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Electrocardiogram (ECG) – 12-lead and In-hospital ECG Monitoring

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    Overview and Recommendations

    • Background

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      Indications for use

      • Screening healthy individuals for cardiovascular disease

      • Patients with suspected or at high risk of cardiovascular disease

      • Patients with known cardiovascular disease

      • Preoperatively in patients undergoing noncardiac surgery

      • ECG monitoring in hospitalized patients

  • Related Summaries

  • Overview

  • Description

  • Basic Principles

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    Technical Aspects

    • ECG signal and processing

    • Proper lead electrode placement

    • Alternative lead applications

    • Common errors

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    Indications for Use

    • Screening healthy individuals for cardiovascular disease

    • In patients with known cardiovascular disease

    • In patients with suspected or at high risk of cardiovascular disease

    • Preoperative resting ECG in patients having noncardiac surgery

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      ECG monitoring in hospital setting

      • Arrhythmia monitoring

      • ST-segment (ischemia) monitoring

      • Corrected QT (QTc) monitoring

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    Standard ECG Features

    • General information

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      Abnormalities in ECG features

      • Ventricular repolarization abnormalities

      • ST-segment abnormalities

      • T-wave abnormalities

      • U-wave abnormalities

      • P-wave abnormalities

      • QT interval prolongation

    • Recommendations for reporting ECG abnormalities

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    ECG Characteristics by Condition

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      Electrical abnormalities and arrhythmias

      • Intraventricular conduction disorders

      • Atrioventricular (AV) conduction disorders

      • Preexcitation

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      Tachyarrhythmias

      • Atrial fibrillation

      • Atrial flutter

      • Supraventricular tachycardia (SVT)

      • Ventricular arrhythmias

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      Structural abnormalities

      • Coronary artery disease (CAD)

      • Acute coronary syndromes

      • Cardiomyopathies

      • Channelopathies

    • Metabolic conditions

    • Drug effect

    • Inflammation

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    ECG Diagnosis of Acute Myocardial Infarction

    • Indications

    • ECG criteria for diagnosis of myocardial infarction in absence of bundle branch block (BBB) or left ventricular hypertrophy (LVH)

    • ECG criteria for diagnosis of myocardial infarction in presence of conduction disturbances (such as bundle branch block) and pacemakers

    • ECG findings based on location of myocardial infarction

    • ECG diagnosis of myocardial infarction in presence of atrial fibrillation

    • ECG images of myocardial infarction

    • Differentiating acute myocardial infarction from nonischemic causes of ECG abnormalities

  • Wellens' electrocardiography (ECG) pattern (also called Wellens' syndrome)

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    Role in Detecting Ventricular Hypertrophy

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      Left ventricular hypertrophy (LVH)

      • Diagnostic criteria

      • Performance of diagnostic criteria

      • Diagnosis in presence of intraventricular conduction disorders

      • Prognostic implication

    • Right ventricular hypertrophy (RVH)

    • Biventricular hypertrophy

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    Guidelines and Resources

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      Guidelines

      • International guidelines

      • United States guidelines

      • European guidelines

    • Review articles

  • Patient Information

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    ICD Codes

    • ICD-10 codes

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    References

    • General references used

    • Recommendation grading systems used

    • Synthesized Recommendation Grading System for DynaMed

    • DynaMed Editorial Process

    • Special acknowledgements

    • How to cite

Topic Editor
Eddy Lang MDCM, CCFP(EM), CSPQ
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Affiliations

Zone Clinical and Academic Department Head for Emergency Medicine and Professor of Emergency Medicine, University of Calgary; Alberta, Canada; Senior Researcher, Alberta Health Services; Alberta, Canada

Conflicts of Interest

Dr. Lang declares no relevant financial conflicts of interest.

Topic Editor
Panagiotis Papageorgiou MD, PhD
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Affiliations

Assistant Professor of Medicine, Harvard Medical School; Massachusetts, United States

Conflicts of Interest

Dr. Papageorgeiou declares no relevant financial conflicts of interest.

Recommendations Editor
Zbys Fedorowicz MSc, DPH, BDS, LDSRCS
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Affiliations

Director of Bahrain Branch of the United Kingdom Cochrane Center, The Cochrane Collaboration; Awali, Bahrain

Conflicts of Interest

Dr. Fedorowicz declares no relevant financial conflicts of interest.

Deputy Editor
Peter Oettgen MD
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Affiliations

Editor in Chief, DynaMed; Cardiologist, Beth Israel Deaconess Medical Center; Massachusetts, United States; Associate Professor of Medicine, Harvard Medical School; Massachusetts, United States

Conflicts of Interest

Dr. Oettgen declares no relevant financial conflicts of interest.

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