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Background and objective: Only few studies addressed ECG findings in healthy members of the Indian armed forces or the general population of India. The study was conducted to assess the prevalence of abnormal electrocardiogram (ECG) detected during a routine medical examination of healthy members of the Indian armed forces. Method: The ECG of all the healthy members performed during a routine medical examination was initially reported by physicians at various armed forces service hospitals in the Eastern Command (EC) and later perused by the cardiologist at Command Hospital Eastern Command (CHEC). Individuals with abnormal ECG underwent relevant cardiac evaluation at CHEC to determine the underlying pathology. Results: A total of 1,045 members of the Indian armed forces were included in the study and were categorised as follows: 244 in Group-1 (aged < 25years), 478 in Group-2 (aged between 25 to 40 years) and 323 in Group-3 (aged > 40years). Abnormal ECG was found in 108 (10.3%) individuals. Left axis deviation was the most common abnormality detected in 18 (1.2%) individuals, followed by incomplete RBBB and T wave inversion which were each found in 15 subjects (1.43% of all individuals and 13.9% of the subjects with abnormal ECG). The prevalence of ECG abnormalities detected in our study was similar to that reported in previous studies. Only five (0.47%) of the 108 individuals with abnormal ECG were found to have underlying cardiovascular disease. Conclusion: Morphological ECG abnormalities were common in the subjects but did not vary significantly from the general population, and only a minority had underlying pathology. While most of the abnormalities may only represent normal variations and their occurrence in healthy individuals during routine health check-ups should not be alarming. Evaluation of structural heart disease should be done for ECG abnormalities with prognostic significance that has been well-characterised.
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Introduction: Rhythm disorders (RDs) or arrhythmias are poor prognostic factors during heart failure (HF). Our objective was to study the frequency of rhythm disorders presented by patients treated for HF in Parakou, Benin in 2017. Methods: This was a cross-sectional, descriptive and analytical study. It consisted of a systematic recruitment of all patients admitted for heart failure in the cardiology units of the city of Parakou from March to August 2017. The diagnosis of RDs was made by cardiac auscultation completed by electrocardiographic recording (standard and Holter over 24 hours). The Lown classification was used to describe the severity of ventricular TRs. The threshold for significance was p < 5%. Results: A total of 83 heart failure patients aged 61.47 ± 15.97 years with a sex ratio of 1.08 were selected. Arrhythmia was detected by auscultation in 20.48%; by standard electrocardiogram (ECG) in 25.83% and by Holter ECG in 97.59% of patients. Among the arrhythmias detected by Holter ECG, 81.48% were atrial, including 28.79% of atrial fibrillation. RDs was ventricular in 90.12% of which 47.95% were severe. Left ventricular systolic dysfunction was significantly associated with ventricular arrhythmias. On the other hand, the frequency of ventricular arrhythmias was not associated with the severity of the HF according to the NYHA classification. Conclusion: In Parakou, RDs are frequent in patients with HF. Holter ECG should be included in the follow-up of heart failure patients in order to improve their management.
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Tele-healthcare is need of the hour to bridge the vast healthcare gap in developing country like India. Being the second most populous country, quality healthcare facility is not easily accessible in the rural outskirts of India. In this research work the proposed system has acquired ECG, heart rate, SpO2 and body temperature data for better diagnosis and prognosis. The proposed system has been tested on the different patients belonging to different age groups and the result obtained on the health monitoring dashboard is found to be satisfactory. It also provides enhanced accessibility as multiple healthcare professionals can collaborate on the patient's data. This paper concludes with real time audio/ video connectivity, scope of interest of which is very effective and applicable in healthcare world.
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Fetal ECG monitoring is a routine clinical detection method that can reflect the changes of fetal heart in utero in real time. At present, most of the clinical fetal heart rate detection adopts the ultrasonic Doppler method, which is technically difficult and highly specialized in operation and expensive. This study introduces a fetal ECG detection system based on the maternal abdominal electrode method. The weak fetal ECG changes are sensed through the maternal abdominal electrode, and the mixed ECG signal is obtained through the corresponding amplification and filtering circuit. Finally, the obtained signal is passed through WiFi, transmitted to the host computer. The host computer uses the adaptive filtering algorithm to estimate the fetal ECG signal. The system has strong feasibility, low operation expertise, low cost, and is more convenient.
