Journal of electrocardiology最新文献

{"title":"Prediction of myocardial fibrosis in hypertrophic cardiomyopathy with machine learning: Insight into ECG analysis","authors":"İsa Ardahanlı , Ramazan Aslan , Murat Akdoğan , Onur Akgün , Ahmet Ardahanlı","doi":"10.1016/j.jelectrocard.2025.153926","DOIUrl":"10.1016/j.jelectrocard.2025.153926","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153926"},"PeriodicalIF":1.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848112","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 of the month: UNUSUAL ST elevation - What's the diagnosis?","authors":"Yuval Avidan MD , Asaf Danon MD, MSc","doi":"10.1016/j.jelectrocard.2025.153934","DOIUrl":"10.1016/j.jelectrocard.2025.153934","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153934"},"PeriodicalIF":1.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828909","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 narrow complex irregular tachycardia: What is the mechanism?","authors":"Matthew Lui MD,&nbsp;Kristen E. Wong MD,&nbsp;Timothy W. Smith DPhil, MD","doi":"10.1016/j.jelectrocard.2025.153928","DOIUrl":"10.1016/j.jelectrocard.2025.153928","url":null,"abstract":"<div><div>Identifying impaired atrioventricular conduction is useful in the diagnosis and management of cardiac arrhythmia. In this case, we present an electrocardiogram demonstrating a complex atrioventricular conduction pattern.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153928"},"PeriodicalIF":1.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838092","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 novel ECG based tool for diagnosing pericardial effusion: A case-control study","authors":"M. Biasin MD,&nbsp;N. Cordioli MD,&nbsp;J. Zaylah MD,&nbsp;A. Varriale MD,&nbsp;A. Comuzzi MD,&nbsp;M. Pilan MD,&nbsp;A. Gambaro MD, PhD,&nbsp;F. Ribichini Prof","doi":"10.1016/j.jelectrocard.2025.153927","DOIUrl":"10.1016/j.jelectrocard.2025.153927","url":null,"abstract":"<div><h3>Background</h3><div>Current electrocardiographic (ECG) criteria for diagnosing pericardial effusion are limited by low sensitivity. This study aimed to evaluate traditional ECG criteria within a contemporary patient cohort and to compare the diagnostic accuracy of a novel ECG-based score, the ARENA score, with conventional low-voltage criteria for the detection of pericardial effusion.</div></div><div><h3>Methods</h3><div>A retrospective case-control study was conducted at a university hospital, including consecutive patients who underwent both echocardiography and ECG, regardless of admission diagnosis. Patients were divided into derivation and validation cohorts, each comprising individuals with and without pericardial effusion (≥1.0 cm). ECGs were analyzed using traditional low-voltage criteria and the ARENA score, with sensitivity, specificity, accuracy and likelihood ratios calculated for both.</div></div><div><h3>Results</h3><div>A total of 244 patients were included, with 104 presenting with pericardial effusion and 140 without. These patients were divided into a derivation cohort (<em>n</em> = 100) and a validation cohort (<em>n</em> = 144). In the validation cohort, sensitivity was 5.6 % (95 % CI: 0.0 %–11.7 %) with traditional criteria and 51.9 % (95 % CI: 38.5 %–65.3 %) with the ARENA score (<em>p</em> &lt; 0.001). Specificity was 92.2 % (95 % CI: 86.7 %–97.8 %) for traditional criteria and 82.2 % (95 % CI: 74.3 %–90.1 %) for the ARENA score (<em>p</em> = 0.047). Accuracy in the validation cohort was 59.7 % (95 % CI: 51.7 %–67.7 %) for traditional criteria and 70.8 % (95 % CI: 63.4 %–78.2 %) for the ARENA score (<em>p</em> = 0.048).</div></div><div><h3>Conclusions</h3><div>The ARENA score demonstrates higher sensitivity and accuracy in detecting pericardial effusion compared to traditional low-voltage ECG criteria, though with a modest reduction in specificity.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153927"},"PeriodicalIF":1.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816975","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":"F-wave sway in paroxysmal and chronic atrial fibrillation","authors":"Agnese Sbrollini ,&nbsp;Massimo W. Rivolta ,&nbsp;Peter Van Dam ,&nbsp;Elisabetta Viani ,&nbsp;Micaela Morettini ,&nbsp;Roberto Sassi ,&nbsp;Laura Burattini ,&nbsp;Emanuela T. Locati","doi":"10.1016/j.jelectrocard.2025.153933","DOIUrl":"10.1016/j.jelectrocard.2025.153933","url":null,"abstract":"<div><div>Vectorcardiography (VCG) can evaluate the vector loops of electrocardiographic waves, being a time-spatial representation of the heart vector into the three orthonormal leads. During atrial fibrillation (AF), F waves reflect the disorganized depolarization