgery (control group). All patients in the ASO group underwent the operation in the neonatal or infantile period. Planar and single photon emission computed tomography (SPECT) images of the myocardium were obtained. Defect score was determined by the SPECT images as a semi-quantitative index. The mean interval between ASO and MIBG scintigraphy was 25.6{+-}14.6 months. Holter ECG was also performed in 14 patients in the ASO group and 19 age-matched normal children. The Holter ECGs were plotted on a Lorenz plot. The H index, which is related to vagal tone for the cardiovascular system, was calculated from the R-R intervals. The mean interval between the ASO and Holter ECG was 8.3{+-}9.7 months. MIBG scintigraphy in the control group demonstrated an almost normal homogeneous tracer uptake, but showed extremely reduced tracer uptake and significantly higher defect score in the ASO group. The extent and degree of the reduction of MIBG uptake improved with time after the ASO. The heart-to-mediastinum MIBG count ratio tended to increase with time. The H index of the ASO group was lower than that of normal children (<12 months: Control group 0.0280{+-}0.0068 vs ASO group 0.0219{+-}0.0083), and gradually increased with time (1-3 years: 0.0470{+-}0.0157 vs 0.0314{+-}0.0124). (author)

Evaluation of cardiac autonomic nerves by iodine-123 metaiodobenzylguanidine scintigraphy and ambulatory electrocardiography in patients after arterial switch operations

International Nuclear Information System (INIS)

Sakurai, Hajime; Maeda, Masanobu; Miyahara, Ken

2000-01-01

The autonomic cardiac nerves reach the heart after passing through the vicinity of the aortic root and the pulmonary trunk. The arterial switch operation (ASO) completely transects the ascending aorta and the pulmonary trunk. Therefore, this surgical procedure virtually denerves the heart. Cardiac sympathetic denervation and reinnervation were evaluated in patients after ASO using iodine-123 metaiodobenzylguanidine (MIBG) myocardial scintigraphy and parasympathetic denervation and reinnervation using ambulatory electrocardiography [Holter electrocardiogram (ECG)]. MIBG scintigraphy was performed in 14 patients who underwent ASO (ASO group) and 3 patients who underwent other open heart surgery (control group). All patients in the ASO group underwent the operation in the neonatal or infantile period. Planar and single photon emission computed tomography (SPECT) images of the myocardium were obtained. Defect score was determined by the SPECT images as a semi-quantitative index. The mean interval between ASO and MIBG scintigraphy was 25.6±14.6 months. Holter ECG was also performed in 14 patients in the ASO group and 19 age-matched normal children. The Holter ECGs were plotted on a Lorenz plot. The H index, which is related to vagal tone for the cardiovascular system, was calculated from the R-R intervals. The mean interval between the ASO and Holter ECG was 8.3±9.7 months. MIBG scintigraphy in the control group demonstrated an almost normal homogeneous tracer uptake, but showed extremely reduced tracer uptake and significantly higher defect score in the ASO group. The extent and degree of the reduction of MIBG uptake improved with time after the ASO. The heart-to-mediastinum MIBG count ratio tended to increase with time. The H index of the ASO group was lower than that of normal children (<12 months: Control group 0.0280±0.0068 vs ASO group 0.0219±0.0083), and gradually increased with time (1-3 years: 0.0470±0.0157 vs 0.0314±0.0124). (author)

Ability of a 5-minute electrocardiography (ECG) for predicting arrhythmias in Doberman Pinschers with cardiomyopathy in comparison with a 24-hour ambulatory ECG.

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Wess, G; Schulze, A; Geraghty, N; Hartmann, K

2010-01-01

Ventricular premature contractions (VPCs) are common in the occult stage of cardiomyopathy in Doberman Pinschers. Although the gold standard for detecting arrhythmia is the 24-hour ambulatory electrocardiography (ECG) (Holter), this method is more expensive, time-consuming and often not as readily available as common ECG. Comparison of 5-minute ECGs with Holter examinations. Eight hundred and seventy-five 5-minute ECGs and Holter examinations of 431 Doberman Pinschers. Each examination included a 5-minute ECG and Holter examination. A cut-off value of > 100 VPCs/24 hours using Holter was considered diagnostic for the presence of cardiomyopathy. Statistical evaluation included calculation of sensitivity, specificity, positive predictive value, and negative predictive value. Holter examinations revealed > 100 VPCs/24 hours in 204/875 examinations. At least 1 VPC during a 5-minute ECG was detected in 131 (64.2%) of these 204 examinations. No VPCs were found in the 5-minute ECG in 73 (35.8%) examinations of affected Doberman Pinschers. A 5-minute ECG with at least 1 VPC as cut-off had a sensitivity of 64.2%, a specificity of 96.7%, a positive predictive value of 85.6% and a negative predictive value of 89.9% for the presence of > 100 VPCs/24 hours. A 5-minute ECG is a rather insensitive method for detecting arrhythmias in Doberman Pinschers. However, the occurrence of at least 1 VPC in 5 minutes strongly warrants further examination of the dog, because specificity (96.7%) and positive predictive value (85.6%) are high and could suggest occult cardiomyopathy.

Comparing twelve-lead electrocardiography with close-to-heart patch based electrocardiography

DEFF Research Database (Denmark)

Hansen, Ingeborg Helbech; Hoppe, Karsten; Gjerde, Anna

2015-01-01

used in the clinic impeding clinical interpretation. In this study, recordings from an ePatch® lead system involving three torso sites are compared with concurrently recorded standard 12-lead ECG. Pearson's correlation coefficients (CC) of −0.90 and 0.91 is found between two of the PEM signals...

Gender-related differences in clinical presentation, electrocardiography signs, laboratory markers and outcome in patients with acute pulmonary embolism.

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Obradović, Slobodan; Džudović, Boris; Rusović, Siniša; Subota, Vesna; Obradović, Dragana

2016-09-01

Acute pulmonary embolism (PE) is a potentially life threating event, but there are scarce data about genderrelated differences in this condition. The aim of this study was to identify gender-specific differences in clinical presentation, the diagnosis and outcome between male and female patients with PE. We analysed the data of 144 consecutive patients with PE (50% women) and compared female and male patients regarding clinical presentation, electrocardiography (ECG) signs, basic laboratory markers and six-month outcome. All the patients confirmed PE by visualized thrombus on the multidetector computed tomography with pulmonary angiography (MDCTPA), ECG and echocardiographic examination at admission. Compared to the men, the women were older and a larger proportion of them was in the third tertile of age (66.0% vs 34.0%, p = 0.008). In univariate analysis the men more often had hemoptysis [OR (95% CI) 3.75 (1.16-12.11)], chest pain [OR (95% CI) 3.31 (1.57-7.00)] febrile state [OR (95% CI) 2.41 (1.12-5.22)] and pneumonia at PE presentation [OR (95% CI) 3.40 (1.25-9.22)] and less likely had heart decompensation early in the course of the disease [OR (95%CI) 0.48 (0.24-0.97)]. In the multivariate analysis a significant difference in the rate of pneumonia and acute heart failure between genders disappeared due to strong influence of age. There was no significant difference in the occurrence of typical ECG signs for PE between the genders. Women had higher level of admission glycaemia [7.7 mmol/L (5.5-8.2 mmol/L) vs 6.9 mmol/L (6.3-9.6 mmol/L), p = 0.006] and total number of leukocytes [10.5 x 109/L (8.8-12.7 x 109/L vs 8.7 x 109/L (7.0-11.6 x 109/L)), p = 0.007]. There was a trend toward higher plasma level of brain natriuretic peptide in women compared to men 127.1 pg/mL (55.0-484.0 pg/mL), p = 0.092] vs [90.3 pg/mL (39.2-308.5 pg/mL). The main 6-month outcomes, death and major bleeding, had similar frequencies in both sexes. There are several important differences

Problems in Recording the Electrocardiogram.

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Webster, John G.

The unwanted signals that arise in electrocardiography are discussed. A technical background of electrocardiography is given, along with teaching techniques that educate students of medical instrumentation to solve the problems caused by these signals. (MJH)

Incremental value of clinical assessment, supine exercise electrocardiography, and biplane exercise radionuclide ventriculography in the prediction of coronary artery disease in men with chest pain

International Nuclear Information System (INIS)

Currie, P.J.; Kelly, M.J.; Harper, R.W.; Federman, J.; Kalff, V.; Anderson, S.T.; Pitt, A.

1983-01-01

The incremental value of clinical assessment, exercise electrocardiography (ECG) and biplane radionuclide ventriculography (RVG) in the prediction of coronary artery disease (CAD) was assessed in 105 men without myocardial infarction who were undergoing coronary angiography for investigation of chest pain. Independent clinical assessment of chest pain was made prospectively by 2 physicians. Graded supine bicycle exercise testing was symptom-limited. Right anterior oblique ECG-gated first-pass RVG and left anterior oblique ECG-gated equilibrium RVG were performed at rest and exercise. Regional wall motion abnormalities were defined by agreement of 2 of 3 blinded observers. A combined strongly positive exercise ECG response was defined as greater than or equal to 2 mm ST depression or 1.0 to 1.9 mm ST depression with exercise-induced chest pain. A multivariate logistic regression model for the preexercise prediction of CAD was derived from the clinical data and selected 2 variables: chest pain class and cholesterol level. A second model assessed the incremental value of the exercise test in prediction of CAD and found 2 exercise variables that improved prediction: RVG wall motion abnormalities, and a combined strongly positive ECG response. Applying the derived predictive models, 37 of the 58 patients (64%) with preexercise probabilities of 10 to 90% crossed either below the 10% probability threshold or above the 90% threshold and 28 (48%) also moved across the 5 and 95% thresholds. Supine exercise testing with ECG and biplane RVG together, but neither test alone, effectively adds to clinical prediction of CAD. It is most useful in men with atypical chest pain and when the ECG and RVG results are concordant

Brugada-Phenocopy Induced by Propafenone Overdose and Successful Treatment: A Case Report

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Mehmet Emre Arı

2017-10-01

Full Text Available Background: Brugada syndrome is an inherited arrhythmogenic disease that may cause sudden cardiac death due to ventricular fibrillation in young adults. Brugada syndrome caused by propafenone intoxication has been noted rarely in the literature. We report a rare case, Brugada phenocopy due to propafenone intoxication and its treatment. Case Report: A 15-year-old girl having a seizure was brought to the emergency room. She took 1.5 g propafenone (Rythmol, Abbott, Chicago, IL, USA for suicidal intention. She had metabolic acidosis. Long QRS interval and ST elevation in leads V1 through V3 were seen on electrocardiography. After bicarbonate infusion for 4 hours, haemodynamic and neurologic findings were recovered, and all electrocardiography abnormalities disappeared. The Brugada-like electrocardiography pattern was not recognized in her surface and 24-hour Holter electrocardiography at follow-up. Ajmaline challenge test was negative 2 weeks later. Conclusion: Absence of symptoms and documented ventricular tachycardia, negative challenge test, and a negative family history demonstrated that the Brugada phenocopy was a transient finding in this case and related to propafenone intoxication

In silico cardiac risk assessment in patients with long QT syndrome

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Hoefen, Ryan; Reumann, Matthias; Goldenberg, Ilan

2012-01-01

The study was designed to assess the ability of computer-simulated electrocardiography parameters to predict clinical outcomes and to risk-stratify patients with long QT syndrome type 1 (LQT1).......The study was designed to assess the ability of computer-simulated electrocardiography parameters to predict clinical outcomes and to risk-stratify patients with long QT syndrome type 1 (LQT1)....

Vectorcardiographic diagnostic & prognostic information derived from the 12-lead electrocardiogram: Historical review and clinical perspective.

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Man, Sumche; Maan, Arie C; Schalij, Martin J; Swenne, Cees A

2015-01-01

In the course of time, electrocardiography has assumed several modalities with varying electrode numbers, electrode positions and lead systems. 12-lead electrocardiography and 3-lead vectorcardiography have become particularly popular. These modalities developed in parallel through the mid-twentieth century. In the same time interval, the physical concepts underlying electrocardiography were defined and worked out. In particular, the vector concept (heart vector, lead vector, volume conductor) appeared to be essential to understanding the manifestations of electrical heart activity, both in the 12-lead electrocardiogram (ECG) and in the 3-lead vectorcardiogram (VCG). Not universally appreciated in the clinic, the vectorcardiogram, and with it the vector concept, went out of use. A revival of vectorcardiography started in the 90's, when VCGs were mathematically synthesized from standard 12-lead ECGs. This facilitated combined electrocardiography and vectorcardiography without the need for a special recording system. This paper gives an overview of these historical developments, elaborates on the vector concept and seeks to define where VCG analysis/interpretation can add diagnostic/prognostic value to conventional 12-lead ECG analysis. Copyright © 2015 Elsevier Inc. All rights reserved.

A combination of troponin T and 12-lead electrocardiography: a valuable tool for early prediction of long-term mortality in patients with chest pain without ST-segment elevation.

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Jernberg, Tomas; Lindahl, Bertil

2002-11-01

Electrocardiography (ECG) obtained on admission and a troponin T (tn-T) level measured early after admission are simple and accessible methods for predicting outcome in patients with suspected unstable angina or myocardial infarction without persistent ST-elevations. However, there are few studies about the combination of these 2 methods as a means of predicting long-term outcome. ECG was obtained on admission, and a tn-T level was analyzed on admission and after 6 hours in 710 consecutive patients admitted because of chest pain and no ST-elevations. Patients were observed for a median time of 40 months for death. ST-segment depressions > or =0.05 mV were present in 266 patients (37%). These patients had a 9.7-fold increased risk of death, compared with patients with normal ECG results. Isolated T-Wave inversions or pathological signs other than ST-T changes were present in 196 patients (28%), who had a 4.5-fold increased risk of death compared with patients who had normal ECG results. At 6 hours after admission, 169 patients (24%) had at least 1 sample of tn-T > or =0.10 microg/L, which resulted in an 3.7-fold increased risk of death. In a multivariate analysis, both ECG on admission and tn-T level came out as independent predictors of outcome. When these methods were combined, patients could be divided into low- (tn-T level or =0.10 microg/L or ST-segment depression), and high-risk groups (tn-T level > or =0.10 microg/L and ST-segment depression). ECG and tn-T level are valuable tools to quickly risk stratify patients with chest pain. The combination of these methods is superior to either one alone.

Evaluation of the indications and arrhythmic patterns of 24 hour Holter electrocardiography among hypertensive and diabetic patients seen at OAUTHC, Ile-Ife Nigeria

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Adebayo RA

2014-11-01

premature ventricular contractions were the commonest arrhythmic pattern among our patients. HRV was reduced in T2DM patients compared with hypertensive patients. Keywords: Holter electrocardiography, arrhythmias, hypertension, diabetes mellitus, Nigerians

High frame rate retrospectively triggered Cine MRI for assessment of murine diastolic function.

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Coolen, Bram F; Abdurrachim, Desiree; Motaal, Abdallah G; Nicolay, Klaas; Prompers, Jeanine J; Strijkers, Gustav J

2013-03-01

To assess left ventricular (LV) diastolic function in mice with Cine MRI, a high frame rate (>60 frames per cardiac cycle) is required. For conventional electrocardiography-triggered Cine MRI, the frame rate is inversely proportional to the pulse repetition time (TR). However, TR cannot be lowered at will to increase the frame rate because of gradient hardware, spatial resolution, and signal-to-noise limitations. To overcome these limitations associated with electrocardiography-triggered Cine MRI, in this paper, we introduce a retrospectively triggered Cine MRI protocol capable of producing high-resolution high frame rate Cine MRI of the mouse heart for addressing left ventricular diastolic function. Simulations were performed to investigate the influence of MRI sequence parameters and the k-space filling trajectory in relation to the desired number of frames per cardiac cycle. An optimized protocol was applied in vivo and compared with electrocardiography-triggered Cine for which a high-frame rate could only be achieved by several interleaved acquisitions. Retrospective high frame rate Cine MRI proved superior to the interleaved electrocardiography-triggered protocols. High spatial-resolution Cine movies with frames rates up to 80 frames per cardiac cycle were obtained in 25 min. Analysis of left ventricular filling rate curves allowed accurate determination of early and late filling rates and revealed subtle impairments in left ventricular diastolic function of diabetic mice in comparison with nondiabetic mice. Copyright © 2012 Wiley Periodicals, Inc.

Methods, qualitative and quantitative evaluations of 201Tl myocardial scintiscans

International Nuclear Information System (INIS)

Buell, U.; Kleinhans, E.; Klepzig, M.; Seiderer, M.; Strauer, B.E.

1981-01-01

Exercise 201 Tl myocardial scintiscanning is a technique used to supplement exercise electrocardiography. The procedure employed should be identical to the standard procedure of electrocardiography. If the coronary disease has already been established by coronary angiography and kineventriculography, 201 Tl examinations should be carried out before surgery in order to determine the ''regional functional reserve''. Visual evaluations of the 201 Tl scintiscans should be supplemented by quantification methods. Quantification is also required between 201 Tl examination and surgery and to assure constant diagnostic accuracy in case of examination by different examiners. (orig./MG) [de

ECG artifact cancellation in surface EMG signals by fractional order calculus application.

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Miljković, Nadica; Popović, Nenad; Djordjević, Olivera; Konstantinović, Ljubica; Šekara, Tomislav B

2017-03-01

New aspects for automatic electrocardiography artifact removal from surface electromyography signals by application of fractional order calculus in combination with linear and nonlinear moving window filters are explored. Surface electromyography recordings of skeletal trunk muscles are commonly contaminated with spike shaped artifacts. This artifact originates from electrical heart activity, recorded by electrocardiography, commonly present in the surface electromyography signals recorded in heart proximity. For appropriate assessment of neuromuscular changes by means of surface electromyography, application of a proper filtering technique of electrocardiography artifact is crucial. A novel method for automatic artifact cancellation in surface electromyography signals by applying fractional order calculus and nonlinear median filter is introduced. The proposed method is compared with the linear moving average filter, with and without prior application of fractional order calculus. 3D graphs for assessment of window lengths of the filters, crest factors, root mean square differences, and fractional calculus orders (called WFC and WRC graphs) have been introduced. For an appropriate quantitative filtering evaluation, the synthetic electrocardiography signal and analogous semi-synthetic dataset have been generated. The examples of noise removal in 10 able-bodied subjects and in one patient with muscle dystrophy are presented for qualitative analysis. The crest factors, correlation coefficients, and root mean square differences of the recorded and semi-synthetic electromyography datasets showed that the most successful method was the median filter in combination with fractional order calculus of the order 0.9. Statistically more significant (p ECG peak reduction was obtained by the median filter application compared to the moving average filter in the cases of low level amplitude of muscle contraction compared to ECG spikes. The presented results suggest that the

Electrocardiography of Grevy's zebras (Equus grevyi).

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Myers, Debbie A; Citino, Scott; Mitchell, Mark A

2008-09-01

Electrocardiograms (ECGs) are a good baseline test for assessing cardiac rhythm. ECGs have not been reported in any zebra species and in very few Perissodactyla species. Standard limb, six-lead ECGs were recorded in 23 anesthetized Grevy's zebras (Equus grevyi). Heart rate, RR interval, P-wave duration, RR maximum/minimum, PR interval, QRS duration, QT interval, ST segment deviation, P-wave amplitude, QRS amplitude, and T-wave amplitude were measured and calculated from lead II ECGs from these Grevy's zebras. Several variables were tested, including gender, age (0-24, 24-48, 48-180, and >180 mo), weight (350 kg), pregnancy status, and anesthetic differences (standard dose or supplemented dose), to see if they affected ECG values in these animals. There were no significant differences in any of the ECG parameters between genders. RR and QT intervals were longer in older zebras; heart rates were faster in younger zebras. The RR and PR intervals, as well as the QRS duration, were greater in heavier zebras; heart rates were faster in lighter zebras. The RR interval was significantly longer in pregnant zebras. There were no significant differences in any of the ECG parameters for zebras anesthetized with a standardized dose of the drug combination etorphine-detomidine-acepromazine compared to those receiving additional supplements of these drugs and/or ketamine. All other parameters were not significantly different among groups, except where noted previously. The results of this research indicate that differences in ECG parameters in zebras may occur between animals of different ages, weights, and pregnancy status and that these factors should be considered when interpreting the respective ECGs of these zebras.

The Use of Fetal Noninvasive Electrocardiography

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Igor Lakhno

2016-01-01

Full Text Available Preeclampsia (PE is one of the severe complications of pregnancy that leads to fetal deterioration. The aim was to survey the validity of fetal distress diagnostics in case of Doppler ultrasonic umbilical vein and arteries blood flow velocity investigation and ECG parameters analysis obtained from maternal abdominal signal before labor in preeclamptic patients. Fetal noninvasive ECG and umbilical arterial and venous Doppler investigation were performed in 120 patients at 34–40 weeks of gestation. And 30 of them had physiological gestation and were involved in Group I. In Group II 52 pregnant women with mild-moderate PE were observed. 38 patients with severe PE were monitored in Group III. The most considerable negative correlation was determined in pair Apgar score 1 versus T/QRS (R=-0.50; p<0.05. So the increased T/QRS ratio was the most evident marker of fetal distress. Fetal noninvasive ECG showed sensitivity of 96.6% and specificity of 98.4% and, therefore, was determined as more accurate method for fetal monitoring.

Propofol-cetamina racêmica e propofol-cetamina levógira em cadelas: parâmetros eletrocardiográficos e outras variáveis fisiológicas Propofol-racemic ketamine or propofol-levogire ketamine in dogs: effects on electrocardiography and other physiological parameters

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R.M. Almeida

2008-12-01

Full Text Available Estudaram-se os efeitos da infusão contínua da associação propofol e cetamina sobre variáveis fisiológicas e eletrocardiográficas e sua possível analgesia em 12 cadelas. Após indução com propofol, os animais receberam 0,4mg/kg/min de propofol + 0,2mg/kg/min de cetamina racêmica (n = 6, grupo PC ou 0,4mg/kg/min de propofol + 0,1mg/kg/min de cetamina S+ (n = 6, grupo PCS. Avaliaram-se: teste álgico, freqüência cardíaca (FC, parâmetros eletrocardiográficos, freqüência respiratória (FR, pressão arterial sistólica, média e diastólica (PAS, PAM, PAD, saturação da oxiemoglobina (SpO2 e temperatura retal (TR. Houve elevação da FC sem alterações eletrocardiográficas, com exceção de aumento na amplitude da onda T em um animal de cada grupo. A FR diminuiu, e os valores de SpO2 ficaram abaixo de 90% em alguns momentos nos dois grupos. PAS, PAM e PAD diminuíram, mas não houve diferença entre os protocolos. Não se observou analgesia em sete animais, três cadelas apresentaram analgesia discreta, e apenas duas demonstraram analgesia favorável. Conclui-se que os protocolos são seguros em cadelas, contudo não há analgesia suficiente para procedimento cirúrgico. As alterações eletrocardiográficas foram relacionadas à FC e à amplitude de onda T, sendo esta sugestiva de hipóxia do miocárdio.The effects of propofol and ketamine on physiological parameters, electrocardiography, and analgesia were evaluated in twelve dogs that received propofol-ketamine (0.4mg/kg/min + 0.2mg/kg/min, n=6, PK group or propofol-S+ketamine (0.4mg/kg/min + 0.1mg/kg/min, n=6, PKS group after induction of anesthesia with propofol (8.0mg/kg. Assessments of pain; heart rate (HR; electrocardiography (ECG; respiratory rate (RR; systolic, medium, and diastolic arterial pressures (SAP, MAP, DAP; saturation of hemoglobin (SpO2; and rectal temperature (RT were conducted. There was a rise in HR with no electrocardiographically changes, but an increase

Design and Development of Intelligent Electrodes for Future Digital Health Monitoring: A Review

Science.gov (United States)

Khairuddin, A. M.; Azir, K. N. F. Ku; Kan, P. Eh

2018-03-01

Electrodes are sensors used in electrocardiography (ECG) monitoring system to diagnose heart diseases. Over the years, diverse types of electrodes have been designed and developed to improve ECG monitoring system. However, more recently, with the technological advances and capabilities from the Internet of Things (IoT), cloud computing and data analytics in personalized healthcare, researchers are attempting to design and develop more effective as well as flexible ECG devices by using intelligent electrodes. This paper reviews previous works on electrodes used in electrocardiography (ECG) monitoring devices to identify the key ftures for designing and developing intelligent electrodes in digital health monitoring devices.

The effect of low-dose β-blocker on heart rate and heart rate variability in health subjects wth a resting heart rate of less than 65 beats per minute: Effect on the quality of prospective electrocardiography-gated coronary CT angiography

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Park, Chul Hwan; Kim, Tae Hoon [Dept. of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Sang Min [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Hong, Yoo Jin [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2015-02-15

We assessed the effect of a low-dose β-blocker on heart rate (HR), HR variability (HRV) and image quality of prospective electrocardiography-gated coronary CT angiography (CCTA) in healthy subjects with low HR. CCTA was performed with a 64-slice CT in 75 subjects with a HR of less than 65 beats per minute (bpm). Subjects were divided into 2 groups: Group 1 (G1), 35 with a low dose β-blocker; and Group 2 (G2), 40 without pre-medication. The image quality (IQ) of the CCTA was assessed on a 4-point grading scale (1, poor; 4, excellent). Initial HR (bpm) was not different between the 2 groups. HR during CCTA was lower in G1 than G2 (50.3 ± 5.6 vs. 53.3 ± 4.8, p = 0.016). HRV was not different between the 2 groups. Per-segment analysis showed better IQ at the mid-segment of the right coronary artery (3.0 ± 0.9 vs. 2.5 ± 1.1, p = 0.039) and the first diagonal branch (3.4 ± 0.6 vs. 3.1 ± 0.7, p = 0.024), in the G1 than the G2 group, respectively. The IQ was negatively correlated with HR, but no correlation was found between HRV and IQ. The IQs in the per-vessel analysis were not different between the 2 groups. Low-dose β-blocker reduced HR and improved the IQ of CCTA in a few segments, even at a HR of less than 65 bpm. However the effect was limited.

The effect of low-dose β-blocker on heart rate and heart rate variability in health subjects wth a resting heart rate of less than 65 beats per minute: Effect on the quality of prospective electrocardiography-gated coronary CT angiography

International Nuclear Information System (INIS)

Park, Chul Hwan; Kim, Tae Hoon; Lee, Sang Min; Hong, Yoo Jin

2015-01-01

We assessed the effect of a low-dose β-blocker on heart rate (HR), HR variability (HRV) and image quality of prospective electrocardiography-gated coronary CT angiography (CCTA) in healthy subjects with low HR. CCTA was performed with a 64-slice CT in 75 subjects with a HR of less than 65 beats per minute (bpm). Subjects were divided into 2 groups: Group 1 (G1), 35 with a low dose β-blocker; and Group 2 (G2), 40 without pre-medication. The image quality (IQ) of the CCTA was assessed on a 4-point grading scale (1, poor; 4, excellent). Initial HR (bpm) was not different between the 2 groups. HR during CCTA was lower in G1 than G2 (50.3 ± 5.6 vs. 53.3 ± 4.8, p = 0.016). HRV was not different between the 2 groups. Per-segment analysis showed better IQ at the mid-segment of the right coronary artery (3.0 ± 0.9 vs. 2.5 ± 1.1, p = 0.039) and the first diagonal branch (3.4 ± 0.6 vs. 3.1 ± 0.7, p = 0.024), in the G1 than the G2 group, respectively. The IQ was negatively correlated with HR, but no correlation was found between HRV and IQ. The IQs in the per-vessel analysis were not different between the 2 groups. Low-dose β-blocker reduced HR and improved the IQ of CCTA in a few segments, even at a HR of less than 65 bpm. However the effect was limited.

Prognostic value of myocardial perfusion SPECT versus exercise electrocardiography in patients with ST-segment depression on resting electrocardiography.

Science.gov (United States)

De Lorenzo, Andrea; Hachamovitch, Rory; Kang, Xingping; Gransar, Heidi; Sciammarella, Maria G; Hayes, Sean W; Friedman, John D; Cohen, Ishac; Germano, Guido; Berman, Daniel S

2005-01-01

The value of exercise-induced ST-segment depression for the prognostic evaluation of patients with 1 mm of ST depression or greater on the resting electrocardiogram is controversial. Patients who underwent exercise myocardial perfusion single photon emission computed tomography (MPS) and had resting ST depression of 1 mm or greater with a nondiagnostic exercise electrocardiographic response (n = 1122) were followed up for 3.4 +/- 2.3 years. Those with paced rhythm, pre-excitation, left bundle branch block, or myocardial revascularization within the first 60 days after MPS were excluded. Additional exercise-induced ST-segment depression was considered significant if > or = 2 mm MPS was scored semiquantitatively by use of a 20-segment model of the left ventricle; the percentage of myocardium involved with stress defects (% myo) was derived by normalizing to the maximal possible score of 80. Hard events were defined as nonfatal myocardial infarction or cardiac death. A Cox analysis was used to determine independent predictors of hard events among clinical, exercise, and nuclear variables. Hard event rates increased as a function of % myo for either patients with exercise-induced ST depression (1.4%/y for normal MPS vs 4.1%/y for % myo >10%, P 10%, P = .0001). Age, diabetes mellitus, shortness of breath as the presenting symptom, and % myo were independent predictors of hard events. Exercise-induced ST depression was predictive of hard events only when it was 3 mm or greater. The presence and extent of perfusion defects, reflected in the % myo, had incremental prognostic value over clinical variables and also over all degrees of exercise-induced ST depression. Although MPS effectively risk-stratifies patients with resting ST depression of 1 mm or greater, the prognostic value of exercise-induced ST depression is limited in these patients, with a small added risk when severe (> or = 3 mm).

Bayesian comparison of cost-effectiveness of different clinical approaches to diagnose coronary artery disease

International Nuclear Information System (INIS)

Patterson, R.E.; Eng, C.; Horowitz, S.F.; Gorlin, R.; Goldstein, S.R.

1984-01-01

The objective of this study was to compare the cost-effectiveness of four clinical policies (policies I to IV) in the diagnosis of the presence or absence of coronary artery disease. A model based on Bayes theorem and published clinical data was constructed to make these comparisons. Effectiveness was defined as either the number of patients with coronary disease diagnosed or as the number of quality-adjusted life years extended by therapy after the diagnosis of coronary disease. The following conclusions arise strictly from analysis of the model and may not necessarily be applicable to all situations. As prevalence of coronary disease in the population increased, it caused a linear increase in cost per patient tested, but a hyperbolic decrease in cost per effect, that is, increased cost-effectiveness. Thus, cost-effectiveness of all policies (I to IV) was poor in populations with a prevalence of disease below 10%. Analysis of the model also indicates that at prevalences less than 80%, exercise thallium scintigraphy alone as a first test (policy II) is a more cost-effective initial test than is exercise electrocardiography alone as a first test (policy I) or exercise electrocardiography first combined with thallium imaging as a second test (policy IV). Exercise electrocardiography before thallium imaging (policy IV) is more cost-effective than exercise electrocardiography alone (policy I) at prevalences less than 80%. 4) Noninvasive exercise testing before angiography (policies I, II and IV) is more cost-effective than using coronary angiography as the first and only test (policy III) at prevalences less than 80%. 5) Above a threshold value of prevalence of 80% (for example patients with typical angina), proceeding to angiography as the first test (policy III) was more cost-effective than initial noninvasive exercise tests (policies I, II and IV)

Screening for Coronary Heart Disease with Electrocardiography

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... resting and completely still or while you are exercising. ECG is used to see whether the heart is beating and functioning normally. Potential Benefits and Harms The Task Force reviewed evidence to ...

Cardiac findings in 31 patients with Noonan's syndrome

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Bertola Débora Romeo

2000-01-01

Full Text Available OBJECTIVE: To evaluate cardiac findings in 31 Noonan syndrome patients. METHODS: Thirty-one (18 males and 13 femalespatients from 26 families affected with Noonan's syndrome were evaluated from the cardiac point of view with electrocardiography and echodopplercardiography. RESULTS: Twenty patients had some type of cardiac abnormality. The most frequent was pulmonary valve stenosis followed by hypertrophic myocardiopathy, commonly associated with valve defects. Upper deviation of the QRS axis was observed in 80% of these patients. CONCLUSION: In view of the high frequency and diversity of cardiac abnormalities present in Noonan syndrome, cardiac evaluation with electrocardiography and echocardiography should be performed in all patients diagnostically suspected of having this disease.

Wavelets and Multifractal Analysis

National Research Council Canada - National Science Library

Teich, Malvin C; Lowen, B; Jost, Bradley M; Vibe-Rheymer, Karin; Heneghan, Conor

2004-01-01

.... Because the electrical activity of the human heart is influenced by many physiological mechanisms, electrocardiography has become an invaluable tool for the diagnosis of a variety of pathologies...

An Analysis of Emergency Healthcare Delivery in Ghana: Lessons ...

African Journals Online (AJOL)

Ghana medical emergencies usually result from road traffic accidents, during which ..... electrocardiography, intravenous therapy, administration of medications, drugs and solutions, use of adjunctive medical devices and trauma care.

Efficient ECG Signal Compression Using Adaptive Heart Model

National Research Council Canada - National Science Library

Szilagyi, S

2001-01-01

This paper presents an adaptive, heart-model-based electrocardiography (ECG) compression method. After conventional pre-filtering the waves from the signal are localized and the model's parameters are determined...

Determination of differences in the left ventricular ejection fraction (LVEF) by radionuclides and echocardiography pre and post treatment with anthracycline in pediatric patients with oncology diagnostic of the La Raza Medical Center

International Nuclear Information System (INIS)

Veras R, H.

2003-01-01

The objective of this work was to correlate the left ventricular ejection fraction determine by radionuclide angiocardiography and echocardiography in pediatric patients under anthracycline treatment. Material and methods: 41 patients were studied with range age from 3 to 14 years, with oncology diagnostic that were treated with anthracycline. Radionuclide angiocardiography and echocardiography were performed before an after anthracycline administration to determine the changes in the Ieft ventricular ejection fraction. Results: Anthracycline treatment caused no changes in the electrocardiography, echocardiogram and radionuclide angiocardiography. Conclusions: In our study anthracycline treatment caused no changes in the electrocardiography, echocardiography and both radionuclide angiocardiography techniques, first-pass and equilibrium. A high correlation was obtaining when left ventricular ejection fraction is compared between radionuclide angiocardiography and echocardiogram. (Author)

Stop the Noise: A Quality Improvement Project to Decrease Electrocardiographic Nuisance Alarms.

Science.gov (United States)

Sendelbach, Sue; Wahl, Sharon; Anthony, Anita; Shotts, Pam

2015-08-01

As many as 99% of alarm signals may not need any intervention and can result in patients' deaths. Alarm management is now a Joint Commission National Patient Safety Goal. To reduce the number of nuisance electrocardiographic alarm signals in adult patients on the medical cardiovascular care unit. A quality improvement process was used that included eliminating duplicative alarms, customizing alarms, changing electrocardiography electrodes daily, standardizing skin preparation, and using disposable electrocardiography leads. In the cardiovascular care unit, the mean number of electrocardiographic alarm signals per day decreased from 28.5 (baseline) to 3.29, an 88.5% reduction. Use of a bundled approach to managing alarm signals decreased the mean number of alarm signals in a cardiovascular care unit. ©2015 American Association of Critical-Care Nurses.

Analysis of Pre-participation Screening Protocols for Football Players in Europe, USA, and Libya: Possible Implications for Preventing Sudden Cardiac Death

Directory of Open Access Journals (Sweden)

Salaheddin Sharif

2017-06-01

Full Text Available Sudden cardiac death is the leading cause of death in sport participants and may result from undiagnosed cardiac diseases. It has been universally agreed upon that pre-participation screening can identify those athletes at risk of sudden cardiac death, and yet, there is no commonly accepted protocol to screen athletes. Although the European Society of Cardiology (ESC and the American Heart Association (AHA recommend the routine screening of athletes to prevent sudden death, there is significant disagreement regarding the guidelines of the protocols. The American Heart Association protocol includes a detailed medical history and a physical examination, whereas the European Society of Cardiology protocol includes 12-lead electrocardiography with a detailed medical history and a physical examination. The cost benefit of using electrocardiography is debatable, particularly if the screening is used to prevent sudden death associated with uncommon diseases. The Libyan Football Federation established a new seasonal pre-competition medical assessment protocol for Libyan football athletes during the 2013-2014 season, which includes a medical history, physical examination, 12 lead electrocardiography, echocardiography, and blood test. Regardless of cost and differences in protocol, there is a significant value in pre-participation screening for athletes in order to decrease the incidence of sudden cardiac death, and this report examines some of these different protocols as well as their potential for identifying athletes at risk for sudden cardiac death.

Neurophenomenology: an integrated approach to exploring awe ...

African Journals Online (AJOL)

We employed questionnaires from psychology, electroencephalography, electrocardiography, and functional near-infrared spectroscopy from neuroscience, and a phenomenological interview technique from philosophy. This neurophenomenological method enabled extensive insight in experiencers and non-experiencers ...

Detection of cardiac magnetic fields (magnetocardiography)

International Nuclear Information System (INIS)

Ribeiro, P.C.

1985-01-01

A brief comment about the biological event of mechanical heart is presented. A comparative evaluation between electrocardiography and magnetocardiography is do done and this last method is described shortly. (M.A.C.) [pt

Atrial fibrillation in the dog: a review of eight cases

International Nuclear Information System (INIS)

Thomas, R.E.

1984-01-01

Eight cases of canine atrial fibrillation encountered in small animal practice are reported. Details are included of age, sex and breed, history and clinical signs, thoracic radiography, electrocardiography, clinical pathology, treatment and survival periods

Extracardiac versus cardiac haemocoelic pulsations in pupae of the mealworm (Tenebrio molitor L.)

Czech Academy of Sciences Publication Activity Database

Sláma, Karel

2000-01-01

Roč. 46, - (2000), s. 977-992 ISSN 0022-1910 Institutional research plan: CEZ:AV0Z5007907 Keywords : haemolymph pressure * electrocardiography * pressure transducers Subject RIV: ED - Physiology Impact factor: 1.468, year: 2000

Atrial fibrillation in the dog: a review of eight cases

Energy Technology Data Exchange (ETDEWEB)

Thomas, R. E. [Vet. Hospital, 34 New Dover Rd, Canterbury, Kent (United Kingdom)

1984-07-01

Eight cases of canine atrial fibrillation encountered in small animal practice are reported. Details are included of age, sex and breed, history and clinical signs, thoracic radiography, electrocardiography, clinical pathology, treatment and survival periods.

Delirium

Science.gov (United States)

... seizure disorder. Electrocardiography (ECG), pulse oximetry (using a sensor that measures oxygen levels in the blood), and ... electrolytes given intravenously, and delirium due to stopping alcohol with benzodiazepines (as well as measures to help ...

Heart Rate Variability in Cavalier King Charles Spaniels with Different Degree of Myxomatous Mitral Valve Disease

DEFF Research Database (Denmark)

Rasmussen, Caroline Elisabeth; Falk, Bo Torkel; Zois, Nora Elisabeth

2010-01-01

Sciences, University of Copenhagen, Frederiksberg, Denmark, 2Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden; and 3Novo Nordic A/S, Maaloev, Denmark. Introduction: Modulation of heart rate by the autonomic nervous system can indirectly be measured by heart rate...... variability (HRV). Reduced HRV is seen in dogs with heart failure secondary to myxomatous mitral valve disease (MMVD). However, HRV is suggested to increase with disease progression in dogs with early stages of MMVD. Comparable results are found in people with primary mitral valve prolapse, a disease...... resembling canine MMVD. Aim: To associate progression of MMVD in dogs with time and frequency domain HRV, analysed from 24-hour electrocardiography. Materials and Methods: Eighty-one Cavalier King Charles Spaniels (CKCS) were examined by echocardiography and 24-hour electrocardiography. CKCS were divided...

An innovative non-intrusive driver assistance system for vital signal monitoring.

NARCIS (Netherlands)

Sun, Y. & Yu, X.

2016-01-01

This paper describes an in-vehicle nonintrusive biopotential measurement system for driver health monitoring and fatigue detection. Previous research has found that the physiological signals including eye features, electrocardiography (ECG), electroencephalography (EEG) and their secondary

Single Doses up to 800 mg of E-52862 Do Not Prolong the QTc Interval--A Retrospective Validation by Pharmacokinetic-Pharmacodynamic Modelling of Electrocardiography Data Utilising the Effects of a Meal on QTc to Demonstrate ECG Assay Sensitivity.

Science.gov (United States)

Täubel, Jörg; Ferber, Georg; Lorch, Ulrike; Wang, Duolao; Sust, Mariano; Camm, A John

2015-01-01

E-52862 is a Sigma-1 receptor antagonist (S1RA) currently under investigation as a potential analgesic medicine. We successfully applied a concentration-effect model retrospectively to a four-way crossover Phase I single ascending dose study and utilized the QTc shortening effects of a meal to demonstrate assay sensitivity by establishing the time course effects from baseline in all four periods, independently from any potential drug effects. Thirty two healthy male and female subjects were included in four treatment periods to receive single ascending doses of 500 mg, 600 mg or 800 mg of E-52862 or placebo. PK was linear over the dose range investigated and doses up to 600 mg were well tolerated. The baseline electrocardiography (ECG) measurements on Day-1 were time-matched with ECG and pharmacokinetic (PK) samples on Day 1 (dosing day). In this conventional mean change to time-matched placebo analysis, the largest time-matched difference to placebo QTcI was 1.44 ms (90% CI: -4.04, 6.93 ms) for 500 mg; -0.39 ms (90% CI: -3.91, 3.13 ms) for 600 mg and 1.32 ms (90% CI: -1.89, 4.53 ms) for 800 mg of E-52862, thereby showing the absence of any QTc prolonging effect at the doses tested. In addition concentration-effect models, one based on the placebo corrected change from baseline and one for the change of QTcI from average baseline with time as fixed effect were fitted to the data confirming the results of the time course analysis. The sensitivity of this study to detect small changes in the QTc interval was confirmed by demonstrating a shortening of QTcF of -8.1 (90% CI: -10.4, -5.9) one hour and -7.2 (90% CI: -9.4, -5.0) three hours after a standardised meal. EU Clinical Trials Register EudraCT 2010 020343 13.

Digitalis toxicity

Science.gov (United States)

... Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 152. Goldberger AL, Goldberger ZD, ... Electrocardiography: A Simplified Approach . 8th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 18. Nelson LS, Ford MD. ...

Is community-based electrocardiography education feasible in the ...

African Journals Online (AJOL)

Carol Olivia Larson

Accreditation authorities expect medical schools to increase their teaching standards and civic engagement, despite .... cation (in various contexts), and proficiency. ... the outer circle (such as self-confidence, time management and initiative) ...

Coronary heart disease index based on longitudinal electrocardiography

Science.gov (United States)

Townsend, J. C.; Cronin, J. P.

1977-01-01

A coronary heart disease index was developed from longitudinal ECG (LCG) tracings to serve as a cardiac health measure in studies of working and, essentially, asymptomatic populations, such as pilots and executives. For a given subject, the index consisted of a composite score based on the presence of LCG aberrations and weighted values previously assigned to them. The index was validated by correlating it with the known presence or absence of CHD as determined by a complete physical examination, including treadmill, resting ECG, and risk factor information. The validating sample consisted of 111 subjects drawn by a stratified-random procedure from 5000 available case histories. The CHD index was found to be significantly more valid as a sole indicator of CHD than the LCG without the use of the index. The index consistently produced higher validity coefficients in identifying CHD than did treadmill testing, resting ECG, or risk factor analysis.

Freeware eLearning Flash-ECG for learning electrocardiography.

Science.gov (United States)

Romanov, Kalle; Kuusi, Timo

2009-06-01

Electrocardiographic (ECG) analysis can be taught in eLearning programmes with suitable software that permits the effective use of basic tools such as a ruler and a magnifier, required for measurements. The Flash-ECG (Research & Development Unit for Medical Education, University of Helsinki, Finland) was developed to enable teachers and students to use scanned and archived ECGs on computer screens and classroom projectors. The software requires only a standard web browser with a Flash plug-in and can be integrated with learning environments (Blackboard/WebCT, Moodle). The Flash-ECG is freeware and is available to medical teachers worldwide.

A medical-grade wireless architecture for remote electrocardiography.

Science.gov (United States)

Kang, Kyungtae; Park, Kyung-Joon; Song, Jae-Jin; Yoon, Chang-Hwan; Sha, Lui

2011-03-01

In telecardiology, electrocardiogram (ECG) signals from a patient are acquired by sensors and transmitted in real time to medical personnel across a wireless network. The use of IEEE 802.11 wireless LANs (WLANs), which are already deployed in many hospitals, can provide ubiquitous connectivity and thus allow cardiology patients greater mobility. However, engineering issues, including the error-prone nature of wireless channels and the unpredictable delay and jitter due to the nondeterministic nature of access to the wireless medium, need to be addressed before telecardiology can be safely realized. We propose a medical-grade WLAN architecture for remote ECG monitoring, which employs the point-coordination function (PCF) for medium access control and Reed-Solomon coding for error control. Realistic simulations with uncompressed two-lead ECG data from the MIT-BIH arrhythmia database demonstrate reliable wireless ECG monitoring; the reliability of ECG transmission exceeds 99.99% with the initial buffering delay of only 2.4 s.

About Arrhythmia

Science.gov (United States)

... heart beats 60 to 100 times a minute. Electrocardiography (ECG or EKG) is a painless, non-invasive procedure that records ... patient sheets Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

Children's (Pediatric) Magnetic Resonance Imaging

Medline Plus

Full Text Available ... six weeks) before being safe for MRI examinations. Examples include but are not limited to: artificial heart ... electrocardiography (ECG). MRI typically costs more and may take more time to perform than other imaging modalities. ...

Magnetic Resonance Imaging (MRI) -- Head

Medline Plus

Full Text Available ... tissue from which they come. The MR scanner captures this energy and creates a picture of the ... imaging based on the electrical activity of the heart, such as electrocardiography (EKG). MRI generally is not ...

How to diagnose cardiac tamponade

NARCIS (Netherlands)

van Steijn, JHM; Sleijfer, DT; van der Graaf, WTA; van der Sluis, A; Nieboer, P

Malignant pericardial effusion is a potentially fatal complication of malignancy unless recognised and treated promptly. Patients with this condition are often difficult to diagnose. Physical examination, chest radiography and electrocardiography have poor diagnostic values in identification of

Magnetic Resonance Imaging (MRI) -- Head

Medline Plus

Full Text Available ... used in tattoos may contain iron and could heat up during an MRI scan, but this is ... imaging based on the electrical activity of the heart, such as electrocardiography (EKG). MRI generally is not ...

Magnetic Resonance Imaging (MRI) -- Head

Medline Plus

Full Text Available ... Examples include but are not limited to: artificial heart valves implanted drug infusion ports artificial limbs or ... imaging based on the electrical activity of the heart, such as electrocardiography (EKG). MRI generally is not ...

Children's (Pediatric) Magnetic Resonance Imaging

Medline Plus

Full Text Available ... MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help ... the heart, such as electrocardiography (ECG). MRI typically costs more and may take more time to perform ...

Children's (Pediatric) Magnetic Resonance Imaging

Medline Plus

Full Text Available ... MRI examination poses almost no risk to the average patient when appropriate safety guidelines are followed. If ... the heart, such as electrocardiography (ECG). MRI typically costs more and may take more time to perform ...

Children's (Pediatric) Magnetic Resonance Imaging

Medline Plus

Full Text Available ... the heart, such as electrocardiography (ECG). MRI typically costs more and may take more time to perform ... accredited facilities database . This website does not provide cost information. The costs for specific medical imaging tests, ...

Thallium-201 scintigraphy in diagnosis of coronary stenosis

International Nuclear Information System (INIS)

Corne, R.A.; Gotsman, M.S.; Weiss, A.; Enlander, D.; Samuels, L.D.; Salomon, J.A.; Warshaw, B.; Atlan, H.

1979-01-01

The sensitivity of rest and exercise thallium-201 scintigraphy for the detection of significant coronary artery disease and myocardial ischaemia was compared with rest and exercise electrocardiography in 46 patients with chest pain. Of 26 patients with greater that 70 per cent coronary stenosis, 16 had abnormal rest thallium-201 scintigrams and 13 had Q waves. Myocardial perfusion defects in the resting scintigram correlated very well with evidence of previous myocardial infarction (16 of 17 patients, 94%) significant Q waves were present in 13 of these 17 patients (76%). After exercise, abnormal thallium-201 scintigrams consistent with ischaemia were found in 21 patients (81%). Abnormal exercise electrocardiograms were present in 15 patients (58%). The combination of abnormal exercise thallium-201 scintigrams or exercise electrocardiograms (23/26, 88%) exceeded abnormal exercise electrocardiograms alone (15/26, 58%). The two procedures were thus complementary. Abnormal rest or exercise thallium-201 scintigrams were obtained in 25/26 patients (96%) compared with abnormal rest or exercise electrocardiograms in 21/26 patients (84%). Twenty patients with less than 50 per cent coronary stenosis had normal rest thallium-201 scintigrams and no Q waves. Two had abnormal exercise thallium-201 scintigrams and 7 had abnormal exercise electrocardiograms. Thus,exercise thallium scintigraphy has higher sensitivity than exercise electrocardiography in detecting exercise induced ischaemia and is more specific. Scintigraphy appears to have a higher sensitivity than electrocardiography in detecting coronary artery disease. (author)

Impact of fasting glucose on electrocardiographic left ventricular hypertrophy in an elderly general population

DEFF Research Database (Denmark)

Diederichsen, Søren Z; Pareek, Manan; Nielsen, Mette L

2015-01-01

OBJECTIVE: To evaluate relationships between fasting plasma glucose (FPG), other cardiovascular risk markers and left ventricular hypertrophy (LVH) as detected by electrocardiography. METHODS: Subjects were selected randomly from groups defined by FPG. Traditional risk markers were assessed. LVH...

Estimation of lung volume and pressure from electrocardiogram

KAUST Repository

Elsayed, Gamal Eldin Fathy Amin; Kosel, Jü rgen; Kaniušas, Eugenijus; Traxler, Stefan

2011-01-01

The Electrocardiography (ECG) is a tool measuring the electrical excitation of the heart that is extensively used for diagnosis and monitoring of heart diseases. The ECG signal reflects not only the heart activity but also many other physiological

Electrocardiographic Characteristics of Patients with Chronic Obstructive Pulmonary Disease

NARCIS (Netherlands)

Warnier, M.J.; Rutten, F.H.; Numans, M.E.; Kors, J.A.; Tan, H.L.; de Boer, A.; Hoes, A.W.; de Bruin, M.L.

2013-01-01

Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease. Electrocardiography (ECG) carries information about cardiac disease and prognosis, but studies comparing ECG characteristics between patients with and without COPD are lacking. We related ECG

Continuous electrocardiogram reveals differenced in the short-term cardiotoxic response of Wistar-Kyoto and spontaneously hypertensive rats to doxorubicin

Science.gov (United States)

Electrocardiography (ECG) is one of the standard technologies used to monitor and assess cardiac function, and provide insight into the mechanisms driving myocardial pathology. Increased understanding of the effects of cardiovascular disease on rat ECG may help make ECG assessmen...

Polymorfe ventriculaire tachycardie met torsades de pointes bij gebruik van terodiline (Mictrol)

NARCIS (Netherlands)

van der Klauw, M M; van Rey, F J; Stricker, B H

1992-01-01

A 63-year-old female was admitted to the hospital because of collapse. She had no history of cardiovascular disease. Prior to admission she used co-trimoxazole, paracetamol, calcium tablets and 50 mg terodiline (Mictrol) daily because of bladder instability. Electrocardiography showed QT

Electrocardiographic left ventricular hypertrophy in GUSTO IV ACS: an important risk marker of mortality in women

DEFF Research Database (Denmark)

Westerhout, Cynthia M; Lauer, Michael S; Fu, Yuling

2007-01-01

AIM: To examine the association of left ventricular hypertrophy (LVH) on admission electrocardiography with adverse outcomes in acute coronary syndrome (ACS) patients. METHODS AND RESULTS: A total of 7443 non-ST-elevation ACS patients in Global Utilization of STrategies to Open occluded arteries ...

Design of wireless sensor system for neonatal monitoring

NARCIS (Netherlands)

Chen, W.; Nguyen, S.T.; Bouwstra, S.; Coops, R.; Brown, L.; Bambang Oetomo, S.; Feijs, L.M.G.

2011-01-01

In this paper, we present the application of wireless sensor technology and the advantages it will inherently have for neonatal care and monitoring at Neonatal Intensive Care Units (NICU). An electrocardiography (ECG) readout board and a wireless transceiver module developed by IMEC at the Holst

Congenital heart disease in the dog

International Nuclear Information System (INIS)

Matic, S.E.

1988-01-01

The clinical findings and investigation of dogs with congenital cardiac disease is described and the role of diagnostic aids including radiography, electrocardiography and echocardiography is outlined. The physical findings, prognosis and therapy of the common defects are reviewed and their aetiology is briefly discussed

Download this PDF file

African Journals Online (AJOL)

raoul

2012-01-14

Jan 14, 2012 ... blood pressure ≥ 140/90 mmHg were excluded. Electrocardiography (ECG) and echocardiogram were done in standard positions. ... in the participants was taken and anthropometric parameters, blood pressure and other ..... Left ventricular mass and exercise responses predict future blood pressure The.

Reliability of Computer Analysis of Electrocardiograms (ECG) of ...

African Journals Online (AJOL)

Background: Computer programmes have been introduced to electrocardiography (ECG) with most physicians in Africa depending on computer interpretation of ECG. This study was undertaken to evaluate the reliability of computer interpretation of the 12-Lead ECG in the Black race. Methodology: Using the SCHILLER ...

High distress in parents whose children undergo predictive testing for long QT syndrome

NARCIS (Netherlands)

Grosfeld, FJM; Wilde, AAM; van den Bout, J; van Langen, IM; van Tintelen, JP; ten Kroode, HFJ

2005-01-01

Objectives: To assess the psychological effect of predictive testing in parents of children at risk for long QT syndrome (LQTS) in a prospective study. Methods: After their child was clinically screened by electrocardiography and blood was taken for DNA analysis, and shortly after delivery of the

Criteria for intraventricular conduction disturbances and pre-excitation

NARCIS (Netherlands)

Willems, J.L.; Robles de Medina, E.O.; Bernard, R.; Coumel, Ph.; Fisch, Ch.; Mazur, N.A.; Meijler, F.L.; Mogensen, L.; Moret, P.; Pisa, Z.; Rautaharju, P.M.; Surawicz, B.; Watanabe, Y.; Wellens, H.J.J.; WHO/ISFC Task Force ad hoc

1985-01-01

In an effort to standardize terminology and criteria for clinical electrocardiography, and as a follow-up of its work on definitions of terms related to cardiac rhythm, an Ad Hoc Working Group established by the World Health Organization and the International Society and Federation of Cardiology

High frame rate retrospectively triggered Cine MRI for assessment of murine diastolic function

NARCIS (Netherlands)

Coolen, Bram F.; Abdurrachim, Desiree; Motaal, Abdallah G.; Nicolay, Klaas; Prompers, Jeanine J.; Strijkers, Gustav J.

2013-01-01

To assess left ventricular (LV) diastolic function in mice with Cine MRI, a high frame rate (>60 frames per cardiac cycle) is required. For conventional electrocardiography-triggered Cine MRI, the frame rate is inversely proportional to the pulse repetition time (TR). However, TR cannot be lowered

Systolic blood pressure estimation using PPG and ECG during physical exercise

NARCIS (Netherlands)

Sun, S.; Bezemer, R.; Long, X.; Muehlsteff, J.; Aarts, R.M.

2016-01-01

In this work, a model to estimate systolic blood pressure (SBP) using photoplethysmography (PPG) and electrocardiography (ECG) is proposed. Data from 19 subjects doing a 40 min exercise was analyzed. Reference SBP was measured at the finger based on the volume-clamp principle. PPG signals were

Comparison of exercise stress testing with dobutamine stress echocardiography and exercise technetium-99m isonitrile single photon emission computerized tomography for diagnosis of coronary artery disease

International Nuclear Information System (INIS)

Oguzhan, A.; Kisacik, H.L.; Ozdemir, K.

1997-01-01

To compare the value of exercise electrocardiography with dobutamine stress echocardiography and exercise technetium-99m isonitrile single-photon emission computed tomography for coronary artery disease, 70 patients with either suspected or proven coronary artery disease underwent dobutamine stress echocardiography, exercise technetium-99m isonitrile single-photon emission computed tomography (mibi-SPECT) and treadmill exercise electrocardiography (ECG). Dobutamine echocardiography and exercise mibi-SPECT revealed a higher overall sensitivity than exercise testing (90 vs 57%, p 0.05; 90 and 62% p<0.05, respectively) but the difference between dobutamine stress echocardiography and exercise mibi-SPECT was not statistically significant. Diagnostic accuracy of dobutamine stress echocardiography and exercise mibi-SPECT was higher than that of exercise testing (90 vs 59%, p<0.001; 89 vs 59%, p<0.001, respectively). Dobutamine stress echocardiography and exercise mibi-SPECT have superiority over exercise testing in the diagnosis of coronary artery disease and dobutamine stress echocardiography is an alternative for exercise mibi-SPECT. (author)

Automated Epileptic Seizure Detection Based on Wearable ECG and PPG in a Hospital Environment.

Science.gov (United States)

Vandecasteele, Kaat; De Cooman, Thomas; Gu, Ying; Cleeren, Evy; Claes, Kasper; Paesschen, Wim Van; Huffel, Sabine Van; Hunyadi, Borbála

2017-10-13

Electrocardiography has added value to automatically detect seizures in temporal lobe epilepsy (TLE) patients. The wired hospital system is not suited for a long-term seizure detection system at home. To address this need, the performance of two wearable devices, based on electrocardiography (ECG) and photoplethysmography (PPG), are compared with hospital ECG using an existing seizure detection algorithm. This algorithm classifies the seizures on the basis of heart rate features, extracted from the heart rate increase. The algorithm was applied to recordings of 11 patients in a hospital setting with 701 h capturing 47 (fronto-)temporal lobe seizures. The sensitivities of the hospital system, the wearable ECG device and the wearable PPG device were respectively 57%, 70% and 32%, with corresponding false alarms per hour of 1.92, 2.11 and 1.80. Whereas seizure detection performance using the wrist-worn PPG device was considerably lower, the performance using the wearable ECG is proven to be similar to that of the hospital ECG.

Misdiagnosis of Bland-White-Garland Syndrome: Report of Two Cases with Different Presentations

Directory of Open Access Journals (Sweden)

Akbar Molaei

2014-03-01

Full Text Available Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA or Bland-White-Garland syndrome is usually an isolated cardiac anomaly but, in rare incidences, has been described with patent ductus arteriosus, ventricular septal defect, and tetralogy of Fallot. This syndrome may cause sudden death in infants and young people but in this case report we present two different types of presentation. First case was a 3 year old girl diagnosed with dilated cardiomyopathy since her infancy. Her electrocardiography showed prominent Q wave in lateral leads. Dilated right coronary artery was revealed by echocardiography. The second case was a girl with prolapsed mitral valve and chest pain but similar to first case she had prominent Q wave in lateral leads at her electrocardiography and dilated right coronary artery but without heart failure. ALCAPA in children may present with ambiguous presentations differing from dilated cardiomyopathy and full blown heart failure to an atypical chest pain attributed to prolapsed mitral valve.

Automated Epileptic Seizure Detection Based on Wearable ECG and PPG in a Hospital Environment

Directory of Open Access Journals (Sweden)

Kaat Vandecasteele

2017-10-01

Full Text Available Electrocardiography has added value to automatically detect seizures in temporal lobe epilepsy (TLE patients. The wired hospital system is not suited for a long-term seizure detection system at home. To address this need, the performance of two wearable devices, based on electrocardiography (ECG and photoplethysmography (PPG, are compared with hospital ECG using an existing seizure detection algorithm. This algorithm classifies the seizures on the basis of heart rate features, extracted from the heart rate increase. The algorithm was applied to recordings of 11 patients in a hospital setting with 701 h capturing 47 (fronto-temporal lobe seizures. The sensitivities of the hospital system, the wearable ECG device and the wearable PPG device were respectively 57%, 70% and 32%, with corresponding false alarms per hour of 1.92, 2.11 and 1.80. Whereas seizure detection performance using the wrist-worn PPG device was considerably lower, the performance using the wearable ECG is proven to be similar to that of the hospital ECG.

Biomedical engineering tasks. [electrode development for electrocardiography and electroencephalography

Science.gov (United States)

1972-01-01

Electrocardiographic and vectorcardiographic bioinstrumentation work centered on the development of a new electrode system harness for Project Skylab. Evaluation of several silver electrode configurations proved superior impedance voltage performance for silver/silver chloride electrodes mounted flush by using a paste adhesive. A portable ECG processor has been designed and a breadboard unit has been built to sample ECG input data at a rate of 500 samples per second for arrhythmia detection. A small real time display driver program has been developed for statistical analysis on selected QPS features. Engineering work on a sleep monitoring cap assembly continued.

Advanced Electrocardiography Can Identify Occult Cardiomyopathy in Doberman Pinschers

Science.gov (United States)

Spiljak, M.; Petric, A. Domanjko; Wilberg, M.; Olsen, L. H.; Stepancic, A.; Schlegel, T. T.; Starc, V.

2011-01-01

Recently, multiple advanced resting electrocardiographic (A-ECG) techniques have improved the diagnostic value of short-duration ECG in detection of dilated cardiomyopathy (DCM) in humans. This study investigated whether 12-lead A-ECG recordings could accurately identify the occult phase of DCM in dogs. Short-duration (3-5 min) high-fidelity 12-lead ECG recordings were obtained from 31 privately-owned, clinically healthy Doberman Pinschers (5.4 +/- 1.7 years, 11/20 males/females). Dogs were divided into 2 groups: 1) 19 healthy dogs with normal echocardiographic M-mode measurements: left ventricular internal diameter in diastole (LVIDd . 47mm) and in systole (LVIDs . 38mm) and normal 24-hour ECG recordings (100 VPCs/24h; 1/12 dogs had only abnormal 24-hour ECG recordings (>100 VPCs/24h). ECG recordings were evaluated via custom software programs to calculate multiple parameters of high-frequency (HF) QRS ECG, heart rate variability, QT variability, waveform complexity and 3-D ECG. Student's t-tests determined 19 ECG parameters that were significantly different (P canine DCM as five selected ECG parameters can with reasonable accuracy identify occult DCM in Doberman Pinschers. Future extensive clinical studies need to clarify if 12-lead A-ECG could be useful as an additional screening test for canine DCM.

