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Background The coronavirus SARS-CoV-2 is highly contagious. Hydroxychloroquine (HCQ) has in vitro activity against SARS-CoV-2. The FDA authorized emergency use of HCQ against COVID-19. HCQ may have dose-related cardiotoxicity. This clinical trial received ethical approval on May 15, 2020, operationalized in June to evaluate a low prophylaxis dose of HCQ (200mg BID) in household contacts of COVID-19-positive patients without physical contact between investigators and participants. It represents the first report of the FDA approved 6-lead EKGs with a smartphone KardiaMobile® 6L application. Methods To reach a sample size of 170, household members were contacted by telephone, emailed consent forms with electronic signature capability, and randomized 2:1 to HCQ or observation for 10 days with follow-up of 14 days. Home saliva PCR tests recorded COVID status on days 1 and 14. Symptoms and 6-lead EKGs were obtained daily. Results Fifty-one participants were randomized with 42 evaluable at day 14. Remote monitoring of 407 EKGs revealed no QTc prolongation or other ECG changes in either group. At time of consent, no participants were symptomatic or COVID+. On days 1 and 14, COVID tests were positive in 4 and 2 in the HCQ group and 4 and 0 in the observation group. No tests converted to positive. There were no deaths or hospitalizations. Conclusions A clinical trial without personal contact, rapidly initiated and operationalized to exclude cardiac toxicity using daily remote 6-lead EKG monitoring, is feasible. Of 407 EKGs from 42 participants, there was no evidence of cardiac toxicity. Clinical trial registration Clinicaltrials.gov: NCT04652648 registration date: December 3, 2020

Improved electrocardiographic (EKG) markers and monitoring platforms for sudden cardiac death risk are urgently needed. Wearable wireless EKG patches offer a patient-friendly novel approach to long-term monitoring, in the range of two weeks, extending traditional Holter monitoring, which is typically limited to 24–48 h. The capacity to transmit recordings via telemetry to health care providers offers a further benefit for real-time detection and analysis of cardiac events. Until recently, the primary application of EKG patches has been evaluation of syncope and atrial and ventricular rhythm abnormalities. Used in combination with highly accurate algorithms for monitoring QT intervals and T-wave alternans, a beat-to-beat fluctuation in ST-segment and T-wave morphology linked to sudden cardiac death risk, the applications of EKG monitoring can be significantly expanded.

Objectives To evaluate national trends in electrocardiogram (EKG) monitoring in Veterans Affairs (VA) beneficiaries prescribed high‐dose citalopram before and after the 2011–12 Food and Drug Administration (FDA) safety warnings. Design Interrupted time‐series analyses. Setting National VA healthcare system data linked to Medicare data for veterans dually eligible for VA and Medicare services. Participants Adult VA outpatients prescribed citalopram or sertraline from February 2010 to September 2013 (N=1,068,816). Measurements EKG monitoring for VA outpatients prescribed high‐dose citalopram (>40 mg/d aged ≤60, >20 mg/d aged >60) or sertraline. Results For individuals prescribed high‐dose citalopram, EKG monitoring increased from 9.0% before the start of the first FDA warning to a peak of 12.6% for individuals aged 18 to 60 and from 14.0% to 19.4% for individuals aged 61 to 100. However, following the second FDA warning in 2012, EKG monitoring declined, returning to prewarning levels in both age groups. EKG monitoring did not increase in individuals with a history of previous cardiac risk factors prescribed high‐dose citalopram in either age group. Conclusions EKG frequency did not significantly change in individuals with cardiac risk factors at greatest potential risk for QT prolongation. Lack of responsiveness to the FDA warnings may be due to many factors, including lack of clarity about which individuals should undergo EKG monitoring, provider substitution of alternative antidepressants for citalopram, conflicting evidence regarding risk for adverse cardiac events with high‐dose citalopram use, and lack of provider knowledge regarding the warnings.