of the atria, replacing the organized P wave. Usually, paroxysmal AF (PAF) spontaneously terminates, differently from chronic AF (CAF), possibly due to the still-preserved main direction of the P-wave vector loop. To investigate this hypothesis, this study aims to evaluate the similarities between the P-wave vector loop and F-wave vector sway in subjects affected by PAF and CAF. Overall, 10-s VCG were acquired from 10 healthy (HEA) subjects showing normal sinus rhythm, 10 subjects affected by PAF (one during normal sinus rhythm and one during AF), and 10 subjects affected by CAF. P waves were extracted using ECGdeli software, while F waves were extracted after QRST cancellation. Ellipse axes and eccentricities were calculated as the root mean square of VCG components and the ratio between axes, respectively. Overall, 84 beats of HEA, 205 beats of PAF (89 beats during normal sinus rhythm and 116 during fibrillation), and 103 beats of CAF were analyzed. Distributions of axes and eccentricities of PAF are not statistically different (<em>P</em>-value&gt;0.05) than normal sinus rhythm but features related to the Z axis of CAF were statistically lower than PAF (P-value〈10⁻³). F-wave vector sway in PAF resembles the P-wave vector loop, suggesting the maintenance of the atrial depolarization main direction in subjects with self-terminating AF. Moreover, the F-wave vector sway is more manifest in PAF than in CAF.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153933"},"PeriodicalIF":1.3,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833350","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 known high-risk p.R190Q KCNQ1-variant needs a second hit for QTc prolongation","authors":"Anton Karabinos ,&nbsp;Drahomira Schwartzova ,&nbsp;Renata Zemjarova Mezenska ,&nbsp;Miroslava Eckertova ,&nbsp;Ivana Lukacova ,&nbsp;Gabriela Magyarova ,&nbsp;Peter Krizan","doi":"10.1016/j.jelectrocard.2025.153924","DOIUrl":"10.1016/j.jelectrocard.2025.153924","url":null,"abstract":"<div><div>The heterozygous missense p.R190Q <em>KCNQ1</em> mutation represents one of the most frequent high-risk variants in long QT syndrome (LQTS). However, the presented case report and the data in literature led us to conclude that this heterozygous variant alone is associated with a low-penetrant clinical and electrocardiographical phenotype, while its co-inheritance with either the heterozygous p.E1053K <em>SCN5A</em> variant, some other LQTS-associated/modifying variant, or with some acquired QTc-inducing condition (like a specific leukaemia medication), may trigger QTc prolongation and thus a risk for arrhytmias.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153924"},"PeriodicalIF":1.3,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746867","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":"Positive T wave in lead aVR is associated with left atrial and ventricular function and cardiac outcomes in heart failure patients with preserved ejection fraction","authors":"Bektas Murat ,&nbsp;Selda Murat ,&nbsp;Fatih Aydın ,&nbsp;Muhammet Dural ,&nbsp;Halit Emre Yalvac ,&nbsp;Fatih Enes Durmaz ,&nbsp;Rabia Okumus ,&nbsp;Yuksel Cavusoglu","doi":"10.1016/j.jelectrocard.2025.153925","DOIUrl":"10.1016/j.jelectrocard.2025.153925","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure with preserved ejection fraction (HFpEF) accounts for a significant proportion of heart failure cases and is associated with high morbidity and mortality. While echocardiography plays a central role in HFpEF assessment, the prognostic value of electrocardiographic (ECG) findings, particularly in lead aVR, remains underexplored. This study investigates the relationship between a positive T wave in lead aVR (TaVR) and left atrial (LA) and left ventricular (LV) function, as well as its prognostic significance in HFpEF patients.</div></div><div><h3>Methods</h3><div>This retrospective study included 231 HFpEF patients diagnosed according to ESC guidelines. Patients underwent comprehensive echocardiography and 12‑lead ECG evaluation. Positive TaVR was defined as a T-wave amplitude ≥1 mm in lead aVR. LA and LV functions were assessed using LA reservoir strain (LASr) and LV global longitudinal strain (GLS), respectively. Multivariate Cox regression and Kaplan-Meier survival analyses were performed to evaluate the prognostic significance of TaVR.</div></div><div><h3>Results</h3><div>Positive TaVR was observed in 34.6 % of patients and was associated with impaired LASr (15.02 ± 6.65 % vs. 17.78 ± 9.10 %, <em>p</em> = 0.023) and LV GLS (−13.66 ± 3.49 % vs. -15.19 ± 3.02 %, <em>p</em> = 0.001). Positive TaVR independently predicted 1-year all-cause mortality (HR = 6.02, <em>p</em> &lt; 0.001) and 6-month all-cause mortality (HR = 9.67, p &lt; 0.001). Patients with positive TaVR had higher hospitalization rates and worse clinical outcomes.