Journal of electrocardiology最新文献

{"title":"Case report: Masked premature ventricular contractions and Intradevice interaction causing ventricular Arrythmias","authors":"Aravinthan Vignarajah MD ,&nbsp;Jose Aguilera MD ,&nbsp;Justin Z. Lee MD","doi":"10.1016/j.jelectrocard.2025.154051","DOIUrl":"10.1016/j.jelectrocard.2025.154051","url":null,"abstract":"<div><div>An implantable cardioverter-defibrillator (ICD) intended to prevent malignant arrhythmias can, in rare cases, precipitate them. We report a 44-year-old man with cardiac sarcoidosis who suffered recurrent polymorphic ventricular tachycardia (VT) and ventricular fibrillation (VF) due to an intradevice timing interaction. Premature ventricular contractions (PVCs) fell within the ICD's post–atrial pacing ventricular blanking period and went undetected (“masked”), resulting in ventricular pacing during the vulnerable period (R-on-T), which triggered VT/VF. Reprogramming the device from DDD to VVI mode prevented further arrhythmias. This case highlights the importance of individualized ICD programming to avoid device-induced arrhythmias.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154051"},"PeriodicalIF":1.3,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144296868","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 ventricular systolic dysfunction screening in muscular dystrophies using deep learning-based electrocardiogram interpretation","authors":"Bauke K.O. Arends ,&nbsp;Peter-Paul M. Zwetsloot ,&nbsp;Pauline S. Heeres ,&nbsp;Wouter A.C. van Amsterdam ,&nbsp;Maarten J. Cramer ,&nbsp;Esther T. Kruitwagen - van Reenen ,&nbsp;Pim van der Harst ,&nbsp;Dirk van Osch ,&nbsp;René van Es","doi":"10.1016/j.jelectrocard.2025.154048","DOIUrl":"10.1016/j.jelectrocard.2025.154048","url":null,"abstract":"<div><h3>Background</h3><div>Routine echocardiographic monitoring is recommended in muscular dystrophy patients to detect left ventricular systolic dysfunction (LVSD) but is often challenging due to physical limitations. This study evaluates whether artificial intelligence-based electrocardiogram interpretation (AI-ECG) can detect and predict LVSD in muscular dystrophy patients.</div></div><div><h3>Methods</h3><div>Patients aged &gt;16 years who underwent an ECG and echocardiogram within 90 days at the University Medical Center Utrecht were included. Patients with Duchenne (DMD), Becker (BMD), limb-girdle muscular dystrophy (LGMD). myotonic dystrophy (MD), and female DMD/BMD carriers, were identified. A convolutional neural network (CNN) was trained on a derivation cohort of patients without muscular dystrophy to detect LVSD and tested on muscular dystrophy patients. A Cox proportional hazards model assessed AI-ECG's predictive value for new-onset LVSD.</div></div><div><h3>Results</h3><div>The derivation cohort included 53,874 ECG-echocardiogram pairs from 30,978 patients, while the muscular dystrophy test set comprised 390 ECG-echo pairs from 390 patients. LVSD prevalence varied from 81.3 % in DMD to 13.4 % in MD. The model achieved an AUROC of 0.83 (0.79–0.87) in the muscular dystrophy test set, with sensitivity 0.87 (0.81–0.93), specificity 0.58 (0.52–0.63), NPV 0.91 (0.86–0.95), and PPV 0.49 (0.43–0.56). AI-ECG predicted new-onset LVSD with an AUROC of 0.72 (0.66–0.78), with AI-ECG probability being a significant predictor.</div></div><div><h3>Conclusions</h3><div>AI-ECG can detect LVSD in muscular dystrophy patients, offering a non-invasive, accessible tool for risk stratification and an alternative to routine echocardiography. It may also predict new-onset LVSD, enabling earlier intervention. Further research should explore external validation, pediatric application, and integration within the clinical care plan.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154048"},"PeriodicalIF":1.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144297352","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":"Isolated atrial myopathy and persistent severe cardiac conduction disorders presented as juvenile stroke: A case report","authors":"Zahra Oskoueian,&nbsp;Alireza Heidari-Bakavoli,&nbsp;Vafa Baradaran Rahimi,&nbsp;Zohreh Mahmoodi,&nbsp;Asal Yadollahi","doi":"10.1016/j.jelectrocard.2025.154050","DOIUrl":"10.1016/j.jelectrocard.2025.154050","url":null,"abstract":"<div><div>Myocarditis can be complicated by various conduction abnormalities, including supraventricular and ventricular arrhythmias. It is rare to see conduction disorders as the first and only presentation of myocarditis, which may be reversible or persistent after the acute phase of myocarditis. Here, we present a case of probable myocarditis with preserved right and left ventricular function, isolated atrial cardiomyopathy, and severe conductive disturbances, including sinoatrial node dysfunction, atrial flutter, interatrial block, transient loss of atrial electromechanical activity and persistent complete atrioventricular block in a young woman presented with acute stroke.