Displaying publications 121 - 140 of 209 in total

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  1. Fulltext Student nurses’ knowledge and practice on performing and interpreting electrocardiography: a cross sectional study
    Hasfena Lamdin, Segaran Ramodran, Regidor III Dioso
    Malaysian Journal of Medicine and Health Sciences, 2020;16(105):57-0.
    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
  2. Fulltext Doppler echocardiography guided cardiac resynchronization therapy in heart failure
    Oemar, Hamed, Abdulgani, Hafil Budianto
    Medical Health Reviews, 2008;2008(1):17-28.
    MyJurnal
    Heart failure (HF) is a major burden in almost all countries. The prevalence of symptomatic HF is still high. Despite our best understanding of its pathophysiologic mechanisms and the recent advances in pharmacologic therapy, it remains a highmortality and morbidity disease. About 30-50% of patients with HF have concurrent electrical delay in the electrocardiogram (ECG), mainly in the form of LBBB.1 This kind of conduction delay commonly occurs in patients with idiopathic dilated cardiomyopathy and ischemic cardiomyopathy as well. The abnormality of left ventricle (LV) conduction will lead to a change in LV contraction pattern resulting dyssynchronized with right ventricle) contraction. Thus, a dyssynchronous LV contractile pattern usually manifested by late activation of the LV lateral wall which in turn impairs LV systolic function, reduces cardiac output, raises filling pressure and worsens mitral regurgitation2. Cardiac resynchronization therapy (CRT) improves cardiac function and exercise capacity leading to an improved survival in patients with advanced heart failure and ventricular conduction delay.3 The underlying mechanisms of these beneficial effects are not fully understood, but they appear to be related to a restored coordination of the left (LV) and right ventricular (RV) contraction and relaxation.4 These effects may directly lead to augmented contractility and reduction of LV filling pressures.5 Echocardiography has been widely used to identify patients who are candidates for CRT and to monitor the response in LV function at follow-up after device implantation. This review addresses the applications of CRT in patients with moderate– severe heart failure and the role of echocardiography in optimizing CRT including patient selection, risk and benefit of CRT and appropriate measures.
    Matched MeSH terms: Electrocardiography
  3. Ebstein's anomaly of the tricuspid valve: a report of 10 cases
    Anuar M, Singham KT
    Med J Malaysia, 1979 Dec;34(2):140-4.
    PMID: 548715
    Matched MeSH terms: Electrocardiography
  4. Ventricular septal defect--autopsy study of 46 cases
    Loh TF
    Med J Malaya, 1970 Jun;24(4):257-60.
    PMID: 4248345
    Matched MeSH terms: Electrocardiography
  5. Application of an optimal class of antisymmetric wavelet filter banks for obstructive sleep apnea diagnosis using ECG signals
    Sharma M, Agarwal S, Acharya UR
    Comput Biol Med, 2018 09 01;100:100-113.
    PMID: 29990643 DOI: 10.1016/j.compbiomed.2018.06.011
    Obstructive sleep apnea (OSA) is a sleep disorder caused due to interruption of breathing resulting in insufficient oxygen to the human body and brain. If the OSA is detected and treated at an early stage the possibility of severe health impairment can be mitigated. Therefore, an accurate automated OSA detection system is indispensable. Generally, OSA based computer-aided diagnosis (CAD) system employs multi-channel, multi-signal physiological signals. However, there is a great need for single-channel bio-signal based low-power, a portable OSA-CAD system which can be used at home. In this study, we propose single-channel electrocardiogram (ECG) based OSA-CAD system using a new class of optimal biorthogonal antisymmetric wavelet filter bank (BAWFB). In this class of filter bank, all filters are of even length. The filter bank design problem is transformed into a constrained optimization problem wherein the objective is to minimize either frequency-spread for the given time-spread or time-spread for the given frequency-spread. The optimization problem is formulated as a semi-definite programming (SDP) problem. In the SDP problem, the objective function (time-spread or frequency-spread), constraints of perfect reconstruction (PR) and zero moment (ZM) are incorporated in their time domain matrix formulations. The global solution for SDP is obtained using interior point algorithm. The newly designed BAWFB is used for the classification of OSA using ECG signals taken from the physionet's Apnea-ECG database. The ECG segments of 1 min duration are decomposed into six wavelet subbands (WSBs) by employing the proposed BAWFB. Then, the fuzzy entropy (FE) and log-energy (LE) features are computed from all six WSBs. The FE and LE features are classified into normal and OSA groups using least squares support vector machine (LS-SVM) with 35-fold cross-validation strategy. The proposed OSA detection model achieved the average classification accuracy, sensitivity, specificity and F-score of 90.11%, 90.87% 88.88% and 0.92, respectively. The performance of the model is found to be better than the existing works in detecting OSA using the same database. Thus, the proposed automated OSA detection system is accurate, cost-effective and ready to be tested with a huge database.
    Matched MeSH terms: Electrocardiography
  6. Fulltext Wellen's syndrome: Challenges in diagnosis
    Agarwal A, Vyas S, Kumar R
    Malays Fam Physician, 2015;10(3):35-7.
    PMID: 27570607
    Wellen's syndrome is a pre-infarction stage of coronary artery disease characterised by predefined clinical and electrocardiographic (ECG) criteria of a subgroup of patients with myocardial ischaemia. Early recognition and appropriate intervention of this syndrome carry significant diagnostic and prognostic value. We report this unusual syndrome in an elderly man who presented with recurrent angina and characteristic ECG changes as T-waves inversion in the precordial leads, especially in V2-V6 during pain-free periods and ECG obtained during episodes of pain demonstrating upright T-waves with possible elevated ST segments from V1-V4. Cardiac enzymes were positive and coronary angiography revealed critical stenosis in the proximal left anterior descending artery. It is important to timely identify this condition and intervene appropriately as these patients may develop extensive myocardial infarction that carries a significant morbidity and mortality.
    Matched MeSH terms: Electrocardiography
  7. A review of automated sleep stage scoring based on physiological signals for the new millennia
    Faust O, Razaghi H, Barika R, Ciaccio EJ, Acharya UR
    Comput Methods Programs Biomed, 2019 Jul;176:81-91.
    PMID: 31200914 DOI: 10.1016/j.cmpb.2019.04.032
    BACKGROUND AND OBJECTIVE: Sleep is an important part of our life. That importance is highlighted by the multitude of health problems which result from sleep disorders. Detecting these sleep disorders requires an accurate interpretation of physiological signals. Prerequisite for this interpretation is an understanding of the way in which sleep stage changes manifest themselves in the signal waveform. With that understanding it is possible to build automated sleep stage scoring systems. Apart from their practical relevance for automating sleep disorder diagnosis, these systems provide a good indication of the amount of sleep stage related information communicated by a specific physiological signal.

