Objetivos: Avaliar a evolução e as complicações dos doentes que sobreviveram a ferimentos cardíacos, atendidos no Pronto-Socorro Municipal 28 de Agosto e Hospital Pronto-Socorro Dr. João Lúcio Pereira Machado, em Manaus, no período de janeiro de 1998 a junho de 2006. Métodos: Foi realizada uma busca de prontuários dos doentes atendidos nos dois prontossocorros, nos quais durante a toracotomia exploradora evidenciou-se o ferimento cardíaco. Os sobreviventes que retornaram ao ambulatório foram avaliados prospectivamente por meio de eletrocardiograma e ecocardiograma, para averiguar a morfologia e a funcionalidade do coração. Foi preenchido um protocolo com registro dos dados dos doentes, tais como: idade, sexo, mecanismo de trauma, complicações intra e pós-operatórias, dentre outras variáveis. Resultados: A população de referência totalizou 100 doentes, dos quais 95% eram homens, 69% entre 20 e 30 anos; 81% das lesões foram por arma branca, sendo que em 78% delas, a entrada se encontrava no precórdio; 41% das lesões acometeram o ventrículo direito (VD) e 38% acometeram o ventrículo esquerdo (VE); em 48% dos casos foi realizada toracotomia ântero-lateral esquerda. A sobrevivência foi de 72%. A população de estudo foi composta por 25 doentes que retornaram ao ambulatório e foram avaliados prospectivamente por meio de eletrocardiograma e ecocardiograma. Das 33 alterações no ecocardiograma (ECO), sete doentes (28%) tinham insuficiência mitral, enquanto nove (36%) não tinham alterações. Das 45 alterações no eletrocardiograma (ECG), oito doentes (32%) tinham taquicardia sinusal, enquanto seis (24%) não tinham alterações. Não houve efeito do tempo no resultado do ECO (p=0,5323) ou do ECG (p=0,6596). Das alterações detectadas no ECO, três (21,4%) foram devidas a lesões grau IV (em VD) e 11 (78,7%) devidas a lesões grau V (em VE) (p=0,048). Das 12 alterações detectadas no ECG, três (25%) relacionaram-se a lesões grau IV e nove (75%) relacionaram-se a lesões grau V (p=0,226). Conclusões: Aproximadamente um terço dos sobreviventes a lesões cardíacas não apresentaram alterações ao eletrocardiograma e ecocardiograma. Ventrículo esquerdo e grau de lesão V da OIS-AAST estiveram relacionados a um maior número de alterações ao eletrocardiograma e ecocardiograma. Taquicardia sinusal e insuficiência mitral foram alterações encontradas em um de cada três doentes que sobreviveram a um ferimento cardíaco. / Objectives: To evaluate the evolution and the complications of the patients that survived cardiac wounds, attended at the Pronto-Socorro Municipal 28 de Agosto and Hospital Pronto-Socorro Dr. João Lúcio Pereira Machado, in Manaus, during the period of January 1998 until June 2006. Methods: A medical records evaluation was made among the patients attended at the two emergency hospitals in which a cardiac wound was found during a exploring thoracotomy. The survivors that returned to the ambulatory were evaluated prospectively through electrocardiogram and echocardiogram, so it was possible to analyze the morphology and the function of the heart. A protocol was filled out with a registry of patients data, such as: age, sex, trauma mechanism, intra-operative and post-operative complications, and other variables. Results: The total reference population in this study was 100 patients, in which 95% were male, the majority (69%) had ages until 30; 81% of the lesions were caused by stab wounds; 78% of the orifice of entry were located at the precordium; 41% of the lesions wounded the right ventricle and 38% wounded the left ventricle; In 48% of the cases a left antero-lateral thoracotomy was executed. The survival rate was 72%. The studied population was of 25 patients that returned to the ambulatory and were prospectively evaluated with electrocardiogram and echocardiogram. Among the 33 echocardiogram alterations (ECO), seven patients (28%) had mitral insufficiency, while nine (36%) didn\'t have any alterations. Among the 45 electrocardiogram alterations (ECG), eight patients (32%) had sinusal tachicardia, while six (24%) had no alterations. Time made no difference in the results of the ECO (p=0,5323) or of the ECG (p=0,6596). Of the 14 detected ECO complications, three (21,4%) were due to IV degree lesions in the right ventricle and eleven (78,7%) were due to V degree lesions (in the left ventricle) (p=0,048). From the 12 left ventricle lesions that complicated (ECG), 9 were V degree. From the 12 alterations detected at the ECG, three (25%) were due to IV degree lesions and nine (75%) were due to V degree lesions (p=0,226). Conclusions: Approximately one third of the cardiac wound survivors did not have alterations in the electrocardiogram and echocardiogram. Left ventricle and V degree lesions from the OIS-AAST were related to a larger number of alterations in the electrocardiogram and echocardiogram. Sinusal Tachicardia and mitral insuficiency were alterations found in one third of the patients that survived a cardiac wound.

