Detection Of Dysrhythmias Research Articles

Detection of Dysrhythmias from Electrocardiogram Signals Using Noise Removal and Deep Learning Techniques

Detection of Dysrhythmias from Electrocardiogram Signals Using Noise Removal and Deep Learning Techniques

Critical Care Nurses’ Competency in Electrocardiogram Interpretation: A Cross-Sectional Study

Introduction: The electrocardiogram is used to assess the heart’s condition. Patients who come with symptoms of acute coronary syndrome must have the ECG immediately and the readings interpreted within 10 minutes, since any delays in giving treatment could result in significant tissue damage to the heart muscle. The objective was to determine the level of knowledge and practices regarding electrocardiogram (ECG) interpretation on cardiac arrhythmia among registered nurses working in critical care units. Method: A cross-sectional study was conducted among nurses at the critical care unit of Hospital Raja Permaisuri Bainun Ipoh, Perak. 105 respondents were recruited by convenience sampling. Respondents were given questionnaire on Knowledge and Practice on ECG interpretation. Results: this study found that 97.1% of the respondents have a good level of knowledge, while 76.2% have a good practice level regarding electrocardiogram interpretation on cardiac dysrhythmia. There were statistically significant differences in the knowledge level of ECG interpretation between the units in the hospital (χ2(3) = 33.962, p = 0.022) and education level (χ2(3) = 9.608, p < 0.001). There were statistically significant differences in the practice level of ECG interpretation between the years of working experience as a nurse (χ2(3) =13.726, p < 0.003) and working unit (χ2(3) = 21.887, p < 0.001). Conclusion: the level of knowledge regarding ECG interpretation on cardiac arrhythmia is generally good. Level of practice can be improved by the development of continuous education on ECG. Early detection of dysrhythmia is a crucial skill among nurses to give a prompt treatment.

Importance of early diagnosis in LMNA-related muscular dystrophy for cardiac surveillance.

The identification of LMNA-related muscular dystrophy is important because it poses life-threatening cardiac complications. However, diagnosis of LMNA-related muscular dystrophy based on clinical features is challenging. We reviewed the clinical phenotypes of 14 children with LMNA variants, focusing on the cardiac function and genotypes. Most patients presented with motor developmental delay or gait abnormalities. Eight (57%) patients had prominent neck extensor weakness or contractures. All patients showed ankle contractures at an early stage. Regular cardiac surveillance allowed for the detection of dysrhythmias in 57% of patients at a mean age of 14 years (range, 5-26). All patients had missense variants; however, there were no clear phenotype-genotype correlations. Early diagnosis of LMNA-related muscular dystrophy provides an opportunity for cardiac surveillance, potentially leading to the prevention of cardiac mortality in children.

Nursing-Based Dysrhythmia Detection on a Dedicated Stroke Unit Using a Unit-Based Cardiac Telemetry Monitoring System.

Acute stroke care includes cardiac rhythm monitoring in the first 24 hours. The method of monitoring varies, as do the reported findings. The nurses' role in this process can be intensive, including primary response and review of all data. Competency is critical as the acute stroke setting can be associated with life-threatening dysrhythmias as well as the detection of atrial fibrillation that affects therapy. Limited studies exist to evaluate the effectiveness of a unit-based cardiac monitoring system for which the bedside nurse has primary responsibility. The goal was to determine if a unit-based cardiac monitoring system for which the bedside nurse was responsible detected clinically significant dysrhythmias. Stroke unit nurses completed a mandatory education program on identifying common dysrhythmias and using the monitoring equipment along with a structured algorithm for cardiac dysrhythmia detection. The nurse was responsible for all alarms as well as review of their patients' data. Their findings were recorded and reviewed by a cardiology team after the 24-hour monitoring was completed. A total of 300 consecutive stokes, transient ischemic attack, and possible stroke patients were enrolled. Nurses identified 96% of all significant dysrhythmias. Twenty-eight percent of the stroke patients had a dysrhythmia, of which 79% were atrial fibrillation/atrial flutter. The bedside nurses did identify all 8 new atrial fibrillation cases. Stroke unit nurses who complete an educational program can identify dysrhythmias on their patients' unit-based cardiac monitoring systems and can improve patient outcomes.

