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1.
Niger J Clin Pract ; 22(10): 1349-1355, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607723

RESUMO

Objective: The objective of the this study is to document the existence of statistically significant differences between parameters of heart rate variability (HRV) and heart rate turbulence (HRT), determined in women with overt hyperthyroidism (hT), compared to controls and to highlight their correlations with the level of thyroid hormones and the incidence of arrhythmias. Methods: We studied the HRV in time and frequency domain, and the HRT in a group of 113 women with overt hT, without other cardiovascular risk factors or comorbidities, admitted to the endocrinology clinic of our hospital, between 2012 and 2016. Depending on the severity and duration of hT and levels of thyroid hormones, the patients were assigned to three groups: mild and moderate forms, severe hT with thyrotoxicosis and persistent cases with a relapse of hT. We performed 24 h Holter monitoring in all patients. Results: HRV parameters in time domain (TD) were significantly depressed in patients comparing to controls. All patients had abnormal, positive values of turbulence onset (TO) with significant statistically differences (P < 0.0001) comparing to controls. Although positive, the values of turbulence slope (TS) decreased according to the severity of hT. Conclusion: Patients with hT had depressed values of HRV parameters in TD, correlated with the severity of the thyroid disease and with the incidence of arrhythmias. All patients presented pathological values of TO. TS values were positive, but lower compared to controls.


Assuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia Ambulatorial/métodos , Frequência Cardíaca/fisiologia , Hipertireoidismo/complicações , Hormônios Tireóideos/sangue , Adulto , Arritmias Cardíacas/epidemiologia , Estudos de Casos e Controles , Doença Crônica , Comorbidade , Feminino , Humanos , Hipertireoidismo/epidemiologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
2.
Medicine (Baltimore) ; 98(43): e17616, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651874

RESUMO

RATIONALE: Simpson-Golabi-Behmel syndrome type 1 (SGBS1) is caused by mutations in GPC3 or in both GPC3 and GPC4. Physical manifestations of SGBS1 include fetal overgrowth and macrostomia, macroglossia. Subclinical hypothyroidism has never been reported in SGBS1 cases. PATIENT CONCERNS: An 8-days-old boy was referred to our hospital with persistent hypoglycemia and special facies. And the infant showed elevated levels of thyroid-stimulating hormone (TSH). Free T4 and free T3 were normal. DIAGNOSES: Definitive diagnosis of SGBS1 depends on clinical features and genetic testing. A nonsense mutation (c.1515C > A, p. Cys505*) was tested by whole-exome sequencing. INTERVENTIONS: Normal blood glucose levels were maintained with glucose infusions. Levothyroxine was given to the patient for treating subclinical hypothyroidism. OUTCOMES: The parents decided to abandon the treatment of the patient. We learned that the patient died of a lung infection by a telephone follow-up. LESSONS: Subclinical hypothyroidism could be added to the known clinical manifestations of SGBS1.


Assuntos
Arritmias Cardíacas/diagnóstico , Doenças Genéticas Ligadas ao Cromossomo X/diagnóstico , Gigantismo/diagnóstico , Cardiopatias Congênitas/diagnóstico , Hipotireoidismo/diagnóstico , Deficiência Intelectual/diagnóstico , China , Diagnóstico Diferencial , Evolução Fatal , Humanos , Recém-Nascido , Masculino
3.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(9): 1071-1077, 2019 Sep 30.
Artigo em Chinês | MEDLINE | ID: mdl-31640959

RESUMO

OBJECTIVE: We propose a heartbeat-based end-to-end classification of arrhythmias to improve the classification performance for supraventricular ectopic beat (SVEB) and ventricular ectopic beat (VEB). METHODS: The ECG signals were preprocessed by heartbeat segmentation and heartbeat alignment. An arrhythmia classifier was constructed based on convolutional neural network, and the proposed loss function was used to train the classifier. RESULTS: The proposed algorithm was verified on MIT-BIH arrhythmia database. The AUC of the proposed loss function for SVEB and VEB reached 0.77 and 0.98, respectively. With the first 5 min segment as the local data, the diagnostic sensitivities for SVEB and VEB were 78.28% and 98.88%, respectively; when 0, 50, 100, and 150 samples were used as the local data, the diagnostic sensitivities for SVEB and VEB reached 82.25% and 93.23%, respectively. CONCLUSIONS: The proposed method effectively reduces the negative impact of class-imbalance and improves the diagnostic sensitivities for SVEB and VEB, and thus provides a new solution for automatic arrhythmia classification.


Assuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia , Algoritmos , Arritmias Cardíacas/classificação , Frequência Cardíaca , Humanos , Complexos Ventriculares Prematuros/classificação , Complexos Ventriculares Prematuros/diagnóstico
4.
Int Heart J ; 60(5): 1196-1200, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31484862

RESUMO

Malignant arrhythmia is a fast cardiac arrhythmia that can lead to a hemodynamic abnormality within a short time, most of which is ventricular tachycardia or ventricular fibrillation (VF), which should be managed in time. Both organic and nonorganic cardiac diseases have the potential to cause malignant arrhythmia. We report a noteworthy case of malignant arrhythmia in a teenager during exercise. Transthoracic echocardiography, cardiac magnetic resonance (CMR), electrophysiological study, magnetic resonance imaging of the brain, electroencephalography, chest X-ray, and blood tests were all normal. Twelve-lead electrocardiography showed incomplete right bundle branch block (IRBBB). Two heterozygous missense variants of the desmocollin-2 gene (DSC2, c.G2446A/p.V816M) and desmoplakin gene (DSP, c.G3620A/p.R1207K) were detected in the peripheral blood of this teenager and his father by genetic testing, which encoded a desmosomal protein that was related to arrhythmogenic right ventricular cardiomyopathy (ARVC). In these two rare variants, DSC2 V816M has been reported but uncertain significance, whereas DSP R1207K is never reported. Therefore, the two site variants in DSC2 and DSP genes are likely to become a new research focus for diagnosis and treatment of ARVC in the future. Meanwhile, this report emphasizes that, in addition to a standard set of laboratory tests and examinations, genetic testing may be useful for analyzing the causes of malignant arrhythmia.


Assuntos
Arritmias Cardíacas/etiologia , Bloqueio de Ramo/genética , Desmocolinas/genética , Eletrocardiografia/métodos , Predisposição Genética para Doença , Adolescente , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/genética , Bloqueio de Ramo/complicações , Bloqueio de Ramo/diagnóstico , Ecocardiografia/métodos , Testes Genéticos/métodos , Humanos , Masculino , Linhagem , Prognóstico , Doenças Raras , Medição de Risco , Índice de Gravidade de Doença
5.
Pan Afr Med J ; 33: 114, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31489092

RESUMO

Introduction: Sudden death that occurs during sporting activity affects patients with ignored heart disease. Black athlete's ECG has been little studied and the features of this ethnic group have been discussed. This study aims to study the epidemiological profile and the peculiarities of repolarization of black athletes. Methods: We conducted a descriptive study of black athletes selected among all the athletes followed in the sectoral Center of Sports Science and Medicine in Sousse over a period of 8 months from March to October 2014. Data were collected using a medical questionnaire. Results: Data on 35 athletes were collected, with a male predominance (94,28%), with an average age of 24,34 years. Four athletes had left ventricular hypertrophy on cardiac ultrasound. There were 8 athletes with atrioventricular block degree I and 8 athletes with electrical type of left ventricular hypertrophy (LVH). ST segment changes were more marked at the level of precordial leads. Five athletes (14.2%) had inverted T waves in V2 and V3. These were the same athletes who ST-segment depression in these same leads. Early repolarization was found in 3 athletes. All these cases had notch signaling. Conclusion: Black athletes have quite specific electrical modifications which are important to know. However, our sample is not sufficiently large to certify these results. A comparative study of white athletes would be very interesting.