    METHODS: This article provides a comprehensive review of automated sleep stage scoring systems, which were created since the year 2000. The systems were developed for Electrocardiogram (ECG), Electroencephalogram (EEG), Electrooculogram (EOG), and a combination of signals.

    RESULTS: Our review shows that all of these signals contain information for sleep stage scoring.

    CONCLUSIONS: The result is important, because it allows us to shift our research focus away from information extraction methods to systemic improvements, such as patient comfort, redundancy, safety and cost.

    Matched MeSH terms: Electrocardiography
  8. Fulltext Hyperthyroidism presenting as ST Elevation Myocardial Infarction with Normal Coronaries - A Case Report
    Krishnan GD, Yahaya N, Yahya M
    J ASEAN Fed Endocr Soc, 2019;34(1):92-94.
    PMID: 33442142 DOI: 10.15605/jafes.034.01.14
    A 31-year-old male, apparently well, presented with typical chest pain. His ECG showed ST-elevation from V1-V4 and echocardiogram revealed anteroseptal wall hypokinesia with ejection fraction of 45%. Normal coronary arteries were seen on coronary angiogram. A thyroid function test showed elevated free T4 levels with suppressed thyroid stimulating hormone (TSH). Treatment with thionamides and beta-blockers improved symptoms. Upon review 4 months later he was well. Repeat echocardiogram showed good ejection fraction with no hypokinetic area.
    Matched MeSH terms: Electrocardiography
  9. Primary cardiac amyloidosis
    Jeyamalar R, Pathmanathan R, Yap SF, Kannan P
    Ann Acad Med Singap, 1991 Nov;20(6):795-7.
    PMID: 1803972
    Cardiac amyloidosis is an uncommon and often unrecognised cause of cardiac failure. It is an infiltrative disease that may mimic either a restrictive or hypertrophic cardiomyopathy, constrictive pericarditis, coronary artery disease or valvular heart disease. The diagnosis should be suspected in a patient with cardiac failure who has low voltage complexes on the electrocardiogram, in association with increased myocardial mass and echogenicity on the echocardiogram. The definitive diagnosis, however, can only be made by endomyocardial biopsy or biopsy of any involved organ in systemic amyloidosis. Prognosis is poor and treatment ineffective.
    Matched MeSH terms: Electrocardiography
  10. The clinical benefit of cardiac resynchronization therapy for narrow QRS compared to broad QRS complex patients
    Yap LB, Qadir F, Nguyen ST, Ma SK, Koh KW, Muhammad Z, et al.
    Int J Cardiol, 2015 Mar 15;183:178-9.
    PMID: 25666128 DOI: 10.1016/j.ijcard.2015.01.042
    Matched MeSH terms: Electrocardiography/methods
  11. Drowsiness detection during different times of day using multiple features
    Sahayadhas A, Sundaraj K, Murugappan M
    Australas Phys Eng Sci Med, 2013 Jun;36(2):243-50.
    PMID: 23719977 DOI: 10.1007/s13246-013-0200-6
    Driver drowsiness has been one of the major causes of road accidents that lead to severe trauma, such as physical injury, death, and economic loss, which highlights the need to develop a system that can alert drivers of their drowsy state prior to accidents. Researchers have therefore attempted to develop systems that can determine driver drowsiness using the following four measures: (1) subjective ratings from drivers, (2) vehicle-based measures, (3) behavioral measures and (4) physiological measures. In this study, we analyzed the various factors that contribute towards drowsiness. A total of 15 male subjects were asked to drive for 2 h at three different times of the day (00:00-02:00, 03:00-05:00 and 15:00-17:00 h) when the circadian rhythm is low. The less intrusive physiological signal measurements, ECG and EMG, are analyzed during this driving task. Statistically significant differences in the features of ECG and sEMG signals were observed between the alert and drowsy states of the drivers during different times of day. In the future, these physiological measures can be fused with vision-based measures for the development of an efficient drowsiness detection system.
