Background There are limited data on the prevalence of electrocardiographic (ECG) abnormalities, and their value for predicting a major adverse cardiovascular event (MACE) in patients at high cardiovascular risk. This...Background There are limited data on the prevalence of electrocardiographic (ECG) abnormalities, and their value for predicting a major adverse cardiovascular event (MACE) in patients at high cardiovascular risk. This study aimed to determine the prevalence of ECG abnormalities in patients at high risk for cardiovascular events, and to identify ECG abnormalities that significantly predict MACE. Methods Patients aged ≥ 45 years with established atherosclerotic disease (EAD) were consecutively enrolled from the outpatient clinics of the six participating hospitals during April 2011 to March 2014. The following data were collected: demographic data, cardiovascular risk factors, history of cardiovascular event, physical examination, ECG and medications. ECG was analyzed using Minnesota Code criteria. MACE included cardiovascular death, non-fatal myocardial infarction, and hospitalization due to unstable angina or heart failure. Results A total of 2009 patients were included, 1048 patients (52.2%) had established EAD, and 961 patients (47.8%) had multiple risk factors (MRF). ECG abnormalities included atrial fibrillation (6.7%), premature ventricular contraction (5.4%), pathological Q-wave (Q/QS)(21.3%), T-wave inversion (20.0%), intraventricular ventricular conduction delay (IVCD)(7.3%), left ventricular hypertrophy (LVH)(12.2%), and AV block (12.5%). MACE occurred in 88 patients (4.4%). Independent predictors of MACE were chronic kidney disease, EAD, and the presence of atrial fibrillation, Q/QS, IVCD or LVH by ECG. Conclusions A high prevalence of ECG abnormalities was found. The prevalence of ECG abnormalities was high even among those with risk factors without documented cardiovascular disease.展开更多
As a result of research, high prevalence of arterial hypertension has been identified in the group of patients with coronary heart disease aged 60 and older. Most often, occurring form of arterial hypertension among g...As a result of research, high prevalence of arterial hypertension has been identified in the group of patients with coronary heart disease aged 60 and older. Most often, occurring form of arterial hypertension among geriatric patients is isolated systolic arterial hypertension (ISAH). The comparison of two ethnic groups of the population has showed higher levels of systolic and diastolic blood pressure (SBP and DBP) in the group of patients of non-indigenous nationality, rather than Yakut patients. Correlation was recorded in the group of non-indigenous patients as they age. Significant increase in the level of SBP was identified in the group of senile and long-livers than in the elderly. Detection of ECG signs of LVH showed the lowest specificity of Cornell voltage criterion comparing to Sokolow-Lyon criterion with its more often occurrence. ECG-signs of left ventricle hypertrophy are significantly more often established by Sokolow-Lyon criterion for men, Cornell voltage—for women. Correlation has been found between the presence of LVH and combination of Cornell voltage criterion with both Gubner-Ungerleider and Sokolow-Lyon criteria.展开更多
AIMTo investigate validity of electrocardiographic(ECG)criteria for left ventricular hypertrophy(LVH)in young adults.METHODS Retrospectively,echocardiograms showing LVH and concomitant electrocardiograms were collecte...AIMTo investigate validity of electrocardiographic(ECG)criteria for left ventricular hypertrophy(LVH)in young adults.METHODS Retrospectively,echocardiograms showing LVH and concomitant electrocardiograms were collected in patients 18 to 39 years old.A control group of patients without LVH was collected.Using echocardiogram as the gold standard,electrocardiograms were analyzed using common voltage criteria.RESULTS Study included 100 subjects(52%male,mean age=28±6.8 years,96%Hispanic or African-American)with 50%LVH prevalence.Sensitivity and specificity for SokolowLyon criteria were 24%(95%CI:13.5%-38.4%)and 88%(95%CI:74.9%-95%).For Cornell criteria,sensitivity was 32%(95%CI:19.9%-46.8%)and specificity 98%(95%CI:87.9%-99.8%).For R in a VL criteria,sensitivity was 12%(95%CI:4.9%-25%)and specificity 100%(95%CI:91.1%-100%).CONCLUSION In young adults common ECG voltage criteria have low sensitivities and high specificities similar to other age groups.Low sensitivities preclude these ECG criteria from serving as effective screening tests.展开更多
