Science.gov

Sample records for abnormal ecg findings

  1. Prevalence of abnormal ECGs in male soccer players decreases with the Seattle criteria, but is still high.

    PubMed

    Berge, H M; Gjesdal, K; Andersen, T E; Solberg, E E; Steine, K

    2015-08-01

    Electrocardiogram (ECG) and echocardiography are mandatory in preparticipation cardiac screening in soccer players. Abnormal ECG findings usually require follow-up investigations. The main aim of this study was to compare the prevalence of abnormal ECG findings in male professional soccer players according to European Society of Cardiology's (ESC) recommendations and the Seattle criteria, and to assess the need for echocardiography. ECGs from 587 of 595 (99%) players were recorded with ClickECG, and measurements were derived with visually adjusted on-screen calipers on the computer-based averaged PQRST complex. Echocardiographic recordings were performed with Vivid 7/i and categorized according to reference values for athlete's heart. After the initial screening, 32 (5.5%) players were recommended for follow-up. The prevalence of abnormal ECGs was 29.3% vs 11.2% according to the ESC's recommendations and the Seattle criteria, respectively. None of the players with abnormal ECGs only according to the ESC's recommendations had abnormal echocardiograms. Echocardiography alone detected one player with abnormalities (athlete's heart). The Seattle criteria reduced the number of athletes with abnormal ECGs considerably compared with the ESC recommendations. Based on echocardiographic evaluations, this increased the specificity of the Seattle criteria, without increasing the number of false-negative ECGs. The need for mandatory echocardiography in soccer players seems limited.

  2. ECG patch monitors for assessment of cardiac rhythm abnormalities.

    PubMed

    Lobodzinski, S Suave

    2013-01-01

    The primary goal of long-term monitoring is the improvement of diagnostic yield. Despite the clear utility of Holter monitoring in clinical cardiology, issues of relatively low diagnostic yield, cost and inconvenience have motivated the development of ultra-portable devices referred to as ECG patch monitors. Although the "gold standard" for assessing cardiac rhythm abnormalities remains a 12-lead Holter, there is an increasing interest in portable monitoring devices that provide the opportunity for evaluating cardiac rhythm in real-world environments such as the workplace or home. To facilitate patient acceptance these monitors underwent a radical miniaturization and redesign to include wireless communication, water proofing and a patch carrier for attaching devices directly to the skin. We review recent developments in the field of "patch" devices primarily designed for very long-term monitoring of cardiac arrhythmic events. As the body of supporting clinical validation data grows, these devices hold promise for a variety of cardiac monitoring applications. From a clinical and research standpoint, the capacity to obtain longitudinal cardiac activity data by patch devices may have significant implications for device selection, monitoring duration, and care pathways for arrhythmia evaluation and atrial fibrillation surveillance. From a research standpoint, the new devices may allow for the development of novel diagnostic algorithms with the goal of finding patterns and correlations with exercise and drug regimens.

  3. ECG findings after myocardial infarction in children after Kawasaki disease

    SciTech Connect

    Nakanishi, T.; Takao, A.; Kondoh, C.; Nakazawa, M.; Hiroe, M.; Matsumoto, Y.

    1988-10-01

    Standard 12-lead ECGs were evaluated in 17 children with myocardial infarction and 78 children without myocardial infarction after Kawasaki disease; sensitivity and specificity of the ECG infarction criteria were determined. The presence or absence of myocardial infarction was determined from either clinical examination results (coronary angiography, ventriculography, and thallium-201 myocardial imaging) or autopsy findings. Of seven patients with inferior infarction, abnormally deep Q waves in lead II, III, or aVF were observed in six, but the duration was greater than 0.04 second in only one (14%). The sensitivity and specificity of inferior infarction criteria based on Q wave amplitude were 86% and 97%, respectively. Of eight patients with anterior infarction, seven (88%) had abnormally deep and wide (greater than or equal to 0.04 second) Q waves in anterior chest leads. The sensitivity and specificity of the infarction criteria based on the amplitude and duration of the Q wave were 75% and 99%, respectively. Of seven patients with lateral infarction, Q waves were observed in lead I, aVL, or both in four patients, and in all of these patients Q waves were wider than 0.04 second. In two patients with both inferior and anterior infarction, Q waves were observed only in leads II, III, and aVF; in only one patient were the Q waves wider than 0.04 second. Thus deep Q waves in lead II, III, or aVF that are not wider than 0.04 second may indicate inferior infarction in children. Q waves in lead I, aVL, and chest leads associated with anterolateral infarction are in most instances deep and wide.

  4. The Abnormal vs. Normal ECG Classification Based on Key Features and Statistical Learning

    NASA Astrophysics Data System (ADS)

    Dong, Jun; Tong, Jia-Fei; Liu, Xia

    As cardiovascular diseases appear frequently in modern society, the medicine and health system should be adjusted to meet the new requirements. Chinese government has planned to establish basic community medical insurance system (BCMIS) before 2020, where remote medical service is one of core issues. Therefore, we have developed the "remote network hospital system" which includes data server and diagnosis terminal by the aid of wireless detector to sample ECG. To improve the efficiency of ECG processing, in this paper, abnormal vs. normal ECG classification approach based on key features and statistical learning is presented, and the results are analyzed. Large amount of normal ECG could be filtered by computer automatically and abnormal ECG is left to be diagnosed specially by physicians.

  5. Detection of Cardiac Abnormalities from Multilead ECG using Multiscale Phase Alternation Features.

    PubMed

    Tripathy, R K; Dandapat, S

    2016-06-01

    The cardiac activities such as the depolarization and the relaxation of atria and ventricles are observed in electrocardiogram (ECG). The changes in the morphological features of ECG are the symptoms of particular heart pathology. It is a cumbersome task for medical experts to visually identify any subtle changes in the morphological features during 24 hours of ECG recording. Therefore, the automated analysis of ECG signal is a need for accurate detection of cardiac abnormalities. In this paper, a novel method for automated detection of cardiac abnormalities from multilead ECG is proposed. The method uses multiscale phase alternation (PA) features of multilead ECG and two classifiers, k-nearest neighbor (KNN) and fuzzy KNN for classification of bundle branch block (BBB), myocardial infarction (MI), heart muscle defect (HMD) and healthy control (HC). The dual tree complex wavelet transform (DTCWT) is used to decompose the ECG signal of each lead into complex wavelet coefficients at different scales. The phase of the complex wavelet coefficients is computed and the PA values at each wavelet scale are used as features for detection and classification of cardiac abnormalities. A publicly available multilead ECG database (PTB database) is used for testing of the proposed method. The experimental results show that, the proposed multiscale PA features and the fuzzy KNN classifier have better performance for detection of cardiac abnormalities with sensitivity values of 78.12 %, 80.90 % and 94.31 % for BBB, HMD and MI classes. The sensitivity value of proposed method for MI class is compared with the state-of-art techniques from multilead ECG. PMID:27118009

  6. Measurement of ECG abnormalities and cardiovascular risk classification: a cohort study of primary care patients in the Netherlands

    PubMed Central

    Groot, Anne; Bots, Michiel L; Rutten, Frans H; den Ruijter, Hester M; Numans, Mattijs E; Vaartjes, Ilonca

    2015-01-01

    Background GPs need accurate tools for cardiovascular (CV) risk assessment. Abnormalities in resting electrocardiograms (ECGs) relate to increased CV risk. Aim To determine whether measurement of ECG abnormalities on top of established risk estimation (SCORE) improves CV risk classification in a primary care population. Design and setting A cohort study of patients enlisted with academic general practices in the Netherlands (the Utrecht Health Project [UHP]). Method Incident CV events were extracted from the GP records. MEANS algorithm was used to assess ECG abnormalities. Cox proportional hazards modelling was applied to relate ECG abnormalities to CV events. For a prediction model only with SCORE variables, and a model with SCORE+ECG abnormalities, the discriminative value (area under the receiver operator curve [AUC]) and the net reclassification improvement (NRI) were estimated. Results A total of 2370 participants aged 38–74 years were included, all eligible for CV risk assessment. During a mean follow-up of 7.8 years, 172 CV events occurred. In 19% of the participants at least one ECG abnormality was found (Lausanne criteria). Presence of atrial fibrillation/flutter (AF) and myocardial infarction (MI) were significantly related to CV events. The AUC of the SCORE risk factors was 0.75 (95% CI = 0.71 to 0.79). Addition of MI or AF resulted in an AUC of 0.76 (95% CI = 0.72 to 0.79) and 0.75 (95% CI = 0.72 to 0.79), respectively. The NRI with the addition of ECG abnormalities was small (MI 1.0%; 95% CI = −3.2% to 6.9%; AF 0.5%; 95% CI = −3.5% to 3.3%). Conclusion Performing a resting ECG in a primary care population does not seem to improve risk classification when SCORE information — age, sex, smoking, systolic blood pressure, and total cholesterol/HDL ratio — is already available. PMID:25548311

  7. Severe hypermagnesemia presenting with abnormal electrocardiographic findings similar to those of hyperkalemia in a child undergoing peritoneal dialysis

    PubMed Central

    Jhang, Won Kyoung; Lee, Yoon Jung; Kim, Young A; Park, Seong Jong

    2013-01-01

    In this report, we present a pediatric case of severe symptomatic hypermagnesemia resulting from the use of magnesium oxide as a laxative in a child undergoing continuous cyclic peritoneal dialysis for end-stage renal disease. The patient showed abnormal electrocardiography (ECG) findings, such as tall T waves, a widened QRS complex, and irregular conduction, which were initially misdiagnosed as hyperkalemia; later, the correct diagnosis of hypermagnesemia was obtained. Emergent hemodialysis successfully returned the serum magnesium concentration to normal without complications. When abnormal ECG changes are detected in patients with renal failure, hypermagnesemia should be considered. PMID:23908672

  8. Mouse ECG findings in aging, with conduction system affecting drugs and in cardiac pathologies: Development and validation of ECG analysis algorithm in mice.

    PubMed

    Merentie, Mari; Lipponen, Jukka A; Hedman, Marja; Hedman, Antti; Hartikainen, Juha; Huusko, Jenni; Lottonen-Raikaslehto, Line; Parviainen, Viktor; Laidinen, Svetlana; Karjalainen, Pasi A; Ylä-Herttuala, Seppo

    2015-12-01

    Mouse models are extremely important in studying cardiac pathologies and related electrophysiology, but very few mouse ECG analysis programs are readily available. Therefore, a mouse ECG analysis algorithm was developed and validated. Surface ECG (lead II) was acquired during transthoracic echocardiography from C57Bl/6J mice under isoflurane anesthesia. The effect of aging was studied in young (2-3 months), middle-aged (14 months) and old (20-24 months) mice. The ECG changes associated with pharmacological interventions and common cardiac pathologies, that is, acute myocardial infarction (AMI) and progressive left ventricular hypertrophy (LVH), were studied. The ECG raw data were analyzed with an in-house ECG analysis program, modified specially for mouse ECG. Aging led to increases in P-wave duration, atrioventricular conduction time (PQ interval), and intraventricular conduction time (QRS complex width), while the R-wave amplitude decreased. In addition, the prevalence of arrhythmias increased during aging. Anticholinergic atropine shortened PQ time, and beta blocker metoprolol and calcium-channel blocker verapamil increased PQ interval and decreased heart rate. The ECG changes after AMI included early JT elevation, development of Q waves, decreased R-wave amplitude, and later changes in JT/T segment. In progressive LVH model, QRS complex width was increased at 2 and especially 4 weeks timepoint, and also repolarization abnormalities were seen. Aging, drugs, AMI, and LVH led to similar ECG changes in mice as seen in humans, which could be reliably detected with this new algorithm. The developed method will be very useful for studies on cardiovascular diseases in mice.

  9. Imaging findings in fetal diaphragmatic abnormalities.

    PubMed

    Alamo, Leonor; Gudinchet, François; Meuli, Reto

    2015-12-01

    Imaging plays a key role in the detection of a diaphragmatic pathology in utero. US is the screening method, but MRI is increasingly performed. Congenital diaphragmatic hernia is by far the most often diagnosed diaphragmatic pathology, but unilateral or bilateral eventration or paralysis can also be identified. Extralobar pulmonary sequestration can be located in the diaphragm and, exceptionally, diaphragmatic tumors or secondary infiltration of the diaphragm from tumors originating from an adjacent organ have been observed in utero. Congenital abnormalities of the diaphragm impair normal lung development. Prenatal imaging provides a detailed anatomical evaluation of the fetus and allows volumetric lung measurements. The comparison of these data with those from normal fetuses at the same gestational age provides information about the severity of pulmonary hypoplasia and improves predictions about the fetus's outcome. This information can help doctors and families to make decisions about management during pregnancy and after birth. We describe a wide spectrum of congenital pathologies of the diaphragm and analyze their embryological basis. Moreover, we describe their prenatal imaging findings with emphasis on MR studies, discuss their differential diagnosis and evaluate the limits of imaging methods in predicting postnatal outcome. PMID:26255159

  10. Cardiac Repolarization Abnormalities and Potential Evidence for Loss of Cardiac Sodium Currents on ECGs of Patients with Chagas' Heart Disease

    NASA Technical Reports Server (NTRS)

    Schlegel, T. T.; Medina, R.; Jugo, D.; Nunez, T. J.; Borrego, A.; Arellano, E.; Arenare, B.; DePalma, J. L.; Greco, E. C.; Starc, V.

    2007-01-01

    were not significantly different between groups. Patients with Chagas heart disease have increased cardiac repolarization abnormalities, especially by advanced ECG. Moreover, as a group, they have decreased uncorrected JT and QT interval durations and increased filtered QRS interval durations (versus age/gender-matched controls), all suggesting a potential loss of cardiac sodium channel function that might be mediated, in part, by cardiac autonomic damage. Overall findings support Brugada et al's recent hypothesis that the pathway leading to sudden death may often be similar in Chagas' disease and Brugada syndrome i.e., damage to the sodium channel (infectious/immunologic/autonomic in Chagas' genetic in Brugada) with consequent loss of sodium currents may facilitate a phase II-reentry based arrhythmic substrate for ventricular fibrillation in both conditions. In general, JT interval-related results have been underreported in the Chagas literature.

  11. Architecture design of the multi-functional wavelet-based ECG microprocessor for realtime detection of abnormal cardiac events.

    PubMed

    Cheng, Li-Fang; Chen, Tung-Chien; Chen, Liang-Gee

    2012-01-01

    Most of the abnormal cardiac events such as myocardial ischemia, acute myocardial infarction (AMI) and fatal arrhythmia can be diagnosed through continuous electrocardiogram (ECG) analysis. According to recent clinical research, early detection and alarming of such cardiac events can reduce the time delay to the hospital, and the clinical outcomes of these individuals can be greatly improved. Therefore, it would be helpful if there is a long-term ECG monitoring system with the ability to identify abnormal cardiac events and provide realtime warning for the users. The combination of the wireless body area sensor network (BASN) and the on-sensor ECG processor is a possible solution for this application. In this paper, we aim to design and implement a digital signal processor that is suitable for continuous ECG monitoring and alarming based on the continuous wavelet transform (CWT) through the proposed architectures--using both programmable RISC processor and application specific integrated circuits (ASIC) for performance optimization. According to the implementation results, the power consumption of the proposed processor integrated with an ASIC for CWT computation is only 79.4 mW. Compared with the single-RISC processor, about 91.6% of the power reduction is achieved.

  12. 42 CFR 37.54 - Notification of abnormal radiographic findings.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ..., abnormality of cardiac shape or size, tuberculosis, lung cancer, or any other significant abnormal findings... shape or size, tuberculosis, cancer, complicated pneumoconiosis, and any other significant abnormal... in accordance with section 203 of the Act (see 30 CFR part 90). Positive findings with regard...

  13. 42 CFR 37.54 - Notification of abnormal radiographic findings.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... shape or size, tuberculosis, lung cancer, or any other significant abnormal findings other than..., tuberculosis, cancer, complicated pneumoconiosis, and any other significant abnormal findings, NIOSH will... section 203 of the Act (see 30 CFR part 90). Positive findings with regard to pneumoconiosis will...

  14. 42 CFR 37.53 - Notification of abnormal roentgenographic findings.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... suggesting, enlarged heart, tuberculosis, lung cancer, or any other significant abnormal findings other than... findings suggesting, abnormality of cardiac shape or size, tuberculosis, lung cancer, or any other... files and the most recent examination was interpreted to show enlarged heart, tuberculosis,...

  15. MRI findings in throwing shoulders: abnormalities in professional handball players.

    PubMed

    Jost, Bernhard; Zumstein, Matthias; Pfirrmann, Christian W A; Zanetti, Marco; Gerber, Christian

    2005-05-01

    Shoulders of throwing athletes are highly stressed joints and likely to have more structural abnormalities seen on magnetic resonance imaging scans. Prevalence and type of structural abnormalities, especially abnormalities of the rotator cuff tendons and the superolateral humeral head, and correlation of magnetic resonance imaging findings with symptoms and clinical tests, are not well known. Throwing and nonthrowing (symptomatic and asymptomatic) shoulders of 30 fully competitive professional handball players and 20 dominant shoulders of randomly selected volunteers were evaluated for comparison clinically and with magnetic resonance imaging. An average of seven abnormal magnetic resonance imaging findings was observed in the throwing shoulders; more than in the nonthrowing and the control shoulders. Although 93% of the throwing shoulders had abnormal magnetic resonance imaging findings, only 37% were symptomatic. Partial rotator cuff tears and mainly superolateral osteochondral defects of the humeral head were identified as typical throwing lesions. Symptoms correlated poorly with abnormalities seen on magnetic resonance imaging scans and findings from clinical tests. This suggests that the evaluation of an athlete's throwing shoulder should be done very thoroughly and should not be based mainly on abnormalities seen on magnetic resonance imaging scans.

  16. Clinical Correlation between Perverted Nystagmus and Brain MRI Abnormal Findings

    PubMed Central

    Han, Won-Gue; Yoon, Hee-Chul; Kim, Tae-Min; Rah, Yoon Chan

    2016-01-01

    Background and Objectives To analyze the clinical correlation between perverted nystagmus and brain magnetic resonance imaging (MRI) abnormal findings and to evaluate whether perverted nystagmus is clinically significant results of brain abnormal lesions or not. Subjects and Methods We performed medical charts review from January 2008 to July 2014, retrospectively. Patients who were suspected central originated vertigo at Frenzel goggles test were included among patients who visited our hospital. To investigate the correlation with nystagmus suspected central originated vertigo and brain MRI abnormal findings, we confirmed whether performing brain MRI or not. Then we exclude that patients not performed brain MRI. Results The number of patients with perverted nystagmus was 15, upbeating was 1 and down-beating was 14. Among these patients, 5 patients have brain MRI abnormal findings. However, 2 patients with MRI abnormal findings were not associated correctly with perverted nystagmus and only 3 patients with perverted nystagmus were considered central originated vertigo and further evaluation and treatment was performed by the department of neurology. Conclusions Perverted nystagmus was considered to the abnormalities at brain lesions, especially cerebellum, but neurologic symptoms and further evaluation were needed for exact diagnosis of central originated vertigo.

  17. Clinical Correlation between Perverted Nystagmus and Brain MRI Abnormal Findings

    PubMed Central

    Han, Won-Gue; Yoon, Hee-Chul; Kim, Tae-Min; Rah, Yoon Chan

    2016-01-01

    Background and Objectives To analyze the clinical correlation between perverted nystagmus and brain magnetic resonance imaging (MRI) abnormal findings and to evaluate whether perverted nystagmus is clinically significant results of brain abnormal lesions or not. Subjects and Methods We performed medical charts review from January 2008 to July 2014, retrospectively. Patients who were suspected central originated vertigo at Frenzel goggles test were included among patients who visited our hospital. To investigate the correlation with nystagmus suspected central originated vertigo and brain MRI abnormal findings, we confirmed whether performing brain MRI or not. Then we exclude that patients not performed brain MRI. Results The number of patients with perverted nystagmus was 15, upbeating was 1 and down-beating was 14. Among these patients, 5 patients have brain MRI abnormal findings. However, 2 patients with MRI abnormal findings were not associated correctly with perverted nystagmus and only 3 patients with perverted nystagmus were considered central originated vertigo and further evaluation and treatment was performed by the department of neurology. Conclusions Perverted nystagmus was considered to the abnormalities at brain lesions, especially cerebellum, but neurologic symptoms and further evaluation were needed for exact diagnosis of central originated vertigo. PMID:27626081

  18. Abnormal Gastroscopy Findings Were Related to Lower Meridian Energy

    PubMed Central

    Huang, Sheng-Miauh; Chien, Li-Yin; Chang, Chun-Chao; Chen, Ping-Ho; Tai, Chen-Jei

    2011-01-01

    According to the theories of Traditional Chinese Medicine (TCM), energy runs through 12 meridians longitudinally up and down the body. The study objectives were to compare the meridian energy between subjects with and without abnormal gastroscopy findings. We applied a cross-sectional and correlational research design. The study included 1,223 participants who had their health examinations at a university hospital in Taipei from 1st August 2005 through 31st August 2007. Meridian energy was examined using a meridian energy analysis device. The gastroscopy was operated by certified gastroenterologists. Participants with abnormal stomach and esophageal findings using gastroscopy had significantly lower mean meridian energy. There were no significant differences in meridian energy between participants with and without abnormal duodenum findings. When all of the meridians were examined individually, participants with abnormal findings in esophagus and stomach had significantly lower meridian energy in each of the meridians. The results of this study demonstrated that structural abnormality in the gastric area was related to lower meridian energy. Whether enhancing meridian energy could improve gastric and esophageal health merits further studies. PMID:21052557

  19. 42 CFR 37.53 - Notification of abnormal roentgenographic findings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... suggesting, enlarged heart, tuberculosis, lung cancer, or any other significant abnormal findings other than... files and the most recent examination was interpreted to show enlarged heart, tuberculosis, cancer... to the miner by MSHA in accordance with section 203 of the act (see 30 CFR part 90)....

  20. 42 CFR 37.53 - Notification of abnormal roentgenographic findings.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... suggesting, enlarged heart, tuberculosis, lung cancer, or any other significant abnormal findings other than... files and the most recent examination was interpreted to show enlarged heart, tuberculosis, cancer... to the miner by MSHA in accordance with section 203 of the act (see 30 CFR part 90)....

  1. Prevalence of high risk Tl-201 scintigraphic findings in patients with coronary artery disease: Relation to coronary anatomy and ECG stress test findings

    SciTech Connect

    Ryan, J.M.; Nygaard, T.W.; Gibson, R.S.; Gascho, J.A.; Watson, D.D.; Beller, G.A.

    1984-01-01

    The prevalence of a high risk exercise (Ex) Tl-201 (Tl) scintigram (scint) was determined in 295 consecutive patients (pts) with angiographic (angio) (>50% stenosis) coronary artery disease (CAD) and correlated with extent of CAD and Ex stress test findings. A high risk scint by quantitative criteria was defined as either: 1) a typical left main (LM) CAD pattern showing greater than or equal to 25% homogenous disease in Tl activity in septal and posterolateral walls; 2) a multivessel disease (MVD) pattern showing abnormal Tl uptake and/or washout in multiple vascular scan segments; 3) increased lung Tl uptake. The typical LMCAD pattern was observed in 6 of 43 pts (14%) with LMCAD compared to 2% of 53 pts with 3VD (p=0.03), 3% of 99 pts with 2VD (p=0.02) and 2% of 100 pts with 1VD (p-0.01). The MVD scint pattern was seen in 67% of pts with LMCAD compared to 49% (p=0.05) in 3VD pts, 41% (p=0.004) in 2VD pts and 24% (p=<0.0001) in 1VD pts. Prevalence of abnormal lung Tl was comparable in LMCAD (42%), 3VD (38%) and 2VD (34%) pts, but greater than observed in 1VD pts (26%; p=0.05). High risk ECG stress test was defined as 2 or more of: 1) >2.0 mm of ST decreasing; 2) greater than or equal to1.0 mm ST decreasing persisting >5 min post-EX; 3) ST decreasing at less than or equal to5 METS; 4) greater than or equal to10 mm Hg decreasing in Ex blood pressure. A high risk ECG stress test was observed in 58% of LMCAD pts compared to 32% of 3VD pts (p=0.009), 31% of 2VD pts (p=0.003) and 16% of 1VD pts (p<0.0001). Eighty-six % of LMCAD and 70% of 2 and 3VD pts had either a high risk Ex scint or stress test. Thus, EX Tl-201 scint appears useful in identifying high risk CAD pts.

  2. Screening of sarcomere gene mutations in young athletes with abnormal findings in electrocardiography: identification of a MYH7 mutation and MYBPC3 mutations.

    PubMed

    Kadota, Chika; Arimura, Takuro; Hayashi, Takeharu; Naruse, Taeko K; Kawai, Sachio; Kimura, Akinori

    2015-10-01

    There is an overlap between the physiological cardiac remodeling associated with training in athletes, the so-called athlete's heart, and mild forms of hypertrophic cardiomyopathy (HCM), the most common hereditary cardiac disease. HCM is often accompanied by unfavorable outcomes including a sudden cardiac death in the adolescents. Because one of the initial signs of HCM is abnormality in electrocardiogram (ECG), athletes may need to monitor for ECG findings to prevent any unfavorable outcomes. HCM is caused by mutations in genes for sarcomere proteins, but there is no report on the systematic screening of gene mutations in athletes. One hundred and two genetically unrelated young Japanese athletes with abnormal ECG findings were the subjects for the analysis of four sarcomere genes, MYH7, MYBPC3, TNNT2 and TNNI3. We found that 5 out of 102 (4.9%) athletes carried mutations: a heterozygous MYH7 Glu935Lys mutation, a heterozygous MYBPC3 Arg160Trp mutation and another heterozygous MYBPC3 Thr1046Met mutation, all of which had been reported as HCM-associated mutations, in 1, 2 and 2 subjects, respectively. This is the first study of systematic screening of sarcomere gene mutations in a cohort of athletes with abnormal ECG, demonstrating the presence of sarcomere gene mutations in the athlete's heart.

  3. Normal and abnormal US findings at the mastectomy site.

    PubMed

    Kim, Sun Mi; Park, Jeong Mi

    2004-01-01

    Evaluation of a mastectomy site is more effective with ultrasonography (US) than with either mammography or chest computed tomography because abnormalities are usually small and close to the skin surface. US does not involve the use of ionizing radiation and has a multiplanar scanning capability. The technique is readily available and inexpensive, and it allows real-time monitoring of needle tip placement during biopsy of a lesion. Normal US anatomy of the chest wall after mastectomy usually consists of four layers: skin, subcutaneous fat, pectoral muscles, and rib and intercostal muscle. The axilla is changed in appearance after lymph node dissection, but it remains the same in patients who have undergone simple mastectomy. US can accurately depict benign and malignant conditions in the mastectomy site, including fluid collection, fibrosis, local recurrent tumor, and metastatic lymphadenopathy, and can enable accurate diagnosis based on findings at fine needle aspiration biopsy.

  4. [Transponder ECG].

    PubMed

    Bedrich, M R

    1997-04-01

    Apart from X-rays, the electrocardiogram (ECG) is probably the most frequently employed routine investigation. The 24-hour (Holter) ECG is a valuable diagnostic tool both for the general practitioner and the cardiologist. For the patient, the procedure can be experienced as something of a nuisance during the course of his/her normal life. Not least of the reasons for this are the leads connecting the electrodes to the device, which impair the movements of the patient's trunk. In addition, the patient feels constrained by a desire to avoid the disconnection of the electrodes by uncontrolled movements. Despite positive findings obtained by other means, this situation often leads to false negative results, making repetition of the procedure at some later date.

  5. Electrocardiograph abnormalities in intracerebral hemorrhage.

    PubMed

    Takeuchi, Satoru; Nagatani, Kimihiro; Otani, Naoki; Wada, Kojiro; Mori, Kentaro

    2015-12-01

    This study investigated the prevalence and type of electrocardiography (ECG) abnormalities, and their possible association with the clinical/radiological findings in 118 consecutive patients with non-traumatic, non-neoplastic intracerebral hemorrhage (ICH). ECG frequently demonstrates abnormalities in patients with ischemic stroke and subarachnoid hemorrhage, but little is known of ECG changes in ICH patients. Clinical and radiological information was retrospectively reviewed. ECG recordings that were obtained within 24 hours of the initial hemorrhage were analyzed. Sixty-six patients (56%) had one or more ECG abnormalities. The most frequent was ST depression (24%), followed by left ventricular hypertrophy (20%), corrected QT interval (QTc) prolongation (19%), and T wave inversion (19%). The logistic regression analysis demonstrated the following: insular involvement was an independent predictive factor of ST depression (p<0.001; odds ratio OR 10.18; 95% confidence interval [CI] 2.84-36.57); insular involvement (p<0.001; OR 23.98; 95% CI 4.91-117.11) and presence of intraventricular hemorrhage (p<0.001; OR 8.72; 95% CI 2.69-28.29) were independent predictive factors of QTc prolongation; deep hematoma location (p<0.001; OR 19.12; 95% CI 3.82-95.81) and hematoma volume >30 ml (p=0.001; OR 6.58; 95% CI 2.11-20.46) were independent predictive factors of T wave inversion. We demonstrate associations between ECG abnormalities and detailed characteristics of ICH.

  6. MRI Findings of Intrinsic and Extrinsic Duodenal Abnormalities and Variations

    PubMed Central

    Erden, Ayse; Ustuner, Evren; Uzun, Caglar; Bektas, Mehmet

    2015-01-01

    This pictorial review aims to illustrate the magnetic resonance imaging (MRI) findings and presentation patterns of anatomical variations and various benign and malignant pathologies of the duodenum, including sphincter contraction, major papilla variation, prominent papilla, diverticulum, annular pancreas, duplication cysts, choledochocele, duodenal wall thickening secondary to acute pancreatitis, postbulbar stenosis, celiac disease, fistula, choledochoduodenostomy, external compression, polyps, Peutz-Jeghers syndrome, ampullary carcinoma and adenocarcinoma. MRI is a useful imaging tool for demonstrating duodenal pathology and its anatomic relationships with adjacent organs, which is critical for establishing correct diagnosis and planning appropriate treatment, especially for surgery. PMID:26576112

  7. Electrocardiographic findings in pulmonary embolism.

    PubMed

    Boey, Elaine; Teo, Swee-Guan; Poh, Kian-Keong

    2015-10-01

    Pulmonary embolism (PE) poses a challenge to physicians, as it can be difficult to diagnose but results in significant mortality and morbidity in patients. Diagnosing PE requires an integrated approach using clinical findings, electrocardiography (ECG), blood investigations and imaging modalities. Abnormalities in ECG are common among patients with massive acute PE and can serve as a prognostic indicator. In this article, we describe the ECG presentations of two patients diagnosed with PE, and review the literature on the various types of ECG presentations and their role in predicting the prognosis of PE.

  8. Focal electroencephalographic abnormalities and computerised tomography findings in children with seizures.

    PubMed Central

    Gibbs, J; Appleton, R E; Carty, H; Beirne, M; Acomb, B A

    1993-01-01

    A persistent focal abnormality was observed in 157 (16%) electroencephalograms undertaken in 964 consecutive children with epileptic and non-epileptic seizures seen over one year. CT head scans were performed in 121 (77%) of the 157 children with a focus on the EEG; 26 (21%) showed an abnormality, and 21 (81%) of the abnormalities were localised. There was no difference in the proportion of abnormal scans associated with a delta or slow wave focus compared with a spike or sharp wave focus. An abnormal scan was uncommon after a single seizure. In only two patients (1.7% of all scans) did the findings on CT alter or greatly influence subsequent management. PMID:8482957

  9. Soft-tissue abnormalities of the external auditory canal: Subject review of CT findings

    SciTech Connect

    Chakeres, D.W.; Kapila, A.; LaMasters, D.

    1985-07-01

    The authors review the normal anatomy and discuss characteristic findings of soft-tissue abnormalities of the external auditory canal (EAC). The indications for computed tomography (CT) of the temporal bone have been significantly expanded with the inclusion of soft-tissue abnormalities of the external ear and the auditory canal. CT scans of 25 patients who had soft-tissue abnormalities of the EAC were reviewed. The clinical data were correlated with the radiographic findings. They conclude that CT is the best overall radiographic modality for evaluating the extent and character of soft-tissue abnormalities of the EAC. Significant clinical information that is helpful in patient management decisions is added by this technique.

  10. Normal versus Abnormal Genital Findings in Children: How Well Do Examiners Agree?

    ERIC Educational Resources Information Center

    Adams, Joyce A.; Wells, Robert

    1993-01-01

    Preselected colposcopic photographs of the anogenital area of 16 patients were shown to 170 medical examiners, who rated their level of suggestion or indication of penetrating injury. Agreement between the participants and experts was higher on the abnormal cases than on the normal cases, and higher on genital findings than on anal findings.…

  11. Time to follow up after an abnormal finding in organized gastric cancer screening in Korea

    PubMed Central

    2012-01-01

    Background The prognosis for an abnormal medical finding is affected by both early detection and adherence to the presecribed schedule for follow-up examinations. In this study, we examined the time to follow up after an abnormal finding and determined the risk factors related to delays in follow up in a population-based screening program. Methods The study population consisted of patients who were newly diagnosed with gastric cancer through a gastric cancer screening program sponsored by the National Cancer Screening Program (NCSP) in 2005. Due to the skewed nature of the distribution of time to follow up, medians and interquartile ranges (IQR) are presented, and we analyzed the number of days preceding the follow-up time as a binary variable (≤90 days or >90 days). We used logistic regression analyses to evaluate the risk factors for a long delay. Results The median number of days to follow-up initiation after an abnormal finding was 11 (IQR 7–27); 13.9% of the patients with gastric cancer obtained their follow-up evaluation more than 90 days. Age, type of health insurance, screening method, and screening results were risk factors for delays in follow up. Conclusions This study examined delays from the time of the discovery of an abnormal finding to time of the follow-up evaluation. Because inadequate follow up of abnormal exam results undermines the potential benefits of cancer screening, it is important to organize services that minimize delays between cancer screening and treatment. PMID:22963347

  12. Abnormal findings on knee magnetic resonance imaging in asymptomatic NBA players.

    PubMed

    Walczak, Brian E; McCulloch, Patrick C; Kang, Richard W; Zelazny, Anthony; Tedeschi, Fred; Cole, Brian J

    2008-01-01

    The purpose of this study was to evaluate the knees of asymptomatic National Basketball Association (NBA) players via magnetic resonance imaging (MRI) and confirm or dispute findings reported in the previous literature. It is thought that a variety of significant abnormalities affecting the knee exist in asymptomatic patients and that these findings can be accurately identified on MRI. Two months prior to the 2005 season, bilateral knee MRI examinations of 14 asymptomatic NBA players (28 knees) were evaluated for abnormalities of the articular cartilage, menisci, and patellar and quadriceps tendons. The presence of joint effusion, subchondral edema, and cystic lesions and the integrity of the collateral and cruciate ligaments were also assessed.

  13. Predictive value of specific ultrasound findings when used as a screening test for abnormalities on VCUG

    PubMed Central

    Logvinenko, Tanya; Chow, Jeanne S.; Nelson, Caleb P.

    2015-01-01

    Summary Background Renal and bladder ultrasound (RBUS) is often used as an initial screening test for children after urinary tract infection (UTI). The 2011 AAP guidelines specifically recommend that RBUS be performed first, with voiding cystourethrogram (VCUG) to be performed only if the ultrasound is abnormal. While prior research has suggested that RBUS is neither sensitive nor specific for VCUG findings, such as vesicoureteral reflux (VUR), it is uncertain as to whether specific RBUS findings, alone or in combination, might make RBUS more useful as a predictor of VCUG abnormalities. Aims To evaluate the association of specific RBUS with VCUG findings, and determine whether predictive models that accurately predict patients at high risk of VCUG abnormalities, based on RBUS findings, can be constructed. Methods and study sample A total of 3995 patients were identified with VCUG and RBUS performed on the same day. The RBUS and VCUG reports were reviewed and the findings were classified. Analysis was limited to patients aged 0–60 months with no prior postnatal genitourinary imaging and no history of prenatal hydronephrosis. Analysis The associations between large numbers of specific RBUS findings with abnormalities seen on VCUG were investigated. Both multivariate logistic models and a neural network machine learning algorithms were constructed to evaluate the predictive power of RBUS for VCUG abnormalities (including VUR or bladder/urethral findings). Sensitivity, specificity, predictive values and area under receiving operating curves (AUROC) of RBUS for VCUG abnormalities were determined. Results A total of 2259 patients with UTI as the indication for imaging were identified. The RBUS was reported as “normal” in 75.0%. On VCUG, any VUR was identified in 41.7%, VUR grade >II in 20.9%, and VUR grade >III in 2.8%. Many individual RBUS findings were significantly associated with VUR on VCUG. Despite these strong univariate associations, multivariate modeling

  14. Incidental findings of pathology and abnormality in pretreatment orthodontic panoramic radiographs.

    PubMed

    Bondemark, Lars; Jeppsson, Malin; Lindh-Ingildsen, Lina; Rangne, Klara

    2006-01-01

    Panoramic radiographs, in combination with a clinical examination, are routinely used as an aid to orthodontic diagnosis and treatment planning. The aim of this study was to evaluate the prevalence and location of incidental findings of pathology and abnormalities in pretreatment orthodontic panoramic radiographs. A total of 496 patients (232 girls and 264 boys; mean age 11.2 years, SD 2.33) were randomly selected from the Orthodontic Clinic at the Faculty of Odontology, University of Malmö, Sweden. All radiographic examinations were performed between 1999 and 2003 at the Department of Oral Radiology, Faculty of Odontology, University of Malmö, Sweden. Two independent examiners analyzed the radiographs for abnormalities and diagnoses of pathology. However, caries and findings related to the orthodontic treatment plan, such as eruption disturbances and missing or supernumerary teeth, were not recorded. All radiographs with positive findings were reexamined by a third examiner, a specialist registrar in oral radiology. A total of 56 findings in 43 patients (8.7%) were recorded, and significantly more findings were detected in girls (P = .007). The most common findings were radiopacities (idiopathic sclerosis) in alveolar bone (n = 22), thickening of mucosal lining in sinus maxillaris (n = 15), and periapical inflammatory lesions (n = 10). The majority of the periapical lesions and radiopacities were found in the mandible. In most cases, the findings had no consequence for the orthodontic treatment plan and did not require medical or odontological management. However, the clinician should be aware of the potential to detect pathology and abnormality in pretreatment orthodontic panoramic radiographs. PMID:16448276

  15. An unusual ECG pattern in restrictive cardimyopathy

    PubMed Central

    Selvaganesh, M.; Arul, A.S.; Balasubramanian, S.; Ganesan, N.; Naina Mohammed, S.; Sivakumar, G.S.; Veeramani, S.R.; Jeyasingh, P.; Sathishkumar, S.; Selvaraju, S.

    2015-01-01

    Restrictive cardiomyopathy is the least common type of primary cardiomyopathies. Electrocardiographic recording is abnormal in 99% of patients with RCM. Biatrial enlargement, obliquely elevated ST segment with notched or biphasic late peaking T waves are considered characteristic ECG finding. Significant ST depression with T inversion mimicking subendocardial ischemia has also been reported in patients with RCM and is even suggested as a predictor of sudden cardiac death. We noted a similar ECG pattern in a 16 yr girl with Idiopathic restrictive cardiomyopathy. Coronaries were normal, stress perfusion imaging did not show any perfusion defect. This diffuse resting ST depression with T inversion in precordial & inferior leads along with ST elevation in aVR was persistent for more than six months. PMID:26304570

  16. An unusual ECG pattern in restrictive cardimyopathy.

    PubMed

    Selvaganesh, M; Arul, A S; Balasubramanian, S; Ganesan, N; Naina Mohammed, S; Sivakumar, G S; Veeramani, S R; Jeyasingh, P; Sathishkumar, S; Selvaraju, S

    2015-01-01

    Restrictive cardiomyopathy is the least common type of primary cardiomyopathies. Electrocardiographic recording is abnormal in 99% of patients with RCM. Biatrial enlargement, obliquely elevated ST segment with notched or biphasic late peaking T waves are considered characteristic ECG finding. Significant ST depression with T inversion mimicking subendocardial ischemia has also been reported in patients with RCM and is even suggested as a predictor of sudden cardiac death. We noted a similar ECG pattern in a 16 yr girl with Idiopathic restrictive cardiomyopathy. Coronaries were normal, stress perfusion imaging did not show any perfusion defect. This diffuse resting ST depression with T inversion in precordial & inferior leads along with ST elevation in aVR was persistent for more than six months. PMID:26304570

  17. Abnormal Magnetic Resonance Imaging Findings in Patients With Sudden Sensorineural Hearing Loss

    PubMed Central

    Jeong, Kyung-Hwa; Choi, Jin Woo; Shin, Jung Eun; Kim, Chang-Hee

    2016-01-01

    Abstract The etiology of sudden sensorineural hearing loss (SSNHL) remains unclear in most cases. This study aimed to assess abnormal magnetic resonance imaging (MRI) findings in patients with SSNHL and evaluate the value of MRI in identifying the cause of SSNHL. A retrospective analysis of the charts and MRI findings of 291 patients with SSNHL was performed. In 291 patients, MRI abnormality, which was considered a cause of SSNHL, was detected in 13 patients. Vestibular schwannoma involving the internal auditory canal (IAC) and/or cerebellopontine angle was observed in 9 patients. All 9 patients had intrameatal tumors, and 6 of the 9 patients displayed extrameatal extension of their tumors. The tumor was small (<1 cm) or medium-sized (1.1–2.9 cm) in these 6 patients. Intralabyrinthine schwannoma, labyrinthine hemorrhage, IAC metastasis, and a ruptured dermoid cyst were each observed in 1 patient. The most commonly observed MRI abnormality in patients with SSNHL was vestibular schwannoma, and all of the lesions were small or medium-sized tumors involving the IAC. PMID:27124066

  18. Computed tomographic findings in children with spastic diplegia: correlation with the severity of their motor abnormality.

    PubMed

    Yokochi, K; Horie, M; Inukai, K; Kito, H; Shimabukuro, S; Kodama, K

    1989-01-01

    Computed tomographic findings of 46 children with spastic diplegia examined at nine months to three years of age corrected for preterm births were analyzed. Both the size of the lateral ventricles measured by the width of the anterior horns, and the volume of the extracerebral low-density areas were enlarged in some patients. Both enlargements did not, however, correlate to the severity of the motor abnormality in the patients. The low-density areas of the periventricular white matter, especially adjacent to the trigone, were reduced in many children, probably due to the atrophy of the cerebral white matter having periventricular leukomalacia. The anterior expansion of the white matter reduction from the trigone corresponded to the severe motor abnormality in the children with spastic diplegia. PMID:2774092

  19. Capsular contracture simulating myocardial infarction on ECG.

    PubMed

    Peters, W; McEwan, P

    1993-03-01

    A patient is presented with severe bilateral class IV capsular contractures who presented 16 years after prepectoral breast augmentation with a "septal infarct" pattern on ECG. This abnormal ECG proved to be an artifact caused by unavoidable misplacement of the V2 and V3 leads because of the severe capsular contracture. Following open capsulotomy, normal anatomic lead placement was possible, and a normal ECG was produced.

  20. Competency in ECG Interpretation Among Medical Students

    PubMed Central

    Kopeć, Grzegorz; Magoń, Wojciech; Hołda, Mateusz; Podolec, Piotr

    2015-01-01

    Background Electrocardiogram (ECG) is commonly used in diagnosis of heart diseases, including many life-threatening disorders. We aimed to assess skills in ECG interpretation among Polish medical students and to analyze the determinants of these skills. Material/Methods Undergraduates from all Polish medical schools were asked to complete a web-based survey containing 18 ECG strips. Questions concerned primary ECG parameters (rate, rhythm, and axis), emergencies, and common ECG abnormalities. Analysis was restricted to students in their clinical years (4th–6th), and students in their preclinical years (1st–3rd) were used as controls. Results We enrolled 536 medical students (females: n=299; 55.8%), aged 19 to 31 (23±1.6) years from all Polish medical schools. Most (72%) were in their clinical years. The overall rate of good response was better in students in years 4th–5th than those in years 1st–3rd (66% vs. 56%; p<0.0001). Competency in ECG interpretation was higher in students who reported ECG self-learning (69% vs. 62%; p<0.0001) but no difference was found between students who attended or did not attend regular ECG classes (66% vs. 66%; p=0.99). On multivariable analysis (p<0.0001), being in clinical years (OR: 2.45 [1.35–4.46] and self-learning (OR: 2.44 [1.46–4.08]) determined competency in ECG interpretation. Conclusions Polish medical students in their clinical years have a good level of competency in interpreting the primary ECG parameters, but their ability to recognize ECG signs of emergencies and common heart abnormalities is low. ECG interpretation skills are determined by self-education but not by attendance at regular ECG classes. Our results indicate qualitative and quantitative deficiencies in teaching ECG interpretation at medical schools. PMID:26541993

  1. Interventions to Improve Follow-Up of Abnormal Findings in Cancer Screening

    PubMed Central

    Bastani, Roshan; Yabroff, K. Robin; Myers, Ronald E.; Glenn, Beth

    2006-01-01

    The potential reduction in morbidity and mortality through cancer screening cannot be realized without receipt of appropriate follow-up care for abnormalities identified via screening. In this paper, the authors critically examine the existing literature on correlates of receipt of appropriate follow-up care for screen-detected abnormalities, as well as the literature on interventions designed to increase rates of receipt of follow-up care. Lessons learned describe what is known and not known about factors that are related to or predict receipt of follow-up care. Similarly, effective interventions to increase follow-up are described and gaps identified. A conceptual model is developed that categorizes the health care system in the United States as comprising four levels: policy, practice, provider, and patient. Some patient-level factors that influence follow-up receipt are identified, but the lack of data severely limit the understanding of provider, practice, and policy-level correlates. The majority of intervention studies to increase follow-up receipt have focused on patient-level factors and have targeted follow-up of abnormal Papanicolaou smears. Insufficient information is available regarding the effectiveness of provider, practice, or policy-level interventions. Standard definitions of what constitutes appropriate follow-up are lacking, which severely limit comparability of findings across studies. The validity of various methods of obtaining outcome data has not been clearly established. More research is needed on interventions targeting provider, system, and policy-level factors, particularly interventions focusing on follow-up of colorectal and breast abnormalities. Standardization of definitions and measures is needed to facilitate comparisons across studies. PMID:15316914

  2. Racial Differences in Follow-up of Abnormal Mammography Findings Among Economically Disadvantaged Women

    PubMed Central

    Adams, Swann Arp; Smith, Emily Rose; Hardin, James; Das, Irene Prabhu; Fulton, Jeanette; Hebert, James R.

    2010-01-01

    Background In the United States and particularly South Carolina, African-American women suffer disproportionately higher mortality rates than do European-American women. The timeliness of patient adherence to the follow-up of mammographic abnormalities may influence prognosis and survival. Consequently, the purpose of the present investigation was to examine racial differences in the completion and completion time of a diagnostic work-up following a finding of a suspicious breast abnormality. Methods Study participants of the Best Chance Network, a state-wide service program that provides free mammography screenings to economically disadvantaged and medically underserved women, were included in the study. Racial differences in tumor characteristics and adherence to recommended work-up were tested using Chi-square and t-tests. Logistic and Cox regression modeling was used to assess the relationship between work-up completion and other factors among African-American and European-American women. Results Completion of the work-up was associated with the number of previous procedures and income, with no significant differences noted by race. The amount of time to completion of the work-up was influenced by previous procedures, income, and race. After accounting for completion time, African-American women were 12% less likely than European-American women to complete the recommended work-up (HR=0.88, p-value=0.01). Conclusion This study established a racial disparity in the time to completion of a diagnostic work-up among Best Chance Network participants. These findings highlight the importance of understanding factors associated with delays and adherence in completion of recommended work-up when breast abnormalities are detected in mammograms. PMID:19859902

  3. Risk stratifying asymptomatic aortic stenosis: role of the resting 12-lead ECG.

    PubMed

    Greve, Anders M

    2014-02-01

    Despite being routinely performed in the clinical follow-up of asymptomatic AS patients, little or no evidence describes the prognostic value of ECG findings in asymptomatic AS populations. This PhD thesis examined the correlates of resting 12-lead ECG variables with echocardiographic measures of AS severity and cardiovascular outcomes in the till date largest cohort (n=1,563) of asymptomatic patients with mild-to-moderate AS. Most importantly, this PhD thesis demonstrated that QRS-duration adds independent predictive value of sudden cardiac death and that the additional presence of ECG LVH/strain for fixed AS severity represents a lethal risk attribute. Finally, ECG abnormalities displayed low/moderate concordance with echocardiographic parameters. This argues that the ECG should be regarded as a separate tool for obtaining prognostically important information. Treatment was not randomized by ECG findings, future studies should therefore examine if and which ECG variables should elicit closer follow-up and/or earlier intervention to improve prognosis in asymptomatic AS populations. PMID:24495893

  4. X-linked hypophosphatemic rickets: enamel abnormalities and oral clinical findings.

    PubMed

    Cremonesi, Ilaria; Nucci, Cesare; D'Alessandro, Giovanni; Alkhamis, Nadia; Marchionni, Silvia; Piana, Gabriela

    2014-01-01

    X-linked hypophosphatemia (XLH) is a genetic disorder related to alterations in bones and teeth formation, due to low levels of phosphate in blood. Oral findings in XLH have been enamel and dentine abnormalities, high pulp horns, large pulp chambers, and some cases of periapical abscesses related to teeth without caries or traumatic injuries. The aim of our study was to assess the presence of enamel alterations, such as microclefts and/or structure defects in patients with XLH and give guidelines of prevention of XLH dental complications. History taking, oral clinical and radiological examination in 10 young patients affected by XLH (average age of 9) and in 6 patients without XLH (average age of 8). Impressions were performed on the vestibular surfaces of teeth in order to obtain replicas. The replicas were analyzed using scanning electron microscope (SEM) and compared to replicas of control group. The images of replicas of XLH patients showed deep microclefts and irregular enamel surface structure compared to replicas of control group. The replica of a patient with spontaneous periapical abscesses showed numerous enamel crater-shaped depressions and deep microcleavages penetrating into the enamel thickness. In absence of caries or fractures, the abscesses pathogenesis may be related to microcleavages of the enamel and dentin, which allow bacterial invasion of the pulp. There could be a relationship between XLH disease and enamel abnormalities. PMID:24677288

  5. [Brugada ECG].

    PubMed

    Richter, Sergio

    2015-09-01

    The Brugada syndrome (BrS) is characterized by a typical electrocardiogram (ECG) pattern of right precordial ST-segment elevation and the cardinal symptoms syncope and sudden cardiac death as clinical correlate of malignant ventricular arrhythmias in young adults without structural heart disease. The diagnosis of a type 1 Brugada-ECG is based on the documentation of a coved-type (≥ 0.2 mV) ST elevation followed by a negative T wave. The use of the ECG criteria postulated in the consensus of 2012 is helpful to distinguish between saddleback-type 2 (or type 3) J point/ST elevation and incomplete right bundle branch block. Spontaneous or drug-induced type 1 ST elevation can frequently only be detected in a single right precordial lead (V1 or V2), occurs sometimes together with a type 2 (or type 3) pattern in one and the same 12-lead ECG and can sometimes only be seen in modified right precordial leads. The ST elevation is less pronounced in females. Spontaneous and exercise-induced type 1 ST elevation, fragmented QRS complex, prolonged PR interval (> 200 ms), QRS prolongation in V2 (≥ 120 ms) and markers of an increased heterogeneity of ventricular repolarization are associated with an increased arrhythmic risk. The occurrence of spontaneous or dynamic type 1 ST elevation, a macroscopic T wave alternans or pronounced inferior (lateral) J point/ST elevation are signs of acute electrical instability.

  6. The maximal exercise ECG in asymptomatic men.

    PubMed

    Cumming, G R; Borysyk, L; Dufresne, C

    1972-03-18

    Lead MC5 bipolar exercise ECG was obtained in 510 asymptomatic males, aged 40 to 65, utilizing the bicycle ergometer, with maximal stress in 71% of the subjects. "Ischemic changes" occurred in 61 subjects, the frequency increasing from 4% at age 40 to 45, to 20% at age 50 to 55, to 37% at age 61 to 65. Subjects having an ischemic type ECG change on exercise had more frequent minor resting ECG changes, more resting hypertension, and a greater incidence of high cholesterol values than subjects with a normal ECG response to exercise, but there was no difference in the incidence of obesity, low fitness, or high systolic blood pressure after exercise. Current evidence suggests that asymptomatic male subjects with an abnormal exercise ECG develop clinical coronary heart disease from 2.5 to over 30 times more frequently than those with a normal exercise ECG.

  7. [ECG mapping in clinical practice].

    PubMed

    Boudík, F; Aschermann, M; Anger, Z

    2002-12-01

    First the authors present a review of important cornerstones in the history of the electrocardiogram (ECG) and ECG mapping. The first to describe the electric cardiac field based on twenty ECGs was A.D. Waller in 1889. The decisive cornerstone for practical use was the introduction of a string galvanometer in 1901 by W. Einthoven and his triaxial lead system. Another very important cornerstone in the development of ECG were the findings of F.N. Wilson. Merits as regards the development and application of ECG mapping are due to B. Taccardi. Workers of the Second Medical Clinic in Prague enhanced after 15 years of studies and comparison of ECG maps with coronarographic findings in subjects with ischaemic heart disease (IHD) and microvascular coronary dysfunction (syndrome X--SyX) substantially the specificity of this method in impaired myocardial vascularization. Better diagnosis was achieved by introduction of diagnostic tests which influence coronary vascularization such as e.g. hyperventilation, as well as other tests. After their application progression of chronic myocardial ischaemia occurs, e.g. by the mechanism of the "steal phenomenon" or restriction of the microcirculation after hyperventilation in patients with SyX. Furthermore the authors present examples of ECG maps after PTCA, after application of diagnostic tests in IHD and SyX and also regression of myocardial ischaemia after marked reduction of total cholesterol. PMID:12744039

  8. A COMPARATIVE STUDY OF PSYCHOLOGICAL FACTORS IN PATIENTS WITH NORMAL AND ABNORMAL ANGIOGRAPHIC FINDINGS

    PubMed Central

    Dave, Malay; Dhavale, H.S.

    1999-01-01

    Chest pain is one of the most common symptoms in psychiatric and primary care practice and a frequent reason for extensive diagnostic work-up. Despite extensive investigations no recognizable medical cause to account for these symptoms is detected in many patients with chest pain. Studies of patients with non-cardiac chest pain have revealed that many continue to report symptoms and disability despite medical reassurances. The aims of the study were to evaluate the prevalence of psychiatric morbidity, personality profile and stressors along with functional impairment in patients with chest pain and normal angiographic findings and compare the same with patients who have chest pain but abnormal angiographic findings and a diagnosis of ischemic heart disease. The study included 30 consecutive patients in each group. The scales used were SCID-I of DSM-III-R, 16-PF, semi structured questionnaire for assessment of type A behaviour, PSLES and GAF scale of DSM-III-R. Panic disorder and depression were highly prevalent in patients with atypical chest pain. These patients had lower prevalence of type A behaviour, a unique 16-PF profile, experienced more stresses at any given point in time and significant impairment in day-day and in socio-occupational functioning. PMID:21430803

  9. Arrhythmia recognition and classification using combined linear and nonlinear features of ECG signals.

    PubMed

    Elhaj, Fatin A; Salim, Naomie; Harris, Arief R; Swee, Tan Tian; Ahmed, Taqwa

    2016-04-01

    Arrhythmia is a cardiac condition caused by abnormal electrical activity of the heart, and an electrocardiogram (ECG) is the non-invasive method used to detect arrhythmias or heart abnormalities. Due to the presence of noise, the non-stationary nature of the ECG signal (i.e. the changing morphology of the ECG signal with respect to time) and the irregularity of the heartbeat, physicians face difficulties in the diagnosis of arrhythmias. The computer-aided analysis of ECG results assists physicians to detect cardiovascular diseases. The development of many existing arrhythmia systems has depended on the findings from linear experiments on ECG data which achieve high performance on noise-free data. However, nonlinear experiments characterize the ECG signal more effectively sense, extract hidden information in the ECG signal, and achieve good performance under noisy conditions. This paper investigates the representation ability of linear and nonlinear features and proposes a combination of such features in order to improve the classification of ECG data. In this study, five types of beat classes of arrhythmia as recommended by the Association for Advancement of Medical Instrumentation are analyzed: non-ectopic beats (N), supra-ventricular ectopic beats (S), ventricular ectopic beats (V), fusion beats (F) and unclassifiable and paced beats (U). The characterization ability of nonlinear features such as high order statistics and cumulants and nonlinear feature reduction methods such as independent component analysis are combined with linear features, namely, the principal component analysis of discrete wavelet transform coefficients. The features are tested for their ability to differentiate different classes of data using different classifiers, namely, the support vector machine and neural network methods with tenfold cross-validation. Our proposed method is able to classify the N, S, V, F and U arrhythmia classes with high accuracy (98.91%) using a combined support

  10. Benign osseous and articular abnormalities of the pelvis: a review of CT imaging findings.

    PubMed

    Belfi, Lily M; Bartolotta, Roger J; Loftus, Michael L; Wladyka, Christopher; Hentel, Keith D

    2015-01-01

    Computed tomography (CT) has become the standard of care for evaluation and follow-up for a wide range of abdominal and pelvic pathology. Many incidental osseous and articular abnormalities of the pelvis are detected on these studies, most of which have a benign etiology. However, most of these studies are interpreted by nonmusculoskeletal radiologists, who may not be familiar with the CT appearances of these benign musculoskeletal abnormalities. Uncertainty often leads to mischaracterization or unnecessary follow-up, resulting in increased health care costs and patient anxiety. This article reviews the CT appearance of the benign musculoskeletal entities that occur in pelvis.

  11. Benign osseous and articular abnormalities of the pelvis: a review of CT imaging findings.

    PubMed

    Belfi, Lily M; Bartolotta, Roger J; Loftus, Michael L; Wladyka, Christopher; Hentel, Keith D

    2015-01-01

    Computed tomography (CT) has become the standard of care for evaluation and follow-up for a wide range of abdominal and pelvic pathology. Many incidental osseous and articular abnormalities of the pelvis are detected on these studies, most of which have a benign etiology. However, most of these studies are interpreted by nonmusculoskeletal radiologists, who may not be familiar with the CT appearances of these benign musculoskeletal abnormalities. Uncertainty often leads to mischaracterization or unnecessary follow-up, resulting in increased health care costs and patient anxiety. This article reviews the CT appearance of the benign musculoskeletal entities that occur in pelvis. PMID:25433854

  12. Preliminary findings of cortical thickness abnormalities in blast injured service members and their relationship to clinical findings.

    PubMed

    Tate, D F; York, G E; Reid, M W; Cooper, D B; Jones, L; Robin, D A; Kennedy, J E; Lewis, J

    2014-03-01

    Though cortical abnormalities have been demonstrated in moderate and severe traumatic brain injured (TBI) patients, there have been no studies examining cortical changes following blast related mild TBI (mTBI). The purpose of this study was to determine the effects and functional relevance of blast mTBI on cortical thickness in a small cohort of carefully screened blast injured US Service Members (SM). Twelve SM with mTBI acquired through blast injury were compared to 11 demographically matched control SM without TBI. Both mTBI and control participants were active duty and had completed a combat deployment. Subjects underwent MRI examination and the T1 weighted anatomic images were processed using the FreeSurfer suite of tools. Cortical thickness maps were compared between groups and examined for relationships with time since injury (TSI). Utilizing a large database of functional imaging results (BrainMap), significant regions of interest (ROI) were used to determine the behavioral profiles most consistently associated with the specific ROI. In addition, clinical variables were examined as part of post-hoc analysis of functional relevance. Group comparisons controlling for age demonstrated several significant clusters of cortical thinning for the blast injured SM. After multiple comparisons correction (False Discovery Rate (FDR)), two left hemisphere clusters remained significant (left superior temporal (STG) and frontal (SFG) gyri). No clusters were significantly correlated with TSI after FDR correction. Behavioral analysis for the STG and SFG clusters demonstrated three significant behavioral/cognitive sub-domains, each associated with audition and language. Blast injured SMs demonstrated distinct areas of cortical thinning in the STG and SFG. These areas have been previously shown to be associated with audition and language. Post-hoc analyses of clinical records demonstrated significant abnormal audiology reports for the blast injured SM suggesting that the

  13. Non-coronary abnormalities of the left heart: CT angiography findings.

    PubMed

    Öztürk, Ersin; Kafadar, Cahit; Tutar, Süleyman; Bozlar, Uğur; Hagspiel, Klaus D

    2016-09-01

    Cardiac computed tomography (CT) is most commonly performed for the evaluation of the coronary arteries; however, non-coronary cardiac pathologies are frequently detected on these scans. In cases where magnetic resonance imaging cannot be used, cardiac CT can serve as the first-line imaging modality to evaluate many non-coronary cardiac pathologies. In this article, we discuss congenital non-coronary abnormalities of the left heart and their cardiac CT imaging features. PMID:27609435

  14. Implementation of a Data Packet Generator Using Pattern Matching for Wearable ECG Monitoring Systems

    PubMed Central

    Noh, Yun Hong; Jeong, Do Un

    2014-01-01

    In this paper, a packet generator using a pattern matching algorithm for real-time abnormal heartbeat detection is proposed. The packet generator creates a very small data packet which conveys sufficient crucial information for health condition analysis. The data packet envelopes real time ECG signals and transmits them to a smartphone via Bluetooth. An Android application was developed specifically to decode the packet and extract ECG information for health condition analysis. Several graphical presentations are displayed and shown on the smartphone. We evaluate the performance of abnormal heartbeat detection accuracy using the MIT/BIH Arrhythmia Database and real time experiments. The experimental result confirm our finding that abnormal heart beat detection is practically possible. We also performed data compression ratio and signal restoration performance evaluations to establish the usefulness of the proposed packet generator and the results were excellent. PMID:25029280

  15. Implementation of a data packet generator using pattern matching for wearable ECG monitoring systems.

    PubMed

    Noh, Yun Hong; Jeong, Do Un

    2014-01-01

    In this paper, a packet generator using a pattern matching algorithm for real-time abnormal heartbeat detection is proposed. The packet generator creates a very small data packet which conveys sufficient crucial information for health condition analysis. The data packet envelopes real time ECG signals and transmits them to a smartphone via Bluetooth. An Android application was developed specifically to decode the packet and extract ECG information for health condition analysis. Several graphical presentations are displayed and shown on the smartphone. We evaluate the performance of abnormal heartbeat detection accuracy using the MIT/BIH Arrhythmia Database and real time experiments. The experimental result confirm our finding that abnormal heart beat detection is practically possible. We also performed data compression ratio and signal restoration performance evaluations to establish the usefulness of the proposed packet generator and the results were excellent. PMID:25029280

  16. Diagnostic Role of ECG Recording Simultaneously With EEG Testing.

    PubMed

    Kendirli, Mustafa Tansel; Aparci, Mustafa; Kendirli, Nurten; Tekeli, Hakan; Karaoglan, Mustafa; Senol, Mehmet Guney; Togrol, Erdem

    2015-07-01

    Arrhythmia is not uncommon in the etiology of syncope which mimics epilepsy. Data about the epilepsy induced vagal tonus abnormalities have being increasingly reported. So we aimed to evaluate what a neurologist may gain by a simultaneous electrocardiogram (ECG) and electroencephalogram (EEG) recording in the patients who underwent EEG testing due to prediagnosis of epilepsy. We retrospectively evaluated and detected ECG abnormalities in 68 (18%) of 376 patients who underwent EEG testing. A minimum of 20 of minutes artifact-free recording were required for each patient. Standard 1-channel ECG was simultaneously recorded in conjunction with the EEG. In all, 28% of females and 14% of males had ECG abnormalities. Females (mean age 49 years, range 18-88 years) were older compared with the male group (mean age 28 years, range 16-83 years). Atrial fibrillation was more frequent in female group whereas bradycardia and respiratory sinus arrhythmia was higher in male group. One case had been detected a critical asystole indicating sick sinus syndrome in the female group and treated with a pacemaker implantation in the following period. Simultaneous ECG recording in conjunction with EEG testing is a clinical prerequisite to detect and to clarify the coexisting ECG and EEG abnormalities and their clinical relevance. Potentially rare lethal causes of syncope that mimic seizure or those that could cause resistance to antiepileptic therapy could effectively be distinguished by detecting ECG abnormalities coinciding with the signs and abnormalities during EEG recording.

  17. Pseudo-ischaemic ECG in a patient with amyotrophic lateral sclerosis surviving for a decade

    PubMed Central

    Zhang, Jian; Yang, Shi-Wei; Wang, Zheng; Wei, Guang-Ru; Zhou, Yu-Jie

    2012-01-01

    A 58-year-old female with no history of heart disease was admitted to our hospital for abnormal ECG mimicking myocardial ischaemia. The ECG revealed persistent T-wave inversion in almost all leads, especially in precordial leads V2–V6. The patient had no complaints of chest pain, chest distress, short of breath or other atypical myocardial ischaemia symptoms. She had a history of amyotrophic lateral sclerosis (ALS) with a disease course more than 20 years. Examinations help rule out other diseases causing persistent T-wave inversion. Importantly, cardiac catheterisation showed nearly normal coronary arteries that could rule out myocardial ischaemia. Accordingly, the authors presumed that the pseudo-ischaemic ECG was associated with ALS in this patient. The findings of the present case provide new evidence that autonomic nervous system may involve in the pathophysiological progress of ALS. PMID:22665549

  18. Microprocessor Based Real-Time Monitoring of Multiple ECG Signals

    PubMed Central

    Nasipuri, M.; Basu, D.K.; Dattagupta, R.; Kundu, M.; Banerjee, S.

    1987-01-01

    A microprocessor based system capable of realtime monitoring of multiple ECG signals has been described. The system consists of a number of microprocessors connected in a hierarchical fashion and capable of working concurrently on ECG data collected from different channels. The system can monitor different arrhythmic abnormalities for at least 36 patients even for a heart rate of 500 beats/min.

  19. Synergistic effect of polymorphisms of paraoxonase gene cluster and arsenic exposure on electrocardiogram abnormality.

    PubMed

    Liao, Ya-Tang; Li, Wan-Fen; Chen, Chien-Jen; Prineas, Ronald J; Chen, Wei J; Zhang, Zhu-Ming; Sun, Chien-Wen; Wang, Shu-Li

    2009-09-01

    Arsenic has been linked to increased prevalence of cancer and cardiovascular disease (CVD), but the long-term impact of arsenic exposure remains unclear. Human paraoxonase (PON1) is a high-density lipoprotein-associated antioxidant enzyme which hydrolyzes oxidized lipids and is thought to be protective against atherosclerosis, but evidence remains limited to case-control studies. Only recently have genes encoding enzymes responsible for arsenic metabolism, such as AS3MT and GSTO, been cloned and characterized. This study was designed to evaluate the synergistic interaction of genetic factors and arsenic exposure on electrocardiogram abnormality. A total of 216 residents from three tap water implemented villages of previous arseniasis-hyperendemic regions in Taiwan were prospectively followed for an average of 8 years. For each resident, a 12-lead conventional electrocardiogram (ECG) was recorded and coded by Minnesota Code standard criteria. Eight functional polymorphisms of PON1, PON2, AS3MT, GSTO1, and GSTO2 were examined for genetic susceptibility to ECG abnormality. Among 42 incident cases with ECG deterioration identified among 121 baseline-normal subjects, arsenic exposure was significantly correlated with incidence of ECG abnormality. In addition, polymorphisms in two paraoxonase genes were also found associated with the incidence of ECG abnormality. A haplotype R-C-S constituted by polymorphisms of PON1 Q192R, -108C/T and PON2 C311S was linked to the increased risk. Subjects exposed to high levels of As (cumulative As exposure >14.7 ppm-year or drinking artesian well water >21 years) and carrying the R-C-S haplotype had significantly increased risks for ECG abnormality over those with only one risk factor. Results of this study showed a long-term arsenic effect on ECG abnormality and significant gene-gene and gene-environment interactions linked to the incidence of CVD. This finding might have important implications for a novel and potentially useful

  20. Synergistic effect of polymorphisms of paraoxonase gene cluster and arsenic exposure on electrocardiogram abnormality

    SciTech Connect

    Liao, Y.-T.; Li, W.-F.; Chen, C.-J.; Prineas, Ronald J.; Chen, Wei J.; Zhang Zhuming; Sun, C.-W.; Wang, S.-L.

    2009-09-01

    Arsenic has been linked to increased prevalence of cancer and cardiovascular disease (CVD), but the long-term impact of arsenic exposure remains unclear. Human paraoxonase (PON1) is a high-density lipoprotein-associated antioxidant enzyme which hydrolyzes oxidized lipids and is thought to be protective against atherosclerosis, but evidence remains limited to case-control studies. Only recently have genes encoding enzymes responsible for arsenic metabolism, such as AS3MT and GSTO, been cloned and characterized. This study was designed to evaluate the synergistic interaction of genetic factors and arsenic exposure on electrocardiogram abnormality. A total of 216 residents from three tap water implemented villages of previous arseniasis-hyperendemic regions in Taiwan were prospectively followed for an average of 8 years. For each resident, a 12-lead conventional electrocardiogram (ECG) was recorded and coded by Minnesota Code standard criteria. Eight functional polymorphisms of PON1, PON2, AS3MT, GSTO1, and GSTO2 were examined for genetic susceptibility to ECG abnormality. Among 42 incident cases with ECG deterioration identified among 121 baseline-normal subjects, arsenic exposure was significantly correlated with incidence of ECG abnormality. In addition, polymorphisms in two paraoxonase genes were also found associated with the incidence of ECG abnormality. A haplotype R-C-S constituted by polymorphisms of PON1 Q192R, -108C/T and PON2 C311S was linked to the increased risk. Subjects exposed to high levels of As (cumulative As exposure > 14.7 ppm-year or drinking artesian well water > 21 years) and carrying the R-C-S haplotype had significantly increased risks for ECG abnormality over those with only one risk factor. Results of this study showed a long-term arsenic effect on ECG abnormality and significant gene-gene and gene-environment interactions linked to the incidence of CVD. This finding might have important implications for a novel and potentially useful

  1. ABNORMAL IMAGING FINDINGS OF THE FEMORAL THIRD TROCHANTER IN 20 HORSES.

    PubMed

    Shields, Georgette E; Whitcomb, Mary Beth; Vaughan, Betsy; Wisner, Erik R

    2015-01-01

    Injuries involving the femoral third trochanter are an uncommon but important source of equine lameness; however, clinical localization can be challenging. The purpose of this retrospective study was to describe ultrasonographic and scintigraphic findings in a group of horses with presumed third trochanter injury. Medical records of an equine referral hospital were searched from 2004-2014, and 20 horses met the inclusion criteria. Lesions consistent with third trochanter fracture were identified with ultrasound in 14/20 horses. Onset of lameness was acute (11), insidious (2), or unknown (1). All but one horse was lame at presentation, ranging from Grade 2-4/5. Ultrasound was the primary diagnostic modality in 5/14 horses with fragmentation, while scintigraphic findings of intense (3), moderate (5), and mild (1) increased radiopharmaceutical uptake (IRU) prompted ultrasonographic examinations in 9/14 fractured horses. A nondisplaced fracture was suspected in an additional horse with intense IRU and negative ultrasound findings. In the remaining five horses, imaging findings included only mild IRU. Lameness was localized to other regions in these cases. Six of 12 fractured horses with available outcome data were returned to function after a prolonged rehabilitation of 8-18 months. Scintigraphic findings helped to direct focused ultrasound exams in the majority of fracture cases. Horses with evidence of third trochanter fracture had similar clinical characteristics to that reported for pelvic fractures and authors therefore recommend ultrasonographic examination of both regions, especially when scintigraphy is unavailable. Prognosis for return to function in horses of the current study was less favorable than previously reported.