    Matched MeSH terms: Electrocardiography/methods*
  12. Fulltext An Asian validation of the TIMI risk score for ST-segment elevation myocardial infarction
    Selvarajah S, Fong AY, Selvaraj G, Haniff J, Uiterwaal CS, Bots ML
    PLoS One, 2012;7(7):e40249.
    PMID: 22815733 DOI: 10.1371/journal.pone.0040249
    Risk stratification in ST-elevation myocardial infarction (STEMI) is important, such that the most resource intensive strategy is used to achieve the greatest clinical benefit. This is essential in developing countries with wide variation in health care facilities, scarce resources and increasing burden of cardiovascular diseases. This study sought to validate the Thrombolysis In Myocardial Infarction (TIMI) risk score for STEMI in a multi-ethnic developing country.
    Matched MeSH terms: Electrocardiography*
  13. Fulltext Fetal supraventricular tachycardia--a case report
    Soh EBS, Raman S, Chia PMK
    Med J Malaysia, 1998 Sep;53(3):280-3.
    PMID: 10968167
    A gravid patient with fetal supraventricular tachycardia is presented. A review of this rare condition and the present recommended mode of therapy are discussed.
    Matched MeSH terms: Electrocardiography*
  14. Real-time signal processing for fetal heart rate monitoring
    Ibrahimy MI, Ahmed F, Mohd Ali MA, Zahedi E
    IEEE Trans Biomed Eng, 2003 Feb;50(2):258-62.
    PMID: 12665042
    An algorithm based on digital filtering, adaptive thresholding, statistical properties in the time domain, and differencing of local maxima and minima has been developed for the simultaneous measurement of the fetal and maternal heart rates from the maternal abdominal electrocardiogram during pregnancy and labor for ambulatory monitoring. A microcontroller-based system has been used to implement the algorithm in real-time. A Doppler ultrasound fetal monitor was used for statistical comparison on five volunteers with low risk pregnancies, between 35 and 40 weeks of gestation. Results showed an average percent root mean square difference of 5.32% and linear correlation coefficient from 0.84 to 0.93. The fetal heart rate curves remained inside a +/- 5-beats-per-minute limit relative to the reference ultrasound method for 84.1% of the time.
    Matched MeSH terms: Electrocardiography, Ambulatory/methods*
  15. Smartphone electrocardiogram for QT interval monitoring in Coronavirus Disease 2019 (COVID-19) patients treated with Hydroxychloroquine
    Andy Ko TY, Chen LS, Pang IX, Ling HS, Wong TC, Sia Tonnii LL, et al.
    Med J Malaysia, 2021 03;76(2):125-130.
    PMID: 33742617
    INTRODUCTION: The global pandemic of Corona Virus Disease 2019 (COVID-19) has led to the re-purposing of medications, such as hydroxychloroquine and lopinavir-ritonavir in the treatment of the earlier phase of COVID-19 before the recognized benefit of steroids and antiviral. We aim to explore the corrected QT (QTc) interval and 'torsadogenic' potential of hydroxychloroquine and lopinavir-ritonavir utilising a combination of smartphone electrocardiogram and 12-lead electrocardiogram monitoring.

