Journal of electrocardiology最新文献

{"title":"The association between ST-segment depressions and sudden cardiac deaths and arrests after acute coronary syndrome.","authors":"Konsta Kivimäki, Hanna Pohjantähti, Jussi Hernesniemi, Leo-Pekka Lyytikäinen, Juho Tynkkynen, Jani Rankinen","doi":"10.1016/j.jelectrocard.2025.154145","DOIUrl":"https://doi.org/10.1016/j.jelectrocard.2025.154145","url":null,"abstract":"<p><strong>Aims of the study: </strong>ST-segment depression in the electrocardiogram (ECG) of acute coronary syndrome (ACS) patients has been associated with higher mortality. But still, its association to sudden cardiac deaths (SCDs) or sudden cardiac arrests (SCAs) has not yet been investigated. We analyzed the association between ST-segment depression in the ECG after angiography and the long-term incidence of SCD and SCA among ACS patients.</p><p><strong>Methods: </strong>Retrospective data of 8565 consecutive ACS patients with a median follow-up time of 7.1 years were analyzed retrospectively. Patients with (n = 1957) and without (n = 6608) ST-segment depression in ECG after angiography were compared after stratification according to the location of ST-segment depression. Incidents of SCDs and SCAs were adjudicated using various sources detailing the circumstances leading to the events. Subdistribution regression (Fine-Gray) models were used in the association analyses.</p><p><strong>Results: </strong>Lateral, inferior, and inferolateral ST-segment depression were associated with the long-term risk for SCD and SCA in age- and sex-adjusted analyses (p-value <0.05). However, only lateral ST-segment depression was associated with a higher risk for SCD (HR 1.58, 95 % CI 1.13-2.20, p-value 0.007) and SCA (HR 1.48, 95 % CI 1.12-1.96, p-value 0.006) when additionally adjusted with several cardiovascular risk factors. The results remained significant in lateral and inferolateral ST-segment depression even after excluding patients with LVEF ≤35 % at baseline.</p><p><strong>Conclusion: </strong>Lateral, inferolateral, and inferior ST-segment depressions in ECG after angiography in ACS patients are associated with a significantly higher long-term risk for SCD and SCA.</p>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"154145"},"PeriodicalIF":1.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308229","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":"The value of P wave parameters in predicting proximal or distal right coronary artery occlusion in patients with inferior myocardial infarction.","authors":"Suleyman Cagan Efe, Murat Karacam, Ali Furkan Tekatli, Baver Bozan, Mustafa Furkan Kilicarslan, Mustafa Kara, Muhammet Bulut, Tuba Unkun, Enver Yucel, Cem Doğan, Gulumser Sevgin Halil, Ozgur Yasar Akbal, Ali Karagoz","doi":"10.1016/j.jelectrocard.2025.154143","DOIUrl":"https://doi.org/10.1016/j.jelectrocard.2025.154143","url":null,"abstract":"<p><strong>Background: </strong>Electrocardiography (ECG) provides valuable information for early diagnosis of myocardial infarction. It is known that the atria receive their blood supply primarily from branches originating from the proximal segments of the coronary arteries. This study aimed to evaluate whether P wave parameters on admission ECG can help determine proximal versus distal right coronary artery (RCA) occlusion in patients presenting with inferior myocardial infarction (IMI).</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive patients presenting with IMI to the emergency department between October 2022 and May 2023. After applying exclusion criteria, a total of 123 patients were included. Admission ECG parameters were analyzed in relation to the angiographically confirmed site of coronary occlusion.</p><p><strong>Results: </strong>The study population was divided into two groups according to proximal or distal RCA occlusion. Demographic characteristics were similar between groups. Statistically significant differences were observed between groups in the following ECG parameters: QT dispersion, P wave terminal force, P wave peak time in leads V1 and V2, and ST elevation in lead V1. In multivariable logistic regression analysis, ST elevation in lead V1 (OR 6.1; 95 % CI: 1.48-26.8; p = 0.013) and P wave peak time in lead V1 (OR 1.08; 95 % CI: 1.01-1.12; p = 0.008) were identified as independent predictors of proximal RCA occlusion. A added variable plot demonstrated that P wave peak time > 56 ms was significantly associated with increased probability of proximal coronary occlusion.</p><p><strong>Conclusion: </strong>In patients presenting with inferior myocardial infarction, P wave peak time in lead V1 on admission ECG may serve as a useful, non-invasive marker in predicting proximal RCA occlusion.</p>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"154143"},"PeriodicalIF":1.