Journal of electrocardiology最新文献

{"title":"Far and near-field electrograms in high density electro-anatomical mapping during sinus rhythm: Description of a confocal technique","authors":"Carlos E. Guzmán MD, PhD ,&nbsp;Edgar Francisco Carrizales-Sepúlveda MD ,&nbsp;Mauricio Cortes-Aguirre MD ,&nbsp;José Ramón Azpiri-López MD, PhD ,&nbsp;Ahmed AlTurki MD, MHPE ,&nbsp;Ramiro Flores-Ramírez MD, PhD","doi":"10.1016/j.jelectrocard.2025.154070","DOIUrl":"10.1016/j.jelectrocard.2025.154070","url":null,"abstract":"<div><h3>Background</h3><div>The atria are complex structures that are still not completely understood. Characterization of atrial bundles has been done in diseased hearts, magnetic resonance tractography, and computational models. To date, no technique has been able to map and characterize <em>endo</em>-epicardial fibers using a standard mapping catheter. The primary purpose of this study was to assess the informational content of far-field electrograms recorded in the left atrium during sinus rhythm.</div></div><div><h3>Methods</h3><div>We included patients who underwent left atrial mapping for atrial fibrillation ablation. A conventional HD-Grid™ catheter was used to perform electro-anatomical mapping of the left atrium, strictly during sinus rhythm and in non-diseased atria. Software programming was used to display additional electrograms selected from electrode pairs at increased inter-electrode distance along the mapping catheter. Four configurations of high density electrograms of varying inter-electrode distances were generated and analyzed.</div></div><div><h3>Results</h3><div>We included 22 patients in the study. The mean age was 50 years, and the mean atrial volume was 30.4 ml/m2. We found two main patterns of left atrial activation. 70 % of patients had a type 1 pattern, where activation initiated in the Bachman's bundle- corresponding region, and type two pattern, where activation started in the septo-atrial bundle-corresponding region. When we increased the interspaced in the electrodes of the mapping catheter, areas of far-field activation were detected and when we compared them to the prior descriptions of tracts and bundles, they seemed to correspond to epicardial activation.</div></div><div><h3>Conclusions</h3><div>We introduce a new technique of confocal mapping that allows for the assessment of <em>endo</em>-epicardial activation and aids in the understanding of the complex atrial structure.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154070"},"PeriodicalIF":1.3,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144695332","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":"Evaluation of P wave and QT interval dispersion in multisystem inflammatory syndrome in children","authors":"Eda Naz Ozdemir ,&nbsp;Melike Emiroglu ,&nbsp;Ahmet Sert ,&nbsp;Sadiye Kubra Tuter Oz ,&nbsp;Melih Timucin Dogan ,&nbsp;Gulsum Alkan","doi":"10.1016/j.jelectrocard.2025.154066","DOIUrl":"10.1016/j.jelectrocard.2025.154066","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the associations between P wave, QT interval, and corrected QT interval dispersion and clinical pathologies in multisystem inflammatory syndrome in children (MIS-C).</div></div><div><h3>Methods</h3><div>This study included 60 children diagnosed with MIS-C according to the US Centers for Disease Control and Prevention criteria and 26 healthy children. Their maximum and minimum P wave durations and QT interval durations were measured by 12‑lead surface electrocardiography.</div></div><div><h3>Results</h3><div>P wave and QT interval dispersion were significantly greater in the children with MIS-C than in the healthy children (<em>p</em> &lt; 0.001). In addition, P wave and QT interval dispersion were significantly greater before than after treatment among the children with MIS-C (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Our study found significantly greater P wave dispersion and QT dispersion in the patient group than in the control group. This correlates with the frequency of arrhythmias seen in MIS-C. We suggest that patients hospitalized with MIS-C should be meticulously monitored for potential arrhythmias.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154066"},"PeriodicalIF":1.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680725","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":"Letter to the editor: “Case report: Masked premature ventricular contractions and Intradevice interaction causing ventricular arrythmias”","authors":"Sudipta Mondal MD, DM, PDF-EP ,&nbsp;Swasthi S. Kumar MD, DM ,&nbsp;Nadeem Afroz Muslim MD, DM","doi":"10.1016/j.jelectrocard.2025.154062","DOIUrl":"10.1016/j.jelectrocard.2025.154062","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154062"},"PeriodicalIF":1.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672147","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":"Detailed association between electrocardiographic and echocardiographic left atrial functional parameters","authors":"Naoya Kataoka,&nbsp;Teruhiko Imamura","doi":"10.1016/j.jelectrocard.2025.154063","DOIUrl":"10.1016/j.jelectrocard.2025.154063","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154063"},"PeriodicalIF":1.