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ECG Monitoring (ecg + monitoring)

Distribution by Scientific Domains

Medical Sciences	100%

Kinds of ECG Monitoring

holter ecg monitoring

Selected Abstracts

Repeatability of Sleep Apnea Detection in 48-Hour Holter ECG Monitoring

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2010
Barbara Uzna, ska M.D.
Background: There is a significant relationship between obstructive sleep apnea (OSA) and cardiovascular diseases. Reliability of new methods evaluating apnea in Holter ECG monitoring is still the matter of investigators' studies. Methods: In 48-hour Holter ECG monitoring recordings of 63 patients, we assessed repeatability, comparing the results from both sleep periods. Results: We found good repeatability in evaluation of apnea-hypopnea index value. There was moderate agreement in three categories, that is, normal or bordeline or apneic assignment. Assignment to "healthy" (normal and borderline) or apneic subgroup during consecutive sleep periods showed high repeatability. Conclusions: Holter ECG monitoring is a repetitive method of preliminary diagnosis in patients evaluated for sleep apnea syndrome. Ann Noninvasive Electrocardiol 2010;15(3):218,222 [source]

Continuous Electrocardiographic Monitoring and Cardiac Arrest Outcomes in 8,932 Telemetry Ward Patients

ACADEMIC EMERGENCY MEDICINE, Issue 6 2000
Michael J. Schull MD
Abstract. Objective: To estimate the benefit of routine electrocardiographic (ECG) telemetry monitoring on in-hospital cardiac arrest survival. Methods: In a tertiary care hospital, all telemetry ward admissions and cardiac arrests occurring over a five-year period were reviewed. Ward location and survival to discharge were determined for all patients outside of critical care areas. Results: During the study period, 8,932 patients were admitted to the telemetry ward, and 20 suffered cardiac arrest (0.2%; 95% CI = 0.1 to 0.3). Telemetry monitors signaled the onset of cardiac arrest in only 56% (95% CI = 30 to 80) of monitored arrests. Three patients survived to discharge, and in two of these three patients the arrest onset was signaled by the monitor. This yields a monitor-signaled survival rate among telemetry ward patients of 0.02% (95% CI = 0 to 0.05). All survivors suffered significant arrhythmias prior to their cardiac arrests. Conclusions: Cardiac arrest is an uncommon event among telemetry ward patients, and monitor-signaled survivors are extremely rare. Routine telemetry offers little cardiac arrest survival benefit to most monitored patients, and a more selective policy for telemetry use might safely avoid ECG monitoring for many patients. [source]

Benefit of Pacing and Beta-Blockers in Idiopathic Repetitive Polymorphic Ventricular Tachycardia

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 11 2001
NICASIO PÉREZ-CASTELLANO M.D.
Pacing and Beta-Blockers in Repetitive Polymorphic VT. An 18-year-old woman presented with recurrent exercise-induced syncopal episodes and severe systolic dysfunction. ECG monitoring disclosed repetitive polymorphic ventricular complexes, paroxysms of bidirectional ventricular tachycardia, and nonsustained bursts of slow polymorphic ventricular tachycardia that increased in length and rate during exercise. Ventricular arrhythmias were refractory to medical treatment, which included verapamil and beta-blockers. Addition of permanent atrial pacing to beta-blocker therapy suppressed the arrhythmias and reversed systolic impairment in the following months. [source]

An introduction to electrocardiogram monitoring

NURSING IN CRITICAL CARE, Issue 1 2010
Phil Jevon
The aim of this paper is to provide an introduction to electrocardiogram (ECG) monitoring. The objectives are to: ,define an ECG; ,describe how the ECG relates to cardiac contraction, with specific reference to the conduction system of the heart; ,recognize sinus rhythm; ,list the indications for ECG monitoring; ,discuss the important features of a modern bedside cardiac monitor; ,describe where to position ECG electrodes; ,outline a suggested procedure for ECG monitoring; ,discuss the infection control issues related to ECG monitoring. [source]

Challenges of Diagnosis of Long-QT Syndrome in Children

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2007
EWA MORIC-JANISZEWSKA Ph.D.
We describe the clinical and genetic characteristics of the family, in which the diagnosis of LQT1 had been made. The electrocardiogram (ECG) characteristics of this patient indicated the likelihood of LQTS1. Polymorphic ventricular extrasystolies and episodes of polymorphic non-sustained ventricular tachycardia were confirmed by Holter ECG monitoring. On the exertional electrocardiogram polymorphic ventricular tachycardia (torsade de pointes) was recorded. Direct sequencing of both DNA strands revealed the absence of mutations or polymorphisms in the KCNQ1, HERG, and SCN5A genes. [source]

Increased Ventricular Ectopic Activity in Relation to C-Reactive Protein, and NT-Pro-Brain Natriuretic Peptide in Subjects With No Apparent Heart Disease