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"92 ","pages":"Article 154050"},"PeriodicalIF":1.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472366","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":"Elevated frontal QRS-T angle as a predictor of cardiovascular risk in graves' disease: A comparative study","authors":"Zhen Wang ,&nbsp;Jia Xu ,&nbsp;Ting-ting Fan ,&nbsp;A. Juan Gong ,&nbsp;Meng-li Li ,&nbsp;Nin-jun Zhu ,&nbsp;Xiao-chen Wang","doi":"10.1016/j.jelectrocard.2025.154040","DOIUrl":"10.1016/j.jelectrocard.2025.154040","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Graves' disease (GD) is linked to cardiovascular complications, but reliable non-invasive predictors are limited. This study aimed to assess whether the frontal QRS-T (fQRS-T) angle could predict mortality and cardiovascular outcomes in GD patients.</div></div><div><h3>Methods</h3><div>Initially, we conducted a retrospective analysis of electrocardiogram (ECG) parameters from 291 GD patients compared with 96 healthy controls. GD patients were then categorized based on the presence of hyperthyroid heart disease. Using logistic regression, we identified predictors of cardiovascular outcomes. Subsequently, a retrospective cohort study followed 41 patients with an fQRS-T angle ≥90° and 162 controls over five years, assessing all-cause mortality, ventricular fibrillation (VF) and first hospitalization for heart failure (HF).</div></div><div><h3>Results</h3><div>Initial analysis showed that a significantly higher proportion of GD patients had an fQRS-T angle ≥90° compared to healthy controls (<em>p</em> &lt; 0.001). Among GD patients, those with hyperthyroid heart disease were more likely to have an fQRS-T angle ≥90° (p &lt; 0.001). Multivariate logistic regression analysis revealed that age, fQRS-T angle, thyroxine (T4), and platelet were independent predictors of hyperthyroid heart disease. In the cohort study, Kaplan-Meier analysis showed significant differences in all-cause mortality or VF (<em>p</em> &lt; 0.001) and first hospitalization for HF (p &lt; 0.001) between the groups. Multivariate Cox regression analyses shown QRS-T angle ≥90° significantly increased the risk of hospitalization for HF (HR 5.04, 95 % CI 2.59–9.81, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>An increased fQRS-T angle may be associated with elevated cardiovascular risk in patients with GD. These preliminary findings suggest that fQRS-T angle could serve as a hypothesis-generating marker for further prospective research.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154040"},"PeriodicalIF":1.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308066","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":"R-wave progression or R-wave rotation? A 3D ECG-based perspective","authors":"Alejandro Jesús Bermejo Valdés","doi":"10.1016/j.jelectrocard.2025.154047","DOIUrl":"10.1016/j.jelectrocard.2025.154047","url":null,"abstract":"<div><div>We applied a three-dimensional framework to the standard electrocardiogram and showed that conventional precordial deflections are discrete projections of a continuous spatial reference. Using only two leads and rotating this reference system, we tracked the morphological progression of QRS-T. In individuals without electrical abnormalities, spatial continuity was preserved with predominantly single, spheroidal loops, while right bundle branch block cases showed frequent disruptions. This method allowed tracking of deflections and notches, providing a geometric alternative to planar analysis for assessing R-wave progression, a parameter with clinical relevance due to its link with sudden cardiac death and other major cardiac conditions.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154047"},"PeriodicalIF":1.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263470","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":"An in-silico analysis of the influence of left bundle branch block and myocardial fibrosis on electrocardiographic QRS duration and morphology and vectorcardiographic QRS area","authors":"Ted E.M. Lempers ,&nbsp;Karin C. Smits ,&nbsp;Johan van Koll ,&nbsp;Muhammet Dural ,&nbsp;Antonius M.W. van Stipdonk ,&nbsp;Joost Lumens ,&nbsp;Justin G.L.M. Luermans ,&nbsp;Kevin Vernooy ,&nbsp;Frits W. Prinzen ,&nbsp;Peter van Dam ,&nbsp;Uyên Châu Nguyên","doi":"10.1016/j.jelectrocard.2025.154043","DOIUrl":"10.1016/j.jelectrocard.2025.154043","url":null,"abstract":"<div><h3>Background and aims</h3><div>Vectorcardiographic (VCG) QRS area has shown great promise as a predictor of cardiac resynchronization therapy outcomes. However, underlying conduction factors influencing the genesis of QRS area and its relationship with myocardial fibrosis remain unexplored. This study aimed to investigate the impact of left bundle branch block (LBBB) and fibrosis on QRS duration and morphology in comparison to QRS area through an in-silico analysis.