Background Case reports of cardiac arrest in temporal proximity to Conducted Electrical Weapon(CEW) exposure raise legitimate concerns about this as a rare possibility. In this pilot study, we respectfully navigate the oversight and regulatory hurdles and demonstrate the intra-shock electrocardiographic effects of an intentional transcardiac CEW discharge using subcutaneous probes placed directly across the precordium of patients with a previously implanted intracardiac EKG sensing lead. Methods Adults scheduled to undergo diagnostic EP studies or replacement of an implanted cardiac device were enrolled. Sterile subcutaneous electrodes were placed at the right sternoclavicular junction and the left lower costal margin at the midclavicular line. A standard police issue TASER Model X26 CEW was attached to the subcutaneous electrodes and a 5 s discharge was delivered. Continuous surface and intracardiac EKG monitoring was performed. Results A total of 157 subjects were reviewed for possible inclusion and 21 were interviewed. Among these, 4 subjects agreed and completed the study protocol. All subjects tolerated the 5 s CEW discharge without clinical complications. There were no significant changes in mean heart rate or blood pressure. Interrogation of the devices after CEW discharge revealed no ventricular pacing, dysrhythmias, damage or interference with the implanted devices. Conclusions In this pilot study, we have successfully navigated the regulatory hurdles and demonstrated the feasibility of performing intracardiac EKG recording during intentional precordial CEW discharges in humans. While no CEW-associated dysrhythmias were noted, the size of this preliminary dataset precludes making conclusions about the risk of such events. Larger studies are warranted and should consider exploring variations of the CEW electrode position in relation to the cardiac silhouette.

Introduction: Many psychotropic medications carry a risk of prolonging the QT interval and increasing the risk of developing Torsade de pointes (TdP). The goal of this study was to evaluate whether patients taking psychotropic agents with a known risk of TdP are being monitored at a community hospital through the use of electrocardiograms (EKGs). Methods: This was a retrospective chart review of 100 adult patients—50 from general medicine floors and 50 from psychiatric units—who were taking at least one psychotropic agent with a known risk of TdP during hospitalization. Results: The mean number of medications with QT-prolongation risk administered to the psychiatric and general medicine patients was 4.2 ± 1.7 and 3.9 ± 2.0, respectively (P = .7484). Thirty-two of the psychiatric patients (64%) and 48 of the general medicine patients (96%) received EKGs during their hospitalization (P 500 ms. Four had repeat EKGs performed, and none had medication changes made to decrease TdP risk. Discussion: Many inpatients on psychiatric medications received multiple medications with a risk of TdP, but not all received monitoring through baseline or repeat EKGs when warranted. Patients with QTc intervals >500 ms were not appropriately managed to lower their risk of TdP. Pharmacists thus can help improve the monitoring and management of QT prolongation.

ZusammenfassungDas vorliegende Positionspapier zur Detektion von Vorhofflimmern nach ischämischem Schlaganfall beinhaltet eine Stellungnahme der Arbeitsgemeinschaft „Herz und Hirn“ der Deutschen Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V. (DGK) und der Deutschen Schlaganfallgesellschaft e. V. (DSG), die in Zusammenarbeit mit der Stroke Unit-Kommission der DSG und dem Kompetenznetz Vorhofflimmern (AFNET) e. V. erstellt wurde.Vorhofflimmern ist in den Leitlinien der Europäischen Gesellschaft für Kardiologie als eine mindestens 30 Sekunden anhaltende Episode einer Vorhofarrhythmie mit fehlenden P-Wellen definiert. Die 30-Sekundengrenze ist arbiträr gewählt und es ist unbekannt, ob das Schlaganfallrisiko bei Episoden von länger als 30 Sekunden höher ist als bei kürzeren Episoden. Bei Patienten, die einen Schlaganfall erlitten haben, sollte die Detektion von Vorhofflimmern üblicherweise zu einer Umstellung der medikamentösen Sekundärprävention führen, da eine orale Antikoagulation einer Thrombozytenaggregationshemmung überlegen ist. Die Detektion eines bis dato nicht diagnostizierten Vorhofflimmerns sollte daher bei Patienten mit ischämischem Schlaganfall verbessert werden, um die medikamentöse Sekundärprävention des Schlaganfalls zu optimieren. In diesem Positionspapier werden interdisziplinär erarbeitete Standards für eine „strukturierte Rhythmusvisite“ auf der Stroke Unit und ein diagnostisches „Stufenschema“ zur Detektion von Vorhofflimmern vorgeschlagen. Das Positionspapier fasst zudem den gegenwärtigen Kenntnisstand zur Detektion von Vorhofflimmern nach ischämischem Schlaganfall zusammen. Das Positionspapier soll den in der Versorgung von Schlaganfallpatienten tätigen Ärzten eine Handhabe geben, auch wenn bisher nicht abschließend geklärt ist, wie lange und mit welcher EKG-Methode Schlaganfallpatienten ohne bisher bekannte Herzrhythmusstörung bestmöglich monitoriert werden sollten. Dem Charakter eines Positionspapiers angemessen, wurde auf die Kennzeichnung von Evidenzgraden verzichtet, da es sich überwiegend um die Meinung von Experten handelt, die auf berichteten Fallserien und klinischer Erfahrung beruht und somit nicht mit einer Leitlinie gleichzusetzen ist und so auch nicht verstanden werden will.