The increase in health care costs is not sustainable and has heightened the need for innovative low cost effective strategies for delivering patient care.Remote monitoring holds great promise for preventing or shorten...The increase in health care costs is not sustainable and has heightened the need for innovative low cost effective strategies for delivering patient care.Remote monitoring holds great promise for preventing or shortening duration of hospitalization even while improving quality of care.We therefore conducted a proof of concept study to examine the quality of electrocardiograph(ECG)recordings obtained remotely and to test its potential utility in detecting harmful rhythms such as atrial fibrillation.We tested a novel adhesive strip ECG monitor and assessed the ECG quality in ambulatory individuals.2630 ECG strips were analyzed and classified as:Sinus,atrial fibrillation(AF),indeterminate,or other.Four readers independently rated ECG quality:0:Noise;1:QRS complexes seen,but P-wave indeterminate;2:QRS complexes seen,P-waves seen but poor quality;and 3:Clean QRS complexes and P-waves.The combined average rating was:Noise 12%;R-R,no P-wave 10%;R-R,no PR interval 18%;and R-R with PR interval 60%(if Sinus).If minimum diagnostic quality was a score of 1,88%of strips were diagnostic.There was moderate to high agreement regarding quality(weighted Kappa statistic values;0.58 to 0.76)and high level of agreement regarding ECG diagnosis(ICC=0.93).A highly variable RR interval(HRV≥7)predicted AF(AUC=0.87).The monitor acquires and transmits diagnostic high quality ECG data and permits characterization of AF.展开更多
<strong>Objective:</strong> <span style="font-family:Verdana;">To determine the early electrocardiographic changes in a cohort of ambulatory cameroonian COVID-19 patients treated with hydro...<strong>Objective:</strong> <span style="font-family:Verdana;">To determine the early electrocardiographic changes in a cohort of ambulatory cameroonian COVID-19 patients treated with hydroxychlo</span><span style="font-family:Verdana;">- </span><span style="font-family:;" "=""><span style="font-family:Verdana;">roquine and Azithromycin. </span><b><span style="font-family:Verdana;">Design:</span></b><span style="font-family:Verdana;"> Prospective study. </span><b><span style="font-family:Verdana;">Setting:</span></b><span style="font-family:Verdana;"> Treatment centres of the city of Yaounde, Cameroon, from May 7</span><sup><span style="font-size:12px;font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> to 24</span><sup><span style="font-size:12px;font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> 2020. </span><b><span style="font-family:Verdana;">Participants:</span></b><span style="font-family:Verdana;"> We enrolled 51 consecutive confirmed COVID-19 on RT-PCR who having mild forms of COVID-19 and treated by hydroxychloroquine 200</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">mg twice daily during seven #days plus Azithromycin 500 mg the first day and 250 mg the remaining 4 days as per national standard. </span><b><span style="font-family:Verdana;">Main Outcomes Measures:</span></b><span style="font-family:Verdana;"> The</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">primary end-point was the change in QTc interval between day 0 (D0), day 3 (D3) and day 7 (D7). Secondary endpoints were changes in all other cardiac electrical conductivity patterns and the occurrence of clinical arrhythmic events during the course of treatment. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The population (29 men and 22 women) was aged 39 ± 11 years (range 17 to 61 years). Mean Tisdale score was 3.35 ± 0.48. No significant change from baseline (D0) of QTc was observed at D7 (429 ± 27 ms at D0 versus 396 ± 26 ms at D7;p = 0.27). A reduction of heart rate was observed between the D0 and D7 (75 ± 13 bpm versus 70 ± 13 bpm, p = 0.02) with increased QRS duration between D0 and D7 (95 ± 10 ms versus 102 ± 17 ms, p = 0.004). No symptomatic arrhythmic events occurred during the treatment course. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">No life-threatening modification of the QT interval was observed in non-severe COVID-19 patients treated ambulatory with hydroxychloroquine and azith</span></span><span style="font-family:Verdana;">romycin. Studies are needed in critical-ill and older patients.</span>展开更多
