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("ECG" OR " EKG") AND "Interpretation"

Joshua Tseng, Harry C Sax, Rodrigo F Alban
Charge markups for health care are variable and inflated several times beyond cost. Using the 2015 Medicare Provider Fee-For-Service Utilization and Payment Data file, we identified providers who billed for critical care hours and related procedures, including CPR, EKG interpretation, central line placement, arterial line placement, chest tube/thoracentesis, and emergent endotracheal intubation. Markup ratios (MRs), defined as the amount charged divided by the amount allowable, were calculated and compared; 42...
October 1, 2018: American Surgeon
Teruhisa Komori
To clarify the physiological and psychological effects of deep breathing, the effects of extreme prolongation of expiration breathing (Okinaga) were investigated using electroencephalogram (EEG) and electrocardiogram (ECG). Participants were five male Okinaga practitioners in their 50s and 60s. Participants performed Okinaga for 31 minutes while continuous EEG and ECG measurements were taken. After 16 minutes of Okinaga, and until the end of the session, the percentages of theta and alpha 2 waves were significantly higher than at baseline...
November 6, 2018: Mental Illness
Qiying Ling, Hong Chen, Min Tang, Yi Qu, Binzhi Tang
The purpose of this study is to investigate the accuracy and safety of intracavitary electrocardiogram (IC-ECG) guidance for the localization of peripherally inserted central catheter (PICC) in neonatal patients. A total of 160 neonatal patients were randomly assigned to receive either anthropometric measurement combined with IC-ECG guidance (n = 80) or conventional anatomical landmark guidance (n = 80) for PICC catheter tip positioning. The catheter tip position was confirmed by postinsertion radiograph and data were interpreted by independent radiologists...
January 2019: Journal of Perinatal & Neonatal Nursing
William E Soares, Lori L Price, Brendan Prast, Elizabeth Tarbox, Timothy J Mader, Rebecca Blanchard
Introduction: Interruptions in the emergency department (ED) are associated with clinical errors, yet are important when providing care to multiple patients. Screening triage electrocardiograms (ECG) for ST-segment elevation myocardial infarction (STEMI) represent a critical interrupting task that emergency physicians (EP) frequently encounter. To address interruptions such as ECG interpretation, many EPs engage in task switching, pausing their primary task to address an interrupting task...
January 2019: Western Journal of Emergency Medicine
Farhad Aziz, Bryan Yeh, Geremiha Emerson, David P Way, Christopher San Miguel, Andrew M King
Introduction: Emergency physicians are interrupted during patient care with such tasks as reading electrocardiograms (ECGs). This phenomenon is known as task-switching which may be a teachable skill. Our objective was to evaluate the potential of a video game for simulating the cognitive demands required of task-switching. Methods: Emergency medicine residents took a pretest on ECG interpretation and then a posttest while attending to a video game, Asteroids®. Results: The 35 residents (63%) who participated, scored worse on the ECG posttest then they did on the pretest (p<...
January 2019: Western Journal of Emergency Medicine
Marion G Borgstede, Majoline J W van den Broeke-Vos, Renate Stevens-Stolmeijer, Heleen Lameijer
CLINICAL INTRODUCTION: A 56-year-old man without known medical history was brought to our ED after he was found next to his bed, agitated and with waxing and waning consciousness. He has been bedbound for 5 days after a long-standing period of malnutrition. Physical examination reveals Kussmaul breathing, heart rate of 62/min and blood pressure of 135/100 mm Hg, normal cardiac, abdominal and a non-focal neurological examination other than confusion and altered level of consciousness...
January 2019: Emergency Medicine Journal: EMJ
Emrah Bozbeyoğlu, Emre Aslanger, Özlem Yıldırımtürk, Barış Şimşek, Burak Hünük, Can Yücel Karabay, Ömer Kozan, Muzaffer Değertekin
BACKGROUND: The currently used scheme for the classification of infarct location and extent in anterior myocardial infarction (MI) is intuitive rather than being evidence-based, and recent evidence suggests that it may be misleading both in anatomic and prognostic sense. MATERIAL AND METHODS: Consecutive patients with the diagnosis of anterior MI were enrolled. All electrocardiograms (ECG) were first classified according to established scheme and then reassessed using newer criteria for angiographic site of occlusion...