As extrassístoles são achados frequentes em pacientes ambulatoriais, o que suscita o interesse em avaliar o seu significado clínico e fatores associados. O objetivo do estudo foi investigar as variáveis relacionadas com a presença de extrassístoles identificadas em pacientes ambulatoriais selecionados ao terem recebido a indicação de eletrocardiograma de rotina na rede básica de saúde. Foi realizado estudo transversal com 407 pacientes (idade média 55,8 anos ± 12 anos, 56% mulheres) encaminhados de Unidades Básicas de Saúde para o Hospital Municipal Doutor Fernando Mauro Pires da Rocha para realização de eletrocardiograma de repouso. Os participantes foram submetidos a questionário, exame físico, exames laboratoriais, ecocardiograma e monitorização eletrocardiográfica ambulatorial de 24 horas, a qual foi empregada para categorizar a frequência de extrassístoles. Depois de análise descritiva e exploratória, a regressão logística foi utilizada para avaliar as associações entre as variáveis. Extrassístoles supraventriculares ( >= 4/hora) se relacionaram com a idade (razão de chances 1,030; intervalo de confiança 95% 1,002 - 1,059; p=0,029), níveis de peptídeos natriuréticos > 20mg/dL (razão de chances 4,489; intervalo de confiança 95% 1,918 - 10,507; p=0.0005), bloqueios intraventriculares (razão de chances 4,184; intervalo de confiança 95% 1,861 - 9,406; p=0,0005) e diâmetro de átrio esquerdo (razão de chances 1,065; intervalo de confiança 95% 1,001 - 1,134; p=0,046). Extrassístoles ventriculares ( >= 5/hora) se associaram com a idade (razão de chances 1,032; intervalo de confiança 95% 1,010 - 1,054; p=0,004), uso de bloqueadores de canais de cálcio (razão de chances 2,248; intervalo de confiança 95% 1,019 - 4,954; p=0,045), níveis de peptídeos natriuréticos > 20mg/dL (razão de chances 2,079; intervalo de confiança 95% 1,062 - 4,068; p=0,033), taxas de HDL-colesterol (razão de chances 0,971; intervalo de confiança 95% 0,951 - 0,992; p=0,007), frequência cardíaca no eletrocardiograma (razão de chances 1,019; intervalo de confiança 95% 1,001 - 1,038; p=0,041), hipertrofia ventricular esquerda (razão de chances 2,292; intervalo de confiança 95% 1,402 - 3,746; p=0,001) e fração de ejeção ventricular esquerda (razão de chances 0,938; intervalo de confiança 95% 0,900 - 0,978; p=0,002). Na população estudada, os batimentos prematuros foram achados recorrentes e de baixa densidade na eletrocardiografia dinâmica de 24 horas. Extrassístoles mais frequentes se associaram a níveis de peptídeos natriuréticos > 20mg/dL e taxas mais baixas de HDL-colesterol; além disso, foi identificada maior dilatação atrial e hipertrofia ventricular no ecocardiograma dos pacientes com esse achado, sugerindo acometimento de órgão alvo decorrente de hipertensão arterial não controlada. Portanto, a detecção de extrassístoles frequentes na monitorização eletrocardiográfica de 24 horas, em pacientes acompanhados no nível de atenção primária, reitera as recomendações dirigidas principalmente para os cuidados com os fatores de risco associados com a sua presença / Premature complexes are common findings in outpatients; thus, it is important to evaluate their clinical significance and related factors. The aim of our study was to examine the variables associated with premature beats identified in outpatients who were followed by general practitioners in a primary public healthcare setting. We performed a cross-sectional study of 407 outpatients (mean age: 55.8±12 years; 56% women) who were referred from Basic Health Units to Doctor Fernando Mauro Pires da Rocha Municipal Hospital to perform a resting 12-lead electrocardiogram for clinical follow-up. They answered a questionnaire and submitted the physical examination, fasting laboratory testing, transthoracic echocardiogram and 24-hour Holter monitoring, which were used to categorize the frequency of premature complexes. After the univariate analysis, logistic regression analyses were performed to evaluate the independent association among the variables. Premature atrial complexes ( >= 4/hour) were associated with age (odds ratio 1.030; confidence interval 95% 1.002 - 1.059; p=0.029), peptide natriuretic levels > 20mg/dL (odds ratio 4.489; confidence interval 95% 1.918 - 10.507; p=0.0005), intraventricular blocks (odds ratio 4.184; confidence interval 95% 1.861 - 