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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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Influence of autonomic nervous system in the inducibility of atrial fibrillation.
Šrutová, Martina ; Provazník, Ivo (referee) ; Kolářová, Jana (advisor)
Cílem této práce je zjištění změn předcházejícím fibrilaci síní. Pozorována je rovnováha mezi sympatikem a parasympatikem. Do experimentu výzkumného ústavu Cleavlendské kliniky bylo zapojeno šest psů různých ras. Signály EKG byly získány Holterovským 24hodinovým monitorováním. Pomocí 40 vysokofrekvenčních impulsů (TI) byla každých 30 minut vyvolávána AF. Z 24hodinového signálu byly extrahovány kratší epizody. Každá z těchto epizod obsahovala 10 minut předcházejících TI a 3 minuty následující po TI. Desetiminutové epizody byly zpracovány automaticky, byly detekovány QRS komplexy a RR intervaly a vypočteny HRV parametry. Přítomnost a délka trvání AF byly zjištěny manuálně z tříminutových intervalů následujících po TI. Byla-li vyvolána AF o délce trvání kratší než 30 sekund došlo ve srovnání s epizodami bez výskytu AF k významným změnám tří HRV parametrů. HF parametr poklesl pro epizody s výskytem AF. LF parametr byl naopak vyšší v epizodách s AF. Pro AF delší než 30 sekund nebyly významné změny pozorovány. Změny v epizodách s krátkou AF mohly být způsobeny změnami vlivu sympatiku a parasympatiku. Ke vzniku dlouhých AF je pravděpodobně zapotřebí i jiného vlivu, který nemusí nutně souviset s nervovým systémem. K dalším analýzám je zapotřebí většího množství signálů.
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Analysis of patient adherence to treatment by DOAC I
Rezáková, Katarína ; Malý, Josef (advisor) ; Smejkalová, Lenka (referee)
Analysis of patient adherence to treatment by DOAC I Author: Katarína Rezáková Tutor: doc. PharmDr. Josef Malý, Ph.D. Consultant: PharmDr. Kateřina Malá, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Atrial fibrillation (AF) is the most common supraventricular tachyarrhythmia associated with increased morbidity and mortality. In clinical practice, direct oral anticoagulants (DOAC) are used as an alternative to warfarin to prevent thromboembolic events in patients with AF. The study aimed to analyse the statements of patients with FiP along with data from medical records focusing on aspects related to the use and management of DOAC, including devices and tools to improve adherence to treatment, patients' level of awareness of DOAC and other therapeutic agents used. Methods: The prospective study was conducted from 2020 to 2022 at the University Hospital Brno. Patients aged ≥ 18 years with AF on DOAC therapy (dabigatran, rivaroxaban and apixaban) were included in the study. Data about pharmacotherapy and patients' health status were obtained from medical records and structured interview with the patient. Patients' interviews were performed at time 0, three and six months after patient has entred the study....
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Analysis of patient adherence to treatment by DOAC II
Janáčková, Natália ; Malý, Josef (advisor) ; Hendrychová, Tereza (referee)
6 Abstract Analysis of patient adherence to treatment by DOAC II Author: Natália Janáčková Tutor: doc. PharmDr. Josef Malý, Ph.D. Consultant: PharmDr. Simona Dvořáčková, Ph.D., Mgr. Eliška Mašková Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aim: Dosing interval may be an important factor influencing adherence to direct oral anticoagulant (DOAC) therapy. In terms of adherence, a once-daily regimen appears to be a better alternative. However, there may be a higher risk of treatment failure if the dose is missed. The aim of the practical part of the thesis was to analyse patients' attitudes and experiences with DOACs, complemented by data from medical records, with a focus on aspects related to DOAC dosing. Methods: Data collection for this prospective study was carried out from 2020 to 2022 at the Internal Cardiology Outpatient Clinic of the University Hospital in Brno. Patients aged ≥ 18 years on DOAC treatment with indicated atrial fibrillation (FS) were approached to participate in the study. Each patient underwent a structured interview with a trained pharmacist on the day of study entry and again after 3 and 6 months. Two validated and three supplementary questionnaires were used in the interview. Patients' attitudes, experiences...
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Pulse Check in Pharmacies I
Frnková, Michaela ; Malá, Kateřina (advisor) ; Horký, Pavel (referee)
Pulse check in pharmacies I Author: Michaela Frnková Supervisor: PharmDr. Kateřina Malá, Ph.D. Consultant: PharmDr. Anna Rejmanová, Ph.D. De artment o ocial an linical Pharmac , Fac lt o Pharmac in ra ec Králov , harle University Introduction: Atrial fibrillation is one of the most common supraventricular disorders of the heart rhythm. Unless properly treated, it leads to higher mortality and morbidity rates. Early detection of such fibrillation, which is often asymptomatic, may prevent further associated complications, especially ischemic stroke, and a sudden cardiac death. Aim: The thesis focused on the feasibility of involving pharmacists in the screening of the patients with heart rhythm disorders. Further increase awareness of the possibilities and meaning of monitoring heart rhythm disorders in pharmacies and ensure that patients can verify their own heart rate at home. Methods: The heart rhythm measurements were carried within four weeks (11/2017; 11/2018; 6/2019; 12/2019), during the global health initiative "Know o r l e". Mea ring took place at the pharmacy in Pardubice; the pharmacy offers individual consultations to patients. Participation in the screening for the atrial fibrillation was offered to all incoming pharmacy persons who were older than 40 years and without chronic...
