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Electrocardiogram

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2. Remote electrocardiogram (ECG) interpretation consultancy services to aid diagnosis and decision making in the primary care setting

Remote electrocardiogram (ECG) interpretation consultancy services to aid diagnosis and decision making in the primary care setting Remote ECG Interpretation (ambulatory testing in the community) - Health Technology Wales > Remote ECG Interpretation (ambulatory testing in the community) Remote ECG Interpretation (ambulatory testing in the community) Topic Status Complete Remote electrocardiogram (ECG) interpretation consultancy services to aid diagnosis and decision making in the primary care (...) setting. Summary Health Technology Wales researchers searched for evidence on the use of remote electrocardiogram (ECG) interpretation consultancy services for the testing of people with suspected cardiovascular disease. HTW’s Assessment Group concluded not to progress this topic further because there is limited evidence on the use of this technology.Health Technology Wales researchers searched for evidence on the use of remote electrocardiogram (ECG) interpretation consultancy services

2019 Health Technology Wales

3. Kendall DL for ECG monitoring in people having cardiac surgery

Kendall DL for ECG monitoring in people having cardiac surgery K Kendall DL for ECG monitoring in people ha endall DL for ECG monitoring in people having ving cardiac surgery cardiac surgery Medtech innovation briefing Published: 18 March 2019 nice.org.uk/guidance/mib177 pathways Summary Summary The technology technology described in this briefing is Kendall DL, a single-patient-use electrocardiogram (ECG) cable and lead wire system. It is used for diagnostic and ongoing patient monitoring (...) of 8limited. The technology The technology The Kendall DL is a single-patient-use electrocardiogram (ECG) cable and lead wire system. It is used to assess and monitor cardiac health for people having cardiac surgery. The Kendall DL comprises: disposable 3-, 5-, 6- and 10-lead wires that connect directly to electrodes a cable that connects the leads to an ECG monitor a universal adaptor for compatibility with different models of ECG monitoring equipment. The disposable design of the technology minimises

2019 National Institute for Health and Clinical Excellence - Advice

4. Lead-I ECG devices for detecting symptomatic atrial fibrillation using single time point testing in primary care

point testing in primary care (DG35) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 40This guidance should be read in conjunction with MIB35. 1 1 Recommendations Recommendations 1.1 There is not enough evidence to recommend the routine adoption of lead-I electrocardiogram (ECG) devices (imPulse, Kardia Mobile, MyDiagnostick and Zenicor-ECG) to detect atrial fibrillation when used for single time point testing (...) electrocardiogram (ECG) devices can be used in primary care to help detect atrial fibrillation in people presenting with signs or symptoms of the condition, who have an irregular pulse on manual pulse palpation. The devices include electrodes, internal storage for ECG recordings and automated software to interpret the ECG trace. Data can be transferred to a local or remote computer for further analysis by a healthcare professional. 2.2 Using lead-I ECG devices may improve detection of atrial fibrillation

2019 National Institute for Health and Clinical Excellence - Diagnostics Guidance

5. Remote ECG interpretation consultancy services for cardiovascular disease

Remote ECG interpretation consultancy services for cardiovascular disease Remote ECG interpretation consultancy services Remote ECG interpretation consultancy services for cardio for cardiovascular disease vascular disease Medtech innovation briefing Published: 27 July 2018 nice.org.uk/guidance/mib152 pathways Summary Summary The technologies technologies described in this briefing are remote electrocardiogram (ECG) interpretation consultancy services. They are used for assisting in diagnosing (...) is only available for 1 out of 6 services in this briefing. The cost cost of the services in this briefing ranges from £3 to £195 per report (excluding VAT). The resource impact resource impact may be cost saving because of reductions in secondary care referrals. © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 16The technology The technology An electrocardiogram (ECG) is a recording of the electrical activity

2018 National Institute for Health and Clinical Excellence - Advice

6. Can smartphone wireless ECGs be used to accurately assess ECG intervals in pediatrics? A comparison of mobile health monitoring to standard 12-lead ECG. Full Text available with Trip Pro

Can smartphone wireless ECGs be used to accurately assess ECG intervals in pediatrics? A comparison of mobile health monitoring to standard 12-lead ECG. Arrhythmias in children are often paroxysmal, complicating the ability to capture the abnormal rhythm on routine ECG during an outpatient visit. The Alivecor Kardia Mobile (KM) device is a wireless mobile health (mHealth) device that generates a single lead ECG tracing with a FDA-approved algorithm for detection of atrial fibrillation (...) in adults.The goal of this study is to assess the accuracy of interval measurements on KM tracings by directly comparing to standard 12-lead ECGs in pediatric patients.This single center, prospective study enrolled pediatric outpatients, age <18 years presenting for cardiology clinic visits, into 3 groups based on age: 0-5 years, 6-10 years, and 11-18 years. Patients were excluded if 12-lead ECG was not ordered during the visit. Each enrolled subject underwent standard 12-lead ECG followed by 30-second KM

