Delta QRS distinguishes Ito -mediated J waves from pseudo J waves produced by conduction delay on body surface electrocardiographic.

Pacing and clinical electrophysiology : PACE Pub Date : 2021-11-01 Epub Date: 2021-10-19 DOI:10.1111/pace.14359
Yinn Shaung Ooi, Mostafa Amer, Datun Qi, Zhen Yang, Chuanyu Gao, Gan-Xin Yan
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Abstract

Background: On surface electrocardiographic (ECGs), it is difficult to differentiate Ito -mediated J waves, a repolarization phenomenon seen in J wave syndromes (JWS) from terminal QRS deflections that mimic J waves (pseudo J waves) in intraventricular conduction delay (IVCD), an abnormality in depolarization. We hypothesize that the difference between the "maximum QRS duration" inclusive of J point or terminal QRS deflections and the minimum QRS duration identified across a 12-lead ECG is significantly larger in Ito -mediated J waves, and can serve as a marker to make this distinction.

Methods: A retrospective analysis was performed on adults with ECGs consisting of one of the four following manifestations: J waves associated with hypothermia and early repolarization, and pseudo J waves associated with right bundle branch block (RBBB) and non-specific intraventricular conduction delay (NS-IVCD). All ECGs were assessed individually and the maximum and minimum discrete QRS deflections on 12-lead tracings, defined as "QRSmax " and QRSmin , were identified. The difference between "QRSmax " and QRSmin , designated as ∆QRS, was calculated and compared across the studied populations.

Results: A total of 60 patients consisting of 15 patients in each arm were included in the study. ΔQRS was significantly larger in the hypothermia and early repolarization groups, compared to RBBB and NS-IVCD (p < .0001), with the following mean ∆QRS: hypothermia 54.3 ± 13.7 ms, early repolarization pattern 47.3 ± 15.3 ms, RBBB 19.3 ± 6.5 ms, and NS-IVCD 16.0 ± 6.6 ms.

Conclusion: ∆QRS may serve as a reliable ECG parameter for distinguishing Ito -mediated J waves from pseudo J waves produced by delayed intraventricular conduction.

Delta QRS在体表心电图上区分伊藤介导的J波与传导延迟产生的伪J波。
背景:在表面心电图(ECGs)上,很难区分伊藤介导的J波(J波综合征(JWS)中的一种复极现象)和脑内传导延迟(IVCD)中的一种去极化异常的模拟J波(伪J波)的终末QRS偏转。我们假设,在Ito介导的J波中,包括J点或末端QRS偏转在内的“最大QRS持续时间”与通过12导联心电图确定的最小QRS持续时间之间的差异要大得多,并且可以作为区分这种差异的标志。方法:回顾性分析具有以下四种表现之一的成人心电图:J波与低温和早期复极相关,伪J波与右束分支阻滞(RBBB)和非特异性脑室传导延迟(NS-IVCD)相关。对所有心电图进行单独评估,并确定12导联示踪的最大和最小离散QRS偏差,定义为“QRSmax”和QRSmin。计算“QRSmax”和QRSmin之间的差值(∆QRS),并在研究人群中进行比较。结果:共纳入60例患者,每组15例。(p)结论:∆QRS可作为区分Ito介导的J波与脑室传导延迟产生的伪J波的可靠心电图参数。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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