</div></div><div><h3>Methods</h3><div>ECGsim was used to simulate four scenarios: normal ventricular activation without (1) and with fibrosis (2), and LBBB without (3) and with (4) fibrosis. Conduction patterns were modified to represent LBBB, while regional conductivity was modified to model focal fibrosis. 12‑lead electrocardiograms and reconstructed VCGs were used to calculate QRS duration and area, and to assess QRS morphology.</div></div><div><h3>Results</h3><div>Myocardial fibrosis induced slight QRS notching during normal ventricular activation, but did not alter QRS morphology during LBBB activation. Furthermore, inducing regional fibrosis during normal ventricular activation hardly changed QRS duration (90 to 96 ms), while QRS area slightly decreased (37 to 32 mV<strong>.</strong>ms). LBBB without fibrosis increased QRS area compared to normal ventricular activation (90 to 145 mV<strong>.</strong>ms). Notably, inducing fibrosis in the LBBB scenario had little effect on QRS duration (145 to 142 ms) but significantly reduced QRS area (146 to 105 mV<strong>.</strong>ms).</div></div><div><h3>Conclusion</h3><div>A LBBB activation, and not myocardial fibrosis, induces a large QRS area. In the presence of LBBB, myocardial fibrosis cannot be clearly identified with QRS morphology and has a limited effect on QRS duration but significantly reduces QRS area.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154043"},"PeriodicalIF":1.3,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253848","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":"Vectorcardiogram signal compression: A hybrid approach using discrete wavelet transform and singular vector sparse reconstruction","authors":"Deepak Mishra,&nbsp;Anil Kumar","doi":"10.1016/j.jelectrocard.2025.154042","DOIUrl":"10.1016/j.jelectrocard.2025.154042","url":null,"abstract":"<div><h3>Aims</h3><div>Vectorcardiography (VCG) records the heart's electrical activity in three dimensions: frontal, transverse, and sagittal for accurate cardiac diagnosis and monitoring. Continuous cardiac monitoring generates vast VCG data daily. The large amount of VCG data poses challenges for storage, dataset management, and transmission, particularly in remote areas with limited resources. The main objective of this research is to develop an efficient VCG data compression technique to streamline the handling and storage of cardiac data, reducing storage space, bandwidth use, and enhancing data transmission speed.</div></div><div><h3>Methods</h3><div>This work proposes a VCG data compression technique combining Discrete Wavelet Transform (DWT) and Singular Vector Sparse Reconstruction (SVSR) to reduce data size, while preserving vital cardiac information. The process consists of two stages: compression and reconstruction. In compression, the VCG signal undergoes decomposition using the Discrete Wavelet Transform with Haar wavelet, extracting low and high-frequency components. Moreover, the compression efficiency is enhanced by applying SVSR in each subband. In the reconstruction phase, the compressed VCG signal is restored by performing interpolation and the inverse discrete wavelet transform (IDWT), improving overall reconstruction performance.</div></div><div><h3>Results</h3><div>The results have been tested using PTB diagnostic ECG databases. The effectiveness of the developed compression method is examined quantitatively and qualitatively, in terms of the following metrics; such as compression ratio, signal-to-noise ratio, peak signal-to-noise ratio, percent root mean square difference (PRD) and structural similarity index. According to the performance metrics results, the proposed method achieves 55.67 % higher CR, and 57.12 % improved PRD as compared to existing method.</div></div><div><h3>Conclusions</h3><div>The proposed method is efficient and adaptable for compressing different VCG signals, offering control over the quality of reconstructed data. Simulated results illustrate that the proposed compression method is a very promising solution for data storage and tele-transmission applications.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154042"},"PeriodicalIF":1.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240939","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":"Wide complex tachycardia and brugada electrocardiographic pattern induced by propafenone: A rare and unpredictable pro-arrhythmic effect","authors":"Acácio Fernandes Cardoso ,&nbsp;Luiz Claudio Behrmann Martins ,&nbsp;Cynthia Aparecida da Silva Rocha ,&nbsp;Nemer Luiz Pichara ,&nbsp;Kjell Nikus ,&nbsp;Andrés Ricardo Pérez-Riera","doi":"10.1016/j.jelectrocard.2025.154031","DOIUrl":"10.1016/j.jelectrocard.2025.154031","url":null,"abstract":"<div><div>Propafenone is a class IC anti-arrhythmic drug used for the rhythm control strategy in atrial fibrillation worldwide, including in Latin America countries. Propafenone intoxication is a potentially life-threatening condition. Ventricular tachycardia and the Brugada electrocardiographic (ECG) pattern are possible pro-arrhythmic manifestations of propafenone poisoning. We present a rare patient case, where therapeutic range dosage of propafenone resulted in a wide complex tachycardia, followed by the Brugada ECG pattern during atrial fibrillation. We discuss the possible mechanisms related to this unusual ECG manifestation.