  2. Modern standards of ECG interpretation in young athletes: yield and effectiveness.

    PubMed

    Asif, Irfan M; Prutkin, Jordan M

    2015-01-01

    Although cardiovascular screening is recommended before participating in competitive sports, the role of the 12-lead electrocardiogram (ECG) has been debated. When added to the medical history and physical examination, an ECG used during the pre-participation screening (PPS) of young athletes can greatly enhance the ability to detect underlying cardiovascular pathology. Concerns over false positive rates, however, have posed an obstacle to large-scale implementation. The recent development of modern athlete-specific ECG interpretation criteria has dramatically reduced false positive rates to levels below other commonly used screening tests (e.g. breast cancer, prostate cancer) and subsequently improved cost effectiveness. There are also emerging data that certain sub-groups have a higher prevalence of ECG abnormalities, including males, athletes of Afro-Caribbean descent, basketball players, and endurance athletes. While false positive rates from a number of studies are reduced with the improved standards, there may be room for continued improvements. Future efforts should focus on refining criteria based on age, race, gender, ethnicity, and sport, while also clearly delineating the appropriate work-up strategies for those with abnormal findings, as this can lead to improved resource utilization. PMID:25595717

  3. Modern standards of ECG interpretation in young athletes: yield and effectiveness.

    PubMed

    Asif, Irfan M; Prutkin, Jordan M

    2015-01-01

    Although cardiovascular screening is recommended before participating in competitive sports, the role of the 12-lead electrocardiogram (ECG) has been debated. When added to the medical history and physical examination, an ECG used during the pre-participation screening (PPS) of young athletes can greatly enhance the ability to detect underlying cardiovascular pathology. Concerns over false positive rates, however, have posed an obstacle to large-scale implementation. The recent development of modern athlete-specific ECG interpretation criteria has dramatically reduced false positive rates to levels below other commonly used screening tests (e.g. breast cancer, prostate cancer) and subsequently improved cost effectiveness. There are also emerging data that certain sub-groups have a higher prevalence of ECG abnormalities, including males, athletes of Afro-Caribbean descent, basketball players, and endurance athletes. While false positive rates from a number of studies are reduced with the improved standards, there may be room for continued improvements. Future efforts should focus on refining criteria based on age, race, gender, ethnicity, and sport, while also clearly delineating the appropriate work-up strategies for those with abnormal findings, as this can lead to improved resource utilization.

  4. A risk score for predicting coronary artery disease in women with angina pectoris and abnormal stress test finding.

    PubMed

    Lo, Monica Y; Bonthala, Nirupama; Holper, Elizabeth M; Banks, Kamakki; Murphy, Sabina A; McGuire, Darren K; de Lemos, James A; Khera, Amit

    2013-03-15

    Women with angina pectoris and abnormal stress test findings commonly have no epicardial coronary artery disease (CAD) at catheterization. The aim of the present study was to develop a risk score to predict obstructive CAD in such patients. Data were analyzed from 337 consecutive women with angina pectoris and abnormal stress test findings who underwent cardiac catheterization at our center from 2003 to 2007. Forward selection multivariate logistic regression analysis was used to identify the independent predictors of CAD, defined by ≥50% diameter stenosis in ≥1 epicardial coronary artery. The independent predictors included age ≥55 years (odds ratio 2.3, 95% confidence interval 1.3 to 4.0), body mass index <30 kg/m(2) (odds ratio 1.9, 95% confidence interval 1.1 to 3.1), smoking (odds ratio 2.6, 95% confidence interval 1.4 to 4.8), low high-density lipoprotein cholesterol (odds ratio 2.9, 95% confidence interval 1.5 to 5.5), family history of premature CAD (odds ratio 2.4, 95% confidence interval 1.0 to 5.7), lateral abnormality on stress imaging (odds ratio 2.8, 95% confidence interval 1.5 to 5.5), and exercise capacity <5 metabolic equivalents (odds ratio 2.4, 95% confidence interval 1.1 to 5.6). Assigning each variable 1 point summed to constitute a risk score, a graded association between the score and prevalent CAD (ptrend <0.001). The risk score demonstrated good discrimination with a cross-validated c-statistic of 0.745 (95% confidence interval 0.70 to 0.79), and an optimized cutpoint of a score of ≤2 included 62% of the subjects and had a negative predictive value of 80%. In conclusion, a simple clinical risk score of 7 characteristics can help differentiate those more or less likely to have CAD among women with angina pectoris and abnormal stress test findings. This tool, if validated, could help to guide testing strategies in women with angina pectoris.

  5. The application of wavelet and feature vectors to ECG signals.

    PubMed

    Matsuyama, A; Jonkman, M

    2006-03-01

    The Electrocardiogram (ECG) is one of the most commonly known biological signals. Traditionally ECG recordings are analysed in the time-domain by skilled physicians. However, pathological conditions may not always be obvious in the original time-domain signal. Fourier analysis provides frequency information but has the disadvantage that time characteristics will be lost. Wavelet analysis, which provides both time and frequency information, can overcome this limitation. Here a new method, the combination of wavelet analysis and feature vectors, is applied with the intent to investigate its suitability as a diagnostic tool. ECG signals with normal and abnormal beats were examined. There were two stages in analysing ECG signals: feature extraction and feature classification. To extract features from ECG signals, wavelet decomposition was first applied and feature vectors of normalised energy and entropy were constructed. These feature vectors were used to classify signals. The results showed that normal beats and abnormal beats composed different clusters in most cases. In conclusion, the combination of wavelet transform and feature vectors has shown potential in detecting abnormalities in an ECG recording. It was also found that normalised energy and entropy are features, which are suitable for classification of ECG signals.

  6. [Impact of indirect factors on the growing prevalence of workers with abnormal findings in periodic general health examinations: a survey on the definition and detection of such abnormal workers by occupational health organizations].

    PubMed

    Hoshuyama, T; Takahashi, K; Fujishiro, K; Uchida, K; Okubo, T

    2000-05-01

    The prevalence of workers with abnormal findings in periodic general health examinations (PGHEx) has been growing recently in Japan and reached 41.2% in 1998. To clarify the indirect factors related to such an increase in workers with abnormal findings in the PGHEx, we carried out a questionnaire survey on the content of the statutory notification form of results of the PGHEx among a representative sample of 136 Occupational Health Organizations (OHOs). Questions on how those workers with abnormal findings were defined and detected and when the definition and the reference intervals for total cholesterol became available were included. Of the 107 OHOs which answered the questionnaire, 85 were included in the analyses because they actually calculated the number of workers with abnormal findings in each company and helped the employer fill out the notification form. The results revealed that there was no standardized definition of workers with abnormal findings in the PGHEx. Both reference intervals of items in the PGHEx and algorithm in detecting workers with abnormal findings in the PGHEx varied among the OHOs. When detecting the workers, 13 OHOs (15.3%) selected them taking into consideration medical background factors such as previous results of the PGHEx and current medical treatment. From the late 1980s to the early 1990s, many OHOs modified the definition of workers with abnormal findings, and have tended to reduce the upper limit of the reference interval for serum cholesterol. This is mainly due to amendment of the Industrial Safety and Health Law and a new recommendation for a reference interval/value proposed by the related scientific society. Although the prevalence of workers with abnormal findings in the PGHEx has continuously increased, it is not valid to compare the prevalence over the years because of modification in the definition of such workers. The prevalence of workers with abnormal findings in the PGHEx, which is one of the most important

  7. Electrocardiographic and echocardiographic abnormalities in residents of rural Bolivian communities hyperendemic for Chagas disease

    PubMed Central

    Fernandez, Antonio B.; Nunes, Maria Carmo P.; Clark, Eva H.; Samuels, Aaron; Menacho, Silvio; Gomez, Jesus; Gutierrez, Ricardo W. Bozo; Crawford, Thomas C.; Gilman, Robert H.; Bern, Caryn

    2015-01-01

    Background Chagas disease is a neglected and preventable tropical disease that causes significant cardiac morbidity and mortality in Latin America. Our objective in this study was to describe cardiac findings among inhabitants of rural communities of the Bolivian Chaco. Methods The cardiac study drew participants from an epidemiologic study in 7 indigenous Guarani communities. All infected participants 10 years or older were asked to undergo a brief physical examination and 12-lead electrocardiogram. A subset had echocardiograms (ECGs). ECGs and echocardiograms were read by one or more cardiologists. Results Of 1137 residents 10 years or older, 753 (66.2%) had T. cruzi infection. Cardiac evaluations were performed for 398 infected participants 10 years or older. Fifty-five (13.8%) participants had one or more ECG abnormality suggestive of Chagas cardiomyopathy. The most frequent abnormalities were bundle branch blocks in 42 (11.3%), followed by rhythm disturbances or ventricular ectopy in 13 (3.3%) and atrioventricular blocks (AVB) in 10 (2.6%) participants. The prevalence of any abnormality rose from 1.1% among those 10-19 years old to 14.2%, 17.3% and 26.4% among those 20-39, 40-59 and older than 60 years, respectively. First degree AVB was seen most frequently in participants 60 years or older, but the 4 patients with 3rd degree AVB were all under 50 years old. Eighteen and two participants had a left ventricular ejection fraction of 40-54% and <40%, respectively. An increasing number of ECG abnormalities was associated with progressively larger left ventricular end-diastolic dimensions and lower left ventricular ejection fraction. Conclusions We found a high prevalence of ECG abnormalities and substantial evidence of Chagas cardiomyopathy. Programs to improve access to basic cardiac care (annual ECGs, antiarrhythmics, pacemakers) could have an immediate impact on morbidity and mortality in these highly endemic communities. PMID:26407511

  8. Abnormal immune system development and function in schizophrenia helps reconcile diverse findings and suggests new treatment and prevention strategies.

    PubMed

    Anders, Sherry; Kinney, Dennis K

    2015-08-18

    Extensive research implicates disturbed immune function and development in the etiology and pathology of schizophrenia. In addition to reviewing evidence for immunological factors in schizophrenia, this paper discusses how an emerging model of atypical immune function and development helps explain a wide variety of well-established - but puzzling - findings about schizophrenia. A number of theorists have presented hypotheses that early immune system programming, disrupted by pre- and perinatal adversity, often combines with abnormal brain development to produce schizophrenia. The present paper focuses on the hypothesis that disruption of early immune system development produces a latent immune vulnerability that manifests more fully after puberty, when changes in immune function and the thymus leave individuals more susceptible to infections and immune dysfunctions that contribute to schizophrenia. Complementing neurodevelopmental models, this hypothesis integrates findings on many contributing factors to schizophrenia, including prenatal adversity, genes, climate, migration, infections, and stress, among others. It helps explain, for example, why (a) schizophrenia onset is typically delayed until years after prenatal adversity, (b) individual risk factors alone often do not lead to schizophrenia, and (c) schizophrenia prevalence rates actually tend to be higher in economically advantaged countries. Here we discuss how the hypothesis explains 10 key findings, and suggests new, potentially highly cost-effective, strategies for treatment and prevention of schizophrenia. Moreover, while most human research linking immune factors to schizophrenia has been correlational, these strategies provide ethical ways to experimentally test in humans theories about immune function and schizophrenia. This article is part of a Special Issue entitled SI: Neuroimmunology in Health And Disease.

  9. Electrocardiographic abnormalities among arsenic-exposed persons through groundwater in Bangladesh.

    PubMed

    Ahmad, S Akhtar; Khatun, Fatema; Sayed, M H Salim Ullah; Khan, Manzurul Haque; Aziz, Rashed; Hossain, Mohammed Zakir; Faruquee, M H

    2006-06-01

    This study was carried out among arsenic-exposed and non-exposed people of Bangladesh to assess and compare their cardiac status based on electrocardiographic (ECG) findings. For the purpose of the study, participants were included in three groups: arsenic-exposed persons with arsenicosis (arsenicosis group), arsenic-exposed persons without arsenicosis (non-arsenicosis group), and persons not exposed to arsenic (non-exposed group). Each group included 50 respondents. In this study, no significant difference in heart rate, rhythm, axis, and pulse rate interval was detected among the arsenicosis, non-arsenicosis and non-exposed groups. A significant difference in corrected QT interval between the arsenicosis and the non-exposed group (p<0.05) was observed. On the contrary, no statistically significant difference in corrected QT interval between the non-arsenicosis and the non-exposed group was found. Abnormal QRS complex was found among 14%, 8%, and 2% of the arsenicosis, non-arsenicosis, and non-exposed groups respectively. ECG findings, indicative of left ventricular hypertrophy, ischaemic heart disease, and right bundle branch block, were high among the arsenicosis group. Overall, abnormal ECG findings were high (58%) among the respondents of the arsenicosis group and were highly significant (p<0.001). The findings revealed that there was a significant association between ECG abnormalities and arsenic exposure.

  10. Empirical mode decomposition of the ECG signal for noise removal

    NASA Astrophysics Data System (ADS)

    Khan, Jesmin; Bhuiyan, Sharif; Murphy, Gregory; Alam, Mohammad

    2011-04-01

    Electrocardiography is a diagnostic procedure for the detection and diagnosis of heart abnormalities. The electrocardiogram (ECG) signal contains important information that is utilized by physicians for the diagnosis and analysis of heart diseases. So good quality ECG signal plays a vital role for the interpretation and identification of pathological, anatomical and physiological aspects of the whole cardiac muscle. However, the ECG signals are corrupted by noise which severely limit the utility of the recorded ECG signal for medical evaluation. The most common noise presents in the ECG signal is the high frequency noise caused by the forces acting on the electrodes. In this paper, we propose a new ECG denoising method based on the empirical mode decomposition (EMD). The proposed method is able to enhance the ECG signal upon removing the noise with minimum signal distortion. Simulation is done on the MIT-BIH database to verify the efficacy of the proposed algorithm. Experiments show that the presented method offers very good results to remove noise from the ECG signal.

  11. Robust and accurate anomaly detection in ECG artifacts using time series motif discovery.

    PubMed

    Sivaraks, Haemwaan; Ratanamahatana, Chotirat Ann

    2015-01-01

    Electrocardiogram (ECG) anomaly detection is an important technique for detecting dissimilar heartbeats which helps identify abnormal ECGs before the diagnosis process. Currently available ECG anomaly detection methods, ranging from academic research to commercial ECG machines, still suffer from a high false alarm rate because these methods are not able to differentiate ECG artifacts from real ECG signal, especially, in ECG artifacts that are similar to ECG signals in terms of shape and/or frequency. The problem leads to high vigilance for physicians and misinterpretation risk for nonspecialists. Therefore, this work proposes a novel anomaly detection technique that is highly robust and accurate in the presence of ECG artifacts which can effectively reduce the false alarm rate. Expert knowledge from cardiologists and motif discovery technique is utilized in our design. In addition, every step of the algorithm conforms to the interpretation of cardiologists. Our method can be utilized to both single-lead ECGs and multilead ECGs. Our experiment results on real ECG datasets are interpreted and evaluated by cardiologists. Our proposed algorithm can mostly achieve 100% of accuracy on detection (AoD), sensitivity, specificity, and positive predictive value with 0% false alarm rate. The results demonstrate that our proposed method is highly accurate and robust to artifacts, compared with competitive anomaly detection methods.

  12. Accurate Interpretation of the 12-Lead ECG Electrode Placement: A Systematic Review

    ERIC Educational Resources Information Center

    Khunti, Kirti

    2014-01-01

    Background: Coronary heart disease (CHD) patients require monitoring through ECGs; the 12-lead electrocardiogram (ECG) is considered to be the non-invasive gold standard. Examples of incorrect treatment because of inaccurate or poor ECG monitoring techniques have been reported in the literature. The findings that only 50% of nurses and less than…

  13. Programmable ECG Waveform

    PubMed Central

    Le Huy, P.; Yvroud, E.; Gilgenkrantz, J.M.; Baille, N.; Aliot, E.

    1984-01-01

    In this paper, the simulation of an electrocardiogram using a CMOS microprocessor is described. The programmability has been made accessible to every user. All inherent parameters of different waves in an ECG, such as amplitude, slope, duration can be independently modified by software. Thus, the testing of some sophisticated devices may be easily performed.

  14. Hybrid ECG signal conditioner

    NASA Technical Reports Server (NTRS)

    Rinard, G. A.; Steffen, D. A.; Sturm, R. E.

    1979-01-01

    Circuit with high common-mode rejection has ability to filter and amplify accepted analog electrocardiogram (ECG) signals of varying amplitude, shape, and polarity. In addition, low power circuit develops standardized pulses that can be counted and averaged by heart/breath rate processor.

  15. Association of Traditional Cardiovascular Risk Factors With Development of Major and Minor Electrocardiographic Abnormalities: A Systematic Review.

    PubMed

    Healy, Caroline F; Lloyd-Jones, Donald M

    2016-01-01

    Electrocardiographic (ECG) abnormalities are prevalent in middle aged and are associated with risk of adverse cardiovascular events. It is unclear whether and to what extent traditional risk factors are associated with the development of ECG abnormalities. To determine whether traditional cardiovascular risk factors are associated with the presence or development of ECG abnormalities, we performed a systematic review of the English-language literature for cross-sectional and prospective studies examining associations between traditional cardiovascular risk factors and ECG abnormalities, including major and minor ECG abnormalities, isolated nonspecific ST-segment and T-wave abnormalities, other ST-segment and T-wave abnormalities, QT interval, Q waves, and QRS duration. Of the 202 papers initially identified, 19 were eligible for inclusion. We examined data analyzing risk factor associations with ECG abnormalities in individuals free of cardiovascular disease. For composite major or minor ECG abnormalities, black race, older age, higher blood pressure, use of antihypertensive medications, higher body mass index, diabetes, smoking, and evidence of left ventricular hypertrophy or higher left ventricular mass are the factors most commonly associated with prevalence and incidence. Risk factor associations differ somewhat according to types of specific ECG abnormalities. Because major and minor ECG abnormalities have important and independent prognostic significance, understanding the groups at risk for their development may inform prevention strategies focused on modifiable risk factors to reduce the burden of ECG abnormalities, which may in turn promote CVD prevention. PMID:27054606

  16. High-frequency ECG

    NASA Technical Reports Server (NTRS)

    Tragardh, Elin; Schlegel, Todd T.

    2006-01-01

    The standard ECG is by convention limited to 0.05-150 Hz, but higher frequencies are also present in the ECG signal. With high-resolution technology, it is possible to record and analyze these higher frequencies. The highest amplitudes of the high-frequency components are found within the QRS complex. In past years, the term "high frequency", "high fidelity", and "wideband electrocardiography" have been used by several investigators to refer to the process of recording ECGs with an extended bandwidth of up to 1000 Hz. Several investigators have tried to analyze HF-QRS with the hope that additional features seen in the QRS complex would provide information enhancing the diagnostic value of the ECG. The development of computerized ECG-recording devices that made it possible to record ECG signals with high resolution in both time and amplitude, as well as better possibilities to store and process the signals digitally, offered new methods for analysis. Different techniques to extract the HF-QRS have been described. Several bandwidths and filter types have been applied for the extraction as well as different signal-averaging techniques for noise reduction. There is no standard method for acquiring and quantifying HF-QRS. The physiological mechanisms underlying HF-QRS are still not fully understood. One theory is that HF-QRS are related to the conduction velocity and the fragmentation of the depolarization wave in the myocardium. In a three-dimensional model of the ventricles with a fractal conduction system it was shown that high numbers of splitting branches are associated with HF-QRS. In this experiment, it was also shown that the changes seen in HF-QRS in patients with myocardial ischemia might be due to the slowing of the conduction velocity in the region of ischemia. This mechanism has been tested by Watanabe et al by infusing sodium channel blockers into the left anterior descending artery in dogs. In their study, 60 unipolar ECGs were recorded from the entire

  17. Electrocardiographic abnormalities in very young Duchenne muscular dystrophy patients precede the onset of cardiac dysfunction.

    PubMed

    James, Jeanne; Kinnett, Kathleen; Wang, Yu; Ittenbach, Richard F; Benson, D Woodrow; Cripe, Linda

    2011-07-01

    Overt cardiac involvement in Duchenne muscular dystrophy (DMD) typically occurs later in the disease. The primary aim was to estimate the proportion of young (<6 years of age) DMD patients with manifestations of cardiac disease by electrocardiography (ECG). Secondary aims were to assess associations between ECG abnormalities and evidence of cardiac disease by echocardiography, as well as to estimate the relationship between dystrophin mutation site and an abnormal ECG. Seventy eight steroid-naive DMD patients <6 years of age were identified. ECG abnormalities were identified in 78%, with LV pathology being the most commonly identified pattern. Only one echocardiogram was abnormal. There was no statistically significant relationship identified between ECG abnormalities and dystrophin genotype. ECG abnormalities are common in very young DMD patients, signaling cardiac involvement well before the onset of clinical symptoms.

  18. The ECG as decision support in STEMI.

    PubMed

    Ripa, Maria Sejersten

    2012-03-01

    -segment resolution at 90 minutes and 4 hours is important for risk stratification after fibrinolysis, but not after pPCI. Interestingly, we found that patients with compete ST-segment resolution treated with fibrinolysis had the highest risk of reinfarction. Consequently, transfer to a PCI-facility should be considered in all patients treated with fibrinolysis as the initial reperfusion therapy. Based on the findings in the present thesis we conclude that the ECG is an important tool for decision support in every step from symptom onset to post-reperfusion therapy in STEMI patients.

  19. The effect of aging on the specialized conducting system: a telemetry ECG study in rats over a 6 month period.

    PubMed

    Rossi, Stefano; Fortunati, Ilaria; Carnevali, Luca; Baruffi, Silvana; Mastorci, Francesca; Trombini, Mimosa; Sgoifo, Andrea; Corradi, Domenico; Callegari, Sergio; Miragoli, Michele; Macchi, Emilio

    2014-01-01

    Advanced age alone appears to be a risk factor for increased susceptibility to cardiac arrhythmias. We previously observed in the aged rat heart that sinus rhythm ventricular activation is delayed and characterized by abnormal epicardial patterns although conduction velocity is normal. While these findings relate to an advanced stage of aging, it is not yet known when and how ventricular electrical impairment originates and which is the underlying substrate. To address these points, we performed continuous telemetry ECG recordings in freely moving rats over a six-month period to monitor ECG waveform changes, heart rate variability and the incidence of cardiac arrhythmias. At the end of the study, we performed in-vivo multiple lead epicardial recordings and histopathology of cardiac tissue. We found that the duration of ECG waves and intervals gradually increased and heart rate variability gradually decreased with age. Moreover, the incidence of cardiac arrhythmias gradually increased, with atrial arrhythmias exceeding ventricular arrhythmias. Epicardial multiple lead recordings confirmed abnormalities in ventricular activation patterns, likely attributable to distal conducting system dysfunctions. Microscopic analysis of aged heart specimens revealed multifocal connective tissue deposition and perinuclear myocytolysis in the atria. Our results demonstrate that aging gradually modifies the terminal part of the specialized cardiac conducting system, creating a substrate for increased arrhythmogenesis. These findings may open new therapeutic options in the management of cardiac arrhythmias in the elderly population.

  20. A novel approach to ECG classification based upon two-layered HMMs in body sensor networks.

    PubMed

    Liang, Wei; Zhang, Yinlong; Tan, Jindong; Li, Yang

    2014-03-27

    This paper presents a novel approach to ECG signal filtering and classification. Unlike the traditional techniques which aim at collecting and processing the ECG signals with the patient being still, lying in bed in hospitals, our proposed algorithm is intentionally designed for monitoring and classifying the patient's ECG signals in the free-living environment. The patients are equipped with wearable ambulatory devices the whole day, which facilitates the real-time heart attack detection. In ECG preprocessing, an integral-coefficient-band-stop (ICBS) filter is applied, which omits time-consuming floating-point computations. In addition, two-layered Hidden Markov Models (HMMs) are applied to achieve ECG feature extraction and classification. The periodic ECG waveforms are segmented into ISO intervals, P subwave, QRS complex and T subwave respectively in the first HMM layer where expert-annotation assisted Baum-Welch algorithm is utilized in HMM modeling. Then the corresponding interval features are selected and applied to categorize the ECG into normal type or abnormal type (PVC, APC) in the second HMM layer. For verifying the effectiveness of our algorithm on abnormal signal detection, we have developed an ECG body sensor network (BSN) platform, whereby real-time ECG signals are collected, transmitted, displayed and the corresponding classification outcomes are deduced and shown on the BSN screen.

  1. Live ECG readings using Google Glass in emergency situations.

    PubMed

    Schaer, Roger; Salamin, Fanny; Jimenez Del Toro, Oscar Alfonso; Atzori, Manfredo; Muller, Henning; Widmer, Antoine

    2015-01-01

    Most sudden cardiac problems require rapid treatment to preserve life. In this regard, electrocardiograms (ECG) shown on vital parameter monitoring systems help medical staff to detect problems. In some situations, such monitoring systems may display information in a less than convenient way for medical staff. For example, vital parameters are displayed on large screens outside the field of view of a surgeon during cardiac surgery. This may lead to losing time and to mistakes when problems occur during cardiac operations. In this paper we present a novel approach to display vital parameters such as the second derivative of the ECG rhythm and heart rate close to the field of view of a surgeon using Google Glass. As a preliminary assessment, we run an experimental study to verify the possibility for medical staff to identify abnormal ECG rhythms from Google Glass. This study compares 6 ECG rhythms readings from a 13.3 inch laptop screen and from the prism of Google Glass. Seven medical residents in internal medicine participated in the study. The preliminary results show that there is no difference between identifying these 6 ECG rhythms from the laptop screen versus Google Glass. Both allow close to perfect identification of the 6 common ECG rhythms. This shows the potential of connected glasses such as Google Glass to be useful in selected medical applications.

  2. Assessing ECG signal quality indices to discriminate ECGs with artefacts from pathologically different arrhythmic ECGs.

    PubMed

    Daluwatte, C; Johannesen, L; Galeotti, L; Vicente, J; Strauss, D G; Scully, C G

    2016-08-01

    False and non-actionable alarms in critical care can be reduced by developing algorithms which assess the trueness of an arrhythmia alarm from a bedside monitor. Computational approaches that automatically identify artefacts in ECG signals are an important branch of physiological signal processing which tries to address this issue. Signal quality indices (SQIs) derived considering differences between artefacts which occur in ECG signals and normal QRS morphology have the potential to discriminate pathologically different arrhythmic ECG segments as artefacts. Using ECG signals from the PhysioNet/Computing in Cardiology Challenge 2015 training set, we studied previously reported ECG SQIs in the scientific literature to differentiate ECG segments with artefacts from arrhythmic ECG segments. We found that the ability of SQIs to discriminate between ECG artefacts and arrhythmic ECG varies based on arrhythmia type since the pathology of each arrhythmic ECG waveform is different. Therefore, to reduce the risk of SQIs classifying arrhythmic events as noise it is important to validate and test SQIs with databases that include arrhythmias. Arrhythmia specific SQIs may also minimize the risk of misclassifying arrhythmic events as noise.

  3. Assessing ECG signal quality indices to discriminate ECGs with artefacts from pathologically different arrhythmic ECGs.

    PubMed

    Daluwatte, C; Johannesen, L; Galeotti, L; Vicente, J; Strauss, D G; Scully, C G

    2016-08-01

    False and non-actionable alarms in critical care can be reduced by developing algorithms which assess the trueness of an arrhythmia alarm from a bedside monitor. Computational approaches that automatically identify artefacts in ECG signals are an important branch of physiological signal processing which tries to address this issue. Signal quality indices (SQIs) derived considering differences between artefacts which occur in ECG signals and normal QRS morphology have the potential to discriminate pathologically different arrhythmic ECG segments as artefacts. Using ECG signals from the PhysioNet/Computing in Cardiology Challenge 2015 training set, we studied previously reported ECG SQIs in the scientific literature to differentiate ECG segments with artefacts from arrhythmic ECG segments. We found that the ability of SQIs to discriminate between ECG artefacts and arrhythmic ECG varies based on arrhythmia type since the pathology of each arrhythmic ECG waveform is different. Therefore, to reduce the risk of SQIs classifying arrhythmic events as noise it is important to validate and test SQIs with databases that include arrhythmias. Arrhythmia specific SQIs may also minimize the risk of misclassifying arrhythmic events as noise. PMID:27454007

  4. Echocardiographic findings and abnormalities in HIV-infected patients: results from a large, prospective, multicenter HIV-heart study

    PubMed Central

    Reinsch, Nico; Kahlert, Philipp; Esser, Stefan; Sundermeyer, Andreas; Neuhaus, Katrin; Brockmeyer, Norbert; Potthoff, Anja; Erbel, Raimund; Buck, Thomas; Neumann, Till

    2011-01-01

    Aims: The aim of the current study was to assess cardiac structure and function as well as cardiac abnormalities in a large patient-population based multicenter study of HIV-infected subjects. Materials and methods: We enrolled 803 HIV-positive adults (83.4% men, mean age: 44.2 ± 10.3 yrs) in this prospective, cross-sectional cohort study. The study protocol included a standardized documentation of patient history, medical treatment and clinical examination. All subjects underwent a standardized transthoracic echocardiographic examination protocol including Doppler and tissue Doppler imaging. Results: Echocardiographic measurements revealed a structural dilatation of the left ventricle in 10.1% of all HIV-infected subjects. Interventricular septum and posterior wall thickness were increased in 18.0% and 11.1%, respectively, with elevated muscle mass in 14.3% male and 19.4% female patients. Of all participants 13.5% exhibited a pathologic contraction characteristic of one or more myocardial segments. Prevalence of systolic and diastolic dysfunction was 34.3% and 48.0%, respectively. However, severe forms of ventricular dysfunction were rare. Conclusions: In conclusion our results demonstrate the relevance of echocardiography in this patient-population in the era of antiretroviral therapy. Above all, left ventricular wall thickness and function should be controlled regularly in HIV-infected subjects. (ClinicalTrials.gov number, NCT01119729). PMID:22254197

  5. Analysis of heart rate variations in patients with multiple sclerosis. A simple measure of autonomic nervous disturbances using an ordinary ECG.

    PubMed Central

    Neubauer, B; Gundersen, H J

    1978-01-01

    A simple method requiring only an ordinary ECG apparatus and a ruler has shown a hitherto unknown abnormality of the autonomic nervous sysyem in patients with multiple sclerosis. The main findings were that both long-term and short-term variations in heart rate were reduced in patients wirh multiple sclerosis. The reduction was comparable with that observed in other patients with autonomic abnormalities-for example, long-term diabetics-but in addition patients with multiple sclerosis presented unexpected large shifts in pulse rate levels, lasting from a few to 10 or 20 beats. PMID:660203

  6. Cloud-ECG for real time ECG monitoring and analysis.

    PubMed

    Xia, Henian; Asif, Irfan; Zhao, Xiaopeng

    2013-06-01

    Recent advances in mobile technology and cloud computing have inspired numerous designs of cloud-based health care services and devices. Within the cloud system, medical data can be collected and transmitted automatically to medical professionals from anywhere and feedback can be returned to patients through the network. In this article, we developed a cloud-based system for clients with mobile devices or web browsers. Specially, we aim to address the issues regarding the usefulness of the ECG data collected from patients themselves. Algorithms for ECG enhancement, ECG quality evaluation and ECG parameters extraction were implemented in the system. The system was demonstrated by a use case, in which ECG data was uploaded to the web server from a mobile phone at a certain frequency and analysis was performed in real time using the server. The system has been proven to be functional, accurate and efficient. PMID:23261079

  7. Cardiac Arrhythmias and Abnormal Electrocardiograms After Acute Stroke.

    PubMed

    Ruthirago, Doungporn; Julayanont, Parunyou; Tantrachoti, Pakpoom; Kim, Jongyeol; Nugent, Kenneth

    2016-01-01

    Cardiac arrhythmias and electrocardiogram (ECG) abnormalities occur frequently but are often underrecognized after strokes. Acute ischemic and hemorrhagic strokes in some particular area of brain can disrupt central autonomic control of the heart, precipitating cardiac arrhythmias, ECG abnormalities, myocardial injury and sometimes sudden death. Identification of high-risk patients after acute stroke is important to arrange appropriate cardiac monitoring and effective management of arrhythmias, and to prevent cardiac morbidity and mortality. More studies are needed to better clarify pathogenesis, localization of areas associated with arrhythmias and practical management of arrhythmias and abnormal ECGs after acute stroke.

  8. Findings

    MedlinePlus

    ... Issue All Issues Explore Findings by Topic Cell Biology Cellular Structures, Functions, Processes, Imaging, Stress Response Chemistry ... Glycobiology, Synthesis, Natural Products, Chemical Reactions Computers in Biology Bioinformatics, Modeling, Systems Biology, Data Visualization Diseases Cancer, ...

  9. Brugada ECG patterns in athletes.

    PubMed

    Chung, Eugene H

    2015-01-01

    Brugada syndrome is responsible for up to 4% of all sudden cardiac deaths worldwide and up to 20% of sudden cardiac deaths in patients with structurally normal hearts. Heterogeneity of repolarization and depolarization, particularly over the right ventricle and the outflow tract, is responsible for the arrhythmogenic substrate. The coved Type I ECG pattern is considered diagnostic of the syndrome but its prevalence is very low. Distinguishing between a saddle back Type 2 Brugada pattern and one of many "Brugada-like" patterns presents challenges especially in athletes. A number of criteria have been proposed to assess Brugada ECG patterns. Proper precordial ECG lead placement is paramount. This paper reviews Brugada syndrome, Brugada ECG patterns, and recently proposed criteria. Recommendations for evaluating a Brugada ECG pattern are provided.

  10. Anatomic distribution of culprit lesions in patients with non-ST-segment elevation myocardial infarction and normal ECG

    PubMed Central

    Moustafa, Abdelmoniem; Abi-Saleh, Bernard; El-Baba, Mohammad; Hamoui, Omar

    2016-01-01

    Background In patients presenting with non-ST-elevation myocardial infarction (NSTEMI), left anterior descending (LAD) coronary artery and three-vessel disease are the most commonly encountered culprit lesions in the presence of ST depression, while one third of patients with left circumflex (LCX) artery related infarction have normal ECG. We sought to determine the predictors of presence of culprit lesion in NSTEMI patients based on ECG, echocardiographic, and clinical characteristics. Methods Patients admitted to the coronary care unit with the diagnosis of NSTEMI between June 2012 and December 2013 were retrospectively identified. Admission ECG was interpreted by an electrophysiologist that was blinded to the result of the coronary angiogram. Patients were dichotomized into either normal or abnormal ECG group. The primary endpoint was presence of culprit lesion. Secondary endpoints included length of stay, re-hospitalization within 60 days, and in-hospital mortality. Results A total of 118 patients that were identified; 47 with normal and 71 with abnormal ECG. At least one culprit lesion was identified in 101 patients (86%), and significantly more among those with abnormal ECG (91.5% vs. 76.6%, P=0.041).The LAD was the most frequently detected culprit lesion in both groups. There was a higher incidence of two and three-vessel disease in the abnormal ECG group (P=0.041).On the other hand, there was a trend of higher LCX involvement (25% vs. 13.8%, P=0.18) and more normal coronary arteries in the normal ECG group (23.4% vs. 8.5%, P=0.041). On multivariate analysis, prior history of coronary artery disease (CAD) [odds ratio (OR) 6.4 (0.8-52)], male gender [OR 5.0 (1.5-17)], and abnormal admission ECG [OR 3.6 (1.12-12)], were independent predictors of a culprit lesion. There was no difference in secondary endpoints between those with normal and abnormal ECG. Conclusions Among patients presenting with NSTEMI, prior history of CAD, male gender and abnormal admission

  11. ECG De-noising: A comparison between EEMD-BLMS and DWT-NN algorithms.

    PubMed

    Kærgaard, Kevin; Jensen, Søren Hjøllund; Puthusserypady, Sadasivan

    2015-08-01

    Electrocardiogram (ECG) is a widely used non-invasive method to study the rhythmic activity of the heart and thereby to detect the abnormalities. However, these signals are often obscured by artifacts from various sources and minimization of these artifacts are of paramount important. This paper proposes two adaptive techniques, namely the EEMD-BLMS (Ensemble Empirical Mode Decomposition in conjunction with the Block Least Mean Square algorithm) and DWT-NN (Discrete Wavelet Transform followed by Neural Network) methods in minimizing the artifacts from recorded ECG signals, and compares their performance. These methods were first compared on two types of simulated noise corrupted ECG signals: Type-I (desired ECG+noise frequencies outside the ECG frequency band) and Type-II (ECG+noise frequencies both inside and outside the ECG frequency band). Subsequently, they were tested on real ECG recordings. Results clearly show that both the methods works equally well when used on Type-I signals. However, on Type-II signals the DWT-NN performed better. In the case of real ECG data, though both methods performed similar, the DWT-NN method was a slightly better in terms of minimizing the high frequency artifacts. PMID:26737124

  12. ECG De-noising: A comparison between EEMD-BLMS and DWT-NN algorithms.

    PubMed

    Kærgaard, Kevin; Jensen, Søren Hjøllund; Puthusserypady, Sadasivan

    2015-08-01

    Electrocardiogram (ECG) is a widely used non-invasive method to study the rhythmic activity of the heart and thereby to detect the abnormalities. However, these signals are often obscured by artifacts from various sources and minimization of these artifacts are of paramount important. This paper proposes two adaptive techniques, namely the EEMD-BLMS (Ensemble Empirical Mode Decomposition in conjunction with the Block Least Mean Square algorithm) and DWT-NN (Discrete Wavelet Transform followed by Neural Network) methods in minimizing the artifacts from recorded ECG signals, and compares their performance. These methods were first compared on two types of simulated noise corrupted ECG signals: Type-I (desired ECG+noise frequencies outside the ECG frequency band) and Type-II (ECG+noise frequencies both inside and outside the ECG frequency band). Subsequently, they were tested on real ECG recordings. Results clearly show that both the methods works equally well when used on Type-I signals. However, on Type-II signals the DWT-NN performed better. In the case of real ECG data, though both methods performed similar, the DWT-NN method was a slightly better in terms of minimizing the high frequency artifacts.

  13. Embedding patients confidential data in ECG signal for healthcare information systems.

    PubMed

    Ibaida, Ayman; Khalil, Ibrahim; Al-Shammary, Dhiah

    2010-01-01

    In Wireless tele-cardiology applications, ECG signal is widely used to monitor cardiac activities of patients. Accordingly, in most e-health applications, ECG signals need to be combined with patient confidential information. Data hiding and watermarking techniques can play a crucial role in ECG wireless tele-monitoring systems by combining the confidential information with the ECG signal since digital ECG data is huge enough to act as host to carry tiny amount of additional secret data. In this paper, a new steganography technique is proposed that helps embed confidential information of patients into specific locations (called special range numbers) of digital ECG host signal that will cause minimal distortion to ECG, and at the same time, any secret information embedded is completely extractable. We show that there are 2.1475 × 10(9) possible special range numbers making it extremely difficult for intruders to identify locations of secret bits. Experiments show that percentage residual difference (PRD) of watermarked ECGs can be as low as 0.0247% and 0.0678% for normal and abnormal ECG segments (taken from MIT-BIH Arrhythmia database) respectively.

  14. Development of a portable wireless system for bipolar concentric ECG recording

    NASA Astrophysics Data System (ADS)

    Prats-Boluda, G.; Ye-Lin, Y.; Bueno Barrachina, J. M.; Senent, E.; Rodriguez de Sanabria, R.; Garcia-Casado, J.

    2015-07-01

    Cardiovascular diseases (CVDs) remain the biggest cause of deaths worldwide. ECG monitoring is a key tool for early diagnosis of CVDs. Conventional monitors use monopolar electrodes resulting in poor spatial resolution surface recordings and requiring extensive wiring. High-spatial resolution surface electrocardiographic recordings provide valuable information for the diagnosis of a wide range of cardiac abnormalities, including infarction and arrhythmia. The aim of this work was to develop and test a wireless recording system for acquiring high spatial resolution ECG signals, based on a flexible tripolar concentric electrode (TCE) without cable wiring or external reference electrode which would make more comnfortable its use in clinical practice. For this, a portable, wireless sensor node for analogue conditioning, digitalization and transmission of a bipolar concentric ECG signal (BC-ECG) using a TCE and a Mason-likar Lead-I ECG (ML-Lead-I ECG) signal was developed. Experimental results from a total of 32 healthy volunteers showed that the ECG fiducial points in the BC-ECG signals, recorded with external and internal reference electrode, are consistent with those of simultaneous ML-Lead-I ECG. No statistically significant difference was found in either signal amplitude or morphology, regardless of the reference electrode used, being the signal-to-noise similar to that of ML-Lead-I ECG. Furthermore, it has been observed that BC-ECG signals contain information that could not available in conventional records, specially related to atria activity. The proposed wireless sensor node provides non-invasive high-local resolution ECG signals using only a TCE without additional wiring, which would have great potential in medical diagnosis of diseases such as atrial or ventricular fibrillations or arrhythmias that currently require invasive diagnostic procedures (catheterization).

  15. Brain MRI abnormalities and spectrum of neurological and clinical findings in three patients with proximal 16p11.2 microduplication.

    PubMed

    Filges, Isabel; Sparagana, Steven; Sargent, Michael; Selby, Kathryn; Schlade-Bartusiak, Kamilla; Lueder, Gregg T; Robichaux-Viehoever, Amy; Schlaggar, Bradley L; Shimony, Joshua S; Shinawi, Marwan

    2014-08-01

    The phenotype of recurrent ∼600 kb microdeletion and microduplication on proximal 16p11.2 is characterized by a spectrum of neurodevelopmental impairments including developmental delay and intellectual disability, epilepsy, autism and psychiatric disorders which are all subject to incomplete penetrance and variable expressivity. A variety of brain MRI abnormalities were reported in patients with 16p11.2 rearrangements, but no systematic correlation has been studied among patients with similar brain anomalies, their neurodevelopmental and clinical phenotypes. We present three patients with the proximal 16p11.2 microduplication exhibiting significant developmental delay, anxiety disorder and other variable clinical features. Our patients have abnormal brain MRI findings of cerebral T2 hyperintense foci (3/3) and ventriculomegaly (2/3). The neuroradiological or neurological findings in two cases prompted an extensive diagnostic work-up. One patient has exhibited neurological regression and progressive vision impairment and was diagnosed with juvenile neuronal ceroid-lipofuscinosis. We compare the clinical course and phenotype of these patients in regard to the clinical significance of the cerebral lesions and the need for MRI surveillance. We conclude that in all three patients the lesions were not progressive, did not show any sign of malignant transformation and could not be correlated to specific clinical features. We discuss potential etiologic mechanisms that may include overexpression of genes within the duplicated region involved in control of cell proliferation and complex molecular mechanisms such as the MAPK/ERK pathway. Systematic studies in larger cohorts are needed to confirm our observation and to establish the prevalence and clinical significance of these neuroanatomical abnormalities in patients with 16p11.2 duplications. PMID:24891046

  16. Lack of Evidence for Regional Brain Volume or Cortical Thickness Abnormalities in Youths at Clinical High Risk for Psychosis: Findings From the Longitudinal Youth at Risk Study.

    PubMed

    Klauser, Paul; Zhou, Juan; Lim, Joseph K W; Poh, Joann S; Zheng, Hui; Tng, Han Ying; Krishnan, Ranga; Lee, Jimmy; Keefe, Richard S E; Adcock, R Alison; Wood, Stephen J; Fornito, Alex; Chee, Michael W L

    2015-11-01

    There is cumulative evidence that young people in an "at-risk mental state" (ARMS) for psychosis show structural brain abnormalities in frontolimbic areas, comparable to, but less extensive than those reported in established schizophrenia. However, most available data come from ARMS samples from Australia, Europe, and North America while large studies from other populations are missing. We conducted a structural brain magnetic resonance imaging study from a relatively large sample of 69 ARMS individuals and 32 matched healthy controls (HC) recruited from Singapore as part of the Longitudinal Youth At-Risk Study (LYRIKS). We used 2 complementary approaches: a voxel-based morphometry and a surface-based morphometry analysis to extract regional gray and white matter volumes (GMV and WMV) and cortical thickness (CT). At the whole-brain level, we did not find any statistically significant difference between ARMS and HC groups concerning total GMV and WMV or regional GMV, WMV, and CT. The additional comparison of 2 regions of interest, hippocampal, and ventricular volumes, did not return any significant difference either. Several characteristics of the LYRIKS sample like Asian origins or the absence of current illicit drug use could explain, alone or in conjunction, the negative findings and suggest that there may be no dramatic volumetric or CT abnormalities in ARMS. PMID:25745033

  17. Fast multi-scale feature fusion for ECG heartbeat classification

    NASA Astrophysics Data System (ADS)

    Ai, Danni; Yang, Jian; Wang, Zeyu; Fan, Jingfan; Ai, Changbin; Wang, Yongtian

    2015-12-01

    Electrocardiogram (ECG) is conducted to monitor the electrical activity of the heart by presenting small amplitude and duration signals; as a result, hidden information present in ECG data is difficult to determine. However, this concealed information can be used to detect abnormalities. In our study, a fast feature-fusion method of ECG heartbeat classification based on multi-linear subspace learning is proposed. The method consists of four stages. First, baseline and high frequencies are removed to segment heartbeat. Second, as an extension of wavelets, wavelet-packet decomposition is conducted to extract features. With wavelet-packet decomposition, good time and frequency resolutions can be provided simultaneously. Third, decomposed confidences are arranged as a two-way tensor, in which feature fusion is directly implemented with generalized N dimensional ICA (GND-ICA). In this method, co-relationship among different data information is considered, and disadvantages of dimensionality are prevented; this method can also be used to reduce computing compared with linear subspace-learning methods (PCA). Finally, support vector machine (SVM) is considered as a classifier in heartbeat classification. In this study, ECG records are obtained from the MIT-BIT arrhythmia database. Four main heartbeat classes are used to examine the proposed algorithm. Based on the results of five measurements, sensitivity, positive predictivity, accuracy, average accuracy, and t-test, our conclusion is that a GND-ICA-based strategy can be used to provide enhanced ECG heartbeat classification. Furthermore, large redundant features are eliminated, and classification time is reduced.

  18. Electrocardiographic abnormalities and cardiac arrhythmias in chronic obstructive pulmonary disease.

    PubMed

    Goudis, Christos A; Konstantinidis, Athanasios K; Ntalas, Ioannis V; Korantzopoulos, Panagiotis

    2015-11-15

    Chronic obstructive pulmonary disease (COPD) is independently associated with an increased burden of cardiovascular disease. Besides coronary artery disease (CAD) and congestive heart failure (CHF), specific electrocardiographic (ECG) abnormalities and cardiac arrhythmias seem to have a significant impact on cardiovascular prognosis of COPD patients. Disturbances of heart rhythm include premature atrial contractions (PACs), premature ventricular contractions (PVCs), atrial fibrillation (AF), atrial flutter (AFL), multifocal atrial tachycardia (MAT), and ventricular tachycardia (VT). Of note, the identification of ECG abnormalities and the evaluation of the arrhythmic risk may have significant implications in the management and outcome of patients with COPD. This article provides a concise overview of the available data regarding ECG abnormalities and arrhythmias in these patients, including an elaborated description of the underlying arrhythmogenic mechanisms. The clinical impact and prognostic significance of ECG abnormalities and arrhythmias in COPD as well as the appropriate antiarrhythmic therapy and interventions in this setting are also discussed.

  19. ECG-based heartbeat classification for arrhythmia detection: A survey.

    PubMed

    Luz, Eduardo José da S; Schwartz, William Robson; Cámara-Chávez, Guillermo; Menotti, David

    2016-04-01

    An electrocardiogram (ECG) measures the electric activity of the heart and has been widely used for detecting heart diseases due to its simplicity and non-invasive nature. By analyzing the electrical signal of each heartbeat, i.e., the combination of action impulse waveforms produced by different specialized cardiac tissues found in the heart, it is possible to detect some of its abnormalities. In the last decades, several works were developed to produce automatic ECG-based heartbeat classification methods. In this work, we survey the current state-of-the-art methods of ECG-based automated abnormalities heartbeat classification by presenting the ECG signal preprocessing, the heartbeat segmentation techniques, the feature description methods and the learning algorithms used. In addition, we describe some of the databases used for evaluation of methods indicated by a well-known standard developed by the Association for the Advancement of Medical Instrumentation (AAMI) and described in ANSI/AAMI EC57:1998/(R)2008 (ANSI/AAMI, 2008). Finally, we discuss limitations and drawbacks of the methods in the literature presenting concluding remarks and future challenges, and also we propose an evaluation process workflow to guide authors in future works.

  20. Clinical findings and white matter abnormalities seen on diffusion tensor imaging in adolescents with very low birth weight.

    PubMed

    Skranes, J; Vangberg, T R; Kulseng, S; Indredavik, M S; Evensen, K A I; Martinussen, M; Dale, A M; Haraldseth, O; Brubakk, A-M

    2007-03-01

    Very low birth weight (VLBW) children are at high risk of perinatal white matter injury, which, when subtle, may not be seen using conventional magnetic resonance imaging. The relationship between clinical findings and fractional anisotropy (FA) measurements in white matter of adolescents born prematurely with VLBW was studied in 34 subjects (age = 15 years, birth weight

  1. Clinical findings and white matter abnormalities seen on diffusion tensor imaging in adolescents with very low birth weight.

    PubMed

    Skranes, J; Vangberg, T R; Kulseng, S; Indredavik, M S; Evensen, K A I; Martinussen, M; Dale, A M; Haraldseth, O; Brubakk, A-M

    2007-03-01

    Very low birth weight (VLBW) children are at high risk of perinatal white matter injury, which, when subtle, may not be seen using conventional magnetic resonance imaging. The relationship between clinical findings and fractional anisotropy (FA) measurements in white matter of adolescents born prematurely with VLBW was studied in 34 subjects (age = 15 years, birth weight

  2. ECG manifestations of multiple electrolyte imbalance: peaked T wave to P wave ("tee-pee sign").

    PubMed

    Johri, Amer M; Baranchuk, Adrian; Simpson, Christopher S; Abdollah, Hoshiar; Redfearn, Damian P

    2009-04-01

    The surface electrocardiogram (ECG) is a useful instrument in the detection of metabolic disturbances. The accurate characterization of these disturbances, however, may be considerably more difficult when more than one metabolic abnormality is present in the same individual. While "classic" ECG presentations of common electrolyte disturbances are well described, multiple electrolyte disturbances occurring simultaneously may generate ECG abnormalities that are not as readily recognizable. We report a case of hyperkalemia, with concurrent hypocalcemia and hypomagnesemia resulting in (1) peaking of the T wave, (2) a prominent U wave, and (3) prolongation of the descending limb of the T wave such that it overlapped with the next P wave. In this particular ECG from a patient with combined electrolyte imbalance, we have dubbed the unusual appearance of the segment between the peak of the T wave to the next P wave as the "tee-pee" sign. PMID:19419407

  3. ECG data compression by modeling.

    PubMed Central

    Madhukar, B.; Murthy, I. S.

    1992-01-01

    This paper presents a novel algorithm for data compression of single lead Electrocardiogram (ECG) data. The method is based on Parametric modeling of the Discrete Cosine Transformed ECG signal. Improved high frequency reconstruction is achieved by separately modeling the low and the high frequency regions of the transformed signal. Differential Pulse Code Modulation is applied on the model parameters to obtain a further increase in the compression. Compression ratios up to 1:40 were achieved without significant distortion. PMID:1482940

  4. Association between sonographic diagnosis of fatty liver with histopathologic abnormalities and liver biopsy findings in middle age patient with non-alcoholic fatty liver disease

    PubMed Central

    Kalantari, Hamid; Moradi, Farhad; Hassanzade, Akbar

    2016-01-01

    Background: Liver biopsy is required to diagnose non-alcoholic steatohepatitis in patients with suspected non-alcoholic fatty liver disease (NAFLD). This study aimed to examine the relationship between sonographic diagnosis of fatty liver with histopathologic abnormalities and liver biopsy findings in patient with NAFLD. Materials and Methods: In this cross-sectional study, a total of 180 patients, with an age range of 18-60 year old, with NAFLD based on ultrasonograghic findings were evaluated. Age, sex, body mass index, diabetes mellitus, hypertension, family history of liver disease and laboratory parameters recorded for all patients. Hence, grade of steatosis and stage of fibrosis were evaluated by liver biopsy. Results: A total of 220 patients were enrolled. Liver biopsy was performed in 180 patients. Mean age was 43 ± 10.6 years old and 66% were male. Ultrasonograghic findings showed mild, moderate and severe NAFLD was define in 100 (55.5%), 72 (40%) and 8 (4.5%) of patients, respectively. Liver biopsies showed that steatosis scores of <5%, 5-33% and 33-66% was define in 56 (31%), 116 (64%) and 9 (5%) of patients, respectively. Furthermore, fibrosis was defined as follow; none 92 (51%), mild 68 (38%), moderate 11 (6%), bridging 5 (3%) and cirrhosis 3 (2%) patients. There was no statistically significant relationship between ultrasonograghic findings and steatosis scores (P = 0.44), but statistically significant relationship was found between ultrasonograghic findings and fibrosis stage (P = 0.017). Conclusion: Findings revealed that, in patients with NAFLD, ultrasonographic finding were not in associate to steatosis, but were in relation with fibrosis stage. PMID:27563632

  5. Simple electrocardiogram (ECG) signal analyzer for homecare system among the elderly.

    PubMed

    Lin, Liuh-Chii; Yeh, Yun-Chi; Ho, Kuei-Jung

    2015-01-01

    This study presents a simple electrocardiogram (ECG) signal analyzer for homecare system among the elderly. It can transmit ECG signals of patient around his/her house through Bluetooth to computers in house. ECG signals are analyzed by the computer. If abnormal case of heartbeat is found, the emergency call is automatically dialed. Meanwhile, the determined heartbeat case of ECG signals will be forwarded to patient's MD through internet. Therefore, the patient can do whatever he/she wants around his/her house with our proposed simple cardiac arrhythmias signal analyzer. The proposed consists of five major processing stages: (i) preprocessing stage for enlarging ECG signals' amplitude and eliminating noises; (ii) ECG signal transmitter/receiver stage, ECG signals are transmitted through Bluetooth to the signal receiver in patient's house; (iii) QRS extraction stage for detecting QRS waveform using the Difference Operation Method (DOM) method; (iv) qualitative features stage for qualitative feature selection on ECG signals; and (v) classification stage for determining patient's heartbeat cases using the Principal Component Analysis (PCA) method. In the experiment, the total classification accuracy (TCA) was approximately 93.19% in average.

  6. Simple electrocardiogram (ECG) signal analyzer for homecare system among the elderly.

    PubMed

    Lin, Liuh-Chii; Yeh, Yun-Chi; Ho, Kuei-Jung

    2015-01-01

    This study presents a simple electrocardiogram (ECG) signal analyzer for homecare system among the elderly. It can transmit ECG signals of patient around his/her house through Bluetooth to computers in house. ECG signals are analyzed by the computer. If abnormal case of heartbeat is found, the emergency call is automatically dialed. Meanwhile, the determined heartbeat case of ECG signals will be forwarded to patient's MD through internet. Therefore, the patient can do whatever he/she wants around his/her house with our proposed simple cardiac arrhythmias signal analyzer. The proposed consists of five major processing stages: (i) preprocessing stage for enlarging ECG signals' amplitude and eliminating noises; (ii) ECG signal transmitter/receiver stage, ECG signals are transmitted through Bluetooth to the signal receiver in patient's house; (iii) QRS extraction stage for detecting QRS waveform using the Difference Operation Method (DOM) method; (iv) qualitative features stage for qualitative feature selection on ECG signals; and (v) classification stage for determining patient's heartbeat cases using the Principal Component Analysis (PCA) method. In the experiment, the total classification accuracy (TCA) was approximately 93.19% in average. PMID:26684565

  7. Prevalence of abnormal findings when adopting new national and international Global Lung Function Initiative reference values for spirometry in the Finnish general population

    PubMed Central

    Kainu, Annette; Lindqvist, Ari; Sovijärvi, Anssi R. A.

    2016-01-01

    Background New Finnish (Kainu2015) and international Global Lung Function Initiative (GLI2012) reference values for spirometry were recently published. The aim of this study is to compare the interpretative consequences of adopting these new reference values with older, currently used Finnish reference values (Viljanen1982) in the general population of native Finns. Methods Two Finnish general population samples including 1,328 adults (45% males) aged 21–74 years were evaluated. Airway obstruction was defined as a reduced ratio of forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), possible restrictive pattern as reduced FVC, and decreased ventilatory capacity as reduced FEV1 below their respective 2.5th percentiles. The severity gradings of reduced lung function were also compared. Results Using the Kainu2015 reference values, the prevalence of airway obstruction in the population was 5.6%; using GLI2012 it was 4.0% and with Viljanen1982 it was 13.0%. Possible restrictive pattern was found in 4.2% using the Kainu2015 values, in 2.0% with GLI2012, and 7.9% with the Viljanen1982 values. The prevalence of decreased ventilatory capacity was 6.8, 4.0, and 13.3% with the Kainu2015, GLI2012 and Viljanen1982 values, respectively. Conclusions The application of the GLI2012 reference values underestimates the prevalence of abnormal spirometric findings in native Finns. The adoption of the Kainu2015 reference values reduces the prevalences of airways obstruction, decreased ventilatory capacity, and restrictive impairment by approximately 50%. Changing from the 2.5th percentile, the previously used lower limit of normal, to the 5th percentile recommended by the American Thoracic Society/European Respiratory Society will not increase the prevalence of abnormal findings in the implementation of spirometry reference values. PMID:27608270

  8. Combined ECG, Echocardiographic, and Biomarker Criteria for Diagnosing Acute Myocardial Infarction in Out-of-Hospital Cardiac Arrest Patients

    PubMed Central

    Lee, Sang-Eun; Uhm, Jae-Sun; Kim, Jong-Youn; Pak, Hui-Nam; Lee, Moon-Hyoung

    2015-01-01

    Purpose Acute coronary lesions commonly trigger out-of-hospital cardiac arrest (OHCA). However, the prevalence of coronary artery disease (CAD) in Asian patients with OHCA and whether electrocardiogram (ECG) and other findings might predict acute myocardial infarction (AMI) have not been fully elucidated. Materials and Methods Of 284 consecutive resuscitated OHCA patients seen between January 2006 and July 2013, we enrolled 135 patients who had undergone coronary evaluation. ECGs, echocardiography, and biomarkers were compared between patients with or without CAD. Results We included 135 consecutive patients aged 54 years (interquartile range 45-65) with sustained return of spontaneous circulation after OHCA between 2006 and 2012. Sixty six (45%) patients had CAD. The initial rhythm was shockable and non-shockable in 110 (81%) and 25 (19%) patients, respectively. ST-segment elevation predicted CAD with 42% sensitivity, 87% specificity, and 65% accuracy. ST elevation and/or regional wall motion abnormality (RWMA) showed 68% sensitivity, 52% specificity, and 70% accuracy in the prediction of CAD. Finally, a combination of ST elevation and/or RWMA and/or troponin T elevation predicted CAD with 94% sensitivity, 17% specificity, and 55% accuracy. Conclusion In patients with OHCA without obvious non-cardiac causes, selection for coronary angiogram based on the combined criterion could detect 94% of CADs. However, compared with ECG only criteria, the combined criterion failed to improve diagnostic accuracy with a lower specificity. PMID:26069108

  9. The future of remote ECG monitoring systems.

    PubMed

    Guo, Shu-Li; Han, Li-Na; Liu, Hong-Wei; Si, Quan-Jin; Kong, De-Feng; Guo, Fu-Su

    2016-09-01

    Remote ECG monitoring systems are becoming commonplace medical devices for remote heart monitoring. In recent years, remote ECG monitoring systems have been applied in the monitoring of various kinds of heart diseases, and the quality of the transmission and reception of the ECG signals during remote process kept advancing. However, there remains accompanying challenges. This report focuses on the three components of the remote ECG monitoring system: patient (the end user), the doctor workstation, and the remote server, reviewing and evaluating the imminent challenges on the wearable systems, packet loss in remote transmission, portable ECG monitoring system, patient ECG data collection system, and ECG signals transmission including real-time processing ST segment, R wave, RR interval and QRS wave, etc. This paper tries to clarify the future developmental strategies of the ECG remote monitoring, which can be helpful in guiding the research and development of remote ECG monitoring. PMID:27582770

  10. The future of remote ECG monitoring systems

    PubMed Central

    Guo, Shu-Li; Han, Li-Na; Liu, Hong-Wei; Si, Quan-Jin; Kong, De-Feng; Guo, Fu-Su

    2016-01-01

    Remote ECG monitoring systems are becoming commonplace medical devices for remote heart monitoring. In recent years, remote ECG monitoring systems have been applied in the monitoring of various kinds of heart diseases, and the quality of the transmission and reception of the ECG signals during remote process kept advancing. However, there remains accompanying challenges. This report focuses on the three components of the remote ECG monitoring system: patient (the end user), the doctor workstation, and the remote server, reviewing and evaluating the imminent challenges on the wearable systems, packet loss in remote transmission, portable ECG monitoring system, patient ECG data collection system, and ECG signals transmission including real-time processing ST segment, R wave, RR interval and QRS wave, etc. This paper tries to clarify the future developmental strategies of the ECG remote monitoring, which can be helpful in guiding the research and development of remote ECG monitoring. PMID:27582770

  11. Frequency of Electrocardiographic Abnormalities in Tramadol Poisoned Patients; a Brief Report

    PubMed Central

    Alizadeh Ghamsari, Anahita; Dadpour, Bita; Najari, Fares

    2016-01-01

    Introduction: Previous studies have raised the probably of cardiac manifestation in tramadol poisoning. However, conclusive information on electrocardiographic (ECG) abnormalities of tramadol overdose remains to be explained. Therefore, the present study aimed to evaluate the epidemiology of ECG abnormalities in tramadol poisoned patients. Methods: In a prospective cross-sectional study, all patients with tramadol poisoning, who were admitted to the emergency department of Loghman Hospital during 2012 – 2013, were evaluated. Patients’ baseline characteristics and ECG findings including axis, rate, rhythm, PR interval, QRS duration, QTc interval, evidence of Brugada pattern, and evidence of blocks were recorded. Obtained Data were descriptively analyzed using SPSS 21.0 statistical software. Results: 1402 patients with the mean age of 24 ± 6 years were studied (71.1% male). Sinus tachycardia was detected in 463 (33%) patients, sinus bradycardia in one patient (0.07%), right axis deviation in 340 (24.2), QRS widening in 91 (6.5%), long QTc interval in 259 (18.4%), dominant S wave in either I or aVL lead in 395 (28.1%), and right bundle branch block in 73 (5.2%). Increased PR interval was not detected in any cases. The evidence of Brugada pattern was observed in 2 (0.14%) patients (100% male), both symptomatized with seizure. All abnormalities had same sex distribution. Conclusion: Based on the results of the present study, the most common types of ECG changes were sinus tachycardia, a deep S wave in leads I and aVL, right axis deviation, and long QTc interval, respectively. Brugada pattern and sinus bradycardia were rarely presented. PMID:27299145

  12. ECG body surface mapping in patients with gestational diabetes mellitus and optimal metabolic compensation.

    PubMed

    Žákovičová, E; Kittnar, O; Slavíček, J; Medová, E; Šváb, P; Charvát, J

    2014-01-01

    Women with gestational diabetes mellitus (GDM) are at increased risk for cardiovascular diseases (CVD) events compared with women without GDM. The aim of the present study was to evaluate 200 parameters of the heart electric field in 35 women with GDM under optimal glycemic compensation compared to 32 healthy pregnant women. All examinations were performed in the 36th week of gestation. The parameters in ECG body surface mapping (BSM) were registered by the diagnostic system Cardiag 112.2. The absolute values of maximum and minimum in depolarization and repolarization isopotential, isointegral and isoarea maps were not significantly different between the groups. These findings correspond to the result of heart rate variability examination. However BSM revealed the significant prolongation of QRS complex (p=0.05), shortening of ventricular myocardial activation time (ICHVAT) (p=0.01), prolongation of mean QT duration (p=0.01) and increase of QT interval dispersion (p=0.01) in women with GDM. Duration of QRS and ICHVAT significantly correlated with interventricular septum and posterior wall thickness in GDM group, QTd interval correlated significantly with HbA1C level. We conclude that despite of optimal metabolic control several significant abnormalities detected by ECG BSM are still present in patients with GDM. PMID:25669679

  13. Investigation of ECG Changes in Absence Epilepsy on WAG/Rij Rats

    PubMed Central

    Es'haghi, Fatemeh; Shahabi, Parviz; Frounchi, Javad; Sadighi, Mina; Yousefi, Hadi

    2015-01-01

    Introduction: Seizures are symptoms associated with abnormal electrical activity in electroencephalogram (EEG). The present study was designed to determine the effect of absence seizure on heart rate (HR) changes in electrocardiogram (ECG). Methods: HR alterations were recorded simultaneous with spike and wave discharges (SWD) by EEG in 6 WAG/Rij rats as a well characterized and validated genetic animal epilepsy model. Moreover, 6 control rats were used to distinguish the differences of HR changes between various groups. Electrodes were placed on the skull and under the chest skin, minimizing time delay and signal attenuation. HR was calculated by an adaptable algorithm based on continues wavelet transform (CWT) particular for this study. Three main features of HR; minimum, maximum, and mean values were estimated for pre-ictal and ictal intervals for all seizures. Results: ECG beats detected with sensitivity of 99.9% and positive predictability of 99.8% based on CWT. HR deceleration was found in 86% of the seizures. There were statistically significant (P<0.001) reductions of these values from pre-ictal to ictal intervals. Interictal HR acceleration and ictal deceleration were the major feature of alterations and in 23% of seizures, this decrease had priority to the onsets. Discussion: These findings may lead to design a seizure alarm system based on HR and to obtain new insights about sudden unexpected death in epilepsy (SUDEP) phenomenon and side-effects of antiepileptic drugs (AED). PMID:27307957

  14. An ECG analysis interactive training system for understanding arrhythmias.

    PubMed

    Lessard, Yvon; Sinteff, Jean-Paul; Siregar, Pridi; Julen, Nathalie; Hannouche, Frédéric; Rio, Stéphane; Le Beux, Pierre

    2009-01-01

    The ECG remains a daily diagnostic tool for the detection of numerous cardiovascular diseases. Our goal was to use a computerized qualitative model (QM) of heart in order to build cases of simple arrhythmias dedicated to initial and more advanced medical teaching. The original QM is able to generate videograms of many cardiac disturbances. A Flash player is used to view ECG, synchronous Lewis diagram and chromatic 2D cardiac animation of a specific case. OAAT is a standardized 18 yes/no answers questionnaire which allows the learner to diagnose five main types of arrhythmias that can be compared with normal sinus rhythm (NSR) analysis. This new tool has been recently used by medical students during practical sessions. Based on medical reasoning learning on NSR video and upon trying to recognize an abnormal cardiac rhythm, all users can reach the 100% winning score since they can perform as many attempts as they like. We believe that unlimited case review with questionnaire answering, ECG and Lewis diagram replay and step-by-step visualization of the abnormal propagation of the cardiac impulse on the 2D heart videos are a highly efficient means to help students understand even complex arrhythmic mechanisms.

  15. An ECG analysis interactive training system for understanding arrhythmias.

    PubMed

    Lessard, Yvon; Sinteff, Jean-Paul; Siregar, Pridi; Julen, Nathalie; Hannouche, Frédéric; Rio, Stéphane; Le Beux, Pierre

    2009-01-01

    The ECG remains a daily diagnostic tool for the detection of numerous cardiovascular diseases. Our goal was to use a computerized qualitative model (QM) of heart in order to build cases of simple arrhythmias dedicated to initial and more advanced medical teaching. The original QM is able to generate videograms of many cardiac disturbances. A Flash player is used to view ECG, synchronous Lewis diagram and chromatic 2D cardiac animation of a specific case. OAAT is a standardized 18 yes/no answers questionnaire which allows the learner to diagnose five main types of arrhythmias that can be compared with normal sinus rhythm (NSR) analysis. This new tool has been recently used by medical students during practical sessions. Based on medical reasoning learning on NSR video and upon trying to recognize an abnormal cardiac rhythm, all users can reach the 100% winning score since they can perform as many attempts as they like. We believe that unlimited case review with questionnaire answering, ECG and Lewis diagram replay and step-by-step visualization of the abnormal propagation of the cardiac impulse on the 2D heart videos are a highly efficient means to help students understand even complex arrhythmic mechanisms. PMID:19745450

  16. A Wearable Context-Aware ECG Monitoring System Integrated with Built-in Kinematic Sensors of the Smartphone

    PubMed Central

    Miao, Fen; Cheng, Yayu; He, Yi; He, Qingyun; Li, Ye

    2015-01-01

    Continuously monitoring the ECG signals over hours combined with activity status is very important for preventing cardiovascular diseases. A traditional ECG holter is often inconvenient to carry because it has many electrodes attached to the chest and because it is heavy. This work proposes a wearable, low power context-aware ECG monitoring system integrated built-in kinetic sensors of the smartphone with a self-designed ECG sensor. The wearable ECG sensor is comprised of a fully integrated analog front-end (AFE), a commercial micro control unit (MCU), a secure digital (SD) card, and a Bluetooth module. The whole sensor is very small with a size of only 58 × 50 × 10 mm for wearable monitoring application due to the AFE design, and the total power dissipation in a full round of ECG acquisition is only 12.5 mW. With the help of built-in kinetic sensors of the smartphone, the proposed system can compute and recognize user’s physical activity, and thus provide context-aware information for the continuous ECG monitoring. The experimental results demonstrated the performance of proposed system in improving diagnosis accuracy for arrhythmias and identifying the most common abnormal ECG patterns in different activities. In conclusion, we provide a wearable, accurate and energy-efficient system for long-term and context-aware ECG monitoring without any extra cost on kinetic sensor design but with the help of the widespread smartphone. PMID:25996508

  17. A Wearable Context-Aware ECG Monitoring System Integrated with Built-in Kinematic Sensors of the Smartphone.

    PubMed

    Miao, Fen; Cheng, Yayu; He, Yi; He, Qingyun; Li, Ye

    2015-05-19

    Continuously monitoring the ECG signals over hours combined with activity status is very important for preventing cardiovascular diseases. A traditional ECG holter is often inconvenient to carry because it has many electrodes attached to the chest and because it is heavy. This work proposes a wearable, low power context-aware ECG monitoring system integrated built-in kinetic sensors of the smartphone with a self-designed ECG sensor. The wearable ECG sensor is comprised of a fully integrated analog front-end (AFE), a commercial micro control unit (MCU), a secure digital (SD) card, and a Bluetooth module. The whole sensor is very small with a size of only 58 × 50 × 10 mm for wearable monitoring application due to the AFE design, and the total power dissipation in a full round of ECG acquisition is only 12.5 mW. With the help of built-in kinetic sensors of the smartphone, the proposed system can compute and recognize user's physical activity, and thus provide context-aware information for the continuous ECG monitoring. The experimental results demonstrated the performance of proposed system in improving diagnosis accuracy for arrhythmias and identifying the most common abnormal ECG patterns in different activities. In conclusion, we provide a wearable, accurate and energy-efficient system for long-term and context-aware ECG monitoring without any extra cost on kinetic sensor design but with the help of the widespread smartphone.

