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Latest & greatest articles for Electrocardiogram
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Prognosis of unrecognised myocardial infarction determined by electrocardiography or cardiac magnetic resonance imaging: systematic review and meta-analysis. To evaluate the prognosis of unrecognised myocardial infarction determined by electrocardiography (UMI-ECG) or cardiac magnetic resonance imaging (UMI-CMR).Systematic review and meta-analysis of prospective studies.Electronic databases, including PubMed, Embase, and Google Scholar.Prospective cohort studies were included if they reported (...) adjusted relative risks, odds ratios, or hazard ratios and 95% confidence intervals for all cause mortality or cardiovascular outcomes in participants with unrecognised myocardial infarction compared with those without myocardial infarction.The primary outcomes were composite major adverse cardiac events, all cause mortality, and cardiovascular mortality associated with UMI-ECG and UMI-CMR. The secondary outcomes were the risks of recurrent coronary heart disease or myocardial infarction, stroke, heart
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
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
Predicting sudden cardiac death in a general population using an electrocardiographic risk score We investigated whether combining several ECG abnormalities would identify general population subjects with a high sudden cardiac death (SCD) risk.In a sample of 6830 participants (mean age 51.2±13.9 years; 45.5% male) in the Mini-Finland Health Survey, a general population cohort representative of the Finnish adults aged ≥30 years conducted in 1978-1980, we examined their ECGs, following subjects (...) for 24.3±10.4 years. We analysed the association between individual ECG abnormalities and 10-year SCD risk and developed a risk score using five ECG abnormalities independently associated with SCD risk: heart rate >80 beats per minute, PR duration >220 ms, QRS duration >110 ms, left ventricular hypertrophy and T-wave inversion. We validated the score using an external general population cohort of 10 617 subjects (mean age 44.0±8.5 years; 52.7% male).No ECG abnormalities were present in 4563 subjects
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
fibrillation using machine learning.We developed an artificial intelligence (AI)-enabled electrocardiograph (ECG) using a convolutional neural network to detect the electrocardiographic signature of atrial fibrillation present during normal sinus rhythm using standard 10-second, 12-lead ECGs. We included all patients aged 18 years or older with at least one digital, normal sinus rhythm, standard 10-second, 12-lead ECG acquired in the supine position at the Mayo Clinic ECG laboratory between Dec 31, 1993 (...) An artificial intelligence-enabled ECG algorithm for the identification of patients with atrial fibrillation during sinus rhythm: a retrospective analysis of outcome prediction. Atrial fibrillation is frequently asymptomatic and thus underdetected but is associated with stroke, heart failure, and death. Existing screening methods require prolonged monitoring and are limited by cost and low yield. We aimed to develop a rapid, inexpensive, point-of-care means of identifying patients with atrial
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
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
A novel electrocardiographic parameter for diagnosis of acute pulmonary embolism: RS time: RS time in acute pulmonary embolism Pulmonary embolism (PE) is one of the leading causes of cardiovascular mortality worldwide. Electrocardiography (ECG) may provide useful information for patients with acute PE. In this study, we aimed to investigate the diagnostic value of the QRS duration and RS time in inferolateral leads in patients admitted to the emergency department, and pre-diagnosed with acute (...) PE.We retrospectively enrolled 136 consecutive patients, admitted to the emergency department, pre-diagnosed with the clinical suspicion of acute PE, and underwent computerized tomographic pulmonary angiography (CTPA) to confirm the PE diagnosis. The study subjects were divided into two groups according to the presence or absence of PE, and the independent predictors of PE were investigated.Sixty-eight patients (50%) had PE. Patients with PE had a longer RS time. Among the ECG parameters, only RS
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
Randomised study comparing heart rate measurement in newly born infants using a monitor incorporating electrocardiogram and pulse oximeter versus pulse oximeter alone To determine whether IntelliVue (ECG plus Masimo pulse oximeter (PO)) measures heart rate (HR) in low-risk newborns more quickly than Nellcor PO (PO alone).Unmasked parallel group randomised (1:1) study.We studied 100 infants, 47 randomised to IntelliVue, 53 to Nellcor. Time to first HR was shorter with IntelliVue ECG than Nellcor (...) (median (IQR) 24 (19, 39) vs 48 (36, 69) s, p<0.001). There was no difference in time to display both HR and SpO2 (52 (47, 76) vs 48 (36, 69) s, p=0.507). IntelliVue PO displayed initial bradycardia more often than the Nellcor (55% vs 6%). Infants monitored with IntelliVue were handled more frequently and for longer.IntelliVue ECG displayed HR more quickly than Nellcor PO. IntelliVue PO often displayed initial bradycardia. Infants monitored with IntelliVue were handled more often. Study of ECG in high
