Displaying publications 121 - 140 of 212 in total

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  1. 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
  2. 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
  3. Fulltext EE-6S: an integrated approach for introducing early clinical exposure in the new Egyptian medical curriculum
    Seif AA, Eldamanhoury HM, Darahim K, Boulos DNK, Bahaa N, A M C, et al.
    Adv Physiol Educ, 2021 Mar 01;45(1):109-120.
    PMID: 33544038 DOI: 10.1152/advan.00166.2020
    The electrocardiogram (ECG) is the primary diagnostic tool in cardiovascular diseases. Hence its interpretation is a core competency in medicine, where obvious deficiencies have been reported among learners. The aim of this study was to introduce the fundamentals of ECG knowledge and interpretation through early clinical exposure (ECE) based on a six-step approach for preclinical students (n = 110) and to study its influence on their knowledge and interpretation skills thereafter. The first step employed a blended learning format using didactic lectures on normal and pathological ECGs, each preceded by preinstructional videos. The second step focused on psychomotor skills and utilized laboratory exercises for ECG recording and interpretation. The third step focused on vertical integration, where the clinical relevance of the procedure was established with integrated lectures. The fourth step used the Moodle platform, where opportunities for peer interactions and clarifications by clinical faculty were made available. The fifth step incorporated clinical and diagnostic reasoning through cardiology ward visits and interpretation of patient ECGs. The sixth step was designed for critical thinking and problem solving through case-based discussions with peers and faculty. Students were assessed with multiple-choice questions and objective structured practical examination. Learner perceptions of the approach were evaluated with a feedback questionnaire and focus group discussion. Statistical analysis showed that ECE through a six-step approach significantly enhanced knowledge and interpretation of ECG as evidenced by the pre- and posttest scores. Analysis of the focus group data revealed that learner engagement and skills of critical thinking were enhanced along with diagnostic and clinical reasoning.
    Matched MeSH terms: Electrocardiography
  4. Fulltext Basic technology and proper usage of home health monitoring devices
    Mondal H, Mondal S
    Malays Fam Physician, 2021 Mar 25;16(1):8-14.
    PMID: 33948137 DOI: 10.51866/rv1097
    Home health monitoring devices are consumer-grade devices that help to monitor the health of individuals at home. These devices are usually low-cost and easily procurable, and they can be operated by patients or their caretakers with minimal training. However, improper usage of these devices may provide erroneous results, which can lead to an unnecessary hospital visit or teleconsultation. In this article, we discuss the basic technology and proper usage of some of these devices, namely automatic blood pressure monitors, blood glucose monitors, body fat monitors, pulse oximeters, electrocardiographs, digital thermometers, and infrared thermometers. This brief document intends to help primary health care professionals and their patients use these devices.
    Matched MeSH terms: Electrocardiography
  5. 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
  6. Ventricular bigeminy following a cobra envenomation
    Ismail AK, Weinstein SA, Auliya M, Appareo P
    Clin Toxicol (Phila), 2012 Jul;50(6):518-21.
    PMID: 22702902 DOI: 10.3109/15563650.2012.696119
    Envenoming by some species of cobras (Naja species) may include cardiotoxic effects including various dysrhythmias. However, dysrhythmias leading specifically to ventricular bigeminy have not been previously documented. We report a case of cardiotoxicity and the development of ventricular bigeminy following a cobra envenomation.
    Matched MeSH terms: Electrocardiography
  7. Multi-sources data fusion framework for remote triage prioritization in telehealth
    Salman OH, Rasid MF, Saripan MI, Subramaniam SK
    J Med Syst, 2014 Sep;38(9):103.
    PMID: 25047520 DOI: 10.1007/s10916-014-0103-4
    The healthcare industry is streamlining processes to offer more timely and effective services to all patients. Computerized software algorithm and smart devices can streamline the relation between users and doctors by providing more services inside the healthcare telemonitoring systems. This paper proposes a multi-sources framework to support advanced healthcare applications. The proposed framework named Multi Sources Healthcare Architecture (MSHA) considers multi-sources: sensors (ECG, SpO2 and Blood Pressure) and text-based inputs from wireless and pervasive devices of Wireless Body Area Network. The proposed framework is used to improve the healthcare scalability efficiency by enhancing the remote triaging and remote prioritization processes for the patients. The proposed framework is also used to provide intelligent services over telemonitoring healthcare services systems by using data fusion method and prioritization technique. As telemonitoring system consists of three tiers (Sensors/ sources, Base station and Server), the simulation of the MSHA algorithm in the base station is demonstrated in this paper. The achievement of a high level of accuracy in the prioritization and triaging patients remotely, is set to be our main goal. Meanwhile, the role of multi sources data fusion in the telemonitoring healthcare services systems has been demonstrated. In addition to that, we discuss how the proposed framework can be applied in a healthcare telemonitoring scenario. Simulation results, for different symptoms relate to different emergency levels of heart chronic diseases, demonstrate the superiority of our algorithm compared with conventional algorithms in terms of classify and prioritize the patients remotely.
