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| 2. |
- Akil, Shahnaz, et al.
(författare)
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Gender aspects on exercise-induced ECG changes in relation to scintigraphic evidence of myocardial ischaemia
- 2018
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Ingår i: Clinical Physiology and Functional Imaging. - : Wiley. - 1475-0961. ; 38:5, s. 798-807
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Tidskriftsartikel (refereegranskat)abstract
- Background: This retrospective study aimed to determine the diagnostic performance of exercise-induced ST response in relation to findings by myocardial perfusion single photon emission computed tomography (MPS), with focus on gender differences, in patients with suspected or established stable ischemic heart disease. Methods: MPS findings of 1 021 patients (518 females) were related to the exercise-induced ST response alone (blinded and unblinded to gender) and ST response together with additional exercise stress test (EST) variables (exercise capacity, blood pressure and heart rate response). Results: Exercise-induced ischaemia by MPS was found in 9% of females and 23% of males. Diagnostic performance of exercise-induced ST response in relation to MPS findings in females versus males was: sensitivity = 48%,70%; specificity = 67%, 64%; PPV = 13%, 38%; NPV = 93%, 87%. Adding more EST variables to the ST response interpretation yielded in females vs males: sensitivity = 44%, 51%; specificity = 84%, 83%; PPV = 22%, 48% and NPV = 93%, 85%. Conclusions: In patients who have performed EST in conjunction with MPS, there is a gender difference in the diagnostic performance of ST response at stress, with a significantly lower PPV in females compared to males. For both genders, specificity can be significantly improved, and a higher PPV can be obtained, while the sensitivity might be compromised by considering more EST variables, in addition to the ST response.
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| 3. |
- Almer, Jakob, et al.
(författare)
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Ischemic QRS prolongation as a biomarker of severe myocardial ischemia.
- 2016
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Ingår i: Journal of Electrocardiology. - : Elsevier BV. - 1532-8430 .- 0022-0736. ; 49:2, s. 139-147
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have shown that QRS prolongation is a sign of depressed collateral flow and increased rate of myocardial cell death during coronary occlusion. The aims of this study were to evaluate ischemic QRS prolongation as a biomarker of severe ischemia by establishing the relationship between prolongation and collateral flow experimentally in a dog model, and test if the same pattern of ischemic QRS prolongation occurs in man.
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| 4. |
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| 5. |
- Elmberg, Viktor, et al.
(författare)
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A 12-lead ECG-method for quantifying ischemia-induced QRS prolongation to estimate the severity of the acute myocardial event.
- 2016
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Ingår i: Journal of Electrocardiology. - : Elsevier BV. - 1532-8430 .- 0022-0736. ; 49:3, s. 272-277
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Tidskriftsartikel (refereegranskat)abstract
- Studies have shown terminal QRS distortion and resultant QRS prolongation during ischemia to be a sign of low cardiac protection and thus a faster rate of myocardial cell death. A recent study introduced a single lead method to quantify the severity of ischemia by estimating QRS prolongation. This paper introduces a 12-lead method that, in contrast to the previous method, does not require access to a prior ECG.
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| 6. |
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| 7. |
- Lam, Anny, et al.
(författare)
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The classical versus the Cabrera presentation system for resting electrocardiography: Impact on recognition and understanding of clinically important electrocardiographic changes.
- 2015
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Ingår i: Journal of Electrocardiology. - : Elsevier BV. - 1532-8430 .- 0022-0736. ; 48:4, s. 476-482
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Forskningsöversikt (refereegranskat)abstract
- The classical system for presentation of the 12-lead electrocardiogram (ECG) reflects the electrical activity of the heart as viewed in the transverse plane by 6 leads with a single anatomically ordered sequence, V1-V6; but in the frontal plane by 6 leads with dual sequences, I, II, and III, and aVR, aVL, and aVF. However, there is also a single anatomically ordered sequence of leads, called the Cabrera display that presents the six frontal plane leads in their anatomically ordered sequence of: aVL, I, -aVR, II, aVF, and III. Although it has been recognized that the Cabrera system has clinical diagnostic advantages compared to the classical display, it is currently only used in Sweden. The primary explanation of why the Cabrera system has not been adopted internationally has been that analog ECG recorders had technical limitations. Currently, however, the classical system is most often seen as a historical remnant that prevails because of conservatism within the cardiology community.
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| 8. |
- Lindow, Thomas, et al.
(författare)
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A patient with non-ST-segment elevation acute coronary syndrome : Is it possible to predict the culprit coronary artery?
- 2016
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Ingår i: Journal of Electrocardiology. - : Elsevier BV. - 0022-0736. ; 49:4, s. 614-619
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Tidskriftsartikel (refereegranskat)abstract
- In acute coronary syndromes without ST-segment elevation (NSTE-ACS), identification of the culprit artery is, most often, not possible. In this case report, we elaborate on the likelihood of different culprit arteries in a patient with NSTE-ACS. While her symptoms were progressing, typical ECG findings of ischemia in the left coronary territories were diminishing. Instead, dynamic T-wave changes in the inferior leads were present and were most likely postischemic and "reischemic." Although the culprit artery could not be identified with certainty by means of these subtle changes, they correlated well with the findings on angiography and the ECG recorded afterward. This case report demonstrates the importance of analyzing ECG and its temporal changes in conjunction with evolving symptoms.
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| 9. |
- Lindow, Thomas, et al.
(författare)
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Akut ocklusion av cirkumflexa kransartären svår att upptäcka : Viktigt att titta i »döda vinkeln« på EKG
- 2017
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Ingår i: Läkartidningen. - 0023-7205. ; 114:41
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Acute coronary artery occlusion should be treated with urgent revascularization. ECG is important in the triage of patients with acute coronary syndrome. ST deviation depends on the relation between the location of the transmural ischemia and the positive poles of the 12 ECG leads. In acute occlusion of the left circumflex artery, ST elevation in two contiguous leads is not always present. Instead, isolated ST depression in leads V1–V3 may be present and represents a »STEMI-equivalent« pattern. Detection of acute occlusion of the left circumflex artery may be improved either by including inverted leads or by recording from electrodes on the posterior thorax.
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| 10. |
- Lindow, Thomas, et al.
(författare)
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Bigeminal sandwiches galore
- 2018
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Ingår i: Annals of Noninvasive Electrocardiology. - : Wiley. - 1082-720X. ; 23:2
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Tidskriftsartikel (refereegranskat)abstract
- A long run of PVCs “sandwiched” in between the sinus beats resulting in an almost doubling of the heart rate—interpolated PVCs in bigeminy—is described. This case illustrates three interesting aspects of interpolated PVCs. Although they are not uncommon, long runs of interpolated PVCs in bigeminy are rare findings. In this case, the arrhythmia had a duration of 3 minutes. Second, it illustrates the “age-old wisdom” of partial retrograde conduction. Also, even though the arrhythmia resulted in an almost doubling of the heart rate, the patient remained asymptomatic.
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