The Normal Electrocardiogram

Harris, P.A.

doi:10.1016/j.cnc.2016.04.002

Cited by 15 publications

(10 citation statements)

References 35 publications

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“…When the heart rhythm was irregular, heart rate was calculated by the number(s) of QRS complexes in 10-s interval (i.e.50 large boxes) multiplied by 6. [22]. Patients with syncope, pre-syncope, or palpitation were assessed with holter monitoring.…”

Section: Methodsmentioning

confidence: 99%

Modes of death and clinical outcomes in adult patients with hypertrophic cardiomyopathy in Thailand

Songsirisuk

Kittipibul

Methachittiphan

et al. 2019

BMC Cardiovasc Disord

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BackgroundThere are limited data about modes of death and major adverse cardiovascular events (MACEs) in patients with hypertrophic cardiomyopathy (HCM) in South East Asian population. The aim of the study was to examine modes of death and clinical outcomes in Thai patients with HCM.MethodsBetween January 1, 2009 and December 31, 2013, 166 consecutive patients with HCM diagnosed in our institution were evaluated. Five patients were excluded because of non-Thai ethnic groups (n = 3) and diagnosis of myocardial infarction at initial presentation documented by coronary angiography (n = 2). The final study population consisted of 161 patients with HCM. HCM-related deaths included: (1) sudden cardiac death (SCD) – death due to sudden cardiac arrest or unexpected sudden death; (2) heart failure – death due to refractory heart failure; or (3) stroke - death due to embolic stroke associated with atrial fibrillation. MACEs included: (1) SCD, sudden unexpected aborted cardiac arrest, fatal, or nonfatal ventricular arrhythmia (ventricular fibrillation or sustained ventricular tachycardia); (2) heart failure (fatal or non-fatal), or heart transplantation; or (3) stroke - fatal or non-fatal embolic stroke associated with atrial fibrillation.ResultsOne hundred and sixty-one Thai patients with HCM (age 66 ± 16 years, 58% female) were enrolled. Forty-two patients (26%) died over a median follow-up period of 6.8 years including 25 patients (16%) with HCM-related deaths (2%/year). The HCM-related deaths included: heart failure (52% of HCM-related deaths; n = 13), SCD (44% of HCM-related deaths; n = 11), and stroke (4% of HCM-related deaths, n = 1). The SCDs occurred in 6.8% of patients (1%/year). Eighty-four major MACEs occurred in 65 patients (41, 5%/year). The MACEs included: 40 heart failures in which 2 patients underwent heart transplants; 22 SCDs and nonfatal ventricular arrhythmias; and 22 fatal or nonfatal strokes.ConclusionsThe most common mode of death in adult patients with HCM in Thailand was heart failure followed by SCD. About one-third of the patients experiencing heart failure died during the 6.8 years of follow-up. SCDs occurred in 7% of patients (1%/year), predominantly in the fourth decade or later.

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Section: Methodsmentioning

confidence: 99%

Modes of death and clinical outcomes in adult patients with hypertrophic cardiomyopathy in Thailand

Songsirisuk

Kittipibul

Methachittiphan

et al. 2019

BMC Cardiovasc Disord

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“…The electrocardiogram (ECG) has been used as a diagnostic investigation for cardiovascular disease and arrhythmia since its invention by Willem Einthoven in 1901 (1). Whilst the ECG was primarily developed as a diagnostic tool (2), it has also been used as an effective screening tool for cardiovascular disease so that patients who are found to have disease can be treated in the early stages before they start presenting with symptoms (3). The development of Artificial Intelligence (AI) algorithms has revolutionised ECG interpretation (4), with their use in devices such as smartwatches (5).…”

Section: Word Count = 144mentioning

confidence: 99%

Telephone training to improve ECG quality in remote screening for atrial fibrillation

Bhayankaram,

Mant,

Brimicombe

et al. 2024

Preprint

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Background and Aims: Self-recorded, single-lead ECGs are increasingly used to diagnose arrhythmias. However, they can be of variable quality, which can affect the reliability of interpretation. In this analysis of ECGs collected in atrial fibrillation screening studies, our aims were to: (i) determine the quality of ECGs when recorded unsupervised (at home); and (ii) investigate whether telephone training improved ECG quality. Methods: Data was obtained from the Screening for Atrial Fibrillation to Reduce stroke (SAFER) programme, where participants recorded single-lead ECGs four times per day for three weeks using a handheld device. ECG quality was assessed using an automated algorithm, and participants who recorded >25% poor quality ECGs from days 4-10 of screening were identified for training. Telephone training to improve ECG recording technique was delivered when research team capacity permitted. Results: 14,727 participants recorded 1,206,972 ECGs, of which 43,513 (3.6%) were poor quality. Most participants (51.9%) did not record any poor-quality ECGs. 1,105 (7.5%) participants met the threshold for training. Of these, 165 participants received training and 896 did not. Comparing these groups, the mean (95% confidence interval) reduction in the proportion of poor-quality ECGs per participant from before training (days 1-3) to after training (days 11-21) was 21.1 (17.5-23.5) % with training and 15.7 (14.5-16.8) % without training (p<0.05). Conclusion: Most participants achieved adequate quality ECGs. For those that did not, ECG quality improved over time regardless, and training further improved ECG quality. Therefore, telephone training could be considered in atrial fibrillation screening programmes using single-lead ECG devices.