January 11, 2019: Annals of Noninvasive Electrocardiology
T Lindow, Y Birnbaum, K Nikus, A Maan, U Ekelund, O Pahlm
BACKGROUND: In the standard ECG display, limb leads are presented in a non-anatomical sequence: I, II, III, aVR, aVL, aVF. The Cabrera system is a display format which instead presents the limb leads in a cranial/left-to-caudal/right sequence, i.e. in an anatomically sequential order. Lead aVR is replaced in the Cabrera display by its inverted version, -aVR, which is presented in its logical place between lead I and lead II. MAIN TEXT: In this debate article possible implications of using the Cabrera display, instead of the standard, non-contiguous lead display, are presented, focusing on its use in patients with possible acute coronary syndrome...
January 10, 2019: BMC Cardiovascular Disorders
Awni Y Hannun, Pranav Rajpurkar, Masoumeh Haghpanahi, Geoffrey H Tison, Codie Bourn, Mintu P Turakhia, Andrew Y Ng
Computerized electrocardiogram (ECG) interpretation plays a critical role in the clinical ECG workflow1 . Widely available digital ECG data and the algorithmic paradigm of deep learning2 present an opportunity to substantially improve the accuracy and scalability of automated ECG analysis. However, a comprehensive evaluation of an end-to-end deep learning approach for ECG analysis across a wide variety of diagnostic classes has not been previously reported. Here, we develop a deep neural network (DNN) to classify 12 rhythm classes using 91,232 single-lead ECGs from 53,549 patients who used a single-lead ambulatory ECG monitoring device...
January 2019: Nature Medicine
Amer M Johri, Paul Poirier, Paul Dorian, Anne Fournier, Jack M Goodman, James McKinney, Nathaniel Moulson, Andrew Pipe, François Philippon, Taryn Taylor, Kim Connelly, Aaron L Baggish, Andrew Krahn, Sanjay Sharma
Sudden cardiac death (SCD), especially in a young seemingly healthy individual, is a tragic and highly publicized event, which is often followed by a strong emotional reaction from the public and medical community." Although rare, SCD in the young is devastating to families and communities, underpinning our society's desire to avoid any circumstances predisposing to the loss of human life during exertion. The Canadian Cardiovascular Society Position Statement on the cardiovascular screening of athletes provides evidence-based recommendations for Canadian sporting organizations and institutions with a focus on the role of routine electrocardiogram (ECG) screening in preventing SCD...
January 2019: Canadian Journal of Cardiology
Júlio C Machado, Miguel A Faria, Armindo Melo, Zita E Martins, Isabel M P L V O Ferreira
The practice of dry-hopping has been used by the brewing industry to obtain beers with increased contents of flavor and bitterness compounds. Notwithstanding this, other compounds such as α-acids (AA) and xhanthohumol (XN) are co-extracted influencing the final characteristics of the beer, particularly its beneficial bioactivity. In this context a model for the understanding of AA and XN extraction by dry-hopping is proposed. The varieties Chinook (CHI), East Kent Goldings (EKG) and Tettnanger (TET) were assayed and robust statistical approaches were applied for data interpretation...
April 25, 2019: Food Chemistry
Sahil Khanna, V Ramesh Iyer, Victoria L Vetter
OBJECTIVES: To assess the impact of participation in an educational presentation on electrocardiogram (ECG) interpretation in children on pediatric practitioners' ability to accurately interpret ECGs. STUDY DESIGN: Pediatric healthcare providers at a pediatric clinic with >65 000 visits/year were eligible to participate. A 1-hour ECG educational module that provided a systematic approach to ECG interpretation was presented to 8 providers who consented (6 pediatricians, 2 pediatric nurse practitioners)...
December 17, 2018: Journal of Pediatrics
Eugene S J Tan, Swee-Chong Seow, Pipin Kojodjojo, Devinder Singh, Wee Tiong Yeo, Toon Wei Lim
Objective: We studied the optimal duration of ambulatory event monitors for symptomatic patients and the predictors of detected events. Methods: Patients with palpitations or dizziness received a patient-activated handheld event monitor which records 30 s single-lead ECG strips. Patients were monitored in an ambulatory setting for a range of 1-4 weeks and ECG strips interpreted by five independent electrophysiologists. Event pick-up rates and clinical covariates were analysed...
2018: Heart Asia
Tricia Adjei, Jingwen Xue, Danilo P Mandic
Sex differences in the study of the human physiological response to mental stress are often erroneously ignored. To this end, we set out to show that our understanding of the stress response is fundamentally altered once sex differences are taken into account. This is achieved by comparing the heart rate variability (HRV) signals acquired during mental maths tests from ten females and ten males of similar maths ability; all females were in the follicular phase of their menstrual cycle. For rigor, the HRV signals from this pilot study were analyzed using temporal, spectral and nonlinear signal processing techniques, which all revealed significant statistical differences between the sexes, with the stress-induced increases in the heart rates from the males being significantly larger than those from the females ( p -value = 4...