Electrocardiography and serum potassium before and after hemodialysis sessions

International Nuclear Information System (INIS)

Tarif, N.; Al-Wakeel, Jamal Saleh; Sulaimani, F.; Memon, Nawaz Ali; Al-Suwaida, Abdul Kareem; Yamani, H.; Bakhsh, Ahmed Jahangir

2008-01-01

This study was undertaken to assess potassium level and electrocardiographic (ECG) changes post hemodialysis and whether fall in potassium level during hemodialysis may potentiate cardiac arrythemia. We studied 21 chronic hemodialysis (HD) patients who had their serum electrolytes measured before and after dialysis session and ECG performed at the same time. The patients included 14 females and 7 males with a mean age of 53.1+-15.6 years and range from 26 to 81 years; 9 (43%) patients were diabetics. All the patients had been on dialysis for a minimum of 6 months each Pre-HD serum potassium levels had no correlation with any ECG parameters except a negative correlation with T wave amplitude r=-0.5, p=0.021. ECG parameters significantly changed post-HD; the T wave amplitude decreased and the R wave amplitude increased. A comparatively higher R wave significantly decreased the T to R wave ratio post dialysis. The QRS duration and QTc interval also increased significantly. The patients with post-HD serum potassium of 3.5 mmol/L had a higher R wave amplitude and a significantly less T to R wave ratio (11.8+-9.7 vs 6.4+-5.1, p=0.045 and 0.4+-0.38 vs 1.0+-0.97, p=0.049, respectively. In patients with serum potassium decrement of >2.0 mmol/L, the T to R wave ratio decreased significantly, 0.32+-0.21 vs 0.85+-0.26, p=0.023; The T wave amplitude decreased more than the rise in R wave. Multiple regression analysis did not reveal any relationship of pre or post HD ECG changes and serum potassium, serum calcium or net change in serum potassium post-HD. We conclude that post-HD serum potassium decrement results in a decrease in T to R wave ratio on ECG; this change may have an arrhythmogenic potential. (author)

Technetium-99m sestamibi myocardial tomography based on dipyridamole echocardiography testing in hypertensive patients with chest pain

Energy Technology Data Exchange (ETDEWEB)

Schillaci, O. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy); Moroni, C. [Department of Internal Medicine, University ``La Sapienza``, Rome (Italy); Scopinaro, F. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy); Tavolaro, R. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy); Danieli, R. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy); Bossini, A. [Department of Internal Medicine, University ``La Sapienza``, Rome (Italy); Cassone, R. [Department of Internal Medicine, University ``La Sapienza``, Rome (Italy); Colella, A.C. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy)

1997-07-01

The aim of this study was to evaluate the diagnostic capability of technetium-99m sestamibi tomography based on dipyridamole echocardiography testing in hypertensives with chest pain, and to compare the scintigraphic results with those of coronary angiography, exercise electrocardiography and dipyridamole echocardiography. Forty subjects with mild to moderate hypertension, chest pain and no previous myocardial infarction were submitted to {sup 99m}Tc-sestamibi tomography (at rest and after high-dose dipyridamole echocardiography) and to exercise electrocardiography testing. At coronary angiography 22 patients (group A) had significant epicardial coronary artery disease ({>=}70% stenosis of at least one major vessel) and 18 normal main coronary vessels (group B). Dipyridamole {sup 99m}Tc-sestamibi imaging was positive in 21/22 patients of group A and in 5/18 of group B. Dipyridamole echocardiography was positive in 18/22 patients of group A and in 5/18 of group B. Exercise electrocardiography was positive in 15/22 patients of group A and in 11/18 of group B. Four out of five subjects in group B with positive results in all the tests showed a slow run-off of angiographic contrast medium, probably due to small-vessel disease. Significant epicardial coronary artery disease in hypertensives with chest pain is unlikely when dipyridamole {sup 99m}Tc-sestamibi tomography is negative. When scintigraphy is positive, either epicardial coronary artery disease or a small-vessel disease condition is possible. The association of scintigraphy with dipyridamole echocardiography testing allows the assessment of contractile function and myocardial perfusion by a single pharmacological stress. (orig./AJ). With 3 figs., 2 tabs.

Interactive Videoconference Supported Teaching in Undergraduate Nursing: A Case Study for ECG

Science.gov (United States)

Celikkan, Ufuk; Senuzun, Fisun; Sari, Dilek; Sahin, Yasar Guneri

2013-01-01

This paper describes how interactive videoconference can benefit the Electrocardiography (ECG) skills of undergraduate nursing students. We have implemented a learning system that interactively transfers the visual and practical aspects of ECG from a nursing skills lab into a classroom where the theoretical part of the course is taught. The…

Prenatal diagnosis of long QT syndrome with the superior vena cava-aorta Doppler approach.

Science.gov (United States)

Chabaneix, Julie; Andelfinger, Gregor; Fournier, Anne; Fouron, Jean-Claude; Raboisson, Marie-Josée

2012-10-01

We describe a fetus at 36 weeks with long QT syndrome presenting with variable types of atrioventricular blocks, ventricular premature beats, and torsades de pointes. All these diagnoses were made with the superior vena cava-aorta Doppler approach and confirmed with postnatal electrocardiography. Copyright © 2012 Mosby, Inc. All rights reserved.

Which test for CAD should be used in patients with left bundle branch block?

Science.gov (United States)

Xu, Bo; Cremer, Paul; Jaber, Wael; Moir, Stuart; Harb, Serge C; Rodriguez, L Leonardo

2018-03-01

Exercise stress electrocardiography is unreliable as a test for obstructive coronary artery disease (CAD) if the patient has left bundle branch block. The authors provide an algorithm for using alternative tests: exercise stress echocardiography, dobutamine echocardiography, computed tomographic (CT) angiography, and nuclear myocardial perfusion imaging. Copyright © 2018 Cleveland Clinic.

Clinical manifestation as acute coronary syndrome without electrocardiographically ischemia: a clue for aortic dissection

Directory of Open Access Journals (Sweden)

Hung Yi Chen

2015-06-01

Full Text Available Aortic dissection is a critical condition requiring immediate assessment and management. Clinical presentation is commonly associated with severe chest pain and high blood pressure. However, misdiagnosis is frequent because of various features. We presented a case of 51-year-old woman who complained of dyspnea for 3 d after she experienced back pain for one week. She was presented with severe respiration distress with impending respiration failure on arrival to our hospital. Her chest X-ray showed cardiomegaly with acute pulmonary edema. The laboratory data revealed elevated cardiac enzyme and electrocardiography demonstrated sinus tachycardia. She was hospitalized under the initial diagnosis of acute coronary syndrome. The patient remained hemodynamically stable, and experienced one episode of chest discomfort. After electrocardiography, she was found with bigeminy ventricular premature beats without ST-T change. Follow-up cardiac enzyme demonstrated progressive declined. Cardiac catheterization was performed on the third day of admission, and coronary angiography revealed large intimal flap on aortic root with bilateral coronary artery involvement. Surgical management was arranged after immediate chest computed tomography study.

Application of radionuclide ventriculography to cardiac screening

International Nuclear Information System (INIS)

Lindsay, J. Jr.; Milner, M.R.; Chandeysson, P.L.; Rodman, D.J.; Okin, P.M.; Goldstein, S.A.

1989-01-01

Screening asymptomatic individuals for latent coronary disease often requires sequential testing because exercise electrocardiography typically produces more false positive than true positive results in a population with a low prevalence of coronary disease. Cardiac scintigraphy is a technique that may be employed as a confirmatory test in lieu of coronary arteriography to further evaluate the significance of a positive exercise electrocardiogram. Radionuclide ventriculography was employed in 98 asymptomatic individuals who were considered to be at moderate risk of heart disease after risk factor analysis and exercise electrocardiography. Seventeen (17%) patients had an abnormal study and underwent cardiac catheterization. Seven had coronary artery disease, two had cardiomyopathy, and eight were normal. Eighty-one (83%) patients had a normal study. Because the sensitivity of radionuclide ventriculography is 63-80%, it was postulated that 2 to 5 individuals with disease were missed. Thus, from a population with an 11-14% prevalence of disease, two subsets were identified. A large subset in which a prevalence of 2-6% could be estimated was separated from a much smaller one in which a prevalence of approximately 50% was demonstrated

Differentiating fasciculoventricular pathway from Wolff-Parkinson-White syndrome by electrocardiography.

Science.gov (United States)

Suzuki, Tsugutoshi; Nakamura, Yoshihide; Yoshida, Shuichiro; Yoshida, Yoko; Shintaku, Haruo

2014-04-01

In school-based cardiovascular screening programs in Japan, Wolff-Parkinson-White (WPW) syndrome is diagnosed based on the presence of an electrocardiographic (ECG) delta wave without differentiation from the fasciculoventricular pathway (FVP), although the risk of sudden death is associated only with the former. The purpose of this study was to differentiate FVP patients among children diagnosed with WPW syndrome by ECG. Children who were diagnosed with WPW syndrome through school screening between April 2006 and March 2008 and had QRS width ≤120 ms were included. Patients with asthma and/or coronary heart disease were excluded. FVP and WPW syndrome were differentiated based on ECG responses to adenosine triphosphate (ATP) injection. Age, PR interval, QRS width, and Rosenbaum classification were compared among patients. Thirty patients (median age 12.7 years, range 6.5-15.7 years) participated in the study. FVP was diagnosed in 23 patients (76.7%), and WPW syndrome in 7 (23.3%). In Rosenbaum type A patients, all six patients had WPW syndrome, whereas FVP was diagnosed in 23 of 24 and WPW syndrome was diagnosed in 1 of 24 of type B patients. Age, PR interval, and QRS width were not significantly different between the two conditions. ATP stress test was reliable in differentiating FVP from WPW syndrome. Although FVP is considered rare, the results of our study indicate that many WPW syndrome patients with QRS width ≤120 ms may actually have FVP. Patients categorized as type B are more likely to have FVP, whereas type A patients are most likely to have WPW syndrome. © 2013 Heart Rhythm Society Published by Heart Rhythm Society All rights reserved.

Electrocardiography in Noonan syndrome PTPN11 gene mutation--phenotype characterization.

NARCIS (Netherlands)

Croonen, E.A.; Burgt, I. van der; Kapusta, L.; Draaisma, J.M.T.

2008-01-01

Noonan syndrome is a developmental disorder with distinctive facial features, short stature and cardiac abnormalities. In this cross-sectional study, we evaluated characteristic electrocardiographic (ECG) findings and cardiac abnormalities in 84 patients with Noonan syndrome, 56 (67%) of who were

Twelve-lead electrocardiography in the young: physiologic and pathologic abnormalities.

Science.gov (United States)

Kobza, Richard; Cuculi, Florim; Abächerli, Roger; Toggweiler, Stefan; Suter, Yves; Frey, Franz; Schmid, Johann Jakob; Erne, Paul

2012-12-01

BACKGROUND/ OBJECTIVE: The purpose of the present study was to analyze the prevalence of physiologic and pathologic ECG abnormalities in a cohort of young conscripts that represents the whole young generation of today. ECGs of all Swiss citizens who underwent conscription for the army during a 29-month period were analyzed manually. ECGs of 43,401 conscripts (mean age 19.2 ± 1.1 years) were analyzed; 158 conscripts were female. Incomplete right bundle branch block was found in 5870 (13.5%) and left anterior fascicular block in 360 (0.83%). First-degree AV block was present in 329 (0.8%) and Mobitz type I (Wenckebach) second-degree AV block in 3 (0.01%). Early repolarization was observed in 1035 (2.4%), T-wave inversion in 39 (0.09%), and minor T-wave changes in 182 (0.42%). Brugada-like abnormalities were observed in 6 (0.01%). None of the conscripts had atrial fibrillation or flutter. ECG abnormalities can be found in a relatively large proportion of young individuals. Incomplete right bundle branch block, left fascicular block, and first-degree AV block are the most frequent findings. No conscript presented with atrial fibrillation or flutter. Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

The Evolutionary Development of Echocardiography

Science.gov (United States)

Maleki, Majid; Esmaeilzadeh, Maryam

2012-01-01

Echocardiography is a non-invasive diagnostic technique which provides information on cardiac morphology, function, and hemodynamics. It is the most frequently used cardiovascular diagnostic test only after electrocardiography. In less than five decades, the evolution in this technique has made it the basic part of cardiovascular medicine. Herein, the evolution of various forms of echocardiography is briefly described. PMID:23390327

MANAGEMENT OF HAEMATOLOGICAL PATIENTS TREATED WITHCARDIOTOXIC DRUG

Directory of Open Access Journals (Sweden)

Jure Dolenc

2008-04-01

Predisposing factors to cardiotoxicity should be taken into consideration when dealingwith such pacients. Careful history, clinical examination, electrocardiography, echocardiography and NT-proBNP measurement should be performed prior and at the end of thetreatment with cardiotoxic drugs. Pacients with slightest clinical, laboratory or echocardiographic parameters of developing heart failure should immediately be reffered to a cardiologist to start with appropriate treatment

Arm exercise-thallium imaging testing for the detection of coronary artery disease

International Nuclear Information System (INIS)

Balady, G.J.; Weiner, D.A.; Rothendler, J.A.; Ryan, T.J.

1987-01-01

Patients with lower limb impairment are often unable to undergo a standard bicycle or treadmill test for the evaluation of coronary artery disease. To establish an alternative method of testing, 50 subjects (aged 56 +/- 10 years) performed arm ergometry testing in conjunction with myocardial thallium scintigraphy. All underwent coronary angiography; significant coronary artery disease (greater than or equal to 70% stenosis) in at least one vessel was present in 41 (82%) of the 50 patients. Thallium scintigraphy was found to have an 83% sensitivity and 78% specificity for detecting coronary disease, compared with a sensitivity and specificity of 54% (p less than 0.01) and 67% (p = NS), respectively, for exercise electrocardiography. In the subgroup of 23 patients who had no prior myocardial infarction or left bundle branch block and were not taking digitalis, thallium scintigraphy had a sensitivity of 80% versus 50% for exercise electrocardiography. Scintigraphy yielded a sensitivity of 84, 74 and 90% for one, two and three vessel disease, respectively. Noninvasive arm ergometry exercise-thallium imaging testing appears to be reliable and useful and should be considered in the evaluation of coronary artery disease in patients with lower limb impairment

Significance of exercise-induced ST segment depression in patients with myocardial infarction involving the left circumflex artery. Evaluation by exercise thallium-201 myocardial single photon emission computed tomography

International Nuclear Information System (INIS)

Koitabashi, Norimichi; Toyama, Takuji; Hoshizaki, Hiroshi

2000-01-01

The significance of exercise-induced ST segment depression in patients with left circumflex artery involvement was investigated by comparing exercise electrocardiography with exercise thallium-201 single photon emission computed tomography (Tl-SPECT) and the wall motion estimated by left ventriculography. Tl-SPECT and exercise electrocardiography were simultaneously performed in 51 patients with left circumflex artery involvement (angina pectoris 30, myocardial infarction 21). In patients with myocardial infarction, exercise-induced ST depression was frequently found in the V 2 , V 3 and V 4 leads. In patients with angina pectoris, ST depression was frequently found in the II, III, aV F , V 5 and V 6 leads. There was no obvious difference in the leads of ST depression in patients with myocardial infarction with ischemia and without ischemia on Tl-SPECT images. In patients with myocardial infarction, the lateral wall motion of the infarcted area evaluated by left ventriculography was more significantly impaired in the patients with ST depression than without ST depression (p<0.01). Exercise-induced ST depression in the precordial leads possibly reflects wall motion abnormality rather than ischemia in the lateral infarcted myocardium. (author)

The Quest for Quality Electrocardiographic Recording

Directory of Open Access Journals (Sweden)

Javier García-Niebla

2015-10-01

Full Text Available For correct electrocardiography ECG diagnosis and interpretation, it is important not only to distinguish normal from pathological electrocardiograms, but also to ensure they have been properly recorded. Heden et al, reported that 2% of 11,000 EEGs analyzed showed interchanged electrode placement. Thus, if 300 million ECGs are performed annually in the world, 6 million are erroneously recorded. This figure could even triple if one includes other frequent mistakes, such as vertical displacement of precordial electrodes and the proximal placement of these on the limbs instead of the trunk. Few manuals on electrocardiography have devoted space to warn about the effects of ECG recordings that do not conform to standards, but it seems that this is changing. This issue of the journal contains two interesting articles by Rosen et al., who form part of the research group led by Dr. Adrian Baranchuk, which address the most common mistakes made in daily practice in relation to improper placement of limb and precordial electrodes, as well as tell-tale signs for their detection. In this editorial we will elaborate on certain issues directly related to possible errors on performing an ECG.

A comparative study for the echo cardiographic, radiologic and electrocardiographic presentation of the sport heart hypertrophy

International Nuclear Information System (INIS)

Reinke, A.

1982-01-01

In this work the three most important non-invasive methods - X-ray pictures, electrocardiography and echo cardiography - were compared as to their ability to evaluate the physiological heart enlargement as a result of physical training. Important also was the study of the value of ultrasonic cardiographs. The subjects used were 162 athletes, 36 patients with cardiovascular diseases, and 22 non-athletic control persons. Radiologically the changes in the total size of the heart were determined. For the question of the adapting reaction of the heart because of athletic training the weight-related heart volume is more meaningful than the absolute value. Electrocardiographically it is not possible to come up with any statistically significant statements about the physiological heart enlargement using the Sokoloff-Lyon indexes. Echo cardiographically the regulative heart enlargements can be differentiated into myocardial hypertrophy or ventricular dilation. As a result of this a line can be drawn between physiological and pathological changes. Female athletes show qualitatively, but not quantitatively, the same adapting reaction. The synopsis of the three procedures shows that echo cardiography and radiology show better results than does electrocardiography. Together the methods complement each other in their diagnostic power. (orig./TRV) [de

Running on Empty? The Compensatory Reserve Index

Science.gov (United States)

2013-12-01

electrocardiography, respiratory rate, and pulse ox- imetry). Researchers and clinicians who have studied and ob- served how these parameters change in the...hemorrhage can quickly lead to poor tissue perfusion, progressive acidosis , and sudden, unexpected hemodynamic decompensation, a condition that is...unacceptably dangerous to the well-being of the sub- ject. We know, however, that LBNP closely mimics the hemo- dynamic,6 autonomic,2 respiratory ,19 and

Immediate and Delayed Drug Therapy Effects on Low Dose Sarin Exposed Mice Myocardial Performance

Science.gov (United States)

2011-03-01

studied using electrocardiography ( EKG ) and histological/immunochemical techniques (staining with hematoxylin/eosin and brain natriuretic peptide, BNP...size and BNP levels than controls (p = 0.001). EKGs showed T-wave anomalies. These results are indicators of cardiac insult. The second treatment...mice include being able to only take short time interval readings and the development of movement artifacts in the recordings. To prevent issues

Acute aortic dissection mimics acute inferoposterior wall myocardial infarction in a Marfan syndrome patient

OpenAIRE

Phowthongkum, Prasit

2010-01-01

A 30-year old man with acute chest pain was diagnosed with acute inferoposterior wall myocardial infarction following electrocardiography. After a failed coronary angiography, an echocardiogram revealed an aortic intimal flap after which acute aortic dissection was diagnosed. The patient received a successful Bentall operation without immediate complication. Retrospective examination then confirmed the diagnosis of Marfan syndrome. This case demonstrates acute aortic dissection may mimic acut...

Accuracy of localization of acute myocardial infarction by 12 lead electrocardiography

International Nuclear Information System (INIS)

Yasuda, T.; Ribeiro, L.G.; Holman, B.L.; Alpert, J.S.; Maroko, P.R.

1982-01-01

Until recently, ECG accuracy in localizing acute myocardial infarction (AMI) could be assessed only by comparing the ECGs with autopsy findings. This approach, however, preselected patients, including only those who died. It is possible that this postmortem group of patients would be different from the whole population of patients with AMI. Myocardial imaging with 99 mTc-pyrophosphate offers the advantage of directly localizing the region of injured myocardium in the acute phase of AMI. In 34 patients with confirmed AMI and focal uptake of 99 mTc-pyrophosphate, serial ECGs were obtained and interpreted by two independent observers. The sensitivity and specificity of serial ECGs in determining the location of AMI in the five left ventricular (LV) wall segments were determined: (1) in the anterior wall sensitivity was 86.7% and specificity was 89.5%; (2) in the lateral wall sensitivity was 73.7% and specificity was 80.0%; (3) in the high lateral wall sensitivity was 80.0% and specificity was 87.5%; (4) in the inferior wall sensitivity was 87.5% and specificity was 100%; (5) in the true posterior wall sensitivity was 83.3% and specificity was 86.4%. Overall, in the 170 LV wall segments (five per patient) examined, scans localized with a sensitivity of 81.9% and a specificity of 88.8%. After four patients with LBBB were excluded, sensitivity increased to 87.1%. Overall, localization of AMI by serial ECG was accurate in 85.9% of the 34 patients included in the study

A blended learning program on undergraduate nursing students' learning of electrocardiography.

Science.gov (United States)

Jang, Keum-Seong; Kim, Yun-Min; Park, Soon-Joo

2006-01-01

This study sought to evaluate the feasibility of applying the blended learning program that combines the advantages of face-to-face(FTF) learning and e-learning. The blended learning program was developed by the authors and implemented for 4 weeks. 56 senior nursing students were recruited at a university in Korea. Significant improvement was noted in learning achievement. No significant differences were noted between FTF and web-based learning in learning motivation. Learning satisfaction and students' experience in taking this course revealed some positive effects of blended learning. The use of blended learning program for undergraduate nursing students will provide an effective learning model.

Differences in alarm events between disposable and reusable electrocardiography lead wires.

Science.gov (United States)

Albert, Nancy M; Murray, Terri; Bena, James F; Slifcak, Ellen; Roach, Joel D; Spence, Jackie; Burkle, Alicia

2015-01-01

Disposable electrocardiographic lead wires (ECG-LWs) may not be as durable as reusable ones. To examine differences in alarm events between disposable and reusable ECG-LWs. Two cardiac telemetry units were randomized to reusable ECG-LWs, and 2 units alternated between disposable and reusable ECG-LWs for 4 months. A remote monitoring team, blinded to ECG-LW type, assessed frequency and type of alarm events by using total counts and rates per 100 patient days. Event rates were compared by using generalized linear mixed-effect models for differences and noninferiority between wire types. In 1611 patients and 9385.5 patient days of ECG monitoring, patient characteristics were similar between groups. Rates of alarms for no telemetry, leads fail, or leads off were lower in disposable ECG-LWs (adjusted relative risk [95% CI], 0.71 [0.53-0.96]; noninferiority P < .001; superiority P = .03) and monitoring (artifact) alarms were significantly noninferior (adjusted relative risk [95% CI]: 0.88, [0.62-1.24], P = .02; superiority P = .44). No between-group differences existed in false or true crisis alarms. Disposable ECG-LWs were noninferior to reusable ECG-LWs for all false-alarm events (N [rate per 100 patient days], disposable 2029 [79.1] vs reusable 6673 [97.9]; adjusted relative risk [95% CI]: 0.81 [0.63-1.06], P = .002; superiority P = .12.) Disposable ECG-LWs with patented push-button design had superior performance in reducing alarms created by no telemetry, leads fail, or leads off and significant noninferiority in all false-alarm rates compared with reusable ECG-LWs. Fewer ECG alarms may save nurses time, decrease alarm fatigue, and improve patient safety. ©2015 American Association of Critical-Care Nurses.

Spontaneous obliteration of right ventricular pseudoaneurysm after blunt chest trauma: Diagnosis and follow-up with multidetector CT

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Kang, Tae Kyung; Kang, Mi Jin; Kim, Jae Hyung [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

2014-06-15

Right ventricular (RV) pseudoaneurysm caused by trauma is very rare. We report a case of RV pseudoaneurysm which resolved without surgical treatment in a patient who survived a falling accident. Echocardiography failed to identify the pseudoaneurysm. Electrocardiography-gated CT showed a 17-mm-sized saccular pseusoaneurysm arsing from the RV outflow tract with a narrow neck. Follow-up CT after two months showed spontaneous obliteration of the lesion.

Acute aortic dissection mimics acute inferoposterior wall myocardial infarction in a Marfan syndrome patient.

Science.gov (United States)

Phowthongkum, Prasit

2010-01-01

A 30-year old man with acute chest pain was diagnosed with acute inferoposterior wall myocardial infarction following electrocardiography. After a failed coronary angiography, an echocardiogram revealed an aortic intimal flap after which acute aortic dissection was diagnosed. The patient received a successful Bentall operation without immediate complication. Retrospective examination then confirmed the diagnosis of Marfan syndrome. This case demonstrates acute aortic dissection may mimic acute myocardial infarction.

Anaesthesia for a patient with Deep Brain Stimulator: Case Report and Review of Literature

Directory of Open Access Journals (Sweden)

Raj mala

2014-07-01

Full Text Available Deep brain stimulator (DBS devices are used for unilateral or bilateral stimulation of thalamus, subthalamus and globus pallidus to treat movement disorders. DBS can interfere with domestic and medical equipment such as electrocardiography (ECG, slow wave diathermy, electrocautery, peripheral nerve stimulators, pacemakers, external and implantable cardioverters and defibrillators. This case report describes a patient with such a device who presented for bilateral (B/L cataract surgery.

Cardiac involvement in myotonic muscular dystrophy (Steinert's disease): a prospective study of 25 patients

International Nuclear Information System (INIS)

Perloff, J.K.; Stevenson, W.G.; Roberts, N.K.; Cabeen, W.; Weiss, J.

1984-01-01

The presence, degree and frequency of disorders of cardiac conduction and rhythm and of regional or global myocardial dystrophy or myotonia have not previously been studied prospectively and systematically in the same population of patients with myotonic dystrophy. Accordingly, 25 adults with classic Steinert's disease underwent electrocardiography, 24-hour ambulatory electrocardiography, vectorcardiography, chest x-rays, echocardiography, electrophysiologic studies, and technetium-99m angiography. Clinically important cardiac manifestations of myotonic dystrophy reside in specialized tissues rather than in myocardium. Involvement is relatively specific, primarily assigned to the His-Purkinje system. The cardiac muscle disorder takes the form of dystrophy rather than myotonia, and is not selective, appearing with approximately equal distribution in all 4 chambers. Myocardial dystrophy seldom results in clinically overt ventricular failure, but may be responsible for atrial and ventricular arrhythmias. Since myotonic dystrophy is genetically transmitted, a primary biochemical defect has been proposed with complete expression of the gene toward striated muscle tissue, whether skeletal or cardiac. Specialized cardiac tissue and myocardium have close, if not identical, embryologic origins, so it is not surprising that the genetic marker affects both. Cardiac involvement is therefore an integral part of myotonic dystrophy, targeting particularly the infranodal conduction system, to a lesser extent the sinus node, and still less specifically, the myocardium

Alternating myocardial sympathetic neural function of athlete's heart in professional cycle racers examined with iodine-123-MIBG myocardial scintigraphy

International Nuclear Information System (INIS)

Koyama, Keiko; Inoue, Tomio; Hasegawa, Akira; Oriuchi, Noboru; Okamoto, Eiichi; Tomaru, Yumi; Endo, Keigo

2001-01-01

Myocardial sympathetic neural function in professional athletes who had the long-term tremendous cardiac load has not been fully investigated by myocardial iodine-123-metaiodobenzylguanidine (MIBG) uptake in comparison with power spectral analysis (PSA) in electrocardiography. Eleven male professional cycle racers and age-matched 11 male healthy volunteers were enrolled in this study. The low frequency components in the power spectral density (LF), the high frequency components in the power spectral density (HF), the LF/HF ratio and mean R-R interval were derived from PSA and time-domain analysis of heart rate variability in electrocardiography. The mean heart-to-mediastinum uptake ratio (H/M ratio) of the MIBG uptake, in professional cycle racers was significantly lower than that in healthy volunteers (p<0.01) and HF power in professional cycle racers was significantly higher than that in healthy volunteers (p<0.05). In the group of professional cycle racers, the H/M ratio showed a significant correlation with the R-R interval, as indices of parasympathetic nerve activity (r=0.80, p<0.01), but not with the LF/HF ratio as an index of sympathetic nerve activity. These results may indicate that parasympathetic nerve activity has an effect on MIBG uptake in a cyclist's heart. (author)

Computational Intelligence Techniques for Electro-Physiological Data Analysis

OpenAIRE

Riera Sardà, Alexandre

2012-01-01

This work contains the efforts I have made in the last years in the field of Electrophysiological data analysis. Most of the work has been done at Starlab Barcelona S.L. and part of it at the Neurodynamics Laboratory of the Department of Psychiatry and Clinical Psychobiology of the University of Barcelona. The main work deals with the analysis of electroencephalography (EEG) signals, although other signals, such as electrocardiography (ECG), electroculography (EOG) and electromiography (EMG) ...

Associations between cardiac pathology and clinical, echocardiographic and electrocardiographic findings in dogs with chronic congestive heart failure

DEFF Research Database (Denmark)

Falk, Bo Torkel; Jönsson, Lennart; Olsen, Lisbeth Høier

2010-01-01

The objective of this study was to correlate defined pathological features with clinical findings in dogs with naturally occurring congestive heart failure (CHF). Fifty-eight dogs with CHF were examined clinically and using echocardiography and electrocardiography. Detailed cardiac post...... such as MMVD, myocardial atrophy and fibrosis, and by arteriosclerosis. Further, more extensive research will be required to establish cause-effect relationships between these cardiac lesions and the pathophysiology of CHF in dogs....

Severe myocardial injury and extracorporeal membrane oxygenation following perinatal asphyxia

Directory of Open Access Journals (Sweden)

P. Benson Ham

2015-05-01

Full Text Available Perinatal asphyxia is a common cause of morbidity and mortality in the newborn and is associated with myocardial injury in a significant proportion of cases. Biomarkers, echocardiography, and rhythm disturbances are sensitive indicators of myocardial ischemia and may predict mortality. We present a case of severe myocardial dysfunction immediately after delivery managed with extracorporeal membrane oxygenation (ECMO and discuss the role of cardiac biomarkers, echocardiography, electrocardiography, and ECMO in the asphyxiated newborn.

Dynamic right ventricular outflow tract (infundibular) stenosis and pectus excavatum in a dog

OpenAIRE

Fournier, Tanya E.

2008-01-01

This is the first published report of a dog with dynamic right ventricular outflow tract (infundibular) stenosis, right ventricular hypertrophy, and pectus excavatum. A juvenile dog presented with a grade V/VI left base systolic heart murmur, tachycardia, and pectus excavatum. Diagnosis of the aforementioned conditions was based on radiography, electrocardiography, and echocardiography. At 9 1/2 wk of age the heart murmur was no longer audible and the right ventricular stenosis and hypertroph...

HEREDITARY INTRAVENTRICULAR CONDUCTION DISORDERS IN THE FAMILY FROM KRASNOYARSK

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A. A. Chernova

2011-01-01

Full Text Available Pedigree of the family from Krasnoyarsk city with hereditary disorders of intracardiac conduction was studied. The diagnosis of each family member was verified by electrocardiography (ECG, echocardiography , bicycle ergometry , ECG Holter monitoring. The family 10-year follow-up showed familial aggregation of intracardiac conduction disorders in grandson, niece, son of the proband niece, ie, in the III-degree relatives. Family history of III-degree relatives with intracardiac conduction disorders and discordant pathology is identified.

Inducing Sadness and Anxiousness through Visual Media: Measurement Techniques and Persistence

OpenAIRE

Kuijsters, Andre; Redi, Judith; de Ruyter, Boris; Heynderickx, Ingrid

2016-01-01

textabstractThe persistence of negative moods (sadness and anxiousness) induced by three visual Mood Induction Procedures (MIP) was investigated. The evolution of the mood after the MIP was monitored for a period of 8 min with the Self-Assessment Manikin (SAM; every 2 min) and with recordings of skin conductance level (SCL) and electrocardiography (ECG). The SAM pleasure ratings showed that short and longer film fragments were effective in inducing a longer lasting negative mood, whereas the ...

Long QT syndrome genotyping by electrocardiography: fact, fiction, or something in between?

DEFF Research Database (Denmark)

Kanters, Jørgen K.; Graff, Claus; Andersen, Mads Peter

2006-01-01

Diagnosis of long QT syndrome (LQTS) is difficult. A prolonged QT interval is easily overlooked, and in 10% of all patients with LQTS, the QT interval is normal. Genotyping is unfortunately not able to detect all patients and healthy subjects correctly. Although QT prolongation is the most used r...... evaluation can serve as a guide for genotyping and can reduce the costs by suggesting which gene to start sequencing, but it is fiction that the ECG can replace genotyping....

The value of electrocardiography for differential diagnosis in wide QRS complex tachycardia.

Science.gov (United States)

Sousa, Pedro A; Pereira, Salomé; Candeias, Rui; de Jesus, Ilídio

2014-03-01

Correct diagnosis in wide QRS complex tachycardia remains a challenge. Differential diagnosis between ventricular and supraventricular tachycardia has important therapeutic and prognostic implications, and although data from clinical history and physical examination may suggest a particular origin, it is the 12-lead surface electrocardiogram that usually enables this differentiation. Since 1978, various electrocardiographic criteria have been proposed for the differential diagnosis of wide complex tachycardias, particularly the presence of atrioventricular dissociation, and the axis, duration and morphology of QRS complexes. Despite the wide variety of criteria, diagnosis is still often difficult, and errors can have serious consequences. To reduce such errors, several differential diagnosis algorithms have been proposed since 1991. However, in a small percentage of wide QRS tachycardias the diagnosis remains uncertain and in these the wisest decision is to treat them as ventricular tachycardias. The authors' objective was to review the main electrocardiographic criteria and differential diagnosis algorithms of wide QRS tachycardia. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Wavelet-sparsity based regularization over time in the inverse problem of electrocardiography.

Science.gov (United States)

Cluitmans, Matthijs J M; Karel, Joël M H; Bonizzi, Pietro; Volders, Paul G A; Westra, Ronald L; Peeters, Ralf L M

2013-01-01

Noninvasive, detailed assessment of electrical cardiac activity at the level of the heart surface has the potential to revolutionize diagnostics and therapy of cardiac pathologies. Due to the requirement of noninvasiveness, body-surface potentials are measured and have to be projected back to the heart surface, yielding an ill-posed inverse problem. Ill-posedness ensures that there are non-unique solutions to this problem, resulting in a problem of choice. In the current paper, it is proposed to restrict this choice by requiring that the time series of reconstructed heart-surface potentials is sparse in the wavelet domain. A local search technique is introduced that pursues a sparse solution, using an orthogonal wavelet transform. Epicardial potentials reconstructed from this method are compared to those from existing methods, and validated with actual intracardiac recordings. The new technique improves the reconstructions in terms of smoothness and recovers physiologically meaningful details. Additionally, reconstruction of activation timing seems to be improved when pursuing sparsity of the reconstructed signals in the wavelet domain.

The effects of sedative music, arousal music, and silence on electrocardiography signals.

Science.gov (United States)

Dousty, Mehdy; Daneshvar, Sabalan; Haghjoo, Majid

2011-01-01

Research indicates that music can affect heart rate, blood pressure, and skin conductance. Music can stimulate central emotions in the brain and release biochemical materials that change the physiologic state. We sought to compare changes in the electrical function of the heart in response to music. Subjects were asked to listen to 2 types of music, namely, sedative and arousal music, in conjunction with two 30-second periods of complete silence. The experiment was conducted in 4 segments: the first and third parts were silence, and the second and fourth parts were music. First, the response to each type of music was compared with that to the preceding period of silence. Next, the responses to both types of music were compared. Finally, the response to music regardless of the type was compared with that to silence. The amplitude of polarization and depolarization changed in response to different kinds of music. The electrical function of the heart in response to music, irrespective of the music type, differed from that in response to silence. The 2 types of music impacted the electrical function of the heart in different ways: the arousal music influenced T-wave maximum amplitude, whereas no such change was recorded in response to the sedative music. The bandwidth of the polarization and depolarization of the heart rate and R-wave amplitude increased in response to music by comparison with silence. In addition, the heart did not seem to try to synchronize with music. The mean R-wave amplitude in sedative music is higher than the arousal music, so our heart works differently when different types of music are heard. Copyright © 2011 Elsevier Inc. All rights reserved.

Old tools for sophisticated diagnosis: Electrocardiography for the assessment of myocardial viability

International Nuclear Information System (INIS)

Margonato, A.; Chierchia, S.

1996-01-01

The identification of residual myocardial viability in patients with a previous myocardial infarction has important clinical implications. Various methods have been developed for the detection of viable myocardium, however most of them are expensive and available only to high-tech centers. In the attempt to obtain reliable information at a low cost, exercise-ECG has been proposed as a useful technique. The results of a series of studies show that ST segment elevation and ventricular arrhythmias elicited by exercise are reliable signs of the presence of reversible myocardial damage

Securing While Sampling in Wireless Body Area Networks With Application to Electrocardiography.

Science.gov (United States)

Dautov, Ruslan; Tsouri, Gill R

2016-01-01

Stringent resource constraints and broadcast transmission in wireless body area network raise serious security concerns when employed in biomedical applications. Protecting data transmission where any minor alteration is potentially harmful is of significant importance in healthcare. Traditional security methods based on public or private key infrastructure require considerable memory and computational resources, and present an implementation obstacle in compact sensor nodes. This paper proposes a lightweight encryption framework augmenting compressed sensing with wireless physical layer security. Augmenting compressed sensing to secure information is based on the use of the measurement matrix as an encryption key, and allows for incorporating security in addition to compression at the time of sampling an analog signal. The proposed approach eliminates the need for a separate encryption algorithm, as well as the predeployment of a key thereby conserving sensor node's limited resources. The proposed framework is evaluated using analysis, simulation, and experimentation applied to a wireless electrocardiogram setup consisting of a sensor node, an access point, and an eavesdropper performing a proximity attack. Results show that legitimate communication is reliable and secure given that the eavesdropper is located at a reasonable distance from the sensor node and the access point.

Intraoperative "Kounis syndrome" that improved electrocardiography changes and hemodynamic situation afteradministering nitroglycerine

Directory of Open Access Journals (Sweden)

Victoria O. Sánchez

2014-07-01

Full Text Available A 58-year-old female without cardiovascular risk factors, was going to be operated to repair the rotator cuff. Induction and interscalene brachial plexus block were uneventful, but after her placement for surgery the patient started with severe bronchospasm, hypotension, cutaneous allergic reaction and ST elevation on the electrocardiogram. An anaphylactic shock was suspected and treated but until the perfusion of nitroglycerina was started no electrocardiographic changes resolved. After necessary diagnostic test the final diagnosis was variant I of Kounis syndrome due to cefazolin and rocuronium. Ephinephrine is the cornerstone of treatment for anaphylaxis but should we use it if the anaphylactic reaction is also accompanied by myocardial ischemia? The answer is that we should not use it because myocardial ischemia in this syndrome is caused by vasospasm, so it would be more useful drugs such as nitroglycerin. But what if we do not know if it is a Kounis syndrome or not? In this article we report our experience that maybe could help you in a similar situation.

Evaluation of the diagnostic efficacy of phase analysis of data from radionuclide ventriculograms in patients with Wolff-Parkinson-White syndrome

Energy Technology Data Exchange (ETDEWEB)

Dormehl, I.C.; Bitter, F.; Henze, E.; Adam, W.E.; Weismueller, P.

1985-10-01

It has been suggested that phase analysis of radionuclide ventriculograms may be of value for detecting and localising the abnormal sequence of ventricular contraction secondary to Wolff-Parkinson-White (WPW) symdrome. The present study was undertaken to test this hypothesis. The space-time sequences of right- and left-ventricular action obtained from radionuclide ventriculograms obtained during rest studies were evaluated in 8 patients with WPW syndrome (confirmed by 12-lead surface electrocardiography) and compared to those of 14 normal subjects. All of the latter showed a consistent ventricular activation pattern, i.e. the first site of ventricular activity in the upper septal region followed by a second site either at the base of the left ventricle or located apically. It was possible to diagnose 11 of the 14 normal subjects (specificity, 79%) and 7 of the 8 patients (sensitivity, 88%). The 4 patients who had been classified as having a left-sided accessory bundle by surface electrocardiography were likewise diagnosed by phase analysis, as were the 2 patients with a confirmed right-sided bypass tract. Two patients with septal posterior accessory pathways could not be identified by phase analysis. Furthermore, cases with an activation pattern which closely resembled that of the 2 patients with right-sided accessory bundles were found to be normal from their ECGs. It is now necessary to evaluate phase analysis against invasive electrophysiological methods in such patients.

Optimisation of Embryonic and Larval ECG Measurement in Zebrafish for Quantifying the Effect of QT Prolonging Drugs

Science.gov (United States)

Dhillon, Sundeep Singh; Dóró, Éva; Magyary, István; Egginton, Stuart; Sík, Attila; Müller, Ferenc

2013-01-01

Effective chemical compound toxicity screening is of paramount importance for safe cardiac drug development. Using mammals in preliminary screening for detection of cardiac dysfunction by electrocardiography (ECG) is costly and requires a large number of animals. Alternatively, zebrafish embryos can be used as the ECG waveform is similar to mammals, a minimal amount of chemical is necessary for drug testing, while embryos are abundant, inexpensive and represent replacement in animal research with reduced bioethical concerns. We demonstrate here the utility of pre-feeding stage zebrafish larvae in detection of cardiac dysfunction by electrocardiography. We have optimised an ECG recording system by addressing key parameters such as the form of immobilization, recording temperature, electrode positioning and developmental age. Furthermore, analysis of 3 days post fertilization (dpf) zebrafish embryos treated with known QT prolonging drugs such as terfenadine, verapamil and haloperidol led to reproducible detection of QT prolongation as previously shown for adult zebrafish. In addition, calculation of Z-factor scores revealed that the assay was sensitive and specific enough to detect large drug-induced changes in QTc intervals. Thus, the ECG recording system is a useful drug-screening tool to detect alteration to cardiac cycle components and secondary effects such as heart block and arrhythmias in zebrafish larvae before free feeding stage, and thus provides a suitable replacement for mammalian experimentation. PMID:23579446

Using a Cloud Computing System to Reduce Door-to-Balloon Time in Acute ST-Elevation Myocardial Infarction Patients Transferred for Percutaneous Coronary Intervention

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Chi-Kung Ho

2017-01-01

Full Text Available Background. This study evaluated the impact on clinical outcomes using a cloud computing system to reduce percutaneous coronary intervention hospital door-to-balloon (DTB time for ST segment elevation myocardial infarction (STEMI. Methods. A total of 369 patients before and after implementation of the transfer protocol were enrolled. Of these patients, 262 were transferred through protocol while the other 107 patients were transferred through the traditional referral process. Results. There were no significant differences in DTB time, pain to door of STEMI receiving center arrival time, and pain to balloon time between the two groups. Pain to electrocardiography time in patients with Killip I/II and catheterization laboratory to balloon time in patients with Killip III/IV were significantly reduced in transferred through protocol group compared to in traditional referral process group (both p<0.05. There were also no remarkable differences in the complication rate and 30-day mortality between two groups. The multivariate analysis revealed that the independent predictors of 30-day mortality were elderly patients, advanced Killip score, and higher level of troponin-I. Conclusions. This study showed that patients transferred through our present protocol could reduce pain to electrocardiography and catheterization laboratory to balloon time in Killip I/II and III/IV patients separately. However, this study showed that using a cloud computing system in our present protocol did not reduce DTB time.

Value of noninvasive diagnostic procedures in cardiology: typical findings in hypertrophic obstructive cardiomyopathy

International Nuclear Information System (INIS)

Riebeling, V.; Bubenheimer, P.

1984-01-01

Routine chest X-ray often yields poor information for diagnosis of heart disease. The diagnostic value of invasive procedures in cardiology is generally accepted. The patient's as well as the physician's risk of the examination, however, has to be considered. A high number of heart diseases, e.g. hypertrophic obstructive cardiomyopathy (HOCM) is mainly detected by noninvasive procedures such as auscultation, electrocardiography, phonomechanocardiography, echocardiography, physical manoeuvres, and pharmacological provocation tests. Typical findings in hypertrophic obstructive cardiomyopathy are demonstrated. (orig.) [de

Comparison between radioisotopic ventriculography in balance with Tc99-albumine-DTPA and quantitative gated SPECT with Tc-99m-MIBI for determining the eject fraction of left ventricle

International Nuclear Information System (INIS)

Noguera, E. C; Jaime, Adelina; Pamellin, Miriam; Veliz, J

2002-01-01

Radionuclide ventriculography (RNV) and electrocardiography gated myocardial perfusion single photon emission computed tomography (GSPECT), can be used to assess the ventricular function.The purpose of this study was:1) to compare left ventricular ejection fraction (LVEF(%) using post-stress or rest gated GSPECT with LVEF by resting RNV and 2) to evaluate the 99m-Tc99m human serum albumin (HAS) with diethylenetriaminepenta-acetic acid (DTPA) (99m-TcHSA-DTPA) as a potential use a as blood pool imaging agent (Au)

Comparison of prospective electrocardiography-gating high-pitch mode and without electrocardiography-synchronization high-pitch mode acquisition for the image quality and radiation doses of the aortic using dual-source CT

International Nuclear Information System (INIS)

Li Jian; Huan Yi; Zhao Hongliang; Wang Ying; Liu Ying; Wei Mengqi; Shi Mingguo; Zheng Minwen

2013-01-01

Objective: To evaluate the application of prospective ECG-gating Flash spiral scan mode dual-source CT in aortography, and compare it's image quality and radiation dose with without ECG-synchronization high-pitch spiral scanning mode. Methods: Fifty consecutive patients (Group A) with suspected aortic dissection or after operations for the aortic dissection were scanned with prospective ECG-gated high-pitch scan and another 50 consecutive patients (Group B) were analyzed by non-ECG-gated high-pitch scan. Image quality of the aortic was assessed by two independent readers. Image noise was measured, radiation dose estimates were calculated. The imaging quality of the aortic and the radiation dose were compared with Mann-whitney U and t test. Results: The average image quality score [(1.18 ± 0.40) in group A and (1.23 ± 0.31) in group B] showed no significant difference between group A and group B (U = 1.20, P = 0.23). The mean radiation dose of group A was lower than that of group B [(1.49 ± 0.38) mSv in group A, (2.79 ± 0.54) mSv in group B, t = 13.677, P < 0.05]. Conclusion: Prospective ECG-gated dual source CT Flash spiral scanning with low radiation dose and good image quality in the aortic dissection with high value of clinical application. (authors)

Pulmonary atresia with intact ventricular septum and agenesis of the ductus arteriosus in a pup

International Nuclear Information System (INIS)

Brown, D.J.; Patterson, D.F.

1989-01-01

A 7-week-old Wire Fox Terrier was admitted with pulmonary atresia with intact ventricular septum. The right ventricle and tricuspid valve were hypoplastic, and venous return to the right atrium reached the left side through an atrial septal defect. Oxygenation was via hyperplastic bronchial arteries. There was no evidence of the ductus arteriosus. Physical examination, plain and contrast radiography, and electrocardiography were performed. Clinical findings for this combination of defects were similar to those of more common defects (tetralogy of Fallot, patent ductus arteriosus

Some New Results on the Estimation of Sinusoids in Noise

DEFF Research Database (Denmark)

Nielsen, Jesper Kjær

2012-01-01

This thesis is concerned with the problem of estimating sinusoidal parameters from noisy observations. This field of research is applicable to solving problems in a large number of areas such as music and speech processing, electrocardiography, seismology, radar and sonar processing, astronomy....... Third, an efficient algorithm for performing inference and interpolation in a dynamic sinusoidal model is proposed. This method is applied to packet-loss concealment, and listening tests indicate that the proposed algorithm can be used for this purpose. Fourth, the Capon filtering method for amplitude...

The Effects of Some Anaesthetics on the Electrocardiograms of Guinea Pigs

OpenAIRE

PİŞKİN, İlksin; ŞİRELİ, Meltem; SAĞMANLIGİL, Vedat; EMRE, Bahri

1998-01-01

This study was carried out to observe the effects on electrocardiography of using droperidol-fentanyl and ketamine-xylazine combinations, urethane and pentothal sodium as anaesthetic doses. In this study, thirty-five 4-5 months-old quinea pigs of both sexes weighing 540-600 g were used. The quinea pigs were divided equally into 5 groups. The first group was used as the control group and nothing was given to this group. The combination of droperidol (20 mg/ml)-fentanyl (0.4 mg/ml) in a dose o...

[Specific features of the functional state of the cardiorespiratory system in athletes differing in the types of muscular activity during the preparatory period of the training cycle].

Science.gov (United States)

Ivanova, N B

2011-01-01

The present study of the functional state of the cadiorespiratory system included athletes engaged in cyclic team sports. The state of the cardiorespiratory system was estimated from the measurement of central hemodynamics and cardiac rhythm variability, results of electrocardiography, spirography, and pneumotachography performed during the preparatory period for the training cycle. It was shown that the cardiovascular and respiratory systems as well as vegetative regulation of the cardiac rhythm of the athletes under examination underwent differently directed structural modification depending on the specific patterns of muscular activity.

Nonsustained Repetitive Upper Septal Idiopathic Fascicular Left Ventricular Tachycardia: Rare Type of VT

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Gokhan Aksan

2016-05-01

Full Text Available Upper septal fascicular ventricular tachycardia is a very rare form of idiopathic fascicular ventricular tachycardia. Upper septal fascicular tachycardia uses the posterior fascicle as the anterograde limb and the septal fascicle as the retrograde limb. When evaluating the electrocardiography for this form of tachycardia, the presence of narrow QRS morphology and normal axis may be misinterpreted as supraventricular tachycardia. Here, we report a very rare subtype of fascicular tachycardia that originates more proximally in the His-Purkinje system at the base of the heart.

Noninvasive identification of left main and triple vessel coronary artery disease: improved accuracy using quantitative analysis of regional myocardial stress distribution and washout of thallium-201

International Nuclear Information System (INIS)

Maddahi, J.; Abdulla, A.; Garcia, E.V.; Swan, H.J.; Berman, D.S.

1986-01-01

The capabilities of visual and quantitative analysis of stress redistribution thallium-201 scintigrams, exercise electrocardiography and exercise blood pressure response were compared for correct identification of extensive coronary disease, defined as left main or triple vessel coronary artery disease, or both (50% or more luminal diameter coronary narrowing), in 105 consecutive patients with suspected coronary artery disease. Extensive disease was present in 56 patients and the remaining 49 had either less extensive coronary artery disease (n = 34) or normal coronary arteriograms (n = 15). Although exercise blood pressure response, exercise electrocardiography and visual thallium-201 analysis were highly specific (98, 88 and 96%, respectively), they were insensitive for identification of patients with extensive disease (14, 45 and 16%, respectively). Quantitative thallium-201 analysis significantly improved the sensitivity of visual thallium-201 analysis for identification of patients with extensive disease (from 16 to 63%, p less than 0.001) without a significant loss of specificity (96 versus 86%, p = NS). Eighteen (64%) of the 28 patients who were misclassified by visual analysis as having less extensive disease were correctly classified as having extensive disease by virtue of quantitative analysis of regional myocardial thallium-201 washout. When the results of quantitative thallium-201 analysis were combined with those of blood pressure and electrocardiographic response to exercise, the sensitivity and specificity for identification of patients with extensive disease was 86 and 76%, respectively, and the highest overall accuracy (0.82) was obtained

An evaluation of the diagnostic efficacy of phase analysis of data from radionuclide ventriculograms in patients with Wolff-Parkinson-White syndrome

International Nuclear Information System (INIS)

Dormehl, I.C.; Bitter, F.; Henze, E.; Adam, W.E.; Weismueller, P.

1985-01-01

It has been suggested that phase analysis of radionuclide ventriculograms may be of value for detecting and localising the abnormal sequence of ventricular contraction secondary to Wolff-Parkinson-White (WPW) symdrome. The present study was undertaken to test this hypothesis. The space - time sequences of right- and left-ventricular action obtained from radionuclide ventriculograms obtained during rest studies were evaluated in 8 patients with WPW syndrome (confirmed by 12-lead surface electrocardiography) and compared to those of 14 normal subjects. All of the latter showed a consistent ventricular activation pattern, i.e. the first site of ventricular activity in the upper septal region followed by a second site either at the base of the left ventricle or located apically. It was possible to diagnose 11 of the 14 normal subjects (specificity, 79%) and 7 of the 8 patients (sensitivity, 88%). The 4 patients who had been classified as having a left-sided accessory bundle by surface electrocardiography were likewise diagnosed by phase analysis, as were the 2 patients with a confirmed right-sided bypass tract. Two patients with septal posterior accessory pathways could not be identified by phase analysis. Furthermore, cases with an activation pattern which closely resembled that of the 2 patients with right-sided accessory bundles were found to be normal from their ECGs. It is now necessary to evaluate phase analysis against invasive electrophysiological methods in such patients. (orig.)

War, Medicine, and Cultural Diplomacy in the Americas: Frank Wilson and Brazilian cardiology.

Science.gov (United States)

Kropf, Simone P; Howell, Joel D

2017-10-01

American cultural diplomacy played a key role in the institutionalization of Brazilian cardiology. In 1942, Frank Wilson, an internationally recognized pioneer in electrocardiography, made an extended wartime visit to Rio de Janeiro and São Paulo. The visit was sponsored by the United States Department of State as part of Roosevelt's Good Neighbor Policy and brought Wilson together with a group of physicians who would establish the specialty of cardiology in Brazil. This US cultural and diplomatic initiative strengthened an academic network that was already evolving and would eventually prove to be of benefit to both sides. Latin American physicians began in the 1920s to visit Wilson's laboratory at the University of Michigan, where they established the relationships on which Wilson would build. While affiliation with the "Wilson school" advanced the cause of Brazilian cardiologists who sought to establish themselves as specialists, cooperation with Latin American physicians benefitted Wilson in his pursuit of wider recognition for his innovations in the use of electrocardiography (ECG). Wilson's identity as a scientific ambassador to Latin America helped in legitimating his approach to the clinical application of the ECG. A close examination of Wilson's relationship to Brazilian cardiology demonstrates the role played by science and medicine as a part of wartime cultural diplomacy, as well as the dynamics of the transnational circulation of scientific knowledge and practices. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Premature Coronary Artery Disease due to Homozygous Familial Hypercholesterolemia in a 12-Year-Old Girl

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Filiz Ekici

2018-03-01

Full Text Available Background: Homozygous familial hypercholesterolemia is a rare inherited metabolic disease caused by low-density lipoprotein receptor abnormality. Patients with homozygous familial hypercholesterolemia have an increased risk of cardiovascular complication that usually occurs in the first decade of life. Here, we report a 12-year-old girl with an unpredicted presentation for coronary artery disease and found to have homozygous familial hypercholesterolemia. Case Report: A 12-year-old girl was admitted to our unit with syncope. Chest X-ray showed bilateral diffuse pneumonic consolidation and mild cardiomegaly. We detected stable ST depression by electrocardiography. Echocardiography showed normal systolic functions. Troponin-1 levels were high (66 mcg/dL, upper limit: 0.04 mcg/dL. Influenza A virus DNA was detected by the respiratory viral panel. After her successful treatment for acute pneumonia and myocarditis due to Influenza A virus, her syncope attacks persisted. Marked ST elevation was observed during exercise electrocardiography. Coronary angiography showed severe occlusions in the coronary arteries. High serum levels of total cholesterol (756 mg/dL and low-density lipoprotein-C (556 mg/dL were noticed. She had no tendon xanthomas. Medical histories revealed that her family members were diagnosed with heterozygous familial hypercholesterolemia. A coronary bypass surgery was performed. Statin and ezetimibe treatments were started. We also planned lipid apheresis. Conclusion: Children with homozygous familial hypercholesterolemia may present with symptoms of premature coronary heart disease requiring a routine lipid test and careful anamnesis.

Quantitative thallium-201 myocardial exercise scintigraphy in normal subjects and patients with normal coronary arteries

International Nuclear Information System (INIS)

Niemeyer, M.G.; St. Antonius Hospital Nieuwegein; Laarman, G.J.; Lelbach, S.; Cramer, M.J.; Ascoop, C.A.P.L.; Verzijlbergen, J.F.; Wall, E.E. van der; Zwinderman, A.H.; Pauwels, E.K.J.

1990-01-01

Quantitative thallium-201 myocardial exercise scintigraphy was tested in two patient populations representing alternative standards for cardiac normality: group I comprised 18 male uncatherized patients with a low likelihood of coronary artery disease (CAD); group II contained 41 patients with normal coronary arteriograms. Group I patients were younger, they achieved a higher rate-pressure product than group II patients; all had normal findings by phisical examination and electrocardiography at rest and exercise. Group II patients comprised 21 females, 11 patients showed abnormal electrocardiography at rest, and five patients showed ischemic ST depression during exercise. Twelve patients had sign of minimal CAD. Twelve patients revealed abnormal visual and quantitative thallium findings, three of these patients had minimal CAD. Profiles of uptake and washout of thallium-201 were derived from both patient groups, and compared with normal limits developed by Maddahi et al. Furthermore, low likelihood and angiographically normal patients may differ substantially, and both sets of normal patients should be considered when establishing criteria of abnormality in exercise thallium imaging. When commercial software containing normal limits for quantitative analysis of exercise thallium-201 imaging is used in clinical practice, it is mandatory to compare these with normal limits of uptake and washout of thallium-201, derived from the less heterogeneous group of low-likelihood subjects, which should be used in selecting a normal population to define normality. (author). 37 refs.; 3 figs; 1 tab

Frequency of cardiac arrhythmias in high and low- yielding dairy cows

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Afshin Jafari Dehkordi

2014-06-01

Full Text Available Electrocardiography (ECG may be used to recognize cardiac disorders. Levels of milk production may change the serum electrolytes which its imbalance has a role in cardiac arrhythmia. Fifty high yielding and fifty low yielding Holstein dairy cows were used in this study. Electrocardiography was recorded by base-apex lead and blood samples were collected from jugular vein for measurement of serum elements such as sodium, potassium, calcium, phosphorous, iron and magnesium. Cardiac dysrhythmias were detected more frequent in low yielding Holstein cows (62.00% compared to high yielding Holstein cows (46.00%. The cardiac dysrhythmias that were observed in low yielding Holstein cows included sinus arrhythmia (34.70%, wandering pacemaker (22.45 %, bradycardia (18.37%, tachycardia (10.20%, atrial premature beat (2.04%, sinoatrial block (2.04%, atrial fibrillation (8.16% and atrial tachycardia (2.04%. The cardiac dysrhythmias were observed in high yielding Holstein cows including, sinus arrhythmia (86.95% and wandering pacemaker (13.05%. Also, notched P wave was observed to be 30% and 14% in high- and low- yielding Holstein cows respectively. The serum calcium concentration of low yielding Holstein cows was significantly lower than that of high yielding Holstein cows. There was not any detectable significant difference in other serum elements between high- and low- yielding Holstein cows. Based on the result of present study, could be concluded that low serum concentration of calcium results to more frequent dysrhythmias in low yielding Holstein cows.

Properties of screen printed electrocardiography smartware electrodes investigated in an electro-chemical cell.

Science.gov (United States)

Rattfält, Linda; Björefors, Fredrik; Nilsson, David; Wang, Xin; Norberg, Petronella; Ask, Per

2013-07-05

ECG (Electrocardiogram) measurements in home health care demands new sensor solutions. In this study, six different configurations of screen printed conductive ink electrodes have been evaluated with respect to electrode potential variations and electrode impedance. The electrode surfaces consisted of a Ag/AgCl-based ink with a conduction line of carbon or Ag-based ink underneath. On top, a lacquer layer was used to define the electrode area and to cover the conduction lines. Measurements were performed under well-defined electro-chemical conditions in a physiologic saline solution. The results showed that all printed electrodes were stable and have a very small potential drift (less than 3 mV/30 min). The contribution to the total impedance was 2% of the set maximal allowed impedance (maximally 1 kΩ at 50 Hz), assuming common values of input impedance and common mode rejection ratio of a regular amplifier. Our conclusions are that the tested electrodes show satisfying properties to be used as elements in a skin electrode design that could be suitable for further investigations by applying the electrodes on the skin.

Factors associated with diagnostic discrepancy for left ventricular hypertrophy between electrocardiography and echocardiography

DEFF Research Database (Denmark)

Sandager Petersen, Søren; Reinholdt Pedersen, Line; Pareek, Manan

2017-01-01

(absolute value/cut-off value for LVH) were used as outcome variables in order to identify explanatory variables associated with diagnostic discrepancies between ECG and echocardiography. RESULTS: Of the 1382 subjects included, 77% did not display any signs of LVH, 6% had LVH defined by ECG only, 13% had...... LVH defined by echocardiography only, and 5% had LVH on both ECG and echocardiography. Older subjects and those with higher blood pressure and RWT were more likely to have a relatively greater LVMI on echocardiography than that predicted on ECG (odds ratio: 1.65 per 10 years (95% confidence interval...... and odds ratio: 1.41 (95% CI: 1.06-1.87), p = .02), but FPG did not independently influence discrepancy between ECG and echocardiography. CONCLUSION: Age, blood pressure, female sex, greater RWT and use of antihypertensive medication were associated with a greater risk of non-consistency between LVH...

Washable and Reliable Textile Electrodes Embedded into Underwear Fabric for Electrocardiography (ECG) Monitoring

OpenAIRE

Amale Ankhili; Xuyuan Tao; Cédric Cochrane; David Coulon; Vladan Koncar

2018-01-01

A medical quality electrocardiogram (ECG) signal is necessary for permanent monitoring, and an accurate heart examination can be obtained from instrumented underwear only if it is equipped with high-quality, flexible, textile-based electrodes guaranteeing low contact resistance with the skin. The main objective of this article is to develop reliable and washable ECG monitoring underwear able to record and wirelessly send an ECG signal in real time to a smart phone and further to a cloud. The ...

