scholarly journals P-wave Centric Ambulatory ECG Monitoring in Infants and Young Children

2020 ◽  
Author(s):  
Angela Romme ◽  
Hoang Nguyen
Keyword(s):  
Holter Monitoring ◽  
P Wave ◽  
Optimal Placement ◽  
Ecg Monitoring ◽  
P Waves ◽  
Small Children ◽  
Left Axilla ◽  
Ambulatory Ecg ◽  
Young Infants ◽  
Ambulatory Ecg Monitoring

AbstractBackgroundP-wave centric ambulatory ECG monitoring has emerged as an important tool aiding the diagnosis of arrhythmias. However, with no specific pediatric approved ambulatory monitors, efficacy and user experience with these devices in young infants have not been established.ObjectiveTo evaluate tracings quality in children less than 10 kilograms who have been prescribed the P-wave centric Carnation Ambulatory Monitor (CAM) patch by Bardy Diagnostics Inc.MethodsWe performed an observational, retrospective study on patients prescribed 48-hour ambulatory Holter monitoring. We aimed to detail our experience with using the CAM patch with a patient population smaller than the recommended weight set forth by Bardy Diagnostics Inc. All patients less than 10 kg who were prescribed a 48-hour CAM patch were included in this review. Additionally, 2 different monitor locations (over the sternum and horizontal over the left axilla) were assessed to address the optimal placement in small children less than 10 kg.ResultsA total of 33 CAM reports from 25 patients, aged 0-15 months were included in the study. Mean patient age was 4.2 months ± 5.0 and mean weight was 5.3 kg ± 2.4. Twenty-Four percent of patients (8/33) had known congenital heart disease. Indications for monitoring included: tachyarrhythmia (15/33, 45%), bradycardia (6/33, 18%), ectopic rhythm (9/33, 27%), cardiac tumor (1/33, 1%), and prolonged QT interval (1/33, 1%). All CAM reports showed clear, identifiable P waves which were diagnostic and lead to changes in medical management for 30% of patients (i.e. medication adjustments or discharge from cardiology care). When comparing the P wave between a 12-lead ECG and the CAM patch, 77% of patients had the same or similar P wave morphology to lead aVF.We found the recommended, upright placement over the sternum performed better than the horizontal placement over the left axilla for small infants and children less than 10 kg.ConclusionA P-wave centric Holter monitor is helpful in providing accurate diagnostics tracings even in infants and small children aiding in their clinical management.

Frequent premature atrial complexes and risk of concurrent atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L.S.B Johnson ◽  
N Napiorkowski ◽  
M Dziubinski ◽  
D Conen ◽  
J.S Healey ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
The United States ◽  
Funding Source ◽  
Ecg Monitoring ◽  
P Waves ◽  
Diagnostic Reliability ◽  
Monitoring Period ◽  
Ambulatory Ecg ◽  
Ambulatory Ecg Monitoring ◽  
Long Term Follow Up

Abstract Background Premature atrial complexes (PACs) predict incident atrial fibrillation (AF) in long-term follow-up studies. It is unclear whether frequent PACs on ambulatory ECG recordings indicate a higher likelihood of concurrent, undiagnosed AF. Furthermore, the reproducibility of a 24 h PAC count is unclear. Objectives To determine if frequent PACs on 24 h ambulatory ECG monitoring predicts concurrent AF during subsequent, prolonged ECG monitoring and to assess the diagnostic reliability of PAC counts on a 24 hour ECG recording. Methods AF was defined as ≥30 seconds of irregular rhythm without P waves, which was detected by a proprietary algorithm and manually verified. The proportion of AF occurrence during the remainder of the monitoring period was calculated for pre-specified levels of PACs during the first 24 h, and a function describing the association was fitted. The diagnostic reproducibility of a 24 h PAC count was assessed by calculating the likelihood of a PAC count ≥1000/day during the entire monitoring duration for prespecified PAC count levels during the first 24h. Results The study population comprised 20,973 patients (41% men, mean age 69.5 years) who had recorded an ambulatory ECG with a monitoring duration of 4–30 days in the United States during the year 2017 (median monitoring duration 16 days). AF was detected in 2,029 (9.7%) of patients and the median time to first occurrence of AF was 5 days. PAC frequency during the first 24 h was associated with AF during the monitoring period beyond the first 24 h, increasing steadily from 4.2% among those with 0–5 PACs, to a plateau around 17% among those with 250–1000 PACs per day and above. (Fig. 1A). The reproducibility of low PAC counts was good. Only 5.5% of patients with 0–5 PACs during the first 24 h of monitoring (31.8% of the population), had ≥1000 PACs on an alternate monitoring day. In contrast, among subjects with 100 PACs the probability of a day with ≥1000 PACs was close to 50% (Fig. 1B). Conclusion In patients undergoing ambulatory ECG monitoring, frequent PACs during the first 24 h indicate a higher likelihood of AF occurrence during subsequent days of monitoring. Less than 5 PACs during the first 24 h indicate a low probability of AF or frequent PACs on a subsequent day of ECG monitoring. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): The Swedish Heart and Lung Foundation; The Swedish Heart and Lung Association

scholarly journals Late, but Before Schedule-A Bigeminal Rhythm with Blocked Premature Junctional Beats

