Displaying publications 41 - 60 of 209 in total

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  1. Shah RP
    Singapore Med J, 2001 Feb;42(2):78-9.
    PMID: 11358196
    Congenital absence of the pericardium is a rare condition,which is frequently missed due its subtle presentation. It may be misdiagnosed as another condition causing right heart dilatation such as an intracardiac shunt. We report the finding of diastolic pressure alternans during cardiac catheterization in this single case report of a patient with congenital total absence of the pericardium. The occurrence of this phenomenon is hypothesized to be due to excessive cardiac hypermobility and paradoxical septal movement. We propose that this finding may be a useful clue to the diagnosis.
    Matched MeSH terms: Electrocardiography
  2. John AA, Subramanian AP, Jaganathan SK, Sethuraman B
    Indian Heart J, 2015 Nov-Dec;67(6):549-51.
    PMID: 26702684 DOI: 10.1016/j.ihj.2015.07.017
    To process the electrocardiogram (ECG) signals using MATLAB-based graphical user interface (GUI) and to classify the signals based on heart rate.
    Matched MeSH terms: Electrocardiography
  3. Ahmad A, Patel I, Asani H, Jagadeesan M, Parimalakrishnan S, Selvamuthukumaran S
    Indian J Pharmacol, 2015 Jan-Feb;47(1):90-4.
    PMID: 25821318 DOI: 10.4103/0253-7613.150360
    Antithrombotic therapy with heparin plus antiplatelets reduces the rate of ischemic events in patients with coronary heart disease. Low molecular weight heparin has a more predictable anticoagulant effect than standard unfractionated heparin, is easier to administer, does not require monitoring and is associated with less ADRs. The purpose of the present study was to evaluate and compare the clinical and cost outcomes of Enoxaparin with a standard unfractionated heparin in patients with coronary heart disease.
    Matched MeSH terms: Electrocardiography
  4. Chou YS, Lin HY, Weng YM, Goh ZNL, Chien CY, Fan HJ, et al.
    Intern Emerg Med, 2020 01;15(1):59-66.
    PMID: 30706252 DOI: 10.1007/s11739-019-02037-z
    Percutaneous coronary interventions (PCIs) within a door-to-balloon timing of 90 min have greatly decreased mortality and morbidity of ST-elevation myocardial infarction (STEMI) patients. Post-PCI, they are routinely transferred into the coronary care unit (CCU) regardless of the severity of their condition, resulting in frequent CCU overcrowding. This study assesses the feasibility of step-down units (SDUs) as an alternative to CCUs in the management of STEMI patients after successful PCI, to alleviate CCU overcrowding. Criteria of assessment include in-hospital complications, length of stay, cost-effectiveness, and patient outcomes up to a year after discharge from hospital. A retrospective case-control study was done using data of 294 adult STEMI patients admitted to the emergency departments of two training and research hospitals and successfully underwent primary PCI from 1 January 2014 to 31 December 2015. Patients were followed up for a year post-discharge. Student t test and χ2 test were done as univariate analysis to check for statistical significance of p 
    Matched MeSH terms: Electrocardiography/methods
  5. Gupta ED, Sakthiswary R
    Asian Cardiovasc Thorac Ann, 2014 May;22(4):397-401.
    PMID: 24771726 DOI: 10.1177/0218492313484917
    The objectives of this study were to determine the incidence of a myocardial infarction "false alarm" and evaluate the efficacy of the initial electrocardiogram and cardiac enzymes in diagnosing myocardial infarction in Malaysia.
    Matched MeSH terms: Electrocardiography*
  6. Subhani AR, Likun X, Saeed Malik A
    PMID: 23366661 DOI: 10.1109/EMBC.2012.6346700
