Thesis (MSc. (Physiology)--Faculty of Health Sciences) - University of Pretoria, 2005. / Includes bibliographical references.

Made available in DSpace on 2016-12-23T13:53:35Z (GMT). No. of bitstreams: 1 Marcelo Borjaille Lima.pdf: 798361 bytes, checksum: 390f0f5564bc81315e64b0626f3a736b (MD5) Previous issue date: 2011-08-17 / The eletrocardiographic test has been used for diagnosis of cardiac arrhythmias and heart disease in horses, as well as performance evaluation and early diagnosis of worsening of athletic performance of various modalities. The activity of mounted police requires that animals are trained for long hours at walk and trotting, thus monitoring of these animals for underlying cardiac diseases that may affect their performance is of great value. In this study from 78 animals of the regiment of mounted Military Police Patrol of Espirito Santo State, Brazil, were divided into groups according to age and underwent electrocardiographic examination, followed by analyses of durations and amplitudes of the waves and QRS. There was statistical difference in T+ wave amplitude which was correlated to animals growth. These horses did not show any arrhythmias at rest, while the most common was the sinus rhythm / O exame eletrocardiográfico tem sido utilizado para o diagnóstico de arritmias e doenças cardíacas em equinos, bem como na avaliação do desempenho atlética e diagnóstico precoce da queda de performance em diversas modalidades. A atividade de policiamento montado requer que os animais estejam aptos a trabalhar ao passo e trote durante horas para atuação da sua função. Portanto, o monitoramento destes animais quanto a doenças cardíacas é importante. Desta forma, 78 animais do regimento de polícia montada do Estado do Espírito Santo, Brasil foram separados em grupos de acordo com a idade e submetidos ao exame eletrocardiográfico para analise das durações e amplitudes de ondas e complexos do traçado. Foi observada diferença estatística somente na amplitude da onda T+ relacionadas com o passar da idade dos animais. Os equinos, em repouso, não apresentam arritmias, sendo o ritmo sinusal o mais comum

Orientador: Aparecido Antonio Camacho / Banca: Wagner Luís Ferreira / Banca: Mirela Tinucci Costa / Resumo: Com o objetivo de investigar a importância de ferramentas que possam identificar as arritmias ou detectar seus possíveis fatores desencadeantes em portadores da cardiomiopatia arritmogênica do ventrículo direito, 25 cães Boxers foram submetidos ao exame eletrocardiográfico convencional (ECG) e variabilidade da frequência cardíaca (VFC), obtida pela avaliação Holter de 24 horas, e 20 foram submetidos ao exame eletrocardiográfico de alta resolução (ECGAR). Os cães foram divididos em três grupos de acordo com o número de extrassístoles ventriculares (EV) obtidas pela avaliação Holter. O GC foi composto por cães apresentando menos de 20 EV/24 horas, o GD1 foi formado por animais com mais de 100 e menos de 1.000 EV/24 horas, enquanto o GD2 foi composto por animais que apresentaram mais de 1.000 EV/24 horas. Levando em consideração a presença de EV e extrassístoles supraventriculares (ESV) no ECG, este teste apresentou 83,33% de sensibilidade, 100% de especificidade, valor preditivo positivo (VPP) de 100% e valor preditivo negativo (VPN) de 86%. Os parâmetros da VFC SDNNIDX (Gc: 194,08 ± 56,29 ms; GD1: 202,20 ± 94,79 ms; GD2: 118,00 ± 43,76 ms) e pNN>50 (Gc: 39,75 ± 12,69 ms; GD1: 46,24 ± 14,08; GD2: 21,52 ± 9,27 ms) foram significativamente menores nos pacientes do GD2. O ECGAR apresentou sensibilidade de 30%, especificidade de 50%, VPP de 37,5% e VPN de 41,67%. Assim, os resultados sugerem que a eletrocardiografia convencional e a VFC são técnicas que podem contribuir substancialmente no diagnóstico da CAVD em cães Boxers, ao contrário da eletrocardiografia de alta resolução que se mostrou ineficaz em identificar a presença de potenciais tardios nos pacientes com esse grau de doença / Abstract: