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PubMed1987

Lead configurations in esophageal electrocardiography.

There are many clinical situations that present the need for special purpose electrocardiography using standard equipment. These include monitoring cardiac activity from temporary myocardial leads implanted following cardiac surgery, detecting signals from intracardiac catheter leads, and noninvasive atrial recording from the esophagus. It is often difficult to connect nonstandard leads and access the individual amplifiers. In this article, we present the case for an esophageal electrode such as the Pill Electrode (Arzco Medical Electronics, Inc., Chicago, IL). We describe several configurations for connecting this electrode to electrocardiographs and comment on the merits and shortcomings of each method.

Electrocardiography↗
PubMed1986

Abdominal electrocardiography in intrapartum fetal heart rate monitoring.

Abdominal fetal electrocardiography (AFECG) as a means of intrapartum fetal heart rate (FHR) monitoring was studied in 700 consecutive labors in a small hospital. Sixty-eight pregnancies were excluded from the study because of the elective cesarean section or because labor was too short for electronic monitoring. AFECG succeeded (at least 30% of fetal heart intervals obtained) throughout labor in 99 of 632 monitored labors (16%). Ultrasound was needed in six cases (1%). The rest (527) were monitored first with the use of AFECG, and later with the use of direct FECG. The mean beat-to-beat variation of FHR (differential index) during last two hours of labor measured from AFECG signal was similar to that measured from AFECG and direct FECG. Hence the same reference values of the differential indices for both methods can be used. The mean long term variation (interval index) measured from AFECG was lower than that measured from abdominal and direct FECGs consecutively. Ultrasound is rarely needed during labor, and it should be avoided except in breech presentations, in association with low placentas and twins, if recording of AFECG fails.

Electrocardiography↗
PubMed1985

Electrocardiography in different types of hypertrophic cardiomyopathies.

Alterations in ECG in hypertrophic cardiomyopathies (HCMP) have been described already earlier when the knowledge of HCMP was not so profound. The aim of this work was to analyse ECG findings in hypertrophic myelopathy and to determine their relation to morphological observations. 76 patients examined echocardiographically with catheterization were performed ECG recordings. Normal ECG had 3 patients (3.9%). In the rest of them electrocardiography confirmed left ventricular hypertrophy (63.2%), large R wave in V1(-3) (14.5%), diminishing of R wave in V1(-3) (28.9%), pathologic Q wave (23.7%), absence of "q" wave in V5,6 (48.8%), ST-T abnormalities (86.7%). Pathologic Q wave was found more often in patients with right ventricular hypertrophy, deep T waves (greater than 10 mm) currently occurred in apical form. It follows that the presence and the range of myocardial hypertrophy cannot be electrocardiographically recorded. Therefore the ECG is applied in great majority of patients only as a screening method.

Adolescent↗
PubMed1985

Persistent ST-segment elevation in patients with anterior myocardial infarctions. Evaluation by exercise electrocardiography, echocardiography and Holter monitoring.

One hundred and seventy patients who suffered an acute myocardial infarction (MI) were followed up at 3-monthly intervals by a full clinical evaluation, exercise electrocardiography and ambulatory Holter monitoring. Fifty-eight patients (34%) had anterior MIs, and of these 23 (40%) had persistent ST-segment elevation over the infarct zone, reflected by leads presenting with Q-S configuration. Fifteen (65,2%) of the latter demonstrated further ST-segment elevation during exercise. They were further investigated by cross-sectional echocardiography. Left ventricular (LV) dysfunction was diagnosed in 87% of patients with persistent ST-segment elevation, and in 93% of the patients with additional exercise-induced ST-segment elevation. Organized thrombi occurred in 2 patients (8,7%) and 1 experienced a transient ischaemic attack. Ventricular arrhythmias occurred frequently (ventricular ectopy--91,3%, ventricular tachycardia--17,4%, and couplets--47,8%). Death occurred in 3 patients (13,1%) and 1 patient (4,3%) had a second MI over a mean follow-up period of 83,6 months. This study suggests that persistent ST-segment elevation on the resting ECG of patients with anterior MIs is a reliable indicator of LV wall motion abnormalities, and that this correlation further increases if it is associated with exercise-induced ST-segment elevation. Furthermore, the role of echocardiography as a diagnostic tool in evaluating LV function is stressed. The prognosis of patients with post-infarction LV dysfunction is notably poor and may be the result of frequent complex ventricular arrhythmias.

Arrhythmias, Cardiac↗
PubMed1985

[Electrocardiography in the horse (1). Principles and normal picture].

The physiological and technical basis of the electrocardiography are shortly explained. The electrodes used for the recording of bipolare thoracal leads, their fixation on the horse, the practical procedure of a ECG-recording, its appearance and variation are described and illustrated. A recommendation for a systematic evaluation and interpretation is being proposed.

