Journal of electrocardiology最新文献

{"title":"Algorithms for locating accessory pathways: How far should we trust?","authors":"Anna Clara de Melo Sousa Ferro MD ,&nbsp;Thiago Baccili Cury Megid MD ,&nbsp;Vinicius Padovese MD ,&nbsp;Eduardo Palmegiani MD ,&nbsp;Adalberto M. Lorga Filho PHD","doi":"10.1016/j.jelectrocard.2025.153936","DOIUrl":"10.1016/j.jelectrocard.2025.153936","url":null,"abstract":"<div><div>Algorithms for locating accessory pathways (APs) are widely used in planning catheter ablation for patients with ventricular preexcitation. These algorithms typically rely on characteristics of the delta wave and QRS complex to predict AP location.</div><div>However, factors such as anatomical variations, age, the presence of multiple APs, and patient biotype can lead to inaccuracies.</div><div>We present the case of a patient with ventricular preexcitation but no comorbidities, whose electrocardiogram (ECG) suggested an AP location entirely different from that predicted by standard algorithms. This discrepancy led to a change in the catheter ablation strategy, which was successfully performed via a retrograde aortic approach.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 153936"},"PeriodicalIF":1.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876952","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":"Triplets in Tandem","authors":"Swasthi S. Kumar MD,&nbsp;Sudipta Mondal MD, DM,&nbsp;Narayanan Namboodiri MD, DM","doi":"10.1016/j.jelectrocard.2025.153930","DOIUrl":"10.1016/j.jelectrocard.2025.153930","url":null,"abstract":"<div><div>An elderly gentleman with ischemic cardiomyopathy with severe left ventricular dysfunction presented with acute decompensated heart failure and recurrent ventricular tachycardia which were cardioverted to sinus rhythm and put on amiodarone infusion. A few hours following cardioversion and amiodarone infusion, the monitor showed grouped beating in triplets and a 12‑lead electrocardiogram documented the same. What is the diagnosis?</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 153930"},"PeriodicalIF":1.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864496","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 relationship between primary hyperparathyroidism and frontal QRS-T angle","authors":"Ozge Apak ,&nbsp;Begum Seyda Avci ,&nbsp;Orkun Apak ,&nbsp;Akkan Avci ,&nbsp;Mustafa Oguz Tugcan ,&nbsp;Abdullah Yildirim ,&nbsp;Mevlut Koc ,&nbsp;Tayyibe Saler","doi":"10.1016/j.jelectrocard.2025.153935","DOIUrl":"10.1016/j.jelectrocard.2025.153935","url":null,"abstract":"<div><h3>Objective</h3><div>Primary hyperparathyroidism (PHPT) is characterized by hypercalcemia due to elevated parathyroid hormone (PTH) levels. It has long been established that cardiac contraction and relaxation are primarily the result of recurrent phasic increases and decreases in cytoplasmic calcium ion concentration. Calcium balance plays a crucial role in ventricular repolarization and depolarization. This study aimed to investigate whether there is a relationship between the frontal QRS-T angle and newly diagnosed PHPT patients.</div></div><div><h3>Methods</h3><div>This study was designed as a prospective cross-sectional study. A total of 142 individuals were included, comprising 71 patients over the age of 18 who consented to participate and 71 healthy volunteers. Patients under the age of 18, those who declined to participate, and those with chronic kidney disease, heart failure, pericardial effusion, or undergoing oncological follow-up for malignancy were excluded from the study.</div></div><div><h3>Results</h3><div>In the patient group, the mean systolic blood pressure was 132 mm-Hg, and the mean diastolic blood pressure was 77.8 mm-Hg. These values were statistically significantly higher compared to the control group (<em>p</em> &lt; 0.001). The mean frontal QRS-T angle on the ECG was −9.0° in the patient group and 2.0° in the control group. It was found that the frontal QRS-T angle in the patient group had wider angle values compared to the control group. This difference was considered statistically weakly significant (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The frontal QRS-T angle in newly diagnosed PHPT patients differs from that in healthy individuals. We believe that the increase in this angle, calculated from the electrocardiogram obtained at the time of diagnosis, could serve as a warning parameter for clinicians in terms of the risk of cardiovascular complications.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153935"},"PeriodicalIF":1.