Minnesota Code Manual of Electrocardiographic Findings (eBook)

Richard S. Crow, Ronald J. Prineas, Zhu-ming Zhang (Autoren)

eBook Download: PDF

2009 | 2nd ed. 2010
XIII, 328 Seiten
Springer London (Verlag)
978-1-84882-778-3 (ISBN)

Infos

The manual is suitable for training electrocardio- without digital recording and that are accompanied graphers and technicians and can be accompanied by other uniquely rich data. Despite my expectations by sets of training ECGs already coded by trainers. during the 1960s that such archives would cease to It is our expectation that the manual will serve as a be used after the introduction of digital recording, reference, guide, and training source for those con- the tide of such treasures has hardly ebbed. ducting studies that require objective evidence of The changes included in this edition arise from cardiac disease, both prevalent and incident, by non- more than a quarter of a century of directing central invasive, highly standardized, inexpensive record- ECG reading and research centers and collectively ing of the electrocardiogram. In our own ECG Read- 60+ large and small epidemiologic studies and m- ing Center, this has included epidemiologic studies ticenter national and international clinical trials. The among healthy populations, diabetics, psychiatric changes include the description of a new measuring patients, pregnant women, cohorts of patients with loupe in Chap. 3, developed over the past decade, to clinical heart disease, populations exposed to envi- better serve a more ef? cient and a more extensive ronmental contaminants such as arsenic, populations span for measurement of relevant durations, voltages, exposed to Chagas disease, and in clinical trials of and deviations from the isoelectric line. In Chap.