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To improve overall satisfaction of patients with the hospital and build a harmonious doctor-patient relationship, a survey on satisfaction of patients with ECG examination was conducted in a tertiary A hospital. The analysis was carried out from the aspects of inspection environment, inspection process, inspection experience and overall satisfaction. Logistic regression model was used to analyze the effect of various variables on satisfaction. This paper found that the overall satisfaction rate of patients with ECG examination was 85.18%, lower than that of outpatients. Patients with different characteristics had different satisfaction degree with ECG examination. Patient satisfaction was lower on Mondays and Wednesdays than that on other inspection days, and was lower between 10 a.m. and 14 p.m. The longer the waiting time, the lower satisfaction degree of patients with examination. Based on the results, hospitals should improve the construction of humanistic soft environment to improve the medical environment, scientifically plan the medical treatment process of ECG examination, and further strengthen doctor-patient communication. The ECG room should further promote its management level and strengthen its cultural construction.
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Cardiovascular complications in COVID-19 include deep vein thrombosis, stroke, angina, myocardial infarction, heart failure and cardiogenic shock.ECG changes including sinus tachycardia, sinus bradycardia and atrial ?brillation . Incidence of cardiovascular complications is directly linked to severity of disease which in turn correlate with in?ammatory markers including CRP, LDH, Ferritin, D Dimer and IL-6. Raised In?ammatory markers also suggest poor outcome of patients. Therefore it is advisable to do in?ammatory markers in admitted patients for management. Followup study at 3 and 6 months revealed new onset cardiovascular complications while no new complications were documented at 12months follow up.Thus regular health checkup is recommended post COVID infections for atleast 6months.
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Abstract Objective: To explore the diagnostic utility of 31 electrocardiogram (ECG) criteria for detecting echocardiographic (Echo) left ventricular geometry using accuracy. Methods: This cross-sectional study included consecutive adults (> 18 years) that were classified by Echo left ventricular geometry as normal (NL), concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). Thirty-one state-of-the-art ECG criteria for Echo left ventricular hypertrophy were calculated. AUC 95%CI, accuracy, sensitivity, specificity, and positive and negative predictive value for detecting Echo left ventricular geometries were compared. Multivariable linear regression models were produced using the ECG criteria as the dependent variable. Results: A total of 672 adults were included in the study. From 31 ECG criteria, Cornell (ECG21, SV3 + RaVL) and modified Cornell (ECG 31, RaVL + deepest S in all leads) criteria have the best overall AUC in differentiating NL versus CH (0.666 and 0.646), NL versus EH (0.686 and 0.656), CR versus CH (0.687 and 0.661), and CR versus EH (0.718 and 0.676). In multivariable linear regression models, CH and EH had the strongest effect on the final voltage in Cor- nell (ECG21) and modified Cornell (ECG31). Conclusions: From 31 state-of-the-art criteria, Cornell and modified Cornell criteria have the best AUC and accuracy for predicting most left ventricular geometries. CH and EH had the strongest effect on the voltage of Cornell and modified Cornell criteria compared to body mass index, age, diabetes, hypertension, and chronic heart disease. The ECG criteria poorly differentiate NL from CR and CH from EH.
Resumen Objetivo: Explorar la utilidad diagnóstica de 31 criterios de ECG para detectar la geometría ecocardiográfica del ventrículo izquierdo usando la exactitud, área bajo la curva, sensibilidad, especificidad, y valor predictivo positivo y negativo. Métodos: Este estudio transversal incluyó adultos (> 18 años) que se sometieron a ECG y ecocardiograma transtorácico. Los pacientes fueron clasificados según la geometría del ventrículo izquierdo: normal (NL), remodelado concéntrico (RC), hipertrofia concéntrica (HC) e hipertrofia excéntrica (HE). Se calcularon 31 criterios clásicos de ECG para detectar hipertrofia ventricular izquierda y se comparó el rendimiento diagnóstico en cada geometría. Creamos un modelo de regresión lineal múltiple usando los criterios de ECG como variable dependiente. Resultados: Se incluyeron 672 adultos. Los criterios de Cornell (ECG 21, SV3 + RaVL) y Cornell modificado (ECG31, RaVL + S mas profunda de las 12 derivaciones) tienen el mejor AUC para diferenciar NL versus HC (0.666 y 0.646), NL versus HE (0.686 y 0.656), RC versus HC (0.687 y 0.661) y RC versus HE (0.718 y 0.676). En el análisis multivariado la geometría del ventrículo izquierdo (HC e HE) fue la variable que mas influyó en el resultado final del criterio de Cornell y de Cornell modificado. Conclusión: De los 31 criterios clásicos explorados, los criterios de Cornell y Cornell modificado tienen el mejor AUC y exactitud para predecir la mayoría de las geometrías del ventrículo izquierdo. Los criterios del ECG no diferencian bien la geometría NL del RC ni HC de la HE.