Washable and Reliable Textile Electrodes Embedded into Underwear Fabric for Electrocardiography (ECG Monitoring

Directory of Open Access Journals (Sweden)

Amale Ankhili

2018-02-01

Full Text Available A medical quality electrocardiogram (ECG signal is necessary for permanent monitoring, and an accurate heart examination can be obtained from instrumented underwear only if it is equipped with high-quality, flexible, textile-based electrodes guaranteeing low contact resistance with the skin. The main objective of this article is to develop reliable and washable ECG monitoring underwear able to record and wirelessly send an ECG signal in real time to a smart phone and further to a cloud. The article focuses on textile electrode design and production guaranteeing optimal contact impedance. Therefore, different types of textile fabrics were coated with modified poly(3,4-ethylenedioxythiophene:poly(styrenesulfonate (PEDOT:PSS in order to develop and manufacture reliable and washable textile electrodes assembled to female underwear (bras, by sewing using commercially available conductive yarns. Washability tests of connected underwear containing textile electrodes and conductive threads were carried out up to 50 washing cycles. The influence of standardized washing cycles on the quality of ECG signals and the electrical properties of the textile electrodes were investigated and characterized.

Washable and Reliable Textile Electrodes Embedded into Underwear Fabric for Electrocardiography (ECG) Monitoring.

Science.gov (United States)

Ankhili, Amale; Tao, Xuyuan; Cochrane, Cédric; Coulon, David; Koncar, Vladan

2018-02-07

A medical quality electrocardiogram (ECG) signal is necessary for permanent monitoring, and an accurate heart examination can be obtained from instrumented underwear only if it is equipped with high-quality, flexible, textile-based electrodes guaranteeing low contact resistance with the skin. The main objective of this article is to develop reliable and washable ECG monitoring underwear able to record and wirelessly send an ECG signal in real time to a smart phone and further to a cloud. The article focuses on textile electrode design and production guaranteeing optimal contact impedance. Therefore, different types of textile fabrics were coated with modified poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) in order to develop and manufacture reliable and washable textile electrodes assembled to female underwear (bras), by sewing using commercially available conductive yarns. Washability tests of connected underwear containing textile electrodes and conductive threads were carried out up to 50 washing cycles. The influence of standardized washing cycles on the quality of ECG signals and the electrical properties of the textile electrodes were investigated and characterized.

Specificity of Electrocardiography and Echocardiography Changes at the Patients with the Pulmonary Embolism

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Amra Macić-Džanković

2006-11-01

Full Text Available We evaluated electrocardiographic and echocardiographic changes of 40 patients with pulmonary thrombo-embolism proved by perfusion scintigrams. ECG-changes included sinus tachycardia or absolute tachyarrhythmia de novo, changes type Q1S3T3 and changes in right precordial leads. Analyses of echocardiography included hyperkinesis and then dilatation and apical hypokinesis of right ventricule and tricuspid regurgitation with maximal transvalvular gradients. We emphasize such a sensibility of echocardiographic changes in early estimation of pulmonary thrombo-embolism severity and necessity for echocardiography as early as possible in suspected patients.

Echocaridography, electrocardiography, and radiography of cats with dilatation cardiomyopathy, hypertrophic cardiomyopathy, and hyperyroidism

International Nuclear Information System (INIS)

Moise, N.S.; Dietze, A.E.; Mezza, L.E.; Strickland, D.; Erb, H.N.; Edwards, N.J.

1986-01-01

The echocardiographic, ECG, and radiographic findings of sequentially examined cats with dilatation cardiomyopathy (DCM, n = 7), hypertrophic cardiomyopathy (HCM, n = 8), and hyperthyroidism (HT, n = 20) were compared with those of healthy control cats (n = 11). Cats with DCM were easily differentiated from healthy cats by echocardiography and from cats with HCM and HT by a dilated left ventricle at end-diastole with a mean +/- SD of 2.20 +/- 0.36 cm, reduced fractional shortening (2.9% +/- 3.7%), reduced aortic amplitude (0.07 +/- 0.05 cm), reduced left ventricular wall amplitude (0.09 +/- 0.09 cm), and increased E-point septal separation (0.83 +/- 0.29 cm). The cats with HCM were most consistently recognized echocardiographically by increased left ventricular wall thickness at end-diastole (0.75 +/- 0.12 cm). Some cats with HT had abnormal echocardiograms with left ventricular wall hypertrophy. These cats could usually be differentiated from the cats with HCM because of normal or increased ventricular wall amplitude, aortic amplitude, or percentage of thickening of the left ventricular wall and interventricular septum. Left atrial enlargement (left atrial diameter greater than 1.57 cm or left atrium/aorta greater than 1.75) was commonly detected by the echocardiogram in cats with DCM, HCM, or HT. The echocardiogram was helpful in differentiating the type of cardiomyopathy (DCM, HCM, or HT) when plain thoracic radiographs indicated that cardiomegaly existed. The ECG may have indicated incorrectly that there was left ventricular enlargement in some cats with HT, and it did not indicate consistently that left ventricular enlargement existed when present in cats with DCM or HCM. The ECG was a poor indicator of left atrial enlargement in all cats

Diagnostic value of electrocardiography, dynamic isotope studies and angiography in coronary heart disease

International Nuclear Information System (INIS)

Haas, J.

1986-01-01

The goal of this work is on the basis of the case histories of 36 patients with heart anamneses (27 with electrocardiographically and/or enzymatically detected heart infarcts, 9 with various cardial diseases) to test the diagnostic value of stress electrocardiograms, dynamic isotope examinations of the heart and coronary angiographies in the cases of myocardial infarcts, heart wall aneurysms, coronary heart disease and in the determination of the global discharge fraction, specifically broad scanning (heart front, side and back walls) as well as fine scanning (individual coronary vessel branches). In the case of myocardial infarct the stress EKG and the heart scintigraphy agree with one another to a large degree, whereby scintigraphy (with 99mTc-DPTA) in addition detects infarcted myocardial regions. In the diagnosis of heart wall aneurysms scintigraphy and ventriculography had the same results in 91.6% of the cases. Coronary heart disease results agreed for all three methods in 91.7% of the cases and with scintigraphy and angiography in 94.4%. The degree of agreement between scintigraphy and coronary angiography is confirmed in the literature. One-, two- and 3-vessel diseases can be determined with these two methods in 90 to 75% agreement. The result lies thereby above the values of 201Tl-myocardial scintigraphy given in the literature. Also the global discharge fraction shows scintigraphic as well as angiographic agreement of almost 90%. (TRV) [de

Indentation in the Right Ventricle by an Incomplete Pericardium on 3-Dimensional Reconstructed Computed Tomography

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Hak Ju Kim

2017-08-01

Full Text Available We report the case of a 17-year-old girl who presented with an indentation in the right ventricle caused by an incomplete pericardium on preoperative 3-dimensional reconstructed computed tomography. She was to undergo surgery for a partial atrioventricular septal defect and secundum atrial septal defect. Preoperative electrocardiography revealed occasional premature ventricular beats. We found the absence of the left side of the pericardium intraoperatively, and this absence caused strangulation of the diaphragmatic surface of the right ventricle. After correcting the lesion, the patient’s rhythm disturbances improved.

Hyperkalemia by Euro-Collins solution in anesthesia for renal transplantation: a case report.

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Hirata, Eunice Sizue; Pereira, Rosa Inês Costa; Filho, Gentil Alves; Braga, Angélica de Fátima Assunção

2013-01-01

To describe anesthesia for renal transplantation that progressed to a sharp potassium increase after kidney reperfusion with Euro-Collins' solution in the operative field. We will also report on diagnosis and treatment used. The use of infusion solutions in the surgical field requires careful monitoring, such as electrocardiography, measurement of serum potassium, and availability of calcium gluconate, insulin, and albuterol for immediate use. The replacement of Euro-Collins' solution for saline solution immediately before the implant may be a useful option in patients with high levels of potassium.

DIAGNOSIS AND THERAPY IN TRANSITORY MYOCARDIAL ISCHEMIA

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Anica Pavlovic

2008-01-01

Full Text Available Cardiac dysfunction occurring within subarachnoid hemorrhage named neurogenic stunned myocardium have great impact on intensive care of patients with SAH. Timely diagnosis and treatment of such condition can provide better haemodynamics of damaged brain. The standard follow-up was performed in 30 patients with SAH during two years at the Clinic of Neurosurgery (2005,2006. Serial electrocardiography, echocardiography, as well as laboratory findings of special biomarkers of left ventricular wall motion abnormalities were performed. All patients were treated with Urapidil, Metoprolol, MgSO4 by cheme and ACE inhibitors. Ninety EKG were analyzed in the study, as well as 16 electrocardiographies. The highest levels of CPK, CK-MB and TnI before and after the therapy were also recoded. EKG showed the signs of ischemia in 9 of 30 patients on 1st day and 7 of 30 patients on 3rd day of the therapy. The highest level of CK-MB was present during the 1st day with mean value of 67,80±1,83 IU/L that decreased on 3rd day of therapy with mean value of 66,8±1,83 IU/L, TnI was positive in 16 cases. It showed statistically significant decrease from 0,29 ng/ml till 0,187 ng/ml and p < 0,01. Myocardial ischaemia has been proven to be a very significant complication in SAH. Appropriate treatment of myocardial ischaemia seems to improve systemic haemodynamics, as well as haemodynamics of the damaged brain.

Smartphone ECG for evaluation of STEMI: results of the ST LEUIS Pilot Study.

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Muhlestein, Joseph Boone; Le, Viet; Albert, David; Moreno, Fidela Ll; Anderson, Jeffrey L; Yanowitz, Frank; Vranian, Robert B; Barsness, Gregory W; Bethea, Charles F; Severance, Harry W; Ramo, Barry; Pierce, John; Barbagelata, Alejandro; Muhlestein, Joseph Brent

2015-01-01

12-lead ECG is a critical component of initial evaluation of cardiac ischemia, but has traditionally been limited to large, dedicated equipment in medical care environments. Smartphones provide a potential alternative platform for the extension of ECG to new care settings and to improve timeliness of care. To gain experience with smartphone electrocardiography prior to designing a larger multicenter study evaluating standard 12-lead ECG compared to smartphone ECG. 6 patients for whom the hospital STEMI protocol was activated were evaluated with traditional 12-lead ECG followed immediately by a smartphone ECG using right (VnR) and left (VnL) limb leads for precordial grounding. The AliveCor™ Heart Monitor was utilized for this study. All tracings were taken prior to catheterization or immediately after revascularization while still in the catheterization laboratory. The smartphone ECG had excellent correlation with the gold standard 12-lead ECG in all patients. Four out of six tracings were judged to meet STEMI criteria on both modalities as determined by three experienced cardiologists, and in the remaining two, consensus indicated a non-STEMI ECG diagnosis. No significant difference was noted between VnR and VnL. Smartphone based electrocardiography is a promising, developing technology intended to increase availability and speed of electrocardiographic evaluation. This study confirmed the potential of a smartphone ECG for evaluation of acute ischemia and the feasibility of studying this technology further to define the diagnostic accuracy, limitations and appropriate use of this new technology. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of Cardiovascular System in Fibromyalgia Syndrome: Tissue Doppler Echocardiographic Investigation

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Selma YAZICI

2010-05-01

Full Text Available Aim: We aim to investigate besides the cardiac structures and functions by both conventionalmethods and Tissue Doppler Echocardiography (TDE which is a new and useful method inpatients with Fibromyalgia (FM. Additionally, we evaluated QT parameters (QT maximum,QT minimum and QT dispertion with the use of electrocardiography in order to measure theautonomic dysfunction which is a possible mechanism in the pathogenesis of the disease. Methods: The study was performed on 42 patients (mean age 41 years, 38 female and 38completely healthy subjects (35 female, mean age of 42 years who were admitted to the sameclinic were collected as the control group. All the individuals were undergone a completephysical examination, electrocardiography (recordings were displayed at 50 mm/s speed andechocardiography evaluation (both conventional methods and TDE.Results: Analysis of electrocardiographic recordings revealed mildly increased mean QTdispertion in the patient group, but this difference was statistically insignificant. Analysis ofconventional echocardiographic parameters revealed similar results between the patient groupand the control cases. However, an important finding of this study is that significant diastolicdysfunction was found in the patient group which was recorded with the TDE technique. Emwave velocity and Em/Am ratios were significantly lower in patients with FM compared withcontrols (p<0.005, p<0.01, respectively. Sm and Am waves velocities were similar in bothgroups. Conclusion: In this study, significant left ventricular diastolic dysfunction which was detectedby TDE technique can partly explain several symptoms such as fatigue and dyspnea in FM. Inaddition, fully cardiac evaluation of patients with FM might be obtained supporting findingsthe autonomic dysfunction theory in fibromyalgia pathogenesis.

Value of the Electrocardiogram as a Predictor of Right Ventricular Dysfunction in Patients With Chronic Right Ventricular Volume Overload.

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Alonso, Pau; Andrés, Ana; Rueda, Joaquín; Buendía, Francisco; Igual, Begoña; Rodríguez, María; Osa, Ana; Arnau, Miguel A; Salvador, Antonio

2015-05-01

Pulmonary regurgitation is a common complication in patients with repaired tetralogy of Fallot or congenital pulmonary stenosis. Electrocardiographic variables have been correlated with parameters used to evaluate right ventricular function. We aimed to analyze the diagnostic value of the width and fragmentation of the electrocardiogram in the identification of patients with right ventricular dysfunction and/or dilation. We selected 107 consecutive patients diagnosed with severe pulmonary insufficiency after repair of pulmonary stenosis or tetralogy of Fallot. The tests included electrocardiography, echocardiography, and magnetic resonance. Each electrocardiogram was analyzed manually to measure QRS duration. We defined QRS fragmentation as the presence of low-voltage waves in the terminal portion of the QRS complex in at least 2 contiguous leads. We found a significant negative correlation between QRS width and right ventricular function, as well as a positive correlation with right ventricular volume. The receiver operating characteristic curve indicated a cut-off point for QRS width of 140ms, which showed good sensitivity for a diagnosis of right ventricular dilation (> 80%) and dysfunction (> 95%). In logistic regression models, a QRS duration > 140ms was found to be the only independent predictor of right ventricular dilation and dysfunction. Electrocardiography is a rapid, widely available, and reproducible tool. QRS width constitutes an independent predictor of the presence of right ventricular dilation and dysfunction. This study is the first to provide a cutoff value for QRS width to screen for right ventricle involvement. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Cost-benefit and cost-savings analyses of antiarrhythmic medication monitoring.

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Snider, Melissa; Carnes, Cynthia; Grover, Janel; Davis, Rich; Kalbfleisch, Steven

2012-09-15

The economic impact of pharmacist-managed antiarrhythmic drug therapy monitoring on an academic medical center's electrophysiology (EP) program was investigated. Data were collected for the initial two years of patient visits (n = 816) to a pharmacist-run clinic for antiarrhythmic drug therapy monitoring. A retrospective cost analysis was conducted to assess the direct costs associated with three appointment models: (1) a clinic office visit only, (2) a clinic visit involving electrocardiography and basic laboratory tests, and (3) a clinic visit including pulmonary function testing and chest x-rays in addition to electrocardiography and laboratory testing. A subset of patient cases (n = 18) were included in a crossover analysis comparing pharmacist clinic care and usual care in an EP physician clinic. The primary endpoints were the cost benefits and cost savings associated with pharmacy-clinic care versus usual care. A secondary endpoint was improvement of overall EP program efficiency. The payer mix was 61.6% (n = 498) Medicare, 33.2% (n = 268) managed care, and 5.2% (n = 42) other. Positive contribution margins were demonstrated for all appointment models. The pharmacist-managed clinic also yielded cost savings by reducing overall patient care charges by 21% relative to usual care. By the second year, the pharmacy clinic improved EP program efficiency by scheduling an average of 24 patients per week, in effect freeing up one day per week of EP physician time to spend on other clinical activities. Pharmacist monitoring of antiarrhythmic drug therapy in an out-patient clinic provided cost benefits, cost savings, and improved overall EP program efficiency.

Successful Radiofrequency Catheter Ablation for Wolff-Parkinson-White Syndrome Within the Neck of a Coronary Sinus Diverticulum

Science.gov (United States)

Jang, Sung-Won; Kim, Dong-Bin; Kwon, Bum-Jun; Cho, Eun-Joo; Shin, Woo-Seung; Kim, Ji-Hoon; Jin, Seung-Won; Oh, Yong-Seog; Lee, Man-Young; Kim, Jae-Hyung

2009-01-01

Posteroseptal accessory pathways are often associated with coronary sinus diverticula. These diverticula contain myocardial coats which serve as a bypass tract. We report a 54-year-old woman who underwent radiofrequency (RF) catheter ablation for Wolff-Parkinson-White (WPW) syndrome. The surface electrocardiography (ECG) demonstrated pre-excitation, indicating a posteroseptal accessory pathway. A catheter ablation via a transaortic approach failed to ablate the accessory pathway. Coronary sinus venography revealed the presence of a diverticulum near the ostium. An electrogram in the neck of the diverticulum showed the coronary sinus myocardial extension potential, which was successfully ablated by delivery of RF energy. PMID:19949625

Increase in Cardiac Troponin I in a Lamb with Tetralogy of Fallot

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NEUWALD, Elisa Barp; SOARES, Frederico Aécio Carvalho; DREYER, Cristina Terres; CARNESELLA, Samuel; WOUTERS, Angelica Terezinha Barth; GONZÁLEZ, Félix Hilario Diaz; DRIEMEIER, David

2013-01-01

ABSTRACT This study describes a case of tetralogy of Fallot in a lamb showing failure to thrive and signs of respiratory distress. Physical examination, electrocardiography, thoracic radiographies, echocardiography and cardiac troponin I evaluation were performed. The value of cardiac troponin I was compared with the values of 10 healthy lambs of the same age and breed, and the affected animal demonstrated an increase in cardiac troponin I. Due to the poor prognosis, euthanasia was indicated, and necropsy confirmed the diagnosis. This is the first report of an increase in cardiac troponin I in a lamb with tetralogy of Fallot. PMID:23685750

[The German physician and pacifist Georg Friedrich Nicolai (1874-1964) as a pupil of the Russian physiologist Ivan Petrovic Pavlov (1849-1936)].

Science.gov (United States)

Kästner, Ingrid

2005-01-01

In 1906, Dr. med. Georg Friedrich Nicolai, a young specialist in the field of electrocardiography from the university of Berlin, spent some months in the laboratory of Pavlov, where he was one of the first German visitors. Two letters written by Nicolai to Pavlov are a mirror of Nicolai's admiration for the brilliant Russian Nobel prize winner, but also of Nicolai's remarkable insight into the perspectives of Pavlov's physiological method for "objective" psychological investigations. Nicolai regarded himself a pupil of Pavlov until his death in South America, where he was forced to emigrate after World War I due to his pacifist activities.

The application of biomedical engineering techniques to the diagnosis and management of tropical diseases: a review.

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Ibrahim, Fatimah; Thio, Tzer Hwai Gilbert; Faisal, Tarig; Neuman, Michael

2015-03-23

This paper reviews a number of biomedical engineering approaches to help aid in the detection and treatment of tropical diseases such as dengue, malaria, cholera, schistosomiasis, lymphatic filariasis, ebola, leprosy, leishmaniasis, and American trypanosomiasis (Chagas). Many different forms of non-invasive approaches such as ultrasound, echocardiography and electrocardiography, bioelectrical impedance, optical detection, simplified and rapid serological tests such as lab-on-chip and micro-/nano-fluidic platforms and medical support systems such as artificial intelligence clinical support systems are discussed. The paper also reviewed the novel clinical diagnosis and management systems using artificial intelligence and bioelectrical impedance techniques for dengue clinical applications.

Electrocardiogram of Clinically Healthy Mithun (Bos frontalis): Variation among Strains

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Sanyal, Sagar; Das, Pradip Kumar; Ghosh, Probal Ranjan; Das, Kinsuk; Vupru, Kezha V.; Rajkhowa, Chandan; Mondal, Mohan

2010-01-01

A study was conducted to establish the normal electrocardiogram in four different genetic strains of mithun (Bos frontalis). Electrocardiography, cardiac electrical axis, heart rate, rectal temperature and respiration rate were recorded in a total of 32 adult male mithun of four strains (n = 8 each). It was found that the respiration and heart rates were higher (P electrocardiogram of mithun revealed that the amplitude and duration of P wave, QRS complex and T wave were different among four different genetic strains of mithun and the electrical axis of QRS complex for Nagamese and Mizoram mithuns are dissimilar to bovine species. PMID:20886013

A multichannel portable ECG system with capacitive sensors

International Nuclear Information System (INIS)

Oehler, M; Schilling, M; Ling, V; Melhorn, K

2008-01-01

Capacitive sensors can be employed for measuring the electrocardiogram of a human heart without electric contact with the skin. This configuration avoids contact problems experienced by conventional electrocardiography. In our studies, we integrated these capacitive electrocardiogram electrodes in a 15-sensor array and combined this array with a tablet personal computer. By placing the system on the patient's body, we can measure a 15-channel electrocardiogram even through clothes and without any preparation. The goal of this development is to provide a new diagnostic tool that offers the user a reproducible, easy access to a fast and spatially resolved diagnostic 'heart view'

The Normal Electrocardiogram: Resting 12-Lead and Electrocardiogram Monitoring in the Hospital.

Science.gov (United States)

Harris, Patricia R E

2016-09-01

The electrocardiogram (ECG) is a well-established diagnostic tool extensively used in clinical settings. Knowledge of cardiac rhythm and mastery of cardiac waveform interpretation are fundamental for intensive care nurses. Recognition of the normal findings for the 12-lead ECG and understanding the significance of changes from baseline in continuous cardiac monitoring are essential steps toward ensuring safe patient care. This article highlights historical developments in electrocardiography, describes the normal resting 12-lead ECG, and discusses the need for continuous cardiac monitoring. In addition, future directions for the ECG are explored briefly. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinical evaluation of left ventricular wall thickness by combined technique with gated planer 201Tl image and gated cardiac pool image

International Nuclear Information System (INIS)

Nakai, Kenji; Katsuragawa, Shigehiko; Takahashi, Tsuneo; Matsushita, Kazuo; Kawamura, Akiyoshi

1983-01-01

To evaluate the left ventricular (LV) wall thickness, combined technique with gated planer 201-Thallium image and gated cardiac pool image was applied to 6 patients with hypertrophic cardiomyopathy (HCM) and 4 patients with secondary hypertrophy due to hypertension (HHD) proven by electrocardiography and ultrasonic-echocardiography. Scintigraphic pattern of hypertrophy on reconstructed planer 201 Tl image showed diffuse or asymmetrical apical hypertrophy in HHD, asymmetrical septal hypertrophy in HCM. It was very interesting that abnormal perfusion was shown in 201 Tl image, despite symmetrical hypertrophy in echocardiography. This techniques provided useful information for evaluating the LV wall thickness and cardiac performance. (author)

Survey of health status and physical fitness in Royal Thai Naval Aircraft Carrier personnel

DEFF Research Database (Denmark)

Supanitayanon, Thanawat; Jensen, Olaf Chresten; Canals, ML

2011-01-01

blood glucose, impaired renal function tests, high uric acid, dyslipidemia, abnormal liver function tests, hypertension, abnormal urine examination, abnormal chest radiography, abnormal electrocardiography, anemia, overweight, obesity, morbid obesity, and high waist circumference. To evaluate physical...... dyslipidemia (52.1% valid only for the group =or>35 years old), overweight (27.6%) and hypertension (14.7%). Results of physical fitness tests show that on Push-Up, 39.9% of the group demonstrated a "very good" performance. Conclusions: Outdoor activities which can help to improve overall physical fitness...... levels in certain parameters such as overweight and dyslipidemia. Keywords: Health Status, Physical Fitness, Naval Medicine, Thailand....

A direct comparison of efficacy between desloratadine and rupatadine in seasonal allergic rhinoconjunctivitis: a randomized, double-blind, placebo-controlled study.

Science.gov (United States)

Lukat, Kf; Rivas, P; Roger, A; Kowalski, Ml; Botzen, U; Wessel, F; Sanquer, F; Agache, I; Izquierdo, I

2013-01-01

H1-antihistamines are recommended as the first-line symptomatic treatment of allergic rhinitis. The objective of this study was to evaluate the effects of rupatadine (RUP) versus desloratadine (DES) in subjects with seasonal allergic rhinitis (SAR). To assess the efficacy and safety of RUP in SAR in comparison with placebo (PL) and DES. A randomized, double-blind, multicenter, international, and PL-controlled study was carried out. The main selection criteria included SAR patients over 12 years old with a positive prick test to a relevant seasonal allergen for the geographic area. Symptomatic patients at screening with a nasal symptom sum score of ≥6 points (nasal discharge, nasal obstruction, sneezing, and nasal pruritus), a non-nasal score of ≥3 points (ocular pruritus, ocular redness, and tearing eyes), and a rhinorrhea score of ≥2 points with laboratory test results and electrocardiography within acceptable limits were included in the study. Change from baseline in the total symptom-score (T7SS) over the 4-week treatment period (reflective evaluation) was considered the primary efficacy variable. Secondary efficacy measures included total nasal symptom score (T4NSS) and conjunctival symptom score (T3NNSS), both of which are reflective and instantaneous evaluations. Furthermore questions related to quality of life (eg, sleep disturbances or impairment of daily activities) have also been evaluated. Safety was assessed according to adverse events reported, as well as laboratory and electrocardiography controls. A total of 379 patients were randomized, of which 356 were included and allocated to PL (n = 122), RUP (n = 117), or DES (n = 117). Mean change of T7SS over the 4-week treatment period was significantly reduced in the RUP (-46.1%, P = 0.03) and DES (-48.9%, P = 0.01) groups, compared with PL. Similarly, RUP and DES were comparable and significantly superior to PL for all secondary endpoints, including nasal and conjunctival symptoms and patients' and

Maximal exercise electrocardiography responses and coronary heart disease mortality among men with diabetes mellitus.

Science.gov (United States)

Lyerly, G William; Sui, Xuemei; Church, Timothy S; Lavie, Carl J; Hand, Gregory A; Blair, Steven N

2008-05-27

An abnormal ECG during maximal exercise testing has been shown to be a powerful predictor of future coronary heart disease (CHD) mortality in asymptomatic men. However, little is known about the relationship between exercise ECG responses and CHD risk in men with diabetes mellitus. We examined the association between exercise ECG responses and mortality in 2854 men with documented diabetes mellitus (mean age 49.5 years) who completed a maximal treadmill exercise test during the period from 1974 to 2001 and who were without a previous cardiovascular disease (CVD) event at baseline. Mortality due to all causes, CHD, and CVD were the main outcome measures across categories of exercise ECG responses, with stratification by cardiorespiratory fitness, quantified as treadmill test duration. During an average follow-up of 16 years, 441 deaths (210 CVD and 133 CHD) were identified. Across normal, equivocal, and abnormal exercise ECG groups, age- and examination year-adjusted CHD mortality rates per 10 000 person-years were 23.0, 48.6, and 69.0, respectively (P(trend)<0.001). After further adjustment for fasting plasma glucose level, smoking, body mass index, hypercholesterolemia, hypertension, family history of CVD or diabetes mellitus, abnormal resting ECG responses, and cardiorespiratory fitness, hazard ratios (95% confidence intervals) were 1.00 (referent), 1.68 (1.01 to 2.77), and 2.21 (1.41 to 3.46; P(trend)<0.001). Similar patterns of associations were noted between exercise ECG testing and both CVD and all-cause mortality risk. Among men with diabetes mellitus, equivocal and abnormal exercise ECG responses were associated with higher risk of all-cause, CVD, and CHD mortality.

Reverse Δ-wave as a possible sign in electrocardiography to diagnose mitral valve prolapse

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Alizadeh-Asl Azin

2011-01-01

Full Text Available Abstract Background Mitral valve prolapse (MVP is defined as superior displacement of the mitral valve leaflets more than 2 mm into the left atrium during systole. Easier and cheaper assessment of this common disease is a priority in cardiac health care facilities. Presentation of the hypothesis In this study I addressed electrocardiographic presentation in 300 patients with MVP compared with 100 healthy individuals. I faced a novel finding in electrocardiogram (ECG examination of these patients. It was a notch (reverse Δ-wave in descending arm of QRS observed in 79% (237/300 of patients, consisting of 58% (174/300 in inferior leads and 21% (63/300 in I and aVL leads. The notch was identified only in 6 men in control group. Testing the hypothesis Considering the relatively higher prevalence of disease, a population-based diagnostic clinical trial study is appropriate to test the hypothesis. Implications of the hypothesis The hypothesis on diagnostic value of reverse Δ-wave in MVP may help in decreasing the rate of unnessessary echocardiography in some patients.

ECG Wave-Maven: An Internet-based Electrocardiography Self-Assessment Program for Students and Clinicians

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Ary L. Goldberger

2003-02-01

Full Text Available Purpose: To create a multimedia internet-based ECG teaching tool, with the ability to rapidly incorporate new clinical cases. Method: We created ECG Wave-Maven (http://ecg.bidmc.harvard.edu, a novel teaching tool with a direct link to an institution-wide clinical repository. We analyzed usage data from the web between December, 2000 and May 2002. Results: In 17 months, there have been 4105 distinct uses of the program. A majority of users are physicians or medical students (2605, 63%, and almost half report use as an educational tool. Conclusions: The internet offers an opportunity to provide easily-expandable, open access resources for ECG pedagogy which may be used to complement traditional methods of instruction

ECG Wave-Maven: An Internet-based Electrocardiography Self-Assessment Program for Students and Clinicians.

Science.gov (United States)

McClennen, Seth; Nathanson, Larry A; Safran, Charles; Goldberger, Ary L

2003-12-01

To create a multimedia internet-based ECG teaching tool, with the ability to rapidly incorporate new clinical cases. We created ECG Wave-Maven ( http://ecg.bidmc.harvard.edu ), a novel teaching tool with a direct link to an institution-wide clinical repository. We analyzed usage data from the web between December, 2000 and May 2002. In 17 months, there have been 4105 distinct uses of the program. A majority of users are physicians or medical students (2605, 63%), and almost half report use as an educational tool. The internet offers an opportunity to provide easily-expandable, open access resources for ECG pedagogy which may be used to complement traditional methods of instruction.

Development and significance of a fetal electrocardiogram recorded by signal-averaged high-amplification electrocardiography.

Science.gov (United States)

Hayashi, Risa; Nakai, Kenji; Fukushima, Akimune; Itoh, Manabu; Sugiyama, Toru

2009-03-01

Although ultrasonic diagnostic imaging and fetal heart monitors have undergone great technological improvements, the development and use of fetal electrocardiograms to evaluate fetal arrhythmias and autonomic nervous activity have not been fully established. We verified the clinical significance of the novel signal-averaged vector-projected high amplification ECG (SAVP-ECG) method in fetuses from 48 gravidas at 32-41 weeks of gestation and in 34 neonates. SAVP-ECGs from fetuses and newborns were recorded using a modified XYZ-leads system. Once noise and maternal QRS waves were removed, the P, QRS, and T wave intervals were measured from the signal-averaged fetal ECGs. We also compared fetal and neonatal heart rates (HRs), coefficients of variation of heart rate variability (CV) as a parasympathetic nervous activity, and the ratio of low to high frequency (LF/HF ratio) as a sympathetic nervous activity. The rate of detection of a fetal ECG by SAVP-ECG was 72.9%, and the fetal and neonatal QRS and QTc intervals were not significantly different. The neonatal CVs and LF/HF ratios were significantly increased compared with those in the fetus. In conclusion, we have developed a fetal ECG recording method using the SAVP-ECG system, which we used to evaluate autonomic nervous system development.

Diagnostic electrocardiography in epidemiological studies of Chagas' disease: multicenter evaluation of a standardized method

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Lázzari Julio O.

1998-01-01

Full Text Available An electrocardiographic recording method with an associated reading guide, designed for epidemiological studies on Chagas' disease, was tested to assess its diagnostic reproducibility. Six cardiologists from five countries each read 100 electrocardiographic (ECG tracings, including 30 from chronic chagasic patients, then reread them after an interval of 6 months. The readings were blind, with the tracings numbered randomly for the first reading and renumbered randomly for the second reading. The physicians, all experienced in interpreting ECGs from chagasic patients, followed printed instructions for reading the tracings. Reproducibility of the readings was evaluated using the kappa (k index for concordance. The results showed a high degree of interobserver concordance with respect to the diagnosis of normal vs. abnormal tracings (k = 0.66; SE 0.02. While the interpretations of some categories of ECG abnormalities were highly reproducible, others, especially those having a low prevalence, showed lower levels of concordance. Intraobserver concordance was uniformly higher than interobserver concordance. The findings of this study justify the use by specialists of the recording of readings method proposed for epidemiological studies on Chagas' disease, but warrant caution in the interpretation of some categories of electrocardiographic alterations.

Diagnostic electrocardiography in epidemiological studies of Chagas' disease: multicenter evaluation of a standardized method

Directory of Open Access Journals (Sweden)

Julio O. Lázzari

1998-11-01

Full Text Available An electrocardiographic recording method with an associated reading guide, designed for epidemiological studies on Chagas' disease, was tested to assess its diagnostic reproducibility. Six cardiologists from five countries each read 100 electrocardiographic (ECG tracings, including 30 from chronic chagasic patients, then reread them after an interval of 6 months. The readings were blind, with the tracings numbered randomly for the first reading and renumbered randomly for the second reading. The physicians, all experienced in interpreting ECGs from chagasic patients, followed printed instructions for reading the tracings. Reproducibility of the readings was evaluated using the kappa (k index for concordance. The results showed a high degree of interobserver concordance with respect to the diagnosis of normal vs. abnormal tracings (k = 0.66; SE 0.02. While the interpretations of some categories of ECG abnormalities were highly reproducible, others, especially those having a low prevalence, showed lower levels of concordance. Intraobserver concordance was uniformly higher than interobserver concordance. The findings of this study justify the use by specialists of the recording of readings method proposed for epidemiological studies on Chagas' disease, but warrant caution in the interpretation of some categories of electrocardiographic alterations.

Myocardial scintigraphy (thallium-201) and electrocardiography at rest and during exercise in angina pectoris

International Nuclear Information System (INIS)

Minning, E.; Scharf-Bornhofen, E.; Brueggeman, Th.; Chen, T.; Barthel, W.; Bluemchen, G.; Sankt-Josef-Hospital, Oberhausen

1980-01-01

Ecg (at rest and during exercise) was compared to Thallium-201 myocardial perfusion imaging (at rest and after exercise) in 65 patients with coronary heart disease (myocardial infarction in 53 patients) and angina pectoris. These results were compared to coronary angiography and left ventricular angiography. (orig./AJ) [de

Eletrocardiografia de cães submetidos a diferentes concentrações de desflurano, pré-tratados ou não com a associação de fentanil/droperidol Electrocardiography of dogs undergoing different desflurane concentrations, premedicated or not with fentanyl/droperidol association

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Paulo Sérgio Patto dos Santos

2001-10-01

Full Text Available Avaliaram-se os efeitos da associação de fentanil e droperidol sobre a freqüência cardíaca (FC e eletrocardiografia (ECG, em cães submetidos à anestesia pelo desflurano. Para tal, foram empregados quarenta animais hígidos, adultos, machos e fêmeas, com peso variando entre 6,5 e 20kg. Os cães foram separados igualmente em dois grupos G1 e G2. Ao G1, administrou-se fentanil (15,7mg/kg associado ao droperidol (0,5mg/kg; ao G2, administrou-se solução fisiológica a 0,9% (placebo, ambos por via intravenosa. Decorridos 15 minutos, induziu-se à anestesia geral com administração intravenosa de propofol (5mg/kg. Ato contínuo, os cães foram submetidos a anestesia inalatória pelo desflurano, diluído em oxigênio, através de circuito anestésico semifechado na concentração inicial de 1,6 CAM. As observações das variáveis tiveram início imediatamente antes da aplicação dos fármacos M1. Novas mensurações foram realizadas 15 minutos após a administração da associação fentanil/droperidol ou placebo M2 e 20 minutos decorridos da indução anestésica M3 (1,6 CAM. As demais colheitas coincidiram com o estabelecimento das concentrações de 1,4; 1,2; e 1,0 CAM, respectivamente M4 a M6. Os dados numéricos destas variáveis foram submetidos à Análise de Perfil, sendo considerado o nível de significância de pThe aim of this work was to evaluate the effects of the fentanil/droperidol association over the heart rate (HR and electrocardiography (ECG of dogs submitted to anesthesia by desflurane. For that, forty healthy adult dogs, males and females were used. The dogs were equally separate in two groups G1 and G2. G1 received fentanil (15.7mg/kg associated to droperidol (0.5mg/kg; while G2 received saline solution at 0.9% (placebo, both applied intravenously. After 15 minutes the general anesthesia was induced with intravenously administration of propofol (5mg/kg. The dogs were submitted to inhalatory anesthesia with desflurane

Observational cohort study of ventricular arrhythmia in adults with Marfan syndrome caused by FBN1 mutations.

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Ali Aydin

Full Text Available Marfan syndrome is associated with ventricular arrhythmia but risk factors including FBN1 mutation characteristics require elucidation.We performed an observational cohort study of 80 consecutive adults (30 men, 50 women aged 42±15 years with Marfan syndrome caused by FBN1 mutations. We assessed ventricular arrhythmia on baseline ambulatory electrocardiography as >10 premature ventricular complexes per hour (>10 PVC/h, as ventricular couplets (Couplet, or as non-sustained ventricular tachycardia (nsVT, and during 31±18 months of follow-up as ventricular tachycardia (VT events (VTE such as sudden cardiac death (SCD, and sustained ventricular tachycardia (sVT. We identified >10 PVC/h in 28 (35%, Couplet/nsVT in 32 (40%, and VTE in 6 patients (8%, including 3 with SCD (4%. PVC>10/h, Couplet/nsVT, and VTE exhibited increased N-terminal pro-brain natriuretic peptide serum levels(P10/h and Couplet/nsVT also related to increased indexed end-systolic LV diameters (P = .024 and P = .020, to moderate mitral valve regurgitation (P = .018 and P = .003, and to prolonged QTc intervals (P = .001 and P = .006, respectively. Moreover, VTE related to mutations in exons 24-32 (P = .021. Kaplan-Meier analysis corroborated an association of VTE with increased NT-proBNP (P<.001 and with mutations in exons 24-32 (P<.001.Marfan syndrome with causative FBN1 mutations is associated with an increased risk for arrhythmia, and affected persons may require life-long monitoring. Ventricular arrhythmia on electrocardiography, signs of myocardial dysfunction and mutations in exons 24-32 may be risk factors of VTE.

The Value of the Electrocardiogram for Evaluating Prognosis in Patients with Idiopathic Pulmonary Arterial Hypertension.

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Cheng, Xiao-Ling; He, Jian-Guo; Liu, Zhi-Hong; Gu, Qing; Ni, Xin-Hai; Zhao, Zhi-Hui; Luo, Qin; Xiong, Chang-Ming

2017-02-01

Association between electrocardiography (ECG) features and right ventricular anatomy and physiology has been established. This study is aimed to identify the value of 12-lead ECG in evaluating prognosis of patients with idiopathic pulmonary arterial hypertension (IPAH). 194 patients with newly diagnosed IPAH were included in this study. Correlations between electrocardiography variables and hemodynamics were assessed. Univariate and multivariable cox regression analysis were performed to identify ECG variables for predicting all-cause mortality in IPAH. Partial correlation analysis showed that P wave amplitude in lead II correlated with the mean pulmonary arterial pressure (mPAP, r = 0.349, p ≤ 0.001) and cardiac index (CI, r = -0.224, p = 0.002); R wave amplitude in V1 correlated with mPAP (r = 0.359, p ≤ 0.001); S wave amplitude in V6 correlated with mPAP (r = 0.259, p = 0.030) and CI (r = -0.220, p = 0.003). P wave amplitude in lead II (HR 1.555, p = 0.033) and R wave amplitude in lead aVR (HR 5.058, p < 0.001) were the independent predictors of all-cause mortality. Kaplan-Meier survival curves showed patients with a p ≥ 0.25 mv in lead II, and R ≥ 0.4 mv in lead aVR had lower 3-year survival (55 vs. 91%, p < 0.001). Specific lead-12 ECG features could reflect right ventricular overload hemodynamics, and are useful to evaluate prognosis of patients with IPAH.

Development of electrocardiogram intervals during growth of FVB/N neonate mice

Science.gov (United States)

2010-01-01

Background Electrocardiography remains the best diagnostic tool and therapeutic biomarker for a spectrum of pediatric diseases involving cardiac or autonomic nervous system defects. As genetic links to these disorders are established and transgenic mouse models produced in efforts to understand and treat them, there is a surprising lack of information on electrocardiograms (ECGs) and ECG abnormalities in neonate mice. This is likely due to the trauma and anaesthesia required of many legacy approaches to ECG recording in mice, exacerbated by the fragility of many mutant neonates. Here, we use a non-invasive system to characterize development of the heart rate and electrocardiogram throughout the growth of conscious neonate FVB/N mice. Results We examine ECG waveforms as early as two days after birth. At this point males and females demonstrate comparable heart rates that are 50% lower than adult mice. Neonatal mice exhibit very low heart rate variability. Within 12 days of birth PR, QRS and QTc interval durations are near adult values while heart rate continues to increase until weaning. Upon weaning FVB/N females quickly develop slower heart rates than males, though PR intervals are comparable between sexes until a later age. This suggests separate developmental events may contribute to these gender differences in electrocardiography. Conclusions We provide insight with a new level of detail to the natural course of heart rate establishment in neonate mice. ECG can now be conveniently and repeatedly used in neonatal mice. This should serve to be of broad utility, facilitating further investigations into development of a diverse group of diseases and therapeutics in preclinical mouse studies. PMID:20735846

Utility of electrocardiogram in the assessment and monitoring of pulmonary hypertension (idiopathic or secondary to pulmonary developmental abnormalities) in patients≤18 years of age.

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Lau, Kelvin C; Frank, David B; Hanna, Brian D; Patel, Akash R

2014-07-15

Electrocardiograms have utility in disease stratification and monitoring in adult pulmonary arterial hypertension (PAH). We examined the electrocardiographic findings that are common in pediatric PAH and assessed for correlation with disease severity and progression. We retrospectively identified patients aged≤18 years followed at a single institution from January 2001 to June 2012 with catheterization-confirmed diagnosis of idiopathic PAH and PAH secondary to pulmonary developmental abnormalities. Patients with an electrocardiography performed within 60 days of catheterization were included. Primary and secondary outcomes are the prevalence of abnormal electrocardiographic findings at the time of catheterization and the association between electrocardiographic and hemodynamic findings and electrocardiographic changes with disease progression on follow-up catheterization, respectively. Of the 100 electrocardiography-catheterization pairs derived from the 46 patients identified, 93% had an electrocardiographic abnormality: 78% had right ventricular hypertrophy (RVH) and 52% had right axis deviation (RAD) for age. In patients with idiopathic PAH, the presence of RVH and RAD correlated with pulmonary vascular resistance and transpulmonary gradient. RAD and RVH on baseline electrocardiogram was associated with an increased risk of disease progression on subsequent catheterization (odds ratio 11.0, 95% confidence interval 1.3 to 96.2, p=0.03) after adjusting for PAH subgroup. The sensitivity, specificity, and positive and negative predictive values of RAD and RVH on baseline electrocardiogram for disease progression were 92%, 48%, 33%, and 95%, respectively. In conclusion, electrocardiographic abnormalities are common in pediatric PAH. RAD and RVH on electrocardiogram were associated with worse hemodynamics, whereas their absence is suggestive of a lack of disease progression. Copyright © 2014 Elsevier Inc. All rights reserved.

The relationship between patient data and pooled clinical management decisions.

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Ludbrook, G I; O'Loughlin, E J; Corcoran, T B; Grant, C

2013-01-01

A strong relationship between patient data and preoperative clinical decisions could potentially be used to support clinical decisions in preoperative management. The aim of this exploratory study was to determine the relationship between key patient data and pooled clinical opinions on management. In a previous study, panels of anaesthetists compared the quality of computer-assisted patient health assessments with outpatient consultations and made decisions on the need for preoperative tests, no preoperative outpatient assessment, possible postoperative intensive care unit/high dependency unit requirements and aspiration prophylaxis. In the current study, the relationship between patient data and these decisions was examined using binomial logistic regression analysis. Backward stepwise regression was used to identify independent predictors of each decision (at P >0.15), which were then incorporated into a predictive model. The number of factors related to each decision varied: blood picture (four factors), biochemistry (six factors), coagulation studies (three factors), electrocardiography (eight factors), chest X-ray (seven factors), preoperative outpatient assessment (17 factors), intensive care unit requirement (eight factors) and aspiration prophylaxis (one factor). The factor types also varied, but included surgical complexity, age, gender, number of medications or comorbidities, body mass index, hypertension, central nervous system condition, heart disease, sleep apnoea, smoking, persistent pain and stroke. Models based on these relationships usually demonstrated good sensitivity and specificity, with receiver operating characteristics in the following areas under curve: blood picture (0.75), biochemistry (0.86), coagulation studies (0.71), electrocardiography (0.90), chest X-ray (0.85), outpatient assessment (0.85), postoperative intensive care unit requirement (0.88) and aspiration prophylaxis (0.85). These initial results suggest modelling of patient

Suspected acute coronary syndrome in the emergency room: Limited added value of heart type fatty acid binding protein point of care or ELISA tests: The FAME-ER (Fatty Acid binding protein in Myocardial infarction Evaluation in the Emergency Room) study.

Science.gov (United States)

Bank, Ingrid Em; Dekker, Marieke S; Hoes, Arno W; Zuithoff, Nicolaas Pa; Verheggen, Peter Whm; de Vrey, Evelyn A; Wildbergh, Thierry X; Timmers, Leo; de Kleijn, Dominique Pv; Glatz, Jan Fc; Mosterd, Arend

2016-08-01

Timely recognition of acute coronary syndrome remains a challenge as many biomarkers, including troponin, remain negative in the first hours following the onset of chest pain. We assessed the diagnostic accuracy of heart-type fatty acid binding protein (H-FABP), a cardiac biomarker with potential value immediately post symptom onset. Prospective monocentre diagnostic accuracy study of H-FABP bedside point of care (CardioDetect®) and ELISA tests in acute coronary syndrome suspected patients presenting within 24 hours of symptom onset to the emergency department, in addition to clinical findings, electrocardiography and the currently recommended biomarker high sensitivity troponin-T (hs-cTnT). The final diagnosis of acute coronary syndrome was adjudicated by two independent cardiologists, blinded to H-FABP results. Acute coronary syndrome was diagnosed in 149 (32.9%) of 453 unselected patients with suspected acute coronary syndrome (56% men, mean age 62.6 years). Negative predictive values were similar for H-FABP point of care and ELISA tests (79% vs. 78% respectively), but inferior to initial hs-cTnT (negative predictive value 86%). The addition of H-FABP point of care results to hs-cTnT increased the negative predictive value to 89%. In a multivariable logistic regression model, H-FABP point of care and ELISA tests yielded relevant diagnostic information in addition to clinical findings and ECG (likelihood ratio test pacute coronary syndrome presenting to the emergency department, H-FABP testing improves diagnostic accuracy in addition to clinical findings and electrocardiography. H-FABP, however, has no additional diagnostic value when hs-cTnT measurements are also available. © The European Society of Cardiology 2015.

Effectiveness of 2-hour Troponin in High-risk Patients With Suspected Acute Coronary Syndrome.

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Bove, Joseph; Hochman, Steven; Miller, Jacob; Artim, Stephen

2017-06-01

Research has shown the safety and effectiveness of drawing a standard troponin level at presentation and again at 2 hours in only low-risk patients. Because high-sensitivity troponins are not currently approved in the United States, we studied the utility of a standard troponin that is presently in use. Our goal was to determine if 2-hour standard troponin would be safe and effective in the evaluation of a high-risk cohort of patients never studied previously. We conducted a single-center prospective observational study of adult patients presenting to the emergency department with signs and symptoms suggestive of acute coronary syndrome. Patients were defined as high risk if the attending physician planned to admit or transfer the patient to the observation unit. History, Electrocardiography, Age, Risk factors, Troponin scores were calculated on all patients to provide verification that the individuals were high risk. The primary outcome was a composite of 30-day myocardial infarction, death, cardiac arrest with return of spontaneous circulation, or dysrhythmia. The secondary outcome was 30-day revascularization. We included a total of 122 patients with an average follow-up of 112 days (minimum 30 days). A total of 86% of cases had History, Electrocardiography, Age, Risk factors, Troponin scores ≥4. The primary outcome was met in 22 (18%) patients, and the secondary outcome occurred in 7 (5.7%) patients. The negative predictive value of negative 2-hour troponins along with no significant delta troponin rise was 98.7%. Discharging patients thought to be high risk who have negative troponins at 0 and 2 hours and no delta troponin rise appears safe. No deaths occurred in follow-up. Larger studies are warranted.

Atrial and Ventricular Electrocardiographic Dromotropic Disturbances in Down Syndrome Patients with Structurally Normal Heart: A Cross-Sectional Study

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Yazdan Ghandi

2018-03-01

Full Text Available Background: We designed a cross-sectional study to determine electrocardiographic disorders in Down syndrome patients with congenitally normal hearts in a bid to predict fatal cardiac arrhythmia in the future. Materials and Methods: We investigated 60 children with DS without congenital abnormal hearts. Sixty healthy juveniles were also included in the study as a control group. Physical examination, electrocardiography, and echocardiography were performed in all subjects. Corrected QT interval (QTc was measured according to Bazett’s formula. Results: Patients with DS consisted of 32 males (53.33%, and 28 females (46.66%, aged 6–13 (9.21 ± 6.24 years old. Healthy subjects comprised 31 males (51.66%, and 29 females (48.33% with a mean age of 9.15 ± 5.01. The two groups were significantly different in terms of heart rate (P=0.006, maximum P-wave duration (P=0.001, and P-wave dispersion (PWd, P=0.0001. There was no statistically significant difference regarding minimum P-wave duration (P=0.176. The patients with DS had a greater maximum QTc interval, QT dispersion, and corrected QT interval dispersion (QTc-d than the healthy control subjects (P=0.001. However, there was no difference in maximum QT interval and minimum QTc interval between the two groups (P=0.67 and P=0.553, respectively. A positive correlation was found between age, heart rate, and all electrocardiographic variables. Conclusion: All DS patients, even in the absence of concomitant congenital heart disease should be followed up carefully by electrocardiography, looking for increased PWd and QTc-d to detect predisposed cases to arrhythmia.

Rupture of an aneurysm of the coronary sinus of Valsalva: diagnosis by helical CT angiography

International Nuclear Information System (INIS)

Azarine, A.; Lions, C.; Beregi, J.P.; Koussa, M.

2001-01-01

A 75-year-old man presented with a 5-day history of upper chest discomfort. On auscultation, there was a systolic murmur in the left parasternal area that radiated to the apex. Electrocardiography showed flat T waves in the anterior precordial leads. Chest X ray revealed mediastinal enlargement. Transthoracic echocardiography showed a dilated proximal ascending aorta with moderate aortic regurgitation. A contrast-enhanced helical CT scan, performed to eliminate an aortic dissection, showed a ruptured left coronary sinus of Valsalva aneurysm, confirmed at surgery. This case highlights the fact that helical CT, in patients with suspected aortic dissection, may reveal other pathology that accounts for the clinical presentation. (orig.)

Rupture of an aneurysm of the coronary sinus of Valsalva: diagnosis by helical CT angiography

Energy Technology Data Exchange (ETDEWEB)

Azarine, A.; Lions, C.; Beregi, J.P. [Dept. of Vascular Surgery, Hopital Cardiologique, CHRU de Lille (France); Koussa, M. [Dept. of Vascular Radiology, Hopital Cardiologique, CHRU de Lille (France)

2001-08-01

A 75-year-old man presented with a 5-day history of upper chest discomfort. On auscultation, there was a systolic murmur in the left parasternal area that radiated to the apex. Electrocardiography showed flat T waves in the anterior precordial leads. Chest X ray revealed mediastinal enlargement. Transthoracic echocardiography showed a dilated proximal ascending aorta with moderate aortic regurgitation. A contrast-enhanced helical CT scan, performed to eliminate an aortic dissection, showed a ruptured left coronary sinus of Valsalva aneurysm, confirmed at surgery. This case highlights the fact that helical CT, in patients with suspected aortic dissection, may reveal other pathology that accounts for the clinical presentation. (orig.)

Radiotherapy with linear accelerator in a patient with permanent pacemaker, methodology and results of dose determination in a case in vivo

International Nuclear Information System (INIS)

Diaz A, P.; Dominguez O, X.; Toledo B, V.; Nungaray, H.; Zazueta L, F.

2010-09-01

This work presents the methodology used by the radiotherapy department of the Hospital San Javier in the patients handling with pacemaker. By means of dosimetry to the implant area of the pacemaker together with electrocardiography measurements during the radiotherapy sessions, the pacemaker performance is evaluated with the objective of detecting any anomaly to the same caused by electromagnetic interference and/or accumulated dose. It is necessary to follow specific protocols in these patients type that guarantee their security during the exposition to ionizing radiation since a definitive consent that allows to calculate the failure probability of pacemaker in this therapeutic condition does not exist. (Author)

Methods for Improving the Diagnosis of a Brugada ECG Pattern.

Science.gov (United States)

Gottschalk, Byron H; Garcia-Niebla, Javier; Anselm, Daniel D; Glover, Benedict; Baranchuk, Adrian

2016-03-01

Brugada syndrome (BrS) is an inherited channelopathy that predisposes individuals to malignant arrhythmias and can lead to sudden cardiac death. The condition is characterized by two electrocardiography (ECG) patterns: the type-1 or "coved" ECG and the type-2 or "saddleback" ECG. Although the type-1 Brugada ECG pattern is diagnostic for the condition, the type-2 Brugada ECG pattern requires differential diagnosis from conditions that produce a similar morphology. In this article, we present a case that is suspicious but not diagnostic for BrS and discuss the application of ECG methodologies for increasing or decreasing suspicion for a diagnosis of BrS. © 2015 Wiley Periodicals, Inc.

Clinical evaluation of left ventricular wall thickness by combined technique with gated planer /sup 201/Tl image and gated cardiac pool image

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Nakai, Kenji; Katsuragawa, Shigehiko; Takahashi, Tsuneo; Matsushita, Kazuo; Kawamura, Akiyoshi

1983-11-01

To evaluate the left ventricular (LV) wall thickness, a combined technique with gated planer 201-thallium image and gated cardiac pool image was applied to 6 patients with hypertrophic cardiomyopathy (HCM) and 4 patients with secondary hypertrophy due to hypertension (HHD) proven by electrocardiography and ultrasonic-echocardiography. Scintigraphic pattern of hypertrophy on reconstructed planer /sup 201/Tl image showed diffuse or asymmetrical apical hypertrophy in HHD, asymmetrical septal hypertrophy in HCM. It was very interesting that abnormal perfusion was shown in /sup 201/Tl image, despite symmetrical hypertrophy in echocardiography. This techniques provided useful information for evaluating the LV wall thickness and cardiac performance.

Incremental value of contrast echocardiography in the evaluation of a cardiac thrombus.

Science.gov (United States)

Po, Jose Ricardo F; Tong, Matthew S; Grove, Erica L; Biederman, Robert W W

2017-02-01

A 52-year-old man presented with altered mental status and report of prior complaint of chest pain. On electrocardiography, anterolateral ST-segment elevations with Q-waves in the septal leads were seen. Initial echocardiography images demonstrated a thickened anteroseptum. Further imaging showed the presence of a well-attached laminated apical thrombus. Contrast echocardiography images showed that the thrombus had minimal attachment to the endocardial surface. CT head subsequently showed the presence of acute stroke. The case demonstrates the additional value of contrast echocardiography in the evaluation of cardiac masses despite the certainty in the diagnosis of a thrombus. © 2017, Wiley Periodicals, Inc.

The Application of Biomedical Engineering Techniques to the Diagnosis and Management of Tropical Diseases: A Review

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Fatimah Ibrahim

2015-03-01

Full Text Available This paper reviews a number of biomedical engineering approaches to help aid in the detection and treatment of tropical diseases such as dengue, malaria, cholera, schistosomiasis, lymphatic filariasis, ebola, leprosy, leishmaniasis, and American trypanosomiasis (Chagas. Many different forms of non-invasive approaches such as ultrasound, echocardiography and electrocardiography, bioelectrical impedance, optical detection, simplified and rapid serological tests such as lab-on-chip and micro-/nano-fluidic platforms and medical support systems such as artificial intelligence clinical support systems are discussed. The paper also reviewed the novel clinical diagnosis and management systems using artificial intelligence and bioelectrical impedance techniques for dengue clinical applications.

Contrast Media Delivery in the Assessment of Anomalous Left Coronary Artery From the Pulmonary Artery.

Science.gov (United States)

Saade, Charbel; Al-Hamra, Salam; Al-Mohiy, Hussain; El-Merhi, Fadi

2016-05-01

A patient with a history of mitral valve prolapse and regurgitation that was corrected with a mitral ring repair 15 years earlier received a diagnosis of anomalous left coronary artery arising from the pulmonary artery and underwent repair. Coronary computed tomography angiography (CTA) was employed to image the patient before surgical intervention. Synchronizing contrast media administration to opacify the right coronary artery in the arterial phase and the left coronary artery in the venous phase required a test-bolus approach. Matching compromised cardiovascular dynamics with patient-specific contrast media administration protocols was improved considerably with the use of a test-bolus technique during electrocardiography-gated coronary CTA.

A Case of Cardiac Cephalalgia Showing Reversible Coronary Vasospasm on Coronary Angiogram

Science.gov (United States)

Yang, YoungSoon; Jin, Dong Gyu; Jang, Il Mi; Jang, YoungHee; Na, Hae Ri; Kim, SanYun

2010-01-01

Background Under certain conditions, exertional headaches may reflect coronary ischemia. Case Report A 44-year-old woman developed intermittent exercise-induced headaches with chest tightness over a period of 10 months. Cardiac catheterization followed by acetylcholine provocation demonstrated a right coronary artery spasm with chest tightness, headache, and ischemic effect of continuous electrocardiography changes. The patient's headache disappeared following intra-arterial nitroglycerine injection. Conclusions A coronary angiogram with provocation study revealed variant angina and cardiac cephalalgia, as per the International Classification of Headache Disorders (code 10.6). We report herein a patient with cardiac cephalalgia that manifested as reversible coronary vasospasm following an acetylcholine provocation test. PMID:20607049

Diagnostic advantages of the association of electrocardiograms and thallium 201 exercise scintigraphy in detecting coronary disease

International Nuclear Information System (INIS)

Tubau, J.F.; Chaitman, B.R.; Dupras, G.; Waters, D.D.; Bourassa, M.G.

1979-01-01

Thallium 201 exercise scintigraphy combined with 14-lead exercise electrocardiography detects coronary artery disease in 95-96 percent of the patients, whether men or women. When both tests were positive, 93 percent of the men and 100 percent of the women had coronary artery disease. In women, thallium 201 seems to do better than 14-lead exercise electrocardiogram, detecting the presence of coronary artery disease in 72 percent and its absence in 83 percent of the cases. In approximately 50 percent of the cases, the results of thallium 201 and multiple-lead exercise testing were discordant; in these cases, an accurate clinical history is helpful. (author) [fr

Clinical evaluation of 99mTc-CPI myocardial perfusion single photon emission computerized tomography in the diagnosis of coronary heart disease

International Nuclear Information System (INIS)

Peng Changping

1991-01-01

Two normal subjects, 5 patients with old myocardial infarction (OMI) and 4 patients with angina pectoris were examined by rest single photon emission computerized tomography revealed that the right ventricular was not imaged, the left ventricular was well exposed in the normal subjects. All the 9 patients had defects in the left ventricle. comparison of SPECT with 99m Tc-CPI with selective coronary arteriography (SCA), echocardiography (UCG), dynamic electrocardiography (DCG) and electrocardiographic (ECG)-exercise test in the diagnosis of myocardial ischemia or necrosis has demonstrated the former to be more significantly sensitive than the latter four. Good agreement between SPECT and SCA has been confirmed

The Child as a Surrogate for Diagnosis of Lupus in the Mother

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Olufemi O. Adelowo

2017-01-01

Full Text Available Introduction. Neonatal lupus erythematosus (NLE is an acquired disease of the newborn caused by transplacental transfer of maternal anti-Ro/SSA, anti-La/SSB, and infrequently anti-U1 RNP antibodies. Methodology. This is a case report of a male infant delivered via Caesarean section at 36-week gestation following detection of fetal bradycardia during routine antenatal clinic visit. Results. The mother was seropositive for antinuclear antibody (ANA and anti-Ro/SSA and had elevated erythrocyte sedimentation rate. The baby was positive for ANA, extractable nuclear antigen (ENA, and anti-Ro/SSA. Pediatric echocardiography was abnormal and electrocardiography confirmed complete heart block.

Radiotherapy with linear accelerator in a patient with permanent pacemaker, methodology and results of dose determination in a case in vivo; Radioterapia con Linac en un paciente con marcapasos permanente, metodologia y resultados de determinacion de dosis en un caso in vivo

Energy Technology Data Exchange (ETDEWEB)

Diaz A, P.; Dominguez O, X.; Toledo B, V.; Nungaray, H.; Zazueta L, F., E-mail: pdiaz@hospitalsanjavier.co [Hospital San Javier, Pablo Casals No. 640, Col. Prados Providencia, 44670 Guadalajara, Jalisco (Mexico)

2010-09-15

This work presents the methodology used by the radiotherapy department of the Hospital San Javier in the patients handling with pacemaker. By means of dosimetry to the implant area of the pacemaker together with electrocardiography measurements during the radiotherapy sessions, the pacemaker performance is evaluated with the objective of detecting any anomaly to the same caused by electromagnetic interference and/or accumulated dose. It is necessary to follow specific protocols in these patients type that guarantee their security during the exposition to ionizing radiation since a definitive consent that allows to calculate the failure probability of pacemaker in this therapeutic condition does not exist. (Author)

74 Year-Old-Man With Pneumopericardium Due to Blunt Chest Trauma: Case Report

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Alper Avcı

2008-12-01

Full Text Available Pneumopericardium is the presence of air in the pericardial space. It may be seen in the context with severe blunt chest trauma. Usually, pneumopericardium is self-limiting and requiring no specific therapy. However, a continuous monitoring of the electrocardiography and the blood pressure is necessary at an intermediate care unit. We report a 74 year-old-man had been presented with Pneumopericardium, after a car striking. He had bilateral pneumohematothoraces, pneumomediastinum and bilateral multiple rib fractures. Pneumopericardium was diasappeared without surgical management like written in english literature. Frequent cardiac and vital signs monitoring and general support treatment were successful in our treatment.