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“…The ECG is utilized in patients’ surveillance for cardiac arrhythmias, myocardial ischemia, and QT interval prolongation ( 3 , 4 ). Therefore, ECG monitoring is highly recommended in patients presenting with chest pain and those with known cardiac risk factors such as patients with stroke, diabetes, acute renal failure, respiratory dysfunction, trauma, drug overdose, sepsis, shock, older adult patients with risk factors of coronary heart disease ( 5 ). For closely monitoring, patients with the aforementioned medical conditions are commonly found in critical care units, including the intensive care unit (ICU) or coronary care unit (CCU) ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, ECG monitoring is highly recommended in patients presenting with chest pain and those with known cardiac risk factors such as patients with stroke, diabetes, acute renal failure, respiratory dysfunction, trauma, drug overdose, sepsis, shock, older adult patients with risk factors of coronary heart disease ( 5 ). For closely monitoring, patients with the aforementioned medical conditions are commonly found in critical care units, including the intensive care unit (ICU) or coronary care unit (CCU) ( 5 ). Hence, it is crucial for nurses working in these units to acquire knowledge of basic ECG rhythms for effective patient monitoring and act accordingly depending on the information displayed on the cardiac monitor ( 1 , 3 , 6 , 7 ).…”

Section: Introductionmentioning

confidence: 99%

ICU nurses’ knowledge and attitude towards electrocardiogram interpretation in Fujian province, China: a cross-sectional study

Buluba,

He,

2023

Front. Med.

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IntroductionThe series of electrocardiograms (ECGs) can help track cardiac abnormalities in patients’ conditions and make an earlier clinical decision. It is crucial for nurses working in critical care environments to acquire ECG knowledge for effective ECG monitoring and act accordingly in case of a change in patient condition. This study aimed at investigating intensive care unit (ICU) nurses’ knowledge and attitude towards ECG interpretation in Fujian province, China. The study also analyzed the relationship between participants’ demographic characteristics and level of ECG knowledge.MethodsThis study was done online at twenty-one hospitals in Fujian province using a quantitative cross-sectional design involving 357 registered nurses working in the ICU between October and December 2021. The selection of hospitals and potential participants involved purposive and convenient sampling methods, respectively. Binary logistic regression was carried out to determine factors that predict ICU nurses’ knowledge of ECG interpretation, and a p-value <0.05 was deemed statistically significant.ResultsThe majority of nurses (70.9%) demonstrated a low level of ECG knowledge. The mean score for ECG knowledge was 5.95 (SD = 2.14), with only 0.8% of ICU nurses answering all questions correctly. The majority portrayed positive attitude towards ECG interpretation; however, more than half (61.6%) believed that nurses should rely on a doctor’s opinion about ECG interpretation. Previous ECG training (AOR = 3.98, 95% CI: 2.12–7.45); frequency of ECG interpretation in comparison with no frequency of ECG interpretation (1–3 times per day: AOR = 15.55, 95% CI: 6.33–38.18; 1–3 times per week: AOR = 18.10, 95% CI: 6.38–51.34); and current working unit in comparison to those working in cardiac ICU (general ICU: AOR = 0.45, 95% CI: 0.21–0.94; medical ICU; AOR = 0.28, 95% CI: 0.12–0.67; and surgical ICU; AOR = 0.05, 95% CI: 0.01–0.43) remained statistically significant after adjusting for confounders.ConclusionThe present study revealed a low level of knowledge about ECG interpretation among ICU nurses. Although the participants demonstrated positive attitudes toward ECG interpretation, the negative attitude still existed. Nurses should acknowledge ECG interpretation as part of their duties and responsibilities in nursing care instead of merely relying on doctors’ opinions.

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The Normal Electrocardiogram

Cited by 15 publications

References 35 publications

Modes of death and clinical outcomes in adult patients with hypertrophic cardiomyopathy in Thailand

Modes of death and clinical outcomes in adult patients with hypertrophic cardiomyopathy in Thailand

Telephone training to improve ECG quality in remote screening for atrial fibrillation

ICU nurses’ knowledge and attitude towards electrocardiogram interpretation in Fujian province, China: a cross-sectional study

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