Inhalt

The Minnesota Code Manual of Electrocardiographic Findings: Standards and Procedures for Measurement and Classification 2
Contents 6
Preface to the Second Edition 7
Preface to the First Edition 9
Acknowledgements 11
Chapter 1 12
What Is the Electrocardiogram or ECG1? 12
The Electricity Part of the ECG 13
Chapter 2 17
ECG Leads 17
Bipolar Limb Leads (I, II, III) 17
Unipolar Limb Leads (aVR, aVL, aVF) 18
Chest Leads (V1, V2, V3, V4, V5, V6) 19
Chapter 3 21
Measuring Devices 21
Recording Paper Grid 21
Measuring Loupe 23
Plastic Ruler 24
Calibration Deflection 24
Beats to Be Measured 24
Mathematical Symbols 26
Differences in Measurement between Visual and Electronic Measurements 26
Reference 26
Chapter 4 27
Q-QS Waves (1-Codes) 27
Chapter 5 60
Frontal Plane QRS Axis (2-Codes) 60
Frontal Plane T-Wave Axis 65
Reference 65
Chapter 6 66
High R-Waves (3-Codes) 66
Chapter 7 71
ST Segment Depression (4-Codes) and Negative T-Waves (5-Codes) 71
Chapter 8 109
Atrioventricular (A-V) Conduction Defects (6-Codes) 109
Chapter 9 122
Intraventricular Conduction Defects (7-Codes) 122
References 144
Chapter 10 145
Arrhythmias, 8-Codes 145
Chapter 11 170
Miscellaneous Codes (9-Codes) 170
Lead Reversals 182
References 197
Chapter 12 198
Exact Measurements 198
References 213
Chapter 13 214
Coding the Whole ECG 214
Coding Hierarchy 214
Data Recording 215
Chapter 14 217
ECG Data Acquisition Procedures and Maintenance of Recording Quality Including Technician Training 217
Preparation of Study Participant 217
Participant Position 217
Fasting State 217
Single Channel Electrocariographs 218
Machine Standardization 218
Electrodes and Electrode Placement 218
Electrode Position Measurement and Marking 218
Application of Electrodes 219
ECG Recording 219
Mounting Electrocardiograms 219
Twelve-Lead ECG Using Multichannel Electrocardiographs 223
Electrode Position Measuring and Marking 223
Electrode Placement 223
Attaching the electrodes 226
Fault Detection Procedures 226
Self-Evaluation of Technical Performance 226
Continued Quality Assurance for Electrocardiographs 229
ECG Quality Grading for Electronic ECGs 233
Training of Clinic Site ECG Technicians Helps to Maintain High Quality ECG Recording 233
Quality Control of ECG Data Collection and Processing Procedures 233
Quality Control at Field Centers 234
Quality Trend Monitoring 234
Minimizing Biologic Variability 234
Rest ECG 234
References 235
Chapter 15 236
Criteria for Significant Electrocardiographic Change 236
Evolving ECG-LVH (Minnesota Code 3-1 and 3-3 or ECG Measures for LVH) 242
Serial Change for Acute Myocardial Infarction 243
Categories of Significant ECG Waveform Change Determined by Minnesota Code Serial Comparison 243
References 272
Chapter 16 273
ECG Indices that Add to Independent Prognostication for Cardiovascular Disease Outcomes 273
QRS/T Angle and Spatial T Axis 273
(A) The spatial QRS/T angle from X, Y, and Z leads by a matrix transformation methods – “QRS/T matrix” 274
(B) The spatial QRS/T angle by using the net QRS and T amplitudes in 3 standard leads – “QRS/T simple” 274
(C) The frontal plane QRS/T angle defi ned as the absolute value of the difference between the frontal plane QRS axis and T axis in the route ECG report directly – “QRS/T frontal” 275
(D) Spatial T-wave axis based on areas of the wave components of the QRS complex and T wave 275
Heart Rate Variability 276
References 279
Chapter 17 280
Quality Control of Visual and Electronic Coding 280
Visual Coding 280
Analysis of Repeatability Tests 281
Qualitative Variables 281
Kappa Statistics 282
Quantitative Variables 282
The Minimum Accepted Standard for Repeatability Tests 283
Quality Control of Electronically Processed ECGs 285
Trend Analysis 286
References 286
Appendix A 287
MINNESOTA CODE 2009 287
Q and QS Patterns 287
QRS Axis Deviation 288
High Amplitude R Waves 288
ST Junction (J) and Segment Depression 289
T-Wave Items 290
A-V Conduction Defect 290
Ventricular Conduction Defect 291
Arrhythmias 292
ST Segment Elevation 293
Miscellaneous Items 293
Incompatible Codes 294
ECG Criteria for Signifi cant Serial ECG Change 294
Evolving Q-wave 294
Evolving ST-Elevation 295
Evolving ST-Depression / T Wave Inversion 295
Evolving Bundle Branch Block 296
Evolving ECG – LVH 5 296
Appendix B 297
The Novacode Criteria for Classifi cation of ECG Abnormalities and Their Clinically Signifi cant Progression and Regression 297
The Structure of the Novacode -- Coding Categories for Prevalent ECG Abnormalities 297
Measurement 297
Dictionary of Variables and Novacode Defi nitions of ECG Wavesa 300
Defi nitions of ECG Waveform Variables 300
General Defi nitions Related to Rhythm Codes 301
Codes for Prevalent ECG Abnormalities 301
1. Rhythm Codes 302
2. Atrioventricular Conduction Abnormalities 306
3. Prolonged Ventricular Excitation 309
4. Prolonged Ventricular Repolarization 310
5. ECG Categories Associated with Prevalent Myocardial Infarction/Ischemia (MI Likelihood) 311
6. Left Ventricular Hypertrophy 312
7. Left Atrial Enlargement 313
8. Right Ventricular Hypertrophy 313
9. Right Atrial Enlargement 313
10. Fascicular Blocks 313
11. Other Clinically Signifi cant Abnormalities 314
Defi nitions of Supplementary Codes (S) 314
The Novacode Criteria for Classifi cation of Myocardial Infarction and Ischemic Abnormalities 318
Waveform Pattern Labels for Coding of Q Wave Abnormalities 318
Lead Groups for Coding of Myocardial Infarctions and Ischemic Abnormalities 319
Coding of Repolarization Abnormalities 319
Classifi cation Criteria for Prevalent Myocardial Infarction and Categorization for Risk Stratifi cation 320
Classifi cation of Incident Myocardial Infarctions 320
Criteria for Other (than Incident MI) Incident or Progressing EGG Abnormalities 327
I 0 Serial Change Uncodable (Totally or Partially) Due to Suppression Code 327
I 1 Incident Arrhythmias 327
I 2 Incident AV Conduction Abnormalities 329
I 3 Incident Prolonged Ventricular Excitation 330
I 4 Incident Prolonged Ventricular Repolarization 332
I 5 Incident ECG Abnormalities Related to Myocardial Infarction and Ischemia 332
I 6 Incident Left Ventricular Hypertrophy (LVH) 332
I 7 Incident Left Atrial Enlargement (LAE) 333
I 8 Incident Right Ventricular Hypertrophy (RVH) 333
I 9 Incident Right Atrial Enlargement (RAE) 333
I 10 Incident Fascicular Block 334
References 334
Appendix C 335
Major and Minor ECG Abnormalities for Population Comparisons with Minnesota Code and Novacode Equivalents 335
Index 337

Produkt-Details

• Erscheint lt. Verlag: 26.10.2009
• Zusatzinfo: XIII, 328 p.
• Verlagsort: London
• Sprache: englisch
• Original-Titel: The Minnesota Code Manual of Electrocardiographic Findings: Standards and Procedures for Measurement and Classification
• Themenwelt: Medizinische Fachgebiete ► Innere Medizin ► Kardiologie / Angiologie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Notfallmedizin
• Schlagworte: Cardiovascular • electrocardiogram (ECG) • Electrocardiographic • necrosis • vascular disease
• ISBN-10: 1-84882-778-4 / 1848827784
• ISBN-13: 978-1-84882-778-3 / 9781848827783