Background: We evaluated the appropriateness of the prescription of echocardiography, exercise testing, Holter monitoring and vascular sonography for ambulatory patients, performed during 4 weeks in 21 outpatient laboratories in Tuscany and Umbria, Italy.
Methods: We collected the following data: the appropriateness of the prescription (according to the guidelines of the Italian Federation of Cardiology), the prescribing physician (cardiologist vs noncardiologist), the synthetic result (normal vs abnormal) and the clinical utility (useful vs useless) of each exam.
Results: We evaluated 5614 prescriptions (patients: 3027 males, 2587 females; mean age 63 years, range 14-96 years).
A survey on patterns of information and informed consent procedures during daily clinical practice has been performed by the Ethical Commission of ANMCO. A structured questionnaire (38 questions) was sent to the 653 cardiological units of the National Health Service in Italy. Four hundred and eighty (73.
View Article and Find Full Text PDFMethods Inf Med
January 2002
Objectives: Fuzzy rules automatically derived from a set of training examples quite often produce better classification results than fuzzy rules translated from medical knowledge. This study aims to investigate the difference in domain representation between a knowledge-based and a data-driven fuzzy system applied to an electrocardiography classification problem.
Methods: For a three-class electrocardiographic arrhythmia classification task a set of fifteen fuzzy rules is derived from medical expertise on the basis of twelve electrocardiographic measures.
Background: Cardiac rupture is a leading cause of death among patients hospitalized for acute myocardial infarction (AMI). The aim of our retrospective study was to evaluate the impact of primary coronary angioplasty (PTCA) on this not common but usually fatal complication.
Methods: Since January 1998 PTCA has been the routine treatment for AMI patients in our Institution monitored during the first 12 hours from symptom onset.
IEEE Trans Biomed Eng
August 1999
A study of the 24-h heart rate variability's (HRV) hidden dynamic is performed hour by hour, in order to investigate the evolution of the nonlinear structure of the underlying nervous system. A hierarchy of null hypotheses of nonlinear Markov models with increasing order n is tested against the hidden dynamic of the HRV time series. The minimum accepted Markov order supplies information about the nonlinearity of the HRV's hidden dynamic and consequently of the underlying nervous system.
View Article and Find Full Text PDFA nonlinear analysis of the underlying dynamics of a biomedical time series is proposed by means of a multi-dimensional testing of nonlinear Markovian hypotheses in the observed time series. The observed dynamics of the original N-dimensional biomedical time series is tested against a hierarchy of null hypotheses corresponding to N-dimensional nonlinear Markov processes of increasing order, whose conditional probability densities are estimated using neural networks. For each of the N time series, a measure based on higher order cumulants quantifies the independence between the past of the N-dimensional time series, and its value r steps ahead.
View Article and Find Full Text PDFNephrol Dial Transplant
March 1998
Background: Late potentials (LP) on the signal-averaged electrocardiogram (SAECG) are predictive of malignant ventricular arrhythmias and sudden cardiac death in patients with ischaemic and non-ischaemic cardiomyopathy. Cardiac dysfunction, both regional and global, as well as supraventricular and ventricular arrhythmias are reported in a high percentage of patients with end-stage renal failure (ESRF). The aim of the study was to assess the prevalence of LP and the effects of haemodialysis on the SAECG of ESRF patients.
View Article and Find Full Text PDFStudy Populations: This study concerned the possible relations between seroreactivity to Chlamydia pneumoniae and myocardial infarction. A group of 29 patients with acute myocardial infarction (AMI), 74 members of a healthy control group, and a subgroup of 24 members of a healthy control group matched for age, sex, and coronary risk factors (HCM) were included in the study. In addition, we evaluated the AMI group in a 1-year patients' follow-up study.
View Article and Find Full Text PDFIn order to achieve widespread use of automated external defibrillators (AEDs) in Italy, we evaluated several models of AEDs in different clinical and artificial settings. We enrolled 268 consecutive patients with various rhythms and arrhythmias. Among these, 129 patients were referred to two different hospitals and 139 were enrolled by the pre-hospital care providers.