Takotsubo cardiomyopathy: a case report.

Science.gov (United States)

Johar, Sandeep; Prasad, Heramba; Kozman, Hani

2007-01-01

A 57-year-old Caucasian woman presented to the emergency department with chest discomfort after testifying in a child custody battle in court. Electrocardiography (ECG) revealed ST-segment elevation in the lateral leads, and T-wave inversions in the inferior and lateral leads. The creatine kinase, creatine kinase-MB, and troponin I concentrations were elevated on presentation. Despite the ECG changes and elevated cardiac markers, coronary angiography demonstrated normal arteries. Left ventricular angiogram revealed an aneurysm at the apex. Takotsubo cardiomyopathy was diagnosed on the basis of these characteristic findings. The patient was discharged on her third hospital day without any complications from the coronary angiography.

Association of heart failure hospitalizations with combined electrocardiography and echocardiography criteria for left ventricular hypertrophy

DEFF Research Database (Denmark)

Gerdts, Eva; Okin, Peter M; Boman, Kurt

2012-01-01

The value of performing echocardiography in hypertensive patients with electrocardiographic left ventricular hypertrophy (LVH) is uncertain.......The value of performing echocardiography in hypertensive patients with electrocardiographic left ventricular hypertrophy (LVH) is uncertain....

Atrial Fibrillation Detection During 24-Hour Ambulatory Blood Pressure Monitoring: Comparison With 24-Hour Electrocardiography.

Science.gov (United States)

Kollias, Anastasios; Destounis, Antonios; Kalogeropoulos, Petros; Kyriakoulis, Konstantinos G; Ntineri, Angeliki; Stergiou, George S

2018-07-01

This study assessed the diagnostic accuracy of a novel 24-hour ambulatory blood pressure (ABP) monitor (Microlife WatchBP O3 Afib) with implemented algorithm for automated atrial fibrillation (AF) detection during each ABP measurement. One hundred subjects (mean age 70.6±8.2 [SD] years; men 53%; hypertensives 85%; 17 with permanent AF; 4 paroxysmal AF; and 79 non-AF) had simultaneous 24-hour ABP monitoring and 24-hour Holter monitoring. Among a total of 6410 valid ABP readings, 1091 (17%) were taken in ECG AF rhythm. In reading-to-reading ABP analysis, the sensitivity, specificity, and accuracy of ABP monitoring in detecting AF were 93%, 87%, and 88%, respectively. In non-AF subjects, 12.8% of the 24-hour ABP readings indicated false-positive AF, of whom 27% were taken during supraventricular premature beats. There was a strong association between the proportion of false-positive AF readings and that of supraventricular premature beats ( r =0.67; P ABP monitoring had 100%/85% sensitivity/specificity (area under the curve 0.91; P ABP monitor with AF detector has high sensitivity and moderate specificity for AF screening during routine ABP monitoring. Thus, in elderly hypertensives, a 24-hour ABP recording with at least 26% of the readings suggesting AF indicates a high probability for AF diagnosis and should be regarded as an indication for performing 24-hour Holter monitoring. © 2018 American Heart Association, Inc.

Fetal heart rate patterns at 20 to 24 weeks gestation as recorded by fetal electrocardiography

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Hofmeyr, F; Groenewald, CA; Nel, DG; Myers, MM; Fifer, WP; Signore, C; Hankins, GDV; Odendaal, HJ

2014-01-01

Introduction With advancing technology it has become possible to accurately record and assess fetal heart rate (FHR) patterns from gestations as early as 20 weeks. The aim of our study was to describe early patterns of FHR, as recorded by transabdominal fetal electrocardiogram according to the Dawes-Redman criteria. Accordingly, short-term variability, basal heart rate, accelerations and decelerations were quantified at 20-24 weeks gestation among women with uncomplicated pregnancies. Methods This study was conducted in a subset of participants enrolled in a large prospective pregnancy cohort study. Our final data set consisted of 281 recordings of women with good perinatal outcomes that had undergone fetal electrocardiographic assessment as part of the Safe Passage Study. Results The success rate of the recordings was 95.4%. The mean frequency of small and large accelerations was 0.5 and 0.1 per 10 minutes respectively and that of small and large decelerations 0.3 and 0.008 per 10 minutes respectively. The mean and basal heart rates were both equal to 148.0 bpm at a median gestation of 161 days. The mean short term variation was 6.2 (SD 1.4) milliseconds and mean minute range 35.1 (SD 7.1) milliseconds. Conclusion The 20 to 24 week fetus demonstrates FHR patterns with more accelerations and decelerations, as well as higher baseline variability than was anticipated. Information from this study provides an important foundation for further, more detailed, studies of early FHR patterns. PMID:23991757

Electrocardiography as the First Step for the Further Examination of Cardiac Involvement in Myasthenia Gravis

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Takao Kato

2016-01-01

Full Text Available Introduction. Cardiac involvement of myasthenia gravis (MG accompanies a poor prognosis. In the present study, we aimed to investigate the relationship between ECG abnormality and cardiac involvement. Methods. Of 178 patients diagnosed with MG between 2001 and 2013 at our hospital, we retrospectively analyzed consecutive 58 patients who underwent both ECG and echocardiography and without underlying cardiovascular disease. ECG abnormalities were defined by computer-assigned Minnesota-codes. Cardiac damage was defined as either (1 ejection fraction (EF 8 on echocardiography. Results. Thirty-three patients (56.8% had ECG abnormality. An elevated E/e′ was observed in patients with ECG abnormality compared to those without ECG abnormality (11.2±3.2, 8.7±2.2, resp., p=0.03. Among patients with ECG abnormality, 14 of 15 patients showed cardiac damage. Among patients without ECG abnormality, 6 of 33 patients showed cardiac damage (p=0.003. Reduced EF was observed in five patients (8.6% with ECG abnormality and none in patients without ECG abnormality. Conclusions. ECG may aid as the first step for the further examination of cardiac damage in patients with MG.

Echocardiographic Wall Motion Abnormality in Posterior Myocardial Infarction: The Diagnostic Value of Posterior Leads

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A Darehzereshki

2008-06-01

Full Text Available Background: For the purpose of ascertaining myocardial infarction (MI and ischemia, the sensitivity of the initial 12-lead ECG is inadequate. It is risky to diagnose posterior MI using only precordial reciprocal changes, since the other leads may be more optimally positioned for the identification of electrocardiographic changes. In this study, we evaluated the relationship between electrocardiography changes and wall motion abnormalities in patients with posterior MI for earlier and better diagnosis of posterior MI.Methods: In this prospective cross-sectional study, we enrolled patients with posterior MI who had come to the Emergency Department of Shariati Hospital with their first episode of chest pain. A 12-lead surface electrocardiogram using posterior leads (V7-V9 was performed for all participants. Patients with ST elevation >0.05 mV or pathologic Q wave in the posterior leads, as well as those with specific changes indicating posterior MI in V1-V2, were evaluated by echocardiography in terms of wall motion abnormalities. All data were analyzed using SPSS and p<0.05 were considered statistically significant.Results: Of a total 79 patients enrolled, 48 (60.8% were men, and the mean age was 57.35±8.22 years. Smoking (54.4% and diabetes (48% were the most prevalent risk factors. In the echocardiographic evaluation, all patients had wall motion abnormalities in the left ventricle and 19 patients (24.1% had wall motion abnormalities in the right ventricle. The most frequent segment with motion abnormality among the all patients was the mid-posterior. The posterior leads showed better positive predictive value than the anterior leads for posterior wall motion abnormality.Conclusion: Electrocardiography of the posterior leads in patients with acute chest pain can help in earlier diagnosis and in time treatment of posterior MI.

Feasibility of low-dose contrast medium high pitch CT angiography for the combined evaluation of coronary, head and neck arteries.

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Zhiwei Wang

Full Text Available PURPOSE: To evaluate the image quality and radiation dose of combined heart, head, and neck CT angiography (CTA using prospectively electrocardiography (ECG-triggered high-pitch spiral scan protocol, compared with single coronary CTA. MATERIALS AND METHODS: 151 consecutive patients were prospectively included and randomly divided into three groups. Group 1 (n = 47 underwent combined heart, neck, and head CTA using prospectively ECG-triggered high-pitch spiral (Flash scan protocol with a single-phase intravenous injection of iodinated contrast and saline flush; Group 2 (n = 51 underwent single coronary CTA with Flash scan protocol; and Group 3 (n = 53 underwent single coronary CTA with prospective sequence scan protocol. All patients were examined on a dual source CT (Definition FLASH. The image quality was determined for each CT study. RESULTS: Patients of scanning protocol Group 1, 2, and 3 showed no significant differences in age, sex, heart rates, and BMI. Evaluation of coronary artery image quality showed comparable results in the three scanning protocol groups on a per patient-based analysis. In group 1, image quality was found to be sufficient to be diagnostic in all arterial segments of carotid arteries. The mean dose-length product (DLP for group 1 was 256.3±24.5 mGy×cm and was significantly higher in comparison with group 2 (93.4±19.9 mGy×cm; p < 0.001. However, there was no significant difference of DLP between group 1 and group 3 (254.1±69.9 mGy×cm. CONCLUSIONS: The combined heart, neck, and head arteries scan using prospectively electrocardiography (ECG-triggered high-pitch spiral scan protocol in 1 single examination resulted in an excellent opacification of the aorta, the carotid arteries, and the coronary arteries and provided a good image quality with low radiation dose.

Carbon monoxide poisoning-induced cardiomyopathy from charcoal at a barbecue restaurant: a case report.

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Kim, Hyun-Jun; Chung, Yun Kyung; Kwak, Kyeong Min; Ahn, Se-Jin; Kim, Yong-Hyun; Ju, Young-Su; Kwon, Young-Jun; Kim, Eun-A

2015-01-01

Acute carbon monoxide poisoning has important clinical value because it can cause severe adverse cardiovascular effects and sudden death. Acute carbon monoxide poisoning due to charcoal is well reported worldwide, and increased use of charcoal in the restaurant industry raises concern for an increase in occupational health problems. We present a case of carbon monoxide poisoning induced cardiomyopathy in a 47-year-old restaurant worker. A male patient was brought to the emergency department to syncope and complained of left chest pain. Cardiac angiography and electrocardiography were performed to rule out acute ischemic heart disease, and cardiac markers were checked. After relief of the symptoms and stabilization of the cardiac markers, the patient was discharged without any complications. Electrocardiography was normal, but cardiac angiography showed up to a 40% midsegmental stenosis of the right coronary artery with thrombotic plaque. The level of cardiac markers was elevated at least 5 to 10 times higher than the normal value, and the carboxyhemoglobin concentration was 35% measured at one hour after syncope. Following the diagnosis of acute carbon monoxide poisoning induced cardiomyopathy, the patient's medical history and work exposure history were examined. He was found to have been exposed to burning charcoal constantly during his work hours. Severe exposure to carbon monoxide was evident in the patient because of high carboxyhemoglobin concentration and highly elevated cardiac enzymes. We concluded that this exposure led to subsequent cardiac injury. He was diagnosed with acute carbon monoxide poisoning-induced cardiomyopathy due to an unsafe working environment. According to the results, the risk of exposure to noxious chemicals such as carbon monoxide by workers in the food service industry is potentially high, and workers in this sector should be educated and monitored by the occupational health service to prevent adverse effects.

Normal ranges for fetal electrocardiogram values for the healthy fetus of 18-24 weeks of gestation: a prospective cohort study.

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Verdurmen, Kim M J; Lempersz, Carlijn; Vullings, Rik; Schroer, Christian; Delhaas, Tammo; van Laar, Judith O E H; Oei, S Guid

2016-08-17

The fetal anomaly ultrasound only detects 65 to 81 % of the patients with congenital heart disease, making it the most common structural fetal anomaly of which a significant part is missed during prenatal life. Therefore, we need a reliable non-invasive diagnostic method which improves the predictive value for congenital heart diseases early in pregnancy. Fetal electrocardiography could be this desired diagnostic method. There are multiple technical challenges to overcome in the conduction of the fetal electrocardiogram. In addition, interpretation is difficult due to the organisation of the fetal circulation in utero. We want to establish the normal ranges and values of the fetal electrocardiogram parameters in healthy fetuses of 18 to 24 weeks of gestation. Women with an uneventful singleton pregnancy between 18 and 24 weeks of gestation are asked to participate in this prospective cohort study. A certified and experienced sonographist performs the fetal anomaly scan. Subsequently, a fetal electrocardiogram recording is performed using dedicated signal processing methods. Measurements are performed at two institutes. We will include 300 participants to determine the normal values and 95 % confidence intervals of the fetal electrocardiogram parameters in a healthy fetus. We will evaluate the fetal heart rate, segment intervals, normalised amplitude and the fetal heart axis. Three months postpartum, we will evaluate if a newborn is healthy through a questionnaire. Fetal electrocardiography could be a promising tool in the screening program for congenital heart diseases. The electrocardiogram is a depiction of the intimate relationship between the cardiac nerve conduction pathways and the structural morphology of the fetal heart, and therefore particularly suitable for the detection of secondary effects due to a congenital heart disease (hypotrophy, hypertrophy and conduction interruption).

Relationship between heart rate and quiescent interval of the cardiac cycle in children using MRI

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Zhang, Wei [Texas Children' s Hospital, E. B. Singleton Department of Pediatric Radiology, Houston, TX (United States); Bogale, Saivivek [Baylor University Medical Center, Department of Radiology, Dallas, TX (United States); Golriz, Farahnaz [Baylor College of Medicine, Department of Radiology, Houston, TX (United States); Krishnamurthy, Rajesh [Nationwide Children' s Hospital, Department of Diagnostic Radiology, Columbus, OH (United States)

2017-11-15

Imaging the heart in children comes with the challenge of constant cardiac motion. A prospective electrocardiography-triggered CT scan allows for scanning during a predetermined phase of the cardiac cycle with least motion. This technique requires knowing the optimal quiescent intervals of cardiac cycles in a pediatric population. To evaluate high-temporal-resolution cine MRI of the heart in children to determine the relationship of heart rate to the optimal quiescent interval within the cardiac cycle. We included a total of 225 consecutive patients ages 0-18 years who had high-temporal-resolution cine steady-state free-precession sequence performed as part of a magnetic resonance imaging (MRI) or magnetic resonance angiography study of the heart. We determined the location and duration of the quiescent interval in systole and diastole for heart rates ranging 40-178 beats per minute (bpm). We performed the Wilcoxon signed rank test to compare the duration of quiescent interval in systole and diastole for each heart rate group. The duration of the quiescent interval at heart rates <80 bpm and >90 bpm was significantly longer in diastole and systole, respectively (P<.0001 for all ranges, except for 90-99 bpm [P=.02]). For heart rates 80-89 bpm, diastolic interval was longer than systolic interval, but the difference was not statistically significant (P=.06). We created a chart depicting optimal quiescent intervals across a range of heart rates that could be applied for prospective electrocardiography-triggered CT imaging of the heart. The optimal quiescent interval at heart rates <80 bpm is in diastole and at heart rates ≥90 bpm is in systole. The period of quiescence at heart rates 80-89 bpm is uniformly short in systole and diastole. (orig.)

Unexpected guest: Atrial fibrillation due to electrical shock

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Mehmet Zihni Bilik

2016-03-01

Full Text Available Cardiac arrhythmias due to electrical injuries are rare among emergency service admittances. A 35 year-old female patient was admitted to emergency service with palpitation after electrical injury as a result of contact with a domestic low-voltage source. Electrocardiography (ECG showed atrial fibrillation with rapid ventricular response. Transthoracic echocardiography findings were normal. Atrial fibrillation spontaneously converted to normal sinus rhythm after rate limiting treatment with beta-blocker. The patient was discharged without any complication on the third day of hospitalization. Although cardiac arrhythmias rarely occur after electrical injury, cardiac monitoring is recommended for all patients with documented rhythm disorder, loss of consciousness, or abnormal ECG at admission.

Improved nonparametric inference for multiple correlated periodic sequences

KAUST Repository

Sun, Ying

2013-08-26

This paper proposes a cross-validation method for estimating the period as well as the values of multiple correlated periodic sequences when data are observed at evenly spaced time points. The period of interest is estimated conditional on the other correlated sequences. An alternative method for period estimation based on Akaike\\'s information criterion is also discussed. The improvement of the period estimation performance is investigated both theoretically and by simulation. We apply the multivariate cross-validation method to the temperature data obtained from multiple ice cores, investigating the periodicity of the El Niño effect. Our methodology is also illustrated by estimating patients\\' cardiac cycle from different physiological signals, including arterial blood pressure, electrocardiography, and fingertip plethysmograph.

ECG changes in gamma-therapy of esophagus cancer

International Nuclear Information System (INIS)

Khajrushev, Zh.A.; Abdrakhmanov, Zh.N.

1978-01-01

Effect of ionizing radiation dose distribution with time in gamma therapy of esophagus cancer has been studied on the basis of the results obtained with electrocardiography. 700 persons were examined before treatment and after completing the full course of irradiation, 426 persons were examined repeatedly. Radiation treatment methods used are given. In most cases ECG changes result in the quickened systole rhythm and diffuse changes in the myocardium due to intoxication. ECG changes associated with the irradiation for patients with esophagus cancer amounted to 16%. Frequency of postirradiation ECG changes depends on the position of esophagus area under irradiation. Different variants of mean dose fractionation were the most sparing with respect to the heart

Wet cupping therapy restores sympathovagal imbalances in cardiac rhythm.

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Arslan, Müzeyyen; Yeşilçam, Nesibe; Aydin, Duygu; Yüksel, Ramazan; Dane, Senol

2014-04-01

A recent study showed that cupping had therapeutic effects in rats with myocardial infarction and cardiac arrhythmias. The current studyaimed to investigate the possible useful effects of cupping therapy on cardiac rhythm in terms of heart rate variability (HRV). Forty healthy participants were included. Classic wet cupping therapy was applied on five points of the back. Recording electrocardiography (to determine HRV) was applied 1 hour before and 1 hour after cupping therapy. All HRV parameters increased after cupping therapy compared with before cupping therapy in healthy persons. These results indicate for the first time in humans that cupping might be cardioprotective. In this study, cupping therapy restored sympathovagal imbalances by stimulating the peripheral nervous system.

Routine clinical heart examinations using SQUID magnetocardiography at University of Tsukuba Hospital

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Inaba, T.; Nakazawa, Y.; Yoshida, K.; Kato, Y.; Hattori, A.; Kimura, T.; Hoshi, T.; Ishizu, T.; Seo, Y.; Sato, A.; Sekiguchi, Y.; Nogami, A.; Watanabe, S.; Horigome, H.; Kawakami, Y.; Aonuma, K.

2017-11-01

A 64-channel Nb-based DC-SQUID magnetocardiography (MCG) system was installed at the University of Tsukuba Hospital (UTH) in March 2007 after obtaining Japanese pharmaceutical approval and insurance reimbursement approval. In the period between 2008 and 2016, the total number of patients was 10 085. The heart diseases diagnosed in fetuses as well as adults are mainly atrial arrhythmia, abnormal repolarization, ventricular arrhythmia, and fetal arrhythmia. In most cases of insufficient diagnostic accuracy with electrocardiography, SQUID MCG precisely revealed these heart diseases as an abnormal electrical current distribution. Based on success in routine examinations, SQUID MCG is now an indispensable clinical instrument with diagnostic software tuned up during routine use at UTH.

A Dog with Pseudo-Addison Disease Associated with Trichuris vulpis Infection

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Luigi Venco

2011-01-01

Full Text Available A female Rottweiler dog was presented with a history of intermittent vomiting and diarrhoea, dysorexia, weakness, and weight loss. Haemocytometry and biochemistry values were within normal ranges except for electrolyte analyses, that demonstrated hyponatremia and hyperkalemia with a decreased sodium/potassium ratio. A diagnosis of hypoadrenocorticism was suspected. Basal and post-ACTH stimulation cortisolemia were within the normal values. Electrocardiography was normal, and thoracic radiography showed no significant modifications. On abdominal ultrasonography, adrenal glands appeared normal, while the bowel was distended, and several thin linear hyperechoic objects floating in the lumen were observed. Two adult female whipworms (Trichuris vulpis were collected following bowel irrigation. Anthelmintic treatment against the parasite was curative.

Acute Carbon Monoxide Poisoning Resulting in ST Elevation Myocardial Infarction: A Rare Case Report

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Po-Chao Hsu

2010-05-01

Full Text Available Acute carbon monoxide (CO poisoning with cardiac complications is well documented in the literature. However, ST segment elevation is a rare presentation, and most of these cases with ST elevation have revealed non-occlusive or normal coronary arteries. We report a case of CO poisoning complicated with ST elevation myocardial infarction. Emergency coronary angiography revealed total occlusion of the left anterior descending artery and primary percutaneous coronary intervention was performed. This report of a rare case should remind physicians that cardiovascular investigations, including electrocardiography, must be performed in cases with CO poisoning because mortality might increase if reperfusion therapy or appropriate medical treatments are not performed in patients with acute coronary artery occlusion.

Preliminary reference values for electrocardiography, echocardiography and myocardial morphometry in the European brown hare (Lepus europaeus

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Slawuta Piotr

2009-01-01

Full Text Available Abstract The study aimed at defining reference values for electrocardiographic (ECG and echocardiographic parameters as well as macroscopic dimensions of the heart and microscopic dimensions of cardiomyocytes in the European brown hare. The studies were conducted on 30 adult, clinically healthy hares of either sex caught in Poland. ECG and echocardiography were performed supravitally on anaesthetized hares. After euthanasia, gross and microscopic myocardial and cardiomyocyte dimensions were determined. Heart rate amounted to 140 ± 37.5 beats/min, the leading rhythm involved the sinus rhythm. P wave time was 26 ± 5 ms, PQ time was 80 ms, QRS time was 29 ± 3.5 ms, and ST was 97.5 ± 7 ms. Echocardiography determined a left ventricular wall end-diastolic diameter of 8.6 ± 2.0 mm and an intraventricular septum end-diastolic diameter of 5.75 ± 1.0 mm. The thickness of the interventricular septum corresponded to that of the free wall of the left ventricle, a finding consistent with physiological hypertrophy. Preliminary reference values were established for echocardiography. The findings were similar to those obtained at necropsy. The ECG and echocardiographic studies represent the first supravital examination of cardiac function in the hare. The obtained results illustrate adaptation of hare's myocardium to its mode of life. The cardiac findings resemble the athlete's heart syndrome described in humans. The findings may prove useful in further studies on the physiology of the cardio-vascular system in the hare.

Subtraction electrocardiography: Detection of ischemia-induced ST displacement without the need to identify the J point.

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Ter Haar, C Cato; Man, Sum-Che; Maan, Arie C; Schalij, Martin J; Swenne, Cees A

2016-01-01

When triaging a patient with acute chest pain at first medical contact, an electrocardiogram (ECG) is routinely made and inspected for signs of myocardial ischemia. The guidelines recommend comparison of the acute and an earlier-made ECG, when available. No concrete recommendations for this comparison exist, neither is known how to handle J-point identification difficulties. Here we present a J-point independent method for such a comparison. After conversion to vectorcardiograms, baseline and acute ischemic ECGs after 3minutes of balloon occlusion during elective PCI were compared in 81 patients of the STAFF III ECG database. Baseline vectorcardiograms were subtracted from ischemic vectorcardiograms using either the QRS onsets or the J points as synchronization instants, yielding vector magnitude difference signals, ΔH. Output variables for the J-point synchronized differences were ΔH at the actual J point and at 20, 40, 60 and 80ms thereafter. Output variables for the onset-QRS synchronized differences were the ΔH at 80, 100, 120, 140 and 160ms after onset QRS. Finally, linear regressions of all combinations of ΔHJ+… versus ΔHQRS+… were made, and the best combination was identified. The highest correlation, 0.93 (pJ point and 160ms after the onset of the QRS complex. With a ΔH ischemia threshold of 0.05mV, 66/81 (J-point synchronized differences) and 68/81 (onset-QRS synchronized differences) subjects were above the ischemia threshold, corresponding to sensitivities of 81% and 84%, respectively. Our current study opens an alternative way to detect cardiac ischemia without the need for human expertise for determination of the J point by measuring the difference vector magnitude at 160ms after the onset of the QRS complex. Copyright © 2016 Elsevier Inc. All rights reserved.

Advanced electrocardiography can predict mitral regurgitation in cavalier king charles spaniels with myxomatous mitral valve disease

DEFF Research Database (Denmark)

Spiljak, Maja; Petric, Alexandra; Olsen, Lisbeth Høier

2011-01-01

(HRV), QT variability (QTV), T-wave complexity, wave morphology and 3-D ECG. One-way ANOVA determined 21 ECG parameters, which were significantly different (P .... Clinic for Surgery and Small Animal Medicine, Veterinary Faculty, University of Ljubljana, Slovenia. 3. Department of Basic Animal and Veterinary Sciences, Faculty of Life Sciences, University of Copenhagen, Denmark. 4. Quality Control Department, Metallurgical and Chemical Industry Cinkarna Celje, INC...

A STUDY OF ELECTROCARDIOGRAPHY AND KIDNEY FUNCTION TEST IN NEWLYDIAGNOSED HYPERTENSIVE PATIENTS IN COASTAL ANDHRA PRADESH

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Ramswaroop

2017-11-01

Full Text Available BACKGROUND As per the fact sheet published by World Health Organisation, South East Asia, nearly one billion people have high blood pressure and are one of the most common causes of premature death worldwide. About one third of the adult population in the South East Asia region is having hypertension. In our country, the number of people with hypertension are undiagnosed and untreated, so early detection and treatment of hypertension will decrease the complication of hypertension and premature death due to it. MATERIALS AND METHODS This is a prospective study conducted in the Department of General Medicine, Konaseema Institute of Medical Sciences, Amalapuram, from May 2015 to August 2017. This study was started with an aim to know that electrocardiographic abnormalities and kidney function at the time of diagnosis of hypertension in a patient in coastal Andhra Pradesh. RESULTS We have found ECG changes in both the stages of hypertensive group patients. In stage-1 hypertensive group patients, out of 80 patients, 6 patients having sinus tachycardia, 2 having sinus bradycardia, 4 patients having left bundle-branch block and 6 having right bundle-branch block. ST elevation was found in 1 patient and ST depression was found in 8 patients. AV block was present in 2 patients. Right ventricular hypertrophy was present in 1 patient and left ventricular hypertrophy was present in 4 patients. T-wave inversion was found in 4 patients. In stage-2 hypertensive patients, sinus tachycardia in 6 patients and bradycardia in 1 patient, LBBB was found in 8 patients. ST depression was found in 6 patients and ST elevation was found in 2 patients out of 40 patients. AV block was present in 3 patients. Left ventricular hypertrophy patients 16 out of 40, but right ventricular hypertrophy was only 1. T-wave inversion was found in 6 patients. CONCLUSION In our study, we have found that stage-2 hypertensive patients have higher BMI, serum urea and creatinine than stage-1 patients. We have found that stage-2 hypertension is associated with increase in PR and QT interval. Left ventricular hypertrophy was commonest ECG abnormality detected. In our study, at the time of diagnosis, already some have developed cardiac manifestation. So, early diagnosis and management of hypertension is essential for further progress of disease.

24-HOUR ELECTROCARDIOGRAPHY IN CLINICAL HEALTHY CAVALIER KING CHARLES SPANIELS, WIRE-HAIRED DACHSHUNDS AND CAIRN TERRIERS

DEFF Research Database (Denmark)

Rasmussen, Caroline Elisabeth; Vesterholm, Stina; Ludvigsen, Trine Pagh

2010-01-01

analysis were analyzed for influence by breed, age, gender, relevant heart rate (HR) parameters and bodyweight. CKCS had a significantly higher HRex (mean 121 ± SD 12 bpm) compared to wD (94±18 bpm) (P>0.0001) and CT (102±16bpm) (P=0.0009). The minimum HR (HRmin) measured during Holter recording...... was significantly higher in CKCS (51±10 bpm) compared to wD (42±7 bpm) (P=0.001) and CT (45±7 bpm) (P=0.05). In addition, CKCS had a higher mean HR (HRmean) during Holter recording (83±13 bpm) compared to wD (68±8 bpm) (P>0.0001) and CT (75±10 bpm) (P=0.04). Both HRmean (P>0.0001) and HRmin (P=0.001) were...

Coronary artery anomalies: Assessment with electrocardiography-gate multidetector-row CT at a single center in Korea

International Nuclear Information System (INIS)

Yi, Bo Ram; Sun, Joo Sung; Yang, Hyoung Mo; Kang, Doo Kyoung

2015-01-01

To determine the prevalence of coronary anomalies using coronary computed tomography angiography (CCTA) and to evaluate the relationship between coronary artery anomalies and chest pain. A total of 12676 patients underwent CCTA scans at our institution between December 2006 and April 2013 using a 64-slice CT and a 128-slice dual-source CT. We determined the prevalence of coronary artery anomalies according to the classification system proposed by Greenberg. The presence or absence of chest pain with each coronary artery anomaly was also evaluated. Coronary anomalies were found in 176 patients (1.39%) at our institute. Anomalies of origination, course, and termination were detected in 118 (0.93%), 28 (0.22%), and 30 (0.24%) patients, respectively. After the exclusion of 32 patients with combined heart disease, typical (n = 16; 11.1%) or atypical (n = 28; 19.4%) chest pain was present in 44 (30.6%) of the 144 patients at the time of diagnosis. The prevalence of coronary artery anomalies was 1.39% at our hospital. After the exclusion of patients with combined heart disease, 11.1% had typical chest pain at the time of diagnosis.

Electroconvulsive therapy-induced Wolff-Parkinson-White syndrome: a case report.

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Enomoto, Shingo; Yoshino, Aihide; Takase, Bonpei; Kuwahara, Tatsuro; Tatsuzawa, Yasutaka; Nomura, Soichiro

2013-01-01

Wolff-Parkinson-White (WPW) syndrome is characterized by premature ventricular excitation due to the presence of an abnormal accessory pathway. Electrocardiography (ECG) of patients with WPW syndrome portrays a short PR interval and a wide QRS interval with a delta wave. Herein, we report the case of a patient with schizophrenia who developed a wide QRS interval with a delta wave immediately following electroconvulsive therapy (ECT). Initially, the delta wave disappeared within 2 days after ECT. However, the duration of the delta wave increased exponentially to 4 months when ECT was repeated. Although the patient's cardiocirculatory dynamics remained normal, we continued to monitor her ECG until the delta wave disappeared because WPW syndrome can lead to serious arrhythmia. Copyright © 2013 Elsevier Inc. All rights reserved.

Transient ischemic attack: diagnostic evaluation.

Science.gov (United States)

Messé, Steven R; Jauch, Edward C

2008-08-01

A transient ischemic attack portends significant risk of a stroke. Consequently, the diagnostic evaluation in the emergency department is focused on identifying high-risk causes so that preventive strategies can be implemented. The evaluation consists of a facilitated evaluation of the patient's metabolic, cardiac, and neurovascular systems. At a minimum, the following tests are recommended: fingerstick glucose level, electrolyte levels, CBC count, urinalysis, and coagulation studies; noncontrast computed tomography (CT) of the head; electrocardiography; and continuous telemetry monitoring. Vascular imaging studies, such as carotid ultrasonography, CT angiography, or magnetic resonance angiography, should be performed on an urgent basis and prioritized according to the patient's risk stratification for disease. Consideration should be given for echocardiography if no large vessel abnormality is identified.

e-SCP-ECG+ Protocol: An Expansion on SCP-ECG Protocol for Health Telemonitoring—Pilot Implementation

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George J. Mandellos

2010-01-01

Full Text Available Standard Communication Protocol for Computer-assisted Electrocardiography (SCP-ECG provides standardized communication among different ECG devices and medical information systems. This paper extends the use of this protocol in order to be included in health monitoring systems. It introduces new sections into SCP-ECG structure for transferring data for positioning, allergies, and five additional biosignals: noninvasive blood pressure (NiBP, body temperature (Temp, Carbon dioxide (CO2, blood oxygen saturation (SPO2, and pulse rate. It also introduces new tags in existing sections for transferring comprehensive demographic data. The proposed enhanced version is referred to as e-SCP-ECG+ protocol. This paper also considers the pilot implementation of the new protocol as a software component in a Health Telemonitoring System.

Pragmatic approach to chest pain patients discharged with undetectable high-sensitivity troponin T and normal electrocardiogram: the STABS + CT protocol.

Science.gov (United States)

Bishop, Warrick; Girao, Gary

2017-06-01

A strategy that discharges chest pain patients with negative high-sensitivity troponin and non-ischaemic electrocardiography changes may still result in 0.44% of patients experiencing myocardial infarction within 30 days. We observed that a pragmatic approach that systematically discharged 25 patients on cardio-protective medications of aspirin, metoprolol and atorvastatin followed with prompt (<10 days) coronary computed tomography angiography resulted in no major adverse cardiac event and adverse drug reaction 30 days post-presentation. The strategy resulted in three patients (12%) ultimately diagnosed with likely unstable angina, which required planned coronary intervention in two patients and medical management in one patient. No unplanned readmissions for chest pains were noted from initial presentation through to 6-month follow up. © 2017 Royal Australasian College of Physicians.

Assessment of potential heart donors: A statement from the French heart transplant community.

Science.gov (United States)

Dorent, Richard; Gandjbakhch, Estelle; Goéminne, Céline; Ivanes, Fabrice; Sebbag, Laurent; Bauer, Fabrice; Epailly, Eric; Boissonnat, Pascale; Nubret, Karine; Amour, Julien; Vermes, Emmanuelle; Ou, Phalla; Guendouz, Soulef; Chevalier, Philippe; Lebreton, Guillaume; Flecher, Erwan; Obadia, Jean-François; Logeart, Damien; de Groote, Pascal

2018-02-01

Assessment of potential donors is an essential part of heart transplantation. Despite the shortage of donor hearts, donor heart procurement from brain-dead organ donors remains low in France, which may be explained by the increasing proportion of high-risk donors, as well as the mismatch between donor assessment and the transplant team's expectations. Improving donor and donor heart assessment is essential to improve the low utilization rate of available donor hearts without increasing post-transplant recipient mortality. This document provides information to practitioners involved in brain-dead donor management, evaluation and selection, concerning the place of medical history, electrocardiography, cardiac imaging, biomarkers and haemodynamic and arrhythmia assessment in the characterization of potential heart donors. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

CORONARY ARTERY FISTULA: A CASE REPORT

Directory of Open Access Journals (Sweden)

MZ Chowdhury

2007-01-01

Full Text Available The prevalence of congenital abnormalities of coronary artery is about 2% of general population. Of these abnormalities 5% were related to coronary artery fistulae (CAF. We report a case of 66 year old diabetic woman who presented with retrosternal chest pain. Her chest pain was associated with exercise and progressively deteriorated over the last 6 months. Electrocardiography showed right bundle branch block and Echo Color Doppler revealed hypo kinetic lateral wall. Coronary angiogram detected nothing abnormal except an aberrant tortuous branch of left circumflex. CT scan revealed a calcified sac medial to the descended thoracic aorta. A contrast enhancement was also done. All these imaging impressions were suggestive of coronary-to-pulmonary fistula. Ibrahim Med. Coll. J. 2007; 1(1: 32-33

Real-time 3D vectorcardiography: an application for didactic use

International Nuclear Information System (INIS)

Daniel, G; Lissa, G; Redondo, D Medina; Vasquez, L; Zapata, D

2007-01-01

The traditional approach to teach the physiological basis of electrocardiography, based only on textbooks, turns out to be insufficient or confusing for students of biomedical sciences. The addition of laboratory practice to the curriculum enables students to approach theoretical aspects from a hands-on experience, resulting in a more efficient and deeper knowledge of the phenomena of interest. Here, we present the development of a PC-based application meant to facilitate the understanding of cardiac bioelectrical phenomena by visualizing in real time the instantaneous 3D cardiac vector. The system uses 8 standard leads from a 12-channel electrocardiograph. The application interface has pedagogic objectives, and facilitates the observation of cardiac depolarization and repolarization and its temporal relationship with the ECG, making it simpler to interpret

High efficiency processing for reduced amplitude zones detection in the HRECG signal

Science.gov (United States)

Dugarte, N.; Álvarez, A.; Balacco, J.; Mercado, G.; Gonzalez, A.; Dugarte, E.; Olivares, A.

2016-04-01

Summary - This article presents part of a more detailed research proposed in the medium to long term, with the intention of establishing a new philosophy of electrocardiogram surface analysis. This research aims to find indicators of cardiovascular disease in its early stage that may go unnoticed with conventional electrocardiography. This paper reports the development of a software processing which collect some existing techniques and incorporates novel methods for detection of reduced amplitude zones (RAZ) in high resolution electrocardiographic signal (HRECG).The algorithm consists of three stages, an efficient processing for QRS detection, averaging filter using correlation techniques and a step for RAZ detecting. Preliminary results show the efficiency of system and point to incorporation of techniques new using signal analysis with involving 12 leads.

Clinical and biochemical monitoring of patients with fatty acid oxidation disorders

DEFF Research Database (Denmark)

Lund, Allan Meldgaard; Skovby, Flemming; Vestergaard, Helle

2010-01-01

complicated assessments by a neuropsychologist, speech therapist, or physical and occupational therapists. Paraclinical measurements are not used for short-chain and medium-chain disorders; electrocardiography (including 24 h monitoring) and echocardiography are done for most patients with long......Evidence-based guidelines for monitoring patients with disorders in fatty acid oxidation (FAO) are lacking, and most protocols are based on expert statements. Here, we describe our protocol for Danish patients. Clinical monitoring is the most important measure and has the main aims of checking...... carnitine is measured to monitor carnitine supplementation in patients with multiple acyl-coenzyme A dehydrogenase deficiency (MADD) and carnitine transporter deficiency (CTD) and to follow metabolic control and disclose deficiency states in other FAO disorders. We are evaluating long-chain acylcarnitines...

CSE database: extended annotations and new recommendations for ECG software testing.

Science.gov (United States)

Smíšek, Radovan; Maršánová, Lucie; Němcová, Andrea; Vítek, Martin; Kozumplík, Jiří; Nováková, Marie

2017-08-01

Nowadays, cardiovascular diseases represent the most common cause of death in western countries. Among various examination techniques, electrocardiography (ECG) is still a highly valuable tool used for the diagnosis of many cardiovascular disorders. In order to diagnose a person based on ECG, cardiologists can use automatic diagnostic algorithms. Research in this area is still necessary. In order to compare various algorithms correctly, it is necessary to test them on standard annotated databases, such as the Common Standards for Quantitative Electrocardiography (CSE) database. According to Scopus, the CSE database is the second most cited standard database. There were two main objectives in this work. First, new diagnoses were added to the CSE database, which extended its original annotations. Second, new recommendations for diagnostic software quality estimation were established. The ECG recordings were diagnosed by five new cardiologists independently, and in total, 59 different diagnoses were found. Such a large number of diagnoses is unique, even in terms of standard databases. Based on the cardiologists' diagnoses, a four-round consensus (4R consensus) was established. Such a 4R consensus means a correct final diagnosis, which should ideally be the output of any tested classification software. The accuracy of the cardiologists' diagnoses compared with the 4R consensus was the basis for the establishment of accuracy recommendations. The accuracy was determined in terms of sensitivity = 79.20-86.81%, positive predictive value = 79.10-87.11%, and the Jaccard coefficient = 72.21-81.14%, respectively. Within these ranges, the accuracy of the software is comparable with the accuracy of cardiologists. The accuracy quantification of the correct classification is unique. Diagnostic software developers can objectively evaluate the success of their algorithm and promote its further development. The annotations and recommendations proposed in this work will allow

Real-Time ECG Simulation for Hybrid Mock Circulatory Loops.

Science.gov (United States)

Korn, Leonie; Rüschen, Daniel; Zander, Niklas; Leonhardt, Steffen; Walter, Marian

2018-02-01

Classically, mock circulatory loops only simulate mechanical properties of the circulation. To connect the hydraulic world with electrophysiology, we present a real-time electrical activity model of the heart and show how to integrate this model into a real-time mock loop simulation. The model incorporates a predefined conduction pathway and a simplified volume conductor to solve the bidomain equations and the forward problem of electrocardiography, resulting in a physiological simulation of the electrocardiogram (ECG) at arbitrary electrode positions. A complete physiological simulation of the heart's excitation would be too CPU intensive. Thus, in our model, complexity was reduced to allow real-time simulation of ECG-triggered medical systems in vitro; this decreases time and cost in the development process. Conversely, the presented model can still be adapted to various pathologies by locally changing the properties of the heart's conduction pathway. To simulate the ECG, the heart is divided into suitable areas, which are innervated by the hierarchically structured conduction system. To distinguish different cardiac regions, a segmentation of the heart was performed. In these regions, Prim's algorithm was applied to identify the directed minimal spanning trees for conduction orientation. Each node of the tree was assigned to a cardiac action potential generated by its hybrid automaton to represent the heart's conduction system by the spatial distribution of action potentials. To generate the ECG output, the bidomain equations were implemented and a simple model of the volume conductor of the body was used to solve the forward problem of electrocardiography. As a result, the model simulates potentials at arbitrary electrode positions in real-time. To verify the developed real-time ECG model, measurements were made within a hybrid mock circulatory loop, including a simple ECG-triggered ventricular assist device control. The model's potential value is to simulate

SU-D-18C-06: Initial Experience with Implementing MRI Safety Guidelines for Patients with Pacemakers - Medical Physicist Perspective

Energy Technology Data Exchange (ETDEWEB)

James, J; Place, V; Panda, A [Mayo Clinic, Scottsdale, AZ (United States); Edmonson, H [Mayo Clinic College of Medicine, Rochester, MN (United States); Felmlee, J [Mayo Clinic, Rochester, MN (United States); Pooley, R [Mayo Clinic, Jacksonville, FL (United States)

2014-06-01

Purpose: Several institutions have developed MRI guidelines for patients with MR-unsafe or MR-conditional pacemakers. Here we highlight the role of a medical physicist in implementing these guidelines for non-pacemaker dependent patients. Guidelines: Implementing these guidelines requires involvement from several medical specialties and a strong collaboration with the site MRI supervisor to develop a structured workflow. A medical physicist is required to be present during the scan to supervise the MR scanning and to maintain a safety checklist that ensures: 1) uninterrupted patient communication with the technologist, 2) continuous patient physiologic monitoring (e.g. blood pressure and electrocardiography) by a trained nurse, 3) redundant patient vitals monitoring (e.g. pulse oximetry) due to the possibility of in vivo electrocardiography reading fluctuations during image acquisition. A radiologist is strongly recommended to be available to review the images before patients are discharged from the scanner. Pacemaker MRI should be restricted to 1.5T field strength. The MRI sequences should be optimized by the physicist with regards to: a) SAR: limited to <1.5 W/Kg for MR-unsafe pacemakers in normal operating mode, b) RF exposure time: <30 min, c) Coils: use T/R coils but not restricted to such, d) Artifacts: further optimization of sequences whenever image quality is compromised due to the pacemaker. In particular, cardiac, breast and left-shoulder MRIs are most susceptible to these artifacts. Possible strategies to lower the SAR include: a) BW reduction, 2) echo-train-length reduction, 3) increase TR, 4) decrease number of averages, 5) decrease flip angle, 6) reduce slices and/or a combination of all the options. Conclusion: A medical physicist in collaboration with the MR supervisor plays an important role in the supervision/implementation of safe MR scanning of pacemaker patients. Developing and establishing a workflow has enabled our institution to scan over

SU-D-18C-06: Initial Experience with Implementing MRI Safety Guidelines for Patients with Pacemakers - Medical Physicist Perspective

International Nuclear Information System (INIS)

James, J; Place, V; Panda, A; Edmonson, H; Felmlee, J; Pooley, R

2014-01-01

Purpose: Several institutions have developed MRI guidelines for patients with MR-unsafe or MR-conditional pacemakers. Here we highlight the role of a medical physicist in implementing these guidelines for non-pacemaker dependent patients. Guidelines: Implementing these guidelines requires involvement from several medical specialties and a strong collaboration with the site MRI supervisor to develop a structured workflow. A medical physicist is required to be present during the scan to supervise the MR scanning and to maintain a safety checklist that ensures: 1) uninterrupted patient communication with the technologist, 2) continuous patient physiologic monitoring (e.g. blood pressure and electrocardiography) by a trained nurse, 3) redundant patient vitals monitoring (e.g. pulse oximetry) due to the possibility of in vivo electrocardiography reading fluctuations during image acquisition. A radiologist is strongly recommended to be available to review the images before patients are discharged from the scanner. Pacemaker MRI should be restricted to 1.5T field strength. The MRI sequences should be optimized by the physicist with regards to: a) SAR: limited to <1.5 W/Kg for MR-unsafe pacemakers in normal operating mode, b) RF exposure time: <30 min, c) Coils: use T/R coils but not restricted to such, d) Artifacts: further optimization of sequences whenever image quality is compromised due to the pacemaker. In particular, cardiac, breast and left-shoulder MRIs are most susceptible to these artifacts. Possible strategies to lower the SAR include: a) BW reduction, 2) echo-train-length reduction, 3) increase TR, 4) decrease number of averages, 5) decrease flip angle, 6) reduce slices and/or a combination of all the options. Conclusion: A medical physicist in collaboration with the MR supervisor plays an important role in the supervision/implementation of safe MR scanning of pacemaker patients. Developing and establishing a workflow has enabled our institution to scan over

Effects of Sweet Bee Venom on cardiovascular system in the conscious telemetered Beagle Dogs

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Lim Chung-San

2010-09-01

Full Text Available Objectives:This study was performed to analyse the effects of Sweet Bee Venom(Sweet BV on cardiovascular system in the conscious telemetered Beagle Dogs. Methods:All experiments were conducted at Biotoxtech Company, a non-clinical studies authorized institution, under the regulations of Good Laboratory Practice (GLP. Male Beagle dogs of 13-19 months old were chosen for the pilot study and surgical implantation was performed for conscious telemetered Beagle dogs. And after confirming condition of Beagle dogs was stable, Sweet BV was administered 4 times(first: 0.0 ㎎/㎏, 2nd: 0.01 ㎎/㎏, 3rd: 0.1 ㎎/㎏, and forth: 0.5 ㎎/㎏, one time/week in thigh muscle of Beagle dogs. And blood pressure, heart rate, electrocardiography and clinical responses were measured. Equal amount of normal saline to the Sweet BV experiment groups was administered to the control group. 1. In the analysis of body weight and taking amount, Beagle dogs did not show significant changes. 2. In the clinical observation, responses of pain and edema were showed depend on dosage of Sweet BV. 3. In the analysis of blood pressure, treatment with Sweet BV did not show significant changes in the dosage of 0.01 ㎎/㎏, but in the dosage of 0.1 ㎎/㎏ and 0.5 ㎎/㎏, treatment with Sweet BV increased blood pressure significantly. 4. In the analysis of heart rate, treatment of Sweet BV did not show significant changes in all dosage and period. 5. In the analysis of electrocardiography, treatment of Sweet BV was not showed significant changes in all dosage and period. Conclusion:Above findings suggest that Sweet BV is relatively safe treatment in the cardiovascular system. But in the using of over dosage, Sweet BV may the cause of increasing blood pressure. Further studies on the subject should be conducted to yield more concrete evidences.

Experimental characterization and analysis of the BITalino platforms against a reference device.

Science.gov (United States)

Batista, Diana; Silva, Hugo; Fred, Ana

2017-07-01

Low-cost hardware platforms for biomedical engineering are becoming increasingly available, which empower the research community in the development of new projects in a wide range of areas related with physiological data acquisition. Building upon previous work by our group, this work compares the quality of the data acquired by means of two different versions of the multimodal physiological computing platform BITalino, with a device that can be considered a reference. We acquired data from 5 sensors, namely Accelerometry (ACC), Electrocardiography (ECG), Electroencephalography (EEG), Electrodermal Activity (EDA) and Electromyography (EMG). Experimental evaluation shows that ACC, ECG and EDA data are highly correlated with the reference in what concerns the raw waveforms. When compared by means of their commonly used features, EEG and EMG data are also quite similar across the different devices.

Characterization of physiological networks in sleep apnea patients using artificial neural networks for Granger causality computation

Science.gov (United States)

Cárdenas, Jhon; Orjuela-Cañón, Alvaro D.; Cerquera, Alexander; Ravelo, Antonio

2017-11-01

Different studies have used Transfer Entropy (TE) and Granger Causality (GC) computation to quantify interconnection between physiological systems. These methods have disadvantages in parametrization and availability in analytic formulas to evaluate the significance of the results. Other inconvenience is related with the assumptions in the distribution of the models generated from the data. In this document, the authors present a way to measure the causality that connect the Central Nervous System (CNS) and the Cardiac System (CS) in people diagnosed with obstructive sleep apnea syndrome (OSA) before and during treatment with continuous positive air pressure (CPAP). For this purpose, artificial neural networks were used to obtain models for GC computation, based on time series of normalized powers calculated from electrocardiography (EKG) and electroencephalography (EEG) signals recorded in polysomnography (PSG) studies.

Features of mitral valve prolapse in young patients

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M. A. Kuznetsova

2015-06-01

Full Text Available Due to the significant increase of complications in young patients with mitral valve prolapse detection of this disease is important. Aim. With the aim of studying the features of mitral valve prolapse 135 persons with mitral valve prolapse at the age of 18–25 years were examined. Methods and results. The features of mitral valve prolapsed were studied with echocardiography, electrocardiography, cardiointervalography. It was established that mitral valve prolapse (MVP in young age had different clinical picture. Patients with MVP 1 degree mainly had autonomic instability, and with 2 degree - mostly signs of connective tissue dysplasia. Conclusion. The presence of MVP is associated with abnormalities of the rhythm and conductivity: 1 degree - sinus tachycardia; the 2nd - sinus arrhythmia, signs of left ventricular hypertrophy and impaired repolarization of the myocardium.

Technological Innovations from NASA

Science.gov (United States)

Pellis, Neal R.

2006-01-01

The challenge of human space exploration places demands on technology that push concepts and development to the leading edge. In biotechnology and biomedical equipment development, NASA science has been the seed for numerous innovations, many of which are in the commercial arena. The biotechnology effort has led to rational drug design, analytical equipment, and cell culture and tissue engineering strategies. Biomedical research and development has resulted in medical devices that enable diagnosis and treatment advances. NASA Biomedical developments are exemplified in the new laser light scattering analysis for cataracts, the axial flow left ventricular-assist device, non contact electrocardiography, and the guidance system for LASIK surgery. Many more developments are in progress. NASA will continue to advance technologies, incorporating new approaches from basic and applied research, nanotechnology, computational modeling, and database analyses.

Normalization of elevated cardiac, kidney, and hemolysis plasma markers within 48 h in Mexican Tarahumara runners following a 78 km race at moderate altitude

DEFF Research Database (Denmark)

Christensen, Dirk Lund; Espino, Diana; Infante-Ramírez, Rocío

2014-01-01

) participated in a 78 km race in Chihuahua, Mexico at 2,400 m above sea level. Cardiac, kidney, and hematology plasma markers were measured pre-race and h, 3 h, 6 h, 24 h, and 48 h post-race. Anthropometry, blood pressure, pulse rate, electrocardiography, HbA1c, hemoglobin and VO2max (estimated from...... the race was 68 (11)%VO2 max. Mean SpO2 was 92 (3)% h post-race, but had returned to pre-race values after 48 h....... The plasma concentrations of mid-regional proatrial natiuretic peptide and copeptin returned to pre-race concentrations after 1 and 6 h, respectively. CONCLUSIONS: Altered cardiac, renal, and hemolysis plasma markers were normalized after 48 h following 78 km of running, suggesting that the impact...

Sygeplejerskeadministreret propofolsedation i forbindelse med endoskopi

DEFF Research Database (Denmark)

Vilmann, Peter; Hornslet, Pernille; Simmons, Hanne

2009-01-01

INTRODUCTION: As an increasing number of therapeutic and diagnostic procedures are performed endoscopically, the demand for sufficient sedation during endoscopy is rising. Propofol sedation administered by nurses (NAPS) has gained increasing popularity. NAPS was introduced at Gentofte Hospital...... in September 2007 after structured training at Roque Valley Surgical Center in Medford, Oregon, USA. The aim of the present study is to present our results with NAPS. MATERIAL AND METHODS: Patients referred for endoscopy were monitored with regard to blood pressure, pulse oxymetry, electrocardiography...... via a nasal tube. Short lasting manual mask ventilation was instituted in five patients. No serious events related to sedation were seen. CONCLUSIONS: NAPS seem to be a suitable method for sedation in endoscopy and should be implemented in Denmark. However, proper training is required in collaboration...

Bigeminy: A result of digoxin and St John’s wort interaction

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Anđelić Slađana

2003-01-01

Full Text Available A case of an by digoxin under unusual circumstances is reported. An 80-year-old man, previously on long-term digoxin treatment, started consuming St John’s wort herbal tea (2 000 ml/daily because of frequent episodes of depression. After the cessation of consuming herbal tea containing Hypericum perforatum, digoxin poisoning developed in our patient. Electrocardiography revealed nodal bradicardia 36/min and bigeminy. Manifested symptoms were the consequence of interaction between digoxin and Hypericum perforatum which were consumed simultaneously, and the cessation of consuming St John’s wort herbal tea afterwards. Therapy was the same as in the standard digitalis poisoning. Consumers of St John’s wort combined with medical products are advised not to discontinue tea consumption on their own, without consulting their physician.

Multi-modal Intelligent Seizure Acquisition (MISA) system - A new approach towards seizure detection based on full body motion measures

DEFF Research Database (Denmark)

Conradsen, Isa; Beniczky, Sándor; Wolf, Peter

2009-01-01

Many epilepsy patients cannot call for help during a seizure, because they are unconscious or because of the affection of their motor system or speech function. This can lead to injuries, medical complications and at worst death. An alarm system setting off at seizure onset could help to avoid...... hazards. Today no reliable alarm systems are available. A Multi-modal Intelligent Seizure Acquisition (MISA) system based on full body motion data seems as a good approach towards detection of epileptic seizures. The system is the first to provide a full body description for epilepsy applications. Three...... test subjects were used for this pilot project. Each subject simulated 15 seizures and in addition performed some predefined normal activities, during a 4-hour monitoring with electromyography (EMG), accelerometer, magnetometer and gyroscope (AMG), electrocardiography (ECG), electroencephalography (EEG...

Feasibility and accuracy of a new mobile electrocardiography device, ER-2000®, in the diagnosis of arrhythmia

Directory of Open Access Journals (Sweden)

Yae Min Park

2015-08-01

Conclusions: A rhythm strip obtained using ER-2000® is accurate in diagnosing arrhythmia, despite some differences in the detailed morphology of the QRS and T-wave, and the pacing spike compared to those obtained by the 12-lead ECG.

Clinical role of electrocardiography and of 201Tl scintigraphy exercise tests in diagnosis of ischemic heart disease

International Nuclear Information System (INIS)

Jelok, I.; Hatala, R.; Mistrik, A.; Borovicova, F.

1988-01-01

The diagnostic potential of ECG and scintigraphy exercise tests is assessed in the light of the experience gained by the authors in the detection of ischemic heart disease, and the complementary character of the two methods is emphasized. The rational and differentiated use of the two noninvasive examination methods requires an optimal clinical assessment of the patient's condition with regard to the probable incidence of the disease. Optimal diagnostic benefit (as compared with the ECG exercise test up to 32%) is shown of scintigraphy, especially in persons with multiple risk factors and atypical chest pain. With regard to the unavailability of perfusion scintigraphy of the myocardium in the authors' clinical practice, they recommend that this examination should mainly be indicated for patients who have a negative or uniterpretable ECG exercise test. (author). 1 tab., 13 refs

Estudo da função ventricular na técnica de plicatura da parede livre do ventrículo esquerdo em cães Left ventricular function after plication of the left ventricular free wall in dogs

Directory of Open Access Journals (Sweden)

James Newton Bizetto Meira de Andrade

2004-06-01

Full Text Available OBJETIVO: Avaliar os efeitos da técnica na função ventricular esquerda em cães hígidos e com cardiomiopatia dilatada induzida pela doxorrubicina. MÉTODO: De 13 cães, oito receberam doxorrubicina até que a fração de encurtamento (FE fosse menor que 20%. Destes, quatro animais e os cinco não induzidos foram submetidos à plicatura da parede livre do ventrículo esquerdo (PPLVE. Os demais cães não foram operados. Foram avaliados débito cardíaco (DC, pressão arterial, exame físico, eletrocardiografia, sistema "Holter" e ecocardiografia, por 180 dias. RESULTADOS: Houve redução do volume ventricular esquerdo. Os cães induzidos melhoraram após a operação e a fração de ejeção (FEj retornou aos valores normais para a espécie. O DC e a FE aumentaram após a operação. Um cão foi a óbito. Nos cães não operados, a FE diminuiu e foram a óbito em torno de 40 dias após a indução; nos cães não induzidos, esta não se alterou. Houve extra-sístoles ventriculares, que se resolveram espontaneamente. CONCLUSÕES: A PPLVE sem circulação extracorpórea reduz o volume ventricular esquerdo e melhora a função cardíaca dos cães com cardiomiopatia dilatada induzida pela doxorrubicina, demonstrando baixa morbidade e mortalidade tardia.OBJECTIVE: We tested a new surgical technique, the plication of the left ventricular free wall, to reduce left ventricular area and volume and improve left ventricular systolic function, without using a cardiopulmonary bypass. METHODS: Dilated cardiomyopathy was induced in eight dogs by the injection of doxorubicin. Plication of the left ventricular free wall was performed in four dogs with induced cardiomyopathy and in five control dogs. Two dogs not submitted to surgery. The other two dogs died during the induction phase. Cardiac output, 2-dimensional and M-mode echocardiography, arterial blood pressure and electrocardiography were recorded over a 180 days period. Ambulatory electrocardiography

Performance Optimization in Sport: A Psychophysiological Approach

Directory of Open Access Journals (Sweden)

Selenia di Fronso

2017-11-01

Full Text Available ABSTRACT In the last 20 years, there was a growing interest in the study of the theoretical and applied issues surrounding psychophysiological processes underlying performance. The psychophysiological monitoring, which enables the study of these processes, consists of the assessment of the activation and functioning level of the organism using a multidimensional approach. In sport, it can be used to attain a better understanding of the processes underlying athletic performance and to improve it. The most frequently used ecological techniques include electromyography (EMG, electrocardiography (ECG, electroencephalography (EEG, and the assessment of electrodermal activity and breathing rhythm. The purpose of this paper is to offer an overview of the use of these techniques in applied interventions in sport and physical exercise and to give athletes, coaches and sport psychology experts new insights for performance improvement.

System of estimations and prognostications of bodily condition of skilled sportsmen in track-and-field

Directory of Open Access Journals (Sweden)

V.I. Bobrovnyk

2013-01-01

Full Text Available The system of estimation and prognostication of bodily condition of skilled athletes is presented. The system includes the complex of pedagogical tests, evaluation tables, estimation of the functional state vegetative, nervous, cardiovascular systems, system of the external breathing. 436 sportsmen took part in research (212 women and 224 men. The analysis of electrocardiography is conducted, variability of cardiac rhythm, determination of vegetative balance, state of myocardium, violations of rhythm of heart, spirometric researches. The estimation of efficiency of activity of sportsman in extreme terms on the basis of type and properties of temperament, level of personality anxiety and estimation of psychological reliability of sportsmen is presented. The criteria of estimation of physical preparedness are certain, functional state of the basic systems of organism, influencing in a greater degree on achievement of high sporting results, psychological state of sportsmen.

Case control study of Electrocardiographic changes in pregnant women

Directory of Open Access Journals (Sweden)

Sharddha Singh

1995-09-01

Full Text Available Pregnancy causes significant haemodynamic changes and imposes stress on the cardiovascular system. Many healthy women develop signs and symptoms of cardiovascular overload during pregnancy. Knowledge of established normal changes in EKG during normal pregnancy is important. The aim of our study was to detect any early damage to myocardium during pregnancy with the help of electrocardiography. Total of 20 pregnant and 20 non pregnant women were studied. The most significant change observed in ECG was T wave inversion with odds ratio 7.43 (95%. Cl = 1.49 to 41.00. P= 0.005. Stratified analysis showed that there was no confounding role of age in the relationship of T wave inversion and ECG findings. Moreover, a significant relationship between anaemia and T wave inversion was also observed. (0=1.74 ■ 1101.06; P= 0.007.

Are ECG monitoring recommendations before prescription of QT-prolonging drugs applied in daily practice?

DEFF Research Database (Denmark)

Warnier, Miriam Jacoba; Rutten, Frans Hendrik; Souverein, Patrick Cyriel

2015-01-01

PURPOSE: Monitoring of the QT duration by electrocardiography (ECG) prior to treatment is frequently recommended in the label of QT-prolonging drugs. It is, however, unknown how often general practitioners in daily clinical practice are adhering to these risk-minimization measures. We assessed...... the frequency of ECG measurements in patients where haloperidol was initiated in primary care. METHODS: Patients (≥18 years) with a first prescription of haloperidol in the UK Clinical Practice Research Datalink (2009-2013) were included. The proportion of ECGs made was determined in two blocks of 4 weeks......: during the exposure period when haloperidol was initiated, and during the control period, 1 year before. Conditional logistic regression analysis was applied to calculate the relative risk of having an ECG in the exposure period compared with the control period. Subgroup analyses were performed to assess...

Fractional flow reserve-guided PCI for stable coronary artery disease

DEFF Research Database (Denmark)

De Bruyne, Bernard; Fearon, William F; Pijls, Nico H J

2014-01-01

.80 received medical therapy alone and were included in a registry. The primary end point was a composite of death from any cause, nonfatal myocardial infarction, or urgent revascularization within 2 years. RESULTS: The rate of the primary end point was significantly lower in the PCI group than in the medical......-therapy group (8.1% vs. 19.5%; hazard ratio, 0.39; 95% confidence interval [CI], 0.26 to 0.57; Pgroup (4.0% vs. 16.3%; hazard ratio, 0.23; 95% CI, 0.14 to 0.38; Pgroup differences...... in the rates of death and myocardial infarction. Urgent revascularizations that were triggered by myocardial infarction or ischemic changes on electrocardiography were less frequent in the PCI group (3.4% vs. 7.0%, P=0.01). In a landmark analysis, the rate of death or myocardial infarction from 8 days to 2...