2018 PLoS ONE

7. Guidance for Cardiac Electrophysiology During the COVID-19 Pandemic from the HRS COVID-19 Task Force, ACC Electrophysiology Section, and the AHA Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology

Guidance for Cardiac Electrophysiology During the COVID-19 Pandemic from the HRS COVID-19 Task Force, ACC Electrophysiology Section, and the AHA Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology Guidance for Cardiac Electrophysiology During the COVID-19 Pandemic from the HRS COVID-19 Task Force, ACC Electrophysiology Section, and the AHA Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology | Heart Rhythm Society Utility Menu Main

2020 Heart Rhythm Society

8. Are all criteria for LVH diagnosis on ECG created equal?

Are all criteria for LVH diagnosis on ECG created equal? Chiefs’ Inquiry Corner 9/3/2019 – Clinical Correlations Search Chiefs’ Inquiry Corner 9/3/2019 September 3, 2019 2 min read Left ventricular hypertrophy (LVH) is associated with increased cardiovascular morbidity and mortality and is therefore important for risk stratification. Although the ECG remains a simple, ubiquitous, and inexpensive way to diagnose LVH, the clinical utility of ECG is limited by the impact of lead placement, body (...) habitus, age, lung pathology, conduction abnormalities, or myocardium pathology on voltage. Additionally, with the AHA endorsing more than 30 ECG criteria for diagnosing LVH, there is no consensus among practitioners on which criteria are most appropriate for clinical use. Studies that have compared some of the most commonly used criteria including the Romhilt-Estes Point-Score system, Sokolow-Lyon, Cornell, and Rodríguez Padial found very low diagnostic value outside of appropriate clinical context

2019 Clinical Correlations

9. How reliable are ECG findings in hyperkalemia?

How reliable are ECG findings in hyperkalemia? Chiefs’ Inquiry Corner – 10/14/19 – Clinical Correlations Search Chiefs’ Inquiry Corner – 10/14/19 October 14, 2019 2 min read The concentration and dose of epinephrine varies by indication. In 2016, the FDA banned the use of ratio expressions of epinephrine dosing, so clinicians should learn concentration-based dosing. An epinephrine auto-injector (aka EpiPen) contains the highest concentration of epinephrine at 1mg/mL. A dose of 0.3mg (0.3mL (...) ) should be injected intramuscularly in anaphylaxis. The concentration of epinephrine indicated in a code is lower, at 0.1mg/mL, as it is delivered intravenously. In ACLS, 10mL are delivered for a total dose of 1mg. Continuous epinephrine drips contain the lowest concentration of epinephrine, delivered at a rate of 0.5mcg/kg/min. References: A retrospective study at a community hospital reviewed 90 ECGs taken from patients with serum potassium greater than 6 mmol/L. Six ECGs demonstrated new QRS

2019 Clinical Correlations

10. Nurse-directed discontinuation of continuous ECG monitoring among non-ICY inpatients

for the HTA database. Citation Lavenberg JG, Holland S, Ballinghoff J, Mull N, Williams, K.. Nurse-directed discontinuation of continuous ECG monitoring among non-ICY inpatients. Philadelphia: Center for Evidence-based Practice (CEP). 2018 Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Electrocardiography; Electrocardiography, Ambulatory; Humans; Inpatients Language Published English Country of organisation United States English summary An English language summary is available (...) Nurse-directed discontinuation of continuous ECG monitoring among non-ICY inpatients Nurse-directed discontinuation of continuous ECG monitoring among non-ICY inpatients Nurse-directed discontinuation of continuous ECG monitoring among non-ICY inpatients Lavenberg JG, Holland S, Ballinghoff J, Mull N, Williams, K. Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made

2018 Health Technology Assessment (HTA) Database.

11. Inter-observer agreement in athletes ECG interpretation using the recent international recommendations for ECG interpretation in athletes among observers with different levels of expertise. Full Text available with Trip Pro

Inter-observer agreement in athletes ECG interpretation using the recent international recommendations for ECG interpretation in athletes among observers with different levels of expertise. International criteria for the interpretation of the athlete's electrocardiogram (ECG) have been proposed. We aimed to evaluate the inter-observer agreement among observers with different levels of expertise.Consecutive ECGs of Swiss elite athletes (≥14 years), recorded during routine pre-participation (...) screening between 2013 and 2016 at the Swiss Federal Institute of Sports were analysed. A medical student (A), a cardiology fellow (B) and an electrophysiologist (C) interpreted the ECG's independently according to the most recent criteria. The frequencies and percentages for each observer were calculated. An inter-observer reliability analysis using Cohen Kappa (κ) statistics was used to determine consistency among observers.A total of 287 ECGs (64.1% males) were analysed. Mean age of the athletes