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154031"},"PeriodicalIF":1.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144263471","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":"Double sequential external defibrillation for refractory ventricular fibrillation: the science, the controversies and the future.","authors":"Sheldon Cheskes MD ,&nbsp;Shelley L. McLeod PhD","doi":"10.1016/j.jelectrocard.2025.154046","DOIUrl":"10.1016/j.jelectrocard.2025.154046","url":null,"abstract":"<div><div>Double sequential external defibrillation (DSED), the technique of providing two rapid shocks from two defibrillators with pads placed in the anterior-lateral and anterior-posterior position has been studied in animal labs and clinical practice for over two decades. In 2022, the Double Sequential External Defibrillation for Refractory Ventricular Fibrillation (DOSE-VF, <span><span>clinicaltrials.gov</span><svg><path></path></svg></span>: <span><span>NCT04080986</span><svg><path></path></svg></span>) trial was published in the New England Journal of Medicine. This cluster randomized crossover trial involved six paramedic services in Ontario, Canada, and compared standard (anterior-lateral) defibrillation to vector change defibrillation (VC, anterior-posterior pad repositioning) or DSED for patients with ventricular fibrillation (VF) and unresponsive to three standard shocks. The trial showed superior outcomes for all primary and secondary endpoints (VF termination, return of spontaneous circulation [ROSC], survival to hospital discharge, and neurologically intact survival) with DSED versus standard defibrillation, and improved VF termination and survival to discharge, but not ROSC or neurologically intact survival, with VC versus standard defibrillation. These findings, along with the 2023 updated ILCOR guidelines endorsing DSED for refractory VF, have generated significant global interest in it's implementation. This manuscript explores the scientific rationale and underlying mechanisms of DSED, examines controversies surrounding its implementation, and outlines directions for future research.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154046"},"PeriodicalIF":1.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230957","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-onset T-wave inversions may predict the diagnosis of non-ST-segment elevation type 1 myocardial infarction over other causes of myocardial injury","authors":"Karl K. Lundin MD ,&nbsp;Alexandra Maloof MD ,&nbsp;Sori K. Lundin PhD ,&nbsp;Allan Jean Zhang BA ,&nbsp;Jeffrey Triska MD ,&nbsp;Patrick Lynch MD ,&nbsp;Ajit Koduri MD ,&nbsp;Adwiteeya Misra MD ,&nbsp;Salim N. Najjar MD ,&nbsp;Yochai Birnbaum MD","doi":"10.1016/j.jelectrocard.2025.154045","DOIUrl":"10.1016/j.jelectrocard.2025.154045","url":null,"abstract":"<div><h3>Background</h3><div>On presentation, non-ST-segment elevation type 1 myocardial infarction (T1-NSTEMI) can be difficult to distinguish from other causes of myocardial injury (OCMI) such as type 2 myocardial infarction or non-ischemic myocardial injury. New-onset T-wave inversions (NTWI) developed on electrocardiogram (ECG) soon after presentation are considered a sign of post-ischemic changes and may be useful to distinguish T1-NSTEMI from OCMI.</div></div><div><h3>Methods</h3><div>We assessed all cases of suspected non-ST-segment elevation myocardial infarction seen at the Baylor-St. Luke's Medical Center from 8/2018–7/2019 to determine a final diagnosis of T1-NSTEMI or OCMI. Encounters with ECGs showing T-wave inversions, ST changes, ventricular pacing, or ventricular conduction delay at presentation were excluded, as were those without a follow-up ECG within 24 h. We used adjusted relative risk analysis to assess whether NTWI was associated with T1-NSTEMI.</div></div><div><h3>Results</h3><div>Of 113 cases included, 33 (29.2 %) developed NTWI and 80 (70.8 %) did not. Twenty-four NTWI cases (72.7 %) and 37 cases without NTWI (46.3 %) were adjudicated as T1-NSTEMIs. The positive and negative likelihood ratios of NTWI for T1-NSTEMI were 2.27 (95 % confidence interval (CI): 1.16, 4.45) and 0.73 (CI: 0.58, 0.93). The unadjusted and adjusted relative risks of T1-NSTEMI for patients with NTWI were 1.57 (CI: 1.15, 2.16, <em>P</em> = 0.005) and 1.69 (CI: 1.22, 2.35, <em>P</em> = 0.002). NTWI had higher specificity (83 %, CI: 70 %, 92 %) for T1-NSTEMI than sensitivity (39 %, CI: 27 %, 53 %).</div></div><div><h3>Conclusion</h3><div>NTWI is associated with T1-NSTEMI in our study population. NTWI within 24 h on follow up ECG may help distinguish between patients with T1-NSTEMI and OCMI.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154045"},"PeriodicalIF":1.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240862","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}