Journal of electrocardiology最新文献

{"title":"Novel electrocardiographic diagnosis of left ventricular hypertrophy with right bundle branch block in a Taiwanese clinical cohort","authors":"Min-Hsin Ou Yang ,&nbsp;Chia-Tung Wu M.D.","doi":"10.1016/j.jelectrocard.2026.154216","DOIUrl":"10.1016/j.jelectrocard.2026.154216","url":null,"abstract":"<div><h3>Background</h3><div>The diagnostic accuracy of electrocardiographic (ECG) criteria for left ventricular hypertrophy (LVH) in Taiwanese adults remains uncertain, particularly in the presence of complete right bundle branch block (CRBBB).</div></div><div><h3>Methods</h3><div>We retrospectively enrolled 431 Taiwanese adults, including 205 with normal conduction and 226 with CRBBB. Echocardiographic left ventricular mass index (LVMI) served as the reference standard. We evaluated the sensitivity, specificity and area under the receiver operating characteristic curve (AUC) of six traditional ECG criteria: Sokolow-Lyon index, RaVL, modified Sokolow-Lyon, Cornell voltage, Gubner-Ungerleider and Peguero-Lo Presti. Linear regression examined associations between individual ECG parameters and LVMI, with a focus on the impact of CRBBB. Exploratory analyses were conducted to derive novel ECG indices.</div></div><div><h3>Results</h3><div>Traditional ECG criteria showed low sensitivity but high specificity overall. In patients with normal conduction, Cornell voltage performed best in females and Gubner-Ungerleider in males. However, diagnostic performance decreased substantially in the presence of CRBBB, particularly for criteria relying on anteroseptal leads. In CRBBB patients, QRS duration demonstrated stronger correlation with LVMI than voltage-based criteria. In our cohort, ECG criteria with superior performance is SD× QRS (AUC 0.754) in males with CRBBB, QRS duration (AUC 0.868) in CRBBB females and BMI&lt;24, and SV4 amplitude (AUC 0.702) in CRBBB females with BMI≥ 24.</div></div><div><h3>Conclusion</h3><div>Traditional ECG criteria for LVH originally developed in Western cohorts demonstrated limited diagnostic performance in Taiwanese adults, particularly in the setting of CRBBB. QRS duration and derived indices may provide more accurate alternatives for detecting LVH in this population.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"95 ","pages":"Article 154216"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306484","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 repolarization abnormalities with 12-lead ECG and 24-hour Holter ECG monitoring in patients with Duchenne muscular dystrophy","authors":"Elif Didinmez Taşkırdı ,&nbsp;Aycan Ünalp ,&nbsp;Ünsal Yılmaz ,&nbsp;Timur Meşe ,&nbsp;Murat Muhtar Yılmazer","doi":"10.1016/j.jelectrocard.2026.154198","DOIUrl":"10.1016/j.jelectrocard.2026.154198","url":null,"abstract":"<div><h3>Background</h3><div>Duchenne muscular dystrophy (DMD) is an inherited neuromuscular disorder causing progressive degeneration of skeletal and cardiac muscles due to dystrophin deficiency. Cardiac involvement ranges from mild to severe, including heart failure, arrhythmias, conduction defects, and sudden cardiac death.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate early markers of cardiac repolarization abnormalities in DMD patients by analyzing standard 12‑lead ECG parameters—QT interval, corrected QT (QTc), T peak to T end (Tp-e), Tp-e/QT, and Tp-e/QTc ratios—and microvolt T-wave alternans (MTWA) from 24-h Holter monitoring.</div></div><div><h3>Methods</h3><div>Seventy-four individuals participated: 39 DMD patients and 35 age- and sex-matched healthy controls. Data on demographics, ambulation status, ECG, and Holter recordings were collected and compared. All participants underwent standard 12‑lead electrocardiography and 24-h Holter electrocardiogram monitoring. ECG measurements were performed manually by a blinded operator using standardized techniques. Holter recordings were collected and compared (analyzable data obtained from 33 patients and 34 controls). The QTc interval was calculated using Bazett's formula. Correlation analyses and statistical comparisons between groups were performed using appropriate parametric and non-parametric tests.</div></div><div><h3>Results</h3><div>DMD patients exhibited significantly higher resting heart rates. The Tp-e interval was similar between groups, while the QT interval was significantly shorter in the patient group, the QTc interval showed no significant difference between groups. Tp-e/QT ratio was higher in the patient group; Tp-e/QTc ratios showed no difference. The QTc interval was significantly prolonged in the non-ambulatory DMD group. MTWA values did not differ significantly between groups. Due to the limited sample size and absence of established pediatric reference values, MTWA findings must be considered inconclusive.