Journal of electrocardiology最新文献

{"title":"Centennial of Einthoven's Nobel prize lecture on electrocardiography","authors":"S. Serge Barold MD , David C. Barold MD","doi":"10.1016/j.jelectrocard.2024.153822","DOIUrl":"10.1016/j.jelectrocard.2024.153822","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"88 ","pages":"Article 153822"},"PeriodicalIF":1.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643985","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":"FlexPoints: Efficient electrocardiogram signal compression for machine learning","authors":"Daniel Bulanda ,&nbsp;Janusz A. Starzyk ,&nbsp;Adrian Horzyk","doi":"10.1016/j.jelectrocard.2024.153825","DOIUrl":"10.1016/j.jelectrocard.2024.153825","url":null,"abstract":"<div><div>The electrocardiogram (ECG) stands out as one of the most frequently used medical tests, playing a crucial role in the accurate diagnosis and treatment of patients. While ECG devices generate a huge amount of data, only a fraction of it holds valuable medical information. To deal with this problem, many compression algorithms and filters have been developed over the years. However, the rapid development of new machine-learning techniques introduces new challenges. To address this class of problems, we have introduced a FlexPoints algorithm. This innovative algorithm searches for characteristic points on the ECG signal and ignores all other points that lack pertinent medical information. The conducted experiments have demonstrated that our proposed algorithm can significantly reduce the number of data points representing ECG signals without losing valuable medical insights. These sparse but essential characteristic points, referred to as flex points, serve as well-fitted input for modern machine learning models. Such models exhibit enhanced performance when using flex points as input, as opposed to raw data or data compressed by other popular algorithms.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"88 ","pages":"Article 153825"},"PeriodicalIF":1.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643994","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":"Nonparoxysmal junctional tachycardia associated with 3:2 Wenckebach exit block in the absence of digitalis therapy","authors":"S. Serge Barold ,&nbsp;Patrick Hermans ,&nbsp;Andreas Kucher ,&nbsp;Rik Willems","doi":"10.1016/j.jelectrocard.2024.153780","DOIUrl":"10.1016/j.jelectrocard.2024.153780","url":null,"abstract":"<div><div>Nonparoxysmal junctional tachycardia with Wenckebach exit block is known to be associated with digitalis toxicity. This report documents the occurrence of this arrhythmia in the absence of digitalis therapy in a patient with structural heart disease.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153780"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554642","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 ECG of a 6-year-old girl","authors":"Leonid Makarov MD, PhD,&nbsp;Anush Akopyan MD,&nbsp;Vera Komoliatova MD, PhD","doi":"10.1016/j.jelectrocard.2024.153819","DOIUrl":"10.1016/j.jelectrocard.2024.153819","url":null,"abstract":"<div><div>A 12-channel ECG and the ECG patterb from Holter monitoring of a 6-year-girl are presented.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153819"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568469","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 de Winter electrocardiographic pattern: A systematic review of case reports","authors":"Sandro Pinelli Felicioni MD, PhD ,&nbsp;José Nunes de Alencar MD ,&nbsp;Marinella Patrizia Centemero MD, PhD ,&nbsp;Uelra Rita Lourenço MD, PhD ,&nbsp;Mariana Fuziy Nogueira De Marchi MD ,&nbsp;Matheus Kiszka Scheffer MD ,&nbsp;Ana Carolina Muniz Costa MD ,&nbsp;Rinaldo Carvalho Fernandes MD ,&nbsp;Vinicius Ruiz Uemoto ,&nbsp;Ramon Baronetti","doi":"10.1016/j.jelectrocard.2024.153821","DOIUrl":"10.1016/j.jelectrocard.2024.153821","url":null,"abstract":"<div><h3>Background</h3><div>It has been established that concurrent ST-T alterations in limb leads can assist in identifying the location of left anterior descending (LAD) artery occlusion. The de Winter pattern is an atypical electrocardiographic manifestation characterized by ST-segment depression associated with LAD artery occlusion. We hypothesized that this atypical pattern could potentially interfere with the accurate localization of the LAD occlusion site on the electrocardiogram. We aimed to describe the distinctive characteristics of the de Winter pattern and to compare electrocardiographic variables in proximal and distal occlusions of the LAD artery.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using the PRISMA guidelines. PubMed, Scopus, and Web of Science were searched from their inception to June 2024. Continuous variables were compared using the Kruskal-Wallis test.</div></div><div><h3>Results</h3><div>Sixty-six cases with LAD related lesions were included. The majority of cases involved young males with a low proportion of prior coronary artery disease. Most patients had sinus rhythm and normal QRS duration. ST-T changes in limb leads were common in the patients studied (91%), but our analysis showed that differentiating between proximal and distal occlusions based on these changes was challenging.