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Article
The ECG Manifestation of Hyperkalemia in End Stage Renal Disease Patients on Maintenance Haemodilysis

Author: Sahban Al- Malah
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 3 Pages: 245-248
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:It is speculated that usual electrocardiographic manifestations of hyperkalemia are less pronounced in patients with end stage renal disease ((ESRD)) than in those with normal renal function, those patients usually have tolerance for hyperkalemia and the usual cardiac and neuromuscular sequalaes are less evident possibly due in part to fluctuation in serum calicium concentraton .METHODS:We studied 70 consecutivly selected stable haemodialysis patients to determine the prevalence of ECG changes of hyperkalemia, predialysis serum potassium concentration and pther electrolytes were measured and smiltaneous 12- lead electrocardiogram obtained.RESULTS:The 70 study subjects ((35 males, 35 females )) age 45.5_+10.6((range 24-60)) mean duration of ESRD was 22_+20 months((range4-60 )).-Mean predialysis serum potassium concentration was 4.7 _+0,9mEq/L(range 3.5-7.1). – Mean precordil leads T wave amplitude for entire group was 5.2_+4.4mm.- Mean T wave to R wave ratio was 0.4 _+ 0.1 .- Mean serum calcium concentration was 9.0_+0.61mq/dl(range 7.5-11.8).-No study subject had evident arrhythmia.-There was no significant difference in T wave amplitude (p=o.11)or T wave to R wave (p=0.12) between quartiles of serum potassium concentration.-Total serum calcium concentration had inverse relation with T wave amplitude ( p=0.007).CONCLUSION:Haemodialysis patients with hyperkalemia may not exhibit the electrocardiographic changes of hyperkalemia, thus the absence of ECG changes in hyperkalemic haemodialysis patients should interpreted with caution

Keywords

ECG --- ESRD --- haemodilysis --- hyperkalemia.


Article
ECG CHANGES DURING UPPER GASTROINTESTINAL TRACT ENDOSCOPY (A PROSPECTIVE STUDY)

Authors: Mutez Nahi Mansur --- Issam Merdan --- Ali Raheem --- Mazin Hawaz Al Hawaz
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2006 Volume: 12 Issue: 1 Pages: 86-91
Publisher: Basrah University جامعة البصرة

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Abstract

This study aimed to evaluate the cardiac changes and complications that occurred in patients who underwent upper gastrointestinal tract endoscopy. The study was conducted from January 2002 to December 2002at Basrah General Hospital and Al-Sadir Teaching Hospital. One hundred and forty eight patients complaining of upper gastrointestinal tract disorders were included in this study. Detailed history, physical examination and ECG was taken before, during and half hour after endoscopic examination. Patients were divided into two groups according if they have previous cardiopulmonary diseases.One hundred and forty eight patients included in the study, 91 males and 57 females. The age group between 20–40 years represent the commonest group underwent oesophago-gastroduodenoscopy (O.G.D) examination.All ECG changes that developed in patients before endoscopic examination arise from those who had cardiopulmonary diseases. Forty-two (40.4%) and 21 (47.7%) patients from group I. and group II. respectively showed abnormal ECG changes while 18 (17.3%) and 13 (29.5%) patients from group I. and group II. respectively showed abnormal ECG findings half hour after endoscopic examination . Bradycardia represents the commonest ECG changes occurred during and half hour after examination. We concluded that OGD is a safe procedure but in elderly patients and those with cardiopulmonary disease ECG monitoring should be done during endoscopic examinationBas J Surg, March, 12, 2006

Keywords

ECG --- GASTROINTESTINAL --- ENDOSCOPY


Article
The relation between ECG changes and troponin test in patients with non ST segment elevation acute coronary syndrome
العلاقة بين رسم القلب الكهربائي وفحص التروبونين I في مرضى المتلازمة التاجية الحادة غير المصاحبة لإرتفاع قطعة ST

