Edorium Journal of

Anesthesia

 
     
Short Report
 
Pre-hospital use of high-frequency QRS analysis in healthy volunteers and patients with symptoms of coronary artery disease in acute care settings
Djordjevic Jelena1, Velickovic Filip1, Rajkovic Tatjana1, Marinkovic Jelena2, Mihajlovic Stevan3, Milan Zoka4
1Doctor of Medicine, Emergency Medical Service Nis, Nis, Serbia
2Professors of Statistics, Belgrade School of Medicine, Belgrade, Serbia
3Consultant Anesthetist, Pancevo Hospital, Pancevo, Serbia
4Consultant Anesthetist, Honorary Professor of Anesthesia, King’s College Hospital, London, UK

Article ID: 100012A05DJ2017
doi:10.5348/A05-2017-12-SR-1

Address correspondence to:
Jelena Djordjevic
Nis
Republic of Serbia

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How to cite this article
Jelena D, Filip V, Tatjana R, Jelena M, Stevan M, Zoka M. Pre-hospital use of high-frequency QRS analysis in healthy volunteers and patients with symptoms of coronary artery disease in acute care settings. Edorium J Anesth 2017;3:1–6.


ABSTRACT
Aims: This study was performed to compare the difference in the incidence of abnormal high frequency QRS (HF-QRS) 12-lead finding and standard ECG ST-T segment changes, as an indicator of myocardial ischemia, between patients admitted to the accident and emergency (A&E) department for ischemic heart symptoms and a control group consisting of A&E departmental employees.
Methods: The study group consisted of 24 patients admitted to the A&E department with some ischemic heart symptoms and the control group consisted of hospital employees who had no symptoms of coronary artery disease (CAD). Results: Control participants were an average of 10 years younger than the patients in the study group, and also had less history of diabetes mellitus and hypertension. The incidence rate of ST-T changes (Control vs patients 5.9% vs 29.2%, p=0.064) and HF-QRS changes (Control vs patients 23.5% vs 33.3%, p=0.497) were not different between the control and study group. However, HF-QRS changes were more frequent than ST-T changes (29.3% vs 19.5%, p < 0. 0001). There were no correlations between ST-T and HF-QRS changes in the two groups (Cramers V 0.089, p = 0.568). In univariate logistic regression analyses, the only predictor of positive HF-QRS was age (odds ratio [OR]: 1.112; 95% confidence interval [CI]: 1.019–1.213); each additional year of age was associated with an 11.2% increase in the risk of positive HF-QRS. However, none of the variables was a predictor of ST-T changes with significance level set at 0.05.
Conclusion: In our pilot study, HF-QRS analysis detected more ECG changes indicating ischemia in acute settings than standard ECG ST segment changes. Larger studies are required to verify the role of HF-QRS technology in detecting early myocardial ischemia in pre-hospital setting.

Keywords: Coronary artery disease, Electrocardiography, High-frequency QRS, Pre-hospital, Volunteers


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Author Contributions
Djordjevic Jelena – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Velickovic Filip – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Rajkovic Tatjana – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Marinkovic Jelena – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Mihajlovic Stevan – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Milan Zoka – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Djordjevic Jelena et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.


About The Authors

Djordjevic Jelena is currently working at Emergency Medical Service Nis, Nis, Serbia. Her area of interest include coronary artery disease. She intends to pursue a fellowship in Internal Medicine. Email: jelena711@yahoo.com



Velickovic Filip is currently working at Emergency Medical Service Nis, Nis, Serbia. His area of interest inculde kidney diseases and hypertension disorders. He intends to persue a fellowship in Nephrology.



Rajkovic Tatjana is currently working at Emergency Medical Service Nis, Nis, Serbia and she is member of European board Examination in Emergency Medicine. She earned postgraduate degree Emergency Medicine Specialist from Medical University Nis, Serbia and started Phd study at Medical University in Belgrade, Serbia. Her research interests include different emergency conditions. She has published more than 30 research papers in national and international academic journals. Email: ehsanurrahman09@gmail.com



Md. Obaidul Haque is currently working as Associate Professor and Head of Physiotherapy Department, BHPI, CRP. He obtained BSc (Hons) in Physiotherapy degree in 2001 and MSc in Physiotherapy degree in 2016 respectively from University of Dhaka. In addition, he obtained Master of Public Health in epidemiology from North South University in 2012. He has published thirteen papers in national and international journal. Email: physioobaid@gmail.com



Marinkovic Jelena Consultant Anesthetist, Pancevo Hospital, Pancevo, Serbia.



Mihajlovic Stevan Professors of Statistics, Belgrade School of Medicine, Belgrade, Serbia.




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