  18. A Wearable Context-Aware ECG Monitoring System Integrated with Built-in Kinematic Sensors of the Smartphone.

    PubMed

    Miao, Fen; Cheng, Yayu; He, Yi; He, Qingyun; Li, Ye

    2015-01-01

    Continuously monitoring the ECG signals over hours combined with activity status is very important for preventing cardiovascular diseases. A traditional ECG holter is often inconvenient to carry because it has many electrodes attached to the chest and because it is heavy. This work proposes a wearable, low power context-aware ECG monitoring system integrated built-in kinetic sensors of the smartphone with a self-designed ECG sensor. The wearable ECG sensor is comprised of a fully integrated analog front-end (AFE), a commercial micro control unit (MCU), a secure digital (SD) card, and a Bluetooth module. The whole sensor is very small with a size of only 58 × 50 × 10 mm for wearable monitoring application due to the AFE design, and the total power dissipation in a full round of ECG acquisition is only 12.5 mW. With the help of built-in kinetic sensors of the smartphone, the proposed system can compute and recognize user's physical activity, and thus provide context-aware information for the continuous ECG monitoring. The experimental results demonstrated the performance of proposed system in improving diagnosis accuracy for arrhythmias and identifying the most common abnormal ECG patterns in different activities. In conclusion, we provide a wearable, accurate and energy-efficient system for long-term and context-aware ECG monitoring without any extra cost on kinetic sensor design but with the help of the widespread smartphone. PMID:25996508

  19. Human Authentication Based on ECG Waves Using Radon Transform

    NASA Astrophysics Data System (ADS)

    Hegde, Chetana; Prabhu, H. Rahul; Sagar, D. S.; Shenoy, P. Deepa; Venugopal, K. R.; Patnaik, L. M.

    Automated security is one of the major concerns of modern times. Secure and reliable authentication systems are in great demand. A biometric trait like electrocardiogram (ECG) of a person is unique and secure. In this paper, we propose a human authentication system based on ECG waves considering a plotted ECG wave signal as an image. The Radon Transform is applied on the preprocessed ECG image to get a radon image consisting of projections for θ varying from 0 o to 180 o . The pairwise distance between the columns of Radon image is computed to get a feature vector. Correlation Coefficient between feature vector stored in the database and that of input image is computed to check the authenticity of a person. Then the confusion matrix is generated to find False Acceptance Ratio (FAR) and False Rejection Ratio (FRR). This methodology of authentication is tested on ECG wave data set of 105 individuals taken from Physionet QT Database. The proposed authentication system is found to have FAR of about 3.19% and FRR of about 0.128%. The overall accuracy of the system is found to be 99.85%.

  20. Plasma antibodies to heat shock protein 60 and heat shock protein 70 are associated with increased risk of electrocardiograph abnormalities in automobile workers exposed to noise.

    PubMed

    Yuan, Jing; Yang, Miao; Yao, Huiling; Zheng, Jianru; Yang, Qiaoling; Chen, Sheng; Wei, Qingyi; Tanguay, Robert M; Wu, Tangchun

    2005-01-01

    In the living and working environment, stressful factors, such as noise, can cause health problems including cardiovascular diseases and noise-induced hearing loss. Some heat shock proteins (Hsps) play an important role in protecting cardiac cells against ischemic injury, and antibodies against these Hsps are associated with the development and prognosis of atherogenesis, coronary heart disease, and hypertension. Whether the presence of such antibodies is associated with abnormal electrocardiography (ECG) in stressed autoworkers exposed to chronic noise is presently unknown. Therefore, we investigated the association between the levels of plasma anti-Hsp60 and anti-Hsp70 with electrocardiograph abnormality in 396 autoworkers exposed to different noise levels by using Western blot, ECG, and multivariate logistic regression analysis. The results showed that the increase in levels of anti-Hsp70 was associated with a higher risk of ECG abnormalities characteristic of chronic myocardial ischemia (P < 0.05), conductive abnormality (P < 0.01), or heart displacement (P < 0.05); in contrast, elevated anti-Hsp60 was related to ECG abnormalities characteristic of sinus arrhythmia, chronic myocardial ischemia, and ectopic rhythm (P < 0.01 for all). Overall, high levels of both anti-Hsp70 and anti-Hsp60 were associated with significantly increased risk of ECG abnormalities (odds ratio [OR] = 1.73 and 95% confidence interval [Cl] = 1.04-2.86 for anti-Hsp70 and OR = 1.36 and 95% Cl = 1.07-1.72 for anti-Hsp60) with and without adjustment for cumulative noise exposure (OR = 1.96 and 95% Cl = 1.20-3.21 for anti-Hsp70 and OR = 3.93 and 95% Cl = 1.72-8.92 for anti-Hsp60). These findings suggest that the production of both anti-Hsp70 and anti-Hsp60 may be independent risk factors for the development and progression of abnormal ECG and therefore possibly cardiovascular diseases in autoworkers exposed to occupational noise.

  1. Non-contact ECG monitoring

    NASA Astrophysics Data System (ADS)

    Smirnov, Alexey S.; Erlikh, Vadim V.; Kodkin, Vladimir L.; Keller, Andrei V.; Epishev, Vitaly V.

    2016-03-01

    The research is dedicated to non-contact methods of electrocardiography. The authors describe the routine of experimental procedure and suggest the approach to solving the problems which arise at indirect signal recording. The paper presents the results of experiments conducted by the authors, covers the flow charts of ECG recorders and reviews the drawbacks of filtering methods used in foreign equivalents.

  2. Misinterpretation of the mouse ECG: ‘musing the waves of Mus musculus’

    PubMed Central

    Boukens, Bastiaan J; Rivaud, Mathilde R; Rentschler, Stacey; Coronel, Ruben

    2014-01-01

    The ECG is a primary diagnostic tool in patients suffering from heart disease, underscoring the importance of understanding factors contributing to normal and abnormal electrical patterns. Over the past few decades, transgenic mouse models have been increasingly used to study pathophysiological mechanisms of human heart diseases. In order to allow extrapolation of insights gained from murine models to the human condition, knowledge of the similarities and differences between the mouse and human ECG is of crucial importance. In this review, we briefly discuss the physiological mechanisms underlying differences between the baseline ECG of humans and mice, and provide a framework for understanding how these inherent differences are relevant to the interpretation of the mouse ECG during pathology and to the translation of the results from the mouse to man. PMID:25260630

  3. Association between obesity and ECG variables in children and adolescents: A cross-sectional study

    PubMed Central

    SUN, GUO-ZHE; LI, YANG; ZHOU, XING-HU; GUO, XIAO-FAN; ZHANG, XIN-GANG; ZHENG, LI-QIANG; LI, YUAN; JIAO, YUN-DI; SUN, YING-XIAN

    2013-01-01

    Obesity exhibits a wide variety of electrocardiogram (ECG) abnormalities in adults, which often lead to cardiovascular events. However, there is currently no evidence of an association between obesity and ECG variables in children and adolescents. The present study aimed to explore the associations between obesity and ECG intervals and axes in children and adolescents. A cross-sectional observational study of 5,556 students aged 5–18 years was performed. Anthropometric data, blood pressure and standard 12-lead ECGs were collected for each participant. ECG variables were measured manually based on the temporal alignment of simultaneous 12 leads using a CV200 ECG Work Station. Overweight and obese groups demonstrated significantly longer PR intervals, wider QRS durations and leftward shifts of frontal P-wave, QRS and T-wave axes, while the obese group also demonstrated significantly higher heart rates, compared with normal weight groups within normotensive or hypertensive subjects (P<0.05). Abdominal obesity was also associated with longer PR intervals, wider QRS duration and a leftward shift of frontal ECG axes compared with normal waist circumference (WC) within normotensive or hypertensive subjects (P<0.05). Gender was a possible factor affecting the ECG variables. Furthermore, the ECG variables, including PR interval, QRS duration and frontal P-wave, QRS and T-wave axes, were significantly linearly correlated with body mass index, WC and waist-to-height ratio adjusted for age, gender, ethnicity and blood pressure. However, there was no significant association between obesity and the corrected QT interval (P>0.05). The results of the current study indicate that in children and adolescents, general and abdominal obesity is associated with longer PR intervals, wider QRS duration and a leftward shift of frontal P-wave, QRS and T-wave axes, independent of age, gender, ethnicity and blood pressure. PMID:24255675

  4. Association of Trypanosoma cruzi infection with risk factors and electrocardiographic abnormalities in northeast Mexico

    PubMed Central

    2014-01-01

    Background American trypanosomiasis is a major disease and public health issue, caused by the protozoan parasite Trypanosoma cruzi. The prevalence of T. cruzi has not been fully documented, and there are few reports of this issue in Nuevo Leon. The aim of this study was to update the seroprevalence rate of T. cruzi infection, including an epidemiological analysis of the risk factors associated with this infection and an electrocardiographic (ECG) evaluation of those infected. Methods Sera from 2,688 individuals from 10 municipalities in the state of Nuevo Leon, Mexico, were evaluated using an enzyme-linked immunosorbent assay and an indirect hemagglutination assay. An ECG case–control study was performed in subjects seropositive for T. cruzi and the results were matched by sex and age to seronegative residents of the same localities. A univariate analysis with χ2 and Fisher’s exact tests was used to determine the association between seropositivity and age (years), sex, and ECG changes. A multivariate analysis was then performed to calculate the odd ratios between T. cruzi seropositivity and the risk factors. Results The seropositive rate was 1.93% (52/2,688). In the ECG study, 22.85% (8/35) of the infected individuals exhibited ECG abnormalities. Triatoma gerstaeckeri was the only vector reported. The main risk factors were ceiling construction material (P ≤ 0.0024), domestic animals (P ≤ 0.0001), and living in rural municipalities (P ≤ 0.0025). Conclusions These findings demonstrate a 10-fold higher prevalence of Chagas disease than previously reported (0.2%), which implies a serious public health threat in northeastern Mexico. The epidemiological profile established in this study differs from that found in the rest of Mexico, where human populations live in close proximity to domiciliary triatomines. PMID:24580840

  5. ECG-ELECTRODE INDUCED HYPOPIGMENTATION.

    PubMed

    Tripi, Paul A; Parthasarathy, Supraja N; Honda, Kord

    2016-06-01

    Skin reactions following the application of electrocardiography (ECG) electrodes have been reported in adults and children, and are postulated to result from contact with the conductive gel or adhesive used on the electrodes. Although contact dermatitis is the usual cause of such reactions, contact depigmentation or hypopigmentation may also occur. We report a case of hypopigmentation in a healthy boy following continuous electrocardiography monitoring during general anesthesia for dental rehabilitation.

  6. ECG-ELECTRODE INDUCED HYPOPIGMENTATION.

    PubMed

    Tripi, Paul A; Parthasarathy, Supraja N; Honda, Kord

    2016-06-01

    Skin reactions following the application of electrocardiography (ECG) electrodes have been reported in adults and children, and are postulated to result from contact with the conductive gel or adhesive used on the electrodes. Although contact dermatitis is the usual cause of such reactions, contact depigmentation or hypopigmentation may also occur. We report a case of hypopigmentation in a healthy boy following continuous electrocardiography monitoring during general anesthesia for dental rehabilitation. PMID:27487645

  7. Towards the clinical use of concentric electrodes in ECG recordings: influence of ring dimensions and electrode position

    NASA Astrophysics Data System (ADS)

    Prats-Boluda, G.; Ye-Lin, Y.; Bueno-Barrachina, JM; Rodriguez de Sanabria, R.; Garcia-Casado, J.

    2016-02-01

    To overcome the limited spatial resolution of standard 12-lead ECG recordings, concentric ring electrodes (CRE) have been proposed to provide valuable data for the diagnosis of a wide range of cardiac abnormalities, including infarction and arrhythmia. Although theoretical studies indicate that the dimensions of the CRE regulate the depth of the electric dipoles sensed by these electrodes, this has not been experimentally confirmed. The aim of this work was to analyze the influence of CRE dimensions and position of a wireless multi-CRE sensor node on the cardiac signal recorded. For this, four wireless multichannel ECG recording nodes based on flexible multi-ring electrodes were placed at positions CMV1 (position comparable to V1), CMV2, CMV4R and CMV5; each node providing three bipolar concentric ECG signals (BC-ECG). Standard 12-lead ECG and 12 BC-ECG signals were recorded in 29 volunteers. The results revealed that a ring with an outer diameter of 33.5 mm achieves a balance between the ease-of-use and spatial resolution of smaller electrodes and improved detectability and higher amplitudes of signals from larger ring electrodes. Although a standard 12-lead ECG outperforms BC-ECC recordings in detectability of cardiac waves, if the relative amplitude of the wave is also considered, BC-ECG at CMV1 proved superior at picking up atrial activity. In fact, in most of the BC-ECG signals picked up at CMV1, P1 and P2 atrial activity waves were more clearly identified than in simultaneous 12-Lead ECG signals. Likewise, BC-ECG signals revealed higher spatial resolution in detecting anomalous electrical activity in local regions, such as impaired intraventricular driving, or atrioventricular blocks. Finally, the wireless multi-CRE sensor node provides enhanced comfort and handling to both patient and clinician over wired systems.

  8. Heart rate, conduction and ultrasound abnormalities in adults with joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type.

    PubMed

    Camerota, Filippo; Castori, Marco; Celletti, Claudia; Colotto, Marco; Amato, Silvia; Colella, Alessandra; Curione, Mario; Danese, Chiara

    2014-07-01

    Joint hypermobility syndrome (JHS) and Ehlers-Danlos syndrome, hypermobility type (EDS-HT) are two clinically overlapping heritable connective tissue disorders strongly associating with pain, fatigue and other secondary aspects. Though not considered a diagnostic criterion for most EDS subtypes, cardiovascular involvement is a well-known complication in EDS. A case-control study was carried out on 28 adults with JHS/EDS-HT diagnosed according to current criteria, compared to 29 healthy subjects evaluating resting electrocardiographic (ECG), 24-h ECG and resting heart ultrasound data. Results obtained in the ECG studies showed a moderate excess in duration of the PR interval and P wave, an excess of heart conduction and rate abnormalities and an increased rate of mitral and tricuspid valve insufficiency often complicating with "true" mitral valve prolapse in the ecocardiographic study. These variable ECG subclinical anomalies reported in our sample may represent the resting surrogate of such a subnormal cardiovascular response to postural changes that are known to be present in patients with JHS/EDS-HT. Our findings indicate the usefulness of a full cardiologic evaluation of adults with JHS/EDS-HT for the correct management. PMID:24752348

  9. Adaptive Fourier decomposition based ECG denoising.

    PubMed

    Wang, Ze; Wan, Feng; Wong, Chi Man; Zhang, Liming

    2016-10-01

    A novel ECG denoising method is proposed based on the adaptive Fourier decomposition (AFD). The AFD decomposes a signal according to its energy distribution, thereby making this algorithm suitable for separating pure ECG signal and noise with overlapping frequency ranges but different energy distributions. A stop criterion for the iterative decomposition process in the AFD is calculated on the basis of the estimated signal-to-noise ratio (SNR) of the noisy signal. The proposed AFD-based method is validated by the synthetic ECG signal using an ECG model and also real ECG signals from the MIT-BIH Arrhythmia Database both with additive Gaussian white noise. Simulation results of the proposed method show better performance on the denoising and the QRS detection in comparing with major ECG denoising schemes based on the wavelet transform, the Stockwell transform, the empirical mode decomposition, and the ensemble empirical mode decomposition.

  10. "Jeopardy" in Abnormal Psychology.

    ERIC Educational Resources Information Center

    Keutzer, Carolin S.

    1993-01-01

    Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

  11. Motion artifact removal algorithm by ICA for e-bra: a women ECG measurement system

    NASA Astrophysics Data System (ADS)

    Kwon, Hyeokjun; Oh, Sechang; Varadan, Vijay K.

    2013-04-01

    Wearable ECG(ElectroCardioGram) measurement systems have increasingly been developing for people who suffer from CVD(CardioVascular Disease) and have very active lifestyles. Especially, in the case of female CVD patients, several abnormal CVD symptoms are accompanied with CVDs. Therefore, monitoring women's ECG signal is a significant diagnostic method to prevent from sudden heart attack. The E-bra ECG measurement system from our previous work provides more convenient option for women than Holter monitor system. The e-bra system was developed with a motion artifact removal algorithm by using an adaptive filter with LMS(least mean square) and a wandering noise baseline detection algorithm. In this paper, ICA(independent component analysis) algorithms are suggested to remove motion artifact factor for the e-bra system. Firstly, the ICA algorithms are developed with two kinds of statistical theories: Kurtosis, Endropy and evaluated by performing simulations with a ECG signal created by sgolayfilt function of MATLAB, a noise signal including 0.4Hz, 1.1Hz and 1.9Hz, and a weighed vector W estimated by kurtosis or entropy. A correlation value is shown as the degree of similarity between the created ECG signal and the estimated new ECG signal. In the real time E-Bra system, two pseudo signals are extracted by multiplying with a random weighted vector W, the measured ECG signal from E-bra system, and the noise component signal by noise extraction algorithm from our previous work. The suggested ICA algorithm basing on kurtosis or entropy is used to estimate the new ECG signal Y without noise component.

  12. Measurement of ventricular function by ECG gating during atrial fibrillation

    SciTech Connect

    Bacharach, S.L.; Green, M.V.; Bonow, R.O.; Findley, S.L.; Ostrow, H.G.; Johnston, G.S.

    1981-03-01

    The assumptions necessary to perform ECG-gated cardiac studies are seemingly not valid for patients in atrial fibrillation (AF). To evaluate the effect of AF on equilibrium gated scintigraphy, beat-by-beat measurements of left-ventricular function were made on seven subjects in AF (mean heart rate 64 bpm), using a high-efficiency nonimaging detector. The parameters evaluated were ejection fraction (EF), time to end-systole (TES), peak rates of ejection and filling (PER,PFR), and their times of occurrence (TPER, TPFR). By averaging together single-beat values of EF, PER, etc., it was possible to determine the true mean values of these parameters. The single-beam mean values were compared with the corresponding parameters calculated from one ECG-gated time-activity curve (TAC) obtained by superimposing all the single-beat TACs irrespective of their length. For this population with slow heart rates, we find that the values for EF, etc., produced from ECG-gated time-activity curves, are very similar to those obtained from the single-beat data. Thus use of ECG gating at low heart rates may allow reliable estimation of average cardiac function even in subjects with AF.

  13. Early and prolonged ECG alterations resembling a myocardial injury after severe amitriptyline poisoning.

    PubMed

    Berlot, G; Vergolini, A; Calderan, C

    2010-01-01

    Evidence of cardiovascular toxicity is present in the majority of tricyclic antidepressant overdoses. We report the case of a 63-year-old woman admitted to our department with a severe amitriptyline poisoning. The ECG at admission showed a pattern mimicking an acute anteroseptal subepicardial infarction. This pattern persisted for 11 days. Myocardial enzymes and echocardiographic findings never confirmed an ischemic event. At discharge, the ECG returned normal without cardiac or neurologic sequelae. Our experience suggest that after severe tricyclic antidepressant ingestion, ECG alterations resembling myocardial injury may occur early and last for a longer period than previously reported.

  14. Meiotic abnormalities

    SciTech Connect

    1993-12-31

    Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.

  15. Pediatric electrocardiograph abnormalities following Centruroides limpidus tecomanus scorpion envenomation.

    PubMed

    Diaz, P; Chowell, G; Ceja, G; D'Auria, T C; Lloyd, R C; Castillo-Chavez, C

    2005-01-01

    Scorpionism is an endemic public health problem in Mexico [Hoffmann, C.C., 1936. La distribucion geografica de los alacranes peligrosos en la Republica Mexicana. Bol. Inst. Hygiene Mex. 2, 321; Hoffmann, C.C., Nieto, D.R., 1939. Segunda contribucion al conocimiento de los alacranes mexicanos. Anal. Inst. Biol. 10, 83-92; Mazzoti, L., Bravo-Becherelle, M.A., 1963. Scorpionism in the Mexican Republic. In: Keegan, H.L., McFarlane, W.V. (Eds.), Venomous and Poissonous Animals and Noxious Plants of the Pacific Area. Pergamon Press, London, pp. 119-131; Monroy-Velasco, J., 1961. Alacranes venenosos de Mexico. Rev. Mex. Cien. Med. Biol., Mex. 1, 1-23; Diaz-Najera, A., 1975. Listas y datos de distribucion geografica de los alacranes de Mexico. Rev. Inv. Salud. Publica. (Mex.) 35, 1; Velasco-Castrejon, O., Lara-Aguilera, R., Alatorre, H., 1976. Aspectos epidemiologicos y clinicos de la picadura de alacran en una area hiperendemica. Rev. Inv. Salud Publica. (Mex.) 36, 93-103; Dehesa-Davila, M., Possani, L.D., 1994. Scorpionism and serotherapy in Mexico. Toxicon 32 (9), 1015-1018]. In this prospective study, we assess cardiovascular disorders in children via electrocardiographic (ECG) recordings following envenomation by scorpion species Centruroides limpidus tecomanus found in the state of Colima, Mexico. We analyzed 113 cases between the ages of 5 and 14 years. Among the most frequent symptoms presented included local pain (99.1%) and paresthesia (75.2%), pruritus (36.3%), sialorrhoea (35.4%), and nystagmus (24.8%). Cardiovascular disorders were observed in 39.8% of cases, 71% of which were rhythm abnormalities. We find a significant association between the frequency of ECG alterations and age, whereby 8-9-year-old children are more likely to experience ECG alterations when compared with other tested age groups.

  16. An integrated healthcare information system for end-to-end standardized exchange and homogeneous management of digital ECG formats.

    PubMed

    Trigo, Jesús Daniel; Martínez, Ignacio; Alesanco, Alvaro; Kollmann, Alexander; Escayola, Javier; Hayn, Dieter; Schreier, Günter; García, José

    2012-07-01

    This paper investigates the application of the enterprise information system (EIS) paradigm to standardized cardiovascular condition monitoring. There are many specifications in cardiology, particularly in the ECG standardization arena. The existence of ECG formats, however, does not guarantee the implementation of homogeneous, standardized solutions for ECG management. In fact, hospital management services need to cope with various ECG formats and, moreover, several different visualization applications. This heterogeneity hampers the normalization of integrated, standardized healthcare information systems, hence the need for finding an appropriate combination of ECG formats and a suitable EIS-based software architecture that enables standardized exchange and homogeneous management of ECG formats. Determining such a combination is one objective of this paper. The second aim is to design and develop the integrated healthcare information system that satisfies the requirements posed by the previous determination. The ECG formats selected include ISO/IEEE11073, Standard Communications Protocol for Computer-Assisted Electrocardiography, and an ECG ontology. The EIS-enabling techniques and technologies selected include web services, simple object access protocol, extensible markup language, or business process execution language. Such a selection ensures the standardized exchange of ECGs within, or across, healthcare information systems while providing modularity and accessibility.

  17. Heritability of ECG Biomarkers in the Netherlands Twin Registry Measured from Holter ECGs

    PubMed Central

    Hodkinson, Emily C.; Neijts, Melanie; Sadrieh, Arash; Imtiaz, Mohammad S.; Baumert, Mathias; Subbiah, Rajesh N.; Hayward, Christopher S.; Boomsma, Dorret; Willemsen, Gonneke; Vandenberg, Jamie I.; Hill, Adam P.; De Geus, Eco

    2016-01-01

    Introduction: The resting ECG is the most commonly used tool to assess cardiac electrophysiology. Previous studies have estimated heritability of ECG parameters based on these snapshots of the cardiac electrical activity. In this study we set out to determine whether analysis of heart rate specific data from Holter ECGs allows more complete assessment of the heritability of ECG parameters. Methods and Results: Holter ECGs were recorded from 221 twin pairs and analyzed using a multi-parameter beat binning approach. Heart rate dependent estimates of heritability for QRS duration, QT interval, Tpeak–Tend and Theight were calculated using structural equation modeling. QRS duration is largely determined by environmental factors whereas repolarization is primarily genetically determined. Heritability estimates of both QT interval and Theight were significantly higher when measured from Holter compared to resting ECGs and the heritability estimate of each was heart rate dependent. Analysis of the genetic contribution to correlation between repolarization parameters demonstrated that covariance of individual ECG parameters at different heart rates overlap but at each specific heart rate there was relatively little overlap in the genetic determinants of the different repolarization parameters. Conclusions: Here we present the first study of heritability of repolarization parameters measured from Holter ECGs. Our data demonstrate that higher heritability can be estimated from the Holter than the resting ECG and reveals rate dependence in the genetic—environmental determinants of the ECG that has not previously been tractable. Future applications include deeper dissection of the ECG of participants with inherited cardiac electrical disease. PMID:27199769

  18. Contact dermatitis caused by ECG electrode paste.

    PubMed

    Cochran, R J; Rosen, T

    1980-12-01

    A case of contact dermatitis caused by ECG electrode cream is presented and the pertinent literature is reviewed. Our patient was found to be allergic to propylene glycol. Patch-testing remains an invaluable tool in the evaluation of patients suspected of being allergic to ECG paste, creams, and gels.

  19. A novel algorithm for Bluetooth ECG.

    PubMed

    Pandya, Utpal T; Desai, Uday B

    2012-11-01

    In wireless transmission of ECG, data latency will be significant when battery power level and data transmission distance are not maintained. In applications like home monitoring or personalized care, to overcome the joint effect of previous issues of wireless transmission and other ECG measurement noises, a novel filtering strategy is required. Here, a novel algorithm, identified as peak rejection adaptive sampling modified moving average (PRASMMA) algorithm for wireless ECG is introduced. This algorithm first removes error in bit pattern of received data if occurred in wireless transmission and then removes baseline drift. Afterward, a modified moving average is implemented except in the region of each QRS complexes. The algorithm also sets its filtering parameters according to different sampling rate selected for acquisition of signals. To demonstrate the work, a prototyped Bluetooth-based ECG module is used to capture ECG with different sampling rate and in different position of patient. This module transmits ECG wirelessly to Bluetooth-enabled devices where the PRASMMA algorithm is applied on captured ECG. The performance of PRASMMA algorithm is compared with moving average and S-Golay algorithms visually as well as numerically. The results show that the PRASMMA algorithm can significantly improve the ECG reconstruction by efficiently removing the noise and its use can be extended to any parameters where peaks are importance for diagnostic purpose.

  20. [Wireless ECG measurement system with capacitive coupling].

    PubMed

    Aleksandrowicz, Adrian; Walter, Marian; Leonhardt, Steffen

    2007-04-01

    This paper describes a measurement system that captures an electrocardiogram (ECG) using capacitively coupled electrodes. The measurement system was integrated into an off-the-shelf office chair (so-called "Aachen SmartChair"). Whereas for classical ECG measurement adhesive is used to attach conductively coupled electrodes to bare skin, the system presented allows ECG measurement through clothing without direct skin contact. Furthermore, a ZigBee communication module was integrated to allow wireless transmission of ECG data to a PC or an ICU patient monitor. For system validation, classical ECG using conductive electrodes was obtained simultaneously. First measurement results, including variations of cloth thickness and material, are presented and some of the system-specific problems of this approach are discussed.

  1. III Lead ECG Pulse Measurement Sensor

    NASA Astrophysics Data System (ADS)

    Thangaraju, S. K.; Munisamy, K.

    2015-09-01

    Heart rate sensing is very important. Method of measuring heart pulse by using an electrocardiogram (ECG) technique is described. Electrocardiogram is a measurement of the potential difference (the electrical pulse) generated by a cardiac tissue, mainly the heart. This paper also reports the development of a three lead ECG hardware system that would be the basis of developing a more cost efficient, portable and easy to use ECG machine. Einthoven's Three Lead method [1] is used for ECG signal extraction. Using amplifiers such as the instrumentation amplifier AD620BN and the conventional operational amplifier Ua741 that would be used to amplify the ECG signal extracted develop this system. The signal would then be filtered from noise using Butterworth filter techniques to obtain optimum output. Also a right leg guard was implemented as a safety feature to this system. Simulation was carried out for development of the system using P-spice Program.

  2. Body surface ECG signal shape dispersion.

    PubMed

    Khaddoumi, Balkine; Rix, Hervé; Meste, Olivier; Fereniec, Małgorzata; Maniewski, Roman

    2006-12-01

    The spatial distribution of the shape of the electrocardiography (ECG) waves obtained by body surface potential mapping (BSPM) is studied, using a 64-channel high-resolution ECG system. The index associated to each lead is the shape difference between its ECG wave and a reference computed taking into account all the leads on the same column. The reference is either a selected real wave or a synthetic signal computed by integral shape averaging (ISA). Better results are obtained with the ISA signal using the distribution function method (DFM) for computing the shape difference. The spatial dispersion of ECG waves is showed to allow the separation of patients after myocardial infarction (MI) from healthy subjects. In addition, the reference signal position for each column is computed. The path linking these positions appears as an invariant, i.e., it is independent of the subject and the ECG wave.

  3. [Transient abnormal Q-waves].

    PubMed

    Godballe, C; Hoeck, H C; Sørensen, J A

    1990-01-01

    We present a case of transient abnormal Q-waves (TAQ) and a review of the literature. TAQ are defined as abnormal Q-waves, which disappear within ten days. They are most often seen in patients with ischemic heart disease (IHD) but are also seen in other conditions. Brief episodes of myocardial ischemia giving rise to reversible biochemical and ultrastructural myocardial changes, resulting in transient ECG changes, provide an accepted theory for the pathogenesis of TAO. Investigations have shown that the occurrence of exercise-induced TAQ may be a symptom of IHD. It is impossible to distinguish TAQ from Q-waves induced by myocardial infarction. Appearance of TAQ during exercise-testing frequently indicates IHD. PMID:2301045

  4. Craniofacial Abnormalities

    MedlinePlus

    ... of the skull and face. Craniofacial abnormalities are birth defects of the face or head. Some, like cleft ... palate, are among the most common of all birth defects. Others are very rare. Most of them affect ...

  5. Chromosome Abnormalities

    MedlinePlus

    ... decade, newer techniques have been developed that allow scientists and doctors to screen for chromosomal abnormalities without using a microscope. These newer methods compare the patient's DNA to a normal DNA ...

  6. Walking abnormalities

    MedlinePlus

    ... include: Arthritis of the leg or foot joints Conversion disorder (a psychological disorder) Foot problems (such as a ... injuries. For an abnormal gait that occurs with conversion disorder, counseling and support from family members are strongly ...

  7. Nail abnormalities

    MedlinePlus

    Beau's lines; Fingernail abnormalities; Spoon nails; Onycholysis; Leukonychia; Koilonychia; Brittle nails ... Just like the skin, the fingernails tell a lot about your health: ... the fingernail. These lines can occur after illness, injury to ...

  8. A combined application of lossless and lossy compression in ECG processing and transmission via GSM-based SMS.

    PubMed

    Mukhopadhyay, S K; Mitra, S; Mitra, M

    2015-02-01

    This paper presents a software-based scheme for reliable and robust Electrocardiogram (ECG) data compression and its efficient transmission using Second Generation (2G) Global System for Mobile Communication (GSM) based Short Message Service (SMS). To achieve a firm lossless compression in high standard deviating QRS complex regions and an acceptable lossy compression in the rest of the signal, two different algorithms have been used. The combined compression module is such that it outputs only American Standard Code for Information Interchange (ASCII) characters and, hence, SMS service is found to be most suitable for transmitting the compressed signal. At the receiving end, the ECG signal is reconstructed using just the reverse algorithm. The module has been tested to all the 12 leads of different types of ECG signals (healthy and abnormal) collected from the PTB Diagnostic ECG Database. The compression algorithm achieves an average compression ratio of ∼22.51, without any major alteration of clinical morphology. PMID:25534118

  9. Improving ECG Services at a Children's Hospital: Implementation of a Digital ECG System

    PubMed Central

    Osei, Frank A.; Gates, Gregory J.; Choi, Steven J.; Hsu, Daphne T.; Pass, Robert H.; Ceresnak, Scott R.

    2015-01-01

    Background. The use of digital ECG software and services is becoming common. We hypothesized that the introduction of a completely digital ECG system would increase the volume of ECGs interpreted at our children's hospital. Methods. As part of a hospital wide quality improvement initiative, a digital ECG service (MUSE, GE) was implemented at the Children's Hospital at Montefiore in June 2012. The total volume of ECGs performed in the first 6 months of the digital ECG era was compared to 18 months of the predigital era. Predigital and postdigital data were compared via t-tests. Results. The mean ECGs interpreted per month were 53 ± 16 in the predigital era and 216 ± 37 in the postdigital era (p < 0.001), a fourfold increase in ECG volume after introduction of the digital system. There was no significant change in inpatient or outpatient service volume during that time. The mean billing time decreased from 21 ± 27 days in the postdigital era to 12 ± 5 days in the postdigital era (p < 0.001). Conclusion. Implementation of a digital ECG system increased the volume of ECGs officially interpreted and reported. PMID:26451150

  10. Atrioventricular block, ECG tracing (image)

    MedlinePlus

    ... abnormal rhythm (arrhythmia) called an atrioventricular (AV) block. P waves show that the top of the heart received electrical activity. Each P wave is usually followed by the tall (QRS) waves. ...

  11. Check your biosignals here: a new dataset for off-the-person ECG biometrics.

    PubMed

    da Silva, Hugo Plácido; Lourenço, André; Fred, Ana; Raposo, Nuno; Aires-de-Sousa, Marta

    2014-02-01

    The Check Your Biosignals Here initiative (CYBHi) was developed as a way of creating a dataset and consistently repeatable acquisition framework, to further extend research in electrocardiographic (ECG) biometrics. In particular, our work targets the novel trend towards off-the-person data acquisition, which opens a broad new set of challenges and opportunities both for research and industry. While datasets with ECG signals collected using medical grade equipment at the chest can be easily found, for off-the-person ECG data the solution is generally for each team to collect their own corpus at considerable expense of resources. In this paper we describe the context, experimental considerations, methods, and preliminary findings of two public datasets created by our team, one for short-term and another for long-term assessment, with ECG data collected at the hand palms and fingers.

  12. Real-Time Online Monitoring of Electrocardiogram (ECG) using Very Low Cost for Developing Countries

    NASA Astrophysics Data System (ADS)

    Singh, Gavendra; Gupta, Varun; Sekharmantri, Anil Kumar; Gupta, Akash; Kumar, Pankaj

    2010-11-01

    An electrocardiogram or ECG (also known as EKG—abbreviated from the German word Elektro-Kardiographie), is an electrical recording of the heart and is used in the investigation of heart disease. `An electrocardiogram (ECG) is a graphic tracing of the electric current generated by the heart muscle during a heartbeat'. The electrocardiogram (ECG)/(EKG) is a surface measurement of the electrical potential generated by electrical activity in cardiac tissue. It has been used extensively in medicine sine its inventions in the early 1900' sand has been proven to be invaluable in various diagnostics applications such as the detection of irregular heartbeat patterns (i.e. fibrillation & arrhythmia), hearts murmurs (other abnormal sounds), tissue/structural damage (such as valve malfunction) and coronary artery blockage. In this paper we made a circuit network by using this circuit we can acquire an ECG signal of the heart electrical activity. This is one of the cheapest circuit to acquire ECG signal. It's whole cost around Rs.250/- only. Instrumentation amplifier AD620AN, notch filter, various resistances, capacitors, wires etc. are used to made this circuit.

  13. High Frequency QRS ECG Accurately Detects Cardiomyopathy

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Arenare, Brian; Poulin, Gregory; Moser, Daniel R.; Delgado, Reynolds

    2005-01-01

    High frequency (HF, 150-250 Hz) analysis over the entire QRS interval of the ECG is more sensitive than conventional ECG for detecting myocardial ischemia. However, the accuracy of HF QRS ECG for detecting cardiomyopathy is unknown. We obtained simultaneous resting conventional and HF QRS 12-lead ECGs in 66 patients with cardiomyopathy (EF = 23.2 plus or minus 6.l%, mean plus or minus SD) and in 66 age- and gender-matched healthy controls using PC-based ECG software recently developed at NASA. The single most accurate ECG parameter for detecting cardiomyopathy was an HF QRS morphological score that takes into consideration the total number and severity of reduced amplitude zones (RAZs) present plus the clustering of RAZs together in contiguous leads. This RAZ score had an area under the receiver operator curve (ROC) of 0.91, and was 88% sensitive, 82% specific and 85% accurate for identifying cardiomyopathy at optimum score cut-off of 140 points. Although conventional ECG parameters such as the QRS and QTc intervals were also significantly longer in patients than controls (P less than 0.001, BBBs excluded), these conventional parameters were less accurate (area under the ROC = 0.77 and 0.77, respectively) than HF QRS morphological parameters for identifying underlying cardiomyopathy. The total amplitude of the HF QRS complexes, as measured by summed root mean square voltages (RMSVs), also differed between patients and controls (33.8 plus or minus 11.5 vs. 41.5 plus or minus 13.6 mV, respectively, P less than 0.003), but this parameter was even less accurate in distinguishing the two groups (area under ROC = 0.67) than the HF QRS morphologic and conventional ECG parameters. Diagnostic accuracy was optimal (86%) when the RAZ score from the HF QRS ECG and the QTc interval from the conventional ECG were used simultaneously with cut-offs of greater than or equal to 40 points and greater than or equal to 445 ms, respectively. In conclusion 12-lead HF QRS ECG employing

  14. [A USB-Based Digital ECG Sensor].

    PubMed

    Shi Bol; Kong, Xiangyong; Ma, Xiaozhi; Zhang, Genxuan

    2016-01-01

    Based on the ECG-specific BMD 101 integrated circun chip, this study designed a digital ECG sensor. In practical application, users just need to connect the ECG sensor 'o upper computer (such as PC or mobile phone) through USB interface, to realize the functions including display, alarm, saving, transfer etc. After tests, They demonstrate that the sensor can be applied to the detection of arrhythmia, such as bigeminy coupled rhythm, proiosystole etc. Besides, the sensor has various advantages in monitoring an managing the heart health of people out of hospital, including low cost, small volume, usableness, simplicity of operation etc. PMID:27197497

  15. Using statistical distances to detect changes in the normal behavior of ECG-Holter signals

    NASA Astrophysics Data System (ADS)

    Bastos de Figueiredo, Julio C.; Furuie, Sergio S.

    2001-05-01

    One of the main problems in the study of complex systems is to define a good metric that can distinguish between different dynamical behaviors in a nonlinear system. In this work we describe a method to detect different types of behaviors in a long term ECG-Holter using short portions of the Holter signal. This method is based on the calculation of the statistical distance between two distributions in a phase-space of a dynamical system. A short portion of an ECG-Holter signal with normal behavior is used to reconstruct the trajectory of an attractor in low dimensional phase-space. The points in this trajectory are interpreted as statistical distributions in the phase-space and assumed to represent the normal dynamical behavior of the ECG recording in this space. A fast algorithm is then used to compute the statistical distance between this attractor and all other attractors that are built using a sliding temporal window over the signal. For normal cases the distance stayed almost constant and below a threshold. For cases with abnormal transients, on the abnormal portion of ECG, the distance increased consistently with morphological changes.

  16. Wireless Sensor-Based Smart-Clothing Platform for ECG Monitoring.

    PubMed

    Wang, Jie; Lin, Chung-Chih; Yu, Yan-Shuo; Yu, Tsang-Chu

    2015-01-01

    The goal of this study is to use wireless sensor technologies to develop a smart clothes service platform for health monitoring. Our platform consists of smart clothes, a sensor node, a gateway server, and a health cloud. The smart clothes have fabric electrodes to detect electrocardiography (ECG) signals. The sensor node improves the accuracy of QRS complexes detection by morphology analysis and reduces power consumption by the power-saving transmission functionality. The gateway server provides a reconfigurable finite state machine (RFSM) software architecture for abnormal ECG detection to support online updating. Most normal ECG can be filtered out, and the abnormal ECG is further analyzed in the health cloud. Three experiments are conducted to evaluate the platform's performance. The results demonstrate that the signal-to-noise ratio (SNR) of the smart clothes exceeds 37 dB, which is within the "very good signal" interval. The average of the QRS sensitivity and positive prediction is above 99.5%. Power-saving transmission is reduced by nearly 1980 times the power consumption in the best-case analysis.

  17. An intelligent telecardiology system using a wearable and wireless ECG to detect atrial fibrillation.

    PubMed

    Lin, Chin-Teng; Chang, Kuan-Cheng; Lin, Chun-Ling; Chiang, Chia-Cheng; Lu, Shao-Wei; Chang, Shih-Sheng; Lin, Bor-Shyh; Liang, Hsin-Yueh; Chen, Ray-Jade; Lee, Yuan-Teh; Ko, Li-Wei

    2010-05-01

    This study presents a novel wireless, ambulatory, real-time, and autoalarm intelligent telecardiology system to improve healthcare for cardiovascular disease, which is one of the most prevalent and costly health problems in the world. This system consists of a lightweight and power-saving wireless ECG device equipped with a built-in automatic warning expert system. This device is connected to a mobile and ubiquitous real-time display platform. The acquired ECG signals are instantaneously transmitted to mobile devices, such as netbooks or mobile phones through Bluetooth, and then, processed by the expert system. An alert signal is sent to the remote database server, which can be accessed by an Internet browser, once an abnormal ECG is detected. The current version of the expert system can identify five types of abnormal cardiac rhythms in real-time, including sinus tachycardia, sinus bradycardia, wide QRS complex, atrial fibrillation (AF), and cardiac asystole, which is very important for both the subjects who are being monitored and the healthcare personnel tracking cardiac-rhythm disorders. The proposed system also activates an emergency medical alarm system when problems occur. Clinical testing reveals that the proposed system is approximately 94% accurate, with high sensitivity, specificity, and positive prediction rates for ten normal subjects and 20 AF patients. We believe that in the future a business-card-like ECG device, accompanied with a mobile phone, can make universal cardiac protection service possible.

  18. An intelligent telecardiology system using a wearable and wireless ECG to detect atrial fibrillation.

    PubMed

    Lin, Chin-Teng; Chang, Kuan-Cheng; Lin, Chun-Ling; Chiang, Chia-Cheng; Lu, Shao-Wei; Chang, Shih-Sheng; Lin, Bor-Shyh; Liang, Hsin-Yueh; Chen, Ray-Jade; Lee, Yuan-Teh; Ko, Li-Wei

    2010-05-01

    This study presents a novel wireless, ambulatory, real-time, and autoalarm intelligent telecardiology system to improve healthcare for cardiovascular disease, which is one of the most prevalent and costly health problems in the world. This system consists of a lightweight and power-saving wireless ECG device equipped with a built-in automatic warning expert system. This device is connected to a mobile and ubiquitous real-time display platform. The acquired ECG signals are instantaneously transmitted to mobile devices, such as netbooks or mobile phones through Bluetooth, and then, processed by the expert system. An alert signal is sent to the remote database server, which can be accessed by an Internet browser, once an abnormal ECG is detected. The current version of the expert system can identify five types of abnormal cardiac rhythms in real-time, including sinus tachycardia, sinus bradycardia, wide QRS complex, atrial fibrillation (AF), and cardiac asystole, which is very important for both the subjects who are being monitored and the healthcare personnel tracking cardiac-rhythm disorders. The proposed system also activates an emergency medical alarm system when problems occur. Clinical testing reveals that the proposed system is approximately 94% accurate, with high sensitivity, specificity, and positive prediction rates for ten normal subjects and 20 AF patients. We believe that in the future a business-card-like ECG device, accompanied with a mobile phone, can make universal cardiac protection service possible. PMID:20371411

  19. Wireless Sensor-Based Smart-Clothing Platform for ECG Monitoring

    PubMed Central

    Wang, Jie; Lin, Chung-Chih; Yu, Yan-Shuo; Yu, Tsang-Chu

    2015-01-01

    The goal of this study is to use wireless sensor technologies to develop a smart clothes service platform for health monitoring. Our platform consists of smart clothes, a sensor node, a gateway server, and a health cloud. The smart clothes have fabric electrodes to detect electrocardiography (ECG) signals. The sensor node improves the accuracy of QRS complexes detection by morphology analysis and reduces power consumption by the power-saving transmission functionality. The gateway server provides a reconfigurable finite state machine (RFSM) software architecture for abnormal ECG detection to support online updating. Most normal ECG can be filtered out, and the abnormal ECG is further analyzed in the health cloud. Three experiments are conducted to evaluate the platform's performance. The results demonstrate that the signal-to-noise ratio (SNR) of the smart clothes exceeds 37 dB, which is within the “very good signal” interval. The average of the QRS sensitivity and positive prediction is above 99.5%. Power-saving transmission is reduced by nearly 1980 times the power consumption in the best-case analysis. PMID:26640512

  20. E-Bra system for women ECG measurement with GPRS communication, Nanosensor, and motion artifact remove algorithm

    NASA Astrophysics Data System (ADS)

    Kwon, Hyeokjun; Oh, Sechang; Kumar, Prashanth S.; Varadan, Vijay K.

    2012-10-01

    CardioVascular Disease(CVD)s lead the sudden cardiac death due to irregular phenomenon of the cardiac signal by the abnormal case of blood vessel and cardiac structure. For last two decades, cardiac disease research for man is under active discussion. As a result, the death rate by cardiac disease in men has been falling gradually compared with relatively increasing the women death rate due to CVD[2]. The main reason of this phenomenon causes the lack a sense of the seriousness to female CVD and different symptom of female CVD compared with the symptoms of male CVD. Usually, because the women CVD accompanies with ordinary symptoms unrecognizing the heart abnormality signal such as unusual fatigue, sleep disturbances, shortness of breath, anxiety, chest discomfort, and indigestion dyspepsia, most women CVD patients do not realize that these symptoms are related to the CVD symptoms. Therefore, periodic ECG signal observation is required for women cardiac disease patients. ElectroCardioGram(ECG) detection, treadmill test/exercise ECG, nuclear scan, coronary angiography, and intracoronary ultrasound are used to diagnose abnormality of heart. Among the medical checkup methods for CVDs checkup, it is very effective method for the diagnosis of cardiac disease and the early detection of heart abnormality to monitor ECG periodically. This paper suggests the effective ECG monitoring system for woman by attaching the system on woman's brassiere by using augmented chest lead attachment method. The suggested system in this paper consists of ECG signal transmission system and a server program to display and analyze the transmitted ECG. The ECG signal transmission system consists of three parts such as ECG physical signal detection part with two electrodes made by gold nanowire structure, data acquisition with AD converter, and data transmission part with GPRS(General Packet Radio Service) communication. Usually, to detect human bio signal, Ag/AgCl or gold cup electrodes are used

  1. Biomechanical factors and physical examination findings in osteoarthritis of the knee: associations with tissue abnormalities assessed by conventional radiography and high-resolution 3.0 Tesla magnetic resonance imaging

    PubMed Central

    2012-01-01

    Introduction We aimed to explore the associations between knee osteoarthritis (OA)-related tissue abnormalities assessed by conventional radiography (CR) and by high-resolution 3.0 Tesla magnetic resonance imaging (MRI), as well as biomechanical factors and findings from physical examination in patients with knee OA. Methods This was an explorative cross-sectional study of 105 patients with knee OA. Index knees were imaged using CR and MRI. Multiple features from CR and MRI (cartilage, osteophytes, bone marrow lesions, effusion and synovitis) were related to biomechanical factors (quadriceps and hamstrings muscle strength, proprioceptive accuracy and varus-valgus laxity) and physical examination findings (bony tenderness, crepitus, bony enlargement and palpable warmth), using multivariable regression analyses. Results Quadriceps weakness was associated with cartilage integrity, effusion, synovitis (all detected by MRI) and CR-detected joint space narrowing. Knee joint laxity was associated with MRI-detected cartilage integrity, CR-detected joint space narrowing and osteophyte formation. Multiple tissue abnormalities including cartilage integrity, osteophytes and effusion, but only those detected by MRI, were found to be associated with physical examination findings such as crepitus. Conclusion We observed clinically relevant findings, including a significant association between quadriceps weakness and both effusion and synovitis, detected by MRI. Inflammation was detected in over one-third of the participants, emphasizing the inflammatory component of OA and a possible important role for anti-inflammatory therapies in knee OA. In general, OA-related tissue abnormalities of the knee, even those detected by MRI, were found to be discordant with biomechanical and physical examination features. PMID:23039323

  2. A decision support system based on an ensemble of random forests for improving the management of women with abnormal findings at cervical cancer screening.

    PubMed

    Bountris, Panagiotis; Haritou, Maria; Pouliakis, Abraham; Karakitsos, Petros; Koutsouris, Dimitrios

    2015-08-01

    In most cases, cervical cancer (CxCa) develops due to underestimated abnormalities in the Pap test. Today, there are ancillary molecular biology techniques available that provide important information related to CxCa and the Human Papillomavirus (HPV) natural history, including HPV DNA tests, HPV mRNA tests and immunocytochemistry techniques such as overexpression of p16. These techniques are either highly sensitive or highly specific, however not both at the same time, thus no perfect method is available today. In this paper we present a decision support system (DSS) based on an ensemble of Random Forests (RFs) for the intelligent combination of the results of classic and ancillary techniques that are available for CxCa detection, in order to exploit the benefits of each technique and produce more accurate results. The proposed system achieved both, high sensitivity (86.1%) and high specificity (93.3%), as well as high overall accuracy (91.8%), in detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+). The system's performance was better than any other single test involved in this study. Moreover, the proposed architecture of employing an ensemble of RFs proved to be better than the single classifier approach. The presented system can handle cases with missing tests and more importantly cases with inadequate cytological outcome, thus it can also produce accurate results in the case of stand-alone HPV-based screening, where Pap test is not applied. The proposed system may identify women at true risk of developing CxCa and guide personalised management and therapeutic interventions.

  3. Wavelets for full reconfigurable ECG acquisition system

    NASA Astrophysics Data System (ADS)

    Morales, D. P.; García, A.; Castillo, E.; Meyer-Baese, U.; Palma, A. J.

    2011-06-01

    This paper presents the use of wavelet cores for a full reconfigurable electrocardiogram signal (ECG) acquisition system. The system is compound by two reconfigurable devices, a FPGA and a FPAA. The FPAA is in charge of the ECG signal acquisition, since this device is a versatile and reconfigurable analog front-end for biosignals. The FPGA is in charge of FPAA configuration, digital signal processing and information extraction such as heart beat rate and others. Wavelet analysis has become a powerful tool for ECG signal processing since it perfectly fits ECG signal shape. The use of these cores has been integrated in the LabVIEW FPGA module development tool that makes possible to employ VHDL cores within the usual LabVIEW graphical programming environment, thus freeing the designer from tedious and time consuming design of communication interfaces. This enables rapid test and graphical representation of results.

  4. A Novel Mobile ECG Telemonitoring System.

    PubMed

    Wu, Baoming; Zhuo, Yu; Zhu, Xinjian; Yan, Qingguang; Zhu, Lingyun; Li, Gang

    2005-01-01

    This paper introduces a novel mobile ECG telemonitoring system. By means of CDMA1x (GPSOne) mobile telecommunication network, the system can perform "full time and space" monitoring of human ECG signal, and once the signal of the monitored subject departed from its normal ranges, the hospital ECG monitoring center can further localize his/her geographical position and give rescue in the first time. Another feature of the system is its high anti-interference capability. In order to reduce 50Hz and RF interferences during mobile monitoring, which are usual much serious than conventional hospital monitoring, a new active recording technology was proposed and an active ECG recording electrode was designed. The system has passed the clinical test and used in China.

  5. ECG Feature Extraction using Time Frequency Analysis

    NASA Astrophysics Data System (ADS)

    Nair, Mahesh A.

    The proposed algorithm is a novel method for the feature extraction of ECG beats based on Wavelet Transforms. A combination of two well-accepted methods, Pan Tompkins algorithm and Wavelet decomposition, this system is implemented with the help of MATLAB. The focus of this work is to implement the algorithm, which can extract the features of ECG beats with high accuracy. The performance of this system is evaluated in a pilot study using the MIT-BIH Arrhythmia database.

  6. The ECG dilemma: guidelines on improving interpretation.

    PubMed

    Mele, Paul F

    2008-01-01

    The "ECG Dilemma" was recognized by the American College of Cardiology (ACC) and the American Heart Association more than 10 years ago. Estimates put the number of patients suffering from significant ECG interpretation errors every year in the same range as deaths from diabetes. Missed MI ranks in the top tier of malpractice dollars lost. Guidelines have been put forth to reduce these losses and improve patient safety and quality of care. These guidelines, and suggestions towards implementing them, are discussed.

  7. Smartphone home monitoring of ECG

    NASA Astrophysics Data System (ADS)

    Szu, Harold; Hsu, Charles; Moon, Gyu; Landa, Joseph; Nakajima, Hiroshi; Hata, Yutaka

    2012-06-01

    A system of ambulatory, halter, electrocardiography (ECG) monitoring system has already been commercially available for recording and transmitting heartbeats data by the Internet. However, it enjoys the confidence with a reservation and thus a limited market penetration, our system was targeting at aging global villagers having an increasingly biomedical wellness (BMW) homecare needs, not hospital related BMI (biomedical illness). It was designed within SWaP-C (Size, Weight, and Power, Cost) using 3 innovative modules: (i) Smart Electrode (lowpower mixed signal embedded with modern compressive sensing and nanotechnology to improve the electrodes' contact impedance); (ii) Learnable Database (in terms of adaptive wavelets transform QRST feature extraction, Sequential Query Relational database allowing home care monitoring retrievable Aided Target Recognition); (iii) Smartphone (touch screen interface, powerful computation capability, caretaker reporting with GPI, ID, and patient panic button for programmable emergence procedure). It can provide a supplementary home screening system for the post or the pre-diagnosis care at home with a build-in database searchable with the time, the place, and the degree of urgency happened, using in-situ screening.

  8. Synthesize, optimize, analyze, repeat (SOAR): Application of neural network tools to ECG patient monitoring

    SciTech Connect

    Watrous, R.; Towell, G.; Glassman, M.S.

    1995-12-31

    Results are reported from the application of tools for synthesizing, optimizing and analyzing neural networks to an ECG Patient Monitoring task. A neural network was synthesized from a rule-based classifier and optimized over a set of normal and abnormal heartbeats. The classification error rate on a separate and larger test set was reduced by a factor of 2. When the network was analyzed and reduced in size by a factor of 40%, the same level of performance was maintained.

  9. Adaptive wavelet Wiener filtering of ECG signals.

    PubMed

    Smital, Lukáš; Vítek, Martin; Kozumplík, Jiří; Provazník, Ivo

    2013-02-01

    In this study, we focused on the reduction of broadband myopotentials (EMG) in ECG signals using the wavelet Wiener filtering with noise-free signal estimation. We used the dyadic stationary wavelet transform (SWT) in the Wiener filter as well as in estimating the noise-free signal. Our goal was to find a suitable filter bank and to choose other parameters of the Wiener filter with respect to the signal-to-noise ratio (SNR) obtained. Testing was performed on artificially noised signals from the standard CSE database sampled at 500 Hz. When creating an artificial interference, we started from the generated white Gaussian noise, whose power spectrum was modified according to a model of the power spectrum of an EMG signal. To improve the filtering performance, we used adaptive setting parameters of filtering according to the level of interference in the input signal. We were able to increase the average SNR of the whole test database by about 10.6 dB. The proposed algorithm provides better results than the classic wavelet Wiener filter.

  10. Adaptive wavelet Wiener filtering of ECG signals.

    PubMed

    Smital, Lukáš; Vítek, Martin; Kozumplík, Jiří; Provazník, Ivo

    2013-02-01

    In this study, we focused on the reduction of broadband myopotentials (EMG) in ECG signals using the wavelet Wiener filtering with noise-free signal estimation. We used the dyadic stationary wavelet transform (SWT) in the Wiener filter as well as in estimating the noise-free signal. Our goal was to find a suitable filter bank and to choose other parameters of the Wiener filter with respect to the signal-to-noise ratio (SNR) obtained. Testing was performed on artificially noised signals from the standard CSE database sampled at 500 Hz. When creating an artificial interference, we started from the generated white Gaussian noise, whose power spectrum was modified according to a model of the power spectrum of an EMG signal. To improve the filtering performance, we used adaptive setting parameters of filtering according to the level of interference in the input signal. We were able to increase the average SNR of the whole test database by about 10.6 dB. The proposed algorithm provides better results than the classic wavelet Wiener filter. PMID:23192472

  11. Comparison of 128-Slice Low-Dose Prospective ECG-Gated CT Scanning and Trans-Thoracic Echocardiography for the Diagnosis of Complex Congenital Heart Disease

    PubMed Central

    Bu, Guilin; Miao, Ying; Bin, Jingwen; Deng, Sheng; Liu, Taowen; Jiang, Hongchun; Chen, Weiping

    2016-01-01

    Objective To compare prospective ECG-gated multi-slice computed tomography (MSCT) and trans-thoracic echocardiography (TTE) in the diagnosis of complex congenital heart disease (CHD). Methods This was a prospective study of consecutive patients with complex CHD (age <7 years) treated at a tertiary hospital between May 2013 and May 2015. All patients were imaged with TTE and prospective ECG-gated 128-slice spiral CT in the week before surgery. Effective radiation dose (ED) was calculated from volume CT dose index (CTDIvol) and dose length product (DLP). Image quality (5-point scale) was assessed independently by two radiologists. Using surgical findings as the reference, the diagnostic capabilities of MSCT and TTE were compared. Results Thirty-five patients (19 males) aged 1.59±1.58 years (range, 3 days to 74 months) were included. CTDIvol, DLP and ED were 0.90±0.24 mGy, 12.9±4.7 mGy∙cm and 0.64±0.21 mSv (range, 0.358–1.196 mSv), respectively. Image quality score was 4.3±0.5, and all images met the diagnostic requirements. The sensitivity, specificity, positive predictive value, and negative predictive value for diagnosing CHD were 97.2%, 99.8%, 99.0%, and 99.5%, respectively, for MSCT, and 90.6%, 99.8%, 99.0%, and 98.4%, respectively, for TTE. MSCT not only had a higher sensitivity than TTE overall (97.2% vs. 90.6%; P<0.05), but was much more sensitive for the diagnosis of extracardiac vascular abnormalities (92.0% vs. 68.0%; P<0.05). Conclusion 128-slice low-dose prospective ECG-gated CT scanning has important clinical value in the diagnosis of complex CHD in children, complementing and extending the findings of TTE. PMID:27788237

  12. Non-Contrast-Enhanced Whole-Body Magnetic Resonance Imaging in the General Population: The Incidence of Abnormal Findings in Patients 50 Years Old and Younger Compared to Older Subjects

    PubMed Central

    Cieszanowski, Andrzej; Maj, Edyta; Kulisiewicz, Piotr; Grudzinski, Ireneusz P.; Jakoniuk-Glodala, Karolina; Chlipala-Nitek, Irena; Kaczynski, Bartosz; Rowinski, Olgierd

    2014-01-01

    Purpose To assess and compare the incidence of abnormal findings detected during non-contrast-enhanced whole-body magnetic resonance imaging (WB-MRI) in the general population in two age groups: (1) 50 years old and younger; and (2) over 50 years old. Materials and Methods The analysis included 666 non-contrast-enhanced WB-MRIs performed on a 1.5-T scanner between December 2009 and June 2013 in a private hospital in 451 patients 50 years old and younger and 215 patients over 50 years old. The following images were obtained: T2-STIR (whole body-coronal plane), T2-STIR (whole spine-sagittal), T2-TSE with fat-saturation (neck and trunk-axial), T2-FLAIR (head-axial), 3D T1-GRE (thorax-coronal, axial), T2-TSE (abdomen-axial), chemical shift (abdomen-axial). Detected abnormalities were classified as: insignificant (type I), potentially significant, requiring medical attention (type II), significant, requiring treatment (type III). Results There were 3375 incidental findings depicted in 659 (98.9%) subjects: 2997 type I lesions (88.8%), 363 type II lesions (10.8%) and 15 type III lesions (0.4%), including malignant or possibly malignant lesions in seven subjects. The most differences in the prevalence of abnormalities on WB-MRI between patients 50 years old and younger and over 50 years old concerned: brain infarction (22.2%, 45.0% respectively), thyroid cysts/nodules (8.7%, 18.8%), pulmonary nodules (5.0%, 16.2%), significant degenerative disease of the spine (23.3%, 44.5%), extra-spinal degenerative disease (22.4%, 61.1%), hepatic steatosis (15.8%, 24.9%), liver cysts/hemangiomas (24%, 34.5%), renal cysts (16.9%, 40.6%), prostate enlargement (5.1% of males, 34.2% of males), uterine fibroids (16.3% of females, 37.9% of females). Conclusions Incidental findings were detected in almost all of the subjects. WB-MRI demonstrated that the prevalence of the vast majority of abnormalities increases with age. PMID:25259581

  13. The HERO-2 ECG sub-studies in patients with ST elevation myocardial infarction: implications for clinical practice.

    PubMed

    Wong, Cheuk-Kit; White, Harvey D

    2013-12-01

    The ECG studies of the international HERO-2 trial in ST elevation myocardial infarction (STEMI) patients evaluated the prognostic value of ECGs systematically recorded at baseline and at 60-min post-administration of fibrinolytic therapy. Patients were overall managed conservatively with a low percentage undergoing angiography. Many of the analyses were pre-specified. While modern management of STEMI has improved, particularly with the widespread use of primary angioplasty, the HERO-2 database documents the prognostic relationship between ECG findings in STEMI patients managed with fibrinolytic therapy and 30-day mortality. This article describes the history of the HERO-2 ECG sub-studies, discloses new information in the project development and summarizes its findings. The strength of having serial ECG recordings is discussed as is the weakness of lacking angiographic correlation. The paper discusses with take-home points (Table 1) the prognostic implications of bundle branch blocks, QRS duration, Q waves in infarct leads, V1 ST elevation during inferior STEMI, lead aVR ST changes and new ST depression in the infarct leads after fibrinolysis. With the ever increasing emphasis on early (including pre-hospital) therapies for STEMI, a diagnosis based on the 12-lead ECG, the current summary article provides helpful hints to fully extract ECG information, and a vision for future STEMI diagnosis and management.

  14. Quality assessment of digital annotated ECG data from clinical trials by the FDA ECG Warehouse.

    PubMed

    Sarapa, Nenad

    2007-09-01

    The FDA mandates that digital electrocardiograms (ECGs) from 'thorough' QTc trials be submitted into the ECG Warehouse in Health Level 7 extended markup language format with annotated onset and offset points of waveforms. The FDA did not disclose the exact Warehouse metrics and minimal acceptable quality standards. The author describes the Warehouse scoring algorithms and metrics used by FDA, points out ways to improve FDA review and suggests Warehouse benefits for pharmaceutical sponsors. The Warehouse ranks individual ECGs according to their score for each quality metric and produces histogram distributions with Warehouse-specific thresholds that identify ECGs of questionable quality. Automatic Warehouse algorithms assess the quality of QT annotation and duration of manual QT measurement by the central ECG laboratory.

  15. Effects of thyroid hormone deficiency on electrocardiogram findings of congenitally hypothyroid neonates.

    PubMed

    Asami, T; Suzuki, H; Yazaki, S; Sato, S; Uchiyama, M

    2001-08-01

    Hypothyroid status is believed to cause various metabolic changes in infants. However, it is interesting that even severely hypothyroid neonates, detected during mass neonatal screening, rarely show bradycardia, hypothermia, or inactivity. To study cardiac functions of screen-detected neonates with congenital hypothyroidism (CH), we recorded the electrocardiograms (ECG) of 53 screen-detected CH neonates before levothyroxine (LT4) replacement therapy, and 15 age-matched normal neonates for controls. The 53 CH neonates were divided into two groups according to initial serum thyroid hormone levels: a mildly hypothyroid group (n = 37), serum thyroid-stimulating hormone (TSH) less than 100 microIU/mL and free thyroxine (FT4) 0.6 ng/dl or more; and a severely hypothyroid group (n = 16), TSH 100 microIU/mL or more and FT4 less than 0.6 ng/dL. TSH, FT4, and other blood chemicals were measured on an autoanalyzer (Hitachi 7170). After blood sampling, the ECG was recorded during induced sleep by oral administration of triclofos sodium syrup. ECG parameters, including HR, PR, QRS, QT time and corrected QT time (QTc) were automatically obtained, using an auto-ECG analyzing system. The following results were obtained. No CH patients showed abnormal ECG findings. There was no significant difference of the mean heart rates (HRs) between the mildly hypothyroid (147.5 +/- 16.3 beats per minute) and the control group (148.3 +/- 12.1 beats per minute). The mean HR in the severely hypothyroid group (134.0 +/- 17.9 beats per minute, p = 0.007) was significantly low compared with the normal control group. However, all values were within normal ranges. QTc in the severely hypothyroid group (0.414 +/- 0.015, p = 0.033) was significantly shorter than in the control group (0.440 +/- 0.052). No statistical differences of PR, QRS, and QT time were noted among the three groups. All ECG parameters were within normal ranges. HR positively correlated with FT4 and log (FT4), and negatively with TSH

  16. ECG Manifestations of the Biggest Outbreak of Chagas Disease due to Oral Infection in Latin-America

    PubMed Central

    Marques, Juan; Mendoza, Iván; Noya, Belkisyolé; Acquatella, Harry; Palacios, Igor; Marques-Mejias, María

    2013-01-01

    Background Chagas disease affects more than 15 million people worldwide. Although vector-borne transmission has decreased, oral transmission has become important. Recently, our group published the clinical and epidemiological characteristics of the largest outbreak of orally transmitted Chagas disease reported till date. Objective: To describe electrocardiographic changes occurring in the study population during the outbreak caused by ingestion of contaminated guava juice. Methods We evaluated 103 positive cases, of which 76 (74%) were aged ≤ 18 years (average age: 9.1 ± 3.1 years) and 27 (26%) were aged > 18 years (average age: 46 ± 11.8 years). All patients underwent clinical evaluations and ECG. If the patients had palpitations or evident alterations of rhythm at baseline, ambulatory ECG monitoring was performed. Results A total of 68 cases (66%; 53 children and 15 adults) had ECG abnormalities. Further, 69.7% (53/76) of those aged ≤ 18 years and 56% (15/27) of those aged >18 years showed some ECG alteration (p = ns). ST-T abnormalities were observed in 37.86% cases (39/103) and arrhythmias were evident in 28.16% cases (29/103). ST alterations occurred in 72% of those aged ≤18 years compared with 19% of th ose aged >18 years (p < 0.0001). Conclusion This study reports the largest number of cases in the same outbreak of acute Chagas disease caused by oral contamination, with recorded ECGs. ECG changes suggestive of acute myocarditis and arrhythmias were the most frequent abnormalities found. PMID:23887736

  17. Pseudoaneurysm of the thoracic aorta sustained during exposure to a tornado diagnosed with ECG-synchronized CT aortography.

    PubMed

    Chakraborty, Amit; von Herrmann, Paul F; Embertson, Ryan E; Landwehr, Kevin P; Winkler, Michael A

    2016-01-01

    A case of a tornado victim with a delayed presentation of injury to the aortic isthmus is discussed. Tornado forces resemble the forces of high energy explosions, and the injuries that can occur as a result of these forces can be bizarre. The patient presented with the unique computed tomography (CT) findings of isolated pseudoaneurysm of the thoracic aorta in the absence of other traumatic injury to the thorax. Equivocal results of the initial CT aortogram (CTA) were confirmed with ECG-synchronized CTA (ECG-CTA), demonstrating the superiority of ECG-CTA as compared to standard CTA. PMID:27317209

  18. Pseudoaneurysm of the thoracic aorta sustained during exposure to a tornado diagnosed with ECG-synchronized CT aortography.

    PubMed

    Chakraborty, Amit; von Herrmann, Paul F; Embertson, Ryan E; Landwehr, Kevin P; Winkler, Michael A

    2016-01-01

    A case of a tornado victim with a delayed presentation of injury to the aortic isthmus is discussed. Tornado forces resemble the forces of high energy explosions, and the injuries that can occur as a result of these forces can be bizarre. The patient presented with the unique computed tomography (CT) findings of isolated pseudoaneurysm of the thoracic aorta in the absence of other traumatic injury to the thorax. Equivocal results of the initial CT aortogram (CTA) were confirmed with ECG-synchronized CTA (ECG-CTA), demonstrating the superiority of ECG-CTA as compared to standard CTA.

  19. 12-lead ECG training: the way forward.

    PubMed

    Alinier, Guillaume; Gordon, Ray; Harwood, Colin; Hunt, William B

    2006-01-01

    The teaching of electrocardiography (ECG) monitoring has not changed for decades and still very much relies on access to real patients for practice. However there is nowadays an even greater need for modern training tools in this field as more healthcare professionals than ever before need to be trained on 12-lead ECG monitoring techniques. For example in many parts of the UK ambulance paramedics use features observed from 12-lead ECG monitoring equipment to determine whether or not a patient can receive pre-hospital thrombolytic therapy. Because important decisions are made without the presence of a cardiologist, it is essential that the training is carried out with the most realistic tools, including tools which give realistic feedback of the consequences of incorrect electrode placement. Current mannequins for ECG training are designed with protruding electrodes on the chest, which act as cues for trainees. There is therefore a need for a realistic simulation training tool to teach 12-lead ECG interpretation which includes the ability to give this feedback. We are currently working on the development of such a training tool and it is expected that it will be of great interest to medical, nursing and paramedic schools.

