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 electrocardiogram/vectorcardiogram will be recorded at baseline. On routine follow-up evaluations, quantitative serial comparisons will be performed by the method of Kornreich. In step 2, beginning with flight school candidates and cadets, all three groups will be studied by the ultrafast computed tomograph (CT) protocol. Those candidates positive for coronary calcium will be studied by coronary angiography and ventriculography, and their eligibility for continued rated flight status will be determined by present criteria. In step 3, those candidates negative for coronary calcium by ultrafast CT will then be screened by the newly defined and improved high-sensitivity treadmill exercise test criteria. In step 4, candidates with a positive treadmill exercise test result, or who are also found in the upper quintile of the USAF/AL risk profile, wild also have exercise nuclear wall motion studies and perfusion scans. If these are abnormal and suggestive of myocardial ischemia, this subset will also be studied by heart catheterization and coronary angiography, and their eligibility for continued rated flight status will be determined by present criteria. The incidence of coronary calcium/no calcium for each degree of stenosis in the 6,000 flyers in each quintile was used to develop the following projections: (1) that more than 3 of 4 rated flyers with unsuspected CAD, and (2) more than 9 of 10 with severe flow-limiting CAD can be identified by these upgraded screening procedures. Evidence is herein presented that these enhancements will result in a major (5-8-fold) increase in case finding of this disease. Based on the estimate of four lost high-performance aircrafts per year from sudden incapacitation of the pilot due to CAD, when this four-step screen is fully operational, it can be expected to reduce the $80 million annual losses to the United States government from CAD by 85%, a savings of $68 million per year.
journal_name
J Electrocardioljournal_title
Journal of electrocardiologyauthors
Selvester RH,Ahmed J,Tolan GDdoi
10.1016/s0022-0736(96)80043-4subject
Has Abstractpub_date
1996-01-01 00:00:00pages
135-44eissn
0022-0736issn
1532-8430journal_volume
29 Supplpub_type
杂志文章,评审abstract::One-to-two atrioventricular conduction, ie, the double response to a single sinus or atrial impulse, resulting in two QRS complexes for one P wave, is a rare manifestation of dual atrioventricular (AV) nodal pathways. This report describes the case of a 61-year-old woman with continuous episodes of supraventricular ta...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(99)90005-5
更新日期:1999-10-01 00:00:00
abstract::Isolated T wave alternans (TWA) could be consistently induced in 13 dogs by infusion of an acid dextrose solution (ACD) and in nine with a 2% EDTA disodium solution. To study the factors concerned in evoking TWA, serial determinations of total and ionized serum calcium (ICa), Mg, K, pH, pCO2 and pO2 were performed. Ar...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(78)80098-3
更新日期:1978-04-01 00:00:00
abstract::We describe a 75-year-old male patient with two-vessel coronary artery disease, who developed transient left posterior hemiblock (LPH) while undergoing an exercise treadmill test (ETT). The intraventricular conduction abnormality initially had the features of alternating LPH, which evolved to stable LPH prior to dissi...
journal_title:Journal of electrocardiology
pub_type: 杂志文章,评审
doi:10.1016/s0022-0736(99)90022-5
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Case reports and unblinded studies suggest that human immunodeficiency virus (HIV) disease is associated with QT prolongation and torsade de pointes ventricular tachycardia. Hepatitis C coinfection is common in patients with HIV disease, and cirrhosis is also associated with QT prolongation. We therefore und...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2005.09.001
更新日期:2006-04-01 00:00:00
abstract::Magnesium ion infusion has been reported for treatment of hypomagnesemia often associated with myocardial infarction and with surgeries involving cardiopulmonary bypass (CPB). Magnesium infusion before CPB has been reported to adversely affect the ability to defibrillate after CPB. However, there are also reports of m...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(98)90045-0
更新日期:1998-04-01 00:00:00
abstract::Early recognition of ST-segment elevation myocardial infarction equivalent electrocardiogram patterns is of paramount importance. Successful identification of these ischemic patterns helps ensure proper triage of patients needing urgent restoration of coronary perfusion. The so-called de Winter sign has become increas...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2020.06.002
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Many variants of the spatial QRS-T angle (QRS-Ta) are in use. We aimed to identify the best QRS-Ta for all-cause mortality prediction among different variants. METHODS:6667 individuals from the Inter99 General Population Study were followed for a median of 12.7 years. Vectorcardiograms were calculated using...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2018.05.011
更新日期:2018-01-01 00:00:00
abstract::Ventricular fibrillation (VF) had been traditionally considered as a highly disorganized process of random electrical activity emanating from multiple, short-lived, reentrant electrical waves. It is the incessant breakup of wave fronts and the creation of new daughter waves (wavebreaks) that perpetuate VF. Other studi...
journal_title:Journal of electrocardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jelectrocard.2007.06.021
更新日期:2007-11-01 00:00:00
abstract::Implantable cardioverter defibrillators (ICDs) detect and defibrillate ventricular fibrillation (VF) and ventricular tachycardia (VT). Other therapies which use less energy are also available to terminate VT. Previous studies have shown that ICD rate schemes often misdiagnose VT as VF. In this study, an improved VF cl...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(98)80060-5
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:The present study investigates spatial properties of atrial fibrillation (AF) by analyzing vectorcardiogram loops synthesized from 12-lead electrocardiograms (ECGs). METHODS:After atrial signal extraction, spatial properties are characterized through analysis of successive, fixed-length signal segments and ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2007.10.006
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Accurate measurement of QRS complex duration (QRSd) remains crucial for the selection of patients for cardiac resynchronization therapy (CRT). However, assessment of QRSd on conventional surface electrocardiograms (ECG), especially when performed without computer assistance, may be challenging due to the lim...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2019.08.011
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:It has been reported in the literature that the increase in body temperature shortens QT interval on electrocardiogram through heart rate modulation. However, the effects of fever on ventricular repolarization are not clearly known. This study elaborates on QT interval of isolated fever, corrected QT (cQT), ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2020.11.016
更新日期:2020-12-03 00:00:00
abstract::Ventricular tachycardia arising from a healed myocardial infarction scar continues to be a significant cause of morbidity and mortality. Drug therapy has been inadequate to meet this challenge, and implantable devices are limited by expense and technical problems. We have proposed the use of gene therapy for cardiac a...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2007.05.036
更新日期:2007-11-01 00:00:00
abstract::Pulmonary vein isolation (PVI) using cryoballoon (CB) technique and cavotricuspid isthmus (CTI) ablation using radiofrequency (RF) are established interventions for drug-resistant atrial fibrillation (AF) and typical atrial flutter (AFL). Twelve patients with a mean age of 62 ± 12 years underwent simultaneous delivery...
