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Novel anticoagulants from the perspective of cardiac patients
KŘÍŽOVÁ, Anna
The bachelor thesis deals with anticoagulant treatment in cardiac patients and their satisfaction with it. Over time, anticoagulant therapy is becoming one of the most widespread areas, which is represented in almost every field of contemporary medicine and nursing. In cardiac patients, anticoagulant treatment plays a very important and irreplaceable role in the prevention and treatment of the disease itself. The aim of this bachelor thesis is to map the awareness, advantages and disadvantages of anticoagulant treatment with warfarin or one of the representatives of NOAK according to the experience of patients with atrial fibrillation and then compare the resulting parameters. A qualitative survey method was chosen for the research survey. Data were obtained through semi-structured interviews with patients. A total of 16 patients were contacted, 8 of whom were taking warfarin and the remaining 8 patients were taking NOAK - 4 Xarelto patients, 3 Pradax patients and 1 Eliquis patient. The results of the research showed that patients are insufficiently informed about their options in the selection of anticoagulants. Another shortcoming in the education of patients about anticoagulant treatment is the insufficient use of an information brochure. The results also showed that patients on NOAK are more satisfied with anticoagulant therapy than on warfarin, as it does not bring them so many limitations. However, side effects were more common in patients with NOAK than with warfarin. Overall, however, both groups of patients evaluate anticoagulant therapy rather positively. Based on the results, an informative brochure for patients with anticoagulant treatment was created as part of the work, which can help them decide between anticoagulant drugs and get acquainted with their options.
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Pulse Check in Pharmacies IV
Kameníková, Andrea ; Malá, Kateřina (advisor) ; Mareček, Aleš (referee)
Pulse check in pharmacies IV Supervisor: PharmDr. Kateřina Malá, Ph.D. Consultant: PharmDr. Anna Rejmanová, Ph.D. Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy Introduction: Atrial fibrillation (AF) is a serious arrhythmia that is also the most common heart rhythm disorder in our population and its incidence continues to rise. It can be a cause of high morbidity and mortality if it is not detected and treated in time. Unfortunately, almost one third of patients have an asymptomatic AF. Screening activities in pharmacies are a possible tool for early detection of hidden arrhythmias. Aim: The aim of the study was to measure heart rate (HR), blood pressure (BP) and to monitor some of the symptoms of AF in patients involved in screening for heart rhythm disorders in a community pharmacy. Methods: HR measurements took place for eight weeks (08-09/2021 and 12/2021-01/2022) in two community pharmacies in Doksy and Cvikov. Patients ≥ 55 years of age were offered the option of AF screening. First, the HR was measured by palpation. Subsequently, it was verified with a Veroval ECG device. BP was then measured with an Omron M6 Comfort pressure device. All measurements took place in a consultation room. An evaluation of selected symptoms, risk factors and...
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Pulse Check in Pharmacies III
Vasilišinová, Ivana ; Rejmanová, Anna (advisor) ; Mareček, Aleš (referee)
Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Pulse check in pharmacies III Author: Ivana Vasilišinová Supervisor: PharmDr. Anna Rejmanová, Ph.D. Consultant: PharmDr. Kateřina Malá, Ph.D. Introduction: Atrial fibrillation (AF) is the most common supraventricular arrhythmia. It is often asymptomatic. If left untreated, the patient is at significant risk of complications, especially of ischemic stroke (IS) and heart failure. These complications can be effectively prevented by early detection of AF and initiation of treatment. Population screening activities performed at pharmacies could serve as an useful tool for detection of latent arrhythmias. Objective: The aim of this diploma thesis was to analyze the heart rate, blood pressure, selected symptoms and risk factors for IS in real patient population and to raise their awareness in the field of heart rate monitoring. Methodology: The measurement took place in a public pharmacy at an outpatient clinic in Prague during the one-day campaign "Pharmacy Day" (18/6/2020) and subsequent data collection (12/2020-02/2021). During this time, education in atrial fibrillation, the heart rate and blood pressure measurement and also evaluation of the selected symptoms and risk factors for the possible future...
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Pulse Check in Pharmacies V
Zyková, Kateřina ; Rejmanová, Anna (advisor) ; Mareček, Aleš (referee)
1 Abstract Pulse check in pharmacies V Author: Kateřina Zyková Supervisor: PharmDr. Anna Rejmanová, Ph.D. Consultant: PharmDr. Kateřina Malá, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction: Pharmacists are in close contact with patients on daily basis and can thus be involved in the detection of several diseases including atrial fibrillation (AF), the prevalence of which is still increasing. Aim: The aim of this study was to raise awareness of the possibility and meaning of heart rate monitoring to detect dysrhythmias, especially atrial fibrillation, to analyze the symptoms and risk factors of heart rhythm disorders, and to monitor blood pressure. A sub-objective was also to demonstrate the possibility of pharmacist involvement in measuring heart rate (HR) and searching for patients with previously undiagnosed heart rhythm abnormalities. Methods: The design was a prospective cross-sectional bicentric study. People aged ≥ 55 years without a history of chronic anticoagulant therapy were addressed between July 26 and August 6, 2021 at the regional hospital pharmacy, and on September 8, 2021, as part of the public awareness-raising campaign. Participants were asked about the presence of selected symptoms, associated diseases,...
