ELECTROCARDIOGRAPHY DEFORMATIONS

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.

Dolor torácico y alteración electrocardiográfica / A man with anginal pain and an abnormal EKG

A 57 year-old man, smoker, with high blood pressure, presented to the emergency unit with intermittent and brief typical anginal pain in the preceding 2 days. Baseline physical examination was normal. Figure 1 depicts de EKG recorded upon admission. Biomarkers for acute coronary syndrome were negative.

Simulador de electrocardiogramas / EKG simulator

Las enfermedades del sistema cardiovascular representan en la actualidad la primera causa de morbi-mortalidad a nivel nacional, de allí que sea necesario para al futuro profesional de medicina, la adquisición de las competencias necesarias para poder diagnosticar a tiempo las patologías cardíacas; no obstante los estudiantes de medicina, consideran el tema de gran complejidad para su fácil comprensión. El objetivo de este trabajo consistió en diseñar una propuesta para optimizar el proceso de enseñanza-aprendizaje, haciendo uso de las herramientas informáticas básicas y basadas en los conocimientos previamente adquiridos por los estudiantes en el área de informática médica. La propuesta presentada se tipificó dentro de la modalidad de simulador, diseñándose un prototipo tipo multimedia; para ello se estipuló un plan de actividades en la cual se convino el análisis de las herramientas tecnológicas existentes, diseño instruccional de la asignatura y elaboración del guión técnico con las respectivas herramientas seleccionadas. La evaluación del prototipo arrojó resultados concluyentes en cuanto a la factibilidad de la aplicación de la propuesta y su pertinencia para la solución de la problemática planteada, demostrando ser factible su desarrollo e implementación como herramienta educativa, de bajo costo representado un valor agregado para la Universidad.

Cardiovascular diseases are the leading cause of morbidity and mortality worldwide. That makes it necessary for the future professional of medicine to acquire the skills needed to diagnose early cardiac pathology; however medical students, consider the subject of great complexity for easy understanding. The intention of this study was to design a proposal to optimize the teaching-learning process, as in the case of cardiac physiology area, using basic computer tools based on the knowledge previously acquired by students in the area of medical informatics. The proposal was typified in the simulator mode, designing a prototype media type. for it In the activities plan was agreed the analysis of existing technological tools, instructional design of the subject and technical script design with the respective selected tools. The prototype evaluation was conclusive as to the factibility of implementing the proposal and its relevance to the solution of the issues exposed above, proving to be factible to the development and implementation of an educational tool, of low cost, representing a aditional value. (AU)

Eletrocardiografia computadorizada em cães: estudo comparativo / Computerized electrocardiography in dogs: a comparative study

Computerized electrocardiography (C-EKG) has been more frequently used in Veterinary Medicine. Many equipment models are available for this purpose. Due to possible device sensitivity and reproducibility differences during examination, the main goal of this study was to compare electrocardiographic parameters of dogs using two different C-EKG systems: Wincardio Micromed® (WIN) and TEB ECGPC® (TEB). Forty two healthy male and female dogs of different breeds (Cocker Spaniel, Dachshund, Labrador, Pinscher, Pitbull Terrier, Poodle, Schnauzer, Shih Tzu, Yorkshire and mongrel dogs), with age between 4 months and 16 years old were grouped according to weight and evaluated by both systems. The electrocardiographic measurements were performed on DII lead for both systems. The study showed that the TEB system was more sensitive for measurement of P wave and QRS complex duration, while the WIN system showed more sensitivity for the measurements of amplitude of the same parameters. The larger animals (26-37kg) showed greater variance in the measurements of P wave and QRS complex amplitude and duration than the groups of medium (14-25kg) or smaller (3-13kg) dogs. These differences must be considered when using diverse computerized electrocardiography systems to perform measurements due to the possibility of erratic interpretation of the results between veterinary medicine services.

