Electrocardiographic changes during cholangiopancreatography: Methods

rate-pressure productAfter the usual skin preparation, modified V2 and V5 electrocardiographic leads were recorded on two channel Circadian Recorders (Circadian Inc, USA). The lead of most significance (V5) was analyzed in detail. The positive electrode was placed in the V5 position and the negative electrode was placed in the right intraclavicular fossa. Because the procedure was elective, electrocardiographic recording usually was initiated 4 h before the procedure and was continued during the examination and 4 h after it. All patients were advised to record in a diary any symptoms of palpitations, shortness of breath or chest pain. Immediately before ERCP, a 12-lead electrocardiogram and resting rhythm strip was available during Valsalva maneuver and during its recovery time. Continuous arterial blood pressure and oximetry monitoring data were recorded throughout the procedure. When it was necessary, arterial blood pressure also was measured by cuff sphygmomanometer in supine position.

During analysis the rate-pressure product was calculated by microcomputer for each of one minute recording. Two channel qualitative and quantitative electrocardiographic analysis was performed by a computerized nontriggered template system. Particular attention was paid to arrhythmias of any kind, change in cardiac axis, conduction defects, pauses, ST segment changes and extrasystoles. The following definitions were used. Myocardial ischemia: a depression or elevation in ST segment of 0.1 mV or more from baseline measured at 60 ms from the j point; episodic hypoxemia: a sudden decrease in oxygen saturation of more than 4% from baseline; tachycardia: a heart rate above 100 beats/min; bradycardia: a heart rate below 50 beats/min; abnormal complexes: abnormal QRS-shaped complexes with a coupling interval of more than 80 % of the preceding RR interval; ventricular extrasystoles: abnormal QRS-shaped complexes with a coupling interval less than 80% of the preceding RR interval. Isn’t it nice to know you will soon be able to shop for your drugs online with the best pharmacy that will take great care of you? You do have this opportunity to buy levitra super active plus now that you have the best pharmacy waiting for your decision and offering cheapest drugs of best quality.

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