Journal of electrocardiology最新文献

{"title":"A proposal for a novel formula for measurement of corrected QT interval in patients undergoing left bundle branch area pacing","authors":"Mert Doğan MD,&nbsp;Uğur Canpolat MD,&nbsp;Kudret Aytemir MD","doi":"10.1016/j.jelectrocard.2025.154030","DOIUrl":"10.1016/j.jelectrocard.2025.154030","url":null,"abstract":"<div><h3>Background</h3><div>Prolongation of the QT interval is associated with malignant ventricular arrhythmias. However, measuring the QT interval is difficult in some clinical conditions, like ventricular paced rhythm. In this study, we aimed to propose a novel formula that measures the QT interval in patients who underwent pacemaker implantation via left bundle branch area pacing (LBBaP).</div></div><div><h3>Methods</h3><div>This is a single-center, retrospective preliminary study (<em>n</em> = 63). All patients underwent pacemaker implantation via LBBaP. Electrocardiographic (ECG) parameters [QRS duration (QRSd), QTc interval (Bazett, Fridericia, Framingham, Hodges, Rautuharju, Spline), Ventricular rate, JT interval] were measured and analyzed before and after the LBBaP.</div></div><div><h3>Results</h3><div>The mean age of the study population was 68 ± 13 years, and 39 (62 %) patients were female. The patients' mean left ventricular ejection fraction (LVEF) was 57.9 ± 4.78 %. The mean QT duration of the patients was 437.73 ± 55 msec at baseline and 427.17 ± 38.79 msec after the procedure. The Hodges formulation before and after LBBaP yielded the closest QTc measurements. As a result of our analysis, we produced the formula for patients who underwent LBBaP and were in paced rhythm: QTc (Dogan) = QTc(<em>H</em>)X0.97 = [QT + 1.75 (HR − 60)]x0.97.</div></div><div><h3>Conclusion</h3><div>There is no precise formula for measuring QTc in patients with ventricular-paced rhythm and pacemaker dependency. In patients with conventional pacemaker implantation, the underlying QT has long been calculated by subtracting 50 msec from the QT duration in a ventricular-paced rhythm. LBBaP is a more physiological method than conventional pacemaker implantation, and its application will increase in the coming years. We propose a novel formula that predicts QTc in these patients.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154030"},"PeriodicalIF":1.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrocardiographic characteristics of children with newly diagnosed Duchenne muscular dystrophy","authors":"Xin Wang MS ,&nbsp;Xinmu Li MS ,&nbsp;Shujuan Chen MD ,&nbsp;Peng Zhao MD ,&nbsp;Tong Liu MD PhD","doi":"10.1016/j.jelectrocard.2025.154029","DOIUrl":"10.1016/j.jelectrocard.2025.154029","url":null,"abstract":"<div><h3>Background</h3><div>The electrocardiograms (ECGs) serve as a critical and routine screening tool of non-invasive imaging for Duchenne muscular dystrophy (DMD) patients. Our study aims to summarize and investigate the electrocardiographic characteristics of newly diagnosed DMD children.</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective study to collect all DMD children diagnosed through genetic testing at Tianjin Children's Hospital from July 2018 to December 2023. 12‑lead ECGs were recorded and ECG parameters were manually measured. The comparative analyses were conducted to assess the differences in ECG parameters between DMD and normal children across various age and genotype subgroups.</div></div><div><h3>Results</h3><div>A total of 44 children diagnosed with DMD were retrospectively enrolled, including 43 males (97.7 %). The average age at diagnosis was 36.78 ± 21.69 months old. Comparison of ECG between the DMD group and control group suggested that the abnormal ECG parameters such as deepened Q wave amplitude in leads V5-V6 (<em>p</em> &lt; 0.01), increased R wave amplitude in chest leads (<em>p</em> &lt; 0.01), a higher R/S wave amplitude ratio in lead V1 (<em>p</em> &lt; 0.01), and an increased Sokolow-Lyon index (<em>p</em> = 0.02). The results revealed after the age of 7, additional ECG abnormalities became evident, reflecting a progression in the severity and number of abnormalities with increasing age.</div></div><div><h3>Conclusions</h3><div>The ECG abnormalities observed in this study could play a crucial role in supporting the early detection of DMD in resource-limited clinical settings.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154029"},"PeriodicalIF":1.