Journal of electrocardiology最新文献

{"title":"Abnormal QRS-T angles in 5796 women and men aged 50–64: an electrocardiographic analysis providing mechanistic insights","authors":"Lennart Bergfeldt ,&nbsp;Rut Hellsing ,&nbsp;David Molnar ,&nbsp;Amar Taha ,&nbsp;Gunilla Lundahl ,&nbsp;Lennart Gransberg ,&nbsp;Göran Bergström","doi":"10.1016/j.jelectrocard.2024.153784","DOIUrl":"10.1016/j.jelectrocard.2024.153784","url":null,"abstract":"<div><h3>Introduction</h3><p>Abnormal QRS-T angles are prognostic markers for cardiovascular deaths including sudden cardiac death. They occur in ∼5–6% of population-based cohorts but in ∼20% of patients with diabetes. The mechanistic background, electrical activation and/or recovery disturbances, is not known and the topic of this study.</p></div><div><h3>Methods</h3><p>Applying Frank vectorcardiography (VCG) and simultaneously recorded scalar 12‑lead ECG, electrical activation and recovery of abnormal QRS-T angles were studied in 311 participants (5.4%) from a population-based cohort of 5796 women and men in the main Swedish CArdio-Pulmonary bio-Imaging Study (SCAPIS) in Gothenburg. Cut-off values for the peak and mean QRS-T angles were &gt; 124° and &gt; 119°, based on the &gt;95th percentile among all 1080 participants in the pilot SCAPIS and reference values for normal directions (Q1-Q3) from 319 apparently healthy (30%) of them.</p></div><div><h3>Results</h3><p>Of 311 cases 17% had known cardiac disease. Deviations of QRS and QRSarea-vectors from reference limits (90%) were significantly more common than deviations of T- and Tarea-vectors (65%). Standard ECG signs suggested pathophysiology in 20%; left bundle branch block (LBBB) and voltage criteria for left ventricular hypertrophy being most frequent (9–10%) each. Sub-group analysis of the 30 with LBBB showed very large variability in vector directions.</p></div><div><h3>Conclusions</h3><p>Our observations provide mechanistic insights about abnormal QRS-T angles of potential value for future prognostic and interventional studies. The results also have potential implications for LBB area pacing and the approach to left ventricular hypertrophy.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0022073624002541/pdfft?md5=f5c71d666db9c85a4e70485ea8a0b707&pid=1-s2.0-S0022073624002541-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080508","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":"The syndrome of inferior non-infarctional Q-waves due to segmental basal left ventricular hypertrophy","authors":"John E. Madias","doi":"10.1016/j.jelectrocard.2024.153785","DOIUrl":"10.1016/j.jelectrocard.2024.153785","url":null,"abstract":"<div><p>Non-infarctional Q-waves in general are often recorded in the ECG, and are attributed to anatomical and electrical ECG axis shifts, presence of accessory pathways, pregnancy, HCM, and other HCM-like segmental LV myocardial hypertrophic states, that are currently not fully characterized, as to their nosological nature. The present focused review concerns in particular inferior Q-waves and their association with segmental basal anterior and/or septal LV hypertophies due to HCM, and other not yet fully characterized basal segmental LV hypertophies. Insights from the currently available literature on the topic are reviewed, and varying opinions about the nature of such hypertophic states are discussed, with some suggestions, for what is needed to be done, for their further pathlogenetic characterization.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142083789","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 stroke patient with an unusual electrocardiogram","authors":"Elena M. Donald MD,&nbsp;James A. Reiffel MD,&nbsp;Jose M. Dizon MD","doi":"10.1016/j.jelectrocard.2024.153781","DOIUrl":"10.1016/j.jelectrocard.2024.153781","url":null,"abstract":"<div><p>We present a case of a 70 year old man with a history of paroxysmal atrial flutter who was admitted to the hospital with symptoms and imaging consistent with an acute stroke. Physical exam was notable for a pulse rate of 50 beats per minute and right sided facial droop with mild dysarthria. Admission ECG shows a junctional bradycardia with evidence of dual AV node physiology, rarely manifested in a retrograde fashion on a standard ECG. The patient likely experienced parasympathetic sinus node slowing in the setting of acute stroke. During post-stroke monitoring, the patient demonstrated return of sinus rhythm with chronotropic competence and he had no additional arrhythmia during admission.