9.406; p=0.0005) and left atrium diameter (odds ratio 1.065; confidence interval 95% 1.001 - 1.134; p=0.046). Premature ventricular complexes ( >= 5/hour) were associated with age (odds ratio 1.032; confidence interval 95% 1.010 - 1.054; p=0.004), the use of calcium channels blockers (odds ratio 2.248; confidence interval 95% 1.019 - 4.954; p=0.045), peptide natriuretic levels > 20mg/dL (odds ratio 2.079; confidence interval 95% 1.062 - 4.068; p=0.033), HDL-cholesterol levels (odds ratio 0.971; confidence interval 95% 0.951 - 0.992; p=0.007), heart rate (odds ratio 1.019; confidence interval 95% 1.001 - 1.038; p=0.041), left ventricle hypertrophy (odds ratio 2.292; confidence interval 95% 1.402 - 3.746; p=0.001) and left ventricle ejection fraction (odds ratio 0.938; confidence interval 95% 0.900 - 0.978; p=0.002). In our population, premature complexes were common findings on 24-hour Holter monitoring, but of low density. Frequent ectopic beats were associated with peptide natriuretic levels > 20mg/dL and lower levels of HDL-cholesterol; left atrial enlargement and ventricular hypertrophy were also identified on the echocardiograms of these patients, suggesting that target organ damage was due to uncontrolled arterial hypertension. Therefore, the identification of frequent premature complexes on 24-hour Holter monitor recording of outpatients in a primary public healthcare setting reaffirms the need for monitoring for the risk factors associated with this finding

The Hilbert transform is a widely used transform in signal processing. In this thesis we explore its use for three different applications: electrocardiography, the Hilbert-Huang transform and modulation. For electrocardiography, we examine how and why the Hilbert transform can be used for QRS complex detection. Also, what are the advantages and limitations of this method? The Hilbert-Huang transform is a very popular method for spectral analysis for nonlinear and/or nonstationary processes. We examine its connection with the Hilbert transform and show limitations of the method. Lastly, the connection between the Hilbert transform and single-sideband modulation is investigated.

Our knowledge of prognostic factors and optimal treatment organisation in schizophrenia is incomplete. The disparity of outcome measures used has been a major obstacle for research. Increasing evidence has shown that schizophrenia is associated with increased cardiovascular mortality, development of obesity and autonomic nervous system imbalance. Assertive community treatment (ACT) has been suggested as a promising direction for organising treatment services for first-episode schizophrenia, but its long-term effect has not been evaluated. One aim of the present thesis was to investigate prognostic factors for 5-year symptomatic and functional outcome and obesity development. A further aim was to evaluate a recently proposed definition of remission and examine the long-term effects of introducing a modified ACT programme (mACT). Thus, we performed a follow-up study of all consecutive first-episode psychosis patients in Uppsala County, Sweden during 1995-2000 (n=144). In the first study we investigated the changes in a broad 5-year outcome of symptoms and function among patients presenting first time ever to psychiatric health care during 3 years before and during 3 years after the implementation of mACT. This change in the psychiatric service, however, was not followed by any long-term clinical benefits. In the second study, we examined the association between remission of eight core schizophrenia symptoms and functional outcome. Remission was strongly associated with having good function and having a higher self-rated satisfaction with life. In the third study, we explored a set of biochemical markers as predictors of weight gain and development of obesity. Haemoglobin, red blood cell count, hematocrit, γ-glutamyltransferase and creatinine were associated with the development of obesity in first-episode schizophrenia. In the fourth and final study, we tested electrocardiographic measures of autonomic imbalance as predictors of symptomatic remission. Higher heart rate and high ST and T-wave amplitudes were related to symptomatic remission, indicating that cardiac autonomic imbalance at baseline may have a prognostic value in first-episode schizophrenia.