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In an Intensive Care Unit, acute respiratory distress syndrome (ARDS) is a serious condition. Non-cardiogenic pulmonary oedema was the prior name for it. It is caused by a variety of illnesses that cause lung injury, but sepsis is the most common cause. It causes interstitial and alveolar oedema, diffuse alveolar damage, refractory hypoxemia, and ventilation perfusion mismatch by damaging the alveolar capillary membrane. Dyspnoea with diffuse in ltration on chest X-ray is a typical clinical symptom. Low tidal volume, high positive end expiratory pressure (PEEP), and low plateau pressure are all used to treat ARDS. Prone placement improves patient perfusion and thereby increases the PaO/FiO ratio. To treat ARDS, doctors are increasingly turning to high frequency oscillation ventilation (HFOV).
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Introduction : The Coronavirus disease 2019 (COVID-19) primarily involves respiratory system but may also affect the Cardiovascular System leading to abnormal ECGs. Its early recognition is crucial as it may be associated with increased mortality. Hence we aimed to find out various Electrocardiographic (ECG) manifestations of COVID19 patients admitted in a Tertiary Care Hospital and its relation to disease severity. Methods : We performed a hospital-based retrospective observational study between April, 2021 to November 2021 and analyzed the ECG changes at admission by three Cardiologists according to standard definitions and diagnostic criteria. Results : Out of 579 patients, ECG of 473 was available for analysis. ECG was normal in 227 (48%) and abnormal in 246 (52%) patients. Most common abnormal ECG finding in COVID19 patients was Sinus Tachycardia(19.5%) and less common findings were Sinus Bradycardia (5.3%), Incomplete Right Bundle Branch Block (RBBB) (3.2%), atrial fibrillation (2.5%), complete RBBB (2.3%), atrial premature complexes (2.3%), S1Q1T3 pattern (2.1%), first degree AV block (1.5%), ST-T wave changes (1.3%), Atrial flutter (1.1%). In mechanically ventilated patients, incidence of acute Right Ventricular Pressure Overload (RVPO) related ECG findings were more frequent. Conclusion : There is a wide spectrum of ECG manifestations in COVID-19 patients which varies depending upon the severity of COVID as well as prior Cardiovascular status, associated comorbidities and need for ventilatory support. Knowledge of ECG changes might help in risk stratification and triaging of COVID-19 patients.
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Background: There are no data on electrocardiographic (ECG) findings from general population of Indian subcontinent. We analyzed ECG abnormalities of in adults as part of a community survey of prevalence of coronary artery disease and risk factors from South India. Methods and results: In this cross-sectional study of men and women between the ages 20 to 79 years, ECGs recorded digitally were analyzed using the Minnesota code. Electrocardiograms were analyzed for abnormalities in 4630 participants (women 59.6%). The overall prevalence of ECG abnormalities (39.9%) was higher in men (47.24% vs. 34.9% p <0.0001). QRS axis deviation, first degree AV block, fascicular blocks, incomplete right bundle branch block, sinus bradycardia and ST elevation in the anterior chest leads were markedly higher in men. Sinus tachycardia and low voltage QRS occurred more often in women. The overall prevalence of atrial fibrillation was 0.32% which was markedly lower than the western data. Brugada and early repolarisation patterns occurred in 1.06% and 1.56% respectively, equal in both age groups, but markedly higher in men. Brugada pattern occurred more often than in the west, but much less than the Far East population. Early repolarisation pattern was similar to rest of Asian population, but significantly less than the Caucasian population Conclusion: In this community-based study, prevalence of major electrocardiographic abnormalities was high. Overall, men had significantly higher ECG abnormalities
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Cardiac rehabilitation (CR) is a comprehensive disease management program for heart failure patients. Most of the heart failure (HF) guidelines are classifying the cardiac rehabilitation for heart failure patients as class 1A which mean highly recommended. However, Arab countries and Middle East are lacking specific CR programs and guidelines. In this study, five cases of chronic heart failure patients were exposed to short term regular exercise for maximum 8 weeks. With a mean of 5.6 exercise visits there are 19. 2% improvement in functional capacity, 35% improvement of exercise distance, 32.5% improvement in quality of life, 25% improvement in quality of sleep and decrease the emergency room visits by 37.5%.The significant improvement was in quality of life, exercise capacity and a decrease in ER visit for all patients.