Endocrine dysfunction has an adverse impact on the cardiovascular system that may be due to an endocrine abnormality that leads to electrocardiogram (EKG) changes. The EKG changes due to endocrine disorder can be reve...Endocrine dysfunction has an adverse impact on the cardiovascular system that may be due to an endocrine abnormality that leads to electrocardiogram (EKG) changes. The EKG changes due to endocrine disorder can be reversible and irreversible and treating underlying disease can reverse EKG changes in some cases. In this article, we review the electrocardiogram manifestations of various endocrine disorders.展开更多
Background Electrocardiographic （ECG） changes occurring during the course of acute brain injury （ABI） have been described frequently, but their significances remain uncertain. The present study was designed to inv...Background Electrocardiographic （ECG） changes occurring during the course of acute brain injury （ABI） have been described frequently, but their significances remain uncertain. The present study was designed to investigate the relation of ECG abnormalities to outcome in the patients with ABI. Methods We performed a retrospective, observational study on the ABI patients admitted to the Department of Neurosurgery of the Beijing Tiantan Hospital between December 2005 and December 2007. All the patients accepted 12-lead electrocardiographic examination within 24 hours after injury, then divided into three groups according to the Glasgow coma score （GCS）. In-hospital mortality and one-month outcome assessed by the Glasgow outcome score （GOS） were investigated. Results Of 335 ABI patients （mean ages 32.4 years）, 246 patients （73.4%） had abnormal ECGs. The most common abnormality was ST-T changes （41.5%）, followed by sinus tachycardia （23.6%）. ECG changes had a significant association with the severity and outcome. Logistic regression analysis showed the presence of ST-T changes （OR 2.587, 95%C/1.009 to 6.629, P=0.048） and QT dispersion prolongation （OR 4.656, 95%C/1.956 to 11.082, P=0.001） significantly associated with short outcomes. Conclusions ABI can lead to myocardial damage and ECG changes had a significant association with the severity. ST-T changes and QT dispersion prolongation were the independent prognosis factors for the negative outcome of ABI patients.展开更多
Cardiovascular diseases(CVDs)are fatal chronic diseases,where electrocardiography(ECG)monitoring could be a prominent solution for early diagnosis.In spite of available commercialized,multilead ECG devices,bulky forma...Cardiovascular diseases(CVDs)are fatal chronic diseases,where electrocardiography(ECG)monitoring could be a prominent solution for early diagnosis.In spite of available commercialized,multilead ECG devices,bulky formats,discontinuous monitoring,and no safety alarm system significantly limit their practical applications.Herein,we present a soft,and stretchable,three-lead ECG device allowing continuous monitoring and wireless transmission of ECG signals.A newly developed organohydrogel patch with a strong adhesive ability(~9.9 kPa)and higher conductivity(~6.5 kΩ)is applied for high-quality ECG signals collection.With a long operation duration(6.5 h)and wireless transmission distance(20.9 m),it could fulfill most of the daily applications.Machine learning algorithms and the graphical user interface are used for real-time ECG monitoring and cardiac abnormalities diagnosis.The vibratory flexible actuator,which is triggered by cardiac abnormalities that need immediate medical treatment,is also integrated as a warning system for the user.As a newly reported stretchable multi-lead ECG device for long-term ECG signal monitoring,there is a high potential for improving users'life quality with the high-risk population of CVDs.展开更多
目的开发急诊信息系统的心电监护报警参数自动计算与预警模块,并探讨其在急诊危重患者安全管理中的应用效果。方法成立危重患者心电监护报警参数设置的改进团队,设计研发急诊信息系统心电监护报警范围自动计算模块与预警模块。选取2023...目的开发急诊信息系统的心电监护报警参数自动计算与预警模块,并探讨其在急诊危重患者安全管理中的应用效果。方法成立危重患者心电监护报警参数设置的改进团队,设计研发急诊信息系统心电监护报警范围自动计算模块与预警模块。选取2023年3—12月浙江省某三甲医院急诊抢救室使用心电监护的危重患者作为研究对象,将报警范围自动计算与预警模块应用前后分为对照组(2023年3—5月)和观察组(2023年10—12月),比较2组患者心电监护报警参数设置正确率、报警设置错误同时期患者基本情况,观察实践效果。结果应用心电监护仪报警参数设置与预警模块后,心电监护报警参数设置正确率由75.53%提高至90.89%(χ2=400.57,P<0.01);应用心电监护仪报警参数设置及预警模块前后监护仪参数设置错误患者基本信息比较发现,模块应用后同时期护士管理急危重患者数明显增加[(5.66±0.41)例vs(7.98±0.67)例,t=-4.46,P<0.01],预检分诊Ⅰ、Ⅱ级危重患者参数设置错误例数明显减少(44例vs 26例,χ2=15.60,P<0.01);2组患者在入抢时改良早期预警评分(modified early warning score,MEWS)差异无统计学意义[(4.38±0.16)分vs(4.46±0.36)分,t=-0.20,P=0.84]。结论应用心电监护报警参数自动计算与预警模块能够提升急诊抢救室报警参数设置正确率,大大提升了护理工作效率,更好地保障护理安全,值得临床推广。展开更多