University of Macau / Faculty of Science and Technology / Department of Electrical and Electronics Engineering

Electrical impedance of biological matter is known as electrical bio-impedance or simply as bio-impedance. Bio-impedance devices are of great value for monitoring the pathological and physiological status of biological tissues in clinical and home environments. The technological progress in instrumentation has significantly contributed to the progress that has been observed during the last past decades in impedance spectroscopy and electrical impedance cardiograph. Although bio-impedance is not a physiological parameter, the method enables tissue characterization and functional monitoring and can contribute to the monitoring of the health status of a person. In this paper an inexpensive portable multi frequency impedance cardiograph device based on impedance spectroscopy technique has been developed. By means of this system the basic thoracic impedance range and the heart-action-caused changes of impedance can be measured and the hemodynamic parameters of the heart function can be determined. This system has small size and low current consumption. The impedance cardiograph signals of the electrodes configuration by Sramek, Penney and Qu in this work was measured; compared and summarized. The differences of the measuring method, the schematic circuit diagram, the measurement results and area of application between impedance cardiograph and impedance spectroscopy were discussed and compared. The performance of this sensor-system was evaluated.

Thesis (MSc. (Human Physiology, Faculty of Health Sciences))--University of Pretoria, 2008. / Summary in English. Includes bibliographical references.

The electrocardiograph (ECG) is a common clinical and biomedical research tool used for both diagnostic and prognostic purposes. In recent years computer aided analysis of the ECG has enabled cardiographic patterns to be found which were hitherto not apparent. Many of these analyses rely upon the segmentation of the ECG into separate time delimited waveforms. The instants delimiting these segments are called the

Electrocardiography (ECG) has been established as one of the most useful diagnostic tools in medicine and is critical in the management of various heart conditions. Automated or semi-automated ECG analysis algorithms are expected to play an important role in the utilization of the ECG data. The correct identification of the QRS complexes is a fundamental step in every ECG analysis method. A major problem that is often encountered in automatic QRS detection is the presence of artifacts in the ECG data, which cause considerable alterations to the signal. Some common filters can smooth the effect of the artifacts, however they cannot eliminate them due to their spectral frequency overlap with the signal components. In this thesis, the objective was to develop a method, based on Time-Frequency Analysis that would be able to automatically detect and remove artifacts in order to increase the reliability of automatic QRS detection. The ECG data used for this purpose was taken from the Physionet library and more specifically from the MIMIC II database. The data in this database was acquired from ICU patients and it contains various types of rhythms as well as artifacts. First, a Graphical User Interface (GUI) was developed in order to manually annotate ECG data and was used for creating the ground truth for testing the methods developed. The Time-Frequency Analysis method used for the analysis of the ECG data, was based on a time-varying Autoregressive (AR) model whose solutions were obtained using Burg’s method. Several factors that affect the effectiveness of the method were investigated in order to optimize the algorithm experimentally. The algorithm implemented