Accuracy of detection of clinically important dysrhythmias with and without a dedicated monitor watcher

Although dedicated monitor watchers are used in many progressive care units with telemetry monitors, this costly practice has not been evaluated. To compare the accuracy of detection of clinically important dysrhythmias with and without a dedicated monitor watcher. On a 26-bed cardiac progressive care unit, documentation of four categories of dysrhythmias during a 7-week period when a monitor watcher was present was compared with that during a 7-week period when no monitor watcher was present. The Hewlett-Packard CareVue Clinical Event Review, a full-disclosure system, was used as the gold standard. Accuracy of detection of nonsustained ventricular tachycardia, supraventricular tachycardia, and pauses was significantly better with a monitor watcher than without. Although the detection of life-threatening rhythms was correct a higher percentage of the time with a monitor watcher, the difference was not significant. The efficiency and quality of patient care can be enhanced by using a dedicated monitor watcher. The results of this study raise the question of whether improved accuracy of detection of dysrhythmias results in better outcomes for patients.

First trial of home ECG and blood pressure telemonitoring system in Macau.

To determine the feasibility of home monitoring of patients with cardiac disease or hypertension. An improved home electrocardiographic and blood pressure telemonitoring system linked to a central workstation was tested in 10 patients in Macau for 3 months. The total number of connections was 1377. Of the automatic alarm connections, 32.5% were false positive, with the percentage of false positives ranging from 7.6 to 54.6 for different patients. Both patients and physicians found the system easy to use. Further investigation is required to match the number of patients with the system capacity. A more robust dysrhythmia detection algorithm is needed to reduce the number of false alarms. Nevertheless, the results were sufficiently good that the trial is being expanded.

The nurse's role in continuous dysrhythmia monitoring.

One of the areas of clinical management where nurses have the most diagnostic influence is cardiac rhythm monitoring and dysrhythmia detection. The critical care nurse must recognize that continuous monitoring is a nursing responsibility, and competence in this skill must be assured. It is essential that nurses understand the significance of accurate electrode placement in obtaining a specific monitoring lead. In addition, the nurse must use current research in determining which monitoring lead is most appropriate for the patient requiring cardiac monitoring in the critical care environment. The author reviews the current research on continuous bedside monitoring and lead selection, examines why nurses continue to make less than optimal lead selection decisions, and offers recommendations to improve the consistency with which patients are accurately monitored.

Time-frequency representation of the electrogastrogram-application of the exponential distribution

The aim of this paper was to examine the applicability of the exponential distribution for the time-frequency representation of the electrogastrogram (EGG). The EGG is a noninvasive measurement of the electrical activity of the stomach by placing electrodes on the abdominal skin. Quantitative analysis of the EGG has relied on spectral methods. The normal frequency of the EGG in humans is 3 cycles/min. Electrical dysrhythmia observed in the EGG is associated with motor disorders of the stomach. The exponential distribution was applied in this work for the estimation of EGG frequency and the detection of dysrhythmia in the EGG. A series of computer simulations was conducted, demonstrating the reliability of the exponential distribution in the analysis of nonstationary electrical signals of the stomach. Applications of the exponential distribution in the spectral analysis of typical EGG's were presented. The results showed that there is a great potential for the use of the exponential distribution in EGG analysis.

Dysrhythmia detection in myocardial revascularization surgery patients

Dysrhythmia detection in myocardial revascularization surgery patients

Dysrhythmia detection in myocardial revascularization surgery patients.

Dysrhythmia detection in myocardial revascularization surgery patients. Med. Sci. Sports Exerc., Vol. 15, No. 4, pp. 281-286, 1983. In order to document the type and prevalence of significant dysrhythmias in myocardial revascularization surgery patients, cardiac electrical activity was recorded during graded exercise testing, 24-h ambulatory electrocardiography, and electrocardiographic-monitored exercise training. Patients participated in a cardiac rehabilitation program that began approximately 2 wk post-surgery, and attended three monitored exercise sessions per week for 12 consecutive weeks. Graded exercise testing and 24-h ambulatory electrocardiography were administered in the second and eighth weeks of the study (weeks 1 and 6 of the exercise program) post-surgery. Eighty-eight percent of the patients exhibited significant dysrhythmias. A greater number of significant dysrhythmias were found during the second 6 wk of the study in comparison with the first 6 wk. Graded exercise testing was not as effective as ambulatory electrocardiography and monitored exercise training in dysrhythmia detection. Not all dysrhythmias were detected by any one technique, thus a combination of methods may be best for optimal surveillance and detection.