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2006
AHMAD SAJADIEH M.D.
Background: Subjects with frequent ventricular premature complexes (VPC) and no apparent heart disease make a heterogenic group with regard to prognosis. Some biomarkers have recently proved useful in risk stratification in different heart diseases. We examined prognostic impact of NT-Pro-brain natriuretic peptide (NT-Pro BNP), and C-reactive protein (CRP) in relation to frequent VPC in subjects with no apparent heart disease. Methods: Six hundred seventy-eight healthy subjects between 55 and 75 years of age with no history of cardiovascular disease were included in the study. All were tested with fasting laboratory testing and 48-hour ambulatory ECG monitoring. Frequent VPC was defined as VPC ,30/hour. Results: In 56 subjects (8%) with frequent VPC the prognosis was much poorer compared to those without frequent VPC (Hazard ratio and 95% CI: 2.3;1.2,4.4, P = 0.01), after adjustment for conventional risk factors. In subjects with frequent VPC increased levels of CRP (above 2.5 ,g/mL) was the only factor among the tested biomarkers, which was associated with a poor prognosis. Taking subjects without frequent VPC as reference, the hazard ratio and 95% CI for subjects with frequent VPC and increased CRP was 3.6;1.8,7.1, P = 0.0004, and for those with frequent VPC and normal CRP 0.8;0.2,3.5, P = 0.83, after correction for conventional risk factors. Conclusions: Among middle-aged and elderly subjects with no apparent heart disease and frequent VPCs, a CRP value ,2.5 ,g/mL is associated with a significantly higher risk of death and acute myocardial infarction. These subjects deserve primary prevention measures and further work up for structural heart disease. [source]

Feasibility of Spinal Cord Stimulation in Angina Pectoris in Patients with Chronic Pacemaker Treatment for Cardiac Arrhythmias

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2003
OLOF EKRE
Spinal cord stimulation (SCS) has been used since 1985 as additional symptom-relieving treatment for patients with severe angina pectoris despite optimal conventional medical and invasive treatment. SCS has antiischemic effects and is safe and effective in long-term use. Several patients with coronary artery disease also suffer from disorders that necessitate the use of a cardiac permanent pacemaker (PPM). The combination of SCS and PPM has previously been considered hazardous because of possible false inhibition of the PPM. To assess if thoracic SCS and PPM can be safely combined in patients with refractory angina pectoris, 18 patients treated with both SCS and PPM were tested. The PPM settings were temporarily modified to increase the probability of interference, while the SCS intensity (used in bipolar mode) was increased to the maximum level tolerated by the patient. Any sign of inhibition of the ventricular pacing was recorded by continuous ECG monitoring. With the aid of a questionnaire, symptoms of interference during long-term treatment were evaluated. No patient had signs of inhibition during the tests. Reprogramming of the pacemaker because of the test results was not needed in any of the patients. The long-term follow-up data revealed no serious events. This study indicates that bipolar SCS and PPM can be safely combined in patients with refractory angina pectoris. However, individual testing is mandatory to ascertain safety in each patient. A testing procedure for patients in need of SCS and PPM is suggested in this article. (PACE 2003; 26:2134,2141) [source]

Sudden Cardiac Death with Left Main Coronary Artery Occlusion in a Patient Whose Presenting ECG Suggested Brugada Syndrome

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 11 2003
TADAYOSHI HATA
This article describes a patient who died suddenly during Holter ECG monitoring. A ventricular premature systole with an extremely short coupling interval of 240 ms was immediately followed by torsades de pointes, soon degenerating into ventricular fibrillation. Retrospective survey of the patient's medical records revealed an incomplete right bundle branch block (iRBBB) configuration with fluctuating saddle back-type ST elevation in leads V1 and V2, these suggesting Brugada syndrome. Autopsy showed complete thrombotic occlusion of the left main coronary artery. (PACE 2003; 26:2175,2177) [source]

Repeatability of Sleep Apnea Detection in 48-Hour Holter ECG Monitoring

Automatic Extraction of ECG Strips from Continuous 12-lead Holter Recordings for QT Analysis at Prescheduled versus Optimized Time Points

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2009
Fabio Badilini Ph.D.
Background: Continuous 12-lead ECG monitoring (Holter) in early-phase pharmaceutical studies is today widely used as an ideal platform to extract discrete ECGs for analysis. The extraction process is typically performed manually by trained readers using commercial Holter processing systems. Methods: Antares, a novel method for automatic 12-lead extraction from continuous Holter recordings applying minimal noise criteria and heart-rate stability conditions is presented. A set of 12-lead Holter recordings from healthy subjects administered with sotalol is used to compare ECG extractions at fixed time points with ECG extractions generated by Antares optimizing noise and heart rate inside 5 minute windows centered around each expected time point of interest. Results: Global, low- and high-frequency noise content of extracted ECGs was significantly reduced via optimized approach by Antares. Heart rate was also slightly reduced (from 69 ± 13 to 64 ± 13 bpm, P < 0.05). Similarly, the corrected QT interval from optimized extractions was significantly reduced (QTcB from 414 ± 32 to 402 ± 30 ms, P < 0.05). Using only baseline data, and after adjusting for intersubject variability, the standard deviation (SD) of QT intervals was highly reduced with optimized extraction (SD of QTcF from 11 ± 8 to 7 ± 2 ms, P < 0.05). Conclusions: Extraction of discrete 12-lead ECG strips from continuous Holter generates less noisy and more stable ECGs leading to more robust QTc data, thereby potentially facilitating the assessment of ECG effects on clinical trials. [source]

