Abstract:
:The American College of Cardiology recommends that patients with high risk acute myocardial infarction (AMI) be triaged to hospitals with percutaneous transluminal coronary angioplasty capability. However, there are no prehospital triage criteria to select candidates for bypassing community hospitals and being taken directly to "cardiac centers." This article assesses which independent variables predict death within 7 days in patients with suspected AMI transported by EMS. This is a retrospective study of 291 AMI patients transported by ambulance to 3 hospitals during 1996-1997. Included were patients who were (n = 244) > or =18 years of age, had a ED chief complaint of chest pain or dyspnea for whom we had mortality data. Mortality at 7 days, our primary outcome measure, was obtained by using a metropolitan Detroit tricounty death index records. Differences between the survivors and nonsurvivors were assessed using the Student's t-test and chi-square tests. Multiple triage criteria were assessed for optimal identification of high risk patients by constructing a logistic multivariate model. Among the study population, 15% died within 7 days (95% confidence interval (CI) 10.3-19.2), and this group represented 63.2% of all deaths over a 2 year surveillance period. Survivors, compared to nonsurvivors, were 14.1 years younger (P < or = .001) and more often men (P < or = 0.001). The dispatch time to ED arrival was less among survivors than nonsurvivors (42.8 vs. 50.6 min, P < or = .01). EMS vital signs differed by survivor status. Among survivors, HR was lower (-11.9 bpm; P < or = 0.01), RR was lower (-6.7 rpm; P < or = .001), SBP was higher (+14.5 mmHg; P < or = 0.05) and DBP was higher (+13.2 mm Hg; P < or = .01). A multivariate model identified the following as independent predictors of early mortality: female gender (OR = 2.3; P < or = .05), age > or =65 (OR = 5.9; P < or = .01), RR > or = 20 (OR = 4.6; P < or = .001), SBP < 120 (OR = 2.4; P < or = .05). The overall model was 86% sensitive and 53% specific with an area under the receiving operating characteristic curve of 0.8 (P < or = .001). A triage rule based on a multivariate model can identify the group at high risk of early cardiac death. This decision rule needs to be prospectively validated.
journal_name
J Electrocardioljournal_title
Journal of electrocardiologyauthors
Grzybowski M,Zalenski RJ,Ross MA,Bock Bdoi
10.1054/jelc.2000.20299keywords:
subject
Has Abstractpub_date
2000-01-01 00:00:00pages
253-8eissn
0022-0736issn
1532-8430journal_volume
33 Supplpub_type
杂志文章abstract:INTRODUCTION:This study is to investigate ventricular repolarization on electrocardiogram (ECG) in a pediatric population receiving methylphenidate (MPH), risperidone (RIS) and combined therapy. METHODS:A total of 215 patients between 6 and 12years with ADHD/conduct disorder receiving methylphenidate, risperidone and ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2017.02.012
更新日期:2017-01-01 00:00:00
abstract::A rigorous mathematical analysis of Electrocardiogram (ECG) data is presented in this paper, as a decision support system for ECG interpretation. The mathematical analysis: provides a new insight to the ECG data, provides flexibility for future understanding of the heart system or the ECG, and avoids the need of measu...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Present methods to extract respiratory myogram interference (RMI) from the Holter-ECG and assess effect of supraventricular arrhythmias (SVAs) onto ECG-based detection of sleep-related breathing disorders (SRBDs) and AHI estimation. METHODS:RMI was quantified as residual energy after ECG cancell...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2014.07.017
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:No direct comparison of current electrocardiogram (ECG) interpretation programs exists. OBJECTIVE:Assess the accuracy of ECG interpretation programs in detecting abnormal rhythms and flagging for priority review records with alterations secondary to acute coronary syndrome (ACS). METHODS:More than 2,000 di...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2019.11.043
更新日期:2020-01-01 00:00:00
abstract::A 53-year-old woman with sinus node dysfunction underwent dual-chamber pacemaker implantation through a persistent left superior vena cava draining into the coronary sinus, which was detected at the time of implantation. We managed to fix the ventricular lead in the right ventricular (RV) apex by forming a clockwise l...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2007.05.016
更新日期:2007-11-01 00:00:00
abstract::Percutaneous transluminal coronary angioplasty (PTCA) occlusion in five individual coronary artery distributions produced significant ST elevation ("current of injury") in 48/50 PTCAs in 46 patients. Four patients had PTCA of two separate coronary arteries. Two patients had no significant ischemic ST changes in the 16...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::The authors present an original method for the discrimination of patients prone to ventricular tachycardia. The wavelet transform, which is a new time-scale technique suitable for transient signal detection, was applied to bipolar unfiltered X, Y, Z signal-averaged electrocardiograms in 20 postinfarction patients with...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(93)90052-f
更新日期:1993-10-01 00:00:00
abstract::Sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) is caused by ventricular tachyarrhythmia that can be effectively treated by implantable cardioverter defibrillator (ICD) therapy. We report of a 28-year-old man with HCM and a dual chamber ICD, originally implanted for primary prevention of SCD, (programm...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2017.06.005
更新日期:2017-01-01 00:00:00
abstract::The authors have proposed a new four-step screening algorithm to detect asymptomatic coronary artery disease (CAD) in flight school candidates, cadets, and rated flyers of the Unites States Air Force (USAF). In step 1, the USAF Armstrong Laboratory (USAF/AL) risk profile and improved 16-lead high-resolution electrocar...