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explainable advanced electrocardiography at rest for ruling out myocardial ischemia on stress echocardiography","authors":"Kevin X. Yang ,&nbsp;Johan von Scheele ,&nbsp;Maren Maanja ,&nbsp;Daniel E. Loewenstein ,&nbsp;Todd T. Schlegel ,&nbsp;Martin Ugander ,&nbsp;Rebecca Kozor","doi":"10.1016/j.jelectrocard.2025.154028","DOIUrl":"10.1016/j.jelectrocard.2025.154028","url":null,"abstract":"<div><h3>Background</h3><div>Stress echocardiography (SE) is relatively resource intensive and has a low incidence of abnormal tests for detecting coronary artery disease (CAD) in low-to-intermediate risk patients. This study aimed to derive and determine the diagnostic performance of a resting advanced electrocardiography (A-ECG) score for detecting inducible myocardial ischemia on SE in patients with low-to-intermediate risk stable chest pain.</div></div><div><h3>Methods</h3><div>Patients were included if they presented with low-to-intermediate risk stable chest pain to the emergency department, had acute coronary syndrome ruled out by electrocardiography (ECG) and high-sensitivity troponin, and subsequently underwent outpatient SE. Patients were excluded if they had known CAD or confounders on resting ECG. A-ECG was retrospectively applied to a standard resting 12‑lead ECG and a multivariable logistic regression score was derived to predict myocardial ischemia on SE.</div></div><div><h3>Results</h3><div>Among 292 patients (51 % male, age 58 ± 14 years), 24 (8 %) exhibited inducible myocardial ischemia on SE. A 3-parameter A-ECG score had an area under the receiver-operating characteristic curve (AUC [bootstrapped 95 % confidence interval]) of 0.85 [0.75–0.93], sensitivity 92 [67–100]%, specificity 67 [64–94]%, positive predictive value 22 [20<strong>–</strong>55]%, negative predictive value 99 [96<strong>–</strong>100]%, positive likelihood ratio 2.8 [2.5–12.0] and inverse negative likelihood ratio 8.1 [2.5–18.0].</div></div><div><h3>Conclusions</h3><div>An A-ECG score had a good overall diagnostic performance and excellent performance for ruling out inducible myocardial ischemia on SE. This supports the use of an A-ECG score to triage and improve the selection of patients with low-intermediate risk stable chest pain that should undergo further testing with SE.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154028"},"PeriodicalIF":1.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-frequency analysis of high-frequency power profile within the QRS complex in patients with ventricular tachycardia using wavelet transform","authors":"Kei Hiramatsu M.D. ,&nbsp;Satoshi Yanagisawa M.D., Ph.D. ,&nbsp;Yasuya Inden M.D., Ph.D. ,&nbsp;Ryota Yamauchi M.D. ,&nbsp;Ryo Watanabe M.D., Ph.D. ,&nbsp;Naoki Tsurumi M.D. ,&nbsp;Noriyuki Suzuki M.D., Ph.D. ,&nbsp;Tomoya Iwawaki M.D. ,&nbsp;Takayuki Goto M.D. ,&nbsp;Shun Kondo M.D. ,&nbsp;Masaya Tachi M.D. ,&nbsp;Masafumi Shimojo M.D. ,&nbsp;Yukiomi Tsuji M.D., Ph.D. ,&nbsp;Toyoaki Murohara M.D., Ph.D.","doi":"10.1016/j.jelectrocard.2025.154027","DOIUrl":"10.1016/j.jelectrocard.2025.154027","url":null,"abstract":"<div><h3>Background</h3><div>Time-frequency analysis using continuous wavelet transform enables the detection of hidden frequency power within the QRS complex in electrocardiography. These frequency profiles may reflect myocardial damage and electrical dispersion. This study evaluated the frequency power profile in patients with a history of ventricular tachycardia (VT) using time-frequency analysis and assessed changes in the profile after catheter ablation.</div></div><div><h3>Methods</h3><div>Thirteen patients with a history of VT and 15 without who underwent implantable cardioverter-defibrillator implantation for secondary and primary prevention, respectively, were included. The time-frequency powers were calculated from QRS onset to the beginning of the T-wave in lead V5 on 3-min electrocardiography pre-implantation using continuous wavelet transform analysis. The frequency power of each scale band (40, 80, 150, 200, and 250 Hz) was evaluated using the mean of three continuous beats.</div></div><div><h3>Results</h3><div>The signal powers in high-frequency bands against that of 80 Hz were significantly higher in the VT group than in the non-VT group (250/80 Hz: 0.214 ± 0.060 vs. 0.146 ± 0.055, <em>p</em> = 0.004; 200/80 Hz: 0.282 ± 0.086 vs. 0.211 ± 0.082, <em>p</em> = 0.036; 150/80 Hz: 0.425 ± 0.118 vs. 0.341 ± 0.097, <em>p</em> = 0.049). Among 11 patients undergoing VT ablation in the secondary prevention group, the high-frequency component ratio significantly decreased post-ablation (250/80 Hz: 0.220 ± 0.062 to 0.183 ± 0.067, <em>p</em> = 0.015; 150/80 Hz: 0.424 ± 0.115 to 0.383 ± 0.108, <em>p</em> = 0.031). Peak signal powers of 250 Hz were detected within the QRS complex in all patients, with significant prolongation after ablation.