Observer Variability and Optimal Criteria of Transient Ischemia During ST Monitoring with Continuous 12-lead ECG

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2002
Ph.D., Tomas Jernberg M.D.
Background: ST monitoring with continuous 12-lead ECG is a well-established method in patients with unstable coronary artery disease (CAD). However, the method lacks documentation on optimal criteria for episodes of transient ischemia and on observer variability. Methods: Observer variability was evaluated in 24-hour recordings from 100 patients with unstable CAD with monitoring in the coronary care unit. Influence on ST changes by variations in body position were evaluated by monitoring 50 patients in different body positions. Different criteria of transient ischemia and their predictive importance were evaluated in 630 patients with unstable CAD who underwent 12 hours of monitoring and thereafter were followed for 1 to 13 months. Two sets of criteria were tested: (1) ST deviation , 0.1 mV for at least 1 minute, and (2) ST depression , 0.05 mV or elevation , 0.1 mV for at least 1 minute. Results: When the first set of criteria were used, the interobserver agreement was good (kappa = 0.72) and 8 (16%) had significant ST changes in at least one body position. Out of 100 patients with symptoms suggestive of unstable CAD and such ischemia, 24 (24%) had a cardiac event during follow-up. When the second set of criteria were used, the interobserver agreement was poor (kappa = 0.32) and 21(42%) had significant ST changes in at least one body position. Patients fulfilling the second but not the first set of criteria did not have a higher risk of cardiac event than those without transient ischemia (5.3 vs 4.3%). Conclusions: During 12-lead ECG monitoring, transient ischemic episodes should be defined as ST deviations , 0.1 mV for at least 1 minute, based on a low observer variability, minor problems with postural ST changes and an important predictive value. A.N.E. 2002;7(3):181,190 [source]

Evaluation of Patients with Palpitations: Cardiac Event Recorder Versus 48-hour Holter Monitoring

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 4 2000
Ewa Makowska M.D.
Objectives: (1) To compare a diagnostic yield of cardiac event recorders with that of 48-hour Holler monitoring, (2) to determine the etiologies of palpitations, and (3) to assess an optimal duration of using an event recorder by a patient. Background: Palpitation is a common symptom which accounts for 16% of total complaints reported by patients in general medical settings. An ambulatory Holter ECG monitoring or an event recorder can be used to establish the cause of palpitations. Methods: (1)The study group consisted of 33 consecutive patients (24 females, 9 males, mean age 50 ± 32 years) with undiagnosed attacks of palpitations, occurring at least once per month. Each patient was randomly allocated to use either an event monitor or 48-hour Holler monitoring. The patient kept the event monitor for 4 weeks. After the first monitor was returned, the patient was given the other device. Results: Holter monitoring determined the etiology of palpitations in 11 (33%) patients, and the event recorder in 21 (64%) patients (P = 0.0138). In the whole study group, the etiology of palpitations was disclosed in 23 (70%) patients. The diagnosis was possible using Holler ECG monitoring in only 2 (9%) patients, whereas the event recorder revealed the underlying mechanism of palpitations in 12 (52%) patients (P = 0.0007). In nine (39%) patients both methods were able to disclose the eliology of palpitations. The findings of 117 recordings obtained using an event recorder during palpitations were atrial fibrillation in 10 (9%), narrow QRS tachycardia in 4 (3%), frequent supraventricular eclopy in 17 (15%), frequent ventricular eclopy in 6 (5%), and episodes of palpitations sinus rhythm were recorded in the remaining 80 (68%). Of patients who experienced episodes of palpitations while using an event recorder, the earliest recording was obtained on the first day of the study, and the latest on the 18 day of using the event recorder. Conclusions: (1) The cardiac event recorders yield more diagnoses than 48-hour Holter monitoring in patients with palpitations occurring at least once per month, (2) in this group of patients the event recorder provided a diagnostic ECG recording during the first 18 days of using the device, and (3) in the majority (57%) of patients a normal sinus rhythm was recorded during episodes of palpitations. A.N.E. 2000;5(4):315,321 [source]

P-P Cycle Alternans During Atrial Tachycardia:

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2000
A Manifestation of Longitudinal Dissociation Within the Atrial Reentry Circuit
Background: A-63 year-old man complaining of palpitations underwent a 24-hour ambulatory ECG monitoring that revealed the presence of recurrent episodes of nonsustained supraventricular tachycardia. Analysis of the tracings suggests an atrial origin of the arrhythmia. Tachycardias, quite regular at the beginning, suddenly showed a P-P cycle alternans, namely, P-P intervals alternately short and long. The evidence of two separate cycle ranges can be explained by the presence of a longitudinal dissociation within a discrete zone of the atrial circuit. [source]