["Habitual" left branch block alternating with 2 "disguised" bracnch block].

Science.gov (United States)

Lévy, S; Jullien, G; Mathieu, P; Mostefa, S; Gérard, R

1976-10-01

Two cases of alternating left bundle branch block and "masquerading block" (with left bundle branch morphology in the stnadard leads and right bundle branch block morphology in the precordial leads) were studied by serial tracings and his bundle electrocardiography. In case 1 "the masquerading" block was associated with a first degree AV block related to a prolongation of HV interval. This case is to our knowledge the first cas of alternating bundle branch block in which his bundle activity was recorded in man. In case 2, the patient had atrial fibrilation and His bundle recordings were performed while differents degrees of left bundle branch block were present: The mechanism of the alternation and the concept of "masquerading" block are discussed. It is suggested that this type of block represents a right bundle branch block associated with severe lesions of the "left system".

Ambient and Unobtrusive Cardiorespiratory Monitoring Techniques.

Science.gov (United States)

Bruser, Christoph; Antink, Christoph Hoog; Wartzek, Tobias; Walter, Marian; Leonhardt, Steffen

2015-01-01

Monitoring vital signs through unobtrusive means is a goal which has attracted a lot of attention in the past decade. This review provides a systematic and comprehensive review over the current state of the field of ambient and unobtrusive cardiorespiratory monitoring. To this end, nine different sensing modalities which have been in the focus of current research activities are covered: capacitive electrocardiography, seismo- and ballistocardiography, reflective photoplethysmography (PPG) and PPG imaging, thermography, methods relying on laser or radar for distance-based measurements, video motion analysis, as well as methods using high-frequency electromagnetic fields. Current trends in these subfields are reviewed. Moreover, we systematically analyze similarities and differences between these methods with respect to the physiological and physical effects they sense as well as the resulting implications. Finally, future research trends for the field as a whole are identified.

Phase-aware echocardiogram stabilization using keyframes.

Science.gov (United States)

Wu, Hui; Huynh, Toan T; Souvenir, Richard

2017-01-01

This paper presents an echocardiogram stabilization method designed to compensate for unwanted auxilliary motion. Echocardiograms contain both deformable cardiac motion and approximately rigid motion due to a number of factors. The goal of this work is to stabilize the video, while preserving the informative deformable cardiac motion. Our approach incorporates synchronized side information, extracted from electrocardiography (ECG), which provides a proxy for cardiac phase. To avoid the computational expense of pairwise alignment, we propose an efficient strategy for keyframe selection, formulated as a submodular optimization problem. We evaluate our approach quantitatively on synthetic data and demonstrate its benefit as a preprocessing step for two common echocardiogram applications: denoising and left ventricle segmentation. In both cases, preprocessing with our method improved the performance compared to no preprocessing or other alignment approaches. Copyright © 2016 Elsevier B.V. All rights reserved.

Seizure detection, seizure prediction, and closed-loop warning systems in epilepsy.

Science.gov (United States)

Ramgopal, Sriram; Thome-Souza, Sigride; Jackson, Michele; Kadish, Navah Ester; Sánchez Fernández, Iván; Klehm, Jacquelyn; Bosl, William; Reinsberger, Claus; Schachter, Steven; Loddenkemper, Tobias

2014-08-01

Nearly one-third of patients with epilepsy continue to have seizures despite optimal medication management. Systems employed to detect seizures may have the potential to improve outcomes in these patients by allowing more tailored therapies and might, additionally, have a role in accident and SUDEP prevention. Automated seizure detection and prediction require algorithms which employ feature computation and subsequent classification. Over the last few decades, methods have been developed to detect seizures utilizing scalp and intracranial EEG, electrocardiography, accelerometry and motion sensors, electrodermal activity, and audio/video captures. To date, it is unclear which combination of detection technologies yields the best results, and approaches may ultimately need to be individualized. This review presents an overview of seizure detection and related prediction methods and discusses their potential uses in closed-loop warning systems in epilepsy. Copyright © 2014. Published by Elsevier Inc.

Toward Hypertension Prediction Based on PPG-Derived HRV Signals: a Feasibility Study.

Science.gov (United States)

Lan, Kun-Chan; Raknim, Paweeya; Kao, Wei-Fong; Huang, Jyh-How

2018-04-21

Heart rate variability (HRV) is often used to assess the risk of cardiovascular disease, and data on this can be obtained via electrocardiography (ECG). However, collecting heart rate data via photoplethysmography (PPG) is now a lot easier. We investigate the feasibility of using the PPG-based heart rate to estimate HRV and predict diseases. We obtain three months of PPG-based heart rate data from subjects with and without hypertension, and calculate the HRV based on various forms of time and frequency domain analysis. We then apply a data mining technique to this estimated HRV data, to see if it is possible to correctly identify patients with hypertension. We use six HRV parameters to predict hypertension, and find SDNN has the best predictive power. We show that early disease prediction is possible through collecting one's PPG-based heart rate information.

Using a Cloud Computing System to Reduce Door-to-Balloon Time in Acute ST-Elevation Myocardial Infarction Patients Transferred for Percutaneous Coronary Intervention.

Science.gov (United States)

Ho, Chi-Kung; Chen, Fu-Cheng; Chen, Yung-Lung; Wang, Hui-Ting; Lee, Chien-Ho; Chung, Wen-Jung; Lin, Cheng-Jui; Hsueh, Shu-Kai; Hung, Shin-Chiang; Wu, Kuan-Han; Liu, Chu-Feng; Kung, Chia-Te; Cheng, Cheng-I

2017-01-01

This study evaluated the impact on clinical outcomes using a cloud computing system to reduce percutaneous coronary intervention hospital door-to-balloon (DTB) time for ST segment elevation myocardial infarction (STEMI). A total of 369 patients before and after implementation of the transfer protocol were enrolled. Of these patients, 262 were transferred through protocol while the other 107 patients were transferred through the traditional referral process. There were no significant differences in DTB time, pain to door of STEMI receiving center arrival time, and pain to balloon time between the two groups. Pain to electrocardiography time in patients with Killip I/II and catheterization laboratory to balloon time in patients with Killip III/IV were significantly reduced in transferred through protocol group compared to in traditional referral process group (both p cloud computing system in our present protocol did not reduce DTB time.

Myocardial perfusion imaging for detection of silent myocardial ischemia

International Nuclear Information System (INIS)

Beller, G.A.

1988-01-01

Despite the widespread use of the exercise stress test in diagnosing asymptomatic myocardial ischemia, exercise radionuclide imaging remains useful for detecting silent ischemia in numerous patient populations, including those who are totally asymptomatic, those who have chronic stable angina, those who have recovered from an episode of unstable angina or an uncomplicated myocardial infarction, and those who have undergone angioplasty or received thrombolytic therapy. Studies show that thallium scintigraphy is more sensitive than exercise electrocardiography in detecting ischemia, i.e., in part, because perfusion defects occur more frequently than ST depression and before angina in the ischemic cascade. Thallium-201 scintigraphy can be performed to differentiate a true- from a false-positive exercise electrocardiographic test in patients with exercise-induced ST depression and no angina. The development of technetium-labeled isonitriles may improve the accuracy of myocardial perfusion imaging. 11 references

Short-term minoxidil use associated with pericardial effusion and cardiac tamponade: an uncommon presentation.

Science.gov (United States)

Pasala, Krishna K; Gujja, Karthik; Prabhu, Hejmadi; Vasavada, Balendu; Konka, Sudarsanam

2012-11-01

A 48-year-old man presented with complaints of shortness of breath and lower extremity swelling. His medical history was significant for hypertension on minoxidil and recent intracerebellar hemorrhage. Electrocardiography showed sinus tachycardia with left ventricular hypertrophy, and cardiomegaly was noted in the chest x-ray. The patient was hypertensive and tachypneic on admission. An echocardiogram taken immediately showed a large pericardial effusion with evidence of cardiac tamponade. He underwent immediate pericardiocentesis with drainage of 900 mL of pericardial fluid with significant improvement in the symptoms. Analysis of the pericardial fluid proved to be nondiagnostic. Infectious and rheumatologic causes were ruled out. After an extensive battery of tests, not yielding any diagnostic results, the pericardial effusion was attributed to minoxidil therapy. Closer monitoring is needed to prevent potentially fatal complications such as cardiac tamponade as in our patient.

Open Access Integrated Therapeutic and Diagnostic Platforms for Personalized Cardiovascular Medicine

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Todd T. Schlegel

2013-08-01

Full Text Available It is undeniable that the increasing costs in healthcare are a concern. Although technological advancements have been made in healthcare systems, the return on investment made by governments and payers has been poor. The current model of care is unsustainable and is due for an upgrade. In developed nations, a law of diminishing returns has been noted in population health standards, whilst in the developing world, westernized chronic illnesses, such as diabetes and cardiovascular disease have become emerging problems. The reasons for these trends are complex, multifactorial and not easily reversed. Personalized medicine has the potential to have a significant impact on these issues, but for it to be truly successful, interdisciplinary mass collaboration is required. We propose here a vision for open-access advanced analytics for personalized cardiac diagnostics using imaging, electrocardiography and genomics.

Common ECG Lead Placement Errors. Part I: Limb Lead Reversals

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Allison V. Rosen

2015-10-01

Full Text Available Background: Electrocardiography (ECG is a very useful diagnostic tool. However, errors in placement of ECG leads can create artifacts, mimic pathologies, and hinder proper ECG interpretation. It is important for members of the health care team to be able to recognize the common patterns resulting from lead placement errors. Methods: 12-lead ECGs were recorded in a single male healthy subject in his mid 20s. Six different limb lead reversals were compared to ECG recordings from correct lead placement. Results: Classic ECG patterns were observed when leads were reversed. Methods of discriminating these ECG patterns from true pathologic findings were described. Conclusion: Correct recording and interpretation of ECGs is key to providing optimal patient care. It is therefore crucial to be able to recognize common ECG patterns that are indicative of lead reversals.

Design and implementation of a telemedicine system using Bluetooth protocol and GSM/GPRS network, for real time remote patient monitoring.

Science.gov (United States)

Jasemian, Yousef; Nielsen, Lars Arendt

2005-01-01

This paper introduces the design and implementation of a generic wireless and Real-time Multi-purpose Health Care Telemedicine system applying Bluetooth protocol, Global System for Mobile Communications (GSM) and General Packet Radio Service (GPRS). The paper explores the factors that should be considered when evaluating different technologies for application in telemedicine system. The design and implementation of an embedded wireless communication platform utilising Bluetooth protocol is described, and the implementation problems and limitations are investigated. The system is tested and its telecommunication general aspects are verified. The results showed that the system has (97.9 +/- 1.3)% Up-time, 2.5 x 10(-5) Bit Error Rate, 1% Dropped Call Rate, 97.4% Call Success Rate, 5 second transmission delay in average, (3.42 +/- 0.11) kbps throughput, and the system may have application in electrocardiography.

Left ventricular diastolic performance at rest in patients with angina and normal systolic function - assessment by equilibrium radionuclide angiography

International Nuclear Information System (INIS)

Maini, C.L.; Bonetti, M.G.; Valle, G.; Antonelli Incalzi, R.; Montenero, A.S.

1985-01-01

The aim of the study was to correlate diastolic function, as evaluated by peak filling rate (PFR) and relative time (TPFR), with the severity of ischemic heart disease, as evaluated by exercise electrocardiography. Accordingly, 83 ischemic patients with effort angina, but normal ejection function at rest and normal left ventricular size, were studied by equilibrium radionuclide angiocardiography within two weeks from the exercise ECG. Diastolic dysfunction, as determined from PFR and, to a lesser extent, from TPFR, is common in patients with ischemic heart disease and normal systolic function. The prevalence and severity of such dysfunction is related more to the severity of the ischemia, as evaluated by the exercise ECG, than to the presence of an old myocardial infarction. Such findings are consistent with the hypothesis that PFR reflects mainly the early diastolic active uncoupling process. (orig.) [de

A Comprehensive Ubiquitous Healthcare Solution on an Android™ Mobile Device

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Pei-Cheng Hii

2011-06-01

Full Text Available Provision of ubiquitous healthcare solutions which provide healthcare services at anytime anywhere has become more favorable nowadays due to the emphasis on healthcare awareness and also the growth of mobile wireless technologies. Following this approach, an Android™ smart phone device is proposed as a mobile monitoring terminal to observe and analyze ECG (electrocardiography waveforms from wearable ECG devices in real time under the coverage of a wireless sensor network (WSN. The exploitation of WSN in healthcare is able to substitute the complicated wired technology, moving healthcare away from a fixed location setting. As an extension to the monitoring scheme, medicine care is taken into consideration by utilizing the mobile phone as a barcode decoder, to verify and assist out-patients in the medication administration process, providing a better and more comprehensive healthcare service.

A stretchable electrode array for non-invasive, skin-mounted measurement of electrocardiography (ECG), electromyography (EMG) and electroencephalography (EEG).

Science.gov (United States)

Ma, Rui; Kim, Dae-Hyeong; McCormick, Martin; Coleman, Todd; Rogers, John

2010-01-01

This paper reports a class of stretchable electrode array capable of intimate, conformal integration onto the curvilinear surfaces of skin on the human body. The designs employ conventional metallic conductors but in optimized mechanical layouts, on soft, thin elastomeric substrates. These devices exhibit an ability to record spontaneous EEG activity even without conductive electrolyte gels, with recorded alpha rhythm responses that are 40% stronger than those collected using conventional tin electrodes and gels under otherwise similar conditions. The same type of device can also measure high quality ECG and EMG signals. The results suggest broad utility for skin-mounted measurements of electrical activity in the body, with advantages in signal levels, wearability and modes of integration compared to alternatives.

Performance of Thallium-201 Electrocardiography-gated Myocardial Perfusion Single Photon Emission Computed Tomography to Assess Left Ventricular Function

Directory of Open Access Journals (Sweden)

Guang-Uei Hung

2005-05-01

Full Text Available This study evaluated the performance of gated single photon emission computed tomography (SPECT with thallium-201 (201Tl in assessing left ventricular ejection fraction (LVEF, end-diastolic volume (EDV, and end-systolic volume (ESV in Taiwanese by determining repeatability and correlation with two-dimensional (2D echocardiography. A total of 18 patients underwent two sequential gated SPECT acquisitions within 30 minutes in the resting state to assess repeatability. Another 28 patients who underwent gated SPECT and 2D echocardiography within 7 days were included for comparison. The two sequential measurements were well correlated with respect to LVEF, EDV, and ESV (r = 0.97, 0.95, and 0.97, respectively, all p < 0.0001. Bland-Altman analysis revealed that two standard deviations of the absolute difference between the two sequential measurements for LVEF, EDV, and ESV were 6.4%, 16.8 mL, and 8.6 mL, respectively. For LVEF, EDV, and ESV, correlations between redistribution 201Tl-gated SPECT and echocardiography were also excellent (all r = 0.83, p < 0.0001. LVEF was similar with 201Tl-gated SPECT and echocardiography, but EDV and ESV were significantly higher with echocardiography (p < 0.05. Our study revealed that 201Tl-gated SPECT has high repeatability and excellent correlation with echocardiography for the assessment of LVEF and volumes in Taiwanese. These results support the clinical application of gated SPECT in routine 201Tl myocardial perfusion imaging in Taiwanese.

Real-Time 12-Lead High-Frequency QRS Electrocardiography for Enhanced Detection of Myocardial Ischemia and Coronary Artery Disease

Science.gov (United States)

Schlegel, Todd T.; Kulecz, Walter B.; DePalma, Jude L.; Feiveson, Alan H.; Wilson, John S.; Rahman, M. Atiar; Bungo, Michael W.

2004-01-01

Several studies have shown that diminution of the high-frequency (HF; 150-250 Hz) components present within the central portion of the QRS complex of an electrocardiogram (ECG) is a more sensitive indicator for the presence of myocardial ischemia than are changes in the ST segments of the conventional low-frequency ECG. However, until now, no device has been capable of displaying, in real time on a beat-to-beat basis, changes in these HF QRS ECG components in a continuously monitored patient. Although several software programs have been designed to acquire the HF components over the entire QRS interval, such programs have involved laborious off-line calculations and postprocessing, limiting their clinical utility. We describe a personal computer-based ECG software program developed recently at the National Aeronautics and Space Administration (NASA) that acquires, analyzes, and displays HF QRS components in each of the 12 conventional ECG leads in real time. The system also updates these signals and their related derived parameters in real time on a beat-to-beat basis for any chosen monitoring period and simultaneously displays the diagnostic information from the conventional (low-frequency) 12-lead ECG. The real-time NASA HF QRS ECG software is being evaluated currently in multiple clinical settings in North America. We describe its potential usefulness in the diagnosis of myocardial ischemia and coronary artery disease.

Effects of steal-prone anatomy on intraoperative myocardial ischemia. The SPI Research Group.

Science.gov (United States)

Leung, J M; Hollenberg, M; O'Kelly, B F; Kao, A; Mangano, D T

1992-11-01

Our study objective was to determine whether the presence of steal-prone anatomy conferred an increased risk in the development of intraoperative myocardial ischemia. Coronary artery steal of collateral blood flow has been demonstrated for many vasodilators, including isoflurane, the most commonly used inhalational anesthetic agent in the United States. It has been postulated that patients with steal-prone anatomy (total occlusion of one coronary artery that is supplied distally by collateral flow from another coronary artery with a > or = 50% stenosis) may be particularly at risk for the development of intraoperative myocardial ischemia when an anesthetic with a vasodilator property is being administered. We evaluated the risk of myocardial ischemia under isoflurane anesthesia (vs. a high dose narcotic technique using sufentanil) using continuous intraoperative electrocardiography and transesophageal echocardiography in patients with and without steal-prone anatomy undergoing coronary artery bypass graft surgery. Sixty-two (33%) of the 186 patients had steal-prone anatomy: in 5 (8%) the collateral-supplying vessel was > or = 50% to 69% stenosed, in 24 (39%) it was > or = 70% to 89% stenosed and in 33 (53%) it was > or = 90% stenosed. The incidence of ischemia (transesophageal echocardiography or intraoperative electrocardiography, or both) was similar in patients with and without steal-prone coronary anatomy (18 [29%] of 62 patients vs. 39 [31%] of 124 patients, p = 0.87, 95% confidence interval = -0.13 to 0.17). The incidence of intraoperative ischemia was similar in patients who received isoflurane or sufentanil anesthesia (20 [32%] of 62 patients vs. 37 [30%] of 124 patients, p = 0.87). The incidence of tachycardia and hypotension was low (increases in heart rate = 9.8%, and decreases in systolic blood pressure = 10.8% of total monitoring time during the prebypass period compared with preoperative baseline values). The incidence of adverse cardiac outcome was

Safety and efficacy of extracorporeal shock wave myocardial revascularization therapy for refractory angina pectoris.

Science.gov (United States)

Cassar, Andrew; Prasad, Megha; Rodriguez-Porcel, Martin; Reeder, Guy S; Karia, Darshak; DeMaria, Anthony N; Lerman, Amir

2014-03-01

To assess the safety and efficacy of extracorporeal shockwave myocardial revascularization (ESMR) therapy in treating patients with refractory angina pectoris. A single-arm multicenter prospective trial to assess safety and efficacy of the ESMR therapy in patients with refractory angina (class III/IV angina) was performed. Screening exercise treadmill tests and pharmacological single-photon emission computed tomography (SPECT) were performed for all patients to assess exercise capacity and ischemic burden. Patients were treated with 9 sessions of ESMR to ischemic areas over 9 weeks. Efficacy end points were exercise capacity by using treadmill test as well as ischemic burden on pharmacological SPECT at 4 months after the last ESMR treatment. Safety measures included electrocardiography, echocardiography, troponin, creatine kinase, and brain natriuretic peptide testing, and pain questionnaires. Fifteen patients with medically refractory angina and no revascularization options were enrolled. There was a statistically significant mean increase of 122.3±156.9 seconds (38% increase compared with baseline; P=.01) in exercise treadmill time from baseline (319.8±157.2 seconds) to last follow-up after the ESMR treatment (422.1±183.3 seconds). There was no improvement in the summed stress perfusion scores after pharmacologically induced stress SPECT at 4 months after the last ESMR treatment in comparison to that at screening; however, SPECT summed stress score revealed that untreated areas had greater progression in ischemic burden vs treated areas (3.69±6.2 vs 0.31±4.5; P=.03). There was no significant change in the mean summed echo score from baseline to posttreatment (0.4±5.1; P=.70). The ESMR therapy was performed safely without any adverse events in electrocardiography, echocardiography, troponins, creatine kinase, or brain natriuretic peptide. Pain during the ESMR treatment was minimal (a score of 0.5±1.2 to 1.1±1.2 out of 10). In this multicenter feasibility

Multiple bio-monitoring system using visible light for electromagnetic-wave free indoor healthcare

Science.gov (United States)

An, Jinyoung; Pham, Ngoc Quan; Chung, Wan-Young

2017-12-01

In this paper, a multiple biomedical data transmission system with visible light communication (VLC) is proposed for an electromagnetic-wave-free indoor healthcare. VLC technology has emerged as an alternative solution to radio-frequency (RF) wireless systems, due to its various merits, e.g., ubiquity, power efficiency, no RF radiation, and security. With VLC, critical bio-medical signals, including electrocardiography (ECG), can be transmitted in places where RF radiation is restricted. This potential advantage of VLC could save more lives in emergency situations. A time hopping (TH) scheme is employed to transfer multiple medical-data streams in real time with a simple system design. Multiple data streams are transmitted using identical color LEDs and go into an optical detector. The received multiple data streams are demodulated and rearranged using a TH-based demodulator. The medical data is then monitored and managed to provide the necessary medical care for each patient.

The Role of Echocardiography in Coronary Artery Disease and Acute Myocardial Infarction

Science.gov (United States)

Esmaeilzadeh, Maryam; Parsaee, Mozhgan; Maleki, Majid

2013-01-01

Echocardiography is a non-invasive diagnostic technique which provides information regarding cardiac function and hemodynamics. It is the most frequently used cardiovascular diagnostic test after electrocardiography and chest X-ray. However, in a patient with acute chest pain, Transthoracic Echocardiography is essential both for diagnosing acute coronary syndrome, zeroing on the evaluation of ventricular function and the presence of regional wall motion abnormalities, and for ruling out other etiologies of acute chest pain or dyspnea, including aortic dissection and pericardial effusion. Echocardiography is a versatile imaging modality for the management of patients with chest pain and assessment of left ventricular systolic function, diastolic function, and even myocardial and coronary perfusion and is, therefore, useful in the diagnosis and triage of patients with acute chest pain or dyspnea. This review has focused on the current applications of echocardiography in patients with coronary artery disease and myocardial infarction. PMID:23646042

The correlation of serum asymmetric dimethylarginine and anti-Müllerian hormone in primary dysmenorrhea

Directory of Open Access Journals (Sweden)

Nermin Akdemir

2016-08-01

Full Text Available In this study, we aimed to investigate the association of serum asymmetric dimethylarginine (ADMA and anti-Müllerian hormone (AMH levels in primary dysmenorrhea patients. The study employed a cross-sectional design. Eighty-nine female university students with primary dysmenorrhea were included in the study. All patients underwent complete clinical and laboratory investigations, including serum ADMA, AMH levels, pelvic ultrasonography, electrocardiography, and echocardiography. Pearson correlation and linear regression analysis were used to evaluate associations between continuous data. Categorical associations were evaluated using χ2 test. Correlation analysis between serum ADMA and AMH levels in the study group showed a highly significant positive relationship (Pearson correlation = 0.978, p = 0.01. Our study has shown a significant positive correlation between serum ADMA and AMH levels in primary dysmenorrhea. Serum ADMA levels may have the potential to demonstrate ovarian reserve.

CMR of microvascular obstruction and hemorrhage in myocardial infarction

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Wu Katherine C

2012-09-01

Full Text Available Abstract Microvascular obstruction (MO or no-reflow phenomenon is an established complication of coronary reperfusion therapy for acute myocardial infarction. It is increasingly recognized as a poor prognostic indicator and marker of subsequent adverse LV remodeling. Although MO can be assessed using various imaging modalities including electrocardiography, myocardial contrast echocardiography, nuclear scintigraphy, and coronary angiography, evaluation by cardiovascular magnetic resonance (CMR is particularly useful in enhancing its detection, diagnosis, and quantification, as well as following its subsequent effects on infarct evolution and healing. MO assessment has become a routine component of the CMR evaluation of acute myocardial infarction and will increasingly play a role in clinical trials of adjunctive reperfusion agents and strategies. This review will summarize the pathophysiology of MO, current CMR approaches to diagnosis, clinical implications, and future directions needed for improving our understanding of this common clinical problem.

Utility of lead aVR for identifying the culprit lesion in acute myocardial infarction

DEFF Research Database (Denmark)

Kühl, Jørgen Tobias; Berg, Ronan M G

2009-01-01

BACKGROUND: Lead aVR is a neglected, however, potentially useful tool in electrocardiography. Our aim was to evaluate its value in clinical practice, by reviewing existing literature regarding its utility for identifying the culprit lesion in acute myocardial infarction (AMI). METHODS: Based...... on a systematic search strategy, 16 studies were assessed with the intent to pool data; diagnostic test rates were calculated as key results. RESULTS: Five studies investigated if ST-segment elevation (STE) in aVR is valuable for the diagnosis of left main stem stenosis (LMS) in non-ST-segment AMI (NSTEMI......). The studies were too heterogeneous to pool, but the individual studies all showed that STE in aVR has a high negative predictive value (NPV) for LMS. Six studies evaluated if STE in aVR is valuable for distinguishing proximal from distal lesions in the left anterior descending artery (LAD) in anterior ST...

Enterprise imaging and multi-departmental PACS

International Nuclear Information System (INIS)

Bergh, Bjoern

2006-01-01

The aim of this review is to present the status of digital image acquisition and archiving outside of radiology and to describe the technical concepts and possibilities of how a ''radiology'' Picture Archiving and Communication System (PACS) can become a multi-departmental (MD-)PACS. First the principles of system integration technology are explained and illustrated by the description of a typical radiology system integration. Then four types of modality integration approaches are defined: the direct modality integration (Type-I), the integration via DICOM acquisition software (Type-II) the integration via specialised systems either with (Type-III) or without PACS connection (Type-IV). The last section is dedicated to the presentation of the PACS requirements of selected interdisciplinary modality types [Endoscopy, Ultrasound and Electrocardiography (ECG)] and clinical disciplines (Pathology, Dermatology, Ophthalmology and Cardiology), which are then compared with the technical possibilities of a MD-PACS. (orig.)

The diagnosis of anthracycline-induced cardiac damage and heart failure

Directory of Open Access Journals (Sweden)

Jarosław Dudka

2009-05-01

Full Text Available Routine examinations during chemotherapy containing anthracyclines evaluate heart function before treatment and monitor cardiotoxic effects during and after therapy. A number of methods are useful in cardiac assessment, including electrocardiography, radiology techniques (RTG, CT, MRI, PET-CT, PET-MRI, echocardiography, radioisotope imaging techniques (scyntygraphy, MUGA, PET, and ultra-structure evaluation in biopsy samples. Nevertheless, there is a continuous need for new methods to predict future damage at the initial stages of cardiac changes. In recent years the therapeutic usefulness of biochemical blood parameters in anthracycline-treated patients has been assessed. The levels of cardiac troponines (cTnI, cTnT, natriuretic peptides (ANP, BNP, and endothelin 1 have been included in the studies. Heart-type fatty acid binding protein (H-FABP is another promising factor showing cardiomyocytic impairment. However, the clinical use of biochemical parameters in diagnosing anthracycline-related cardiotoxicity is still a controversial issue.

Comparison of electrocardiography and thallium-201 myocardial scintigraphy for the detection of ergonovine-induced coronary artery spasm: angiographic correlation

International Nuclear Information System (INIS)

Shanes, J.G.; Pavel, D.; Blend, M.

1987-01-01

This study was performed to determine the sensitivity of thallium imaging vs ECG monitoring for detecting coronary artery spasm noninvasively following intravenous ergonovine administration as compared to simultaneous coronary angiography. Thirty-two patients with insignificant coronary artery disease and chest pain underwent 12-lead ECG monitoring, thallium imaging, and coronary arteriography following the administration of 0.05, 0.1, 0.2, and 0.3 mg of ergonovine given 5 minutes apart or until chest pain occurred. One minute following the last dose of ergonovine, 2.5 mCi of thallium-201 was injected intravenously, and a final ECG was recorded and repeat coronary arteriography performed. Within 10 minutes following the injection of thallium, imaging was performed in the 40-degree and 70-degree left anterior oblique and anterior projections. The ECG, thallium study, and coronary arteriogram were read blindly and results were compared. The ECG, angiogram, and thallium study were read as positive if the following occurred, respectively: greater than or equal to 1 mm ST segment elevation, depression, or T wave reversal; greater than 50% vessel narrowing,; and reversible perfusion defect. Five patients were excluded from analysis because of either catheter-induced spasm, suboptimal thallium studies, or protocol violations. Of the 27 patients included for analysis, six had chest pain, five had a positive angiogram, five had a positive thallium study, and one had a positive ECG. The sensitivity of thallium vs ECG monitoring was 80% vs 25%, and the accuracy was 92% vs 80%. We conclude that thallium imaging greatly increases the noninvasive detection of ergonovine-induced coronary spasm as compared with the ECG with no loss of accuracy

Feasibility and outcomes of atrial fibrillation screening using intermittent electrocardiography in a primary healthcare setting: A cross-sectional study.

Directory of Open Access Journals (Sweden)

Faris Ghazal

Full Text Available Atrial fibrillation (AF is a major risk factor for ischemic stroke unless treated with an anticoagulant. Detecting AF can be difficult because AF is often paroxysmal and asymptomatic. The aims of this study were to develop a screening model to detect AF in a primary healthcare setting and to initiate oral anticoagulant therapy in high-risk patients to prevent stroke.This was a cross-sectional study. All 70- to 74-year-old individuals registered at a single primary healthcare center in Stockholm were invited to participate in AF screening upon visiting the center during a ten-month period. Those who did not have contact with the center during this period were invited to participate by letter. Thirty-second intermittent ECG recordings were made twice a day using a handheld Zenicor device over a 2-week period in participants without AF. Oral anticoagulant therapy was offered to patients with newly detected AF.Of the 415 eligible individuals, a total of 324 (78.1% patients participated in the study. The mean age of the participants was 72 years, 52.2% were female, and the median CHA2DS2-VASc score of the participants was 3. In the target population, 34 (8.2% individuals had previously diagnosed AF. Among participants without previously known AF, 16 (5.5% cases of AF were detected. The final AF prevalence in the target population was 12%. Oral anticoagulant therapy was successfully initiated in 88% of these patients with newly detected AF.The AF screening project exhibited a high participation rate and resulted in a high rate of newly discovered AF; of these newly diagnosed patients, 88% could be treated with an oral anticoagulant.

Electroretinography: A biopotential to assess the function/dysfunction of the retina

Science.gov (United States)

Quintana, Quinteros; Benedetto, M. L.; Maldonado, M. M.; de Payer E., A. C. Vera; Contin, M. A.

2016-04-01

The Electroretinography (ERG) is a noninvasive technique that allows the assessment of functional integrity of the retina. The ERG recordings are biopotencials acquired in the corneal surface as a response of retinal tissue against controlled light stimuli. In clinical ophthalmology ERG is not commonly used but nowadays, because of the high incidence of degenerative diseases of the retina (RD), its use should be increased. Like other biopotentials as electrocardiography (ECG), electroencephalogram (EEG) and electromyography (EMG), ERG is a low amplitude signal, in this case a few hundred of microvolts (µV), which must be fitted and processed. The ERG signals are affected in morphology in the presence of pathologies that affects the integrity of the different retinal cell groups, for example due to some RD. In advanced cases of RD recordings can be abolished in the time domain; and yet in them it is believed that there is relevant clinical information making the ERG a great potential diagnostic tool.

Fabrication of Flexible Microneedle Array Electrodes for Wearable Bio-Signal Recording.

Science.gov (United States)

Ren, Lei; Xu, Shujia; Gao, Jie; Lin, Zi; Chen, Zhipeng; Liu, Bin; Liang, Liang; Jiang, Lelun

2018-04-13

Laser-direct writing (LDW) and magneto-rheological drawing lithography (MRDL) have been proposed for the fabrication of a flexible microneedle array electrode (MAE) for wearable bio-signal monitoring. Conductive patterns were directly written onto the flexible polyethylene terephthalate (PET) substrate by LDW. The microneedle array was rapidly drawn and formed from the droplets of curable magnetorheological fluid with the assistance of an external magnetic field by MRDL. A flexible MAE can maintain a stable contact interface with curved human skin due to the flexibility of the PET substrate. Compared with Ag/AgCl electrodes and flexible dry electrodes (FDE), the electrode-skin interface impedance of flexible MAE was the minimum even after a 50-cycle bending test. Flexible MAE can record electromyography (EMG), electroencephalography (EEG) and static electrocardiography (ECG) signals with good fidelity. The main features of the dynamic ECG signal recorded by flexible MAE are the most distinguishable with the least moving artifacts. Flexible MAE is an attractive candidate electrode for wearable bio-signal monitoring.

Early detection of myocardial dysfunction using two-dimensional speckle tracking echocardiography in a young cat with hypertrophic cardiomyopathy

Directory of Open Access Journals (Sweden)

Ryohei Suzuki

2018-02-01

Full Text Available Case summary A 5-month-old intact female Scottish Fold cat was presented for cardiac evaluation. Careful auscultation detected a slight systolic murmur (Levine I/VI. The findings of electrocardiography, thoracic radiography, non-invasive blood pressure measurements and conventional echocardiographic studies were unremarkable. However, two-dimensional speckle tracking echocardiography revealed abnormalities in myocardial deformations, including decreased early-to-late diastolic strain rate ratios in longitudinal, radial and circumferential directions, and deteriorated segmental systolic longitudinal strain. At the follow-up examinations, the cat exhibited echocardiographic left ventricular hypertrophy and was diagnosed with hypertrophic cardiomyopathy using conventional echocardiography. Relevance and novel information This is the first report on the use of two-dimensional speckle tracking echocardiography for the early detection of myocardial dysfunction in a cat with hypertrophic cardiomyopathy; the myocardial dysfunction was detected before the development of hypertrophy. The findings from this case suggest that two-dimensional speckle tracking echocardiography can be useful for myocardial assessment when conventional echocardiographic and Doppler findings are ambiguous.

Blunt Cardiac Injury in Trauma Patients with Thoracic Aortic Injury

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Rathachai Kaewlai

2011-01-01

Full Text Available Trauma patients with thoracic aortic injury (TAI suffer blunt cardiac injury (BCI at variable frequencies. This investigation aimed to determine the frequency of BCI in trauma patients with TAI and compare with those without TAI. All trauma patients with TAI who had admission electrocardiography (ECG and serum creatine kinase-MB (CK-MB from January 1999 to May 2009 were included as a study group at a level I trauma center. BCI was diagnosed if there was a positive ECG with either an elevated CK-MB or abnormal echocardiography. There were 26 patients (19 men, mean age 45.1 years, mean ISS 34.4 in the study group; 20 had evidence of BCI. Of 52 patients in the control group (38 men, mean age 46.9 years, mean ISS 38.7, eighteen had evidence of BCI. There was a significantly higher rate of BCI in trauma patients with TAI versus those without TAI (77% versus 35%, P<0.001.

High job control enhances vagal recovery in media work.

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Lindholm, Harri; Sinisalo, Juha; Ahlberg, Jari; Jahkola, Antti; Partinen, Markku; Hublin, Christer; Savolainen, Aslak

2009-12-01

Job strain has been linked to increased risk of cardiovascular diseases. In modern media work, time pressures, rapidly changing situations, computer work and irregular working hours are common. Heart rate variability (HRV) has been widely used to monitor sympathovagal balance. Autonomic imbalance may play an additive role in the development of cardiovascular diseases. To study the effects of work demands and job control on the autonomic nervous system recovery among the media personnel. From the cross-sectional postal survey of the employees in Finnish Broadcasting Company (n = 874), three age cohorts (n = 132) were randomly selected for an analysis of HRV in 24 h electrocardiography recordings. In the middle-aged group, those who experienced high job control had significantly better vagal recovery than those with low or moderate control (P work rather than low demands seemed to enhance autonomic recovery in middle-aged media workers. This was independent of poor health habits such as smoking, physical inactivity or alcohol consumption.

Imaging of cardiovascular malformations in Williams syndrome

International Nuclear Information System (INIS)

Li Shiguo; Zhao Shihua; Jiang Shiliang; Huang Lianjun; Xu Zhongying; Ling Jian; Zheng Hong; Yan Chaowu; Lu Jinguo

2008-01-01

Objective: To evaluate the imaging methods for cardiovascular malformations in Williams syndrome(WS). Methods: Thirteen cases of WS (7 males and 6 females) aged 10 months to 13 years were involved in this study. All patients underwent chest X-ray radiography, electrocardiography, echocardiography and physical examination. 3 cases underwent electronic beam computed tomography (EBCT), cardiac catheterization and angiography were performed in 8 cases. Results: Twelve patients were referred to our hospital for cardiac murmur and 1 case for cyanosis after birth. 7 patients were found with 'elfin-like' facial features, 6 patients with pulmonary arterial stenosis, 2 cases with patent ductus arteriosus, 2 cases with severe pulmonary hypertension and 1 case with total endocardial cushion defect. Sudden death occurred in 2 patients during and after catheterization, respectively. Conclusions: Conventional angiography is the golden standard for the diagnosis of cardiovascular malformations in WS. Noninvasive methods such as MSCT and MRI should be suggested because of the risk of sudden death in conventional angiography. (authors)

Challenges of ECG monitoring and ECG interpretation in dialysis units.

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Poulikakos, Dimitrios; Malik, Marek

Patients on hemodialysis (HD) suffer from high cardiovascular morbidity and mortality due to high rates of coronary artery disease and arrhythmias. Electrocardiography (ECG) is often performed in the dialysis units as part of routine clinical assessment. However, fluid and electrolyte changes have been shown to affect all ECG morphologies and intervals. ECG interpretation thus depends on the time of the recording in relation to the HD session. In addition, arrhythmias during HD are common, and dialysis-related ECG artifacts mimicking arrhythmias have been reported. Studies using advanced ECG analyses have examined the impact of the HD procedure on selected repolarization descriptors and heart rate variability indices. Despite the challenges related to the impact of the fluctuant fluid and electrolyte status on conventional and advanced ECG parameters, further research in ECG monitoring during dialysis has the potential to provide clinically meaningful and practically useful information for diagnostic and risk stratification purposes. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Matrix of regularity for improving the quality of ECGs

International Nuclear Information System (INIS)

Xia, Henian; Garcia, Gabriel A; Zhao, Xiaopeng; Bains, Jujhar; Wortham, Dale C

2012-01-01

The 12-lead electrocardiography (ECG) is the gold standard for diagnosis of abnormalities of the heart. However, the ECG is susceptible to artifacts, which may lead to wrong diagnosis and thus mistreatment. It is a clinical challenge of great significance differentiating ECG artifacts from patterns of diseases. We propose a computational framework, called the matrix of regularity, to evaluate the quality of ECGs. The matrix of regularity is a novel mechanism to fuse results from multiple tests of signal quality. Moreover, this method can produce a continuous grade, which can more accurately represent the quality of an ECG. When tested on a dataset from the Computing in Cardiology/PhysioNet Challenge 2011, the algorithm achieves up to 95% accuracy. The area under the receiver operating characteristic curve is 0.97. The developed framework and computer program have the potential to improve the quality of ECGs collected using conventional and portable devices. (paper)

An analytical approach to characterize morbidity profile dissimilarity between distinct cohorts using electronic medical records.

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Schildcrout, Jonathan S; Basford, Melissa A; Pulley, Jill M; Masys, Daniel R; Roden, Dan M; Wang, Deede; Chute, Christopher G; Kullo, Iftikhar J; Carrell, David; Peissig, Peggy; Kho, Abel; Denny, Joshua C

2010-12-01

We describe a two-stage analytical approach for characterizing morbidity profile dissimilarity among patient cohorts using electronic medical records. We capture morbidities using the International Statistical Classification of Diseases and Related Health Problems (ICD-9) codes. In the first stage of the approach separate logistic regression analyses for ICD-9 sections (e.g., "hypertensive disease" or "appendicitis") are conducted, and the odds ratios that describe adjusted differences in prevalence between two cohorts are displayed graphically. In the second stage, the results from ICD-9 section analyses are combined into a general morbidity dissimilarity index (MDI). For illustration, we examine nine cohorts of patients representing six phenotypes (or controls) derived from five institutions, each a participant in the electronic MEdical REcords and GEnomics (eMERGE) network. The phenotypes studied include type II diabetes and type II diabetes controls, peripheral arterial disease and peripheral arterial disease controls, normal cardiac conduction as measured by electrocardiography, and senile cataracts. Copyright © 2010 Elsevier Inc. All rights reserved.

Thallium 201 scintigraphy of the myocardium. A bibliographical survey for image optimisation

International Nuclear Information System (INIS)

Chatelier, Luc.

1979-01-01

At the request of a Nuclear Medicine Service we compiled a review of the literature on thallium 201 myocardium scintigraphy in order to define the optimum parameters for image acquisition; included also are the bibliograhical references of studies on the sensitivities, specificities and accuracies of this technique as compared with electrocardiography in the diagnosis and evaluation of ischemic heart diseases. This examination seems to have a part to play at all stages in the evaluation of ischemic heart diseases, whether for the detection (ischemia) emergency handling (thrombosis) or post-surgical checking (permeability of an aorto-coronary transplant) of these diseases, the great frequency and gravity of which have no longer to be proved. This study covers the whole period since thallium scintigraphy began (1970) until June 1978. Thallium seems to have a great future in cardiology and may be even in other fields since its use is quoted (in only a few publications as yet) for brain, kidney and pancreas scintigraphy [fr

Cardiopulmonary fitness and muscle strength in patients with osteogenesis imperfecta type I.

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Takken, Tim; Terlingen, Heike C; Helders, Paul J M; Pruijs, Hans; Van der Ent, Cornelis K; Engelbert, Raoul H H

2004-12-01

To evaluate cardiopulmonary function, muscle strength, and cardiopulmonary fitness (VO 2 peak) in patients with osteogenesis imperfecta (OI). In 17 patients with OI type I (mean age 13.3 +/- 3.9 years) cardiopulmonary function was assessed at rest using spirometry, plethysmography, electrocardiography, and echocardiography. Exercise capacity was measured using a maximal exercise test on a bicycle ergometer and an expired gas analysis system. Muscle strength in shoulder abductors, hip flexors, ankle dorsal flexor, and grip strength were measured. All results were compared with reference values. Cardiopulmonary function at rest was within normal ranges, but when it was compared with normal height for age and sex, vital capacities were reduced. Mean absolute and relative VO 2 peak were respectively -1.17 (+/- 0.67) and -1.41 (+/- 1.52) standard deviations lower compared with reference values ( P exercise tolerance and muscle strength were significantly reduced in patients with OI, which might account for their increased levels of fatigue during activities of daily living.

Echocardiogram enhancement using supervised manifold denoising.

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Wu, Hui; Huynh, Toan T; Souvenir, Richard

2015-08-01

This paper presents data-driven methods for echocardiogram enhancement. Existing denoising algorithms typically rely on a single noise model, and do not generalize to the composite noise sources typically found in real-world echocardiograms. Our methods leverage the low-dimensional intrinsic structure of echocardiogram videos. We assume that echocardiogram images are noisy samples from an underlying manifold parametrized by cardiac motion and denoise images via back-projection onto a learned (non-linear) manifold. Our methods incorporate synchronized side information (e.g., electrocardiography), which is often collected alongside the visual data. We evaluate the proposed methods on a synthetic data set and real-world echocardiograms. Quantitative results show improved performance of our methods over recent image despeckling methods and video denoising methods, and a visual analysis of real-world data shows noticeable image enhancement, even in the challenging case of noise due to dropout artifacts. Copyright © 2015 Elsevier B.V. All rights reserved.

Wavelet-Based Watermarking and Compression for ECG Signals with Verification Evaluation

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Kuo-Kun Tseng

2014-02-01

Full Text Available In the current open society and with the growth of human rights, people are more and more concerned about the privacy of their information and other important data. This study makes use of electrocardiography (ECG data in order to protect individual information. An ECG signal can not only be used to analyze disease, but also to provide crucial biometric information for identification and authentication. In this study, we propose a new idea of integrating electrocardiogram watermarking and compression approach, which has never been researched before. ECG watermarking can ensure the confidentiality and reliability of a user’s data while reducing the amount of data. In the evaluation, we apply the embedding capacity, bit error rate (BER, signal-to-noise ratio (SNR, compression ratio (CR, and compressed-signal to noise ratio (CNR methods to assess the proposed algorithm. After comprehensive evaluation the final results show that our algorithm is robust and feasible.

Chronic thromboembolic pulmonary hypertension in young woman with history of caesarian section

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Nitia A. Asbarinsyah

2015-01-01

Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is one of subgroups of pulmonary hypertension. This is a serious medical condition that severely under diagnosed. CTEPH is commonly underdiagnosed due to non specific symptoms and lack of diagnostic tools. The aim of this presentation is to discuss the etiology, risk factors, diagnosis and management of CTEPH. A 36-year-old woman presented with easily fatigue and dyspneu on effort since two years ago. The symptom occured about three months after she gave birth with caesarian section due to preeclampsia. Further history taking, physical examination, electrocardiography (ECG and echocardiography were highly suggestive of pulmonary hypertension. No deep vein thrombosis (DVT was found on vascular femoral sonography. It was found after the lung perfusion scintigraphy performed that she actually had CTEPH. This patient was categorized as inoperable because CT pulmonary angiography showed no thrombus. The patient got pulmonary vasodilator and oral anticoagulant for lifelong.

Audit of availability and distribution of paediatric cardiology services and facilities in Nigeria.

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Ekure, Ekanem N; Sadoh, Wilson E; Bode-Thomas, Fidelia; Orogade, Adeola A; Animasahun, Adeola B; Ogunkunle, Oluwatoyin O; Babaniyi, Iretiola; Anah, Maxwell U; Otaigbe, Barbara E; Olowu, Adebiyi; Okpokowuruk, Frances; Omokhodion, Samuel I; Maduka, Ogechi C; Onakpoya, Uvie U; Adiele, Daberechi K; Sani, Usman M; Asani, Mustapha; Yilgwan, Christopher S; Daniels, Queennette; Uzodimma, Chinyere C; Duru, Chika O; Abdulkadir, Mohammad B; Afolabi, Joseph K; Okeniyi, John A

Paediatric cardiac services in Nigeria have been perceived to be inadequate but no formal documentation of availability and distribution of facilities and services has been done. To evaluate and document the currently available paediatric cardiac services in Nigeria. In this questionnaire-based, cross-sectional descriptive study, an audit was undertaken from January 2010 to December 2014, of the personnel and infrastructure, with their distributions according to geopolitical zones of Nigeria. Forty-eight centres participated in the study, with 33 paediatric cardiologists and 31 cardiac surgeons. Echocardiography, electrocardiography and pulse oximetry were available in 45 (93.8%) centres while paediatric intensive care units were in 23 (47.9%). Open-heart surgery was performed in six (12.5%) centres. South-West zone had the majority of centres (20; 41.7%). Available paediatric cardiac services in Nigeria are grossly inadequate and poorly distributed. Efforts should be intensified to upgrade existing facilities, establish new and functional centres, and train personnel.

Cardiovascular evaluation of lowland gorillas

International Nuclear Information System (INIS)

Junge, R.E.; Mezei, L.E.; Muhlbauer, M.C.; Weber, M.

1998-01-01

To design a diagnostic protocol that uses appropriate techniques, including ultrasonography, to assess cardiovascular health and detect primary cardiac diseases in gorillas and to establish a database of reference values for cardiac measurements in clinically normal gorillas. Prospective study. 5 adult male lowland gorillas from 11 to 18 years old. A complete cardiac evaluation was performed on anesthetized gorillas, including physical examination, thoracic radiography, electrocardiography, echocardiography, blood pressure determination, CBC, serum biochemical analyses, and serologic assay for viral diseases. Standard cardiac measurements were made from images collected during ultrasonography. Cardiac measurements derived from ultrasonographic images were consistent with those considered normal in human beings. Results of other diagnostic tests were also considered normal. Cardiac disease is the primary cause of mortality in old captive gorillas. The technique used here provided excellent evaluation of cardiac function. Use of these techniques will allow early detection of cardiac disease, making treatment or medical management possible

Developing barbed microtip-based electrode arrays for biopotential measurement.

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Hsu, Li-Sheng; Tung, Shu-Wei; Kuo, Che-Hsi; Yang, Yao-Joe

2014-07-10

This study involved fabricating barbed microtip-based electrode arrays by using silicon wet etching. KOH anisotropic wet etching was employed to form a standard pyramidal microtip array and HF/HNO3 isotropic etching was used to fabricate barbs on these microtips. To improve the electrical conductance between the tip array on the front side of the wafer and the electrical contact on the back side, a through-silicon via was created during the wet etching process. The experimental results show that the forces required to detach the barbed microtip arrays from human skin, a polydimethylsiloxane (PDMS) polymer, and a polyvinylchloride (PVC) film were larger compared with those required to detach microtip arrays that lacked barbs. The impedances of the skin-electrode interface were measured and the performance levels of the proposed dry electrode were characterized. Electrode prototypes that employed the proposed tip arrays were implemented. Electroencephalogram (EEG) and electrocardiography (ECG) recordings using these electrode prototypes were also demonstrated.

Developing Barbed Microtip-Based Electrode Arrays for Biopotential Measurement

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Li-Sheng Hsu

2014-07-01

Full Text Available This study involved fabricating barbed microtip-based electrode arrays by using silicon wet etching. KOH anisotropic wet etching was employed to form a standard pyramidal microtip array and HF/HNO3 isotropic etching was used to fabricate barbs on these microtips. To improve the electrical conductance between the tip array on the front side of the wafer and the electrical contact on the back side, a through-silicon via was created during the wet etching process. The experimental results show that the forces required to detach the barbed microtip arrays from human skin, a polydimethylsiloxane (PDMS polymer, and a polyvinylchloride (PVC film were larger compared with those required to detach microtip arrays that lacked barbs. The impedances of the skin-electrode interface were measured and the performance levels of the proposed dry electrode were characterized. Electrode prototypes that employed the proposed tip arrays were implemented. Electroencephalogram (EEG and electrocardiography (ECG recordings using these electrode prototypes were also demonstrated.

A cloud computing based 12-lead ECG telemedicine service.

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Hsieh, Jui-Chien; Hsu, Meng-Wei

2012-07-28

Due to the great variability of 12-lead ECG instruments and medical specialists' interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists' decision making support in emergency telecardiology. We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis. This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan.

QRS slopes for assessment of myocardial damage in chronic chagasic patients

International Nuclear Information System (INIS)

Pueyo, E; Laciar, E; Anzuola, E; Laguna, P; Jane, R

2007-01-01

In this study the slopes of the QRS complex are evaluated for determination of the degree of myocardial damage in chronic chagasic patients. Previous studies have demonstrated the ability of the slope indices to reflect alterations in the conduction velocity of the cardiac impulse. Results obtained in the present study show that chronic chagasic patients have significantly flatter QRS slopes as compared to healthy subjects. Not only that but the extent of slope lessening turns out to be proportional to the degree of myocardial damage caused by the disease. Additionally, when incorporating the slope indices into a classification analysis together with other indices indicative of the presence of ventricular late potentials obtained from high resolution electrocardiography, results show that the percentages of correct classification increase up to 62.5%, which means eight points above the percentages obtained prior to incorporation of the slope indices. It can be concluded that QRS slopes have great potential for assessing the degree of severity associated with Chagas' disease

Noninvasive risk stratification of lethal ventricular arrhythmias and sudden cardiac death after myocardial infarction

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Kenji Yodogawa, MD

2014-08-01

Full Text Available Prediction of lethal ventricular arrhythmias leading to sudden cardiac death is one of the most important and challenging problems after myocardial infarction (MI. Identification of MI patients who are prone to ventricular tachyarrhythmias allows for an indication of implantable cardioverter-defibrillator placement. To date, noninvasive techniques such as microvolt T-wave alternans (MTWA, signal-averaged electrocardiography (SAECG, heart rate variability (HRV, and heart rate turbulence (HRT have been developed for this purpose. MTWA is an indicator of repolarization abnormality and is currently the most promising risk-stratification tool for predicting malignant ventricular arrhythmias. Similarly, late potentials detected by SAECG are indices of depolarization abnormality and are useful in risk stratification. However, the role of SAECG is limited because of its low predictive accuracy. Abnormal HRV and HRT patterns reflect autonomic disturbances, which may increase the risk of lethal ventricular arrhythmias, but the existing evidence is insufficient. Further studies of noninvasive assessment may provide a new insight into risk stratification in post-MI patients.

smRithm: Graphical user interface for heart rate variability analysis.

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Nara, Sanjeev; Kaur, Manvinder; Datta, Saurav

2015-01-01

Over the past 25 years, Heart rate variability (HRV) has become a non-invasive research and clinical tool for indirectly carrying out investigation of both cardiac and autonomic system function in both healthy and diseased. It provides valuable information about a wide range of cardiovascular disorders, pulmonary diseases, neurological diseases, etc. Its primary purpose is to access the functioning of the nervous system. The source of information for HRV analysis is the continuous beat to beat measurement of inter-beat intervals. The electrocardiography (ECG or EKG) is considered as the best way to measure inter-beat intervals. This paper proposes an open source Graphical User Interface (GUI): smRithm developed in MATLAB for HRV analysis that will apply effective techniques on the raw ECG signals to process and decompose it in a simpler manner to obtain more useful information out of signals that can be utilized for more powerful and efficient applications in the near future related to HRV.

Reliability and limitation of various diagnostic methods including nuclear medicine in myocardial disease

International Nuclear Information System (INIS)

Tokuyasu, Yoshiki; Kusakabe, Kiyoko; Yamazaki, Toshio

1981-01-01

Electrocardiography (ECG), echocardiography, nuclear method, cardiac catheterization, left ventriculography and endomyocardial biopsy (biopsy) were performed in 40 cases of cardiomyopathy (CM), 9 of endocardial fibroelastosis and 19 of specific heart muscle disease, and the usefulness and limitation of each method was comparatively estimated. In CM, various methods including biopsy were performed. The 40 patients were classified into 3 groups, i.e., hypertrophic (17), dilated (20) and non-hypertrophic.non-dilated (3) on the basis of left ventricular ejection fraction and hypertrophy of the ventricular wall. The hypertrophic group was divided into 4 subgroups: 9 septal, 4 apical, 2 posterior and 2 anterior. The nuclear study is useful in assessing the site of the abnormal ventricular thickening, perfusion defect and ventricular function. Echocardiography is most useful in detecting asymmetric septal hypertrophy. The biopsy gives the sole diagnostic clue, especially in non-hypertrophic.non-dilated cardiomyopathy. ECG is useful in all cases but correlation with the site of disproportional hypertrophy was not obtained. (J.P.N.)

Metabolism of inhaled 239PuO2 particles in rat pulmonary

International Nuclear Information System (INIS)

Su Yuanfu; Guo Yao

1986-01-01

The changes in myocardial ultrastructure showed distinct dose-effect relation ship. Myocardial fibres maintained normal feature at doses below 150 Gy, even though small intestine epithelial lining was damaged and myocardial microvessels degenerated apparently. With the radiation dose increased to 250 Gy, degeneration and destruction of myocardial fibrils appeared. This events revealed the direct dependence of myocardial fibrillar changes to radiation doses but not to vascular lesion. Electrocardiography showed S-T segment in addition to the prolongation of Q-T intervals and T waves, while myocardial fibrils, myocardial mitochondria, T and L tubular systems and intercalate discs all underwent alterations. These abnormalities in dicated aberration of depolarization and repolarization in the animals heart. In parallel with the electrocardiographic changes, the level of plasma LDH 1 increased, which suggested cellular lesion and leakage of intracellular enzymes. All above changes supported the concept on presence of a 'cardio-vascular type' in acute radiation sickness

Normal SPECT thallium-201 bull's-eye display: gender differences

International Nuclear Information System (INIS)

Eisner, R.L.; Tamas, M.J.; Cloninger, K.

1988-01-01

The bull's-eye technique synthesizes three-dimensional information from single photon emission computed tomographic 201 TI images into two dimensions so that a patient's data can be compared quantitatively against a normal file. To characterize the normal database and to clarify differences between males and females, clinical data and exercise electrocardiography were used to identify 50 males and 50 females with less than 5% probability of coronary artery disease. Results show inhomogeneity of the 201 TI distributions at stress and delay: septal to lateral wall count ratios are less than 1.0 in both females and males; anterior to inferior wall count ratios are greater than 1.0 in males but are approximately equal to 1.0 in females. Washout rate is faster in females than males at the same peak exercise heart rate and systolic blood pressure, despite lower exercise time. These important differences suggest that quantitative analysis of single photon emission computed tomographic 201 TI images requires gender-matched normal files

Dose-related ethanol intake, Cx43 and Nav1.5 remodeling: Exploring insights of altered ventricular conduction and QRS fragmentation in excessive alcohol users.

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Hung, Chung-Lieh; Lai, Yu-Jun; Chi, Po-Ching; Chen, Liang-Chia; Tseng, Ya-Ming; Kuo, Jen-Yuan; Lin, Cheng-I; Chen, Yao-Chang; Lin, Shing-Jong; Yeh, Hung-I

2018-01-01

Chronic, excessive ethanol intake has been linked with various electrical instabilities, conduction disturbances, and even sudden cardiac death, but the underlying cause for the latter is insufficiently delineated. We studied surface electrocardiography (ECG) in a community-dwelling cohort with moderate-to-heavy daily alcohol intake (grouped as >90g/day, ≤90g/day, and nonintake). Compared with nonintake, heavier alcohol users showed markedly widened QRS duration and higher prevalence of QRS fragmentation (64.3%, 50.9%, and 33.7%, respectively, χ 2 12.0, both pchronically given a 4% or 6% alcohol diet and showed dose-related slower action potential upstroke, reduced resting membrane potential, and disorganized or decreased intraventricular conduction (all pChronic excessive alcohol ingestion is associated with dose-related phenotypic intraventricular conduction disturbances and QRS fragmentation that can be recapitulated in mice. The mechanisms may involve suppressed gap junction and sodium channel functions, together with enhanced cardiac fibrosis that may contribute to arrhythmogenesis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Automated detection of sleep apnea from electrocardiogram signals using nonlinear parameters

International Nuclear Information System (INIS)

Acharya, U Rajendra; Faust, Oliver; Chua, Eric Chern-Pin; Lim, Teik-Cheng; Lim, Liang Feng Benjamin

2011-01-01

Sleep apnoea is a very common sleep disorder which can cause symptoms such as daytime sleepiness, irritability and poor concentration. To monitor patients with this sleeping disorder we measured the electrical activity of the heart. The resulting electrocardiography (ECG) signals are both non-stationary and nonlinear. Therefore, we used nonlinear parameters such as approximate entropy, fractal dimension, correlation dimension, largest Lyapunov exponent and Hurst exponent to extract physiological information. This information was used to train an artificial neural network (ANN) classifier to categorize ECG signal segments into one of the following groups: apnoea, hypopnoea and normal breathing. ANN classification tests produced an average classification accuracy of 90%; specificity and sensitivity were 100% and 95%, respectively. We have also proposed unique recurrence plots for the normal, hypopnea and apnea classes. Detecting sleep apnea with this level of accuracy can potentially reduce the need of polysomnography (PSG). This brings advantages to patients, because the proposed system is less cumbersome when compared to PSG

Alcohol drinking triggers acute myocardial infarction in a case of hypertrophic obstructive cardiomyopathy

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Po-Chao Hsu

2011-05-01

Full Text Available Alcohol ingestion–related increased left ventricular outflow tract (LVOT pressure gradient in hypertrophic obstructive cardiomyopathy (HOCM has been reported in the literature; however, acute myocardial infarction (AMI after alcohol drinking in this patient group is rarely reported. Herein, we report a 68-year-old man with chronic alcoholism suffering from AMI after alcohol drinking. Electrocardiography revealed complete left bundle branch block, and chest X-ray showed acute pulmonary edema. Intubation was done for respiratory failure and intra-aortic balloon pump was also inserted for unstable hemodynamics. However, emergent coronary angiography revealed normal coronary arteries. HOCM was diagnosed by a high pressure gradient over LVOT and systolic anterior motion of mitral valve by echocardiography. This patient became stable under intensive care and medical treatment. This case reminds physicians that alcohol ingestion might cause AMI in HOCM patients because of increased LVOT pressure gradient and decreased coronary perfusion despite normal coronary arteries.

Professor André Jouve (1909-2001): A French cardiologist who was a pioneer of clinical vector-electrocardiography and cardiovascular epidemiology.

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Puddu, Paolo Emilio

2016-01-01

André, Julien, Auguste Jouve was born in Marseilles on June 10, 1909 son of Xavier Marie Francois Louis Jouve MD and Marie Louise Charlotte Vigliengo his wife. He had a brilliant medical career in Marseilles: Resident at Marseilles Hospitals in 1931, major of his promotion, then an Assistant in 1943 and a Chief in 1951, to become Associate Professor of Medicine in 1946 and finally Full Professor of Clinical and Experimental Cardiology in 1954. Fellow of several Cardiological Societies, he became President of the French Society of Cardiology in 1968, Vice-President of the European Society of Cardiology in 1972 and finally President of the French College of Vascular Pathology in 1973. He had been a WHO Expert for degenerative and cardiovascular diseases from 1958 to 1981 and a National correspondent of the Academy of Medicine in 1977. He was decorated by the Légion d'Honneur (Officer in 1975). He retired in 1981 and died in 2001. Clinical vector-electrocardiology and cardiovascular epidemiology were the main areas of his interest where he made essential contributions such as the famous treatise on ECG. The Heart Cantini Center was considered his leading creation and action, where the first French heart transplantation was performed in 1968, the first French epidemiological investigation on coronary risk factors took place, the idea of starting prevention at pediatric age was clearly outlined and the need of concentrating on psychological and dysmetabolic factors was precisely advocated for indexing later development of ischemic heart diseases. These achievements are reviewed and put into perspective. Copyright © 2016 Elsevier Inc. All rights reserved.