journal_title:Journal of electrocardiology
pub_type: 杂志文章,评审
doi:10.1016/s0022-0736(96)80043-4
更新日期:1996-01-01 00:00:00
abstract::Here we report the identification of two novel mutations in a previously asymptomatic young man who suffered an out-of-hospital sudden cardiac arrest. During following evaluation, diagnosis of early stage dilated cardiomyopathy was established, while electrocardiogram monitoring showed frequent complex ventricular arr...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2018.12.015
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Ventricular arrhythmias and sudden cardiac deaths are the most common cause of mortality in patients with end-stage renal disease (ESRD). Index of cardiac-electrophysiological balance (iCEB) (QT/QRS) may predict malignant ventricular arrhythmias. In this study, we investigated whether iCEB value is increased...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2019.03.011
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to investigate the effect of cardiac resynchronization therapy (CRT) on P wave maximum duration (PWM) and P wave dispersion (PWD) in patients with advanced heart failure. METHODS:Forty-six patients (33 men; mean age, 60 +/- 11 years) with CRT were enrolled in the present study. P...
journal_title:Journal of electrocardiology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jelectrocard.2009.02.005
更新日期:2009-07-01 00:00:00
abstract::To elucidate the electrocardiographic (ECG) characteristics of dilated cardiomyopathy (DCM), the authors analyzed the 12-lead ECGs and echocardiograms in 45 patients with DCM, 54 patients with left ventricular (LV) dilatation secondary to valvular heart disease (VHD), 101 hypertensive patients with LV hypertrophy, and...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(05)80270-5
更新日期:1994-10-01 00:00:00
abstract::Sintered Ag-AgCl needle electrodes were used to record unipolar directly coupled (DC) electrograms transmurally from right and left ventricular myocardium. Direct coupling yields unfiltered low-frequency signal content, preserving repolarization waveform morphology. These electrograms were analyzed using completely au...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(88)90102-1
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:Coronary artery disease and myocardial ischemia cause substantial morbidity and mortality. While ischemia is traditionally diagnosed on the 12-lead electrocardiogram (ECG) by shifts in the ST segment, electrical changes are also produced within the QRS complex during depolarization of ischemic ventricular ti...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2014.09.005
更新日期:2015-01-01 00:00:00
abstract::Dilated cardiomyopathy is associated with an increase in transverse plane QRS voltage but a decrease in frontal plane QRS voltage. To study this paradoxical relationship further, electrocardiograms (ECGs) were retrospectively analyzed from five groups of men. Frontal plane QRS voltage was computed as the sum of peak-t...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(85)80032-7
更新日期:1985-01-01 00:00:00
abstract::The importance of plasma electrolytes and pH levels in determining heart rate is not yet well grounded. Hemodynamic and biochemical data were collected during 8 purely diffusive hemodialysis, which allowed changes in extracellular fluid to be achieved without eliciting notable changes in the autonomic control of heart...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1054/jelc.2002.31819
更新日期:2002-04-01 00:00:00
abstract::A wide spectrum of types of right bundle branch block (RBBB) were studied utilizing the body surface potential maps (BSPMs) of 37 children. Although the spectrum varied from very advanced RBBB to minimal partial RBBB, a common diagnostic feature was the absence of evidence for right ventricular breakthrough in the map...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(84)80070-9
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:The appearance of a discrete upward deflection of the ST segment, termed the ST hump sign during exercise testing has been associated with resting hypertension and exaggerated blood pressure response to exercise. OBJECTIVE:We investigated the correlation between the presence of hump sign during exercise tes...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2009.09.001
更新日期:2010-03-01 00:00:00
abstract::Controlled physical training has been shown to be a valuable therapeutic addition to a pharmacological treatment in patients with chronic heart failure (CHF). It is speculated that repeated physical training can improve the autonomic modulation of the cardiovascular system in patients with CHF. The present study evalu...
