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Electrocardiogram

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161. Significance of Coronary Artery Calcium Found on Non-Electrocardiogram-Gated Computed Tomography During Preoperative Evaluation for Liver Transplant. Full Text available with Trip Pro

Significance of Coronary Artery Calcium Found on Non-Electrocardiogram-Gated Computed Tomography During Preoperative Evaluation for Liver Transplant. Guidelines to evaluate patients for coronary artery disease (CAD) during preoperative evaluation for orthotopic liver transplantation (OLT) are conflicting. Cardiac catheterization is not without risk in patients with end-stage liver disease. No study to date has looked at the utility of non-electrocardiogram-gated chest computed tomography (CT (...) %), respectively, could have theoretically avoided catheterization without missing significant CAD. In conclusion, our data identify the strength of CACS in ruling out coronary disease in patients being evaluated for OLT. Calcium scoring from non-electrocardiogram-gated CT studies may be integrated into preoperative algorithms to rule out obstructive CAD and help avoid invasive angiography in this high-risk population.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 American Journal of Cardiology

162. Electrocardiogram Characteristics and Their Association With Psychotropic Drugs Among Patients With Schizophrenia. (Abstract)

Electrocardiogram Characteristics and Their Association With Psychotropic Drugs Among Patients With Schizophrenia. There are limited data on electrocardiogram (ECG) characteristics and their association with psychotropic drugs in schizophrenia.Using a cross-sectional design, we included Danish primary care patients with first-time digital ECGs from 2001 to 2015. Patients diagnosed with schizophrenia before ECG recording were matched 1:5 on age, sex, and ECG recording year to controls without (...) psychiatric disease. Multivariable logistic regression was used to compute odds ratios (ORs) with 95% confidence intervals (CIs).We included 4486 patients with schizophrenia matched with 22 430 controls (median age, 47 years; male, 55%). Between groups, the prevalence of abnormal ECGs was similar (54%, P = .536), but patients with schizophrenia demonstrated higher median heart rate (79 vs 69 beats per minute, P < .001) and Fridericia-corrected QT (QTc) interval (416 vs 412 ms, P < .001) than controls. QTc

2019 Schizophrenia bulletin

163. Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from Copenhagen. Full Text available with Trip Pro

Thyroid dysfunction and electrocardiographic changes in subjects without arrhythmias: a cross-sectional study of primary healthcare subjects from Copenhagen. The objective of the present study was to investigate associations of both overt and subclinical thyroid dysfunction with common ECG parameters in a large primary healthcare population.Cross-sectional study.The study population comprised of primary healthcare patients in Copenhagen, Denmark, who had a thyroid function test and an ECG (...) recorded within 7 days of each other between 2001 and 2011.The Danish National Patient Registry was used to collect information regarding baseline characteristics and important comorbidities.Common ECG parameters were determined using Marquette 12SL software and were compared between the study groups. The study population was divided into five groups based on their thyroid status. Euthyroid subjects served as the reference group in all analyses.A total of 132 707 patients (age 52±17 years; 50% female

2019 BMJ open

164. External continuous ECG versus loop recording for atrial fibrillation detection in patients who had a stroke. Full Text available with Trip Pro

External continuous ECG versus loop recording for atrial fibrillation detection in patients who had a stroke. Detection of atrial fibrillation (AF) in patients who had ischaemic stroke and transient ischaemic attack (IS/TIA) is recommended. We aimed to compare external loop recording (ELR) against simultaneous continuous ECG recording for AF detection in patients who had acute IS/TIA and determine sensitivity, specificity and positive predictive value of AF detection using ELR. We hypothesised (...) ELR to detect 15% fewer patients with AF than continuous ECG recording.In this prospective cohort study, we included 1412 patients who had acute IS/TIA without prior AF. Monitoring was 48 hours. Primary outcome was AF >30 s. Cardiologist verified AF in continuous ECG was gold standard.In continuous ECG, 38 (2.7%) patients had AF. ELR automatically categorised 219/1412 patients (15.5%) with AF, including 32/38 (85%) patients with AF in continuous ECG. After cardiologist adjudication of ELR