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655736","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":"Left and right axis deviation on ECG as predictors of long-term mortality","authors":"Spencer Bradshaw MS ,&nbsp;Mohammad Reza Movahed MD","doi":"10.1016/j.jelectrocard.2025.154064","DOIUrl":"10.1016/j.jelectrocard.2025.154064","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have linked electrocardiographic QRS axis deviation to increased mortality, but they have primarily focused on narrowly defined populations and rarely examined long-term mortality.</div></div><div><h3>Objective</h3><div>To evaluate the extent to which left axis deviation (LAD) and right axis deviation (RAD) are associated with 10-year all-cause mortality while controlling for demographic and electrocardiographic variables.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 1287 randomly selected ECGs performed at a single academic medical center. ECGs were categorized as normal axis, LAD, or RAD. Patients were followed for up to 10 years. Cox proportional hazards regression was used to estimate mortality risk, adjusting for demographic and electrocardiographic covariates.</div></div><div><h3>Results</h3><div>Most ECGs showed a normal axis (90.3 %), while 6.7 % had LAD and 3.0 % had RAD. Ten-year mortality was significantly higher in patients with LAD (65.1 %) and RAD (48.7 %) compared to those with a normal axis (28.4 %) (log-rank <em>p</em> &lt; 0.001). In univariate analysis, LAD (hazard ratio [HR] = 3.04, 95 % CI: 2.29–4.04, <em>p</em> &lt; 0.001) and RAD (HR = 2.16, 95 % CI: 1.36–3.43, <em>p</em> = 0.001) were associated with significantly increased mortality risk. In adjusted analyses, both LAD (HR = 1.58, 95 % CI: 1.15–2.18, <em>p</em> = 0.005) and RAD (HR = 2.17, 95 % CI: 1.32–3.58, <em>p</em> = 0.002) remained associated with increased mortality.</div></div><div><h3>Conclusion</h3><div>QRS axis deviation is a significant predictor of 10-year all-cause mortality and may serve as a useful tool for long-term mortality risk stratification.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154064"},"PeriodicalIF":1.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672146","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 effect of use contrast medium on frontal plane QRS-T angle in patients who had elective coronary angiography","authors":"Barış Açıkel ,&nbsp;Metin Karayakalı ,&nbsp;Fuat Bice ,&nbsp;Mustafa Yılmaz ,&nbsp;Kayıhan Karaman ,&nbsp;Mehmet Eyüboğlu ,&nbsp;Çağrı Zorlu ,&nbsp;Gülşen Genç Tapar ,&nbsp;Sefa Erdi Ömür ,&nbsp;Ataç Çelik","doi":"10.1016/j.jelectrocard.2025.154061","DOIUrl":"10.1016/j.jelectrocard.2025.154061","url":null,"abstract":"<div><h3>Background</h3><div>Contrast medium used in coronary angiography may cause changes in the electrophysiological properties of the myocardium, which may lead to some changes in the electrocardiography (ECG). Frontal plane QRS-T (fQRS-T) angle, which can be easily calculated from surface ECG, is an indicator of ventricular repolarization heterogeneity and predictive of arrhythmia.</div></div><div><h3>Aims</h3><div>The aim of our study was to investigate the effect of contrast medium use on the fQRS-T angle in patients undergoing elective coronary angiography with the diagnosis of stable angina pectoris.</div></div><div><h3>Methods</h3><div>Our study included 343 patients diagnosed with stable angina pectoris who underwent elective coronary angiography. Demographic data and risk factors of all patients were recorded at admission. The frontal plane QRS-T angle was calculated from routine ECG recordings of patients included in the study before and after coronary angiography and the change was recorded. The amount of contrast agent used was also noted for each patient.</div></div><div><h3>Results</h3><div>The mean age of the patients included in the study was 57.03 ± 9.10, and 185 (53.9 %) were male. The change in fQRS-T angle was statistically significant after the use of contrast media (30.04 ± 30.76 vs 33.87 ± 32.6, <em>p</em> value &lt;0.001).</div></div><div><h3>Conclusions</h3><div>In our study, although there was a statistically significant increase in the fQRS-T angle of the patients after contrast material, it did not exceed the pathological limit and no life-threatening ventricular arrhythmia was observed.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154061"},"PeriodicalIF":1.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623789","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":"Previously undescribed transient trifascicular block: left septal fascicular block associated with left anterior fascicular block and complete right bundle branch block","authors":"Kjell Nikus MD ,&nbsp;Jani Rankinen MD ,&nbsp;Raine Virtanen MD ,&nbsp;Yochai Birnbaum MD ,&nbsp;Andrés Ricardo Pérez-Riera MD","doi":"10.1016/j.jelectrocard.2025.154060","DOIUrl":"10.1016/j.jelectrocard.2025.154060","url":null,"abstract":"<div><div>Exercise-induced complete right bundle branch block (CRBBB) remains a rare finding during a treadmill test. Both exercise-induced CRBBB and left anterior fascicular block (LAFB) have been associated with coronary artery disease, more specifically with stenosis of the left anterior descending coronary artery. Left septal fascicular block (LSFB) has been associated with acute and chronic coronary syndromes. We describe a patient case with severe left main coronary artery disease. In an exercise test, a rare combination of these three ventricular conduction disorders developed. In a second exercise test after coronary bypass surgery, LAFB and typical CRBBB developed without LSFB.