journal_title:Journal of electrocardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jelectrocard.2012.01.002
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Presence of severe autonomic failure (SAF), defined as coincidence of abnormal heart rate turbulence and abnormal deceleration capacity, identifies a group of patients with very poor prognosis among post-infarction patients with diabetes mellitus. However, factors contributing to development of SAF are entir...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2012.07.010
更新日期:2012-11-01 00:00:00
abstract::High-resolution (HI-RES) ECG analysis software and a new front end have been designed for a standard 12-lead ECG cart, MAC-12. The front end acquires orthogonal ECG at 1,000 samples/sec and 1.2 microV/bit and transmits to the cart. The HI-RES software delineates QRS complexes and correlates them with a template in fre...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(88)90062-3
更新日期:1988-01-01 00:00:00
abstract::Acute coronary syndromes due to involvement of the left main trunk usually present with subtotal occlusion and electrocardiographic pattern with predominant ST depression (non-ST-elevation myocardial infarction). The cases with complete occlusion frequently present an ST-elevation myocardial infarction pattern, but th...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2012.05.001
更新日期:2012-09-01 00:00:00
abstract::The relative contributions of left ventricular structural changes, dysfunction, and subendocardial ischemia in determining electrocardiographic repolarization abnormalities were assessed in 53 patients with chronic, pure aortic regurgitation and no evidence of coronary artery disease. Thirty-six patients with an abnor...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(94)80001-4
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:For the assessment of patients with chest pain, the 12-lead electrocardiogram (ECG) is the initial investigation. Major management decisions are based on the ECG findings, both for attempted coronary artery revascularization and risk stratification. The aim of this study was to determine if the current 6 pre...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2011.03.010
更新日期:2011-07-01 00:00:00
abstract::Congenital long QT syndrome (LQTS) is known to be a critical syndrome associated with a bizarre T wave, prolonged QT interval, and ventricular arrhythmias and is followed by syncope and/or sudden death. Body surface mapping, especially QRST isointegral departure mapping, was used after exercise to assess exercise-indu...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2005.02.005
更新日期:2005-07-01 00:00:00
abstract::Hypertrophic cardiomyopathy (HCM) have been reported to display impaired heart rate variability, although little is known regarding its prognostic value. By using fast Fourier transformation of 24-hour Holter recordings in 73 HCM patients at a stable clinical condition, we computed 4 spectral components: very low freq...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2003.08.005
更新日期:2003-10-01 00:00:00
abstract::We reported a case of Wolff-Parkinson-White syndrome with atrial double potential in coronary sinus (CS) electrograms during paroxysmal supraventricular tachycardia and ventricular pacing. The first component was low in frequency, and its timing was the same as atrial potential recorded by ablation catheter above the ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2007.02.002
更新日期:2007-09-01 00:00:00
abstract::The myocardial electrical conduction is significantly influenced by the sympathetic and parasympathetic nervous systems. Hypervagotonia refers to increased vagal tone leading to sinus bradycardia, sinus pause, or any degree of atrioventricular (AV) block. There are many clinical, electrocardiographic, and electrophysi...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2009.07.018
更新日期:2009-11-01 00:00:00
abstract::A 57-year-old man without prior history of organic heart disease was admitted with a diagnosis of unstable angina because of chest pain and new electrocardiographic (ECG) changes of global T wave inversion and QT interval prolongation. Left and right heart catheterization with coronary angiography, pulmonary angiograp...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(93)90070-t
更新日期:1993-01-01 00:00:00