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308230","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":"A novel multichannel sparse convolutional autoencoder for electrocardiogram signal compression.","authors":"Tahir Bekiryazıcı, Mehmet Damkacı, Gürkan Aydemir, Hakan Gürkan","doi":"10.1016/j.jelectrocard.2025.154125","DOIUrl":"https://doi.org/10.1016/j.jelectrocard.2025.154125","url":null,"abstract":"<p><p>Electrocardiogram (ECG) signal compression is paramount in continuously monitoring cardiac patients, as it reduces data storage and transmission costs. Deep neural networks, particularly autoencoders, offer significant potential for compressing ECG signals by mapping them to lower-dimensional spaces. This paper presents a novel multichannel convolutional autoencoder model designed to compress ECG signals efficiently. The proposed approach encodes the ECG signal into a four-channel lower-dimensional space using a convolutional encoder, which is subsequently reconstructed by a deconvolutional decoder. Unlike traditional autoencoder-based methods, the first channel in the model remains unconstrained, while increasing levels of sparsity constraints are imposed on the remaining channels. Different quantization levels are applied to each channel to optimize compression further, reflecting the varying numerical ranges caused by the sparsity constraints. The quantized channels are then encoded using Huffman coding, resulting in a higher compression ratio. The model's effectiveness is evaluated on a popular benchmark dataset, using normalized percent root mean square difference (PRDN) error and compression ratio as performance metrics. The proposed method achieves an average compression ratio of 20.23:1, with an average PRDN error of 9.86%, demonstrating its capability to compress ECG signals efficiently while maintaining reconstruction accuracy.</p>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"154125"},"PeriodicalIF":1.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301285","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":"Narrow QRS tachycardia? What is the diagnosis?","authors":"Victoria Fanucci B.S. ,&nbsp;Utkarsh Kohli M.D","doi":"10.1016/j.jelectrocard.2025.154146","DOIUrl":"10.1016/j.jelectrocard.2025.154146","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154146"},"PeriodicalIF":1.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266162","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":"Transient atypical advanced interatrial block in a pre-adolescent with sequelae of rheumatic fever.","authors":"Andrés Ricardo Pérez-Riera, Raimundo Barbosa-Barros, Maurício da Silva Rocha, Cynthia Aparecida da Silva Rocha, Luciano Evaristo Pereira Rejálaga, Kjell Nikus","doi":"10.1016/j.jelectrocard.2025.154141","DOIUrl":"https://doi.org/10.1016/j.jelectrocard.2025.154141","url":null,"abstract":"<p><p>We present a case of a pre-adolescent girl with mitral stenosis caused by rheumatic fever. The 12‑lead ECG showed prolonged P-wave duration indicating interatrial block. In addition, the P waves in the inferior leads showed a transient atypical interatrial block with a triphasic pattern in lead II. The appearance of the atypical interatrial block resulted in the attenuation of the P terminal force in lead V1. Atypical interatrial block is associated with atrial cardiomyopathy and is a potential risk factor for atrial fibrillation or stroke.</p>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"154141"},"PeriodicalIF":1.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292320","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":"A hemodynamically stable wide complex tachycardia: What is the diagnosis?","authors":"Hannah E Wey, Timothy W Smith","doi":"10.1016/j.jelectrocard.2025.154144","DOIUrl":"https://doi.org/10.1016/j.jelectrocard.2025.154144","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"154144"},"PeriodicalIF":1.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301312","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":"Increased fragmented QRS and decreased basophil in earthquake-related post-traumatic stress disorder.","authors":"Dilek Örüm, Yaşar Kapıcı, Sabri Abuş","doi":"10.1016/j.jelectrocard.2025.154140","DOIUrl":"https://doi.org/10.1016/j.jelectrocard.2025.154140","url":null,"abstract":"<p><strong>Aims: </strong>Many people died or were injured in two consecutive huge earthquakes in Turkey in February 2023. The earthquakes caused serious psychiatric disorders including post-traumatic stress disorder (PTSD). This study aimed to compare various electrocardiography (ECG) parameters including fragmented QRS (fQRS) and complete blood count (CBC) parameters including basophil to lymphocyte ratio (BLR) of earthquake-exposed with and without post-traumatic stress disorder (PTSD) subjects.</p><p><strong>Methods: </strong>ECG and CBC parameters were obtained from 47 earthquake-exposed with PTSD subjects and 51 earthquake-exposed without PTSD subjects. Additional psychiatric and general medical conditions that might affect ECG and CBC were excluded. The PTSD severity scale (PCL-5) and the Symptom Checklist-90-Revised (SCL-90-R) were used.</p><p><strong>Results: </strong>Gender, age, education level, marital and smoking status, PTSD history, location at the time of earthquakes, and residence damage were similar between groups (p > 0.05). The SCL-90-R score of the earthquake-exposed with PTSD group was higher than the earthquake-exposed without PTSD group (p < 0.001). The fQRS count (p = 0.041), presence of fQRS (p = 0.024) and frontal QRS-T angle (p = 0.004) were significantly higher in the earthquake-exposed with PTSD group. This significance persisted for frontal QRS-T angle (adjusted p = 0.049) after controlling for the effects of age, gender, smoking status, post-earthquake migration, and body mass index (BMI) as covariance. After controlling for the effect of age, gender, and BMI in the earthquake-exposed with PTSD group, a significant correlation was detected between fQRS count and PCL-5 (r = 0.764, p < 0.001). The area under the ROC curve of basophil count was 0.857 (p < 0.001; 95 % CI (0.779-0.936)). In the binary logistic regression analysis, BLR contributed significantly to the model (p < 0.001).