</div></div><div><h3>Conclusion</h3><div>The de Winter pattern is primarily observed in young males with a low proportion of prior coronary artery disease. While ST-T changes in limb leads are frequent, localizing the LAD occlusion site based on these changes can be difficult. Further research is needed to understand the underlying mechanisms, prevalence, and improve diagnostic accuracy for this atypical pattern.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153821"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603297","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":"Right bundle branch block in suspected acute coronary syndromes: Diagnostic challenges, treatment and prognosis","authors":"Juliana Senftinger MD ,&nbsp;Nils A. Sörensen MD ,&nbsp;Stefan Blankenberg MD, DMSc ,&nbsp;Peter Clemmensen MD, DMSc","doi":"10.1016/j.jelectrocard.2024.153824","DOIUrl":"10.1016/j.jelectrocard.2024.153824","url":null,"abstract":"<div><h3>Background</h3><div>There is still conflicting evidence regarding the prognostic implications of right bundle branch block (RBBB) in the general population but also in patients with heart diseases like acute coronary syndromes (ACS). In accordance with current guidelines, RBBB in ACS patients is considered as STEMI equivalent. However, recent studies indicate that further differentiation is necessary in this group, as we will outline below.</div></div><div><h3>Methods and results</h3><div>A literature search was conducted in PubMed and Google Scholar.</div><div>In previous studies, RBBB in the general population were mostly considered benign changes of the electrical conduction system. However, recent studies indicate that both complete and incomplete RBBB are associated with increased cardiovascular morbidity and mortality. In addition, among unselected patients with suspected ACS presenting to the emergency department, the prevalence of RBBB was 3 % and it was associated with elevated mortality. The subsequent angiographic identification of a culprit coronary artery stenosis leading to stent implantation was similar at approximately 2 % regardless of the initial ECG presentation with narrow QRS complexes, left bundle branch block (LBBB), or RBBB.</div><div>Finally, in a group of high-risk patients for ST-elevation myocardial infarction (STEMI), the prevalence of RBBB was 12 %. While RBBB was associated with poor outcome compared to non-BBB and LBBB patients, diagnostic accuracy of STEMI criteria was not affected by the presence of RBBB. However, RBBB patients without distinct STEMI signs in ECG often showed acute STEMI on angiography indicating a potential benefit from immediate transfer to the cardiac catheterization laboratory.</div></div><div><h3>Conclusion</h3><div>In the general population, patients with RBBB and risk factors may need further evaluation. Regarding ACS patients, recent studies support current guidelines that recommend acute invasive evaluation for high-risk ACS patients with RBBB, regardless of ST-T deviations. However, in an unselected group of ACS patients, differential diagnoses should also be investigated through additional diagnostic procedures.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153824"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639017","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 adolescent obesity and ventricular repolarization.","authors":"Naoya Kataoka, Teruhiko Imamura","doi":"10.1016/j.jelectrocard.2024.153816","DOIUrl":"10.1016/j.jelectrocard.2024.153816","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":" ","pages":"153816"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467183","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":"Use of ST/HR hysteresis decreases false positive rate in exercise electrocardiography test of middle-aged asymptomatic women","authors":"Miro Enroth ,&nbsp;Harri Sievanen ,&nbsp;Tuikku Tuula-Maria Agnes Asikainen ,&nbsp;Jari Viik","doi":"10.1016/j.jelectrocard.2024.153820","DOIUrl":"10.1016/j.jelectrocard.2024.153820","url":null,"abstract":"<div><h3>Background</h3><div>Exercise electrocardiography (ECG) is a common diagnostic and prognostic method for the detection of coronary artery disease (CAD). However, its accuracy in asymptomatic women has not been comprehensively investigated and the diagnostic criteria may require refinements. This study evaluated the performance of ECG-derived ST/HR-index, ST/HR hysteresis and ST-segment depression parameters among asymptomatic middle-aged women.</div></div><div><h3>Methods</h3><div>108 women (mean age 56 ± 4 years) performed exercise ECG test on treadmill until exhaustion three times within a nine-month period. False-positive rates of maximum ST/HR-index, ST/HR hysteresis, and ST-segment depression values measured from 12 leads at peak exercise and after one-minute recovery were evaluated with recommended diagnostic partition values. Repeatability was assessed with intraclass correlation (ICC) and Bland-Altman plot analysis.