{"title":"Simulating left atrial arrhythmias with an interactive N-body model","authors":"Bryant Wyatt , Gavin McIntosh , Avery Campbell , Melanie Little , Leah Rogers , Brandon Wyatt","doi":"10.1016/j.jelectrocard.2024.153762","DOIUrl":"10.1016/j.jelectrocard.2024.153762","url":null,"abstract":"<div><h3>Background</h3><p>Heart disease and strokes are leading global killers. While atrial arrhythmias are not deadly by themselves, they can disrupt blood flow in the heart, causing blood clots. These clots can travel to the brain, causing strokes, or to the coronary arteries, causing heart attacks. Additionally, prolonged periods of elevated heart rates can lead to structural and functional changes in the heart, ultimately leading to heart failure if untreated. The left atrium, with its more complex topology, is the primary site for complex arrhythmias. Much remains unknown about the causes of these arrhythmias, and computer modeling is employed to study them.</p></div><div><h3>Methods</h3><p>We use N-body modeling techniques and parallel computing to build an interactive model of the left atrium. Through user input, individual muscle attributes can be adjusted, and ectopic events can be placed to induce arrhythmias in the model. Users can test ablation scenarios to determine the most effective way to eliminate these arrhythmias.</p></div><div><h3>Results</h3><p>We set up muscle conditions that either spontaneously generate common arrhythmias or, with a properly timed and located ectopic event, induce an arrhythmia. These arrhythmias were successfully eliminated with simulated ablation.</p></div><div><h3>Conclusions</h3><p>We believe the model could be useful to doctors, researchers, and medical students studying left atrial arrhythmias.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141766230","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}
Ruixia Liu , Huichen Hu , Shuaishuai Zhang , Yanjun Deng , Zhaoyang Liu , Yongjian Chen , Zhe Chen
{"title":"An ECG denoising technique based on AHIN block and gradient difference max loss","authors":"Ruixia Liu , Huichen Hu , Shuaishuai Zhang , Yanjun Deng , Zhaoyang Liu , Yongjian Chen , Zhe Chen","doi":"10.1016/j.jelectrocard.2024.153761","DOIUrl":"10.1016/j.jelectrocard.2024.153761","url":null,"abstract":"<div><p>The electrocardiogram (ECG) signal is susceptible to interference from unknown noises during the acquisition process due to their low frequency and amplitude, resulting in the loss of significant information in the signals. Recent advancements in deep learning models have shown promising results in signal processing. However, these models lack robustness against various types of noise and often overlook the gradient difference between denoised and original signals. In this study, we propose a novel deep learning denoising method based on an attention half instance normalization block (AHIN block) and a gradient difference max loss function (GDM Loss). Our approach consists of two stages: firstly, we input the noisy ECG signal to obtain a denoised version; secondly, we reconstruct the denoised signal by fusing preliminary results from the first stage while correcting waveform distortions caused by initial denoising to minimize information loss. Additionally, we introduce a new loss function that considers differences between slopes of the denoised ECG signal and clean ECG signal. To validate our proposed method's effectiveness, extensive experiments were conducted on both our model architecture and loss function compared with other state-of-the-art methods. Results demonstrate that our approach achieves excellent performance in terms of both signal-to-noise ratio (SNR) and root-mean-square error (RMSE). The proposed noise reduction method improves 8.86%, 12.05% and 10.50% respectively under BW, MA and EM noise.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852683","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}
Paul M. Hendriks , Zoë A. Keuning , Jan A. Kors , Allard T. van den Hoven , Laurie W. Geenen , Jannet A. Eindhoven , Vivan J.M. Baggen , Judith A.A.E. Cuypers , Robert M. Kauling , Jolien W. Roos-Hesselink , Annemien E. van den Bosch
