Learning Objective #1: Understand specific ECG measurements that may improve noninvasive risk stratification of sudden cardiac death

Learning Objective #2: Understand the importance of the 12-lead ECG in evidence-based nursing practice

---

Background: Sudden cardiac death (SCD) is a leading cause of cardiovascular mortality in the United States; however the best combination of variables only yields a predictive sensitivity of 41% for sudden death. Thus, major efforts are needed to improve accurate identification of these patients. Noninvasive electrocardiography (ECG) offers a wide spectrum of techniques capturing the various mechanisms leading to arrhythmogenic conditions; likely the precursor to sudden cardiac death. The low cost, noninvasive nature and universal accessibility of the ECG makes it an attractive screening test for SCD. Purpose: The purpose of this presentation is to evaluate various ECG measurements currently available to assist nurses to better identify patients at risk for SCD. Standard 12-lead high-resolution (1000Hz sampling) ECG recordings will be presented. Baseline rates and rhythms will be identified in addition to electrocardiographic abnormalities including bundle branch blocks or intraventricular conduction defects, ST segment deviation (depression or elevation), premature ventricular contractions, electronically paced rhythms, etc. Further measurements including QRS duration, QTc duration and T-wave alternans will also be interpreted. Research methodological issues for translational evidence based practice will be addressed. For example, attendees will learn the best strategies to make such measurements both manually and with computer assistance (i.e., trending) in the acute care setting. Accurate interpretation of specific ECG measurements may improve noninvasive risk stratification of sudden cardiac death.