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Medical Forum / General / Cardiology / February 2006ECG software development
Hello to the group, I am an experienced software developer investigating opportunities in the areas of embedded system software development with manufacturers of electrocardiographs. I am familiar with basic ECG data acquisition and instrumentation and exercise stress systems. But I wonder about the future of electrocardiography. Not that everyone is getting (not yet anyway) cheap calcium scoring an other imaging tests via radiology equipment, but does electrocardiography at the physicians office and ER still have a promising future? > Hello to the group, > [quoted text clipped - 9 lines] > via radiology equipment, but does electrocardiography at the physicians > office and ER still have a promising future? I don't see why not. It is about the quickest, easiest, cheapest thing you can do - other than using a stethoscope and it gives you a lot of information. Calcium scoring would not tell you if you are having an MI for example. Bill - not a Dr. > I don't see why not. It is about the quickest, easiest, cheapest thing you > can do - other than using a stethoscope and it gives you a lot of > information. Calcium scoring would not tell you if you are having an MI > for example. Nether ECG at 100%. It is not reliable test to detect MI. If ECG is so good, why ER docs do CK-MB, LDH, troponin...? >> I don't see why not. It is about the quickest, easiest, cheapest thing you >> can do - other than using a stethoscope and it gives you a lot of [quoted text clipped - 4 lines] > > If ECG is so good, why ER docs do CK-MB, LDH, troponin...? There is no 100%. You could not just check cardiac enzymes either. I think the EKG is better because it will detect problems where cardiac enzymes are not involved and it is quicker - which is obviously important if you are having an MI. Also some of the enzyme tests can give false positives. Also, you might have asked yourself the reverse question: If EKGs are not useful why are they being done at all? Bill > >> I don't see why not. It is about the quickest, easiest, cheapest thing you > >> can do - other than using a stethoscope and it gives you a lot of [quoted text clipped - 14 lines] > Also, you might have asked yourself the reverse question: If EKGs are not > useful why are they being done at all? They are being done because the criteria for emergency therapies to treat acute myocardial infarction (ie heart attack) are EKG-based. Will be available to "glow" and chat about this and other things like cardiology, diabetes, Bird Flu, cooking and nutrition that interest those following this thread here during the next on-line chat (02/16/06) from 6 to 7 pm EST: http://tinyurl.com/8w7uq For those who are put off by the signature, my advance apologies for how the LORD has reshaped me: http://tinyurl.com/bgfqt Prayerfully in Christ's love, Andrew http://tinyurl.com/8juld Yes, codesmith, I believe there will always be a future for EKG's, at least for the next 10 years, I imagine. It is a quick, safe test. Calcium scoring is Xray dependent--so the radiation comes at a cost, and cannot be repeated. EKG's can be repeated ad nauseum (just ask ER docs who sometimes it seems order one every 5 minutes on a patient). For diagnosis of acute chest pain, no test is quicker than an EKG--and time is essential, so EKGs will always be needed. In doctor's office, the traditional wheeled EKG machine will be used--perhaps with some modifications, like an EKG vest, so posterior and right sided EKG's will be easier to obtain (PURE speculation and hypothesis here--am talking about the future of EKG) In ER's, we may see a shift to a full 24hour mobile telemetry solution, combining instant EKG with telemetry monitoring, monitoring ST segment shifts. Again, all pure speculation on my part--I do not in any way see a decline in EKG's, but a steady continuance of their use. To further elucidate my point, there is a recent article in American Heart Journal. http://www.ahjonline.com/article/PIIS0002870305004370/abstract?browse_volume=151 &issue_key=TOC%40%40JOURNALSNOSUPP%40YMHJ%400151%400002&issue_preview=no&select1 =no&select1=no&vol= American Heart Journal Volume 151, Issue 2, Pages 508-513 (February 2006) Long-term prognostic value of the preoperative 12-lead electrocardiogram before major noncardiac surgery in coronary artery disease Raban V. Jeger, MDa, Cecilia Probst, MDb, Ruza Arsenic, MDb, Thomas Lippuner, MDc, Matthias E. Pfisterer, MDa, Manfred D. Seeberger, MDb, Miodrag Filipovic, MDbCorresponding Author Informationemail address Received 17 November 2004; accepted 28 April 2005 Background Knowledge of the prognostic information of preoperative 12-lead electrocardiogram (ECG) recordings in patients with coronary artery disease (CAD) undergoing noncardiac surgery is limited. Methods The prognostic information derived from the preoperative ECGs of 172 CAD patients undergoing major noncardiac surgery was analyzed to determine its predictive value for long-term outcome. Primary end point was all-cause mortality; secondary end point was major adverse cardiac events (MACE) at 2 years. Results Prevalence of ECG abnormalities was 53% for T-wave alterations; 46% for Q waves; 38% for ST deviations; and, depending on the criterion used, 2% to 19% for left ventricular hypertrophy. During follow-up, 40 (23%) patients died and 31 (18%) had MACE. After adjustment for clinical baseline findings, including current medication with ß-blockers, ST depressions (odds ratio [OR] 4.5, 95% confidence interval [CI] 1.9-10.5) and faster heart rate (HR) (OR 1.6, 95% CI 1.1-2.4, per 10 beats per minute [bpm] increase) were independent predictors of all-cause mortality. Faster HR (OR 1.7, 95% CI 1.1-2.6, per 10-bpm increase) was also an independent predictor of MACE. The predictive value of ECG variables did not change after adjustment for occurence of perioperative ischemia. Conclusion In CAD patients, the preoperative ECG contains important prognostic information and is predictive of long-term outcome independent of clinical findings and perioperative ischemia. |
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