O método de eletrocardiografia computadorizada (ECG-C) vem sendo crescentemente difundido na medicina veterinária, havendo atualmente diversas marcas e modelos de eletrocardiógrafos disponíveis no mercado. Diante da possibilidade de diferenças na sensibilidade e na reprodutibilidade das medidas obtidas nos traçados, o presente estudo teve como objetivo comparar os parâmetros eletrocardiográficos de cães, obtidos por dois sistemas. Foram avaliados dois diferentes softwares computadorizados, o Wincardio Micromed® (WIN) e o modelo TEB ECGPC® (TEB). Quarenta e dois cães hígidos, de diferentes raças (Cocker Spaniel, Daschund, Labrador, Pinscher, Pit Bull Terrier Poodle, Schnauzer, Shit Tzu, Yorkshire e sem raça definida), machos e fêmeas e com idade entre 4 meses e 16 anos foram agrupados segundo o peso e examinados pelos dois sistemas. As medidas eletrocardiográficas dos diferentes traçados foram analisadas na derivação DII. Os resultados indicaram que o sistema TEB apresentou maior sensibilidade na obtenção das medidas de duração da onda P e do complexo QRS, enquanto o sistema WIN foi mais sensível para determinar as medidas de amplitude dos mesmos parâmetros. Os animais de maior porte (26-37kg) apresentaram maior variância nas medidas de duração e amplitude de onda P e duração do complexo QRS em comparação aos cães de médio (14-25kg) e pequeno (1-13kg) porte. O achado de diferenças entre os sistemas testados deve ser levado em consideração ao se empregar os diversos equipamentos para diagnóstico por meio de ECG-C na rotina clínica, de modo a evitarem-se divergências na interpretação dos exames entre diferentes prestadores de serviços veterinários.

A Case of Prolonged QT Interval Association with Galantamine / 고신대학교의과대학학술지

Among the Acetylcholinesterase inhibitors as used for Alzheimer's disease treatment, Galantamine has been recently developed and widely used owing to proven its clinical efficacy and safety. However, it has reported that prolonged QT interval, which can lead to ventricular arrythimias such as Torsade de points, has developed in Galantamine-treated patients. A 74-year-old female Alzheimer's patient been treated with galantamine for 8 months visited the hospital complaining about frequent dizziness. ECG monitor was performed promptly, it was informed that the prolonged QTc interval was increased 450 ms to 486 ms. So, we made her stop taking the galantamine, and after that QTc interval has normalized to 406 ms. In this article, we reported the first case on prolonged QT interval associated with galantamine in Korea.

Urban transmission of Chagas disease in Cochabamba, Bolivia

Chagas disease is a major public health problem in Bolivia. In the city of Cochabamba, 58 percent of the population lives in peripheral urban districts ("popular zones") where the infection prevalence is extremely high. From 1995 to 1999, we studied the demographics of Chagas infections in children from five to 13 years old (n = 2218) from the South zone (SZ) and North zone (NZ) districts, which differ in social, environmental, and agricultural conditions. Information gathered from these districts demonstrates qualitative and quantitative evidence for the active transmission of Trypanosoma cruzi in urban Cochabamba. Seropositivity was high in both zones (25 percent in SZ and 19 percent in NZ). We observed a high risk of infection in children from five to nine years old in SZ, but in NZ, a higher risk occurred in children aged 10-13, with odds ratio for infection three times higher in NZ than in SZ. This difference was not due to triatomine density, since more than 1,000 Triatoma infestans were captured in both zones, but was possibly secondary to the vector infection rate (79 percent in SZ and 37 percent in NZ). Electrocardiogram abnormalities were found to be prevalent in children and pre-adolescents (SZ = 40 percent, NZ = 17 percent), indicating that under continuous exposure to infection and re-infection, a severe form of the disease may develop early in life. This work demonstrates that T. cruzi infection should also be considered an urban health problem and is not restricted to the rural areas and small villages of Bolivia.