Die Katheterablation von Vorhofflimmern (VHF) mittels Pulmonalvenenisolation (PVI) hat sich als Therapieverfahren weithin etabliert, und ihre Indikation ist in den aktuellen VHF-Leitlinien entsprechend definiert. Anfanglich ausschlieslich auf Patienten mit paroxysmalem VHF ohne strukturelle Herzerkrankung beschrankt, wird eine PVI zwischenzeitlich auch in breiteren Patientenpopulationen eingesetzt. Die PVI ist unverandert einem fliesenden methodologischen und technischen Fortschritt unterworfen, gleichzeitig werden unterschiedliche Erfolgsraten der Prozedur berichtet. Der Erfolg der PVI kann klinisch und/oder elektrokardiographisch definiert werden. Bis jetzt fehlen Empfehlungen bezuglich einer einheitlichen Nachbeobachtung. Daruber hinaus variiert die klinische Praxis der Verlaufsbeobachtung nach PVI zwischen spezialisierten Zentren, Kardiologen, Internisten und Allgemeinmedizinern, aber auch innerhalb der entsprechenden Sektoren der Patientenversorgung. Die Erarbeitung diesbezuglicher Empfehlungen ist daher wunschenswert. Um den aktuellen Stand der Nachbeobachtung zu erfassen, hat die Arbeitsgruppe Rhythmologie der DGK eine Umfrage unter niedergelassenen Kardiologen sowie akademischen und/oder universitaren Krankenhausern initiiert, um ihr Vorgehen hinsichtlich Indikationsstellung und Praxis nach PVI zu erfassen. In der vorliegenden Ubersicht wird in diesem Kontext der aktuelle Stand der Literatur zusammengefasst.

International audience; BACKGROUND: Paroxysmal atrial fibrillation (PAF) may remain underdiagnosed after stroke, as suggested by long-duration EKG monitoring. Here we report the sensitivity of transtelephonic EKG monitoring (TTM) for detection of PAF in patients following a recent stroke or TIA and a negative 24-hour Holter. METHODS: We analyzed data from 98 consecutive patients with TTM and noncardioembolic TOAST stroke (n = 78) or TIA (n = 20). Most were cryptogenic events (82%). Patients started TTM 0.8 months (interquartile range 0.4-2.5) after the indexed event and randomly recorded about 1 EKG per day for 1 month. Univariate and multivariate analyses were run to identify PAF predictors. RESULTS: Seventeen PAF episodes were detected in 9.2% (9/98) of the patients. The estimated duration of PAF episodes ranged from 4 to 72 hours. Two predictors were identified: premature atrial ectopic beats (more than 100) in 24-hour routine Holter (odds ratio [OR] = 11.0; 95% confidence interval [CI] 1.9-62; p = 0.007) and nonlacunar anterior circulation DWI hypersignals (OR = 9.9; 95% CI 1.1-90.6; p = 0.04). The PAF detection rate varied from 42.6% for patients meeting both criteria to 0% for patients with neither of them. CONCLUSIONS: Transtelephonic EKG monitoring increases detection rate of paroxysmal atrial fibrillation in stroke and TIA patients whose 24-hour Holter result was negative, especially if they had frequent premature atrial ectopic beats, recent anterior circulation infarct on MRI, or both.