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044702","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":"Clinical implication of polysomnography findings for predicting atrial fibrillation","authors":"Naoya Kataoka MD,&nbsp;Teruhiko Imamura MD","doi":"10.1016/j.jelectrocard.2024.153770","DOIUrl":"10.1016/j.jelectrocard.2024.153770","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141990658","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":"Ventricular preexcitation of every other beat or ventricular bigeminy or both?","authors":"Zehra Güven Çetin MD,&nbsp;Özcan Özeke MD,&nbsp;Serkan Çay MD,&nbsp;Serkan Topaloğlu MD","doi":"10.1016/j.jelectrocard.2024.153778","DOIUrl":"10.1016/j.jelectrocard.2024.153778","url":null,"abstract":"<div><p>Bigeminy is a cardiac arrhythmia in which there is a single ectopic beat, or irregular heartbeat, following each regular heartbeat. This case demonstrates the diagnostic challenges that can be encountered while interpreting ECGs of patients with “apparent ventricular bigeminy’.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993453","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":"Reversal of left arm and left leg leads rather than alternating left fascicular block","authors":"Mazen M. Kawji MD","doi":"10.1016/j.jelectrocard.2024.153774","DOIUrl":"10.1016/j.jelectrocard.2024.153774","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995799","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":"Clinical and electrocardiographic characteristics of immune checkpoint inhibitor-related myocarditis","authors":"Wenhua Song ,&nbsp;Ziliang Chen ,&nbsp;Yi Zheng ,&nbsp;Yu Xu ,&nbsp;Yihong Sun ,&nbsp;Zhiqiang Zhao ,&nbsp;Bingxin Xie ,&nbsp;Nan Zhang ,&nbsp;Xuhong Geng ,&nbsp;Yueying Wang ,&nbsp;Jun Zhao ,&nbsp;Xiaowei Zhang ,&nbsp;Yanmin Xu ,&nbsp;Gary Tse ,&nbsp;Guangping Li ,&nbsp;Lili Hong ,&nbsp;Tong Liu","doi":"10.1016/j.jelectrocard.2024.153779","DOIUrl":"10.1016/j.jelectrocard.2024.153779","url":null,"abstract":"<div><h3>Background</h3><p>Immune checkpoint inhibitor (ICI) has become a major breakthrough in the field of tumor therapy, leading to improved survival. This study evaluated the clinical and electrocardiographic characteristics of patients with ICI-related myocarditis.</p></div><div><h3>Methods</h3><p>Patients with ICI-related myocarditis were enrolled from 4 centers in China until September 2023. Demographic data (age, sex, comorbidity), types of ICI, clinical manifestations, electrocardiogram (ECG) and treatment were analyzed retrospectively. Arrhythmia and characteristics of ECG were compared according to prognosis and grading.</p></div><div><h3>Results</h3><p>A total of 29 participants (13 females with a median age of 63.25 years) with ICI-related myocarditis were enrolled. Lung cancer was the most, with a proportion of 31.03 % (9/29). The median time from the first administration of ICI to the diagnosis of myocarditis was 50 days. Camrelizumab was the main type of ICI (9/29). Most patients had non-specific symptoms, dyspnea (<em>n</em> = 16) and palpitation (<em>n</em> = 9) were common. The overall mortality rate was 37.93 % (11/29) with a median follow-up of 9(4,11) days. Compared with the survivors, P-wave abnormality was more common in participants who were dead (24.14 %vs6.90 %, <em>p</em> = 0.010). A total of 19 patients with severe ICI-related myocarditis were included in this study. The proportions of sinus tachycardia (34.48 %vs0.00 %, <em>p</em> = 0.005), premature ventricular complex (27.59 %vs0.00 %, <em>p</em> = 0.027) and atrioventricular block (34.48 %vs3.45 %, <em>p</em> = 0.044) were higher in severe ICI-related myocarditis.