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Background:Early detection of electrocardiogram (ECG) abnormalities in high risk cardiovascular patients with routine ECG screening is the need of the hour. The aim of the e-survey was to understand the use of ECG in high risk cardio-metabolically deranged patients at outpatient departments (OPDs) by Indian physicians.Methods:A cross-sectional India office ECG (IOECG) e-survey was conducted using Google form questionnaire from November 2021 to December 2021 among Indian physicians. Survey results were collected and analysed using Google form survey tool.Results:We received total of 1863 responses. The results of the survey showed that while 90% of physicians agreed to the necessity of doing 12 lead ECG of cardio-metabolically deranged patients, only 61% of all physicians could perform ECG screening in less than 40% of high risk cardio-metabolic patients mainly, due to several practical challenges. Among physicians, 40.2% physicians believed that 12 lead ECG was too time consuming, 35.8% physicians believed that the unavailability of ECG device was common reason while 27.5% physicians believed that there was a lack of trained staff. Majority of physicians (69.7%) agreed to use point of care ECG device which can be a solution for more screening of such patients whether symptomatic or asymptomatic. According to the survey, 88.7% physicians would appreciate if a portable handheld ECG device was made available to facilitate screening in their practice.Conclusions:There is a need of the portable handheld ECG device which helps physicians to screen large number of cardio-metabolically deranged patients in their busy OPDs.
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Background: Medical literature has reports of isolated cases of atrioventricular conduction disorders, supraventricular arrhythmias, and myocarditis in dengue fever (DF).There is a paucity of data available in the published literature on the cardiac manifestations of DF from India. The aim of the present study was to assess the cardiac manifestations of DF. Methods: The140 patients aged ?18 years with DF confirmed with a serology-dengue non-structural protein 1 antigen-positivewere included for this prospective observational study. Three serial ECGs were taken on day one, day three and day seven or day of discharge. All the patients were evaluated using 2D echo on day one, day seven or day of discharge. The primary outcome measures were to find the incidence and type of echocardiographic abnormalities and electrocardiographic changes in dengue.Results: The incidence of cardiac abnormalities on ECG and 2D echo was 30 (21.4%), and 5 (7.0%) respectively. On ECG, 14 (10%) 9 (6.4%) 3 (2.1%) 3 (2.1%) and 1 (0.7%) patients had sinus bradycardia, sinus tachycardia, non-specific ST-T changes, right bundle branch block and atrio-ventricular block respectively. On 2D echo, 7 (5.0%), 5 (3.6%) and 1 (0.7%) patient had systolic dysfunction, ejection fraction (<45.0%) and diastolic dysfunctionrespectively. Conclusions: The incidence of cardiac abnormalities on ECG and 2D ECHO in dengue patients was considerable. ECG and 2 D echo should be undertaken in patients with DF.