</div></div><div><h3>Conclusion</h3><div>In conclusion, our study reveals subtle repolarization alterations in DMD patients, including elevated resting heart rate and a trend toward increased Tp-e/QT ratio. While these findings do not yet establish a definitive arrhythmic phenotype, they suggest the presence of early electrophysiological changes that may warrant longitudinal cardiac evaluation. Prospective follow-up studies are essential to determine the prognostic significance of these parameters and their relationship to clinical arrhythmic outcomes in the pediatric DMD population.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"95 ","pages":"Article 154198"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074047","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":"Exercise high-frequency QRS versus exercise stress electrocardiography in diagnosing myocardial ischemia: A meta-analysis","authors":"Zhewen Wang ,&nbsp;Siteng Wang ,&nbsp;Ming Liu ,&nbsp;Dan Li ,&nbsp;Jinsheng Hua ,&nbsp;Xiangyong Kong ,&nbsp;Hongwu Chen ,&nbsp;Hao Hu ,&nbsp;Chao Gao ,&nbsp;Jianyuan Pan","doi":"10.1016/j.jelectrocard.2026.154190","DOIUrl":"10.1016/j.jelectrocard.2026.154190","url":null,"abstract":"<div><h3>Background and objects</h3><div>Exercise stress high-frequency QRS (ES-HFQRS) is a new non-invasive diagnostic technique mainly for myocardial ischemia, which has been demonstrated with favorable diagnostic efficacy in patients with early ischemic symptoms. Multiple studies confirmed ES-HFQRS's superior diagnostic performance over traditional exercise stress electrocardiography (EST) analysis. However, until now, there is still no meta-analysis that compares the diagnostic efficacy of ES-HFQRS and EST.Therefore, this meta aims to compare the diagnostic value of ES-HFQRS with EST.</div></div><div><h3>Methods</h3><div>Databases were searched up to August 4, 2025, using keywords including “exercise stress HFQRS” and “exercise stress electrocardiography”. Sensitivity and specificity were pooled using a bivariate random-effects model. Summary receiver operating characteristic (SROC) curves were plotted, and the area under the curve (AUC) was calculated. Subgroup analyses and Meta-regression explored sources of heterogeneity.</div></div><div><h3>Results</h3><div>Ten studies involving 3352 patients were included. The pooled sensitivity of ES-HFQRS was significantly higher than that of EST (65% [95% CI: 55%–73%] vs. 37% [95% CI: 29%–45%]; <em>P</em> &lt; 0.001), with no significant difference in specificity (78% [95% CI: 72%–83%] for HFQRS vs. 85% [95% CI: 78%–90%] for EST; <em>P</em> = 0.12). The AUCs of ES-HFQRS and EST were 0.77 and 0.64, respectively. Parallel test combining both methods achieved significantly higher sensitivity than EST alone (76% [95% CI: 69%–82%] vs. 37% [95% CI: 29%–45%]; <em>P</em> &lt; 0.001) while maintaining stable specificity at 64% (95% CI: 58%–70%). The serial test increased specificity to 96% (95% CI: 94%–97%),with a significantly lower sensitivity of 22% (95% CI: 17%–29%).</div></div><div><h3>Conclusion</h3><div>ES-HFQRS had superior sensitivity to EST for the non-invasive diagnosis of myocardial ischemia. Combining both analytical methods flexibly could enhance the diagnostic value in the detection of myocardial ischemia.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"95 ","pages":"Article 154190"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018745","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":"Prolonged P-wave duration is associated with increased left atrial volume and delayed atrial conduction assessed by electro-anatomic mapping in patients with atrial fibrillation","authors":"Tomoyuki Kabutoya,&nbsp;Hisaki Makimoto,&nbsp;Kazunori Anno,&nbsp;Yuko Torigoe- Kurosu,&nbsp;Yoshifumi Kimura,&nbsp;Takafumi Okuyama,&nbsp;Hiroaki Watanabe,&nbsp;Ayako Yokota,&nbsp;Masashi Kamioka,&nbsp;Tomonori Watanabe,&nbsp;Takahiro Komori,&nbsp;Yasushi Imai,&nbsp;Kazuomi Kario","doi":"10.1016/j.jelectrocard.2026.154201","DOIUrl":"10.1016/j.jelectrocard.2026.154201","url":null,"abstract":"<div><h3>Background</h3><div>Atrial remodeling contributes to atrial fibrillation through structural and electrical alterations. Prolonged P-wave duration indicates conduction delay, while 3D mapping quantifies left atrial (LA) volume and conduction time.</div></div><div><h3>Methods</h3><div>This study enrolled 27 patients with atrial fibrillation (mean age 63 ± 10 years, 18 men) who underwent catheter ablation. Post-ablation 3D mapping was performed to assess atrial conduction time and LA volume. LA volume was also measured by transthoracic echocardiography. Electrocardiograms for analysis were obtained the following day while all patients were in sinus rhythm. Standard 12‑lead ECGs were recorded, and P-wave duration was digitally measured in each lead; the maximum value (Pmax) was used for analysis. Atrial conduction time and LA volume were compared between patients with Pmax ≥140 ms and those with Pmax &lt;140 ms.