The arterial pulse tapping artifact,known as Aslanger’s sign,is an electrocardiographic artifact resulting from the transmission of arterial pulsation onto the limb electrodes of the standard 12-lead electrocardiogra...The arterial pulse tapping artifact,known as Aslanger’s sign,is an electrocardiographic artifact resulting from the transmission of arterial pulsation onto the limb electrodes of the standard 12-lead electrocardiograph(ECG)which are placed near the radial or posterior tibial arteries.[1-16]This electromechanical artifact is of cardiac origin and is synchronous with the cardiac cycle.[17]Nearly all reported cases of Aslanger’s sign exhibit an unusual waveform morphology in all 12 leads except one limb lead.[1-14,16]However,we previously reported a case of Aslanger’s sign that showed distorted waveforms from the ST to TP segments observed only in five limb leads among 12 leads.展开更多
Background:The accurate identification of cardiac abnormalities is essential for proper diagnosis and effective treatment of cardiovascular diseases.Method:This work introduces an advanced methodology for detecting ca...Background:The accurate identification of cardiac abnormalities is essential for proper diagnosis and effective treatment of cardiovascular diseases.Method:This work introduces an advanced methodology for detecting cardiac abnormalities and estimating electrocardiographic age(ECG Age)using sophisticated signal processing and deep learning techniques.This study looks at six main heart conditions found in 12-lead electrocardiogram(ECG)data.It addresses important issues like class imbalances,missing lead scenarios,and model generalizations.A modified residual neural network(ResNet)architecture was developed to enhance the detection of cardiac abnormalities.Results:The proposed ResNet demonst rated superior performance when compared with two linear models and an alternative ResNet architectures,achieving an overall classification accuracy of 91.25%and an F1 score of 93.9%,surpassing baseline models.A comprehensive lead loss analysis was conducted,evaluating model performance across 4096 combinations of missing leads.The results revealed that pulse rate-based factors remained robust with up to 75%lead loss,while block-based factors experienced significant performance declines beyond the loss of four leads.Conclusion:This analysis highlighted the importance of addressing lead loss impacts to maintain a robust model.To optimize performance,targeted training approaches were developed for different conditions.Based on these insights,a grouping strategy was implemented to train specialized models for pulse rate-based and block-based conditions.This approach resulted in notable improvements,achieving an overall classification accuracy of 95.12%and an F1 score of 95.79%.展开更多
基金supported by the Heart Association of Thailand under the Royal Patronage of H.M. the King, National Research Council of Thailand
文摘Background There are limited data on the prevalence of electrocardiographic (ECG) abnormalities, and their value for predicting a major adverse cardiovascular event (MACE) in patients at high cardiovascular risk. This study aimed to determine the prevalence of ECG abnormalities in patients at high risk for cardiovascular events, and to identify ECG abnormalities that significantly predict MACE. Methods Patients aged ≥ 45 years with established atherosclerotic disease (EAD) were consecutively enrolled from the outpatient clinics of the six participating hospitals during April 2011 to March 2014. The following data were collected: demographic data, cardiovascular risk factors, history of cardiovascular event, physical examination, ECG and medications. ECG was analyzed using Minnesota Code criteria. MACE included cardiovascular death, non-fatal myocardial infarction, and hospitalization due to unstable angina or heart failure. Results A total of 2009 patients were included, 1048 patients (52.2%) had established EAD, and 961 patients (47.8%) had multiple risk factors (MRF). ECG abnormalities included atrial fibrillation (6.7%), premature ventricular contraction (5.4%), pathological Q-wave (Q/QS)(21.3%), T-wave inversion (20.0%), intraventricular ventricular conduction delay (IVCD)(7.3%), left ventricular hypertrophy (LVH)(12.2%), and AV block (12.5%). MACE occurred in 88 patients (4.4%). Independent predictors of MACE were chronic kidney disease, EAD, and the presence of atrial fibrillation, Q/QS, IVCD or LVH by ECG. Conclusions A high prevalence of ECG abnormalities was found. The prevalence of ECG abnormalities was high even among those with risk factors without documented cardiovascular disease.
