ABSTRACT
Electrocardiogram (ECG) monitoring owns important clinical value in diagnosis, prevention and rehabilitation of cardiovascular disease (CVD). With the rapid development of Internet of Things (IoT), big data, cloud computing, artificial intelligence (AI) and other advanced technologies, wearable ECG is playing an increasingly important role. With the aging process of the population, it is more and more urgent to upgrade the diagnostic mode of CVD. Using AI technology to assist the clinical analysis of long-term ECGs, and thus to improve the ability of early detection and prediction of CVD has become an important direction. Intelligent wearable ECG monitoring needs the collaboration between edge and cloud computing. Meanwhile, the clarity of medical scene is conducive for the precise implementation of wearable ECG monitoring. This paper first summarized the progress of AI-related ECG studies and the current technical orientation. Then three cases were depicted to illustrate how the AI in wearable ECG cooperate with the clinic. Finally, we demonstrated the two core issues-the reliability and worth of AI-related ECG technology and prospected the future opportunities and challenges.
Subject(s)
Humans , Artificial Intelligence , Reproducibility of Results , Electrocardiography , Cardiovascular Diseases , Wearable Electronic DevicesABSTRACT
Objective To design a new modified sick clothes for electrocardiogram (ECG) monitoring, and to observe its clinical application effect. Methods In order to overcome the shortcomings of the existing modified ECG monitoring clothes, a new type of modified sick clothes was designed on the basis of the traditional sick clothes, and a national utility model patent was obtained. 408 conscious patients with ECG monitoring admitted to department of neurology of the First Affiliated Hospital of Fujian Medical University from January 2015 to June 2018 were enrolled, and they were randomly divided into three groups according to the order of admission for comparing the wearing effect of three kinds of sick clothes. 133 patients dressed traditional clothes, while 139 patients dressed modified ECG monitoring clothes. According to the method reported in the literature, the pockets were removed on the basis of the traditional patient clothes, and a circular hole 5 cm in diameter was made at the position of the electrodes for ECG monitoring, which was used to pass through the lead wire and the electrodes. 136 patients dressed the new modified sick clothes. In view of the inconvenience of ECG monitoring and stimulation of patients' thoracic and abdominal skin by traditional sick clothes, the existing modified ECG monitoring clothes were not easy to operate, the location of electrodes sticking was not easy to judge and the lead line was messy, the new modified sick clothes were still based on the traditional ones. The three circular holes of the existing modified ECG monitoring clothes were made into incisions about 12 cm in length to facilitate the ECG monitoring lead line and electrodes sticking. A compression band or a simple patch was added to each side near the shoulder for tidying up the fixed lead. The self-evaluation of patient's comfort, the operation time of ECG monitoring by nurses, skin allergy rate and lead damage rate were recorded and compared among the three groups. Results Compared with the traditional sick clothes and the modified ECG monitoring clothes groups, the patients in the new modified sick clothes group had higher comfort [the proportion of no discomfort: 11.0% (15/136) vs. 0% (0/133), 5.8% (8/139); the proportion of severe discomfort: 0% (0/136) vs. 4.5% (6/133), 0.7% (1/139), all P < 0.05], the installation and disassembly time of ECG monitoring by nurses was significantly shortened [installation time (s): 69.12±16.47 vs. 96.74±3.89, 88.24±9.83; disassembly time (s): 50.24±4.54 vs. 75.76±4.98, 66.54±7.86, all P < 0.01], and the skin allergies rate [3.7% (5/136) vs. 15.8% (21/133), 8.6% (12/139)] and the insulation loss rate of the lead wires [2.9% (4/136) vs. 15.8% (21/133), 7.9% (11/139)] were significantly lowered (all P < 0.05). Conclusion The ECG monitoring patients using new modified sick clothes could increase their comfort, reduce the workload of nurses, save medical consumables, and have beautiful appearance and high practicability, which was worthy of clinical application.
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Objective To analyze the effect of dental anxiety on tooth extractionin patients with cardiovascular disease,provide guidance for clinical work. Methods A total of 157 cases were selected from patients with cardiovascular disease who underwent tooth extraction by electrocardiograph monitoring in stomatology department. The Modified Dental Anxiety Scale (MDAS) and Wong-Baker Facial Scale was used to assess preoperative anxiety, pain degree of operation. The heart rate and blood pressure were recorded by biological measurements, and the length of operation was recorded.Whether or not could hemostasis after the operation.According to the MDAS scoring standard, patients who scored more than or equal to 13 points were classified as anxiety. Results The age of the patient was (74.73±8.98) years,the anxiety score was (9.95±3.35) points, there was a negative correlation between age of patients and anxiety score (r=-0.383, P<0.05). There was a positive correlation between anxiety score and the degree of pain in the patient, the length of the operation (r=0.340-0.445, P<0.05). Forty-nine cases of anxiety patients and 108 cases of non anxiety patients. The diastolic blood pressure after anesthesia for 5 minutes was (80.24± 8.10) mmHg(1 mmHg=0.133 kPa) in the patients with dental anxiety, the diastolic blood pressure afteranesthesia for 5 minutes was (77.04 ± 9.15) mmHg in the patients without dental anxiety,there were statistic differences in diastolic blood pressure after anesthesia for 5 minutes between the patients of two groups (t=2.11, P<0.05). The effective hemostasis rate of the patients with dental anxiety was 77.551％(38/49) and the patients without dental anxiety was 92.592％(100/108), there were statistical differences in hemostatic effect after the operation between the two groups of patients (χ2=7.169, P<0.05).Conclusions Medical staff can assess dental anxiety condition in patients with cardiovascular diseases who underwent tooth extraction and analysis its effecton surgery, implement targeted and personalized health education, eliminate the negative emotions of patients, reduce the incidence of anxiety, thereby reduce the adverse effects of anxiety on surgery, and guarantee safety during operation.