2019 Heart

165. Effects of home-based cardiac exercise rehabilitation with remote electrocardiogram monitoring in patients with chronic heart failure: a study protocol for a randomised controlled trial. Full Text available with Trip Pro

Effects of home-based cardiac exercise rehabilitation with remote electrocardiogram monitoring in patients with chronic heart failure: a study protocol for a randomised controlled trial. Patients with chronic heart failure (CHF) can benefit from exercise rehabilitation (ER) with significant improvements in exercise capacity, quality of life and reduction in hospitalisations. Despite its reported benefits, only a small number of patients with CHF attend ER due to poor adherence, and improper (...) exercise may even lead to adverse events. Remote ECG monitoring system (REMS) has the potential to overcome these obstacles. We hypothesise that home-based cardiac ER using REMS in CHF patients is effective compared with conventional ER without monitoring.This study is a prospective, randomised, parallel controlled clinical trial designed to evaluate the effectiveness of home-based phase-II ER with REMS in the treatment of CHF with a target enrolment of 120 patients (left ventricular ejection fraction

2019 BMJ open Controlled trial quality: uncertain

166. Can laypeople identify a drug-induced QT interval prolongation? A psychophysical and eye-tracking experiment examining the ability of nonexperts to interpret an ECG. Full Text available with Trip Pro

Can laypeople identify a drug-induced QT interval prolongation? A psychophysical and eye-tracking experiment examining the ability of nonexperts to interpret an ECG. The study sought to quantify a layperson's ability to detect drug-induced QT interval prolongation on an electrocardiogram (ECG) and determine whether the presentation of the trace affects such detection.Thirty layperson participants took part in a psychophysical and eye-tracking experiment. Following training, participants (...) completed 21 experimental trials, in which each trial consisted of 2 ECGs (a baseline and a comparison stimulus, both with a heart rate of 60 beats/min). The experiment used a 1 alternative forced-choice paradigm, in which participants indicated whether or not they perceived a difference in the QT interval length between the 2 ECGs. The ECG trace was presented in 3 ways: a single complex with the signals aligned by the R wave, a single complex without alignment, and a 10-second rhythm strip. Performance

2019 Journal of the American Medical Informatics Association

167. mDixon ECG-gated 3-dimensional cardiovascular magnetic resonance angiography in patients with congenital cardiovascular disease. Full Text available with Trip Pro

mDixon ECG-gated 3-dimensional cardiovascular magnetic resonance angiography in patients with congenital cardiovascular disease. Cardiovascular magnetic resonance (CMR) angiography (CMRA) is an important non-invasive imaging tool for congenital heart disease (CHD) and aortopathy patients. The conventional 3D balanced steady-state free precession (bSSFP) sequence is often confounded by imaging artifacts. We sought to compare the respiratory navigated and electrocardiogram (ECG) gated modified (...) measurement in 6/192 (3%) and 4/192 (2%) of total vascular measurements for the mDixon and bSSFP, respectively. However, the size of signal void and field distortion were significantly worse in the latter, particularly for flow and metal induced artifacts.In patients with congenital heart disease, ECG gated mDixon angiography yields high fidelity vascular images including better delineation of head and neck vasculature and pulmonary veins and fewer artifacts than the comparable bSSFP sequence. It should

2019 Journal of Cardiovascular Magnetic Resonance

168. Effects of occupational exposure to dust on chest radiograph, pulmonary function, blood pressure and electrocardiogram among coal miners in an eastern province, China. Full Text available with Trip Pro

Effects of occupational exposure to dust on chest radiograph, pulmonary function, blood pressure and electrocardiogram among coal miners in an eastern province, China. Coal dust is one of the most serious risk factor that leads to respiratory diseases and cardiovascular diseases in miners. This study aimed to observe the effects of occupational dust exposure on chest radiograph, pulmonary function (PF), blood pressure (BP) and electrocardiogram (ECG) indexes in coal miners and explore (...) the related risk factors.In the Chinese Occupational Disease Monitoring and Occupational Health Risk Assessment Program, a total of 11,061 subjects in 2015 and 12,597 subjects in 2016 were recruited in this study. The chest radiograph, PF, BP and ECG of coal miners were surveyed using radiograph machine, spirometer, sphygmomanometer and electrocardiograph, respectively.The prevalence of aberrant BP was the highest in coal miners, followed by abnormal ECG, PF and radiograph. Significant differences