    MATERIALS AND METHODS: Between 16-April-2020 to 30-April- 2020, patients with suspected or confirmed for COVID-19 indicated for in-patient treatment with hydroxychloroquine with or without lopinavir-ritonavir to the Sarawak General Hospital were monitored with KardiaMobile smartphone electrocardiogram (AliveCor®, Mountain View, CA) or standard 12-lead electrocardiogram. The baseline and serial QTc intervals were monitored till the last dose of medications or until the normalization of the QTc interval.

    RESULTS: Thirty patients were treated with hydroxychloroquine, and 20 (66.7%) patients received a combination of hydroxychloroquine and lopinavir-ritonavir therapy. The maximum QTc interval was significantly prolonged compared to baseline (434.6±28.2msec vs. 458.6±47.1msec, p=0.001). The maximum QTc interval (456.1±45.7msec vs. 464.6±45.2msec, p=0.635) and the delta QTc (32.6±38.5msec vs. 26.3±35.8msec, p=0.658) were not significantly different between patients on hydroxychloroquine or a combination of hydroxychloroquine and lopinavir-ritonavir. Five (16.7%) patients had QTc of 500msec or more. Four (13.3%) patients required discontinuation of hydroxychloroquine and 3 (10.0%) patients required discontinuation of lopinavirritonavir due to QTc prolongation. However, no torsade de pointes was observed.

    CONCLUSIONS: QTc monitoring using smartphone electrocardiogram was feasible in COVID-19 patients treated with hydroxychloroquine with or without lopinavir-ritonavir. The usage of hydroxychloroquine and lopinavir-ritonavir resulted in QTc prolongation, but no torsade de pointes or arrhythmogenic death was observed.