  20. Development and Validation of Electronic Health Record-based Triggers to Detect Delays in Follow-up of Abnormal Lung Imaging Findings.

    PubMed

    Murphy, Daniel R; Thomas, Eric J; Meyer, Ashley N D; Singh, Hardeep

    2015-10-01

    . Conclusion EHR-based triggers can be used to identify patients with suspicious imaging findings in whom follow-up diagnostic evaluation was delayed. (©) RSNA, 2015.

  1. Development and Validation of Electronic Health Record-based Triggers to Detect Delays in Follow-up of Abnormal Lung Imaging Findings.

    PubMed

    Murphy, Daniel R; Thomas, Eric J; Meyer, Ashley N D; Singh, Hardeep

    2015-10-01

    . Conclusion EHR-based triggers can be used to identify patients with suspicious imaging findings in whom follow-up diagnostic evaluation was delayed. (©) RSNA, 2015. PMID:25961634

  2. Sonography in Hypotension and Cardiac Arrest (SHoC): Rates of Abnormal Findings in Undifferentiated Hypotension and During Cardiac Arrest as a Basis for Consensus on a Hierarchical Point of Care Ultrasound Protocol

    PubMed Central

    Milne, James; Lewis, David; Fraser, Jacqueline; Diegelmann, Laura; Olszynski, Paul; Stander, Melanie; Lamprecht, Hein

    2016-01-01

    Introduction Point of care ultrasound (PoCUS) has become an established tool in the initial management of patients with undifferentiated hypotension. Current established protocols (RUSH and ACES) were developed by expert user opinion, rather than objective, prospective data. PoCUS also provides invaluable information during resuscitation efforts in cardiac arrest by determining presence/absence of cardiac activity and identifying reversible causes such as pericardial tamponade. There is no agreed guideline on how to safely and effectively incorporate PoCUS into the advanced cardiac life support (ACLS) algorithm. We wished to report disease incidence as a basis to develop a hierarchical approach to PoCUS in hypotension and during cardiac arrest. Methods We summarized the recorded incidence of PoCUS findings from the initial cohort during the interim analysis of two prospective studies. We propose that this will form the basis for developing a modified Delphi approach incorporating this data to obtain the input of a panel of international experts associated with five professional organizations led by the International Federation of Emergency Medicine (IFEM). The modified Delphi tool will be developed to reach an international consensus on how to integrate PoCUS for hypotensive emergency department patients as well as into cardiac arrest algorithms. Results Rates of abnormal PoCUS findings from 151 patients with undifferentiated hypotension included left ventricular dynamic changes (43%), IVC abnormalities (27%), pericardial effusion (16%), and pleural fluid (8%). Abdominal pathology was rare (fluid 5%, AAA 2%). During cardiac arrest there were no pericardial effusions, however abnormalities of ventricular contraction (45%) and valvular motion (39%) were common among the 43 patients included. Conclusions A prospectively collected disease incidence-based hierarchy of scanning can be developed based on the reported findings. This will inform an international consensus

  3. Automatic detection of respiration rate from ambulatory single-lead ECG.

    PubMed

    Boyle, Justin; Bidargaddi, Niranjan; Sarela, Antti; Karunanithi, Mohan

    2009-11-01

    Ambulatory electrocardiography is increasingly being used in clinical practice to detect abnormal electrical behavior of the heart during ordinary daily activities. The utility of this monitoring can be improved by deriving respiration, which previously has been based on overnight apnea studies where patients are stationary, or the use of multilead ECG systems for stress testing. We compared six respiratory measures derived from a single-lead portable ECG monitor with simultaneously measured respiration air flow obtained from an ambulatory nasal cannula respiratory monitor. Ten controlled 1-h recordings were performed covering activities of daily living (lying, sitting, standing, walking, jogging, running, and stair climbing) and six overnight studies. The best method was an average of a 0.2-0.8 Hz bandpass filter and RR technique based on lengthening and shortening of the RR interval. Mean error rates with the reference gold standard were +/-4 breaths per minute (bpm) (all activities), +/-2 bpm (lying and sitting), and +/-1 breath per minute (overnight studies). Statistically similar results were obtained using heart rate information alone (RR technique) compared to the best technique derived from the full ECG waveform that simplifies data collection procedures. The study shows that respiration can be derived under dynamic activities from a single-lead ECG without significant differences from traditional methods. PMID:19775978

  4. Intermittent short ECG recording is more effective than 24-hour Holter ECG in detection of arrhythmias

    PubMed Central

    2014-01-01

    Background Many patients report symptoms of palpitations or dizziness/presyncope. These patients are often referred for 24-hour Holter ECG, although the sensitivity for detecting relevant arrhythmias is comparatively low. Intermittent short ECG recording over a longer time period might be a convenient and more sensitive alternative. The objective of this study is to compare the efficacy of 24-hour Holter ECG with intermittent short ECG recording over four weeks to detect relevant arrhythmias in patients with palpitations or dizziness/presyncope. Methods Design: prospective, observational, cross-sectional study. Setting: Clinical Physiology, University Hospital. Patients: 108 consecutive patients referred for ambiguous palpitations or dizziness/presyncope. Interventions: All individuals underwent a 24-hour Holter ECG and additionally registered 30-second handheld ECG (Zenicor EKG® thumb) recordings at home, twice daily and when having cardiac symptoms, during 28 days. Main outcome measures: Significant arrhythmias: atrial fibrillation (AF), paroxysmal supraventricular tachycardia (PSVT), atrioventricular (AV) block II–III, sinus arrest (SA), wide complex tachycardia (WCT). Results 95 patients, 42 men and 53 women with a mean age of 54.1 years, completed registrations. Analysis of Holter registrations showed atrial fibrillation (AF) in two patients and atrioventricular (AV) block II in one patient (= 3.2% relevant arrhythmias [95% CI 1.1–8.9]). Intermittent handheld ECG detected nine patients with AF, three with paroxysmal supraventricular tachycardia (PSVT) and one with AV-block-II (= 13.7% relevant arrhythmias [95% CI 8.2–22.0]). There was a significant difference between the two methods in favour of intermittent ECG with regard to the ability to detect relevant arrhythmias (P = 0.0094). With Holter ECG, no symptoms were registered during any of the detected arrhythmias. With intermittent ECG, symptoms were registered during half of the arrhythmia

  5. The chaos and order in human ECG under the influence of the external perturbations

    NASA Astrophysics Data System (ADS)

    Ragulskaya, Maria; Valeriy, Pipin

    model reconstruction of the individual cardiac beat. It is found that the positions of the stationary points of the typical ECG attractor are in vicinities of Q and T waves. Additionally, we find that the stiffness of the beat is important for the general stability of ECG. The given results agues for the increase the relative disorder of the human cardiac system under external perturbations due to changes in the space weather and climatic factors. Also, the results of monitoring show that cardiac system can be stabilized by "internal" (physical) stress. The given difference in the cardiac sys-tem behavior under the different types of stress is obtained in the earth labaratory conditions. However, it should be considered as important factors influencing on the health of cosmonauts during the space missions, as well.

  6. [Implementation of ECG Monitoring System Based on Internet of Things].

    PubMed

    Lu, Liangliang; Chen, Minya

    2015-11-01

    In order to expand the capabilities of hospital's traditional ECG device and enhance medical staff's work efficiency, an ECG monitoring system based on internet of things is introduced. The system can monitor ECG signals in real time and analyze data using ECG sensor, PDA, Web servers, which embeds C language, Android systems, .NET, wireless network and other technologies. After experiments, it can be showed that the system has high reliability and stability and can bring the convenience to medical staffs.

  7. [Implementation of ECG Monitoring System Based on Internet of Things].

    PubMed

    Lu, Liangliang; Chen, Minya

    2015-11-01

    In order to expand the capabilities of hospital's traditional ECG device and enhance medical staff's work efficiency, an ECG monitoring system based on internet of things is introduced. The system can monitor ECG signals in real time and analyze data using ECG sensor, PDA, Web servers, which embeds C language, Android systems, .NET, wireless network and other technologies. After experiments, it can be showed that the system has high reliability and stability and can bring the convenience to medical staffs. PMID:27066681

  8. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiographic ECG/respirator synchronizer. 892.1970... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic ECG/respirator synchronizer. (a) Identification. A radiographic ECG/respirator synchronizer is a device intended to be used...

  9. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Radiographic ECG/respirator synchronizer. 892.1970... (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic ECG/respirator synchronizer. (a) Identification. A radiographic ECG/respirator synchronizer is a device intended to be used...

  10. Multichannel ECG and Noise Modeling: Application to Maternal and Fetal ECG Signals

    NASA Astrophysics Data System (ADS)

    Sameni, Reza; Clifford, Gari D.; Jutten, Christian; Shamsollahi, Mohammad B.

    2007-12-01

    A three-dimensional dynamic model of the electrical activity of the heart is presented. The model is based on the single dipole model of the heart and is later related to the body surface potentials through a linear model which accounts for the temporal movements and rotations of the cardiac dipole, together with a realistic ECG noise model. The proposed model is also generalized to maternal and fetal ECG mixtures recorded from the abdomen of pregnant women in single and multiple pregnancies. The applicability of the model for the evaluation of signal processing algorithms is illustrated using independent component analysis. Considering the difficulties and limitations of recording long-term ECG data, especially from pregnant women, the model described in this paper may serve as an effective means of simulation and analysis of a wide range of ECGs, including adults and fetuses.

  11. ECG of the month. Electrocardiogram in a man with chronic kidney failure. ECG is abnormal and indicative of heart disease.

    PubMed

    Clancy, D Luke; Ali, Rehan; Lathia, Viral

    2012-01-01

    A 70-year-old man came to the Access to Primary Care Clinic at the Interim LSU Public Hospital because he had been told at another hospital that he needed a kidney doctor. The patient had a history of high blood pressure, type 2 diabetes mellitus, long-standing kidney disease, an above the knee amputation on the left, gout, a possible coronary stent procedure five years ago, and recently poor appetite and inability to care for himself. He had a long history of medical noncompliance and was taking no medications when he came to the hospital. He denied all cardiac symptoms, including chest discomfort. He was admitted to hospital because of a blood pressure of 240/110 mmHg, a serum creatinine of 6.0 mg/dL, and an estimated glomerular filtration rate of 11 mL/min - i.e., chronic kidney disease, stage V. His electrocardiogram was read by the computer as normal (Figure 1).

  12. Preprocessing and analysis of the ECG signals

    NASA Astrophysics Data System (ADS)

    Zhu, Jianmin; Zhang, Xiaolan; Wang, Zhongyu; Wang, Xiaoling

    2008-10-01

    According to the request of automatic analysis and depressing high frequency interference of the ECG signals, this paper applies low-pass filter to preprocess ECG signals, and proposes a QRS complex detection method based on wavelet transform, which takes advantage of Marr wavelet to decompose and filter the ECG signals with Mallat algorithm, using the relationship between wavelet transform and signal singularity to detect QRS complex with amplitude threshold method in scale 3, and to detect P wave and R wave in scale 4. Meanwhile, compositive detection method is used for re-detection, thus to improving the detection accuracy ratio. At last, records from ECG database of MIT/BIH which is widely accepted in the world are used to test the algorithm. And the result shows that correction detecting ratio under this algorithm has been more than 99.8 percent. The detection method in this paper is simple and running fast, and is easy to be realized in the real-time detecting system using for clinical diagnosis.

  13. Human Identification Using Compressed ECG Signals.

    PubMed

    Camara, Carmen; Peris-Lopez, Pedro; Tapiador, Juan E

    2015-11-01

    As a result of the increased demand for improved life styles and the increment of senior citizens over the age of 65, new home care services are demanded. Simultaneously, the medical sector is increasingly becoming the new target of cybercriminals due the potential value of users' medical information. The use of biometrics seems an effective tool as a deterrent for many of such attacks. In this paper, we propose the use of electrocardiograms (ECGs) for the identification of individuals. For instance, for a telecare service, a user could be authenticated using the information extracted from her ECG signal. The majority of ECG-based biometrics systems extract information (fiducial features) from the characteristics points of an ECG wave. In this article, we propose the use of non-fiducial features via the Hadamard Transform (HT). We show how the use of highly compressed signals (only 24 coefficients of HT) is enough to unequivocally identify individuals with a high performance (classification accuracy of 0.97 and with identification system errors in the order of 10(-2)). PMID:26364201

  14. A Mathematical Model for Segmenting ECG Signals

    NASA Astrophysics Data System (ADS)

    Feier, Horea; Roşu, Doina; Falniţǎ, Lucian; Roşu, Şerban; Pater, Liana

    2010-09-01

    This paper deals with the behavior of the modulus of the continuous wavelet transform (CWT) for some known mother wavelets like the Morlet wavelet and the Mexican Hat. By exploiting these properties, the models presented can behave as a segmentation/ recognition signal processing tool by modeling the temporal structure of the observed surface ECG.

  15. ECG biometric identification: A compression based approach.

    PubMed

    Bras, Susana; Pinho, Armando J

    2015-08-01

    Using the electrocardiogram signal (ECG) to identify and/or authenticate persons are problems still lacking satisfactory solutions. Yet, ECG possesses characteristics that are unique or difficult to get from other signals used in biometrics: (1) it requires contact and liveliness for acquisition (2) it changes under stress, rendering it potentially useless if acquired under threatening. Our main objective is to present an innovative and robust solution to the above-mentioned problem. To successfully conduct this goal, we rely on information-theoretic data models for data compression and on similarity metrics related to the approximation of the Kolmogorov complexity. The proposed measure allows the comparison of two (or more) ECG segments, without having to follow traditional approaches that require heartbeat segmentation (described as highly influenced by external or internal interferences). As a first approach, the method was able to cluster the data in three groups: identical record, same participant, different participant, by the stratification of the proposed measure with values near 0 for the same participant and closer to 1 for different participants. A leave-one-out strategy was implemented in order to identify the participant in the database based on his/her ECG. A 1NN classifier was implemented, using as distance measure the method proposed in this work. The classifier was able to identify correctly almost all participants, with an accuracy of 99% in the database used. PMID:26737619

  16. Novel electrodes for underwater ECG monitoring.

    PubMed

    Reyes, Bersain A; Posada-Quintero, Hugo F; Bales, Justin R; Clement, Amanda L; Pins, George D; Swiston, Albert; Riistama, Jarno; Florian, John P; Shykoff, Barbara; Qin, Michael; Chon, Ki H

    2014-06-01

    We have developed hydrophobic electrodes that provide all morphological waveforms without distortion of an ECG signal for both dry and water-immersed conditions. Our electrode is comprised of a mixture of carbon black powder (CB) and polydimethylsiloxane (PDMS). For feasibility testing of the CB/PDMS electrodes, various tests were performed. One of the tests included evaluation of the electrode-to-skin contact impedance for different diameters, thicknesses, and different pressure levels. As expected, the larger the diameter of the electrodes, the lower the impedance and the difference between the large sized CB/PDMS and the similarly-sized Ag/AgCl hydrogel electrodes was at most 200 kΩ, in favor of the latter. Performance comparison of CB/PDMS electrodes to Ag/AgCl hydrogel electrodes was carried out in three different scenarios: a dry surface, water immersion, and postwater immersion conditions. In the dry condition, no statistical differences were found for both the temporal and spectral indices of the heart rate variability analysis between the CB/PDMS and Ag/AgCl hydrogel (p > 0.05) electrodes. During water immersion, there was significant ECG amplitude reduction with CB/PDMS electrodes when compared to wet Ag/AgCl electrodes kept dry by their waterproof adhesive tape, but the reduction was not severe enough to obscure the readability of the recordings, and all morphological waveforms of the ECG signal were discernible even when motion artifacts were introduced. When water did not penetrate tape-wrapped Ag/AgCl electrodes, high fidelity ECG signals were observed. However, when water penetrated the Ag/AgCl electrodes, the signal quality degraded to the point where ECG morphological waveforms were not discernible.

  17. Novel electrodes for underwater ECG monitoring.

    PubMed

    Reyes, Bersain A; Posada-Quintero, Hugo F; Bales, Justin R; Clement, Amanda L; Pins, George D; Swiston, Albert; Riistama, Jarno; Florian, John P; Shykoff, Barbara; Qin, Michael; Chon, Ki H

    2014-06-01

    We have developed hydrophobic electrodes that provide all morphological waveforms without distortion of an ECG signal for both dry and water-immersed conditions. Our electrode is comprised of a mixture of carbon black powder (CB) and polydimethylsiloxane (PDMS). For feasibility testing of the CB/PDMS electrodes, various tests were performed. One of the tests included evaluation of the electrode-to-skin contact impedance for different diameters, thicknesses, and different pressure levels. As expected, the larger the diameter of the electrodes, the lower the impedance and the difference between the large sized CB/PDMS and the similarly-sized Ag/AgCl hydrogel electrodes was at most 200 kΩ, in favor of the latter. Performance comparison of CB/PDMS electrodes to Ag/AgCl hydrogel electrodes was carried out in three different scenarios: a dry surface, water immersion, and postwater immersion conditions. In the dry condition, no statistical differences were found for both the temporal and spectral indices of the heart rate variability analysis between the CB/PDMS and Ag/AgCl hydrogel (p > 0.05) electrodes. During water immersion, there was significant ECG amplitude reduction with CB/PDMS electrodes when compared to wet Ag/AgCl electrodes kept dry by their waterproof adhesive tape, but the reduction was not severe enough to obscure the readability of the recordings, and all morphological waveforms of the ECG signal were discernible even when motion artifacts were introduced. When water did not penetrate tape-wrapped Ag/AgCl electrodes, high fidelity ECG signals were observed. However, when water penetrated the Ag/AgCl electrodes, the signal quality degraded to the point where ECG morphological waveforms were not discernible. PMID:24845297

  18. Optimising diagnostic accuracy with the exercise ECG: opportunities for women and men with stable ischaemic heart disease

    PubMed Central

    Shaw, Leslee J; Xie, Joe X; Phillips, Lawrence M; Goyal, Abhinav; Reynolds, Harmony R; Berman, Daniel S; Picard, Michael H; Bhargava, Balram; Devlin, Gerard; Chaitman, Bernard R

    2016-01-01

    The exercise ECG is an integral part within the evaluation algorithm for diagnosis and risk stratification of patients with stable ischaemic heart disease (SIHD). There is evidence, both older and new, that the exercise ECG can be an effective and cost-efficient option for patients capable of performing at maximal levels of exercise with suitable resting ECG findings. In this review, we will highlight the major dilemmas in interpreting suspected coronary artery disease symptoms in women and identify optimal strategies for employing exercise ECG as a first-line diagnostic test in the SIHD evaluation algorithm. We will highlight current evidence as well as recent guideline statements on this subject. Trial registration number NCT01471522; Pre-results. PMID:27326241

  19. The Development of a Portable ECG Monitor Based on DSP

    NASA Astrophysics Data System (ADS)

    Nan, CHI Jian; Tao, YAN Yan; Meng Chen, LIU; Li, YANG

    With the advent of global information, researches of Smart Home system are in the ascendant, the ECG real-time detection, and wireless transmission of ECG become more useful. In order to achieve the purpose we developed a portable ECG monitor which achieves the purpose of cardiac disease remote monitoring, and will be used in the physical and psychological disease surveillance in smart home system, we developed this portable ECG Monitor, based on the analysis of existing ECG Monitor, using TMS320F2812 as the core controller, which complete the signal collection, storage, processing, waveform display and transmission.

  20. Sparse Matrix for ECG Identification with Two-Lead Features

    PubMed Central

    Tseng, Kuo-Kun; Luo, Jiao; Wang, Wenmin; Haiting, Dong

    2015-01-01

    Electrocardiograph (ECG) human identification has the potential to improve biometric security. However, improvements in ECG identification and feature extraction are required. Previous work has focused on single lead ECG signals. Our work proposes a new algorithm for human identification by mapping two-lead ECG signals onto a two-dimensional matrix then employing a sparse matrix method to process the matrix. And that is the first application of sparse matrix techniques for ECG identification. Moreover, the results of our experiments demonstrate the benefits of our approach over existing methods. PMID:25961074

  1. [Development of multi-function ECG signal generator].

    PubMed

    Cheng, F; Wei, Y X

    2000-07-01

    This paper describes the development of a portable multi-function ECG signal generator, which is based on micro-controller. It uses technique of LCD screen, and realizes man-machine interaction by keyboard. In constructing and disposing data module of the ECG signal, Eigen-heartbeat Code mapping method gets ROM saved greatly. Therefore it can generate all kinds of user-defined ECG signal sequence with no extension of on-board memory chips. This system can also simulate kinds of ECG signals, which have various heart rates and symptoms. It can meet the needs of researching and maintenance of kinds of ECG instruments. PMID:12583134

  2. ECG phenomena: pseudopreexcitation and repolarization disturbances resembling ST-elevation myocardial infarction caused by an intraatrial rhabdomyoma in a newborn.

    PubMed

    Paech, Christian; Gebauer, Roman Antonin

    2014-01-01

    As is known from other reports, a rhabdomyoma or tumor metastasis may alter intracardiac electrical conduction, producing electrical phenomena like pseudopreexcitation or repolarization disturbances resembling ST-elevation myocardial infarction or Brugada's syndrome. We present a newborn with a giant atrial rhabdomyoma and additionally multiple ventricular rhabdomyomas. He presented with several electrocardiogram (ECG) phenomena due to tumor-caused atrial depolarization and repolarization disturbances. Except from the cardiac tumors, the physical status was within normal range. Initial ECG showed a rapid atrial tachycardia with a ventricular rate of 230 bpm, which was terminated by electrical cardioversion. Afterwards, the ECG showed atrial rhythm with frequent atrial premature contractions and deformation of the PR interval with large, broad P waves and loss of discret PR segment, imposing as pseudopreexcitation. The following QRS complex was normal, with seemingly abnormal ventricular repolarization resembeling ST-elevation myocardial infarction. The atrial tumor was resected with consequent vast atrial reconstruction using patch plastic. The ventricular tumors were left without manipulation. After surgery, pseudopreexcitation and repolarization abnormalities vanished entirely and an alternans between sinus rhythm and ectopic atrial rhythm was present. These phenomena were supposably caused by isolated atrial depolarization disturbances due to tumor-caused heterogenous endocardial activation. The seemingly abnormal ventricular repolarization is probably due to repolarization of the atrial mass, superimposed on the ventricular repolarization. Recognizably, the QRS complex before and after surgical resection of the rhabdomyoma is identical, underlining the atrial origin of the repolarization abnormalities before surgery.

  3. The development of wireless sensor network for ECG monitoring.

    PubMed

    Lin, Jun-Liang; Liu, Hsien-Chieh; Tai, Yu-Ting; Wu, Hsin-Hsien; Hsu, Shuo-Jen; Jaw, Fu-Shan; Chen, You-Yin

    2006-01-01

    The main problem we want to solve contains two subjects: The first one is the patient's pressure due to wired physiological signal estimation. With wireless sensor network technique, patients only need to carry a few small nodes, and then the physiological signal can be transmitted in the air. The other subject of the vital problem is that some protocols, like Bluetooth, provide a peer to peer wireless communication technique, but such peer to peer network may need a complex algorithm to find the best data transmission path. In this study, we use the hierarchy routing as network topology that three-layer architecture contains PAN coordinator, router and device. The study focuses on implementation of a prototype electrocardiography (ECG) system which replaces wired connections between sensor points and a central node with wireless links. Successful implementation of the final system would be of benefit to all involved in the use of ECG as access to and movement of the patient would not be impeded by the physical constraints imposed by the cables. Most aspects of the design would also be portable to other sensor applications, making the work relevant to a vast range of systems where movement of sensors is desirable and constrained by hard-wired links. PMID:17946570

  4. A mobile device system for early warning of ECG anomalies.

    PubMed

    Szczepański, Adam; Saeed, Khalid

    2014-01-01

    With the rapid increase in computational power of mobile devices the amount of ambient intelligence-based smart environment systems has increased greatly in recent years. A proposition of such a solution is described in this paper, namely real time monitoring of an electrocardiogram (ECG) signal during everyday activities for identification of life threatening situations. The paper, being both research and review, describes previous work of the authors, current state of the art in the context of the authors' work and the proposed aforementioned system. Although parts of the solution were described in earlier publications of the authors, the whole concept is presented completely for the first time along with the prototype implementation on mobile device-a Windows 8 tablet with Modern UI. The system has three main purposes. The first goal is the detection of sudden rapid cardiac malfunctions and informing the people in the patient's surroundings, family and friends and the nearest emergency station about the deteriorating health of the monitored person. The second goal is a monitoring of ECG signals under non-clinical conditions to detect anomalies that are typically not found during diagnostic tests. The third goal is to register and analyze repeatable, long-term disturbances in the regular signal and finding their patterns. PMID:24955946

  5. A Mobile Device System for Early Warning of ECG Anomalies

    PubMed Central

    Szczepański, Adam; Saeed, Khalid

    2014-01-01

    With the rapid increase in computational power of mobile devices the amount of ambient intelligence-based smart environment systems has increased greatly in recent years. A proposition of such a solution is described in this paper, namely real time monitoring of an electrocardiogram (ECG) signal during everyday activities for identification of life threatening situations. The paper, being both research and review, describes previous work of the authors, current state of the art in the context of the authors' work and the proposed aforementioned system. Although parts of the solution were described in earlier publications of the authors, the whole concept is presented completely for the first time along with the prototype implementation on mobile device—a Windows 8 tablet with Modern UI. The system has three main purposes. The first goal is the detection of sudden rapid cardiac malfunctions and informing the people in the patient's surroundings, family and friends and the nearest emergency station about the deteriorating health of the monitored person. The second goal is a monitoring of ECG signals under non-clinical conditions to detect anomalies that are typically not found during diagnostic tests. The third goal is to register and analyze repeatable, long-term disturbances in the regular signal and finding their patterns. PMID:24955946

  6. Microprocessor-Based Ambulatory ECG Monitoring System

    PubMed Central

    Le-Huy, P.; L'Huillier, J.P.; Oumerzouk, Y.; Yvroud, E.

    1983-01-01

    Ambulatory monitoring of electrocardiograms (ECGs) was facilitated by the introduction of Holter method in the early '60s. Since this time, many researchs have been undertaken in order to improve the overall performances of the recorder and analyser, two unseparated parts of this method. The principal drawbacks of Holter method are well-known: • Recording of ECG is based on the assumption that the arrhythmia of interest will be occurred in monitoring period. • Analysis and arrhythmia detection could be processed only after the monitoring period. This is a time-consuming and tedious job, and subjected to human error. • Process “Recording-Play-back - Analysis - Diagnosis” takes usually many days. In this paper, the design of a microprocessor - based portable recorder will be described. The analysis and classification of arrhythmia are processed immediately upon their occurrence according to a look-up table, which could be programmed to suit a particular need.

  7. Single frequency RF powered ECG telemetry system

    NASA Technical Reports Server (NTRS)

    Ko, W. H.; Hynecek, J.; Homa, J.

    1979-01-01

    It has been demonstrated that a radio frequency magnetic field can be used to power implanted electronic circuitry for short range telemetry to replace batteries. A substantial reduction in implanted volume can be achieved by using only one RF tank circuit for receiving the RF power and transmitting the telemetered information. A single channel telemetry system of this type, using time sharing techniques, was developed and employed to transmit the ECG signal from Rhesus monkeys in primate chairs. The signal from the implant is received during the period when the RF powering radiation is interrupted. The ECG signal is carried by 20-microsec pulse position modulated pulses, referred to the trailing edge of the RF powering pulse. Satisfactory results have been obtained with this single frequency system. The concept and the design presented may be useful for short-range long-term implant telemetry systems.

  8. [Clinical evaluation of ECG at the onset subjective symptoms using real-time analysis electrocardiograph (event recorder)].

    PubMed

    Takizawa, Yoshinori; Shimetani, Naoto; Uchiyama, Kenji; Takayanagi, Kan; Mori, Mikio

    2005-05-01

    Examination of patient complaining of palpitation, chest pain and chest discomfort is usually performed by 12-lead electrocardiograph. However, the recording time is short and there are few opportunities to capture an ECG demonstrating conditions during subjective symptoms. To investigate the cause, we need to obtain an ECG during subjective symptoms. Thus, we frequently use a Holter ECG, which can be recorded for 24 hours. However, some patients have a low frequency of subjective symptoms, which may not appear during a 24-hour examination. We used a real-time electrocardiograph (Event Recorder CG-6106 made by Card Guard Scientific Survival Limited) as a monitor during subjective symptoms. Thereafter, ECG findings at the onset of subjective symptoms could be analyzed in 30 patients who did not have a clear cardiac disease. In this examination, arrhythmia was recorded in 25 of 30 cases. Although in these cases ECG during subjective symptoms could not be captured even when Holter examination was performed several times ECG during subjective symptoms was captured using an Event Recorder. This method using an Event Recorder is simple and convenient, moreover, is considered very useful for investigation of subjective symptoms. In the future, the use of an Event Recorder for heart-health-care in the daily life of healthy people and/or cardiac disease patient is highly anticipated.

  9. ECG Sensor Card with Evolving RBP Algorithms for Human Verification.

    PubMed

    Tseng, Kuo-Kun; Huang, Huang-Nan; Zeng, Fufu; Tu, Shu-Yi

    2015-08-21

    It is known that cardiac and respiratory rhythms in electrocardiograms (ECGs) are highly nonlinear and non-stationary. As a result, most traditional time-domain algorithms are inadequate for characterizing the complex dynamics of the ECG. This paper proposes a new ECG sensor card and a statistical-based ECG algorithm, with the aid of a reduced binary pattern (RBP), with the aim of achieving faster ECG human identity recognition with high accuracy. The proposed algorithm has one advantage that previous ECG algorithms lack-the waveform complex information and de-noising preprocessing can be bypassed; therefore, it is more suitable for non-stationary ECG signals. Experimental results tested on two public ECG databases (MIT-BIH) from MIT University confirm that the proposed scheme is feasible with excellent accuracy, low complexity, and speedy processing. To be more specific, the advanced RBP algorithm achieves high accuracy in human identity recognition and is executed at least nine times faster than previous algorithms. Moreover, based on the test results from a long-term ECG database, the evolving RBP algorithm also demonstrates superior capability in handling long-term and non-stationary ECG signals.

  10. ECG Sensor Card with Evolving RBP Algorithms for Human Verification.

    PubMed

    Tseng, Kuo-Kun; Huang, Huang-Nan; Zeng, Fufu; Tu, Shu-Yi

    2015-01-01

    It is known that cardiac and respiratory rhythms in electrocardiograms (ECGs) are highly nonlinear and non-stationary. As a result, most traditional time-domain algorithms are inadequate for characterizing the complex dynamics of the ECG. This paper proposes a new ECG sensor card and a statistical-based ECG algorithm, with the aid of a reduced binary pattern (RBP), with the aim of achieving faster ECG human identity recognition with high accuracy. The proposed algorithm has one advantage that previous ECG algorithms lack-the waveform complex information and de-noising preprocessing can be bypassed; therefore, it is more suitable for non-stationary ECG signals. Experimental results tested on two public ECG databases (MIT-BIH) from MIT University confirm that the proposed scheme is feasible with excellent accuracy, low complexity, and speedy processing. To be more specific, the advanced RBP algorithm achieves high accuracy in human identity recognition and is executed at least nine times faster than previous algorithms. Moreover, based on the test results from a long-term ECG database, the evolving RBP algorithm also demonstrates superior capability in handling long-term and non-stationary ECG signals. PMID:26307995

  11. ECG Sensor Card with Evolving RBP Algorithms for Human Verification

    PubMed Central

    Tseng, Kuo-Kun; Huang, Huang-Nan; Zeng, Fufu; Tu, Shu-Yi

    2015-01-01

    It is known that cardiac and respiratory rhythms in electrocardiograms (ECGs) are highly nonlinear and non-stationary. As a result, most traditional time-domain algorithms are inadequate for characterizing the complex dynamics of the ECG. This paper proposes a new ECG sensor card and a statistical-based ECG algorithm, with the aid of a reduced binary pattern (RBP), with the aim of achieving faster ECG human identity recognition with high accuracy. The proposed algorithm has one advantage that previous ECG algorithms lack—the waveform complex information and de-noising preprocessing can be bypassed; therefore, it is more suitable for non-stationary ECG signals. Experimental results tested on two public ECG databases (MIT-BIH) from MIT University confirm that the proposed scheme is feasible with excellent accuracy, low complexity, and speedy processing. To be more specific, the advanced RBP algorithm achieves high accuracy in human identity recognition and is executed at least nine times faster than previous algorithms. Moreover, based on the test results from a long-term ECG database, the evolving RBP algorithm also demonstrates superior capability in handling long-term and non-stationary ECG signals. PMID:26307995

  12. Three dimensional quantification of left ventricular wall motion by ECG-gated blood pool emission tomography

    SciTech Connect

    Underwood, S.R.; Walton, S.; Laming, P.J.; Jarritt, P.H.; Ell, P.J.; Emanuel, R.W.; Swanton, R.H.

    1985-05-01

    ECG-gated blood pool emission tomography is a relatively new technique, and this study establishes a simple method for displaying the three dimensional data obtained, determines a normal range for ejection fraction in all regions of the left ventricle, and compares wall motion in abnormal subjects with that determined by X-ray contrast ventriculography. The short axis sections dividing the ventricle in slices from apex to base, were used to calculate ejection fraction for all parts of the ventricle and the results were plotted on a single colour coded circular image. The apex was represented in the centre, the base around the circumference, and all other parts of the ventricle were represented in between. The image was divided into 15 segments, and normal segmental ejection fraction was defined as within two standard deviations of the mean in a group of 10 normal subjects. In 25 subjects with coronary artery disease, motion of the anterior, apical, and inferior walls agreed in every case with the right anterior oblique contrast ventriculogram, but in 12 of these, the three dimensional ejection fraction image showed abnormal septal motion, and in a further 3, abnormal lateral wall motion in addition. In the 12 subjects there was disease of the left anterior descending coronary artery, and in the further 3 there was left circumflex disease. ECG-gated blood pool emission tomography thus provides an accurate quantitative assessment of left ventricular wall motion in three dimensions, and has significant advantages over conventional planar techniques.

  13. Effect of Green Tea Extract on Doxorubicin Induced Cardiovascular Abnormalities: Antioxidant Action

    PubMed Central

    Patil, Leena; Balaraman, R

    2011-01-01

    Doxorubicin (DOX) induces oxidative stress leading to cardiovascular abnormalities. Green tea extract (GTE) is reported to possess antioxidant activity mainly by means of its polyphenolic constituent, catechins. Our study was aimed to find out the effect of GTE (100 mg/kg / day p.o. for 28 days) on DOX induced (3 mg/kg, IP on days 1, 7, 14, 21, 28) cardiovascular abnormalities in rat heart. DOX treatment led to significant increase in blood pressure, ST interval, serum levels of LDH, CK, SGOT, lipid peroxidation .The antioxidant enzymes such as super oxide dismutase, catalase and reduced-glutathione were decreased considerably in the heart of DOX treated rats as compared to the normal control. A combined treatment with GTE and DOX showed a considerable decrease in serum markers of cardiotoxicity such as LDH, CK, SGOT and lipid peroxides. There was significant increase in the activities of antioxidant enzymes and also showed improvement in hemodynamic parameters and ECG changes as compared to DOX treated animals. DOX treatment caused disorganization of myocardial tissue which was restored in animals treated with GTE along with DOX. Thus it can be concluded that GTE possesses an antioxidant activity and by virtue of this action it can protect the heart from DOX induced cardiovascular abnormalities. PMID:24363686

  14. To decide medical therapy according to ECG criteria in patients with supraventricular tachycardia in emergency department: adenosine or diltiazem

    PubMed Central

    Dogan, Halil; Ozucelik, Dogac Niyazi; Aciksari, Kurtulus; Caglar, Ilker Murat; Okutan, Nursel; Yazicioglu, Mustafa; Avyaci, Baris Murat; Simsek, Cem; Ozasir, Derya; Giray, Tufan Akin; Ayan, Cem; Celikmen, Feridun; Okuturlar, Yıldız; Sarikaya, Sezgin

    2015-01-01

    The aim of this study is to investigate the effect of ECG criteria which are used for the distinction between AVNRT and AVRT for the choice of treatment in patients with Supraventricular Tachycardia (SVT). The 77 patients with narrow QRS complex SVT which was treated with Adenosine or Diltiazem in the Emergency Department were evaluated retrospectively. All 12-lead ECG during tachycardia were blindly reviewed according to ECG criteria (Pseudo-r` in V1, Pseudo-S-wave in the inferior leads, Visible P-wave, aVL notch) by a cardiologist and an emergency physician. In this study, while 59.6% of the patients returned to normal sinus rhythm (NSR) after the first dose 6 mg, 64.91% of them after the first dose 12 mg and 71.92% of them after the second dose of 12 mg adenosine, 95% of the patients returned to NSR after the 0.25 mg/kg diltiazem. The most visible ECG findings were visible P waves and the least visible ECG findings were Pseudo-S waves in the inferior leads. It was statistically significant between converted by adenosine to NSR and converted by diltiazem to NSR to the presence of visible P-wave and the aVL lead notch in their ECG findings. Conclusion: The rate of return to NSR through diltiazem was found higher than that of adenosine in narrow complex SVT patients. Also, diltiazem may be the first medication to be preferred in the presence of retrograt P wave and aVL notch in the ECG of the patients with narrow QRS complex stable SVT. PMID:26309644

  15. Chromosome abnormalities in glioma

    SciTech Connect

    Li, Y.S.; Ramsay, D.A.; Fan, Y.S.

    1994-09-01

    Cytogenetic studies were performed in 25 patients with gliomas. An interesting finding was a seemingly identical abnormality, an extra band on the tip of the short arm of chromosome 1, add(1)(p36), in two cases. The abnormality was present in all cells from a patient with a glioblastoma and in 27% of the tumor cells from a patient with a recurrent irradiated anaplastic astrocytoma; in the latter case, 7 unrelated abnormal clones were identified except 4 of those clones shared a common change, -Y. Three similar cases have been described previously. In a patient with pleomorphic astrocytoma, the band 1q42 in both homologues of chromosome 1 was involved in two different rearrangements. A review of the literature revealed that deletion of the long arm of chromosome 1 including 1q42 often occurs in glioma. This may indicate a possible tumor suppressor gene in this region. Cytogenetic follow-up studies were carried out in two patients and emergence of unrelated clones were noted in both. A total of 124 clonal breakpoints were identified in the 25 patients. The breakpoints which occurred three times or more were: 1p36, 1p22, 1q21, 1q25, 3q21, 7q32, 8q22, 9q22, 16q22, and 22q13.

  16. ECG gated NMR-CT for cardiovascular diseases

    SciTech Connect

    Nishikawa, J.; Machida, K.; Iio, M.; Yoshimoto, N.; Sugimoto, T.; Kawaguchi, H.; Mano, H.

    1984-01-01

    The authors applied NMR-CT to cardiac study with ECG gated technique to evaluate the left ventricular (LV) function and compared it with cardiovascular nuclear medicine study (NM). The NMR-CT machine has resistive air-core magnet with 0.15 Tesla. The saturation recovery image or inversion recovery image were obtained as 256 x 256 matrix and 15 mm in thickness. The study population was ten patients who were evaluated both by NMR image and by NM performed within one week interval. The heart muscle was able to be visualized without any contrast material nor radioisotopes in inversion recovery images, whereas saturation recovery images failed to separate heart muscle from blood pool. The wall motions of LV in both methods were well correlated except for inferior wall. The values of ejection fraction in NMR image were moderately low, but two modalities showed satisfactory correlation (r=0.85). The region of myocardial infarction was revealed as wall thinning and/or wall motion abnormality. It is still preliminary to draw a conclusion, however, it can be said that in the evaluation of LV function, method by NMR might be of equal value to those of NM. It can be certain that eventually gated NMR-CT will become more effective method for various aspects of cardiovascular evaluation.

  17. Patient-specific ECG beat classification technique.

    PubMed

    Das, Manab K; Ari, Samit

    2014-09-01

    Electrocardiogram (ECG) beat classification plays an important role in the timely diagnosis of the critical heart condition. An automated diagnostic system is proposed to classify five types of ECG classes, namely normal (N), ventricular ectopic beat (V), supra ventricular ectopic beat (S), fusion (F) and unknown (Q) as recommended by the Association for the Advancement of Medical Instrumentation (AAMI). The proposed method integrates the Stockwell transform (ST), a bacteria foraging optimisation (BFO) algorithm and a least mean square (LMS)-based multiclass support vector machine (SVM) classifier. The ST is utilised to extract the important morphological features which are concatenated with four timing features. The resultant combined feature vector is optimised by removing the redundant and irrelevant features using the BFO algorithm. The optimised feature vector is applied to the LMS-based multiclass SVM classifier for automated diagnosis. In the proposed technique, the LMS algorithm is used to modify the Lagrange multiplier, which in turn modifies the weight vector to minimise the classification error. The updated weights are used during the testing phase to classify ECG beats. The classification performances are evaluated using the MIT-BIH arrhythmia database. Average accuracy and sensitivity performances of the proposed system for V detection are 98.6% and 91.7%, respectively, and for S detections, 98.2% and 74.7%, respectively over the entire database. To generalise the capability, the classification performance is also evaluated using the St. Petersburg Institute of Cardiological Technics (INCART) database. The proposed technique performs better than other reported heartbeat techniques, with results suggesting better generalisation capability.

  18. A 24-HOUR AMBULATORY ECG MONITORING IN ASSESSMENT OF QT INTERVAL DURATION AND DISPERSION IN ROWERS WITH PHYSIOLOGICAL MYOCARDIAL HYPERTROPHY

    PubMed Central

    Kim, Z.F.; Bilalova, R.R.; Tsibulkin, N.A.; Almetova, R.R.; Mudarisova, R.R.; Ahmetov, I.I.

    2013-01-01

    Myocardial hypertrophy (MH) due to cardiac pathology is characterized by an increase in QT interval duration and dispersion, while the findings for exercise-induced myocardial hypertrophy are contradictory. The majority of published research findings have not explored this relationship, but there have only been a few conducted studies using 24-hour ECG monitoring. The aim of the study was to determine the QT interval duration and dispersion in short-term and 24-hour ECG in endurance athletes with myocardial hypertrophy and without it. Methods: A total of 26 well-trained rowers underwent a resting 12-lead ECG, 24-hour ECG monitoring and echocardiography. Results: Athletes with MH (n = 7) at rest did not show any increase in QTc interval duration and dispersion, or mean and maximal QTc duration in Holter monitoring compared to athletes without MH (n = 19). Left ventricular mass was not significantly correlated with any QTc characteristics. Furthermore, athletes with MH had significantly longer mean QT (P = 0.01) and maximal QT (P = 0.018) intervals in Holter monitoring and higher 24-hour heart rate variability indexes due to stronger vagal effects. Conclusions: The present study demonstrated that athlete's heart syndrome with myocardial hypertrophy as a benign phenomenon does not lead to an increase in QT interval duration, or increases in maximal and mean duration in a 24-hour ECG. An increase in QT interval duration in athletes may have an autonomic nature. PMID:24744494

  19. A novel biometric authentication approach using ECG and EMG signals.

    PubMed

    Belgacem, Noureddine; Fournier, Régis; Nait-Ali, Amine; Bereksi-Reguig, Fethi

    2015-05-01

    Security biometrics is a secure alternative to traditional methods of identity verification of individuals, such as authentication systems based on user name and password. Recently, it has been found that the electrocardiogram (ECG) signal formed by five successive waves (P, Q, R, S and T) is unique to each individual. In fact, better than any other biometrics' measures, it delivers proof of subject's being alive as extra information which other biometrics cannot deliver. The main purpose of this work is to present a low-cost method for online acquisition and processing of ECG signals for person authentication and to study the possibility of providing additional information and retrieve personal data from an electrocardiogram signal to yield a reliable decision. This study explores the effectiveness of a novel biometric system resulting from the fusion of information and knowledge provided by ECG and EMG (Electromyogram) physiological recordings. It is shown that biometrics based on these ECG/EMG signals offers a novel way to robustly authenticate subjects. Five ECG databases (MIT-BIH, ST-T, NSR, PTB and ECG-ID) and several ECG signals collected in-house from volunteers were exploited. A palm-based ECG biometric system was developed where the signals are collected from the palm of the subject through a minimally intrusive one-lead ECG set-up. A total of 3750 ECG beats were used in this work. Feature extraction was performed on ECG signals using Fourier descriptors (spectral coefficients). Optimum-Path Forest classifier was used to calculate the degree of similarity between individuals. The obtained results from the proposed approach look promising for individuals' authentication. PMID:25836061

  20. A novel biometric authentication approach using ECG and EMG signals.

    PubMed

    Belgacem, Noureddine; Fournier, Régis; Nait-Ali, Amine; Bereksi-Reguig, Fethi

    2015-05-01

    Security biometrics is a secure alternative to traditional methods of identity verification of individuals, such as authentication systems based on user name and password. Recently, it has been found that the electrocardiogram (ECG) signal formed by five successive waves (P, Q, R, S and T) is unique to each individual. In fact, better than any other biometrics' measures, it delivers proof of subject's being alive as extra information which other biometrics cannot deliver. The main purpose of this work is to present a low-cost method for online acquisition and processing of ECG signals for person authentication and to study the possibility of providing additional information and retrieve personal data from an electrocardiogram signal to yield a reliable decision. This study explores the effectiveness of a novel biometric system resulting from the fusion of information and knowledge provided by ECG and EMG (Electromyogram) physiological recordings. It is shown that biometrics based on these ECG/EMG signals offers a novel way to robustly authenticate subjects. Five ECG databases (MIT-BIH, ST-T, NSR, PTB and ECG-ID) and several ECG signals collected in-house from volunteers were exploited. A palm-based ECG biometric system was developed where the signals are collected from the palm of the subject through a minimally intrusive one-lead ECG set-up. A total of 3750 ECG beats were used in this work. Feature extraction was performed on ECG signals using Fourier descriptors (spectral coefficients). Optimum-Path Forest classifier was used to calculate the degree of similarity between individuals. The obtained results from the proposed approach look promising for individuals' authentication.

  1. Fetal ECG: a novel predictor of atrioventricular block in anti‐Ro positive pregnancies

    PubMed Central

    Gardiner, Helena M; Belmar, Cristian; Pasquini, Lucia; Seale, Anna; Thomas, Matthew; Dennes, William; Taylor, Myles J O; Kulinskaya, Elena; Wimalasundera, Ruwan

    2007-01-01

    Objective Approximately 2.8% of pregnancies are Ro/La antibody positive. 3–15% of fetuses develop complete heart block (CHB). First‐degree atrioventricular heart block (1° AVB) is reported in a third of Ro/La fetuses but as most have a normal postnatal ECG this may reflect inadequacies of Doppler measurement techniques. Methods Comparison was made between mechanical (mPR) and electrical (ePR) intervals obtained prospectively using Doppler and non‐invasive fetal ECG (fECG) in 52 consecutive Ro/La pregnancies in 46 women carrying 54 fetuses in an observational study at a fetal medicine unit. 121 mPR and 37 ePR intervals were recorded in 49 Ro/La fetuses. Five were referred with CHB and excluded. ePR was measured successfully in 35/37 (94%) and mPR was measured in all cases. 1° AVB was defined as PR >95% CI. Logistic regression predicted abnormal final fetal rhythm from first mPR or ePR. Results The ePR model gave 66.7% sensitivity (6 of 8 final abnormal fetal rhythm cases were predicted correctly in fetuses >20 weeks) and 96.2% specificity. mPR gave 44.4% sensitivity (4 of 9 cases) and 88.5% specificity. Z scores for ePR (zPR) were calculated from 199 normal fetuses. The area under the receiver operator characteristic (ROC) curve was 0.88 (95% CI, 0.754 to 1.007). A cut‐off of 1.65 gave a sensitivity of 87.5% and specificity of 95% for those with prolonged and normal ePR intervals, respectively. Conclusion zPR is better than mPR at differentiating between normal and prolonged PR intervals, suggesting that fECG is the diagnostic tool of choice to investigate the natural history and therapy of conduction abnormalities in Ro/La pregnancies. PMID:17085531

  2. Agreement between clinical and portable EMG/ECG diagnosis of sleep bruxism.

    PubMed

    Castroflorio, T; Bargellini, A; Rossini, G; Cugliari, G; Deregibus, A; Manfredini, D

    2015-10-01

    The aim of this study was to compare clinical sleep bruxism (SB) diagnosis with an instrumental diagnosis obtained with a device providing electromyography/electrocardiography (EMG/ECG) recordings. Forty-five (N = 45) subjects (19 males and 26 females, mean age 28 ± 11 years) were selected among patients referring to the Gnathology Unit of the Dental School of the University of Torino. An expert clinician assessed the presence of SB based on the presence of one or more signs/symptoms (i.e., transient jaw muscle pain in the morning, muscle fatigue at awakening, presence of tooth wear, masseter hypertrophy). Furthermore, all participants underwent an instrumental recording at home with a portable device (Bruxoff; OT Bioelettronica, Torino, Italy) allowing a simultaneous recording of EMG signals from both the masseter muscles as well as heart frequency. Statistical procedures were performed with the software Statistical Package for the Social Science v. 20.0 (SPSS 20.0; IBM, Milan, Italy). Based on the EMG/ECG analysis, 26 subjects (11 males, 15 females, mean age 28 ± 10 years) were diagnosed as sleep bruxers, whilst 19 subjects (7 males, 12 females, mean age 30 ± 10 years) were diagnosed as non-bruxers. The correlation between the clinical and EMG/ECG SB diagnoses was low (ϕ value = 0.250), with a 62.2% agreement (28/45 subjects) between the two approaches (kappa = 0.248). Assuming instrumental EMG/ECG diagnosis as the standard of reference for definite SB diagnosis in this investigation, the false-positive and false-negative rates were unacceptable for all clinical signs/symptoms. In conclusion, findings from clinical assessment are not related with SB diagnosis performed with a portable EMG/ECG recorder.

  3. The evolution of ambulatory ECG monitoring.

    PubMed

    Kennedy, Harold L

    2013-01-01

    Ambulatory Holter electrocardiographic (ECG) monitoring has undergone continuous technological evolution since its invention and development in the 1950s era. With commercial introduction in 1963, there has been an evolution of Holter recorders from 1 channel to 12 channel recorders with increasingly smaller storage media, and there has evolved Holter analysis systems employing increasingly technologically advanced electronics providing a myriad of data displays. This evolution of smaller physical instruments with increasing technological capacity has characterized the development of electronics over the past 50 years. Currently the technology has been focused upon the conventional continuous 24 to 48 hour ambulatory ECG examination, and conventional extended ambulatory monitoring strategies for infrequent to rare arrhythmic events. However, the emergence of the Internet, Wi-Fi, cellular networks, and broad-band transmission has positioned these modalities at the doorway of the digital world. This has led to an adoption of more cost-effective strategies to these conventional methods of performing the examination. As a result, the emergence of the mobile smartphone coupled with this digital capacity is leading to the recent development of Holter smartphone applications. The potential of point-of-care applications utilizing the Holter smartphone and a vast array of new non-invasive sensors is evident in the not too distant future. The Holter smartphone is anticipated to contribute significantly in the future to the field of global health. PMID:24215744

  4. Multiprocessor system for Holter tape analysis (ECG)

    SciTech Connect

    Feldman, C.L.; Hubelbank, M.; Valvo, V.; Lane, B.

    1983-01-01

    Although techniques for recording and analyzing longterm ambulatory ECGS have been in existence for more than 20 years, the clinical usefulness and frequency of application of the technique continue to grow at an extraordinary rate. To meet the need for faster, more efficient processing of Holter tapes and the growing requirement that the analysis of the tape be quantitatively accurate, a new Holter analysis system has been developed. This system is built around two LSI11 microprocessors and a special purpose byte processor which incorporates an AMD 2903 bit slice chip. It includes 30 MB of mass storage and an impact printer with alphanumeric and graphic capabilities. In a test which included 55 separate readings of 34 12- or 24-hour tapes, correlations with hand counts of vpbs was greater than .99. The system processes either cassette or reel-to-reel tapes at 120* with simultaneous print/process capabilities, has a variety of user interactive displays to assure continuous operator validation, is remarkably nonfatiguing to operate, and automatically produces reports with tables, graphs, and sample ECG strips. 8 references.

  5. A method of ECG template extraction for biometrics applications.

    PubMed

    Zhou, Xiang; Lu, Yang; Chen, Meng; Bao, Shu-Di; Miao, Fen

    2014-01-01

    ECG has attracted widespread attention as one of the most important non-invasive physiological signals in healthcare-system related biometrics for its characteristics like ease-of-monitoring, individual uniqueness as well as important clinical value. This study proposes a method of dynamic threshold setting to extract the most stable ECG waveform as the template for the consequent ECG identification process. With the proposed method, the accuracy of ECG biometrics using the dynamic time wraping for difference measures has been significantly improved. Analysis results with the self-built electrocardiogram database show that the deployment of the proposed method was able to reduce the half total error rate of the ECG biometric system from 3.35% to 1.45%. Its average running time on the platform of android mobile terminal was around 0.06 seconds, and thus demonstrates acceptable real-time performance. PMID:25570031

  6. ECG Signal Analysis and Arrhythmia Detection using Wavelet Transform

    NASA Astrophysics Data System (ADS)

    Kaur, Inderbir; Rajni, Rajni; Marwaha, Anupma

    2016-06-01

    Electrocardiogram (ECG) is used to record the electrical activity of the heart. The ECG signal being non-stationary in nature, makes the analysis and interpretation of the signal very difficult. Hence accurate analysis of ECG signal with a powerful tool like discrete wavelet transform (DWT) becomes imperative. In this paper, ECG signal is denoised to remove the artifacts and analyzed using Wavelet Transform to detect the QRS complex and arrhythmia. This work is implemented in MATLAB software for MIT/BIH Arrhythmia database and yields the sensitivity of 99.85 %, positive predictivity of 99.92 % and detection error rate of 0.221 % with wavelet transform. It is also inferred that DWT outperforms principle component analysis technique in detection of ECG signal.

  7. Noncontact ECG system for unobtrusive long-term monitoring.

    PubMed

    McDonald, Neil J; Anumula, Harini A; Duff, Eric; Soussou, Walid

    2012-01-01

    This paper describes measurements made using an ECG system with QUASAR's capacitive bioelectrodes integrated into a pad system that is placed over a chair. QUASAR's capacitive bioelectrode has the property of measuring bioelectric potentials at a small separation from the body. This enables the measurement of ECG signals through fabric, without the removal of clothing or preparation of skin. The ECG was measured through the subject's clothing while the subject sat in the chair without any supporting action from the subject. The ECG pad system is an example of a high compliance system that places minimal requirements upon the subject and, consequently, can be used to generate a long-term record from ECG segments collected on a daily basis, providing valuable information on long-term trends in cardiac health.

  8. A capacitive ECG array with visual patient feedback.

    PubMed

    Eilebrecht, Benjamin; Schommartz, Antje; Walter, Marian; Wartzek, Tobias; Czaplik, Michael; Leonhardt, Steffen

    2010-01-01

    Capacitive electrocardiogram (ECG) sensing is a promising technique for less constraining vital signal measurement and close to a commercial application. Even bigger trials testing the diagnostic significance were already done with single lead systems. Anyway, most applications to be found in research are limited to one channel and thus limited in its diagnostic relevance as only diseases coming along with a change of the heart rate can be diagnosed adequately. As a consequence the need for capacitive multi-channel ECGs combining the diagnostic relevance and the advantages of capacitive ECG sensing emerges. This paper introduces a capacitive ECG measurement system which allows the recording of standardized ECG leads according to Einthoven and Goldberger by means of an electrode array with nine electrodes.

  9. A method of ECG template extraction for biometrics applications.

    PubMed

    Zhou, Xiang; Lu, Yang; Chen, Meng; Bao, Shu-Di; Miao, Fen

    2014-01-01

    ECG has attracted widespread attention as one of the most important non-invasive physiological signals in healthcare-system related biometrics for its characteristics like ease-of-monitoring, individual uniqueness as well as important clinical value. This study proposes a method of dynamic threshold setting to extract the most stable ECG waveform as the template for the consequent ECG identification process. With the proposed method, the accuracy of ECG biometrics using the dynamic time wraping for difference measures has been significantly improved. Analysis results with the self-built electrocardiogram database show that the deployment of the proposed method was able to reduce the half total error rate of the ECG biometric system from 3.35% to 1.45%. Its average running time on the platform of android mobile terminal was around 0.06 seconds, and thus demonstrates acceptable real-time performance.

  10. A novel similarity comparison approach for dynamic ECG series.

    PubMed

    Yin, Hong; Zhu, Xiaoqian; Ma, Shaodong; Yang, Shuqiang; Chen, Liqian

    2015-01-01

    The heart sound signal is a reflection of heart and vascular system motion. Long-term continuous electrocardiogram (ECG) contains important information which can be helpful to prevent heart failure. A single piece of a long-term ECG recording usually consists of more than one hundred thousand data points in length, making it difficult to derive hidden features that may be reflected through dynamic ECG monitoring, which is also very time-consuming to analyze. In this paper, a Dynamic Time Warping based on MapReduce (MRDTW) is proposed to make prognoses of possible lesions in patients. Through comparison of a real-time ECG of a patient with the reference sets of normal and problematic cardiac waveforms, the experimental results reveal that our approach not only retains high accuracy, but also greatly improves the efficiency of the similarity measure in dynamic ECG series.

  11. Sequential Total Variation Denoising for the Extraction of Fetal ECG from Single-Channel Maternal Abdominal ECG

    PubMed Central

    Lee, Kwang Jin; Lee, Boreom

    2016-01-01

    Fetal heart rate (FHR) is an important determinant of fetal health. Cardiotocography (CTG) is widely used for measuring the FHR in the clinical field. However, fetal movement and blood flow through the maternal blood vessels can critically influence Doppler ultrasound signals. Moreover, CTG is not suitable for long-term monitoring. Therefore, researchers have been developing algorithms to estimate the FHR using electrocardiograms (ECGs) from the abdomen of pregnant women. However, separating the weak fetal ECG signal from the abdominal ECG signal is a challenging problem. In this paper, we propose a method for estimating the FHR using sequential total variation denoising and compare its performance with that of other single-channel fetal ECG extraction methods via simulation using the Fetal ECG Synthetic Database (FECGSYNDB). Moreover, we used real data from PhysioNet fetal ECG databases for the evaluation of the algorithm performance. The R-peak detection rate is calculated to evaluate the performance of our algorithm. Our approach could not only separate the fetal ECG signals from the abdominal ECG signals but also accurately estimate the FHR. PMID:27376296

  12. Preprocessing and Analysis of Digitized ECGs

    NASA Astrophysics Data System (ADS)

    Villalpando, L. E. Piña; Kurmyshev, E.; Ramírez, S. Luna; Leal, L. Delgado

    2008-08-01

    In this work we propose a methodology and programs in MatlabTM that perform the preprocessing and analysis of the derivative D1 of ECGs. The program makes the correction to isoelectric line for each beat, calculates the average cardiac frequency and its standard deviation, generates a file of amplitude of P, Q and T waves, as well as the segments and intervals important of each beat. Software makes the normalization of beats to a standard rate of 80 beats per minute, the superposition of beats is done centering R waves, before and after normalizing the amplitude of each beat. The data and graphics provide relevant information to the doctor for diagnosis. In addition, some results are displayed similar to those presented by a Holter recording.

  13. Performance characterstics of a commerical ECG gate

    SciTech Connect

    Graham, M.; Cavailloles, F.; Ritchie, J.L.; Williams, D.L.; Hamilton, G.W.

    1980-04-01

    A commercial ECG gate was tested to evaluate its ability to predict accurately the time of end-systole. The predicted times followed the manufacturer's specifications quite well. These times were compared with the actual times of end-systole as determined by computer-derived left-ventricular time-activity curves using Tc-99m-labeled red blood cells. Although there was moderate scatter, the predicted times of end-systole correlated well with the actual time (n = 59, r = 0.829). If the left-ventricular ejection fraction was calculated using the predicted time of end-systole, the error would be 0.03, or less, for 95% of the subjects.

  14. Prevalence of pre-transplant electrocardiographic abnormalities and post-transplant cardiac events in patients with liver cirrhosis

    PubMed Central

    2014-01-01

    Background Although cardiovascular disease is thouht to be common in cirrhosis, there are no systematic investigations on the prevalence of electrocardiographic (ECG) abnormalities in these patients and data on the occurrence of post-transplant cardiac events in comparison with the general population are lacking. We aimed to study the prevalence and predictors of ECG abnormalities in patients with cirrhosis undergoing liver transplantation and to define the risk of cardiac events post-transplant compared to the general population. Methods Cirrhotic patients undergoing first-time liver transplantation between 1999–2007 were retrospectively enrolled. ECGs at pre-transplant evaluation were reviewed using the Minnesota classification and compared to healthy controls. Standardized incidence ratios for post-transplant cardiac events were calculated. Results 234 patients with cirrhosis were included, 186 with an available ECG (36% with alcoholic and 24% with viral cirrhosis; mean follow-up 4 years). Cirrhotics had a prolonged QTc interval, a Q wave, abnormal QRS axis deviation, ST segment depression and a pathologic T wave more frequently compared to controls (p < 0.05 for all). Arterial hypertension, older age, cirrhosis severity and etiology were related to ECG abnormalities. Compared to the general Swedish population, patients were 14 times more likely to suffer a cardiac event post-transplant (p < 0.001). A prolonged QTc interval and Q wave were related to post-transplant cardiac events (p < 0.05 for all). Conclusions Pre-transplant ECG abnormalities are common in cirrhosis and are associated with cardiovascular risk factors and cirrhosis severity and etiology. Post-transplant cardiac events are more common than in the general population. PMID:24708568

  15. Variable threshold method for ECG R-peak detection.

    PubMed

    Kew, Hsein-Ping; Jeong, Do-Un

    2011-10-01

    In this paper, a wearable belt-type ECG electrode worn around the chest by measuring the real-time ECG is produced in order to minimize the inconvenient in wearing. ECG signal is detected using a potential instrument system. The measured ECG signal is transmits via an ultra low power consumption wireless data communications unit to personal computer using Zigbee-compatible wireless sensor node. ECG signals carry a lot of clinical information for a cardiologist especially the R-peak detection in ECG. R-peak detection generally uses the threshold value which is fixed. There will be errors in peak detection when the baseline changes due to motion artifacts and signal size changes. Preprocessing process which includes differentiation process and Hilbert transform is used as signal preprocessing algorithm. Thereafter, variable threshold method is used to detect the R-peak which is more accurate and efficient than fixed threshold value method. R-peak detection using MIT-BIH databases and Long Term Real-Time ECG is performed in this research in order to evaluate the performance analysis.

  16. ECG signals denoising using wavelet transform and independent component analysis

    NASA Astrophysics Data System (ADS)

    Liu, Manjin; Hui, Mei; Liu, Ming; Dong, Liquan; Zhao, Zhu; Zhao, Yuejin

    2015-08-01

    A method of two channel exercise electrocardiograms (ECG) signals denoising based on wavelet transform and independent component analysis is proposed in this paper. First of all, two channel exercise ECG signals are acquired. We decompose these two channel ECG signals into eight layers and add up the useful wavelet coefficients separately, getting two channel ECG signals with no baseline drift and other interference components. However, it still contains electrode movement noise, power frequency interference and other interferences. Secondly, we use these two channel ECG signals processed and one channel signal constructed manually to make further process with independent component analysis, getting the separated ECG signal. We can see the residual noises are removed effectively. Finally, comparative experiment is made with two same channel exercise ECG signals processed directly with independent component analysis and the method this paper proposed, which shows the indexes of signal to noise ratio (SNR) increases 21.916 and the root mean square error (MSE) decreases 2.522, proving the method this paper proposed has high reliability.

  17. Real time ECG artifact removal for myoelectric prosthesis control.

    PubMed

    Zhou, Ping; Lock, Blair; Kuiken, Todd A

    2007-04-01

    The electrocardiogram (ECG) artifact is a major noise source contaminating the electromyogram (EMG) of torso muscles. This study investigates removal of ECG artifacts in real time for myoelectric prosthesis control, a clinical application that demands speed and efficiency. Three methods with simple and fast implementation were investigated. Removal of ECG artifacts by digital high-pass filtering was implemented. The effects of the cutoff frequency and filter order of high-pass filtering on the resulting EMG signal were quantified. An alternative adaptive spike-clipping approach was also developed to dynamically detect and suppress the ECG artifacts in the signal. Finally, the two methods were combined. Experimental surface EMG recordings with different ECG/EMG ratios were used as testing signals to evaluate the proposed methods. As a key parameter for clinical myoelectric prosthesis control, the average rectified amplitude of the signal was used as the performance indicator to quantitatively analyze the EMG content distortion and the ECG artifact suppression imposed by the two methods. Aiming at clinical application, the optimal parameter assignment for each method was determined on the basis of the performance using the suite of testing signals with various ECG/EMG ratios. PMID:17395995

  18. A cloud computing based 12-lead ECG telemedicine service

    PubMed Central

    2012-01-01

    Background Due to the great variability of 12-lead ECG instruments and medical specialists’ interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists’ decision making support in emergency telecardiology. Methods We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis. Results This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. Conclusions This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan. PMID:22838382

  19. ECG gating of thallium-201 myocardial images: effect on detection of ischemic heart disease

    SciTech Connect

    McKillop, J.H.; Fawcett, H.D.; Baumert, J.E.; McDougall, I.R.; DeBusk, R.F.; Harrison, D.C.; Goris, M.L.

    1981-03-01

    Using the angiographic findings as the standard, we have examined the sensitivity and specificity of ECG-gated static thallium-201 myocardial images in 54 patients undergoing selective coronary arteriography. Gated and nongated images, each in anterior, 45 LAO, and 65 LAO projections, were processed by interpolative background subtraction. They were then analyzed separately by four independent observers who were unaware of patient identity, the results of coronary arteriography, and which studies were gated or nonongated. No significant differences were observed between the gated and ngated images regarding sensitivity or specificity, the detection rate for reversible myocardial ischmia, the accuracy of prediction of arteriographic extent of disease, or the degree of inter-or intraobserver variability. We conclude that ECG-gated acquisition of Tl-201 images does not produce any significant advantages, at least when interpolative background subtraction is used.

  20. The 24-lead ECG display for enhanced recognition of STEMI-equivalent patterns in the 12-lead ECG.

    PubMed

    Pahlm, Ulrika; Pahlm, Olle; Wagner, Galen S

    2014-01-01

    In a patient with chest pain and suspected acute coronary syndrome, the electrocardiogram (ECG) is the only readily available diagnostic tool. It is important to maximize its usefulness to detect acute myocardial ischemia that may evolve to myocardial infarction unless the patient is treated expediently with reperfusion therapy. Since diagnostic guidelines have usually included only ST-elevation myocardial infarction (STEMI) as the entity that should be diagnosed and treated urgently, a patient with coronary occlusion represented on ECG as ST depression is likely not to be considered a candidate for receiving immediate coronary angiography and coronary intervention. ECG criteria for STEMI detection require that ST elevation meet predetermined millivolt thresholds and appear in at least two spatially contiguous ECG leads. The typical ECG reader recognizes only three contiguous pairs: aVL and I; II and aVF; aVF and III. However, viewing the "orderly sequenced" 12-lead ECG display, two more contiguous pairs become obvious in the frontal plane: +I and -aVR; -aVR and +II. The 24-lead ECG is a display of the standard 12-lead ECG as both the classical positive leads and their negative (inverted) counterparts. Leads +V1, +V2, +V3, +V4, +V5, and +V6 and their inverted counterparts are used to generate a "clock-face display" for the transverse plane. Similarly, +aVL, +I, -aVR, +II, +aVF, +III in the frontal plane and their inverted counterparts are used to generate a clock-face display for the frontal plane. Optimum results, 78% sensitivity and 93% specificity, were obtained using the following 19 ECG leads: frontal plane: +aVR, -III, +aVL, +I, -aVR, +II, +aVF, +III, -aVL; transverse plane: +V1, +V2, +V3, +V4, +V5, +V6, -V1, -V2, -V3.

  1. The 24-lead ECG display for enhanced recognition of STEMI-equivalent patterns in the 12-lead ECG.

    PubMed

    Pahlm, Ulrika; Pahlm, Olle; Wagner, Galen S

    2014-01-01

    In a patient with chest pain and suspected acute coronary syndrome, the electrocardiogram (ECG) is the only readily available diagnostic tool. It is important to maximize its usefulness to detect acute myocardial ischemia that may evolve to myocardial infarction unless the patient is treated expediently with reperfusion therapy. Since diagnostic guidelines have usually included only ST-elevation myocardial infarction (STEMI) as the entity that should be diagnosed and treated urgently, a patient with coronary occlusion represented on ECG as ST depression is likely not to be considered a candidate for receiving immediate coronary angiography and coronary intervention. ECG criteria for STEMI detection require that ST elevation meet predetermined millivolt thresholds and appear in at least two spatially contiguous ECG leads. The typical ECG reader recognizes only three contiguous pairs: aVL and I; II and aVF; aVF and III. However, viewing the "orderly sequenced" 12-lead ECG display, two more contiguous pairs become obvious in the frontal plane: +I and -aVR; -aVR and +II. The 24-lead ECG is a display of the standard 12-lead ECG as both the classical positive leads and their negative (inverted) counterparts. Leads +V1, +V2, +V3, +V4, +V5, and +V6 and their inverted counterparts are used to generate a "clock-face display" for the transverse plane. Similarly, +aVL, +I, -aVR, +II, +aVF, +III in the frontal plane and their inverted counterparts are used to generate a clock-face display for the frontal plane. Optimum results, 78% sensitivity and 93% specificity, were obtained using the following 19 ECG leads: frontal plane: +aVR, -III, +aVL, +I, -aVR, +II, +aVF, +III, -aVL; transverse plane: +V1, +V2, +V3, +V4, +V5, +V6, -V1, -V2, -V3. PMID:24880763

  2. Effects of cuff inflation and deflation on pulse transit time measured from ECG and multi-wavelength PPG.

    PubMed

    Liu, Jing; Li, Yao; Ding, Xiao-Rong; Dai, Wen-Xuan; Zhang, Yuan-Ting

    2015-01-01

    Pulse transit time (PTT), which refers to the time it takes a pulse wave to travel between two arterial sites is a promising index for cuff-less blood pressure (BP) estimation, as well as non-invasive assessment of arterial functions. However, it has not been investigated whether PTTs measured from ECG and different wavelength PPG are equally affected by the arterial status. Furthermore, comparison between the changes of different PTTs can provide enlightenment on the hardware implementation of the PTT-based BP estimation method. This work mainly studied the changes of PTTs calculated from electrocardiogram (ECG) and multi-wavelength photoplethysmogram (PPG) after exerting cuff pressure on the upper arm. A four-channel PPG acquisition system was developed to collect the multi-wavelength PPG signals of red, yellow, green and blue light at the fingertip simultaneously. Ten subjects participated in the experiment and their PTTs measured from different PPG and ECG signals before and after exerting cuff pressure were compared. This study found that within one minute after the four-minute cuff inflation and deflation process, the PTT measured from ECG and yellow PPG experienced a significant increase (p<;0.05) while the PTT from ECG and blue PPG had no statistical difference (p>0.9) compared with that before exerting cuff pressure. This indicates that PTTs calculated from different wavelength PPG have different recoverability from smooth muscle relaxation. Another interesting finding is that the PTT calculated from ECG and yellow PPG had a strong correlation (|r|>0.7) with the time difference between yellow PPG and other PPG signals, which implies the potential of the time difference between yellow PPG and other PPGs as a complementary to PTT-based model for blood pressure estimation. PMID:26737652

  3. A Differential ECG Amplifier with Single-Ended Output

    NASA Technical Reports Server (NTRS)

    Katchis, L.

