Journal of electrocardiology最新文献

{"title":"Exploring mortality representation and the impact of COVID-19 in Modena: insights from “An ECG-based machine-learning approach for mortality risk assessment in a large European population”","authors":"P. Giovanardi , C. Vernia , M. Doneda , on behalf of the whole research team","doi":"10.1016/j.jelectrocard.2025.153890","DOIUrl":"10.1016/j.jelectrocard.2025.153890","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153890"},"PeriodicalIF":1.3,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422480","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 new VCG signal compression technique based on discrete Karhunen-Loeve expansion and tunable quality wavelet transform","authors":"Ronak Vimal,&nbsp;A. Kumar,&nbsp;Aditya Tiwari","doi":"10.1016/j.jelectrocard.2025.153894","DOIUrl":"10.1016/j.jelectrocard.2025.153894","url":null,"abstract":"<div><div>This paper presents a novel two-stage compression technique for vectorcardiogram (VCG) signals, combining Discrete Karhunen-Loeve (K-L) Expansion and Tunable Q-Factor Wavelet Transform (TQWT). In the first stage, VCG signals undergo discrete K-L expansion and a secondary rotation to reduce variance caused by physiological factors, such as respiration and varying heart orientations among patients. This process effectively simplifies the dataset by leveraging eigenvector-based transformation, while standardizing the data across different VCG records. In the second stage, the standardized data is processed using TQWT, with finely tuned parameters (Q-factor of 4, redundancy factor of 1.2, and 6 stages), followed by quantization and Run-Length Encoding (RLE). The RLE method efficiently compresses the long sequences of zeros generated during the process, further enhancing the data reduction. The proposed method was rigorously evaluated using the PTB Diagnostic ECG Database, demonstrating remarkable compression efficiency. When compared with standard approaches like Discrete K-L Transform and Discrete Cosine Transform (DCT), the method achieved a superior average compression ratio of 15.43. Key evaluation metrics further highlight its efficacy, including an average Percent Root Difference (PRD) of 7.39 %, Fidelity of 99.72 %, Peak Signal-to-Noise Ratio (PSNR) of 37.38 dB, and a Quality Score (QS) of 2.13 %. Moreover, the method's rapid processing speed of 0.076 s per record makes it well-suited for real-time applications. This innovative approach provides an effective solution for VCG signal compression, enhancing the storage and transmission efficiency, while preserving high signal fidelity for clinical use.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"89 ","pages":"Article 153894"},"PeriodicalIF":1.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387285","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":"Machine-learning computer-assisted ECG analysis to predict myocardial fibrosis in patients with hypertrophic cardiomyopathy","authors":"Dafne Viliani ,&nbsp;Alberto Cecconi ,&nbsp;Beatriz López-Melgar ,&nbsp;Álvaro Montes Muñiz ,&nbsp;Pablo Martínez-Vives ,&nbsp;Sofia Cuenca ,&nbsp;Pablo Lozano Jiménez ,&nbsp;Yolanda Carrión García ,&nbsp;Carmen De Benavides ,&nbsp;Susana Hernández ,&nbsp;Paloma Caballero ,&nbsp;Guillermo J Ortega ,&nbsp;Luis Jesús Jiménez-Borreguero ,&nbsp;Fernando Alfonso","doi":"10.1016/j.jelectrocard.2025.153892","DOIUrl":"10.1016/j.jelectrocard.2025.153892","url":null,"abstract":"<div><h3>Aims</h3><div>The application of computer assisted techniques to the electrocardiogram (ECG) analysis is showing promising results. Our main aim was to apply a machine learning approach to the ECG analysis in patients with hypertrophic cardiomyopathy (HCM), to identify predictors of macroscopic fibrosis, a marker of ventricular arrhythmias and sudden cardiac death.</div></div><div><h3>Methods</h3><div>136 patients diagnosed with HCM were included. The main clinical and echocardiographic variables were collected. All patients underwent cardiac magnetic resonance (CMR) and the presence of macroscopic fibrosis was assessed on late gadolinium enhancement (LGE) sequences. From the 12‑lead digitized ECGs of each patient 468 morphological variables were quantified with a dedicated software.</div></div><div><h3>Results</h3><div>The mean age of the population was 62.6 ± 14.1 years, and in 82 patients (60.3 %) LGE was observed. After preselecting significant ECG variables from the univariate analysis, a multivariate regression was performed, obtaining a predictive model composed of five parameters: the duration of the QRS in I, the duration of the QT interval in V3<em>,</em> the duration of the T wave in aVF<em>,</em> the peak-to peak amplitude of the QRS in V1, and the amplitude of the S wave in V4. A random forest algorithm confirmed that the duration of the QRS was the strongest predictor of fibrosis.</div></div><div><h3>Conclusion</h3><div>In patients with HCM the addition of a computer-assisted ECG analysis can help to identify predictors of LGE, being the duration of the QRS the strongest one. Our findings can be especially useful when access to CMR is scarce, to select patients at higher risk.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153892"},"PeriodicalIF":1.