Animals↗
PubMed1985

Recommendations for measurement standards in quantitative electrocardiography. The CSE Working Party.

A set of recommendations aimed at standardizing measurements in quantitative electrocardiography is presented. It is the result of studies based on a measurement reference library analysed independently by a group of cardiologists and by various computer programs, and of discussions held at several meetings of the CSE Working Party. The nomenclature and definitions previously established by various Committees of the American Heart Association have been updated. An evaluation method has been proposed for testing the results of wave recognition computer programs analysing XYZ or 12-lead ECGs in groups of three simultaneously recorded leads, and recommendations have been formulated for minimum wave requirements, amplitude and interval measurement procedures.

Arrhythmias, Cardiac↗
PubMed1985

Evaluation of the ICR 6201 G3 ambulatory electrocardiography system in quantitation of arrhythmias.

The performance of a commercial ambulatory electrocardiography analyzer was evaluated when used for the quantitative analysis of arrhythmias in an antiarrhythmic research investigation. The detection and classification of the QRS complexes were examined. The variation between the edited trend report obtained in the investigation and the true arrhythmia quantities established by visual counting was determined for ventricular and atrial premature beats. The analyzer system adequately fulfilled the demands of the research program in establishing changes in the frequency of the arrhythmias.

Ambulatory Care↗
PubMed1979

Comparison of lateral and sternal recumbent positions for electrocardiography of the cat.

Comparison was made of the effects of lateral and sternal recumbent positions for recording (by electrocardiography) cardiac functions in nonanesthetized normal cats of various breeds and ages and both sexes. Reference values of the cats in lateral recumbency were P wave, 0.2 mV by 0.04 s; PR interval, 0.09 s, QRS complex, 0.9 mV by 0.04 s; QT interval, 0.18 s; and 0 to 160 degree axis. Similar values were obtained in the cats in sternal recumbency except that the height of the P wave was 0.3 mV, the height of QRS complex was 1.0 mV, and the axis was -10 degrees to 150 degrees. The only differences between these values and values previously reported were faster heart rate, higher P wave, narrower QRS complex, and more variable electrical axis.

Animals↗
PubMed1977

[Direct fetal electrocardiography in umbilical cord complications and congenital heart abnormalities].

The modern obstetrics allows with help of electronical control a prenatale and intranatale state-diagnosis of the fetal heart. By use of direct fetal electrocardiography is it possible under consideration of QRS-deformations and ST-segment-depressions to add a suspicious diagnosis, so that can avoid dangerous complications of the umbilical cord or in case of absence of such complications can early detect congenital heart diseases.

Asphyxia Neonatorum↗
PubMed1984

[Value of long-term electrocardiography in patients with cerebral ischemic accidents].

Continuous 24 hour electrocardiography (Holter monitoring) was performed in 226 patients aged 20 to 85 years (mean 61 years) presenting with focal signs of a cerebrovascular accident (CVA). The technique was the same in all patients; the study was limited to paroxysmal atrial arrhythmias. Eighty four of the 226 patients examined had atrial arrhythmias which were already known in 39 patients before Holter monitoring. In the other 187 cases, the following results were obtained: 1) 9 patients (4,8%) had paroxysmal atrial fibrillation (AF), 2) 6 patients (3,2%) had paroxysmal atrial tachycardia (PAT), 3) 11 patients (5,9%) had runs of atrial extrasystoles, 4) 19 patients (10%) had isolated atrial extrasystoles (IAE). When patients with underlying cardiac disease constituting a diagnostic indicator for arrhythmia were excluded, the following incidences were obtained: AF = 3,7%, PAT = 2,7% and runs of atrial extrasystoles = 4,3%. The majority of these arrhythmias occurred in elderly patients in whom atrial arrhythmias are known to occur and may be asymptomatic. There were practical consequences of these results, i.e. antiarrhythmic and anticoagulant therapy in 12 patients (6,4%) alone. As Holter monitoring is also associated with a number of false negative results with respect to paroxysmal atrial tachycardia, we do not believe that this investigation should be offered routinely to patients with CVA in the absence of other clinical or electrocardiographic indications.

Adult↗
PubMed1983

Assessment of a geriatric exercise programme using ambulatory electrocardiography.

The purpose of this study was to assess the efficacy as well as the immediate possible cardiovascular risk of a geriatric exercise programme, administered without prior medical screening or evaluation of the exercise capacity of the participants, in improving cardiorespiratory fitness. Ambulatory electrocardiography performed during exercise on 6 randomly selected male participants in a physiotherapist-controlled geriatric exercise programme revealed heart rates of 72-97/min, values unlikely to produce significant improvements in cardiorespiratory fitness. This low-intensity exercise session did not induce any ischaemic ST-segment displacements, or arrhythmias displaying the generally accepted criteria for premonitory arrhythmias known to precede the development of ventricular fibrillation. However, subsequent stress testing, performed at the lower threshold intensity of exercise needed to elicit a significant physiological training effect, resulted in an adverse cardiac response in 3 subjects, of whom 2 were asymptomatic. We conclude that the geriatric exercise programme under investigation would be unlikely to result in improved cardiorespiratory fitness in the majority of participants, but if such a programme is to be implemented in a safe manner in a geriatric population, prior medical screening including exercise testing is mandatory.