</div></div><div><h3>Results</h3><div>Pmax was significantly correlated with LA conduction time (<em>R</em> = 0.51, <em>p</em> = 0.016), total atrial conduction time (<em>R</em> = 0.62, <em>p</em> &lt; 0.001), and the LA volume index (<em>R</em> = 0.48, <em>p</em> = 0.034). Patients with Pmax ≥140 ms showed delayed conduction and a larger LA volume index compared with those with Pmax &lt;140 ms (LA conduction time 137.3 ± 41.0 vs. 104.5 ± 19.9, <em>p</em> = 0.010; total atrial conduction time 178.8 ± 40.0 vs. 140.8 ± 24.2, <em>p</em> = 0.007; LA volume index 73.7 ± 8.4 vs. 53.6 ± 16.0 mL/m², <em>p</em> = 0.014). Moreover, Pmax was significantly correlated with the LA volume index measured by echocardiography (<em>R</em> = 0.52, <em>p</em> = 0.013).</div></div><div><h3>Conclusions</h3><div>Prolongation of Pmax on electrocardiography was significantly associated with delayed atrial conduction and increased LA volume as measured by electro-anatomic mapping.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"95 ","pages":"Article 154201"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074048","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":"Optimizing atrial fibrillation detection through ECG feature selection using Extra-Trees and statistical association measures","authors":"Georgios Petmezas ,&nbsp;Vasileios E. Papageorgiou ,&nbsp;Rod S. Passman ,&nbsp;John A. Rogers ,&nbsp;Leandros Stefanopoulos ,&nbsp;Aggelos K. Katsaggelos ,&nbsp;Nicos Maglaveras","doi":"10.1016/j.jelectrocard.2026.154199","DOIUrl":"10.1016/j.jelectrocard.2026.154199","url":null,"abstract":"<div><h3>Introduction</h3><div>Atrial fibrillation (AFib) is the most prevalent abnormal heart rhythm, significantly increasing the risk of stroke and heart failure. Accurate and timely detection remains challenging, particularly due to the complexity of 12‑lead electrocardiogram (ECG) interpretation. While machine learning (ML) and deep learning (DL) models have demonstrated high accuracy in AFib detection, selecting the optimal input features is often non-trivial. This study aims to develop a hybrid feature selection methodology that objectively identifies the most discriminative ECG-based features for distinguishing AFib from normal sinus rhythm (NSR).</div></div><div><h3>Material &amp; methods</h3><div>We propose a hybrid framework that combines Extremely Randomized Trees (Extra-Trees) with statistical association measures to identify physiologically meaningful ECG features. Our analysis evaluates morphological, entropy-based and spectral hand-crafted features extracted from 12‑lead ECG recordings of patients who underwent catheter ablation for AFib. Two novel metrics, the feature importance score (FIS) and overall feature importance score (OFIS), are introduced to quantify feature relevance.</div></div><div><h3>Results</h3><div>The proposed approach ranked 97 extracted features and identified the 10 most important per ECG lead and 20 most relevant overall, with high consistency across leads. The interquartile range of RR-intervals achieved the highest normalized OFIS value (0.064), followed by other rhythm-related and entropy-based measures, confirming their strong discriminative power. The dimensionality of the feature space was thus reduced by nearly 80% while preserving interpretability and physiological meaning.</div></div><div><h3>Conclusions</h3><div>This methodology provides a reproducible, interpretable and statistically grounded framework for ECG-based feature discovery, offering a preprocessing step for ML/DL models and aiding clinicians in real-time AFib detection.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"95 ","pages":"Article 154199"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074049","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":"Correlation between Electrical Synchrony Index values measured by Synchromax® and left ventricular mechanical dispersion assessed by strain echocardiography","authors":"Hugo Villarroel-Ábrego ,&nbsp;Raúl Norberto Garillo ,&nbsp;Daniela Benzano Bumaguin ,&nbsp;Bernardo Neuhaus Lignati ,&nbsp;Andrés Di Leoni Ferrari","doi":"10.1016/j.jelectrocard.2026.154203","DOIUrl":"10.1016/j.jelectrocard.2026.154203","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular (LV) mechanical dyssynchrony results from nonuniform myocardial activation, leading to inefficient LV contraction and worse clinical outcomes. Synchromax® is a noninvasive system that performs real-time spatial variance analysis of QRS complexes from a standard electrocardiogram, generating an electrical synchrony index (ESI) that may be a potential marker of LV mechanical dyssynchrony. This study evaluated the efficacy of the ESI in predicting LV mechanical dyssynchrony compared to the gold standard: LV mechanical dispersion (LVMD) &gt; 60 ms as measured by speckle-tracking strain echocardiography.