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The effect of nutritional intervention in patients with obesity and atrial fibrillation
Buzická, Julie ; Souza Lopes, Kristýna (advisor) ; Havránek, Štěpán (referee)
Introduction: Due to its high and increasing prevalence, obesity is among the most prevalent and one of the most serious risk factors for cardiovascular diseases. It is well established that there is an epidemiological link between obesity and atrial fibrillation and the risk of atrial fibrillation increases with increasing BMI. Studies show that weight reduction combined with antiarrhythmic drug therapy has a good effect in the treatment of atrial fibrillation in some patients. Nutritional intervention is an important part of the treatment of obesity and for this reason this paper focuses on its effect. Objectives: The aim of this theses is to evaluate the effect of individual nutritional intervention using telemedicine in obese patients with atrial fibrillation on the intake of total energy, individual major nutrients and fibre. In addition, the development of body weight and adipose tissue mass over a 6 month period should be evaluated. A secondary objective is to evaluate the exercise intervention based on the number of steps per day. Methods: Data were collected on III. Department of Internal Medicine, Department of Endocrinology and Metabolism, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, in the outpatient clinic of dietitians. The study included...
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Detection of atrial fibrillation using intracardiac ECG
Kašparová, Michaela ; Novotná, Petra (referee) ; Ředina, Richard (advisor)
Atrial fibrillation is one of the most common heart rhythm disorders. It is caused by irreg- ular activation of the atria, which causes uncoordinated atrial contractions with a very high frequency, and therefore its early diagnosis is very important. The aim of this bachelor thesis is the automatic detection of atrial fibrillation in intracardiac recordings. The automatic detection allows finding the sections with atrial fibrillation and thus medi- ate a faster diagnosis. Testing of the developed algorithm was carried out on the available database of paediatric patients who underwent electrophysiological examination at the Children’s Hospital of the University Hospital Brno in the Czech Republic.
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Morphological and functional changes in microvasculature and endomysium in human atrial myocardium with atrial fibrillation
Smorodinova, Natalia ; Kučera, Tomáš (advisor) ; Čížková, Dana (referee) ; Čížková, Kateřina (referee)
This doctorial thesis was focused on morphological and functional changes in microvasculature and endomysium in human atrial myocardium with atrial fibrillation. Atrial fibrillation (AF) is one of the most common arrhythmias in the clinical practice and it is associated with an increase in mortality risk that is strongly related with old age. Its pathogenesis is still not sufficiently explored. One of the generally recognized factors contributing to the initiation and maintenance of atrial fibrillation is structural remodeling of the myocardium. Structural remodeling is reflected by changes that affect both atrial cardiomyocytes as well as endomysium. We analyzed atrial biopsies obtained from patients undergoing bypass or mitral valve surgery. The patients had a regular sinus rhythm or were suffering from AF. Immunohistochemistry was used to visualize collagen I, collagen III, elastin, desmin, smooth muscle actin and VEGF in the atrial samples.To detect capillaries UEA-lectin was used. For detection of different types of immune cells the following markers were detected immunohistochemically: CD45 as a pan- leukocyte marker, CD3 for T-lymphocytes, CD68 for monocyte/macrophages, mast cell tryptase for mast cells and DC-SIGN for immature dendritic cells. Our results document that in patients...
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P Wave Detection in Pathological ECG Signals
Šaclová, Lucie ; Černý, Martin (referee) ; Tkacz, Ewaryst (referee) ; Vítek, Martin (advisor)
Důležitou součástí hodnocení elektrokardiogramu (EKG) a následné detekce srdečních patologií, zejména v dlouhodobém monitorování, je detekce vln P. Výsledky detekce vln P umožňují získat ze záznamu EKG více informací o srdeční činnosti. Podle správně detekovaných pozic vln P je možné detekovat a odlišit patologie, které současné programy používané v medicínské praxi identifikovat neumožňují (např. atrioventrikulární blok 1., 2. a 3. stupně, cestující pacemaker, Wolffův-Parkinsonův-Whiteův syndrom). Tato dizertační práce představuje novou metodu detekce vln P v záznamech EKG během fyziologické a zejména patologické srdeční činnosti. Metoda je založena na fázorové transformaci, inovativních pravidlech detekce a identifikaci možných patologií zpřesňující detekci vln P. Dalším důležitým výsledkem práce je vytvoření dvou veřejně dostupných databází záznamů EKG s obsahem patologií a anotovanými vlnami P. Dizertační práce je rozdělena na teoretickou část a soubor publikací představující příspěvek autora v oblasti detekce vlny P.
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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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