2019 BMC Public Health

169. Automated and Interpretable Patient ECG Profiles for Disease Detection, Tracking, and Discovery. Full Text available with Trip Pro

Automated and Interpretable Patient ECG Profiles for Disease Detection, Tracking, and Discovery. The ECG remains the most widely used diagnostic test for characterization of cardiac structure and electrical activity. We hypothesized that parallel advances in computing power, machine learning algorithms, and availability of large-scale data could substantially expand the clinical inferences derived from the ECG while at the same time preserving interpretability for medical decision-making.We (...) identified 36 186 ECGs from the University of California, San Francisco database that would enable training of models for estimation of cardiac structure or function or detection of disease. We segmented the ECG into standard component waveforms and intervals using a novel combination of convolutional neural networks and hidden Markov models and evaluated this segmentation by comparing resulting electrical intervals against 141 864 measurements produced during the clinical workflow. We then built

2019 Circulation. Cardiovascular quality and outcomes

170. Age and Sex Estimation Using Artificial Intelligence From Standard 12-Lead ECGs. Full Text available with Trip Pro

Age and Sex Estimation Using Artificial Intelligence From Standard 12-Lead ECGs. Sex and age have long been known to affect the ECG. Several biologic variables and anatomic factors may contribute to sex and age-related differences on the ECG. We hypothesized that a convolutional neural network (CNN) could be trained through a process called deep learning to predict a person's age and self-reported sex using only 12-lead ECG signals. We further hypothesized that discrepancies between CNN (...) -predicted age and chronological age may serve as a physiological measure of health.We trained CNNs using 10-second samples of 12-lead ECG signals from 499 727 patients to predict sex and age. The networks were tested on a separate cohort of 275 056 patients. Subsequently, 100 randomly selected patients with multiple ECGs over the course of decades were identified to assess within-individual accuracy of CNN age estimation.Of 275 056 patients tested, 52% were males and mean age was 58.6±16.2 years

2019 Circulation. Arrhythmia and electrophysiology

171. Ambulatory ECG monitoring in the age of smartphones. Full Text available with Trip Pro

Ambulatory ECG monitoring in the age of smartphones. Ambulatory electrocardiography (ECG) allows for extended monitoring of arrhythmias in a real-world setting. This article reviews the currently available ambulatory ECG devices and their differences in design, function, indications, efficacy, cost, and optimal use in clinical practice.Copyright © 2019 Cleveland Clinic.

2019 Cleveland Clinic Journal of Medicine

172. Assessment of the ECG T-Wave in Patients With Subarachnoid Hemorrhage. (Abstract)

Assessment of the ECG T-Wave in Patients With Subarachnoid Hemorrhage. Prolongation of the interval from the peak to the end of the T wave (Tp-Te) on a 12-lead electrocardiogram (ECG) is associated with ventricular arrhythmias. The aim of this study was to clarify associations between Tp-Te, Tp-Te/QT, and Tp-Te/rate-corrected QT (QTc) with clinical severity of subarachnoid hemorrhage (SAH) and clinical outcomes.This retrospective study included 222 patients with acute SAH (group S) and 306 (...) patients with unruptured cerebral aneurysms (group U). Tp-Te, Tp-Te/QT, and Tp-Te/QTc were manually measured in standard 12-lead ECG recordings on admission and comparisons made between patients in groups S and U. The relationships of these ECG parameters with Hunt and Hess grade and Glasgow outcome scale were analyzed using multiple logistic regression analysis after adjustment for confounding factors.Tp-Te, Tp-Te/QT, and Tp-Te/QTc were significantly greater in group S than in group U (group S: 109±30