Aged↗
PubMed1982

Lack of correlation between the clinical assessment of cardiovascular status and exercise electrocardiography.

One hundred and seventy-one patients who had had a myocardial infarction were evaluated at the Institute for Aviation Medicine, Pretoria. Patients were graded according to the New York City Heart Association classification of cardiac functional capacity and then subjected to exercise electrocardiography. Only 20% of the 74 patients whose exercise electrocardiograms revealed ischaemic heart disease felt that their cardiovascular function was limiting their daily activity. This lack of correlation between the two forms of assessment was highly significant (P less than 0,0001). It is therefore concluded that clinical evaluation of an individual with known ischaemic heart disease may be misleading.

Adult↗
PubMedDate not supplied

[Late arrhythmias in the operated interatrial communication. Analysis of sinus node function and the conduction pathways by His bundle electrocardiography].

Four hundred patients with atrial septal defect treated surgically were reviewed. Thirty five (8.7%) developed arrhytmias post-surgery which persisted for over a year. Sinus bradycardia was found in 10 patients, nodal rhythm in 21, and atrial fibrilation and flutter in 4 patients. Thirty five per cent of the patients with late arrhythmias developed related symptomatology. In 14 patients the function of the sinus node was studied with electrical stimulation of the atrium and with His registry. The interatrial conduction time, AV node and His Purkinje were analized employing various stimulation frequencies. All the cases studied had normal intra-atrial conduction; the response of the atrio-ventricular node to increasing frequencies was normal, an the intraventricular conduction remained constant. In 8 patients (52%), alterations of the sinus node were found; these consisted of prolonged post-stimulation pauses, Wenckebach's type sinoatrial block and suppression of sinus automatism employing vagal procedures or through electrical stimulation. A patient with severe bradycardia detected by dynamic electrocardiography had to be treated with a permanent pacemaker. We confirm that these arrhytmias are not produced by lesions of the internodal tracts, and that an alteration of the sinus node is frequent without a concomitant lesion of the intraventricular pathway. The lesion to the nutrient artery could be due to trauma and/or surgically induced. The response to anticholinergic drugs was good. Prolonged observation of these patients could increase the morbility of these arrythmias and raise doubts of the surgical indications in cases with moderate hemodynamic repercussion.

Adolescent↗
PubMedDate not supplied

[Evaluation of coronary heart disease by kinetocardiography and electrocardiography before and after injection of dopamine and isoproterenol].

Eighty patients with coronary insufficiency, with or without infarction, were studied by kinetocardiography and electrocardiography before and after the infusion of dopamine (40 patients) or isoproterenol (40 patients). Twenty healthy subjects for dopamine and 20 for isoproterenol served as controls. The basal ECG has a moderate (52.5%) sensitivity and a high (92.5%) specificity. KCG-25 has a poor (19,7%) sensitivity and a high (95%) specificity. KCG-45 has a high (76.2%) sensitivity and a moderate (50%) specificity, 25/40 healthy subjects had at least one pathological finding: either the ECG or the KCG-25 or the KCG-45. The mechanisms and the relevance of the false positives of the KCG are reviewed. In spite of different pharmacological properties, there is no statistical difference in the effect of dopamine and isoproterenol on the ECG and KCG. The KCG may be considered equivalent to the ECG, taking into account that it brings different information. The infusion of dopamine or isoproterenol induces dyskinesia in some patients with coronary insufficiency. Only two statistically significant changes were observed: dopamine increases the sensitivity of KCG-25 (up to 44.4%) and the specificity of KCG-45 (up to 95%). In selected cases the infusion of dopamine may be a useful test.

Adolescent↗
PubMed1981

A curriculum in electrocardiography for family physicians.

A competency based curriculum in electrocardiography for family physicians is presented. An outline and definitions for those electrocardiographic entities that occur most frequently in ambulatory family practice patients are described. The body of knowledge contained in the curriculum can be taught in 10 to 12 hours of lecture and demonstration, but maintenance of skills requires continuing practice.

Competency-Based Education↗
PubMed1981

[Esophageal electrocardiography--new variants in derivation technics].

Oesophageal electrocardiography provides for an analysis of heart rhythm that must be considered more accurate than the one obtained in a conventional electrocardiogram. Bipolar intraoesophageal and oesophagosternal or oesophagoparasternal leads, using adequate electrode cables, permit recordings, satisfactory from a technical point of view, even when applying the methods of provocations (ergometry).

Arrhythmias, Cardiac↗