Author: Arwa M. Fuzi Al-Sarraf اروى محمود فوزي الصراف
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2013 Volume: 39 Issue: 1 Pages: 12-18
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACTObjectives: This article focuses on unstable angina and non ST segment elevation myocardial infarction. The objectives are to clarify different ECG pattern, to correlate it with troponin results, and to evaluate the effects of risk factors. Methods: Seventy patients with clinical diagnosis of acute coronary syndrome were collected from coronary care unit in Ibn Sina Teaching Hospital in Mosul, 20 patients with ST segment elevation were excluded, and ECG changes were evaluated. Forty five patients had troponin I test, and the results were compared to their ECG changes. The risk factors and their numbers were studied. Data statistically analyzed using Z- 2 proportion and Chi-square tests. Results: Fifty patients with a mean age 57 year (SD 13.2), including 26 males and 24 females, show (in order of frequency): ST depression (44%), non-specific ECG (24%), T wave inversion (22%), and BBB (10%). Fifteen (33%) had positive troponin test, most of them were males (80%), showed significant association with T wave inversion (p value= 0.05). Specific ECG changes were associated with male gender, diabetes mellitus, hypertension, and old age (p value<0.03). Troponin positivity was associated with male sex (p value=0.003). Male gender and smoking were associated with positive troponin in significant ECG group (p value<0.04). All patients with positive troponin had at least two risk factors (p value=0.002).Conclusion: ST segment depression was the most common ECG changes in non ST elevation acute coronary syndrome, but T wave inversion was more significantly associated with troponin positivity, which differs from previous studies. Male gender was the most critical risk factor; this was consistent with previous studies. Number of risk factor has important effect on ECG and troponin results.

الخلاصةالأهداف: هذه الدراسة تركز على النوبة القلبية غيرالمستقرة، وإحتشاء عضلة القلب غير المصاحب لإرتفاع قطعة ST . الأهداف هي توضيح أنماط رسم القلب الكهربائي، إختبار إيجابية فحص تروبونين I ، وتقييم عواملِ الخطورة.الطريقة: سبعون مريضا شخصوا سريريا بالمتلازمة التاجية الحادة جمعوا من وحدة العناية القلبية في مستشفى ابن سينا التعليمي في الموصل، بعد إستثناء 20 حالة مصاحبة لإرتفاع قطعةST ، تم دراسة أنماط تغييرات رسم القلب لهؤلاء المرضى. وأجري إختبار التروبونين لخمسة وأربعون مريضا منهم، وقورنت نتائج إختبار التروبونين لديهم مع تغييرات رسم القلب الكهربائي. درست عوامل الخطورة وعددها وتأثيرها على أنماط رسم القلب الكهربائي ونتائج إختبار التروبونين. حللت نتائج هذه البيانات إحصائيا بإستخدام إختباري كاي وZ.النَتائِج: تم تشخيص خمسين مريضا بالمتلازمة التاجية الحادة غير المصاحبة لإرتفاع قطعة .STمتوسط أعمارهم 57 سنة: (26 ذكرا و 24 أنثى). أظهر رسم القلب الكهربائي لديهم التغييرات الآتية (من الأكثر الى الأقل شيوعا) : إنخفاض فطعة ST (44%)، تغييرات غير محددة في رسم الفلب (24% (، إنعكاس موجة T (22% (وحصرالحزيمة BBB ) 10%.( كان إختبار تروبونين إيجابي لدى خمسة عشر مريضا (33%) ، ومعظمهم كانوا ذكورا (80%)، وأظهروا علاقة إحصائية مهمة مع إنعكاس موجة .Tإرتبط وجود تغييرات مهمة في رسم القلب الكهربائي بالعوامل التالية: الجنس الذكر، داء السكري، إرتفاع ضغط الدم، والشيخوخة. فيما إرتبطت إيجابية اختبار التروبونين بالجنس الذكر. كان فحص التروبونين إيجابيا في المجموعة التي أظهرت تغييرات مهمة في رسم القلب في الذكور والمدخنون. كل المرضى الذين أظهروا فحص تروبونين إيجابي كان لديهم عاملي خطورة على الأقل.الخاتمة: إنخفاض القطعة ST كان التغير الأكثر شيوعاً في رسم القلب الكهربائي لمرضى المتلازمة التاجية الحادة غير المصاحبة لإرتفاع قطعة ST، لكن إنعكاس موجة Tكان أكثر إرتباطا بإيجابية فحص التروبونين، وهذا معارض لبعض الدراسات السابقة. الجنس الذكر كان عامل الخطورة الأكثر حرجا في المتلازمة التاجية الحادّة، وهذا كان متسقا مع الدراسات السابقة. عدد عوامل الخطورة له تأثير مهم على رسم القلب الكهربائي ونتائج فحص التروبونين.