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with consecutive adult patients undergoing echocardiography in San Salvador, El Salvador. Clinical, electrocardiographic (rhythm, QRS duration, ESI), and echocardiographic (LVMD, LV ejection fraction, global longitudinal strain) data were collected.</div></div><div><h3>Results</h3><div>Eighty-four studies from 83 patients were analyzed. Mean ESI was 0.36 ± 0.31 and mean LVMD was 58.4 ± 27.1 ms. The ESI showed a sensitivity of 70.0% and a specificity of 88.9%, with negative and positive predictive values of 84.2% and 77.8%, respectively. Agreement with the gold standard was moderate (kappa = 0.60; <em>p</em> &lt; 0.001). ROC curve analysis demonstrated good discriminative performance (area under the curve = 0.81), superior to QRS duration (area under the curve = 0.71) for identifying LV mechanical dyssynchrony.</div></div><div><h3>Conclusions</h3><div>The optimal ESI cutoff was 0.42. ESI correlated consistently and significantly with LVMD, indicating that it may be a more sensitive functional marker than QRS duration, especially in cases without evident dyssynchrony. The ESI is a simple, accessible tool for complementary assessment of ventricular electromechanical synchrony.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"95 ","pages":"Article 154203"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131065","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":"Beyond STEMI criteria: The electrocardiographic “South African Flag Sign” revealing an isolated proximal ramus intermedius occlusion","authors":"Lucio Giuseppe Granata MD ,&nbsp;Alfredo Busà MD ,&nbsp;Marcello Marchetta MD ,&nbsp;Giulia Alagna MD ,&nbsp;Francesco Amico MD","doi":"10.1016/j.jelectrocard.2026.154195","DOIUrl":"10.1016/j.jelectrocard.2026.154195","url":null,"abstract":"<div><div>The South African Flag Sign (SAFS) is an emerging ECG marker of acute coronary occlusion and a potential STEMI-equivalent, though not yet included in guidelines. It features ST elevation in I-aVL and V2 with reciprocal depression in III (and often in additional inferior leads) usually associated with first diagonal branch (D1) occlusion. We report a 66-year-old man with chest pain and SAFS, found to have an isolated sub-occlusive proximal ramus intermedius lesion successfully treated with primary PCI. This case shows that SAFS reflects an occlusion myocardial infarction and serves as a marker of the ischaemic territory rather than a specific culprit vessel, being generated by arteries other than D1 when they share a similar course and perfusion territory. Greater awareness may prevent misclassification and expedite reperfusion therapy.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"95 ","pages":"Article 154195"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979128","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":"Mechanisms of atrial fibrillation in mitral regurgitation patients: Insights from noninvasive electrocardiographic imaging","authors":"Ramya Vijayakumar PhD ,&nbsp;Tari-Ann Yates MD ,&nbsp;Martha McGilvray MD, MSt, MPHS ,&nbsp;Nicholas Razo BS ,&nbsp;Laurie A. Sinn BSN, RN ,&nbsp;Richard B. Schuessler PhD ,&nbsp;Christian W. Zemlin PhD ,&nbsp;Yoram Rudy PhD ,&nbsp;Ralph J. Damiano Jr. MD ,&nbsp;Matthew R. Schill MD","doi":"10.1016/j.jelectrocard.2026.154209","DOIUrl":"10.1016/j.jelectrocard.2026.154209","url":null,"abstract":"<div><h3>Objective</h3><div>Noninvasive Electrocardiographic Imaging (ECGI) was used to define the mechanisms of atrial fibrillation (AF) in mitral regurgitation (MR), which remain poorly understood.</div></div><div><h3>Methods</h3><div>Seventeen patients with degenerative MR and AF undergoing were studied. Thirteen age-matched patients with lone AF provided a control group. Epicardial electrograms were constructed noninvasively with ECGI using 256 body surface electrocardiograms and patient-specific heart-torso geometry from delayed-enhancement magnetic resonance imaging (DE-MRI) or computed tomography (CT) scans. Bi-atrial epicardial activation time maps and phase maps were generated. AF drivers were classified as focal (radial activation) or rotors (high curvature wavefront rotating about a center). Left atrial (LA) fibrosis was quantified from the DE-MRI scans in 5 MR patients.</div></div><div><h3>Results</h3><div>The LA and right atrium (RA) harbored 61% and 36% of drivers, respectively and the anterior inter-atrial groove had 3% of the sources. 