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838091","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 changes associated with SSRI use: Insights from a cross-sectional study in Fasa Adults Cohort Study (FACS)","authors":"Fateme Keshtkar ,&nbsp;Saba Zangeneh ,&nbsp;Mojtaba Farjam ,&nbsp;Bahareh Fakhraei ,&nbsp;Reza Tabrizi ,&nbsp;Azizallah Dehghan ,&nbsp;Nematollah Jafari","doi":"10.1016/j.jelectrocard.2025.153932","DOIUrl":"10.1016/j.jelectrocard.2025.153932","url":null,"abstract":"<div><h3>Background</h3><div>Serotonin reuptake inhibitors (SSRIs), commonly prescribed for psychiatric disorders, have raised concerns about potential cardiovascular effects. Investigating their influence on specific electrocardiogram (ECG) parameters is crucial for a detailed clinical understanding.</div></div><div><h3>Methods</h3><div>This cross-sectional study, that utilizes data from the Fasa Adult Cohort Study in Iran, examined 133 individuals on SSRIs. We focused on participants without existing heart conditions, collecting drug details and daily doses through an online survey. ECG recordings that were analyzed by Cardiax® 28 provided insights into various parameters. Statistical analyses, including Mann-Whitney U and linear regression, assessed connections between SSRIs and ECG changes. Ethical approval was obtained for study validity.</div></div><div><h3>Results</h3><div>Among 133 participants, including citalopram (<em>n</em> = 38), fluoxetine (<em>n</em> = 63), and sertraline (<em>n</em> = 32) groups, this study revealed distinctive electrocardiogram (ECG) changes linked to selective serotonin reuptake inhibitor (SSRI) usage. Significant correlations between SSRIs, and various ECG parameters, with the exception of P duration, were discernible. SSRIs suggested negative correlations with HR, PR, QTC, QRS-axis, RdV5, Sd v2, and reductions in STJ V2, STJ V5, STM V2, STM V5, STE V2, and STE V5 (<em>p</em> &lt; 0.01 or <em>p</em> &lt; 0.05). Positive correlations were observed for QRS, QT, P-axis, and P a2 (p &lt; 0.01 or p &lt; 0.05), highlighting the complicated impact of SSRIs on cardiac electrophysiology.</div></div><div><h3>Conclusion</h3><div>In conclusion, careful monitoring of ECG parameters during SSRIs treatment is essential, especially in patients with pre-existing cardiac conditions. The observed associations highlight the need for personalized medical guidance when prescribing SSRIs. These findings provide valuable insights into the current medical knowledge, highlighting the need for additional research to completely understand the intricate link between SSRIs and cardiovascular health and to ensure the best possible patient safety. The limitations of this study included the possibility of errors in completing the questionnaires and their incompleteness, lake of baseline ECG which resulted in a decreased number of available cases.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 153932"},"PeriodicalIF":1.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851502","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":"Severely ill patient with two types of pacemaker tachycardia","authors":"Laszlo Littmann","doi":"10.1016/j.jelectrocard.2025.153929","DOIUrl":"10.1016/j.jelectrocard.2025.153929","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153929"},"PeriodicalIF":1.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838093","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":"Prediction of myocardial fibrosis in hypertrophic cardiomyopathy with machine learning: Insight into ECG analysis","authors":"İsa Ardahanlı ,&nbsp;Ramazan Aslan ,&nbsp;Murat Akdoğan ,&nbsp;Onur Akgün ,&nbsp;Ahmet Ardahanlı","doi":"10.1016/j.jelectrocard.2025.153926","DOIUrl":"10.1016/j.jelectrocard.2025.153926","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153926"},"PeriodicalIF":1.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848112","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 of the month: UNUSUAL ST elevation - What's the diagnosis?","authors":"Yuval Avidan MD ,&nbsp;Asaf Danon MD, MSc","doi":"10.1016/j.jelectrocard.2025.153934","DOIUrl":"10.1016/j.jelectrocard.2025.153934","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153934"},"PeriodicalIF":1.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828909","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 narrow complex irregular tachycardia: What is the mechanism?","authors":"Matthew Lui MD,&nbsp;Kristen E. Wong MD,&nbsp;Timothy W. Smith DPhil, MD","doi":"10.1016/j.jelectrocard.2025.153928","DOIUrl":"10.1016/j.jelectrocard.2025.153928","url":null,"abstract":"<div><div>Identifying impaired atrioventricular conduction is useful in the diagnosis and management of cardiac arrhythmia. In this case, we present an electrocardiogram demonstrating a complex atrioventricular conduction pattern.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153928"},"PeriodicalIF":1.