Keywords

ECG --- troponin --- ACS


Article
EVALUATION OF DOG ELECTROCARDIOGRAPHY IN HYPOKALEMIA

Author: Israa Abdul Wadood Mohammad Ali
Journal: Basrah Journal of Veterinary Research. مجلة البصرة للابحاث البيطرية ISSN: Print:18138497 E; 24108456 Year: 2014 Volume: 13 Issue: 2 Pages: 87-94
Publisher: Basrah University جامعة البصرة

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Abstract

The objective of the work was to study Electrocardiography in normal doges and in dogs treated with intravenous furosemide for 14 days.In present study eight dogs in different sex and two years age used ,serum potassium level determined using commercial kit and ECG evaluate twice daily pre and post furosemide use .ECG tracing compared in the two groups (treated and control) . when serum k+reach (4.4 mEq/ L ±1.044) at day four from starting , and in the last five days oftreatment the mean of serum potassium reach (3.2 m Eq /L ± 0.504 ). the electrocardiographic changes shows features of hypokalemia T inversion or flatting of T wave in limb leads (I,II,III),avl, avf and most of the chest leads .

Keywords

Furosemide --- ECG --- Serum.


Article
ECG MONITORING SYSTEM BASED ON MICROCONTROLLER
نظام مراقبة لأشارة تخطيط القلب بالاعتماد على المسيطر الدقيق

Authors: Hadeel Nasrat Abdullah هديل نصرت عبد الله --- Wajid Dawood Alwan واجد داود علوان
Journal: DIYALA JOURNAL OF ENGINEERING SCIENCES مجلة ديالى للعلوم الهندسية ISSN: 19998716/26166909 Year: 2016 Volume: 9 Issue: 2 Pages: 62-72
Publisher: Diyala University جامعة ديالى

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Abstract

Health monitoring systems becomes a hot topic and important research field. Electrocardiogram (ECG) signal is a diagnoses tool that measures and records the electrical activity of the heart, taking care of patient’s health. Therefore, monitoring this signal becomes a necessary need to take care of human health. In this paper, two procedures are proposed; first, monitoring the ECG signal, second for sending the signal of monitoring patients and ECG data through Serial communication port to the other pc or nurse. AT89C51 microcontroller uses to perform these procedures including all the necessary connections of the microcontroller with other components and programming the microcontroller using assembly language to send the signal serially. At both transmitting and receiving sides, the signal was gives the same setting of baud rate, stop bits, number of data bits, parity to ensure secure arrival of data without any lossless.

أصبحت أنظمة مراقبة الصحة موضوعا بارزا ومجال بحث مهم في الحاضر. حيث تفسر أشارة تخطيط القلب بأنها أداة تشخيص التي تقوم بقياس وتسجيل النشاط الكهربائي للقلب والعناية بصحة المريض . لذلك أصبحت مراقبة هذه الأشارة ضرورية للأهتمام بصحة الأنسان. تم في هذا العمل دراسة مراقبة هذه الاشارة و كيفية أرسالها باستخدام الأرسال المتوالي . تم أستخدام المسيطر الدقيق لتنفيذ مراقبة الاشارة متضمنة برمجة المسيطر الدقيق بلغة الماكنة وأرسال الأشارة عن طريق الـ ((TXD PIN الى حاسبة اخرى ليتم تحليل الاشارة ورسمها باستخدام حزمة الماثلاب. في كلا جانبي الارسال والاستلام تم اعطاء نفس (Baud Rate), (Stop Bits), (Number of Data Bits) لضمان وصول الاشارة بدون اي خسارة. تم أختيار عدد محدود من ال((Samples لمحدودية حجم الـ (Buffers) في كلا الجانبين.