performs three main functions: “Artifact Hypothesis Testing,” “Artifact Detection and Removal,” and “QRS Complex Detection.” The first step, “Artifact Hypothesis Testing,” examines whether the signal contains any artifact or not. This is performed with a correct classification rate of 95.56%. The second step was the “Artifact Detection and Removal,” which could detect and remove the artifact area with an accuracy of 95.60% based on each signal sample identified as artifact or not. The final step, the “QRS Complex Detection,” correctly identified 92% of QRS complexes (322 out of 335 annotated QRS complexes). Finally, the proposed method was compared with one of the most commonly used methods in ECG analysis, the Wavelet Transform Analysis (WTA). The two methods were tested on exactly the same dataset. The WTA resulted in an overall score of 65.3% mainly due to the large number of false positive detections in the regions of artifact. / Το ηλεκτροκαρδιογράφημα (ΗΚΓ) έχει καθιερωθεί ως ένα από τα πιο χρήσιμα εργαλεία διάγνωσης στην ιατρική και είναι πολύ σημαντικό στη διαχείριση καρδιαγγειακών παθήσεων. Αυτοματοποιημένοι ή ημι-αυτοματοποιημένοι αλγόριθμοι ανάλυσης του ΗΚΓ αναμένεται να έχουν σημαντικό ρόλο στη χρήση των δεδομένων του ΗΚΓ. Η σωστή αναγνώριση των συμπλεγμάτων QRS είναι βασικό βήμα σε κάθε μέθοδο ανάλυσης του ΗΚΓ. Ένα σημαντικό πρόβλημα που συχνά προκύπτει σε αυτόματη ανίχνευση QRS είναι η παρουσία των τεχνητών σφαλμάτων (artifacts) στα δεδομένα ΗΚΓ, τα οποία προκαλούν σημαντικές αλλαγές στο σήμα. Κάποια κοινά φίλτρα μπορούν να εξομαλύνουν τις επιπτώσεις των τεχνητών σφαλμάτων, ωστόσο δεν μπορούν να τα εξαλείψουν λόγω της μεγάλης επικάλυψης του φάσματος συχνοτήτων τους με αυτού των στοιχείων του σήματος. Στην παρούσα εργασία στόχος ήταν η ανάπτυξη μιας μεθόδου, βασισμένης στην Ανάλυση Χρόνου-Συχνότητας, που θα είναι σε θέση να εντοπίσει αυτόματα και να αφαιρεί τα τεχνητά σφάλματα, ώστε να έχουμε μια πιο αξιόπιστη μέθοδο αυτόματης ανίχνευσης των QRS. Τα δεδομένα ΗΚΓ που χρησιμοποιήθηκαν για το σκοπό αυτό λήφθηκαν από τη βιβλιοθήκη Physionet και πιο συγκεκριμένα από τη βάση δεδομένων MIMIC II. Τα δεδομένα σε αυτή τη βάση δεδομένων προέρχονται από ασθενείς της Μονάδας Εντατικής Θεραπείας, και ως εκ τούτου, περιέχουν διάφορα είδη ρυθμών αλλά και τεχνητών σφαλμάτων. Αρχικά, ένα Γραφικό Περιβάλλον Χρήστη (GUI), σχεδιάστηκε για τη χειροκίνητη σηματοδότηση των διάφορων περιοχών ΗΚΓ σημάτων και χρησιμοποιήθηκε για τη δημιουργία των αληθών αποτελεσμάτων για δοκιμή της μεθόδου. H Ανάλυση Χρόνου-Συχνότητας έγινε με τη χρήση ενός χρονικά μεταβαλλόμενου Αυτοπαλινδρομικού (AR) μοντέλου οι λύσεις του οποίου βρέθηκαν με τη μέθοδο Burg. Ακολούθησε η διερεύνηση διαφόρων παραγόντων που επηρεάζουν την αποτελεσματικότητα της μεθόδου, προκειμένου να βελτιστοποιηθεί πειραματικά η μέθοδος. Ο αλγόριθμος που υλοποιήθηκε εκτελεί τρεις βασικές λειτουργίες: “Artifact Hypothesis Testing,” “Artifact Detection and Removal” και “QRS Complex Detection.” Κατ’ αρχήν, το βήμα "Artifact Hypothesis Testing" εξετάζει αν το σήμα περιέχει τεχνητό σφάλμα ή όχι, με το ποσοστό σωστής ταξινόμησης να ανέρχεται στο 95.56%. Το δεύτερο βήμα, η ανίχνευση και αφαίρεση της περιοχής του τεχνητού σφάλματος, έγινε με ακρίβεια 95.60% με βάση το πόσα σημεία του σήματος αναγνωρίστηκαν ως τεχνητό σφάλμα ή όχι. Τέλος, το συνολικό ποσοστό ορθής ανίχνευσης των συμπλεγμάτων QRS ήταν 92% (322 από τα 335 QRS που επισημάνθηκαν χειροκίνητα). Τέλος, έγινε μια σύγκριση μεταξύ της προτεινόμενης μεθόδου και μιας μεθόδου ανάλυσης ΗΚΓ που χρησιμοποιείται πολύ συχνά, της ανάλυσης με Μετασχηματισμό Wavelet (WTA). Οι δύο μέθοδοι δοκιμάστηκαν στα ίδια ακριβώς δεδομένα. Η ορθή ανίχνευση των συμπλεγμάτων QRS με τη μέθοδο WTA ήταν 65.3% κυρίως λόγω του μεγάλου αριθμού ψευδώς θετικών αποτελεσμάτων στις περιοχές των τεχνητών σφαλμάτων.

