Biomedical subjects

Maya E Guglin

Publications and source records attributed to Maya E Guglin.

4 recordsLinked to original sources

PubMed2006

Electrocardiograms with pacemakers: accuracy of computer reading.

OBJECTIVE: We analyzed the accuracy with which a computer algorithm reads electrocardiograms (ECGs) with electronic pacemakers (PMs). METHODS: Electrocardiograms were screened for the presence of electronic pacing spikes. Computer-derived interpretations were compared with cardiologists' readings. RESULTS: Computer-drawn interpretations required revision by cardiologists in 61.3% of cases. In 18.4% of cases, the ECG reading algorithm failed to recognize the presence of a PM. The misinterpretation of paced beats as intrinsic beats led to multiple secondary errors, including myocardial infarctions in varying localization. The most common error in computer reading was the failure to identify an underlying rhythm. This error caused frequent misidentification of the PM type, especially when the presence of normal sinus rhythm was not recognized in a tracing with a DDD PM tracking the atrial activity. CONCLUSION: The increasing number of pacing devices, and the resulting number of ECGs with pacing spikes, mandates the refining of ECG reading algorithms. Improvement is especially needed in the recognition of the underlying rhythm, pacing spikes, and mode of pacing.

Artifacts↗

PubMed2006

Common errors in computer electrocardiogram interpretation.

OBJECTIVE: The aim of the study was to determine the frequency and nature of errors in computer electrocardiogram (ECG) reading. METHODS: The ECGs were collected in the tertiary care VA Hospital from both inpatients and outpatients. They were read by the electrocardiograph built-in computer software, and then reread by two cardiologists. Statistical analysis was performed using sensitivity, specificity, positive and negative predicted value to analyze the data. An error index was formulated as indicator of diagnostic accuracy. RESULTS: Out of 2072 ECGs, 776 (37.5%) were normal, and 1296 (62.5%) were abnormal. In 9.9% of all ECGs and in 15.9% of abnormal ECGs there were significant disagreements between the computer and cardiologists. The errors in diagnosis of arrhythmia, conduction disorders and electronic pacemakers accounted for 178 cases, or 86.4% of all errors. The rest was represented by misdetection of chamber enlargement (7 cases, 3.4%), misdiagnosis of ischemia and acute myocardial infarction (16 cases, 7.8%), and lead misplacement (5 cases, 2.4%). CONCLUSIONS: The most frequent errors in computer ECG interpretation are related to arrhythmias, conduction disorders, and electronic pacemakers. Computer ECG diagnosis of life threatening conditions e.g. acute myocardial infarction or high degree AV blocks are frequently not accurate (40.7% and 75.0% errors, respectively). Improvement in the diagnostic algorithms should focus on these areas. Error index is a convenient and informative tool for evaluation of diagnostic accuracy.

Diagnosis, Computer-Assisted↗

PubMed2004

Immediate and 1-year survival of out-of-hospital cardiac arrest victims in southern New Jersey: 1995-2000.

Most studies report the out-of-hospital cardiac arrest (OHCA) survival to hospital discharge. One-year survival and neurological outcomes in southern New Jersey in 1996-2000 were analyzed using a retrospective data review. There were 1,597 cases of OHCA. Initial survival ranged between 15% in 2000 and 19% in 1997. Survival to hospital discharge, taken as a percent of the initial survivors, decreased from 44% in 1997 to 22% in 2000. In relation to all OHCA victims, survival to discharge decreased from 7.2% to 2.4%, respectively. On discharge from the hospital 19-50% of people had the diagnosis of anoxic brain damage. In ventricular fibrillation, survival to discharge was 41%, 46.7%, 40.7%, 37.5%, and 17.4%, respectively, from 1996 to 2000. The response time increased from 6.6 to 8.1 minutes. Correlation coefficient between in-hospital survival and response time was -0.73. The percent of people discharged with neurological damage increased from 38% to 50%. Initial survival was 29.2% in shockable and 7.5% in nonshockable rhythm (P < 0.001). Survival to discharge was 11.3% versus 1.6%, and survival to 1 year was 9.6% versus 0.7%, respectively (P < 0.001 for all). Overall, the neurologically favorable 1-year survival rate was 2.3% of all OHCA victims. One-year survival of OHCA victims without neurological deficits is low. In southern New Jersey the survival rate did not improve over the 5-year study. Not only initial (prehospital) mortality, but also "delayed" (in-hospital mortality) increases with increase of response time.

Brain Damage, Chronic↗

PubMedDate not supplied

Cardiovascular effects of erythropoietin: anemia and beyond.

We did a PubMed and Cochrane Database System review of different studies on the diverse effects of erythropoietin (EPO), focusing mainly on the cardiovascular system. The direct erythropoietic action of EPO is well studied and widely used. Published studies report dramatic improvement in the course of heart failure with EPO treatment. New controlled clinical trials on large and diverse groups of patients are warranted. Antiapoptotic effects of EPO are newly discovered, opening new horizons in both clinical investigation and therapy. The salvage of cardiomyocytes in acute coronary syndromes, limiting the size of myocardial infarction and improving functional recovery, is only one of multiple potential applications of this effect. Derivatives of EPO with selective antiapoptotic properties seem to hold the best prospects for future studies. Heart failure and ischemic heart disease are potential areas where adding EPO to the conventional treatment may be beneficial.

Anemia↗