View Article and Find Full Text PDFUnlabelled: Chlamydia pneumoniae (C.p.) has been correlated with acute myocardial infarction (AMI).
View Article and Find Full Text PDFWith the aim of better understanding the dynamic changes in sympatho-vagal tone occurring during the night, human heart rate variability (HRV) during the various sleep stages was evaluated by means of autoregressive spectral analysis. Each recording consisted of an electroencephalogram, an electrooculogram, and electromyogram, and electrocardiogram, and a spirometry trace. All of the data were sampled and stored in digital form.
View Article and Find Full Text PDFMinerva Cardioangiol
September 1996
The authors report a 57 year old patient affected by rhinopharyngeal NH lymphoma that appeared as a parapharyngeal space lesions-syncope syndrome. The activation of a cardioinhybitory reflex by the stimulation of the glossopharyngeal nerve seems to be the pathogenetic basis for his syndrome.
View Article and Find Full Text PDFBackground: Infections in intensive care unit are nowadays well documented. As no recent papers about catheter related infections in cardiological intensive care units were found, we decided to approach them during a period of six months with a surveillance study including a clinical, nursing and microbiological protocol.
Methods: The microbiological protocol the semiquantitative Maki cultural evaluation of the tips, the interior of the hubs and the skin around the catheter insertion point.
Over the past decade there have been considerable advances in cardiac electrostimulation technologies. However, there are still reports of electromagnetic interference with pacemakers and pacemaker patients. We have studied the effects of various electromagnetic sources (short-wave diathermy, electrosurgical knives, electrotherapy and radiofrequencies) on both humans and animals.
View Article and Find Full Text PDFMinerva Cardioangiol
December 1992
Unlabelled: It is an acknowledged fact that the prognosis for patients with a first myocardial infarction depends mainly on the degree of residual left ventricle function. We wanted to evaluate the importance that certain simple clinical and instrumental variables can have in stratifying post-infarction cardiovascular risk with particular emphasis on chronic obstructive lung disease (COLD). We selected 97 out of the 512 patients treated in the coronary intensive care unit (CICU) from February 1, 1988 to October 31, 1990 according to the following criteria: First myocardial infarction; no cardiogenic shock; no serious concomitant diseases with considered negative prognosis within 6 months.
View Article and Find Full Text PDFFrom the literature we find that the most frequent electrical alterations in Ebstein's anomaly are: the abnormal right atriogram; ventricular pre-excitation; supraventricular tachycardia; right bundle branch block and lengthening of the PR tract. These alterations are also present in cases of Ebstein's anomaly diagnosed in adults. The study of the activation of the right ventricle, which offers a variety of forms of development, is a source of particular interest.
View Article and Find Full Text PDFChronobiological analysis of the circadian variations of heart rate, ventricular and atrial ectopies, was carried out on 11 patients with previous myocardial infarction matched with 11 controls. Individual circadian rhythms in heart rate were seen in all the control subjects but only in 6 patients with previous myocardial infarction. The behaviour of the individual circadian rhythms of premature beats was not significantly different between the two groups.
View Article and Find Full Text PDFFew papers deal with the chronobiologic characteristics of heart rate in neonates. A better knowledge of this topic could be useful under both clinical and therapeutical point of view. We studied the circadian and ultradian rhythms of heart rate in 10 healthy neonates (5 males and 5 females).
View Article and Find Full Text PDFSixteen subjects, mean age 59 +/- 18, 11 normal and 5 with coronary artery disease, all having premature ventricular and/or atrial beats in the standard resting electrocardiogram (ECG), were studied to analyse the chronobiologic parameters of these arrhythmias. Single cosinor analysis of the data obtained by 96-hour ECG performed according to the Holter system, demonstrated: A) significant circadian rhythm in heart rate for all the subjects, with acrophases occurring between 12.56 and 17.
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