File Name: understanding intracardiac egms and ecgs .zip
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- Understanding Intracardiac EGMs and ECGs - E-bog
- Understanding Intracardiac EGMs and ECGs (2010) (PDF) Fred M. Kusumoto
- Intracardiac ECGs and EGMs
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Understanding Intracardiac EGMs and ECGs - E-bog
Current cardiac implantable devices offer improved processing power and recording capabilities. Some of these devices already provide basic telemonitoring features that may help to reduce health care expenditure. A challenge is posed in particular for the telemonitoring of the patient's cardiac electrical activity. Indeed, only intracardiac electrograms EGMs are acquired by the implanted device and these signals are difficult to analyze directly by clinicians. In this paper, we propose a patient-specific method to synthesize the surface electrocardiogram ECG from a set of EGM signals, based on a 3D representation of the cardiac electrical activity and principal component analysis PCA.
Although the electrocardiogram ECG is accepted as a standard clinical tool, electrograms EGMs recorded during electrophysiology studies are considered complex and confusing. In this brief paperback, an award-winning teacher provides the newcomer with an introductory guide to electrophysiology studies and the interpretation of electrograms. Kusumoto divides the 15 chapters into two main sections, Electrophysiology Concepts and Specific Arrhythmias. First, he reviews the basics of electrophysiology testing and the diagnostic evaluation of general types of arrhythmias. From that foundation, he proceeds to discuss specific arrhythmia types and techniques for evaluation and ablation: Accessory pathways AV node reentry Focal atrial tachycardia Atrial flutter Atrial fibrillation Ventricular tachycardiaThe final chapter considers implantable cardiac devices as they relate to ECGs and electrograms. Each short chapter includes a bullet-point summary and helpful review questions.
Understanding Intracardiac EGMs and ECGs (2010) (PDF) Fred M. Kusumoto
We present a case of a patient with significant structural heart disease from previous cardiac surgeries who presented for an electrophysiology study and radiofrequency ablation. The case highlights the significance of intra-atrial conduction delays in such patients and potential pitfalls it can present while interpreting intra-cardiac electrograms especially during implantable cardioverter defibrillator ICD interrogations. Her past medical history is remarkable for non-ischemic cardiomyopathy, aortic valve replacement done twice mechanical followed by tissue bioprosthesis for hemolysis , implantable cardioverter defibrillator ICD placed for primary prevention in March During electrophysiology study, a narrow complex tachycardia was easily induced at a cycle length of msec. Using entrainment and 3-D mapping ESI it was confirmed to be reverse typical slow isthmus dependent atrial flutter.
Catheter ablation has become a very efficient strategy to terminate sustained cardiac arrhythmias like atrial flutter AFlut. Identification of the optimal ablation spot, however, often proves difficult when scar from previous ablations is present. Although the application of electro-anatomical mapping systems allows to record thousands of intracardiac electrograms EGMs from each atrium, state-of-the-art techniques provide limited options for automatic signal processing. Goal of the presented research was the development of an algorithm to detect EGMs that present double potentials DPs , as these often indicate functional or anatomical lines of block for cardiac excitation. Using an annotated database, we developed several features based on the morphological descriptors of DPs.
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Intracardiac ECGs and EGMs
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Although the electrocardiogram ECG is accepted as a standard clinical tool, electrograms EGMs recorded during electrophysiology studies are considered complex and confusing. In this brief paperback, an award-winning teacher provides the newcomer with an introductory guide to electrophysiology studies and the interpretation of electrograms. Kusumoto divides the 15 chapters into two main sections, Electrophysiology Concepts and Specific Arrhythmias.
It is a graph of voltage versus time of the electrical activity of the heart  using electrodes placed on the skin. These electrodes detect the small electrical changes that are a consequence of cardiac muscle depolarization followed by repolarization during each cardiac cycle heartbeat. Changes in the normal ECG pattern occur in numerous cardiac abnormalities, including cardiac rhythm disturbances such as atrial fibrillation and ventricular tachycardia , inadequate coronary artery blood flow such as myocardial ischemia and myocardial infarction , and electrolyte disturbances such as hypokalemia and hyperkalemia. In a conventional lead ECG, ten electrodes are placed on the patient's limbs and on the surface of the chest. The overall magnitude of the heart's electrical potential is then measured from twelve different angles "leads" and is recorded over a period of time usually ten seconds.
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