</div></div><div><h3>Conclusion</h3><div>The distribution shift of the powers in the high-frequency bands was relevant in patients with VT. The time-frequency analysis was useful for stratifying ventricular arrhythmia risk.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154027"},"PeriodicalIF":1.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Missing the beat: Unaddressed dimensions in the electrocardiographic evaluation of Duchenne muscular dystrophy","authors":"Muhammad Khubaib Iftikhar,&nbsp;Qurat ul ain Iftikhar,&nbsp;Mirza Muhammad Ali Baig","doi":"10.1016/j.jelectrocard.2025.154021","DOIUrl":"10.1016/j.jelectrocard.2025.154021","url":null,"abstract":"<div><div>The recent study by Krishnamurthy et al. explores electrocardiographic (ECG) patterns in Duchenne muscular dystrophy (DMD), a timely topic in cardiomyopathy surveillance. However, the study omits crucial aspects that could enhance clinical relevance: early ECG deviations in young asymptomatic patients, genotype-informed risk stratification, integration with imaging modalities, and implications for patient monitoring protocols. We propose a multidimensional framework—age-specific, mutation-aware, and imaging-supported—for future ECG studies to better align with the goals of anticipatory cardiac care in DMD.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154021"},"PeriodicalIF":1.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beneath the surface: Complete atrioventricular block combined with Wolff-Parkinson-White syndrome and sick sinus syndrome","authors":"Dongmei Xie M.D ,&nbsp;Ting Yan M.D ,&nbsp;Xin Zhang M.D ,&nbsp;Xingbin Liu M.D","doi":"10.1016/j.jelectrocard.2025.154025","DOIUrl":"10.1016/j.jelectrocard.2025.154025","url":null,"abstract":"<div><div>The combination of Wolff–Parkinson–White (WPW) syndrome, sick sinus syndrome (SSS), and complete atrioventricular block (AVB) is seldom reported. We present a case of A 61-year-old male who was admitted with syncope and palpitations. His electrocardiogram showed a preexcited QRS pattern consistent with transient cardiac pauses. WPW syndrome with SSS syndrome was diagnosed. The electrophysiologic study demonstrated the preexcitation through the left accessory pathway, but after its blockages, completed atrioventricular block emerged. The patient ultimately required pacemaker implantation, followed by the ablation of the accessory pathway. AVB may be masked by ventricular preexcitation, and atrioventricular node function should be evaluated before ablation.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154025"},"PeriodicalIF":1.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking loss of capture and prolonged left ventricular latency by the Biotronik desynchronization-detection algorithm","authors":"S. Serge Barold MD ,&nbsp;Andreas Kucher MSc, PhD","doi":"10.1016/j.jelectrocard.2025.154023","DOIUrl":"10.1016/j.jelectrocard.2025.154023","url":null,"abstract":"<div><div>Loss of pacing capture of the right or left ventricle as well as prolongation of the device-defined LV latency can be automatically unmasked in Biotronik CRT-D devices by Home Monitory of the CRT pacing interrupt algorithm. These situations are associated with short intervals from a pacing stimulus to conducted ventricular activation. These intervals are relatively constant with device-defined latency while those from loss of capture are longer and may be more variable. The true LV latency interval should be re-evaluated whenever the device-defined latency is apparent and prolonged.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154023"},"PeriodicalIF":1.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrowing of QRS complex during ablation of premature ventricular contractions","authors":"Helge Haarmann,&nbsp;Nibras Soubh,&nbsp;Eva Rasenack,&nbsp;Markus Zabel,&nbsp;Leonard Bergau","doi":"10.1016/j.jelectrocard.2025.154024","DOIUrl":"10.1016/j.jelectrocard.2025.154024","url":null,"abstract":"<div><div>In this case we experienced a narrowing of the QRS complex during ablation of premature ventricular contractions in a patient with a left bundle branch block.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154024"},"PeriodicalIF":1.