    1972-01-01

    Three-stage amplifier is used for ECG measurements which require conversion of differential input to single-ended output. Circuit may be useful in biological telemetry for amplification of signals from specimen-implanted sensors.

  4. A Harmonic Linear Dynamical System for Prominent ECG Feature Extraction

    PubMed Central

    Nguyen Thi, Ngoc Anh; Yang, Hyung-Jeong; Kim, SunHee; Do, Luu Ngoc

    2014-01-01

    Unsupervised mining of electrocardiography (ECG) time series is a crucial task in biomedical applications. To have efficiency of the clustering results, the prominent features extracted from preprocessing analysis on multiple ECG time series need to be investigated. In this paper, a Harmonic Linear Dynamical System is applied to discover vital prominent features via mining the evolving hidden dynamics and correlations in ECG time series. The discovery of the comprehensible and interpretable features of the proposed feature extraction methodology effectively represents the accuracy and the reliability of clustering results. Particularly, the empirical evaluation results of the proposed method demonstrate the improved performance of clustering compared to the previous main stream feature extraction approaches for ECG time series clustering tasks. Furthermore, the experimental results on real-world datasets show scalability with linear computation time to the duration of the time series. PMID:24719648

  5. A harmonic linear dynamical system for prominent ECG feature extraction.

    PubMed

    Thi, Ngoc Anh Nguyen; Yang, Hyung-Jeong; Kim, SunHee; Do, Luu Ngoc

    2014-01-01

    Unsupervised mining of electrocardiography (ECG) time series is a crucial task in biomedical applications. To have efficiency of the clustering results, the prominent features extracted from preprocessing analysis on multiple ECG time series need to be investigated. In this paper, a Harmonic Linear Dynamical System is applied to discover vital prominent features via mining the evolving hidden dynamics and correlations in ECG time series. The discovery of the comprehensible and interpretable features of the proposed feature extraction methodology effectively represents the accuracy and the reliability of clustering results. Particularly, the empirical evaluation results of the proposed method demonstrate the improved performance of clustering compared to the previous main stream feature extraction approaches for ECG time series clustering tasks. Furthermore, the experimental results on real-world datasets show scalability with linear computation time to the duration of the time series.

  6. The segmented-beat modulation method for ECG estimation.

    PubMed

    Agostinelli, A; Giuliani, C; Fioretti, S; Di Nardo, F; Burattini, L

    2015-08-01

    Electrocardiographic (ECG) tracings corrupted by noise with frequency components in the ECG frequency band, may result useless unless appropriately processed. The estimation of the clean ECG from such recordings, however, is quite challenging; being linear filtering inappropriate. In the common situations in which the R peaks are detectable, template-based techniques have been proposed to estimate the ECG by a template-beat concatenation. However, such techniques have the major limit of not being able to reproduce physiological heart-rate and morphological variability. Thus, the aim of the present study was to propose the segmented-beat modulation method (SBMM) as the technique that overcomes such limit. The SBMM is an improved template-based technique that provides good-quality estimations of ECG tracings characterized by some heart-rate and morphological variability. It segments the template ECG beat into QRS and TUP segments and then, before concatenation, it applies a modulation/demodulation process to the TUP-segment so that the estimated-beat duration and morphology adjust to those of the corresponding original-beat. To test its performance, the SBMM was applied to 19 ECG tracings from normal subjects. There were no errors in estimating the R peak location, and the errors in the QRS and TUP segments were low (≤65 μV and ≤30 μV, respectively), with the former ones being significantly higher than the latter ones. Eventually, TUP errors tended to increase with increasing heart-rate variability (correlation coefficient: 0.59, P<;10(-2)). In conclusion, the new SBMM proved to be a useful tool for providing good-quality ECG estimations of tracings characterized by heart-rate and morphological variability.

  7. Human ECG signal parameters estimation during controlled physical activity

    NASA Astrophysics Data System (ADS)

    Maciejewski, Marcin; Surtel, Wojciech; Dzida, Grzegorz

    2015-09-01

    ECG signal parameters are commonly used indicators of human health condition. In most cases the patient should remain stationary during the examination to decrease the influence of muscle artifacts. During physical activity, the noise level increases significantly. The ECG signals were acquired during controlled physical activity on a stationary bicycle and during rest. Afterwards, the signals were processed using a method based on Pan-Tompkins algorithms to estimate their parameters and to test the method.

  8. A method for the determination of ECG gate signal delays

    SciTech Connect

    Wery, R.; Hill, J.; Dworkin, H.J.

    1981-06-01

    A simple device using a rotating radioactive source was developed to monitor the presence of a delay between the patient's R wave and the gate signal being sent to the computer. Three commercial ECG gates were tested and significant delays were found in two of them. Identical patient data evaluated using ECG gates with and without significant delays produced calculated left-ventricular ejection fractions of 0.05 and 0.64, respectively.

  9. Microprocessor-based simulator of surface ECG signals

    NASA Astrophysics Data System (ADS)

    Martínez, A. E.; Rossi, E.; Siri, L. Nicola

    2007-11-01

    In this work, a simulator of surface electrocardiogram recorded signals (ECG) is presented. The device, based on a microcontroller and commanded by a personal computer, produces an analog signal resembling actual ECGs, not only in time course and voltage levels, but also in source impedance. The simulator is a useful tool for electrocardiograph calibration and monitoring, to incorporate as well in educational tasks and in clinical environments for early detection of faulty behaviour.

  10. Variability in surface ECG morphology: signal or noise?

    NASA Technical Reports Server (NTRS)

    Smith, J. M.; Rosenbaum, D. S.; Cohen, R. J.

    1988-01-01

    Using data collected from canine models of acute myocardial ischemia, we investigated two issues of major relevance to electrocardiographic signal averaging: ECG epoch alignment, and the spectral characteristics of the beat-to-beat variability in ECG morphology. With initial digitization rates of 1 kHz, an iterative a posteriori matched filtering alignment scheme, and linear interpolation, we demonstrated that there is sufficient information in the body surface ECG to merit alignment to a precision of 0.1 msecs. Applying this technique to align QRS complexes and atrial pacing artifacts independently, we demonstrated that the conduction delay from atrial stimulus to ventricular activation may be so variable as to preclude using atrial pacing as an alignment mechanism, and that this variability in conduction time be modulated at the frequency of respiration and at a much lower frequency (0.02-0.03Hz). Using a multidimensional spectral technique, we investigated the beat-to-beat variability in ECG morphology, demonstrating that the frequency spectrum of ECG morphological variation reveals a readily discernable modulation at the frequency of respiration. In addition, this technique detects a subtle beat-to-beat alternation in surface ECG morphology which accompanies transient coronary artery occlusion. We conclude that physiologically important information may be stored in the variability in the surface electrocardiogram, and that this information is lost by conventional averaging techniques.

  11. Rationale and objectives for ECG screening in infancy.

    PubMed

    Saul, J Philip; Schwartz, Peter J; Ackerman, Michael J; Triedman, John K

    2014-12-01

    Electrocardiographic (ECG) screening in infants and children who may be at risk of sudden cardiac death (SCD) is controversial, and both rational and emotional arguments have often been given equal weight. We all have direct experience in this field, but have different backgrounds and have expressed divergent views on this topic. We attempted to build consensus among ourselves on the basis of the available facts, in the hope of providing an unbiased review of the relevant science and policy issues in favor of or against ECG screening in infants and children. This report presents our shared view on this medically and societally important topic. Long QT syndrome (LQTS) satisfies several criteria that may make ECG screening worthwhile: it is not rare (~1 in 2000 births); ECG diagnosis is feasible and can be used to trigger appropriate genetic testing; it causes approximately 10% of cases of sudden infant death syndrome (SIDS) as well as deaths in childhood and later in life, and effective treatments are available. By stimulating cascade screening in family members, diagnosis of affected infants may also prompt identification of asymptomatic but affected individuals. Neonatal screening is cost-effective by conventional criteria, and with a corrected QT (QTc) cutoff of 460 ms in 2 different ECGs, the number of false positives is estimated to be low (~1 in 1000 births). It is our conclusion that parents of newborn children should be informed about LQTS, a life-threatening but treatable disease of significant prevalence that may be diagnosed by a simple ECG. PMID:25239430

  12. Tooth - abnormal shape

    MedlinePlus

    Hutchinson incisors; Abnormal tooth shape; Peg teeth; Mulberry teeth; Conical teeth ... The appearance of normal teeth varies, especially the molars. ... conditions. Specific diseases can affect tooth shape, tooth ...

  13. ECG manifestations of left ventricular electrical remodeling.

    PubMed

    Estes, E Harvey

    2012-01-01

    Research and thinking about the electrocardiographic manifestations of left ventricular hypertrophy has been constrained by a limited conceptual model of the process: heart disease produces chamber enlargement (increased mass), which in turn produces an altered electrocardiogram. The process is much more complex than can be represented in this simple model. A more robust and intricate model is proposed, in which heart (and vascular) disease causes structural changes, electrical changes, biochemical changes, and others, all of which interact to produce electrical remodeling of ventricular myocardium. This electrical remodeling results in a variety of ECG changes. All of these changes interact, leading to an altered clinical course, and to premature death. It is suggested that research, based on this model, can provide new clues to the processes involved, and improve the prediction of clinical outcomes. New directions in research, in recording equipment, and in organizational activities are suggested to test this new model, and to improve the usefulness of the electrocardiogram as a research and diagnostic tool.

  14. A micropower dry-electrode ECG preamplifier.

    PubMed

    Burke, M J; Gleeson, D T

    2000-02-01

    This paper describes the development of a very low-power preamplifier intended for use in pasteless-electrode recording of the human electrocardiogram. The expected input signal range is 100 microV-10 mV from a lead-II electrode configuration. The amplifier provides a gain of 43 dB in a 3-dB bandwidth of 0.05 Hz-2 kHz with a defined high input impedance of 75 M omega. It uses a driven common electrode to enhance rejection of common-mode interfering signals, including low-frequency motion artifact, achieving a common-mode rejection ratio (CMRR) of better than 80 dB over its entire bandwidth. The gain and phase characteristics meet the recommendations of the American Heart Association, ensuring low distortion of the output ECG signal and making it suitable for clinical monitoring. The amplifier has a power consumption of 30 microW operating from a 3.3-V battery and is intended for use in small, lightweight, portable electrocardiographic equipment and heart-rate monitoring instrumentation.

  15. Standard-compliant real-time transmission of ECGs: harmonization of ISO/IEEE 11073-PHD and SCP-ECG.

    PubMed

    Trigo, Jesús D; Chiarugi, Franco; Alesanco, Alvaro; Martínez-Espronceda, Miguel; Chronaki, Catherine E; Escayola, Javier; Martínez, Ignacio; García, José

    2009-01-01

    Ambient assisted living and integrated care in an aging society is based on the vision of the lifelong Electronic Health Record calling for HealthCare Information Systems and medical device interoperability. For medical devices this aim can be achieved by the consistent implementation of harmonized international interoperability standards. The ISO/IEEE 11073 (x73) family of standards is a reference standard for medical device interoperability. In its Personal Health Device (PHD) version several devices have been included, but an ECG device specialization is not yet available. On the other hand, the SCP-ECG standard for short-term diagnostic ECGs (EN1064) has been recently approved as an international standard ISO/IEEE 11073-91064:2009. In this paper, the relationships between a proposed x73-PHD model for an ECG device and the fields of the SCP-ECG standard are investigated. A proof-of-concept implementation of the proposed x73-PHD ECG model is also presented, identifying open issues to be addressed by standards development for the wider interoperability adoption of x73-PHD standards.

  16. [Cardiological findings in acromegaly].

    PubMed

    Ferramosca, B; Bianchi, D; Serra, D; Savini, R; Villecco, A S; Bugiardini, R

    1987-12-31

    Acromegaly involves cardiovascular complications mostly due to the presence of hypertension, diabetes and atherosclerosis. However the appearance of cardiac decompensation and arrhythmias in the absence of predisposing factors tends to support the hypothesis of a specific myocardiopathy caused by excess GH. In order to assess the existence and course of subclinical cardiac alterations, 8 acromegaly patients were examined: 4 males and 4 females aged 31-56 with GH levels of 24-70 ng/ml (M + CD X 47 +/- 16) and no cardiovascular symptoms. One of the patients had moderate hypertension and 2 reduced glucose tolerance. The basal ECG showed sporadic ventricular extrasystoles in 2 cases and alterations compatible with left ventricular hypertrophy in another, while the effort ECG produced an asymptomatic depression of the ST segment in the hypertensive patient. The chest X-ray was normal in all cases. The echocardiography study investigated: the thickness of the interventricular septum (IVS = 13.9 +/- 2.8 mm), the thickness of the posterior wall of the left ventricle (LPW = 10.6 +/- 2.9 mm), the septum/posterior wall ratio (IVS/LPW = 1.3 +/- 0.2 the diastolic diameter (DD = 15.4 +/- 11.4 mm), the fraction of shortening (FS = 39.1 +/- 14.5%), the ejection fraction (EF = 64.1 +/- 18.4%) and revealed asymmetrical septal hypertrophy in 3 cases, concentric hypertrophy in another two. In two cases the DD and EF were distinctly altered. The patients were re-examined 2-4 years after surgical or radiation treatment. GH levels (M +/- SD = 10.3 +/- 10.1 ng/ml) were normal in 4 cases and still high, though lower in another two. The remaining two patients had borderline GH levels with high Sm-C. The ECG and chest X-ray were unchanged while echocardiography revealed a significant deterioration in heart function as far as DD (56.4 +/- 10.8 mm, p less than 0.05) were concerned with frankly pathological results in 4 and 3 cases respectively. These data confirm the view that most acromegalic

  17. Structurally abnormal human autosomes

    SciTech Connect

    1993-12-31

    Chapter 25, discusses structurally abnormal human autosomes. This discussion includes: structurally abnormal chromosomes, chromosomal polymorphisms, pericentric inversions, paracentric inversions, deletions or partial monosomies, cri du chat (cat cry) syndrome, ring chromosomes, insertions, duplication or pure partial trisomy and mosaicism. 71 refs., 8 figs.

  18. Morphological abnormalities among lampreys

    USGS Publications Warehouse

    Manion, Patrick J.

    1967-01-01

    The experimental control of the sea lamprey (Petromyzon marinus) in the Great Lakes has required the collection of thousands of lampreys. Representatives of each life stage of the four species of the Lake Superior basin were examined for structural abnormalities. The most common aberration was the presence of additional tails. The accessory tails were always postanal and smaller than the normal tail. The point of origin varied; the extra tails occurred on dorsal, ventral, or lateral surfaces. Some of the extra tails were misshaped and curled, but others were normal in shape and pigment pattern. Other abnormalities in larval sea lampreys were malformed or twisted tails and bodies. The cause of the structural abnormalities is unknown. The presence of extra caudal fins could be genetically controlled, or be due to partial amputation or injury followed by abnormal regeneration. Few if any lampreys with structural abnormalities live to sexual maturity.

  19. Prognostic Role of Ventricular Ectopic Beats in Systemic Sclerosis: A Prospective Cohort Study Shows ECG Indexes Predicting the Worse Outcome

    PubMed Central

    Gabrielli, Francesca Augusta; Berardi, Giorgia; Parisi, Federico; Rucco, Manuela; Canestrari, Giovanni; Loperfido, Francesco; Galiuto, Leonarda; Crea, Filippo; Ferraccioli, Gianfranco

    2016-01-01

    Background Arrhythmias are frequent in Systemic Sclerosis (SSc) and portend a bad prognosis, accounting alone for 6% of total deaths. Many of these patients die suddenly, thus prevention and intensified risk-stratification represent unmet medical needs. The major goal of this study was the definition of ECG indexes of poor prognosis. Methods We performed a prospective cohort study to define the role of 24h-ECG-Holter as an additional risk-stratification technique in the identification of SSc-patients at high risk of life-threatening arrhythmias and sudden cardiac death (SCD). One-hundred SSc-patients with symptoms and/or signs suggestive of cardiac involvement underwent 24h-ECG-Holter. The primary end-point was a composite of SCD or need for implantable cardioverter defibrillator (ICD). Results Fifty-six patients (56%) had 24h-ECG-Holter abnormalities and 24(24%) presented frequent ventricular ectopic beats (VEBs). The number of VEBs correlated with high-sensitive cardiac troponin T (hs-cTnT) levels and inversely correlated with left-ventricular ejection fraction (LV-EF) on echocardiography. During a mean follow-up of 23.1±16.0 months, 5 patients died suddenly and two required ICD-implantation. The 7 patients who met the composite end-point had a higher number of VEBs, higher levels of hs-cTnT and NT-proBNP and lower LV-EF (p = 0.001 for all correlations). All these 7 patients had frequent VEBs, while LV-EF was not reduced in all and its range was wide. At ROC curve, VEBs>1190/24h showed 100% of sensitivity and 83% of specificity to predict the primary end-point (AUROC = 0.92,p<0.0001). Patients with VEBS>1190/24h had lower LV-EF and higher hs-cTnT levels and, at multivariate analysis, the presence of increased hs-cTnT and of right bundle branch block on ECG emerged as independent predictors of VEBs>1190/24h. None of demographic or disease-related characteristics emerged as predictors of poor outcome. Conclusions VEBS>1190/24h identify patients at high risk of

  20. Electrocardiographic method for identifying drug-induced repolarization abnormalities associated with a reduction of the rapidly activating delayed rectifier potassium current.

    PubMed

    Couderc, J P; Vaglio, M; Xia, X; McNitt, S; Hyrien, O

    2006-01-01

    Several important non-cardiac drugs have been removed from the market after revealing harmful effect that was not identified during prior safety-assessment studies. We developed a new technique for the measurements of repolarization abnormalities from surface ECGs; this method improves sensitivity and specificity of the current technique used to identify the presence of abnormal ion current kinetics in the myocardial cells namely a prolongation of the QT interval on the surface ECG signal. We described in this paper the method and preliminary results, revealing the superiority of our technique that may play a role in the future of drug-safety assessment.

  1. Detecting motion artifact ECG noise during sleeping by means of a tri-axis accelerometer.

    PubMed

    Kishimoto, Yoshifumi; Kutsuna, Yasunari; Oguri, Koji

    2007-01-01

    The electrocardiogram (ECG) monitoring has become a helpful tool for detecting a number of heart diseases. High quality ECG is utilized by the physicians for interpretation and identification of physiological and pathological phenomena. ECG recordings, however, are often corrupted by motion artifacts even when patient is sleeping due to his or her positional change. In this paper, we proposed a new method of detecting motion artifact ECG noise during sleeping based on acceleration data. The experimental recordings of ECG and acceleration signal were collected from 8 subjects. The result in this study demonstrated that the proposed approach is effective for detecting corruption of ECG signal.

  2. Evaluation of repolarization dynamics using the QT-RR regression line slope and intercept relationship during 24-h Holter ECG.

    PubMed

    Fujiki, Akira; Yoshioka, Ryozo; Sakabe, Masao

    2015-03-01

    QT-RR linear regression consists of two parameters, slope and intercept, and the aim of this study was to evaluate repolarization dynamics using the QT-RR linear regression slope and intercept relationship during 24-h Holter ECG. This study included 466 healthy subjects (54.6 ± 14.6 years; 200 men and 266 women) and 17 patients with ventricular arrhythmias, consisted of 10 patients with idiopathic ventricular fibrillation (IVF) and 7 patients with torsades de pointes (TDP). QT and RR intervals were measured from ECG waves based on a 15-s averaged ECG during 24-h Holter recording using an automatic QT analyzing system. The QT interval dependence on the RR interval was analyzed using a linear regression line for each subject ([QT] = A[RR] + B; where A is the slope and B is the y-intercept). The slope of the QT-RR regression line in healthy subjects was significantly greater in women than in men (0.185 ± 0.036 vs. 0.161 ± 0.033, p < 0.001) and the intercept was significantly smaller in women than in men (0.229 ± 0.028 vs. 0.240 ± 0.027, p < 0.001). A scatter diagram of the QT-RR regression line slope and intercept among healthy subjects demonstrated a statistically significant negative correlation (B = -0.62A + 0.34, r = -0.79). Distribution of both scatter diagrams of the slope and the intercept of the QT-RR regression line in patients with IVF and TDP was different from healthy subjects (left corner for IVF and upward shift for TDP). The slope and intercept relationship of the QT-RR linear regression line based on 24-h Holter ECG may become a simple useful marker for abnormality of ventricular repolarization dynamics.

  3. A controlled study of a new ECG electrode system.

    PubMed

    Sheffield, L T; Roitman, D I; Kansal, S

    1978-07-01

    A newly marketed resting ECG electrode system was compared with conventional metal suction and plate electrodes, electrode cream and patient cable. Two experienced technicians were given special training in the use of the new electrode, electrolyte and patient cable system and alternated daily in using new and conventional equipment. Nearly equal numbers of perfect-scoring ECGs were recorded with each system, attesting to the impartiality of the technicians. A total of 1,062 ECGs were evaluated, 554 with the new system and 508 with the conventional one. ECG tracings were evaluated by electrocardiographers unaware of which system was used for each. A quantitative scoring system was used to measure the technical quality of each tracing in terms of baseline drift, powerline artifact and myographic plus miscellaneous artifacts. The new system received mean scores of 2.33, 3.08, and 2.72, respectively, while the conventional electrodes received scores of 2.56, 3.03 and 2.79. We concluded that the two types of electrodes produced ECGs of essentially equal quality.

  4. Exploiting prior knowledge in compressed sensing wireless ECG systems.

    PubMed

    Polanía, Luisa F; Carrillo, Rafael E; Blanco-Velasco, Manuel; Barner, Kenneth E

    2015-03-01

    Recent results in telecardiology show that compressed sensing (CS) is a promising tool to lower energy consumption in wireless body area networks for electrocardiogram (ECG) monitoring. However, the performance of current CS-based algorithms, in terms of compression rate and reconstruction quality of the ECG, still falls short of the performance attained by state-of-the-art wavelet-based algorithms. In this paper, we propose to exploit the structure of the wavelet representation of the ECG signal to boost the performance of CS-based methods for compression and reconstruction of ECG signals. More precisely, we incorporate prior information about the wavelet dependencies across scales into the reconstruction algorithms and exploit the high fraction of common support of the wavelet coefficients of consecutive ECG segments. Experimental results utilizing the MIT-BIH Arrhythmia Database show that significant performance gains, in terms of compression rate and reconstruction quality, can be obtained by the proposed algorithms compared to current CS-based methods. PMID:24846672

  5. A system for intelligent home care ECG upload and priorisation.

    PubMed

    D'Angelo, Lorenzo T; Tarita, Eugeniu; Zywietz, Tosja K; Lueth, Tim C

    2010-01-01

    In this contribution, a system for internet based, automated home care ECG upload and priorisation is presented for the first time. It unifies the advantages of existing telemonitoring ECG systems adding functionalities such as automated priorisation and usability for home care. Chronic cardiac diseases are a big group in the geriatric field. Most of them can be easily diagnosed with help of an electrocardiogram. A frequent or long-term ECG analysis allows early diagnosis of e.g. a cardiac infarction. Nevertheless, patients often aren't willing to visit a doctor for prophylactic purposes. Possible solutions of this problem are home care devices, which are used to investigate patients at home without the presence of a doctor on site. As the diffusion of such systems leads to a huge amount of data which has to be managed and evaluated, the presented approach focuses on an easy to use software for ECG upload from home, a web based management application and an algorithm for ECG preanalysis and priorisation.

  6. SLOPE--a real-time ECG data compressor.

    PubMed

    Tai, S C

    1991-03-01

    An ECG sampled at a rate of 250 samples s-1 or more produces a large amount of redundant data that are difficult to store and transmit. In the paper, a real-time ECG data compressor, SLOPE, is presented. SLOPE considers some adjacent samples as a vector, and this vector is extended if the coming sample falls in a fan spanned by this vector and a threshold angle; otherwise, it is delimited as a linear segment. By this means SLOPE repeatedly delimits linear segments of different lengths and different slopes. The Huffman codes for the parameters to describe this linear segment are transmitted for that linear segment. SLOPEa, which is a slightly modified version of SLOPE, is used to compress ambulatory ECG data. All the operations used by SLOPE and SLOPEa are simple integer operations, both SLOPE and SLOPEa being real-time compressors. Experimental results show that an average of 192 bits per channel per second (bpcs) for each ECG signal is obtained by SLOPE and an average of 148 bpcs for each ECG signal is obtained by SLOPEa.

  7. Abnormal uterine bleeding.

    PubMed

    Jennings, J C

    1995-11-01

    Physicians who care for female patients cannot avoid the frequent complaint of abnormal uterine bleeding. Knowledge of the disorders that cause this problem can prevent serious consequences in many patients and improve the quality of life for many others. The availability of noninvasive and minimally invasive diagnostic studies and minimally invasive surgical treatment has revolutionized management of abnormal uterine bleeding. Similar to any other disorder, the extent to which a physician manages abnormal uterine bleeding depends on his or her own level of comfort. When limitations of either diagnostic or therapeutic capability are encountered, consultation and referral should be used to the best interest of patients.

  8. [Chromosome abnormalities in human cancer].

    PubMed

    Salamanca-Gómez, F

    1995-01-01

    Recent investigation on the presence of chromosome abnormalities in neoplasias has allowed outstanding advances in the knowledge of malignant transformation mechanisms and important applications in the clinical diagnosis and prognosis of leukaemias, lymphomas and solid tumors. The purpose of the present paper is to discuss the most relevant cytogenetic aberrations, some of them described at the Unidad de Investigación Médica en Genética Humana, Instituto Mexicano del Seguro Social, and to correlate these abnormalities with recent achievements in the knowledge of oncogenes, suppressor genes or antioncogenes, their chromosome localization, and their mutations in human neoplasia; as well as their perspectives in prevention and treatment of cancer that such findings permit to anticipate.

  9. Abnormal Uterine Bleeding

    MedlinePlus

    ... Abnormal uterine bleeding is any bleeding from the uterus (through your vagina) other than your normal monthly ... or fibroids (small and large growths) in the uterus can also cause bleeding. Rarely, a thyroid problem, ...

  10. Abnormal Uterine Bleeding FAQ

    MedlinePlus

    ... as cancer of the uterus, cervix, or vagina • Polycystic ovary syndrome How is abnormal bleeding diagnosed? Your health care ... before the fetus can survive outside the uterus. Polycystic Ovary Syndrome: A condition characterized by two of the following ...

  11. Design intelligent wheelchair with ECG measurement and wireless transmission function.

    PubMed

    Chou, Hsi-Chiang; Wang, Yi-Ming; Chang, Huai-Yuan

    2015-01-01

    The phenomenon of aging populations has produced widespread health awareness and magnified the need for improved medical quality and technologies. Statistics show that ischemic heart disease is the leading cause of death for older people and people with reduced mobility; therefore, wheelchairs have become their primary means of transport. Hence, an arrhythmia-detecting smart wheelchair was proposed in this study to provide real-time electrocardiography (ECG)-monitoring to patients with heart disease and reduced mobility. A self-developed, handheld ECG-sensing instrument was integrated with a wheelchair and a lab-written, arrhythmia-detecting program. The measured ECG data were transmitted through a Wi-Fi module and analyzed and diagnosed using the human-machine interface.

  12. Chaos control applied to cardiac rhythms represented by ECG signals

    NASA Astrophysics Data System (ADS)

    Borem Ferreira, Bianca; Amorim Savi, Marcelo; Souza de Paula, Aline

    2014-10-01

    The control of irregular or chaotic heartbeats is a key issue in cardiology. In this regard, chaos control techniques represent a good alternative since they suggest treatments different from those traditionally used. This paper deals with the application of the extended time-delayed feedback control method to stabilize pathological chaotic heart rhythms. Electrocardiogram (ECG) signals are employed to represent the cardiovascular behavior. A mathematical model is employed to generate ECG signals using three modified Van der Pol oscillators connected with time delay couplings. This model provides results that qualitatively capture the general behavior of the heart. Controlled ECG signals show the ability of the strategy either to control or to suppress the chaotic heart dynamics generating less-critical behaviors.

  13. Nonstationary harmonic modeling for ECG removal in surface EMG signals.

    PubMed

    Zivanovic, Miroslav; González-Izal, Miriam

    2012-06-01

    We present a compact approach for mitigating the presence of electrocardiograms (ECG) in surface electromyographic (EMG) signals by means of time-variant harmonic modeling of the cardiac artifact. Heart rate and QRS complex variability, which often account for amplitude and frequency time variations of the ECG, are simultaneously captured by a set of third-order constant-coefficient polynomials modulating a stationary harmonic basis in the analysis window. Such a characterization allows us to significantly suppress ECG from the mixture by preserving most of the EMG signal content at low frequencies (less than 20 Hz). Moreover, the resulting model is linear in parameters and the least-squares solution to the corresponding linear system of equations efficiently provides model parameter estimates. The comparative results suggest that the proposed method outperforms two reference methods in terms of the EMG preservation at low frequencies. PMID:22453600

  14. [An improved wavelet threshold algorithm for ECG denoising].

    PubMed

    Liu, Xiuling; Qiao, Lei; Yang, Jianli; Dong, Bin; Wang, Hongrui

    2014-06-01

    Due to the characteristics and environmental factors, electrocardiogram (ECG) signals are usually interfered by noises in the course of signal acquisition, so it is crucial for ECG intelligent analysis to eliminate noises in ECG signals. On the basis of wavelet transform, threshold parameters were improved and a more appropriate threshold expression was proposed. The discrete wavelet coefficients were processed using the improved threshold parameters, the accurate wavelet coefficients without noises were gained through inverse discrete wavelet transform, and then more original signal coefficients could be preserved. MIT-BIH arrythmia database was used to validate the method. Simulation results showed that the improved method could achieve better denoising effect than the traditional ones. PMID:25219225

  15. ECG compression: evaluation of FFT, DCT, and WT performance.

    PubMed

    GholamHosseini, H; Nazeran, H; Moran, B

    1998-12-01

    This work investigates a set of ECG data compression schemes to compare their performances in compressing and preparing ECG signals for automatic cardiac arrhythmia classification. These schemes are based on transform methods such as fast Fourier transform (FFT), discrete cosine transform (DCT), wavelet transform (WT), and their combinations. Each specific transform is applied to a pre-selected data segment from the MIT-BIH database and then compression is performed in the new domain. These transformation methods are known as an important class of ECG compression techniques. The WT has been shown as the most efficient method for further improvement. A compression ratio of 7.98 to 1 has been achieved with a percent of root mean square difference (PRD) of 0.25%, indicating that the wavelet compression technique offers the best performance over the other evaluated methods.

  16. Design intelligent wheelchair with ECG measurement and wireless transmission function.

    PubMed

    Chou, Hsi-Chiang; Wang, Yi-Ming; Chang, Huai-Yuan

    2015-01-01

    The phenomenon of aging populations has produced widespread health awareness and magnified the need for improved medical quality and technologies. Statistics show that ischemic heart disease is the leading cause of death for older people and people with reduced mobility; therefore, wheelchairs have become their primary means of transport. Hence, an arrhythmia-detecting smart wheelchair was proposed in this study to provide real-time electrocardiography (ECG)-monitoring to patients with heart disease and reduced mobility. A self-developed, handheld ECG-sensing instrument was integrated with a wheelchair and a lab-written, arrhythmia-detecting program. The measured ECG data were transmitted through a Wi-Fi module and analyzed and diagnosed using the human-machine interface. PMID:26444818

  17. ECG-synchronized DSA exposure control: improved cervicothoracic image quality

    SciTech Connect

    Kelly, W.M.; Gould, R.; Norman, D.; Brant-Zawadzki, M.; Cox, L.

    1984-10-01

    An electrocardiogram (ECG)-synchronized x-ray exposure sequence was used to acquire digital subtraction angiographic (DSA) images during 13 arterial injection studies of the aortic arch or carotid bifurcations. These gated images were compared with matched ungated DSA images acquired using the same technical factors, contrast material volume, and patient positioning. Subjective assessments by five experienced observers of edge definition, vessel conspicuousness, and overall diagnostic quality showed overall preference for one of the two acquisition methods in 69% of cases studied. Of these, the ECG-synchronized exposure series were rated superior in 76%. These results, as well as the relatively simple and inexpensive modifications required, suggest that routine use of ECG exposure control can facilitate improved arterial DSA evaluations of suspected cervicothoracic vascular disease.

  18. On ECG reconstruction using weighted-compressive sensing.

    PubMed

    Zonoobi, Dornoosh; Kassim, Ashraf A

    2014-06-01

    The potential of the new weighted-compressive sensing approach for efficient reconstruction of electrocardiograph (ECG) signals is investigated. This is motivated by the observation that ECG signals are hugely sparse in the frequency domain and the sparsity changes slowly over time. The underlying idea of this approach is to extract an estimated probability model for the signal of interest, and then use this model to guide the reconstruction process. The authors show that the weighted-compressive sensing approach is able to achieve reconstruction performance comparable with the current state-of-the-art discrete wavelet transform-based method, but with substantially less computational cost to enable it to be considered for use in the next generation of miniaturised wearable ECG monitoring devices.

  19. On ECG reconstruction using weighted-compressive sensing

    PubMed Central

    Kassim, Ashraf A.

    2014-01-01

    The potential of the new weighted-compressive sensing approach for efficient reconstruction of electrocardiograph (ECG) signals is investigated. This is motivated by the observation that ECG signals are hugely sparse in the frequency domain and the sparsity changes slowly over time. The underlying idea of this approach is to extract an estimated probability model for the signal of interest, and then use this model to guide the reconstruction process. The authors show that the weighted-compressive sensing approach is able to achieve reconstruction performance comparable with the current state-of-the-art discrete wavelet transform-based method, but with substantially less computational cost to enable it to be considered for use in the next generation of miniaturised wearable ECG monitoring devices. PMID:26609381

  20. In vivo studies of Scn5a+/− mice modeling Brugada syndrome demonstrate both conduction and repolarization abnormalities

    PubMed Central

    Martin, Claire A.; Zhang, Yanmin; Grace, Andrew A.; Huang, Christopher L.-H.

    2010-01-01

    Objectives We investigate the extent to which the electrocardiographic (ECG) properties of intact Scn5a+/− mice reproduce the corresponding clinical Brugada syndrome phenotype and use this model to investigate the role of conduction and repolarization abnormalities in the arrhythmogenic mechanism. Methods and Results The ECGs were obtained from anesthetized wild-type and Scn5a+/− mice, before and after administration of the known pro- and antiarrhythmic agents flecainide and quinidine. The ECG intervals were measured and their dispersions calculated. Scn5a+/− hearts showed ventricular arrhythmias, ST elevation, and conduction disorders including increased QT dispersion, accentuated by flecainide. Quinidine did not cause ventricular arrhythmias but exerted variable effects on ST segments and worsened conduction abnormalities. Conclusions The ECG features in an Scn5a+/− mouse establish it as a suitable model for Brugada syndrome and demonstrate abnormal conduction and repolarization phenomena. Altered QT dispersion, taken to indicate increased transmural repolarization gradients, may be useful in clinical risk stratification. PMID:20638671

  1. Nail abnormalities in patients with vitiligo*

    PubMed Central

    Topal, Ilteris Oguz; Gungor, Sule; Kocaturk, Ozgur Emek; Duman, Hatice; Durmuscan, Mustafa

    2016-01-01

    Background Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. Methods This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Results Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). Conclusions Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study. PMID:27579738

  2. Adaptive filtering for ECG rejection from surface EMG recordings.

    PubMed

    Marque, C; Bisch, C; Dantas, R; Elayoubi, S; Brosse, V; Pérot, C

    2005-06-01

    Surface electromyograms (EMG) of back muscles are often corrupted by electrocardiogram (ECG) signals. This noise in the EMG signals does not allow to appreciate correctly the spectral content of the EMG signals and to follow its evolution during, for example, a fatigue process. Several methods have been proposed to reject the ECG noise from EMG recordings, but seldom taking into account the eventual changes in ECG characteristics during the experiment. In this paper we propose an adaptive filtering algorithm specifically developed for the rejection of the electrocardiogram corrupting surface electromyograms (SEMG). The first step of the study was to choose the ECG electrode position in order to record the ECG with a shape similar to that found in the noised SEMGs. Then, the efficiency of different algorithms were tested on 28 erector spinae SEMG recordings. The best algorithm belongs to the fast recursive least square family (FRLS). More precisely, the best results were obtained with the simplified formulation of a FRLS algorithm. As an application of the adaptive filtering, the paper compares the evolutions of spectral parameters of noised or denoised (after adaptive filtering) surface EMGs recorded on erector spinae muscles during a trunk extension. The fatigue test was analyzed on 16 EMG recordings. After adaptive filtering, mean initial values of energy and of mean power frequency (MPF) were significantly lower and higher respectively. The differences corresponded to the removal of the ECG components. Furthermore, classical fatigue criteria (increase in energy and decrease in MPF values over time during the fatigue test) were better observed on the denoised EMGs. The mean values of the slopes of the energy-time and MPF-time linear relationships differed significantly when established before and after adaptive filtering. These results account for the efficacy of the adaptive filtering method proposed here to denoise electrophysiological signals.

  3. A computationally efficient QRS detection algorithm for wearable ECG sensors.

    PubMed

    Wang, Y; Deepu, C J; Lian, Y

    2011-01-01

    In this paper we present a novel Dual-Slope QRS detection algorithm with low computational complexity, suitable for wearable ECG devices. The Dual-Slope algorithm calculates the slopes on both sides of a peak in the ECG signal; And based on these slopes, three criterions are developed for simultaneously checking 1)Steepness 2)Shape and 3)Height of the signal, to locate the QRS complex. The algorithm, evaluated against MIT/BIH Arrhythmia Database, achieves a very high detection rate of 99.45%, a sensitivity of 99.82% and a positive prediction of 99.63%. PMID:22255619

  4. Amplifier input impedance in dry electrode ECG recording.

    PubMed

    Assambo, Cedric; Burke, Martin J

    2009-01-01

    This paper presents a novel approach for designing the front-end of instrumentation amplifiers for use in dry electrode recording of the human electrocardiogram (ECG). The method relies on information provided by the characterization of the skin-electrode interface and the analysis of low frequency ECG criteria defined by international standards. Marginal measurements of capacitive elements of the skin-electrode interface as small as 0.01 microF, suggest values of input impedance in the order of 1.3 GOmega. However, results in 99% of the data analyzed indicate that a recording amplifier providing an input impedance of 500 MOmega should ensure clear signal sensing without distortion.

  5. P wave detection in ECG signals using an extended Kalman filter: an evaluation in different arrhythmia contexts.

    PubMed

    Rahimpour, M; Mohammadzadeh Asl, B

    2016-07-01

    Monitoring atrial activity via P waves, is an important feature of the arrhythmia detection procedure. The aim of this paper is to present an algorithm for P wave detection in normal and some abnormal records by improving existing methods in the field of signal processing. In contrast to the classical approaches, which are completely blind to signal dynamics, our proposed method uses the extended Kalman filter, EKF25, to estimate the state variables of the equations modeling the dynamic of an ECG signal. This method is a modified version of the nonlinear dynamical model previously introduced for a generation of synthetic ECG signals and fiducial point extraction in normal ones. It is capable of estimating the separate types of activity of the heart with reasonable accuracy and performs well in the presence of morphological variations in the waveforms and ectopic beats. The MIT-BIH Arrhythmia and QT databases have been used to evaluate the performance of the proposed method. The results show that this method has Se  =  98.38% and Pr  =  96.74% in the overall records (considering normal and abnormal rhythms). PMID:27321699

  6. ECG-gated blood pool tomography in the determination of left ventricular volume, ejection fraction, and wall motion

    SciTech Connect

    Underwood, S.R.; Ell, P.J.; Jarritt, P.H.; Emanuel, R.W.; Swanton, R.H.

    1984-01-01

    ECG-gated blood pool tomography promises to provide a ''gold standard'' for noninvasive measurement of left ventricular volume, ejection fraction, and wall motion. This study compares these measurements with those from planar radionuclide imaging and contrast ventriculography. End diastolic and end systolic blood pool images were acquired tomographically using an IGE400A rotating gamma camera and Star computer, and slices were reconstructed orthogonal to the long axis of the heart. Left ventricular volume was determined by summing the areas of the slices, and wall motion was determined by comparison of end diastolic and end systolic contours. In phantom experiments this provided an accurate measurement of volume (r=0.98). In 32 subjects who were either normal or who had coronary artery disease left ventricular volume (r=0.83) and ejection fraction (r=0.89) correlated well with those using a counts based planar technique. In 16 of 18 subjects who underwent right anterior oblique X-ray contrast ventriculography, tomographic wall motion agreed for anterior, apical, and inferior walls, but abnormal septal motion which was not apparent by contrast ventriculography, was seen in 12 subjects tomographically. All 12 had disease of the left anterior descending coronary artery and might have been expected to have abnormal septal motion. ECG-gated blood pool tomography can thus determine left ventricular volume and ejection fraction accurately, and provides a global description of wall motion in a way that is not possible from any single planar image.

  7. P wave detection in ECG signals using an extended Kalman filter: an evaluation in different arrhythmia contexts.

    PubMed

    Rahimpour, M; Mohammadzadeh Asl, B

    2016-07-01

    Monitoring atrial activity via P waves, is an important feature of the arrhythmia detection procedure. The aim of this paper is to present an algorithm for P wave detection in normal and some abnormal records by improving existing methods in the field of signal processing. In contrast to the classical approaches, which are completely blind to signal dynamics, our proposed method uses the extended Kalman filter, EKF25, to estimate the state variables of the equations modeling the dynamic of an ECG signal. This method is a modified version of the nonlinear dynamical model previously introduced for a generation of synthetic ECG signals and fiducial point extraction in normal ones. It is capable of estimating the separate types of activity of the heart with reasonable accuracy and performs well in the presence of morphological variations in the waveforms and ectopic beats. The MIT-BIH Arrhythmia and QT databases have been used to evaluate the performance of the proposed method. The results show that this method has Se  =  98.38% and Pr  =  96.74% in the overall records (considering normal and abnormal rhythms).

  8. Association of Long-Term Air Pollution with Ventricular Conduction and Repolarization Abnormalities

    PubMed Central

    Van Hee, Victor C; Szpiro, Adam A; Prineas, Ronald; Neyer, Jonathan; Watson, Karol; Siscovick, David; Park, Sung Kyun; Kaufman, Joel D

    2011-01-01

    Background Short-term exposure to air pollution may affect ventricular repolarization, but there is limited information on how long-term exposures might affect the surface ventricular electrocardiographic (ECG) abnormalities associated with cardiovascular events. We carried out a study to determine whether long-term air pollution exposure is associated with abnormalities of ventricular repolarization and conduction in adults without known cardiovascular disease. Methods A total of 4783 participants free of clinical cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis underwent 12-lead ECG examinations, cardiac-computed tomography and calcium scoring, as well as estimation of air pollution exposure using a finely resolved spatio-temporal model to determine long-term average individual exposure to fine particulate matter (PM2.5) and proximity to major roadways. We assessed ventricular electrical abnormalities including presence of QT prolongation (Rautaharju QTrr criteria) and intraventricular conduction delay (QRS duration > 120 msec). We used logistic regression to determine the adjusted relationship between air pollution exposures and ECG abnormalities. Results A 10 µg/m3-increase in estimated residential PM2.5 was associated with an increased odds of prevalent QT prolongation (adjusted odds ratio [OR]= 1.6 [95% confidence interval (CI)= 1.2 to 2.2]) and intraventricular conduction delay (OR 1.7, 95% CI: 1.0 to 2.6, independent of coronary-artery calcium score. Living near major roadways was not associated with ventricular electrical abnormalities. No significant evidence of effect modification by traditional risk factors or study site was observed. Conclusions This study demonstrates an association between long-term exposure to air pollution and ventricular repolarization and conduction abnormalities in adults without clinical cardiovascular disease, independent of subclinical coronary arterial calcification. PMID:21918454

  9. Antiequine chorionic gonadotropin (eCG) antibodies generated in goats treated with eCG for the induction of ovulation modulate the luteinizing hormone and follicle-stimulating hormone bioactivities of eCG differently.

    PubMed

    Hervé, Virginie; Roy, François; Bertin, Jean; Guillou, Florian; Maurel, Marie-Christine

    2004-01-01

    In dairy goats, treatments associating a progestogen and the equine chorionic gonadotropin (eCG) are the easiest way to induce and synchronize estrus and ovulation and to permit artificial insemination (AI) and/or out of season breeding. From the first treatment, the injection of eCG induces, in some females, the production of anti-eCG antibodies (Abs) that will interfere with the effectiveness of subsequent treatments. These anti-eCG Abs delay the preovulatory LH surge and the ovulation time, leading to poor fertility of the treated females. In this study, by in vitro bioassays, we show that anti-eCG Abs can positively or negatively modulate the LH and/or FSH bioactivities of eCG. Moreover, the modulation level of eCG bioactivity does not depend on the anti-eCG Ab affinity for eCG, as shown by surface plasmon resonance technology. The specificity of anti-eCG Abs tested by competitive ELISA highlighted the importance of a glycan environment in the recognition mechanism, especially the sialic acids specific to eCG. The different effects of anti-eCG Abs on eCG bioactivities could be explained by two hypotheses. First, steric hindrance preventing the interaction of eCG with its receptors would explain the inhibitory effect of some anti-eCG Abs; second, a conformational change in eCG by anti-eCG Abs could induce inhibition or potentiation of eCG bioactivities. It is significant that these modulations of eCG bioactivities by anti-eCG Abs impact mainly on the FSH bioactivity of eCG, which is essential for ovarian stimulation and subsequent fertility after treatment and AI, and to a lesser extent on LH bioactivity.

  10. [Endocrine abnormalities in HIV infections].

    PubMed

    Verges, B; Chavanet, P; Desgres, J; Kisterman, J P; Waldner, A; Vaillant, G; Portier, H; Brun, J M; Putelat, R

    The finding of endocrine gland lesions at pathological examination in AIDS and reports of several cases of endocrine disease in patients with this syndrome have prompted us to study endocrine functions in 63 patients (51 men, 12 women) with HIV-1 infection. According to the Center for Disease Control (CDC) classification system, 13 of these patients were stage CDC II, 27 stage CDC III and 23 stage CDC IV. We explored the adrenocortical function (ACTH, immediate tetracosactrin test) and the thyroid function (free T3 and T4 levels, TRH on TSH test) in all 63 patients. The hypothalamic-pituitary-gonadal axis (testosterone levels, LHRH test) and prolactin secretion (THR test) were explored in the 51 men. The results obtained showed early peripheral testicular insufficiency at stage CDC II and early pituitary gland abnormalities with hypersecretion of ACTH and prolactin also at stage CDC II. On the other hand, adrenocortical and pituitary abnormalities were not frequently found. The physiopathology of the endocrine abnormalities observed in HIV-1-infected patients remains unclear, but one may suspect that it involves interleukin-1 since this protein factor has recently been shown to stimulate the corticotropin-releasing hormone secretion and to act directly on the glycoprotein capsule of the virus (gp 120) whose structure is similar to that of some neurohormones.

  11. Magnetic resonance imaging of the pericardium: normal and pathologic findings

    SciTech Connect

    Stark, D.D.; Higgins, C.B.; Lanzer, P.; Lipton, M.J.; Schiller, N.; Crooks, L.E.; Botvinick, E.B.; Kaufman, L.

    1984-02-01

    Twenty normal subjects and ten patients with pericardial abnormalities underwent ECG-gated magnetic resonance (MR) imaging of the thorax using a 0.35-tesla superconducting system. The patients with pericardial abnormalities were also evaluated with serial chest radiography, ultrasound, computed tomography, and/or angiography. ECG gating was necessary to identify the normal pericardium, which was visualized as a 1- to 2-mm-wide curvilinear structure of low signal intensity. Pericardial thickening in constrictive pericarditis was clearly delineated on gated MR images. Pericardial inflammation caused a marked increase in signal intensity as well as thickening of the pericardium. Pericardial effusions and pericardial adhesions were also demonstrated. A simple pericardial cyst and a complex pericardial mass were identified and differentiated from pericardial fat and diaphragmatic eventration. MR appears to be an important modality for the evaluation of pericardial disease.

  12. Foot abnormalities of wild birds

    USGS Publications Warehouse

    Herman, C.M.; Locke, L.N.; Clark, G.M.

    1962-01-01

    The various foot abnormalities that occur in birds, including pox, scaly-leg, bumble-foot, ergotism and freezing are reviewed. In addition, our findings at the Patuxent Wildlife Research Center include pox from dove, mockingbird, cowbird, grackle and several species of sparrows. Scaly-leg has been particularly prevalent on icterids. Bumble foot has been observed in a whistling swan and in a group of captive woodcock. Ergotism is reported from a series of captive Canada geese from North Dakota. Several drug treatments recommended by others are presented.

  13. ECG-cryptography and authentication in body area networks.

    PubMed

    Zhang, Zhaoyang; Wang, Honggang; Vasilakos, Athanasios V; Fang, Hua

    2012-11-01

    Wireless body area networks (BANs) have drawn much attention from research community and industry in recent years. Multimedia healthcare services provided by BANs can be available to anyone, anywhere, and anytime seamlessly. A critical issue in BANs is how to preserve the integrity and privacy of a person's medical data over wireless environments in a resource efficient manner. This paper presents a novel key agreement scheme that allows neighboring nodes in BANs to share a common key generated by electrocardiogram (ECG) signals. The improved Jules Sudan (IJS) algorithm is proposed to set up the key agreement for the message authentication. The proposed ECG-IJS key agreement can secure data communications over BANs in a plug-n-play manner without any key distribution overheads. Both the simulation and experimental results are presented, which demonstrate that the proposed ECG-IJS scheme can achieve better security performance in terms of serval performance metrics such as false acceptance rate (FAR) and false rejection rate (FRR) than other existing approaches. In addition, the power consumption analysis also shows that the proposed ECG-IJS scheme can achieve energy efficiency for BANs.

  14. ECG gated NMR-CT for cardiovascular diseases

    SciTech Connect

    Nishikawa, J.; Ohtake, T.; Machida, K.; Iio, M.; Yoshimoto, N.; Sugimoto, T.

    1985-05-01

    The authors have been applying ECG gated NMR-CT to mainly patients with myocardial infarction (MI), and hypertrophic cardiomyopathy (HCM). Thirteen patients with MI, 8 with HCM and 5 without any heart diseases were studied by ECG gated NMR imaging (spin-echo technique, TR: depends on patient heart rate, TE: 35 and 70 msec.) with 0.35 T superconducting magnet. On NMR images (MRI), the authors examined the wall thickness, wall motion and T/sub 2/ relaxation time in the area of diseased myocardium. The lesions of old MI were depicted as the area of thin wall and T/sub 2/ relaxation time of those lesions were similar to the area of non-infarcted myocardium. The lesions of recent MI (up to 3.5 months from the recent attack) were shown as the same wall thickness as the non-infarcted myocardium and the area of prolonged T/sub 2/ relaxation time compared with that of non-infarcted myocardium. MRI demonstrated diffusely thick myocardium in all patients with HCM. T/sub 2/ relaxation time of the areas of HCM was almost the same as that of normal myocardium, and it's difference among each ventricular wall in patients with HCM was not statistically significant. The authors conclude that ECG gated NMR-CT offers 3-D morphological information of the heart without any contrast material nor radioisotopes. ECG gated MRI provides the useful informations to diagnose MI, especially in the differential diagnosis between old and recent MI.

  15. ECG Monitoring in Cardiac Rehabilitation: Is It Needed?

    ERIC Educational Resources Information Center

    Greenland, Philip; Pomilla, Paul V.

    1989-01-01

    Discusses the controversial use of continuous electrocardiogram (ECG) monitoring as a safety measure in cardiac rehabilitation exercise programs. Little evidence substantiates its value for all patients during exercise. In the absence of empirical evidence documenting the worth of this expensive procedure, it is recommended for use with high-risk…

  16. [Fetal ECG monitoring system based on MCU processing].

    PubMed

    Hu, Gang; Chen, Wei; Xie, Xicheng; Zhang, Hao

    2004-12-01

    In order to monitor the fetus in labor, the signal characteristic from fetal scalp electrode is researched, An adaptation algorithm and a peak to peak detecting technology are adopted in signal processing, and an adaptation gain control method is used to eliminate disturber from base-line shift. A fetal ECG monitoring system is designed on the basis of C8051F020 MCU.

  17. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Radiographic ECG/respirator synchronizer. 892.1970 Section 892.1970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic...

  18. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Radiographic ECG/respirator synchronizer. 892.1970 Section 892.1970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic...

  19. 21 CFR 892.1970 - Radiographic ECG/respirator synchronizer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Radiographic ECG/respirator synchronizer. 892.1970 Section 892.1970 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1970 Radiographic...

  20. Can myocardial ischemia be recognized by the exercise electrocardiogram in coronary disease patients with abnormal resting Q waves

    SciTech Connect

    Ahnve, S.; Savvides, M.; Abouantoun, S.; Atwood, J.E.; Froelicher, V.

    1986-05-01

    This study was performed in order to determine whether exercise-induced myocardial ischemia demonstrated by thallium-201 imaging could be detected by ST segment shifts in patients with abnormal Q waves at rest. Fifty-four patients with coronary artery disease and exercise-induced thallium-201 defects were compared to 22 patients with similar Q wave patterns but without thallium-201 exercise defects and to 14 normal subjects. Exercise data were analyzed visually in the 12-lead ECG and for spatial ST vector shifts. Both ST segment depression observed on the 12-lead ECG and spatial criteria were reasonably sensitive and specific for ischemia when the resting ECG showed no Q waves or inferior Q waves (range 69% to 93%). However, when anterior Q waves were present, ST segment shifts could not distinguish patients with ischemia from those with normal perfusion as determined by thallium imaging.

  1. [Hair shaft abnormalities].

    PubMed

    Itin, P H; Düggelin, M

    2002-05-01

    Hair shaft disorders may lead to brittleness and uncombable hair. In general the hair feels dry and lusterless. Hair shaft abnormalities may occur as localized or generalized disorders. Genetic predisposition or exogenous factors are able to produce and maintain hair shaft abnormalities. In addition to an extensive history and physical examination the most important diagnostic examination to analyze a hair shaft problem is light microscopy. Therapy of hair shaft disorders should focus to the cause. In addition, minimizing traumatic influences to hair shafts, such as dry hair with an electric dryer, permanent waves and dyes is important. A short hair style is more suitable for such patients with hair shaft disorders.

  2. ECG changes in factory workers exposed to 27.2  MHz radiofrequency radiation.

    PubMed

    Chen, Qingsong; Xu, Guoyong; Lang, Li; Yang, Aichu; Li, Shilin; Yang, Liwen; Li, Chaolin; Huang, Hanlin; Li, Tao

    2013-05-01

    To research the effect of 27.2 MHz radiofrequency radiation on electrocardiograms (ECG), 225 female workers operating radiofrequency machines at a shoe factory were chosen as the exposure group and 100 female workers without exposure from the same factory were selected as the control group. The 6 min electric field strength that the female workers were exposed to was 64.0 ± 25.2 V/m (mean ± SD), which exceeded 61 V/m, the International Commission on Non-Ionizing Radiation Protection reference root mean square levels for occupational exposure. A statistical difference was observed between the exposed group and the control group in terms of the rate of sinus bradycardia (χ(2)  = 11.48, P = 0.003). When several known risk factors for cardiovascular disease were considered, including smoking, age, alcohol ingestion habit, and so on, the exposure duration was not an effective factor for ECG changes, sinus arrhythmia, or sinus bradycardia according to α = 0.05, while P = 0.052 for sinus arrhythmia was very close to 0.05. We did not find any statistical difference in heart rate, duration of the QRS wave (ventricular depolarization), or corrected QT intervals (between the start of the Q wave and end of the T wave) between the exposed and control groups. Occupational exposure to radiofrequency radiation was not found to be a cause of ECG changes after consideration of the confounding factors.

  3. Improvements in ECG accuracy for diagnosis of left ventricular hypertrophy in obesity

    PubMed Central

    Rider, Oliver J; Ntusi, Ntobeko; Bull, Sacha C; Nethononda, Richard; Ferreira, Vanessa; Holloway, Cameron J; Holdsworth, David; Mahmod, Masliza; Rayner, Jennifer J; Banerjee, Rajarshi; Myerson, Saul; Watkins, Hugh; Neubauer, Stefan

    2016-01-01

    Objectives The electrocardiogram (ECG) is the most commonly used tool to screen for left ventricular hypertrophy (LVH), and yet current diagnostic criteria are insensitive in modern increasingly overweight society. We propose a simple adjustment to improve diagnostic accuracy in different body weights and improve the sensitivity of this universally available technique. Methods Overall, 1295 participants were included—821 with a wide range of body mass index (BMI 17.1–53.3 kg/m2) initially underwent cardiac magnetic resonance evaluation of anatomical left ventricular (LV) axis, LV mass and 12-lead surface ECG in order to generate an adjustment factor applied to the Sokolow–Lyon criteria. This factor was then validated in a second cohort (n=520, BMI 15.9–63.2 kg/m2). Results When matched for LV mass, the combination of leftward anatomical axis deviation and increased BMI resulted in a reduction of the Sokolow–Lyon index, by 4 mm in overweight and 8 mm in obesity. After adjusting for this in the initial cohort, the sensitivity of the Sokolow–Lyon index increased (overweight: 12.8% to 30.8%, obese: 3.1% to 27.2%) approaching that seen in normal weight (37.8%). Similar results were achieved in the validation cohort (specificity increased in overweight: 8.3% to 39.1%, obese: 9.4% to 25.0%) again approaching normal weight (39.0%). Importantly, specificity remained excellent (>93.1%). Conclusions Adjusting the Sokolow–Lyon index for BMI (overweight +4 mm, obesity +8 mm) improves the diagnostic accuracy for detecting LVH. As the ECG, worldwide, remains the most widely used screening tool for LVH, implementing these findings should translate into significant clinical benefit. PMID:27486142

  4. Binary optimization for source localization in the inverse problem of ECG.

    PubMed

    Potyagaylo, Danila; Cortés, Elisenda Gil; Schulze, Walther H W; Dössel, Olaf

    2014-09-01

    The goal of ECG-imaging (ECGI) is to reconstruct heart electrical activity from body surface potential maps. The problem is ill-posed, which means that it is extremely sensitive to measurement and modeling errors. The most commonly used method to tackle this obstacle is Tikhonov regularization, which consists in converting the original problem into a well-posed one by adding a penalty term. The method, despite all its practical advantages, has however a serious drawback: The obtained solution is often over-smoothed, which can hinder precise clinical diagnosis and treatment planning. In this paper, we apply a binary optimization approach to the transmembrane voltage (TMV)-based problem. For this, we assume the TMV to take two possible values according to a heart abnormality under consideration. In this work, we investigate the localization of simulated ischemic areas and ectopic foci and one clinical infarction case. This affects only the choice of the binary values, while the core of the algorithms remains the same, making the approximation easily adjustable to the application needs. Two methods, a hybrid metaheuristic approach and the difference of convex functions (DC), algorithm were tested. For this purpose, we performed realistic heart simulations for a complex thorax model and applied the proposed techniques to the obtained ECG signals. Both methods enabled localization of the areas of interest, hence showing their potential for application in ECGI. For the metaheuristic algorithm, it was necessary to subdivide the heart into regions in order to obtain a stable solution unsusceptible to the errors, while the analytical DC scheme can be efficiently applied for higher dimensional problems. With the DC method, we also successfully reconstructed the activation pattern and origin of a simulated extrasystole. In addition, the DC algorithm enables iterative adjustment of binary values ensuring robust performance.

  5. Ability of Serum Glial Fibrillary Acidic Protein, Ubiquitin C-Terminal Hydrolase-L1, and S100B To Differentiate Normal and Abnormal Head Computed Tomography Findings in Patients with Suspected Mild or Moderate Traumatic Brain Injury.

    PubMed

    Welch, Robert D; Ayaz, Syed I; Lewis, Lawrence M; Unden, Johan; Chen, James Y; Mika, Valerie H; Saville, Ben; Tyndall, Joseph A; Nash, Marshall; Buki, Andras; Barzo, Pal; Hack, Dallas; Tortella, Frank C; Schmid, Kara; Hayes, Ronald L; Vossough, Arastoo; Sweriduk, Stephen T; Bazarian, Jeffrey J

    2016-01-15

    Head computed tomography (CT) imaging is still a commonly obtained diagnostic test for patients with minor head injury despite availability of clinical decision rules to guide imaging use and recommendations to reduce radiation exposure resulting from unnecessary imaging. This prospective multicenter observational study of 251 patients with suspected mild to moderate traumatic brain injury (TBI) evaluated three serum biomarkers' (glial fibrillary acidic protein [GFAP], ubiquitin C-terminal hydrolase-L1 [UCH-L1] and S100B measured within 6 h of injury) ability to differentiate CT negative and CT positive findings. Of the 251 patients, 60.2% were male and 225 (89.6%) had a presenting Glasgow Coma Scale score of 15. A positive head CT (intracranial injury) was found in 36 (14.3%). UCH-L1 was 100% sensitive and 39% specific at a cutoff value >40 pg/mL. To retain 100% sensitivity, GFAP was 0% specific (cutoff value 0 pg/mL) and S100B had a specificity of only 2% (cutoff value 30 pg/mL). All three biomarkers had similar values for areas under the receiver operator characteristic curve: 0.79 (95% confidence interval; 0.70-0.88) for GFAP, 0.80 (0.71-0.89) for UCH-L1, and 0.75 (0.65-0.85) for S100B. Neither GFAP nor UCH-L1 curve values differed significantly from S100B (p = 0.21 and p = 0.77, respectively). In our patient cohort, UCH-L1 outperformed GFAP and S100B when the goal was to reduce CT use without sacrificing sensitivity. UCH-L1 values <40 pg/mL could potentially have aided in eliminating 83 of the 215 negative CT scans. These results require replication in other studies before the test is used in actual clinical practice.

  6. PLI cancellation in ECG signal based on adaptive filter by using Wiener-Hopf equation for providing initial condition.

    PubMed

    Manosueb, Anchalee; Koseeyaporn, Jeerasuda; Wardkein, Paramote

    2014-01-01

    This paper presents a technique for finding the optimal initial weight for adaptive filter by using difference equation. The obtained analytical response of the system identifies the appropriate weights for the system and shows that the MSE depends on the initial weight. The proposed technique is applied to eliminate the known frequency power line interference (PLI) signal in the electrocardiogram (ECG) signal. The PLI signal is considered as a combination of cosine and sine signals. The adaptive filter, therefore, attempts to adjust the amplitude of cosine and sine signals to synthesize a reference signal very similar to the contaminated PLI signal. To compare the potential of the proposed technique to other techniques, the system is simulated by using the Matlab program and the TMS320C6713 digital board. The simulation results demonstrate that the proposed technique enables the system to eliminate the PLI signal with the fastest time and gains the superior results of the recovered ECG signal.

  7. Some regularity on how to locate electrodes for higher fECG SNRs

    NASA Astrophysics Data System (ADS)

    Zhang, Jie-Min; Huang, Xiao-Lin; Guan, Qun; Liu, Tie-Bing; Li, Ping; Zhao, Ying; Liu, Hong-Xing

    2015-03-01

    The electrocardiogram (ECG) recorded from the abdominal surface of a pregnant woman is a composite of maternal ECG, fetal ECG (fECG) and other noises, while only the fECG component is always needed by us. With different locations of electrode pairs on the maternal abdominal surface to measure fECGs, the signal-to-noise ratios (SNRs) of the recorded abdominal ECGs are also correspondingly different. Some regularity on how to locate electrodes to obtain higher fECG SNRs is needed practically. In this paper, 343 groups of abdominal ECG records were acquired from 78 pregnant women with different electrode pairs locating, and an appropriate extended research database is formed. Then the regularity on fECG SNRs corresponding to different electrode pairs locating was studied. Based on statistical analysis, it is shown that the fECG SNRs are significantly higher in certain locations than others. Reasonable explanation is also provided to the statistical result using the theories of the fetal cardiac electrical axis and the signal phase delay. Project supported by the National Natural Science Foundation of China (Grant No. 61271079) and the Supporting Plan Project of Jiangsu Province, China (Grant No. BE2010720).

  8. Ability of Serum Glial Fibrillary Acidic Protein, Ubiquitin C-Terminal Hydrolase-L1, and S100B To Differentiate Normal and Abnormal Head Computed Tomography Findings in Patients with Suspected Mild or Moderate Traumatic Brain Injury.

    PubMed

    Welch, Robert D; Ayaz, Syed I; Lewis, Lawrence M; Unden, Johan; Chen, James Y; Mika, Valerie H; Saville, Ben; Tyndall, Joseph A; Nash, Marshall; Buki, Andras; Barzo, Pal; Hack, Dallas; Tortella, Frank C; Schmid, Kara; Hayes, Ronald L; Vossough, Arastoo; Sweriduk, Stephen T; Bazarian, Jeffrey J

    2016-01-15

    Head computed tomography (CT) imaging is still a commonly obtained diagnostic test for patients with minor head injury despite availability of clinical decision rules to guide imaging use and recommendations to reduce radiation exposure resulting from unnecessary imaging. This prospective multicenter observational study of 251 patients with suspected mild to moderate traumatic brain injury (TBI) evaluated three serum biomarkers' (glial fibrillary acidic protein [GFAP], ubiquitin C-terminal hydrolase-L1 [UCH-L1] and S100B measured within 6 h of injury) ability to differentiate CT negative and CT positive findings. Of the 251 patients, 60.2% were male and 225 (89.6%) had a presenting Glasgow Coma Scale score of 15. A positive head CT (intracranial injury) was found in 36 (14.3%). UCH-L1 was 100% sensitive and 39% specific at a cutoff value >40 pg/mL. To retain 100% sensitivity, GFAP was 0% specific (cutoff value 0 pg/mL) and S100B had a specificity of only 2% (cutoff value 30 pg/mL). All three biomarkers had similar values for areas under the receiver operator characteristic curve: 0.79 (95% confidence interval; 0.70-0.88) for GFAP, 0.80 (0.71-0.89) for UCH-L1, and 0.75 (0.65-0.85) for S100B. Neither GFAP nor UCH-L1 curve values differed significantly from S100B (p = 0.21 and p = 0.77, respectively). In our patient cohort, UCH-L1 outperformed GFAP and S100B when the goal was to reduce CT use without sacrificing sensitivity. UCH-L1 values <40 pg/mL could potentially have aided in eliminating 83 of the 215 negative CT scans. These results require replication in other studies before the test is used in actual clinical practice. PMID:26467555

  9. Ability of Serum Glial Fibrillary Acidic Protein, Ubiquitin C-Terminal Hydrolase-L1, and S100B To Differentiate Normal and Abnormal Head Computed Tomography Findings in Patients with Suspected Mild or Moderate Traumatic Brain Injury

    PubMed Central

    Ayaz, Syed I.; Lewis, Lawrence M.; Unden, Johan; Chen, James Y.; Mika, Valerie H.; Saville, Ben; Tyndall, Joseph A.; Nash, Marshall; Buki, Andras; Barzo, Pal; Hack, Dallas; Tortella, Frank C.; Schmid, Kara; Hayes, Ronald L.; Vossough, Arastoo; Sweriduk, Stephen T.; Bazarian, Jeffrey J.