{"title":"Prognostic value of the electrocardiogram in patients with bicuspid aortic valve disease","authors":"Paul M. Hendriks , Zoë A. Keuning , Jan A. Kors , Allard T. van den Hoven , Laurie W. Geenen , Jannet A. Eindhoven , Vivan J.M. Baggen , Judith A.A.E. Cuypers , Robert M. Kauling , Jolien W. Roos-Hesselink , Annemien E. van den Bosch","doi":"10.1016/j.jelectrocard.2024.153760","DOIUrl":"10.1016/j.jelectrocard.2024.153760","url":null,"abstract":"<div><h3>Background</h3><p>Identifying bicuspid aortic valve (BAV) patients at risk for cardiac events remains challenging and the role of the electrocardiogram (ECG) has not yet been described. Therefore, this study aims to describe ECG parameters in BAV patients, and investigate their prognostic value.</p></div><div><h3>Methods</h3><p>In this single-center prospective study patients with BAV without a prior aortic valve replacement (AVR) were included. Transthoracic echocardiogram and 12‑lead resting-ECG were obtained. Associations between ECG parameters and the composite endpoint of all-cause mortality and AVR were assessed using Cox-proportional hazard analysis.</p></div><div><h3>Results</h3><p>120 patients with BAV were included (median age 30 years, 61% male). Median aortic jet velocity was 2.4 m/s [IQR: 1.7–3.4] and 5 patients (4%) had severe aortic regurgitation. All patients were in sinus rhythm. Any ECG abnormality was present in 57 patients (48%). Median PR-interval was 156 [IQR: 138–170] msec. A deviating QRS axis was found in 17 patients (14%) and Cornell criteria for LVH were fulfilled in 20 patients (17%). Repolarization abnormalities were present in 12 patients (10%). Median follow-up duration was 7.0 [6.3–9.8] years, during which 23 patients underwent AVR and 2 patients died. After adjusting for age, a longer PR-interval was associated with worse intervention-free survival (HR 1.02, 95% CI: 1.01–1.04).</p></div><div><h3>Conclusion</h3><p>Almost half of the patients with BAV had abnormalities on their ECG. Moreover, the PR-interval may be an interesting prognostic marker for intervention-free survival in BAV patients.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0022073624002309/pdfft?md5=1390aba17af0b5c5e675bb174af2803b&pid=1-s2.0-S0022073624002309-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852268","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}
Zuzana Koscova , Ali Bahrami Rad , Samaneh Nasiri , Matthew A. Reyna , Reza Sameni , Lynn M. Trotti , Haoqi Sun , Niels Turley , Katie L. Stone , Robert J. Thomas , Emmanuel Mignot , Brandon Westover , Gari D. Clifford
{"title":"From sleep patterns to heart rhythm: Predicting atrial fibrillation from overnight polysomnograms","authors":"Zuzana Koscova , Ali Bahrami Rad , Samaneh Nasiri , Matthew A. Reyna , Reza Sameni , Lynn M. Trotti , Haoqi Sun , Niels Turley , Katie L. Stone , Robert J. Thomas , Emmanuel Mignot , Brandon Westover , Gari D. Clifford","doi":"10.1016/j.jelectrocard.2024.153759","DOIUrl":"10.1016/j.jelectrocard.2024.153759","url":null,"abstract":"<div><h3>Background</h3><p>Atrial fibrillation (AF) is often asymptomatic and thus under-observed. Given the high risks of stroke and heart failure among patients with AF, early prediction and effective management are crucial. Given the prevalence of obstructive sleep apnea among AF patients, electrocardiogram (ECG) analysis from polysomnography (PSG) offers a unique opportunity for early AF prediction. Our aim is to identify individuals at high risk of AF development from single‑lead ECGs during standard PSG.</p></div><div><h3>Methods</h3><p>We analyzed 18,782 single‑lead ECG recordings from 13,609 subjects undergoing PSG at the Massachusetts General Hospital sleep laboratory. AF presence was identified using ICD-9/10 codes. The dataset included 15,913 recordings without AF history and 2054 recordings from patients diagnosed with AF between one month to fifteen years post-PSG. Data were partitioned into training, validation, and test cohorts ensuring that individual patients remained exclusive to each cohort. The test set was held out during the training process.</p><p>We employed two different methods for feature extraction to build a final model for AF prediction: Extraction of hand-crafted ECG features and a deep learning method. For extraction of ECG-hand-crafted features, recordings were split into 30-s windows, and those with a signal quality index (SQI) below 0.95 were discarded. From each remaining window, 150 features were extracted from the time, frequency, time-frequency domains, and phase-space reconstructions of the ECG. A compilation of 12 statistical features summarized these window-specific features per recording, resulting in 1800 features (12 × 150).</p><p>A pre-trained deep neural network from the PhysioNet Challenge 2021 was updated using transfer learning to discriminate recordings with and without AF. The model processed PSG ECGs in 16-s windows to generate AF probabilities, from which 13 statistical features were extracted. Combining 1800 features from feature extraction with 13 from the deep learning model, we performed a feature selection and subsequently trained a shallow neural network to predict future AF and evaluated its performance on the test cohort.