2018 PLoS ONE

12. I saw this computer "normal" ECG in a stack of ECGs I was reading

I saw this computer "normal" ECG in a stack of ECGs I was reading Dr. Smith's ECG Blog: I saw this computer "normal" ECG in a stack of ECGs I was reading Monday, January 7, 2019 While I had a few moments, I was reading a series of consecutive ECGs recorded in the ED. I came across this one: The computer read was: Normal ECG The cardiologist formal overread was Normal ECG "No significant change" However, it is diagnostic. Of what? In V2-V6, the flat ST segments, sharp upturn of the T-waves (...) , narrow base of the T-waves, and peaked T-waves are diagnostic of hyperkalemia. So I looked to see the patient chart. The patient was a dialysis patient who was there for a clotted dialysis shunt. The K was 5.6 and the ECG hyperkalemia was noticed by the ED physicians. She had been in the ED the day before with the same problem, and had this ECG recorded: The T-waves are normal The K was 4.6 mEq/L This one is close to normal. Do you see the change? Here I put them side-by-side: There is clearly

2019 Dr Smith's ECG Blog

13. General medicine: Screening ECGs in low-risk patients are associated with increased risk of downstream cardiac testing

wasteful healthcare services that provide little or no benefit to patients. 2 One such low-value care practice has been the performance of an electrocardiogram (ECG) in low-risk patients to screen for cardiovascular diseases. The downstream consequence of obtaining an ECG in a low-risk population is not well described in the literature. Methods This population-based retrospective cohort study was performed using the administrative healthcare databases from Canada between 2010 and 2015. 3 The primary (...) General medicine: Screening ECGs in low-risk patients are associated with increased risk of downstream cardiac testing Screening ECGs in low-risk patients are associated with increased risk of downstream cardiac testing | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username

2018 Evidence-Based Medicine

14. Long-Term Continuous Ambulatory ECG Monitors and External Cardiac Loop Recorders for Cardiac Arrhythmia

Committee Recommendations The Ontario Health Technology Advisory Committee recommends continuing to publicly fund (1) long-term continuous ambulatory electrocardiography (ECG) monitors and (2) external cardiac loop recorders that can detect abnormal heart rhythm without the patient initiating the recording of the event The Ontario Health Technology Advisory Committee recommends discontinuing public funding for external cardiac loop recorders that rely solely on patient-initiated recording of the event (...) Cardiac arrhythmia means that the heartbeat is erratic, too fast, or too slow. An arrhythmia can increase the risk of stroke, heart attack, or sudden cardiac death. To diagnose the specific problem, doctors often initially use an electrocardiograph (ECG). Patients whose symptoms occur too infrequently to be detected by this test in the hospital may be asked to wear a device called an ambulatory ECG monitor for several days or weeks while at home. Health Quality Ontario Reviews Long-Term Ambulatory ECG

2017 Health Quality Ontario

15. Atrial Fibrillation: Screening With Electrocardiography

Atrial Fibrillation: Screening With Electrocardiography Recommendation | United States Preventive Services Taskforce Toggle navigation Main navigation Main navigation Recommendation to see the latest documents available. Recommendation Summary Population Recommendation Adults The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for atrial fibrillation with electrocardiography (ECG). See the Clinical Considerations section (...) to assess whether screening with electrocardiography identifies older adults with previously undiagnosed atrial fibrillation more effectively than usual care. Treatments and Interventions Treatment of atrial fibrillation has 2 components: managing arrhythmia and preventing stroke. In general, these treatment goals are independent of each other. Arrhythmia can be managed by controlling the heart rate to minimize symptoms (usually through medication) or by restoring a normal rhythm. Treatment

2018 U.S. Preventive Services Task Force

16. Cardiovascular Disease Risk: Screening With Electrocardiography

Cardiovascular Disease Risk: Screening With Electrocardiography Recommendation | United States Preventive Services Taskforce Toggle navigation Main navigation Main navigation Recommendation Adults at low risk of CVD events The USPSTF recommends against screening with resting or exercise electrocardiography (ECG) to prevent cardiovascular disease (CVD) events in asymptomatic adults at low risk of CVD events. D Adults at intermediate or high risk of CVD events The USPSTF concludes (...) . 2007;297(9):978-85. 26. Badheka AO, Patel N, Tuliani TA, et al. Electrocardiographic abnormalities and reclassification of cardiovascular risk: insights from NHANES-III. Am J Med . 2013;126(4):319-26.e2. 27. Auer R, Bauer DC, Marques-Vidal P, et al; Health ABC Study. Association of major and minor ECG abnormalities with coronary heart disease events. JAMA . 2012;307(14):1497-505. 28. Badheka AO, Patel NJ, Grover PM, et al. ST-T wave abnormality in lead aVR and reclassification of cardiovascular risk