Assuntos
Arritmias Cardíacas/diagnóstico , Atletas , Cardiopatias/diagnóstico , Hipertrofia Ventricular Esquerda/diagnóstico , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Arritmias Cardíacas/epidemiologia , Bloqueio Atrioventricular/diagnóstico , Bloqueio Atrioventricular/epidemiologia , Morte Súbita/prevenção & controle , Ecocardiografia , Eletrocardiografia/métodos , Feminino , Cardiopatias/epidemiologia , Humanos , Hipertrofia Ventricular Esquerda/epidemiologia , Masculino , Estudos Retrospectivos , Esportes , Inquéritos e Questionários , Adulto Jovem
6.
Undersea Hyperb Med ; 46(4): 421-427, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31509898

RESUMO

Introduction: About 26% of diving-related fatalities are caused by cardiac disease, part of which might be associated with fatal arrhythmias. This raises the question as to whether fatal arrhythmias are being provoked by hyperbaric conditions themselves or if exercise or stress provokes the fatal arrhythmias in cases of underlying (ischemic) cardiac disease. Objective: To measure the influence of hyperbaric conditions (50 msw) on cardiac conduction and arrhythmias in professional divers by means of ECG. Methods: This is a prospective study on military divers in a hyperbaric chamber with continuous ECG monitoring using Holter registrations. Supraventricular and ventricular ectopy was registered during hyperbaric conditions. RR, PR, QRS, QT and QTc intervals were calculated at 50 msw and compared with ECGs at rest. Results: Included were 17 male military divers who made 20 dives. A total of 10 PVCs, 45 PACs, four atrial runs and four atrial pairs were seen. Significant prolongation of the PR interval was seen and a decrease of in QRS duration at 50 msw. There was no significant change in the RR, QT and QTc intervals. Conclusion: In these divers, no clinically relevant arrhythmias were observed during wet dives in a recompression chamber at 50 msw. We observed a small prolongation of PR interval that is probably not clinically relevant in divers without any known conduction disorders.


Assuntos
Arritmias Cardíacas/diagnóstico , Mergulho/efeitos adversos , Pressão/efeitos adversos , Adulto , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/fisiopatologia , Descompressão , Mergulho/fisiologia , Eletrocardiografia Ambulatorial/instrumentação , Eletrocardiografia Ambulatorial/métodos , Sistema de Condução Cardíaco/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Militares , Estudos Prospectivos , Água do Mar , Taquicardia Supraventricular/diagnóstico , Taquicardia Supraventricular/etiologia , Taquicardia Supraventricular/fisiopatologia , Fatores de Tempo , Complexos Ventriculares Prematuros/diagnóstico , Complexos Ventriculares Prematuros/etiologia , Complexos Ventriculares Prematuros/fisiopatologia
7.
Bratisl Lek Listy ; 120(9): 676-679, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31475553

RESUMO

OBJECTIVES: Medial arterial calcification (MAC) is a nonobstructive condition leading to reduced arterial compliance. The disease most commonly occurs in diabetes mellitus. Decreased ankle-brachial pressure index (ABI) is a well-known marker of increased cardiovascular mortality. However, also the values of ABI above 1.3, typical in MAC, are associated with increased mortality. METHODS: By means of Holter ECG monitoring, we investigated 41 patients (25 men, 16 women) with mean age of 59±8 years, suffering of type 2 diabetes mellitus and identified as having MAC, and Holter ECG monitoring with an average duration of recording 22.36 hours, was carried out by GE-Marquette MARS ECG Holter system. RESULTS: We found frequent incidence of cardiac arrhythmias and myocardial ischemia in 22 patients (53.7 %). Only 19 patients (46.3 %) had normal Holter ECG recordings. ABI values were significantly higher in patients with abnormal ECG Holter recordings. CONCLUSION: Our results confirm the importance of ABI estimation in clinical practice. As the central goal of therapy for patients with myocardial ischemia and/or complex forms of cardiac arrhythmias is the reduction or elimination of these episodes. Ambulatory Holter ECG monitoring plays an important role in the management of these patients (Tab. 7, Ref. 16).