Eletrocardiografia em cães anestesiados com cetamina-s ou cetamina Electrocardiography in dogs anesthetized with s-ketamine or ketamine

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Almir Pereira de Souza

2002-10-01

Full Text Available A cetamina, fármaco derivado da fenciclidina, há muito é usada na anestesia veterinária, sendo que o seu isômero (+, a cetamina S, recém-lançada no mercado, tem tido emprego principalmente na anestesia humana. Em vista disso, objetivou-se, com este experimento avaliar comparativamente, as possíveis alterações eletrocardiográficas em cães anestesiados com cetamina S ou cetamina e avaliar as freqüências respiratória e cardíaca, saturação de oxihemoglobina e pressão arterial. Para tanto, foram utilizados 10 cães adultos, machos e fêmeas, sem raça definida e hígidos. Os animais foram distribuídos em dois grupos (G1 e G2 de igual número. Ao G1 administrou-se, por via intramuscular, cetamina S na dose de 20mg/kg, e ao G2, cetamina na mesma dose e via de administração empregados no G1. As observações das variáveis tiveram início imediatamente antes da aplicação dos fármacos (M1 e a cada 10 minutos (M2, M3 e M4, respectivamente. Os dados numéricos foram submetidos ao teste de Tukey, para análises repetidas no grupo, a fim de verificar significado estatístico ou não entre as médias, nos vários momentos, sendo considerado o nível de significância de 5% (pKetamine is a drug derived of the phenciclidine and has been used in veterinary anaesthesia for a long time. Its (+ isomers, s-ketamine, was recently introduced in the clinical practice and has been used mainly in human anaesthesia. So, this experiment was performed to evaluate comparatively possible electrocardiographic changes in dogs anesthetized with S-ketamine or ketamine and also evaluate heart rate, respiratory rate, oxihemoglobine saturation and arterial pressure. Ten adult male and female dogs were used in this study. All dogs were healthy and mix breed. The animals were divided in two equal number groups (G1 and G2. The G1 received 20mg/kg of S-ketamine intra-muscularly and G2 received the same dose of ketamine with the injection protocol. The electrocardiographic changes started immediately before the drug administration (M1 and were repeated every 10 minutes (M2, M3 and M4, respectively. The numeric data were submitted to Tukey test for analysis of the repetitions in the group to verify if the averages were statistically significant or not in the several moments with significant value of 5% (p<0.05. The presented results were heart rate elevation with both drugs, mild arterial pressure changes could also be observed. No changes in the SpO2 were detected and no electrocardiographic changes with clinic importance could be identified. Consequently it is possible to assume as a conclusive hypotheses that S-ketamine and ketamine have similar effects over the miocardium electrical conductivity.

A cloud computing based 12-lead ECG telemedicine service

Science.gov (United States)

2012-01-01

Background Due to the great variability of 12-lead ECG instruments and medical specialists’ interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists’ decision making support in emergency telecardiology. Methods We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis. Results This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. Conclusions This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan. PMID:22838382

Fabrication of Flexible Microneedle Array Electrodes for Wearable Bio-Signal Recording

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Lei Ren

2018-04-01

Full Text Available Laser-direct writing (LDW and magneto-rheological drawing lithography (MRDL have been proposed for the fabrication of a flexible microneedle array electrode (MAE for wearable bio-signal monitoring. Conductive patterns were directly written onto the flexible polyethylene terephthalate (PET substrate by LDW. The microneedle array was rapidly drawn and formed from the droplets of curable magnetorheological fluid with the assistance of an external magnetic field by MRDL. A flexible MAE can maintain a stable contact interface with curved human skin due to the flexibility of the PET substrate. Compared with Ag/AgCl electrodes and flexible dry electrodes (FDE, the electrode–skin interface impedance of flexible MAE was the minimum even after a 50-cycle bending test. Flexible MAE can record electromyography (EMG, electroencephalography (EEG and static electrocardiography (ECG signals with good fidelity. The main features of the dynamic ECG signal recorded by flexible MAE are the most distinguishable with the least moving artifacts. Flexible MAE is an attractive candidate electrode for wearable bio-signal monitoring.

Fabrication of a Micro-Needle Array Electrode by Thermal Drawing for Bio-Signals Monitoring.

Science.gov (United States)

Ren, Lei; Jiang, Qing; Chen, Keyun; Chen, Zhipeng; Pan, Chengfeng; Jiang, Lelun

2016-06-17

A novel micro-needle array electrode (MAE) fabricated by thermal drawing and coated with Ti/Au film was proposed for bio-signals monitoring. A simple and effective setup was employed to form glassy-state poly (lactic-co-glycolic acid) (PLGA) into a micro-needle array (MA) by the thermal drawing method. The MA was composed of 6 × 6 micro-needles with an average height of about 500 μm. Electrode-skin interface impedance (EII) was recorded as the insertion force was applied on the MAE. The insertion process of the MAE was also simulated by the finite element method. Results showed that MAE could insert into skin with a relatively low compression force and maintain stable contact impedance between the MAE and skin. Bio-signals, including electromyography (EMG), electrocardiography (ECG), and electroencephalograph (EEG) were also collected. Test results showed that the MAE could record EMG, ECG, and EEG signals with good fidelity in shape and amplitude in comparison with the commercial Ag/AgCl electrodes, which proves that MAE is an alternative electrode for bio-signals monitoring.

Fabrication of a Micro-Needle Array Electrode by Thermal Drawing for Bio-Signals Monitoring

Directory of Open Access Journals (Sweden)

Lei Ren

2016-06-01

Full Text Available A novel micro-needle array electrode (MAE fabricated by thermal drawing and coated with Ti/Au film was proposed for bio-signals monitoring. A simple and effective setup was employed to form glassy-state poly (lactic-co-glycolic acid (PLGA into a micro-needle array (MA by the thermal drawing method. The MA was composed of 6 × 6 micro-needles with an average height of about 500 μm. Electrode-skin interface impedance (EII was recorded as the insertion force was applied on the MAE. The insertion process of the MAE was also simulated by the finite element method. Results showed that MAE could insert into skin with a relatively low compression force and maintain stable contact impedance between the MAE and skin. Bio-signals, including electromyography (EMG, electrocardiography (ECG, and electroencephalograph (EEG were also collected. Test results showed that the MAE could record EMG, ECG, and EEG signals with good fidelity in shape and amplitude in comparison with the commercial Ag/AgCl electrodes, which proves that MAE is an alternative electrode for bio-signals monitoring.

Medical image of the week: atherosclerotic aneurysm of aortic arch and descecnding thoracic aorta

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Parasram M

2016-02-01

Full Text Available No abstract available. Article truncated after 150 words. A 94-year-old Spanish-speaking woman presented to the hospital with intermittent episodes of dyspnea and abdominal pain for one week. Her past medical history was notable for 30 pack-year smoking history and hypertension, which was reportedly controlled with medical therapy. Physical exam showed trace peripheral edema bilaterally, intact peripheral pulses, and a mild abdominal bruit. Work up at the emergency department revealed a non-ST elevation myocardial infarction with troponin T of 0.34 ng/mL but no ST-wave abnormality on electrocardiography. Chest x-ray displayed an incidental thoracic aneurysm (Figure 1. Chest computed tomography with contrast demonstrated a continuous aneurysm of the aortic arch and descending thoracic aorta with diameters measuring 6.8 cm and 6 cm, respectively (Figure 2A and 2B. Eccentric thrombi are noted in the aortic arch and the descending aorta. Interestingly, the distal descending thoracic aorta curves as it transitions to the abdominal aorta, which is evidence of a tortuous descending ...

The Telemetric and Holter ECG Warehouse Initiative (THEW): a Data Repository for the Design, Implementation and Validation of ECG-related Technologies

Science.gov (United States)

Couderc, Jean-Philippe

2011-01-01

We present an initiative supported by the National Heart Lung, and Blood Institute and the Food and Drug Administration for the development of a repository containing continuous electrocardiographic information to be shared with the worldwide scientific community. We believe that sharing data reinforces open scientific inquiry. It encourages diversity of analysis and opinion while promoting new research and facilitating the education of new researchers. In this paper, we present the resources available in this initiative for the scientific community. We describe the set of ECG signals currently hosted and we briefly discuss the associated clinical information (medical history. Disease and study-specific endpoints) and software tools we propose. Currently, the repository contains more than 250GB of data from eight clinical studies including healthy individuals and cardiac patients. This data is available for the development, implementation and validation of technologies related to body-surface ECGs. To conclude, the Telemetric and Holter ECG Warehouse (THEW) is an initiative developed to benefit the scientific community and to advance the field of quantitative electrocardiography and cardiac safety. PMID:21097349

A DESIGN FRAMEWORK FOR HUMAN EMOTION RECOGNITION USING ELECTROCARDIOGRAM AND SKIN CONDUCTANCE RESPONSE SIGNALS

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KHAIRUN NISA’ MINHAD

2017-11-01

Full Text Available Identification of human emotional state while driving a vehicle can help in understanding the human behaviour. Based on this identification, a response system can be developed in order to mitigate the impact that may be resulted from the behavioural changes. However, the adaptation of emotions to the environment at most scenarios is subjective to an individual’s perspective. Many factors, mainly cultural and geography, gender, age, life style and history, level of education and professional status, can affect the detection of human emotional affective states. This work investigated sympathetic responses toward human emotions defined by using electrocardiography (ECG and skin conductance response (SCR signals recorded simultaneously. This work aimed to recognize ECG and SCR patterns of the investigated emotions measured using selected sensor. A pilot study was conducted to evaluate the proposed framework. Initial results demonstrated the importance of suitability of the stimuli used to evoke the emotions and high opportunity for the ECG and SCR signals to be used in the automotive real-time emotion recognition systems.

Implantation of stem cells in the treatment of acute myocardial infarction

International Nuclear Information System (INIS)

Obregon Santos, Angel; Wilford de Leon, Mario; Aroche Aportela, Ronald; Isla Garcia, Rosa; Conde Cerdeira, Hector; Vila Garcia, Elena

2007-01-01

A lot of investigations demonstrate the possibility of regeneration of the cardiomiocity from stem cells. A longitudinal, prospective, observational study was conducted in patients with acute myocardial infarction in CIMEQ'S hospital since January 2004 up to January 2007 with the purpose to evaluate the security and efficacy of the intracoronary transfer of autologous bone-marrow-cells during acute myocardial infarction. Patients within seven days of the onset of symptoms of a first ST-segment elevation myocardial infarction, and between 18 and 70 years old. The patients are evaluated previous to apply the procedure and 6 months for clinic, electrocardiography, echocardiography, ergometry and coronariography. The drug eluting stent is placed on the culprit lesion and the bone marrow is stimulated with granulocyte colony-stimulating factor (G-CSF). The mononuclear's cells which are obtained have been implanted using the intracoronary way. The implantation by means of the intracoronary way of stem cells, after of stimulation of bone marrow during acute myocardial infarction demonstrated to be an effective and safety procedure

High-tension electrical injury to the heart as assessed by radionuclide imaging

Energy Technology Data Exchange (ETDEWEB)

Iino, Hitoshi; Chikamori, Taishiro; Hatano, Tsuguhisa [Tokyo Medical Coll. (Japan)] [and others

2002-12-01

The purpose of this study was to evaluate cardiac complications associated with electrical injury, 7 patients with high-tension electrical injury (6,600 V alternating current) underwent {sup 201}Tl and {sup 123}I-metaiodobenzylguanidine (MIBG) imaging in addition to conventional electrocardiographic and echocardiographic assessments. Electrocardiography showed transient atrial fibrillation, second degree atrioventricular block, ST-segment depression, and sinus bradycardia in each patient. Echocardiography showed mild hypokinesis of the anterior wall in only 2 patients, but {sup 201}Tl and {sup 123}I-MIBG myocardial scintigraphy showed an abnormal scan image in 6/7 and 5/6 patients, respectively. Decreased radionuclide accumulation was seen primarily in areas extending from the anterior wall to the septum. Decreased radionuclide accumulation was smaller in extent and milder in degree in {sup 123}I-MIBG than in {sup 201}Tl imaging. These results suggest that even in patients without definite evidence of severe cardiac complications in conventional examinations, radionuclide imaging detects significant damage due to high-tension electrical injury, in which sympathetic nerve dysfunction might be milder than myocardial cell damage. (author)

Report on the results of the seventh medical examination of atomic bomb survivors in the South America

International Nuclear Information System (INIS)

Ishioka, Shinichi; Ohta, Nobuhiro; Taguchi, Atsushi; Okada, Fumio; Hara, Tokihiro; Ueno, Kouki.

1997-01-01

The medical examination was carried out in Brazil, Paraguay, Bolivia, Argentina and Peru on 80, 4, 7, 11 and 3 survivors, respectively, from Oct. 30 to Nov. 15, 1996. They (43 males and 62 females) were 66.5 years old in average. The examination involved physical measurements, blood and urine analyses, electrocardiography, health questionnaire and consultation with blood pressure measurement. Results were as follows: Anamnesis; hypertension (51.4%), heart diseases (23.8%), cancer (21.0%), diabetes (19.0%), hemorrhoids (19.0%), stroke (18.1%), stomach ulcer (12.4%) and others: Present major disease; hypertension (23.8%), diabetes (6.7%), heart diseases (6.7%), cancer (6.7%) and others. Loss of vigor (63.8%), complete exhaustion or fatigue (63.8%), heat intolerance (60.0%), numbness or tingling (43.8%), failure of memory (42.9%) and many others were recognized as subjective symptoms. Blood pressure measurement gave hypertensive findings in 31.4%. Normal ECG was found in 67.7%. Cases judged to be necessary for further examinations or for treatment were in 46.7%. This examination was concluded to be continued. (K.H.)

Report on the results of the seventh medical examination of atomic bomb survivors in the South America

Energy Technology Data Exchange (ETDEWEB)

Ishioka, Shinichi [Hiroshima Univ. (Japan). School of Medicine; Ohta, Nobuhiro; Taguchi, Atsushi; Okada, Fumio; Hara, Tokihiro; Ueno, Kouki

1997-06-01

The medical examination was carried out in Brazil, Paraguay, Bolivia, Argentina and Peru on 80, 4, 7, 11 and 3 survivors, respectively, from Oct. 30 to Nov. 15, 1996. They (43 males and 62 females) were 66.5 years old in average. The examination involved physical measurements, blood and urine analyses, electrocardiography, health questionnaire and consultation with blood pressure measurement. Results were as follows: Anamnesis; hypertension (51.4%), heart diseases (23.8%), cancer (21.0%), diabetes (19.0%), hemorrhoids (19.0%), stroke (18.1%), stomach ulcer (12.4%) and others: Present major disease; hypertension (23.8%), diabetes (6.7%), heart diseases (6.7%), cancer (6.7%) and others. Loss of vigor (63.8%), complete exhaustion or fatigue (63.8%), heat intolerance (60.0%), numbness or tingling (43.8%), failure of memory (42.9%) and many others were recognized as subjective symptoms. Blood pressure measurement gave hypertensive findings in 31.4%. Normal ECG was found in 67.7%. Cases judged to be necessary for further examinations or for treatment were in 46.7%. This examination was concluded to be continued. (K.H.)

Mastication suppresses initial gastric emptying by modulating gastric activity.

Science.gov (United States)

Ohmure, H; Takada, H; Nagayama, K; Sakiyama, T; Tsubouchi, H; Miyawaki, S

2012-03-01

Because various mastication-related factors influence gastric activity, the functional relationship between mastication and gastric function has not been fully elucidated. To investigate the influence of mastication on gastric emptying and motility, we conducted a randomized trial to compare the effects of mastication on gastric emptying and gastric myoelectrical activity under conditions that excluded the influences of food comminution, taste, and olfaction. A (13)C-acetate breath test with electrogastrography and electrocardiography was performed in 14 healthy men who ingested a test meal with or without chewing gum. Autonomic nerve activity was evaluated by fluctuation analysis of heart rate. Gastric emptying was significantly delayed in the 'ingestion with mastication' group. Gastric myoelectrical activity was significantly suppressed during mastication and increased gradually in the post-mastication phase. A decrease in the high-frequency power of heart rate variability was observed coincidentally with gastric myoelectrical activity suppression. These findings suggest that initial gastric emptying is suppressed by mastication, and that the suppression is caused by mastication-induced inhibition of gastric activity (UMIN Clinical Trial Registration no. UMIN000005351).

Inducing sadness and anxiousness through visual media: measurement techniques and persistence

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Andre Kuijsters

2016-08-01

Full Text Available The persistence of negative moods (sadness and anxiousness induced by three visual Mood Induction Procedures (MIP was investigated. The evolution of the mood after the MIP was monitored for a period of 8 minutes with the Self-Assessment Manikin (every 2 minutes and with recordings of skin conductance level (SCL and electrocardiography (ECG. The SAM pleasure ratings showed that short and longer film fragments were effective in inducing a longer lasting negative mood, whereas the negative mood induced by the IAPS slideshow was short lived. The induced arousal during the anxious MIPs diminished quickly after the mood induction; nevertheless, the SCL data suggest longer lasting arousal effects for both movies. The decay of the induced mood follows a logarithmic function; diminishing quickly in the first minutes, thereafter returning slowly back to baseline. These results reveal that caution is needed when investigating the effects of the induced mood on a task or the effect of interventions on induced moods, because the induced mood diminishes quickly after the mood induction.

Inducing Sadness and Anxiousness through Visual Media: Measurement Techniques and Persistence.

Science.gov (United States)

Kuijsters, Andre; Redi, Judith; de Ruyter, Boris; Heynderickx, Ingrid

2016-01-01

The persistence of negative moods (sadness and anxiousness) induced by three visual Mood Induction Procedures (MIP) was investigated. The evolution of the mood after the MIP was monitored for a period of 8 min with the Self-Assessment Manikin (SAM; every 2 min) and with recordings of skin conductance level (SCL) and electrocardiography (ECG). The SAM pleasure ratings showed that short and longer film fragments were effective in inducing a longer lasting negative mood, whereas the negative mood induced by the IAPS slideshow was short lived. The induced arousal during the anxious MIPs diminished quickly after the mood induction; nevertheless, the SCL data suggest longer lasting arousal effects for both movies. The decay of the induced mood follows a logarithmic function; diminishing quickly in the first minutes, thereafter returning slowly back to baseline. These results reveal that caution is needed when investigating the effects of the induced mood on a task or the effect of interventions on induced moods, because the induced mood diminishes quickly after the mood induction.

Atrioventricular conduction abnormality and hyperchloremic metabolic acidosis in toluene sniffing

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Jian-Hsiung Tsao

2011-10-01

Full Text Available Toluene is an aromatic hydrocarbon with widespread industrial use as an organic solvent. As a result of the euphoric effect and availability of these substances, inhalation of toluene-based products is popular among young adults and children. Chronic or acute exposure is known to cause acid–base and electrolyte disorders, and to be toxic to the nervous and hematopoietic systems. We report a 38-year-old man who suffered from general muscular weakness of all extremities after toluene sniffing, which was complicated with hypokalemic paralysis, atrioventricular conduction abnormality, and normal anion gap hyperchloremic metabolic acidosis. Renal function, serum potassium and acid–base status normalized within 3 days after aggressive potassium chloride and intravenous fluid replacement. Electrocardiography showed regression of first-degree atrioventricular block. Exposure to toluene can lead to cardiac arrhythmias and sudden sniffing death syndrome. Tachyarrhythmia is the classical manifestation of toluene cardiotoxicity. Atrioventricular conduction abnormalities have been rarely mentioned in the literature. Knowledge of the toxicology and medical complications associated with toluene sniffing is essential for clinical management of these patients.

The state of the cardiovascular system in young patients with mitral valve prolapse

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M. A. Kuznetsova

2014-12-01

Full Text Available Aim. Due to the signifi cant increase of complications developing in young patients with mitral valve prolapse detection of this disease is important.In order to examine the state of the cardiovascular system in young patients 135 patients with mitral valve prolapse at the age of 16–25 years were examined. Methods and results. During the survey medical history was taken, the information from the medical records of оutpatients and extracts from the medical histories of patients were studied, clinical examination, electrocardiography (ECG and echocardiography (EchoCG were conducted with subsequent analysis of the obtained data. Conclusion. It was established that signifi cant differences were obtained in the analysis of auscultative symptoms in groups with MVP of grade 1 and grade 2. ECG studies in young patients showed that functional impairment was signifi cantly more frequently observed in the group with grade 2 MVP (56.4%, less frequently – in the group with grade 1 MVP (50.0% and only in 30.0% of cases in the control group (p <0.01.

Assessment of subclinical right ventricular systolic dysfunction in coal miners using myocardial isovolumic acceleration.

Science.gov (United States)

Ozcan Abacıoglu, Ozge; Kaplan, Mehmet; Abacıoglu, Serkan; Quisi, Ala

2017-09-01

Several studies have been conducted regarding the effects of coal mining on the respiratory system. However, there is a lack of data concerning potential effects of coal mining on the cardiovascular system. In this study, we aimed to evaluate the potential subclinical right and left ventricular dysfunction in coal miners. This single-center, prospective study included a total of 102 patients. Patient and control groups consisted of 54 coal miners and 48 healthy men, respectively. All patients underwent 12-lead electrocardiography, transthoracic echocardiography, and pulmonary function test. As compared to control group, coal miners had significantly higher right ventricular myocardial performance index (RVMPI) (0.41 ± 0.03 vs 0.37 ± 0.02, P right ventricular fractional area change (RVFAC) (33.55% ± 6.70% vs 37.04 ± 9.26 P right and left ventricular dysfunction, including RVMPI, RVFAC, TAPSE, IVA, and AD, are impaired in coal miners. © 2017 The Authors Echocardiography Published by Wiley Periodicals, Inc.

Intravenous administration of puppy deciduous teeth stem cells in degenerative valve disease

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Soontaree Petchdee

2016-12-01

Full Text Available Aim: The objective of this study is to investigate the improvement of heart function in dogs with chronic valvular heart disease after puppy deciduous teeth stem cells (pDSCs administration. Materials and Methods: 20 client-owned dogs with degenerative valvular heart disease underwent multiple intravenous injections of allogeneic pDSCs. Dogs were randomly assigned to two groups: (i Control group (n=10 with standard treatment for heart failure and (ii group with standard treatment and multiple administrations of pDSCs (n=10. Electrocardiography, complete transthoracic echocardiography, thoracic radiography, and blood pressure were recorded before and after pDSCs injections for 15, 30 and 60 days. Results: Post pDSCs injection showed measurable improvement in left ventricular ejection fraction, American College of Veterinary Internal Medicine (ACVIM functional class significantly improved and improved quality of life scores were observed. In the control group, there were no significant enhancements in heart function or ACVIM class. Conclusions: This finding suggests that pDSCs could be a supplement for valvular heart disease treatment.

PROPOSED SIMPLE METHOD FOR ELECTROCARDIOGRAM RECORDING IN FREE-RANGING ASIAN ELEPHANTS (ELEPHAS MAXIMUS).

Science.gov (United States)

Chai, Norin; Pouchelon, Jean Louis; Bouvard, Jonathan; Sillero, Leonor Camacho; Huynh, Minh; Segalini, Vincent; Point, Lisa; Croce, Veronica; Rigaux, Goulven; Highwood, Jack; Chetboul, Valérie

2016-03-01

Electrocardiography represents a relevant diagnostic tool for detecting cardiac disease in animals. Elephants can present various congenital and acquired cardiovascular diseases. However, few electrophysiologic studies have been reported in captive elephants, mainly due to challenging technical difficulties in obtaining good-quality electrocardiogram (ECG) tracings, and no data are currently available for free-ranging Asian elephants (Elephas maximus). The purpose of this pilot prospective study was to evaluate the feasibility of using a simple method for recording ECG tracings in wild, apparently healthy, unsedated Asian elephants (n = 7) in the standing position. Successful six-lead recordings (I, II, III, aVR, aVL, and aVF) were obtained, with the aVL lead providing the best-quality tracings in most animals. Variables measured in the aVL lead included heart rate, amplitudes and duration of the P waves, QRS complexes, T and U waves, and duration of the PR, QT, and QU intervals. A negative deflection following positive P waves, representative of an atrial repolarization wave (Ta wave), was observed for five out of the seven elephants.

EPILAB: a software package for studies on the prediction of epileptic seizures.

Science.gov (United States)

Teixeira, C A; Direito, B; Feldwisch-Drentrup, H; Valderrama, M; Costa, R P; Alvarado-Rojas, C; Nikolopoulos, S; Le Van Quyen, M; Timmer, J; Schelter, B; Dourado, A

2011-09-15

A Matlab®-based software package, EPILAB, was developed for supporting researchers in performing studies on the prediction of epileptic seizures. It provides an intuitive and convenient graphical user interface. Fundamental concepts that are crucial for epileptic seizure prediction studies were implemented. This includes, for example, the development and statistical validation of prediction methodologies in long-term continuous recordings. Seizure prediction is usually based on electroencephalography (EEG) and electrocardiography (ECG) signals. EPILAB is able to process both EEG and ECG data stored in different formats. More than 35 time and frequency domain measures (features) can be extracted based on univariate and multivariate data analysis. These features can be post-processed and used for prediction purposes. The predictions may be conducted based on optimized thresholds or by applying classifications methods such as artificial neural networks, cellular neuronal networks, and support vector machines. EPILAB proved to be an efficient tool for seizure prediction, and aims to be a way to communicate, evaluate, and compare results and data among the seizure prediction community. Copyright © 2011 Elsevier B.V. All rights reserved.

Stress myocardial scintigraphy in coronary artery disease

International Nuclear Information System (INIS)

Hata, Noritake; Koumi, Shin-ichi; Yasutake, Masahiro; Imaizumi, Takahiro; Saito, Tsutomu; Kishida, Hiroshi; Hayakawa, Hirokazu

1991-01-01

To evaluate the clinical significance of asymptomatic ischemic heart disease, exercise electrocardiography and stress myocardial scintigraphy were performed. These were correlated with symptoms during exercise tests and histories of myocardial infarction (MI). The study subjects consisted of 70 patients with coronary artery disease, including 34 with MI, and 36 without MI but with angina pectoris. Stress tests were performed using bicycle ergometer under electrocardiographic monitoring throughout the test. Transient myocardial ischemia was confirmed by perfusion defects on thallium myocardial imaging demonstrated immediately after exercise, but not 3 hours after the stress test. Asymptomatic ST depression was observed in 18 of 34 patients with MI (53%) and in 21 of the 36 patients with angina (58%); however, transient myocardial perfusion defects were confimred in 61% of the patients with MI (11 of 18 patients), but in only 33% of those with angina (7 of 21 patients). The difference was statistically significant (p<0.05). It was suggested that there are some differences in the clinical significance of asymptomatic ST depression between the patients with MI and those without MI but with angina pectoris. (author)

[Clinical significance of early percutaneous coronary intervention in patients with Braunwald III-B type unstable angina pectoris].

Science.gov (United States)

Nozaki, Katsuhiro; Nakao, Koichi; Horiuchi, Kenji; Kasanuki, Hiroshi; Honda, Takashi

2003-06-01

To assess the efficacy of early invasive strategy for the treatment of Braunwald III-B type unstable angina pectoris. This study included 573 consecutive patients of whom 267 underwent percutaneous coronary intervention (PCI) (312 lesions). The patients were divided into two groups, 95 treated with the early invasive strategy of coronary angiography within 24 hr of admission (Group PCI-I) and the remaining 172 treated with the early conservative strategy of coronary angiography 24 hr after admission (Group PCI-C). No significant differences were noted in the baseline characteristics of the two groups except for ST segment elevation on electrocardiography at presentation, which occurred significantly less frequently in Group PCI-C (36.8% vs 8.1%, p strategy for unstable angina pectoris were almost equivalent to those of the early conservative strategy, despite more frequent ST segmental elevation at admission in Group PCI-I. These findings suggest that the early invasive strategy for unstable angina pectoris may be acceptable even in the current Japanese clinical setting without the use of GP IIb/IIIa receptor antagonist, low molecular weight heparin or clopidogrel.

Evaluation of the Effectiveness of Sugammadex for Digoxin Intoxication: An Experimental Study.

Science.gov (United States)

Ozbilgin, Sule; Yurtlu, Derya Aslan; Küçükoztaş, Beyza; Kamacı, Gonca; Korkut, Sezen; Yurtlu, Bülent Serhan; Ensari Güneli, M; Hancı, Volkan; Günerli, Ali

2018-03-16

Previous studies have shown that cyclodextrin group medicines bind to various drugs. The hypothesis of our study is to determine whether sugammadex could bind to digoxin and delay the cardiovascular toxicity of that drug. Twenty-eight sedated Wistar rats were infused with digoxin at 3 mg/h (0.25 mg/ml). Five minutes after the start of infusion, animals were treated with a bolus of either 16 mg/kg (Sgdx16), 100 mg/kg (Sgdx100), or 1000 mg/kg (Sgdx1000) sugammadex. The control group infusion did not contain sugammadex. Heart rate, electrocardiography, and respiratory rate were monitored. The primary endpoint was time to asystole. Digoxin infusion continued until the animals arrested. The time to asystole for the Sgdx1000 group was significantly longer compared to that for the control group (p sugammadex 1000 group (p sugammadex delayed digoxin cardiotoxicity in a rat model of digoxin toxicity. We conclude that further research must be conducted on the interaction between digoxin and sugammadex.

Smartphone home monitoring of ECG

Science.gov (United States)

Szu, Harold; Hsu, Charles; Moon, Gyu; Landa, Joseph; Nakajima, Hiroshi; Hata, Yutaka

2012-06-01

A system of ambulatory, halter, electrocardiography (ECG) monitoring system has already been commercially available for recording and transmitting heartbeats data by the Internet. However, it enjoys the confidence with a reservation and thus a limited market penetration, our system was targeting at aging global villagers having an increasingly biomedical wellness (BMW) homecare needs, not hospital related BMI (biomedical illness). It was designed within SWaP-C (Size, Weight, and Power, Cost) using 3 innovative modules: (i) Smart Electrode (lowpower mixed signal embedded with modern compressive sensing and nanotechnology to improve the electrodes' contact impedance); (ii) Learnable Database (in terms of adaptive wavelets transform QRST feature extraction, Sequential Query Relational database allowing home care monitoring retrievable Aided Target Recognition); (iii) Smartphone (touch screen interface, powerful computation capability, caretaker reporting with GPI, ID, and patient panic button for programmable emergence procedure). It can provide a supplementary home screening system for the post or the pre-diagnosis care at home with a build-in database searchable with the time, the place, and the degree of urgency happened, using in-situ screening.

Autonomic nervous system function, activity patterns, and sleep after physical or cognitive challenge in people with chronic fatigue syndrome.

Science.gov (United States)

Cvejic, Erin; Sandler, Carolina X; Keech, Andrew; Barry, Benjamin K; Lloyd, Andrew R; Vollmer-Conna, Uté

2017-12-01

To explore changes in autonomic functioning, sleep, and physical activity during a post-exertional symptom exacerbation induced by physical or cognitive challenge in participants with chronic fatigue syndrome (CFS). Thirty-five participants with CFS reported fatigue levels 24-h before, immediately before, immediately after, and 24-h after the completion of previously characterised physical (stationary cycling) or cognitive (simulated driving) challenges. Participants also provided ratings of their sleep quality and sleep duration for the night before, and after, the challenge. Continuous ambulatory electrocardiography (ECG) and physical activity was recorded from 24-h prior, until 24-h after, the challenge. Heart rate (HR) and HR variability (HRV, as high frequency power in normalized units) was derived from the ECG trace for periods of wake and sleep. Both physical and cognitive challenges induced an immediate exacerbation of the fatigue state (pfatigue in a well-defined group of participants with CFS. Larger studies employing challenge paradigms are warranted to further explore the underlying pathophysiological mechanisms of post-exertional fatigue in CFS. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of electrocardiographic contamination on surface electromyography assessment of back muscles.

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Hu, Yong; Mak, Joseph N F; Luk, Keith D K

2009-02-01

The purpose of this study was to demonstrate the relative effect of electrocardiography (ECG) on back muscle surface electromyography (SEMG) parameters and their corresponding sensitivity in low back pain (LBP) assessment. Back muscle SEMG activities were recorded from 17 healthy subjects and 18 chronic LBP patients under static postures (straight sitting and upright standing), and dynamic action (flexion-extension). ECG cancellation based on independent component analysis (ICA) method was performed. Root mean square (RMS) and median frequency (MF) of raw and denoised SEMG data were computed respectively. Multiple comparisons were then performed. A consistent trend of change (increased MF and decreased RMS) followed ECG removal was noticed. In particular, in SEMG measurements under static postures, a significant decrease in RMS (pcorruption by ECG artifacts on SEMG measurements was found to be more serious and prominent in static postures than that in dynamic action. After ECG removal, significant improvements in the ability of SEMG to discriminate LBP patients from healthy subjects were seen in RMS amplitude recorded while standing (peffect of ECG contamination on back muscles SEMG parameters and LBP assessment.

Impact of human emotions on physiological characteristics

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Partila, P.; Voznak, M.; Peterek, T.; Penhaker, M.; Novak, V.; Tovarek, J.; Mehic, Miralem; Vojtech, L.

2014-05-01

Emotional states of humans and their impact on physiological and neurological characteristics are discussed in this paper. This problem is the goal of many teams who have dealt with this topic. Nowadays, it is necessary to increase the accuracy of methods for obtaining information about correlations between emotional state and physiological changes. To be able to record these changes, we focused on two majority emotional states. Studied subjects were psychologically stimulated to neutral - calm and then to the stress state. Electrocardiography, Electroencephalography and blood pressure represented neurological and physiological samples that were collected during patient's stimulated conditions. Speech activity was recording during the patient was reading selected text. Feature extraction was calculated by speech processing operations. Classifier based on Gaussian Mixture Model was trained and tested using Mel-Frequency Cepstral Coefficients extracted from the patient's speech. All measurements were performed in a chamber with electromagnetic compatibility. The article discusses a method for determining the influence of stress emotional state on the human and his physiological and neurological changes.

Semiautomatic three-dimensional CT ventricular volumetry in patients with congenital heart disease: agreement between two methods with different user interaction.

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Goo, Hyun Woo; Park, Sang-Hyub

2015-12-01

To assess agreement between two semi-automatic, three-dimensional (3D) computed tomography (CT) ventricular volumetry methods with different user interactions in patients with congenital heart disease. In 30 patients with congenital heart disease (median age 8 years, range 5 days-33 years; 20 men), dual-source, multi-section, electrocardiography-synchronized cardiac CT was obtained at the end-systolic (n = 22) and/or end-diastolic (n = 28) phase. Nineteen left ventricle end-systolic (LV ESV), 28 left ventricle end-diastolic (LV EDV), 22 right ventricle end-systolic (RV ESV), and 28 right ventricle end-diastolic volumes (RV EDV) were successfully calculated using two semi-automatic, 3D segmentation methods with different user interactions (high in method 1, low in method 2). The calculated ventricular volumes of the two methods were compared and correlated. A P value volumetry shows good agreement and high correlation between the two methods, but method 2 tends to slightly underestimate LV ESV, LV EDV, and RV ESV.

Value of Exercise ECG for Risk Stratification in Suspected or Known CAD in the Era of Advanced Imaging Technologies.

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Bourque, Jamieson M; Beller, George A

2015-11-01

Exercise stress electrocardiography (ExECG) is underutilized as the initial test modality in patients with interpretable electrocardiograms who are able to exercise. Although stress myocardial imaging techniques provide valuable diagnostic and prognostic information, variables derived from ExECG can yield substantial data for risk stratification, either supplementary to imaging variables or without concurrent imaging. In addition to exercise-induced ischemic ST-segment depression, such markers as ST-segment elevation in lead aVR, abnormal heart rate recovery post-exercise, failure to achieve target heart rate, and poor exercise capacity improve risk stratification of ExECG. For example, patients achieving ≥10 metabolic equivalents on ExECG have a very low prevalence of inducible ischemia and an excellent prognosis. In contrast, cardiac imaging techniques add diagnostic and prognostic value in higher-risk populations (e.g., poor functional capacity, diabetes, or chronic kidney disease). Optimal test selection for symptomatic patients with suspected coronary artery disease requires a patient-centered approach factoring in the risk/benefit ratio and cost-effectiveness. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

The Effect of Heart Rate on Exposure Window and Best Phase for Stress Perfusion Computed Tomography: Lessons From the CORE320 Study.

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Steveson, Chloe; Schuijf, Joanne D; Vavere, Andrea L; Mather, Richard T; Caton, Teresa; Mehra, Vishal; Betoko, Aisha; Cox, Christopher; Lima, Joao Ac; George, Richard T

The aim of this study is to evaluate the effect of heart rate on exposure window, best phase, and image quality for stress computed tomography perfusion (CTP) in the CORE320 study. The CTP data sets were analyzed to determine the best phase for perfusion analysis. A predefined exposure window covering 75% to 95% of the R-R cycle was used. Of the 368 patients included in the analysis, 93% received oral β blockade before the rest scan. The median heart rate during the stress acquisition was 69 bpm (interquartile range [IQR], 60-77). The median best phase was 81% (IQR, 76-90), and length of exposure window was 22% (IQR, 19-24). The best phase was significantly later in the cardiac cycle with higher heart rates (P stress scan was 5.3 mSv (IQR, 3.8-6.1). Stress myocardial CTP imaging can be performed using prospective electrocardiography triggering, an exposure window of 75% to 95%, and β-blockade resulting in good or excellent image quality in the majority (80%) of patients while maintaining a low effective radiation dose.

A cloud computing based 12-lead ECG telemedicine service

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Hsieh Jui-chien

2012-07-01

Full Text Available Abstract Background Due to the great variability of 12-lead ECG instruments and medical specialists’ interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists’ decision making support in emergency telecardiology. Methods We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG service to realize ubiquitous 12-lead ECG tele-diagnosis. Results This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. Conclusions This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan.

Empirical mode decomposition of the ECG signal for noise removal

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Khan, Jesmin; Bhuiyan, Sharif; Murphy, Gregory; Alam, Mohammad

2011-04-01

Electrocardiography is a diagnostic procedure for the detection and diagnosis of heart abnormalities. The electrocardiogram (ECG) signal contains important information that is utilized by physicians for the diagnosis and analysis of heart diseases. So good quality ECG signal plays a vital role for the interpretation and identification of pathological, anatomical and physiological aspects of the whole cardiac muscle. However, the ECG signals are corrupted by noise which severely limit the utility of the recorded ECG signal for medical evaluation. The most common noise presents in the ECG signal is the high frequency noise caused by the forces acting on the electrodes. In this paper, we propose a new ECG denoising method based on the empirical mode decomposition (EMD). The proposed method is able to enhance the ECG signal upon removing the noise with minimum signal distortion. Simulation is done on the MIT-BIH database to verify the efficacy of the proposed algorithm. Experiments show that the presented method offers very good results to remove noise from the ECG signal.

Influence of Respiratory Gating, Image Filtering, and Animal Positioning on High-Resolution Electrocardiography-Gated Murine Cardiac Single-Photon Emission Computed Tomography

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Chao Wu

2015-01-01

Full Text Available Cardiac parameters obtained from single-photon emission computed tomographic (SPECT images can be affected by respiratory motion, image filtering, and animal positioning. We investigated the influence of these factors on ultra-high-resolution murine myocardial perfusion SPECT. Five mice were injected with 99m technetium (99mTc-tetrofosmin, and each was scanned in supine and prone positions in a U-SPECT-II scanner with respiratory and electrocardiographic (ECG gating. ECG-gated SPECT images were created without applying respiratory motion correction or with two different respiratory motion correction strategies. The images were filtered with a range of three-dimensional gaussian kernels, after which end-diastolic volumes (EDVs, end-systolic volumes (ESVs, and left ventricular ejection fractions were calculated. No significant differences in the measured cardiac parameters were detected when any strategy to reduce or correct for respiratory motion was applied, whereas big differences (> 5% in EDV and ESV were found with regard to different positioning of animals. A linear relationship (p < .001 was found between the EDV or ESV and the kernel size of the gaussian filter. In short, respiratory gating did not significantly affect the cardiac parameters of mice obtained with ultra-high-resolution SPECT, whereas the position of the animals and the image filters should be the same in a comparative study with multiple scans to avoid systematic differences in measured cardiac parameters.

Is an Abnormal ECG Just the Tip of the ICE-berg? Examining the Utility of Electrocardiography in Detecting Methamphetamine-Induced Cardiac Pathology.

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Paratz, Elizabeth D; Zhao, Jessie; Sherwen, Amanda K; Scarlato, Rose-Marie; MacIsaac, Andrew I

2017-07-01

Methamphetamine use is escalating in Australia and New Zealand, with increasing emergency department attendance and mortality. Cardiac complications play a large role in methamphetamine-related mortality, and it would be informative to assess the frequency of abnormal electrocardiograms (ECGs) amongst methamphetamine users. To determine the frequency and severity of ECG abnormalities amongst methamphetamine users compared to a control group. We conducted a retrospective cohort analysis on 212 patients admitted to a tertiary hospital (106 patients with methamphetamine use, 106 age and gender-matched control patients). Electrocardiograms were analysed according to American College of Cardiology guidelines. Mean age was 33.4 years, with 73.6% male gender, with no significant differences between groups in smoking status, ECG indication, or coronary angiography rates. Methamphetamine users were more likely to have psychiatric admissions (22.6% vs 1.9%, pmethamphetamine users, particularly tachyarrhythmias (38.7% vs 26.4%, pmethamphetamine users than age and gender-matched controls. Due to the high frequency of abnormalities, ECGs should be performed in all methamphetamine users who present to hospital. Methamphetamine users with abnormal ECGs should undergo further cardiac investigations. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

External validation of heart-type fatty acid binding protein, high-sensitivity cardiac troponin, and electrocardiography as rule-out for acute myocardial infarction.

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Van Hise, Christopher B; Greenslade, Jaimi H; Parsonage, William; Than, Martin; Young, Joanna; Cullen, Louise

2018-02-01

To externally validate a clinical decision rule incorporating heart fatty acid binding protein (h-FABP), high-sensitivity troponin (hs-cTn) and electrocardiogram (ECG) for the detection of acute myocardial infarction (AMI) on presentation to the Emergency Department. We also investigated whether this clinical decision rule improved identification of AMI over algorithms incorporating hs-cTn and ECG only. This study included data from 789 patients from the Brisbane ADAPT cohort and 441 patients from the Christchurch TIMI RCT cohort. The primary outcome was index AMI. Sensitivity, specificity, positive predictive value and negative predictive value were used to assess the diagnostic accuracy of the algorithms. 1230 patients were recruited, including 112 (9.1%) with AMI. The algorithm including h-FABP and hs-cTnT had 100% sensitivity and 32.4% specificity. The algorithm utilising h-FABP and hs-cTnI had similar sensitivity (99.1%) and higher specificity (43.4%). The hs-cTnI and hs-cTnT algorithms without h-FABP both had a sensitivity of 98.2%; a result that was not significantly different from either algorithm incorporating h-FABP. Specificity was higher for the hs-cTnI algorithm (68.1%) compared to the hs-cTnT algorithm (33.0%). The specificity of the algorithm incorporating hs-cTnI alone was also significantly higher than both of the algorithms incorporating h-FABP (p<0.01). For patients presenting to the Emergency Department with chest pain, an algorithm incorporating h-FABP, hs-cTn and ECG has high accuracy and can rule out up to 40% of patients. An algorithm incorporating only hs-cTn and ECG has similar sensitivity and may rule out a higher proportion of patients. Each of the algorithms can be used to safely identify patients as low risk for AMI on presentation to the Emergency Department. Copyright © 2017 The Canadian Society of Clinical Chemists. All rights reserved.

Oxygen uptake kinetics during and after exercise are useful markers of coronary artery disease in patients with exercise electrocardiography suggesting myocardial ischemia

International Nuclear Information System (INIS)

Tajima, Akihiko; Ohkoshi, Nobuyuki; Kawara, Tokuhiro; Aizawa, Tadanori; Itoh, Haruki; Maeda, Tomoko; Osada, Naohiko; Omiya, Kazuto; Wasserman, K.

2009-01-01

The aim of the current study was to determine if the slowed exercise oxygen uptake (VO 2 ) kinetics, which is developed by myocardial ischemia, would be accompanied by delayed recovery VO 2 kinetics in patients with coronary artery disease (CAD). Thirty-seven patients with significant ST depression during treadmill exercise underwent cardiopulmonary exercise testing with cycle ergometer. Measurements performed are the ratios of change in increase in oxygen (O 2 ) uptake relative to increase in work rate (ΔVO 2 /ΔWR) across anaerobic threshold (AT) and 1 mm ST depression point (ST-dep), the time constants of VO 2 during recovery (T 1/2 VO 2 ), stress radio-isotope scintigraphy and coronary angiography. Patients were divided into CAD positive (CAD+) and CAD negative (CAD-) groups, based on coronary angiography. In CAD+, ΔVO 2 /ΔWR decreased above AT and ST-dep, in contrast to CAD- patients. The T 1/2 VO 2 in CAD+ (103.1±13.0 s) was greater than that of CAD- (76.5±8.7 s) and showed negative correlations to the ratios of ΔVO 2 /ΔWR across AT and ST-dep. These parameters improved in the patients who underwent coronary bypass surgery. Exercise and recovery VO 2 kinetics were slowed when myocardial ischemia was provoked by exercise. Measurement of exercise and recovery VO 2 kinetics improve the accuracy of the exercise electrocardiogram diagnosis of CAD. (author)

Exercise thallium-201 scintigraphy in the diagnosis and prognosis of coronary artery disease

International Nuclear Information System (INIS)

Kotler, T.S.; Diamond, G.A.

1990-01-01

The objective of this study is to determine the discriminant accuracy of exercise thallium-201 myocardial perfusion scintigraphy for the diagnosis and prognosis of patients with known or suspected coronary artery disease. This is a survey of the National Library of Medicine MEDLINE database. The key medical subject headings used were coronary disease, myocardial infarction, radionuclide imaging, and thallium. A total of 122 retrieved studies were considered relevant and were reviewed in depth. Only studies reporting both the sensitivity and specificity of thallium scintigraphy were analyzed. Discriminant accuracy for diagnosis and prognosis was summarized in terms of pooled sensitivity and specificity. Exercise thallium scintigraphy is useful in the noninvasive diagnosis of coronary artery disease, especially in patients with abnormal resting electrocardiograms, restricted exercise tolerance, and intermediate probability of having disease at the time of testing as well as of defining the prognosis of patients with known or suspected coronary artery disease, especially in those with previous myocardial infarction. Because of various shortcomings in the published record, however, the marginal discriminant accuracy and cost effectiveness of thallium scintigraphy compared with conventional clinical assessment and exercise electrocardiography remain controversial. 193 references

Multi-modal pain measurements in infants.

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Worley, A; Fabrizi, L; Boyd, S; Slater, R

2012-04-15

A non-invasive integrated method was developed to measure neural and behavioural responses to peripheral sensory and noxious stimulation in human infants. The introduction of a novel event-detection interface allows synchronous recording of: (i) muscle and central nervous system activity with surface electromyography (EMG), scalp electroencephalography (EEG) and near-infrared spectroscopy (NIRS); (ii) behavioural responses with video-recording and (iii) autonomic responses (heart rate, oxygen saturation, respiratory rate and cardiovascular activity) with electrocardiography (ECG) and pulse oximetry. The system can detect noxious heel lance and touch stimuli with precision (33 μs and 624 μs respectively) and accuracy (523 μs and 256 μs) and has 100% sensitivity and specificity for both types of stimulation. Its ability to detect response latencies accurately was demonstrated by a shift in latency of the vertex potential of 20.7 ± 15.7 ms (n=6 infants), following touch of the heel and of the shoulder, reflecting the distance between the two sites. This integrated system has provided reliable and reproducible measurements of responses to sensory and noxious stimulation in human infants on more than 100 test occasions. Copyright © 2012 Elsevier B.V. All rights reserved.

Printed soft-electronics for remote body monitoring

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Mantysalo, Matti; Vuorinen, Tiina; Jeihani, Vala; Vehkaoja, Antti

2017-08-01

Wearable electronics has emerged into the consumer markets over the past few years. Wrist worn and textile integrated devices are the most common apparatuses for unobtrusive monitoring in sports and wellness sectors. Disposable patches and bandages, however, represent the new era of wearable electronics. Soft and stretchable electronics is the enabling technology of this paradigm shift. It can conform to temporary transfer tattoo and deform with the skin without detachment or fracture. In this paper, we focus on screen-printed soft-electronics for remote body monitoring. We will present a fabrication process of a skin conformable electrode bandage designed for long-term outpatient electrocardiography (ECG) monitoring. The soft bandage is designed to be attached to the patient chest and miniaturized data collection device is connected to the bandage via Micro-USB connector. The fabricated bandage is tested in short exercise as well as continued long-term (72 hours) monitoring during normal daily activities. The attained quality of the measured ECG signals is fully satisfactory for rhythm-based cardiac analysis also during moderate-intensity exercise. After pre-processing, the signals could be used also for more profound morphological analysis of ECG wave shapes.

A rare case of renal infarction caused by infective endocarditis.

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Zakaria, Rasheed; Forsyth, Vhari; Rosenbaum, Tomas

2009-10-01

A 29-year-old man presented to the emergency department of a general hospital complaining of sudden onset left loin pain, radiating to the groin, which had started 48 h previously. He described no urological symptoms and had no medical history of note. Physical examination, electrocardiography, dipstick testing of urine, radiography of the chest and abdomen, blood tests (white blood cell count and serum urea, creatinine, sodium, potassium and C-reactive protein levels), CT of the renal tract, blood and urine cultures, renal angiography, thromboembolic blood panel, urine and blood tests for illicit drugs, transthoracic echocardiography, transesophageal echocardiography, renal ultrasonography. Infective endocarditis resulting in thromboembolic unilateral renal infarction. The patient was started on anticoagulation therapy with low-molecular-weight heparin and treated with intravenous gentamicin and benzylpenicillin for 4 weeks. He was seen in an outpatient clinic 4 weeks after discharge, at which time serum urea and creatinine levels and repeat ultrasonography of the renal tract confirmed normal renal function. He will be followed up regularly by cardiologists and urologists, at 6 weeks initially, and every 6 months to 1 year thereafter by his family physician.

Advances in diagnostic ultrasonography.

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Reef, V B

1991-08-01

A wide variety of ultrasonographic equipment currently is available for use in equine practice, but no one machine is optimal for every type of imaging. Image quality is the most important factor in equipment selection once the needs of the practitioner are ascertained. The transducer frequencies available, transducer footprints, depth of field displayed, frame rate, gray scale, simultaneous electrocardiography, Doppler, and functions to modify the image are all important considerations. The ability to make measurements off of videocassette recorder playback and future upgradability should be evaluated. Linear array and sector technology are the backbone of equine ultrasonography today. Linear array technology is most useful for a high-volume broodmare practice, whereas sector technology is ideal for a more general equine practice. The curved or convex linear scanner has more applications than the standard linear array and is equipped with the linear array rectal probe, which provides the equine practitioner with a more versatile unit for equine ultrasonographic evaluations. The annular array and phased array systems have improved image quality, but each has its own limitations. The new sector scanners still provide the most versatile affordable equipment for equine general practice.

A Case Report of Coronary Arteriovenous Fistulas with an Unruptured Coronary Artery Aneurysm Successfully Treated by Surgery

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Nobuhiro Takeuchi

2012-01-01

Full Text Available A 58-year-old female with a history of Wolff-Parkinson-White syndrome presented at our institution with palpitations and chest pain. Electrocardiography revealed paroxysmal supraventricular tachycardia with a heart rate of 188 beats/min. Antiarrhythmic drugs were ineffective, and tachycardia was resolved by electrical cardioversion. Transthoracic echocardiography revealed abnormal vessels around the right coronary artery (RCA and pulmonary artery (PA; in addition, we suspected coronary arteriovenous fistula (CAVF. Coronary angiography and coronary computed tomography revealed dilated fistula vessels, with a 1 cm saccular aneurysm around the RCA, originating from the proximal RCA and left anterior descending artery into the main trunk of PA. Therefore, we confirmed the diagnosis of CAVF with an unruptured aneurysm. We surgically ligated and clipped the fistula vessels and resected the aneurysm. The resected aneurysm measured  cm in size. Pathological examination of the resected aneurysm revealed hypertrophic walls comprising proliferating fibroblasts cells thin elastic fibers. Very few atherosclerotic changes manifested in the aneurysm walls. We report the case of a patient with CAVF and an unruptured coronary artery aneurysm who was successfully treated by surgery.

Preliminary data from γ-cardiography during the abatement of an asthmatic attack (1961)

International Nuclear Information System (INIS)

Georges, R.; Vernejoul, P. de; Raynaud, C.; Blanchon, P.; Kellershohn, C.; Turiaf, J.

1961-01-01

The authors used gamma cardiology during the abatement of 16 cases of asthma with a view to detecting heart attacks not otherwise visible with routine methods of examination: clinical, radiological and electro-cardio-graphical. In gamma cardiology, a radioactive indicator is used and its path followed in the cavities of the heart. The method makes it possible to study the circulation in the right heart, the pulmonary crossing, and the left heart, as well as evaluation of the heart-flow. As a result of their investigations the authors, after having discussed the significance of the data obtained with the method, suggest that it is possible by the use of gamma cardiography during the abatement of an asthma attack: 1- To confirm attacks of the right heart which have already been detected by ordinary methods. 2- To confirm the presence of modifications in the recorded curves which suggest, in the case of the left heart, possible attack; such on attack is also indicated, in a small number of cases, by electrocardiography curves. Some considerations are put forward by the authors concerning the physiopathology of attacks on the left heart. (authors) [fr

The ECG component of thallium-201 exercise testing significantly alters patient management

International Nuclear Information System (INIS)

Deague, J.; Salehi, N.; Grigg, L.; Lichtenstein, M.; Better, N.

1998-01-01

Full text: Thallium exercise testing (Tlex) offers superior sensitivity and specificity to exercise electrocardiography (ECG), but the value of the ECG data in Tlex remains poorly studied. While a normal Tlex is associated with an excellent prognosis, patients with a positive Tlex have a higher cardiac event rate. We aimed to see if a negative ECG component of the Tlex (ECGTI) was associated with an improved outcome compared with a positive ECGTI, in those patients with a reversible Tlex defect. We followed 100 consecutive patients retrospectively with a reversible defect on Tlex (50 with negative and 50 with positive (ECGTI) for 12 months. The ECG was reviewed as positive (1 mm ST depression 0.08 seconds after J point or > 2 mm if on digoxin or prior ECG changes), negative, equivocal or uninterpretable. We excluded patients with pharmacological testing, and those with equivocal or uninterpretable ECGs. Over the ensuing 12 months no patients with negative ECGTl was admitted with unstable angina, myocardium infarction or had a cardiac death. It is concluded that in patients with reversible defects on Tlex, a negative ECGTl is associated with a low incidence of cardiac events and a decreased incidence of a cardiac intervention

Investigations of sensitivity and resolution of ECG and MCG in a realistically shaped thorax model

International Nuclear Information System (INIS)

Mäntynen, Ville; Konttila, Teijo; Stenroos, Matti

2014-01-01

Solving the inverse problem of electrocardiography (ECG) and magnetocardiography (MCG) is often referred to as cardiac source imaging. Spatial properties of ECG and MCG as imaging systems are, however, not well known. In this modelling study, we investigate the sensitivity and point-spread function (PSF) of ECG, MCG, and combined ECG+MCG as a function of source position and orientation, globally around the ventricles: signal topographies are modelled using a realistically-shaped volume conductor model, and the inverse problem is solved using a distributed source model and linear source estimation with minimal use of prior information. The results show that the sensitivity depends not only on the modality but also on the location and orientation of the source and that the sensitivity distribution is clearly reflected in the PSF. MCG can better characterize tangential anterior sources (with respect to the heart surface), while ECG excels with normally-oriented and posterior sources. Compared to either modality used alone, the sensitivity of combined ECG+MCG is less dependent on source orientation per source location, leading to better source estimates. Thus, for maximal sensitivity and optimal source estimation, the electric and magnetic measurements should be combined. (paper)

Effects of parenteral administration of enrofloxacin on electrocardiographic parameters in hospitalized dogs

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Carlos Fernando Agudelo Ramírez

2012-01-01

Full Text Available The effect of enrofloxacin on the QT interval of the electrocardiogram was studied in 30 hospitalized dogs. The experimental group (n = 15 received enrofloxacin parenterally (subcutaneously at a dose of 5 mg/kg twice daily and amoxicillin-clavulanate intravenously at a dose of 22 mg/kg three times daily. The control group (n = 15 received only amoxicillin-clavulanate. Electrocardiography was carried out for 5 min once daily for 6 days. The QT interval was corrected by four different formulae. No differences were found between the two groups or within each group for the duration of the study. On the last day of the study the average QT interval for the control and experimental groups was 213.2 ms and 202.9 ms, respectively. Enrofloxacin did not cause prolongation of the QT or corrected QT intervals. We can conclude that the parenteral administration of enrofloxacin in non-cardiac dogs does not adversely affect the electrocardiographic indicators (no prolongation of the QT or corrected QT interval and does not induce ventricular arrhythmias. Parenteral use of enrofloxacin is thus safe and effective in non-cardiac dogs.

Chagas Disease in Dogs from Endemic Areas of Costa Rica

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Montenegro Victor M

2002-01-01

Full Text Available Dogs with the presumptive diagnosis of Chagas disease are commonly sent to our School of Veterinary Medicine by independent veterinarians. This prompted us to evaluate the prevalence of canine trypanosomiasis in some villages of the Central Valley of Costa Rica. A total of 54 dogs (21 males and 33 females from five rural villages, with ages between 3 months and 10 years old, were bled and submitted to three serological tests: indirect immunofluorescence, indirect hemagglutination and ELISA. Among all animals, 15 (27.7% revealed antibodies (6 pure bred and 9 mongrels and in 3 of them the parasite was also demonstrated by xenodiagnosis. All positive animals except 1, and 9 negative animals (control group were examined by X-rays and electrocardiography, revealing different degrees of cardiomegaly and ECG alteration, consistent with Chagas disease pathology in one dog (SA-11 of the infected ones. Examination of 50 inhabitants living in the houses where dogs and Triatoma dimidiata were found, yielded negative serological reactions. This was assumed to support the hypothesis that dogs are commonly infected by the oral route, a more effective means of infection compared with the vector transmission mechanism that occurs in humans.

Reflections on the role of open source in health information system interoperability.

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Sfakianakis, S; Chronaki, C E; Chiarugi, F; Conforti, F; Katehakis, D G

2007-01-01

This paper reflects on the role of open source in health information system interoperability. Open source is a driving force in computer science research and the development of information systems. It facilitates the sharing of information and ideas, enables evolutionary development and open collaborative testing of code, and broadens the adoption of interoperability standards. In health care, information systems have been developed largely ad hoc following proprietary specifications and customized design. However, the wide deployment of integrated services such as Electronic Health Records (EHRs) over regional health information networks (RHINs) relies on interoperability of the underlying information systems and medical devices. This reflection is built on the experiences of the PICNIC project that developed shared software infrastructure components in open source for RHINs and the OpenECG network that offers open source components to lower the implementation cost of interoperability standards such as SCP-ECG, in electrocardiography. Open source components implementing standards and a community providing feedback from real-world use are key enablers of health care information system interoperability. Investing in open source is investing in interoperability and a vital aspect of a long term strategy towards comprehensive health services and clinical research.

Evaluation of cardiovascular anomalies in patients with asymptomatic turner syndrome using multidetector computed tomography.

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Lee, Sun Hee; Jung, Ji Mi; Song, Min Seob; Choi, Seok jin; Chung, Woo Yeong

2013-08-01

Turner syndrome is well known to be associated with significant cardiovascular abnormalities. This paper studied the incidence of cardiovascular abnormalities in asymptomatic adolescent patients with Turner syndrome using multidetector computed tomography (MDCT) instead of echocardiography. Twenty subjects diagnosed with Turner syndrome who had no cardiac symptoms were included. Blood pressure and electrocardiography (ECG) was checked. Cardiovascular abnormalities were checked by MDCT. According to the ECG results, 11 had a prolonged QTc interval, 5 had a posterior fascicular block, 3 had a ventricular conduction disorder. MDCT revealed vascular abnormalities in 13 patients (65%). Three patients had an aberrant right subclavian artery, 2 had dilatation of left subclavian artery, and others had an aortic root dilatation, aortic diverticulum, and abnormal left vertebral artery. As for venous abnormalities, 3 patients had partial anomalous pulmonary venous return and 2 had a persistent left superior vena cava. This study found cardiovascular abnormalities in 65% of asymptomatic Turner syndrome patients using MDCT. Even though, there are no cardiac symptoms in Turner syndrome patients, a complete evaluation of the heart with echocardiography or MDCT at transition period to adults must be performed.

Race differences in ventricular remodeling and function among college football players.

Science.gov (United States)

Haddad, Francois; Peter, Shanon; Hulme, Olivia; Liang, David; Schnittger, Ingela; Puryear, Josephine; Gomari, Fatemeh A; Finocchiaro, Gherardo; Myers, Jonathan; Froelicher, Victor; Garza, Daniel; Ashley, Euan A

2013-07-01

Athletic training is associated with increases in ventricular mass and volume. Recent studies have shown that left ventricular mass increases proportionally in white athletes with a mass/volume ratio approaching unity. The objective of this study was to compare the proportionality in ventricular remodeling and ventricular function in black versus white National Collegiate Athletic Association Division I football players. From 2008 to 2011, football players at Stanford University underwent cardiovascular screening with a 12-point history and physical examination, electrocardiography, and focused echocardiography. Compared with white players, black players had on average higher left ventricular mass indexes (77 ± 11 vs 71 ± 11 g/m(2), p = 0.009), higher mass/volume ratios (1.18 ± 0.16 vs 1.06 ± 0.09 g/ml, p 1.2. Mass/volume ratio was inversely related to early diastolic tissue Doppler velocity e' (r = -0.50, p football players exhibit more concentric ventricular remodeling, lower early diastolic annular velocities, and increased ventricular voltage compared with white players. Ventricular mass increases proportionally to volume in white players but not in black players. Copyright © 2013 Elsevier Inc. All rights reserved.

