GE ECG Analysis and Storage System
We are users of the General Electric MUSE and have on-line visualization of the stored ECGs via the VA Imaging software as well as direct ECG acquisition thru the ER and CCU monitors. An exciting project on-going with this system is the follow up of nearly 50,000 patients with ECGs gathered since 1987. All of the computer measurements and interpretive statements were entered into a database. Most recently we have obtained the digital version of these records through collaboration with Marek Malik, MD, PhD. Endpoints are death, cardiac events, atrial fibrillation and what ever else comes to mind. We have used Number Crunching Statistical Software (NCSS) for analysis and published numerous papers. This data set has been and continues to be a source of answers for many important clinical questions (simple ECG score, women vs men). Got any ideas??


NHLBI Specialized Center of Clinically Oriented Research (SCCOR) on abdominal aortic aneurysms (AAAs)

We were recently funded for the clinical portion of a package of studies developed by a consortium of investigators at Stanford and the Palo Alto VAMC. We will be responsible for a randomized trial of exercise training in 400 patients with small aortic aneurysms. There are supportive studies that increased flow can keep the endothelium healthy and lessen aneurysm development. Also, we will demonstrate the safety of exercise training in these clinically problematic patients.

Exercise Testing Studies

1. Follow up and Angiographic correlative Studies: We have analyzed data bases of patients from the Long Beach VA and the Palo Alto VA with digitized exercise ECGs and angiography. We also have a data base of over 10,000 Veterans on which we are performing a follow up.

2. Expired gas Analysis: Jon published a follow up of patients that had measured VO2 from exercise tests accomplished on Stanford Heart transplant candidates and patients in the Palo Alto clinical lab.

3. Exercise Testing Scores: We have collaborated with Tony Morise at the University of West Virginia to validate the scores that we develop.

4. Scores vs Physicians: Before he left for medical school at Virginia Commonwealth, Mike Lipinsky analyzed questionnaires he sent out to doctors to evaluate whether the scores do as well as physicians at classifying patient probability for CAD. This work has resulted in several peer reviewed articles and abstracts at scientific sessions.

5. Heart rate variability: Rick Dewey is a Stanford Medical student who has been working with us thru the Medical Student Scholar program. At the 2006 ACC Scientific Sessions, he came in second in the Junior Investigator contest for his work on heart rate variability during exercise (HRV and prognosis, HRV physiology).