Article
ECG abnormalities in first visit of diabetic patients in Al Sammawah Diabetic center: cohort study

Author: Saad Hallawee
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2017 Volume: 4 Issue: 1 Pages: 23-34
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Diabetes Mellitus is a very common progressive endocrine disease in Iraq (and our society) as part of whole world, and diabetic patients are more likely to have cardiovascular diseases than patients without diabetes. ECG is the most widely used simple noninvasive test for evaluation of cardiovascular risk, so our study was focused to assess the relation between the frequency of ECG changes with the patients glycemic control and their age group. A 600 patients with newly diagnosed diabetes Mellitus were identified from diabetic center in Al Sammawah teaching hospital. All are evaluated for variables; age, gender, glycemic control (HbA1c level) and ECG abnormalities. Then they are divided in two groups those with and others without ECG changes during evaluation of their above variables. The selected patients are 294 female and 309 male with most age distribution affected are 50-59 years 189(32%) followed by 40- 49 years,130(22%)then 60-69 age group119 (20%), 30-39 years 68(11%), >70 years 52 (9%) and <30 years about 37(6%). 327 patients with normal ECG and 273 patients with abnormal ECG, female was predominant by 55%, and ECG abnormality was distributed among low voltage in 110 patients (18 %), bradycardia in 54 patients (9%), with variable percent for the other ECG abnormalities. Diabetic control for most of the patients was poor according to HbA1c level which measured in the first visit and 77% of patients with HbA1c above 8. In conclusion; the age group distribution in Samawah city is comparable to the other population, but with very bad diabetic control which require more effective educational and advance therapeutic approaches to control this propagating challenge. ECG changes seen were predominantly low voltage, then bradycardia which may reflect other association which require more future research.

Keywords

Diabetes Mellitus --- ECG --- HbA1c


Article
QT interval analysis in type 2 diabetic patients

Author: Kawthar H. Msayer
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 4 Pages: 462-467
Publisher: Baghdad University جامعة بغداد

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Abstract

Summary:-Background: The electrocardiographic QT interval has been extensively studied in diabetes mellitus. Recently, there has been increasing interest in the relationship between diabetes and QT abnormalities .The QT interval, which is easily obtained from a standard resting electrocardiogram( ECG), reflected the total duration of ventricular myocardial depolarization and repolarization. The heart rate corrected QT interval (QTc) by Bazett's formula on the electrocardiogram has been proposed as a risk factor for ventricular arrhythmias in diabetes mellitus. Dispersion of QT(QTd) is defined as the difference between maximum and minimum QT interval QT interval on 12 lead ECG, which reflected spatial ventricular repolarization in homogeneity ,has been report to increase in diabetic subjects compare with non diabetic subjects. Patients and Methods: Type 2 diabetic patients (n=80) and healthy subjects (n=25) were required to have 12-lead ECG suitable for QT analysis ,QT interval was measured in each lead to found(maximum, minimum, and mean ).QT interval vary according to the heart rate, it can be corrected using Bazett's formula to give QTc interval, and to found (maximum, minimum, and mean).Dispersion of QT interval(QTd) was calculate using the difference between the maximum and minimum QT interval duration as same as for dispersion of corrected QT interval(QTcd). Result: There were significant difference in QT interval indices between type 2 diabetic and healthy subjects (P<0.05) as well as the correct QT interval indices. ROC curve analysis of QT and QTc interval duration parameters demonstrated that no QT parameters performs better than maximum and minimum of QT and QTc, areas under ROC curve were(0.69 and 0.66 P<0.001)for maximum and mean QT respectively and (0.80 and 0.75 P<0.001) for maximum and mean QTc respectively. From this result we can say that QTc parameters better than QT parameters in context of patients and control differences. In multiple linear regression models, maximum, mean, and dispersion of QT interval were significantly affect by diabetes mellitus after adjustment for age, gender, body mass index (BMI), and heart rate. Whereas, only maximum and mean QTc were significantly affected by diabetes mellitus after adjustment for age, gender, and BMI. Prolongation of QT interval (QTc and QTd) also seen in a diabetic subjects which significant different as compare to the healthy subjects. Conclusion: The result of this study indicate that corrected QT interval (maximum and mean)in a routine ECG is a useful marker to identify the QT abnormalities differentiating diabetes type 2 from healthy subjects.