51% of the drivers were mapped in the posterior LA. One third of drivers occurred repeatedly. The left PV and LA appendage regions had the most repetitive drivers. Activation patterns varied from single macro-reentry to simultaneous wavelets resulting in wave breaks and collisions. Driver distribution and activation patterns remained similar between MR and lone AF groups, except stable rotors were not observed in MR. DE-MRI maps showed bi-atrial fibrosis. Drivers and discontinuous wavefront propagation were often localized in fibrotic regions.</div></div><div><h3>Conclusions</h3><div>AF activation patterns in MR were complex and exhibited spatio-temporal variability. Bi-atrial drivers were present. The posterior LA harbored the highest percentage of drivers. This region also exhibited fibrosis in a subset of patients, suggesting that it may play a role in creating the AF substrate.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"95 ","pages":"Article 154209"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201834","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":"Diagnostic agreement of smartphone-based electrocardiogram with coronary angiography in identifying vessel involvement in patients with myocardial infarction","authors":"Chandra Mohan ,&nbsp;Kunal Gururani ,&nbsp;Anurag Rawat ,&nbsp;Yogendra Singh ,&nbsp;Nitin Chandola ,&nbsp;Deeksha Agarwal ,&nbsp;Sengar Yashwardhan Pratap Singh ,&nbsp;Milan Prabhakar","doi":"10.1016/j.jelectrocard.2026.154210","DOIUrl":"10.1016/j.jelectrocard.2026.154210","url":null,"abstract":"<div><h3>Background</h3><div>Acute myocardial infarction (MI) remains one of the major causes of morbidity and mortality throughout the world. The objectives of this study were to determine the diagnostic agreement between the findings from Portable (Spandan Pro) and Conventional Electrocardiogram with coronary angiography (CAG) regarding vessel involvement in MI patients, and to assess related risk factors.</div></div><div><h3>Methodology</h3><div>This study was an Observational, Single-arm, Cross-sectional study performed on 109 subjects at a local hospital in Dehradun. The study was approved by the Institutional Ethics Committee, and informed consent was obtained from all the participants. For diagnostic agreement, Statistical analyses such as Cohen's κ, weighted κ, prevalence- and bias-adjusted κ (PABAK), and Jaccard index were used.</div></div><div><h3>Results</h3><div>The mean age of the included patients was 58 ± 11.96 years, with a significant male predominance (88.07%). For overall vessel involvement of ECGs with CAG, portable ECG showed a higher sensitivity (84.76 vs. 78.10%), and for LAD artery, it also showed higher sensitivity (88.46% vs. 82.05%) compared to the conventional ECG. Diagnostic agreement showed substantial agreement with CAG (PABAK 0.68), and according to the Jaccard Index, there was a moderate agreement (approximately 50%) between the ECG-derived findings with CAG across all types of vessel diseases. The most prevalent confounding factor among the participants was smoking (41.9%), followed by Hypertension (39.0%) and diabetes (34.3%).</div></div><div><h3>Conclusion</h3><div>This study indicates that Portable ECG performed comparably to conventional ECG and had a moderate level of diagnostic agreement with CAG in the detection of vessel involvement in patients with MI.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"95 ","pages":"Article 154210"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189088","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":"Unmasking the J-wave: 3D ECG shows terminal depolarization mimicking early repolarization","authors":"Alejandro Jesús Bermejo Valdés","doi":"10.1016/j.jelectrocard.2026.154191","DOIUrl":"10.1016/j.jelectrocard.2026.154191","url":null,"abstract":"<div><div>We used three-dimensional (3D) electrocardiography (ECG) to track the J-wave in V6 through viewing planes inaccessible to standard ECG. Across three identified J-loop phenotypes, we found that the planar morphology of the end QRS deflection, whether J-wave or slurring, depended on projection and was interconvertible under rotation. Although traditionally attributed to phase-1 of the action potential, the 3D J-loop showed that the J-wave becomes concealed and occupies depolarization regions in V1. Here, we examine this discrepancy and show that 3D ECG can more accurately reinterpret the electrophysiological and pathological phenomena associated with early repolarization.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"95 ","pages":"Article 154191"},"PeriodicalIF":1.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979127","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}