    Cerebral activation and autonomic nervous system have importance in studies such as mental stress. The aim of this study is to analyze variations in EEG scalp potential which may influence autonomic activation of heart while playing video games. Ten healthy participants were recruited in this study. Electroencephalogram (EEG) and electrocardiogram (ECG) signals were measured simultaneously during playing video game and rest conditions. Sympathetic and parasympathetic innervations of heart were evaluated from heart rate variability (HRV), derived from the ECG. Scalp potential was measured by the EEG. The results showed a significant upsurge in the value theta Fz/alpha Pz (p<0.001) while playing game. The results also showed tachycardia while playing video game as compared to rest condition (p<0.005). Normalized low frequency power and ratio of low frequency/high frequency power were significantly increased while playing video game and normalized high frequency power sank during video games. Results showed synchronized activity of cerebellum and sympathetic and parasympathetic innervation of heart.
    Matched MeSH terms: Electrocardiography
  7. Hasfena Lamdin, Segaran Ramodran, Regidor III Dioso
    MyJurnal
    Introduction: In clinical settings, nurses are often the first to be called upon to perform ECG procedures and as such, it is imperative nurses can interpret and immediately report basic anomalies in electrocardiograms. In Universiti Malaysia Sabah (UMS), although student nurses are taught ECG both in theory and hands-on learning through sim- ulation, there is no study examining the extent of student’s knowledge-skill retention regarding ECG. This study is to determine the learning attitude, level of knowledge and skill retention on electrocardiography among student nurses in UMS. Methods: A study entails a descriptive cross-sectional design. Nonprobability purposive sampling was used, where 100 (N) nursing students (2nd year n=50, 3rd-year n= 50) with selection criteria of respondents with prior learning on ECG were recruited for the study. A validated questionnaire (Cronbach α=0.81) benchmarked from a previous study was used to assessed learning attitude, level of knowledge and practice (skills) regarding ECG. Results: 85% (n=80) of the student nurses in this study had good to fair level knowledge and 15% (n=15) scored poor level of knowledge regarding ECG. With regards to practice competency, 87% (n=87) had fair to good level and 13% (n=13) scored poor skill level regarding ECG. Learning attitude towards ECG was positive among 88% (n=88) with 12% having a negative stance on readiness towards learning ECG. Sub-analyses showed a strong positive correlation between knowledge on ECG and practice (r=0.64). Conclusion: There is fair to good learning attitude, knowledge, and practice competency regarding ECG among the majority of nursing students in this study but a small cohort of students in this study have competency deficit regarding ECG. The deficit may compromise their ability to report critical anomalies present in patient electrocardiograms and there is a need to address this knowledge- practice gap.
    Matched MeSH terms: Electrocardiography
  8. Teh HS, Tan HJ, Loo CY, Raymond AA
    Med J Malaysia, 2007 Jun;62(2):104-8.
    PMID: 18705439
    Epilepsy patients have a higher mortality rate than the general population. Sudden unexpected death in epilepsy (SUDEP) is a major cause of mortality for these patients. The possibility of cardiac involvement in the pathogenesis of SUDEP has been suggested by many previous studies. This study compared the QT interval in epilepsy patients and normal controls, and identified the factors that affected the QT interval. Standard 12-lead ECGs were recorded from 70 consecutive epilepsy patients from the neurology clinic of HUKM and 70 age, race and gender matched controls. The mean QT interval corrected for heart rate (QTc) was calculated and compared. The mean QTc among the epilepsy patients was 0.401 +/- 0.027s. It was significantly shorter than the QTc (0.420 +/- 0.027s) in the control group (p<0.0005). Thirty five epilepsy patients (50%) and 17 matched controls (24.3%) had a mean QTc shorter than 0.40s (p=0.001). Among the epilepsy patients, the mean QTc did not significantly differ between patients in the duration (F=0.836, p=0.438) of the epilepsy, frequency (F=0.273, p=0.845) and types of seizures (p=0.633). There was no significant difference in the mean QTc between the epilepsy patients on different number of antiepileptic agents (F=0.444, p=0.643). Patients with cryptogenic epilepsy had a mean QTc of 0.392 +/- 0.029s, which was significantly shorter than patients with symptomatic epilepsy (QTc = 0.410 +/- 0.027s, p = 0.015). The mean QTc of the same subjects showed no significant interobserver difference (p=0.661). This study, for the first time, demonstrates that epilepsy patients have a significantly shorter QTc than controls, particularly in the subgroup of patients with cryptogenic epilepsy.