    2016-01-01

    Abstract Head computed tomography (CT) imaging is still a commonly obtained diagnostic test for patients with minor head injury despite availability of clinical decision rules to guide imaging use and recommendations to reduce radiation exposure resulting from unnecessary imaging. This prospective multicenter observational study of 251 patients with suspected mild to moderate traumatic brain injury (TBI) evaluated three serum biomarkers' (glial fibrillary acidic protein [GFAP], ubiquitin C-terminal hydrolase-L1 [UCH-L1] and S100B measured within 6 h of injury) ability to differentiate CT negative and CT positive findings. Of the 251 patients, 60.2% were male and 225 (89.6%) had a presenting Glasgow Coma Scale score of 15. A positive head CT (intracranial injury) was found in 36 (14.3%). UCH-L1 was 100% sensitive and 39% specific at a cutoff value >40 pg/mL. To retain 100% sensitivity, GFAP was 0% specific (cutoff value 0 pg/mL) and S100B had a specificity of only 2% (cutoff value 30 pg/mL). All three biomarkers had similar values for areas under the receiver operator characteristic curve: 0.79 (95% confidence interval; 0.70–0.88) for GFAP, 0.80 (0.71–0.89) for UCH-L1, and 0.75 (0.65–0.85) for S100B. Neither GFAP nor UCH-L1 curve values differed significantly from S100B (p = 0.21 and p = 0.77, respectively). In our patient cohort, UCH-L1 outperformed GFAP and S100B when the goal was to reduce CT use without sacrificing sensitivity. UCH-L1 values <40 pg/mL could potentially have aided in eliminating 83 of the 215 negative CT scans. These results require replication in other studies before the test is used in actual clinical practice. PMID:26467555

  10. Relationship between T-wave normalization on exercise ECG and myocardial functional recovery in patients with acute myocardial infarction

    PubMed Central

    Kim, Kyung Jin; Shim, Wan Joo; Jung, Seong Won; Pak, Hui Nam; Lee, Soo Jin; Song, Woo Hyuk; Kim, Young Hoon; Seo, Hong Seog; Oh, Dong Joo; Ro, Young Moo

    2002-01-01

    Background Several studies suggested that T-wave normalization (TWN) in exercise ECG indicates the presence of viable myocardium. But the clinical implication of this phenomenon in patients with acute myocardial infarction who received proper revascularization therapy was not determined. Precisely the aim of this study was to investigate the relationship between TWN in exercise ECG and myocardial functional recovery after acute myocardial infarction. Methods We studied 30 acute myocardial infarction patients with negative T waves in infarct related electrocardiographic leads and who had received successful revascularization therapy. Exercise ECG was performed 10–14days after infarct onset using Naughton protocol. Patients were divided into 2 groups according to presence (group I; n=14) or not (group II; n=16) of TWN in exercise ECG. Exercise parameters and coronary angiographic findings were compared between groups. Baseline and follow-up (mean 11 months) regional and global left ventricular function was analyzed by echocardiography. Results Exercise parameters were similar between groups. There was no difference in baseline ejection fraction and wall motion score between group I and II (EF; 56±12% vs 52±11%, p=ns. WMS; 21±3 vs 23±4, p=ns) and it was improved at the tenth month by similar magnitude (group I/group II, EF % change=12±12% vs 7±6%, p=ns, WMS % change=6±6% vs 7±5%, p=ns). The finding of no relation between TWN and functional recovery was observed also when the patients were analysed according to infarct location and presence or absence of Q-waves. Conclusion As the exercise-induced TWN in patients with acute myocardial infarction was not related with better functional recovery of dysfunctional regional wall motion and ejection fraction, TWN does not appear to be an indicator of myocardial viability. PMID:12164089

  11. Time-frequency characterization of atrial fibrillation from surface ECG based on Hilbert-Huang transform.

    PubMed

    Huang, Z; Chen, Y; Pan, M

    2007-01-01

    In this paper, based on Hilbert-Huang transform (HHT), we develop a new non-invasive time-frequency analysis method to characterize the dynamic behaviour of atrial fibrillation (AF) from surface ECG. We first extract f waves from single-lead ECG records of AF patients using PCA analysis. To capture the non-stationary behaviours of AF signals at different time scales, we use HHT to find the Hilbert spectrum and instantaneous frequency (IF) distribution of residual signals from principal component analysis. Two important feature variables, namely mean IF (mIF) and index of frequency stability over time (IS), are derived from the IF distribution, and in combination will be able to effectively discriminate two different AF types: self-terminating and non-terminating termination. The proposed AF signal decomposition and analysis method will help us efficiently differentiate individual AF patients, advance our understanding of AF mechanisms, and provide useful guidelines for improving administration of AF patients, especially paroxysmal AF.

  12. Sample entropy of ECG time series of fearful flyers: preliminary results.

    PubMed

    Bornas, Xavier; Llabrés, Jordi; Noguera, Miquel; Pez, Ana

    2006-07-01

    Research within the framework of the nonlinear dynamical systems (NDS) in the field of anxiety disorders has shown that greater irregularity/complexity appears in the output from healthy systems. In this study we measured the Heart rate variability (HRV) and the sample sntropy (SampEn) of the ECG mV time series of fearful flyers (N = 15) and a matched control group (N = 15) when confronted with three combinations of feared stimuli (pictures, sounds, and pictures with sounds) as well as relaxing stimuli (pictures and sounds). Fearful flyers had lower SampEn than controls in all conditions, including baseline. Non-phobics showed significant entropy decreases from baseline in two out of three exposure conditions. No differences on HRV were found between groups, and HRV was not sensitive to condition changes. The main finding of the study is that the SampEn calculated on very short ECG mV recordings (10 to 60 seconds, easy to obtain in clinical settings) may be a useful diagnostic measure since it can distinguish fearful from non-fearful flyers. PMID:16762174

  13. Detection of driving fatigue by using noncontact EMG and ECG signals measurement system.

    PubMed

    Fu, Rongrong; Wang, Hong

    2014-05-01

    Driver fatigue can be detected by constructing a discriminant mode using some features obtained from physiological signals. There exist two major challenges of this kind of methods. One is how to collect physiological signals from subjects while they are driving without any interruption. The other is to find features of physiological signals that are of corresponding change with the loss of attention caused by driver fatigue. Driving fatigue is detected based on the study of surface electromyography (EMG) and electrocardiograph (ECG) during the driving period. The noncontact data acquisition system was used to collect physiological signals from the biceps femoris of each subject to tackle the first challenge. Fast independent component analysis (FastICA) and digital filter were utilized to process the original signals. Based on the statistical analysis results given by Kolmogorov-Smirnov Z test, the peak factor of EMG (p < 0.001) and the maximum of the cross-relation curve of EMG and ECG (p < 0.001) were selected as the combined characteristic to detect fatigue of drivers. The discriminant criterion of fatigue was obtained from the training samples by using Mahalanobis distance, and then the average classification accuracy was given by 10-fold cross-validation. The results showed that the method proposed in this paper can give well performance in distinguishing the normal state and fatigue state. The noncontact, onboard vehicle drivers' fatigue detection system was developed to reduce fatigue-related risks.

  14. Morphological abnormalities in elasmobranchs.

    PubMed

    Moore, A B M

    2015-08-01

    A total of 10 abnormal free-swimming (i.e., post-birth) elasmobranchs are reported from The (Persian-Arabian) Gulf, encompassing five species and including deformed heads, snouts, caudal fins and claspers. The complete absence of pelvic fins in a milk shark Rhizoprionodon acutus may be the first record in any elasmobranch. Possible causes, including the extreme environmental conditions and the high level of anthropogenic pollution particular to The Gulf, are briefly discussed.

  15. [Congenital foot abnormalities].

    PubMed

    Delpont, M; Lafosse, T; Bachy, M; Mary, P; Alves, A; Vialle, R

    2015-03-01

    The foot may be the site of birth defects. These abnormalities are sometimes suspected prenatally. Final diagnosis depends on clinical examination at birth. These deformations can be simple malpositions: metatarsus adductus, talipes calcaneovalgus and pes supinatus. The prognosis is excellent spontaneously or with a simple orthopedic treatment. Surgery remains outstanding. The use of a pediatric orthopedist will be considered if malposition does not relax after several weeks. Malformations (clubfoot, vertical talus and skew foot) require specialized care early. Clubfoot is characterized by an equine and varus hindfoot, an adducted and supine forefoot, not reducible. Vertical talus combines equine hindfoot and dorsiflexion of the forefoot, which is performed in the midfoot instead of the ankle. Skew foot is suspected when a metatarsus adductus is resistant to conservative treatment. Early treatment is primarily orthopedic at birth. Surgical treatment begins to be considered after walking age. Keep in mind that an abnormality of the foot may be associated with other conditions: malposition with congenital hip, malformations with syndromes, neurological and genetic abnormalities. PMID:25524290

  16. Mobile measurement system of ECG signal in vehicle environment

    NASA Astrophysics Data System (ADS)

    Oh, Kwang-seok; Lee, Sang-Ryong; Lee, Choon-Young; Kim, Myun-Hee

    2005-12-01

    This paper proposed a new method to measure the ECG signal from the driver. The ECG signal is often measured in the room. But it is mixed with many kinds of noise when it is measured during the vehicle moving. Noise occupied most many parts as the experimental among them was classified. And one suitable filter for each noise was designed. It used ALE(Adaptive Line Enhancement) to remove the noise occurred to electromagnetic wave in vehicle. To remove the noise occurred to steering or vibration of vehicle, the paper used Wavelet transformation after ALE(preprocessing filter). To realize unconscious measurement, this research used the stainless steel(not the electrode) fixed at steering wheel and designed the adaptive filter without using reference signal.

  17. Combining Wavelet Transform and Hidden Markov Models for ECG Segmentation

    NASA Astrophysics Data System (ADS)

    Andreão, Rodrigo Varejão; Boudy, Jérôme

    2006-12-01

    This work aims at providing new insights on the electrocardiogram (ECG) segmentation problem using wavelets. The wavelet transform has been originally combined with a hidden Markov models (HMMs) framework in order to carry out beat segmentation and classification. A group of five continuous wavelet functions commonly used in ECG analysis has been implemented and compared using the same framework. All experiments were realized on the QT database, which is composed of a representative number of ambulatory recordings of several individuals and is supplied with manual labels made by a physician. Our main contribution relies on the consistent set of experiments performed. Moreover, the results obtained in terms of beat segmentation and premature ventricular beat (PVC) detection are comparable to others works reported in the literature, independently of the type of the wavelet. Finally, through an original concept of combining two wavelet functions in the segmentation stage, we achieve our best performances.

  18. Using ordinal partition transition networks to analyze ECG data.

    PubMed

    Kulp, Christopher W; Chobot, Jeremy M; Freitas, Helena R; Sprechini, Gene D

    2016-07-01

    Electrocardiogram (ECG) data from patients with a variety of heart conditions are studied using ordinal pattern partition networks. The ordinal pattern partition networks are formed from the ECG time series by symbolizing the data into ordinal patterns. The ordinal patterns form the nodes of the network and edges are defined through the time ordering of the ordinal patterns in the symbolized time series. A network measure, called the mean degree, is computed from each time series-generated network. In addition, the entropy and number of non-occurring ordinal patterns (NFP) is computed for each series. The distribution of mean degrees, entropies, and NFPs for each heart condition studied is compared. A statistically significant difference between healthy patients and several groups of unhealthy patients with varying heart conditions is found for the distributions of the mean degrees, unlike for any of the distributions of the entropies or NFPs.

  19. Use of electrocardiogram (ECG) electrodes for Bioelectrical Impedance Analysis (BIA)

    NASA Astrophysics Data System (ADS)

    Caicedo-Eraso, J. C.; González-Correa, C. H.; González-Correa, C. A.

    2012-12-01

    BIA is a safe, noninvasive, portable and relatively inexpensive method of estimating body composition that is practical and suitable for individual use and large-scale studies. However, the cost of the electrodes recommended by some BIA manufacturers is too high for developing countries; where very often the long and complicated process of importation reduces the time they can be used. The purpose of this study was to evaluate the use of two types of ECG electrodes (2290 and 2228 by 3M®) in BIA measurements to decrease the costs of the test. The results showed that the 2228 ECG electrodes can be used in BIA measurements for adult's body composition assessment. These electrodes are available in the domestic market and their costs are 92% lower than the electrodes recommended by manufacturer. The results show a new cost-benefit relation for BIA method and make this a more accessible tool for individual tests, large-scale researches and studies in the community.

  20. The feasibility of bench tests for disposable ECG electrode adhesiveness.

    PubMed

    Baker, C D; Schoenberg, A A; Booth, H E

    1979-01-01

    The feasibility of recommending one standard bench test that adequately qualifies electrode adhesives for clinical use was examined by UBTL. Small strips, cut from whole, commercially available disposable ECG electrodes, were attached to three types of surfaces, and samples of each type of electrode were peel tested at 15 minutes, 8 hours, and 48 hours after attachment. A program was developed to average, display, and calculate peel strength parameters. Analysis of the data showed that (a) the peel strength of electrodes varied by more than a factor of 10 when measured on human skin, and by more than a factor of 3 when measured on bench test surfaces, and (b) the peel strength of the electrode adhesive strips did not correlate with intact electrode loss on ambulatory subjects. Therefore, UBTL could not recommend one bench test that would measure adhesion performance for all electrode types appropriate for inclusion in an AAMI ECG electrode standard.

  1. ECG contamination of EEG signals: effect on entropy.

    PubMed

    Chakrabarti, Dhritiman; Bansal, Sonia

    2016-02-01

    Entropy™ is a proprietary algorithm which uses spectral entropy analysis of electroencephalographic (EEG) signals to produce indices which are used as a measure of depth of hypnosis. We describe a report of electrocardiographic (ECG) contamination of EEG signals leading to fluctuating erroneous Entropy values. An explanation is provided for mechanism behind this observation by describing the spread of ECG signals in head and neck and its influence on EEG/Entropy by correlating the observation with the published Entropy algorithm. While the Entropy algorithm has been well conceived, there are still instances in which it can produce erroneous values. Such erroneous values and their cause may be identified by close scrutiny of the EEG waveform if Entropy values seem out of sync with that expected at given anaesthetic levels.

  2. Using ordinal partition transition networks to analyze ECG data

    NASA Astrophysics Data System (ADS)

    Kulp, Christopher W.; Chobot, Jeremy M.; Freitas, Helena R.; Sprechini, Gene D.

    2016-07-01

    Electrocardiogram (ECG) data from patients with a variety of heart conditions are studied using ordinal pattern partition networks. The ordinal pattern partition networks are formed from the ECG time series by symbolizing the data into ordinal patterns. The ordinal patterns form the nodes of the network and edges are defined through the time ordering of the ordinal patterns in the symbolized time series. A network measure, called the mean degree, is computed from each time series-generated network. In addition, the entropy and number of non-occurring ordinal patterns (NFP) is computed for each series. The distribution of mean degrees, entropies, and NFPs for each heart condition studied is compared. A statistically significant difference between healthy patients and several groups of unhealthy patients with varying heart conditions is found for the distributions of the mean degrees, unlike for any of the distributions of the entropies or NFPs.

  3. Patient ECG recording control for an automatic implantable defibrillator

    NASA Technical Reports Server (NTRS)

    Fountain, Glen H. (Inventor); Lee, Jr., David G. (Inventor); Kitchin, David A. (Inventor)

    1986-01-01

    An implantable automatic defibrillator includes sensors which are placed on or near the patient's heart to detect electrical signals indicative of the physiology of the heart. The signals are digitally converted and stored into a FIFO region of a RAM by operation of a direct memory access (DMA) controller. The DMA controller operates transparently with respect to the microprocessor which is part of the defibrillator. The implantable defibrillator includes a telemetry communications circuit for sending data outbound from the defibrillator to an external device (either a patient controller or a physician's console or other) and a receiver for sensing at least an externally generated patient ECG recording command signal. The patient recording command signal is generated by the hand held patient controller. Upon detection of the patient ECG recording command, DMA copies the contents of the FIFO into a specific region of the RAM.

  4. Diverse and composite features for ECG signals processing.

    PubMed

    Ubeyli, Elif Derya

    2008-01-01

    The automated diagnostic systems employing diverse and composite features for electrocardiogram (ECG) signals were analyzed and their accuracies were determined. Because of the importance of making the right decision, classification procedures classifying the ECG signals with high accuracy were investigated. The classification accuracies of multilayer perceptron neural network (MLPNN), recurrent neural network (RNN), and mixture of experts (ME) trained on composite features and modified mixture of experts (MME) trained on diverse features were compared. The inputs of these automated diagnostic systems were composed of diverse or composite features (wavelet coefficients and power levels of the power spectral density estimates obtained by the eigenvector methods) and were chosen according to the network structures. The conclusions of this study demonstrated that the MME trained on diverse features achieved accuracy rates which were higher than that of the other automated diagnostic systems trained on composite features. PMID:18408257

  5. Abnormal pressures as hydrodynamic phenomena

    USGS Publications Warehouse

    Neuzil, C.E.

    1995-01-01

    So-called abnormal pressures, subsurface fluid pressures significantly higher or lower than hydrostatic, have excited speculation about their origin since subsurface exploration first encountered them. Two distinct conceptual models for abnormal pressures have gained currency among earth scientists. The static model sees abnormal pressures generally as relict features preserved by a virtual absence of fluid flow over geologic time. The hydrodynamic model instead envisions abnormal pressures as phenomena in which flow usually plays an important role. This paper develops the theoretical framework for abnormal pressures as hydrodynamic phenomena, shows that it explains the manifold occurrences of abnormal pressures, and examines the implications of this approach. -from Author

  6. Discussion of "Computational Electrocardiography: Revisiting Holter ECG Monitoring".

    PubMed

    Baumgartner, Christian; Caiani, Enrico G; Dickhaus, Hartmut; Kulikowski, Casimir A; Schiecke, Karin; van Bemmel, Jan H; Witte, Herbert

    2016-08-01

    This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Computational Electrocardiography: Revisiting Holter ECG Monitoring" written by Thomas M. Deserno and Nikolaus Marx. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the paper of Deserno and Marx. In subsequent issues the discussion can continue through letters to the editor.

  7. Capacitive driven-right-leg grounding in Indirect-contact ECG measurement.

    PubMed

    Lim, Yong Gyu; Chung, Gih Sung; Park, Kwang Suk

    2010-01-01

    For the reduction of common-mode noise level in Indirect-contact ECG (IDC-ECG) measurement, a driven-right-leg grounding method was applied to the IDC-ECG. Because the IDC-ECG does not require any direct contact between the electrodes and the human skin, it is adequate for un-constraining long-term ECG measurement at home and its various applications are now under development. However, larger 60 Hz noise induced by power line appears in IDC-ECG than in conventional ECG, that is a restriction of IDC-ECG application. In this study, the driven-right-leg ground which has been used in conventional direct-contact ECG, was adapted to the IDC-ECG measurement, by feedback of the inversion of amplified common-mode noise to the body through the conductive textile laid on the chair seat. It was shown that the level of 60Hz power line noise was reduced to about -40 dB when the driven-right-leg gain was 1000.

  8. Extended Kalman smoother with differential evolution technique for denoising of ECG signal.

    PubMed

    Panigrahy, D; Sahu, P K

    2016-09-01

    Electrocardiogram (ECG) signal gives a lot of information on the physiology of heart. In reality, noise from various sources interfere with the ECG signal. To get the correct information on physiology of the heart, noise cancellation of the ECG signal is required. In this paper, the effectiveness of extended Kalman smoother (EKS) with the differential evolution (DE) technique for noise cancellation of the ECG signal is investigated. DE is used as an automatic parameter selection method for the selection of ten optimized components of the ECG signal, and those are used to create the ECG signal according to the real ECG signal. These parameters are used by the EKS for the development of the state equation and also for initialization of the parameters of EKS. EKS framework is used for denoising the ECG signal from the single channel. The effectiveness of proposed noise cancellation technique has been evaluated by adding white, colored Gaussian noise and real muscle artifact noise at different SNR to some visually clean ECG signals from the MIT-BIH arrhythmia database. The proposed noise cancellation technique of ECG signal shows better signal to noise ratio (SNR) improvement, lesser mean square error (MSE) and percent of distortion (PRD) compared to other well-known methods. PMID:27542170

  9. Capacitive driven-right-leg grounding in Indirect-contact ECG measurement.

    PubMed

    Lim, Yong Gyu; Chung, Gih Sung; Park, Kwang Suk

    2010-01-01

    For the reduction of common-mode noise level in Indirect-contact ECG (IDC-ECG) measurement, a driven-right-leg grounding method was applied to the IDC-ECG. Because the IDC-ECG does not require any direct contact between the electrodes and the human skin, it is adequate for un-constraining long-term ECG measurement at home and its various applications are now under development. However, larger 60 Hz noise induced by power line appears in IDC-ECG than in conventional ECG, that is a restriction of IDC-ECG application. In this study, the driven-right-leg ground which has been used in conventional direct-contact ECG, was adapted to the IDC-ECG measurement, by feedback of the inversion of amplified common-mode noise to the body through the conductive textile laid on the chair seat. It was shown that the level of 60Hz power line noise was reduced to about -40 dB when the driven-right-leg gain was 1000. PMID:21095911

  10. Extended Kalman smoother with differential evolution technique for denoising of ECG signal.

    PubMed

    Panigrahy, D; Sahu, P K

    2016-09-01

    Electrocardiogram (ECG) signal gives a lot of information on the physiology of heart. In reality, noise from various sources interfere with the ECG signal. To get the correct information on physiology of the heart, noise cancellation of the ECG signal is required. In this paper, the effectiveness of extended Kalman smoother (EKS) with the differential evolution (DE) technique for noise cancellation of the ECG signal is investigated. DE is used as an automatic parameter selection method for the selection of ten optimized components of the ECG signal, and those are used to create the ECG signal according to the real ECG signal. These parameters are used by the EKS for the development of the state equation and also for initialization of the parameters of EKS. EKS framework is used for denoising the ECG signal from the single channel. The effectiveness of proposed noise cancellation technique has been evaluated by adding white, colored Gaussian noise and real muscle artifact noise at different SNR to some visually clean ECG signals from the MIT-BIH arrhythmia database. The proposed noise cancellation technique of ECG signal shows better signal to noise ratio (SNR) improvement, lesser mean square error (MSE) and percent of distortion (PRD) compared to other well-known methods.

  11. Comparative clinical implications of admission electrocardiographic findings for patients with non-ST-segment elevation myocardial infarction.

    PubMed

    Jin, Eun-Sun; Park, Chang-Bum; Kim, Dong-Hee; Hwang, Hui-Jeong; Cho, Jin-Man; Sohn, Il Suk; Kim, Chong-Jin

    2016-09-01

    Early risk stratification is crucial for appropriate management using invasive strategies in non-ST elevation myocardial infarction (NSTEMI), and electrocardiography (ECG) has been widely used for risk stratification. However, ECG findings in NSTEMI vary, and there is a need to define the clinical characteristics and outcomes according to ECG.We analyzed the admission ECGs of 345 NSTEMI patients who underwent coronary angiography from 2006 to 2013. Demographics, procedural characteristics, and clinical outcomes were analyzed.The ST-segment depression, T-wave inversion, and no ECG change groups included 114, 90, and 141 patients, respectively. The ST-segment depression group trended toward older, nonsmoking, and female, with a lower body mass index (BMI) and a higher incidence of comorbidities, than the no ECG change group. The ST-segment depression group also had a higher Killip class, a lower left ventricular ejection fraction, a higher regional wall motion score index (RWMSI), and 3-vessel coronary artery disease angiographically, than the no ECG change group. Patients with T-wave inversion trended toward older, female, lower BMI, less smoking, lower creatine kinase MB, and more left anterior descending (LAD) artery involvement, than the no ECG change group. In clinical outcomes, the ST-segment depression group had a higher mortality rate at 30 days and 12 months after the index procedure than the no ECG change group, whereas the T-wave inversion group showed similar clinical outcomes.Patients with ST-segment depression have a greater burden of comorbidities with risk factors and worse clinical outcomes, whereas patients with T-wave inversion have an intermediate number of risk factors but similar outcomes, compared with the no ECG change group. Further study is necessary to evaluate the prognostic impact of the baseline ECG on admission. PMID:27631250

  12. [Genome Abnormality and Histological Findings in Breast Carcinoma].

    PubMed

    Moriya, Takuya; Suzuki, Soichiro; Kanomata, Naoki

    2016-03-01

    Breast cancers contain variable histologies as well as biology. Gene expression profiling and cluster analyses have been performed since the beginning of the 21st century. The use of intrinsic subtype classification has replaced histological classification of breast carcinomas, as it frequently yields the same results. For examples, around 80% of triple negative (estrogen receptor-, progesterone receptor-, and HER2-negative) cancers are of the basal-like subtype. In daily practice, adjuvant therapy is selected based on histological features, but the results of ordinal cluster analyses and histological intrinsic subtypes are not always the same for individual cases. With advanced genetic analysis, new concepts have been elucidated, ie, the molecular identification of claudin-low breast cancer. Proposals of a new classification system and a new therapeutic approach are expected in the future. PMID:27067844

  13. Clinical findings and immunological abnormalities in Yu-Cheng patients

    SciTech Connect

    Lue, Y.C.; Wu, Y.C.

    1985-02-01

    An outbreak of poisoning caused by ingestion of rice bran oil which was accidentally contaminated with polychlorinated biphenyls (PCBs) broke out in Taiwan in February 1979. Diagnosis, management, and follow-up of the patients were performed at special clinics, and subjective symptoms and cutaneous changes such as peculiar acneform eruptions and pigmentation were recorded. The patients were divided into six age groups of both essex, and the body surface of the patients was divided into 12 sections according to the nature of skin. The prevalence of each type of cutaneous change was proved statistically by the chi-square test. The examination of the immune system function in the patients at 1 year revealed: decreased concentration of IgM and IgA but not of IgG; decreased percentage of total T-cells, active T-cells, and helper T-cells, normal percentage of B-cells and suppressor T-cells; suppression of delayed type response to recalling antigens; enhancement of lymphocyte spontaneous proliferation; and enhancement of lymphocyte proliferation with PHA, PWM, and PPD stimulation but not ConA. Follow-up studies 3 years later showed decreased blood PCB levels; some improvement of subjective symptoms and cutaneous changes; recovery of skin testing response to PPD; normal percentage of total T-cells and increased percentage of suppressor T-cells; and enhancement of lymphocyte proliferation spontaneously or under the stimulation of various mitogens.

  14. Real-time ECG transmission via Internet for nonclinical applications.

    PubMed

    Hernández, A I; Mora, F; Villegas, G; Passariello, G; Carrault, G

    2001-09-01

    Telemedicine is producing a great impact in the monitoring of patients located in remote nonclinical environments such as homes, elder communities, gymnasiums, schools, remote military bases, ships, and the like. A number of applications, ranging from data collection, to chronic patient surveillance, and even to the control of therapeutic procedures, are being implemented in many parts of the world. As part of this growing trend, this paper discusses the problems in electrocardiogram (ECG) real-time data acquisition, transmission, and visualization over the Internet. ECG signals are transmitted in real time from a patient in a remote nonclinical environment to the specialist in a hospital or clinic using the current capabilities and availability of the Internet. A prototype system is composed of a portable data acquisition and preprocessing module connected to the computer in the remote site via its RS-232 port, a Java-based client-server platform, and software modules to handle communication protocols between data acquisition module and the patient's personal computer, and to handle client-server communication. The purpose of the system is the provision of extended monitoring for patients under drug therapy after infarction, data collection in some particular cases, remote consultation, and low-cost ECG monitoring for the elderly.

  15. A constrained two-layer compression technique for ECG waves.

    PubMed

    Byun, Kyungguen; Song, Eunwoo; Shim, Hwan; Lim, Hyungjoon; Kang, Hong-Goo

    2015-08-01

    This paper proposes a constrained two-layer compression technique for electrocardiogram (ECG) waves, of which encoded parameters can be directly used for the diagnosis of arrhythmia. In the first layer, a single ECG beat is represented by one of the registered templates in the codebook. Since the required coding parameter in this layer is only the codebook index of the selected template, its compression ratio (CR) is very high. Note that the distribution of registered templates is also related to the characteristics of ECG waves, thus it can be used as a metric to detect various types of arrhythmias. The residual error between the input and the selected template is encoded by a wavelet-based transform coding in the second layer. The number of wavelet coefficients is constrained by pre-defined maximum distortion to be allowed. The MIT-BIH arrhythmia database is used to evaluate the performance of the proposed algorithm. The proposed algorithm shows around 7.18 CR when the reference value of percentage root mean square difference (PRD) is set to ten. PMID:26737691

  16. Unsupervised feature relevance analysis applied to improve ECG heartbeat clustering.

    PubMed

    Rodríguez-Sotelo, J L; Peluffo-Ordoñez, D; Cuesta-Frau, D; Castellanos-Domínguez, G

    2012-10-01

    The computer-assisted analysis of biomedical records has become an essential tool in clinical settings. However, current devices provide a growing amount of data that often exceeds the processing capacity of normal computers. As this amount of information rises, new demands for more efficient data extracting methods appear. This paper addresses the task of data mining in physiological records using a feature selection scheme. An unsupervised method based on relevance analysis is described. This scheme uses a least-squares optimization of the input feature matrix in a single iteration. The output of the algorithm is a feature weighting vector. The performance of the method was assessed using a heartbeat clustering test on real ECG records. The quantitative cluster validity measures yielded a correctly classified heartbeat rate of 98.69% (specificity), 85.88% (sensitivity) and 95.04% (general clustering performance), which is even higher than the performance achieved by other similar ECG clustering studies. The number of features was reduced on average from 100 to 18, and the temporal cost was a 43% lower than in previous ECG clustering schemes. PMID:22672933

  17. Compressive sensing exploiting wavelet-domain dependencies for ECG compression

    NASA Astrophysics Data System (ADS)

    Polania, Luisa F.; Carrillo, Rafael E.; Blanco-Velasco, Manuel; Barner, Kenneth E.

    2012-06-01

    Compressive sensing (CS) is an emerging signal processing paradigm that enables sub-Nyquist sampling of sparse signals. Extensive previous work has exploited the sparse representation of ECG signals in compression applications. In this paper, we propose the use of wavelet domain dependencies to further reduce the number of samples in compressive sensing-based ECG compression while decreasing the computational complexity. R wave events manifest themselves as chains of large coefficients propagating across scales to form a connected subtree of the wavelet coefficient tree. We show that the incorporation of this connectedness as additional prior information into a modified version of the CoSaMP algorithm can significantly reduce the required number of samples to achieve good quality in the reconstruction. This approach also allows more control over the ECG signal reconstruction, in particular, the QRS complex, which is typically distorted when prior information is not included in the recovery. The compression algorithm was tested upon records selected from the MIT-BIH arrhythmia database. Simulation results show that the proposed algorithm leads to high compression ratios associated with low distortion levels relative to state-of-the-art compression algorithms.

  18. Unsupervised feature relevance analysis applied to improve ECG heartbeat clustering.

    PubMed

    Rodríguez-Sotelo, J L; Peluffo-Ordoñez, D; Cuesta-Frau, D; Castellanos-Domínguez, G

    2012-10-01

    The computer-assisted analysis of biomedical records has become an essential tool in clinical settings. However, current devices provide a growing amount of data that often exceeds the processing capacity of normal computers. As this amount of information rises, new demands for more efficient data extracting methods appear. This paper addresses the task of data mining in physiological records using a feature selection scheme. An unsupervised method based on relevance analysis is described. This scheme uses a least-squares optimization of the input feature matrix in a single iteration. The output of the algorithm is a feature weighting vector. The performance of the method was assessed using a heartbeat clustering test on real ECG records. The quantitative cluster validity measures yielded a correctly classified heartbeat rate of 98.69% (specificity), 85.88% (sensitivity) and 95.04% (general clustering performance), which is even higher than the performance achieved by other similar ECG clustering studies. The number of features was reduced on average from 100 to 18, and the temporal cost was a 43% lower than in previous ECG clustering schemes.

  19. Feeling Abnormal: Simulation of Deviancy in Abnormal and Exceptionality Courses.

    ERIC Educational Resources Information Center

    Fernald, Charles D.

    1980-01-01

    Describes activity in which student in abnormal psychology and psychology of exceptional children classes personally experience being judged abnormal. The experience allows the students to remember relevant research, become sensitized to the feelings of individuals classified as deviant, and use caution in classifying individuals as abnormal.…

  20. Level of urinary liver-type fatty acid-binding protein is associated with cardiac markers and electrocardiographic abnormalities in type-2 diabetes with chronic kidney disease stage G1 and G2.

    PubMed

    Maeda, Yoshiteru; Suzuki, Atsushi; Ishii, Junnichi; Sekiguchi-Ueda, Sahoko; Shibata, Megumi; Yoshino, Yasumasa; Asano, Shogo; Hayakawa, Nobuki; Nakamura, Kazuhiro; Akiyama, Yasukazu; Kitagawa, Fumihiko; Sakuishi, Toshiaki; Fujita, Takashi; Hashimoto, Shuji; Ozaki, Yukio; Itoh, Mitsuyasu

    2015-05-01

    Urinary liver-type fatty acid-binding protein (L-FABP) reflects the degree of stress in proximal tubules of the kidney. We examined the level of L-FABP in type-2 diabetes mellitus (T2DM) patients with chronic kidney disease (CKD) stage G1 and G2, and its relationship with cardiac markers and electrocardiographic (ECG) abnormalities. T2DM patients whose estimated glomerular filtration rate (eGFR) was ≥60 mL/min/1.73 m(2) were recruited [n = 276 (165 males), mean age 64 years]. The median level of urinary L-FABP was 6.6 μg/gCr. Urinary L-FABP showed significant correlation with urinary albumin-to-creatinine ratio (ACR) (r = 0.51, p < 0.0001). Median (25th-75th percentile) eGFR was 82 (72-95) mL/min/1.73 m2. We divided patients into four subgroups (group 1, L-FABP ≤8.4 μg/gCr and ACR ≤30 mg/gCr; group 2, L-FABP ≤8.4 μg/gCr and ACR >30 mg/gCr; group 3, L-FABP >8.4 μg/gCr and ACR ≤30 mg/gCr; group 4, L-FABP >8.4 μg/gCr and ACR >30 mg/gCr). Compared with group 1, group 4 was significantly higher in systolic blood pressure, and eGFR using standardized serum cystatin C, high-sensitivity troponin T, and N-terminal pro-brain natriuretic peptide (NT-proBNP). Group 4 had significantly higher level of NT-proBNP than group 3. Groups 2, 3 and 4 showed more ECG abnormalities than group 1. These findings suggest that simultaneous measurement of urinary L-FABP and ACR should be useful to assess cardiovascular damage reflecting on the elevation of cardiac markers and ECG abnormalities in T2DM with CKD G1 and G2.

  1. Abnormal human sex chromosome constitutions

    SciTech Connect

    1993-12-31

    Chapter 22, discusses abnormal human sex chromosome constitution. Aneuploidy of X chromosomes with a female phenotype, sex chromosome aneuploidy with a male phenotype, and various abnormalities in X chromosome behavior are described. 31 refs., 2 figs.

  2. Exercises to Improve Gait Abnormalities

    MedlinePlus

    ... Home About iChip Articles Directories Videos Resources Contact Exercises to Improve Gait Abnormalities Home » Article Categories » Exercise and Fitness Font Size: A A A A Exercises to Improve Gait Abnormalities Next Page The manner ...

  3. Abnormal ionization in sonoluminescence

    NASA Astrophysics Data System (ADS)

    Zhang, Wen-Juan; An, Yu

    2015-04-01

    Sonoluminescence is a complex phenomenon, the mechanism of which remains unclear. The present study reveals that an abnormal ionization process is likely to be present in the sonoluminescing bubble. To fit the experimental data of previous studies, we assume that the ionization energies of the molecules and atoms in the bubble decrease as the gas density increases and that the decrease of the ionization energy reaches about 60%-70% as the bubble flashes, which is difficult to explain by using previous models. Project supported by the Research Fund for the Doctoral Program of Higher Education of China (Grant No. 20120002110031) and the National Natural Science Foundation of China (Grant No. 11334005).

  4. Heritability of Abnormalities in Cardiopulmonary Coupling in Sleep Apnea: Use of an Electrocardiogram-based Technique

    PubMed Central

    Ibrahim, Lamia H.; Jacono, Frank J.; Patel, Sanjay R.; Thomas, Robert J.; Larkin, Emma K.; Mietus, Joseph E.; Peng, Chung-Kang; Goldberger, Ary L.; Redline, Susan

    2010-01-01

    Rationale: Studies of the genetics of obstructive sleep apnea may be facilitated by identifying intermediate traits with high heritability that quantify etiological pathways, such as those related to respiratory control. Electrocardiogram (ECG)-based sleep spectrograms, measuring the coupling between respiratory modulation of ECG QRS-wave amplitude and heart rate variability, may provide measures of sleep state and ventilatory dynamics during sleep. We evaluated the familial aggregation of distinctive spectrographic biomarkers of unstable sleep, related to elevated-low frequency cardiopulmonary coupling (e-LFC), to assess their utility in genetic studies. Methods: 622 participants from 137 families from the Cleveland Family Study underwent standardized polysomnography (PSG). From the ECG signal on the PSG, the interbeat interval time series and the corresponding ECG-derived respiratory signal were extracted, and the low frequency (0.01-0.1 Hz) component of their coupling was computed using a fully automated method. Narrow sense heritability of e-LFC was calculated using variance component methods. Results: A spectral marker of abnormal low frequency cardiopulmonary coupling (e-LFC) demonstrated moderate correlation with apnea hypopnea index (AHI; r = 0.35, P < 0.0001). The heritability estimate for e-LFC, after adjusting for age and sex was 0.32 (P < 10-5) and remained unchanged after additionally adjusting for body mass index or AHI. In biological relatives of those with sleep apnea, a related marker of e-LFC was more prevalent than in controls (P = 0.05). Conclusions: Approximately 30% of the variability of e-LFC, measured from a continuous ECG during sleep, is explained by familial factors other than BMI. ECG-based spectrographic measures of cardiopulmonary coupling may provide novel phenotypes for characterizing subgroups of individuals with different propensities and genetic etiologies for sleep apnea or for other conditions associated with sleep fragmentation

  5. Abnormal hematological indices in cirrhosis

    PubMed Central

    Qamar, Amir A; Grace, Norman D

    2009-01-01

    Abnormalities in hematological indices are frequently encountered in cirrhosis. Multiple causes contribute to the occurrence of hematological abnormalities. Recent studies suggest that the presence of hematological cytopenias is associated with a poor prognosis in cirrhosis. The present article reviews the pathogenesis, incidence, prevalence, clinical significance and treatment of abnormal hematological indices in cirrhosis. PMID:19543577

  6. An Artificial Vector Model for Generating Abnormal Electrocardiographic Rhythms

    PubMed Central

    Clifford, Gari D.; Nemati, Shamim; Sameni, Reza

    2010-01-01

    We present generalizations of our previously published artificial models for generating multi-channel ECG to provide simulations of abnormal cardiac rhythms. Using a three-dimensional vectorcardiogram (VCG) formulation, we generate the normal cardiac dipole for a patient using a sum of Gaussian kernels, fitted to real VCG recordings. Abnormal beats are specified either as perturbations to the normal dipole or as new dipole trajectories. Switching between normal and abnormal beat types is achieved using a first-order Markov chain. Probability transitions can be learned from real data or modeled by coupling to heart rate and sympathovagal balance. Natural morphology changes from beat-to-beat are incorporated by varying the angular frequency of the dipole as a function of the inter-beat (RR) interval. The RR interval time series is generated using our previously described model whereby time- and frequency-domain heart rate (HR) and heart rate variability characteristics can be specified. QT-HR hysteresis is simulated by coupling the Gaussian kernels associated with the T-wave in the model with a nonlinear factor related to the local HR (determined from the last n RR intervals). Morphology changes due to respiration are simulated by introducing a rotation matrix couple to the respiratory frequency. We demonstrate an example of the use of this model by simulating HR-dependent T-Wave Alternans (TWA) with and without phase-switching due to ectopy. Application of our model also reveals previously unreported effects of common TWA estimation methods. PMID:20308774

  7. A Comparison of IIR and Wavelet Filtering for Noise Reduction of the ECG

    PubMed Central

    Sørensen, JS; Johannesen, L; Grove, USL; Lundhus, K; Couderc, J-P; Graff, C

    2011-01-01

    This study compares the ability to preserve information and reduce noise contaminants on the ECG for five wavelet filters and three IIR filters. Two 3-lead Holter ECGs were used. White Gaussian Noise was added to the first ECG in increments of 10% coverage. The second ECG contained alternating muscle transients and noise-free segments. Computation times and SNR improvements for different noise coverages were calculated and compared. RMS errors were calculated from noise-free segments on the ECG with transient muscle noise. Wavelet filters improved SNR more than IIR filters when the signal coverage was more than 50% noise. In contrast, the computation times were shorter for IIR filters (6 s) than for wavelet filters (88 s). On the ECG with transient muscle noise there was a trade-off in performance between wavelet and IIR filtering. In a clinical setting where the amount of noise is unknown, using IIR filters appears to be preferred for consistent performance. PMID:22068831

  8. [Design of the Mobile ECG Monitoring System Based on Android 4.3].

    PubMed

    Zhang, Shun; Lian, Yuxi; Qin, Yajie; Wang, Yuanyuan

    2015-07-01

    To monitor and record Electrocardiograph (ECG) signals for 24 hours, a mobile ECG monitoring system is designed based on Android 4.3. In this system, domestic indigenous E9622A is used to acquire ECG signals and TI CC2541 is adopted to communicate with mobile phones. The program is implemented on the Android platform to display and process ECG signals. The whole system is integrated on a 2 cm x 2 cm PCB. From experiments, it is shown that ECG signals can be obtained effectively when this system is worn, and clear ECG waveforms and parameters can be shown on the phones. With this system, arrhythmia can be diagnosed preliminarily. It is also shown that the system is low-power, low-cost, flexible and portable.

  9. Spirometric abnormalities among welders

    SciTech Connect

    Rastogi, S.K.; Gupta, B.N.; Husain, T.; Mathur, N.; Srivastava, S. )

    1991-10-01

    A group of manual welders age group 13-60 years having a mean exposure period of 12.4 {plus minus} 1.12 years were subjected to spirometry to evaluate the prevalence of spirometric abnormalities. The welders showed a significantly higher prevalence of respiratory impairment than that observed among the unexposed controls as a result of exposure to welding gases which comprised fine particles of lead, zinc, chromium, and manganese. This occurred despite the lower concentration of the pollutants at the work place. In the expose group, the smoking welders showed a prevalence of respiratory impairment significantly higher than that observed in the nonsmoking welders. The results of the pulmonary function tests showed a predominantly restrictive type of pulmonary impairment followed by a mixed ventilatory defect among the welders. The effect of age on pulmonary impairment was not discernible. Welders exposed for over 10 years showed a prevalence of respiratory abnormalities significantly higher than those exposed for less than 10 years. Smoking also had a contributory role.

  10. Diagnostic impact of thallium scintigraphy and cardiac fluoroscopy when the exercise ECG is strongly positive

    SciTech Connect

    Chaitman, B.R.; Brevers, G.; Dupras, G.; Lesperance, J.; Bourassa, M.G.

    1984-08-01

    We studied 83 men, who had a chest pain syndrome, no prior history of myocardial infarction, and exercise-induced horizontal or downsloping ST segment depression greater than or equal to 0.2 mV. The 38 patients unable to complete Bruce stage II had a significant increased risk of coronary (0.97 vs 0.71) and multivessel (0.88 vs 0.61) disease (p less than 0.01) compared to the pretest risk; data obtained from exercise-reperfusion thallium scintigraphy and cardiac fluoroscopy did not alter the risk of coronary or multivessel disease. The 45 patients who had ST depression greater than or equal to 0.2 mV and a peak work capacity greater than or equal to Bruce stage III did not have a significant increased risk of coronary (0.76) or multivessel disease (0.44). When both exercise-reperfusion thallium scintigraphy and cardiac fluoroscopy were abnormal in this latter patient subgroup, the post-test risk of multivessel disease was increased from 0.44 to 0.82 (p less than 0.03); when both tests were normal, none of the patients had multivessel disease (p less than 0.03) and only 0.18 had coronary artery disease. Thus, cardiac fluoroscopy and exercise thallium scintigraphy increase the diagnostic content of the strongly positive exercise ECG, particularly in men who have a peak work capacity greater than or equal to Bruce stage III.

  11. The Telemetric and Holter ECG Warehouse (THEW): the first three years of development and research.

    PubMed

    Couderc, Jean-Philippe

    2012-01-01

    The Telemetric and Holter ECG Warehouse (THEW) hosts more than 3700 digital 24-Holter ECG recordings from 13 independent studies. In addition to the ECGs, the repository includes patient information in separate clinical database with content varying according to the study focus. In its third year of activities, the THEW database has been accessed by researchers from 37 universities and 16 corporations located in 16 countries worldwide. Twenty publications were released primarily focusing on the development and validation of ECG-based technologies. This communication describes the content of the databases of the repository with brief summary of the research and development projects completed using these data.

  12. Clinical evaluation of a wireless ECG sensor system for arrhythmia diagnostic purposes.

    PubMed

    Fensli, Rune; Gundersen, Torstein; Snaprud, Tormod; Hejlesen, Ole

    2013-06-01

    In a clinical study, a novel wireless electrocardiogram (ECG) recorder has been evaluated with regard to its ability to perform arrhythmia diagnostics. As the ECG recorder will detect a "non-standard" ECG signal, it has been necessary to compare those signals to "standard" ECG recording signals in order to evaluate the arrhythmia detection ability of the new system. Simultaneous recording of ECG signals from both the new wireless ECG recorder and a conventional Holter recorder was compared by two independent cardiology specialists with regard to signal quality for performing arrhythmia diagnosis. In addition, calculated R-R intervals from the two systems were correlated. A total number of 16 patients participated in the study. It can be considered that recorded ECG signals obtained from the wireless ECG system had an acceptable quality for arrhythmia diagnosis. Some of the patients used the wireless sensor while doing physical sport activities, and the quality of the recorded ECG signals made it possible to perform arrhythmia diagnostics even under such conditions. Consequently, this makes possible improvements in correlating arrhythmias to physical activities.

  13. Schizophrenia and abnormal brain network hubs

    PubMed Central

    Rubinov, Mikail; Bullmore, Ed.

    2013-01-01

    Schizophrenia is a heterogeneous psychiatric disorder of unknown cause or characteristic pathology. Clinical neuroscientists increasingly postulate that schizophrenia is a disorder of brain network organization. In this article we discuss the conceptual framework of this dysconnection hypothesis, describe the predominant methodological paradigm for testing this hypothesis, and review recent evidence for disruption of central/hub brain regions, as a promising example of this hypothesis. We summarize studies of brain hubs in large-scale structural and functional brain networks and find strong evidence for network abnormalities of prefrontal hubs, and moderate evidence for network abnormalities of limbic, temporal, and parietal hubs. Future studies are needed to differentiate network dysfunction from previously observed gray- and white-matter abnormalities of these hubs, and to link endogenous network dysfunction phenotypes with perceptual, behavioral, and cognitive clinical phenotypes of schizophrenia. PMID:24174905

  14. Echocardiographic abnormalities in the mucopolysaccharide storage diseases.

    PubMed

    Gross, D M; Williams, J C; Caprioli, C; Dominguez, B; Howell, R R

    1988-01-01

    The mucopolysaccharide storage diseases express themselves clinically with a wide variety of abnormalities, including growth and mental retardation, skeletal abnormalities, clouded corneas, nerve compression syndromes, upper airway obstruction and cardiovascular involvement, to name the most common. In most cases the cause of early death is cardiorespiratory failure secondary to cardiovascular involvement and upper airway obstruction. The findings of cardiac ultrasound examination in 29 children, adolescents and young adults are presented. In addition to the previously well-described abnormalities of the mitral and aortic valves in several types of mucopolysaccharide storage disease, we report patchy involvement in some cases, 3 instances of asymmetric septal hypertrophy not previously reported in mucopolysaccharide storage diseases, cardiac involvement in half of our patients with Sanfilippo syndrome and a lack of age-related severity of cardiac involvement even within the specific syndromes. PMID:3122547

  15. Retinal abnormalities in β-thalassemia major.

    PubMed

    Bhoiwala, Devang L; Dunaief, Joshua L

    2016-01-01

    Patients with beta (β)-thalassemia (β-TM: β-thalassemia major, β-TI: β-thalassemia intermedia) have a variety of complications that may affect all organs, including the eye. Ocular abnormalities include retinal pigment epithelial degeneration, angioid streaks, venous tortuosity, night blindness, visual field defects, decreased visual acuity, color vision abnormalities, and acute visual loss. Patients with β-thalassemia major are transfusion dependent and require iron chelation therapy to survive. Retinal degeneration may result from either retinal iron accumulation from transfusion-induced iron overload or retinal toxicity induced by iron chelation therapy. Some who were never treated with iron chelation therapy exhibited retinopathy, and others receiving iron chelation therapy had chelator-induced retinopathy. We will focus on retinal abnormalities present in individuals with β-thalassemia major viewed in light of new findings on the mechanisms and manifestations of retinal iron toxicity. PMID:26325202

  16. Schizophrenia and abnormal brain network hubs.

    PubMed

    Rubinov, Mikail; Bullmore, Ed

    2013-09-01

    Schizophrenia is a heterogeneous psychiatric disorder of unknown cause or characteristic pathology. Clinical neuroscientists increasingly postulate that schizophrenia is a disorder of brain network organization. In this article we discuss the conceptual framework of this dysconnection hypothesis, describe the predominant methodological paradigm for testing this hypothesis, and review recent evidence for disruption of central/hub brain regions, as a promising example of this hypothesis. We summarize studies of brain hubs in large-scale structural and functional brain networks and find strong evidence for network abnormalities of prefrontal hubs, and moderate evidence for network abnormalities of limbic, temporal, and parietal hubs. Future studies are needed to differentiate network dysfunction from previously observed gray- and white-matter abnormalities of these hubs, and to link endogenous network dysfunction phenotypes with perceptual, behavioral, and cognitive clinical phenotypes of schizophrenia.

  17. Application of Wavelet Based Denoising for T-Wave Alternans Analysis in High Resolution ECG Maps

    NASA Astrophysics Data System (ADS)

    Janusek, D.; Kania, M.; Zaczek, R.; Zavala-Fernandez, H.; Zbieć, A.; Opolski, G.; Maniewski, R.

    2011-01-01

    T-wave alternans (TWA) allows for identification of patients at an increased risk of ventricular arrhythmia. Stress test, which increases heart rate in controlled manner, is used for TWA measurement. However, the TWA detection and analysis are often disturbed by muscular interference. The evaluation of wavelet based denoising methods was performed to find optimal algorithm for TWA analysis. ECG signals recorded in twelve patients with cardiac disease were analyzed. In seven of them significant T-wave alternans magnitude was detected. The application of wavelet based denoising method in the pre-processing stage increases the T-wave alternans magnitude as well as the number of BSPM signals where TWA was detected.

  18. Electrocardiographic Abnormalities and QTc Interval in Patients Undergoing Hemodialysis

    PubMed Central

    Nie, Yuxin; Zou, Jianzhou; Liang, Yixiu; Shen, Bo; Liu, Zhonghua; Cao, Xuesen; Chen, Xiaohong; Ding, Xiaoqiang

    2016-01-01

    Background Sudden cardiac death is one of the primary causes of mortality in chronic hemodialysis (HD) patients. Prolonged QTc interval is associated with increased rate of sudden cardiac death. The aim of this article is to assess the abnormalities found in electrocardiograms (ECGs), and to explore factors that can influence the QTc interval. Methods A total of 141 conventional HD patients were enrolled in this study. ECG tests were conducted on each patient before a single dialysis session and 15 minutes before the end of dialysis session (at peak stress). Echocardiography tests were conducted before dialysis session began. Blood samples were drawn by phlebotomy immediately before and after the dialysis session. Results Before dialysis, 93.62% of the patients were in sinus rhythm, and approximately 65% of the patients showed a prolonged QTc interval (i.e., a QTc interval above 440 ms in males and above 460ms in females). A comparison of ECG parameters before dialysis and at peak stress showed increases in heart rate (77.45±11.92 vs. 80.38±14.65 bpm, p = 0.001) and QTc interval (460.05±24.53 ms vs. 470.93±24.92 ms, p<0.001). After dividing patients into two groups according to the QTc interval, lower pre-dialysis serum concentrations of potassium (K+), calcium (Ca2+), phosphorus, calcium* phosphorus (Ca*P), and higher concentrations of plasma brain natriuretic peptide (BNP) were found in the group with prolonged QTc intervals. Patients in this group also had a larger left atrial diameter (LAD) and a thicker interventricular septum, and they tended to be older than patients in the other group. Then patients were divided into two groups according to ΔQTc (ΔQTc = QTc peak-stress- QTc pre-HD). When analyzing the patients whose QTc intervals were longer at peak stress than before HD, we found that they had higher concentrations of Ca2+ and P5+ and lower concentrations of K+, ferritin, UA, and BNP. They were also more likely to be female. In addition, more cardiac

  19. Does individual learning styles influence the choice to use a web-based ECG learning programme in a blended learning setting?

    PubMed Central

    2012-01-01

    Background The compressed curriculum in modern knowledge-intensive medicine demands useful tools to achieve approved learning aims in a limited space of time. Web-based learning can be used in different ways to enhance learning. Little is however known regarding its optimal utilisation. Our aim was to investigate if the individual learning styles of medical students influence the choice to use a web-based ECG learning programme in a blended learning setting. Methods The programme, with three types of modules (learning content, self-assessment questions and interactive ECG interpretation training), was offered on a voluntary basis during a face to face ECG learning course for undergraduate medical students. The Index of Learning Styles (ILS) and a general questionnaire including questions about computer and Internet usage, preferred future speciality and prior experience of E-learning were used to explore different factors related to the choice of using the programme or not. Results 93 (76%) out of 123 students answered the ILS instrument and 91 the general questionnaire. 55 students (59%) were defined as users of the web-based ECG-interpretation programme. Cronbach's alpha was analysed with coefficients above 0.7 in all of the four dimensions of ILS. There were no significant differences with regard to learning styles, as assessed by ILS, between the user and non-user groups; Active/Reflective; Visual/Verbal; Sensing/Intuitive; and Sequential/Global (p = 0.56-0.96). Neither did gender, prior experience of E-learning or preference for future speciality differ between groups. Conclusion Among medical students, neither learning styles according to ILS, nor a number of other characteristics seem to influence the choice to use a web-based ECG programme. This finding was consistent also when the usage of the different modules in the programme were considered. Thus, the findings suggest that web-based learning may attract a broad variety of medical students. PMID:22248183

  20. Abnormalities of the QT interval in primary disorders of autonomic failure

    NASA Technical Reports Server (NTRS)

    Choy, A. M.; Lang, C. C.; Roden, D. M.; Robertson, D.; Wood, A. J.; Robertson, R. M.; Biaggioni, I.

    1998-01-01

    BACKGROUND: Experimental evidence shows that activation of the autonomic nervous system influences ventricular repolarization and, therefore, the QT interval on the ECG. To test the hypothesis that the QT interval is abnormal in autonomic dysfunction, we examined ECGs in patients with severe primary autonomic failure and in patients with congenital dopamine beta-hydroxylase (DbetaH) deficiency who are unable to synthesize norepinephrine and epinephrine. SUBJECTS AND METHODS: Maximal QT and rate-corrected QT (QTc) intervals and adjusted QTc dispersion [(maximal QTc - minimum QTc on 12 lead ECG)/square root of the number of leads measured] were determined in blinded fashion from ECGs of 67 patients with primary autonomic failure (36 patients with multiple system atrophy [MSA], and 31 patients with pure autonomic failure [PAF]) and 17 age- and sex-matched healthy controls. ECGs of 5 patients with congenital DbetaH deficiency and 6 age- and sex-matched controls were also analyzed. RESULTS: Patients with MSA and PAF had significantly prolonged maximum QTc intervals (492+/-58 ms(1/2) and 502+/-61 ms(1/2) [mean +/- SD]), respectively, compared with controls (450+/-18 ms(1/2), P < .05 and P < .01, respectively). A similar but not significant trend was observed for QT. QTc dispersion was also increased in MSA (40+/-20 ms(1/2), P < .05 vs controls) and PAF patients (32+/-19 ms(1/2), NS) compared with controls (21+/-5 ms(1/2)). In contrast, patients with congenital DbetaH deficiency did not have significantly different RR, QT, QTc intervals, or QTc dispersion when compared with controls. CONCLUSIONS: Patients with primary autonomic failure who have combined parasympathetic and sympathetic failure have abnormally prolonged QT interval and increased QT dispersion. However, QT interval in patients with congenital DbetaH deficiency was not significantly different from controls. It is possible, therefore, that QT abnormalities in patients with primary autonomic failure are not

  1. A Study on the Optimal Positions of ECG Electrodes in a Garment for the Design of ECG-Monitoring Clothing for Male.

    PubMed

    Cho, Hakyung; Lee, Joo Hyeon

    2015-09-01

    Smart clothing is a sort of wearable device used for ubiquitous health monitoring. It provides comfort and efficiency in vital sign measurements and has been studied and developed in various types of monitoring platforms such as T-shirt and sports bra. However, despite these previous approaches, smart clothing for electrocardiography (ECG) monitoring has encountered a serious shortcoming relevant to motion artifacts caused by wearer movement. In effect, motion artifacts are one of the major problems in practical implementation of most wearable health-monitoring devices. In the ECG measurements collected by a garment, motion artifacts are usually caused by improper location of the electrode, leading to lack of contact between the electrode and skin with body motion. The aim of this study was to suggest a design for ECG-monitoring clothing contributing to reduction of motion artifacts. Based on the clothing science theory, it was assumed in this study that the stability of the electrode in a dynamic state differed depending on the electrode location in an ECG-monitoring garment. Founded on this assumption, effects of 56 electrode positions were determined by sectioning the surface of the garment into grids with 6 cm intervals in the front and back of the bodice. In order to determine the optimal locations of the ECG electrodes from the 56 positions, ECG measurements were collected from 10 participants at every electrode position in the garment while the wearer was in motion. The electrode locations indicating both an ECG measurement rate higher than 80.0 % and a large amplitude during motion were selected as the optimal electrode locations. The results of this analysis show four electrode locations with consistently higher ECG measurement rates and larger amplitudes amongst the 56 locations. These four locations were abstracted to be least affected by wearer movement in this research. Based on this result, a design of the garment-formed ECG monitoring platform

  2. A Rare Stapes Abnormality

    PubMed Central

    Kanona, Hala; Virk, Jagdeep Singh; Kumar, Gaurav; Chawda, Sanjiv; Khalil, Sherif

    2015-01-01

    The aim of this study is to increase awareness of rare presentations, diagnostic difficulties alongside management of conductive hearing loss and ossicular abnormalities. We report the case of a 13-year-old female reporting progressive left-sided hearing loss and high resolution computed tomography was initially reported as normal. Exploratory tympanotomy revealed an absent stapedius tendon and lack of connection between the stapes superstructure and footplate. The footplate was fixed. Stapedotomy and stapes prosthesis insertion resulted in closure of the air-bone gap by 50 dB. A review of world literature was performed using MedLine. Middle ear ossicular discontinuity can result in significant conductive hearing loss. This can be managed effectively with surgery to help restore hearing. However, some patients may not be suitable or decline surgical intervention and can be managed safely conservatively. PMID:25628909

  3. Quantification of motion artifact in ECG electrode design.

    PubMed

    Kearney, Kenneth; Thomas, Chris; McAdams, Eric

    2007-01-01

    We have developed a more accurate and reproducible method of quantifying motion artifact in ECG (electrocardiogram) electrodes to assist in electrode assessment and design. It uses an algorithm developed by Sensor Technology & Devices Ltd. to reliably overcome the variation in results due to differing skin types and other causes of spurious readings such as reproducibility of movements used. The method combines a clear, concise experimental protocol with a software package and DSP algorithm to produce a transferable result for one pair of electrodes that can be used for comparison.

  4. ECG in stress testing: child of a lesser diagnostic god?

    PubMed

    Longo, S; Del Negro, B; Picano, E

    1997-01-01

    When new technologies are added to the previously existing ones, the latter can be prematurely discarded and judged obsolete not only on the basis of rational scientific facts, but also on irrational trends. Old techniques, like electrocardiography, suffer from diagnostic ambiguities that can be solved by combination with a cardiac imaging technique, like stress echocardiography. ECG monitoring during all forms of stress testing can still offer surprising dividends for a better understanding of the complex physiology of coronary artery disease, a better clinical characterization of patients with microvascular angina, and may serve as an important adjunct marker to cardiac imaging techniques. PMID:9350596

  5. Real-time ECG algorithms for ambulatory patient monitoring.

    PubMed

    Pino, Esteban; Ohno-Machado, Lucila; Wiechmann, Eduardo; Curtis, Dorothy

    2005-01-01

    Brigham & Women's Hospital is designing a wireless monitoring system for patients on the waiting area of the Emergency Department. A real-time ECG algorithm is required to monitor and alert changes in patients that have not yet been admitted to the Emergency Room. For this purpose, three simple algorithms are compared in terms of processing time, beat detection accuracy and heart rate (HR) estimation. Varying amounts of noise were added to records from the MIT-BIH Arrhythmia Database [1] to mimic expected waiting room conditions. Some recommendations regarding selection of an algorithm and further processing of HR series are presented.

  6. The study and design of a wireless ECG monitoring system.

    PubMed

    Yang, Hongli; Chai, Jihong

    2012-01-01

    This paper describes a research project on wireless electrocardiogram (ECG) monitoring systems. A detection and measurement processor designed by a MSP430 microcontroller accomplishes the analog-to-digital conversion, digital filtering, QRS wave detection, and heart rate calculation. The data of detection can be sent to the central controller and personal computer (PC) by wireless on-chip MG2455 through a ZigBee network. This design can be used widely in home healthcare, community healthcare, and sports training, as well as in healthcare facilities, due to its characteristics of low power consumption, small size, and reliability. PMID:23039742

  7. Advanced ECG in 2016: is there more than just a tracing?

    PubMed

    Reichlin, Tobias; Abächerli, Roger; Twerenbold, Raphael; Kühne, Michael; Schaer, Beat; Müller, Christian; Sticherling, Christian; Osswald, Stefan

    2016-01-01

    The 12-lead electrocardiogram (ECG) is the most frequently used technology in clinical cardiology. It is critical for evidence-based management of patients with most cardiovascular conditions, including patients with acute myocardial infarction, suspected chronic cardiac ischaemia, cardiac arrhythmias, heart failure and implantable cardiac devices. In contrast to many other techniques in cardiology, the ECG is simple, small, mobile, universally available and cheap, and therefore particularly attractive. Standard ECG interpretation mainly relies on direct visual assessment. The progress in biomedical computing and signal processing, and the available computational power offer fascinating new options for ECG analysis relevant to all fields of cardiology. Several digital ECG markers and advanced ECG technologies have shown promise in preliminary studies. This article reviews promising novel surface ECG technologies in three different fields. (1) For the detection of myocardial ischaemia and infarction, QRS morphology feature analysis, the analysis of high frequency QRS components (HF-QRS) and methods using vectorcardiography as well as ECG imaging are discussed. (2) For the identification and management of patients with cardiac arrhythmias, methods of advanced P-wave analysis are discussed and the concept of ECG imaging for noninvasive localisation of cardiac arrhythmias is presented. (3) For risk stratification of sudden cardiac death and the selection of patients for medical device therapy, several novel markers including an automated QRS-score for scar quantification, the QRS-T angle or the T-wave peak-to-end-interval are discussed. Despite the existing preliminary data, none of the advanced ECG markers and technologies has yet accomplished the transition into clinical practice. Further refinement of these technologies and broader validation in large unselected patient cohorts are the critical next step needed to facilitate translation of advanced ECG technologies

  8. Advanced ECG in 2016: is there more than just a tracing?

    PubMed

    Reichlin, Tobias; Abächerli, Roger; Twerenbold, Raphael; Kühne, Michael; Schaer, Beat; Müller, Christian; Sticherling, Christian; Osswald, Stefan

    2016-01-01

    The 12-lead electrocardiogram (ECG) is the most frequently used technology in clinical cardiology. It is critical for evidence-based management of patients with most cardiovascular conditions, including patients with acute myocardial infarction, suspected chronic cardiac ischaemia, cardiac arrhythmias, heart failure and implantable cardiac devices. In contrast to many other techniques in cardiology, the ECG is simple, small, mobile, universally available and cheap, and therefore particularly attractive. Standard ECG interpretation mainly relies on direct visual assessment. The progress in biomedical computing and signal processing, and the available computational power offer fascinating new options for ECG analysis relevant to all fields of cardiology. Several digital ECG markers and advanced ECG technologies have shown promise in preliminary studies. This article reviews promising novel surface ECG technologies in three different fields. (1) For the detection of myocardial ischaemia and infarction, QRS morphology feature analysis, the analysis of high frequency QRS components (HF-QRS) and methods using vectorcardiography as well as ECG imaging are discussed. (2) For the identification and management of patients with cardiac arrhythmias, methods of advanced P-wave analysis are discussed and the concept of ECG imaging for noninvasive localisation of cardiac arrhythmias is presented. (3) For risk stratification of sudden cardiac death and the selection of patients for medical device therapy, several novel markers including an automated QRS-score for scar quantification, the QRS-T angle or the T-wave peak-to-end-interval are discussed. Despite the existing preliminary data, none of the advanced ECG markers and technologies has yet accomplished the transition into clinical practice. Further refinement of these technologies and broader validation in large unselected patient cohorts are the critical next step needed to facilitate translation of advanced ECG technologies

  9. ECG of the Month: Subtle ECG Change in a 31 Year-Old Man with Recent Chest Pain.

    PubMed

    Glancy, D Luke

    2016-01-01

    A 31-year-old man had an hour of pain across the upper portion of his chest anteriorly, and it radiated down the inner aspects of both arms. The pain came while he was walking and gradually disappeared as he sat quietly. Six Rolaid tablets did not seem to alter the pain. The pain was unaccompanied by dyspnea, sweating, nausea or vomiting. The night before the patient had had similar pain relieved by Rolaids and belching. After the second episode of pain, he went to the emergency department of a local hospital where an ECG was recorded. PMID:27598900

  10. Ictal Cardiac Ryhthym Abnormalities

    PubMed Central

    Ali, Rushna

    2016-01-01

    Cardiac rhythm abnormalities in the context of epilepsy are a well-known phenomenon. However, they are under-recognized and often missed. The pathophysiology of these events is unclear. Bradycardia and asystole are preceded by seizure onset suggesting ictal propagation into the cortex impacting cardiac autonomic function, and the insula and amygdala being possible culprits. Sudden unexpected death in epilepsy (SUDEP) refers to the unanticipated death of a patient with epilepsy not related to status epilepticus, trauma, drowning, or suicide. Frequent refractory generalized tonic-clonic seizures, anti-epileptic polytherapy, and prolonged duration of epilepsy are some of the commonly identified risk factors for SUDEP. However, the most consistent risk factor out of these is an increased frequency of generalized tonic–clonic seizures (GTC). Prevention of SUDEP is extremely important in patients with chronic, generalized epilepsy. Since increased frequency of GTCS is the most consistently reported risk factor for SUDEP, effective seizure control is the most important preventive strategy. PMID:27347227

  11. Ictal Cardiac Ryhthym Abnormalities.

    PubMed

    Ali, Rushna

    2016-01-01

    Cardiac rhythm abnormalities in the context of epilepsy are a well-known phenomenon. However, they are under-recognized and often missed. The pathophysiology of these events is unclear. Bradycardia and asystole are preceded by seizure onset suggesting ictal propagation into the cortex impacting cardiac autonomic function, and the insula and amygdala being possible culprits. Sudden unexpected death in epilepsy (SUDEP) refers to the unanticipated death of a patient with epilepsy not related to status epilepticus, trauma, drowning, or suicide. Frequent refractory generalized tonic-clonic seizures, anti-epileptic polytherapy, and prolonged duration of epilepsy are some of the commonly identified risk factors for SUDEP. However, the most consistent risk factor out of these is an increased frequency of generalized tonic-clonic seizures (GTC). Prevention of SUDEP is extremely important in patients with chronic, generalized epilepsy. Since increased frequency of GTCS is the most consistently reported risk factor for SUDEP, effective seizure control is the most important preventive strategy. PMID:27347227

  12. Communication and abnormal behaviour.

    PubMed

    Crown, S

    1979-01-01

    In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential).

  13. Communication and abnormal behaviour.

    PubMed

    Crown, S

    1979-01-01

    In this paper the similarities between normal and abnormal behaviour are emphasized and selected aspects of communication, normal and aberrant, between persons are explored. Communication in a social system may be verbal or non-verbal: one person's actions cause a response in another person. This response may be cognitive, behavioural or physiological. Communication may be approached through the individual, the social situation or social interaction. Psychoanalysis approaches the individual in terms of the coded communications of psychoneurotic symptoms or psychotic behaviour; the humanist-existential approach is concerned more with emotional expression. Both approaches emphasize the development of individual identity. The interaction between persons and their social background is stressed. Relevant are sociological concepts such as illness behaviour, stigma, labelling, institutionalization and compliance. Two approaches to social interactions are considered: the gamesplaying metaphor, e.g. back pain as a psychosocial manipulation--the 'pain game'; and the 'spiral of reciprocal perspectives' which emphasizes the interactional complexities of social perceptions. Communicatory aspects of psychological treatments are noted: learning a particular metaphor such as 'resolution' of the problem (psychotherapy), learning more 'rewarding' behaviour (learning theory) or learning authenticity or self-actualization (humanist-existential). PMID:261653

  14. Abnormal uterine bleeding.

    PubMed

    Whitaker, Lucy; Critchley, Hilary O D

    2016-07-01

    Abnormal uterine bleeding (AUB) is a common and debilitating condition with high direct and indirect costs. AUB frequently co-exists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a menstrual bleeding complaint. A structured approach for establishing the cause using the Fédération International de Gynécologie et d'Obstétrique (FIGO) PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy (and hyperplasia), Coagulopathy, Ovulatory disorders, Endometrial, Iatrogenic and Not otherwise classified) classification system will facilitate accurate diagnosis and inform treatment options. Office hysteroscopy and increasing sophisticated imaging will assist provision of robust evidence for the underlying cause. Increased availability of medical options has expanded the choice for women and many will no longer need to recourse to potentially complicated surgery. Treatment must remain individualised and encompass the impact of pressure symptoms, desire for retention of fertility and contraceptive needs, as well as address the management of AUB in order to achieve improved quality of life. PMID:26803558

  15. Abortion for fetal abnormality.

    PubMed

    Maclean, N E

    1979-07-25

    I wish to thank Dr. Pauline Bennett for her reply (NZ Med J, 13 June). She has demonstrated well that in dealing with sensitive difficult issues such as abortion for fetal abnormality, the one thing the doctor is not recommended to do is to speak the truth] I am prompted to write this letter for 2 reasons. Firstly, the excellent letter written by Dr. A. M. Rutherford (NZ Med J, 13 June) on the subject of abortion stated, "The most disturbing feature about the whole controversy is the 'blunting of our conscience'." When the doctors are not encouraged to be honest with patients then indeed our conscience has been blunted. Secondly, I watched Holocaust last night, and cannot refrain from stating that I see frightening parallels between our liberal abortion policy and the activities of the Nazis. As I watched the "mental patients" being herded into the shed for gassing by the polite, tidy, white coated medical staff, and then heard the compassionate, sensitive, letter of the hospital authorities to the relatives of the deceased, the parallel became obvious. The mental patients were weak, defenseless, burdensome, and uneconomic; the unborn are weak, defenseless, burdensome, and uneconomic. The hospital authority's letter was acceptable in many ways, acceptable except that its words bore no relation to the truth. It is said that the "first casualty of war is the truth". Whether that war involves the Jews, or the insane, or the unborn, the statement would seem correct.