    Matched MeSH terms: Electrocardiography*
  16. Automated diagnosis of congestive heart failure using dual tree complex wavelet transform and statistical features extracted from 2s of ECG signals
    Sudarshan VK, Acharya UR, Oh SL, Adam M, Tan JH, Chua CK, et al.
    Comput Biol Med, 2017 04 01;83:48-58.
    PMID: 28231511 DOI: 10.1016/j.compbiomed.2017.01.019
    Identification of alarming features in the electrocardiogram (ECG) signal is extremely significant for the prediction of congestive heart failure (CHF). ECG signal analysis carried out using computer-aided techniques can speed up the diagnosis process and aid in the proper management of CHF patients. Therefore, in this work, dual tree complex wavelets transform (DTCWT)-based methodology is proposed for an automated identification of ECG signals exhibiting CHF from normal. In the experiment, we have performed a DTCWT on ECG segments of 2s duration up to six levels to obtain the coefficients. From these DTCWT coefficients, statistical features are extracted and ranked using Bhattacharyya, entropy, minimum redundancy maximum relevance (mRMR), receiver-operating characteristics (ROC), Wilcoxon, t-test and reliefF methods. Ranked features are subjected to k-nearest neighbor (KNN) and decision tree (DT) classifiers for automated differentiation of CHF and normal ECG signals. We have achieved 99.86% accuracy, 99.78% sensitivity and 99.94% specificity in the identification of CHF affected ECG signals using 45 features. The proposed method is able to detect CHF patients accurately using only 2s of ECG signal length and hence providing sufficient time for the clinicians to further investigate on the severity of CHF and treatments.
    Matched MeSH terms: Electrocardiography/methods*
  17. Automated characterization of cardiovascular diseases using relative wavelet nonlinear features extracted from ECG signals
    Adam M, Oh SL, Sudarshan VK, Koh JE, Hagiwara Y, Tan JH, et al.
    Comput Methods Programs Biomed, 2018 Jul;161:133-143.
    PMID: 29852956 DOI: 10.1016/j.cmpb.2018.04.018
    Cardiovascular diseases (CVDs) are the leading cause of deaths worldwide. The rising mortality rate can be reduced by early detection and treatment interventions. Clinically, electrocardiogram (ECG) signal provides useful information about the cardiac abnormalities and hence employed as a diagnostic modality for the detection of various CVDs. However, subtle changes in these time series indicate a particular disease. Therefore, it may be monotonous, time-consuming and stressful to inspect these ECG beats manually. In order to overcome this limitation of manual ECG signal analysis, this paper uses a novel discrete wavelet transform (DWT) method combined with nonlinear features for automated characterization of CVDs. ECG signals of normal, and dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM) and myocardial infarction (MI) are subjected to five levels of DWT. Relative wavelet of four nonlinear features such as fuzzy entropy, sample entropy, fractal dimension and signal energy are extracted from the DWT coefficients. These features are fed to sequential forward selection (SFS) technique and then ranked using ReliefF method. Our proposed methodology achieved maximum classification accuracy (acc) of 99.27%, sensitivity (sen) of 99.74%, and specificity (spec) of 98.08% with K-nearest neighbor (kNN) classifier using 15 features ranked by the ReliefF method. Our proposed methodology can be used by clinical staff to make faster and accurate diagnosis of CVDs. Thus, the chances of survival can be significantly increased by early detection and treatment of CVDs.
    Matched MeSH terms: Electrocardiography*
  18. Diastolic dysfunction grading, echocardiographic and electrocardiogram findings in 50 patients with apical hypertrophic cardiomyopathy
    Aslannif R, Suraya K, Koh HB, Tey YS, Tan KL, Tham CH, et al.
    Med J Malaysia, 2019 12;74(6):521-526.
    PMID: 31929479
    INTRODUCTION: Apical Hypertrophic Cardiomyopathy (Apical HCM) is an uncommon variant of hypertrophic cardiomyopathy, but it is relatively more common in Asian countries. This is a retrospective, non-randomised, single centre study of patients with Apical HCM focusing on their diastolic dysfunction grading, echocardiographic parameters and electrocardiograms (ECG).

    METHODS: All Apical HCM patients coming for clinic visits at the Institut Jantung Negara from September 2017 to September 2018 were included. We assessed their echocardiography images, grade their diastolic function and reviewed their ECG on presentation.

    RESULTS: Fifty patient were included, 82% (n=41) were males and 18% (n=9) females. The diastolic function grading of 37 (74%) patients were able to be determined using the updated 2016 American Society of Echocardiography (ASE) diastolic guidelines. Fifty percent (n=25) had the typical ace-ofspades shape left ventricle (LV) appearance in diastole and 12% (n=6) had apical pouch. All patients had T inversion in the anterior leads of their ECG, and only 52% (n=26) fulfilled the ECG left ventricular hypertrophy (LVH) criteria. Majority of our patients presented with symptoms of chest pain (52%, n=26) and dyspnoea (42%, n=21).

    CONCLUSION: The updated 2016 ASE guideline makes it easier to evaluate LV diastolic function in most patients with Apical HCM. It also helps in elucidating the aetiology of dyspnoea, based on left atrial pressure. Clinicians should have a high index of suspicion for Apical HCM when faced with deep T inversion on ECG, in addition to a thick LV apex with an aceof- spades appearance during diastole.

    Matched MeSH terms: Electrocardiography/methods*
  19. Fulltext A comparison of long-term outcomes between narrow and broad QRS complex patients treated with cardiac resynchronization therapy
    Yap LB, Nguyen ST, Qadir F, Ma SK, Muhammad Z, Koh KW, et al.
    Acta Cardiol, 2016 Jun;71(3):323-30.
    PMID: 27594128 DOI: 10.2143/AC.71.3.3152093
    Matched MeSH terms: Electrocardiography/methods*
  20. Myocardial infarction false alarm: initial electrocardiogram and cardiac enzymes
    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*
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