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838092","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 ECG based tool for diagnosing pericardial effusion: A case-control study","authors":"M. Biasin MD,&nbsp;N. Cordioli MD,&nbsp;J. Zaylah MD,&nbsp;A. Varriale MD,&nbsp;A. Comuzzi MD,&nbsp;M. Pilan MD,&nbsp;A. Gambaro MD, PhD,&nbsp;F. Ribichini Prof","doi":"10.1016/j.jelectrocard.2025.153927","DOIUrl":"10.1016/j.jelectrocard.2025.153927","url":null,"abstract":"<div><h3>Background</h3><div>Current electrocardiographic (ECG) criteria for diagnosing pericardial effusion are limited by low sensitivity. This study aimed to evaluate traditional ECG criteria within a contemporary patient cohort and to compare the diagnostic accuracy of a novel ECG-based score, the ARENA score, with conventional low-voltage criteria for the detection of pericardial effusion.</div></div><div><h3>Methods</h3><div>A retrospective case-control study was conducted at a university hospital, including consecutive patients who underwent both echocardiography and ECG, regardless of admission diagnosis. Patients were divided into derivation and validation cohorts, each comprising individuals with and without pericardial effusion (≥1.0 cm). ECGs were analyzed using traditional low-voltage criteria and the ARENA score, with sensitivity, specificity, accuracy and likelihood ratios calculated for both.</div></div><div><h3>Results</h3><div>A total of 244 patients were included, with 104 presenting with pericardial effusion and 140 without. These patients were divided into a derivation cohort (<em>n</em> = 100) and a validation cohort (<em>n</em> = 144). In the validation cohort, sensitivity was 5.6 % (95 % CI: 0.0 %–11.7 %) with traditional criteria and 51.9 % (95 % CI: 38.5 %–65.3 %) with the ARENA score (<em>p</em> &lt; 0.001). Specificity was 92.2 % (95 % CI: 86.7 %–97.8 %) for traditional criteria and 82.2 % (95 % CI: 74.3 %–90.1 %) for the ARENA score (<em>p</em> = 0.047). Accuracy in the validation cohort was 59.7 % (95 % CI: 51.7 %–67.7 %) for traditional criteria and 70.8 % (95 % CI: 63.4 %–78.2 %) for the ARENA score (<em>p</em> = 0.048).</div></div><div><h3>Conclusions</h3><div>The ARENA score demonstrates higher sensitivity and accuracy in detecting pericardial effusion compared to traditional low-voltage ECG criteria, though with a modest reduction in specificity.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153927"},"PeriodicalIF":1.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816975","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":"F-wave sway in paroxysmal and chronic atrial fibrillation","authors":"Agnese Sbrollini ,&nbsp;Massimo W. Rivolta ,&nbsp;Peter Van Dam ,&nbsp;Elisabetta Viani ,&nbsp;Micaela Morettini ,&nbsp;Roberto Sassi ,&nbsp;Laura Burattini ,&nbsp;Emanuela T. Locati","doi":"10.1016/j.jelectrocard.2025.153933","DOIUrl":"10.1016/j.jelectrocard.2025.153933","url":null,"abstract":"<div><div>Vectorcardiography (VCG) can evaluate the vector loops of electrocardiographic waves, being a time-spatial representation of the heart vector into the three orthonormal leads. During atrial fibrillation (AF), F waves reflect the disorganized depolarization of the atria, replacing the organized P wave. Usually, paroxysmal AF (PAF) spontaneously terminates, differently from chronic AF (CAF), possibly due to the still-preserved main direction of the P-wave vector loop. To investigate this hypothesis, this study aims to evaluate the similarities between the P-wave vector loop and F-wave vector sway in subjects affected by PAF and CAF. Overall, 10-s VCG were acquired from 10 healthy (HEA) subjects showing normal sinus rhythm, 10 subjects affected by PAF (one during normal sinus rhythm and one during AF), and 10 subjects affected by CAF. P waves were extracted using ECGdeli software, while F waves were extracted after QRST cancellation. Ellipse axes and eccentricities were calculated as the root mean square of VCG components and the ratio between axes, respectively. Overall, 84 beats of HEA, 205 beats of PAF (89 beats during normal sinus rhythm and 116 during fibrillation), and 103 beats of CAF were analyzed. Distributions of axes and eccentricities of PAF are not statistically different (<em>P</em>-value&gt;0.05) than normal sinus rhythm but features related to the Z axis of CAF were statistically lower than PAF (P-value〈10⁻³). F-wave vector sway in PAF resembles the P-wave vector loop, suggesting the maintenance of the atrial depolarization main direction in subjects with self-terminating AF. Moreover, the F-wave vector sway is more manifest in PAF than in CAF.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153933"},"PeriodicalIF":1.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833350","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}