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422479","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":"Enhancing postoperative arrhythmia diagnosis: An observational study of atrial ECG recording techniques","authors":"Matija Bakoš ,&nbsp;Dražen Belina ,&nbsp;Toni Matić ,&nbsp;Tomo Svaguša","doi":"10.1016/j.jelectrocard.2025.153895","DOIUrl":"10.1016/j.jelectrocard.2025.153895","url":null,"abstract":"<div><div>Temporary atrial and ventricular electrodes are frequently utilized for diagnosing and treating cardiac arrhythmias in children during the early postoperative period following cardiac surgery. Traditionally, lead I electrodes (right and left hand) are connected to atrial wires to facilitate arrhythmia diagnosis, resulting in high atrial signal display. In the manuscript we described an alternative method involving connecting atrial wires to the right and left leg electrodes, leaving lead I without the atrial ECG signal. This approach serves as a reference lead for postoperative arrhythmia detection, offering potential diagnostic clarity in selected clinical scenarios.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"89 ","pages":"Article 153895"},"PeriodicalIF":1.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379314","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":"Case report: Slow conducting accessory pathway in an Ebstein's anomaly patient: Is this a Mahaim fiber?","authors":"Yi Liu ,&nbsp;Yuwei Chen ,&nbsp;Qiang Xiao ,&nbsp;Yao Cai ,&nbsp;Xingyao Xiao ,&nbsp;Xiangbin Xiao MD","doi":"10.1016/j.jelectrocard.2025.153891","DOIUrl":"10.1016/j.jelectrocard.2025.153891","url":null,"abstract":"<div><div>We report a case of multiple accessory pathways (APs) in an Ebstein's anomaly patient with a history of prior ablation. Electrophysiological study demonstrated a slow conducting AP which pre-excited ventricle only during atrial tachycardia or rapid atrial pacing. The non-decremental property and a longstanding fragment potential at the ablation target site rule out Mahaim fiber. The slow conducting AP might be caused by inadequate prior ablation, and highlights that delta wave absent and prolonged AV interval in target point could not definitely indicate anterograde conduction block when we ablate a manifest AP. Rapid atrial pacing may unveil the slow conducting AP.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"89 ","pages":"Article 153891"},"PeriodicalIF":1.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-dependent influence of T wave amplitude on short period temporal dispersion in healthy subjects","authors":"Gianfranco Piccirillo ,&nbsp;Federica Moscucci ,&nbsp;Martina Mezzadri ,&nbsp;Cristina Caltabiano ,&nbsp;Giovanni Cisaria ,&nbsp;Guendalina Vizza ,&nbsp;Valerio De Santis ,&nbsp;Marco Giuffrè ,&nbsp;Sara Stefano ,&nbsp;Claudia Scinicariello ,&nbsp;Ilaria Lospinuso ,&nbsp;Susanna Sciomer ,&nbsp;Pietro Rossi ,&nbsp;Giovambattista Desideri","doi":"10.1016/j.jelectrocard.2025.153883","DOIUrl":"10.1016/j.jelectrocard.2025.153883","url":null,"abstract":"<div><h3>Background</h3><div>T wave amplitude and repolarization variability in ECG showed inverse correlations. Sympathetic activation, induced by head-up tilt, is associated to a reduced T wave amplitude.</div></div><div><h3>Methods</h3><div>Noninvasive hemodynamic and ECG data from three healthy subjects' groups (Group 1: 10–19 years-old; Group 2: 40–49 years-old; Group 3: 80–89 years-old) were analyzed. Measurements were taken during controlled-breathing rest, and during head-up tilt. The mean and standard deviation (_SD) were calculated for these ECG intervals: QT, STp (from S to Tpeak) and Te (from Tpeak to Tend). Results: During tilt, a significant decrease in T wave amplitude was observed in the younger groups (<em>p</em> &lt; 0.001), but not in Group 3. At rest, Group 1 exhibited higher voltage compared to Group 2 (<em>p</em> &lt; 0.05) and 3 (<em>p</em> &lt; 0.001), as Group 2 compared to Group 3 (<em>p</em> &lt; 0.05). A negative correlation was confirmed between T wave amplitude and QT_SD, STp_SD and Te_SD (<em>p</em> &lt; 0.001). Low-frequency normalized units (<em>p</em> &lt; 0.05) and high-frequency normalized units (<em>p</em> &lt; 0.001) were inversely related to T-wave amplitude.</div></div><div><h3>Conclusion</h3><div>The findings suggest an age-dependent decline in T wave amplitude during tilt and elucidates the relationship between systolic function and T wave amplitude among healthy subjects. These insights warrant further investigations in clinical and research settings for cardiovascular diseases.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"89 ","pages":"Article 153883"},"PeriodicalIF":1.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379313","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":"New emerging T-wave inversion in an elderly patient after atrial fibrillation ablation","authors":"Jun-Peng Liu MD, PhD,&nbsp;Yu-Hao Wan MD","doi":"10.1016/j.jelectrocard.2025.153884","DOIUrl":"10.1016/j.jelectrocard.2025.153884","url":null,"abstract":"<div><div>Takotsubo syndrome (TTS) is often misdiagnosed as acute coronary syndrome (ACS) due to the similarities in clinical presentation. The characteristic changes of ECG are helpful for the diagnosis of TTS. We present a case of TTS that occurred during the perioperative period of AF ablation. The ECG changes in this case are representative and helpful to understand the ECG characteristics of TTS.