Article
Electro Cardiographic Features of PtientsWith Tetralogy of Fallot

Authors: Dhia’a Hassan --- Fadhil Al-Rubaiy --- Sadiq M. Al-Hamash
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2007 Volume: 4 Issue: 1 Pages: 19-22
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: For many decades, the ECG was the workhorse of non-invasive cardiac test and today although other techniques provide more details about the structural anomalies in congenital heart diseases, ECG is likely to be part of clinical evaluation of patients with such diseases because it is inexpensive, easy to perform and in certain situations may be both sensitive and specific.
Objective: this study carried out to identify the pattern of ECG study in patients with TOF.
Methods: this is a retrospective study of 200 patients with TOF, referred to Ibn Al-Bitar cardiac center from April 1993 to May 1999. The diagnosis of TOF established by echocrdiographic, catheterization and angiographic study. For each patient, the ECG tracing had been analyzed for rhythm, p-wave, P-R interval, QRS axis, duration and T-wave in V1 and any chamber enlargement.
Results: The ECG analysis revealed that all patients had sinus rhythm, normal P-R interval and normal p-wave duration and amplitude, and normal QRS duration. All studied patients had one criteria of RVH and 95% of them had two or more of such criteria.
Conclusion: we found that in the absence of RVH criteria, the diagnosis of TOF is unlikely and the present of northwest axis should indicate canal type VSD.
Key words: ECG, TOF, congenital heart disease

Keywords

ECG --- TOF --- congenital heart disease


Article
Role of Flavonoinds From Nigella sativum seeds in Decreasing the Effect of Hydrogen Peroxide on ECG in Adult Male Rabbits
دور الفلافونيدات المعزولة من بذور الحبة السوداء في التقليل من تأثير بيرو كسيد الهيدروجين على المخطط الكهربائي للعضلة القلبية في ذكور الأرانب البالغة

Author: Barra Najim Al-Okaily براء نجم العقيلي
Journal: The Iraqi Journal of Veterinary Medicine المجلة الطبية البيطرية العراقية ISSN: 16095693 Year: 2009 Volume: 33 Issue: 1 Pages: 141-148
Publisher: Baghdad University جامعة بغداد

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Abstract

This experiment was carried out to evaluate the role of flavonoinds of Nigella sativum seeds to reduce the effect of hydrogen peroxide on electrocardiography in rabbits. Eighteen adult male rabbits were divided into three equal groups (6group) and were treated for six weeks as follows: first group (control), which were given ordinary tap water, second treated group (T1), animals in this group given 0.5%H2O2 in drinking water and third treated group (T2) was handled as in T1 plus oral intubation of flavonoinds (27.5mgKg B.W). Electrocardiography was recordings from rabbits after 3 and 6 weeks of treatment. The results conducted that H2O2 treated group (T1) showed significant increased in P-R interval, R-voltage and significant decreased in T-wave voltage and heart beats. While treatment of animals with flavonoinds of Nigella sativum seeds caused significant decrease in P-R interval and R-voltage with an increase in T-wave voltage and heart beats, direct to ward their control levels. It was concluded that the flavonoinds of Nigella sativum can ameliorate the deleterious effects of hydrogen peroxide on electrocardiography .More studies are needed to convince these findings.