</p></div><div><h3>Results</h3><p>On the test set, our model exhibited sensitivity, specificity, and precision of 0.67, 0.81, and 0.3, respectively, for AF prediction. Survival analysis revealed a hazard ratio of 8.36 (<em>p</em>-value: 1.93 × 10<sup>−52</sup>) for AF outcomes using the log-rank test.</p></div><div><h3>Conclusions</h3><p>Our proposed ECG analysis method, utilizing overnight PSG data, shows promise in AF prediction despite modest precision, suggesting false positives. This approach could enable low-cost screening and proactive treatment for high-risk patients. Refinements, including additional physiological parameters, may reduce false positives, enhancing clinical utility and accuracy.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788162","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":"Inferior ST elevation myocardial infarction with ST elevation in V1 and V6","authors":"Yochai Birnbaum MD , Kjell Nikus MD","doi":"10.1016/j.jelectrocard.2024.07.002","DOIUrl":"10.1016/j.jelectrocard.2024.07.002","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701837","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}
Ricardo Lopez Santi , Shyla Gupta , Adrian Baranchuk
{"title":"Artificial intelligence, the challenge of maintaining an active role","authors":"Ricardo Lopez Santi , Shyla Gupta , Adrian Baranchuk","doi":"10.1016/j.jelectrocard.2024.07.001","DOIUrl":"10.1016/j.jelectrocard.2024.07.001","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703347","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":"Enhancing ECG readability in LVAD patients: A comparative analysis of Denoising techniques with an emphasis on discrete wavelet transform.","authors":"","doi":"10.1016/j.jelectrocard.2024.06.044","DOIUrl":"10.1016/j.jelectrocard.2024.06.044","url":null,"abstract":"<div><h3>Background</h3><p><span>Electrocardiograms (ECGs) are vital for diagnosing cardiac conditions but obtaining clean signals in Left Ventricular Assist Device (LVAD) patients is hindered by </span>electromagnetic interference (EMI). Traditional filters have limited efficacy. There is a current need for an easy and effective method.</p></div><div><h3>Methods</h3><p><span>Raw ECG data obtained from 5 patients with LVADs. LVAD types included HeartMate II, III at multiple impeller speeds<span>, and a case with HeartMate III and a ProtekDuo. ECG spectral profiles were examined ensuring the presence of diverse types of EMI in the study. ECGs were then processed with four denoising techniques: </span></span>Moving Average Filter<span><span>, Finite Impulse Response Filter, </span>Fast Fourier Transform, and Discrete Wavelet Transform.</span></p></div><div><h3>Results</h3><p>Discrete Wavelet Transform proved as the most promising method. It offered a one solution fits all, enabling automatic processing with minimal user input while preserving crucial high-frequency components and reducing LVAD EMI artifacts.</p></div><div><h3>Conclusion</h3><p>Our study demonstrates the practicality and efficiency of Discrete Wavelet Transform in obtaining high-fidelity ECGs in LVAD patients. This method could enhance clinical diagnosis and monitoring.</p></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544909","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":"Deep learning model-enabled electrocardiogram to localize premature ventricular contractions in patients referred for catheter ablation","authors":"Abhishek Deshmukh, Tiffany Woelber","doi":"10.1016/j.jelectrocard.2024.06.010","DOIUrl":"10.1016/j.jelectrocard.2024.06.010","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952016","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}
Lukas Hughes-Noehrer , Alaa Alahmadi , Leda Channer , Adina Rahim , Richard Body , Caroline Jay
{"title":"Attitudes of clinicians to a ‘human-like’ explainable AI based on pseudo-colouring of ECGs that exposes life-threatening anomalies","authors":"Lukas Hughes-Noehrer , Alaa Alahmadi , Leda Channer , Adina Rahim , Richard Body , Caroline Jay","doi":"10.1016/j.jelectrocard.2024.06.009","DOIUrl":"10.1016/j.jelectrocard.2024.06.009","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952019","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}
Ingegerd Östman-Smith , Gunnar Sjöberg , Eszter Szepesvary , Jenny Alenius Dahlqvist , Per Larsson , Eva Fernlund
{"title":"Electrocardiographic phenotype as quantified by ECG Risk-score has higher predictive power than HCMRisk-Kids, PRIMACY and ESC HCM risk-calculators in childhood hypertrophic cardiomyopathy","authors":"Ingegerd Östman-Smith , Gunnar Sjöberg , Eszter Szepesvary , Jenny Alenius Dahlqvist , Per Larsson , Eva Fernlund","doi":"10.1016/j.jelectrocard.2024.06.011","DOIUrl":"10.1016/j.jelectrocard.2024.06.011","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952020","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}