Normal mice (C57) and mice prone to develop atherosclerosis (ApoE-/-) were implanted with electrocardiograph (EKG), core body temperature, and motion transmitters were exposed daily for 6 h to Tuxedo, NY, concentrated ambient particles (CAPs) for 5 day/wk during the spring and summer of 2003. The series of 5-min EKG monitoring and body-temperature measurements were obtained for each animal in the CAPs and filtered air sham exposure groups. Our hypothesis was that chronic exposure could cause cumulative health effects. We used our recently developed nonparametric method to estimate the daily time periods that mean heart rates (HR), body temperature, and physical activity differed significantly between the CAPs and sham exposed group. CAPs exposure most affected heart rate between 1:30 a.m. and 4:30 a.m. With the response variables being the average heart rate, body temperature, and physical activity, we adopted a two-stage modeling approach to obtain the estimates of chronic and acute effects on the changes of these three response variables. In the first stage, a time-varying model estimated daily crude effects. In the second stage, the true means of the estimated crude effects were modeled with a polynominal function of time for chronic effects, a linear term of daily CAPs exposure concentrations for acute effects, and a random component for unknown noise. A Bayesian framework combined these two stages. There were significant decreasing patterns of HR, body temperature, and physical activity for the ApoE-/- mice over the 5 mo of CAPs exposure, with smaller and nonsignificant changes for the C57 mice. The chronic effect changes of the three response variables for ApoE-/- mice were maximal in the last few weeks. There was also a significant relationship between CAPs exposure concentration and short-term changes of heart rate in ApoE-/- mice during exposure. Response variables were also defined for examining fluctuations of 5-min heart rates within long (i.e., 3-6 h) and short time periods (i.e., approximately 15 min). The results for the ApoE-/- mice showed that heart-rate fluctuation within the longer periods increased to 1.35-fold by the end of exposure experiment, while the heart-rate fluctuation within 15 min decreased to 0.7-fold.

Objective. – To study the value and limitations of carotid sinus massage in healthy individuals older then 50 years of age, in order to assess the validity of the widely used criteria for the diagnosis of hypersensitive carotid sinus syndrome Methods. – Right and left carotid sinus massage was performed in 120 healthy individuals older then 50 years of age (74 males and 46 females aged 59 ± 7 years) who had no prior history of syncope, pre–syncope, or abnormal bradyarrythmia, during EKG monitoring. Results. – Hypersensitivity of the carotid sinus (HSCS) defined as a pause > 3 s, was found in 28 individuals (23,3 %). The pause was induced by right carotid sinus massage in 20 cases and by left carotid sinus massage in 8 cases. Patients demonstrating HSCS were older compared to those who did not develop a pause. One or multiple blocked P wave was seen in 16 cases when carotid sinus massage was performed on the left side compared to 8 with right carotid sinus massage. Conclusion. – In healthy individuals older then 50 years of age, it is not rare to induce a significant pause following carotid sinus massage. This limits the validity of the widely used criteria for the diagnosis of hypersensitive carotid sinus syndrome. Additional criteria are proposed to make this diagnosis in front of a brief loss of consciousness.