2018: Frontiers in Physiology
David M Thomas, Patrick D McLaughlin, James P Nugent, Sarah A Barrett, John R Mayo, Ana-Maria Bilawich, Graham C Wong, Savvas Nicolaou
PURPOSE: This retrospective study reports the frequency and severity of coronary artery motion on dual-source high-pitch (DSHP), conventional pitch single-source (SS), and dual-source dual-energy (DE) CT pulmonary angiography (CTPA) studies. METHODS: Two hundred eighty-eight consecutive patients underwent CTPA scans for suspected pulmonary embolism between September 1, 2013 and January 31, 2014. One hundred ninety-four at DSHP scans, 57 SS scans, and 37 DE scans were analyzed...
December 12, 2018: Emergency Radiology
Grant H Kruger, Rakesh Latchamsetty, Nicholas B Langhals, Miki Yokokawa, Aman Chugh, Fred Morady, Hakan Oral, Omer Berenfeld
INTRODUCTION: Atrial Fibrillation (AF) is the most common cardiac arrhythmia, presenting a significant independent risk factor for stroke and thromboembolism. With the emergence of m-Health devices, the importance of automatic detection of AF in an off-clinic setting is growing. This study demonstrates the performance of a bimodal classifier for distinguishing AF from sinus rhythm (SR) that could be used for automated detection of AF episodes. METHODS: Surface recordings from a hand-held research device and standard electrocardiograms (ECG) were collected and analyzed from 68 subjects...
November 22, 2018: Computers in Biology and Medicine
Nils Strodthoff, Claas Strodthoff
We aim to provide an algorithm for the detection of myocardial infarction that operates directly on ECG data without any preprocessing and to investigate its decision criteria.&#13; &#13; Approach: We train an ensemble of fully convolutional neural networks on the PTB ECG dataset and apply state-of-the-art attribution methods.&#13; &#13; Main results: Our classifier reaches 93.3% sensitivity and 89.7% specificity evaluated using 10-fold cross-validation with sampling based on patients. The presented method outperforms state-of-the-art approaches and reaches the performance level of human cardiologists for detection of myocardial infarction...
November 23, 2018: Physiological Measurement
Binliang Liu, Tao An, Meiying Li, Zongbi Yi, Chunxiao Li, Xiaoying Sun, Xiuwen Guan, Lixi Li, Yanfeng Wang, Yuhui Zhang, Binghe Xu, Fei Ma, Yixin Zeng
BACKGROUND: An increasing number of cancer patients die of cardiovascular diseases. The cardiotoxicity of chemotherapy is particularly important in triple-negative breast cancer (TNBC) with limited therapeutic options. Cardiac autophagy is an important mechanism of cardiotoxicity. This research was aimed to investigate the cardiotoxicity of chemotherapy in TNBC, screen the susceptible population, and determine the relationship between cardiotoxicity and autophagy-related polymorphisms...
December 4, 2018: Cancer communications
Rita Brito, Louis-Paulin Mondouagne, Carine Stettler, Christophe Combescure, Haran Burri
BACKGROUND: Handheld ECG recorders may have algorithms which automatically inform the user of presence of arrhythmia. The main objectives of this study were to evaluate the accuracy of the arrhythmia diagnosis algorithm of Beurer ME90 recorder to diagnose atrial fibrillation (AF)/flutter, and to evaluate whether recording technique (finger versus precordial) affects diagnostic performance. METHODS: Consecutive patients admitted at the cardiology ward of a tertiary care hospital were enrolled...
November 2018: Journal of Electrocardiology
Stephen W Smith, Brooks Walsh, Ken Grauer, Kyuhyun Wang, Jeremy Rapin, Jia Li, William Fennell, Pierre Taboulet
BACKGROUND: Cardiologs® has developed the first electrocardiogram (ECG) algorithm that uses a deep neural network (DNN) for full 12‑lead ECG analysis, including rhythm, QRS and ST-T-U waves. We compared the accuracy of the first version of Cardiologs® DNN algorithm to the Mortara/Veritas® conventional algorithm in emergency department (ED) ECGs. METHODS: Individual ECG diagnoses were prospectively mapped to one of 16 pre-specified groups of ECG diagnoses, which were further classified as "major" ECG abnormality or not...
November 16, 2018: Journal of Electrocardiology
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