and these differences can be detected by electrocardiography (ECG). Methods: Electrocardiographic data from spontaneous type 1 and non-type 1 BrS patients were analyzed. ECG parameters were measured from leads V1 to V3. Values were expressed as median [lower quartile-upper quartile] and compared using Kruskal-Wallis ANOVA. Results: Compared to non-type 1 BrS patients (n = 29), patients with spontaneous type 1 patterns (n = 22) showed similar (P > 0.05) heart rate (73 [64-77] vs. 68 [62-80] bpm), QRS duration (136 (...) Higher Dispersion Measures of Conduction and Repolarization in Type 1 Compared to Non-type 1 Brugada Syndrome Patients: An Electrocardiographic Study From a Single Center Background: Brugada syndrome (BrS) is a cardiac ion channelopathy that predisposes affected individuals to sudden cardiac death (SCD). Type 1 BrS is thought to take a more malignant clinical course than non-type 1 BrS. We hypothesized that the degrees of abnormal repolarization and conduction are greater in type 1 subjects
have a stroke associated with atrial fibrillation are first diagnosed with atrial fibrillation at the time of stroke or shortly thereafter.To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for atrial fibrillation with electrocardiography (ECG).The USPSTF reviewed the evidence on the benefits and harms of screening for atrial fibrillation with ECG in adults 65 years and older, the effectiveness of screening with ECG for detecting previously undiagnosed atrial (...) Screening for Atrial Fibrillation With Electrocardiography: US Preventive Services Task Force Recommendation Statement. Atrial fibrillation is the most common type of cardiac arrhythmia (irregular heartbeat), and its prevalence increases with age, affecting about 3% of men and 2% of women aged 65 to 69 years and about 10% of adults 85 years and older. Atrial fibrillation is a major risk factor for ischemic stroke, increasing risk of stroke by as much as 5-fold. Approximately 20% of patients who
Effects of intra-resuscitation antiarrhythmic administration on rearrest occurrence and intra-resuscitation ECG characteristics in the ROC ALPS trial Intra-resuscitation antiarrhythmic drugs may improve resuscitation outcomes, in part by avoiding rearrest, a condition associated with poor out-of-hospital cardiac arrest (OHCA) outcomes. However, antiarrhythmics may also alter defibrillation threshold. The objective of this study was to investigate the relationship between rearrest and intra (...) spectrum area, median slope, and centroid frequency of the ventricular fibrillation (VF) ECG were calculated and compared across treatment groups.A total of 1144 (40.4%) cases with study drug prior to first ROSC were included. Rearrest rate was 44.0% overall; 42.9% for placebo, 45.7% for lidocaine, and 43.0% for amiodarone. In multivariable logistic regression models, ALPS treatment group was not associated with rearrest, though rearrest was associated with poor survival and neurologic outcomes. AMSA
Effect of a Home-Based Wearable Continuous ECG Monitoring Patch on Detection of Undiagnosed Atrial Fibrillation: The mSToPS Randomized Clinical Trial. Opportunistic screening for atrial fibrillation (AF) is recommended, and improved methods of early identification could allow for the initiation of appropriate therapies to prevent the adverse health outcomes associated with AF.To determine the effect of a self-applied wearable electrocardiogram (ECG) patch in detecting AF and the clinical (...) study, 2 deidentified age-, sex- and CHA2DS2-VASc-matched controls were selected for each actively monitored individual.The actively monitored cohort wore a self-applied continuous ECG monitoring patch at home during routine activities for up to 4 weeks, initiated either immediately after enrolling (n = 1364) or delayed for 4 months after enrollment (n = 1291).The primary end point was the incidence of a new diagnosis of AF at 4 months among those randomized to immediate monitoring vs delayed
Peguero Electrocardiographic Left Ventricular Hypertrophy Criteria and Risk of Mortality Background: Peguero electrocardiographic left ventricular hypertrophy (ECG-LVH) criteria are newly developed criteria that have shown better diagnostic performance than the traditional Cornell-voltage and Sokolow-Lyon criteria. However, prediction of poor outcomes rather than detection of increased left ventricular mass is becoming the primary use for ECG-LVH criteria which requires investigating any new (...) ECG-LVH criteria in terms of prediction. Aims: To examine the prognostic significance of the newly developed Peguero ECG-LVH criteria. Methods: We compared the prognostic significance of Peguero ECG-LVH with Cornell-voltage and Sokolow-Lyon ECG-LVH criteria in 7,825 participants (age 59.8 ± 13.4 years; 52.7% women) from the third National Health and Nutrition Examination Survey who were free of major intraventricular conduction defects. ECG-LVH criteria were derived from digital ECG tracings