  16. Analysis of ECG from pole-zero models.

    PubMed

    Murthy, I S; Prasad, G S

    1992-07-01

    A complete solution to the fundamental problem of ECG analysis, viz., delineation of the signal into its component waves, is proposed from a system theoretic point of view. The discrete cosine transform of a bell shaped biphasic function is approximated mathematically by a system function with two poles and two zeros, i.e., of order (2, 2). Using this concept as the basis, a pole-zero model of suitable order is derived from the discrete cosine transform (DCT) of the given signal using Steiglitz-McBride method. This model is expanded into a unique set of partial fractions each of order (2, 2), and a biphasic function is recovered from each one of these fractions in the inverse process. Each of the P and T waves usually requires only one biphasic function, while the QRS complex needs two or at most three such fractions. A one-to-one relationship between the pole pattern in the z-plane and component wave pattern in the time signal is established. Results of analysis of continuous strips of ECG show that the delineated component waves are in excellent agreement with the original waves both qualitatively and quantitatively. The method is robust for the analysis of signals with artifacts of various kinds, independent of the sampling rate used, and is free from ad hoc back and forth search procedures. PMID:1516941

  17. Ubiquitous wireless ECG recording: a powerful tool physicians should embrace.

    PubMed

    Saxon, Leslie A

    2013-04-01

    The use of smart phones has increased dramatically and there are nearly a billion users on 3G and 4G networks worldwide. Nearly 60% of the U.S. population uses smart phones to access the internet, and smart phone sales now surpass those of desktop and laptop computers. The speed of wireless communication technology on 3G and 4G networks and the widespread adoption and use of iOS equipped smart phones (Apple Inc., Cupertino, CA, USA) provide infrastructure for the transmission of wireless biomedical data, including ECG data. These technologies provide an unprecedented opportunity for physicians to continually access data that can be used to detect issues before symptoms occur or to have definitive data when symptoms are present. The technology also greatly empowers and enables the possibility for unprecedented patient participation in their own medical education and health status as well as that of their social network. As patient advocates, physicians and particularly cardiac electrophysiologists should embrace the future and promise of wireless ECG recording, a technology solution that can truly scale across the global population.

  18. A low computational complexity algorithm for ECG signal compression.

    PubMed

    Blanco-Velasco, Manuel; Cruz-Roldán, Fernando; López-Ferreras, Francisco; Bravo-Santos, Angel; Martínez-Muñoz, Damián

    2004-09-01

    In this work, a filter bank-based algorithm for electrocardiogram (ECG) signals compression is proposed. The new coder consists of three different stages. In the first one--the subband decomposition stage--we compare the performance of a nearly perfect reconstruction (N-PR) cosine-modulated filter bank with the wavelet packet (WP) technique. Both schemes use the same coding algorithm, thus permitting an effective comparison. The target of the comparison is the quality of the reconstructed signal, which must remain within predetermined accuracy limits. We employ the most widely used quality criterion for the compressed ECG: the percentage root-mean-square difference (PRD). It is complemented by means of the maximum amplitude error (MAX). The tests have been done for the 12 principal cardiac leads, and the amount of compression is evaluated by means of the mean number of bits per sample (MBPS) and the compression ratio (CR). The implementation cost for both the filter bank and the WP technique has also been studied. The results show that the N-PR cosine-modulated filter bank method outperforms the WP technique in both quality and efficiency. PMID:15271283

  19. An Adaptive Framework for Real-Time ECG Transmission in Mobile Environments

    PubMed Central

    2014-01-01

    Wireless electrocardiogram (ECG) monitoring involves the measurement of ECG signals and their timely transmission over wireless networks to remote healthcare professionals. However, fluctuations in wireless channel conditions pose quality-of-service challenges for real-time ECG monitoring services in a mobile environment. We present an adaptive framework for layered coding and transmission of ECG data that can cope with a time-varying wireless channel. The ECG is segmented into layers with differing importance with respect to the quality of the reconstructed signal. According to this observation, we have devised a simple and efficient real-time scheduling algorithm based on the earliest deadline first (EDF) policy, which decides the order of transmitting or retransmitting packets that contain ECG data at any given time for the delivery of scalable ECG data over a lossy channel. The algorithm takes into account the differing priorities of packets in each layer, which prevents the perceived quality of the reconstructed ECG signal from degrading abruptly as channel conditions worsen, while using the available bandwidth efficiently. Extensive simulations demonstrate this improvement in perceived quality. PMID:25097886

  20. A novel approach for an ECG electrode integrated into a transcutaneous sensor.

    PubMed

    Hölscher, U

    1987-01-01

    The integration of an ECG-electrode into a common transcutaneous sensor allows simple handling and leads to a reduction of the physiological stress of pre-term infants. Furthermore it may allow future replacement of an invasive method to measure the ECG under labour by a non-invasive one.

  1. Interactive Videoconference Supported Teaching in Undergraduate Nursing: A Case Study for ECG

    ERIC Educational Resources Information Center

    Celikkan, Ufuk; Senuzun, Fisun; Sari, Dilek; Sahin, Yasar Guneri

    2013-01-01

    This paper describes how interactive videoconference can benefit the Electrocardiography (ECG) skills of undergraduate nursing students. We have implemented a learning system that interactively transfers the visual and practical aspects of ECG from a nursing skills lab into a classroom where the theoretical part of the course is taught. The…

  2. Effects of electrocardiography contamination and comparison of ECG removal methods on upper trapezius electromyography recordings.

    PubMed

    Marker, Ryan J; Maluf, Katrina S

    2014-12-01

    Electromyography (EMG) recordings from the trapezius are often contaminated by the electrocardiography (ECG) signal, making it difficult to distinguish low-level muscle activity from muscular rest. This study investigates the influence of ECG contamination on EMG amplitude and frequency estimations in the upper trapezius during muscular rest and low-level contractions. A new method of ECG contamination removal, filtered template subtraction (FTS), is described and compared to 30 Hz high-pass filter (HPF) and averaged template subtraction (ATS) methods. FTS creates a unique template of each ECG artifact using a low-pass filtered copy of the contaminated signal, which is subtracted from contaminated periods in the original signal. ECG contamination results in an over-estimation of EMG amplitude during rest in the upper trapezius, with negligible effects on amplitude and frequency estimations during low-intensity isometric contractions. FTS and HPF successfully removed ECG contamination from periods of muscular rest, yet introduced errors during muscle contraction. Conversely, ATS failed to fully remove ECG contamination during muscular rest, yet did not introduce errors during muscle contraction. The relative advantages and disadvantages of different ECG contamination removal methods should be considered in the context of the specific motor tasks that require analysis.

  3. Interoperability in digital electrocardiography: harmonization of ISO/IEEE x73-PHD and SCP-ECG.

    PubMed

    Trigo, Jesús D; Chiarugi, Franco; Alesanco, Alvaro; Martínez-Espronceda, Miguel; Serrano, Luis; Chronaki, Catherine E; Escayola, Javier; Martínez, Ignacio; García, José

    2010-11-01

    The ISO/IEEE 11073 (x73) family of standards is a reference frame for medical device interoperability. A draft for an ECG device specialization (ISO/IEEE 11073-10406-d02) has already been presented to the Personal Health Device (PHD) Working Group, and the Standard Communications Protocol for Computer-Assisted ElectroCardioGraphy (SCP-ECG) Standard for short-term diagnostic ECGs (EN1064:2005+A1:2007) has recently been approved as part of the x73 family (ISO 11073-91064:2009). These factors suggest the coordinated use of these two standards in foreseeable telecardiology environments, and hence the need to harmonize them. Such harmonization is the subject of this paper. Thus, a mapping of the mandatory attributes defined in the second draft of the ISO/IEEE 11073-10406-d02 and the minimum SCP-ECG fields is presented, and various other capabilities of the SCP-ECG Standard (such as the messaging part) are also analyzed from an x73-PHD point of view. As a result, this paper addresses and analyzes the implications of some inconsistencies in the coordinated use of these two standards. Finally, a proof-of-concept implementation of the draft x73-PHD ECG device specialization is presented, along with the conversion from x73-PHD to SCP-ECG. This paper, therefore, provides recommendations for future implementations of telecardiology systems that are compliant with both x73-PHD and SCP-ECG.

  4. A review on digital ECG formats and the relationships between them.

    PubMed

    Trigo, Jesús Daniel; Alesanco, Alvaro; Martínez, Ignacio; García, José

    2012-05-01

    A plethora of digital ECG formats have been proposed and implemented. This heterogeneity hinders the design and development of interoperable systems and entails critical integration issues for the healthcare information systems. This paper aims at performing a comprehensive overview on the current state of affairs of the interoperable exchange of digital ECG signals. This includes 1) a review on existing digital ECG formats, 2) a collection of applications and cardiology settings using such formats, 3) a compilation of the relationships between such formats, and 4) a reflection on the current situation and foreseeable future of the interoperable exchange of digital ECG signals. The objectives have been approached by completing and updating previous reviews on the topic through appropriate database mining. 39 digital ECG formats, 56 applications, tools or implantation experiences, 47 mappings/converters, and 6 relationships between such formats have been found in the literature. The creation and generalization of a single standardized ECG format is a desirable goal. However, this unification requires political commitment and international cooperation among different standardization bodies. Ongoing ontology-based approaches covering ECG domain have recently emerged as a promising alternative for reaching fully fledged ECG interoperability in the near future.

  5. Mechanisms of exercise-recovery hysteresis in the ECG: ISCE 2015 paper.

    PubMed

    Swenne, Cees A

    2015-01-01

    This paper gives an overview of multiple factors, like the mechanisms governing rate adaptation of ventricular action potentials and autonomic mechanisms, which play a role in the genesis of exercise-recovery hysteresis in the ECG. It also discusses the possible association between exercise-recovery ECG hysteresis and arrhythmogeneity.

  6. Non-invasive assessment of functionally significant coronary stenoses through mathematical analysis of spectral ECG components

    PubMed Central

    Amano, Tetsuya; Shinoda, Norihiro; Kunimura, Ayako; Harada, Ken; Uetani, Tadayuki; Takashima, Hiroaki; Ando, Hirohiko; Kumagai, Soichiro; Gosho, Masahiko; Murohara, Toyoaki

    2014-01-01

    Objectives The aim of this study was to evaluate the accuracy of the Multifunction CardioGram (MCG) in detecting the presence of functionally significant coronary ischaemia. Methods and results This prospective study evaluated the accuracy of the MCG, a new ECG analysis device used to diagnose ischaemic coronary artery disease (CAD). A consecutive 112 participants suspected to have CAD who were scheduled for elective coronary angiography (CAG) from October 2012 to December 2013 were examined. Their predictive values of relevant ischaemia were measured by MCG, standard ECG and Framingham Risk Score (FRS) and compared. Five levels of ischaemia based on CAG findings adjusted by fractional flow reserve (FFR) values and three levels of MCG score of high, borderline or low were used. The MCG (OR=2.67 (1.60 to 4.44), p<0.001) was the only test significantly associated with ischaemia level. The FFR values for individual MCG scores with low, borderline and high were 0.77 (0.70 to 0.86), 0.78 (0.71 to 0.82) and 0.69 (0.65 to 0.77), respectively, p=0.042. A high MCG score had a specificity of 90.4% (87.0% to 93.9%) in model 1 adjusted by FFR≤0.8 threshold and of 87.0% (83.2% to 90.8%) in model 2 adjusted by FFR≤0.75 threshold, and a negative predictive value of 82.5% (78.3% to 86.7%) in model 1 and of 83.8% (79.6% to 87.9%) in model 2 for the prediction of severe ischaemia. Conclusions The MCG showed high specificity with a high negative predictive value, suggesting that the MCG could be used not only to identify functionally significant ischaemia but to reduce unnecessary CAGs. Trial registration number UMIN ID: 000009992. PMID:25469309

  7. Mitral valve prolapse in the ventriculogram: scintigraphic, electrocardiographic, and hemodynamic abnormalities

    SciTech Connect

    Tebbe, U.; Schicha, H.; Neumann, P.; Voth, E.; Emrich, D.; Neuhaus, K.L.; Kreuzer, H.

    1985-06-01

    Patients with mitral valve prolapse (MVP) frequently have chest pain, which may be difficult to differentiate from angina pectoris in coronary artery disease (CAD). The authors performed resting and exercise ECGs, pulmonary arterial pressure measurements, radionuclide ventriculography (/sup 99m/technetium), and perfusion scintigrams (/sup 201/thallium) in 56 patients with angiographically proven MVP and no CAD. Pathological results were obtained in 31% of exercise ECGs, 33% of pulmonary arterial pressure measurements during exercise, 22% of radionuclide ventriculographies, and in 75% of thallium perfusion scintigrams. A significant correlation in pathological results was found only between exercise ECG and both radionuclide ventriculography and pulmonary arterial pressure measurements. Because of the high prevalence of false-positive perfusion scintigrams in patients with typical or atypical chest pain, the use of exercise /sup 201/Tl imaging as a screening method to separate patients with MVP from those with CAD will not be appropriate. The variability of cardiac abnormalities in our patients with MVP and angiographically normal coronary arteries suggests that the MVP syndrome may represent a variable combination of metabolic, ischemic, or myopathic disorders.

  8. Relative Amplitude based Features of characteristic ECG-Peaks for Identification of Coronary Artery Disease

    NASA Astrophysics Data System (ADS)

    Gohel, Bakul; Tiwary, U. S.; Lahiri, T.

    Coronary artery disease or Myocardial Infarction is the leading cause of death and disability in the world. ECG is widely used as a cheap diagnostic tool for diagnosis of coronary artery disease but has low sensitivity with the present criteria based on ST-segment, T wave and Q wave changes. So to increase the sensitivity of the ECG we have introduced relative amplitude based new features of characteristic ‘R’ and ‘S’ ECG-peaks between two leads. Relative amplitude based features shows remarkable capability in discriminating Myocardial Infarction and Healthy pattern using backpropogation neural network classifier yield results with 81.82% sensitivity and 81.82% specificity. Also relative amplitude might be an efficient method in minimizing the effect of body composition on ECG amplitude based features without use of any information from other than ECG

  9. [Computer assisted long-term ECG analysis: method and clinical importance (author's transl)].

    PubMed

    Weber, H; Joskowicz, G; Glogar, D; Steinbach, K

    1982-01-01

    The basic principle of computer assisted analysis of Holter recordings is to store the whole ECG after data reduction and AD conversion in digitized form on random access medium like magnetic disks. In "Multipass Scanning" the linear segmentation techniques leads to highly reproducible ECG-data, which were analysed during multiple passes under continuous operator control. The field of clinical applications of such a highly sophisticated method reaches from supraventricular over ventricular to symptomatic arrhythmias. In combination with ECG-telefon-telemetry computer assisted LT-ECG analysis could be used in more than 75% of the patients successfully. The clinical expectations during routine could be fulfilled in more than 75%. Commonly a detailed numerical or graphical description of clinical relevant arrhythmias were necessary in the demand of the routine. So computer assisted LT-ECG analysis is not only a tool for research, but also valuable in the clinical routine.

  10. Removal of baseline wandering in ECG signal by improved detrending method.

    PubMed

    Shin, Seung-Won; Kim, Kyeong-Seop; Song, Chul-Gyu; Lee, Jeong-Whan; Kim, Jeong-Hwan; Jeung, Gyeo-Wun

    2015-01-01

    The very first step to process electrocardiogram (ECG) signal is to eliminate baseline wandering interference that is usually caused by electrode-skin impedance mismatch, motion artifacts due to a patient's body moment or respiratory breathing. A new method is thus suggested to remove baseline wandering in ECG by improving the detrending method that was originally proposed for eliminating slow non-stationary trends from heart rate variability (HRV). In our proposed method, a global trend is estimated in terms of baseline wandering by merging the local trend based on an ECG segment that represents a part of the ECG signal. The experimental results show that the improved detrending method can efficiently resolve baseline wandering without distorting any morphological characteristic embedded in the ECG signal in no time delay manner.

  11. Capacitive ECG recording and beat-to-beat interval estimation after major cardiac event.

    PubMed

    Leicht, Lennart; Skobel, Erik; Mathissen, Marcel; Leonhardt, Steffen; Weyer, Soren; Wartzek, Tobias; Reith, Sebastian; Mohler, Werner; Teichmann, Daniel

    2015-08-01

    Today, heart diseases are the most common cause of death in the U.S.. Due to improved healthcare, more and more patients survive a major cardiac event, e.g. a heart attack. However, participation in everyday activity (e.g. driving a car) can be impaired afterwards. Patients might benefit from heart activity monitoring while driving using a capacitive ECG (cECG). However, it is unknown whether cECG is an appropriate monitoring tool for such patients. In this work, first results from a study including 10 patients having survived at least one major cardiac event are presented. It is shown that cECG can be used to diagnose heart rhythm deviations and estimate beat-to-beat intervals similar to conventional ECG. PMID:26738055

  12. Respiratory Motion Detection and Correction in ECG-Gated SPECT: a New Approach

    PubMed Central

    Bitarafan, Ahmad; Rajabi, Hossein; Gruy, Bernhard; Rustgou, Feridoon; Sharafi, Ali Akbar; Firoozabady, Hasan; Yaghoobi, Nahid; Malek, Hadi; Pirich, Christian; Langesteger, Werner

    2008-01-01

    .001 versus y = 0.8046x + 5.1704; r = 0.89, p < 0.001). Nineteen (19/26) patients (73.1%) showed abnormal myocardial perfusion scans with reversible regional myocardial defects; of the 19 patients, 14 (14/26) patients underwent coronary angiography. Conclusion Respiratory induced motion can be successfully corrected simultaneously with the use of ECG-gated SPECT in MPI studies using this proposed technique. Moreover, the use of ECG-gated SPECT improved image quality, especially in the inferior and septal regions that are mostly affected by diaphragmatic attenuation. However, the effect of respiratory correction depends mainly on the patient respiratory pattern and may be clinically relevant in certain cases. PMID:19039264

  13. Neuroimaging of schizophrenia: structural abnormalities and pathophysiological implications

    PubMed Central

    Buckley, Peter F

    2005-01-01

    Schizophrenia, once considered a psychological malady devoid of any organic brain substrate, has been the focus of intense neuroimaging research. Findings reveal mild but generalized tissue loss as well as more selective focal loss. It is unclear whether these abnormalities reflect neurodevelopmental or neurodegenerative processes, or some combination of each; current evidence favors a preponderance of neurodevelopmental abnormalities. The pattern of brain abnormalities is also influenced by environmental and genetic risk factors, as well as by the course (and possibly even treatment) of this illness. These findings are described in this article. PMID:18568069

  14. Enhancement of low sampling frequency recordings for ECG biometric matching using interpolation.

    PubMed

    Sidek, Khairul Azami; Khalil, Ibrahim

    2013-01-01

    Electrocardiogram (ECG) based biometric matching suffers from high misclassification error with lower sampling frequency data. This situation may lead to an unreliable and vulnerable identity authentication process in high security applications. In this paper, quality enhancement techniques for ECG data with low sampling frequency has been proposed for person identification based on piecewise cubic Hermite interpolation (PCHIP) and piecewise cubic spline interpolation (SPLINE). A total of 70 ECG recordings from 4 different public ECG databases with 2 different sampling frequencies were applied for development and performance comparison purposes. An analytical method was used for feature extraction. The ECG recordings were segmented into two parts: the enrolment and recognition datasets. Three biometric matching methods, namely, Cross Correlation (CC), Percent Root-Mean-Square Deviation (PRD) and Wavelet Distance Measurement (WDM) were used for performance evaluation before and after applying interpolation techniques. Results of the experiments suggest that biometric matching with interpolated ECG data on average achieved higher matching percentage value of up to 4% for CC, 3% for PRD and 94% for WDM. These results are compared with the existing method when using ECG recordings with lower sampling frequency. Moreover, increasing the sample size from 56 to 70 subjects improves the results of the experiment by 4% for CC, 14.6% for PRD and 0.3% for WDM. Furthermore, higher classification accuracy of up to 99.1% for PCHIP and 99.2% for SPLINE with interpolated ECG data as compared of up to 97.2% without interpolation ECG data verifies the study claim that applying interpolation techniques enhances the quality of the ECG data. PMID:23062461

  15. Ultrasound findings in dengue haemorrhagic fever.

    PubMed

    Pramuljo, H S; Harun, S R

    1991-01-01

    The ultrasound examination of 29 children, aged between 2 to 13 years with clinical and serological proven dengue haemorrhagic fever were reviewed and correlated with the findings in the literature. Ultrasound findings consisted of: (1) ascites, (2) pleural effusion, (3) abnormal gallbladder wall and (4) abnormal liver parenchyma. Ascites is common in DHF. Pleural effusion was found on the right and on bilateral pleural spaces. There was no isolated left pleural effusions. The abnormal gallbladder wall has never been mentioned before in the literature and the abnormal liver parenchyma might be due to intraparenchymal and subcapsular haemorrhages.

  16. Haem degradation in abnormal haemoglobins.

    PubMed Central

    Brown, S B; Docherty, J C

    1978-01-01

    The coupled oxidation of certain abnormal haemoglobins leads to different bile-pigment isomer distributions from that of normal haemoglobin. The isomer pattern may be correlated with the structure of the abnormal haemoglobin in the neighbourhood of the haem pocket. This is support for haem degradation by an intramolecular reaction. PMID:708385

  17. Systemic abnormalities in liver disease

    PubMed Central

    Minemura, Masami; Tajiri, Kazuto; Shimizu, Yukihiro

    2009-01-01

    Systemic abnormalities often occur in patients with liver disease. In particular, cardiopulmonary or renal diseases accompanied by advanced liver disease can be serious and may determine the quality of life and prognosis of patients. Therefore, both hepatologists and non-hepatologists should pay attention to such abnormalities in the management of patients with liver diseases. PMID:19554648

  18. Abnormal pressure in hydrocarbon environments

    USGS Publications Warehouse

    Law, B.E.; Spencer, C.W.

    1998-01-01

    Abnormal pressures, pressures above or below hydrostatic pressures, occur on all continents in a wide range of geological conditions. According to a survey of published literature on abnormal pressures, compaction disequilibrium and hydrocarbon generation are the two most commonly cited causes of abnormally high pressure in petroleum provinces. In young (Tertiary) deltaic sequences, compaction disequilibrium is the dominant cause of abnormal pressure. In older (pre-Tertiary) lithified rocks, hydrocarbon generation, aquathermal expansion, and tectonics are most often cited as the causes of abnormal pressure. The association of abnormal pressures with hydrocarbon accumulations is statistically significant. Within abnormally pressured reservoirs, empirical evidence indicates that the bulk of economically recoverable oil and gas occurs in reservoirs with pressure gradients less than 0.75 psi/ft (17.4 kPa/m) and there is very little production potential from reservoirs that exceed 0.85 psi/ft (19.6 kPa/m). Abnormally pressured rocks are also commonly associated with unconventional gas accumulations where the pressuring phase is gas of either a thermal or microbial origin. In underpressured, thermally mature rocks, the affected reservoirs have most often experienced a significant cooling history and probably evolved from an originally overpressured system.

  19. Electrocardiograph abnormalities revealed during laparoscopy.

    PubMed

    Nijjer, Sukhjinder; Dubrey, Simon William

    2010-01-01

    This brief case presents a well patient in whom an electrocardiograph abnormality consistent with an accessory pathway was found during a routine procedure. We present the electrocardiographs, explain the underlying condition, and consider why the abnormality was revealed in this manner.

  20. Coronary angiographic findings in asymptomatic systemic sclerosis.

    PubMed

    Tarek, El-Gohary; Yasser, Amin E; Gheita, Tamer

    2006-07-01

    The objective of this study was to assess coronary arterial involvement in asymptomatic systemic sclerosis (SSc) patients. Fourteen female patients with SSc (five limited and nine diffuse) were recruited for this study. All patients fulfilled the following 1980 American College of Rheumatology criteria for classification of SSc Masi et al (Arthritis Rheum 23:581-590 1980). None of them had chest pain nor electrocardiogram (ECG) changes suggestive of myocardial ischemia. All patients underwent thorough history taking, full clinical examination, routine laboratory investigations, and basic screening for conventional atherosclerotic disease risk factors. ECG and coronary catheterization were done for all patients. We detected 19 coronary angiographic abnormalities in our cohort. Three out of nine diffuse SSc patients (33.33%) had ectasia of the coronary arteries, and all of them had slow flow but none in the limited type. One patient with limited SSc showed spasm. Three out of five patients with limited type (60%) had stenosis, one of them had uncontrolled hypertension, while none of the diffuse type had. Five patients (55.55%) of the diffuse type had tortuosity, while it was found in only two patients (40%) of the limited type. Three patients (33.3%) of the diffuse type had calcification of the coronaries, while it was seen in two patients (40%) of the limited type. Pathological involvement of coronary arteries in asymptomatic SSc patients is not uncommon but not paralleled by clinical symptomatology.

  1. Craniofacial abnormalities among patients with Edwards Syndrome

    PubMed Central

    Rosa, Rafael Fabiano M.; Rosa, Rosana Cardoso M.; Lorenzen, Marina Boff; Zen, Paulo Ricardo G.; Graziadio, Carla; Paskulin, Giorgio Adriano

    2013-01-01

    OBJECTIVE To determine the frequency and types of craniofacial abnormalities observed in patients with trisomy 18 or Edwards syndrome (ES). METHODS This descriptive and retrospective study of a case series included all patients diagnosed with ES in a Clinical Genetics Service of a reference hospital in Southern Brazil from 1975 to 2008. The results of the karyotypic analysis, along with clinical data, were collected from medical records. RESULTS: The sample consisted of 50 patients, of which 66% were female. The median age at first evaluation was 14 days. Regarding the karyotypes, full trisomy of chromosome 18 was the main alteration (90%). Mosaicism was observed in 10%. The main craniofacial abnormalities were: microretrognathia (76%), abnormalities of the ear helix/dysplastic ears (70%), prominent occiput (52%), posteriorly rotated (46%) and low set ears (44%), and short palpebral fissures/blepharophimosis (46%). Other uncommon - but relevant - abnormalities included: microtia (18%), orofacial clefts (12%), preauricular tags (10%), facial palsy (4%), encephalocele (4%), absence of external auditory canal (2%) and asymmetric face (2%). One patient had an initial suspicion of oculo-auriculo-vertebral spectrum (OAVS) or Goldenhar syndrome. CONCLUSIONS: Despite the literature description of a characteristic clinical presentation for ES, craniofacial alterations may be variable among these patients. The OAVS findings in this sample are noteworthy. The association of ES with OAVS has been reported once in the literature. PMID:24142310

  2. [Renal abnormalities in ankylosing spondylitis].

    PubMed

    Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease. PMID:22520483

  3. [Renal abnormalities in ankylosing spondylitis].

    PubMed

    Samia, Barbouch; Hazgui, Faiçal; Abdelghani, Khaoula Ben; Hamida, Fethi Ben; Goucha, Rym; Hedri, Hafedh; Taarit, Chokri Ben; Maiz, Hedi Ben; Kheder, Adel

    2012-07-01

    We will study the epidemiologic, clinical, biological, therapeutic, prognostic characteristics and predictive factors of development of nephropathy in ankylosing spondylitis patients. We retrospectively reviewed the medical record of 32 cases with renal involvement among 212 cases of ankylosing spondylitis followed in our service during the period spread out between 1978 and 2006. The renal involvement occurred in all patients a mean of 12 years after the clinical onset of the rheumatic disease. Thirty-two patients presented one or more signs of renal involvement: microscopic hematuria in 22 patients, proteinuria in 23 patients, nephrotic syndrome in 11 patients and decreased renal function in 24 patients (75%). Secondary renal amyloidosis (13 patients), which corresponds to a prevalence of 6,1% and tubulointerstitial nephropathy (7 patients) were the most common cause of renal involvement in ankylosing spondylitis followed by IgA nephropathy (4 patients). Seventeen patients evolved to the end stage renal disease after an average time of 29.8 ± 46 months. The average follow-up of the patients was 4,4 years. By comparing the 32 patients presenting a SPA and renal disease to 88 with SPA and without nephropathy, we detected the predictive factors of occurred of nephropathy: tobacco, intense inflammatory syndrome, sacroileite stage 3 or 4 and presence of column bamboo. The finding of 75% of the patients presented a renal failure at the time of the diagnosis of renal involvement suggests that evidence of renal abnormality involvement should be actively sought in this disease.

  4. The XXXXY Sex Chromosome Abnormality

    PubMed Central

    Barr, M. L.; Carr, D. H.; Pozsonyi, J.; Wilson, R. A.; Dunn, H. G.; Jacobson, T. S.; Miller, J. R.; Chown, B.

    1962-01-01

    The most common sex chromosome complex in sex chromatin-positive males with Klinefelter's syndrome is XXY. When the complex is XXYY or XXXY, the clinical findings do not seem to differ materially from those seen in XXY subjects, although more patients with these intersexual chromosome complements need to be studied to establish possible phenotypical expressions of the chromosomal variants. Two male children with an XXXXY sex chromosome abnormality are described. The data obtained from the study of these cases and five others described in the literature suggest that the XXXXY patient is likely to have congenital defects not usually seen in the common form of the Klinefelter syndrome. These include a triad of (1) skeletal anomalies (including radioulnar synostosis), (2) hypogenitalism (hypoplasia of penis and scrotum, incomplete descent of testes and defective prepubertal development of seminiferous tubules), and (3) greater risk of severe mental deficiency. That the conclusions are based on data from a small number of patients is emphasized, together with the need for a cytogenetic survey of a large control or unselected population. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9Fig. 10 PMID:13969480

  5. [Abnormal movements. Historical notes].

    PubMed

    García-Ruiz, P J

    Most of the knowledge about movement disorders comes from the last fifty years. However, the ancients made some remarkable neurological depictions. We still can find some neurological descriptions including Parkinson's disease in the Bible, and the ancient writings of Atreya and Susruta. In addition, classic tests provide us of valuable information on historical personages, including the dystonia of Alexander the Great.

  6. Phenotypic abnormalities: terminology and classification.

    PubMed

    Merks, Johannes H M; van Karnebeek, Clara D M; Caron, Hubert N; Hennekam, Raoul C M

    2003-12-15

    Clinical morphology has proved essential for the successful delineation of hundreds of syndromes and as a powerful instrument for detecting (candidate) genes (Gorlin et al. [2001]; Syndromes of the Head and Neck; Oxford: Oxford University Press. 1 p]. The major approach to reach this has been careful clinical evaluations of patients, focused on congenital anomalies. A similar careful physical examination performed in patients, who have been treated for childhood cancer, may allow detection of concurrent patterns of anomalies and provide clues for causative genes. In the past, several studies were performed describing the prevalence of anomalies in patients with cancer. However, in most studies, it was not possible to indicate the biologic relevance of the recorded anomalies, or to judge their relative importance. Are the detected anomalies common variants, and should they thus be regarded as normal, or are they minor anomalies or true abnormalities, indicating a possible developmental cause? Classification of items in the categories of common variants (disturbances of phenogenesis with a prevalence >4%), minor anomalies (disturbances of phenogenesis with a prevalence abnormal physical findings by a nomenclature for errors of morphogenesis detectable on surface examination, and secondly a uniform classification system. This should allow investigators to evaluate systematically the presence of patterns in phenotypic anomalies, in the general population, and in patients with various disorders, suspected to be a developmental anomaly. Also

  7. ECG scores for a triage of patients with acute myocardial infarction transported by the emergency medical system.

    PubMed

    Zalenski, R J; Grzybowski, M; Ross, M A; Blaustein, N; Bock, B

    2000-01-01

    Prehospital triage of cardiac patients for bypass from community hospitals to cardiac centers may improve survival. This article determines if electrocardiogram (ECG)-based scoring triage methods (Aldrich MI scoring, QRS distortion, and the TIMI classification) and location of infarct (via 12 lead ECG) are associated with mortality before and after adjusting for age, sex, and race. It is a retrospective study of 291 AMI adult patients transported by ambulance to community hospitals or cardiac centers. Patients with an ED chief complaint of chest pain or dyspnea, presence of MI as defined by ECG findings of 0.1 mV of ST segment elevation in two leads or positive CPK-MB were eligible for the study. The primary outcome variable was 2-year mortality as determined with a metropolitan Detroit tri-county death index. Logistic regression was used to calculate the unadjusted and adjusted odds ratios (with 95% CIs) of the predictor variables with mortality. Of the initial population selected for the study (n = 291), 229 patients were eligible for the analysis. The mean age was 66 years (SD of 14.4) with 63.8% being male and 54% being white. The overall mortality point estimate was 21.3% (95% CI of 15.2 to 27.3%). Aldrich scores and QRS distortion (yes/no) were not associated with mortality. Patients classified as a "high risk" for AMI per TIMI status were almost 3 times more likely to die than those at "low risk" and reached borderline statistical significance (P = .06) after adjusting for the covariates. Having an anterior infarct, as opposed to an inferior infarct, was significantly associated with death before and after adjusting for the covariates (Unadjusted OR = 2.6, Adjusted OR = 2.8). Properly training emergency medical system professionals in this area may prove useful for identifying higher risk AMI patients in the prehospital setting. PMID:11265729

  8. P and T wave detection on multichannel ECG using FRI.

    PubMed

    Nair, Amrish; Marziliano, Pina

    2014-01-01

    This paper proposes a new method for detecting P and T waves in multilead ECG based on the Finite Rate of Innovation(FRI) technique [8]. A simple QRS detection scheme will be presented followed by a novel P and T wave detection algorithm. The novelty here is the modelling of the P and T wave using a Gaussian kernel. Using a 2D wavelet decomposition, the approximation coefficients are windowed based on the QRS locations. The FRI method is then used to identify the Gaussian distribution present in the window which will in turn provide the locations of the P and T wave. This method was tested on more than an hour of clean and noisy data and shows good performance in the noisy case. PMID:25570440

  9. Personalized USB Biosensor Module for Effective ECG Monitoring.

    PubMed

    Sladojević, Srdjan; Arsenović, Marko; Lončar-Turukalo, Tatjana; Sladojević, Miroslava; Ćulibrk, Dubravko

    2016-01-01

    The burden of chronic disease and associated disability present a major threat to financial sustainability of healthcare delivery systems. The need for cost-effective early diagnosis and disease prevention is evident driving the development of personalized home health solutions. The proposed solution presents an easy to use ECG monitoring system. The core hardware component is a biosensor dongle with sensing probes at one end, and micro USB interface at the other end, offering reliable and unobtrusive sensing, preprocessing and storage. An additional component is a smart phone, providing both the biosensor's power supply and an intuitive user application for the real-time data reading. The system usage is simplified, with innovative solutions offering plug and play functionality avoiding additional driver installation. Personalized needs could be met with different sensor combinations enabling adequate monitoring in chronic disease, during physical activity and in the rehabilitation process. PMID:27225580

  10. Microcontroller-based underwater acoustic ECG telemetry system.

    PubMed

    Istepanian, R S; Woodward, B

    1997-06-01

    This paper presents a microcontroller-based underwater acoustic telemetry system for digital transmission of the electrocardiogram (ECG). The system is designed for the real time, through-water transmission of data representing any parameter, and it was used initially for transmitting in multiplexed format the heart rate, breathing rate and depth of a diver using self-contained underwater breathing apparatus (SCUBA). Here, it is used to monitor cardiovascular reflexes during diving and swimming. The programmable capability of the system provides an effective solution to the problem of transmitting data in the presence of multipath interference. An important feature of the paper is a comparative performance analysis of two encoding methods, Pulse Code Modulation (PCM) and Pulse Position Modulation (PPM).

  11. [ECG indices in dogs after inhalation of 239Pu].

    PubMed

    Karpova, V N

    1985-11-01

    Dogs of both sexes aged 2 to 4 were subjected to inhalation inoculation with polymer 239Pu or submicron 239PuO2 aerosols in amounts close to acute, subacute and chronically effective ones. ECG was recorded in standard, amplified and single leads (V3). All calculations were done by lead II. Signs of the right heart overburdening were noted in the presence of the P-pulmonale complex, deep S1 wave or cardiac electrical axis of SI-SII-SIII type. Signs of the right heart overburdening were revealed after inhalation of polimer 239Pu (70%). The absence of similar changes in damage caused by 239Pu could be attributed to its fast resorption from the lungs resulting in more moderate lesion of the respiratory organs.

  12. Chromosomal abnormalities in human sperm

    SciTech Connect

    Martin, R.H.

    1985-01-01

    The ability to analyze human sperm chromosome complements after penetration of zona pellucida-free hamster eggs provides the first opportunity to study the frequency and type of chromosomal abnormalities in human gametes. Two large-scale studies have provided information on normal men. We have studied 1,426 sperm complements from 45 normal men and found an abnormality rate of 8.9%. Brandriff et al. (5) found 8.1% abnormal complements in 909 sperm from 4 men. The distribution of numerical and structural abnormalities was markedly dissimilar in the 2 studies. The frequency of aneuploidy was 5% in our sample and only 1.6% in Brandriff's, perhaps reflecting individual variability among donors. The frequency of 24,YY sperm was low: 0/1,426 and 1/909. This suggests that the estimates of nondisjunction based on fluorescent Y body data (1% to 5%) are not accurate. We have also studied men at increased risk of sperm chromosomal abnormalities. The frequency of chromosomally unbalanced sperm in 6 men heterozygous for structural abnormalities varied dramatically: 77% for t11;22, 32% for t6;14, 19% for t5;18, 13% for t14;21, and 0% for inv 3 and 7. We have also studied 13 cancer patients before and after radiotherapy and demonstrated a significant dose-dependent increase of sperm chromosome abnormalities (numerical and structural) 36 months after radiation treatment.

  13. A Review of Fetal ECG Signal Processing; Issues and Promising Directions

    PubMed Central

    Sameni, Reza; Clifford, Gari D.

    2010-01-01

    The field of electrocardiography has been in existence for over a century, yet despite significant advances in adult clinical electrocardiography, signal processing techniques and fast digital processors, the analysis of fetal ECGs is still in its infancy. This is, partly due to a lack of availability of gold standard databases, partly due to the relatively low signal-to-noise ratio of the fetal ECG compared to the maternal ECG (caused by the various media between the fetal heart and the measuring electrodes, and the fact that the fetal heart is simply smaller), and in part, due to the less complete clinical knowledge concerning fetal cardiac function and development. In this paper we review a range of promising recording and signal processing techniques for fetal ECG analysis that have been developed over the last forty years, and discuss both their shortcomings and advantages. Before doing so, however, we review fetal cardiac development, and the etiology of the fetal ECG. A selection of relevant models for the fetal/maternal ECG mixture is also discussed. In light of current understanding of the fetal ECG, we then attempt to justify recommendations for promising future directions in signal processing, and database creation. PMID:21614148

  14. Compressed ECG biometric: a fast, secured and efficient method for identification of CVD patient.

    PubMed

    Sufi, Fahim; Khalil, Ibrahim; Mahmood, Abdun

    2011-12-01

    Adoption of compression technology is often required for wireless cardiovascular monitoring, due to the enormous size of Electrocardiography (ECG) signal and limited bandwidth of Internet. However, compressed ECG must be decompressed before performing human identification using present research on ECG based biometric techniques. This additional step of decompression creates a significant processing delay for identification task. This becomes an obvious burden on a system, if this needs to be done for a trillion of compressed ECG per hour by the hospital. Even though the hospital might be able to come up with an expensive infrastructure to tame the exuberant processing, for small intermediate nodes in a multihop network identification preceded by decompression is confronting. In this paper, we report a technique by which a person can be identified directly from his / her compressed ECG. This technique completely obviates the step of decompression and therefore upholds biometric identification less intimidating for the smaller nodes in a multihop network. The biometric template created by this new technique is lower in size compared to the existing ECG based biometrics as well as other forms of biometrics like face, finger, retina etc. (up to 8302 times lower than face template and 9 times lower than existing ECG based biometric template). Lower size of the template substantially reduces the one-to-many matching time for biometric recognition, resulting in a faster biometric authentication mechanism. PMID:20703779

  15. A Hygroscopic Sensor Electrode for Fast Stabilized Non-Contact ECG Signal Acquisition.

    PubMed

    Fong, Ee-May; Chung, Wan-Young

    2015-08-05

    A capacitive electrocardiography (cECG) technique using a non-invasive ECG measuring technology that does not require direct contact between the sensor and the skin has attracted much interest. The system encounters several challenges when the sensor electrode and subject's skin are weakly coupled. Because there is no direct physical contact between the subject and any grounding point, there is no discharge path for the built-up electrostatic charge. Subsequently, the electrostatic charge build-up can temporarily contaminate the ECG signal from being clearly visible; a stabilization period (3-15 min) is required for the measurement of a clean, stable ECG signal at low humidity levels (below 55% relative humidity). Therefore, to obtain a clear ECG signal without noise and to reduce the ECG signal stabilization time to within 2 min in a dry ambient environment, we have developed a fabric electrode with embedded polymer (FEEP). The designed hygroscopic FEEP has an embedded superabsorbent polymer layer. The principle of FEEP as a conductive electrode is to provide humidity to the capacitive coupling to ensure strong coupling and to allow for the measurement of a stable, clear biomedical signal. The evaluation results show that hygroscopic FEEP is capable of rapidly measuring high-accuracy ECG signals with a higher SNR ratio.

  16. A Hygroscopic Sensor Electrode for Fast Stabilized Non-Contact ECG Signal Acquisition

    PubMed Central

    Fong, Ee-May; Chung, Wan-Young

    2015-01-01

    A capacitive electrocardiography (cECG) technique using a non-invasive ECG measuring technology that does not require direct contact between the sensor and the skin has attracted much interest. The system encounters several challenges when the sensor electrode and subject’s skin are weakly coupled. Because there is no direct physical contact between the subject and any grounding point, there is no discharge path for the built-up electrostatic charge. Subsequently, the electrostatic charge build-up can temporarily contaminate the ECG signal from being clearly visible; a stabilization period (3–15 min) is required for the measurement of a clean, stable ECG signal at low humidity levels (below 55% relative humidity). Therefore, to obtain a clear ECG signal without noise and to reduce the ECG signal stabilization time to within 2 min in a dry ambient environment, we have developed a fabric electrode with embedded polymer (FEEP). The designed hygroscopic FEEP has an embedded superabsorbent polymer layer. The principle of FEEP as a conductive electrode is to provide humidity to the capacitive coupling to ensure strong coupling and to allow for the measurement of a stable, clear biomedical signal. The evaluation results show that hygroscopic FEEP is capable of rapidly measuring high-accuracy ECG signals with a higher SNR ratio. PMID:26251913

  17. A low-power portable ECG sensor interface with dry electrodes

    NASA Astrophysics Data System (ADS)

    Xiaofei, Pu; Lei, Wan; Hui, Zhang; Yajie, Qin; Zhiliang, Hong

    2013-05-01

    This paper describes a low-power portable sensor interface dedicated to sensing and processing electrocardiogram (ECG) signals. Dry electrodes were employed in this ECG sensor, which eliminates the need of conductive gel and avoids complicated and mandatory skin preparation before electrode attachment. This ECG sensor system consists of two ICs, an analog front-end (AFE) and a successive approximation register analog-to-digital converter (SAR ADC) containing a relaxation oscillator. This proposed design was fabricated in a 0.18 μm 1P6M standard CMOS process. The AFE for extracting the biopotential signals is essential in this ECG sensor. In measurements, the AFE obtains a mid-band gain of 45 dB, a bandwidth from 0.6 to 160 Hz, and a total input referred noise of 2.8 μV rms while consuming 1 μW from the 1.8 V supply. The noise efficiency factor (NEF) of our design is 3.4. After conditioning, the amplified ECG signal is digitized by a 12-bit SAR ADC with 61.8 dB SNDR and 220 fJ/conversion-step. Finally, a complete ECG sensor interface with three dry copper electrodes is demonstrated in real-word setting, showing successful recordings of a capture ECG waveform.

  18. Synthetic ECG Generation and Bayesian Filtering Using a Gaussian Wave-Based Dynamical Model

    PubMed Central

    Sayadi, Omid; Shamsollahi, Mohammad B.; Clifford, Gari D.

    2011-01-01

    In this paper, we describe a Gaussian wave-based state space to model the temporal dynamics of electrocardiogram (ECG) signals. It is shown that this model may be effectively used for generating synthetic ECGs as well as separate characteristic waves (CWs) such as the atrial and ventricular complexes. The model uses separate state variables for each CW, i.e. P, QRS and T, and hence is capable of generating individual synthetic CWs as well as realistic ECG signals. The model is therefore useful for generating arrhythmias. Simulations of sinus bradycardia, sinus tachycardia, ventricular flutter, atrial fibrillation, and ventricular tachycardia are presented. In addition, discrete versions of the equations are presented for a model-based Bayesian framework for denoising. This framework, together with an extended Kalman filter (EKF) and extended Kalman smoother (EKS), were used for denoising the ECG for both normal rhythms and arrhythmias. For evaluating the denoising performance the signal-to-noise ratio (SNR) improvement of the filter outputs and clinical parameter stability were studied. The results demonstrate superiority over a wide range of input SNRs, achieving a maximum 12.7 dB improvement. Results indicate that preventing clinically relevant distortion of the ECG is sensitive to the number of model parameters. Models are presented which do not exhibit such distortions. The approach presented in this paper may therefore serve as an effective framework for synthetic ECG generation and model-based filtering of noisy ECG recordings. PMID:20720288

  19. Dry Electrodes for ECG and Pulse Transit Time for Blood Pressure: A Wearable Sensor and Smartphone Communication Approach

    NASA Astrophysics Data System (ADS)

    Shyamkumar, Prashanth

    Cardiovascular Diseases (CVDs) have been a major cause for deaths in both men and women in United States. Cerebrovascular Diseases like Strokes are known to have origins in CVDs as well. Moreover, nearly 18 Million Americans have a history of myocardial infarction and are currently undergoing cardiac rehabilitation. Consequently, CVDs are the highest costing disease groups and cost more than all types of cancer combined. However, significant cost reduction is possible through the effective use of the vast advances in embedded and pervasive electronic devices for healthcare. These devices can automate and move a significant portion of disease management to the patient's home through cyber connectivity, a concept known as point-of-care (POC) diagnostics and healthcare services. POC can minimize hospital visits and potentially avoid admission altogether with prognostic tools that give advanced notice of any abnormalities or chronic illnesses so that the treatment can be planned in advance. The POC concept requires continuous remote health monitoring. Therefore, the various sensors needed for comprehensive monitoring need to be worn daily and throughout the day. Moreover, true "roaming" capability is necessary so that it does not restrict the user's travel or his/her quotidian activities. Two biomedical signals namely, Electrocardiogram (ECG) and Blood Pressure are important diagnostic tests in assessing the cardiac health of a person. To that end, the research presented in this thesis: First , describes the development of a remote monitoring solution based on Bluetooth(TM), smartphones and cyber infrastructure for cardiac care called e-nanoflex. Second, Sensors for ECG that are compatible with everyday life style namely, (a) dry, gel-less vertically aligned gold nanowire electrodes, (b) dry textile-based conductive sensor electrodes to address the need for this technology to monitor cardiovascular diseases in women are tested with e-nanoflex and discussed. Third, non

  20. The patient's motivation during bicycle stress ECG test is dependent on the investigator's sex in male patients.

    PubMed

    Jung, Christian; Ferrari, Markus; Goebel, Bjoern; Figulla, Hans R

    2009-08-21

    The exercise electrocardiogram is a commonly used non-invasive method for detection of electrocardiogram (ECG) changes secondary to myocardial ischemia. Studies showed the importance of the patient's motivation to reach the estimated submaximal heart rate. The purpose of this study was to test whether the patient's motivation is dependent on the investigator's sex. We included 1170 patients (in-hospital patients and out-clinic patients; 63.5% male, 36.5% female) in this study. Stress test data (stationary bicycle with gradually increasing intensity) were collected retrospectively: patient's age, sex, maximal power stage, ECG-abnormalities, angina pectoris, and attending physician's sex. Male patients achieved a higher power stage than their female counterparts (126.5+/-47.7 W vs. 89.7+/-30.4 W). When male patients were supervised by a female doctor they reached higher maximum power stages (136.6+/-53.5 W vs. 121.6+/-43.3 W; p=0,001), more often the submaximal heart rate (47.9% vs. 38.3%; p=0.02) but complained less frequent about angina pectoris (5.6% vs. 17.3%). In contrast, none of these parameters was dependent on the attending physician's sex in female patients. The attending physician's sex influences the maximum exercise ability and the incidence of complaints during bicycle stress in male patients but not in females. We would speculate that men try to impress women with physical strength and try to dissimulate physical discomfort or pain. This could possibly influence the validity of such non-invasive methods with exercise dependent detection of myocardial ischemia.

  1. Deployment of an Advanced Electrocardiographic Analysis (A-ECG) to Detect Cardiovascular Risk in Career Firefighters

    NASA Technical Reports Server (NTRS)

    Dolezal, B. A.; Storer, T. W.; Abrazado, M.; Watne, R.; Schlegel, T. T.; Batalin, M.; Kaiser, W.; Smith, D. L.; Cooper, C. B.

    2011-01-01

    INTRODUCTION: Sudden cardiac death is the leading cause of line of duty death among firefighters, accounting for approximately 45% of fatalities annually. Firefighters perform strenuous muscular work while wearing heavy, encapsulating personal protective equipment in high ambient temperatures, under chaotic and emotionally stressful conditions. These factors can precipitate sudden cardiac events like myocardial infarction, serious dysrhythmias, or cerebrovascular accidents in firefighters with underlying cardiovascular disease. PURPOSE: The purpose of this study was to deploy and then evaluate the contribution of resting advanced ECG (A-ECG) in addition to other screening tools (family history, lipid profiles, and cardiopulmonary exercise tests, XT) in assessment of an individual fs cardiac risk profile. METHODS: Forty-four career firefighters were recruited to perform comprehensive baseline assessments including tests of aerobic performance, fasting lipids and glucose. Five-min resting 12-lead A-ECGs were obtained in a subset of firefighters (n=21) and transmitted over a secure networked system to a NASA physician collaborator. Using myocardial perfusion and other imaging as the gold standard, A-ECG scoring has been proven useful in accurately identifying a number of cardiac pathologies including coronary artery disease (CAD), left ventricular hypertrophy, hypertrophic cardiomyopathy, and non-ischemic and ischemic cardiomyopathy. RESULTS: Subjects f mean (SD) age was 43 (8) years, weight 91 (13) kg, and BMI 28 (3) kg/m2. Fifty-one percent of subjects had .3 cardiovascular risk factors. One subject had ST depression on XT ECG, at least one positive A-ECG score for CAD, and documented CAD based on cardiology referral. While all other subjects, including those with fewer risk factors, higher aerobic fitness, and normal exercise ECGs, were classified as healthy by A-ECG, there was no trend for association between risk factors and any of 20 A-ECG parameters in the

  2. Can Functional Cardiac Age be Predicted from ECG in a Normal Healthy Population

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd; Starc, Vito; Leban, Manja; Sinigoj, Petra; Vrhovec, Milos

    2011-01-01

    In a normal healthy population, we desired to determine the most age-dependent conventional and advanced ECG parameters. We hypothesized that changes in several ECG parameters might correlate with age and together reliably characterize the functional age of the heart. Methods: An initial study population of 313 apparently healthy subjects was ultimately reduced to 148 subjects (74 men, 84 women, in the range from 10 to 75 years of age) after exclusion criteria. In all subjects, ECG recordings (resting 5-minute 12-lead high frequency ECG) were evaluated via custom software programs to calculate up to 85 different conventional and advanced ECG parameters including beat-to-beat QT and RR variability, waveform complexity, and signal-averaged, high-frequency and spatial/spatiotemporal ECG parameters. The prediction of functional age was evaluated by multiple linear regression analysis using the best 5 univariate predictors. Results: Ignoring what were ultimately small differences between males and females, the functional age was found to be predicted (R2= 0.69, P < 0.001) from a linear combination of 5 independent variables: QRS elevation in the frontal plane (p<0.001), a new repolarization parameter QTcorr (p<0.001), mean high frequency QRS amplitude (p=0.009), the variability parameter % VLF of RRV (p=0.021) and the P-wave width (p=0.10). Here, QTcorr represents the correlation between the calculated QT and the measured QT signal. Conclusions: In apparently healthy subjects with normal conventional ECGs, functional cardiac age can be estimated by multiple linear regression analysis of mostly advanced ECG results. Because some parameters in the regression formula, such as QTcorr, high frequency QRS amplitude and P-wave width also change with disease in the same direction as with increased age, increased functional age of the heart may reflect subtle age-related pathologies in cardiac electrical function that are usually hidden on conventional ECG.

  3. Diagnostic quality of time-averaged ECG-gated CT data

    NASA Astrophysics Data System (ADS)

    Klein, Almar; Oostveen, Luuk J.; Greuter, Marcel J. W.; Hoogeveen, Yvonne; Schultze Kool, Leo J.; Slump, Cornelis H.; Renema, W. Klaas Jan

    2009-02-01

    Purpose: ECG-gated CTA allows visualization of the aneurysm and stentgraft during the different phases of the cardiac cycle, although with a lower SNR per cardiac phase than without ECG gating using the same dose. In our institution, abdominal aortic aneurysm (AAA) is evaluated using non-ECG-gated CTA. Some common CT scanners cannot reconstruct a non-gated volume from ECG-gated acquired data. In order to obtain the same diagnostic image quality, we propose offline temporal averaging of the ECG-gated data. This process, though straightforward, is fundamentally different from taking a non-gated scan, and its result will certainly differ as well. The purpose of this study is to quantitatively investigate how good off-line averaging approximates a non-gated scan. Method: Non-gated and ECG-gated CT scans have been performed on a phantom (Catphan 500). Afterwards the phases of the ECG-gated CTA data were averaged to create a third dataset. The three sets are compared with respect to noise properties (NPS) and frequency response (MTF). To study motion artifacts identical scans were acquired on a programmable dynamic phantom. Results and Conclusions: The experiments show that the spatial frequency content is not affected by the averaging process. The minor differences observed for the noise properties and motion artifacts are in favor of the averaged data. Therefore the averaged ECG-gated phases can be used for diagnosis. This enables the use of ECG-gating for research on stentgrafts in AAA, without impairing clinical patient care.

  4. Abnormalities in signaling pathways in diabetic nephropathy

    PubMed Central

    Brosius, Frank C; Khoury, Charbel C; Buller, Carolyn L; Chen, Sheldon

    2010-01-01

    Diabetic nephropathy (DN) is characterized by a plethora of signaling abnormalities that together ultimately result in the clinical and pathologic hallmarks of DN, namely progressive albuminuria followed by a gradual decline in glomerular filtration rate leading to kidney failure, and accompanied by podocyte loss, progressive glomerular sclerosis and, ultimately, progressive tubulointerstitial fibrosis. Over the past few years, the general understanding of the abnormalities in signaling pathways that lead to DN has expanded considerably. In this review, some of the important pathways that appear to be involved in driving this process are discussed, with special emphasis on newer findings and insights. Newer concepts regarding signaling changes in bradykinin, mTOR, JAK/STAT, MCP-1, VEGF, endothelial nitric oxide synthase, activated protein C and other pathways are discussed. PMID:20224802

  5. An MLP neural network for ECG noise removal based on Kalman filter.

    PubMed

    Moein, Sara

    2010-01-01

    In this paper, application of Artificial Neural Network (ANN) for electrocardiogram (ECG) signal noise removal has been investigated. First, 100 number of ECG signals are selected from Physikalisch-Technische Bundesanstalt (PTB) database and Kalman filter is applied to remove their low pass noise. Then a suitable dataset based on denoised ECG signal is configured and used to a Multilayer Perceptron (MLP) neural network to be trained. Finally, results and experiences are discussed and the effect of changing different parameters for MLP training is shown.

  6. Real-time ECG emulation: a multiple dipole model for electrocardiography simulation.

    PubMed

    Abkai, Ciamak; Hesser, Jürgen

    2009-01-01

    A new model for describing electrocardiography (ECG) is presented, which is based on multiple dipoles compared to standard single dipole approaches in vector electrocardiography. The multiple dipole parameters are derived from real data (e.g. four dipoles from 12-channel ECG) by solving the backward problem of ECG numerically. Results are transformed to a waveform description based on Gaussian mixture for every dimension of each dipole. These compact parameterized descriptors are used for a very realistic real-time simulation applying the forward solution of the proposed model.

  7. Evaluation of novel ECG signal processing on quantification of transient ischemia and baseline wander suppression.

    PubMed

    Kostic, Marko N; Fakhar, Sina; Foxall, Tom; Drakulic, Budimir S; Krucoff, Mitchell W

    2007-01-01

    The performance assessment of a novel ECG signal processing technology in Fidelity 100 (test) and four modern ECG systems (controls) was conducted. A quantitative evaluation for one control and a test system was done by simultaneous recordings on 54 patients undergoing percutaneous coronary intervention (PCI) and on a biological reference signal from an ECG simulator. A qualitative performance of baseline wander suppression was done on all five systems. The results showed that the Fidelity 100 system provided excellent detection and quantification of transient ischemia and baseline wander suppression.

  8. A low-power asynchronous ECG acquisition system in CMOS technology.

    PubMed

    Hwang, Sungkil; Trakimas, Michael; Sonkusale, Sameer

    2010-01-01

    An asynchronous electrocardiogram (ECG) acquisition system is presented for wearable ambulatory monitoring. The proposed system consists of a low noise front-end amplifier (AFE) with tunable bandwidth, an asynchronous analog-to-digital converter (ADC), and digital signal processing (DSP). Data compression is achieved by the inherent signal dependent sampling rate of the asynchronous architecture. This makes the system attractive for compact wearable ECG monitoring applications. The AFE and ADC were fabricated in a 0.18 microm CMOS technology and consume a total of 79 microW. Measured results demonstrating ECG monitoring are presented. PMID:21096052

  9. Sonographic Findings of Hydropneumothorax.

    PubMed

    Nations, Joel Anthony; Smith, Patrick; Parrish, Scott; Browning, Robert

    2016-09-01

    Ultrasound is increasingly being used in examination of the thorax. The sonographic features of normal aerated lung, abnormal lung, pneumothorax, and intrapleural fluid have been published. The sonographic features of uncommon intrathoracic syndromes are less known. Hydropneumothorax is an uncommon process in which the thoracic cavity contains both intrapleural air and water. Few published examples of the sonographic findings in hydropneumothorax exist. We present 3 illustrative cases of the sonographic features of hydropneumothorax with comparative imaging and a literature review of the topic. PMID:27556194

  10. Rock Finding

    ERIC Educational Resources Information Center

    Rommel-Esham, Katie; Constable, Susan D.

    2006-01-01

    In this article, the authors discuss a literature-based activity that helps students discover the importance of making detailed observations. In an inspiring children's classic book, "Everybody Needs a Rock" by Byrd Baylor (1974), the author invites readers to go "rock finding," laying out 10 rules for finding a "perfect" rock. In this way, the…

  11. Circadian Rhythm Abnormalities

    PubMed Central

    Zee, Phyllis C.; Attarian, Hrayr; Videnovic, Aleksandar

    2013-01-01

    Purpose: This article reviews the recent advances in understanding of the fundamental properties of circadian rhythms and discusses the clinical features, diagnosis, and treatment of circadian rhythm sleep disorders (CRSDs). Recent Findings: Recent evidence strongly points to the ubiquitous influence of circadian timing in nearly all physiologic functions. Thus, in addition to the prominent sleep and wake disturbances, circadian rhythm disorders are associated with cognitive impairment, mood disturbances, and increased risk of cardiometabolic disorders. The recent availability of biomarkers of circadian timing in clinical practice has improved our ability to identify and treat these CRSDs. Summary: Circadian rhythms are endogenous rhythms with a periodicity of approximately 24 hours. These rhythms are synchronized to the physical environment by social and work schedules by various photic and nonphotic stimuli. CRSDs result from a misalignment between the timing of the circadian rhythm and the external environment (eg, jet lag and shift work) or a dysfunction of the circadian clock or its afferent and efferent pathways (eg, delayed sleep-phase, advanced sleep-phase, non–24-hour, and irregular sleep-wake rhythm disorders). The most common symptoms of these disorders are difficulties with sleep onset and/or sleep maintenance and excessive sleepiness that are associated with impaired social and occupational functioning. Effective treatment for most of the CRSDs requires a multimodal approach to accelerate circadian realignment with timed exposure to light, avoidance of bright light at inappropriate times, and adherence to scheduled sleep and wake times. In addition, pharmacologic agents are recommended for some of the CRSDs. For delayed sleep-phase, non–24-hour, and shift work disorders, timed low-dose melatonin can help advance or entrain circadian rhythms; and for shift work disorder, wake-enhancing agents such as caffeine, modafinil, and armodafinil are options

  12. ECG Artifact Removal from Surface EMG Signal Using an Automated Method Based on Wavelet-ICA.

    PubMed

    Abbaspour, Sara; Lindén, Maria; Gholamhosseini, Hamid

    2015-01-01

    This study aims at proposing an efficient method for automated electrocardiography (ECG) artifact removal from surface electromyography (EMG) signals recorded from upper trunk muscles. Wavelet transform is applied to the simulated data set of corrupted surface EMG signals to create multidimensional signal. Afterward, independent component analysis (ICA) is used to separate ECG artifact components from the original EMG signal. Components that correspond to the ECG artifact are then identified by an automated detection algorithm and are subsequently removed using a conventional high pass filter. Finally, the results of the proposed method are compared with wavelet transform, ICA, adaptive filter and empirical mode decomposition-ICA methods. The automated artifact removal method proposed in this study successfully removes the ECG artifacts from EMG signals with a signal to noise ratio value of 9.38 while keeping the distortion of original EMG to a minimum. PMID:25980853

  13. Removing movement artifacts from equine ECG recordings acquired with textile electrodes.

    PubMed

    Lanata, Antonio; Guidi, Andrea; Baragli, Paolo; Paradiso, Rita; Valenza, Gaetano; Scilingo, Enzo Pasquale

    2015-08-01

    This study reports on the implementation of a novel system to detect and reduce movement artifact (MA) contribution in electrocardiogram (ECG) recordings acquired from horses in free movement conditions. The system comprises both integrated textile electrodes for ECG acquisition and one triaxial accelerometer for movement monitoring. Here, ECG and physical activity are continuously acquired from seven horses through the wearable system and a model that integrates cardiovascular and movement information to estimate the MA contribution is implemented. Moreover, in this study we propose a new algorithm where the Stationary Wavelet Transform (SWT) decomposition algorithm is employed to identify and remove movement artifacts from ECG recodigns. Achieved results showed a reduction of MA percentage greater than 40% between before- and after- the application of the proposed algorithm to seven hours of recordings. PMID:26736667

  14. A Primary Study of Indirect ECG Monitor Embedded in a Bed for Home Health Care

    NASA Astrophysics Data System (ADS)

    Ueno, Akinori; Shiogai, Yuuki; Ishiyama, Yoji

    A system for monitoring electrocardiogram (ECG) through clothes inserted between the measuring electrodes and the body surface of a subject when lying on a mattress has been proposed. The principle of the system is based on capacitive coupling involving the electrode, the clothes, and the skin. Validation of the system revealed the following: (1) In spite of the gain attenuation in the pass band of the system, distortion of the detected signal was subtle even when clothes thicker than 1mm were inserted, (2) The system was able to yield a stable ECG from a subject particularly during sound sleep, (3) The system succeeded in detecting ECG after changing the posture into any of supine, right lateral, or left lateral positions by adopting a newly devised electrode configuration. Therefore, the proposed system appears promising for application to bedding as a non-invasive and awareness-free system for ECG monitoring during sleep.

  15. A Human ECG Identification System Based on Ensemble Empirical Mode Decomposition

    PubMed Central

    Zhao, Zhidong; Yang, Lei; Chen, Diandian; Luo, Yi

    2013-01-01

    In this paper, a human electrocardiogram (ECG) identification system based on ensemble empirical mode decomposition (EEMD) is designed. A robust preprocessing method comprising noise elimination, heartbeat normalization and quality measurement is proposed to eliminate the effects of noise and heart rate variability. The system is independent of the heart rate. The ECG signal is decomposed into a number of intrinsic mode functions (IMFs) and Welch spectral analysis is used to extract the significant heartbeat signal features. Principal component analysis is used reduce the dimensionality of the feature space, and the K-nearest neighbors (K-NN) method is applied as the classifier tool. The proposed human ECG identification system was tested on standard MIT-BIH ECG databases: the ST change database, the long-term ST database, and the PTB database. The system achieved an identification accuracy of 95% for 90 subjects, demonstrating the effectiveness of the proposed method in terms of accuracy and robustness. PMID:23698274

  16. CinC Challenge 2013: comparing three algorithms to extract fetal ECG

    NASA Astrophysics Data System (ADS)

    Loja, Juan; Velecela, Esteban; Palacio-Baus, Kenneth; Astudillo, Darwin; Medina, Rubén.; Wong, Sara

    2015-12-01

    This paper reports a comparison between three fetal ECG (fECG) detectors developed during the CinC 2013 challenge for fECG detection. Algorithm A1 is based on Independent Component Analysis, A2 is based on fECG detection of RS Slope and A3 is based on Expectation-Weighted Estimation of Fiducial Points. The proposed methodology was validated using the annotated database available for the challenge. Each detector was characterized in terms of its performance by using measures of sensitivity, (Se), positive predictive value (P+) and delay time (td). Additionally, the database was contaminated with white noise for two SNR conditions. Decision fusion was tested considering the most common types of combination of detectors. Results show that the decision fusion of A1 and A2 improves fQRS detection, maintaining high Se and P+ even under low SNR conditions without a significant td increase.

  17. Compression and Encryption of ECG Signal Using Wavelet and Chaotically Huffman Code in Telemedicine Application.

    PubMed

    Raeiatibanadkooki, Mahsa; Quchani, Saeed Rahati; KhalilZade, MohammadMahdi; Bahaadinbeigy, Kambiz

    2016-03-01

    In mobile health care monitoring, compression is an essential tool for solving storage and transmission problems. The important issue is able to recover the original signal from the compressed signal. The main purpose of this paper is compressing the ECG signal with no loss of essential data and also encrypting the signal to keep it confidential from everyone, except for physicians. In this paper, mobile processors are used and there is no need for any computers to serve this purpose. After initial preprocessing such as removal of the baseline noise, Gaussian noise, peak detection and determination of heart rate, the ECG signal is compressed. In compression stage, after 3 steps of wavelet transform (db04), thresholding techniques are used. Then, Huffman coding with chaos for compression and encryption of the ECG signal are used. The compression rates of proposed algorithm is 97.72 %. Then, the ECG signals are sent to a telemedicine center to acquire specialist diagnosis by TCP/IP protocol.

  18. A PD control-based QRS detection algorithm for wearable ECG applications.

    PubMed

    Choi, Changmok; Kim, Younho; Shin, Kunsoo

    2012-01-01

    We present a QRS detection algorithm for wearable ECG applications using a proportional-derivative (PD) control. ECG data of arrhythmia have irregular intervals and magnitudes of QRS waves that impede correct QRS detection. To resolve the problem, PD control is applied to avoid missing a small QRS wave followed from a large QRS wave and to avoid falsely detecting noise as QRS waves when an interval between two adjacent QRS waves is large (e.g. bradycardia, pause, and arioventricular block). ECG data was obtained from 78 patients with various cardiovascular diseases and tested for the performance evaluation of the proposed algorithm. The overall sensitivity and positive predictive value were 99.28% and 99.26%, respectively. The proposed algorithm has low computational complexity, so that it can be suitable to apply mobile ECG monitoring system in real time. PMID:23367208

  19. Removing movement artifacts from equine ECG recordings acquired with textile electrodes.

    PubMed

    Lanata, Antonio; Guidi, Andrea; Baragli, Paolo; Paradiso, Rita; Valenza, Gaetano; Scilingo, Enzo Pasquale

    2015-01-01

    This study reports on the implementation of a novel system to detect and reduce movement artifact (MA) contribution in electrocardiogram (ECG) recordings acquired from horses in free movement conditions. The system comprises both integrated textile electrodes for ECG acquisition and one triaxial accelerometer for movement monitoring. Here, ECG and physical activity are continuously acquired from seven horses through the wearable system and a model that integrates cardiovascular and movement information to estimate the MA contribution is implemented. Moreover, in this study we propose a new algorithm where the Stationary Wavelet Transform (SWT) decomposition algorithm is employed to identify and remove movement artifacts from ECG recodigns. Achieved results showed a reduction of MA percentage greater than 40% between before- and after- the application of the proposed algorithm to seven hours of recordings.

  20. Unobtrusive monitoring of ECG-derived features during daily smartphone use.

    PubMed

    Kwon, Sungjun; Kang, Seungwoo; Lee, Youngki; Yoo, Chungkuk; Park, Kwangsuk

    2014-01-01

    Heart rate variability (HRV) is known to be one of the representative ECG-derived features that are useful for diverse pervasive healthcare applications. The advancement in daily physiological monitoring technology is enabling monitoring of HRV in people's everyday lives. In this study, we evaluate the feasibility of measuring ECG-derived features such as HRV, only using the smartphone-integrated ECG sensors system named Sinabro. We conducted the evaluation with 13 subjects in five predetermined smartphone use cases. The result shows the potential that the smartphone-based sensing system can support daily monitoring of ECG-derived features; The average errors of HRV over all participants ranged from 1.65% to 5.83% (SD: 2.54~10.87) for five use cases. Also, all of individual HRV parameters showed less than 5% of average errors for the three reliable cases.

  1. Segmentation of ECG from Surface EMG Using DWT and EMD: A Comparison Study

    NASA Astrophysics Data System (ADS)

    Shahbakhti, Mohammad; Heydari, Elnaz; Luu, Gia Thien

    2014-10-01

    The electrocardiographic (ECG) signal is a major artifact during recording the surface electromyography (SEMG). Removal of this artifact is one of the important tasks before SEMG analysis for biomedical goals. In this paper, the application of discrete wavelet transform (DWT) and empirical mode decomposition (EMD) for elimination of ECG artifact from SEMG is investigated. The focus of this research is to reach the optimized number of decomposed levels using mean power frequency (MPF) by both techniques. In order to implement the proposed methods, ten simulated and three real ECG contaminated SEMG signals have been tested. Signal-to-noise ratio (SNR) and mean square error (MSE) between the filtered and the pure signals are applied as the performance indexes of this research. The obtained results suggest both techniques could remove ECG artifact from SEMG signals fair enough, however, DWT performs much better and faster in real data.

  2. Design and implementation of a 3-lead ECG wireless remote monitoring system

    NASA Astrophysics Data System (ADS)

    Zhang, Shi; Jia, Xiaonan; Shang, Shuai

    2006-11-01

    Cardiovascular disease is one of the main diseases that menaces human health. It is necessary to monitor the patient's real-time electrocardiograph (ECG) for a long time to realize diagnosis and salvage. Remote ECG monitoring system is the solution. This paper introduces the design and implement of a 3-lead ECG wireless remote monitoring system. It collects, stores and transmits user's ECG which can be received by hospital and diagnosed by doctors. The development of the whole system contains three parts, the hardware and embedded software implementation of MONITOR, software of the MONITORING CENTER, and the routing software of NETWORK CENTER. According to the clinic experimentation, this system has high reliability and utility. There will be great social and economic benefit if this system is put into use.