Abstract Physical activity with regular physical exercise (PE) has long been advocated because it lowers morbidity and mortality. However, there have been concerns about a transiently increased risk of adverse cardiac events such as sudden cardiac death (SCD) during PE. Our aim was to identify risk factors related to SCD during PE and clarify the effect of PE on cardiovascular well-being in the general population. In study I we found out that male gender as well as coronary artery disease (CAD), cardiac hypertrophy and myocardial scarring as autopsy-findings were clearly more common among exercise-related SCD. Typical northern activities in skiing and snow shoveling were among the three most common types of PE alongside cycling. In study II we analyzed the previously recorded electrocardiograms (ECG) of victims of SCD. Fragmented QRS complex (fQRS) in anterior leads was a common finding among subjects who died during exercise, especially among subjects with a prior diagnosis of CAD. In study III, we collected retrospectively out-of-hospital sudden cardiac arrest (SCA) data in Northern Ostrobothnia between the years 2007 and 2012. The subjects who suffered SCA in relation to PE were younger and previously healthier, and they had more often a shockable rhythm as the initial rhythm. There was a markedly better prognosis for hospital discharge when SCA occurred during PE. In study IV, we noticed a decrease in cardiac mortality in subjects who were physically active or became active during follow-up in a population of 1,746 stable CAD patients. A similar effect could be seen affecting SCD mortality. No increase in cardiac mortality could be seen among those with the highest levels of habitual PE. In conclusion, ischemic heart disease and male gender, especially when fQRS is present in anterior leads, are characteristics related to exercise-related SCD. On the other hand, when SCA takes place during PE, the prognosis is markedly better compared to SCA occurring at rest. An active lifestyle is also linked to decreased cardiac mortality. / Tiivistelmä Säännöllinen aktiivinen elämäntapa on yhteydessä pienempään fyysisten ja psyykkisten sairauksien riskiin. Tutkimuksissa on kuitenkin havaittu raskaampaan liikuntaan liittyvä väliaikaisesti lisääntynyt akuutin sydäntapahtuman, kuten äkkikuoleman, riski. Väitöskirjatutkimuksessa tutkitaan rasitukseen liittyvän sydänperäisen äkkikuoleman erityispiirteitä ja fyysisen aktiivisuuden merkitystä hyvinvoinnille. Ensimmäisessä osajulkaisussa havaittiin, että rasitukseen liittyvissä kuolemissa oli ruumiinavauslöydöksenä merkittävästi enemmän sepelvaltimotautia, sydänlihaksen arpeutumista ja sydänlihaksen liikakasvua verrattuna äkkikuolemiin levossa. Miessukupuoli oli selkeästi yliedustettuna rasituspopulaatiossa, sillä peräti 94 % oli miehiä. Yleisimmät rasitusmuodot olivat hiihto, pyöräily ja lumenluonti. Toisessa osatutkimuksessa tutkittiin edeltävien EKG-muutosten yhteyttä rasitusperäisiin äkkikuolemiin. Havaitsimme, että QRS-kompleksin pirstoutuminen etuseinäkytkennöissä oli selkeästi yleisempi löydös rasitusryhmässä. Tämä löydös oli erityisen merkittävä sepelvaltimotautipotilailla. Kolmas julkaisu sisältää tiedot sairaalan ulkopuolisista sydänpysähdyksistä Pohjois-Pohjanmaalla vuosina 2007–2012. Tässä aineistossa havaitsimme, että rasitukseen liittyvän sydänpysähdyksen alkurytmi oli useammin defibrilloitava, potilaat olivat nuorempia ja terveempiä, ja maallikkoelvytys aloitettiin useammin. Rasituksessa elottomaksi menneillä oli suhteellisen hyvä selviämisennuste. Neljännessä tutkimuksessa havaitsimme selkeästi paremman ennusteen niillä stabiilia sepelvaltimotautia sairastaneilla, jotka olivat liikunnallisesti aktiivisia. Sydänperäinen kuolleisuus oli pienempi myös niillä potilailla, jotka onnistuivat lisäämään liikunnallista aktiivisuuttaan. Samankaltainen tulos todettiin sydänperäisten äkkikuolemien osalta. Sepelvaltimotauti ja miessukupuoli ovat hyvin yleisiä löydöksiä, kun sydänperäinen äkkikuolema tapahtuu rasituksessa. Myös QRS-kompleksin pirstoutuminen etuseinäkytkennöissä liittyi rasitusperäisiin kuolemiin. Toisaalta potilaan ennuste selvitä on selkeästi parempi sydänpysähdyksen tapahtuessa rasituksessa. Osoitimme myös, että liikunnallinen aktiivisuus ja sen pienikin lisäys parantavat sepelvaltimotautipotilaiden ennustetta.