2018 U.S. Preventive Services Task Force

17. Long-term continuous ambulatory ECG monitors and external cardiac loop recorders for cardiac arrhythmia:a health technology assessment

Long-term continuous ambulatory ECG monitors and external cardiac loop recorders for cardiac arrhythmia:a health technology assessment Long-term continuous ambulatory ECG monitors and external cardiac loop recorders for cardiac arrhythmia: a health technology assessment Long-term continuous ambulatory ECG monitors and external cardiac loop recorders for cardiac arrhythmia: a health technology assessment Health Quality Ontario Record Status This is a bibliographic record of a published health (...) technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Health Quality Ontario. Long-term continuous ambulatory ECG monitors and external cardiac loop recorders for cardiac arrhythmia: a health technology assessment. Toronto: Health Quality Ontario (HQO). Ontario health technology assessment series; 17(1). 2017 Authors' conclusions Although both long-term continuous ambulatory ECG monitors and external cardiac loop

2017 Health Technology Assessment (HTA) Database.

18. Screening of pregnant women aged 40 years old and above for cardiac abnormalities using electrocardiography (ECG) to prevent maternal mortality

and electrocardiographic changes found in these healthy pregnant Nigerian women. The study showed that, there were some distinctive ECG features which may help to differentiate cardiac disease in pregnancy from normal cardiac findings in our practice area. However, this is considered as fair level evidence which warrants high quality clinical research. Final publication URL INAHTA brief and checklist INAHTA brief and checklist Indexing Status Subject indexing assigned by CRD MeSH Electrocardiography; Female; Heart (...) Screening of pregnant women aged 40 years old and above for cardiac abnormalities using electrocardiography (ECG) to prevent maternal mortality Screening of pregnant women aged 40 years old and above for cardiac abnormalities using electrocardiography (ECG) to prevent maternal mortality Screening of pregnant women aged 40 years old and above for cardiac abnormalities using electrocardiography (ECG) to prevent maternal mortality Malaysian Health Technology Assessment (MaHTAS) Record Status

2014 Health Technology Assessment (HTA) Database.

19. Is this ECG diagnostic of coronary occlusion? Also: Inferior de Winter's T-waves on prehospital ECG??

of symptoms and who have no prior ecgs to compare with, who then usually sign refusal consent for further observation and leave but I believe patients agree to what you tell them esp when they know you. . Any suggetions to thist? You can't let someone like this go home! tom fiero interesting. its not uncommon that the medic i greet at the ambulance bay might say " ekg was just nsr doc". and i'm almost embarrassed to ask then to dig it out of their pockets, or sometimes to go back to the van to retrieve (...) it. i am implying that i , while i highly respect them, am saying "i have to see that ekg", that i might be "better" at interpretation. but this blog, like many others, bring home the overwhelming point that every ekg, and serial ekg's when warranted, are essential. thanks, guys. tom @ Tom Fiero — I learned the "hard way" that when I was Attending, that I ALWAYS needed to see the ECG being reported on. Even when the providers were highly capable — I would catch things often that were missed

2018 Dr Smith's ECG Blog

20. Electrocardiographic Effects of Propofol versus Etomidate in Patients with Brugada Syndrome (Abstract)

Electrocardiographic Effects of Propofol versus Etomidate in Patients with Brugada Syndrome Brugada Syndrome is an inherited arrhythmogenic disease, characterized by the typical coved type ST-segment elevation in the right precordial leads from V1 through V3. The BrugadaDrugs.org Advisory Board recommends avoiding administration of propofol in patients with Brugada Syndrome. Since prospective studies are lacking, it was the purpose of this study to assess the electrocardiographic effects (...) with etomidate. This trial failed to establish any evidence to suggest that changes in either group differed, with most percentiles being zero (median [25th, 75th], 0 [0, 0] vs. 0 [0, 0]). Finally, no new arrhythmias occurred perioperatively in both groups.In this trial, there does not appear to be a significant difference in electrocardiographic changes in patients with Brugada syndrome when propofol versus etomidate were administered for induction of anesthesia. This study did not investigate

2020 EvidenceUpdates

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