Aiming to investigate the importance of tools that could identify arrhythmias or detect its possible inciting factor in patients affected by arrhythmogenic right ventricular cardiomyopathy, 25 Boxer dogs were submitted to conventional electrocardiogram (ECG), heart rate variability (HRV), obtained by 24-hours Holter evaluation, and 20 were submitted to high resolution electrocardiogram (HRECG). Dogs were divided into three different groups according to the number of ventricular complexes (VC) obtained in Holter analysis. The GC was formed by dogs presenting less than 20 VC/24 hours, the GD1 was formed by animals presenting more than 100 and less than 1.000 VC/24 hours, while the GD2 was composed of dogs presenting over a 1.000 VC/24 hours. Considering the presence of ventricular or supraventricular complexes on the ECG, this test had 83,33% of sensitivity, 100% of specificity, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 86%. The HRV parameters SDNNIDX (Gc: 194.08 ± 56.29 ms; GD1: 202.20 ± 94.79 ms; GD2: 118.00 ± 43.76 ms) and pNN>50 (Gc: 39.75 ± 12.69 ms; GD1: 46.24 ± 14.08; GD2: 21.52 ± 9.27 ms) were significantly lower in the patients of GD2. The HRECG showed 30% of sensitivity, 50% of specificity, PPV of 37,5% and NPV of 41,67%. Thus, the results suggest that conventional ECG and HRV are techniques that can strongly contribute in the diagnosis of ARVD in Boxer dogs, opposed to HRECG that showed itself inefficient to detect the presence of late potentials in patients with this degree of disease / Mestre

Heart rhythm disorders alias arrhythmias rank among the most frequent heart diseases. They result from a disorder of generation or conduction of electric impulses at the heart. There are often arrhythmias of which one is not conscious and which may be detected in long-term ECG monitoring. Patients{\crq} problems mostly arise from rhythm disorders that are paroxysmal or permanent. These may endanger the patient{\crq}s life. Subjective troubles reported by patients include uncomfortable heart palpitation, fatigue, breathlessness, distress, shorter breath, dizziness or even unconsciousness; sometimes patients may feel unpleasant chest pain. These subjective feelings are very uncomfortable for a person suffering from heart arrhythmia and can make it impossible for him/her to manage routine daily activities. The task of a nurse is to help a patient overcome this difficult period and instruct him/her of a healthy lifestyle as a prevention of heart diseases. In this respect, cooperation between the nurses in hospitals and the nurses in cardiologic out-patient departments is important. Four hypotheses were raised. The first hypothesis was to confirm that the care of patients with heart arrhythmia after their discharge to home-care is sufficient in respect of their needs. This hypothesis was confirmed. The second hypothesis was to confirm that the patients are sufficiently instructed on prevention of recurrence of heart arrhythmias. This hypothesis was not confirmed. The third hypothesis was to confirm that patients know the impacts of heart arrhythmias on their overall health state, and was not confirmed. The fourth hypothesis was to confirm that patients are aware of other options of the care after discharge from hospital. This hypothesis was not confirmed. In the practical part of the thesis I used a quantitative research. The research was conducted in hospitals in České Budějovice, Jihlava, Plzeň and Prague, in the form of anonymous questionnaires distributed to patients in cardiologic out-patient departments. The results have been processed in charts and tables in the SPSS programme. The objectives were fulfilled. The appendix to the thesis contains a brief proposal suggesting on what the nursing care should be focused after a patient{\crq}s discharge from hospital. The results will be offered to deputy managers for the nursing care and to nurses in cardiologic out-patient departments.

