Diagnostic capabilities of episodes ECG

focused registration during several days with ELSCAN system

                         A.B. Trevozhenko, A.V. Nikitchuk, A.N. Simonov, A.I. Maslyuk, A.A. Kostrikin

Federal medical- and biological Agency

Public Health Federal Establishment

 clinical hospital  ¹81

Insertion

       During five decades of history ECG Holter monitoring had significantly changes and  firmly entered in the daily clinic practice.

        At the present time transparently argued high reliability of this method not only for primary diagnostics of  ischemic heart disease or for  cardiac rhythm disturbance, but also for risk stratification of  attack ominous cardiological  condition.

        Traditional method of 24-hour ECG registration is enough effortful, it brings some discomfort for patient in time of using multielement leads and huge registrars.

         Also Holter-monitoring devices and registrars cost-price is rather high and devices in time of ambulatory using often come off line. But the main defect of this methodic is insufficient duration ECG registration in the course of the day, which doesn’t allow catch infrequent episodes stroke oà cardiac disease.  

         In our joint research we trying to learn diagnostic opportunities of unique product created by native manufacturer medical techniques.

         The main aim consists in equipment quality estimation and capability definition of episodic multidiurnal register of electrocardiographic events in detection of ischemic episodes, cardiac rhythm disturbance and automatism of sinus node.

MATERIAL AND METHODS

         In compliance with STARD recommendations in research took part 42 volunteer (30 men and 12 women), at the age of 30-72 years, middle age was 56 ±12 years.

         For all patients provided ECG episode registration during several days with ELSCAN-system (Electropulse, Russia).

        Research carrying out in outpatient conditions, in day-to-day activity conditions.

        Automatic diagram registration was spontaneous and began every 2 hours during 2 minutes.

        Motivated “catches” patients make by themselves in time of complaints, domestic exercise stress, after dinner, before going to sleep, after awakening. For volunteers recommended as frequent as possible activate device and enjoyed simple lifestyle.

RESULTS

        Whole ECG episodes registrar duration was from 2 to 5, 5 days (at the average 3, 5 ± 1, 5).

       Quality of diagrams was high, tremulous and networking artifacts were in 8 observation, they were spreading on only 1 channel, and were admitted as diagnostic non-significant.

       Usage of mobile phones, plug-in, physical activity and shift of clothes has no effect on devices work.

       Premature elements deflation wasn’t registered, duration of data transmission on base computer consist from 2 to 4 minutes (at the average 3 ± 1 min).

       Number of ECG “catches” varied from 28 to 46 (at the average 38 ± 4), from which patient activated number was from 12 to 20 (at the average 16 ± 3).

In the opinion polls, we understand that this method doesn’t cause difficulties or activity restriction.

       Life threatening arrhythmia was detected from 4 patients among 28 volunteers, which equals 14%.

       In other 23 observations cardiac rhythm disturbance wasn’t detected, but in 7 cases was registered rare ventricular or atrial extrasystole.

       For all volunteers was led transesophagus electrophysiological research, which confirm sick sinus syndrome for two volunteers with pauses in time of ECG episode registrations. (Pic.5)

DISCUSSION

       Dynamic ECG research allows identify pathological changes of cardiovascular system and completely decides expert questions about treatment effectiveness of different cardiological diseases.

       Estimation of cardiac rhythm variability, statement of amount appearance arrhythmia and Ischemia equivalents give good opportunities for prognosis and selection of therapeutic tactics.

       But some holding actions don’t allow widespread use Holter monitoring ECG and require theirs optimal modernization.

       Development of simple alternative for difficult and effortful method was initiated by scientist and physics of Electropulse in zone of technique and innovation. (Tomsk)

       The main idea of focused registration during several days consists in “cutting off” unpractical information and catching pathology changed diagrams, which are very important for cardiovascular diseases detection.

       This prototype completely decides diagnostic problems of practical cardiology, and it was confirmed in research.

       Also there was confirmed hypothesis about high reliability of ELSCAN technology for detection of tachyarrhythmia or Brady arrhythmia because of device automatic reaction on heart rate changes.

       Automatism sinus abnormality was detected in 100% of cases.

       In Detection of ischemia episodes method sensitivity was higher than middle level and was comparable with trivial Holter-monitoring.

       High degree of discretization allows take diagrams with perfect quality, tiny size of register device and minimal number of ECG lead elements,   which cancel any discomfort for patients.

       At once was detected some restrictions in this technology for diagnostic insensible pathology changes.

       Research shows us that paroxysmal form of arterial fibrillation with low frequency ventricular beat could be passed.

       This circumstance requires slight device improvement with increasing of spontaneous ECG episode registration, till hourly periodicity.

      None the least of the method aspects was his efficiency as significant reducing of doctor working hours. Because of enough simple software, not difficult interface and limited number of diagrams, data analysis takes less than 7% of operator labors time and doesn’t require doctor strong qualifications.

CONCLUSION

      Focused ECG episodes registration during several days with ELSCAN is the optimal alternative for Holter monitoring, adapted for practical cardiology problem solving.

      Diagnostic method safety for detection life threatening arrhythmia with pathologically high or low heart rate is perfect, for registration of ischemic episodes – higher then intermediate, for detection not dangerous cardiac rhythm disturbance with good heart rate – not high.

      ELSCAN is presented as qualitative and reliable, with high level of noise-immunity and differ with heightened operational profitability.