Assuntos
Arritmias Cardíacas/diagnóstico , Calcinose/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Eletrocardiografia Ambulatorial , Isquemia Miocárdica/diagnóstico , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
8.
Med Clin North Am ; 103(5): 767-774, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378323

RESUMO

This article represents an overview of the basic concepts of cardiac electrophysiology. This relatively new field became a subspecialty of cardiology in the mid-1990s due to the rapid development of equipment that allowed the study and cure of cardiac arrhythmias percutaneously. Simultaneously, technology provided the field with percutaneous cardiac implantable electronic devices designed to protect patients from life-threatening bradyarrhythmias and tachyarrhythmias. Recently, the field has focused on the ablative treatment of atrial fibrillation, the most common arrhythmia facing an aging population, and the diagnosis and management of many inherited arrhythmias through advances in understanding of their genetic cause.


Assuntos
Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/terapia , Eletrocardiografia , Fenômenos Eletrofisiológicos , Humanos , Marca-Passo Artificial , Ablação por Radiofrequência
9.
Med Clin North Am ; 103(5): 785-791, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378325

RESUMO

Palpitation is common. It is often accompanied by dizziness, lightheadedness, near syncope, and even syncope. It may be difficult to confirm a diagnosis in patients with infrequent symptoms. Several tools are available to document arrhythmias in the workup of a patient with palpitation, including 24-hour Holter monitoring, 30-day external continuous monitoring, and implantable loop recorders. A number of private companies are now able to empower patients to monitor heart rates and even give accurate rhythm strips. This article reviews the current data on how to make the diagnosis and which tools to use in the primary care setting.


Assuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia/instrumentação , Eletrocardiografia/métodos , Eletrocardiografia Ambulatorial , Humanos , Avaliação de Sintomas , Fatores de Tempo
10.
Med Clin North Am ; 103(5): 793-807, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378326

RESUMO

Cardiac arrhythmia is a common cause of syncope. The prompt identification of arrhythmic syncope has diagnostic and prognostic implications. In this article, an approach to identifying and managing arrhythmic syncope is discussed, including key findings from the history, physical examination, electrocardiogram, role of risk stratification, use of supplemental investigations, and treatment.


Assuntos
Arritmias Cardíacas/diagnóstico , Síncope/etiologia , Arritmias Cardíacas/complicações , Eletrocardiografia , Humanos , Exame Físico , Prognóstico , Síncope/epidemiologia
11.
Med Clin North Am ; 103(5): 809-820, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31378327

RESUMO

With recent advances in genetic diagnostics, many inherited diseases, which can cause life-threatening arrhythmias, are being better characterized. Many of these diseases are caused by genetic disorders that affect the function of the ion channels that regulate the action potential or the function of important cardiac muscle regulatory proteins. This article summarizes the diseases that we have learned about, such as the long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. The article examines the diagnosis, genetic screening of patients and their relatives, management, and referral to a specialist for further therapy.


Assuntos
Arritmias Cardíacas/congênito , Canalopatias/diagnóstico , Morte Súbita Cardíaca/etiologia , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/etiologia , Canalopatias/complicações , Humanos , Prognóstico , Avaliação de Sintomas
12.
Med Clin North Am ; 103(5): xv-xvi, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31378337
16.
Pediatr Cardiol ; 40(6): 1175-1182, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31172229