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Daniel Manna
Keyword(s):  
Heart Rate ◽  
Refractory Period ◽  
Cardiac Cycle ◽  
Ecg Monitoring ◽  
P Waves ◽  
Abrupt Decrease ◽  
Ambulatory Ecg ◽  
Ambulatory Ecg Monitoring ◽  
Ectopic Beats ◽  
Activation Site

Premature supraventricular ectopic beats are common findings in ambulatory ECG monitoring. Blocked ectopic beats may occur if the premature beat coincides with the refractory period of the downstream conductive tissues. We report of an uncommon, symptomatic bigeminal rhythm which resulted in an abrupt decrease of the heart rate because of blocked P waves. The blocked P waves appeared uncommonly late in the cardiac cycle because of a very His-near activation site. For anatomic reasons treatment was difficult and the patient received a pacemaker.

Ambulatory ECG Monitoring in Atrial Fibrillation Management

2013 ◽  
Vol 56 (2) ◽  
pp. 143-152 ◽  
Author(s):  
Spencer Z. Rosero ◽  
Valentina Kutyifa ◽  
Brian Olshansky ◽  
Wojciech Zareba
Keyword(s):  
Atrial Fibrillation ◽  
Ecg Monitoring ◽  
Ambulatory Ecg ◽  
Ambulatory Ecg Monitoring

Can Changes in S Wave Amplitude be Used to Detect Ischaemia during Ambulatory ECG Monitoring?

1986 ◽  
Vol 70 (s13) ◽  
pp. 1P-1P
Author(s):  
J.J. Glazier ◽  
S. Chierchia ◽  
A. Maseri
Keyword(s):  
Wave Amplitude ◽  
Ecg Monitoring ◽  
S Wave ◽  
Ambulatory Ecg ◽  
Ambulatory Ecg Monitoring

System for Continuous and Prolonged Ambulatory ECG Monitoring with Hosting and Visualization on the Cloud

2021 ◽  
Vol 10 (1) ◽  
pp. 57
Author(s):  
Daniel Cuevas-González ◽  
Juan Pablo García-Vázquez ◽  
Miguel Bravo-Zanoguera ◽  
Roberto López-Avitia ◽  
Marco A. Reyna ◽  
...  
Keyword(s):  
Health Care ◽  
Sampling Rate ◽  
Cloud Services ◽  
Ecg Signal ◽  
Ecg Monitoring ◽  
Ambulatory Ecg ◽  
Ambulatory Ecg Monitoring ◽  
Access Information ◽  
Electrocardiogram Ecg ◽  
Small File

In this paper, we propose investigating the ability to integrate a portable Electrocardiogram (ECG) device to commercial platforms to analyze and visualize information hosted in the cloud. Our ECG system based on the ADX8232 microchip was evaluated regarding its performance of recordings of a synthetic ECG signal for periods of 1, 2, 12, 24, and 36 h on six different cloud services to investigate whether it maintains reliable ECG records. Our results show that there are few cloud services capable of 24 h or longer ECG recordings. But some existing services are limited to small file sizes of less than 1,000,000 lines or 100 MB, or approximately 45 min of an ECG recording at a sampling rate of 360 Hz, making it difficult an extended time monitoring. Cloud platforms reveal some limitations of storage and visualization in order to provide support to health care specialists to access information related to a patient at any time.

Continuous ambulatory ECG monitoring during fluorouracil therapy: a prospective study.

1989 ◽  
Vol 7 (4) ◽  
pp. 509-514 ◽  
Author(s):  
S Rezkalla ◽  
R A Kloner ◽  
J Ensley ◽  
M al-Sarraf ◽  
S Revels ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Toxicity ◽  
Ecg Monitoring ◽  
Ecg Changes ◽  
Ambulatory Ecg ◽  
Ambulatory Ecg Monitoring ◽  
St Segment ◽  
Artery Disease ◽  
A Prospective Study

Although there have been anecdotal reports of cardiac toxicity associated with fluorouracil (5-FU) therapy, this phenomenon has not been studied in a systematic fashion. We prospectively performed continuous ambulatory ECG monitoring on 25 patients undergoing 5-FU infusion for treatment of solid tumors in order to assess the incidence of ischemic ST changes. Patients were monitored for 23 +/- 4 hours before 5-FU infusion, and 98 +/- 9 hours during 5-FU infusion. Anginal episodes were rare: only one patient had angina (during 5-FU infusion). However, asymptomatic ST changes (greater than or equal to 1 mm ST deviation) were common: six of 25 patients (24%) had ST changes before 5-FU infusion v 17 (68%) during 5-FU infusion (P less than .002). The incidence of ischemic episodes per patient per hour was 0.05 +/- 0.02 prior to 5-FU infusion v 0.13 +/- 0.03 during 5-FU infusion (P less than .001); the duration of ECG changes was 0.6 +/- 0.3 minutes per patient per hour before 5-FU v 1.9 +/- 0.5 minutes per patient per hour during 5-FU (P less than .01). ECG changes were more common among patients with known coronary artery disease. There were two cases of sudden death, both of which occurred at the end of the chemotherapy course. We conclude that 5-FU infusion is associated with a significant increase in silent ST segment deviation suggestive of ischemia, particularly among patients with coronary artery disease. The mechanism and clinical significance of these ECG changes remain to be determined.

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