Submitted by Jaqueline Silva (jtas29@gmail.com) on 2014-12-12T19:36:47Z No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação-Adriana Sebba Barroso de Souza Marques.pdf: 867953 bytes, checksum: 6484d53b38c78accaea85498548eb55f (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2014-12-16T09:23:56Z (GMT) No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação-Adriana Sebba Barroso de Souza Marques.pdf: 867953 bytes, checksum: 6484d53b38c78accaea85498548eb55f (MD5) / Made available in DSpace on 2014-12-16T09:23:56Z (GMT). No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertação-Adriana Sebba Barroso de Souza Marques.pdf: 867953 bytes, checksum: 6484d53b38c78accaea85498548eb55f (MD5) Previous issue date: 2013-12-20 / Background: Treatment with stem cells in various cardiomyopathies may be related to the increase in arrhythmias. Objective: To determine whether intracoronary injection of stem cells in patients with Chagas cardiomyopathy is associated with increased frequency of ventricular arrhythmias, compared to the control group. Methods: A retrospective cohort study that evaluatedt he medical records of 60 patients Who participated previously on sectional study.The following data was collected : age, sex , and drugs used and Holter variables that demonstrated the presence of arrhythmias.Holter was performed in four stages: randomization , 2 , 6 and 12 months segments. The control group (CG) received medical treatment and intracoronary injection of placebo and the study group (SG) drug treatment and autologous stem cell implant. Results: There was no difference between EG and CG analyzing the criteria of arrhythmia. In the intra-group analysis, significant difference was found between the Holter tests study group in the variable of total ventricular ectopic compared with baseline, being between H1 and H2 p=0.014, between H1 and H3 p=0.004, between H1and H4 p=0.014. The variable non-sustained ventricular tachycardia between H1 and H3 with p = 0.036. Conclusion: The intracoronary injection of stem cells did not increase the incidence of ventricular arrhythmias in patients with Chagas cardiomopatia compared to the control group. / Fundamento: O tratamento com células-tronco nas diversas cardiomiopatias pode estar relacionado ao aumento nas arritmias. Objetivo: Determinar se a injeção intracoronária de células-tronco em portadores de cardiomiopatia chagásica está associada ao aumento da frequência de arritmias ventriculares, comparado ao grupo controle. Método: Estudo de coorte retrospectivo que avaliou o prontuário de 60 pacientes que participaram de estudo transversal anterior. Foram coletados os seguintes dados: idade, sexo, medicamentos utilizados e variáveis do Holter que demonstraram presença de arritmia. O Holter foi realizado em quatro momentos: randomização, 2, 6 e 12 meses de seguimento. O grupo controle (GC) recebeu tratamento medicamentoso e injeção intracoronária de placebo e o grupo estudo (GE) tratamento medicamentoso e implante autólogo de células tronco. Resultados: Não houve diferença entre o GE e o GC nos critérios de arritmia analisados. Na analise intra-grupo foi encontrado diferença com significância entre os exames de HOLTER do grupo estudo na variável total de extrassístoles ventriculares comparado com o basal, sendo entre H1 e H2 p=0.014, entre H1 e o H3 p=0.004, entre H1 e H4 p=0.014. A variável taquicardia ventricular não sustentada entre H1 e H3 com p=0.036. Conclusão: A injeção intracoronária de células-tronco não aumentou a incidência de arritmias ventriculares em pacientes com cardiomopatia chagásica comparada ao grupo controle.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-02-24T12:24:27Z No. of bitstreams: 1 brunogouveadebarros.pdf: 4637517 bytes, checksum: 0db5f859f17bd37484772dd26a331ce5 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-02-24T15:33:28Z (GMT) No. of bitstreams: 1 brunogouveadebarros.pdf: 4637517 bytes, checksum: 0db5f859f17bd37484772dd26a331ce5 (MD5) / Made available in DSpace on 2017-02-24T15:33:28Z (GMT). No. of bitstreams: 1 brunogouveadebarros.pdf: 4637517 bytes, checksum: 0db5f859f17bd37484772dd26a331ce5 (MD5) Previous issue date: 2013-02-25 / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / Os modelos computacionais tornaram-se ferramentas valiosas para o estudo e compreensão dos fenômenos da eletrofisiologia cardíaca. No entanto, a elevada complexidade dos processos biofísicos e o nível microscópico de detalhes exigem complexos modelos computacionais. Aspectos-chave da eletrofisiologia cardíaca, tais como condução lenta e bloqueio de condução tem sido tema de pesquisa de muitos estudos, uma vez que estão fortemente relacionados à arritmia cardíaca. No entanto, ao reproduzir estes fenômenos os modelos necessitam de uma discretização sub-celular para a solução das equações diferenciais e uma condutividade eléctrica do tecido não uniforme e heterogênea. Devido aos elevados custos computacionais de simulações que reproduzem a microestrutura fina do tecido cardíaco, estudos prévios têm considerado experimentos de tecido de pequenas dimensões e têm