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The burden of atrial fibrillation (AF) is increasing worldwide. It is often asymptomatic, with stroke being the first manifestation in some. AF burden in the community and the practice of stroke prophylaxis has not been studied in India. The problem might be higher in rural regions due to poor health awareness and challenges to healthcare access. This study aimed to estimate the prevalence of AF, clinical profile and stroke risk in rural India. Methods: This is a community-based cross-sectional study done in rural Andhra Pradesh (AP). Adults from 40 villages formed the study population. We did a door-to door survey to collect information on demographics, and medical history. Electrocardiogram was recorded using a smart phone based Alivecor device. Participants diagnosed with AF underwent echocardiogram. Study cardiologists assessed the cardiovascular risk profile and collected detailed medical history. Results: Fourteen of the 4281 individuals screened had AF (0.3%). The mean age of the sampled population was 44 ± 16.5 years with 56% women. The mean age of participants with AF was 71 ±7.8 years; males were 71%. Except for one, all were non-valvular AF. Majority had a CHA2D2S2Vasc score of 2. Three had history of stroke. Two were on anticoagulant therapy but without INR monitoring. Conclusion: The prevalence of AF is lower in this study compared to studies from the developed countries. Non-rheumatic cardiovascular risk factors were primary causes for AF. Non-adherence to stroke prophylaxis is a major threat that needs to be addressed
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An electrocardiogram records the electrical signals in the heart. It's a common and painless test used to quickly detect heart problems and monitor the heart's health. An electrocardiogram — also called ECG or EKG — is often done in a health care provider's office, a clinic or a hospital room. ECG machines are standard equipment in operating rooms and ambulances. Some personal devices, such as smartwatches, offer ECG monitoring. Ask your health care provider if this is an option for you.
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Objectives: Listening to music is entertaining but also has different health benefits. Music medicine involves passive listening to music, while music therapy involves active music-making. Indian music is broadly classified into Hindustani and Carnatic music, each having its system of musical scales (ragas). Scientific studies of Indian music as an intervention are meagre. The present study determines the effect of passive listening to one melodic scale of Indian music on cardiovascular electrophysiological parameters. Materials and Methods: After informed consent, healthy individuals aged 18–30 years of either gender were recruited and randomly divided into two groups (n = 34 each). Group A was exposed to passive listening to the music intervention (Hindustani melodic scale elaboration [Bhimpalas raga alaap]), while Group B received no intervention except for a few natural sounds (played once in every 2 min). Blood pressure (BP, systolic, SBP; diastolic, DBP) and electrocardiogram in Lead II were recorded with each condition lasting for 10 min (pre, during and post). Heart rate variability (HRV) analysis was done. Data were analysed using SPSS 18.0 version and P ? 0.05 was considered significant. Results: In Group A, the SBP did not change during the intervention but increased mildly after the intervention (P = 0.054). The DBP increased in both the groups during the intervention, significant in Group A (P = 0.009), with an increase of 1.676 mmHg (P = 0.012) from pre-during and 1.824 mmHg (P = 0.026) from pre-post intervention. On HRV analysis, mean NN interval increased and HR reduced in both the groups, but was significant only in Group B (P = 0.041 and 0.025, respectively). In Group A, most of the HRV parameters were reduced during music intervention that tended to return toward baseline after the intervention, but the change was statistically significant for total power (P = 0.031) and low frequency (P = 0.013); while in Group B, a consistent significant rise in parasympathetic indicators (SDNN, RMSSD, total power and HF [ms2 ]) over 30 min was observed. Conclusion: Unique cardiovascular effects were recorded on passive listening to a particular Indian music melodic scale. The scale, raga Bhimpalas, produced a mild arousal response. This could be due to attention being paid to the melodic scale as it was an unfamiliar tune or due to the features of this melodic scale that led to an arousal or excitation response. In contrast, the control group had only a relaxation response. Exploring electrophysiological effects of different genres, melodic scales and their properties after familiarising with the music may thus be illustrative.