Detection of dysrhythmia in pediatric patients with mitral valve prolapse.

The association of dysrhythmias with mitral valve prolapse in pediatric patients was investigated by graded treadmill exercise testing and 24-hour ambulatory ECG monitoring. Twenty-six unselected patients with a clinical diagnosis of mitral valve prolapse confirmed by echocardiography or angiocardiography or both were studied. On 24-hour ambulatory ECG monitoring, six patients (23%) had potentially serious ventricular dysrhythmias. Five of these patients also manifested ventricular dysrhythmias on treadmill exercise testing. Neither standard ECG abnormalities nor clinical symptoms correlated with detected dysrhythmias. This study shows that potentially serious ventricular arrhythmias are common in pediatric patients with mitral valve prolapse and that ambulatory ECG monitoring and treadmill exercise testing are useful for detecting dysrhythmias.

Effect of electrocardiographic recording duration on ventricular dysrhythmia detection after myocardial infection.

SUMMARY To determine the effect of varying the duration of electrocardiographic recording on the detection of high premature ventricular complex (PVC) rates (30 or more PVCs/hour) and/or complex PVCs (multiform PVCs, couplets or runs) in survivors of myocardial infarction, we evaluated 175 24-hour ECG tapes with such arrhythmias for their occurrences detected in the first 1, 2, 6, 12 and 18 hours of the recordings. The first hour of recording disclosed only 47% of the tapes that, over 24 hours, showed high PVC rates or complex PVCs or both, whereas 6 hours of recording uncovered 89% of the tapes with these arrhythmias. Although a 12-hour ECG recording uncovered only 84% of the tapes with couplets and 75% of those with runs, it identified 92% of the tapes with high PVC rates and/or complex PVCs. The detection rate of high PVC rates or complex PVCs is logarithmically related to the recording duration. Seventy-eight percent of the tapes that had complex PVCs and peak PVC rates greater than 100 beats/hour, and 63% of the tapes with these complex PVCs and peak PVC rates of 30–100 beats/hour, showed these complex PVCs in the first hour. In contrast, only 22% of the tapes with complex PVCs and peak PVC rates less than 30 beats/hour were identified during the same interval. We also found that the average number of PVCs/hour was slightly higher in the first than the last 12 hours of the tapes (51 vs 43 PVCs/hour). This study demonstrates that (1) the detection rate for complex PVCs during the first hour of recording is related to the peak PVC rate, (2) a 12-hour recording during the waking period is sufficient to identify most survivors of myocardial infarction who have high PVC rates and/or complex PVCs, and (3) the detection of tapes with high PVC rates or complex PVCs can be predicted from its logarithmic relationship with the recording duration.

Superiority of 24-hour outpatient monitoring over multi-stage exercise testing for the evaluation of syncope

Twenty-four hour outpatient monitoring was compared with maximum multi-stage Treadmill exercise testing for the detection of dysrhythmias producing syncope or near syncope in 119 patients. All patients had cardiovascular disorders; only 21% had coronary artery disease. Patients with obvious cause of syncope and/or significant dysrhythmias by resting electrocardiograms (ECGs) were excluded. A significant dysrhythmia was found which was considered the probable cause of syncope or pre-syncope in 76 patients (64%). A non-cardiac cause was found in tachycardia, exercise testing identified only patients with complex ventricular dysrhythmias and missed 64% of these. Overall, dysrhythmias were found by ambulatory monitoring alone in 63 patients, by exercise testing alone in only three, and by both in 10. It is concluded that: 1) in the majority of patients with syncope or pre-syncope suspected to be of a cardiac origin, a dysrhythmia can be found; 2) ambulatory monitoring is far superior to exercise testing for detection of dysrhythmias; 3) exercise testing increases the yield for complex ventricular dysrhythmias.

Automatic Detection of Dysrhythmias in the Coronary Care Unit

An on-line dysrhythmia monitoring system which uses simultaneously peripheral and intra-auricular leads has been developed.Preprocessing hardware converts the ECG signals to pulses related to the P and QRS waves. The pulses are transmitted to and processed by the computer using a program which studies pulse chronological features. Important informations on the basic rhythm and on differential diagnosis of the APC and VPC are displayed in the unit at request. Interactive procedures have been designed to provide great flexibility. The acceptance of the computer system by the clinical staff is discussed and assessment of the routine use is reported.