utilizados modelos simples de células cardíacas. Neste trabalho, desenvolvemos um modelo (modelo microscópico) da eletrofisiologia cardíaca que capta a microestrutura do tecido cardíaco usando uma discretização espacial muito fina (8µm) e utilizamos um modelo celular moderno e complexo baseado em Cadeias de Markov para a caracterização da estrutura e dinâmica dos canais iônicos. Para lidar com os desafios computacionais, o modelo foi paralelizado usando uma abordagem híbrida: a computação em cluster e GPGPUs (General-purpose computing on Graphics Processing Units). Nossa implementação paralela deste modelo, utilizando uma plataforma multi-GPU, foi capaz de reduzir os tempos de execução das simulações de mais de 6 dias (em um único processador) para 21 minutos (em um pequeno cluster de 8 nós equipado com 16 GPUs). Além disso, para diminuir ainda mais o custo computacional, foi desenvolvido um modelo discreto equivalente ao modelo microscópico. Este novo modelo foi paralelizado usando a mesma abordagem do modelo microscópico e foi capaz de executar simulações que demoravam 21 minutos em apenas 65 segundos. Acreditamos que esta nova implementação paralela abre caminho para a investigação de muitas questões em aberto associadas à natureza complexa e discreta da propagação dos potenciais de ação no tecido cardíaco. / Computer models have become valuable tools for the study and comprehension of the complex phenomena of cardiac electrophysiology. However, the high complexity of the biophysical processes and the microscopic level of details demand complex mathematical and computational models. Key aspects of cardiac electrophysiology, such as slow conduction, conduction block and saltatory effects have been the research topic of many studies since they are strongly related to cardiac arrhythmia. However, to reproduce these phenomena the numerical models need to use sub-cellular discretization for the solution of the PDEs and nonuniform, heterogeneous tissue electric conductivity. Due to the high computational costs of simulations that reproduce the fine microstructure of cardiac tissue, previous studies have considered tissue experiments of small or moderate sizes and used simple cardiac cell models. In this work we develop a cardiac electrophysiology model (microscopic model) that captures the microstructure of cardiac tissue by using a very fine spatial discretization (8µm) and uses a very modern and complex cell model based on Markov Chains for the characterization of ion channel's structure and dynamics. To cope with the computational challenges, the model was parallelized using a hybrid approach: cluster computing and GPGPUs (General-purpose computing on graphics processing units). Our parallel implementation of this model using a Multi-GPU platform was able to reduce the execution times of the simulations from more than 6 days (on a single processor) to 21 minutes (on a small 8-node cluster equipped with 16 GPUs). Furthermore, in order to decrease further the computational cost we have developed a discrete model equivalent to the microscopic one. This new model was also parallelized using the same approach as the microscopic model and was able to perform simulations that took 21 minutes to be executed in just 65 seconds. We believe that this new parallel implementation paves the way for the investigation of many open questions associated

O sistema Holter é considerado padrão ouro para detecção de arritmias cardíacas, possibilitando o seu diagnóstico e sua relação com os sintomas do paciente. As novas gerações de marcapassos (MP) detectam e registram eletrogramas intracavitários e poderiam dispensar o Holter no seguimento dos pacientes. Os diferentes MP dispõem de algoritmos de detecção de arritmias ventriculares (AV) que variam de acordo com o modelo e sua correlação diagnóstica com Holter foi pouco estudada. O objetivo desse estudo foi avaliar 1. a correlação entre o monitor de eventos dos MP e do Holter na detecção de AV e 2. a concordância das AV detectadas nos dois sistemas. Foram estudados129 pacientes portadores de MP com função de detecção de arritmias, com idade média de 68,6+19.1 anos (entre 19 e 94), 54,8% do sexo feminino. Os pacientes foram submetidos à monitorização com Holter por 72 horas. Assim que o sistema foi ligado, os contadores de eventos dos marcapassos foram reiniciados e os relógios sincronizados, para que ambos os sistemas detectassem os eventos simultaneamente. Os MP foram programados para detecção de eventos com o menor valor de frequência ventricular (FV) e o menor número de batimentos sequenciais (BT) possíveis. Depois de 72 horas, os sistemas Holter foram retirados e os registros analisados, assim como os registros simultâneos dos gravadores dos MP. Foram qualificados como eventos arrítmicos no Holter e MP, respectivamente: EV isoladas e \"PVC\"; extra-sístoles em pares e \"couplets\"; TVNS (> 3BT) e \"triplets\"(3BT), \"runs\"(3 a 8 ou > 8 BT) e \"HVR\" (3 ou 4 BT). As correlações de Spearman foram utilizadas para avaliar se o marcapasso acompanha a detecção dos parâmetros do Holter. Os coeficientes