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Master Thesis

Revue de littérature sur les palpitations et évaluation des pratiques professionnelles par une enquête de pratique : impact de l’utilisation de l’électrocardiogramme sur la prise en charge de deux cas de palpitations en Médecine Générale

Abstract : Introduction: palpitations are associated with various pathologies, the most prominent of which are cardiac arrhyythmias. Initial clinical evaluation is based on the interview, the physical examination and the electrocardiogram (ECG). In general practice, recommendations for good clinical pratice are almost non-existent in palpitations and the majority of praticioners do not have ECGs. Material and methods: we approached a literature review concerning palpitations, then we conducted a practice survey addressed to 502 general practitioners in Gironde whose goal was to evaluate the impact of ECG in diagnostic and therapeutic management. This study is structured in two clinical cases, each one presented without then with an ECG : one patient with atrial fibrillation (AF) and one patient with premature ventricular contraction (PVC). Results: in the first case, in the absence of ECG, 76.2% of the patients treated at home without anticoagulation, they are 13,2% in case of realization of an ECG (p<0.001) ; without an ECG, the cardiological assessment is planned by 62.4% of the doctors and by 80.8% after the ECG (p<0.001). In the second case, in the absence of ECG, it contains 7.5% prescriptions of betablockers and 12.9% after the ECG (p=0.23); without ECG, cardiological assessment is provided by 82.8% of doctors, after ECG it is expected by 81.7% (p=0.85). Discussion: in the first case, the ECG provides better prevention of thromboembolic risk in patients who are going back home and better management in terms of cardiological assessment. In the second case, the ECG would not seem to bring a profit whether the correct diagnosis is made or not. Conclusion: the ECG is useful in the context of an AF whereas it appears inconclusive in the context of PVC.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02494222
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, February 28, 2020 - 3:06:47 PM
Last modification on : Thursday, March 5, 2020 - 5:19:03 PM
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Sam Aizooky, Benoît Hannhart. Revue de littérature sur les palpitations et évaluation des pratiques professionnelles par une enquête de pratique : impact de l’utilisation de l’électrocardiogramme sur la prise en charge de deux cas de palpitations en Médecine Générale. Médecine humaine et pathologie. 2019. ⟨dumas-02494222⟩

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