صمم هذا البحث لتقييم دور فلافونيدات بذور الحبة السوداء في التقليل من الأذى المحدث ببيرو كسيد الهيدروجين مع ماء الشرب على المخطط الكهربائي للعضلة القلبية في ذكور الأرانب . تم استخدام 18 أرنباً بالغاً قسمت الى ثلاث مجاميع متساوية (6/مجموعة) وعوملت لمدة ستة أسابيع كالأتي:المجموعة الأولى (السيطرة)أعطيت ماء الشرب الاعتيادي ،مجموعة المعاملة الثانية(T1) أعطيت ماء الشرب الاعتيادي مضافاً إليه بيروكسيد الهيدروجين بتركيز0.5% أما المجموعة الثالثة (T2) تم معاملتها كما في T1 بالإضافة الى تجريعها فلافونيدات بذور الحبة السوداء ( 27.5 ملغم/كغم من وزن الجسم). جمعت نماذج الدم قبل المعاملة وبعد مرور ثلاثة وستة أسابيع من المعاملة لغرض حساب عدد الصفيحات المويه وزمن تخثر البروثرومبين . تم تسجيل المخطط الكهربائي للعضلة القلبية (ECG)خلال هذه الفترة من المعاملة. أظهرت نتائج المخطط الكهربائي للقلب حدوث زيادة معنوية في طول فترة P-R ومعدلات فولتية R إضافة الى وجود انخفاض معنوي في موجة T ومعدل ضربات القلب في ألمجموعه المعاملة ببيروكسيد الهيدروجين ، في حين لوحظ وجود انخفاض معنوي في طول فترة P-R وقيم فولتية R وارتفاع في موجة T وزيادة في معدل ضربات القلب عند معاملة الحيوانات بفلافونيدات بذور الحبة السوداء واقتربت المعدلات من مثيلاتها في مجموعة السيطرة. يستنتج من هذه الدراسة إن فلافونيدات بذور الحبة السوداء ربما تؤدي الى تحسن المخطط الكهربائي للعضلة القلبية من خلال تقليل الدور التخريبي لبيروكسيد الهيدروجين،والتي بحاجه الى المزيد من الدراسات لتفسيرها.

Keywords

P-wave --- ECG --- H2O2 --- flavonoids


Article
Remote ECG Signal Monitoring Via Internet
مراقبة اشارة نبضات القلب عبر الانترنيت

Authors: Saleh M. Al-Qaraawy --- Hamid Mousa Hasan --- Maher Faik Esmaile
Journal: Engineering and Technology Journal مجلة الهندسة والتكنولوجيا ISSN: 16816900 24120758 Year: 2009 Volume: 27 Issue: 7 Pages: 1324-1335
Publisher: University of Technology الجامعة التكنولوجية

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Abstract

In this paper the Internet was used as a media for transmission an ECG (Electro-Cardio-gram) signal from a patient directly to a remotely reside doctor or consultant whowill respond via the same media directly. The ECG signal (at patient side) has beencompressed in a manner to achieve low bandwidth requirement by using Matlabcapabilities. Also, at consultant side the original signal is reconstructed using the samecapabilities of Matlab. The Internet works as the center of communication between thetwo sides. A database was used to store the patient information which can be handledeasily by consultant. Respecting the internet no more than a simple rented web site wasrequired as a file storage shared between the consultant and patient. The results showthat the received signal at the doctor side after reconstruction had the complete andcompatible to the signal used for diagnosis.

في هذه البحث ، إستعمل ْ ت شبكة الإنترنت كوسيلة لإرسالِ إشارَة (إي سي جي ) مِ  ن المريضمباشرة إلى الط بيب أو الاستشاري ع  ن ب  عد والذي سي  ر  د عن طريق نفس المنظومة مباشر ة. ضغِط ْ تإشارة ال ( إي سي جي ) في جانبِ المريض باسلوب للحصول على متطلبِ ذو المجالِ المنخفضِأيضاً في جانب الطبيب أو الاستشاري فان الإشارَة الأصلي َ ة سيعاد ، Matlab بإستعمال قابلياتِ الالإنترنت تَ  عملُ كمركز الإتصالِ بين الجانبين . هنالك قاعدة .Matlab بناءها باستخدام نفس قابلياتِبيانات قد انشأت لخزن معلومات المريض والتي من الممكن الوصول اليها بسهولة من قبل الاستشاري .كذلك بالنسبة الى الانترنيت لم نحتاج الى اكثر من موقع بسيط تم استأجار ه ليعمل كواسطة لخزنالملفات ويتم استخدامه من قبل الاشتشاري والمريض . أظهرت النتائج بان الاشارة المستلمة من قبلالطبيب كاملة المواصفات بعد اعادة بنائها ومطابقة للاشارة المرسلة لاستخدامها للاغراض التشخيصية

Keywords

ECG Monitoring --- Via Internet --- FTP

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