•CHANGES IN PRACTICE have made knowledge of the cardiac conduction system and basic electrocardiogram (EKG) interpretation a necessity because perioperative nurses are required to manage an increasing number of patients undergoing IV conscious sedation who require EKG monitoring. •RAPID EKG INTERPRETATION can reveal arrhythmias before a patient becomes symptomatic. An EKG can reveal underlying cardiac problems and uncover electrolyte imbalances that, if left untreated, could hinder positive patient outcomes. •THE CONDUCTION AND CORONARY ARTERY SYSTEMS of the heart are described to enable identification of normal and abnormal EKG rhythms. Each arrhythmia is described, and potential causes and probable treatments are discussed. AORN J 78 (October 2003) 572–589.

In this paper the system for the electrocardiogram (EKG) monitoring based on the of Arduino microcontroller is presented. Detailed description of the electrocardiogram itself serves as a ground for building the proposed hardware and software solution. The software implementation is in a form of both, Matlab environment, and own application. Final output enables retrieval of the actual data in real time and further and provide the rudimentary diagnosis. Utilization of such device is for self home diagnosis of arrhythmia.

Aim: to assess if intravenous infusion of 900 mg of lidocaine over 6 hours is associated with Subjects : 15 adult patients with chronic benign pain. Method: all subjects received an intravenous infusion of 900 mg lidocaine intravenously over 6 hours. Supine blood pressure and heart rate were recorded prior to infusion and at 15 minute intervals for 7 hours, while erect blood pressure and heart rate were recorded prior to infustion and at hourly intervals for 7 hours. Continous EKG monitoring was also employed. Results: No patient experienced side effects during or after the infusion period. There were no changes from baseline levels in either supine or erect blood pressure or heart rates. There were no new cardiac arrhythmias observered during the infusion period. Conclusion : the intravenous infusion of 900 mg lidocaine over 6 hours is not associated with overt evidence of myocardial depression or cardiac arrhythmia.

Thoughthe riskof magnetic resonanceimaging(MRI)inducedburns has been previously published, the overwhelmingnature of this injury combined with its preventable etiology,merit reiteration of the morbidity associated with the use ofnon-MR-compatible devices in MRI sessions. After describingthe patient details, we provide guidelines aimed at decreasingthe potential risk of burns during routine magnetic resonanceimaging.MRI scans expose the patient to electromagnetic (EM)radiation. The EM spectrum contains non-ionizing radiationwhichdoesnotcauseirreversiblecelldamage[1].Itis,however,capable of inducing thermal damage. Various devices wereshown to induce burns in MRI settings. The list includes smallcircularmetallicimplantsinrabbits[2],tattoos[3,4],deepbrainimplanted stimulators [5], halo pins [6], cylindrical and otherimplanted devices [7], EKG monitoring devices [8],andtransdermal patches [9]. Previous studies have shown thatsubstantial heating (with temperature elevation up to 63.1 8C)[10]can becausedbyaresonantconducting loopcoupledtoaninduced EM field [11]. This situation occurs when inductanceand capacitance are equal and opposite: a state which can besustainedbyaconductingwirewithinthemagneticfieldsofanactive MR session. It is further speculated that several wiresbundled together in a linear arrangement are also capable ofthermal damage through a similar mechanism [15].

Current rapid development medical science is already at such level that its aim is to meet need of patients in maximum possible extend and there are significant achievements in modern medical treatment. It does not promise full recovery, however quality of patients life may improve earlier or acute problems can be eliminated on time thanks to early diagnostics, well chosen treatment or early medical action and last but not least approach of entire attending medical staff and professional attitude of a nurse, who is an essential part of complex care, since he/she is often the first one in contact with patients, can recognize a problem and make sure it will be looked at.

The use of textile electrodes in wearable EKG monitoring systems is presented. We show that if motion does not exist, textile electrodes offer comparable quality to medical grade electrodes. Upon solving problems and artifacts arising mainly due to motion, textile electrodes can a basis for a more user friendly long and short term monitoring garment.