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Objective: To discuss the essential aspects of per operation period nursing intervention in tooth extraction under electrocardiogram monitoring for the elderly patients, so as to improve the success rate of surgery. Methods:According to the physiology and psychology characteristics of the elderly patients, psychological intervention and correct cooperation were provided by nurse along with the electrocardiogram monitoring during the whole process. Results:Seven hundred and nineteen cases of elderly patients went through a smooth operation of tooth extraction under electrocardiogram monitoring. Conclusion: It is highly important that we combine professional medical team with tacit cooperation, appropriate psychological intervention as well as good management system to succeed in tooth extraction under electrocardiogram monitoring.
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Objective To explore the highly effective teaching and training approaches to electrocardiogram (ECG) monitoring. Methods Using computer simulation and digital programming, ECG data-gathering platform was set up. Results Not only ECG data were gathered and stored automatically in real time, but its dynamic databases including examination database were established as well. Therefore the teaching and training approaches to ECG monitoring achieved digitization with network and multimedia. Conclusion On the basis of new computer techniques, the application study on teaching and training approaches to ECG monitoring helps to the organic integration of teaching, scientific research and clinical practice, and also helps to the improvement in the training level or quality.
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Objetivo Avaliar correlação entre alterações do segmento ST indicativas de isquemia miocárdica, detectadas pela monitorização eletrocardiográfica ambulatorial, e os achados da cinecoronariografia. Métodos Cinqüenta pacientes, 48 homens, com idades entre 20 e 73 (média 49 ± 13) anos, divididos em três grupos: I) assintomático (16 pacientes, 32%); II) precordialgia atípica (15 pacientes, 30%); e III) angina (19 pacientes, 38%). Procedeu-se à monitorização eletrocardiográfica ambulatorial por período de 24 horas, utilizando-se o sistema Cardiac Care Units (Compass TM). Os pacientes que apresentaram alterações do segmento ST, compatíveis com isquemia miocárdica transitória foram submetidos à cinecoronariografia. Quando esta foi considerada normal, o estudo foi complementado pela ecocardiografia e pelo teste de esforço. Resultados A presença de doença coronária ateroesclerótica (lesões obstrutivas ou fluxo lento) foi constatada em 24 (48%) pacientes. Em 26 (52%) pacientes, as artérias coronárias se apresentaram normais. Dentre esses, em 18 (36%) a ecocardiografia mostrou alqum tipo de afecção ou alteração anatômica (hipertrofia ventricular esquerda, prolapso da valva mitral, hipertrofia septal não obstrutiva, miocardiopatia dilatada). O ecocardiograma foi normal em 8 (16%) pacientes, dos quais em 5 (10%), o teste de esforço foi negativo, entre os quais 1 paciente (2% ) apresentava ponte miocárdica para a artéria descendente anterior, 2 (4%) alterações sintomáticas do segmento ST, e outros 2 paci entes (4%) eram assintomáticos...
Purpose To determine the usefulness of an ambulatory electrocardiographic monitoring system, in identifying atherosclerotic coronary artery disease among symptomatic and asymptomatic patients, through a comparison of ST-segment depression with angiographic findings. Methods Fifty patients, 48 men, with the mean age 49 ± 13 years (range 20 to 73), presenting ST-segment depression, were submitted to coronary angiography, complemented by echocardiogram and exercise testing, when the angiography was considered normal. According to the symptoms patients were divided into three groups: Iasymptomatic (16-32%); II¾ atypical chest pain (15-30%); and IIIangina (19-38%). The Cardiac Care Units(Compass TM) system was used for the ambulatory electrocardiographic monitoring.Results Twenty-four patients (48%) had significant atherosclerotic coronary artery disease documented angiographically. Twenty-six patients (52%) had normal coronary arteries by angiography: 18 (36%), presented some pathology demonstrated by echocardiographic studies (left ventricle hypertrophy, mitral valve prolapse, non-obstructive septal hypertrophy, dilated cardiomyopathy). Eight patients (16%) had normal echocardiograms, and in (6%) the exercise test was positive and in the other 5 (6%) negative. One of those patients (2%), with negative exercise test, had a myocardial bridge over the anterior descending branch of the left coronary artery, 2 patients (4%) presented symptomatic episodes of ST depression, and 2 other patients (4%) were assymptomatic...