Evaluación del efecto antiarrítmico de propafenona en niños con taquicardia paroxística supraventricular / Evaluation of anti-arrhythmic effect of propafenone in children with supraventricular paroxistic tachycardia

Introducción. Las taquicardias supraventriculares (TSV) son arritmias tratadas con propafenona, debido a su utilidad en población pediátrica. Objetivo: evaluar el efecto antiarrítmico de propafenona, así como su farmacocinética en niños con TSV. Métodos. Se trata de un estudio prospectivo donde se incluyeron niños del servicio de cardiología con diagnóstico de TSV. La evolución clínica de los pacientes fue evaluada mediante monitoreo electrocardiográfico; además, se hizo un estudio farmacocinético de propafenona, utilizando un método de cromatografía de líquidos de alta resolución con detección por fluorescencia. Resultados. Se revisaron los expedientes de 85 niños con diagnóstico de TSV durante el período de 2000 a 2007; actualmente existen 11 pacientes que son tratados con propafenona, y en 3 de ellos se hizo el estudio farmacocinético. El estudio electrocardiográfico mostró trazos normales después del tratamiento con propafenona. Los parámetros farmacocinéticos del medicamento fueron similares a los reportados en estudios previos. Conclusiones. En los pacientes incluidos se observó remisión de la arritmia; además, sus parámetros farmacocinéticos fueron semejantes a los reportados en la literatura, por lo que el uso del medicamento puede ser considerado en niños con dicho padecimiento.

Introduction. Supraventricular tachycardia (SVT) involves arrhythmias treated with propafenone in children due to its utility. The aim of this study was to evaluate the anti-arrhythmic effect of propafenone as well as its pharmacokinetics in children with SVT. Methods. A prospective study was conducted in children with SVT. The evolution of their treatment with propafenone was followed by EKG monitoring. A pharmacokinetic study was carried out by using HPLC with fluorescence detection. Results. The files of 85 children with SVT from 2000 to 2007 were reviewed; currently 11 patients are treated with propafenone, Pharmacokinetics study was performed in 3 of the current patients. The EKG study showed regular registers after propafenone treatment. Propafenone pharmacokinetic parameters were similar to those reported previously. Conclusions. The patients included showed an arrhythmia remission, and their pharmacokinetic parameters were similar to those reported in the literature. Thus, the use of propafenone may be considered appropriate for SVT treatment in children.

Estudio comparativo de alteraciones electrocardiográficas, frecuencia cardiaca y presión arterial entre seropositivos y seronegativos para Trypanosoma cruzi en el valle de Vítor, Arequipa-Perú / Comparative study of electrocardiographic alterations, heart rate and arterial blood pressure between seropositives and seronegatives for Trypanosoma cruzi in valley of Vítor, Arequipa-Perú

Introducción: La forma clínica cardiaca es la principal causa de morbimortalidad de la enfermedad de Chagas, y su patogenia estaría relacionada con alteraciones del sistema nervioso autónomo que afectarían la fisiología cardiovascular. Objetivos: Comparar los valores de frecuencia cardiaca, presión arterial y las alteraciones electrocardiográficas de pobladores infectados con T. cruzi y sujetos control. Material y métodos: estudio analítico, observacional, transversal; realizado en el valle de Vítor de Arequipa en el período 2004-2005. Se estudiaron 75 voluntarios mayores de 15 años de edad, distribuidos en 25 seropositivos y 50 seronegativos para T. cruzi, pareados por edad y sexo. Se midió frecuencia cardiaca, presión arterial y se realizó electrocardiografía estándar, comparándose los resultados en ambos grupos. Resultados: Los valores de frecuencia cardiaca y presión arterial fueron similares entre los sujetos infectados con T. cruzi y los controles, al igual que la presencia de bradicardia sinusal, hipotensión e hipertensión arterial. En 40% de los sujetos seropositivos hubo alteraciones electrocardiográficas, y en sujetos control en 26% diferencia estadísticamente no significativa. Las alteraciones más frecuentes en ambos grupos fueron los cambios inespecíficos de repolarización, bradicardia sinusal, hemibloqueo anerior izquierdo, extrasistolias supraventriculares. Se presentó bloqueo completo de rama derecha y hemibloqueo anterior izquierdo en personas infectadas con T. cruzi menores de 40 años. Conclusiones: La prevalencia de alteraciones cardiovasculares fue similar en población infectada con T. cruzi y sujetos control. Las alteraciones al EKG más frecuentes no son las típicamente descritas en enfermedad de Chagas.

