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Recent technological developments have brought long-term ambulatory electro cardiography to the front of clinical cardiology. Its application for solving clinical problems potentially related to cardiac arrhythmias is rapidly increasing. In the meantime, the method has found widespread use in the identification of patients at risk for cardiac death as well as in the assessment of therapeutic interventions. It was the purpose of this symposium to bring together an international group of authorities in order both to provide an overall view of the field and to discuss critically the value of clinical, epidemiological and research applications of long term ambulatory electrocardiography in the light of new concepts and recent advances. The first section of this volume discusses the methodology and the performance criteria of the equipment and analysis systems. In the second section, the potentials and problems encountered in the use of long-term ambulatory electrocardiography for solving clinical questions and for predicting the occurrence of clinically important arrhythmias are extensively as continuous ST segment monitoring, blood dealt with. New applications such pressure measurement and other physiologic parameters are also included. Prevalence variability and prognostic aspects of ventricular arrhythmias, both in normals and in patients with cardiac disease, are the subject of section 3. The last section provides a critical review of the use of the method for the evaluation of therapeutic interventions with drugs. The editors feel that this volume represents the 'state of the art' in this newly important area of clinical cardiology.
Ambulatory electrocardiography (ECG) monitors are often used to detect cardiac arrhythmia. For patients with symptoms, an external cardiac loop recorder will often be recommended. The improved recording capacity of newer Holter monitors and similar devices, collectively known as long-term continuous ambulatory ECG monitors, suggests that they will perform just as well as, or better than, external loop recorders. This health technology assessment aimed to evaluate the effectiveness, cost-effectiveness, and budget impact of long-term continuous ECG monitors compared with external loop recorders in detecting symptoms of cardiac arrhythmia.
With a focus on the growing field of cardiology remote monitoring, this state-of-the-art reference provides must-know clinical and technical information as well as recent advances in application, engineering, and clinical impact from the current literature. Authoritative coverage of implantable devices and ambulatory ECG brings you up to speed on recent practice changes in remote monitoring that have alleviated the volume of in-office patient follow-ups, allowed for physicians to monitor more patients, enabled better patient compliance, and most importantly, provided earlier warning signs of cardiac problems.
The book is divided in 4 parts. In the first one, the importance of the analysis of the cardiac dynamics using the ambulatory monitoring technique is presented. The second part contains the description of foundations of impedance cardiography (ICG), the models used to describe the ICG technique and the description of available systems for ambulatory monitoring of cardiac hemodynamics. The third part is devoted to the validation of the ambulatory ICG method, the verification of the quality of long term ICG recordings and the discussion of the limitations of this technique. In the last part, some clinical and research applications of the ICG ambulatory monitoring are presented. The simultaneous recordings of electrocardiogram (ECG) and ICG in the transient cardiac arrhythmia events illustrate the potential applications of that method for quantitative analysis of hemodynamics when the implementation of the stationary methods would be either difficult or not possible to do. The book is followed by references, alphabetical index and appendices containing the technical data of the available systems for portable monitoring of cardiac hemodynamics.
This book is a comprehensive overview of electrocardiography and the major effects of current cardiac pharmacological therapy on electrocardiography. The text is based on work presented at the International Symposium on Non-invasive Cardiovascular Diagnosis and Therapy, held in May, 1987 at the University of Cologne. The theme of the book is to review, in broad clinical perspective the current state-of-the-art of electrocardiography as it pertains to standard electrocar diograms, exercise testing, ambulatory electrocardiography, electrocardiographic telemetry, and high resolution electrocardiography. Furthermore, advance!, in cardiac drug therapy in relation to diuretics, beta blocking drugs, antiarrhythmic agents and thrombolytic agents are reviewed. The emphasis of the conference and this book is to review the clinical state-of-the-art information and applications in this regard. In the initial section on electrocardiography, Dr. Spodick reviews our present day physiologic and pathophysiologic understanding of systolic time intervals, and how they are affected by a variety of cardiac disease states and pharmacologic agents. Dr. Ellestad examines problems and provides pragmatic tips on exercise testing in the diagnosis of coronary artery disease, and advances in exercise scores and computer analysis. Dr. Graboys reviews the value of exercise testing in the diagnosis and management of patients with serious ventricular arrhythmias. Dr. Kellermann presents the complimentary role that exercise testing plays in com prehensive follow-up therapy of the cardiac patient, and the use of exercise for work and physical training. Detailed information concerning the interaction of cardiac rehabilitation and ventricular arrhythmias are examined.
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