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"89 ","pages":"Article 153884"},"PeriodicalIF":1.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to “Acute myocardial infarction with ST elevation isolated to lead III (and aVR)”","authors":"Emre K. Aslanger MD","doi":"10.1016/j.jelectrocard.2025.153889","DOIUrl":"10.1016/j.jelectrocard.2025.153889","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"89 ","pages":"Article 153889"},"PeriodicalIF":1.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143153817","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":"Phasic electrical remodeling of ventricular myocardium affects arrhythmogenesis in rats with type 1 diabetes mellitus","authors":"Ekaterina N. Sedyakina MD ,&nbsp;Alena S. Tsvetkova PhD ,&nbsp;Mikhail A. Gonotkov PhD ,&nbsp;Alexandra V. Durkina MS ,&nbsp;Olesya G. Bernikova MD, PhD ,&nbsp;Jan E. Azarov PhD ,&nbsp;Alexey O. Ovechkin MD, PhD","doi":"10.1016/j.jelectrocard.2025.153887","DOIUrl":"10.1016/j.jelectrocard.2025.153887","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes mellitus (DM) causes myocardial electrical remodeling and promotes ventricular tachycardia and/or fibrillation (VT/VF). However, experimental studies have been frequently unsuccessful in developing a DM model with the expected high level of arrhythmic outcomes. The present study aims at evaluating cardiac electrophysiological properties in the rats with different Type 1 DM (T1DM) durations and identifying an electrophysiological phenotype associated with the high incidence of VT/VF.</div></div><div><h3>Methods</h3><div>The experiments were performed in 109 male Wistar rats (6–10 weeks old), subdivided into the groups of control, 4-weeks and 8-weeks T1DM (streptozotocin model). The animals were studied with epicardial electrophysiological mapping, whole-cell patch-clamp and histological examination. The VT/VF susceptibility was tested in ischemia/reperfusion induced in the anesthetized animals.</div></div><div><h3>Results</h3><div>In the 4-weeks T1DM group, we observed the increase in the incidence of reperfusion VT/VF, collagen deposition and dispersion of repolarization, slowed longitudinal and transverse conduction velocity, prolonged action potential duration, increased INa and ICaL currents, nonchanged Ito and IK1 currents. In the 8-weeks T1DM group, the VT/VF incidence, dispersion of repolarization, INa and Ito currents decreased. Other parameters persisted unchanged as compared to the 4-weeks T1DM group.</div></div><div><h3>Conclusions</h3><div>Relatively early (4 weeks) diabetic electrical remodeling was proarrhythmic and included augmentation of sodium and calcium currents in the presence of fibrosis and slowed conduction and increased dispersion of repolarization. An unexpected finding was that diabetic arrhythmogenesis was associated with the increase in depolarizing transmembrane currents. Further research is warranted to elucidate molecular mechanisms and test the potential for the control of observed changes.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"89 ","pages":"Article 153887"},"PeriodicalIF":1.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152992","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":"Can electrocardiographic repolarization predict diabetes incidence: the Atherosclerosis Risk in Communities Study","authors":"Chunyu Zhang ,&nbsp;Peng Yu ,&nbsp;Ming Liu ,&nbsp;Lei Zhang ,&nbsp;Xiaomu Li ,&nbsp;Hong Jiang","doi":"10.1016/j.jelectrocard.2025.153885","DOIUrl":"10.1016/j.jelectrocard.2025.153885","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes is marked by metabolic dysregulation and high cardiovascular risk. Preceding diabetes onset, cardiac change markers often appear, yet predicting occurrence of diabetes remains challenging.</div></div><div><h3>Methods</h3><div>The study included 11,297 ARIC Study participants aged 45–64 without baseline diabetes or heart disease, with 12‑lead ECGs recorded. Cox regression models were used to analyze repolarization parameters (QTc intervals, J-point level, T-wave amplitude, T-wave to R-wave (T/R) ratio) in relation to diabetes risk. Correlation analyses explored links between ECG findings, metabolic parameters, and myocardial fat content.</div></div><div><h3>Results</h3><div>Over 23 years, 3338 participants (29.5 %) developed type 2 diabetes. A reduced T/R ratio showed dose-response relationship with diabetes risk, notably in lead I (HR 1.22, 95 % CI 1.15–1.31) and lead V5 (HR 1.15, 95 % CI 1.07–1.24) per standard deviation (SD) decrease after adjustment for common covariates. J-point level and T-wave amplitude also exhibited associations, though weaker. Negative correlations were found between repolarization markers, including T-wave amplitude, T/R ratio with metabolic parameters.</div></div><div><h3>Conclusions</h3><div>ECG parameters, especially T-wave amplitude and T/R ratio, predict incident type 2 diabetes and serve as potential early biomarkers for metabolic-induced cardiac change. These findings underscore their clinical relevance in identifying individuals at risk for diabetes.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"89 ","pages":"Article 153885"},"PeriodicalIF":1.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074693","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}