The reliability and accuracy of a noncontact electrocardiograph system for screening purposes.

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Czaplik, Michael; Eilebrecht, Benjamin; Walocha, Rafael; Walter, Marian; Schauerte, Patrick; Leonhardt, Steffen; Rossaint, Rolf

2012-02-01

Electrocardiography (ECG) requires the application of electrodes to the skin and often necessitates undressing. Capacitively coupled electrodes embedded in a normal chair would be a rational alternative for ECG screening. We evaluated the reliability and accuracy of ECG electrodes imbedded in a chair cushion. Two independent clinicians compared ECG recordings obtained using skin electrodes with recordings obtained using capacitively coupled electrodes that were embedded in a chair cushion in an anesthesiology premedication room, a cardiology outpatient ward, and a cardiology day ward. We analyzed the data to compare the sensitivity and specificity for the diagnosis of cardiac arrhythmias. ECG recordings were obtained from 107 patients. Heart rate was accurately measured using the capacitively coupled electrodes, but motion artifacts made the identification of P and T waves unreliable. Signal quality was poor for patients with low body weight, patients wearing clothing containing mixed fibers, and patients wearing sweaty shirts. Heart rate was accurately measured, and some cardiac arrhythmias were correctly diagnosed using capacitive ECG electrodes. Capacitive electrodes embedded into an examination chair are a promising tool for preoperative screening. Improved artifact reduction algorithms are needed before capacitive electrodes will replace skin electrodes.

Biosignals reflect pair-dynamics in collaborative work: EDA and ECG study of pair-programming in a classroom environment.

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Ahonen, Lauri; Cowley, Benjamin Ultan; Hellas, Arto; Puolamäki, Kai

2018-02-16

Collaboration is a complex phenomenon, where intersubjective dynamics can greatly affect the productive outcome. Evaluation of collaboration is thus of great interest, and can potentially help achieve better outcomes and performance. However, quantitative measurement of collaboration is difficult, because much of the interaction occurs in the intersubjective space between collaborators. Manual observation and/or self-reports are subjective, laborious, and have a poor temporal resolution. The problem is compounded in natural settings where task-activity and response-compliance cannot be controlled. Physiological signals provide an objective mean to quantify intersubjective rapport (as synchrony), but require novel methods to support broad deployment outside the lab. We studied 28 student dyads during a self-directed classroom pair-programming exercise. Sympathetic and parasympathetic nervous system activation was measured during task performance using electrodermal activity and electrocardiography. Results suggest that (a) we can isolate cognitive processes (mental workload) from confounding environmental effects, and (b) electrodermal signals show role-specific but correlated affective response profiles. We demonstrate the potential for social physiological compliance to quantify pair-work in natural settings, with no experimental manipulation of participants required. Our objective approach has a high temporal resolution, is scalable, non-intrusive, and robust.

Electrocardiographic features of sudden unexpected death in epilepsy.

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Chyou, Janice Y; Friedman, Daniel; Cerrone, Marina; Slater, William; Guo, Yu; Taupin, Daniel; O'Rourke, Sean; Priori, Silvia G; Devinsky, Orrin

2016-07-01

Sudden unexpected death in epilepsy (SUDEP) is the most common cause of epilepsy-related mortality. We hypothesized that electrocardiography (ECG) features may distinguish SUDEP cases from living subjects with epilepsy. Using a matched case-control design, we compared ECG studies of 12 consecutive cases of SUDEP over 10 years and 22 epilepsy controls matched for age, sex, epilepsy type (focal, generalized, or unknown/mixed type), concomitant antiepileptic, and psychotropic drug classes. Conduction intervals and prevalence of abnormal ventricular conduction diagnosis (QRS ≥110 msec), abnormal ventricular conduction pattern (QRS <110 msec, morphology of incomplete right or left bundle branch block or intraventricular conduction delay), early repolarization, and features of inherited cardiac channelopathies were assessed. Abnormal ventricular conduction diagnosis and pattern distinguished SUDEP cases from matched controls. Abnormal ventricular conduction diagnosis was present in two cases and no controls. Abnormal ventricular conduction pattern was more common in cases than controls (58% vs. 18%, p = 0.04). Early repolarization was similarly prevalent in cases and controls, but the overall prevalence exceeded that of published community-based cohorts. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

Ultraconformable Temporary Tattoo Electrodes for Electrophysiology

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Ferrari, Laura M.; Sudha, Sudha; Tarantino, Sergio; Esposti, Roberto; Bolzoni, Francesco; Cavallari, Paolo; Cipriani, Christian

2018-01-01

Abstract Electrically interfacing the skin for monitoring personal health condition is the basis of skin‐contact electrophysiology. In the clinical practice the use of stiff and bulky pregelled or dry electrodes, in contrast to the soft body tissues, imposes severe restrictions to user comfort and mobility while limiting clinical applications. Here, in this work dry, unperceivable temporary tattoo electrodes are presented. Customized single or multielectrode arrays are readily fabricated by inkjet printing of conducting polymer onto commercial decal transfer paper, which allows for easy transfer on the user's skin. Conformal adhesion to the skin is provided thanks to their ultralow thickness (Tattoo electrode–skin contact impedance is characterized on short‐ (1 h) and long‐term (48 h) and compared with standard pregelled and dry electrodes. The viability in electrophysiology is validated by surface electromyography and electrocardiography recordings on various locations on limbs and face. A novel concept of tattoo as perforable skin‐contact electrode, through which hairs can grow, is demonstrated, thus permitting to envision very long‐term recordings on areas with high hair density. The proposed materials and patterning strategy make this technology amenable for large‐scale production of low‐cost sensing devices. PMID:29593975

Syncope in Children and Adolescents

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Pejčić Ljiljana

2017-09-01

Full Text Available In the pediatric age group, most cases of syncope represent benign, neutrally-mediated alterations in vasomotor tone. Due to the global cerebral hypoperfusion, syncope is defined as a transient loss of consciousness followed by spontaneous recovery and/or a state of presyncope, including dizziness, lightheadedness, pallor, diaphoresis and palpitations which may precede the loss of consciousness. These symptoms could be a sign of a life-threatening event in a small subset of patients, even though most causes of syncope in childhood are benign, and life-threatening causes of syncope generally have cardiac etiology. In all these cases, routine evaluation includes history, physical examination and a 12-lead standard electrocardiogram which should be performed. Further investigation is indicated by worrying features which include syncope that occurs without warning, syncope during exercise, history of familial sudden death, and abnormalities on clinical exam or electrocardiography. The fact is that syncope generates great fear of injury or sudden death among parents and doctors, and the main aim of the present paper is to help the physician involved in the care of children to differentiate the life-threatening causes of syncope from the common, more benign neutrally-mediated syncope.

[Effects of electromagnetic radiation on health and immune function of operators].

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Li, Yan-zhong; Chen, Shao-hua; Zhao, Ke-fu; Gui, Yun; Fang, Si-xin; Xu, Ying; Ma, Zi-jian

2013-08-01

To investigate the effects of electromagnetic radiation on the physiological indices and immune function of operators. The general conditions and electromagnetic radiation awareness rate of 205 operators under electromagnetic radiation were evaluated using a self-designed questionnaire. Physical examination, electrocardiography, and routine urine test were performed in these operators. Peripheral blood was collected from the operators under electromagnetic radiation for blood cell counting and biochemical testing, and their peripheral blood lymphocytes were cultured for determination of chromosomal aberrant frequency and micronucleus frequency. The data from these operators (exposure group) were compared with those of 95 ordinary individuals (control group). The chief complaint of giddiness, tiredness, dizziness, and amnesia showed significant differences between the exposure group and control group (P electromagnetic radiation damage was significantly higher in the exposure group than in the control group. The difference in bradycardia was significant between the two groups (P Electromagnetic radiation may lead to the changes in physiological indices, genetic effects, and immune function and affect the health and immune function in operators. The adverse effects are increased as the working years increase. So it is important to strengthen occupational protection of operators under electromagnetic radiation.

The Comparative Study of ECG Findings in the Patients Suffered from Subarachnoid Hemorrhage and Control Group in Northeastern Iran

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Karim Nikkhah

2015-04-01

Full Text Available Introduction: Subarachnoid Hemorrhage (SAH which accounts for (5% to 10% of cerebrovascular accidents is an important cause of mortality and disability. It can be complicated by many neurological and medical conditions including cardiovascular complications. During the course of SAH morphologic Electrocardiography (ECG changes, arrhythmias, myocardial injury and elevation of cardiac enzymes, subendocardial hemorrhage and necrosis may be observed. Materials and Methods:102 SAH patients, without any history of Ischemic heart Disease (IHD, admitted in Ghaem Hospital were studied. Their clinical and radiological parameters were evaluated. Three serial ECGs were performed within the first 72 hours for each patient and the ECG findings were analyzed. The control group consisted of 102 elective patients of Ghaem hospital without any expected heart disease. Results: ECG changes were observed in 60.8% of SAH patients with average age of (53.4±14.2 years and in (2.9% of control group. The ECG findings were as follows: chamber abnormalities (6.9%, conduction abnormalities (7.8%, repolarization abnormalities (49%, rhythm abnormalities (22.5% and pathologic Q wave (6.9%. According to this study, ECG changes are related to subarachnoid hemorrhage (p

Preoperative prediction of reversible myocardial asynergy by postexercise radionuclide ventriculography

International Nuclear Information System (INIS)

Rozanski, A.; Berman, D.; Gray, R.; Diamond, G.; Raymond, M.; Prause, J.; Maddahi, J.; Swan, H.J.; Matloff, J.

1982-01-01

Myocardial asynergy is sometimes reversed by coronary bypass, and a noninvasive method of predicting which assess are reversible would be desirable. To assess whether changes in myocardial wall motion observed immediately after exercise can differentiate reversible from nonreversible myocardial asynergy, we evaluated 53 patients by radionuclide ventriculography before and after exercise and again at rest after coronary bypass surgery. Preoperative improvement in wall motion immediately after exercise was highly predictive of the surgical outcome (average chance-corrected agreement, 91 per cent). At surgery the asynergic segments that had improved after exercise were free of grossly apparent epicardial scarring. The accuracy of these predictions for postoperative improvement was significantly greater (P less than 0.01) than that of analysis of Q waves on resting electrocardiography (average chance-corrected agreement, 40 per cent). In contrast, preoperative changes in left ventricular ejection fraction after exercise were not predictive of postoperative resting ejection fraction. We conclude that postexercise radionuclide ventriculography can be used to identify reversible resting myocardial asynergy. This test should prove effective in predicting which patients with myocardial asynergy are most likely to benefit from aortocoronary revascularization

A review of the epidemiologic literature on the role of environmental arsenic exposure and cardiovascular diseases

International Nuclear Information System (INIS)

Wang, C.-H.; Hsiao, C.K.; Chen, C.-L.; Hsu, L.-I; Chiou, H.-Y.; Chen, S.-Y.; Hsueh, Y.-M.; Wu, M.-M.; Chen, C.-J.

2007-01-01

Cardiovascular disease is the leading cause of mortality worldwide. Arsenic is a ubiquitous metalloid in the crust of the earth. Chronic arsenic poisoning is becoming an emerging epidemic in Asia. Epidemiological studies have shown that chronic arsenic poisoning through ingestion of arsenic-contaminated water is associated with various cardiovascular diseases in dose-response relationships. These cardiovascular disorders include carotid atherosclerosis detected by ultrasonography, impaired microcirculation, prolonged QT interval and increased QT dispersion in electrocardiography, and clinical outcomes such as hypertension, blackfoot disease (a unique peripheral vascular disease endemic in southwestern Taiwan), coronary artery disease and cerebral infarction. Chronic arsenic poisoning is an independent risk factor for cardiovascular disease. The adverse cardiovascular effects of long-term arsenic exposure may be persistent and/or irreversible. Arsenic-induced cardiovascular diseases in human population may result from the interaction among genetic, environment and nutritional factors. The major adverse cardiovascular effect of chronic arsenic poisoning has been established qualitatively and quantitatively in the high arsenic exposure areas, but the low-dose effect of arsenic on cardiovascular diseases remains to be explored. Cardiovascular death is the major cause of mortality worldwide, and a small increased risk may imply a large quantity of excess mortality

Preclinical evidence of mitochondrial nicotinamide adenine dinucleotide as an effective alarm parameter under hypoxia

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Shi, Hua; Sun, Nannan; Mayevsky, Avraham; Zhang, Zhihong; Luo, Qingming

2014-01-01

Early detection of tissue hypoxia in the intensive care unit is essential for effective treatment. Reduced nicotinamide adenine dinucleotide (NADH) has been suggested to be the most sensitive indicator of tissue oxygenation at the mitochondrial level. However, no experimental evidence comparing the kinetics of changes in NADH and other physiological parameters has been provided. The aim of this study is to obtain the missing data in a systematic and reliable manner. We constructed four acute hypoxia models, including hypoxic hypoxia, hypemic hypoxia, circulatory hypoxia, and histogenous hypoxia, and measured NADH fluorescence, tissue reflectance, cerebral blood flow, respiration, and electrocardiography simultaneously from the induction of hypoxia until death. We found that NADH was not always the first onset parameter responding to hypoxia. The order of responses was mainly affected by the cause of hypoxia. However, NADH reached its alarm level earlier than the other monitored parameters, ranging from several seconds to >10 min. As such, we suggest that the NADH can be used as a hypoxia indicator, although the exact level that should be used must be further investigated. When the NADH alarm is detected, the body still has a chance to recover if appropriate and timely treatment is provided.

‘YES YES HEAD TREMOR’ case developing after cerebellar infarction

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Uygar Utku

2015-12-01

Full Text Available Movement disorders, developing after cerebellar infarctions, are rare. One of them is 'Yes / Yes tremor' head tremor. A 73-year-old female patient was brought to the emergency department of our hospital with complaints of dizziness, nausea and vomiting. There was hypertension on her past history. She was taking anti-hypertension drug. Her neurological examination was normal except for right dysmetria, disdiadikokinesia and damaged knee-heel test. Electrocardiography was atrial fibrillation with rapid ventricular response. On the right cerebellar hemisphere, brain computerized tomography revealed consistent lesions with acute ischemic stroke. The patient showed clinically significant improvement in time and discharged with coumadine. When she came for drug control after two weeks, we detected her ‘Yes / Yes’ revealed style of head tremor started three days ago. The tremor was resting-postural. Its activity increased with excitement, decreased after resting and stopped while sleeping. She was intolerant although we initiated the treatment with primidone 250 mg tablets divided into eight. After continuing the treatment with gabapentine titrated 300 mg tablets, the head tremor of patient improved remarkedly in a short period of time. The phenomenon is presented due to its rarity and remarkableness.

Haematological and electrocardiographic variations during menstrual cycle

International Nuclear Information System (INIS)

Rajnee, A.; Binawara, B.K.; Choudhary, S.; Chawla, V.K.; Choudhary, R.

2010-01-01

Menstruation coupled periodic bleeding from the blood vessels, at the time of shedding of the uterine mucosa has directed interest, more especially in the haematological changes during different phases of menstrual cycle. Methods: The present study was carried out on 30 healthy female medical students in the age group of 18 to 23 years with the normal menstrual cycle of 30 +- 3 days. The various haematological parameter and electrocardiography were studied on the second, eleventh, fourteenth and twenty second day of menstrual cycle. Result: The study reveals that the total leukocyte count and total platelet count significantly increased (p<0.001) around mid cycle, however total eosinophil count significantly decreased (p<0.05) during the same period. Differential leukocyte count, bleeding time, clotting time, heart rate, P-R interval and Q-T interval did not show any significant change during different phases of menstrual cycle, although some mild changes were observed. Conclusion: This study was a moderate attempt to determine regular variation in the different haematological parameters and ECG during the different phases of menstrual cycle in normal healthy females and evaluate conflicting reports on the subjects. (author)

Design, fabrication and skin-electrode contact analysis of polymer microneedle-based ECG electrodes

Science.gov (United States)

O'Mahony, Conor; Grygoryev, Konstantin; Ciarlone, Antonio; Giannoni, Giuseppe; Kenthao, Anan; Galvin, Paul

2016-08-01

Microneedle-based ‘dry’ electrodes have immense potential for use in diagnostic procedures such as electrocardiography (ECG) analysis, as they eliminate several of the drawbacks associated with the conventional ‘wet’ electrodes currently used for physiological signal recording. To be commercially successful in such a competitive market, it is essential that dry electrodes are manufacturable in high volumes and at low cost. In addition, the topographical nature of these emerging devices means that electrode performance is likely to be highly dependent on the quality of the skin-electrode contact. This paper presents a low-cost, wafer-level micromoulding technology for the fabrication of polymeric ECG electrodes that use microneedle structures to make a direct electrical contact to the body. The double-sided moulding process can be used to eliminate post-process via creation and wafer dicing steps. In addition, measurement techniques have been developed to characterize the skin-electrode contact force. We perform the first analysis of signal-to-noise ratio dependency on contact force, and show that although microneedle-based electrodes can outperform conventional gel electrodes, the quality of ECG recordings is significantly dependent on temporal and mechanical aspects of the skin-electrode interface.

Design, fabrication and skin-electrode contact analysis of polymer microneedle-based ECG electrodes

International Nuclear Information System (INIS)

O’Mahony, Conor; Grygoryev, Konstantin; Ciarlone, Antonio; Giannoni, Giuseppe; Kenthao, Anan; Galvin, Paul

2016-01-01

Microneedle-based ‘dry’ electrodes have immense potential for use in diagnostic procedures such as electrocardiography (ECG) analysis, as they eliminate several of the drawbacks associated with the conventional ‘wet’ electrodes currently used for physiological signal recording. To be commercially successful in such a competitive market, it is essential that dry electrodes are manufacturable in high volumes and at low cost. In addition, the topographical nature of these emerging devices means that electrode performance is likely to be highly dependent on the quality of the skin-electrode contact.This paper presents a low-cost, wafer-level micromoulding technology for the fabrication of polymeric ECG electrodes that use microneedle structures to make a direct electrical contact to the body. The double-sided moulding process can be used to eliminate post-process via creation and wafer dicing steps. In addition, measurement techniques have been developed to characterize the skin-electrode contact force. We perform the first analysis of signal-to-noise ratio dependency on contact force, and show that although microneedle-based electrodes can outperform conventional gel electrodes, the quality of ECG recordings is significantly dependent on temporal and mechanical aspects of the skin-electrode interface. (paper)

Role of Magnetocardiography in Emergency Room

International Nuclear Information System (INIS)

Kwon, H.; Kim, K.; Kim, J. M.; Lee, Y. H.; Kim, T. E.; Lim, H. K.; Park, Y. K.; Ko, Y. G.; Chung, N.

2006-01-01

In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

The influence of the perinatal environment on the heart: morphological, electrocardiographic, and multimodality imaging features

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Giuseppe Mercuro

2015-10-01

Full Text Available The purpose of this paper is to review the studies performed to evaluate the influence of perinatal environment on neonatal heart, detected by electrocardiography, echocardiography, and other imaging techniques. Prenatal conditions (such as intrauterine growth retardation and prematurity at birth and some post-natal events (such as perinatal asphyxia and corticosteroids administration, may have early and late detrimental effects on the heart may predispose to a number of future cardiovascular adverse events. For example, subjects born preterm may be at potentially higher risk of developing malignant ventricular arrhythmias as well. Moreover, in individuals born with an extremely low birthweight atrial septal aneurysms are present in about one third of the subjects in the study. Thus, a long-life follow up is suggested in these subjects.Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the Netherlands, Gavino Faa (Cagliari, Italy, Antonio Giordano (Philadelphia, USA

Possible Cardiotoxic Effects of Vanadium

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Parveen Parkash

1990-12-01

Full Text Available Vanadium, a ubiquitous element, is physiologically and pharmacologically an active substance and is present in most of mammalian tissues Jandhala and Horn, 1983. Large corpus of information exists on the mode of action of vanadium on cardiac muscles (Jandhala and Horn, 1983., Solaro et al, 1980, but the basis of pharma­cological lesion underlying its cardiac toxi­city is still poorly understood. Except for the solitary report of Lewis (1958 to best of our knowledge no information exists on the effect of vanadium on the functioning of heart as shown by electrocardiography.Large amounts of vanadium are relea­sed into atmosphere by combustion of fossil fuel (Vouk, 1979 and due to rapid indus­trialisation its environmental concentra­tion is reported to be increasing (Goldberg et al, 1974., Jaffe and Walters, 1977., Vouk, 1979. This necessitates the monitoring of its environmental and occupational hazards. In the present study cardiac side effects of vanadium, as revealed through ECG has been investigated in rabbits, since the electrocardiogram of rabbit resembles with of man in essential details (Weisborth et al, 1974.

Dispersion durations of P-wave and QT interval in children treated with a ketogenic diet.

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Doksöz, Önder; Güzel, Orkide; Yılmaz, Ünsal; Işgüder, Rana; Çeleğen, Kübra; Meşe, Timur

2014-04-01

Limited data are available on the effects of a ketogenic diet on dispersion duration of P-wave and QT-interval measures in children. We searched for the changes in these measures with serial electrocardiograms in patients treated with a ketogenic diet. Twenty-five drug-resistant patients with epilepsy treated with a ketogenic diet were enrolled in this study. Electrocardiography was performed in all patients before the beginning and at the sixth month after implementation of the ketogenic diet. Heart rate, maximum and minimum P-wave duration, P-wave dispersion, and maximum and minimum corrected QT interval and QT dispersion were manually measured from the 12-lead surface electrocardiogram. Minimum and maximum corrected QT and QT dispersion measurements showed nonsignificant increase at month 6 compared with baseline values. Other previously mentioned electrocardiogram parameters also showed no significant changes. A ketogenic diet of 6 months' duration has no significant effect on electrocardiogram parameters in children. Further studies with larger samples and longer duration of follow-up are needed to clarify the effects of ketogenic diet on P-wave dispersion and corrected QT and QT dispersion. Copyright © 2014 Elsevier Inc. All rights reserved.

A Comparison of Physiological Signal Analysis Techniques and Classifiers for Automatic Emotional Evaluation of Audiovisual Contents.

Science.gov (United States)

Colomer Granero, Adrián; Fuentes-Hurtado, Félix; Naranjo Ornedo, Valery; Guixeres Provinciale, Jaime; Ausín, Jose M; Alcañiz Raya, Mariano

2016-01-01

This work focuses on finding the most discriminatory or representative features that allow to classify commercials according to negative, neutral and positive effectiveness based on the Ace Score index. For this purpose, an experiment involving forty-seven participants was carried out. In this experiment electroencephalography (EEG), electrocardiography (ECG), Galvanic Skin Response (GSR) and respiration data were acquired while subjects were watching a 30-min audiovisual content. This content was composed by a submarine documentary and nine commercials (one of them the ad under evaluation). After the signal pre-processing, four sets of features were extracted from the physiological signals using different state-of-the-art metrics. These features computed in time and frequency domains are the inputs to several basic and advanced classifiers. An average of 89.76% of the instances was correctly classified according to the Ace Score index. The best results were obtained by a classifier consisting of a combination between AdaBoost and Random Forest with automatic selection of features. The selected features were those extracted from GSR and HRV signals. These results are promising in the audiovisual content evaluation field by means of physiological signal processing.

Nonlinear Methods to Assess Changes in Heart Rate Variability in Type 2 Diabetic Patients

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Bhaskar, Roy, E-mail: imbhaskarall@gmail.com [Indian Institute of Technology (India); University of Connecticut, Farmington, CT (United States); Ghatak, Sobhendu [Indian Institute of Technology (India)

2013-10-15

Heart rate variability (HRV) is an important indicator of autonomic modulation of cardiovascular function. Diabetes can alter cardiac autonomic modulation by damaging afferent inputs, thereby increasing the risk of cardiovascular disease. We applied nonlinear analytical methods to identify parameters associated with HRV that are indicative of changes in autonomic modulation of heart function in diabetic patients. We analyzed differences in HRV patterns between diabetic and age-matched healthy control subjects using nonlinear methods. Lagged Poincaré plot, autocorrelation, and detrended fluctuation analysis were applied to analyze HRV in electrocardiography (ECG) recordings. Lagged Poincare plot analysis revealed significant changes in some parameters, suggestive of decreased parasympathetic modulation. The detrended fluctuation exponent derived from long-term fitting was higher than the short-term one in the diabetic population, which was also consistent with decreased parasympathetic input. The autocorrelation function of the deviation of inter-beat intervals exhibited a highly correlated pattern in the diabetic group compared with the control group. The HRV pattern significantly differs between diabetic patients and healthy subjects. All three statistical methods employed in the study may prove useful to detect the onset and extent of autonomic neuropathy in diabetic patients.

Oxygen transport and cardiovascular function at extreme altitude: lessons from Operation Everest II

Science.gov (United States)

Sutton, J. R.; Reeves, J. T.; Groves, B. M.; Wagner, P. D.; Alexander, J. K.; Hultgren, H. N.; Cymerman, A.; Houston, C. S.

1992-01-01

Operation Everest II was designed to examine the physiological responses to gradual decompression simulating an ascent of Mt Everest (8,848 m) to an inspired PO2 of 43 mmHg. The principal studies conducted were cardiovascular, respiratory, muscular-skeletal and metabolic responses to exercise. Eight healthy males aged 21-31 years began the "ascent" and six successfully reached the "summit", where their resting arterial blood gases were PO2 = 30 mmHg and PCO2 = 11 mmHg, pH = 7.56. Their maximal oxygen uptake decreased from 3.98 +/- 0.2 L/min at sea level to 1.17 +/- 0.08 L/min at PIO2 43 mmHg. The principal factors responsible for oxygen transport from the atmosphere to tissues were (1) Alveolar ventilation--a four fold increase. (2) Diffusion from the alveolus to end capillary blood--unchanged. (3) Cardiac function (assessed by hemodynamics, echocardiography and electrocardiography)--normal--although maximum cardiac output and heart rate were reduced. (4) Oxygen extraction--maximal with PvO2 14.8 +/- 1 mmHg. With increasing altitude maximal blood and muscle lactate progressively declined although at any submaximal intensity blood and muscle lactate was higher at higher altitudes.

Nonlinear Methods to Assess Changes in Heart Rate Variability in Type 2 Diabetic Patients

International Nuclear Information System (INIS)

Bhaskar, Roy; Ghatak, Sobhendu

2013-01-01

Heart rate variability (HRV) is an important indicator of autonomic modulation of cardiovascular function. Diabetes can alter cardiac autonomic modulation by damaging afferent inputs, thereby increasing the risk of cardiovascular disease. We applied nonlinear analytical methods to identify parameters associated with HRV that are indicative of changes in autonomic modulation of heart function in diabetic patients. We analyzed differences in HRV patterns between diabetic and age-matched healthy control subjects using nonlinear methods. Lagged Poincaré plot, autocorrelation, and detrended fluctuation analysis were applied to analyze HRV in electrocardiography (ECG) recordings. Lagged Poincare plot analysis revealed significant changes in some parameters, suggestive of decreased parasympathetic modulation. The detrended fluctuation exponent derived from long-term fitting was higher than the short-term one in the diabetic population, which was also consistent with decreased parasympathetic input. The autocorrelation function of the deviation of inter-beat intervals exhibited a highly correlated pattern in the diabetic group compared with the control group. The HRV pattern significantly differs between diabetic patients and healthy subjects. All three statistical methods employed in the study may prove useful to detect the onset and extent of autonomic neuropathy in diabetic patients

Myocardial imaging with 201Tl: an analysis of clinical usefulness based on Bayes' theorem

International Nuclear Information System (INIS)

Hamilton, G.W.; Trobaugh, G.B.; Ritchie, J.L.; Gould, K.L.; DeRouen, T.A.; Williams, D.L.

1978-01-01

Rest-exercise thallium-201 ( 201 Tl) myocardial imaging and rest-exercise electrocardiography were performed in 137 patients with suspected coronary artery disease (CAD). The final diagnosis of coronary disease was made by arteriography. Sensitivity and specificity for the ECG and thallium studies alone or combined were then determined. Based on these data, the posttest probability of CAD with a normal or abnormal test was calculated using Bayes' theorem for disease prevalences ranging from 1% to 99%. The difference between the probability of disease with a normal test and the probability of disease with an abnormal test was also calculated for each prevalence range. The results demonstrate that 201 Tl imaging discriminates between disease absence or presence better than does the ECG. However, both the ECG and thallium studies provide rather poor discrimination between disease and no disease when the disease prevalence is low (less than 0.20) or high (greater than 0.70). Because of this characteristic, it is unlikely that screening tests for CAD will prove useful unless the disease prevalence in the group under study is in the moderate (0.20 to 0.70) range

Flexible Graphene Electrodes for Prolonged Dynamic ECG Monitoring

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Cunguang Lou

2016-11-01

Full Text Available This paper describes the development of a graphene-based dry flexible electrocardiography (ECG electrode and a portable wireless ECG measurement system. First, graphene films on polyethylene terephthalate (PET substrates and graphene paper were used to construct the ECG electrode. Then, a graphene textile was synthesized for the fabrication of a wearable ECG monitoring system. The structure and the electrical properties of the graphene electrodes were evaluated using Raman spectroscopy, scanning electron microscopy (SEM, and alternating current impedance spectroscopy. ECG signals were then collected from healthy subjects using the developed graphene electrode and portable measurement system. The results show that the graphene electrode was able to acquire the typical characteristics and features of human ECG signals with a high signal-to-noise (SNR ratio in different states of motion. A week-long continuous wearability test showed no degradation in the ECG signal quality over time. The graphene-based flexible electrode demonstrates comfortability, good biocompatibility, and high electrophysiological detection sensitivity. The graphene electrode also combines the potential for use in long-term wearable dynamic cardiac activity monitoring systems with convenience and comfort for use in home health care of elderly and high-risk adults.

Wireless sensor and data transmission needs and technologies for patient monitoring in the operating room and intensive care unit.

Science.gov (United States)

Paksuniemi, M; Sorvoja, H; Alasaarela, E; Myllyla, R

2005-01-01

In the intensive care unit, or during anesthesia, patients are attached to monitors by cables. These cables obstruct nursing staff and hinder the patients from moving freely in the hospital. However, rapidly developing wireless technologies are expected to solve these problems. To this end, this study revealed problem areas in current patient monitoring and established the most important medical parameters to monitor. In addition, usable wireless techniques for short-range data transmission were explored and currently employed wireless applications in the hospital environment were studied. The most important parameters measured of the patient include blood pressures, electrocardiography, respiration rate, heart rate and temperature. Currently used wireless techniques in hospitals are based on the WMTS and WLAN standards. There are no viable solutions for short-range data transmission from patient sensors to patient monitors, but potentially usable techniques in the future are based on the WPAN standards. These techniques include Bluetooth, ZigBee and UWB. Other suitable techniques might be based on capacitive or inductive coupling. The establishing of wireless techniques depends on ensuring the reliability of data transmission, eliminating disturbance by other wireless devices, ensuring patient data security and patient safety, and lowering the power consumption and price.

[Telecardiology: Tasks and duties of telemedicine].

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Borbás, János; Forczek, Erzsébet; Sepp, Róbert; Bari, Ferenc

2017-11-01

Telemedicine is a young science that integrates innovations of information-technology and telecommunications into medical science. A successful telemedicine procedure should guarantee reduced workload of the healthcare system with well secured and cost-effective processes. Our goal was to collect the development phases of telemedicine projects through existing telecardiology solutions. Subsequent to reviewing international publications we analyzed the past and present situation of blood pressure monitoring, remote diagnostics of electrocardiography, implantable cardioverter defibrillator monitoring and pocket ultrasound devices. In case of new solutions (a) several internationally accepted, confidently reproducible "good practices" are needed for creating (b) guidelines and recommendations of international medical associations. They have to ensure (c) cost-effective work, with well-designed sustainability and (d) patient confidentiality. Improving (e) education for professionals and patients is essential. We recommend to telemedicine developers to use our standards in order to introduce their products more effectively into clinical practice. It is encouraging that current possibilities of telecardiology partly or fully meet the aforementioned criteria. Further development of the topic can contribute to financial sustainability of our healthcare and might be able to resolve limitations of human resources. Orv Hetil. 2017; 158(44): 1741-1746.

Sokolow-Lyon voltage is suitable for monitoring improvement in cardiac function and prognosis of patients with idiopathic dilated cardiomyopathy.

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Fukaya, Kenji; Takeshita, Kyosuke; Okumura, Takahiro; Hiraiwa, Hiroaki; Aoki, Soichiro; Ichii, Takeo; Sugiura, Yuki; Kitagawa, Katsuhide; Kondo, Toru; Watanabe, Naoki; Kano, Naoaki; Furusawa, Kenji; Sawamura, Akinori; Morimoto, Ryota; Bando, Yasuko; Murohara, Toyoaki

2017-09-01

The clinical significance of electrocardiogram in the assessment of patients with idiopathic dilated cardiomyopathy (IDCM) is currently unknown. The aim of this study was to determine the feasibility of recording serial changes in Sokolow-Lyon voltage (∆%QRS-voltage) in one year to estimate left ventricular reverse remodeling (LVRR) and predict a prognosis of IDCM patients under tailored medical therapy. Sixty-eight consecutive patients with mild symptoms (52.1 ± 13 years old; 69% men; NYHA I/II/III/IV; 33/29/6/0) underwent electrocardiography and echocardiography at baseline and 12 month follow-up (follow-up period: 3.9 years). LVRR was observed in 30 patients (44.1%). The ∆%QRS-voltage was significantly lower in the LVRR group (LVRR; -26.9%, non-LVRR: -9.2%, p voltage correlated with ∆%LV end-diastolic diameter (r = .634, p voltage group (voltage is associated with improvement in cardiac function and favorable prognosis in IDCM patients on medical therapy, suggesting that this index is a feasible marker for response to treatment of IDCM. © 2017 Wiley Periodicals, Inc.

Ambulatory diffuse optical tomography and multimodality physiological monitoring system for muscle and exercise applications

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Hu, Gang; Zhang, Quan; Ivkovic, Vladimir; Strangman, Gary E.

2016-09-01

Ambulatory diffuse optical tomography (aDOT) is based on near-infrared spectroscopy (NIRS) and enables three-dimensional imaging of regional hemodynamics and oxygen consumption during a person's normal activities. Although NIRS has been previously used for muscle assessment, it has been notably limited in terms of the number of channels measured, the extent to which subjects can be ambulatory, and/or the ability to simultaneously acquire synchronized auxiliary data such as electromyography (EMG) or electrocardiography (ECG). We describe the development of a prototype aDOT system, called NINscan-M, capable of ambulatory tomographic imaging as well as simultaneous auxiliary multimodal physiological monitoring. Powered by four AA size batteries and weighing 577 g, the NINscan-M prototype can synchronously record 64-channel NIRS imaging data, eight channels of EMG, ECG, or other analog signals, plus force, acceleration, rotation, and temperature for 24+ h at up to 250 Hz. We describe the system's design, characterization, and performance characteristics. We also describe examples of isometric, cycle ergometer, and free-running ambulatory exercise to demonstrate tomographic imaging at 25 Hz. NINscan-M represents a multiuse tool for muscle physiology studies as well as clinical muscle assessment.

SERCA2a gene transfer improves electrocardiographic performance in aged mdx mice

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Hajjar Roger

2011-08-01

Full Text Available Abstract Background Cardiomyocyte calcium overloading has been implicated in the pathogenesis of Duchenne muscular dystrophy (DMD heart disease. The cardiac isoform of sarcoplasmic reticulum calcium ATPase (SERCA2a plays a major role in removing cytosolic calcium during heart muscle relaxation. Here, we tested the hypothesis that SERCA2a over-expression may mitigate electrocardiography (ECG abnormalities in old female mdx mice, a murine model of DMD cardiomyopathy. Methods 1 × 1012 viral genome particles/mouse of adeno-associated virus serotype-9 (AAV-9 SERCA2a vector was delivered to 12-m-old female mdx mice (N = 5 via a single bolus tail vein injection. AAV transduction and the ECG profile were examined eight months later. Results The vector genome was detected in the hearts of all AAV-injected mdx mice. Immunofluorescence staining and western blot confirmed SERCA2a over-expression in the mdx heart. Untreated mdx mice showed characteristic tachycardia, PR interval reduction and QT interval prolongation. AAV-9 SERCA2a treatment corrected these ECG abnormalities. Conclusions Our results suggest that AAV SERCA2a therapy may hold great promise in treating dystrophin-deficient heart disease.

Diagnosis of acute myocardial infarction in patients undergoing open heart surgery: a comparison of serial myocardial imaging with cardiac enzymes, electrocardiography, and vectocardiography

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Lowenthal, I.S.; Parisi, A.F.; Tow, D.E.; Barsamian, E.M.; Sasahara, A.A.; McCaughan, D.; Clemson, H.C.

1977-01-01

In 44 consecutive patients undergoing elective open heart surgery (OHS), serial electrocardiograms (ECG), vectorcardiograms (VCG), serum CPK, cardiac isoenzymes (CPKMB), and myocardial images using Tc-99m pyrophosphate were obtained, before and after the operation, for the detection of acute myocardial infarction (AMI). Twenty-nine patients developed one or more positive tests postoperatively. Two patients had positive myocardial scintiscans; both had other evidence of infarction. Conversely, the appearance of CPKMB, or new ECG and VCG changes, occurred frequently without evidence of infarction, and were not associated with the development of a positive scintiscan. The results show that false-negative results are infrequent in patients imaged early after OHS, and that cardiac surgical procedures do not cause a high incidence of false-positive scintigrams. Consequently, radionuclide imaging for AMI offers an important adjunct for excluding acute infarction following open heart surgery

Depressed heart rate variability as an independent predictor of death in chronic congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy.

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Ponikowski, P; Anker, S D; Chua, T P; Szelemej, R; Piepoli, M; Adamopoulos, S; Webb-Peploe, K; Harrington, D; Banasiak, W; Wrabec, K; Coats, A J

1997-06-15

After acute myocardial infarction, depressed heart rate variability (HRV) has been proven to be a powerful independent predictor of a poor outcome. Although patients with chronic congestive heart failure (CHF) have also markedly impaired HRV, the prognostic value of HRV analysis in these patients remains unknown. The aim of this study was to investigate whether HRV parameters could predict survival in 102 consecutive patients with moderate to severe CHF (90 men, mean age 58 years, New York Heart Association [NYHA] class II to IV, CHF due to idiopathic dilated cardiomyopathy in 24 patients and ischemic heart disease in 78 patients, ejection fraction [EF], 26%; peak oxygen consumption, 16.9 ml/kg/min) after exclusion of patients in atrial fibrilation with diabetes or with chronic renal failure. In the prognostic analysis (Cox proportional-hazards model, Kaplan-Meier survival analysis), the following factors were investigated: age, CHF etiology, NYHA class, EF, peak oxygen consumption, presence of ventricular tachycardia on Holter monitoring, and HRV measures derived from 24-hour electrocardiography monitoring, calculated in the time (standard deviation of all normal RR intervals [SDNN], standard deviation of 5-minute RR intervals [SDANN], mean of all 5-minute standard deviations of RR intervals [SD], root-mean-square of difference of successive RR intervals [rMSSD], and percentage of adjacent RR intervals >50 ms different [pNN50]) and frequency domain (total power [TP], power within low-frequency band [LF], and power within high-frequency band [HF]). During follow-up of 584 +/- 405 days (365 days in all who survived), 19 patients (19%) died (mean time to death: 307 +/- 315 days, range 3 to 989). Cox's univariate analysis identified the following factors to be predictors of death: NYHA (p = 0.003), peak oxygen consumption (p = 0.01), EF (p = 0.02), ventricular tachycardia on Holter monitoring (p = 0.05), and among HRV measures: SDNN (p = 0.004), SDANN (p = 0.003), SD

Neonatal hypokalemia

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Sarici D

2012-03-01

Full Text Available Dilek Sarici1, S Umit Sarici21Kecioren Research and Education Hospital, Kecioren, Ankara, 2Chief of Division of Neonatology, Division of Neonatology, Department of Pediatrics, Gulhane Military Medical Academy, Ankara, TurkeyAbstract: In this article, distribution of potassium (K+ in body fluids, pathophysiology, causes, clinical signs and symptoms, and the evaluation and treatment of neonatal hypokalemia are reviewed. K+ is the most important intracellular cation and normal serum K+ is stabilized between 3.5 and 5.5 mEq/L. Hypokalemia may be caused by increased renal losses, increased extrarenal (gastrointestinal losses, redistribution or prolonged insufficient K+ intake. Clinical signs and symptoms occur as the result of functional changes in striated muscle, smooth muscle, and the heart. Hypokalemia is usually asymptomatic when K+ levels are between 3.0 and 3.5 mEq/L; however, there may sometimes be slight muscle weakness. Moderate hypokalemia is observed when serum K+ is between 2.5 and 3.0 mEq/L. Proximal muscle weakness is observed most commonly in lower extremities; cranial muscles are normal, but constipation and distention are prominent. Severe hypokalemia develops when serum K+ falls below 2.5 mEq/L. Rhabdomyolysis, myoglobinuria, severe muscle weakness, paralysis, respiratory distress, and respiratory arrest are observed. The clinical signs and symptoms may be unremarkable in cases of chronically developing hypokalemia; however, appropriate treatment is essential when serum K+ level falls below 2.5 mEq/L as the most dangerous complication of hypokalemia is fatal cardiac arrythmia, and changes visible with electrocardiography may not always correlate with the level of hypokalemia. Sodium (Na+, K+, chloride (Cl-, bicarbonate, creatinine, blood sugar, magnesium (Mg, plasma renin activity, aldosterone, and blood gases should be investigated by laboratory testing. Aspartate aminotransferase, alanine aminotransferase, creatinine kinase, and

Relationship between sleep stages and nocturnal trapezius muscle activity.

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Müller, Christian; Nicoletti, Corinne; Omlin, Sarah; Brink, Mark; Läubli, Thomas

2015-06-01

Former studies reported a relationship between increased nocturnal low level trapezius muscle activity and neck or shoulder pain but it has not been explored whether trapezius muscle relaxation is related to sleep stages. The goal of the present study was to investigate whether trapezius muscle activity is related to different sleep stages, as measured by polysomnography. Twenty one healthy subjects were measured on four consecutive nights in their homes, whereas the first night served as adaptation night. The measurements included full polysomnography (electroencephalography (EEG), electrooculography (EOG), electromyography (EMG) and electrocardiography (ECG)), as well as surface EMG of the m. trapezius descendens of the dominant arm. Periods with detectable EMG activity of the trapezius muscle lasted on average 1.5% of the length of the nights and only in four nights it lasted longer than 5% of sleeping time. Neither rest time nor the length of periods with higher activity levels of the trapezius muscle did significantly differ between sleep stages. We found no evidence that nocturnal trapezius muscle activity is markedly moderated by the different sleep stages. Thus the results support that EMG measurements of trapezius muscle activity in healthy subjects can be carried out without concurrent polysomnographic recordings. Copyright © 2015 Elsevier Ltd. All rights reserved.

Unusual Survival of Anomalous Left Coronary Artery From the Pulmonary Artery With Severe Rheumatic Mitral Stenosis in Septuagenarian Women: Foes Becoming Friends?

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Sinha, Santosh Kumar; Khanra, Dibbendhu; Jha, Mukesh Jitendra; Singh, Karandeep; Razi, Mahamdulla; Goel, Amit; Mishra, Vikas; Asif, Mohammad; Sachan, Mohit; Afdaali, Nasar; Kumar, Ashutosh; Thakur, Ramesh; Krishna, Vinay; Pandey, Umeshwar; Varma, Chandra Mohan

2016-10-01

ALCAPA syndrome (anomalous origin of the left coronary artery from the pulmonary artery) is a rare disease but lethal with clinical expression from myocardial infarction, congestive heart failure to death during early infancy and unusual survival to adulthood. We report a 73-year-old woman with ALCAPA who presented with exertional dyspnea (NYHA functional class II) over past 2 years. Physical examination revealed soft S, long mid diastolic rumbling murmur and apical pan-systolic murmur. Electrocardiography displayed biatrial enlargement and poor R progression and normal sinus rhythm. Echocardiography established calcified severe mitral stenosis (MS), presence of continuous flow entering the pulmonary trunk, turbulent continuous flow in inter-ventricular septum with left to right shunt in contrast echocardiography and normal systolic function. Coronary angiogram showed absence of left coronary artery (LCA) originating from aorta, dilated and tortuous right coronary artery (RCA) and abundant Rentrop grade 3 intercoronary collateral communicating with LCA originating from pulmonary trunk which was also confirmed on coronary CT angiogram thus establishing diagnosis of ALCAPA. It is exceedingly rare to be associated with severe MS. However, such a long survival in our patient can be explained by the severe pulmonary arterial hypertension which may be contributing to lesser coronary steal.

Dual-source computed tomography in patients with acute chest pain: feasibility and image quality

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Schertler, Thomas; Scheffel, Hans; Frauenfelder, Thomas; Desbiolles, Lotus; Leschka, Sebastian; Stolzmann, Paul; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Department of Medical Radiology, Institute of Diagnostic Radiology, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Department of Biostatistics, Zurich (Switzerland); Flohr, Thomas G. [Computed Tomography CTE PA, Siemens Medical Solutions, Forchheim (Germany)

2007-12-15

The aim of this study was to determine the feasibility and image quality of dual-source computed tomography angiography (DSCTA) in patients with acute chest pain for the assessment of the lung, thoracic aorta, and for pulmonary and coronary arteries. Sixty consecutive patients (32 female, 28 male, mean age 58.1{+-}16.3 years) with acute chest pain underwent contrast-enhanced electrocardiography-gated DSCTA without prior beta-blocker administration. Vessel attenuation of different thoracic vascular territories was measured, and image quality was semi-quantitatively analyzed by two independent readers. Image quality of the thoracic aorta was diagnostic in all 60 patients, image quality of pulmonary arteries was diagnostic in 59, and image quality of coronary arteries was diagnostic in 58 patients. Pairwise intraindividual comparisons of attenuation values were small and ranged between 1{+-}6 HU comparing right and left coronary artery and 56{+-}9 HU comparing the pulmonary trunk and left ventricle. Mean attenuation was 291{+-}65 HU in the ascending aorta, 334{+-}93 HU in the pulmonary trunk, and 285{+-}66 HU and 268{+-}67 HU in the right and left coronary artery, respectively. DSCTA is feasible and provides diagnostic image quality of the thoracic aorta, pulmonary and coronary arteries in patients with acute chest pain. (orig.)

Correlation between Bronchovascular and Cardiovascular Disorders in Children with Bronchial Asthma: Multifacetedness and Inexhaustibility of Problem Study

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T.Ye. Shumna

2014-11-01

Full Text Available Due to tight functional interrelation between respiratory apparatus and blood circulation, exacerbation of bronchial asthma in children is associated with changes of cardiovascular system. Multifacetedness of this problem determines comprehensive approach to examination of children with bronchial asthma, involving most available methods of heart function evaluation: echocardiographic heart study with Doppler sonography and electrocardiography. Of great importance is investigation of systemic and pulmonary hemodynamics and microcirculation in bronchial asthma depending on its clinical course. It was found that children with exacerbation of bronchial asthma were detected with pulmonary hypertension, which had gradual regression after attack alleviation. During the remission stage, hemodynamics disturbances in lesser circulation were present in long-lasting and severe course of disease. However, the increase in the pulmonary blood flow parameters in patients only in the early period after attack can be regarded as a compensatory response from the lesser circulation to the decline in respiratory function indices. Therefore, despite the great achievements of science in the study of pathophysiological mechanisms and clinical features of bronchial asthma at different ages, it is necessary to continue further study of all aspects of bronchial asthma in children, because it is not as well studied as asthma in adults.

Development and investigation of the nanosensor-based apparatus to assess the psycho-emotional state of a person

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Avdeeva, D. K.; Ivanov, M. L.; Natalinova, N. M.; Nguyen, D. K.; Rybalka, S. A.; Turushev, N. V.

2017-08-01

Psycho-emotional state is one of the factors effecting human health. Its evaluation allows revealing hidden psychological trauma which can be reason of chronic stress, depression or psychosomatic disorders. Modern techniques of objective psycho-emotional state assessment involve a device which detects electrophysiological parameters of human body connected with emotional reaction and psychological condition. The present study covers development and testing of psycho-emotional state assessment device. The developed implement uses three methods of electrophysiological activity evaluation: electrocardiography, electroencephalography and galvanic skin response detection. The device represents hardware-software complex consisting of nanosensors, measuring unit, lead wires and laptop. Filters are excluded from the measuring circuit due to metrological parameters and noise immunity of implemented nanosensors. This solution minimizes signal distortion and allows measuring signals of 0.3 μV and higher in a wide frequency range (0-10000 Hz) with minimal data loss. In addition, results of preliminary medical studies aimed to find correspondence between different psycho-emotional states and electrophysiological parameters are described. Impact of filters on electrophysiological studies was studied. According to the results conventional filters significantly distort EEG channel information. Further research will be directed to the creation of complete base of electrophysiological parameters related to a particular emotion.

LV dyssynchrony as assessed by phase analysis of gated SPECT myocardial perfusion imaging in patients with Wolff-Parkinson-White syndrome.

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Chen, Chun; Li, Dianfu; Miao, Changqing; Feng, Jianlin; Zhou, Yanli; Cao, Kejiang; Lloyd, Michael S; Chen, Ji

2012-07-01

The purpose of this study was to evaluate left ventricular (LV) mechanical dyssynchrony in patients with Wolff-Parkinson-White (WPW) syndrome pre- and post-radiofrequency catheter ablation (RFA) using phase analysis of gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). Forty-five WPW patients were enrolled and had gated SPECT MPI pre- and 2-3 days post-RFA. Electrophysiological study (EPS) was used to locate accessory pathways (APs) and categorize the patients according to the AP locations (septal, left and right free wall). Electrocardiography (ECG) was performed pre- and post-RFA to confirm successful elimination of the APs. Phase analysis of gated SPECT MPI was used to assess LV dyssynchrony pre- and post-RFA. Among the 45 patients, 3 had gating errors, and thus 42 had SPECT phase analysis. Twenty-two patients (52.4%) had baseline LV dyssynchrony. Baseline LV dyssynchrony was more prominent in the patients with septal APs than in the patients with left or right APs (p syndrome. Septal APs result in the greatest degree of LV mechanical dyssynchrony and afford the most benefit after RFA. This study supports further investigation in the relationship between electrical and mechanical activation using EPS and phase analysis of gated SPECT MPI.

Reversion of left ventricular systolic dysfunction and abnormal stress test: by catheter ablation, in a patient with Wolff-Parkinson-White syndrome from Para-Hisian Kent bundle.

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Tu, Chung-Ming; Chu, Kai-Ming; Cheng, Cheng-Chung; Cheng, Shu-Mung; Lin, Wei-Shiang

2010-01-01

The diagnosis of Wolff-Parkinson-White syndrome is typically reserved for patients who experience ventricular pre-excitation and symptoms that are related to paroxysmal supraventricular tachycardia, such as chest pain, dyspnea, dizziness, palpitations, or syncope. Herein, we report the case of a 38-year-old woman who presented at our outpatient department because of exercise intolerance. Cardiac auscultation revealed a grade 2/6 pansystolic murmur over the left lower sternal border. Twelve-lead electrocardiography showed sinus rhythm at a rate of 76 beats/min, with a significant delta wave. Transthoracic echocardiography revealed abnormal left ventricular systolic function. The results of a thallium stress test were also abnormal. Coronary artery disease was suspected; however, coronary angiography yielded normal results. Electrophysiologic study revealed a para-Hisian Kent bundle and a dual atrioventricular nodal pathway. After radiofrequency catheter ablation was performed, the patient's left ventricular function improved and her symptoms disappeared. In Wolff-Parkinson-White syndrome, left ventricular systolic dyssynchrony can yield abnormal findings on echocardiography and thallium scanning--even in persons who have no cardiovascular risk factors. Physicians who are armed with this knowledge can avoid performing coronary angiography unnecessarily. Catheter ablation can reverse the dyssynchrony of the ventricle and improve the patient's symptoms.

A young patient with atypical type-B Wolff–Parkinson–White syndrome accompanied by left ventricular dysfunction

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Takeuchi, Takahiro; Tomita, Takeshi; Kasai, Hiroki; Kashiwagi, Daisuke; Yoshie, Koji; Yaguchi, Tomonori; Oguchi, Yasutaka; Kozuka, Ayako; Gautam, Milan; Motoki, Hirohiko; Okada, Ayako; Shiba, Yuji; Aizawa, Kazunori; Izawa, Atsushi; Miyashita, Yusuke; Koyama, Jun; Hongo, Minoru; Ikeda, Uichi

2014-01-01

A 15-year-old asymptomatic male patient presented with an electrocardiographic abnormality and left ventricular (LV) dysfunction (left ventricle ejection fraction of 40%) in a physical examination performed 2 years previously. LV dysfunction did not improve despite optimal medical therapy for dilated cardiomyopathy. Twelve-lead electrocardiography revealed a normal PR interval (138 ms) with a small delta-like wave in V2, but not a typical diagnostic wave that could be diagnosed as Wolff–Parkinson–White (WPW) syndrome by an electrocardiogram auto-analysis. Transthoracic echocardiography showed a remarkable asynchronous septal motion. An electrophysiological study was performed to exclude WPW syndrome. An accessory pathway (AP) was revealed on the lateral wall of the right ventricle, and radiofrequency catheter ablation was successfully performed to disconnect the AP. Thereafter, the dyssynchrony disappeared, and LV function improved. The intrinsic atrioventricular nodal conduction was very slow (A-H, 237 ms). The results of electrocardiogram auto-analysis could not be used to confirm the diagnosis of WPW syndrome because of the atypical delta wave. Conduction via the right lateral AP caused electrical dyssynchrony in the LV. This case suggests that atypical delta waves should be evaluated without depending on electrocardiographic auto-analyses in patients with LV dysfunction accompanied by dyssynchrony. PMID:26336525

A young patient with atypical type-B Wolff–Parkinson–White syndrome accompanied by left ventricular dysfunction

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Takahiro Takeuchi, MD

2015-02-01

Full Text Available A 15-year-old asymptomatic male patient presented with an electrocardiographic abnormality and left ventricular (LV dysfunction (left ventricle ejection fraction of 40% in a physical examination performed 2 years previously. LV dysfunction did not improve despite optimal medical therapy for dilated cardiomyopathy. Twelve-lead electrocardiography revealed a normal PR interval (138 ms with a small delta-like wave in V2, but not a typical diagnostic wave that could be diagnosed as Wolff–Parkinson–White (WPW syndrome by an electrocardiogram auto-analysis. Transthoracic echocardiography showed a remarkable asynchronous septal motion. An electrophysiological study was performed to exclude WPW syndrome. An accessory pathway (AP was revealed on the lateral wall of the right ventricle, and radiofrequency catheter ablation was successfully performed to disconnect the AP. Thereafter, the dyssynchrony disappeared, and LV function improved. The intrinsic atrioventricular nodal conduction was very slow (A-H, 237 ms. The results of electrocardiogram auto-analysis could not be used to confirm the diagnosis of WPW syndrome because of the atypical delta wave. Conduction via the right lateral AP caused electrical dyssynchrony in the LV. This case suggests that atypical delta waves should be evaluated without depending on electrocardiographic auto-analyses in patients with LV dysfunction accompanied by dyssynchrony.

A general framework for time series data mining based on event analysis: application to the medical domains of electroencephalography and stabilometry.

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Lara, Juan A; Lizcano, David; Pérez, Aurora; Valente, Juan P

2014-10-01

There are now domains where information is recorded over a period of time, leading to sequences of data known as time series. In many domains, like medicine, time series analysis requires to focus on certain regions of interest, known as events, rather than analyzing the whole time series. In this paper, we propose a framework for knowledge discovery in both one-dimensional and multidimensional time series containing events. We show how our approach can be used to classify medical time series by means of a process that identifies events in time series, generates time series reference models of representative events and compares two time series by analyzing the events they have in common. We have applied our framework on time series generated in the areas of electroencephalography (EEG) and stabilometry. Framework performance was evaluated in terms of classification accuracy, and the results confirmed that the proposed schema has potential for classifying EEG and stabilometric signals. The proposed framework is useful for discovering knowledge from medical time series containing events, such as stabilometric and electroencephalographic time series. These results would be equally applicable to other medical domains generating iconographic time series, such as, for example, electrocardiography (ECG). Copyright © 2014 Elsevier Inc. All rights reserved.

CT imaging before transcatheter aortic valve implantation (TAVI) using variable helical pitch scanning and its diagnostic performance for coronary artery disease

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Matsumoto, Shunsuke; Yamada, Yoshitake; Hashimoto, Masahiro; Okamura, Teppei; Jinzaki, Masahiro [Keio University School of Medicine, Department of Diagnostic Radiology, Shinanomachi, Shinjuku-ku, Tokyo (Japan); Yamada, Minoru [Keio University School of Medicine, Research Park, Tokyo (Japan); Yashima, Fumiaki; Hayashida, Kentaro; Fukuda, Keiichi [Keio University School of Medicine, Department of Cardiology, Tokyo (Japan)

2017-05-15

To evaluate the effectiveness of CT before TAVI using variable helical pitch (VHP) scanning and its diagnostic performance for coronary artery disease (CAD). Sixty patients (84.4 ± 4.6 years) scheduled for TAVI underwent CT using VHP scanning with the contrast material (CM) volume calculated as scanning time x weight [kg] x 0.06 mL. Retrospective electrocardiography (ECG)-gated scanning was utilized to examine the thorax, and non-ECG-gated scanning of the abdomen immediately followed. We analyzed CT attenuation values of the coronary arteries, aorta, iliac and femoral arteries. The coronary CT angiography images were evaluated for the presence of stenosis (≥50 %); invasive coronary angiography served as a reference standard. The average attenuations of all of the arteries were greater than 400 HU. We could evaluate the peripheral access vessels and dimensions of the ascending aorta, aortic root, and aortic annulus in all patients. The average volume of CM was 38.7 ± 8.5 mL. On per-patient and vessel analysis, CT showed 91.7 % and 89.5 % sensitivity, and 91.3 % and 97.4 % negative predictive value (NPV). CT using VHP scanning with an average CM volume of 38.7 mL is useful before TAVI and had a high sensitivity and NPV in excluding obstructive CAD. (orig.)

A Hygroscopic Sensor Electrode for Fast Stabilized Non-Contact ECG Signal Acquisition.

Science.gov (United States)

Fong, Ee-May; Chung, Wan-Young

2015-08-05

A capacitive electrocardiography (cECG) technique using a non-invasive ECG measuring technology that does not require direct contact between the sensor and the skin has attracted much interest. The system encounters several challenges when the sensor electrode and subject's skin are weakly coupled. Because there is no direct physical contact between the subject and any grounding point, there is no discharge path for the built-up electrostatic charge. Subsequently, the electrostatic charge build-up can temporarily contaminate the ECG signal from being clearly visible; a stabilization period (3-15 min) is required for the measurement of a clean, stable ECG signal at low humidity levels (below 55% relative humidity). Therefore, to obtain a clear ECG signal without noise and to reduce the ECG signal stabilization time to within 2 min in a dry ambient environment, we have developed a fabric electrode with embedded polymer (FEEP). The designed hygroscopic FEEP has an embedded superabsorbent polymer layer. The principle of FEEP as a conductive electrode is to provide humidity to the capacitive coupling to ensure strong coupling and to allow for the measurement of a stable, clear biomedical signal. The evaluation results show that hygroscopic FEEP is capable of rapidly measuring high-accuracy ECG signals with a higher SNR ratio.

Electrogastrography in Adults and Children: The Strength, Pitfalls, and Clinical Significance of the Cutaneous Recording of the Gastric Electrical Activity

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Giuseppe Riezzo

2013-01-01

Full Text Available Cutaneous electrogastrography (EGG is a non-invasive technique to record gastric myoelectrical activity from the abdominal surface. Although the recent rapid increase in the development of electrocardiography, EGG still suffers from several limitations. Currently, computer analysis of EGG provides few reliable parameters, such as frequency and the percentage of normal and altered slow wave activity (bradygastria and tachygastria. New EGG hardware and software, along with an appropriate arrangement of abdominal electrodes, could detect the coupling of the gastric slow wave from the EGG. At present, EGG does not diagnose a specific disease, but it puts in evidence stomach motor dysfunctions in different pathological conditions as gastroparesis and functional dyspepsia. Despite the current pitfalls of EGG, a multitasking diagnostic protocol could involve the EGG and the 13C-breath testing for the evaluation of the gastric emptying time—along with validated gastrointestinal questionnaires and biochemical evaluations of the main gastrointestinal peptides—to identify dyspeptic subgroups. The present review tries to report the state of the art about the pathophysiological background of the gastric electrical activity, the recording and processing methodology of the EGG with particular attention to multichannel recording, and the possible clinical application of the EGG in adult and children.

Evaluation of diabetic autonomic neuropathy by 123I-metaiodobenzyl-guanidine (MIBG) cardiac imaging. Initial report

International Nuclear Information System (INIS)

Osonoi, Takeshi; Fukumoto, Yoshihiro; Saitou, Miyoko; Kuroda, Yasuhisa; Uchimi, Nobuo; Ishioka, Kuniharu; Onuma, Tomio; Suga, Shigeki; Takebe, Kazuo.