</div></div><div><h3>Conclusion</h3><div>Positive TaVR is associated with LA dysfunction, LV remodeling, and poor prognosis in HFpEF. Incorporating this ECG parameter into routine clinical assessments could enhance risk stratification and guide management strategies for HFpEF patients.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153925"},"PeriodicalIF":1.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143785189","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":"Abnormal P wave terminal force in lead V1 is correlated with adverse cardiac remodeling in patients with left ventricular noncompaction: A useful noninvasive indicator of disease severity","authors":"Huaibing Cheng MD ,&nbsp;Yangfei Xu MM ,&nbsp;Minjie Lu MD ,&nbsp;Gang Yin MS ,&nbsp;Fang Liu MM ,&nbsp;Wenxuan Zhai MM ,&nbsp;Jia He MM ,&nbsp;Lan Wang MB ,&nbsp;Chunfang Wang MM ,&nbsp;Hailan Chen MB ,&nbsp;Shihua Zhao MD ,&nbsp;Xiaohan Fan MD","doi":"10.1016/j.jelectrocard.2025.153923","DOIUrl":"10.1016/j.jelectrocard.2025.153923","url":null,"abstract":"<div><h3>Background</h3><div>Abnormal P wave terminal force in lead V1 (PTFV1) has been associated with adverse outcomes in various cardiovascular conditions. However, the potential role of PTFV1 in patients with left ventricular noncompaction (LVNC) has not been reported. Therefore, this study aims to investigate the prevalence of PTFV1 in patients with LVNC and explore its possible association with abnormalities in both the left atrium (LA) and left ventricle (LV).</div></div><div><h3>Methods</h3><div>From January 2016 to December 2017, 93 patients diagnosed with LVNC via cardiovascular magnetic resonance (CMR) were enrolled in the study. Clinical, echocardiographic, CMR, and electrocardiogram data were retrospectively collected and analyzed independently.</div></div><div><h3>Results</h3><div>The mean age of the 93 patients at diagnosis was 44.3 ± 13.9 years, with 64.5 % being male. Abnormal PTFV1 was present in 23.6 % of the patients. Those with abnormal PTFV1 had significantly higher rates of NYHA functional class III or IV (86.4 % vs. 19.7 %, <em>p</em> &lt; 0.001), LV thrombus (9.0 % vs. 4.2 %, <em>p</em> = 0.049), and late gadolinium enhancement (63.6 % vs. 33.8 %, <em>p</em> = 0.013). These patients also had significantly greater mitral regurgitation grades, larger LA and LV volume indices, and lower LV ejection fraction (LVEF). Receiver operating characteristic curve analysis showed moderate-to-high area under the curve (AUC) values (ranging from 0.72 to 0.83) for various indices in identifying abnormal PTFV1, with LVEF showing the highest AUC of 0.83. Binary logistic regression identified LVEF as the only independent factor associated with abnormal PTFV1 (OR = 0.89, <em>p</em> = 0.003).</div></div><div><h3>Conclusion</h3><div>Abnormal PTFV1, observed in approximately one-quarter of LVNC patients, is linked to more severe cardiac remodeling and dysfunction, and its presence can be predicted by a reduced LVEF.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153923"},"PeriodicalIF":1.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683050","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":"Fentanyl-induced Brugada phenocopy: A case report","authors":"Serhat Kesriklioglu ,&nbsp;Sener Gur ,&nbsp;Ahmet Taha Sahin ,&nbsp;Ahmet Lutfu Sertdemir ,&nbsp;Enes Elvin Gul","doi":"10.1016/j.jelectrocard.2025.153922","DOIUrl":"10.1016/j.jelectrocard.2025.153922","url":null,"abstract":"<div><div>Brugada Syndrome (BrS) is a genetic condition characterized by specific electrocardiographic (ECG) findings and an increased risk of life-threatening arrhythmias. Brugada phenocopy (BrP) refers to reversible ECG changes mimicking BrS caused by external factors, such as drugs or metabolic disturbances. Here, we present a case of a 45-year-old male with Brugada phenocopy due to high-dose of fentanyl transdermal patch.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153922"},"PeriodicalIF":1.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636513","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":"An unclassifiable case of advanced interatrial block after dialysis treatment","authors":"Marco Marano ,&nbsp;Luigi Senigalliesi ,&nbsp;Vincenzo Russo","doi":"10.1016/j.jelectrocard.2025.153910","DOIUrl":"10.1016/j.jelectrocard.2025.153910","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"90 ","pages":"Article 153910"},"PeriodicalIF":1.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636511","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}