Journal of electrocardiology最新文献

{"title":"Exploring artificial intelligence methods for cardiac syncope diagnosis combined with electrocardiogram parameters and clinical characteristics","authors":"Xiulian Li ,&nbsp;Deyun Zhang ,&nbsp;Xinmu Li ,&nbsp;Xinyi Gao ,&nbsp;Yan Liang ,&nbsp;Gary Tse ,&nbsp;Qingpeng Zhang ,&nbsp;Huayue Tao ,&nbsp;Kangyin Chen ,&nbsp;Weilun Xu ,&nbsp;Guangping Li ,&nbsp;Wenling Liu ,&nbsp;Gan-Xin Yan ,&nbsp;Shenda Hong ,&nbsp;Tong Liu","doi":"10.1016/j.jelectrocard.2025.154018","DOIUrl":"10.1016/j.jelectrocard.2025.154018","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac syncope can be life-threatening, but there is no clinical tool for initial screening. The study explored and developed optimal artificial intelligence methods for automatic diagnosis of cardiac syncope based on combinations of electrocardiogram parameters and clinical characteristics.</div></div><div><h3>Methods</h3><div>The patients presenting with syncope and hospitalized between June 21, 2018 and August 23, 2022 at the Second Hospital of Tianjin Medical University. The patients enrolled were divided into development cohort who were then randomly split into a training set and an internal validation set (4: 1) and temporal validation cohort. Fifteen features of syncope patients were ranked and valuable features were selected. Six supervised machine learning models were developed to explore a potential prediction model for cardiac syncope. The area under the curve (AUC) was the primary metric used to evaluate classification performance.</div></div><div><h3>Results</h3><div>A total of 380 patients (340 in the development cohort and 40 in the temporal validation cohort) were included in the final analysis. The random forest showed the best performance using the top twelve features ranked by importance, demonstrating an AUC of 0.85 (sensitivity: 0.72, specificity: 0.85, F1 score: 0.74) in the development cohort, and an AUC of 0.75 (sensitivity: 0.70, specificity: 0.65, F1 score: 0.68) in the validation cohort. The novel approach for automatic diagnosis of cardiac syncope has been proposed as web service for further application.</div></div><div><h3>Conclusions</h3><div>Artificial intelligence methods may assist in syncope classification, and which have the potential to serve as a cost-effective and efficient screening tool for cardiac syncope.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154018"},"PeriodicalIF":1.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936558","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 of electrocardiographic and echocardiographic parameters in assessing left atrial dysfunction","authors":"Aleksandra Zivanic ,&nbsp;Milan Gajic ,&nbsp;Nikola Milovanovic ,&nbsp;Sofija Aleksandra Neskovic ,&nbsp;Ivona Vranic Jovanovic ,&nbsp;Ivan Stankovic","doi":"10.1016/j.jelectrocard.2025.154017","DOIUrl":"10.1016/j.jelectrocard.2025.154017","url":null,"abstract":"<div><h3>Background</h3><div>Electrocardiographic (ECG) indices, such as the morphology-voltage-P-wave (MVP) score, and echocardiographic parameters like left atrial volume index (LAVi), left atrial reservoir strain (LASr), and left atrial appendage (LAA) emptying velocity (LAAev) are associated with atrial fibrillation (AF) risk. However, the relationships between these markers remain incompletely understood.</div></div><div><h3>Aims</h3><div>This study aimed to investigate correlations between the ECG MVP score and echocardiographic indices of LA size and function.</div></div><div><h3>Methods</h3><div>In this prospective study, 60 patients in sinus rhythm, including 8 patients with paroxysmal AF, scheduled for transesophageal echocardiography underwent a 12‑lead ECG and transthoracic echocardiography within 30 min.</div></div><div><h3>Results</h3><div>Significant correlations were observed between the mitral E/e’ ratio and LAVi (<em>r</em> = 0.30, <em>p</em> = 0.029), LASr (<em>r</em> = −0.42, <em>p</em> = 0.002), and LAAev (<em>r</em> = −0.29, <em>p</em> = 0.037). In comparison to patients with mid-high MVP scores, LAAev was significantly lower in those with low MVP scores (49 ± 21 vs. 61 ± 23 cm/s, <em>p</em> = 0.027). No significant differences were observed between the groups in LAVi (40 ± 20 vs. 42 ± 12 ml/m², <em>p</em> = 0.187), LASr (26 ± 11 vs. 25 ± 10 %, <em>p</em> = 0.967), or mitral E/e’ ratio (8.2 ± 1.6 vs. 7.3 ± 1.3, <em>p</em> = 0.876). Additionally, patients with paroxysmal AF had significantly lower LASr and higher mitral E/e’ ratio compared to those without paroxysmal AF.