RESUMO

Non-invasive fetal electrocardiography (ECG) is a promising method for evaluating fetal cardiac electrical activity. Despite advances in fetal ECG technology, its ability to provide reliable, interpretable results in a typical outpatient fetal cardiology setting remains unclear. We sought to determine the feasibility of measuring standard ECG intervals in an outpatient fetal cardiology practice using an abdominal fetal ECG device that employs blind source separation with reference, an innovative signal-processing technique for fetal ECG extraction. Women scheduled for clinically indicated outpatient fetal echocardiogram underwent 10 min of fetal ECG acquisition from the maternal abdomen using specialized gel electrodes. A bedside laptop computer performed fetal ECG extraction, allowing real-time visualization of fetal and maternal ECG signals. Offline post-processing of 1 min of recorded data yielded fetal P-wave duration, PR interval, QRS duration, RR interval, QT interval, and QTc. Fifty-five fetuses were studied with gestational age 18-37 weeks, including 13 with abnormal fetal echocardiogram findings and three sets of twins. Interpretable results were obtained in 91% of fetuses, including 85% during the vernix period and 100% of twin fetuses. PR interval and RR interval of 18-24 week gestation fetuses were significantly shorter than those with gestational age 25-31 and 32-37 weeks. Of the six fetuses with abnormal rhythms on fetal echocardiogram, fetal ECG tracing was interpretable in five and matched the rhythm noted on fetal echocardiogram. Abdominal fetal ECG acquisition is feasible for arrhythmia detection and ECG interval calculation in a routine clinical setting.


Assuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia/métodos , Frequência Cardíaca Fetal , Diagnóstico Pré-Natal/métodos , Adulto , Instituições de Assistência Ambulatorial , Eletrocardiografia/instrumentação , Estudos de Viabilidade , Feminino , Idade Gestacional , Humanos , Pessoa de Meia-Idade , Gravidez , Adulto Jovem
17.
Chin Med J (Engl) ; 132(12): 1406-1413, 2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31205097

RESUMO

BACKGROUND: The long-term predicted value of microvolt T-wave alternans (MTWA) for ventricular tachyarrhythmia in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) remains unclear. Our study explored the characteristics of MTWA and its prognostic value when combined with an electrophysiologic study (EPS) in patients with ARVC. METHODS: All patients underwent non-invasive MTWA examination with modified moving average (MMA) analysis and an EPS. A positive event was defined as the first occurrence of sudden cardiac death, documented sustained ventricular tachycardia (VT), ventricular fibrillation, or the administration of appropriate implantable cardioverter defibrillator therapy including shock or anti-tachycardia pacing. RESULTS: Thirty-five patients with ARVC (age 38.6 ±â€Š11.0 years; 28 males) with preserved left ventricular (LV) function were recruited. The maximal TWA value (MaxValt) was 17.0 (11.0-27.0) µV. Sustained VT was induced in 22 patients by the EPS. During a median follow-up of 99.9 ±â€Š7.7 months, 15 patients had positive clinical events. When inducible VT was combined with the MaxValt, the area under the curve improved from 0.739 to 0.797. The receiver operating characteristic curve showed that a MaxValt of 23.5 µV was the optimal cutoff value to identify positive events. The multivariate Cox regression model for survival showed that MTWA (MaxValt, hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.01-1.11; P = 0.01) and inducible VT (HR, 5.98; 95% CI, 1.33-26.8; P = 0.01) independently predicted positive events in patients with ARVC. CONCLUSIONS: MTWA assessment with MMA analysis complemented by an EPS might provide improved prognostic ability in patients with ARVC with preserved LV function during long-term follow-up.


Assuntos
Arritmias Cardíacas/diagnóstico , Displasia Arritmogênica Ventricular Direita/diagnóstico , Eletrocardiografia/métodos , Eletrofisiologia/métodos , Taquicardia Ventricular/diagnóstico , Adulto , Teste de Esforço , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Função Ventricular Esquerda/fisiologia
18.
Med. infant ; 26(2): 123-129, Junio 2019. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1015231