Introduction: the cardiac syndrome is the main cause of morbidty and mortality in Chagas disease, and its pathogenesis appears to be related to abnormalities of the autonomous nervous system which affect cardiovascular physiology. Objectives: to compare the values of heart rate ,blood pressure and electrocardiographic (EKG) abnormalities of the infected population with those of the control population. Materials and Methods: this is an analytic, observational, cross sectional study made in the valley of Vítor, Arequipa, from 2004 to 2005. Volunteers over 15 yearse of age ere studied: 25 T. cruzi seropositive an 50 T. cruzi seronegative persons. Examinations including heart rate, blood pressure and standard 12-lead EDGs were performed, comparing the results between the groups. Results: heart rate and blood pressure values were similar between seropositive subjects and their controls; the same was true of sinus bradycardia, hypotension and hypertension. EKG abnormalities were found in 40% of seropositives and 26% of the controls; the difference didn’t reach statistical significance. The EKG abnormalities detected most often in the 2 groups were nonspecific repolarization changes, sinus bradycardia, left anterior bundle block, and supraventricular estrasystoles. Complete right bundle block and partial left anterior bundle block were seen in seropositive persons under 40. Conclusions: the prevalence of cardiovascular abnormalities was similar between subjects infected with T. cruzi and their controls. The EKG abnormalities seen most frequently are different from those typically described in Chagas disease patients.

Review of non-surgical procedures in medical wards: From utilization review results to process improvement.

The Department of Medicine Utilization Review Committee undertook review of non-surgical procedures performed for in-patients in medical wards by examining records, results of orders, results and charges for 4 representative wards during a one-month period. Altogether 45 procedures were performed. Adequate documentations were identified in only 51.06% and 83.7% of order sheets and nurse progress notes, respectively. Loss incurred by failure to charge accounted for 11.82% of total charges. The 3 highest loss rates pertained to oxygen therapy, EKG, and Hudson’s nebulizer treatment. After a period of intensive campaigning as well as procedural record sheet implementation, the loss in charge was reduced to 7.98% while the completeness of documentation increased to 67.7% and 84.6% in order sheets and nurse progress notes, respectively. Among all procedures, EKG was the only one without improvement. This, a 2-month pilot study was then began to compare the loss rate between the usual EKG process done by ward staffs and one done by EKG nurses. The result showed near total completeness of documentation and charges, and a significantly increased net income. We concluded that utilization review should be performed routinely and results should enable an organization to take actual steps to modify its process in order to best use its resources.

Diagnosis of Coronary Artery Disease Based on Cost-effectiveness Analysis

Dlagnostic strategies for coronary artery disease are diverse and include 10 exercise EKG to coronary angiography, 20 myocardial SPECT to coronary angiography, dobutamine or exercise echocardiography to coronary angiography, and direct coronary angiography. Costeffectiveness analysis can be performed considering (1) that the cost should include the costs of the diagnostic tests themselves, the cost of notdiagnosing the patients, the final test costs on false positive patients, and the cost to treat complications and 20 that the effect should include qualityadjusted life year (QAEY) with the fraction of proper diagnosis influenced by the diagnostic performance of the initial noninvasive tests. Based on the prior costeffectiveness analysis, the pretest likelihood affected most of the costeffectiveness of a diagnostic strategy. Direct angiography was most costeffective when the pretest likelihood was high (>60%), while SPECT with or without a prior exercise EKG to angiography was most costeffective when the pretest likelihood was intermediate or low. Compared to stress echocardiography, stress myocardial SPECT was more costeffective when the likelihood was moderate or high. While the prognostic significance of negative (including falsenegative) cases was important to maintain costeffectiveness of a strategy, myocardial SPECT to coronary angiography was the most costeffective method to diagnose coronary artery disease.