    Matched MeSH terms: Electrocardiography
  8. Fetal heart rate monitoring based on independent component analysis
    Najafabadi FS, Zahedi E, Mohd Ali MA
    Comput Biol Med, 2006 Mar;36(3):241-52.
    PMID: 16446158
    In this paper, an algorithm based on independent component analysis (ICA) for extracting the fetal heart rate (FHR) from maternal abdominal electrodes is presented. Three abdominal ECG channels are used to extract the FHR in three steps: first preprocessing procedures such as DC cancellation and low-pass filtering are applied to remove noise. Then the algorithm for multiple unknown source extraction (AMUSE) algorithm is fed to extract the sources from the observation signals include fetal ECG (FECG). Finally, FHR is extracted from FECG. The method is shown to be capable of completely revealing FECG R-peaks from observation leads even with a SNR=-200dB using semi-synthetic data.
    Matched MeSH terms: Electrocardiography
  9. Takotsubo cardiomyopathy in association with hyperthyroidism
    Zuhdi AS, Yaakob ZH, Sadiq MA, Ismail MD, Undok AW, Ahmad WA
    Medicina (Kaunas), 2011;47(4):219-21.
    PMID: 21829054
    Takotsubo cardiomyopathy is a rare, acute, nonischemic cardiomyopathy causing transient left ventricular dysfunction, which can mimic myocardial infarction on its presentation. While many cardiac manifestations have been associated with hyperthyroidism, we report a rare case where it has precipitated takotsubo cardiomyopathy.
    Matched MeSH terms: Electrocardiography
  10. Fulltext Myocardial infarction induced by appetite suppressants in Malaysia
    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
  11. Arrhythmia recognition and classification using combined linear and nonlinear features of ECG signals
    Elhaj FA, Salim N, Harris AR, Swee TT, Ahmed T
    Comput Methods Programs Biomed, 2016 Apr;127:52-63.
    PMID: 27000289 DOI: 10.1016/j.cmpb.2015.12.024
    Arrhythmia is a cardiac condition caused by abnormal electrical activity of the heart, and an electrocardiogram (ECG) is the non-invasive method used to detect arrhythmias or heart abnormalities. Due to the presence of noise, the non-stationary nature of the ECG signal (i.e. the changing morphology of the ECG signal with respect to time) and the irregularity of the heartbeat, physicians face difficulties in the diagnosis of arrhythmias. The computer-aided analysis of ECG results assists physicians to detect cardiovascular diseases. The development of many existing arrhythmia systems has depended on the findings from linear experiments on ECG data which achieve high performance on noise-free data. However, nonlinear experiments characterize the ECG signal more effectively sense, extract hidden information in the ECG signal, and achieve good performance under noisy conditions. This paper investigates the representation ability of linear and nonlinear features and proposes a combination of such features in order to improve the classification of ECG data. In this study, five types of beat classes of arrhythmia as recommended by the Association for Advancement of Medical Instrumentation are analyzed: non-ectopic beats (N), supra-ventricular ectopic beats (S), ventricular ectopic beats (V), fusion beats (F) and unclassifiable and paced beats (U). The characterization ability of nonlinear features such as high order statistics and cumulants and nonlinear feature reduction methods such as independent component analysis are combined with linear features, namely, the principal component analysis of discrete wavelet transform coefficients. The features are tested for their ability to differentiate different classes of data using different classifiers, namely, the support vector machine and neural network methods with tenfold cross-validation. Our proposed method is able to classify the N, S, V, F and U arrhythmia classes with high accuracy (98.91%) using a combined support vector machine and radial basis function method.
    Matched MeSH terms: Electrocardiography
  12. 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*
  13. 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*
  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. 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*
  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. 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*
  18. 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*
  19. 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*
  20. 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
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