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At least 73 records · Page 4Linked to original sources

Simple method for computer-aided analysis of echocardiograms.

The use of echocardiography in the diagnosis and assessment of heart disease is increasing as greater familiarity is obtained with this noninvasive procedure. Quantitative evaluation of echocardiographic studies has heretofore required time-consuming manipulation of mathematical formulas. A simple method utilizing a sonic digitizing tablet has been developed for computer-aided analysis of M-mode echocardiograms. This device can convert a point located manually with a digitizing pen into X and Y coordinates and with use of the standard telephone network can communicate on a time-shared basis with a DECSYSTEM-10 computer. A program has been written to compute and type the results of standard calculations involving mitral valve motion and left ventricular function. The information can also be stored on disk by the computer for future use. This simple, relatively inexpensive system is valuable because of the ease with which it permits usually laboriously obtained information to be extracted from the standard echocardiogram.

Diagnosis, Computer-Assisted

Impact of field-transmitted electrocardiography on time to in-hospital thrombolytic therapy in acute myocardial infarction.

To assess the impact of a field-transmitted electrocardiogram (ECG) on patients with possible acute myocardial infarction, randomized and open trials were performed with a portable electrocardiographic system coupled with a cellular phone programmed to automatically transmit ECGs to the base hospital. Consecutive patients served by the 6 units of the Salt Lake City Emergency Rescue System were studied; 71 patients were randomized to in-field ECG (n = 34) versus no ECG (n = 37). Time on scene was 16.4 +/- 9.7 minutes for the ECG group versus 16.1 +/- 7.0 minutes for the non ECG group (difference not significant). Time of transport averaged 18.2 +/- 9.9 and 17.6 +/- 13.1 minutes, respectively (difference not significant). Six of 34 patients with in-field ECG showed acute myocardial infarction, qualified for and received thrombolytic therapy at 48 +/- 12 minutes after hospital arrival (range 30 to 60) compared with 103 +/- 44 minutes (p less than 0.01) for 51 historical control patients and 68 +/- 29 minutes for 6 concurrent control patients without in-field ECG. Thus, in-field ECG causes negligible delays in paramedic time, leads to significant decreases in time to in-hospital thrombolysis and may make in-field therapy feasible. In-field ECG may be an important addition to reperfusion strategies.

Allied Health Personnel

Detection of preterm labor by ambulatory monitoring of uterine activity for the management of oral tocolysis.

A study to evaluate whether ambulatory tocodynamometry at home could enhance the management of oral tocolysis was performed. On discharge from the hospital, after completing parenteral tocolysis, 60 patients received a lightweight tocodynamometer, designed for storage and transmission of uterine activity data. Sixty additional contemporary patients, who were matched for maternal age, parity, and risk factors, served as a control group. In addition to instructions regarding self-detection of recurrent preterm labor, monitored patients recorded uterine activity for greater than or equal to 200 min/day and then transmitted the data to the study center. Tocolytic dosage was adjusted to maintain mean uterine contraction frequency of less than 4/hr. Persistent uterine contractions of greater than or equal to 4/hr lead to in-hospital evaluation for recurrent preterm labor. The results indicate that the monitored group had a lower incidence of preterm births mostly because of a decrease in the proportion of patients with failed tocolysis. It is suggested that surveillance of uterine activity at home during oral treatment for preterm labor may be instrumental in improving perinatal outcome in high-risk patients.

Adult

Systems analysis of computerized EKG processing center.

A functional description of a computerized system for analysis of electrocardiograms (EKGs) is presented. Although it is recognized that the diagnostic accuracy of the program is the critical parameter in determining system acceptance, other system features such as quality control, turn around time and cost are shown to be of high importance. A digital simulation of alternative configurations for on-line data acquisition is presented. The simulation predicts the system throughout and wait times in different phases of a telephone EKG transmission for combinations of interfaces, telephone lines and acquisition procedures. These results should be helpful in selecting the appropriate configuration for each special situation.

Computers

Advances in the management of cardiac arrhythmias in children.

The authors discuss several recent developments in the diagnosis and management of cardiac arrhythmias in the young, focusing on areas in which the greatest progress has been made so that the pediatrician can incorporate these developments into his practice and participate more fully in the management of the patient requiring tertiary care.

Adolescent

Cardiac telemetry exercise program.

To train cardiac consultants who interpret electrocardiogram rhythm strips from the field, we designed a series of prerecorded telemetered rhythms and discussions which can be sent into telemetry consoles. The patterns represent cardiac arrhythmias (eg, ventricular tachycardia, complete heart block, etc), as well as equipment problems (loose leads, misplaced leads, etc). We selected and modified some of the patterns of "Arrhythmia Resusci Anne" (Laerdal Medical Corporation), sent these through ambulance radios (to create a tone), recorded the signal on a standard tape recorder and dubbed in the monologue. The physician is asked to interpret the pattern and give instructions to the ambulance attendant. The answers and response times are recorded by the technician running the taped exercise. At the end of the quiz, the rhythms are replayed along with a discussion of each pattern.

Ambulances

Palpitations and arrhythmias. Separating the benign from the dangerous.

Palpitations are a nonspecific symptom and do not necessarily imply serious heart disease. The vast majority of palpitations are benign. Goals in evaluation include detecting and identifying an arrhythmia, clarifying symptom severity, and defining the extent of underlying heart disease. If palpitations are infrequent and not accompanied by angina, congestive heart failure, or syncope, outpatient transtelephonic monitoring yields useful clinical information in most patients and is more cost-effective than Holter monitoring. Patients with major symptoms require hospitalization for aggressive cardiac evaluation and, possibly, electrophysiologic testing to guide treatment.

Arrhythmias, Cardiac