Heart Diseases Prevalence of Elementary School Children in Kyonggi Province / 예방의학회지

OBJECTIVE: The heart diseases are known as a major cause of sudden death, as well as a cause of poor life-quality of school-age children. But there have been few mass screening of heart diseases in these children in Korea. This study was done to estimate the prevalence of heart diseases of these population. METHODS: We screened all elementary students(grade 1) in 12 cities and 16 counties(Gun) in Kyonggi province from 1992 to 1995. The first screening was done by auscultation of doctors and simultaneously by checking using 'auto-interpreter of EKG-cardiac sound'(Fukuda Densi ECP 50A). We conducted futher examinations to whom classified as being abnormal condition in first screening, by using EKG, chest x-ray, doppler echocardiograpy(if needed). RESULTS: The total number of examined students was 161,308(92% of the population), the male were 83,238 and female were 78,070. The congenital heart diseases(CHD) patients were 290(18 per 10,000) - male 155(18.6 per 10,000) and female 135(17.3 per 10,000). The most frequent disease was ventricula septal defect(VSD, 45.5%), Atrial septal defect(ASD, 14.8%), Tetralogy of Follot(TOF, 11.7%), and Patent Dutus Arteriosis(PDA, 7.6%) in order. In female, the order was VSD(48.1%), ASD(13.3%), TOF(11.1%), and PDA(10.4%). The total number of EKG abnormality were 433(62.7 per 10,000) among 69,056 screened children in 1995. The complete right bundle branch block(CRBBB) and paroxymal ventricular contraction(PVC) were frequent(26.6%, 26.3% in each), and incomplete right bunddle branch block(IRBBB,14.6%), paroxymal atrial contraction(PAC, 6.7%), abnormal Q(5.8%), Wolf-Pakinson-White syndrom (5.5%) in order. In female, the most frequent abnormality was PVC(29.8%), and CRBBB(19.9%) in order. CONCLUSION: We could present the stable prevalence of the rare heart disease. The prevalence of congenital heart diseases was 18.0 per 10,000 and of EKG abnormality was 62.7 per 10,000 among school children.

ST-Segment Displacement during Isoflurane and Enflurane Anesthesia / 대한마취과학회지

BACKGROUND: Isoflurane and enflurane have different activity on the cytoplasmic calcium movements of a cardiac muscle cell and a vascular smooth muscle cell. Isoflurane is less depressive in cardiac contraction, and more potent in vasodilation than enflurane. This study is to elucidate the effects of these anesthetics on the ST-segment displacement. METHODS: The anesthesia was induced by the intravenous injection of thiopental (6 mg.kg 1) and pipecuronium (0.1 mg.kg 1). The patients (n=80) undergoing tympanoplasty were randomly allocated to two groups for the maintenance METHODS: Group I was inhaled with isoflurane (1~2%), O2 (2 L.min 1), and N2O (2 L.min 1), Group II, enflurane (1.5~2.5%), O2 and N2O. Continuous electrocardiographic recordings with Holter monitor were made during anesthesia. The recordings were scanned on an Avionics Electrocardioscanner with particular emphasis on ST-segment changes. The criteria describe an episode as ST-segment displacement greater than or equal to 0.1 mV measured 80 ms from J-point lasting for more than 1 minutes. Mean heart rate was calculated. Results were categorized as induction, maintenance, and emergence, and inferred from unpaired t-test, x2-test, and Mann-Whitney U test with p<0.05 considered significant. RESULTS: Enflurane had higher incidence of ST-segment depression during induction, more maximally depressed ST-segment during maintenance and slower heart rate during induction and maintenance than isoflurane. CONCLUSION: It could be suggested that enflurane make stronger influence on the ST-segment depression than isoflurane. However, the clinical significance remains to be studied.

Electrosurgical Burn at the Site of EKG Electrode: A case report / 대한마취과학회지

In the operation room, members of the surgical team have the ultimate responsibility of safe guarding the patient from electrical devices. The electrosurgical unit is one instrument commonly used during surgical procedures. We have experienced accidental burning. Sixty-seven years-old patient received burn at the site of the ECG electrode which was caused by an electrocautery used in conjunction with electronic monitoring equipment. Although cutting and coagulation powers were very low, the normal size of the ECG electrodes led to the generation of a high current density. Prevention of interactions of this kind between properly functioning monitoring and surgical units requires good communication among all members of the operating room team and every electrical instruments should inspected, tested regularly.