    Study site: Neurology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Electrocardiography*
  9. Ong PK, Ramanathan M
    Med J Malaysia, 1987 Sep;42(3):215-6.
    PMID: 3506649
    We report a case of transient complete heart block with Stokes-Adams attack due to acute rheumatic fever. The patient was a 12-year old boy whose illness satisfied the criteria of acute rheumatic fever. A temporary transvenous cardiac pacer was necessary to tide him over the complete heart block. The rarity of this complication of acute rheumatic fever is highlighted.
    Matched MeSH terms: Electrocardiography
  10. Bakar AA, Lim YL, Wilson SJ, Fuentes M, Bertling K, Taimre T, et al.
    Physiol Meas, 2013 Feb;34(2):281-9.
    PMID: 23363933 DOI: 10.1088/0967-3334/34/2/281
    Optical sensing offers an attractive option for detection of surface biopotentials in human subjects where electromagnetically noisy environments exist or safety requirements dictate a high degree of galvanic isolation. Such circumstances may be found in modern magnetic resonance imaging systems for example. The low signal amplitude and high source impedance of typical biopotentials have made optical transduction an uncommon sensing approach. We propose a solution consisting of an electro-optic phase modulator as a transducer, coupled to a vertical-cavity surface-emitting laser and the self-mixing signal detected via a photodiode. This configuration is physically evaluated with respect to synthesized surface electrocardiographic (EKG) signals of varying amplitudes and using differing optical feedback regimes. Optically detected EKG signals using strong optical feedback show the feasibility of this approach and indicate directions for optimization of the electro-optic transducer for improved signal-to-noise ratios. This may provide a new means of biopotential detection suited for environments characterized by harsh electromagnetic interference.
    Matched MeSH terms: Electrocardiography/instrumentation*
  11. Murali A, Balu K, Paari V, Rajendiran G
    Med J Malaysia, 2011 Dec;66(5):499-500.
    PMID: 22390111
    A 38 year old gentleman presented with fever and right hypochondrial pain. On further evaluation he was detected to have an amoebic liver abscess (ALA) in the right lobe of the liver. The abscess yielded anchovy sauce pus on percutaneous drainage. Following the percutaneous drainage the patient developed tachycardia. Electrocardiogram revealed atrial flutter with rapid ventricular rate and ST elevation in all leads suggestive of pericarditis. The atrial flutter was reverted to sinus rhythm by cardioversion. The patient then had an uncomplicated convalescence. Amoebic pericarditis, though rare, is a serious complication of amoebic liver abscess. Pericardial complications are usually seen with left lobe liver abscess due to its proximity. Both pericarditis and cardiac arrhythmias due to amoebic liver abscess especially from right lobe are very rare.
    Matched MeSH terms: Electrocardiography
  12. Wickramatilake CM, Mohideen MR, Pathirana C
    Indian Heart J, 2017 02 12;69(2):291.
    PMID: 28460787 DOI: 10.1016/j.ihj.2017.02.002
    Matched MeSH terms: Electrocardiography*
  13. Joseph PG, Healey JS, Raina P, Connolly SJ, Ibrahim Q, Gupta R, et al.
    Cardiovasc Res, 2021 05 25;117(6):1523-1531.
    PMID: 32777820 DOI: 10.1093/cvr/cvaa241
    AIMS: To compare the prevalence of electrocardiogram (ECG)-documented atrial fibrillation (or flutter) (AF) across eight regions of the world, and to examine antithrombotic use and clinical outcomes.