Positron emission tomography (PET) has shown an increase in both sensitivity and specificity over computed tomography (CT) in particular for lung cancer. Motion artifacts in the fluoro-2-deoxy-d-glucose (FDG) PET images caused by respiration persists to be an important factor in degrading PET image quality and quantification. A lot of different methods have been developed to overcome this problem using breathing protocols or on-line monitoring systems. We constructed a respiratory gating device that monitor the breathing cycle through a pressure sensor and send the information to the electrocardiography (EKG) connector of our PET/CT system. In this work we will illustrate how this device, named ABCDE, works and discuss its use and limitations. ABCDE was tested on a small cohort of patients to prove the feasibility of the system in clinical practice. This preliminary investigation showed an improvement in the target-to-background ratio and a reduction in apparent lesion volume for all the patients we studied. This work was conducted as a proof of principle gating could improve the quantification and the resolution of PET images and that the system could be of use in clinical practice.

The objective of this proposal was twofold. First, upgrade existing MRI equipment, specifically a research 4.1T whole-body system. Second, purchase a clinical, state-of-the-art 3T MRI system tailored specifically to cardiovascular and neurological applications. This project was within the guidelines of ''Medical Applications and Measurement Science''. The goals were: [1] to develop beneficial applications of magnetic resonance imaging; [2] discover new applications of MR strategies for medical research; and [2] apply them for clinical diagnosis. Much of this proposal searched for breakthroughs in this noninvasive and nondestructive imaging technology. Finally, this proposal's activities focused on research in the basic science of chemistry, biochemistry, physics, and engineering as applied to bioengineering. The centerpiece of this grant was our 4.1T ultra-high field whole-body nuclear magnetic resonance system and the newly acquired state-of-the-art, heart and head dedicated 3T clinical MRI system. We have successfully upgraded the equipment for the 4.1T system so that it is now state-of-the-art with new gradient and radio frequency amplifiers. We also purchase a unique In Vivo EKG monitoring unit that will permit tracking clinical quality EKG signals while the patient is in a high field MR scanner. Important upgrades of a peripheral vascular coil and a state-of-the-art clinical workstation for processing complex heart images were implemented. The most recent acquisition was the purchase of a state-of-the-art Philips 3T Intera clinical MRI system. This system is unique in that the magnet is only 5 1/2 feet long compare to over 12 feet long magnet of our 4.1T MRI system. The 3T MRI system is fully functional and its use and applications are already greatly benefiting the UAB with 200-300 micron resolution brain images and diagnostic quality MR angiography of coronary arteries in less than 5 minutes.

Migraine-like headache is the most common presenting symptom of stroke-like episode in patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS).1,2⇓ This study was designed to investigate the mechanism of headache in patients with MELAS and based on our recent report that neuronal hyperexcitability might initiate stroke-like episodes in MELAS.2 After obtaining informed consent, sumatriptan 3 mg was subcutaneously injected for intractable headache under serial EKG monitoring in two patients with MELAS, who carried the A3243G transition in transfer RNALeu(UUR) gene, when headache intensity exceeded 8/10 of the Headache Scale. The clinical data obtained from a patient, who received an injection during the stroke-like episode, were compared with those in our series of 15 consecutive stroke-like episodes of six patients with MELAS, who did not receive injections during the episodes.2,3⇓ The first patient was a 40-year-old woman with incomplete phenotype of MELAS who had never had stroke-like episode but otherwise had typical manifestations. Since age 31, she had headaches characterized by episodic, bilateral, and throbbing pain with moderate or severe intensity and …

During the operation, it is difficult to continuously record the EKG, because the various noises present. Most important problem is a high frequency (HF) interference from the electrosurgical unit (ESU). There are three routes that the HF interference passes through a patient body as follows1); 1. Conduction through the alternating current (AC) power line 2. Radiation; HF interference is transmitted via electric and magnetic field coupling into the monitoring circuit cable 3. Conduction directly through a patient into the monitoring device

Twenty-one normal subjects and 64 diabetics with varying severity of autonomic damage underwent 24-h ambulatory EKG monitoring. No diabetics had the “sick sinus syndrome,” and the frequency of arrhythmias was no higher than in the normal subjects. The diabetics had higher mean hourly heart rates, and with increasing autonomic damage there was reduction in diurnal heart rate variation. The mean waking and sleeping heart rates were higher in the diabetics. The maximum heart rates were not significantly different, but the minimum heart rates were significantly higher in the diabetics. These previously unrecognized abnormal 24-h heart rate patterns provide further evidence of damage to the heart rate-controlling mechanisms in diabetes mellitus.