Survival Analysis EKG Monitor and Anesthetic Machine in Operating Room / 대한마취과학회지

We have done survival analysis of the EKG monitor(from March, 1976 to February, 1993) and anesthetic machine(from February, 1915 to February, 1993) retrospectively in operating room at Severance hospital. Thirty eight EKG monitors and twenty eight anesthetic machines were included. Also EKG monitors were divided into two groups(one group was made in foreign country and another was made in Korea) and its survival function were compared. All statistics were treated with Product-limited estimate of survival function(Kaplan and Meier, 1958) with BMDP 1L. Mean survival time(+/-S.E) of all EKG monitor was 113.61(+/-5.70) months and the EKG made in foreign country was 106.65(+/-8.22) months and made in Korea was 113.35(+/-8.97) months. But there was no statistical differences between two groups. And mean survival time of anesthetic machine was shown to be 189.45(+/-6.09) months. It is advisable to replace aging machine before malfunction and failure to protect patients from mishaps stem from equipment failure. We conclude that life cycle of equipment for proper time to replace the equipment is not underestimated to reduce the accident by aging machine failure.

The Change of Late Potential in Acute Myocardial Infarction and the Influence of Patency of Infarct-Related Artery on Its Development

BACKGROUND: The restoration of anterograde flow in the infarct-related artery(IRA) may improve electrophysiological consequences and survival. Patients with occluded IRA are more likely than those with patent IRA to have late potentials on signal-averaged electrocardiogram(SAEKG). The natural history of late potentials in the acute phase after AMI was reported to vary in recent studies and requires further investigation. Therefore, we investigated 1) whether parameters of SAEKG and incidence of late potentials are changed in 2 weeks after AMI, and 2) whether the status of IRA, ejection fraction, ventricular premature beats(VPB) on Holter and the use of thrombolytic agent can influence the developement of late potentials. METHOD: SAEKGs were performed in 40 patients with acute myocardial infarction(AMI, mean age : 56.6yr) and 20 normal controls(mean age : 53.0yr). SAEKGs were recorded first in 48 hours and then 2 weeks after AMI. Late potential were considered to be positive if two of the three following criteria were identified : 1) duration of filtered QRS complex>118ms, 2) duration of HFLA signal>40 ms, and 3) RMS voltage<20microV. RESULT: 1) The duration of filtered QRS complex and HFLA signal in patients with AMI in 48 hours and 2 weeks were longer than in the controls(p<0.01, p<0.05. respectively), and the RMS voltage in only 2 weeks was lower than in the controls(p<0.05). 2) There was no significant difference in the 3 parameters of SAEKG between 48 hours and 2 weeks after AMI, but the incidence of late potentials increased from 35%(14/40) to 42.5%(17/40). Of the 26 patients with a normal initial SAEKG, 3(11.5%) had late potentials in 2 weeks, whereas none of the patients with positive late potentials on initial SAEKG was normalized in 2 weeks. 3) The ejection fraction, the degree of VPB on the Holter EKG and the history of thrombolyic therapy in patients whose late potentials were positive were not different from those in patients with normal SAEKG. 4) In the 3 parameters of SAEKG, RMS voltage in patients with occluded IRA was significantly lower than in those with open IRA(p<0.05), and the incidence of late potentials were higher in the patients with occluded IRA(75%) than in those with open IRA(28.6%)(p<0.05). CONCLUSION: The incidence of late potentials on SAEKG after AMI was modestly increased in 2 weeks, but the development of late potentials was not influenced by the degree of frequently in patients with occluded IRA. These findings may indicate that the development of late potential after AMI tends to increase even in 2 weeks, and that the occlusion in IRA may unfavorably alter the electrophysiological state identified by SAEKG.