RESUMO

Introducción: Las taquiarritmias en pediatría son uno de las principales motivos cardiológicos de consulta a la guardia. Durante el primer año de vida presentan una significativa morbi-mortalidad, por lo que el tratamiento farmacológico inmediato es fundamental para reducir la misma. Hasta los 3 años existe la posibilidad de curación espontánea en un porcentaje de éstos pacientes. La indicación de procedimientos de ablación durante los primero 4 años de vida se limita a casos refractarios al tratamiento antiarrítmico, dado que cuanto menor peso presenta el paciente, más pequeño es el corazón y más riesgoso es el mismo. Las taquicardias en pacientes con cardiopatía empeora el pronóstico de la misma. A pesar que el tratamiento farmacológico ha permitido el control de la gran mayoría de ellas, en muchos casos se requieren más de una droga antiarrítmica, con mayor exposición a efectos adversos, y en muchos otros se vuelven refractarias. En las últimas 3 décadas se ha desarrollado en forma exponencial el tratamiento de las taquiarritmias por medio de la ablación por radiofrecuencia o por frío (crioablación). Estos procedimientos han permitido obtener la curación de la mayor parte de las taquiarritmias en pediatría. En nuestro trabajo se evaluaron las indicaciones de dichos procedimientos en una población pediátrica, como así también la tasa de éxito, recurrencia, y la morbimortalidad tanto globalmente, como en cada arritmia (AU)


In children, tachyarrhythmias are one of the main reasons for cardiological consultation at the Department of Emergency. In the first year of life, they are associated with significant morbiditymortality and therefore, immediate drug treatment is essential up to 3 years of age. The indication of ablation procedures during the first 4 years of life is limited to patients refractory to antiarrhythmic treatment, since the lower weight of the patient, the smaller the heart and the riskier the intervention. In patients with heart disease, tachycardia worsens the prognosis. Although pharmacological treatment controls the vast majority of tachyarrhythmias, more than one antiarrhythmic drug is often required, leading to greater exposure to adverse effects, and many become refractory. Over the past three decades, treatment of tachyarrhythmias has developed exponentially with the advent of radiofrequency or cold ablation (cryoablation). These procedures have led to the cure of most tachyarrhythmias in children. Our study assessed the indications for these procedures in a pediatric population, as well as the success and recurrence rates, and morbidity both overall and of each arrhythmia episode (AU)


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Arritmias Cardíacas/epidemiologia , Taquicardia/epidemiologia , Registros , Criocirurgia , /métodos , Arritmias Cardíacas/cirurgia , Arritmias Cardíacas/diagnóstico , Taquicardia/cirurgia , Taquicardia/diagnóstico , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento
20.
Scand J Med Sci Sports ; 29(9): 1375-1382, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31059145

RESUMO

PURPOSE: Although both European (EACPR) and American (ACSM) Scientific Societies have devised cardiovascular protocols for the assessment of "middle-aged/older" individuals who are about to participate in sports or physical exercise, there are no data regarding the guidelines' sensitivity of these measures. The aim of this study was to compare the outcomes of different international screening protocols. METHODS: This observational cross-sectional study evaluated 525 subjects (80% males; median age 50 [35-85] years) seeking medical certification before participating in sports or regular exercise. The screening protocol consisted in completing a personal history profile, a physical examination, a resting ECG, a maximal exercise test, and, when required, additional instrumental evaluations. The effectiveness of the current EACPR as well as the former and new ACSM guidelines was thereby analyzed. RESULTS: The full screening protocol uncovered 100 previously undetected cardiovascular conditions (main pathologies detected: 21 coronary artery disease (CAD), 14 arterial hypertension, 38 complex arrhythmias). When the European guideline was used, 49% of these conditions went undetected, including 10 CAD. When the former American guideline was used, 29% (6 CAD) went undetected; when the recently updated edition was used, 50% including 11 CAD went undetected. CONCLUSION: The former ACSM guideline demonstrated a higher diagnostic sensitivity than the newer version and the EACPR guideline. Current screening protocols might be adapted for subjects performing high-intensity exercise due to their higher risk for cardiovascular and exercise-associated adverse events. The use of an incremental ECG-monitored maximal exercise test seems to improve these screening outcomes.


Assuntos
Doenças Cardiovasculares/diagnóstico , Teste de Esforço , Guias de Prática Clínica como Assunto , Medicina Esportiva/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/diagnóstico , Doença da Artéria Coronariana/diagnóstico , Estudos Transversais , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Medição de Risco , Sensibilidade e Especificidade , Sociedades Médicas , Esportes
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