</div></div><div><h3>Conclusions</h3><div>While LAVi, LASr, and LAAev were all related to noninvasively assessed left ventiricular (LV) filling pressure, only LAAev was able to differentiate risk categories based on the MVP score. Our findings suggest that a multiparametric approach to evaluating LA and LAA function, and LV filling pressures may offer a more comprehensive assessment of AF risk than using individual parameters.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154017"},"PeriodicalIF":1.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916936","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 QRS tachycardia: Widen your perspectives when a shock is ineffective","authors":"Claudio Mario Ciampi ,&nbsp;Giovanni Malanchini","doi":"10.1016/j.jelectrocard.2025.154016","DOIUrl":"10.1016/j.jelectrocard.2025.154016","url":null,"abstract":"<div><div>In this Challenging ECG we underscore the importance of Adenosine response during rhythmic wide QRS tachycardia in every setting.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154016"},"PeriodicalIF":1.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923213","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 T-wave sensing by a CRT-D device","authors":"S. Serge Barold MD ,&nbsp;Andreas Kucher MSc, PhD","doi":"10.1016/j.jelectrocard.2025.154019","DOIUrl":"10.1016/j.jelectrocard.2025.154019","url":null,"abstract":"<div><div>This report describes the occurrence of T wave sensing by the left ventricular (LV) channel of implantable defibrillators with cardiac resynchronization therapy (CRT-D devices) of Biotronik during biventricular pacing. This finding is different from reported cases that involved T-wave wave sensing by the right ventricular channel of CRT devices.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154019"},"PeriodicalIF":1.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948359","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":"Cardiac dysregulation in Duchenne muscular dystrophy: An ECG analysis","authors":"Krishnamurthy Arjun ,&nbsp;Ganagarajan Inbaraj ,&nbsp;Adoor Meghana ,&nbsp;Veeramani Preethish-Kumar ,&nbsp;Anu P. John ,&nbsp;Kiran Polavarapu ,&nbsp;Krishna Prasad B S ,&nbsp;B.N. Nandeesh ,&nbsp;Chandregowda Nandan ,&nbsp;Boris W. Kramer ,&nbsp;Harry W.M. Steinbusch ,&nbsp;Atchayaram Nalini ,&nbsp;Kaviraja Udupa ,&nbsp;Talakad N. Sathyaprabha","doi":"10.1016/j.jelectrocard.2025.154015","DOIUrl":"10.1016/j.jelectrocard.2025.154015","url":null,"abstract":"<div><h3>Background and objective</h3><div>Duchenne Muscular Dystrophy (DMD) is a progressive X-linked recessive disorder characterized by severe muscle degeneration and premature death, often due to cardiac complications. Despite the high prevalence of arrhythmogenic cardiomyopathy in DMD, the utility of Electrocardiogram (ECG) analysis in detecting subclinical cardiac dysregulation remains underexplored. This study aimed to investigate alterations in Lead II ECG parameters in children with DMD, potentially indicating an elevated risk of Sudden Cardiac Death (SCD).</div></div><div><h3>Methods</h3><div>In this cross-sectional study, Lead II ECG recordings from 54 genetically confirmed DMD patients were compared against 31 age-matched healthy-controls. Parameters analyzed included PR interval, QRS duration, QT and QTc intervals, Tp-Te interval, and amplitudes of P, Q, R, S, and T waves. Analysis was conducted using LabChart Pro 8 software and the Hamilton-Tompkins QRS detection algorithm. Heart-rate–corrected QT interval (QTc) was calculated using Bazett's formula (QTc = QT/√RR). An independent samples <em>t</em>-test with a significance level of <em>p</em> &lt; 0.05 was used for comparisons between groups.</div></div><div><h3>Results</h3><div>The study revealed significant ECG alterations in the DMD group compared to controls, included a reduced PR interval, prolonged QRS and QT intervals, decreased QTc, and increased Tp-Te interval. Additionally, significant increases in P, Q, R wave amplitudes, and ST height were observed, indicative of atrial hypertrophy and potential ventricular arrhythmias.</div></div><div><h3>Conclusions</h3><div>Lead II ECG analysis in children with DMD demonstrates critical alterations suggestive of subclinical cardiac dysregulation, highlighting a potential non-invasive marker for early detection of cardiac involvement. These findings emphasize the importance of regular cardiac monitoring in DMD patients to mitigate SCD risk through timely interventions and underscore the need for further research into the underlying pathophysiological mechanisms.