  3. Threshold-based system for noise detection in multilead ECG recordings.

    PubMed

    Jekova, Irena; Krasteva, Vessela; Christov, Ivaylo; Abächerli, Roger

    2012-09-01

    This paper presents a system for detection of the most common noise types seen on the electrocardiogram (ECG) in order to evaluate whether an episode from 12-lead ECG is reliable for diagnosis. It implements criteria for estimation of the noise corruption level in specific frequency bands, aiming to identify the main sources of ECG quality disruption, such as missing signal or limited dynamics of the QRS components above 4 Hz; presence of high amplitude and steep artifacts seen above 1 Hz; baseline drift estimated at frequencies below 1 Hz; power-line interference in a band ±2 Hz around its central frequency; high-frequency and electromyographic noises above 20 Hz. All noise tests are designed to process the ECG series in the time domain, including 13 adjustable thresholds for amplitude and slope criteria which are evaluated in adjustable time intervals, as well as number of leads. The system allows flexible extension toward application-specific requirements for the noise levels in acceptable quality ECGs. Training of different thresholds' settings to determine different positive noise detection rates is performed with the annotated set of 1000 ECGs from the PhysioNet database created for the Computing in Cardiology Challenge 2011. Two implementations are highlighted on the receiver operating characteristic (area 0.968) to fit to different applications. The implementation with high sensitivity (Se = 98.7%, Sp = 80.9%) appears as a reliable alarm when there are any incidental problems with the ECG acquisition, while the implementation with high specificity (Sp = 97.8%, Se = 81.8%) is less susceptible to transient problems but rather validates noisy ECGs with acceptable quality during a small portion of the recording.

  4. Kidney transplantation in abnormal bladder

    PubMed Central

    Mishra, Shashi K.; Muthu, V.; Rajapurkar, Mohan M.; Desai, Mahesh R.

    2007-01-01

    Structural urologic abnormalities resulting in dysfunctional lower urinary tract leading to end stage renal disease may constitute 15% patients in the adult population and up to 20-30% in the pediatric population. A patient with an abnormal bladder, who is approaching end stage renal disease, needs careful evaluation of the lower urinary tract to plan the most satisfactory technical approach to the transplant procedure. Past experience of different authors can give an insight into the management and outcome of these patients. This review revisits the current literature available on transplantation in abnormal bladder and summarizes the clinical approach towards handling this group of difficult transplant patients. We add on our experience as we discuss the various issues. The outcome of renal transplant in abnormal bladder is not adversely affected when done in a reconstructed bladder. Correct preoperative evaluation, certain technical modification during transplant and postoperative care is mandatory to avoid complications. Knowledge of the abnormal bladder should allow successful transplantation with good outcome. PMID:19718334

  5. Sleep apnea classification using ECG-signal wavelet-PCA features.

    PubMed

    Rachim, Vega Pradana; Li, Gang; Chung, Wan-Young

    2014-01-01

    Sleep apnea is often diagnosed using an overnight sleep test called a polysomnography (PSG). Unfortunately, though it is the gold standard of sleep disorder diagnosis, a PSG is time consuming, inconvenient, and expensive. Many researchers have tried to ameliorate this problem by developing other reliable methods, such as using electrocardiography (ECG) as an observed signal source. Respiratory rate interval, ECG-derived respiration, and heart rate variability analysis have been studied recently as a means of detecting apnea events using ECG during normal sleep, but these methods have performance weaknesses. Thus, the aim of this study is to classify the subject into normal- or apnea-subject based on their single-channel ECG measurement in regular sleep. In this proposed study, ECG is decomposed into five levels using wavelet decomposition for the initial processing to determine the detail coefficients (D3-D5) of the signal. Approximately 15 features were extracted from every minute of ECG. Principal component analysis and a support vector machine are used for feature dimension reduction and classification, respectively. According to classification that been done from a data set consisting of thirty-five patients, the proposed minute-to-minute classifier specificity, sensitivity, and subject-based classification accuracy are 95.20%, 92.65%, and 94.3%, respectively. Furthermore, the proposed system can be used as a basis for future development of sleep apnea screening tools. PMID:25226993

  6. CNT/PDMS composite flexible dry electrodes for long-term ECG monitoring.

    PubMed

    Jung, Ha-Chul; Moon, Jin-Hee; Baek, Dong-Hyun; Lee, Jae-Hee; Choi, Yoon-Young; Hong, Joung-Sook; Lee, Sang-Hoon

    2012-05-01

    We fabricated a carbon nanotube (CNT)/ polydimethylsiloxane (PDMS) composite-based dry ECG electrode that can be readily connected to conventional ECG devices, and showed its long-term wearable monitoring capability and robustness to motion and sweat. While the dispersion of CNTs in PDMS is challenging, we optimized the process to disperse untreated CNTs within PDMS by mechanical force only. The electrical and mechanical characteristics of the CNT/PDMS electrode were tested according to the concentration of CNTs and its thickness. The performances of ECG electrodes were evaluated by using 36 types of electrodes which were fabricated with different concentrations of CNTs, and with a differing diameter and thickness. The ECG signals were obtained by using electrodes of diverse sizes to observe the effects of motion and sweat, and the proposed electrode was shown to be robust to both factors. The CNT concentration and diameter of the electrodes were critical parameters in obtaining high-quality ECG signals. The electrode was shown to be biocompatible from the cytotoxicity test. A seven-day continuous wearability test showed that the quality of the ECG signal did not degrade over time, and skin reactions such as itching or erythema were not observed. This electrode could be used for the long-term measurement of other electrical biosignals for ubiquitous health monitoring including EMG, EEG, and ERG.

  7. On the resolution of ECG acquisition systems for the reliable analysis of the P-wave.

    PubMed

    Censi, Federica; Calcagnini, Giovanni; Corazza, Ivan; Mattei, Eugenio; Triventi, Michele; Bartolini, Pietro; Boriani, Giuseppe

    2012-02-01

    The analysis of the P-wave on surface ECG is widely used to assess the risk of atrial arrhythmias. In order to provide reliable results, the automatic analysis of the P-wave must be precise and reliable and must take into account technical aspects, one of those being the resolution of the acquisition system. The aim of this note is to investigate the effects of the amplitude resolution of ECG acquisition systems on the P-wave analysis. Starting from ECG recorded by an acquisition system with a less significant bit (LSB) of 31 nV (24 bit on an input range of 524 mVpp), we reproduced an ECG signal as acquired by systems with lower resolution (16, 15, 14, 13 and 12 bit). We found that, when the LSB is of the order of 128 µV (12 bit), a single P-wave is not recognizable on ECG. However, when averaging is applied, a P-wave template can be extracted, apparently suitable for the P-wave analysis. Results obtained in terms of P-wave duration and morphology revealed that the analysis of ECG at lowest resolutions (from 12 to 14 bit, LSB higher than 30 µV) could lead to misleading results. However, the resolution used nowadays in modern electrocardiographs (15 and 16 bit, LSB <10 µV) is sufficient for the reliable analysis of the P-wave.

  8. Investigations of sensitivity and resolution of ECG and MCG in a realistically shaped thorax model

    NASA Astrophysics Data System (ADS)

    Mäntynen, Ville; Konttila, Teijo; Stenroos, Matti

    2014-12-01

    Solving the inverse problem of electrocardiography (ECG) and magnetocardiography (MCG) is often referred to as cardiac source imaging. Spatial properties of ECG and MCG as imaging systems are, however, not well known. In this modelling study, we investigate the sensitivity and point-spread function (PSF) of ECG, MCG, and combined ECG+MCG as a function of source position and orientation, globally around the ventricles: signal topographies are modelled using a realistically-shaped volume conductor model, and the inverse problem is solved using a distributed source model and linear source estimation with minimal use of prior information. The results show that the sensitivity depends not only on the modality but also on the location and orientation of the source and that the sensitivity distribution is clearly reflected in the PSF. MCG can better characterize tangential anterior sources (with respect to the heart surface), while ECG excels with normally-oriented and posterior sources. Compared to either modality used alone, the sensitivity of combined ECG+MCG is less dependent on source orientation per source location, leading to better source estimates. Thus, for maximal sensitivity and optimal source estimation, the electric and magnetic measurements should be combined.

  9. Self-organized neural network for the quality control of 12-lead ECG signals.

    PubMed

    Chen, Yun; Yang, Hui

    2012-09-01

    Telemedicine is very important for the timely delivery of health care to cardiovascular patients, especially those who live in the rural areas of developing countries. However, there are a number of uncertainty factors inherent to the mobile-phone-based recording of electrocardiogram (ECG) signals such as personnel with minimal training and other extraneous noises. PhysioNet organized a challenge in 2011 to develop efficient algorithms that can assess the ECG signal quality in telemedicine settings. This paper presents our efforts in this challenge to integrate multiscale recurrence analysis with a self-organizing map for controlling the ECG signal quality. As opposed to directly evaluating the 12-lead ECG, we utilize an information-preserving transform, i.e. Dower transform, to derive the 3-lead vectorcardiogram (VCG) from the 12-lead ECG in the first place. Secondly, we delineate the nonlinear and nonstationary characteristics underlying the 3-lead VCG signals into multiple time-frequency scales. Furthermore, a self-organizing map is trained, in both supervised and unsupervised ways, to identify the correlations between signal quality and multiscale recurrence features. The efficacy and robustness of this approach are validated using real-world ECG recordings available from PhysioNet. The average performance was demonstrated to be 95.25% for the training dataset and 90.0% for the independent test dataset with unknown labels.

  10. An efficient unsupervised fetal QRS complex detection from abdominal maternal ECG.

    PubMed

    Varanini, M; Tartarisco, G; Billeci, L; Macerata, A; Pioggia, G; Balocchi, R

    2014-08-01

    Non-invasive fetal heart rate is of great relevance in clinical practice to monitor fetal health state during pregnancy. To date, however, despite significant advances in the field of electrocardiography, the analysis of abdominal fetal ECG is considered a challenging problem for biomedical and signal processing communities. This is mainly due to the low signal-to-noise ratio of fetal ECG and difficulties in cancellation of maternal QRS complexes, motion and electromyographic artefacts. In this paper we present an efficient unsupervised algorithm for fetal QRS complex detection from abdominal multichannel signal recordings combining ICA and maternal ECG cancelling, which outperforms each single method. The signal is first pre-processed to remove impulsive artefacts, baseline wandering and power line interference. The following steps are then applied: maternal ECG extraction through independent component analysis (ICA); maternal QRS detection; maternal ECG cancelling through weighted singular value decomposition; enhancing of fetal ECG through ICA and fetal QRS detection. We participated in the Physionet/Computing in Cardiology Challenge 2013, obtaining the top official scores of the challenge (among 53 teams of participants) of event 1 and event 2 concerning fetal heart rate and fetal interbeat intervals estimation section. The developed algorithms are released as open-source on the Physionet website.

  11. Real-time CHF detection from ECG signals using a novel discretization method.

    PubMed

    Orhan, Umut

    2013-10-01

    This study proposes a new method, equal frequency in amplitude and equal width in time (EFiA-EWiT) discretization, to discriminate between congestive heart failure (CHF) and normal sinus rhythm (NSR) patterns in ECG signals. The ECG unit pattern concept was introduced to represent the standard RR interval, and our method extracted certain features from the unit patterns to classify by a primitive classifier. The proposed method was tested on two classification experiments by using ECG records in Physiobank databases and the results were compared to those from several previous studies. In the first experiment, an off-line classification was performed with unit patterns selected from long ECG segments. The method was also used to detect CHF by real-time ECG waveform analysis. In addition to demonstrating the success of the proposed method, the results showed that some unit patterns in a long ECG segment from a heart patient were more suggestive of disease than the others. These results indicate that the proposed approach merits additional research.

  12. Investigations of sensitivity and resolution of ECG and MCG in a realistically shaped thorax model.

    PubMed

    Mäntynen, Ville; Konttila, Teijo; Stenroos, Matti

    2014-12-01

    Solving the inverse problem of electrocardiography (ECG) and magnetocardiography (MCG) is often referred to as cardiac source imaging. Spatial properties of ECG and MCG as imaging systems are, however, not well known. In this modelling study, we investigate the sensitivity and point-spread function (PSF) of ECG, MCG, and combined ECG+MCG as a function of source position and orientation, globally around the ventricles: signal topographies are modelled using a realistically-shaped volume conductor model, and the inverse problem is solved using a distributed source model and linear source estimation with minimal use of prior information. The results show that the sensitivity depends not only on the modality but also on the location and orientation of the source and that the sensitivity distribution is clearly reflected in the PSF. MCG can better characterize tangential anterior sources (with respect to the heart surface), while ECG excels with normally-oriented and posterior sources. Compared to either modality used alone, the sensitivity of combined ECG+MCG is less dependent on source orientation per source location, leading to better source estimates. Thus, for maximal sensitivity and optimal source estimation, the electric and magnetic measurements should be combined.

  13. Wavelet-Based ECG Steganography for Protecting Patient Confidential Information in Point-of-Care Systems.

    PubMed

    Ibaida, Ayman; Khalil, Ibrahim

    2013-12-01

    With the growing number of aging population and a significant portion of that suffering from cardiac diseases, it is conceivable that remote ECG patient monitoring systems are expected to be widely used as point-of-care (PoC) applications in hospitals around the world. Therefore, huge amount of ECG signal collected by body sensor networks from remote patients at homes will be transmitted along with other physiological readings such as blood pressure, temperature, glucose level, etc., and diagnosed by those remote patient monitoring systems. It is utterly important that patient confidentiality is protected while data are being transmitted over the public network as well as when they are stored in hospital servers used by remote monitoring systems. In this paper, a wavelet-based steganography technique has been introduced which combines encryption and scrambling technique to protect patient confidential data. The proposed method allows ECG signal to hide its corresponding patient confidential data and other physiological information thus guaranteeing the integration between ECG and the rest. To evaluate the effectiveness of the proposed technique on the ECG signal, two distortion measurement metrics have been used: the percentage residual difference and the wavelet weighted PRD. It is found that the proposed technique provides high-security protection for patients data with low (less than 1%) distortion and ECG data remain diagnosable after watermarking (i.e., hiding patient confidential data) and as well as after watermarks (i.e., hidden data) are removed from the watermarked data.

  14. Low-cost compact ECG with graphic LCD and phonocardiogram system design.

    PubMed

    Kara, Sadik; Kemaloğlu, Semra; Kirbaş, Samil

    2006-06-01

    Till today, many different ECG devices are made in developing countries. In this study, low cost, small size, portable LCD screen ECG device, and phonocardiograph were designed. With designed system, heart sounds that take synchronously with ECG signal are heard as sensitive. Improved system consist three units; Unit 1, ECG circuit, filter and amplifier structure. Unit 2, heart sound acquisition circuit. Unit 3, microcontroller, graphic LCD and ECG signal sending unit to computer. Our system can be used easily in different departments of the hospital, health institution and clinics, village clinic and also in houses because of its small size structure and other benefits. In this way, it is possible that to see ECG signal and hear heart sounds as synchronously and sensitively. In conclusion, heart sounds are heard on the part of both doctor and patient because sounds are given to environment with a tiny speaker. Thus, the patient knows and hears heart sounds him/herself and is acquainted by doctor about healthy condition. PMID:16848133

  15. A robust approach for ECG-based analysis of cardiopulmonary coupling.

    PubMed

    Zheng, Jiewen; Wang, Weidong; Zhang, Zhengbo; Wu, Dalei; Wu, Hao; Peng, Chung-Kang

    2016-07-01

    Deriving respiratory signal from a surface electrocardiogram (ECG) measurement has advantage of simultaneously monitoring of cardiac and respiratory activities. ECG-based cardiopulmonary coupling (CPC) analysis estimated by heart period variability and ECG-derived respiration (EDR) shows promising applications in medical field. The aim of this paper is to provide a quantitative analysis of the ECG-based CPC, and further improve its performance. Two conventional strategies were tested to obtain EDR signal: R-S wave amplitude and area of the QRS complex. An adaptive filter was utilized to extract the common component of inter-beat interval (RRI) and EDR, generating enhanced versions of EDR signal. CPC is assessed through probing the nonlinear phase interactions between RRI series and respiratory signal. Respiratory oscillations presented in both RRI series and respiratory signals were extracted by ensemble empirical mode decomposition for coupling analysis via phase synchronization index. The results demonstrated that CPC estimated from conventional EDR series exhibits constant and proportional biases, while that estimated from enhanced EDR series is more reliable. Adaptive filtering can improve the accuracy of the ECG-based CPC estimation significantly and achieve robust CPC analysis. The improved ECG-based CPC estimation may provide additional prognostic information for both sleep medicine and autonomic function analysis. PMID:27118307

  16. Research of fetal ECG extraction using wavelet analysis and adaptive filtering.

    PubMed

    Wu, Shuicai; Shen, Yanni; Zhou, Zhuhuang; Lin, Lan; Zeng, Yanjun; Gao, Xiaofeng

    2013-10-01

    Extracting clean fetal electrocardiogram (ECG) signals is very important in fetal monitoring. In this paper, we proposed a new method for fetal ECG extraction based on wavelet analysis, the least mean square (LMS) adaptive filtering algorithm, and the spatially selective noise filtration (SSNF) algorithm. First, abdominal signals and thoracic signals were processed by stationary wavelet transform (SWT), and the wavelet coefficients at each scale were obtained. For each scale, the detail coefficients were processed by the LMS algorithm. The coefficient of the abdominal signal was taken as the original input of the LMS adaptive filtering system, and the coefficient of the thoracic signal as the reference input. Then, correlations of the processed wavelet coefficients were computed. The threshold was set and noise components were removed with the SSNF algorithm. Finally, the processed wavelet coefficients were reconstructed by inverse SWT to obtain fetal ECG. Twenty cases of simulated data and 12 cases of clinical data were used. Experimental results showed that the proposed method outperforms the LMS algorithm: (1) it shows improvement in case of superposition R-peaks of fetal ECG and maternal ECG; (2) noise disturbance is eliminated by incorporating the SSNF algorithm and the extracted waveform is more stable; and (3) the performance is proven quantitatively by SNR calculation. The results indicated that the proposed algorithm can be used for extracting fetal ECG from abdominal signals.

  17. Performance evaluation of carbon black based electrodes for underwater ECG monitoring.

    PubMed

    Reyes, Bersain A; Posada-Quintero, Hugo F; Bales, Justin R; Chon, Ki H

    2014-01-01

    Underwater electrocardiogram (ECG) monitoring currently uses Ag/AgCl electrodes and requires sealing of the electrodes to avoid water intrusion, but this procedure is time consuming and often results in severe irritations or even tearing of the skin. To alleviate these problems, our research team developed hydrophobic electrodes comprised of a mixture of carbon black powder (CB) and polydimethylsiloxane (PDMS) that provide all morphological waveforms without distortion of an ECG signal for dry and water-immersed conditions. Performance comparison of CB/PDMS electrodes to adhesive Ag/AgCl hydrogel electrodes was carried out in three different scenarios which included recordings from a dry surface, water immersion, and post-water immersion conditions. CB/PDMS electrodes were able to acquire ECG signals highly correlated with those from adhesive Ag/AgCl electrodes during all conditions. Statistical reduction in ECG amplitude (p<0.05) was only found during the immersed condition with CB/PDMS electrodes when compared to Ag/AgCl electrodes sealed with their waterproof adhesive tape. Besides this reduction readability of the recordings was not obscured and all morphological waveforms of the ECG signal were discernible. The advantages of our CB/PDMS electrodes are that they are reusable, can be fabricated economically, and most importantly, high-fidelity underwater ECG signals can be acquired without relying on the heavy use of waterproof sealing. PMID:25570300

  18. Development of a portable Linux-based ECG measurement and monitoring system.

    PubMed

    Tan, Tan-Hsu; Chang, Ching-Su; Huang, Yung-Fa; Chen, Yung-Fu; Lee, Cheng

    2011-08-01

    This work presents a portable Linux-based electrocardiogram (ECG) signals measurement and monitoring system. The proposed system consists of an ECG front end and an embedded Linux platform (ELP). The ECG front end digitizes 12-lead ECG signals acquired from electrodes and then delivers them to the ELP via a universal serial bus (USB) interface for storage, signal processing, and graphic display. The proposed system can be installed anywhere (e.g., offices, homes, healthcare centers and ambulances) to allow people to self-monitor their health conditions at any time. The proposed system also enables remote diagnosis via Internet. Additionally, the system has a 7-in. interactive TFT-LCD touch screen that enables users to execute various functions, such as scaling a single-lead or multiple-lead ECG waveforms. The effectiveness of the proposed system was verified by using a commercial 12-lead ECG signal simulator and in vivo experiments. In addition to its portability, the proposed system is license-free as Linux, an open-source code, is utilized during software development. The cost-effectiveness of the system significantly enhances its practical application for personal healthcare.

  19. Fast data-driven calibration of a cardiac electrophysiology model from images and ECG.

    PubMed

    Zettinig, Oliver; Mansi, Tommaso; Georgescu, Bogdan; Kayvanpour, Elham; Sedaghat-Hamedani, Farbod; Amr, Ali; Haas, Jan; Steen, Henning; Meder, Benjamin; Katus, Hugo; Navab, Nassir; Kamen, Ali; Comaniciul, Dorin

    2013-01-01

    Recent advances in computational electrophysiology (EP) models make them attractive for clinical use. We propose a novel data-driven approach to calibrate an EP model from standard 12-lead electrocardiograms (ECG), which are in contrast to invasive or dense body surface measurements widely available in clinical routine. With focus on cardiac depolarization, we first propose an efficient forward model of ECG by coupling a mono-domain, Lattice-Boltzmann model of cardiac EP to a boundary element formulation of body surface potentials. We then estimate a polynomial regression to predict myocardium, left ventricle and right ventricle endocardium electrical diffusion from QRS duration and ECG electrical axis. Training was performed on 4,200 ECG simulations, calculated in aproximately 3 s each, using different diffusion parameters on 13 patient geometries. This allowed quantifying diffusion uncertainty for given ECG parameters due to the ill-posed nature of the ECG problem. We show that our method is able to predict myocardium diffusion within the uncertainty range, yielding a prediction error of less than 5 ms for QRS duration and 2 degree for electrical axis. Prediction results compared favorably with those obtained with a standard optimization procedure, while being 60 times faster. Our data-driven model can thus constitute an efficient preliminary step prior to more refined EP personalization. PMID:24505642

  20. Low-cost compact ECG with graphic LCD and phonocardiogram system design.

    PubMed

    Kara, Sadik; Kemaloğlu, Semra; Kirbaş, Samil

    2006-06-01

    Till today, many different ECG devices are made in developing countries. In this study, low cost, small size, portable LCD screen ECG device, and phonocardiograph were designed. With designed system, heart sounds that take synchronously with ECG signal are heard as sensitive. Improved system consist three units; Unit 1, ECG circuit, filter and amplifier structure. Unit 2, heart sound acquisition circuit. Unit 3, microcontroller, graphic LCD and ECG signal sending unit to computer. Our system can be used easily in different departments of the hospital, health institution and clinics, village clinic and also in houses because of its small size structure and other benefits. In this way, it is possible that to see ECG signal and hear heart sounds as synchronously and sensitively. In conclusion, heart sounds are heard on the part of both doctor and patient because sounds are given to environment with a tiny speaker. Thus, the patient knows and hears heart sounds him/herself and is acquainted by doctor about healthy condition.

  1. The use of a portable three-lead ECG monitor to detect atrial fibrillation in general practice

    PubMed Central

    Kristensen, Anne N.; Jeyam, Brintha; Riahi, Sam; Jensen, Martin B.

    2016-01-01

    Objective To evaluate how well an inexpensive portable three-lead ECG monitor PEM identified patients with atrial fibrillation (AF) compared to a normal 12-lead ECG. Design Cross-sectional method comparison study. Setting From April 2014 to February 2015, we included patients coming to the general practice clinic “Lægerne Sløjfen”, Aalborg, Denmark for a routine ECG. Patients with severe dementia, mental illness or poor ECG readings were excluded. After oral and written informed consent an ECG and PEM recordings were obtained simultaneously. The PEM recordings were analyzed by two general practitioners (GPs) in training and ECG recordings were evaluated by a senior GP and a cardiologist. Both the PEM and the ECG recordings were analysed blinded. Subjects Ninety-three patients were included and four were excluded due to poor ECG readings. Main outcome measures The sensitivity and specificity of PEM compared to a standard 12-lead ECG. Results Eighty-nine of the 93 (95.7%) patients had ECGs of a satisfactory technical quality and were included in the study. The sensitivity of diagnosing AF by PEM recordings was 86.7% and the specificity was 98.7% when compared to a 12-lead ECG. According to the cardiologist, the misclassification of three PEM recordings were due to interpretation errors and not related to the PEM recording per se. Conclusions The inexpensive portable PEM device recording diagnosed AF with a high sensitivity and specificity. Key Points Simple ECG monitors could be useful to identify atrial fibrillation and thereby lead to a better prevention of stroke.The PEM device was easy to use and 95.7% of the recordings were technically acceptable for detecting atrial fibrillation.The PEM device has a high sensitivity and specificity in detecting atrial fibrillation compared to a standard 12-lead ECG.Further studies should evaluate the clinical usefulness of the PEM device, e.g. to detect intermittent atrial fibrillation. PMID:27409151

  2. [Prediction of cardiac function deviations (ECG data) in the course of permanent cosmonaut's monitoring starting from selection till return to earth after short-duration space flight].

    PubMed

    Kotovskaia, A R; Koloteva, M I; Luk'ianiuk, V Iu; Stepanova, G P; Filatova, L M; Buĭlov, S P; Zhernavkov, A F; Kondratiuk, L L

    2007-01-01

    Analyzed were deviations in cardiac function in 29 cosmonauts with previous aviation and other occupations ranging of 29 to 61 y.o. who made 8- to 30-day space flights (totai number of flights = 34) between 1982 and 2006. The deviations were identified in ECG records collected during clinical selection, clinical physiological examination (CPE) before flight, insertion and deorbit in transport vehicles, and post-flight CPE. Based on the analysis, the cosmonauts were distributed into three groups. The first group (55.2% of the cosmonauts) did not exhibit noticeable shifts and unfavorable trends in ECG at any time of the period of observation. The second group (34.5%) showed some deviations during selection and pre-flight CPE that became more apparent in the period of deorbit and were still present in post-flight ECG records. The third group (10.3%) displayed health-threatening deviations in cardiac function during deorbit. These findings give start to important investigations with the purpose to define permissible medical risks and ensuing establishment and perfection of medical criteria for candidates to cosmonauts with certain health problems.

  3. Ocular abnormalities in thin basement membrane disease

    PubMed Central

    Colville, D.; Savige, J.; Branley, P.; Wilson, D.

    1997-01-01

    AIM/BACKGROUND—Alport syndrome is an X linked disease that results in renal failure, deafness, and ocular abnormalities including a dot and fleck retinopathy and anterior lenticonus. The ultrastructural appearance of the glomerular basement membrane in thin basement membrane disease (TBMD) resembles that seen in some patients with Alport syndrome, and in some cases this disease is inherited too. The aim of this study was to determine whether patients with TBMD have any ocular abnormalities.
METHODS—The eyes of 17 unrelated individuals with TBMD were studied by slit-lamp, including biomicroscopic fundus examination with a 78 D lens, by direct ophthalmoscopy, and by fundal photographs. The findings were compared with those in patients with IgA glomerulonephritis or Alport syndrome, and in normals.
RESULTS—No patient with TBMD had a dot and fleck retinopathy or anterior lenticonus. A corneal dystrophy (n = 2) or pigmentation (n = 1), and retinal pigment epithelial clumping and maculopathy (n = 1) were noted. Corneal, lens, and retinal dots were found in five (29%), three (18%), and 16 (94%) patients, respectively, but these were also demonstrated in individuals with other renal diseases and in normal individuals.
CONCLUSIONS—The dot and fleck retinopathy and anterior lenticonus typical of Alport syndrome do not occur in TBMD. The protein abnormality and genetic defect in TBMD are not known, but the lack of ocular lesions suggests that the abnormal protein in this disease is more sparsely distributed or less important in the basement membranes of the eye than of the kidney. Alternatively, the protein may be less affected by the mutations responsible for TBMD.

 PMID:9227202

  4. Cranial computed tomographic abnormalities in leptomeningeal metastasis

    SciTech Connect

    Lee, Y.Y.; Glass, J.P.; Geoffray, A.; Wallace, S.

    1984-11-01

    Sixty-four (57.6%) of 111 cancer patients with cerebrospinal fluid cytology positive for malignant cells had cranial computed tomographic (CT) scans within 2 weeks before or after a lumbar puncture. Twenty-two (34.3%) of the 64 had abnormal CT findings indicative of leptomeningeal metastasis. Thirteen (59.6%) of these 22 patients had associated parenchymal metastases. Recognition of leptomeningeal disease may alter the management of patients with parenchymal metastases. Communicating hydrocephalus in cancer patients should be considered to be related to leptomeningeal metastasis until proven otherwise.

  5. Using new non-invasive quick method to detect Borrelia Burgdorferi (B.B.) infection from specific parts of the heart in "seemingly normal" ECGs, and from the ECGs of Atrial Fibrillation (AF), a majority of AF ECGs are found to have: 1) Significant B.B. infection, 2) Markedly increased ANP, 3) Increased Cardiac Troponin I & 4) Markedly reduced Taurine. These 4 factors were mainly localized at infected areas of the SA node area, R-&L-Atria & pulmonary veins at the L-atrium.

    PubMed

    Omura, Yoshiaki; Lu, Dominic; Jones, Marilyn K; Nihrane, Abdallah; Duvvi, Harsha; Yapor, Dario; Shimotsuura, Yasuhiro; Ohki, Motomu

    2015-01-01

    Lyme disease is found in a majority of people we tested. Once Borrelia Burgdorferi (B.B.) spirochete enters human body, it not only causes pain by infecting joints, but it also often enters the brain and the heart. Infection of brain can be quickly detected from the pupil and infection of the heart by ECGs non-invasively. By evaluating recorded ECGs of atrial fibrillation (AF), using U.S. patented non-invasive highly sensitive electromagnetic field (EMF) resonance phenomenon between 2 identical molecules or between a molecule and its antibody, we examined 25 different AF patients' ECGs and found the majority of them suffer from various degrees of B.B. spirochete infection in SA node areas, also in the right & left atria, and pulmonary vein near and around its junction at left atrium & lesser degrees of infection at the AV node & His Bundle. When B.B. infection reaches over 224-600ng or higher at these areas, AF often appears in the majority of all AF analyzed. In order to develop AF, the 4 abnormal factors must be present simultaneously: 1) B.B. infection must be increased to 224-600ng or higher, 2) Atrial Natriuretic Peptide (ANP) must be markedly reduced from normal value of less than 4ng to over 100-400ng, 3) A significant increase of Cardiac Troponin I from normal value of less than 3ng to over 12ng and 4) Taurine must also be markedly reduced from normal value of 4-6ng to 0.25ng. These 4 changes were mainly found only at infected sites of the SA node area, both atria and between the end of the T wave & the beginning of the SA node area, which corresponds to U waves at recorded ECG. Origin of the U wave is mainly due to abnormal electrical potential of pulmonary vein at L-atrium. If all 4 factors do not occur at the infection site, no AF will develop. In seemingly normal ECGs, if using this method, one can detect invisible B.B. infection in early stages. Long before AF appears, AF can be prevented by improved treatment with Amoxicillin 500ng 3 times

  6. Deployment of an Advanced Electrocardiographic Analysis (A-ECG) to Detect Cardiovascular Risk in Career Firefighters

    NASA Technical Reports Server (NTRS)

    Dolezal, B. A.; Storer, T. W.; Abrazado, M.; Watne, R.; Schlegel, T. T.; Batalin, M.; Kaiser, W.; Smith, D. L.; Cooper, C. B.

    2011-01-01

    INTRODUCTION Sudden cardiac death is the leading cause of line of duty death among firefighters, accounting for approximately 45% of fatalities annually. Firefighters perform strenuous muscular work while wearing heavy, encapsulating personal protective equipment in high ambient temperatures, under chaotic and emotionally stressful conditions. These factors can precipitate sudden cardiac events like myocardial infarction, serious dysrhythmias, or cerebrovascular accidents in firefighters with underlying cardiovascular disease. Screening for cardiovascular risk factors is recommended but not always followed in this population. PHASER is a project charged with identifying and prioritizing risk factors in emergency responders. We have deployed an advanced ECG (A-ECG) system developed at NASA for improved sensitivity and specificity in the detection of cardiac risk. METHODS Forty-four professional firefighters were recruited to perform comprehensive baseline assessments including tests of aerobic performance and laboratory tests for fasting lipid profiles and glucose. Heart rate and conventional 12-lead ECG were obtained at rest and during incremental treadmill exercise testing (XT). In addition, a 5-min resting 12-lead A-ECG was obtained in a subset of firefighters (n=18) and transmitted over a secure networked system to a physician collaborator at NASA for advanced-ECG analysis. This A-ECG system has been proven, using myocardial perfusion and other imaging, to accurately identify a number of cardiac pathologies including coronary artery disease (CAD), left ventricular hypertrophy, hypertrophic cardiomyopathy, non-ischemic cardiomyopathy, and ischemic cardiomyopathy. RESULTS Subjects mean (SD) age was 43 (8) years, weight 91 (13) kg, and BMI of 28 (3) kg/square meter. Maximum oxygen uptake (VO2max) was 39 (9) ml/kg/min. This compares with the 45th %ile in healthy reference values and a recommended standard of 42 ml/kg/min for firefighters. The metabolic threshold (VO

  7. Complex patterns of abnormal heartbeats

    NASA Technical Reports Server (NTRS)

    Schulte-Frohlinde, Verena; Ashkenazy, Yosef; Goldberger, Ary L.; Ivanov, Plamen Ch; Costa, Madalena; Morley-Davies, Adrian; Stanley, H. Eugene; Glass, Leon

    2002-01-01

    Individuals having frequent abnormal heartbeats interspersed with normal heartbeats may be at an increased risk of sudden cardiac death. However, mechanistic understanding of such cardiac arrhythmias is limited. We present a visual and qualitative method to display statistical properties of abnormal heartbeats. We introduce dynamical "heartprints" which reveal characteristic patterns in long clinical records encompassing approximately 10(5) heartbeats and may provide information about underlying mechanisms. We test if these dynamics can be reproduced by model simulations in which abnormal heartbeats are generated (i) randomly, (ii) at a fixed time interval following a preceding normal heartbeat, or (iii) by an independent oscillator that may or may not interact with the normal heartbeat. We compare the results of these three models and test their limitations to comprehensively simulate the statistical features of selected clinical records. This work introduces methods that can be used to test mathematical models of arrhythmogenesis and to develop a new understanding of underlying electrophysiologic mechanisms of cardiac arrhythmia.

  8. ECG response of koalas to tourists proximity: a preliminary study.

    PubMed

    Ropert-Coudert, Yan; Brooks, Lisa; Yamamoto, Maki; Kato, Akiko

    2009-01-01

    Koalas operate on a tight energy budget and, thus, may not always display behavioral avoidance reaction when placed in a stressful condition. We investigated the physiological response of captive koalas Phascolarctos cinereus in a conservation centre to the presence of tourists walking through their habitat. We compared, using animal-attached data-recorders, the electrocardiogram activity of female koalas in contact with tourists and in a human-free area. One of the koalas in the tourist zone presented elevated heart rate values and variability throughout the recording period. The remaining female in the exhibit area showed a higher field resting heart rates during the daytime than that in the isolated area. In the evening, heart rate profiles changed drastically and both the koalas in the exhibit and in the tourist-free zones displayed similar field resting heart rates, which were lower than those during the day. In parallel, the autonomic nervous systems of these two individuals evolved from sympathetic-dominant during the day to parasympathetic-dominant in the evening. Our results report ECG of free-living koalas for the first time. Although they are preliminary due to the difficulty of having sufficient samples of animals of the same sex and age, our results stress out the importance of studies investigating the physiological reaction of animals to tourists. PMID:19823679

  9. Ambulatory respiratory rate detection using ECG and a triaxial accelerometer.

    PubMed

    Chan, Alexander M; Ferdosi, Nima; Narasimhan, Ravi

    2013-01-01

    Continuous monitoring of respiratory rate in ambulatory conditions has widespread applications for screening of respiratory diseases and remote patient monitoring. Unfortunately, minimally obtrusive techniques often suffer from low accuracy. In this paper, we describe an algorithm with low computational complexity for combining multiple respiratory measurements to estimate breathing rate from an unobtrusive chest patch sensor. Respiratory rates derived from the respiratory sinus arrhythmia (RSA) and modulation of the QRS amplitude of electrocardiography (ECG) are combined with a respiratory rate derived from tri-axial accelerometer data. The three respiration rates are combined by a weighted average using weights based on quality metrics for each signal. The algorithm was evaluated on 15 elderly subjects who performed spontaneous and metronome breathing as well as a variety of activities of daily living (ADLs). When compared to a reference device, the mean absolute error was 1.02 breaths per minute (BrPM) during metronome breathing, 1.67 BrPM during spontaneous breathing, and 2.03 BrPM during ADLs.

  10. Anomalous ECG downloads from semi-automatic external defibrillators.

    PubMed

    Calle, P A; Vanhaute, O; Ranhoff, J F; Buylaert, W A

    1998-08-01

    The coincidental print-out by two different Laerdal systems (subsequently called 'system A' and 'system B') of the same medical control module (MCM) for a Laerdal Heartstart 2000 semi-automatic external defibrillator (SAED) led to the discovery of three deficiencies in the information storage and printing processes. First, we noted that the impedance reported via system A was consistently higher. Second, we found the attachment of 'mysterious' ECG samples in the reports from system B, but not from system A. A third problem was the unpredictable (in)ability of system B to print out the information from the MCMs. Further investigations with help from the company suggested that the above-mentioned problems were caused by incompatibilities between the software in the different parts of equipment used (i.e. SAED devices, MCMs, printing systems and a computer program to store the information in a database). These observations demonstrate the need for strict medical supervision on all aspects of a SAED project, and for feed-back from clinicians to manufacturers. PMID:9863574

  11. Clinically accurate fetal ECG parameters acquired from maternal abdominal sensors

    PubMed Central

    CLIFFORD, Gari; SAMENI, Reza; WARD, Mr. Jay; ROBINSON, Julian; WOLFBERG, Adam J.

    2011-01-01

    OBJECTIVE To evaluate the accuracy of a novel system for measuring fetal heart rate and ST-segment changes using non-invasive electrodes on the maternal abdomen. STUDY DESIGN Fetal ECGs were recorded using abdominal sensors from 32 term laboring women who had a fetal scalp electrode (FSE) placed for a clinical indication. RESULTS Good quality data for FHR estimation was available in 91.2% of the FSE segments, and 89.9% of the abdominal electrode segments. The root mean square (RMS) error between the FHR data calculated by both methods over all processed segments was 0.36 beats per minute. ST deviation from the isoelectric point ranged from 0 to 14.2% of R-wave amplitude. The RMS error between the ST change calculated by both methods averaged over all processed segments was 3.2%. CONCLUSION FHR and ST change acquired from the maternal abdomen is highly accurate and on average is clinically indistinguishable from FHR and ST change calculated using FSE data. PMID:21514560

  12. Automatic sleep staging based on ECG signals using hidden Markov models.

    PubMed

    Ying Chen; Xin Zhu; Wenxi Chen

    2015-08-01

    This study is designed to investigate the feasibility of automatic sleep staging using features only derived from electrocardiography (ECG) signal. The study was carried out using the framework of hidden Markov models (HMMs). The mean, and SD values of heart rates (HRs) computed from each 30-second epoch served as the features. The two feature sequences were first detrended by ensemble empirical mode decomposition (EEMD), formed as a two-dimensional feature vector, and then converted into code vectors by vector quantization (VQ) method. The output VQ indexes were utilized to estimate parameters for HMMs. The proposed model was tested and evaluated on a group of healthy individuals using leave-one-out cross-validation. The automatic sleep staging results were compared with PSG estimated ones. Results showed accuracies of 82.2%, 76.0%, 76.1% and 85.5% for deep, light, REM and wake sleep, respectively. The findings proved that HRs-based HMM approach is feasible for automatic sleep staging and can pave a way for developing more efficient, robust, and simple sleep staging system suitable for home application. PMID:26736316

  13. [Emotion Disorders and Abnormal Perspiration].

    PubMed

    Umeda, Satoshi

    2016-08-01

    This article reviewed the relationship between emotional disorders and abnormal perspiration. First, I focused on local brain areas related to emotional processing, and summarized the functions of the emotional network involving those local areas. Functional disorders followed by the damage in the amygdala, orbitofrontal cortex, and insular cortex were reviewed, including related abnormal perspiration. I then addressed the mechanisms of how autonomic disorders influence emotional processing. Finally, possible future directions for integrated understanding of the connection between neural activities and bodily reactions were discussed. PMID:27503817

  14. [Emotion Disorders and Abnormal Perspiration].

    PubMed

    Umeda, Satoshi

    2016-08-01

    This article reviewed the relationship between emotional disorders and abnormal perspiration. First, I focused on local brain areas related to emotional processing, and summarized the functions of the emotional network involving those local areas. Functional disorders followed by the damage in the amygdala, orbitofrontal cortex, and insular cortex were reviewed, including related abnormal perspiration. I then addressed the mechanisms of how autonomic disorders influence emotional processing. Finally, possible future directions for integrated understanding of the connection between neural activities and bodily reactions were discussed.

  15. Is Having Clonal Cytogenetic Abnormalities the Same as Having Leukaemia.

    PubMed

    Farina, Mirko; Rossi, Giuseppe; Bellotti, Daniella; Marchina, Eleonora; Gale, Robert Peter

    2016-01-01

    A finding of cytogenetic abnormalities, even when these are clonal and even when the abnormalities are typically associated with leukaemia, is not the same as a person having leukaemia. We describe a person who had acute myeloid leukaemia (AML) and achieved a complete haematological remission and who then had persistent and transient clonal cytogenetic abnormalities for 22 years but no recurrence of leukaemia. These data suggest that clones of myeloid cells with mutations and capable of expanding to levels detectable by routine cytogenetic analyses do not all eventuate in leukaemia, even after a prolonged observation interval. The possibility of incorrectly diagnosing a person as having leukaemia becomes even greater when employing more sensitive techniques to detect mutations such as by polymerase chain reaction and whole-exome or whole-genome sequencing. Caution is needed when interpreting clonal abnormalities in AML patients with normal blood and bone marrow parameters.

  16. Influence of network topology on the abnormal phase order

    NASA Astrophysics Data System (ADS)

    Zhou, Yinzuo; Zhou, Jie; Liu, Zonghua

    2008-12-01

    The abnormal phase order of coupled logistic maps, i.e., the ratio of two sequential "up phases" in the total iterations, can be characterized by the direction phase (Phys. Rev. Lett., 84 (2000) 2610). We here consider the case of coupled logistic maps on complex networks and study how the network topology influences the abnormal phase order. Our numerical simulations reveal that the critical point for the appearance of abnormal phase order increases with the coupling strength but decreases with the degree of heterogeneity of complex networks. Moreover, we find that unlike in the case of normal phase order, it is possible for the system to show a periodic window in the case of abnormal phase order, but only within an appropriate range of coupling strengths, and finally, that the heterogeneity can reduce the maximum number of the phase clusters in a given periodic window.

  17. Diverticular Disease of the Colon: Neuromuscular Function Abnormalities.

    PubMed

    Bassotti, Gabrio; Villanacci, Vincenzo; Bernardini, Nunzia; Dore, Maria P

    2016-10-01

    Colonic diverticular disease is a frequent finding in daily clinical practice. However, its pathophysiological mechanisms are largely unknown. This condition is likely the result of several concomitant factors occurring together to cause anatomic and functional abnormalities, leading as a result to the outpouching of the colonic mucosa. A pivotal role seems to be played by an abnormal colonic neuromuscular function, as shown repeatedly in these patients, and by an altered visceral perception. There is recent evidence that these abnormalities might be related to the derangement of the enteric innervation, to an abnormal distribution of mucosal neuropeptides, and to low-grade mucosal inflammation. The latter might be responsible for the development of visceral hypersensitivity, often causing abdominal pain in a subset of these patients. PMID:27622368

  18. The significance of ultrastructural abnormalities of human cilia.

    PubMed

    Fox, B; Bull, T B; Makey, A R; Rawbone, R

    1981-12-01

    The electronmicroscopic structure of cilia was studied from the inferior turbinate of the nose in 22 adults, and in 84 biopsies from the bronchial tree of 40 adults. The incidence of compound cilia and abnormal microtubular structures was assessed. There were significant variations in the incidence of abnormalities in different parts of the airways and even within different areas of the same electronmicroscopic section. The focal nature of differences in structure of cilia indicate that abnormalities found in a single biopsy do not necessarily reflect a generalized change in the bronchial tree. Thus, such a finding should not be used as evidence that the abnormalities of cilia are the cause of decrease in mucociliary clearance or that they play a role in the pathogenesis of bronchiectasis and sinusitis.

  19. Hysterosalpingographic features of cervical abnormalities: acquired structural anomalies

    PubMed Central

    Zafarani, F; Shahrzad, G

    2015-01-01

    Cervical abnormalities may be congenital or acquired. Congenital cervical structural anomalies are relatively uncommon, whereas acquired cervical abnormalities are commonly seen in gynaecology clinics. Acquired abnormalities of the cervix can cause cervical factor infertility and recurrent spontaneous abortion. Various imaging tools have been used for evaluation of the uterine cavity and fallopian tubes. Hysterosalpingography (HSG) is a quick and minimally invasive tool for evaluation of infertility that facilitates visualization of the inner surfaces of the uterine cavity and fallopian tubes, as well as the cervical canal and isthmus. The lesions of the uterine cervix show various imaging manifestations on HSG such as narrowing, dilatation, filling defects, irregularities and diverticular projections. This pictorial review describes and illustrates the hysterosalpingographic appearances of normal variants and acquired structural abnormalities of the cervix. Accurate diagnosis of such cases is considered essential for optimal treatment. The pathological findings and radiopathological correlation will be briefly discussed. PMID:26111269

  20. Cytogenetic abnormalities in Tunisian women with premature ovarian failure.

    PubMed

    Ayed, Wiem; Amouri, Ahlem; Hammami, Wajih; Kilani, Olfa; Turki, Zinet; Harzallah, Fatma; Bouayed-Abdelmoula, Nouha; Chemkhi, Imen; Zhioua, Fethi; Slama, Claude Ben

    2014-12-01

    To identify the distribution of chromosome abnormalities among Tunisian women with premature ovarian failure (POF) referred to the department of Cytogenetic at the Pasteur Institute of Tunis (Tunisia), standard cytogenetic analysis was carried out in a total of 100 women younger than 40 affected with premature ovarian failure. We identified 18 chromosomal abnormalities, including seven X-numerical anomalies in mosaic and non-mosaic state (45,X; 47,XXX), four sex reversal, three X-structural abnormalities (terminal deletion and isochromosomes), one autosomal translocation and one supernumerary marker. The overall prevalence of chromosomal abnormalities was 18% in our cohort. X chromosome aneuploidy was the most frequent aberration. This finding confirms the essential role of X chromosome in ovarian function and underlies the importance of cytogenetic investigations in the routine management of POF. PMID:25433561

  1. Construction of a Resting High Fidelity ECG "SuperScore" for Management and Screening of Heart Disease

    NASA Technical Reports Server (NTRS)

    Schlegel, Todd T.; Delgado, Reynolds; Poulin, Greg; Starc, Vito; Arenare, Brian; Rahman, M. A.

    2006-01-01

    Resting conventional ECG is notoriously insensitive for detecting coronary artery disease (CAD) and only nominally useful in screening for cardiomyopathy (CM). Similarly, conventional exercise stress test ECG is both time- and labor-consuming and its accuracy in identifying CAD is suboptimal for use in population screening. We retrospectively investigated the accuracy of several advanced resting electrocardiographic (ECG) parameters, both alone and in combination, for detecting CAD and cardiomyopathy (CM).

  2. Transform Domain Robust Variable Step Size Griffiths' Adaptive Algorithm for Noise Cancellation in ECG

    NASA Astrophysics Data System (ADS)

    Hegde, Veena; Deekshit, Ravishankar; Satyanarayana, P. S.

    2011-12-01

    The electrocardiogram (ECG) is widely used for diagnosis of heart diseases. Good quality of ECG is utilized by physicians for interpretation and identification of physiological and pathological phenomena. However, in real situations, ECG recordings are often corrupted by artifacts or noise. Noise severely limits the utility of the recorded ECG and thus needs to be removed, for better clinical evaluation. In the present paper a new noise cancellation technique is proposed for removal of random noise like muscle artifact from ECG signal. A transform domain robust variable step size Griffiths' LMS algorithm (TVGLMS) is proposed for noise cancellation. For the TVGLMS, the robust variable step size has been achieved by using the Griffiths' gradient which uses cross-correlation between the desired signal contaminated with observation or random noise and the input. The algorithm is discrete cosine transform (DCT) based and uses symmetric property of the signal to represent the signal in frequency domain with lesser number of frequency coefficients when compared to that of discrete Fourier transform (DFT). The algorithm is implemented for adaptive line enhancer (ALE) filter which extracts the ECG signal in a noisy environment using LMS filter adaptation. The proposed algorithm is found to have better convergence error/misadjustment when compared to that of ordinary transform domain LMS (TLMS) algorithm, both in the presence of white/colored observation noise. The reduction in convergence error achieved by the new algorithm with desired signal decomposition is found to be lower than that obtained without decomposition. The experimental results indicate that the proposed method is better than traditional adaptive filter using LMS algorithm in the aspects of retaining geometrical characteristics of ECG signal.

  3. The emergency department ECG and immediately life-threatening complications in initially uncomplicated suspected myocardial ischemia.

    PubMed

    Zalenski, R J; Sloan, E P; Chen, E H; Hayden, R F; Gold, I W; Cooke, D

    1988-03-01

    The emergency physician's disposition of patients with suspected myocardial ischemia is currently debated; some physicians believe that a subgroup of patients can be managed safely outside the coronary care unit. Clinical predictors are needed in assessing the patient with suspected myocardial ischemia to help identify this subgroup. Through a retrospective cohort study, we investigated the value of the initial emergency department ECG in discriminating between chest pain patients with low and high risk for immediately life-threatening complications. Two hundred eleven initially uncomplicated consecutive coronary care unit admissions with suspected unstable angina or myocardial infarction were studied. Patient outcome, including the incidence of myocardial infarction, complications, and mechanical and pharmacologic interventions, was reviewed. Immediately life-threatening complications included ventricular fibrillation, ventricular tachycardia, shock, 2 degrees and 3 degrees block, and death. Mechanical interventions included electrocardioversion or defibrillation, endotracheal intubation, intra-aortic balloon pump, Swan-Ganz catheter, or pacemaker insertion. Pressors, antiarrhythmics, and vasodilators were the reviewed pharmacologic interventions. A positive ECG was defined by the presence of ST elevation or depression, T wave inversion, left ventricular hypertrophy, left bundle branch block, paced rhythm, or new Q waves. All other ECG interpretations were considered negative. Patients were divided into two groups based on this initial emergency physician ECG interpretation and their complication incidences compared. Of the 211 patients, 96 had a positive ECG; 115 had negative ECGs. Patients with positive ECGs were older, had a greater history and concurrent incidence of myocardial infarction, and more complications and intensive interventions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3345014

  4. Abnormal Neuroimaging in a Case of Infant Botulism.

    PubMed

    Good, Ryan J; Messacar, Kevin; Stence, Nicholas V; Press, Craig A; Carpenter, Todd C

    2015-01-01

    We present the first case of abnormal neuroimaging in a case of infant botulism. The clinical findings of the patient with constipation, bulbar weakness, and descending, symmetric motor weakness are consistent with the classic findings of infant botulism. Magnetic resonance imaging (MRI), however, revealed restricted diffusion in the brain and enhancement of the cervical nerve roots. Traditionally, normal neuroimaging was used to help differentiate infant botulism from other causes of weakness in infants. Abnormal neuroimaging is seen in other causes of weakness in an infant including metabolic disorders and hypoxic-ischemic injury, but these diagnoses did not fit the clinical findings in this case. The explanation for the MRI abnormalities in the brain and cervical nerve roots is unclear as botulinum toxin acts at presynaptic nerve terminals and does not cross the blood-brain barrier. Possible explanations for the findings include inflammation from the botulinum toxin at the synapse, alterations in sensory signaling and retrograde transport of the botulinum toxin. The patient was treated with human botulism immune globulin and had rapid recovery in weakness. A stool sample from the patient was positive for Type A Clostridium botulinum toxin eventually confirming the diagnosis of infant botulism. The findings in this case support use of human botulism immune globulin when the clinical findings are consistent with infant botulism despite the presence of MRI abnormalities in the brain and cervical nerve roots. PMID:26697417

  5. Abnormal Neuroimaging in a Case of Infant Botulism

    PubMed Central

    Good, Ryan J.; Messacar, Kevin; Stence, Nicholas V.; Press, Craig A.; Carpenter, Todd C.

    2015-01-01

    We present the first case of abnormal neuroimaging in a case of infant botulism. The clinical findings of the patient with constipation, bulbar weakness, and descending, symmetric motor weakness are consistent with the classic findings of infant botulism. Magnetic resonance imaging (MRI), however, revealed restricted diffusion in the brain and enhancement of the cervical nerve roots. Traditionally, normal neuroimaging was used to help differentiate infant botulism from other causes of weakness in infants. Abnormal neuroimaging is seen in other causes of weakness in an infant including metabolic disorders and hypoxic–ischemic injury, but these diagnoses did not fit the clinical findings in this case. The explanation for the MRI abnormalities in the brain and cervical nerve roots is unclear as botulinum toxin acts at presynaptic nerve terminals and does not cross the blood–brain barrier. Possible explanations for the findings include inflammation from the botulinum toxin at the synapse, alterations in sensory signaling and retrograde transport of the botulinum toxin. The patient was treated with human botulism immune globulin and had rapid recovery in weakness. A stool sample from the patient was positive for Type A Clostridium botulinum toxin eventually confirming the diagnosis of infant botulism. The findings in this case support use of human botulism immune globulin when the clinical findings are consistent with infant botulism despite the presence of MRI abnormalities in the brain and cervical nerve roots. PMID:26697417

  6. [Research on ECG de-noising method based on ensemble empirical mode decomposition and wavelet transform using improved threshold function].

    PubMed

    Ye, Linlin; Yang, Dan; Wang, Xu

    2014-06-01

    A de-noising method for electrocardiogram (ECG) based on ensemble empirical mode decomposition (EEMD) and wavelet threshold de-noising theory is proposed in our school. We decomposed noised ECG signals with the proposed method using the EEMD and calculated a series of intrinsic mode functions (IMFs). Then we selected IMFs and reconstructed them to realize the de-noising for ECG. The processed ECG signals were filtered again with wavelet transform using improved threshold function. In the experiments, MIT-BIH ECG database was used for evaluating the performance of the proposed method, contrasting with de-noising method based on EEMD and wavelet transform with improved threshold function alone in parameters of signal to noise ratio (SNR) and mean square error (MSE). The results showed that the ECG waveforms de-noised with the proposed method were smooth and the amplitudes of ECG features did not attenuate. In conclusion, the method discussed in this paper can realize the ECG denoising and meanwhile keep the characteristics of original ECG signal. PMID:25219236

  7. Reduction of Motion Artifacts and Improvement of R Peak Detecting Accuracy Using Adjacent Non-Intrusive ECG Sensors

    PubMed Central

    Choi, Minho; Jeong, Jae Jin; Kim, Seung Hun; Kim, Sang Woo

    2016-01-01

    Non-intrusive electrocardiogram (ECG) monitoring has many advantages: easy to measure and apply in daily life. However, motion noise in the measured signal is the major problem of non-intrusive measurement. This paper proposes a method to reduce the noise and to detect the R peaks of ECG in a stable manner in a sitting arrangement using non-intrusive sensors. The method utilizes two capacitive ECG sensors (cECGs) to measure ECG, and another two cECGs located adjacent to the sensors for ECG are added to obtain the information on motion. Then, active noise cancellation technique and the motion information are used to reduce motion noise. To verify the proposed method, ECG was measured indoors and during driving, and the accuracy of the detected R peaks was compared. After applying the method, the sum of sensitivity and positive predictivity increased 8.39% on average and 26.26% maximally in the data. Based on the results, it was confirmed that the motion noise was reduced and that more reliable R peak positions could be obtained by the proposed method. The robustness of the new ECG measurement method will elicit benefits to various health care systems that require noninvasive heart rate or heart rate variability measurements. PMID:27196910

  8. [Research on ECG de-noising method based on ensemble empirical mode decomposition and wavelet transform using improved threshold function].

    PubMed

    Ye, Linlin; Yang, Dan; Wang, Xu

    2014-06-01

    A de-noising method for electrocardiogram (ECG) based on ensemble empirical mode decomposition (EEMD) and wavelet threshold de-noising theory is proposed in our school. We decomposed noised ECG signals with the proposed method using the EEMD and calculated a series of intrinsic mode functions (IMFs). Then we selected IMFs and reconstructed them to realize the de-noising for ECG. The processed ECG signals were filtered again with wavelet transform using improved threshold function. In the experiments, MIT-BIH ECG database was used for evaluating the performance of the proposed method, contrasting with de-noising method based on EEMD and wavelet transform with improved threshold function alone in parameters of signal to noise ratio (SNR) and mean square error (MSE). The results showed that the ECG waveforms de-noised with the proposed method were smooth and the amplitudes of ECG features did not attenuate. In conclusion, the method discussed in this paper can realize the ECG denoising and meanwhile keep the characteristics of original ECG signal.

  9. Reduction of Motion Artifacts and Improvement of R Peak Detecting Accuracy Using Adjacent Non-Intrusive ECG Sensors.

    PubMed

    Choi, Minho; Jeong, Jae Jin; Kim, Seung Hun; Kim, Sang Woo

    2016-01-01

    Non-intrusive electrocardiogram (ECG) monitoring has many advantages: easy to measure and apply in daily life. However, motion noise in the measured signal is the major problem of non-intrusive measurement. This paper proposes a method to reduce the noise and to detect the R peaks of ECG in a stable manner in a sitting arrangement using non-intrusive sensors. The method utilizes two capacitive ECG sensors (cECGs) to measure ECG, and another two cECGs located adjacent to the sensors for ECG are added to obtain the information on motion. Then, active noise cancellation technique and the motion information are used to reduce motion noise. To verify the proposed method, ECG was measured indoors and during driving, and the accuracy of the detected R peaks was compared. After applying the method, the sum of sensitivity and positive predictivity increased 8.39% on average and 26.26% maximally in the data. Based on the results, it was confirmed that the motion noise was reduced and that more reliable R peak positions could be obtained by the proposed method. The robustness of the new ECG measurement method will elicit benefits to various health care systems that require noninvasive heart rate or heart rate variability measurements. PMID:27196910

  10. Discrete wavelet transform and singular value decomposition based ECG steganography for secured patient information transmission.

    PubMed

    Edward Jero, S; Ramu, Palaniappan; Ramakrishnan, S

    2014-10-01

    ECG Steganography provides secured transmission of secret information such as patient personal information through ECG signals. This paper proposes an approach that uses discrete wavelet transform to decompose signals and singular value decomposition (SVD) to embed the secret information into the decomposed ECG signal. The novelty of the proposed method is to embed the watermark using SVD into the two dimensional (2D) ECG image. The embedding of secret information in a selected sub band of the decomposed ECG is achieved by replacing the singular values of the decomposed cover image by the singular values of the secret data. The performance assessment of the proposed approach allows understanding the suitable sub-band to hide secret data and the signal degradation that will affect diagnosability. Performance is measured using metrics like Kullback-Leibler divergence (KL), percentage residual difference (PRD), peak signal to noise ratio (PSNR) and bit error rate (BER). A dynamic location selection approach for embedding the singular values is also discussed. The proposed approach is demonstrated on a MIT-BIH database and the observations validate that HH is the ideal sub-band to hide data. It is also observed that the signal degradation (less than 0.6%) is very less in the proposed approach even with the secret data being as large as the sub band size. So, it does not affect the diagnosability and is reliable to transmit patient information. PMID:25187409

  11. Revisiting QRS Detection Methodologies for Portable, Wearable, Battery-Operated, and Wireless ECG Systems

    PubMed Central

    Elgendi, Mohamed; Eskofier, Björn; Dokos, Socrates; Abbott, Derek

    2014-01-01

    Cardiovascular diseases are the number one cause of death worldwide. Currently, portable battery-operated systems such as mobile phones with wireless ECG sensors have the potential to be used in continuous cardiac function assessment that can be easily integrated into daily life. These portable point-of-care diagnostic systems can therefore help unveil and treat cardiovascular diseases. The basis for ECG analysis is a robust detection of the prominent QRS complex, as well as other ECG signal characteristics. However, it is not clear from the literature which ECG analysis algorithms are suited for an implementation on a mobile device. We investigate current QRS detection algorithms based on three assessment criteria: 1) robustness to noise, 2) parameter choice, and 3) numerical efficiency, in order to target a universal fast-robust detector. Furthermore, existing QRS detection algorithms may provide an acceptable solution only on small segments of ECG signals, within a certain amplitude range, or amid particular types of arrhythmia and/or noise. These issues are discussed in the context of a comparison with the most conventional algorithms, followed by future recommendations for developing reliable QRS detection schemes suitable for implementation on battery-operated mobile devices. PMID:24409290

  12. Simplified 2D Bidomain Model of Whole Heart Electrical Activity and ECG Generation

    NASA Astrophysics Data System (ADS)

    Sovilj, Siniša; Magjarević, Ratko; Abed, Amr Al; Lovell, Nigel H.; Dokos, Socrates

    2014-06-01

    The aim of this study was the development of a geometrically simple and highly computationally-efficient two dimensional (2D) biophysical model of whole heart electrical activity, incorporating spontaneous activation of the sinoatrial node (SAN), the specialized conduction system, and realistic surface ECG morphology computed on the torso. The FitzHugh-Nagumo (FHN) equations were incorporated into a bidomain finite element model of cardiac electrical activity, which was comprised of a simplified geometry of the whole heart with the blood cavities, the lungs and the torso as an extracellular volume conductor. To model the ECG, we placed four electrodes on the surface of the torso to simulate three Einthoven leads VI, VII and VIII from the standard 12-lead system. The 2D model was able to reconstruct ECG morphology on the torso from action potentials generated at various regions of the heart, including the sinoatrial node, atria, atrioventricular node, His bundle, bundle branches, Purkinje fibers, and ventricles. Our 2D cardiac model offers a good compromise between computational load and model complexity, and can be used as a first step towards three dimensional (3D) ECG models with more complex, precise and accurate geometry of anatomical structures, to investigate the effect of various cardiac electrophysiological parameters on ECG morphology.

  13. Subject identification via ECG fiducial-based systems: influence of the type of QT interval correction.

    PubMed

    Gargiulo, Francesco; Fratini, Antonio; Sansone, Mario; Sansone, Carlo

    2015-10-01

    Electrocardiography (ECG) has been recently proposed as biometric trait for identification purposes. Intra-individual variations of ECG might affect identification performance. These variations are mainly due to Heart Rate Variability (HRV). In particular, HRV causes changes in the QT intervals along the ECG waveforms. This work is aimed at analysing the influence of seven QT interval correction methods (based on population models) on the performance of ECG-fiducial-based identification systems. In addition, we have also considered the influence of training set size, classifier, classifier ensemble as well as the number of consecutive heartbeats in a majority voting scheme. The ECG signals used in this study were collected from thirty-nine subjects within the Physionet open access database. Public domain software was used for fiducial points detection. Results suggested that QT correction is indeed required to improve the performance. However, there is no clear choice among the seven explored approaches for QT correction (identification rate between 0.97 and 0.99). MultiLayer Perceptron and Support Vector Machine seemed to have better generalization capabilities, in terms of classification performance, with respect to Decision Tree-based classifiers. No such strong influence of the training-set size and the number of consecutive heartbeats has been observed on the majority voting scheme.

  14. Discrete wavelet transform and singular value decomposition based ECG steganography for secured patient information transmission.

    PubMed

    Edward Jero, S; Ramu, Palaniappan; Ramakrishnan, S

    2014-10-01

    ECG Steganography provides secured transmission of secret information such as patient personal information through ECG signals. This paper proposes an approach that uses discrete wavelet transform to decompose signals and singular value decomposition (SVD) to embed the secret information into the decomposed ECG signal. The novelty of the proposed method is to embed the watermark using SVD into the two dimensional (2D) ECG image. The embedding of secret information in a selected sub band of the decomposed ECG is achieved by replacing the singular values of the decomposed cover image by the singular values of the secret data. The performance assessment of the proposed approach allows understanding the suitable sub-band to hide secret data and the signal degradation that will affect diagnosability. Performance is measured using metrics like Kullback-Leibler divergence (KL), percentage residual difference (PRD), peak signal to noise ratio (PSNR) and bit error rate (BER). A dynamic location selection approach for embedding the singular values is also discussed. The proposed approach is demonstrated on a MIT-BIH database and the observations validate that HH is the ideal sub-band to hide data. It is also observed that the signal degradation (less than 0.6%) is very less in the proposed approach even with the secret data being as large as the sub band size. So, it does not affect the diagnosability and is reliable to transmit patient information.

  15. Simulation of elevated T-waves of an ECG inside a static magnetic field (MRI).

    PubMed

    Gupta, Aditya; Weeks, Arthur R; Richie, Samuel M

    2008-07-01

    In MRI, the flow of blood in the patient is subjected to a strong static magnetic field (B(0)). The movement of charge carriers in a magnetic field causes a magnetofluid dynamic (MFD) effect that induces a voltage across the artery. This induced voltage distorts the ECG signal of the patient and appears as an elevation of the T-wave of the ECG signal. Flow of blood through the aortic arch is perpendicular to the magnetic field and coincides with the occurrence of the T-wave of the ECG. Based on these facts, it is proposed that the elevation in the T-wave occurs because of the voltage induced across the aortic arch. In this paper, the elevation is computed mathematically using the equations of MFD. A method is developed to measure this induced voltage based on discretization of the aortic arch and measuring the blood flow profile in the aorta. The results are compared to the ECG signals measured in humans in the bore of 1.5 T imaging magnet. The computed ECG signals at the 12 leads are very similar to the measured values. PMID:18595808

  16. Prediction and prevention of sudden death in young populations: the role of ECG screening.

    PubMed

    Dougherty, Kevin R; Friedman, Richard A; Link, Mark S; Estes, N A Mark

    2013-03-01

    Sudden cardiac death (SCD), particularly when it affects a child or a young athlete who is presumed to be healthy, is an emotionally charged event that has a widespread impact. An effective ECG screening strategy for this population is intuitively appealing. The primary objective of ECG screening is to detect occult cardiovascular conditions likely to manifest with SCD. Such an endeavor is only effective if it is highly sensitive with an acceptably low false-positive rate. It also must be accompanied by an intervention that reduces the risk of SCD and improves outcomes. Despite significant advancements, considerable knowledge gaps remain about the etiology of SCD and the frequency with which SCD occurs. Reports of screening programs that have reduced the incidence of SCD have limited generalizability based on program design and the populations studied. Within the USA, considerable gaps in knowledge exist related to the frequency of SCD in youth and to the incremental predictive value of an ECG when added to a standardized history and physical examination. The strategy of ECG screening of young populations needs careful consideration based on principles of effective screening and evidence-based medicine. From a health policy perspective, additional data are needed from robust registries and carefully designed trials before advancing ECG screening in youth. PMID:23179925

  17. Modeling left and right atrial contributions to the ECG: A dipole-current source approach.

    PubMed

    Jacquemet, Vincent

    2015-10-01

    This paper presents the mathematical formulation, the numerical validation and several illustrations of a forward-modeling approach based on dipole-current sources to compute the contribution of a part of the heart to the electrocardiogram (ECG). Clinically relevant applications include identifying in the ECG the contributions from the right and the left atrium. In a Courtemanche-based monodomain computer model of the atria and torso, 1000 dipoles distributed throughout the atrial mid-myocardium are found to be sufficient to reproduce body surface potential maps with a relative error <1% during both sinus rhythm and atrial fibrillation. When the boundary element method is applied to solve the forward problem, this approach enables fast offline computation of the ECG contribution of any anatomical part of the atria by applying the principle of superposition to the dipole sources. In the presence of a right-left activation delay (sinus rhythm), pulmonary vein isolation (sinus rhythm) or left-right differences in refractory period (atrial fibrillation), the decomposition of the ECG is shown to help interpret ECG morphology in relation to the atrial substrate. These tools provide a theoretical basis for a deeper understanding of the genesis of the P wave or fibrillatory waves in normal and pathological cases.

  18. Finding food

    PubMed Central

    Forsyth, Ann; Lytle, Leslie; Riper, David Van

    2011-01-01

    A significant amount of travel is undertaken to find food. This paper examines challenges in measuring access to food using Geographic Information Systems (GIS), important in studies of both travel and eating behavior. It compares different sources of data available including fieldwork, land use and parcel data, licensing information, commercial listings, taxation data, and online street-level photographs. It proposes methods to classify different kinds of food sales places in a way that says something about their potential for delivering healthy food options. In assessing the relationship between food access and travel behavior, analysts must clearly conceptualize key variables, document measurement processes, and be clear about the strengths and weaknesses of data. PMID:21837264

  19. Bradycardia as a Marker of Chronic Cocaine Use: A Novel Cardiovascular Finding.

    PubMed

    Sharma, Jyoti; Rathnayaka, Nuvan; Green, Charles; Moeller, F Gerard; Schmitz, Joy M; Shoham, Daniel; Dougherty, Anne Hamilton

    2016-01-01

    Few studies have examined the effects of chronic cocaine use on the resting surface electrocardiogram (ECG) between exposures to cocaine. Researchers compared 12-lead ECGs from 97 treatment-seeking cocaine-dependent patients, with ECG parameters from 8,513 non-cocaine-using control patients from the Atherosclerosis Risk in Communities study. After matching and adjusting for relevant covariates, cocaine use demonstrated large and statistically reliable effects on early repolarization, bradycardia, severe bradycardia, and heart rate. Current cocaine dependence corresponds to an increased odds of demonstrating early repolarization by a factor of 4.92 and increased odds of bradycardia and severe bradycardia by factors 3.02 and 5.11, respectively. This study demonstrates the novel finding that long-lasting effects of cocaine use on both the cardiac conduction and the autonomic nervous system pose a risk of adverse cardiovascular events between episodes of cocaine use, and that bradycardia is a marker of chronic cocaine use.

  20. Ultrasound screening for fetal abnormalities.

    PubMed

    Chitty, L S

    1995-12-01

    Ultrasound screening for fetal abnormalities is increasingly becoming part of routine antenatal care in Europe and the UK. However, there has been very little formal evaluation of this practice. In this article reports of routine ultrasound screening are reviewed and the advantages and disadvantages discussed. The majority of routine anomaly scanning is done in the second trimester but there may be a case for screening at other times in pregnancy and alternative anomaly screening policies are discussed. PMID:8710765