Clinical Applications of Ambulatory Electrocardiography

Kligfield, Paul

doi:10.1159/000173656

Cited by 11 publications

(3 citation statements)

References 91 publications

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“…Simple arrhythmias are common in clinical normal subjects [ 17], and in this study, we were unable to find any significant differences between the two groups for any dis turbances in cardiac rhythm. Neither group had any seri ous cardiac arrhythmias.…”

Section: Discussioncontrasting

confidence: 69%

Analysis of 24-Hour ECG in Patients with Panic Disorder

et al. 1997

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Previous evidence suggests an increased cardiovascular morbidity in patients with panic disorder. In this study, we compared 24-hour ECG in patients with panic disorder (n = 22; age: 36.1 ± 7.6 years) and healthy controls (n = 21; age: 34.6 ± 10.0 years). The QT_C intervals during the day or night were not significantly different between patients and controls. Ventricular ectopic beats were also not significantly different between the two groups. These results do not suggest any overt cardiac arrhythmias in this age group of patients with panic disorder.

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Section: Discussioncontrasting

confidence: 69%

Analysis of 24-Hour ECG in Patients with Panic Disorder

et al. 1997

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“…In 12 patients loss of consciousness was the dominant symptom, hut eight of these also experienced intermittent dizziness. Duration of symptoms was variable: 1-6 months (20); 7-12 months (6); 5-10 years (5); 16 years (1). Ail the patients had underlying cardiac pathology; the majority had rheumatic and ischemic heart disease.…”

Section: Resultsmentioning

confidence: 99%

Intermittent Ventricular Standstill During Chronic Atrial Fibrillation in Patients with Dizziness or Syncope

Rebello

Brownlee

1987

Pacing Clinical Electrophis

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Thirty-two patients with atrial fibrillation and normal ventricular rates who complained of dizziness or loss of consciousness underwent 24-hour ambulatory electrocardiographic monitoring. A control group of 25 patients in atrial fibrillation but without symptoms of dizziness or loss of consciousness was likewise investigated. All patients remained in atrial fibrillation; periods of ventricular standstill (mean, 2.9; range, 1.8-8.0) were present in 31 symptomatic patients but in only three of the control patients (mean, 1.9 s; range, 1.7-2.4). Twenty-three symptomatic patients with pauses greater than or equal to 2.0 s received a demand pacemaker. Following pacing, nineteen became completely asymptomatic; four patients continued to have dizziness but three of these, who also experienced syncope, no longer did so (mean follow-up, 13 months; range, 6-30). It is suggested that ventricular standstill may commonly occur in patients with controlled atrial fibrillation who complain of dizziness or syncope and that the majority will benefit from permanent cardiac pacing.

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“…lectrocardiography is the most commonly performed cardiovascular diagnostic test, 1 and electrocardiogram (ECG) interpretation is an essential skill for most physicians. [2][3][4] Interpretation of an ECG is a complex task that requires integration of knowledge of anatomy, electrophysiology, and pathophysiology, visual pattern recognition, and diagnostic reasoning.…”

mentioning

confidence: 99%

Accuracy of Physicians’ Electrocardiogram Interpretations

Cook

Pusic³

2020

JAMA Intern Med

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STUDY SELECTION Of 1138 articles initially identified, 78 studies that assessed the accuracy of physicians' or medical students' ECG interpretations in a test setting were selected.DATA EXTRACTION AND SYNTHESIS Data on study purpose, participants, assessment features, and outcomes were abstracted, and methodological quality was appraised with the Medical Education Research Study Quality Instrument. Results were pooled using random-effects meta-analysis. MAIN OUTCOMES AND MEASURES Accuracy of ECG interpretation.RESULTS Of 1138 studies initially identified, 78 assessed the accuracy of ECG interpretation. Across all training levels, the median accuracy was 54% (interquartile range [IQR], 40%-66%; n = 62 studies) on pretraining assessments and 67% (IQR, 55%-77%; n = 47 studies) on posttraining assessments. Accuracy varied widely across studies. The pooled accuracy for pretraining assessments was 42.0% (95% CI, 34.3%-49.6%; n = 24 studies; I 2 = 99%) for medical students, 55.8% (95% CI, 48.1%-63.6%; n = 37 studies; I 2 = 96%) for residents, 68.5% (95% CI, 57.6%-79.5%; n = 10 studies; I 2 = 86%) for practicing physicians, and 74.9% (95% CI, 63.2%-86.7%; n = 8 studies; I 2 = 22%) for cardiologists. CONCLUSIONS AND RELEVANCEPhysicians at all training levels had deficiencies in ECG interpretation, even after educational interventions. Improved education across the practice continuum appears warranted. Wide variation in outcomes could reflect real differences in training or skill or differences in assessment design.

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Clinical Applications of Ambulatory Electrocardiography

Cited by 11 publications

References 91 publications

Analysis of 24-Hour ECG in Patients with Panic Disorder

Analysis of 24-Hour ECG in Patients with Panic Disorder

Intermittent Ventricular Standstill During Chronic Atrial Fibrillation in Patients with Dizziness or Syncope

Accuracy of Physicians’ Electrocardiogram Interpretations

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