    METHODS AND RESULTS: Baseline ECGs were collected in 153 152 middle-aged participants (ages 35-70 years) to document AF in two community-based studies, spanning 20 countries. Medication use and clinical outcome data (mean follow-up of 7.4 years) were available in one cohort. Cross-sectional analyses were performed to document the prevalence of AF and medication use, and associations between AF and clinical events were examined prospectively. Mean age of participants was 52.1 years, and 57.7% were female. Age and sex-standardized prevalence of AF varied 12-fold between regions; with the highest in North America, Europe, China, and Southeast Asia (270-360 cases per 100 000 persons); and lowest in the Middle East, Africa, and South Asia (30-60 cases per 100 000 persons) (P 

    Matched MeSH terms: Electrocardiography/trends
  14. Abdul-Kadir NA, Mat Safri N, Othman MA
    Comput Methods Programs Biomed, 2016 Nov;136:143-50.
    PMID: 27686711 DOI: 10.1016/j.cmpb.2016.08.021
    BACKGROUND: Atrial fibrillation (AF) can cause the formation of blood clots in the heart. The clots may move to the brain and cause a stroke. Therefore, this study analyzed the ECG features of AF and normal sinus rhythm signals for AF recognition which were extracted by using a second-order dynamic system (SODS) concept.
    OBJECTIVE: To find the appropriate windowing length for feature extraction based on SODS and to determine a machine learning method that could provide higher accuracy in recognizing AF.
    METHOD: ECG features were extracted based on a dynamic system (DS) that uses a second-order differential equation to describe the short-term behavior of ECG signals according to the natural frequency (ω), damping coefficient, (ξ), and forcing input (u). The extracted features were windowed into 2, 3, 4, 6, 8, and 10 second episodes to find the appropriate windowing size for AF signal processing. ANOVA and t-tests were used to determine the significant features. In addition, pattern recognition machine learning methods (an artificial neural network (ANN) and a support vector machine (SVM)) with k-fold cross validation (k-CV) were used to develop the ECG recognition system.
    RESULTS: Significant differences (p 
    Matched MeSH terms: Electrocardiography/methods*
  15. Abdul-Kadir NA, Mat Safri N, Othman MA
    Int J Cardiol, 2016 Nov 01;222:504-8.
    PMID: 27505342 DOI: 10.1016/j.ijcard.2016.07.196
    BACKGROUND: The feasibility study of the natural frequency (ω) obtained from a second-order dynamic system applied to an ECG signal was discovered recently. The heart rate for different ECG signals generates different ω values. The heart rate variability (HRV) and autonomic nervous system (ANS) have an association to represent cardiovascular variations for each individual. This study further analyzed the ω for different ECG signals with HRV for atrial fibrillation classification.

    METHODS: This study used the MIT-BIH Normal Sinus Rhythm (nsrdb) and MIT-BIH Atrial Fibrillation (afdb) databases for healthy human (NSR) and atrial fibrillation patient (N and AF) ECG signals, respectively. The extraction of features was based on the dynamic system concept to determine the ω of the ECG signals. There were 35,031 samples used for classification.

    RESULTS: There were significant differences between the N & NSR, N & AF, and NSR & AF groups as determined by the statistical t-test (p<0.0001). There was a linear separation at 0.4s(-1) for ω of both databases upon using the thresholding method. The feature ω for afdb and nsrdb falls within the high frequency (HF) and above the HF band, respectively. The feature classification between the nsrdb and afdb ECG signals was 96.53% accurate.

    CONCLUSIONS: This study found that features of the ω of atrial fibrillation patients and healthy humans were associated with the frequency analysis of the ANS during parasympathetic activity. The feature ω is significant for different databases, and the classification between afdb and nsrdb was determined.

    Matched MeSH terms: Electrocardiography/classification*
  16. Azarisman SM, Magdi YA, Noorfaizan S, Oteh M
    N Engl J Med, 2007 Nov 1;357(18):1873-4.
    PMID: 17978302 DOI: 10.1056/NEJMc070990
    Matched MeSH terms: Electrocardiography
  17. Oon YY, Koh KT, Khaw CS, Mohd Amin NH, Ong TK
    Med J Malaysia, 2019 08;74(4):328-330.
    PMID: 31424042
    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is primarily a familial disease with autosomal dominant inheritance. Incomplete penetrance and variable expression are common, resulting in broad disease spectrum. Three patterns of phenotypic expression have been described: (1) "classic" subtype, with predominant right ventricle involvement, (2) "left dominant" subtype, with early and dominant left ventricle involvement, and (3) "biventricular" subtype, with both ventricles equally affected. Genotypephenotype associations have been described, but there are other genetic and non-genetic factors that can affect disease expression. We describe two different phenotypic expressions of ARVC in a family.
    Matched MeSH terms: Electrocardiography
  18. Koh KT, Law WC, Zaw WM, Foo DHP, Tan CT, Steven A, et al.
    Europace, 2021 07 18;23(7):1016-1023.
    PMID: 33782701 DOI: 10.1093/europace/euab036
    AIMS: Atrial fibrillation (AF) is a preventable cause of ischaemic stroke but it is often undiagnosed and undertreated. The utility of smartphone electrocardiogram (ECG) for the detection of AF after ischaemic stroke is unknown. The aim of this study is to determine the diagnostic yield of 30-day smartphone ECG recording compared with 24-h Holter monitoring for detecting AF ≥30 s.