文摘As a result of research, high prevalence of arterial hypertension has been identified in the group of patients with coronary heart disease aged 60 and older. Most often, occurring form of arterial hypertension among geriatric patients is isolated systolic arterial hypertension (ISAH). The comparison of two ethnic groups of the population has showed higher levels of systolic and diastolic blood pressure (SBP and DBP) in the group of patients of non-indigenous nationality, rather than Yakut patients. Correlation was recorded in the group of non-indigenous patients as they age. Significant increase in the level of SBP was identified in the group of senile and long-livers than in the elderly. Detection of ECG signs of LVH showed the lowest specificity of Cornell voltage criterion comparing to Sokolow-Lyon criterion with its more often occurrence. ECG-signs of left ventricle hypertrophy are significantly more often established by Sokolow-Lyon criterion for men, Cornell voltage—for women. Correlation has been found between the presence of LVH and combination of Cornell voltage criterion with both Gubner-Ungerleider and Sokolow-Lyon criteria.
文摘AIMTo investigate validity of electrocardiographic(ECG)criteria for left ventricular hypertrophy(LVH)in young adults.METHODS Retrospectively,echocardiograms showing LVH and concomitant electrocardiograms were collected in patients 18 to 39 years old.A control group of patients without LVH was collected.Using echocardiogram as the gold standard,electrocardiograms were analyzed using common voltage criteria.RESULTS Study included 100 subjects(52%male,mean age=28±6.8 years,96%Hispanic or African-American)with 50%LVH prevalence.Sensitivity and specificity for SokolowLyon criteria were 24%(95%CI:13.5%-38.4%)and 88%(95%CI:74.9%-95%).For Cornell criteria,sensitivity was 32%(95%CI:19.9%-46.8%)and specificity 98%(95%CI:87.9%-99.8%).For R in a VL criteria,sensitivity was 12%(95%CI:4.9%-25%)and specificity 100%(95%CI:91.1%-100%).CONCLUSION In young adults common ECG voltage criteria have low sensitivities and high specificities similar to other age groups.Low sensitivities preclude these ECG criteria from serving as effective screening tests.
文摘The increase in health care costs is not sustainable and has heightened the need for innovative low cost effective strategies for delivering patient care.Remote monitoring holds great promise for preventing or shortening duration of hospitalization even while improving quality of care.We therefore conducted a proof of concept study to examine the quality of electrocardiograph(ECG)recordings obtained remotely and to test its potential utility in detecting harmful rhythms such as atrial fibrillation.We tested a novel adhesive strip ECG monitor and assessed the ECG quality in ambulatory individuals.2630 ECG strips were analyzed and classified as:Sinus,atrial fibrillation(AF),indeterminate,or other.Four readers independently rated ECG quality:0:Noise;1:QRS complexes seen,but P-wave indeterminate;2:QRS complexes seen,P-waves seen but poor quality;and 3:Clean QRS complexes and P-waves.The combined average rating was:Noise 12%;R-R,no P-wave 10%;R-R,no PR interval 18%;and R-R with PR interval 60%(if Sinus).If minimum diagnostic quality was a score of 1,88%of strips were diagnostic.There was moderate to high agreement regarding quality(weighted Kappa statistic values;0.58 to 0.76)and high level of agreement regarding ECG diagnosis(ICC=0.93).A highly variable RR interval(HRV≥7)predicted AF(AUC=0.87).The monitor acquires and transmits diagnostic high quality ECG data and permits characterization of AF.