There are increasing reports of serious side effects in children with clinical use of imipramine in high doses. Our analysis of the EKG effects of imipramine in 25 hyperactive and 8 school phobic children suggests that children on a dose of imipramine of 3.5 mg/kg or more are likely to show an increase in PR interval of .02 seconds or more and that such increases are more likely to occur in patients with a small pretreatment PR interval. In 7 children the PR interval prolongation was above the rate-corrected norm. EKG monitoring seems desirable in children maintained on imipramine dose of 3.5 mg/kg or more.

Previously reported clinical studies have suggested sodium hydroxide as an effective agent in causing pleural symphysis. To explore the sclerosing poten tial of this agent, we instilled 0.5% sodium hydroxide into the pericardium of four dogs. Normal saline was instilled into the pericardium of one control dog. Echocardiograms, 24 hour EKG monitoring and intracardiac pressures were recorded. One dog was sacrificed at the end of 24 hours, another at the end of seven days and three other dogs were sacrificed at the end of 28 days. ST elevations and prolonged episodes of supra-ventricular and ventricular tachycardia were noted during and within 24 hours after the intrapericardial instillation of sodium hydroxide in all the dogs. No arrhythmias were noted in the control dog. None of the dogs showed pericardial symphysis. These results suggest that sodium hydroxide causes serious cardiac arrhythmias when in stilled intrapericardially and is of limited value in causing pericardial sym physis.

Cardiac dysrhythmia may be responsible for signs of cerebrovascular insufficiency in some patients. Ten patients with cerebrovascular insufficiency were monitored for up to 24 hours with the Holter EKG monitor. Eight of the patients had transient ischemic attacks and two had mild deficits from a completed stroke. Eight of the ten patients had associated abnormal cerebral angiography, the most frequent finding being carotid stenosis. Holter EKG monitor in these ten patients showed no abnormalities in four patients. The remaining six had a variety of cardiac dysrhythmias. Although there were a variety of cardiac, cerebrovascular, and neurological abnormalities in these ten patients, six of these patients had a disturbance in cardiac rhythm or conduction which could have been directly associated with or suggest an etiology for the patient's neurological event.

One hundred adult patients with tricyclic antidepressant poisoning were studied by clinical observation and EKG monitoring. Sinus tachycardia was common but dysrhythmias were uncommon and unimportant. EKG monitoring did not influence the treatment of these patients and the value of its routine use in tricyclic antidepressant poisoning is questioned.

Summary The full graphic capabilities of a mini-computer have been applied to rapid and versatile analysis of long-term electrocardiographic tape recordings. Interfaced to a standard Avionics tape analyzer, the system's multiple display options provide a powerful tool for arrhythmia detection in a reasonable amount of time. Detection accuracy of the system compares very favorably with previously published figures for computer EKG monitoring. Quantitation of arrhythmic beats is an integral feature of the tape scanning. A method for analog display of randomly selectable EKG complexes is also desribed.

We evaluated the night-time heart rate recognition performance of our wireless EKG measurement system with four persons during fourteen nights. The system uses fabric electrodes, which rely on moisture of the skin as the electrolyte for optimal operation. Even with the small amount of sweating during night, we achieved an average of 99.8 % R-peak recognition rate when data transmission failures of the wireless network were not considered. Based on our test the performance of the textile electrodes is on par with commercial disposable gel EKG electrodes that were used as a comparison.

BILATERAL OCULAR COMPRESSION DURING EKG MONITORING: A PROSPECTIVE STUDY TO EVALUATE VAGAL TONE IN CHILDREN

A simple, inexpensive and reliable method of removing 60 Hz interference for remote EKG monitoring is presented.