    METHODS AND RESULTS: In this multicentre, open-label study, we randomly assigned 203 participants to undergo one additional 24-h Holter monitoring (control group, n = 98) vs. 30-day smartphone ECG monitoring (intervention group, n = 105) using KardiaMobile (AliveCor®, Mountain View, CA, USA). Major inclusion criteria included age ≥55 years old, without known AF, and ischaemic stroke or transient ischaemic attack (TIA) within the preceding 12 months. Baseline characteristics were similar between the two groups. The index event was ischaemic stroke in 88.5% in the intervention group and 88.8% in the control group (P = 0.852). AF lasting ≥30 s was detected in 10 of 105 patients in the intervention group and 2 of 98 patients in the control group (9.5% vs. 2.0%; absolute difference 7.5%; P = 0.024). The number needed to screen to detect one AF was 13. After the 30-day smartphone monitoring, there was a significantly higher proportion of patients on oral anticoagulation therapy at 3 months compared with baseline in the intervention group (9.5% vs. 0%, P = 0.002).

    CONCLUSIONS: Among patients ≥55 years of age with a recent cryptogenic stroke or TIA, 30-day smartphone ECG recording significantly improved the detection of AF when compared with the standard repeat 24-h Holter monitoring.

    Matched MeSH terms: Electrocardiography; Electrocardiography, Ambulatory
  19. Quek DK, Khor PG, Ong SB
    Singapore Med J, 1992 Apr;33(2):177-81.
    PMID: 1621124
    Silent myocardial ischaemia is now well-recognised in patients with symptomatic coronary artery disease. Its pathogenesis remains speculative, though diminished sensitivity to pain is thought to be one of the mechanisms involved. Because cardiovascular autonomic dysfunction occurs frequently in diabetic patients, we postulate that it contributes towards painless myocardial ischaemia among them. Forty consecutive diabetic (type II) male patients and ten normal volunteers were studied. Using 5 previously-validated noninvasive tests for autonomic dysfunction, 14 of these diabetic men had definite autonomic neuropathy (at least 2 abnormal tests). All 50 subjects were then exercised on a motor-driven treadmill to either exhaustion or chest pains. Thirty-three diabetic subjects were tested positive, with significant (greater than 1 mm) ST segment depression over at least 2 contiguous leads. Of these, 18 were associated with typical angina but the other 15 stopped because of fatigue or exhaustion (ie painless). Thirteen subjects who had definite autonomic neuropathy (AN+) had positive exercise ECG tests-10 had painless ischaemia, and only 3 had angina. This contrasted with 15 patients who had painful ischaemia and 5 who had painless ischaemia among the group without (AN-)autonomic dysfunction (p = 0.0047, Fisher's exact test). There were no significant differences among the various groups for peak rate-pressure-product, all subjects attaining similar maximal oxygen consumption states during which ischaemic ST segment changes were noted (painful AN+: 21917 +/- 4753; painless AN+: 20117 +/- 6752; painful AN-: 16544 +/- 4063; painless AN-: 22220 +/- 4341, p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
    Matched MeSH terms: Electrocardiography
  20. Quek DK, Ong SB
    Singapore Med J, 1990 Apr;31(2):185-8.
    PMID: 2371586
    A 26-year old woman with congenital complete heart block and prolonged QT interval presented for the first time with syncopal attacks associated with torsade de pointes in adulthood. Cardioversion followed by overdrive pacing was needed to finally control the unstable rhythm. During episodes of non-capture, paraoxysms of torsade de pointes leading to ventricular flutter were recorded by a 24-hour ambulatory electrocardiographic monitoring. Beta-blockade and permanent ventricular pacing finally abolished both the syncopal attacks and the torsade phenomena. The prognosis of congenital complete heart block associated with QT prolongation resembles that of the Romano-Ward syndrome. Recognition of this variant would facilitate earlier treatment of this rare but potentially lethal disorder.
    Matched MeSH terms: Electrocardiography
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