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Detection of paroxysmal atrial fibrillation and atrial flutter
Krmela, Jan ; Němcová, Andrea (referee) ; Smíšek, Radovan (advisor)
This bachelor thesis deals with the problem of atrial fibrillation and flutter, the pathophysiology of these arrhythmias and their automatic detection. It includes a theoretical introduction necessary to understand the basal anatomy of the heart, its function, the origin and description of the electrocardiogram and a chapter on cardiac arrhythmias. It also includes a review of automatic detection of atrial fibrillation. The databases used in the practical part of the thesis are also described. The implementation of heart rhythm classification and automatic detection of the beginning and end of paroxysmal episodes is performed in MATLAB environment, the proposed algorithm is tested on the described databases and the results are evaluated.
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Deep-learning based localization of cardiac arrhythimas in ECG
Khaliullina, Sabina ; Novotná, Petra (referee) ; Ronzhina, Marina (advisor)
The thesis deals with the localization and classification of atrial atrial fibrillation. In Python, a detection method using convolutional neural networks with multi-instance learning (MIL) and the method of local maxima for localization were implemented. Segments from two ECG leads were used. In the binary classification using the first subset and subsequent post processing, the F1 score reached 100 %, in the classification using the second subset 92 %. In the discussion and conclusion of the work, the success of classification and localization was evaluated, the achieved results were discussed and compared the with the results of other authors.
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Detection of selected cardiac arrhythmias in ECG
Němečková, Karolína ; Ředina, Richard (referee) ; Ronzhina, Marina (advisor)
This thesis deals with classification of ECG records focusing on less classifiable arrhythmia (atrial flutter, atriventricular block I. and II. degree). In the theoretical part of the thesis deep learning used in classification of ECG records with a focus on the convolutional neural networks are described. The database of ECG records with a brief description of detected arrhythmias is further described. The practical part implements the proposed convolutional neural network in the Python environment. The evaluation of the arrhythmia detection quality was done using mainly the F1 score. The results were discussed at the end of the thesis.
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Detection of poorly differentiated cardiac arrhythmias
Kantor, Marek ; Ronzhina, Marina (referee) ; Novotná, Petra (advisor)
This thesis focusses on the detection methods of atrial fibrilation, atrial flutter and sinus rhythm from ECG. Thesis also concentrate on the description of this arrhythmias and the learning algorithms used. In this thesis are implemented several classification approaches. For extraction of features is used convolution neural network and classification artifitial neural network. Selected 1D CNN method achived classification accuracy global F1 - score is 91 %. Moreover, the proposed CNN optimized with GA appears to be fast shallow network with better accuracy than the deep network. Created model are used for classification other type of arrhythmias too.
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Identification of supraventricular tachycardia segments using multiple-instance learning
Abbrent, Jakub ; Novotná, Petra (referee) ; Ronzhina, Marina (advisor)
Supraventricular tachycardias have a high incidence in the population and often cause health disorders. The aim of this thesis is to automatically detect and localize atrial fibrillation in ECG records. The algorithm, implemented in Python, uses a convolutional neural network ResNet for detection with multiple-instance learning and decision rules. The output of the detection in the form of a feature signal is used for localization. The classification achieved F1 score of 0.87 on the test dataset. Then, paroxysmal atrial fibrillation was localized with a deviation of -0.40±2.26 seconds for the onsets and 1.09±2.75 seconds for the terminations of the episodes. Lastly, the obtained results are evaluated and discussed.
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Comparison of Methods of Left Appendage Exclusion During Surgical Ablation of Atrial Fibrillation
Kohut, Marián ; Kuntscher, Vilém (advisor) ; Skalický, Tomáš (referee) ; Rohn, Vilém (referee)
Comparison of methods of left atrial appendage exclusion during surgical ablation of atrial fibrilation Abstract Atrial fibrillation is the most common heart arrhytmia affecting a significant part of the population over 60 years of age and it is an eminent source of cardio-embolic events. Leading source of intra-cardial thrombi is the left atrium of the heart, specifically the left atrial appendage. Randomised studies show significant reduction of cerebral ictus by the use of Warfarin in patients with atrial fibrillation, however the use of anticoagulation has its restrictions, side effects and contraindications. There are several surgical techniques of excision or exclusion of the left atrial auricle. This dissertation thesis is focusing on the comparison of the two most common surgical techniques - resection of the left atrial appendage using a stapler and the exclusion of the left auricle using a clip applied from the pericardial side. At the same time, we've set an objective of confirming the electrical insulation of the left atrial appendage as a significant source of fibrillation impulses when using the clip for the left appendage exclusion. In a group of 30 patients with atrial fibrillation and who underwent the surgical atrial fibrillation ablation using a clip or stapler amputation during complex...
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