文摘<strong>Objective:</strong> <span style="font-family:Verdana;">To determine the early electrocardiographic changes in a cohort of ambulatory cameroonian COVID-19 patients treated with hydroxychlo</span><span style="font-family:Verdana;">- </span><span style="font-family:;" "=""><span style="font-family:Verdana;">roquine and Azithromycin. </span><b><span style="font-family:Verdana;">Design:</span></b><span style="font-family:Verdana;"> Prospective study. </span><b><span style="font-family:Verdana;">Setting:</span></b><span style="font-family:Verdana;"> Treatment centres of the city of Yaounde, Cameroon, from May 7</span><sup><span style="font-size:12px;font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> to 24</span><sup><span style="font-size:12px;font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> 2020. </span><b><span style="font-family:Verdana;">Participants:</span></b><span style="font-family:Verdana;"> We enrolled 51 consecutive confirmed COVID-19 on RT-PCR who having mild forms of COVID-19 and treated by hydroxychloroquine 200</span></span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">mg twice daily during seven #days plus Azithromycin 500 mg the first day and 250 mg the remaining 4 days as per national standard. </span><b><span style="font-family:Verdana;">Main Outcomes Measures:</span></b><span style="font-family:Verdana;"> The</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">primary end-point was the change in QTc interval between day 0 (D0), day 3 (D3) and day 7 (D7). Secondary endpoints were changes in all other cardiac electrical conductivity patterns and the occurrence of clinical arrhythmic events during the course of treatment. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The population (29 men and 22 women) was aged 39 ± 11 years (range 17 to 61 years). Mean Tisdale score was 3.35 ± 0.48. No significant change from baseline (D0) of QTc was observed at D7 (429 ± 27 ms at D0 versus 396 ± 26 ms at D7;p = 0.27). A reduction of heart rate was observed between the D0 and D7 (75 ± 13 bpm versus 70 ± 13 bpm, p = 0.02) with increased QRS duration between D0 and D7 (95 ± 10 ms versus 102 ± 17 ms, p = 0.004). No symptomatic arrhythmic events occurred during the treatment course. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">No life-threatening modification of the QT interval was observed in non-severe COVID-19 patients treated ambulatory with hydroxychloroquine and azith</span></span><span style="font-family:Verdana;">romycin. Studies are needed in critical-ill and older patients.</span>
文摘Endocrine dysfunction has an adverse impact on the cardiovascular system that may be due to an endocrine abnormality that leads to electrocardiogram (EKG) changes. The EKG changes due to endocrine disorder can be reversible and irreversible and treating underlying disease can reverse EKG changes in some cases. In this article, we review the electrocardiogram manifestations of various endocrine disorders.
基金This study was supported by the National Natural Science Foundation of China （No. C03030201）
文摘Background Electrocardiographic （ECG） changes occurring during the course of acute brain injury （ABI） have been described frequently, but their significances remain uncertain. The present study was designed to investigate the relation of ECG abnormalities to outcome in the patients with ABI. Methods We performed a retrospective, observational study on the ABI patients admitted to the Department of Neurosurgery of the Beijing Tiantan Hospital between December 2005 and December 2007. All the patients accepted 12-lead electrocardiographic examination within 24 hours after injury, then divided into three groups according to the Glasgow coma score （GCS）. In-hospital mortality and one-month outcome assessed by the Glasgow outcome score （GOS） were investigated. Results Of 335 ABI patients （mean ages 32.4 years）, 246 patients （73.4%） had abnormal ECGs. The most common abnormality was ST-T changes （41.5%）, followed by sinus tachycardia （23.6%）. ECG changes had a significant association with the severity and outcome. Logistic regression analysis showed the presence of ST-T changes （OR 2.587, 95%C/1.009 to 6.629, P=0.048） and QT dispersion prolongation （OR 4.656, 95%C/1.956 to 11.082, P=0.001） significantly associated with short outcomes. Conclusions ABI can lead to myocardial damage and ECG changes had a significant association with the severity. ST-T changes and QT dispersion prolongation were the independent prognosis factors for the negative outcome of ABI patients.
基金supported by Hong Kong Center for Cerebra-Cardiovascular Health Engineering,City University of Hong Kong(Grants No.9667221,9680322)Research Grants Council of the Hong Kong Special Administrative Region(Nos.21210820,11213721)National Natural Science Foundation of China(No.62122002).