</p></div><div><h3>Conclusions</h3><p>Clinical manifestations of ICI-related myocarditis usually lacked specificity. ECGs can be manifested as new-onset arrhythmias, ST-T segment changes, fragmented QRS complex, abnormal P wave, prolonged QTc interval and multi‑lead low voltage.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141990657","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":"Performance of electrocardiographic criteria for detecting LVH in hypertensive Africans","authors":"David Vandroux MD ,&nbsp;Salmane Amidou MD, PhD ,&nbsp;Souleymane Issa Sarki MD ,&nbsp;Julien Magne MD, PhD ,&nbsp;Yessito Corine Houehanou MD, PhD ,&nbsp;Lucie Chastaingt MD ,&nbsp;Victor Aboyans MD, PhD, FESC ,&nbsp;Philippe Lacroix MD, PhD ,&nbsp;on behalf of TAHES study investigators","doi":"10.1016/j.jelectrocard.2024.153773","DOIUrl":"10.1016/j.jelectrocard.2024.153773","url":null,"abstract":"<div><h3>Aims</h3><p>To evaluate the performance of the currently accepted LVH electrocardiographic (ECG) criteria from ethnic-specific normal values.</p></div><div><h3>Methods and results</h3><p>We included 309 hypertensive subjects with both ECG (12‑leads device) and echocardiographic analysis. The diagnosis of LVH was established by echocardiography from specific norms. Current ECG criteria for the diagnosis of LVH have low performances. Area Under Curve of Sokolow-Lyon, Peguero-Lo Presti, Cornell voltage and Cornell Product were respectively 0.61, 0.65, 0.72 and 0.71.</p></div><div><h3>Conclusion</h3><p>In hypertensive African, the most accurate criterion for diagnosing LVH is Cornell voltage.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036019","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":"Anterior ST elevation in a patient with RBBB","authors":"Yochai Birnbaum MD ,&nbsp;Kjell Nikus MD","doi":"10.1016/j.jelectrocard.2024.153771","DOIUrl":"10.1016/j.jelectrocard.2024.153771","url":null,"abstract":"<div><p>A 79-year-old male with a history of coronary artery disease presented to the Emergency Department with chest pain. ECG showed RBBB with mild ST elevation and positive T waves in I, aVL and V2. In patients with RBBB lack of ST depression and T wave inversion in the anterior leads could signify ischemia secondary to left anterior descending coronary artery occlusion. However, the patient did not have acute coronary syndrome and the presenting ECG was comparable to an ECG recorded five years earlier.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049259","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":"Technical article: Overview of hospital-based data capture systems that acquire continuous ECG and physiologic data","authors":"Michele M. Pelter RN, PhD ,&nbsp;Priya A. Prasad PhD ,&nbsp;David W. Mortara PhD ,&nbsp;Fabio Badilini PhD","doi":"10.1016/j.jelectrocard.2024.153777","DOIUrl":"10.1016/j.jelectrocard.2024.153777","url":null,"abstract":"<div><p>Data capture systems that acquire continuous hospital-based electrocardiographic (ECG) and physiologic (vital signs) data can foster robust research (i.e., large sample sizes from consecutive patients). However, the application of these systems and the data generated are complex and requires careful human oversight to ensure that accurate and high quality data are procured. This technical article will describe two different data capture systems created by our research group designed to examine false alarms associated with alarm fatigue in nurses. The following aspects regarding these data capture systems will be discussed: (1) history of development; (2) summary of advantages, challenges, and important considerations; (3) their use in research; (4) their use in clinical care; and (5) future developments.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142040370","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}