Document Detail

Celebrating the 100th birthday of the electrocardiogram: lessons learned from research in cardiac monitoring.
MedLine Citation:
PMID:  12102439     Owner:  NLM     Status:  MEDLINE    
The electrocardiogram continues to be the gold standard for the diagnosis of cardiac arrhythmias and acute myocardial ischemia. The treatment of arrhythmias in critical care units has become less aggressive during the past decade because research indicates that antiarrhythmic agents can be proarrhythmic, causing malignant ventricular arrhythmias such as torsade de pointes. However, during the same period, the treatment of acute myocardial ischemia has become more aggressive, with the goal of preventing or interrupting myocardial infarction by using new antithrombotic and antiplatelet agents and percutaneous coronary interventions. For this reason, critical care nurses should learn how to use ST-segment monitoring to detect acute ischemia, which is often asymptomatic, in patients with acute coronary syndromes. Because the electrocardiographic lead must be facing the localized ischemic zone of the heart to depict the telltale signs of ST-segment deviation, the challenge is to find ways to monitor patients continuously for ischemia without using an excessive number of electrodes and lead wires. The current trend is to use reduced lead set configurations in which 5 or 6 electrodes, placed at convenient places on the chest, are used to construct a full 12-lead electrocardiogram. Nurse scientists at the University of California, San Francisco, School of Nursing are at the forefront in developing and assessing the diagnostic accuracy of these reduced lead set electrocardiograms.
Barbara J Drew
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of critical care : an official publication, American Association of Critical-Care Nurses     Volume:  11     ISSN:  1062-3264     ISO Abbreviation:  Am. J. Crit. Care     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-09     Completed Date:  2002-12-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9211547     Medline TA:  Am J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  378-86; quiz 387-8     Citation Subset:  IM; N    
Department of Physiological Nursing, University of California, San Francisco, USA.
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MeSH Terms
Arrhythmias, Cardiac / diagnosis,  physiopathology
Biomedical Research
Critical Care / methods*
Education, Nursing, Continuing
Electrocardiography / instrumentation*,  methods,  nursing
Intensive Care Units
Middle Aged
Monitoring, Physiologic / instrumentation,  methods,  nursing
Myocardial Ischemia / diagnosis,  physiopathology
Grant Support
9 R01HL69753-07/HL/NHLBI NIH HHS; R01NR03436-06/NR/NINR NIH HHS
Erratum In:
Am J Crit Care 2002 Nov;11(6):503
Am J Crit Care. 2002 Sep;11(5):411.

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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