de correlação intraclasse e os respectivos intervalos com 95% de confiança, calculados para avaliar a concordâncias entre os parâmetros equivalentes do marcapasso e do Holter. Foram calculados os coeficientes Kappa para avaliar a concordância na detecção de > 10 \"PVC\"/h com > 10 EV/h. Resultados: Os monitores dos marcapassos subestimaram o Holter. Os registros de \"PVC\", \"triplet\" e \"HVR\" por TVNS apresentaram correlações positivas em relação aos parâmetros do Holter, sendo a mais alta aquela entre \"PVC\" e EV (r=0,501). Porém, a concordância entre os tipos de arritmias detectadas foi baixa (CCI < 0,5), exceção feita à concordância de \"triplet\" com TVNS de três batimentos (CCI=0.984). A concordância na detecção de mais de 10 PVC/h e mais de 10 EV/h foi moderada (kappa= 0,483), embora para os MP da Medtronic, o coeficiente de concordância foi alto (kappa=0.877). Para os MP com algoritmo de detecção de sequências de três batimentos com FV menor que 140bpm ( < 140/3), a correlação entre HVR e TVNS foi expressiva (r = 1), sendo a concordância entre esses parâmetros também bastante alta (CCI = 0,800). Conclusões: A correlação e a concordância na detecção de AV registradas nos MP e no Holter foram inconsistentes. Padronização dos algoritmos de detecção de AV, semelhantes os do sistema Holter, é necessária para que os pacientes portadores de dispositivos implantáveis possam se beneficiar dessa função para seguimento clínico e estratificação de risco / The Holter monitoring is considered the gold standard method for detection of cardiac arrhythmias, enabling its diagnosis and its correlation with the patient\'s symptoms. New generations of artificial pacemakers can detect and record intracavitary electrograms and, theoretically, could discard the Holter during the follow-up of the patients. Pacemakers have different ventricular arrhythmias (VA) detection algorithms, varying according to the model. Their diagnosis capacity comparing to Holter monitoring has been poorly studied. The aim of this study was to evaluate 1. the correlation between the event monitor of the pacemaker and the Holter in VA detection and 2. the agreement between the VA detected in both systems. We studied 129 patients with implanted pacemakers, which had arrhythmia detection function, mean age of 68.6 + 19.1 years (19 to 94), 54.8% female. The patients underwent Holter monitoring for 72 hours. Once the system was connected, event counters of pacemakers were reset and the clocks synchronized, so that both systems could detect the arrhythmic events simultaneously. The pacemakers were programmed to detect events with the lowest ventricular rate and lowest number of sequential beats allowed for each model. After 72 hours, Holter systems were removed and the records analyzed, as well as the simultaneous records of the pacemakers. Were considered as arrhythmic events: PVC isolated (in the pacemaker described as \"PVC\"); premature beats in pairs (pacemaker described as \"couplets\"); NSVT (pacemaker described as \"triplets\"- 3beats, \"runs\"- 4 to 8 or > 8 beats and \"HVR\"- 3 to 4 beats). Spearman rank correlations were used to assess whether the pacemaker and Holter identified the same parameters. The intraclass correlation coefficients and the respective intervals with 95% confidence were calculated to evaluate the concordance between the equivalent parameters of the pacemaker and Holter. Kappa coefficients were calculated to assess the agreement in the detection of > 10 PVC/h by the pacemakers and by the Holter. Results: The pacemakers underestimated the arrhythmias detection of Holter. Records of \"PVC\", \"triplet\" and \"HVR\" by NSVT showed positive correlations with the Holter parameters, and the highest one was among \"PVC\" and EV (r = 0.501). The agreement between the types of arrhythmias detected was quite low (CCI < 0.5), except for \"triplet\" detected by pacemakers and three beats NSVT by Holter (ICC = 0.984). The correlation detection for more than 10 PVC /h was moderate (kappa = 0.483), except for Medtronic pacemakers (kappa=0.877). When the pacemaker was programmed to detect sequences of three beats with heart rate lower than 140bpm ( < 140/3), the correlation between HVR and NSVT was perfect (r = 1) and the agreement between these parameters was also quite high (ICC = 0.800). Conclusions: The correlation and agreement between pacemakers and Holter monitoring in the detection of VA were not consistent. A standardization of the pacemakers\' detection algorithms is necessary before using this function for clinical follow-up and risk stratification of the patients