journal_title:Journal of electrocardiology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jelectrocard.2015.03.013
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:We assessed the specificity of wide QRS complex tachycardia (WCT) differentiating algorithms in patients with preexistent left bundle branch block (LBBB) and heart failure. METHODS:Three hundred fourteen patients with resynchronization devices were retrospectively screened. electrocardiograms with supravent...
journal_title:Journal of electrocardiology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jelectrocard.2011.08.012
更新日期:2012-05-01 00:00:00
abstract:UNLABELLED:Cardiac function management devices, including implantable pacemakers and implantable defibrillators, include at least 1 cardiac lead having an electrode for making contact with a portion of the heart. It has been previously shown that the braided multifilament wire electrodes have a high failure rate both f...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2009.07.019
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The use of vectorcardiography (VCG) has regained interest, however, original Frank-VCG equipment is rare. This study compares the measured VCGs with those synthesized from the 12-lead electrocardiogram (ECG) in patients with heart failure and conduction abnormalities, who are candidate for cardiac resynchron...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2015.04.001
更新日期:2015-07-01 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::A patient who had chronic coarse atrial fibrillation developed severe hyperkalemia accompanied by total loss of fibrillatory waves while an irregularly irregular ventricular rhythm persisted. Correction of hyperkalemia resulted in prompt return of coarse atrial fibrillation. This sequence of events renders strong supp...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(75)80040-9
更新日期:1975-01-01 00:00:00
abstract:BACKGROUND:Measuring repolarization characteristics is challenging and has been reserved for experienced physicians. In electrocardiographic imaging (ECGI), activation-recovery interval (ARI) is used as a measure of local cardiac repolarization duration. We hypothesized that repolarization characteristics, such as loca...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2020.02.003
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Analysis of ST-segment elevation for assessment of patients with suspected acute coronary occlusion is in widespread use for diagnostic and prognostic purposes. In this study, changes in the QRS complex also were analyzed to determine if these changes that are seldom used clinically can provide additional pr...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2006.09.001
更新日期:2007-01-01 00:00:00
abstract::Precise recording of the standard 12-lead electrocardiogram (ECG) is technically time consuming. Placing limb leads on the torso has the major advantages of ease of use, increased speed of application, and decreased artifact. This modified ECG frequently substitutes for the standard 12-lead ECG in intensive care units...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2007.11.004
更新日期:2008-05-01 00:00:00
abstract::Body surface potential mapping is superior to 12-lead electrocardiogram in detection of acute and old myocardial infarctions. We examined the capability of the ST-T integral and T wave to detect exercise-induced ischemia in body surface potential mapping. Body surface potential mapping with 123 channels was recorded i...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1054/jelc.2003.50013
更新日期:2003-04-01 00:00:00
abstract::Quantitative analysis of ST-segment deviations (STdev) and their resolution by treatment (STR; calculated from a combined sum of STdev in multiple leads) are used in trials on reperfusion for myocardial infarction (MI). Unreadable or unavailable electrocardiogram (ECG) leads are a common reason for exclusion, decreasi...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(03)00030-x
更新日期:2003-07-01 00:00:00
abstract:AIMS:To study the effect of electrical neurostimulation on the ST segment shift in patients with ST elevation myocardial infarction (STEMI) with residual ST elevation after primary percutaneous coronary intervention (PCI). METHODS:After primary PCI, 38 patients with STEMI were divided into 2 groups. Group 1 received 1...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2007.05.014
更新日期:2007-11-01 00:00:00
abstract::In the last 10 years the molecular substrate of a diversity of primary electrical diseases has been unraveled. Disease-causing mutations in ion-channel genes have been identified and have challenged clinical and basic electrophysiologists to mechanistically link the observed genetic aberrancies to the phenotype. Indee...
journal_title:Journal of electrocardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jelectrocard.2005.06.103
更新日期:2005-10-01 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::The origin of ST depression in ischemia remains poorly understood. The accepted source is of intracellular current flowing between the ischemic and non ischaemic muscle both in systole and diastole such that the AC recorded electrocardiogram shows ST elevation over the ischemic area. The difficulty comes with partial ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2003.09.002
更新日期:2003-01-01 00:00:00
abstract::A 21year old gentleman was admitted with shortness of breath and heart failure. He was noted to have incessant supraventricular tachycardia which was refractory to pharmacological and electrical cardioversion. Electrophysiology study revealed focal atrial tachycardia from an unusual location which was successfully abl...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2017.09.015
更新日期:2018-01-01 00:00:00
abstract::Electrocardiographic manifestation mimicking the hyperacute phase of myocardial infarction and the electrical alternans of the elevated ST-segment in association with subarachnoid hemorrhage were reported in two patients with no evidence of heart disease. In both cases the ST-segment changes were transient and there w...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(89)90082-4
更新日期:1989-04-01 00:00:00