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154015"},"PeriodicalIF":1.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916935","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":"Lower intercostal space V1 placement to guide conduction system pacing lead implants","authors":"Felix Ayala Valani ,&nbsp;Vartan Mardigyan MD ,&nbsp;Karol Curila MD ,&nbsp;Mehrdad Golian MD ,&nbsp;Andres Klein MD ,&nbsp;Luciano Ayala Valani BSc ,&nbsp;Louis Philip Pelchat MD ,&nbsp;Mouhannad M. Sadek MD ,&nbsp;Felix Ayala-Paredes MD, PhD","doi":"10.1016/j.jelectrocard.2025.153938","DOIUrl":"10.1016/j.jelectrocard.2025.153938","url":null,"abstract":"<div><div>The initial criterion to achieve conduction system area pacing (CSP) is the presence of a terminal R wave in lead V1. Different configurations were used to determine that placing V1 in lower right intercostal spaces results in a greater amplitude of the terminal R waves when the CSP lead is placed deep in the mid-septal or antero-septal locations. Easily identified terminal R wave in V1 will be more practical and potentially reduce the number of sites attempted for left bundle branch area pacing (LBBaP), resulting in faster procedures and reducing potential complications such as septal perforation.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 153938"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923212","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":"ECG-based detection of CTEPH: Insights and considerations on a novel diagnostic model","authors":"Ramazan Aslan ,&nbsp;İsa Ardahanlı","doi":"10.1016/j.jelectrocard.2025.154013","DOIUrl":"10.1016/j.jelectrocard.2025.154013","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 154013"},"PeriodicalIF":1.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917672","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":"Application analysis of a new pre-localization series algorithm for differentiating wide QRS complex tachycardia","authors":"Honglin Ni ,&nbsp;Yue Huang ,&nbsp;Xiaowei Pan ,&nbsp;Xiaoli Zhang ,&nbsp;Lifang Xu ,&nbsp;Zhiyong Wang ,&nbsp;Changlin Zhai ,&nbsp;Haihua Pan","doi":"10.1016/j.jelectrocard.2025.153937","DOIUrl":"10.1016/j.jelectrocard.2025.153937","url":null,"abstract":"<div><h3>Background</h3><div>Accurate diagnosis of wide QRS complex tachycardia (WCT) holds significant clinical value for further diagnosis and treatment.</div></div><div><h3>Objective</h3><div>To evaluate a new WCT differentiation algorithm, defined as the pre-localization series algorithm, which includes the series process for differentiating ventricular tachycardia (VT) from supraventricular tachycardia (SVT) and differentiating VT from preexcited tachycardia (PXT).</div></div><div><h3>Methods</h3><div>A retrospective analysis of electrocardiograms (ECGs) from 185 patients with WCT was conducted using the pre-localization single-process algorithm (differentiating VT from SVT without differentiating VT from PXT), the pre-localization series algorithm, the limb lead algorithm, and the Basel algorithm. The ECGs were differentiated into VT or SVT. The pre-localization series algorithm further differentiated the initially diagnosed VT into VT or PXT, and the results were compared with the confirmed diagnoses to assess the diagnostic value of the four algorithms.</div></div><div><h3>Results</h3><div>The pre-localization single-process algorithm had higher AUC values (0.777 vs. 0.711 vs. 0.646), sensitivity (0.955 vs. 0.809 vs. 0.745), and accuracy (0.811 vs. 0.730 vs. 0.665) compared with the limb lead algorithm and the Basel algorithm. The pre-localization series algorithm had higher AUC values (0.901 vs. 0.711 vs. 0.646), sensitivity (0.909 vs. 0.809 vs. 0.745), specificity (0.893 vs. 0.613 vs. 0.547), and accuracy (0.903 vs. 0.730 vs. 0.665) compared with the limb lead algorithm and the Basel algorithm, the pre-localization series algorithm also had higher specificity (0.893 vs. 0.600) and accuracy (0.903 vs. 0.811) than the pre-localization single-process algorithm, but sensitivity(0.909 vs. 0.955) was slightly lower, with statistically significant differences (all <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The pre-localization single-process algorithm had higher sensitivity and accuracy compared with the limb lead algorithm and the Basel algorithm. The series algorithm, due to its improved specificity, further enhanced diagnostic value and can be considered for diagnosing VT, SVT, and PXT.