Introdução: É comum a associação entre apnéia do sono e a doença arterial coronária (DAC), devido a fatores predisponentes comuns como sexo masculino e obesidade. Entretanto, ainda não existe uma definição objetiva da relação entre apnéia e DAC. Objetivo: Avaliar se os episódios de isquemia miocárdica, a variabilidade da freqüência cardíaca (VFC) e as arritmias cardíacas de portadores de DAC sofrem alteração na presença da apnéia do sono. Métodos: Cinqüenta e três pacientes portadores de DAC foram submetidos à monitorização eletrocardiográfica ambulatorial de 48 horas e ao estudo do sono na primeira noite da monitorização. Os pacientes foram divididos de acordo com o índice de apnéia e hipopnéia (IAH) em: grupo Controle (IAH<=15) e grupo Apnéia (IAH>15). Os grupos foram comparados quanto à isquemia miocárdica, VFC e arritmias cardíacas ocorridas no período da vigília e do sono. Uma subanálise apenas com pacientes portadores de apnéia grave (IAH>30 - grupo Ap-Grave) foi realizada e comparada ao grupo Controle. A análise estatística foi realizada utilizando-se o teste de Mann-Whitney, teste de Fisher e teste T de student. Resultados: Não foram observadas diferenças nas características clínicas básicas entre os grupos, exceto pelos níveis de pressão arterial mais elevada no grupo Ap-Grave (p<0,05). Nenhum dos pacientes despertou por angina noturna; 75% foram submetidos a cateterismo cardíaco, sem diferença quanto à gravidade da DAC e aos valores da fração de ejeção. Foi registrada isquemia em 39 (73,58%) pacientes, com carga isquêmica de 2892,26 minutos na vigília e 1186 no sono. Na vigília, foi menor a duração dos episódios isquêmicos no grupo Ap- Grave (p<0,05); no período do sono não houve diferença entre os grupos. Não houve diferença nas medidas da VFC e arritmias entre os grupos. Não foram registradas pausas >2 segundos, fibrilação ou flutter atrial, ou qualquer tipo de bloqueio atrioventricular. Conclusão: A apnéia do sono não apresentou relação direta com isquemia miocárdica, variabilidade da freqüência cardíaca e arritmias cardíacas em pacientes portadores de DAC. / Introduction: It is common to associate obstructive sleep apnea (OSA) with coronary artery disease (CAD) given the common predisposing factors; however, there are still controversies on the influence of OSA in the progression of CAD. Objective: To assess if OSA causes any changes in myocardial ischemia episodes, heart rate variability (HRV) and cardiac arrhythmias in patients with CAD. Methods: Fifty-three people with CAD were submitted to ambulatory electrocardiographic monitoring and to polysomnography) simultaneously and divided according to the apnea-hypopnea index (AHI) into two groups: Control (AHI<=15) and Apnea (AHI>15). A sub analysis including only people with severe apnea (AHI>30) was done and compared with the control group. Results: Differences in the basic clinical characteristics between the groups were not found, except for higher blood pressure levels in the Severe Apnea Group (p<0.05). None of the patients woke up because of nocturnal angina. The groups did not differ in relation to the extension of coronary artery disease and ejection fraction values. Myocardial ischemia was recorded in 39 (73.58%) patients. The total ischemic burden was 2892.26 minutes while awake and 1186 minutes while asleep; the groups did not differ during sleep. There was also no significant difference in HRV and arrhythmia measurements between the groups. Pauses >2 seconds, fibrillation or atrial flutter or any type of atrioventricular blocks were not registered. Conclusion: OSA did not present a direct relationship with myocardial ischemia, heart rate variability and arrhythmias in patients with CAD.

The theoretical part of the thesis contains a brief description of the anatomy and electrophysiology of the heart, as well as both, surface and intracardiac electrocardiograms. The thesis also describes the different types of cardiac tachycardias, their differential diagnosis and what is known as The Expert System. The practical section of the thesis notes and outlines the tree diagrams, and additionally describes various software solutions of The Expert System. Further, the thesis includes the classification of the heart rhythm, using The Expert System method with three typical tachycardia cases, and including a list of questions asked by The Expert System to the user. Answers to all questions asked are being assessed in the text, as well as illustrated in submitted examples of intracardiac ECG recordings. The Expert System has been verified during a series of catheterization procedures on 26 patients (where the evaluated cardiac rhythm was 34). The classication of the type of heart rhythm (per The Expert System) when comparing the results with the doctors coincided in 100 % of tested cases.

The thesis describes design, algorithmization and realization of graphical application for recording EKG and PPG signal using LabJack UE9 tool in Matlab program, it also describes subsequent deposition of recorded signals and their processing, such as optional selection, cropping and filtering. Furthermore there are described types of filters, methods for detecting basic parameters of EKG and PPG signals and methods for detecting R waves and Systolic peaks. Based on detection of those parameters, algorithms for computing average heart rate and finding arrhythmias were designed and tested. Last part of the thesis includes an evaulation which compares values detected by designed algorithms with values from public database which includes reference annotation.