2019 Journal of neurosurgical anesthesiology

173. Economic evaluation of prolonged and enhanced ECG Holter monitoring in acute ischemic stroke patients. (Abstract)

Economic evaluation of prolonged and enhanced ECG Holter monitoring in acute ischemic stroke patients. Objective: Atrial fibrillation (AF) is a major cause for recurrent stroke, has severe impact on a patient's health and imposes a high economic burden for society. Current guidelines recommend 24 h ECG monitoring (standard-of-care, SoC) to detect AF after stroke to reduce the risk of future events. However, paroxysmal AF (PAF) is difficult to detect within this period as it occurs infrequently (...) and unpredictably. In a randomized controlled trial (Find-AFRANDOMISED), prolonged and enhanced Holter ECG monitoring (EPM) revealed a significantly higher detection rate of AF compared to SoC, although its cost-effectiveness has not yet been investigated. Methods: Based on the data of FIND-AFRANDOMISED, an economic evaluation was conducted. One group received EPM for 10 days after the event, and at 3 and 6 months; the other group received SoC. Healthcare resource use and quality of life (QoL) data were

2019 Current medical research and opinion Controlled trial quality: uncertain

174. ECG pre-hospital teletransmission by emergency teams staffed with an emergency physician and paramedics and its impact on transportation and hospital admission. Full Text available with Trip Pro

ECG pre-hospital teletransmission by emergency teams staffed with an emergency physician and paramedics and its impact on transportation and hospital admission. Electrocardiography (ECG) is essential to detect and diagnose life threatening cardiac conditions and to determine further treatment. Correct interpretation of an ECG can be challenging, especially in the out-of-hospital setting and by less experienced emergency team members.The aim of this study was to compare the rate of ECG (...) performed during a 12-month period and were analyzed for this study.In 124 out of 5864 (2.1%) out-of-hospital emergencies, an ECG transmission from the out-of-hospital scene to an in-hospital cardiologist on call was performed. Rate of transmission was similar between both teams (EMT-B n = 70, 2.2% vs EMT-S n = 54, 2.0%, P = .054). After coordinating with the cardiologist on call, 11 patients (15.7%) of the EMT-B (15.7%) and 24 patients (44.4%) of the EMT-S were directly transported from the scene

2019 Medicine

175. Electrocardiographic predictors of adverse in-hospital outcomes in the Takotsubo syndrome. (Abstract)

Electrocardiographic predictors of adverse in-hospital outcomes in the Takotsubo syndrome. Takotsubo syndrome (TS) is a life-threatening acute heart failure syndrome. However, little is known about risk factors for worse outcomes in TS and no high-risk ECG criteria have been defined. We sought to identify ECG predictors of life-threatening in-hospital complications in TS.Using the nationwide Swedish Angiography and Angioplasty Registry (SCAAR) we obtained data on all consecutive patients (...) undergoing coronary angiography at Sahlgrenska University Hospital between June 2008 and February 2019. For all patients with TS we conducted in-depth chart reviews to confirm the TS diagnosis. For those with confirmed TS we then evaluated all ECGs obtained during the index hospitalization. The primary endpoint was the occurrence of in-hospital major adverse cardiac event (MACE), defined as the composite of death, ventricular tachycardia or fibrillation (VT/VF), or atrioventricular block ≥2 or asystole

2019 International journal of cardiology

176. Incidental abnormal ECG findings and long-term cardiovascular morbidity and all-cause mortality: A population based prospective study. (Abstract)

Incidental abnormal ECG findings and long-term cardiovascular morbidity and all-cause mortality: A population based prospective study. The additional prognostic value of resting electrocardiogram (ECG) in long-term cardiovascular disease (CVD)-risk-assessment is unclear. We evaluated the association of incidental abnormal ECG findings with long-term CVD-risk and all-cause mortality, and assessed the additional prognostic value of ECG as a screening tool in adults without known CVD.A cohort (...) of 2601 Israeli men and women without known CVD were actively followed from 1976 to 1982 for 23-year cumulative CVD-incidence, and until May 2017 for all-cause mortality. At baseline and follow-up, participants underwent interviews, physical examinations, blood tests and ECG.At baseline, 1199 (46.1%) had incidental abnormal ECG findings (exposed-group). CVD cumulative incidence reached 31.6% among the 930 survivors who participated in the active follow-up (294/930). During a 31-year median follow-up