</div></div><div><h3>Results</h3><div>False-positive rate was lower for all variables when a two‑lead configuration was used instead of a single‑lead configuration. Using a two‑lead configuration, ST/HR hysteresis (0–1.9 %) and ST-segment depression after one-minute recovery (0–2.8 %) had lower false-positive rates compared to ST/HR index (3.7–20.4 %) and ST-segment depression at peak exercise (9.3–27.8 %). ICC values indicated moderate repeatability for ST/HR hysteresis while ST/HR index, ST-segment at peak exercise, and ST-segment after one-minute recovery had moderate-to-good repeatability. Bland-Altman analysis indicated poor repeatability for all evaluated ECG variables.</div></div><div><h3>Conclusion</h3><div>In asymptomatic middle-aged women, practitioners should prefer the use of ST/HR hysteresis and ST-segment after one-minute recovery over the conventional ST-segment depression at peak exercise or ST/HR index, and evaluate the ECG data from a two‑lead configuration instead of single‑lead.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153820"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590628","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":"Chest pain and AI interpretation: The essential role of clinical judgment and quality data","authors":"Marco Biasin MD ,&nbsp;Sara Lomi MD ,&nbsp;Laura Pagani MD,&nbsp;Gabriele Facci MD,&nbsp;Davide Betta MD,&nbsp;Giovanni Morani MD","doi":"10.1016/j.jelectrocard.2024.153823","DOIUrl":"10.1016/j.jelectrocard.2024.153823","url":null,"abstract":"<div><div>Chest pain is a common and complex condition in emergency departments, often complicating the diagnostic process due to its wide range of potential causes. This case report presents a 72-year-old man with chest pain and ST-segment elevation on ECG, initially suggestive of acute coronary syndrom. AI-assisted ECG analysis reinforced this suspicion; however, angiography revealed patent coronary arteries. When his symptoms persisted, further investigation uncovered a pneumothorax. Additional evaluation identified a digitization error affecting the AI interpretation. This case underscores the importance of a comprehensive clinical approach for chest pain and highlights the need for quality data input and alternative imaging, such as thoracic ultrasound, for accurate and timely differential diagnoses.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153823"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621826","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":"QRS prolongation is associated with associated with adverse cardiac remodeling in hypertrophic cardiomyopathy","authors":"Hernan L. Vera-Sarmiento ,&nbsp;Talha Tanriverdi ,&nbsp;David Hurtado-de-Mendoza ,&nbsp;Sanjay Sivalokanathan ,&nbsp;Ramses Ramirez Damera ,&nbsp;Dolores Ketty ,&nbsp;Daiyin Lu ,&nbsp;Stefan Zimmerman ,&nbsp;Sunil Sinha ,&nbsp;Melvin Scheinman ,&nbsp;M. Roselle Abraham","doi":"10.1016/j.jelectrocard.2024.153818","DOIUrl":"10.1016/j.jelectrocard.2024.153818","url":null,"abstract":"<div><h3>Background</h3><div>Signal-averaged electrocardiogram (SAECG) records myocardial depolarization, and can detect inhomogeneous/slow conduction in fibrotic myocardium, which promotes reentrant ventricular arrhythmias (VAs). Hypertrophic cardiomyopathy (HCM) is associated with a high prevalence of cardiac fibrosis and VAs, but abnormal SAECG has low predictive power for VAs. We hypothesized that HCM-specific structural/electrical remodeling underlies this result.</div></div><div><h3>Methods</h3><div>We tested our hypothesis by retrospectively studying HCM patients (n = 73) who underwent transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) imaging within 12 months of SAECG and 12‑lead ECG. Patients were divided into 2 groups (normal-SAECG, abnormal-SAECG) based on filtered-QRS duration (<em>fQRS</em>d), root-mean-square-voltage (<em>RMS40</em>) and low-amplitude (&lt;40 μV) signal of terminal 40 ms of filtered-QRS (late potentials)<em>.</em> Abnormal SAECG was defined as <em>fQRS</em>d <em>&gt;</em> <em>114</em> <em>ms, RMS40</em> <em>&lt;</em> <em>20</em> μ<em>V</em> or <em>LAS40</em> <em>&gt;</em> <em>38</em> <em>ms.</em></div></div><div><h3>Results</h3><div>Abnormal SAECG was seen in ∼50 % of HCM patients (37/73). In the abnormal-SAECG group, 78 % (n = 29) only had prolonged <em>fQRS</em>d<em>,</em> and 22 % (n = 8) had prolonged <em>fQRS</em>d plus late potentials (<em>RMS40</em> <em>&lt;</em> <em>20</em> μV or <em>LAS40</em> <em>&gt;</em> <em>38</em> <em>ms)</em>. Mean <em>fQRS</em>d and <em>LAS40</em> were significantly higher in the abnormal-SAECG group. The abnormal-SAECG group had significantly larger LA size, lower global-LV longitudinal systolic strain/strain rate and early-diastolic strain rate by TTE; higher LV-mass index (LVMI) and LV-scar burden by CMR; higher prevalence of repolarization abnormalities on 12‑lead ECG. LVEF and adverse outcomes (VT/VF, heart failure, death) were similar in the 2 groups. Univariate analysis showed that <em>fQRS</em>d is positively correlated with LVMI, LV-scar mass, and negatively correlated with global-LV early diastolic strain rate.</div></div><div><h3>Conclusions</h3><div>In HCM, abnormal SAECG is associated with greater structural/electrical LV-remodeling, reflecting a severe global myopathy.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153818"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621827","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}