</p><p><strong>Conclusions: </strong>This study suggests that there may be significant differences between surface ECG and CBC parameters of individuals with and without earthquake-related PTSD.</p>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"154140"},"PeriodicalIF":1.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301302","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":"Novel presentation of CACNA1C variant as neonatal complete atrioventricular block, heart failure and non-compaction cardiomyopathy with oligogenic influences","authors":"Sydney R. Rooney MD ,&nbsp;Brock Karolcik MD ,&nbsp;Shawn West MD ,&nbsp;Christopher Follansbee MD ,&nbsp;Mousumi Moulik MD ,&nbsp;Gaurav Arora MD","doi":"10.1016/j.jelectrocard.2025.154139","DOIUrl":"10.1016/j.jelectrocard.2025.154139","url":null,"abstract":"<div><div>Pathogenic CACNA1C variants are associated with long QT syndrome, cardiac conduction disorders (CCD), short QT or Brugada syndromes, sudden cardiac death, and rarely hypertrophic cardiomyopathy. Neonatal complete AV block (CAVB) has not been previously reported in patients with CACNA1C-mutations. We present a neonate with CAVB, severe heart failure, and non-compaction cardiomyopathy, found to have a de novo, likely pathogenic, heterozygous CACNA1C variant and heterozygous variants of uncertain significance (VUS) in TNNI3K, GATA6, and PDHK1 genes. This case expands the CACNA1C-associated phenotype to include neonatal CAVB and suggests a potential oligogenic contribution to severe neonatal cardiac disease.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154139"},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244534","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 LVH criteria: Poor diagnostic accuracy even with optimized cutoffs. Insights from MESA study","authors":"José Nunes de Alencar ,&nbsp;Sandro Pinelli Felicioni","doi":"10.1016/j.jelectrocard.2025.154138","DOIUrl":"10.1016/j.jelectrocard.2025.154138","url":null,"abstract":"<div><h3>Background</h3><div>Electrocardiographic (ECG) “left ventricular hypertrophy (LVH) criteria” are widely used as surrogates for increased LV mass but show limited sensitivity. We evaluated their diagnostic performance against cardiac magnetic resonance (CMR) in a large population cohort.</div></div><div><h3>Methods</h3><div>We analyzed 4849 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with standardized digital 12‑lead ECGs and CMR-derived LV mass indexed to body surface area (LVMi). LVH was defined as LVMi &gt;91 g/m² (men) and &gt; 77 g/m² (women). We assessed Sokolow-Lyon, Cornell voltage, Cornell product, Peguero–Lo Presti, Sokolow-aVL, and MESA-LVH (SV1 + SV2 + RV5). Diagnostic accuracy was calculated for classic (“pre-specified”) thresholds and for cutoffs optimized by the Youden index. We also tested whether combining indices via elastic-net penalized logistic regression improved discrimination.</div></div><div><h3>Results</h3><div>LVH prevalence was 30.2 %. Across classic thresholds, sensitivities were very low (3.7–15.2 %) with high specificities (&gt;94 %); likelihood ratios were modest (typical LR+ &lt;4; LR− ≈ 0.89–0.96). Youden-optimized cutoffs improved sensitivity (48.9–64.8 %) at the expense of specificity (54.4–74.3 %), yielding weak LR+ (1.42–1.94) and LR− (0.64–0.71). Pooled area under the ROC curve (AUC) for individual indices ranged 0.62–0.66. An elastic-net model combining all indices did not enhance discrimination beyond the best single measure (AUC 0.646).</div></div><div><h3>Conclusions</h3><div>In MESA, ECG voltage criteria—whether applied at classic or optimized thresholds—show poor diagnostic performance for CMR-defined LVH. Aggregating indices provides no material gain. These findings support reframing voltage positivity as an amplitude-based electrical phenotype with prognostic value rather than a reliable diagnostic surrogate for structural hypertrophy.</div></div><div><h3>Clinical trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier <span><span>NCT00005487</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154138"},"PeriodicalIF":1.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199561","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":"Delayed QT prolongation and electrical storm following cardioversion","authors":"Edward Dababneh ,&nbsp;Dylan Young ,&nbsp;Sachin Nayyar ,&nbsp;Maria Gabriela Matta","doi":"10.1016/j.jelectrocard.2025.154136","DOIUrl":"10.1016/j.jelectrocard.2025.154136","url":null,"abstract":"<div><div>A 68-year-old woman developed delayed QT prolongation and Torsades de Pointes (TdP) following electrical cardioversion for atrial fibrillation. Despite early discontinuation of Sotalol and optimal electrolyte replacement, she experienced bradycardia-associated TdP approximately 66 h post-cardioversion, requiring resuscitation and temporary overdrive pacing. QTc normalised with pacing, and no further episodes occurred. This case highlights a vulnerable window for proarrhythmia in the days following cardioversion, particularly in patients with multiple QT-prolonging risk factors. Extended ECG monitoring and consideration of early pacing may be critical in preventing life-threatening arrhythmias in high-risk individuals.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154136"},"PeriodicalIF":1.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191877","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}