G Ian Rowlandson

Publications of G Ian Rowlandson

• Overcoming barriers to developing seamless ST-segment elevation myocardial infarction care systems in the United States: recommendations from a comprehensive Prehospital 12-lead Electrocardiogram Working Group.

  Authors: Daniel M Frendl, Sebastian T Palmeri, J Robert Clapp, David Hampton, Maria Sejersten, Dwayne Young, Barbara Drew, Robert Farrell, Jan Innes, James Russell, G Ian Rowlandson, Yanina Purim-Shem-Tov, B Kevin Underhill, Sophia Zhou, Galen S Wagner

  Journal of electrocardiology. 06/2009;

  BACKGROUND: Reducing time to reperfusion treatment for patients with ST-segment elevation myocardial infarction (STEMI) improves patient outcomes. Few medical systems consistently meet currentBACKGROUND: Reducing time to reperfusion treatment for patients with ST-segment elevation myocardial infarction (STEMI) improves patient outcomes. Few medical systems consistently meet current benchmarks regarding timely access to treatment. Studies have widely demonstrated that prehospital 12-lead electrocardiography can facilitate early catheterization laboratory activation and is the most effective means of decreasing patients' time to treatment. METHODS: We gathered experts to examine the barriers to implementation of prehospital 12-lead electrocardiographic monitoring and transmission to in-hospital cardiologists in creating seamless STEMI care systems (STEMI-CS) and propose multidisciplinary approaches to overcoming these barriers. RESULTS AND CONCLUSIONS: Physicians, hospital systems, and emergency medical services often lack coordination of care delivery and receive fragmented funding and oversight. Clinical and regulatory guidelines do not emphasize local solutions to achieving clinical benchmarks, do not target incentives at all components of the STEMI-CS, and underemphasize risk-based approaches to protecting patient health. Integration of the multiple complex components involved in STEMI-CS is essential to improving care delivery.

• The effects of noise on computerized electrocardiogram measurements.

  Authors: Robert M Farrell, G Ian Rowlandson

  Journal of electrocardiology. 11/2006; 39(4 Suppl):S165-73.

  Computerized measurements provide objective and reproducible assessments of the electrocardiogram (ECG). These measurements may be affected by noise or other lead quality issues. The effects of noiseComputerized measurements provide objective and reproducible assessments of the electrocardiogram (ECG). These measurements may be affected by noise or other lead quality issues. The effects of noise on the repeatability of computer-measured PR interval, QRS duration, QT interval, P/QRS/T axes, and ST levels were examined. METHODS: The 125 ECGs of the Common Standards for Quantitative Electrocardiography (CSE) measurement database (MO1 series) were merged with records from the MIT Noise Stress Test database. For each CSE ECG, 720 unique noise ECGs were created, for a total of 90,000 noisy ECGs. Computerized measurements from the noisy ECGs were compared to the original ECG measurements. The repeatability of the measurements was assessed as a function of a lead quality score. RESULTS: The repeatability of the measurements was found to be in excellent agreement with the original ECG measurements when the noise level was no worse than that of the original ECGs. Noise did not introduce any bias to the measurements, although not surprisingly, the variation of the errors increased as the lead quality degraded.