Incidence of Cardiac Arrhythmias during anesthesia / 대한마취과학회지

The incidence of cardiac arrhythmias during anesthesia in a total 5,845 surgical patients who were admitted to Hanyang university hospital from Janury 1 to December 31, 1988 was investigated using on-line continuous EKG monitoring. The results were as follows: 1) Among study patients, 111 patients (1.9%) had pre-existing cardiac arrhythmias before anesthesia and showed significantly higher incidence of arrhythmias (49.5%) than that of patients without pre-existisng arrhythmias before anesthesia (2.9%). 2) Among arrhythmias found during anesthesia, most types of arrhythmias were ventricular premature contractions (77.4% in the patients with pre-existing cardiac arrhythmias and 43.6% in the patients without pre-existing cardiac arrhythmias) except sinus bradycardia and tachycardia. 3) Although the incidence of arrhythmias during the induction of anesthesia was similar to that during anesthesia maintenance, it was somewhat greater on the basis of incidence per unit time. 4) The incidence of arrhythmias was increased with age. 5) The incidence of arrhythmias when anesthesia was induced with halothane (3.7%) was greater than that when anesthesia was induced with enflurane (2.1%). 6) Most of the arrhythmias were controlled with sufficient ventilation and oxygen supply, adjusting concentration of inhaled anesthetics or changing anesthetics, and occasionally, intravenous admininstration of 1% lidocaine (1.0-1.5 mg/kg). Considering the above results, it may be an appropriate conclusion that the continuous on-line EKG monitoring during the induction and maintenance of anesthesia is a noninvasive and simple method for detecting early signs of cardiac arrhythmias and hemodynamic changes during anesthesia, and consequently, improving the overall efficiency of patient care. Therefore, we are impressed with an idea that the continuous EKG monitoring should be mandatory for all surgical patients to be anesthetized.

Advances in Bioengineering and Holter Monitoring in Future ; System Validation of Ambulatory EKG-Analysis System HP(Hewlett Packard) 43420A

In a systemvalidation of a ambulatory EKG analysis system we examined the HP 43420A ambulatory EKG analysis system(Fa.Hewlett packard, USA). The complete capture module 43405A with the applied software is able to record 24 hours events without single beat lable. Model 43400B patient analyzer records intermittant the EKG events and represents these in the Ambulatory EKG report. By means of the devices 31 patients were examined. Beat-to-beat analysis of the complete full disclosure is visually carried out. Sensitivity and postitve predictive value were 94(96)% and 100% for ventricular ectopic beat(VEB). The sensitivity amounted to 87% in the detecting of VEB pair(couplet), the positive predictive value 94%. VEB Run/VT(ventriular tachycardia) resulted in a sensitivity of 82% and in positive predictive value of 93%. The automatically edited Ambulatory EKG report with his EKG strips is representative of full disclosure and reliable in comparison with the analyzed results of full disclosure. The HP 43420A Ambulatory EKG Analysis system, a new and developed device with all digital recording system and full disclosure capability is found comparable to the best ones of the presently available Holter monitoring system.

Placement of CVP Catheter by EKG / 대한마취과학회지

Measurement of Central venous pressure is very helpful to assess, the circulating blood volume, venous tone and preload of right ventricle. To obtain an accurate CVP, the correct placement of a CVP catheter is mandatory, There are many means of identifing the correct placement of a CVP catheter which was inserted through the internal jugular vein, subclavian vein and other veins. Authors have chosen the method of intracardiac EKG, which was very easy and useful clinically. The placement of a CVP catheter by intracardiac EKG using modified Lead II was verified by postoperative chest X-ray.

THE TOXICITY OF XIXIN OIL AND ITS EFFECT ON EKG OF RABBITS / 中国药理学通报

Xixin [Asarum heterotropoides Fr. Schmidt Var mandshuricum ( Maxim ) kitag] is a Chinese drug which has a little toxicityas recorded in ancient Chinese medical books. It was demon-strated in this article that the toxicity of Xixin was caused by itsessential oil. When the mice were administered with Xixin oil and its decoction without oil in equal doses separately, the mortality rate for the oil group was 70%, whereas no death was observed in the group of decoction without oil. By synchronous recording the EKG and EEG of cerebral cortex, hippocampus and reticular formation of midbrain in the rabbits, it was revealed that the EKG underwent following changes after the administration of Xixin oil: fast wave of low amplitude→slow wave of high amplitude→slow wave of low amplit ude→burst-suppression pattern→electrical silence. EEG vanished after the electrical silence of cerebral cortex,hippocampus and midbrain reticular formation.The LD50 and ED50 of Xixin oil was calculated 27.0?0.4ml/kg and 18.3?0.8ml/kg respectively,safety coefficient 1.47, being significantly less than control drug sodium amytal.