Interpretation of EKG with Image Recognition and Convolutional Neural Networks.

Electrocardiograms (EKG) form the backbone of all cardiovascular diagnosis, treatment and follow up. Given the pivotal role it plays in modern medicine, there have been multiple efforts to computerize the EKG interpretation with algorithms to improve efficiency and accuracy. Unfortunately, many of these algorithms are machine specific and run-on proprietary signals generated by that machine, hence not generalizable.

Safety of left atrial appendage closure in heart failure patients.

Introduction: Left atrial appendage closure (LAAC) is an intervention aimed at stroke prevention in nonvalvular atrial fibrillation (AF). There is a three-fold increased risk of stroke in patients with concomitant presence of AF and heart failure (HF). While anticoagulation is effective, only 60% receive it.

Reversible Mechanical Atrioventricular Block Caused By A Steerable Introducer Sheath During Transseptal Catheterization.

A 62-year-old woman presents for pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation. During transseptal catheterization (TSC) the patient sustained mechanical injury to the atrioventricular node (AVN) with consequent complete heart block (CHB). Injury to the AVN and CHB recovered after approximately forty minutes.

Shortness of breath and palpitations in an elderly man: Bad device behavior or malfunction?

70-year-old male with sinus node dysfunction (SND) and paroxysmal atrial fibrillation presents with shortness of breath and palpitations. Presenting EKG shows AF with rapid ventricular rates requiring direct current cardioversion (DCCV). Post-DCCV EKG shows sinus rhythm with competing ventricular pacing.

Cybersecurity: The need for data and patient safety with cardiac implantable electronic devices.

Remote monitoring of cardiac implantable electronic devices (CIEDs) has become routine practice as a result of the advances in biomedical engineering, the advent of interconnectivity between the devices through the Internet, and the demonstrated improvement in patient outcomes, survival, and hospitalizations. However, this increased dependency on the Internet of Things comes with risks in the form of cybersecurity lapses and possible attacks. Although no cyberattack leading to patient harm has been reported to date, the threat is real and has been demonstrated in research laboratory scenarios and echoed in patient concerns.

In memory of tachycardia: A wide complex tachycardia in a young male.

We present a case of a 24-year-old male with palpitations and a wide complex tachycardia. Baseline electrocardiogram (ECG) after termination of tachycardia demonstrates a normal rhythm but with inferior/anterolateral T-wave inversions (TWIs). Electrophysiologic study confirmed the diagnosis of posterior fascicular ventricular tachycardia successfully terminated by anatomic ablation of the left posterior fascicle.

Brugada Phenocopy Induced by Recreational Drug Use.

Recreational drugs are commonly abused in all age groups. Intoxication with these substances can induce silent but significant electrocardiographic signs which may lead to sudden death. In this case study, we present a 49-year-old male with no medical comorbidities who came to the emergency department requesting opioid detoxification.

Inappropriate shock in a subcutaneous cardiac defibrillator due to residual air.

Inappropriate shock due to residual air in subcutaneous implantable cardiac defibrillators is not a well-known complication. Obtaining overpenetrated X-rays, recognizing electrocardiogram findings, limiting blunt finger dissection, and switching to sense at another vector are techniques which might lead to avoidance of unnecessary wound exploration or device removal.

Feasibility of early discharge after implantable cardioverter-defibrillator procedures.

Introduction: Registry data demonstrate considerably low complication rates after implantable cardioverter-defibrillator (ICD) procedures for primary prevention of sudden death. Yet standard of care includes postimplant overnight in-hospital observation that may levy substantial unnecessary financial burden on health care systems. In appropriate patients, discharge soon after implant could translate into significant cost savings, if such practice does not result in complications.

The use of a modified sphygmomanometer to detect atrial fibrillation in outpatients.

This study was designed to assess the accuracy of a modified sphygmomanometer, that measures pulse irregularity, to detect atrial fibrillation (AF). An irregularity index, defined as the standard deviation of the time intervals between beats divided by the mean of the time intervals, was used to analyze standard 12-lead ECGs from hospitalized patients. A threshold irregularity index was selected such that all ECGs with AF exceeded this irregularity index value.

Determinants of left atrial size in patients with newly diagnosed untreated hypertension.

The present study determined the relationships between ambulatory blood pressure, left ventricular mass, body mass index, and other clinical and demographic variables to left atrial size in previously untreated hypertensive and normotensive subjects. Left atrial size was measured uni-dimensionally using M-mode echocardiography in 58 newly diagnosed never-treated hypertensive patients (office blood pressure 149/96 +/- 15/7 mmHg) and 28 normotensive control subjects (office blood pressure, 122/78 +/- 8/8 mmHg). Left ventricular mass, septal and posterior wall thickness were significantly increased in hypertensive compared to normotensive subjects (230 +/- 63 g versus 181 +/- 45 g, 1.