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154060"},"PeriodicalIF":1.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605919","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":"QT dispersion and T wave peak-to-end in pediatric patients with sickle cell disease","authors":"Hanaa H. Eldash MD,&nbsp;Rana Mostafa MBBCh,&nbsp;Heba A. Borayek MD","doi":"10.1016/j.jelectrocard.2025.154059","DOIUrl":"10.1016/j.jelectrocard.2025.154059","url":null,"abstract":"<div><h3>Aim</h3><div>The aim of the study was to detect cardiac repolarization changes and the risk of arrhythmias in children with sickle cell disease (SCD) and sickle thalassemia using echocardiography and electrocardiography (ECG).</div></div><div><h3>Methods</h3><div>This is an observational case-control study that compared 20 patients with SCD and 20 patients with sickle thalassemia who regularly follow in the outpatient hematology clinic of Fayoum University Hospital with 40 healthy controls with history of non-hematological or cardiac illness who attended the general outpatient clinic from November 2022 to July 2023. All patients were evaluated clinically and by routine echocardiography, tissue Doppler imaging (TDI), and long-strip ECG.</div></div><div><h3>Results</h3><div>The QT, QT corrected (QTc), and QT dispersion (QTd) intervals were significantly higher in the case groups (all <em>p</em> = 0.001). There was a significantly higher T-wave peak-to-end interval (Tp-e) among sickle patients in comparison to controls. There was a statistically significant higher level of Tei index and velocity of the e’ wave among each case group in comparison to the control group (<em>p</em> &lt; 0.05). As regards QTc and QTd intervals, there was a statistically significant positive correlation with each of estimated pulmonary artery pressure (ESPAP), isovolumetric contraction time (IVCT), Tei index, and velocity of the s' wave among study groups.</div></div><div><h3>Conclusions</h3><div>The risk of malignant arrhythmia and sudden cardiac death may occur in children with SCD and sickle thalassemia. They had longer QTc, QTd, and Tp-e intervals than healthy individuals. Prolonged QTc was significantly associated with increased left ventricular dimensions, pulmonary hypertension, and global myocardial dysfunction.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154059"},"PeriodicalIF":1.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623788","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":"Challenging ECG of the month A peculiar brady-arrhythmia in acute inferior wall infarction","authors":"Anton P.M. Gorgels MD, PhD FESC ,&nbsp;Göran Olivecrona MD, PhD ,&nbsp;Pyotr G. Platonov MD, PhD FHRS FESC ,&nbsp;Marina M. Demidova MD, PhD FESC","doi":"10.1016/j.jelectrocard.2025.154058","DOIUrl":"10.1016/j.jelectrocard.2025.154058","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154058"},"PeriodicalIF":1.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570815","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":"Age, sex, hypertension and the sensitivity and specificity of traditional, new and a machine learning ECG criteria for prediction of left ventricular hypertrophy","authors":"Niyoosha Yoosefi HBSc ,&nbsp;Jeremy C.J. Zhou MD ,&nbsp;Golmehr Khosrokhavar BSc ,&nbsp;Simon W. Rabkin MD","doi":"10.1016/j.jelectrocard.2025.154052","DOIUrl":"10.1016/j.jelectrocard.2025.154052","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of age, sex and hypertension to improve ECG diagnosis of Left Ventricular Hypertrophy (LVH).</div></div><div><h3>Methods</h3><div>The study evaluated 14 different QRS voltage criteria as well as our recently proposed criteria of S in V3 plus S in V4 in a population of 159 patients, of whom 14.5 % had echocardiographic evidence of LVH. Statistical analyses assessed the influence of age, sex, and hypertension on the sensitivity and specificity of each criterion. In addition, a machine learning model was used for enhanced diagnostic accuracy.</div></div><div><h3>Results</h3><div>The new SV3 + SV4 criterion had the highest F1 and AUC scores. Among traditional ECG criteria, the Peguero criterion showed the highest sensitivity (0.438), while Wilson and Mazeloni criteria demonstrated the highest specificity (0.9412). The new SV3 + SV4 criterion with sex-specific cut offs achieves a sensitivity of 0.500 and specificity of 0.809 in females, while in males, sensitivity reached 0.556 with specificity at 0.910. Multiple regression analysis indicated that age, sex, and hypertension significantly improved the diagnostic performance of specific criteria, including Sokolow-Lyon, Romhilt voltage, Murphy, and Grant criteria. However, other criteria were not impacted by considering age, sex, or hypertension. ML analysis improved diagnostic accuracy with clinical variables, with the highest performance in males with the addition of age (accuracy 0.959, sensitivity 0.556, and specificity 1.00).</div></div><div><h3>Conclusion</h3><div>Considering age, sex, and hypertension can enhance the diagnostic performance of certain ECG criteria and especially in a ML model for LVH. Findings support a more individualized approach for LVH diagnosis in diverse patient populations.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154052"},"PeriodicalIF":1.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680724","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}