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ECG-derived DETERMINE score can provide information about procedure success in chronic total occlusion patients","authors":"Muzaffer Kahyaoğlu MD,&nbsp;Büşra Güvendi Şengör MD,&nbsp;Müge Ildızlı Demirbaş MD,&nbsp;Çetin Geçmen MD,&nbsp;Elnur Alizade MD,&nbsp;Regayip Zehir MD,&nbsp;Ali Karagöz MD","doi":"10.1016/j.jelectrocard.2025.154022","DOIUrl":"10.1016/j.jelectrocard.2025.154022","url":null,"abstract":"<div><h3>Background</h3><div>Successful chronic total occlusion (CTO) interventions may provide symptomatic relief, improve left ventricular ejection fraction (LVEF), and improve clinical outcomes. In contrast, unsuccessful interventions may increase major adverse cardiovascular event rates. Several studies have investigated various scoring systems used to predict procedural success. The DETERMINE score is an electrocardiography (ECG) score that includes Q waves, fragmented QRS, and T wave inversions. This study aimed to investigate the relationship between the procedural success of CTO and the ECG-derived DETERMINE score system.</div></div><div><h3>Methods</h3><div>Our study included 301 patients. The patients were divided into successful revascularization (69 %) and unsuccessful revascularization (31 %).</div></div><div><h3>Results</h3><div>The unsuccessful revascularization group had a higher history of coronary artery disease, lower glomerular filtration rate (GFR) levels, lower left LVEF, higher j-CTO score, less good coronary collateral, higher retrograde approach, longer QRS interval, longer QT and QTc interval, and higher DETERMINE score than the successful revascularization group. The multivariate logistic regression test results indicated LVEF, j-CTO score, absence of good coronary collateral, and DETERMINE score as independent predictive parameters for unsuccessful revascularization.</div></div><div><h3>Conclusion</h3><div>Predicting procedural success in CTO patients is crucial, especially when selecting patients. The DETERMINE score, obtained from the ECG, may aid in decision-making.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154022"},"PeriodicalIF":1.3,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrocardiographic diagnostic possibilities for atrial fibrillation using artificial intelligence: Differentiation from sinus rhythm and other arrhythmias with the PMcardio app in COVID-19 patients","authors":"Rita Vainoryte ,&nbsp;Jonas Jucevicius ,&nbsp;Edis Baubonis ,&nbsp;Albinas Naudziunas ,&nbsp;Andrius Alisauskas ,&nbsp;Egle Kalinauskiene","doi":"10.1016/j.jelectrocard.2025.154020","DOIUrl":"10.1016/j.jelectrocard.2025.154020","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) has shown potential in enhancing ECG analysis, but its accuracy in detecting atrial fibrillation (AF) in COVID-19 patients remains unstudied. Given the increased risk of arrhythmias and thromboembolic events in this population, AI could aid in timely correct diagnosis, reduce unnecessary consultations, tests, and minimize infection spread. This study evaluated the diagnostic performance of the AI-based PMcardio application in detecting AF in COVID-19 patients.</div></div><div><h3>Methods</h3><div>The study analyzed 116 hospitalized COVID-19 consecutive patients using paper-based medical records, with a particular focus on ECGs. The presence and type of arrhythmias were determined by an experienced cardiologist and compared with assessments by the infectious disease specialists collected from patient medical records and the PMcardio application.</div></div><div><h3>Results</h3><div>The mean patient age was 63.28 (14.980) years. The PMcardio AI application demonstrated perfect diagnostic performance, achieving a sensitivity and specificity of 1.00 for AF detection compared to cardiologist's evaluations. Infectious disease specialists showed lower sensitivity (0.85) but retained high specificity (0.97). No significant association was found between the AI confidence score and diagnostic accuracy (<em>p</em> = 0.660), indicating consistent performance across confidence levels. Additionally, the AI's severity classification correlated significantly with rhythm diagnoses (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>AI-powered ECG analysis using PMcardio highly accurately detected AF in COVID-19 patients, outperforming infectious disease specialists and matching cardiologist's accuracy. The integration of AI in clinical practice may enhance arrhythmia detection and streamline diagnostic workflows, particularly in resource-limited and infectious disease settings.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154020"},"PeriodicalIF":1.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}