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 153937"},"PeriodicalIF":1.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901933","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":"Post-infarct lateral extension—Brody effect or stent thrombosis?","authors":"Li Feng ,&nbsp;Zhongyuan Lin ,&nbsp;Yajun Ji ,&nbsp;Pitt O. Lim","doi":"10.1016/j.jelectrocard.2025.154014","DOIUrl":"10.1016/j.jelectrocard.2025.154014","url":null,"abstract":"<div><div>It is a common dilemma in determining whether to restudy a patient who has just received a stent in the left anterior descending artery for an anterior ST-elevation myocardial infarction, particularly when the ST-segments rise again and extend to lateral precordial leads. As a precaution, such patients frequently undergo repeat coronary angiography, which usually confirms stent patency. It appears that a dilated post-infarct left ventricle, affected by reperfusion injury, produces a Brody effect that mimics lateral infarction. The increase in intracavity blood volume renders the heart more electrically conductive and radially amplifies electrocardiographic signals.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"91 ","pages":"Article 154014"},"PeriodicalIF":1.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901934","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 clinical significance of early repolarization: A meta-analysis of mortality risk","authors":"Khaled Elenizi MD ,&nbsp;Rasha Alharthi MD ,&nbsp;Sahar Gamil MD ,&nbsp;Abdullah Sharaf Aldeen MD ,&nbsp;Wael Alqarawi MD","doi":"10.1016/j.jelectrocard.2025.153939","DOIUrl":"10.1016/j.jelectrocard.2025.153939","url":null,"abstract":"<div><h3>Background</h3><div>Early repolarization (ER), historically regarded as benign, have emerged as potential markers for increased risk of cardiovascular (CV) events, including sudden cardiac arrest (SCA) and ventricular fibrillation (VF). This meta-analysis seeks to consolidate evidence from available studies to assess the mortality risks and clinical implications associated with ER.</div></div><div><h3>Objectives</h3><div>The aim of this meta-analysis is to evaluate the association between ER and various mortality outcomes, including all-cause mortality, CV mortality, and the incidence of VF and SCA in different patient populations.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed across two major medical databases (EMBASE and PubMed) from inception to April 2024. After removing duplicates and screening, 36 studies were included in the final analysis. The studies included diverse populations, such as the general public, ICD patients, myocardial infarction (MI)/acute coronary syndrome (ACS) patients, and survivors of SCA. Odds Ratios (ORs) were calculated using a random-effects model to account for heterogeneity among studies. The I² statistic was employed to quantify heterogeneity, and publication bias was assessed using the Eggers regression and funnel plots.</div></div><div><h3>Results</h3><div>Out of 744 initially identified articles, 36 studies met the inclusion criteria for the meta-analysis, including general populations, ICD patients, MI/ ACS patients, and survivors of SCA. The analysis revealed that the presence of ER was not significantly associated with all-cause mortality (OR = 1.2, 95% CI 0.92–1.59, p = 0.18, I² = 96%) or CV mortality (OR = 1.3, 95% CI: 0.87–1.9, P = 0.19, I² = 94%) in the general population. However, ER was significantly associated with an increased risk of VF and SCA (OR = 3.57, 95% CI 1.2–10.7, p = 0.02, I² = 90%), and particularly with VF in ICD, SCA survivors and MI/ACS patients (OR = 4.01, 95% CI 2.5–6.4, p &lt; 0.001, I² = 76%). These findings underscore the need to consider ER patterns in risk assessments, especially for patients with a history of MI or those at high risk for ventricular arrhythmias.</div></div><div><h3>Conclusions</h3><div>This meta-analysis confirms that while ER patterns do not significantly impact all-cause or CV mortality, they are strongly associated with an increased risk of VF and SCA, particularly in patients with a history of MI or ACS. These findings highlight the importance of considering ER patterns in clinical risk assessments, especially in high-risk populations.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153939"},"PeriodicalIF":1.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882425","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}