1994-01-01

Single-photon emission computed tomography was performed in 52 diabetics and 10 healthy volunteers using MIBG. The diabetics had no particular findings of electrocardiography, echocardiography, or exercise thallium imaging and no cardiovascular episodes. The healthy volunteers had no abnormal findings on exercise thallium imaging or glucose tolerance test. The average relative regional uptake (RRU) was decreased in the inferoposterior wall compared with the anterior or lateral wall in both the diabetics and volunteers. According to the RRU and visual images, we divided the diabetics into the following four groups: 14 who were normal (group N), 30 with segmental defects (group S), 4 with diffuse defects (group D) and 4 without accumulation (group DH). Diabetic complications (retinopathy, nephropathy, and neuropathy) and hypertension were more frequent in group S than group N. However, there were no significant differences in the physiological evidence of autonomic neuropathy (C.V. of the R-R interval on the ECG and blood pressure response to standing or deep breathing) between groups S and N. Vibration sense was significantly more impaired in group S than in group N. These results suggest that cardiac imaging with MIBG might be a useful examination for the early diagnosis of diabetic autonomic neuropathy. (author)

Economic analysis of the use of coronary calcium scoring as an alternative to stress ECG in the non-invasive diagnosis of coronary artery disease

International Nuclear Information System (INIS)

Raman, Vivek; McWilliams, Eric T.M.; Holmberg, Stephen R.M.; Miles, Ken

2012-01-01

To conduct an economic analysis (EA) of coronary calcium scoring (CCS) using a 0 score, as alternative to stress electrocardiography (sECG) in diagnosing coronary artery disease (CAD). A decision tree was constructed to compare four strategies for investigation of suspected CAD previously assessed in the formulation of clinical guidelines for the United Kingdom (UK) to two new strategies incorporating CCS. Sensitivity (96%; 95% CI 95.4-96.4%) and specificity (40%; 95% CI 38.7-41.4%) values for CCS were derived from a meta-analysis of 10,760 patients. Other input variables were obtained from a previous EA and average prices for hospital procedures in the UK. A threshold of pound 30,000/Quality-adjusted Life Year (QALY) was considered cost-effective. Using net monetary benefit calculations, CCS-based strategies were found to be cost-effective compared to sECG equivalents at all assessed prevalence of CAD. Using CCS prior to myocardial perfusion scintigraphy (MPS) and catheter angiography (CA) was found to be cost-effective at pre-test probabilities (PTP) below 30%. Adoption of CCS as an alternative to sECG in investigating suspected stable angina in low PTP population ( 30%, proceeding to MPS or CA would be more cost-effective than performing either CCS or sECG. (orig.)

Severe symptomatic bradycardia after a dinner of spicy oleander soup

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Andrea Tampieri

2016-10-01

Full Text Available Cardiac glycosides similar to digoxin are produced by different plants in nature. Nerium oleander, commonly grown as an ornamental shrub, can be found worldwide in temperate countries. Intentional or accidental ingestion of any part of the plant can lead to clinically relevant intoxication. A 63-year-old woman came to the emergency department with acute dyspeptic symptoms after eating vegetable soup flavored with unfamiliar flowers she have collected herself. However, the electrocardiography (ECG showed abnormalities that raised suspicions for an overdose of digoxin-like cardiac glycosides. The patient was not on treatment with digoxin and a careful anamnesis revealed that she had eaten oleander leaves. Digoxin specific Fab antibody fragments were administered for marked bradycardia that was not responding to atropine administration, after counseling with the reference toxicology center. The patient was also treated with activated charcoal and magnesium sulphate, intravenous fluids and pantoprazole. Four days later she was discharged as asymptomatic, with normal sinus rhythm. Emergency physicians should be aware of this type of poisoning, especially in cases with typical ECG alterations in patients not treated with digoxin and medical history of plants ingestion. Cardio-active glycosides are present in different plants, often used inappropriately, with potential toxic effects and harmful drug interactions.

Electrocardiografía clínica: Taquiarritmias supraventriculares de origen atrial

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Abraham Katime Zúñiga

2013-10-01

Full Text Available  Resumen Las arritmias se pueden definir como “cualquier anormalidad en la frecuencia, regularidad o sitio de origen del impulso cardiaco o trastorno de la conducción que produce una alteración de la activación auricular o ventricular”; mientras que taquicardia se define como “frecuencia cardiaca en adultos, mayor de 100 latidos por minuto (lat/ min.”. Por tanto, las taquiarritmias supraventriculares son “aquellas taquicardias que requieren tejido atrial o de conducción atrioventricular para su iniciación y mantenimiento”. En este artículo se expondrán las características electrocardiográficas de aquellas provenientes del tejido auricular. (DUAZARY 2010, 117 - 124AbstractThe arrhythmias are defined as “any abnormality in the frequency, regularity, or site of origin of the cardiac impulse or conduction disorder that produces an alteration in the atrial or ventricular activation”; whereas tachycardia is defined as a “heart rate in adults greater than 100 beats per minute”. Therefore, supraventricular tachyarrhythmias are “those tachycardias who require atrial tissue or atrioventricular conduction for its initiation and maintenance”. This article explains the electrocardiographic characteristics of those arrhythmias from atrial tissue.Keywords: Tachyarrhythmia; Tachycardia; Atrial; Auricular; Fibrilation; Flutter; Sinusal; Electrocardiography.

Assessment of atrial electromechanical interval and P wave dispersion in patients with polycystic ovary syndrome.

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Bayır, Pınar Türker; Güray, Ümit; Duyuler, Serkan; Demirkan, Burcu; Kayaalp, Oya; Kanat, Selçuk; Güray, Yeşim

2016-02-01

Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risk, including ischemic stroke. Prolonged atrial electromechanical interval (EMI) is related to increased atrial fibrillation (AF) risk. The aim of the study is to evaluate atrial EMI and electrocardiographic P-wave indices related to increased AF risk in patients with PCOS. Forty PCOS patients diagnosed on the basis of the Rotterdam criteria and 20 age-matched controls were prospectively included. patients with atrioventricular or intraventricular conduction abnormalities, dysrhythmia or taking antiarrhythmic drugs, atherosclerotic heart disease, cardiomyopathies, valvular lesions, pericardial disease, a history of pulmonary emboli or pulmonary hypertension, and abnormal thyroid function were excluded. Intra and interatrial EMI were measured by tissue Doppler imaging and P-wave dispersion (Pd) was calculated on 12-lead electrocardiography (ECG). The Isovolumetric relaxation time was the interval between the aortic valve closure artifact at the end of the LV outflow envelope and the mitral valve opening artifact at the beginning of the mitral E wave. Patients with PCOS had significantly higher interatrial [38 (24-65) ms vs. 16 (9-19) ms pPCOS group compared with control group [45 (27-60) ms vs. 30 (26-38) ms, pPCOS. PCOS is associated with prolonged inter- and intra-atrial conduction times, which are related to increased AF risk.

Prediction and early detection of delirium in the intensive care unit by using heart rate variability and machine learning.

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Oh, Jooyoung; Cho, Dongrae; Park, Jaesub; Na, Se Hee; Kim, Jongin; Heo, Jaeseok; Shin, Cheung Soo; Kim, Jae-Jin; Park, Jin Young; Lee, Boreom

2018-03-27

Delirium is an important syndrome found in patients in the intensive care unit (ICU), however, it is usually under-recognized during treatment. This study was performed to investigate whether delirious patients can be successfully distinguished from non-delirious patients by using heart rate variability (HRV) and machine learning. Electrocardiography data of 140 patients was acquired during daily ICU care, and HRV data were analyzed. Delirium, including its type, severity, and etiologies, was evaluated daily by trained psychiatrists. HRV data and various machine learning algorithms including linear support vector machine (SVM), SVM with radial basis function (RBF) kernels, linear extreme learning machine (ELM), ELM with RBF kernels, linear discriminant analysis, and quadratic discriminant analysis were utilized to distinguish delirium patients from non-delirium patients. HRV data of 4797 ECGs were included, and 39 patients had delirium at least once during their ICU stay. The maximum classification accuracy was acquired using SVM with RBF kernels. Our prediction method based on HRV with machine learning was comparable to previous delirium prediction models using massive amounts of clinical information. Our results show that autonomic alterations could be a significant feature of patients with delirium in the ICU, suggesting the potential for the automatic prediction and early detection of delirium based on HRV with machine learning.

Estimation of respiratory rate from thermal videos of preterm infants.

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Pereira, Carina Barbosa; Heimann, Konrad; Venema, Boudewijn; Blazek, Vladimir; Czaplik, Michael; Leonhardt, Steffen

2017-07-01

Studies have demonstrated that respiratory rate (RR) is a good predictor of the patient condition as well as an early marker of patient deterioration and physiological distress. However, it is also referred as "the neglected vital parameter". This is mainly due to shortcoming of current monitoring techniques. Moreover, in preterm infants, the removal of adhesive electrodes cause epidermal stripping, skin disruption, and with it pain. This paper proposes a new algorithm for estimation of RR in thermal videos of moderate preterm infants. It uses the temperature modulation around the nostrils over the respiratory cycle to extract this vital parameter. To compensate movement artifacts the approach incorporates a tracking algorithm. In addition, a new reliable and accurate algorithm for robust estimation of local (breath-to-breath) intervals was included. To evaluate the performance of this approach, thermal recordings of four moderate preterm infants were acquired. Results were compared with RR derived from body surface electrocardiography. The results showed an excellent agreement between thermal imaging and gold standard. On average, the relative error between both monitoring techniques was 3.42%. In summary, infrared thermography may be a clinically relevant alternative to conventional sensors, due to its high thermal resolution and outstanding characteristics.

Motion Artifact Quantification and Sensor Fusion for Unobtrusive Health Monitoring.

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Hoog Antink, Christoph; Schulz, Florian; Leonhardt, Steffen; Walter, Marian

2017-12-25

Sensors integrated into objects of everyday life potentially allow unobtrusive health monitoring at home. However, since the coupling of sensors and subject is not as well-defined as compared to a clinical setting, the signal quality is much more variable and can be disturbed significantly by motion artifacts. One way of tackling this challenge is the combined evaluation of multiple channels via sensor fusion. For robust and accurate sensor fusion, analyzing the influence of motion on different modalities is crucial. In this work, a multimodal sensor setup integrated into an armchair is presented that combines capacitively coupled electrocardiography, reflective photoplethysmography, two high-frequency impedance sensors and two types of ballistocardiography sensors. To quantify motion artifacts, a motion protocol performed by healthy volunteers is recorded with a motion capture system, and reference sensors perform cardiorespiratory monitoring. The shape-based signal-to-noise ratio SNR S is introduced and used to quantify the effect on motion on different sensing modalities. Based on this analysis, an optimal combination of sensors and fusion methodology is developed and evaluated. Using the proposed approach, beat-to-beat heart-rate is estimated with a coverage of 99.5% and a mean absolute error of 7.9 ms on 425 min of data from seven volunteers in a proof-of-concept measurement scenario.

Validation of a Novel Digital Tool in Automatic Scoring of an Online ECG Examination at an International Cardiology Meeting.

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Quinn, Kieran L; Crystal, Eugene; Lashevsky, Ilan; Arouny, Banafsheh; Baranchuk, Adrian

2016-07-01

We have previously developed a novel digital tool capable of automatically recognizing correct electrocardiography (ECG) diagnoses in an online exam and demonstrated a significant improvement in diagnostic accuracy when utilizing an inductive-deductive reasoning strategy over a pattern recognition strategy. In this study, we sought to validate these findings from participants at the International Winter Arrhythmia School meeting, one of the foremost electrophysiology events in Canada. Preregistration to the event was sent by e-mail. The exam was administered on day 1 of the conference. Results and analysis were presented the following morning to participants. Twenty-five attendees completed the exam, providing a total of 500 responses to be marked. The online tool accurately identified 195 of a total of 395 (49%) correct responses (49%). In total, 305 responses required secondary manual review, of which 200 were added to the correct responses pool. The overall accuracy of correct ECG diagnosis for all participants was 69% and 84% when using pattern recognition or inductive-deductive strategies, respectively. Utilization of a novel digital tool to evaluate ECG competency can be set up as a workshop at international meetings or educational events. Results can be presented during the sessions to ensure immediate feedback. © 2015 Wiley Periodicals, Inc.

Neural activity induced by visual food stimuli presented out of awareness: a preliminary magnetoencephalography study.

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Takada, Katsuko; Ishii, Akira; Matsuo, Takashi; Nakamura, Chika; Uji, Masato; Yoshikawa, Takahiro

2018-02-15

Obesity is a major public health problem in modern society. Appetitive behavior has been proposed to be partially driven by unconscious decision-making processes and thus, targeting the unconscious cognitive processes related to eating behavior is essential to develop strategies for overweight individuals and obese patients. Here, we presented food pictures below the threshold of awareness to healthy male volunteers and examined neural activity related to appetitive behavior using magnetoencephalography. We found that, among participants who did not recognize food pictures during the experiment, an index of heart rate variability assessed by electrocardiography (low-frequency component power/high-frequency component power ratio, LF/HF) just after picture presentation was increased compared with that just before presentation, and the increase in LF/HF was negatively associated with the score for cognitive restraint of food intake. In addition, increased LF/HF was negatively associated with increased alpha band power in Brodmann area (BA) 47 caused by food pictures presented below the threshold of awareness, and level of cognitive restraint was positively associated with increased alpha band power in BA13. Our findings may provide valuable clues to the development of methods assessing unconscious regulation of appetite and offer avenues for further study of the neural mechanisms related to eating behavior.

COMPARATIVE EFFECTS OF MONOTHERAPY WITH MAGNESIUM AND COMBINED THERAPY WITH MAGNESIUM AND Β-BLOCKER ON PRIMARY MITRAL VALVE PROLAPSE WITH HEART RHYTHM DISORDERS

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E. G. Nurtdinova

2007-01-01

Full Text Available Aim. To compare effects of monotherapy with magnesium and combined therapy with magnesium and β-blocker on primary mitral valve prolapse (MVP with heart rhythm disorders.Material and methods. 71 patients with primary MVP 1-2 degree and heart rhythm disorders were involved in the study. The patients were split into three groups. Group I (25 persons received monotherapy with magnesium orotate at a dose of 1-3 g per day; group II (28 persons received combined therapy with magnesium orotate and betaxolol. The control group (18 persons received no therapy. Initially and after 12 weeks of observation all the patients underwent electrocardiography (ECG, ECG-Holter monitoring, echocardiography and autonomic balance assessment by A.M. Vein’s questionnaire.Results. In 12 weeks of treatment groups I and II showed positive dynamics in the MVP manifestations, including significant reduction in severity of the autonomic dysfunction syndrome, ECG positive dynamics, antiarrhythmic effect, decrease in the degree of prolapse, diminution of mitral regurgitation and left auricle volumes. More substantial hemodynamic effects were found in the group of patients who received combination therapy.Conclusion. Combined therapy has proven advantages in comparison with magnesium monotherapy in terms of daily quantity of extrasystoles, reduction in heart rate, decrease in autonomic disfunction and normalization of intracardiac hemodynamics.

COMPARATIVE EFFECTS OF MONOTHERAPY WITH MAGNESIUM AND COMBINED THERAPY WITH MAGNESIUM AND Β-BLOCKER ON PRIMARY MITRAL VALVE PROLAPSE WITH HEART RHYTHM DISORDERS

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E. G. Nurtdinova

2015-12-01

Full Text Available Aim. To compare effects of monotherapy with magnesium and combined therapy with magnesium and β-blocker on primary mitral valve prolapse (MVP with heart rhythm disorders.Material and methods. 71 patients with primary MVP 1-2 degree and heart rhythm disorders were involved in the study. The patients were split into three groups. Group I (25 persons received monotherapy with magnesium orotate at a dose of 1-3 g per day; group II (28 persons received combined therapy with magnesium orotate and betaxolol. The control group (18 persons received no therapy. Initially and after 12 weeks of observation all the patients underwent electrocardiography (ECG, ECG-Holter monitoring, echocardiography and autonomic balance assessment by A.M. Vein’s questionnaire.Results. In 12 weeks of treatment groups I and II showed positive dynamics in the MVP manifestations, including significant reduction in severity of the autonomic dysfunction syndrome, ECG positive dynamics, antiarrhythmic effect, decrease in the degree of prolapse, diminution of mitral regurgitation and left auricle volumes. More substantial hemodynamic effects were found in the group of patients who received combination therapy.Conclusion. Combined therapy has proven advantages in comparison with magnesium monotherapy in terms of daily quantity of extrasystoles, reduction in heart rate, decrease in autonomic disfunction and normalization of intracardiac hemodynamics.

Features of History, Anthropometric Data and Individual Functions of the Liver in Children with Prolonged Jaundice

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O.V. Tyajka

2016-11-01

Full Text Available Background. Neonatal jaundice is one of the urgent problems in neonatology. There is a tendency to increase the incidence of prolonged jaundice. The aim of our study was to explore the features of history, anthropometric data and some liver functions in children with prolonged jaundice. Materials and methods. The study involved 111 children with prolonged jaundice aged from 3 weeks to 3 months. In all children with prolonged jaundice, we have examined complete blood count, urinalysis, blood chemistry (determination of total bilirubin and fractions, total protein, albumin, glucose and used instrumental methods of examination — ultrasound of the abdominal cavity and cranial ultrasonography, electrocardiography. Most children with prolonged jaundice were breastfed and were term infants. Results. Indicators of physical development at birth (body weight, body length, head circumference, chest circumference in children with prolonged jaundice and in healthy children had not statistically significant differences. Neonatal jaundice was prolonged in children, who were born from the first pregnancy, — 60 children (54.1 %. A high level of total and indirect bilirubin was accompanied by a low level of albumin in the blood serum of children with prolonged jaundice. Protein-synthesis function of the liver was reduced in children with prolonged jaundice.

Advances in Photopletysmography Signal Analysis for Biomedical Applications

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Jermana L. Moraes

2018-06-01

Full Text Available Heart Rate Variability (HRV is an important tool for the analysis of a patient’s physiological conditions, as well a method aiding the diagnosis of cardiopathies. Photoplethysmography (PPG is an optical technique applied in the monitoring of the HRV and its adoption has been growing significantly, compared to the most commonly used method in medicine, Electrocardiography (ECG. In this survey, definitions of these technique are presented, the different types of sensors used are explained, and the methods for the study and analysis of the PPG signal (linear and nonlinear methods are described. Moreover, the progress, and the clinical and practical applicability of the PPG technique in the diagnosis of cardiovascular diseases are evaluated. In addition, the latest technologies utilized in the development of new tools for medical diagnosis are presented, such as Internet of Things, Internet of Health Things, genetic algorithms, artificial intelligence and biosensors which result in personalized advances in e-health and health care. After the study of these technologies, it can be noted that PPG associated with them is an important tool for the diagnosis of some diseases, due to its simplicity, its cost–benefit ratio, the easiness of signals acquisition, and especially because it is a non-invasive technique.

Growth Status of Iranian Children with Hemodynamically Important Congenital Heart Disease

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Mohammad Dalili

2011-02-01

Full Text Available The relationship between congenital heart disease (CHD and growth retardation is well documented. We investigated the growth condition of Iranian children with several types of congenital heart disease (CHD and compared it with worldwide researches. Growth condition was investigated in 469 patients with important CHD aged from 1 month to 18 years. The patients were divided into two groups; infants (aged 12 months or less, and children (1-18 yrs of age. Children with hemodynamically unimportant small VSDs or small ASDs were not studied. Other exclusion criteria were prematurity, known genetic disorders and neurologic disease affecting growthd. All patients' cardiac diagnoses were made on the basis of clinical and laboratory examinations; including electrocardiography, echocardiography, cardiac catheterization, and angiography. Body weight and height of all patients were measured using conventional methods and compared with standard growth charts. In all patients body weights and heights were significantly lower than normal population. This difference was greater in the weight of female children. Other risk factors for growth failure were large left-to-right intracardiac shunts, pulmonary hypertension and cyanosis. Iranian children with CHD have growth failure somewhat different from other countries. Lower body weights of cyanotic patients and female children indicated that these patients need more nutritional and psychosocial attention.

Follow-up of P dispersion after transcatheter closure of an atrial septal defect in children

International Nuclear Information System (INIS)

Baspinar, O.; Kervancioglu, M.; Kilinc, M.; Irdem, A.; Koruk, S.

2014-01-01

Objectives: To determine in paediatric patients with atrial septal defects whether differences in P wave dispersion occurred with transcatheter closures using the Amplatzer septal occluder. Method: A total of 31 children who had undergone transcathater closures were evaluated. P maximum, P minimum, and P dispersion were measured with 12-lead surface electrocardiography, before the procedure and one week, one month, three months, six months and one year following the procedure. SPSS 10 was used for statistical analysis. Results: There were 23 (74.2%) females and 8 (25.8%) males with an overall mean age of 7.5+-4.1 years and mean weight of 26.2+-16.9kg. The P maximum and P minimum measurements differed between patients during the follow-up period. Both measurements decreased with time. However, P dispersion was not significantly different throughout the follow-up period (before the procedure P maximum 95.4+-15.6 ms, P minimum 64.5+-15.4 ms, and P dispersion 30.8+-11.4ms; one year later, P maximum 76.1+-14.6 ms, P minimum 47.1+-12.1 ms, and P dispersion 29.1+-9.1ms). Conclusion: Over time, there are no P dispersion differences in transcatheter closures using the Amplatzer septal occluder. (author)

Segmental quantitative analysis of digital thallium-201 myocardial scintigrams in diagnosis of coronary artery disease

International Nuclear Information System (INIS)

Wainwright, R.J.; Maisey, M.N.; Sowton, E.

1981-01-01

One hundred and forty-nine patients with suspected ischaemic heart disease were evaluated by exercise thallium-201 myocardial scintigraphy ( 201 Tl SMS), single lead exercise electrocardiography, and coronary arteriography. Myocardial distribution of tracer was assessed semi-quantitatively from digital 201 Tl scintigrams and compared with tracer distribution in subjects with normal hearts. Fifty-two of 54 (96%) patients with normal coronary arteries had normal myocardial scintigrams whereas three patients had a positive ischaemic exercise electrocardiogram and were scan normal. Conversely, 36 of 95 (38%) patients with coronary artery disease had a positive ischaemic electrocardiogram compared with 94 of 95 (99%) patients who had a positive myocardial scintigram. Disease was predicted correctly in 76 out of 80 (95%) of left anterior descending coronary stenoses, in 48 out of 64 (75%) of right coronary artery stenoses, and in 55 out of 64 (85%) of left circumflex coronary artery stenoses, despite the presence of infarcted myocardium in other territories. 201 Tl SMS with segmental quantitative analysis is a highly sensitive and specific technique in the diagnosis of coronary artery disease and may be a useful screening procedure to select patients for further investigation, particularly those with evidence of life-threatening severe left coronary artery disease. (author)

Biologic variability of N-terminal pro-brain natriuretic peptide in adult healthy cats.

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Harris, Autumn N; Estrada, Amara H; Gallagher, Alexander E; Winter, Brandy; Lamb, Kenneth E; Bohannon, Mary; Hanscom, Jancy; Mainville, Celine A

2017-02-01

Objectives The biologic variability of N-terminal pro-brain natriuretic peptide (NT-proBNP) and its impact on diagnostic utility is unknown in healthy cats and those with cardiac disease. The purpose of this study was to determine the biologic variation of NT-proBNP within-day and week-to-week in healthy adult cats. Methods Adult cats were prospectively evaluated by complete blood count (CBC), biochemistry, total thyroxine, echocardiography, electrocardiography and blood pressure, to exclude underlying systemic or cardiac disease. Adult healthy cats were enrolled and blood samples were obtained at 11 time points over a 6 week period (0, 2 h, 4 h, 6 h, 8 h, 10 h and at weeks 2, 3, 4, 5 and 6). The intra-individual (coefficient of variation [CV I ]) biologic variation along with index of individuality and reference change values (RCVs) were calculated. Univariate models were analyzed and included comparison of the six different time points for both daily and weekly samples. This was followed by a Tukey's post-hoc adjustment, with a P value of cats. Further research is warranted to evaluate NT-proBNP variability, particularly how serial measurements of NT-proBNP may be used in the diagnosis and management of cats with cardiac disease.

IEEE-802.15.4-based low-power body sensor node with RF energy harvester.

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Tran, Thang Viet; Chung, Wan-Young

2014-01-01

This paper proposes the design and implementation of a low-voltage and low-power body sensor node based on the IEEE 802.15.4 standard to collect electrocardiography (ECG) and photoplethysmography (PPG) signals. To achieve compact size, low supply voltage, and low power consumption, the proposed platform is integrated into a ZigBee mote, which contains a DC-DC booster, a PPG sensor interface module, and an ECG front-end circuit that has ultra-low current consumption. The input voltage of the proposed node is very low and has a wide range, from 0.65 V to 3.3 V. An RF energy harvester is also designed to charge the battery during the working mode or standby mode of the node. The power consumption of the proposed node reaches 14 mW in working mode to prolong the battery lifetime. The software is supported by the nesC language under the TinyOS environment, which enables the proposed node to be easily configured to function as an individual health monitoring node or a node in a wireless body sensor network (BSN). The proposed node is used to set up a wireless BSN that can simultaneously collect ECG and PPG signals and monitor the results on the personal computer.

Bi-level positive pressure ventilation and adaptive servo ventilation in patients with heart failure and Cheyne-Stokes respiration.

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Fietze, Ingo; Blau, Alexander; Glos, Martin; Theres, Heinz; Baumann, Gert; Penzel, Thomas

2008-08-01

Nocturnal positive pressure ventilation (PPV) has been shown to be effective in patients with impaired left ventricular ejection fraction (LVEF) and Cheyne-Stokes respiration (CSR). We investigated the effect of a bi-level PPV and adaptive servo ventilation on LVEF, CSR, and quantitative sleep quality. Thirty-seven patients (New York heart association [NYHA] II-III) with LVEFCSR were investigated by electrocardiography (ECG), echocardiography and polysomnography. The CSR index (CSRI) was 32.3+/-16.2/h. Patients were randomly treated with bi-level PPV using the standard spontaneous/timed (S/T) mode or with adaptive servo ventilation mode (AutoSetCS). After 6 weeks, 30 patients underwent control investigations with ECG, echocardiography, and polysomnography. The CSRI decreased significantly to 13.6+/-13.4/h. LVEF increased significantly after 6 weeks of ventilation (from 25.1+/-8.5 to 28.8+/-9.8%, plevel PPV and adaptive servo ventilation: the CSRI decreased more in the AutoSetCS group while the LVEF increased more in the bi-level PPV group. Administration of PPV can successfully attenuate CSA. Reduced CSA may be associated with improved LVEF; however, this may depend on the mode of PPV. Changed LVEF is evident even in the absence of significant changes in blood pressure.

Correlation of prolonged QT interval and severity of cirrhosis of liver

International Nuclear Information System (INIS)

Tarique, S.; Sarwar, S.

2011-01-01

To determine correlation between prolonged QT interval and severity of disease in patients of cirrhosis of liver. Study Design: Descriptive cross sectional study. Patients and Methods: One hundred and seventeen patients of cirrhosis were included. Baseline haematological and biochemical parameters were determined. Model for end stage liver disease (MELD) score was determined for all patients to document stage of liver disease. Corrected QT interval was determined from electrocardiography of each patient using QT cirrhosis formula. Correlation between QT interval and MELD score was determined using Pearson correlation and Receiver Operating Characteristic (ROC) curve. Results: One hundred and seventeen included patients had mean age of 53.58 (+- 12.11) while male to female ratio was 1.78/1 (75 / 42). Mean MELD score was 17.08 (+- 6.54) in study patients varying between 6 and 37 while mean corrected QT interval was 0.44 seconds (+- 0.06). Pearson correlation revealed no significant relation between severity of liver disease as determined with MELD score and prolonged QT interval (p value 0.18) Area under curve with ROC curve for correlation between prolonged QT interval and severity of liver disease was 0.42. Conclusion: Prolonged QT interval is not an indicator of severity of disease in cirrhosis of liver. (author)

Fabrication of Micro-Needle Electrodes for Bio-Signal Recording by a Magnetization-Induced Self-Assembly Method

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Keyun Chen

2016-09-01

Full Text Available Micro-needle electrodes (MEs have attracted more and more attention for monitoring physiological electrical signals, including electrode-skin interface impedance (EII, electromyography (EMG and electrocardiography (ECG recording. A magnetization-induced self-assembling method (MSM was developed to fabricate a microneedle array (MA. A MA coated with Ti/Au film was assembled as a ME. The fracture and insertion properties of ME were tested by experiments. The bio-signal recording performance of the ME was measured and compared with a typical commercial wet electrode (Ag/AgCl electrode. The results show that the MA self-assembled from the magnetic droplet array under the sum of gravitational surface tension and magnetic potential energies. The ME had good toughness and could easily pierce rabbit skin without being broken or buckling. When the compression force applied on the ME was larger than 2 N, ME could stably record EII, which was a lower value than that measured by Ag/AgCl electrodes. EMG signals collected by ME varied along with the contraction of biceps brachii muscle. ME could record static ECG signals with a larger amplitude and dynamic ECG signals with more distinguishable features in comparison with a Ag/AgCl electrode, therefore, ME is an alternative electrode for bio-signal monitoring in some specific situations.

Evaluating compliance with institutional preoperative testing guidelines for minimal-risk patients undergoing elective surgery.

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Siriussawakul, Arunotai; Nimmannit, Akarin; Rattana-arpa, Sirirat; Chatrattanakulchai, Siritda; Saengtawan, Puttachard; Wangdee, Aungsumat

2013-01-01

Few investigations preoperatively are important for low-risk patients. This study was designed to determine the level of compliance with preoperative investigation guidelines for ASA I patients undergoing elective surgery. Secondary objectives included the following: to identify common inappropriate investigations, to evaluate the impact of abnormal testing on patient management, to determine factors affecting noncompliant tests, and to estimate unnecessary expenditure. This retrospective study was conducted on adult patients over a one-year period. The institute's guidelines recommend tests according to the patients' age groups: a complete blood count (CBC) for those patients aged 18-45; CBC, chest radiograph (CXR) and electrocardiography (ECG) for those aged 46-60; and CBC, CXR, ECG, electrolytes, blood glucose, blood urea nitrogen (BUN), and creatinine (Cr) for patients aged 61-65. The medical records of 1,496 patients were reviewed. Compliant testing was found in only 12.1% (95% CI, 10.5-13.9). BUN and Cr testings were the most frequently overprescribed tests. Overinvestigations tended to be performed on major surgery and younger patients. Overall, overinvestigation incurred an estimated cost of US 200,000 dollars during the study period. The need to utilize the institution's preoperative guidelines should be emphasized in order to decrease unnecessary testing and the consequential financial burden.

Dual-source computed tomography in patients with acute chest pain: feasibility and image quality

International Nuclear Information System (INIS)

Schertler, Thomas; Scheffel, Hans; Frauenfelder, Thomas; Desbiolles, Lotus; Leschka, Sebastian; Stolzmann, Paul; Marincek, Borut; Alkadhi, Hatem; Seifert, Burkhardt; Flohr, Thomas G.

2007-01-01

The aim of this study was to determine the feasibility and image quality of dual-source computed tomography angiography (DSCTA) in patients with acute chest pain for the assessment of the lung, thoracic aorta, and for pulmonary and coronary arteries. Sixty consecutive patients (32 female, 28 male, mean age 58.1±16.3 years) with acute chest pain underwent contrast-enhanced electrocardiography-gated DSCTA without prior beta-blocker administration. Vessel attenuation of different thoracic vascular territories was measured, and image quality was semi-quantitatively analyzed by two independent readers. Image quality of the thoracic aorta was diagnostic in all 60 patients, image quality of pulmonary arteries was diagnostic in 59, and image quality of coronary arteries was diagnostic in 58 patients. Pairwise intraindividual comparisons of attenuation values were small and ranged between 1±6 HU comparing right and left coronary artery and 56±9 HU comparing the pulmonary trunk and left ventricle. Mean attenuation was 291±65 HU in the ascending aorta, 334±93 HU in the pulmonary trunk, and 285±66 HU and 268±67 HU in the right and left coronary artery, respectively. DSCTA is feasible and provides diagnostic image quality of the thoracic aorta, pulmonary and coronary arteries in patients with acute chest pain. (orig.)

Effects of electric paravertebral muscle relaxation processes in the athletes heart

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D. V. Syshko

2013-02-01

Full Text Available Influence of paravertebrals miorelaxation on electric processes in a heart at sportsmen is studied. Paravertebrals miorelaxation was the complex of exercises in a water environment directed on the decline of tone of paravertebral muscles. Before and after it was used of paravertebrals miorelaxation registered the indexes of electrocardiography at the sportsmen engaged in the Greek-Roman fight (n=22 by football (n=24 and heavy athletics (n=25. It is got, that at the sportsmen of engaged in the Greek -Roman fight after paravertebrals miorelaxation QRS and QT were it was increased, and R-R and PQ went down. At the sportsmen of engaged in heavy athletics HR and PQ went down after paravertebrals miorelaxation, R-R, QRS and QT were it was increased. At the sportsmen of getting busy by football the PQ interval shortened, and QRS and QT has multiplied. Findings testify to the presence of different mechanisms of adaptation of the conducting system of heart in the conditions of influencing of paravertebrals miorelaxation. These distinctions are fated by two basic factors: by the functional being of the cardio-vessels system on the whole and functional being of sine knot and conducting system of heart in particular.

Stress Recovery Effects of High- and Low-Frequency Amplified Music on Heart Rate Variability.

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Nakajima, Yoshie; Tanaka, Naofumi; Mima, Tatsuya; Izumi, Shin-Ichi

Sounds can induce autonomic responses in listeners. However, the modulatory effect of specific frequency components of music is not fully understood. Here, we examined the role of the frequency component of music on autonomic responses. Specifically, we presented music that had been amplified in the high- or low-frequency domains. Twelve healthy women listened to white noise, a stress-inducing noise, and then one of three versions of a piece of music: original, low-, or high-frequency amplified. To measure autonomic response, we calculated the high-frequency normalized unit (HFnu), low-frequency normalized unit, and the LF/HF ratio from the heart rate using electrocardiography. We defined the stress recovery ratio as the value obtained after participants listened to music following scratching noise, normalized by the value obtained after participants listened to white noise after the stress noise, in terms of the HFnu, low-frequency normalized unit, LF/HF ratio, and heart rate. Results indicated that high-frequency amplified music had the highest HFnu of the three versions. The stress recovery ratio of HFnu under the high-frequency amplified stimulus was significantly larger than that under the low-frequency stimulus. Our results suggest that the high-frequency component of music plays a greater role in stress relief than low-frequency components.

Hybrid-Aware Model for Senior Wellness Service in Smart Home.

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Jung, Yuchae

2017-05-22

Smart home technology with situation-awareness is important for seniors to improve safety and security. With the development of context-aware computing, wearable sensor technology, and ubiquitous computing, it is easier for seniors to manage their health problem in smart home environment. For monitoring senior activity in smart home, wearable, and motion sensors-such as respiration rate (RR), electrocardiography (ECG), body temperature, and blood pressure (BP)-were used for monitoring movements of seniors. For context-awareness, environmental sensors-such as gas, fire, smoke, dust, temperature, and light sensors-were used for senior location data collection. Based on senior activity, senior health status can be classified into positive and negative. Based on senior location and time, senior safety is classified into safe and emergency. In this paper, we propose a hybrid inspection service middleware for monitoring elderly health risk based on senior activity and location. This hybrid-aware model for the detection of abnormal status of seniors has four steps as follows: (1) data collection from biosensors and environmental sensors; (2) monitoring senior location and time of stay in each location using environmental sensors; (3) monitoring senior activity using biometric data; finally, (4) expectation-maximization based decision-making step recommending proper treatment based on a senior health risk ratio.

Classification of a Driver's cognitive workload levels using artificial neural network on ECG signals.

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Tjolleng, Amir; Jung, Kihyo; Hong, Wongi; Lee, Wonsup; Lee, Baekhee; You, Heecheon; Son, Joonwoo; Park, Seikwon

2017-03-01

An artificial neural network (ANN) model was developed in the present study to classify the level of a driver's cognitive workload based on electrocardiography (ECG). ECG signals were measured on 15 male participants while they performed a simulated driving task as a primary task with/without an N-back task as a secondary task. Three time-domain ECG measures (mean inter-beat interval (IBI), standard deviation of IBIs, and root mean squared difference of adjacent IBIs) and three frequencydomain ECG measures (power in low frequency, power in high frequency, and ratio of power in low and high frequencies) were calculated. To compensate for individual differences in heart response during the driving tasks, a three-step data processing procedure was performed to ECG signals of each participant: (1) selection of two most sensitive ECG measures, (2) definition of three (low, medium, and high) cognitive workload levels, and (3) normalization of the selected ECG measures. An ANN model was constructed using a feed-forward network and scaled conjugate gradient as a back-propagation learning rule. The accuracy of the ANN classification model was found satisfactory for learning data (95%) and testing data (82%). Copyright © 2016 Elsevier Ltd. All rights reserved.

320-row detector computed tomography angiography findings of a case with multiple

International Nuclear Information System (INIS)

Akay, S.; Bozlar, U.; Demirkol, S.; Tasar, M.

2012-01-01

Full text: Introduction: Computed tomography angiography (CTA) with three-dimensional imaging capability is a very reliable imaging modality for the evaluation of the coronary arteries. Objectives and tasks: To discuss the 320-row detector CTA findings of a case with multiple coronary artery course anomaly. Materials and methods: A 46-year-old man with palpitation, admitted to Cardiology department of our hospital. On electrocardiography, polymorphic ventricular early beats were observed. The patient was referred to Radiology department for CTA examination in terms of probable coronary artery anomaly. Results: On CTA, left main coronary artery was short. The bridging causes nearly 75% luminal stenosis was observed in the middle part of left descending artery. Circumflex artery was continuing as the first obtuse margin and this branch was separating to four branches in the middle part. They were coursing subepicardially in the middle and distal part. Right main coronary artery has also subepicardial course in its middle and distal part. Conclusion: Myocardial bridging is not a rare situation in routine clinical practice. But bridging in all of the three coronary arteries is very uncommon. Multidetector CTA is an effective and non-invasive imaging modality for understanding the normal anatomy and detecting the congenital anomalies of the coronary arteries

The spectrum of myopathies in the city of São Paulo

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José A. Levy

1976-12-01

Full Text Available A review of all myopathic patients treated at the Neurologic Clinic of the Medical School of the University of São Paulo during the past 15 years is reported. A total of 466 cases were examined and distributed as follows: 56% of progressive muscular dystrophy; 31% of myasthenia gravis; 6% of polymyositis; 4% of myotonic dystrophy; and the remainder of several different diseases (central core disease, Kearns-syndrome, myotonia congenita, adynamia episodica hereditaria, diabetic myopathy and Eaton-Lambert syndrome. Enzymatic dosages, electromyography, muscle biopsy, electrocardiography and genetic counselling are also reported.Os autores fazem uma revisão de todos os casos de miopatias tratados na Clínica Neurológica da F.M.U.S.P. durante os últimos 15 anos. Foram examinados 466 casos, assim distribuídos: 56% de distrofia muscular progressiva; 31% de miastenia grave; 6% de polimiosite; 4% de distrofia miotônica e, o restante, de várias outras moléstias (Central core disease, síndrome de Kearns, miotonia congênita, adinamia episódica hereditária, miopatia diabética e síndrome de Eaton-Lambert. São relatadas também as dosagens enzimáticas, eletromiografia, biópsia muscular, eletrocardiografia e aconselhamento genético.

Providing Telehealth Services to a Public Primary Care Network: The Experience of RedeNUTES in Pernambuco, Brazil.

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Diniz, Paula Rejane Beserra; Ribeiro Sales, Fernando José; de Araújo Novaes, Magdala

2016-08-01

Information technologies have been applied in primary care domains to improve the delivery of health services. This article reports the telehealth network experience in Pernambuco, Brazil. Five different data sets were used, one by each service and the structural aspects of the network, collected from 2008 until August 2015. The data include solicited themes for educational activities, users' evaluation of services, numbers of sites, municipalities participating, participants in tele-education activities, teleconsultations, telediagnosis, and remote screenings. The analysis was done in absolute and percentage values using Microsoft Excel (version 2007). The indicators show high utilization of tele-education resources, followed by the teleconsultation service. The synchronous modality was the most used and the general clinical question was the most frequent type of question. Nurses are the professional category that most used the teleconsultation services (36%). Telediagnosis of electrocardiography has growth utilization, overcoming teleconsulting more recently. The satisfaction rate was 89%, and 68.5% of professionals changed their planning to patients' referrals to specialists. Telehealth has been considered effective since it avoids inappropriate referrals of the patient and provides continuous actualization to health professionals. Our results provide evidence of the feasibility and importance of using telehealth as a tool to ensure the universality, equality, and completeness in the health system.

Analysis of physiological signals for recognition of boredom, pain, and surprise emotions.

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Jang, Eun-Hye; Park, Byoung-Jun; Park, Mi-Sook; Kim, Sang-Hyeob; Sohn, Jin-Hun

2015-06-18

The aim of the study was to examine the differences of boredom, pain, and surprise. In addition to that, it was conducted to propose approaches for emotion recognition based on physiological signals. Three emotions, boredom, pain, and surprise, are induced through the presentation of emotional stimuli and electrocardiography (ECG), electrodermal activity (EDA), skin temperature (SKT), and photoplethysmography (PPG) as physiological signals are measured to collect a dataset from 217 participants when experiencing the emotions. Twenty-seven physiological features are extracted from the signals to classify the three emotions. The discriminant function analysis (DFA) as a statistical method, and five machine learning algorithms (linear discriminant analysis (LDA), classification and regression trees (CART), self-organizing map (SOM), Naïve Bayes algorithm, and support vector machine (SVM)) are used for classifying the emotions. The result shows that the difference of physiological responses among emotions is significant in heart rate (HR), skin conductance level (SCL), skin conductance response (SCR), mean skin temperature (meanSKT), blood volume pulse (BVP), and pulse transit time (PTT), and the highest recognition accuracy of 84.7% is obtained by using DFA. This study demonstrates the differences of boredom, pain, and surprise and the best emotion recognizer for the classification of the three emotions by using physiological signals.

Coexistent coronary artery disease or myocardial bridging in patients with hypertrophic cardiomyopathy using coronary CT angiography

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Lee, Jae Hwan; Chun, Eun Ju; Kim, Yeo Koon; Yoo, Jin Young; Choi, Sang Il; Choi, Dong Ju [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

2015-07-15

To evaluate the prevalence of coexistent coronary artery disease (CAD) or myocardial bridging (MB) in patients with hypertrophic cardiomyopathy (HCM) using coronary CT angiography (CCTA) and assess the role of CCTA. The prevalence of obstructive CAD (> 50% luminal reduction) and MB (partial and full encasement) were assessed in 150 patients with HCM diagnosed by clinical findings, electrocardiography, and echocardiography of 19588 consecutive patients who underwent CCTA for suspected CAD. The overall feasibility of coronary artery visualization was 98.9% with CCTA. In patients with HCM, the prevalence of obstructive CAD and MB (14.7% partial and 28.0% full encasement) were 23.3% and 42.7%, respectively. Age, hypertension, family history of premature CAD, Framingham risk score and severe chest pain were associated with CAD, whereas male gender and septal type were associated with MB (all p < 0.05). In comparison to invasive coronary angiography (n = 37), the diagnostic accuracy of CCTA for the detection of CAD and full encasement MB was 89.2% and 86.5%, respectively. One-quarter of patients with HCM had coexistent obstructive CAD or full encasement MB. CCTA can be a feasible and accurate noninvasive imaging modality for the detection of CAD and MB in patients with HCM.

Pleuritic Chest Pain: Sorting Through the Differential Diagnosis.

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Reamy, Brian V; Williams, Pamela M; Odom, Michael Ryan

2017-09-01

Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made. Validated clinical decision rules are available to help exclude coronary artery disease. Viruses are common causative agents of pleuritic chest pain. Coxsackieviruses, respiratory syncytial virus, influenza, parainfluenza, mumps, adenovirus, cytomegalovirus, and Epstein-Barr virus are likely pathogens. Treatment is guided by the underlying diagnosis. Nonsteroidal anti-inflammatory drugs are appropriate for pain management in those with virally triggered or nonspecific pleuritic chest pain. In patients with persistent symptoms, persons who smoke, and those older than 50 years with pneumonia, it is important to document radiographic resolution with repeat chest radiography six weeks after initial treatment.

123I-β-methyl-iodophenyl-pentadecanoic acid myocardial scintigraphy in diabetic patients without overt ischemic heart disease

International Nuclear Information System (INIS)

Shinmura, Ken; Tani, Masato; Suganuma, Yukako; Hasegawa, Hiroshi; Kawamura, Masatoshi; Nakamura, Yoshiro; Hashimoto, Jun; Kubo, Atsushi

1995-01-01

We evaluated 123 I-β-methyl-iodophenyl-pentadecanoic acid (BMIPP) myocardial scintigraphy in 15 diabetes mellitus patients without overt coronary heart disease. Patients with overt coronary heart disease were excluded by careful history taking, resting electrocardiography, treadmill exercise testing echocardiography and resting 201 Tl scintigraphy. Patients with remarkably impaired left ventricular (LV) systolic function (%FS 2 , FBS: 178 vs 114 mg/dl, HbA1c: 7.6 vs 6.2%, IRI: 18.5 vs 9.5 μU/ml, LVEDD: 52 vs 44 mm). 123 I-metaiodobenzyl-guanidine (MIBG) scintigraphy in the 5 patients with abnormal BMIPP uptake showed more severe defects than in the 10 patients with normal BMIPP imaging. BMIPP scintigraphy demonstrated a significant correlation between H/M and L/M by BMIPP (r=0.74). Correlation between H/M by BMIPP scintigraphy and clinical parameters (BMI, systolic blood pressure, FBS, HbA1c, IRI) were found, suggesting that diabetes mellitus patients without over coronary heart disease show abnormal BMIPP imaging when their general glucose utility and 123 I-MIBG uptake are severely impaired (progression of insulin resistance and sympathetic nerve involvement). BMIPP scintigraphy may be useful in investigating the pathogenesis and subclinical abnormality of diabetic heart. (J.P.N.)

Case report: patient with Weil’s disease, chest pain, hepatitis b, hepatorenal syndrome, and electrolyte imbalance

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Mustopa; Susilo, R. S. B.; Arifin; Redhono, D.; Sumandjar, T.

2018-03-01

A 48-years-old man was hospitalized due to febrile for 5 days accompanied by headache and left chest pain radiating into the back. Pain calf, abdominal pain and tea color urine has occured since 1 week before admission. Physical examination revealed temperature 38.5° C, conjungtival suffusion, jaundice sclera, irregularheart sound, hepatomegaly, gastrocnemius tenderness, Faine score 23. Laboratory tests showed leukocytosis, thrombocytopenia, elevated transaminase enzyme, ureum 181 mg/dl, creatinine 4.3 mg/dl, albumin 2.4 g/dl, sodium 110 mmol/L, potassium 2.3 mmol/L, reactive HbsAg, CKMB 68.06 ng/ml, increased HBV-DNA, negative IgM anti Leptospira. MAT demonstrated 4 positive serovar. Electrocardiography revealed AF rapid ventrikel response. Chest x-ray showed cardiomegaly. Abdominal ultrasound revealed hepatomegaly with chronic parenchimal liver disease, renal insuficiency. Fibroscan showed severe fibrosis. Patient was diagnosed with Weil’s disease and hepatorenal syndrome as complication. Patient was given clavulanate amoxicillin injections. This patient was not dialysis, only fluid balance monitoring and checked ureum-creatinine per 3 days, and there was improvement of ureum-creatinine. Hepatorenal syndrome in Weil’s disease contributed to electrolyte imbalance. In addition, chronic hepatitis B on this patient was treated with tenofovir.

Simultaneous Left Ventricular and Deep Vein Thrombi Caused by Protein C Deficiency

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Harufumi Maki

2017-01-01

Full Text Available Protein C deficiency is a risk of venous thrombosis because of poor fibrinolytic activity. It remains controversial whether protein C deficiency causes arterial thrombosis. A 21-year-old woman was referred with a chief complaint of right leg pain and numbness. Contrast-enhanced computed tomography revealed a low-density mass in the left ventricle (LV, splenic infarction, and peripheral arterial obstructions in her right leg. Thrombosis extending from the renal vein to the inferior vena cava was also detected. Electrocardiography revealed ST depression in leads II, III, and aVF. Transthoracic echocardiography revealed hypokinesis of the apex and interventricular septum and a hypoechoic mass in the LV (26 × 20 mm. She was diagnosed with acute arterial obstruction caused by the LV thrombus, which might have resulted from previous myocardial infarction. Protein C activation turned out to be low (41% 5 days after admission. The anticoagulant therapy was switched from heparin to rivaroxaban 16 days after admission. The LV thrombus disappeared 24 days after initial treatment, and she has had no thrombotic episodes for 2.8 years under rivaroxaban therapy. Thrombophilia should be investigated for cases of simultaneous left ventricular and deep venous thrombi. Rivaroxaban can be effective in prevention of further thrombotic events.

Trastuzumab (Herceptin)-associated cardiomyopathy presented as new onset of complete left bundle-branch block mimicking acute coronary syndrome: a case report and literature review.

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Tu, Chung-Ming; Chu, Kai-Ming; Yang, Shin-Ping; Cheng, Shu-Mung; Wang, Wen-Been

2009-09-01

Trastuzumab (Herceptin) is well documented in reducing suffering and mortality from breast cancer. The clinically most important side effect of Herceptin is cardiotoxicity, which is reported in 2.6% to 4.5% of patients receiving trastuzumab alone and in as many as 27% of patients when trastuzumab is combined with an anthracycline in metastatic disease. We reported the case of a 50-year-old woman who presented to our emergency department (ED) because of chest pain and shortness of breath. On physical examination, holosystolic murmur over apex could be heard. Pulmonary and abdominal examinations were unremarkable. Twelve-lead electrocardiography showed sinus tachycardia and new onset of complete left bundle-branch block. Emergent transthoracic echocardiography revealed generalized hypokinesia of left ventricle and akinesia over interventricular septum and apex. She subsequently underwent immediate coronary angiography that revealed normal coronary angiography, and left ventriculogram revealed generalized hypokinesia with severe left ventricle dysfunction with ejection fraction of 33%. During right heart catheterization and endomyocardial biopsy, cardiac tamponade developed and was successfully relieved by pericardial window. She was discharged event-free 3 weeks later with conservative treatment. Although new onset of complete left bundle-branch block in a patient with chest pain may be acute coronary syndrome, careful review of medicine history is mandatory to avoid unnecessary procedure and complications.

Measurement of cardiac ventricular volumes using multidetector row computed tomography: comparison of two- and three-dimensional methods

International Nuclear Information System (INIS)

Montaudon, M.; Laffon, E.; Berger, P.; Corneloup, O.; Latrabe, V.; Laurent, F.

2006-01-01

This study compared a three-dimensional volumetric threshold-based method to a two-dimensional Simpson's rule based short-axis multiplanar method for measuring right (RV) and left ventricular (LV) volumes, stroke volumes, and ejection fraction using electrocardiography-gated multidetector computed tomography (MDCT) data sets. End-diastolic volume (EDV) and end-systolic volume (ESV) of RV and LV were measured independently and blindly by two observers from contrast-enhanced MDCT images using commercial software in 18 patients. For RV and LV the three-dimensionally calculated EDV and ESV values were smaller than those provided by two-dimensional short axis (10%, 5%, 15% and 26% differences respectively). Agreement between the two methods was found for LV (EDV/ESV: r=0.974/0.910, ICC=0.905/0.890) but not for RV (r=0.882/0.930, ICC=0.663/0.544). Measurement errors were significant only for EDV of LV using the two-dimensional method. Similar reproducibility was found for LV measurements, but the three-dimensional method provided greater reproducibility for RV measurements than the two-dimensional. The threshold value supported three-dimensional method provides reproducible cardiac ventricular volume measurements, comparable to those obtained using the short-axis Simpson based method. (orig.)

Spiral computed tomographic pulmonary angiography in patients with acute pulmonary emboli and no pre-existing comorbidity: a prospective prognostic panel study

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Javadrashid, Reza; Mozayan, Maryam; Tarzamni, Mohammad Kazem [Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Department of Radiology, Tabriz (Iran, Islamic Republic of); Ghaffari, Mohammad Reza [Imam Reza Teaching Hospital, Tabriz University of Medical Sciences, Department of Lung and Respiratory Disease, Tabriz (Iran, Islamic Republic of); Fouladi, Daniel F. [Tabriz University of Medical Sciences, Drug Applied Research Center, Tabriz (Iran, Islamic Republic of)

2015-01-15

To investigate the prognostic validity of the right ventricular to left ventricular diameter (RVD/LVD) ratio and Qanadli pulmonary artery obstruction score (PAOS) in hemodynamically stable patients with no pre-existing comorbidities. Sixty-three patients with no previous comorbidity were recruited for this study. The RVD/LVD ratio was calculated based on axial image measurements obtained from contrast-enhanced non-electrocardiography-gated spiral computed tomography (CT) pulmonary angiographic studies. Patients were followed up for 60 days after the initial CT and study variables including demographic data, the RVD/LVD ratio and PAOS were compared between deceased cases and survivors via univariate and multivariate statistical models. The 60-day mortality rate was 22.2 %. The deceased and surviving groups were comparable for PAOS, whereas both the median age and RVD/LVD ratio were significantly higher in the first group. In multivariate analysis, however, age was the only significant, independent predictor of 60-day mortality (p = 0.02, Exp(B) = 1.06). At a cut-off age of 63 years the 60-day mortality was predicted with a sensitivity and specificity of 64.3 % and 69.4 %, respectively. The RVD/LVD ratio and PAOS are not independent predictors of mortality in hemodynamically stable patients with acute PE and no pre-existing comorbidities. (orig.)

The effects of detomidine, romifidine or acepromazine on echocardiographic measurements and cardiac function in normal horses.

Science.gov (United States)

Buhl, Rikke; Ersbøll, Annette K; Larsen, Nanna H; Eriksen, Lis; Koch, Jørgen

2007-01-01

To evaluate by echo- and electrocardiography the cardiac effects of sedation with detomidine hydrochloride, romifidine hydrochloride or acepromazine maleate in horses. An experimental study using a cross-over design without randomization. Eight clinically normal Standardbred trotters. Echocardiographic examinations (two-dimensional, guided M-mode and colour Doppler) were recorded on five different days. Heart rate (HR) and standard limb lead electrocardiograms were also obtained. Subsequently, horses were sedated with detomidine (0.01 mg kg(-1)), romifidine (0.04 mg kg(-1)) or acepromazine (0.1 mg kg(-1)) administered intravenously and all examinations repeated. Heart rate before treatment with the three drugs did not differ significantly (p = 0.98). Both detomidine and romifidine induced a significant decrease (p detomidine, there was a significant increase in LVIDd (left ventricular internal diameter in diastole; p = 0.034) and LVIDs (left ventricular internal diameter in systole; p detomidine and to a lesser extent romifidine at the doses given in this study has a significant effect on heart function, echocardiographic measurements of heart dimensions and the occurrence of valvular regurgitation. Although the clinical significance of these results may be minimal, the potential effects of sedative drugs should be taken into account when echocardiographic variables are interpreted in clinical cases.

Relationship between obesity and left ventricular hypertrophy in children

Directory of Open Access Journals (Sweden)

Johnny Rompis

2016-10-01

Full Text Available Background Obesity is a chronic metabolic disorder associated with cardiovascular disease (CVD increasing morbidity-mortality rates. It is apparent that a variety of adaptations/alterations in cardiac structure and function occurs as excessive adipose tissue accumulates. This leads to a decrease in diastolic compliance, eventually resulting in an increase in left ventricular filling pressure and left ventricular enlargement. Objective To evaluate left ventricular hypertrophy (LVH among  obese using electrocardiographic (ECG criteria. Methods A cross-sectional study was conducted on 74 children aged 10-15 years from February 2009 to October 2009. The subjects were divided into obese and control groups. Physical examination and standard 12 lead electrocardiography (ECG were done in both groups. Results Of 37 obese children, LVH were featured in 3 subjects, while in control group, only 1 child had LVH (P= 0.304. We found that mean RV6 in obese and control group were 9.8446 (SD 3.5854 and 11.9662 (SD 3.2857, respectively (P=0.005. As an additional findings, we found that birth weight was related to obesity in children. Conclusion There is no relation between obesity and left ventricular using ECG criteria in obese children aged 10-15 years.

Physical comorbidities of post-traumatic stress disorder in Australian Vietnam War veterans.

Science.gov (United States)

McLeay, Sarah C; Harvey, Wendy M; Romaniuk, Madeline Nm; Crawford, Darrell Hg; Colquhoun, David M; Young, Ross McD; Dwyer, Miriam; Gibson, John M; O'Sullivan, Robyn A; Cooksley, Graham; Strakosch, Christopher R; Thomson, Rachel M; Voisey, Joanne; Lawford, Bruce R

2017-04-03

To determine whether the prevalence of physical comorbidities in Australian Vietnam War veterans with post-traumatic stress disorder (PTSD) is higher than in trauma-exposed veterans without PTSD. Cross-sectional analysis of the health status (based on self-reported and objective clinical assessments) of 298 Australian Vietnam War veterans enrolled by the Gallipoli Medical Research Institute (Brisbane) during February 2014 - July 2015, of whom 108 were confirmed as having had PTSD and 106 served as trauma-exposed control participants.Main outcomes and measures: Diagnostic psychiatric interview and psychological assessments determined PTSD status, trauma exposure, and comorbid psychological symptoms. Demographic data, and medical and sleep history were collected; comprehensive clinical examination, electrocardiography, spirometry, liver transient elastography, and selected pathology assessments and diagnostic imaging were performed. Outcomes associated with PTSD were identified; regression analysis excluded the effects of potentially confounding demographic and risk factors and comorbid symptoms of depression and anxiety. The mean total number of comorbidities was higher among those with PTSD (17.7; SD, 6.1) than in trauma-exposed controls (14.1; SD, 5.2; P Vietnam veterans is associated with comorbidities in several organ systems, independent of trauma exposure. A comprehensive approach to the health care of veterans with PTSD is needed.

Echoguided closed commissurotomy for mitral valve stenosis in a dog.

Science.gov (United States)

Trehiou-Sechi, Emilie; Behr, Luc; Chetboul, Valérie; Pouchelon, Jean-Louis; Castaignet, Maud; Gouni, Vassiliki; Misbach, Charlotte; Petit, Amandine M P; Borenstein, Nicolas

2011-09-01

Surgical treatment of mitral stenosis (MS) usually consists of open mitral commissurotomy (MC) or percutaneous balloon MC, which require a cardiopulmonary bypass or transseptal approach, respectively. We describe here the first surgical management of congenital MS in a dog using a less invasive procedure, a surgical closed MC under direct echo guidance. A 5-year-old female Cairn terrier was referred for ascites, weakness, and marked exercise intolerance for 2 months, which was refractory to medical treatment. Diagnosis of severe MS associated with atrial fibrillation (AF) was confirmed by echo-Doppler examination and electrocardiography. Poor response to medical treatment suggested a corrective procedure on the valve was indicated. However, due to the cost and high mortality rate associated with cardiopulmonary bypass, a hybrid MC was recommended. A standard left intercostal thoracotomy was performed and three balloon valvuloplasty catheters of differing diameters were sequentially inserted through the left atrium under direct echo guidance. Transesophageal echocardiography revealed a 62% reduction in the pressure half-time compared to the pre-procedure. Thirteen months after surgery the dog is still doing well with resolution of ascites and a marked improvement of most echo-Doppler variables. Copyright © 2011 Elsevier B.V. All rights reserved.

Smart ECG Monitoring Patch with Built-in R-Peak Detection for Long-Term HRV Analysis.

Science.gov (United States)

Lee, W K; Yoon, H; Park, K S

2016-07-01

Since heart rate variability (HRV) analysis is widely used to evaluate the physiological status of the human body, devices specifically designed for such applications are needed. To this end, we developed a smart electrocardiography (ECG) patch. The smart patch measures ECG using three electrodes integrated into the patch, filters the measured signals to minimize noise, performs analog-to-digital conversion, and detects R-peaks. The measured raw ECG data and the interval between the detected R-peaks can be recorded to enable long-term HRV analysis. Experiments were performed to evaluate the performance of the built-in R-wave detection, robustness of the device under motion, and applicability to the evaluation of mental stress. The R-peak detection results obtained with the device exhibited a sensitivity of 99.29%, a positive predictive value of 100.00%, and an error of 0.71%. The device also exhibited less motional noise than conventional ECG recording, being stable up to a walking speed of 5 km/h. When applied to mental stress analysis, the device evaluated the variation in HRV parameters in the same way as a normal ECG, with very little difference. This device can help users better understand their state of health and provide physicians with more reliable data for objective diagnosis.

The Association between Myocardial Iron Load and Ventricular Repolarization Parameters in Asymptomatic Beta-Thalassemia Patients

Directory of Open Access Journals (Sweden)

Mehmet Kayrak

2012-01-01

Full Text Available Previous studies have demonstrated impaired ventricular repolarization in patients with β-TM. However, the effect of iron overload with cardiac T2* magnetic resonance imaging (MRI on cardiac repolarization remains unclear yet. We aimed to examine relationship between repolarization parameters and iron loading using cardiac T2* MRI in asymptomatic β-TM patients. Twenty-two β-TM patients and 22 age- and gender-matched healthy controls were enrolled to the study. From the 12-lead surface electrocardiography, regional and transmyocardial repolarization parameters were evaluated manually by two experienced cardiologists. All patients were also undergone MRI for cardiac T2* evaluation. Cardiac T2* score <20 msec was considered as iron overload status. Of the QT parameters, QT duration, corrected QT interval, and QT peak duration were significantly longer in the β-TM group compared to the healthy controls. Tp−Te and Tp−Te dispersions were also significantly prolonged in β-TM group compared to healthy controls. (Tp-Te/QT was similar between groups. There was no correlation between repolarization parameters and cardiac T2* MRI values. In conclusion, although repolarization parameters were prolonged in asymptomatic β-TM patients compared with control, we could not find any relation between ECG findings and cardiac iron load.

Possibilities for the early detection of hypertensive disease in pregnant women

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Ye. B. Savinova

2012-01-01

Full Text Available Objective: to evaluate morphofunctional changes in the cardiovascular system of pregnant women with arterial hypertension (AH to detectchronic AH - hypertensive disease.Subjects and methods. 126 pregnant women with AH (at 28–34 weeks gestation; mean age 26.1 ± 1.7 years were examined. All the pregnantwomen underwent assessment of risk factors for AH, double measurement of office blood pressure, 24-hour blood pressure monitoring, electrocardiography, carotid ultrasonography, a microalbumin urine test, and eyeground examination. The pattern of AH was specified 12 weeks after childbirth.Results. Chronic AH – hypertensive disease – was diagnosed in 51 % of the examined pregnant women with AH. There was a considerable spread of risk factors for AH in this patient group. 26 % of them were found to have lesions of target organs (heart and/or arterial vessels; the rate of microalbuminuria registration was 41 %.Conclusion. Among our examined group of pregnant patients with AH, the prevalence of hypertensive disease is 51 %. In the identified patientgroup, cardiac and arterial vascular changes that could be considered as target organ lesions were found in almost a third of cases. Pregnant women with AH need to be meticulously examined and followed up by a therapist and a cardiologist in the postpartum period.