2019 International journal of cardiology

177. Clinical outcomes of discordant exercise electrocardiographic and echocardiographic findings compared with concordant findings in patients with chest pain and no history of coronary artery disease: An observational study. Full Text available with Trip Pro

Clinical outcomes of discordant exercise electrocardiographic and echocardiographic findings compared with concordant findings in patients with chest pain and no history of coronary artery disease: An observational study. The aim of this study was to evaluate comparative clinical outcomes of discordant electrocardiographic (ECG) and echocardiographic (Echo) findings compared with concordant findings during treadmill exercise echocardiography in patients with chest pain and no history (...) of coronary artery disease (CAD).A total of 1725 consecutive patients who underwent treadmill echocardiography with chest pain and no history of CAD were screened. The patients were classified into 4 groups: ECG-/Echo- (negative ECG and Echo), ECG+/Echo- (positive ECG and negative Echo), ECG-/Echo+, and ECG+/Echo+. Concomitant CAD was determined using coronary angiography or coronary computed tomography. Major adverse cardiac events (MACEs) were defined as a composite of coronary revascularization, acute

2019 Medicine

178. Predictive risk stratification using HEART (history, electrocardiogram, age, risk factors, and initial troponin) and TIMI (thrombolysis in myocardial infarction) scores in non-high risk chest pain patients: An African American urban community based hospit Full Text available with Trip Pro

Predictive risk stratification using HEART (history, electrocardiogram, age, risk factors, and initial troponin) and TIMI (thrombolysis in myocardial infarction) scores in non-high risk chest pain patients: An African American urban community based hospit Validated risk scoring systems in African American (AA) population are under studied. We utilized history, electrocardiogram, age, risk factors, and initial troponin (HEART) and thrombolysis in myocardial infarction (TIMI) scores to predict

2019 Medicine

179. The effect of revascularization of a chronic total coronary occlusion on electrocardiographic variables. A sub-study of the EXPLORE trial. Full Text available with Trip Pro

The effect of revascularization of a chronic total coronary occlusion on electrocardiographic variables. A sub-study of the EXPLORE trial. Chronic total coronary occlusions (CTOs) have been associated with a higher prevalence of ventricular arrhythmias compared to patients without a CTO. We evaluated the effect of CTO revascularization on electrocardiographic (ECG) variables.We studied a selection of ST-elevation myocardial infarction patients with a concomitant CTO enrolled in the EXPLORE (...) trial. ECG variables and cardiac function were analysed at baseline and at 4 months follow-up.Patients were randomized to percutaneous coronary intervention (PCI) of their CTO (n = 77) or to no-CTO PCI (n = 81). At follow-up, median QT dispersion was significantly lower in the CTO PCI group compared to the no-CTO PCI group (46 ms [33-58] vs. 54 ms [37-68], P = 0.043). No independent association was observed between ECG variables and cardiac function.Revascularization of a CTO after STEMI

2019 Journal of electrocardiology Controlled trial quality: uncertain

180. Orderly display of limb lead ECGs raises Chinese intern's diagnostic accuracy when determining frontal plane QRS axis. Full Text available with Trip Pro

Orderly display of limb lead ECGs raises Chinese intern's diagnostic accuracy when determining frontal plane QRS axis. There is limited information on whether the orderly display of limb lead ECGs (electrocardiograms) can facilitate students to determine frontal plane QRS complex wave electrical axis.The study investigated whether the orderly display of limb lead ECGs can raise Chinese undergraduate intern's diagnostic accuracy when determining frontal plane axis.A total of 147 fifth-year (...) undergraduate interns aged between 21 and 25 years were randomly arranged into 2 groups: one group was given classically displayed ECGs of limb leads while the other group was given orderly displayed ECGs of limb leads. They were then taught to determine frontal plane axis with one of the above displays. The intern's diagnostic accuracy and time used were measured.After teaching, the orderly display can more effectively raise diagnostic accuracy when determining axis as compared to the classical display

2019 Medical education online Controlled trial quality: uncertain

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