文摘Cardiovascular diseases(CVDs)are fatal chronic diseases,where electrocardiography(ECG)monitoring could be a prominent solution for early diagnosis.In spite of available commercialized,multilead ECG devices,bulky formats,discontinuous monitoring,and no safety alarm system significantly limit their practical applications.Herein,we present a soft,and stretchable,three-lead ECG device allowing continuous monitoring and wireless transmission of ECG signals.A newly developed organohydrogel patch with a strong adhesive ability(~9.9 kPa)and higher conductivity(~6.5 kΩ)is applied for high-quality ECG signals collection.With a long operation duration(6.5 h)and wireless transmission distance(20.9 m),it could fulfill most of the daily applications.Machine learning algorithms and the graphical user interface are used for real-time ECG monitoring and cardiac abnormalities diagnosis.The vibratory flexible actuator,which is triggered by cardiac abnormalities that need immediate medical treatment,is also integrated as a warning system for the user.As a newly reported stretchable multi-lead ECG device for long-term ECG signal monitoring,there is a high potential for improving users'life quality with the high-risk population of CVDs.
文摘目的开发急诊信息系统的心电监护报警参数自动计算与预警模块,并探讨其在急诊危重患者安全管理中的应用效果。方法成立危重患者心电监护报警参数设置的改进团队,设计研发急诊信息系统心电监护报警范围自动计算模块与预警模块。选取2023年3—12月浙江省某三甲医院急诊抢救室使用心电监护的危重患者作为研究对象,将报警范围自动计算与预警模块应用前后分为对照组(2023年3—5月)和观察组(2023年10—12月),比较2组患者心电监护报警参数设置正确率、报警设置错误同时期患者基本情况,观察实践效果。结果应用心电监护仪报警参数设置与预警模块后,心电监护报警参数设置正确率由75.53%提高至90.89%(χ2=400.57,P<0.01);应用心电监护仪报警参数设置及预警模块前后监护仪参数设置错误患者基本信息比较发现,模块应用后同时期护士管理急危重患者数明显增加[(5.66±0.41)例vs(7.98±0.67)例,t=-4.46,P<0.01],预检分诊Ⅰ、Ⅱ级危重患者参数设置错误例数明显减少(44例vs 26例,χ2=15.60,P<0.01);2组患者在入抢时改良早期预警评分(modified early warning score,MEWS)差异无统计学意义[(4.38±0.16)分vs(4.46±0.36)分,t=-0.20,P=0.84]。结论应用心电监护报警参数自动计算与预警模块能够提升急诊抢救室报警参数设置正确率,大大提升了护理工作效率,更好地保障护理安全,值得临床推广。
文摘The arterial pulse tapping artifact,known as Aslanger’s sign,is an electrocardiographic artifact resulting from the transmission of arterial pulsation onto the limb electrodes of the standard 12-lead electrocardiograph(ECG)which are placed near the radial or posterior tibial arteries.[1-16]This electromechanical artifact is of cardiac origin and is synchronous with the cardiac cycle.[17]Nearly all reported cases of Aslanger’s sign exhibit an unusual waveform morphology in all 12 leads except one limb lead.[1-14,16]However,we previously reported a case of Aslanger’s sign that showed distorted waveforms from the ST to TP segments observed only in five limb leads among 12 leads.
文摘Background:The accurate identification of cardiac abnormalities is essential for proper diagnosis and effective treatment of cardiovascular diseases.Method:This work introduces an advanced methodology for detecting cardiac abnormalities and estimating electrocardiographic age(ECG Age)using sophisticated signal processing and deep learning techniques.This study looks at six main heart conditions found in 12-lead electrocardiogram(ECG)data.It addresses important issues like class imbalances,missing lead scenarios,and model generalizations.A modified residual neural network(ResNet)architecture was developed to enhance the detection of cardiac abnormalities.Results:The proposed ResNet demonst rated superior performance when compared with two linear models and an alternative ResNet architectures,achieving an overall classification accuracy of 91.25%and an F1 score of 93.9%,surpassing baseline models.A comprehensive lead loss analysis was conducted,evaluating model performance across 4096 combinations of missing leads.The results revealed that pulse rate-based factors remained robust with up to 75%lead loss,while block-based factors experienced significant performance declines beyond the loss of four leads.Conclusion:This analysis highlighted the importance of addressing lead loss impacts to maintain a robust model.To optimize performance,targeted training approaches were developed for different conditions.Based on these insights,a grouping strategy was implemented to train specialized models for pulse rate-based and block-based conditions.This approach resulted in notable improvements,achieving an overall classification accuracy of 95.12%and an F1 score of 95.79%.
