Journal of electrocardiology
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Acute myocardial ischemia has several characteristic ECG findings, including clinically detectable ST-segment deviations. However, the sensitivity and specificity of diagnosis based on ST-segment changes are low. Furthermore, ST-segment deviations have been shown to be transient and spontaneously recover without any indication the ischemic event has subsided. ⋯ Our data show that remote ischemic signal recovery correlates with a recovery of the subepicardial myocardium, whereas subendocardial ischemic development persists.
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The Tiger Tech Warfighter Monitor (WFM) is a novel single-limb device for ECG acquisition. The WFM provides true (not derived) single limb Electrocardiogram monitoring (ECG) to provide heart rate and R-R interval monitoring between QRS complexes. Herein, we evaluate the diagnostic accuracy of the WFM heart rate, R-R interval monitoring, and heart rate variability monitoring in comparison to a 2‑lead chest ECG. ⋯ Results demonstrate that the WFM achieves excellent correlation with chest ECG for heart rate, R-R internals, and heart rate variability.
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Patients with LBBB of unknown onset presenting with chest pain can pose a diagnostic challenge in the ED while Smith-Modified-Sgarbossa (SMS) ECG criteria might facilitate AMI diagnosis. We demonstrate a case of a 79-year-old man that presented to the ED with chest pain. ⋯ The coronary angiogram showed the total occlusion of the culprit left anterior descending artery. In this case, awareness of SMS criteria aided in the early prehospital diagnosis of AMI in the setting of LBBB and impacted the course of treatment.
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Observational Study
Accuracy of intracoronary ECG parameters for myocardial ischemia detection.
The electrocardiogram (ECG) is a valuable diagnostic tool for the diagnosis of myocardial ischemia during acute coronary syndrome. Aside from the commonly used ST-segment shift indicative of ischemia, several other ECG parameters are pathophysiologically reasonable. Thus, the goal of this study was to assess the accuracy of different ischemia parameters as obtained by the highly susceptible intracoronary ECG (icECG). ⋯ When tested in a setting with artificially induced absolute myocardial ischemia, icECG ST-segment shift at a threshold of 0.365 mV most accurately distinguishes between absent and present ischemia.
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Observational Study
Effect of hydroxychloroquine, azithromycin and lopinavir/ritonavir on the QT corrected interval in patients with COVID-19.
Administration of Hydroxychloroquine and Azithromycin in patients with coronavirus disease 2019 (COVID-19) prolongs QTc corrected interval (QTc). The effect and safety of Lopinavir/Ritonavir in combination with these therapies have seldom been studied. ⋯ DT and TT prolong the QTc in patients with COVID-19. Addition of Lopinavir/Ritonavir on top of Hydroxychloroquine and Azithromycin did not increase QTc compared to DT.