Dissertations and Theses @ UNI

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Open Access Thesis

Keywords

Heart--Diseases--Patients--Rehabilitation--Iowa; Arrhythmia; Heart--Diseases--Patients--Rehabilitation; Iowa;

Abstract

The purpose of the present study was to determine the prevalence of cardiac arrhythmias and ischemic electrocardiographic changes during monitored Phase II Cardiovascular Rehabilitation sessions in patients at the University of Iowa Hospitals and Clinics (UIHC). A secondary purpose of this study was to determine if the identified arrhythmias and ischemic electrocardiographic changes documented during monitored exercise sessions had occurred in the patients prior medical history. A third purpose of this study was to determine the monetary cost of telemetry monitoring in during cardiovascular rehabilitation exercise sessions. Subjects consisted of 176 males and 58 females with an average age of 58 years. Each subject's medical record, including cardiovascular rehabilitation data, was reviewed. The data was compiled to determine the frequency of cardiac arrhythmias and ischemic electrocardiographic changes that occurred during monitored exercise sessions. Analysis of the data determined 1,855 (48.30%) of the 3,840 sessions in which subjects participated had a documented cardiac arrhythmia or ischemic electrocardiographic change. Seventy-one (30.34%) of the 234 subjects did not have a history of any cardiac arrhythmia documented in the medical chart, but did have some type of arrhythmia during participation in cardiac rehabilitation. Ventricular arrhythmias occurred in 1,834 (98.87%) of the 1,855 problematic sessions in which subjects participated. Ventricular arrhythmias included isolated, paired, bigeminal, trigeminal, quadrigeminal premature ventricular complexes, and ventricular tachycardia. A total of 521 episodes of ventricular tachycardia occurred in 13 subjects over 52 monitored exercise sessions. Supraventricular arrhythmias noted during sessions include premature atrial complexes, atrial tachycardia, new onset atrial fibrillation or flutter, sinus pauses, supraventricular tachycardia, premature nodal complexes, and bigeminal premature atrial complexes: Six subjects had new onset atrial fibrillation and one subject had new onset atrial flutter. Two of the subjects had never exhibited atrial fibrillation or atrial flutter at any time in their past medical history. One subject experienced three episodes of Mobitz type I (Wenckebach) during two separate exercise sessions. Another subject participated in 37 sessions where his heart rhythm varied between sinus, alternating junctional rhythm with atrioventricular block and sinus, and in some sessions all junctional rhythm with atrioventricular block during exercise. Ischemic electrocardiographic changes occurred during 34 exercise sessions involving 14 subjects. All changes were greater than 1mm of ST segment depression. Four of the subjects had no prior ischemic changes. This study determined that seventy-one (30.34%) subjects experienced a new onset cardiac arrhythmia during a monitored exercise session. Ischemic electrocardiographic events were found in 14 (5.89%) of the subjects studied, of which four (28.57%) subjects experienced this for the initial time during cardiovascular rehabilitation.

Year of Submission

1996

Degree Name

Master of Arts

Department

School of Health, Physical Education, and Leisure Services

First Advisor

Forrest Dolgener

Second Advisor

Sue Joslyn

Third Advisor

Sharon Huddleston

Comments

If you are the rightful copyright holder of this thesis and wish to have it removed from the Open Access Collection, please submit a request to scholarworks@uni.edu and include clear identification of the work, preferably with URL.

Date Original

1996

Object Description

1 PDF file (76 leaves)

Language

en

File Format

application/pdf

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