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Background: Patients with coronary slow flow phenomenon (CSFP) exhibit the following characteristics: Predominantly middle-aged males, the majority have mixed pattern angina, persistent chest pain sensations after therapy, and many have had repeated invasive and non-invasive examinations. Objectives: Our study aimed to determine the base of non-invasive predictors of coronary slow flow phenomenon in patients presenting with chronic coronary syndrome. Patients and Methods: This a case-control study included 100 participants of suspected coronary artery disease were divided into two groups matched in age and sex group I: 50 patients with primary CSFP and group II: 50 patients with normal coronary angiography. Each patient was undergoing to demographic data taking, physical investigation, good hydration, restrict fasting hours requested for coronary angiography, 12 lead-Electrocardiogram (ECG)s were obtained for each patient at rest, laboratory parameters, coronary angiography, treadmill exercise ECG, transthoracic echocardiography to assess the thickness of the left ventricle’s (LV) wall, its interior dimensions, as well as the LV’s ejection fraction (EF) using M-mood method and the aortic propagation velocity. Results: male sex and the Canadian Cardiovascular Society Angina grade’s (CCSA) class 3 were significantly decreased in group I compared to group II and male sex, Diabetes mellitus (DM), smoker and CCSA class 4 were substantially increase in group I compared to group II (P <0.05). P wave max, P Wave dispersion (PWd), corrected QT dispersion (QTcd) at resting ECG, T wave inversion and ST Waves segment depression at stress ECG were significantly increase in group I compared to group II. QTc min was significantly lower in group I compared to group II (P <0.05). LA diameter was significantly increased in group I than group II. Aortic propagation velocity was significantly decreased in group I than group II (P <0.05). Hematocrit, total leucocytic count, mean platelet volume and High-sensitivity C-reactive protein (hsCRP) were significantly increase group I compared to group II (P <0.05). Conclusions: Patients suspected of having a coronary artery disease who are diagnosed with coronary slow flow, male sex, dilated LA, CCSA class 3 or 4, elevated hematocrit value, elevated total leucocytic count, increased mean platelet volume, increased HsCRP, P max, PWd, QTcd, T wave inversion, ST segment depression, and decreased aortic propagation were statistically higher in CSFP patient compared to controls
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Heart rate variability (HRV) is a relevant physiological variable for the estimation of cardiac autonomic function. Although the gold standard for HRV registration is the electrocardiogram (ECG), several applications (APPs) have been increasingly developed. The evaluation carried out by these devices must be compatible with ECG standards. The aim of this study was to compare the data obtained simultaneously with ECG and APP with chest heart rate transmitters. Fifty-six healthy individuals (28 men and 28 women) were evaluated at rest through a short simultaneous HRV measurement with both devices. Data from both acquisition systems were analyzed separately using their own analysis software and exported and analyzed using a validated software. Signal recordings were compatible between the two acquisition systems (Pearson r=0.99; P<0.0001). Although a high correlation was found for the HRV variables obtained in the time domain (Spearman r=0.99; P<0.0001), the correlation decreased in the frequency domain (Pearson r=0.85; P<0.0001) when two software programs were used. Comparison of the averages of spectral analysis parameters also showed differences when HRV data were analyzed separately in each device for low-frequency (LF) and high-frequency (HF) bands. Although the portability of these mobile devices allows for optimal HRV evaluation, the direct analysis obtained from these devices must be carefully evaluated with respect to frequency domain parameters.
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This study introduces the design and application of home wireless electrocardiograph(ECG) machine based on Internet. The world's first three-lead dry electrode mobile electrocardiograph machine has been developed, on the basis of the successful development of dry electrodes. Moreover, it is not only chips filtering, but also wireless, as a result it is applied to ECG monitoring and diagnosis of patients. Compared with traditional electrocardiograph machine, the machine is very convenient and comes into the home, ECG Machines is connected to mobile phones by Bluetooth, wireless upload, therefore we recommend to achieve remote monitoring and early warning and reduce sudden death, to achieve Internet medical by using Internet technology, people can be self-test. It is playing an increasingly important role and it is an inevitable machine to improve the success rate of diagnosis, monitoring and first aid.
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Humans , Cell Phone , Electrocardiography , Electrodes , Internet , Wireless TechnologyABSTRACT
In order to solve the problem of communication interference and communication distance caused by the rapid pacing system when establishing the rapid atrial fibrillation model, a low-power implantable pacing system based on 433 MHz communication frequency to form a star network is designed. The system includes an implantable pacemaker, a programmer head, and programmer software. The pacemaker is composed of a wireless communication module, a pacing module, an ECG monitoring module, and a power management module. The programmer head acts as an intermediate node in the star network and is controlled by PC programmer software to program each pacemaker. This article introduces the hardware design and software flow of each part of the system, and describes the results of in vivo simulation and in vivo animal models of the system. The results show that the designed system and application method are effective and feasible for the rapid atrial pacing atrial fibrillation model. 433 MHz wireless communication, implantable, pacemaker system, low-power, ECG monitoring.