Journal of electrocardiology最新文献

{"title":"Narrow QRS tachycardia? What is the diagnosis?","authors":"Victoria Fanucci B.S. , Utkarsh Kohli M.D","doi":"10.1016/j.jelectrocard.2025.154146","DOIUrl":"10.1016/j.jelectrocard.2025.154146","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154146"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266162","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":"Two beats for one: A hidden fire in the conduction system","authors":"Albert Roig MD , Antonio Thomaz de Andrade MD , Pedro Yuri Paiva Lima MD","doi":"10.1016/j.jelectrocard.2025.154152","DOIUrl":"10.1016/j.jelectrocard.2025.154152","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154152"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458834","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 uncommon ECG presentation of post-Fontan patient: ECG challenge","authors":"Atul Kaushik ,&nbsp;Aparna Jaswal ,&nbsp;Anita Saxena ,&nbsp;Akshay Aggrawal","doi":"10.1016/j.jelectrocard.2025.154151","DOIUrl":"10.1016/j.jelectrocard.2025.154151","url":null,"abstract":"<div><div>We report a 26-year patient with univentricular physiology who underwent bidirectional Glenn with left pulmonary artery plasty followed by pulmonary artery stenting and finally underwent fenestrated extra-cardiac Fontan operation at age of 5 years. He was asymptomatic with an interesting ECG with atrial ectopic at presentation. We try to explain the basic mechanism and patterns of arrythmias in post-Fontan patients.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154151"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145481655","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":"QT and RR interval analysis in genetic cardiac diseases using the AccuQT and advanced heart rate variability methods","authors":"Aliisa Lönnrot ,&nbsp;Matias Kanniainen ,&nbsp;Teemu Pukkila ,&nbsp;Mary Vaarpu ,&nbsp;Katriina Aalto-Setälä ,&nbsp;Esa Räsänen","doi":"10.1016/j.jelectrocard.2025.154098","DOIUrl":"10.1016/j.jelectrocard.2025.154098","url":null,"abstract":"<div><div>The QT interval is a key indicator in assessing arrhythmia risk, evaluating drug safety, and supporting clinical diagnosis in cardiology. The QT interval is significantly influenced by heart rate so it must be accurately corrected to ensure reliable clinical interpretation. Conventional correction formulas, such as Bazett's formula, are widely utilized but often criticized for inaccuracies, either under- or overcorrecting QT intervals in different physiological conditions. The recently developed AccuQT method, utilizing transfer entropy for QT correction, has demonstrated superior consistency in healthy populations and improved accuracy in diagnosing long QT syndrome (LQTS) compared to conventional approaches.</div><div>In this study, we evaluate the AccuQT method using 24-h Holter recordings from patients with various genetic heart diseases, including hypertrophic cardiomyopathy (HCM) and LQTS, compared to the healthy controls. Additionally, we analyzed heart rate variability with the recently developed scaled-dependent detrended fluctuation analysis (DFA).</div><div>The mean QTc using the AccuQT method in the patient group was significantly longer (476 ms) than in the healthy population (410 ms), as expected. The Bazett's formula resulted in significantly longer mean QTc in the healthy population (460 ms) and in patient group (490 ms). The DFA scaling exponent was lower at short scales for patient group compared to healthy controls. It also detected a difference between HCM patients with clinical disease and asymptomatic gene carriers with no signs of the disease.</div><div>In conclusion, the AccuQT method provides reliable QT interval correction in patients with genetic cardiac diseases, demonstrating superior precision compared to Bazett's formula. AccuQT effectively captures time-dependent QT interval changes, enhancing diagnostic accuracy. Additionally, scale-dependent DFA analysis shows promise in differentiating patients with clinical hypertrophic cardiomyopathy from asymptomatic gene carriers, suggesting potential utility in earlier identification of at-risk individuals.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154098"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010887","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":"Diagnostic accuracy of atrial fibrillation by computerized electrocardiogram analysis versus cardiologist interpretation","authors":"José Escabí-Mendoza MD,&nbsp;Norwin Rivera-Guzmán MD,&nbsp;Jaime Rivera-Babilonia MD,&nbsp;Jorge Martínez-Díaz MD,&nbsp;María R. Cochran-Pérez MD,&nbsp;Jonathan X. Rodríguez-Santiago MD,&nbsp;Gerardo Jovet-Toledo,&nbsp;Andrew Engel-Rodriguez MD","doi":"10.1016/j.jelectrocard.2025.154147","DOIUrl":"10.1016/j.jelectrocard.2025.154147","url":null,"abstract":"<div><h3>Background</h3><div>Advancements in computerized electrocardiogram (ECG) interpretation have improved efficiency, but concerns remain regarding diagnostic accuracy for atrial fibrillation (AF). Misclassification may result in inappropriate treatment and adverse outcomes.</div></div><div><h3>Objectives</h3><div>To compare the diagnostic accuracy of computerized ECG interpretation versus cardiologist over-read for AF and evaluate the clinical consequences of diagnostic errors.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of 5000 ECGs obtained at the Veterans Affairs Caribbean Healthcare System between September and November 2017. All ECGs were initially interpreted by automated software. A subset of 905 ECGs underwent over-read at the time of care. Separately, two board-certified cardiologists independently reviewed all 5000 ECGs in a blinded fashion and completed standardized interpretation forms. Diagnostic metrics were compared using 2-proportion z-tests and McNemar's test. Logistic regression identified predictors of misclassification. Clinical records were reviewed for treatment consequences.</div></div><div><h3>Results</h3><div>Computerized interpretation identified 803 (16 %) AF-related ECGs; of these, 70 % were true AF, 11 % false positives, and 19 % false negatives. Cardiologist interpretation showed higher accuracy: sensitivity 87 % vs. 78 %, specificity 99 % vs. 97 %, PPV 98 % vs. 86 %, NPV 99 % vs. 97 % (all <em>p</em> &lt; 0.01). Ventricular pacing (OR 10.2), undetermined rhythm (OR 13.4), and tachycardia (OR 1.8) independently predicted misclassification (<em>p</em> &lt; 0.001). Among misclassified ECGs, 41 % of errors were unrecognized, leading to delayed anticoagulation (18 %), inappropriate initiation (12 %), and three adverse events.</div></div><div><h3>Conclusions</h3><div>Computerized ECG interpretation of AF is prone to diagnostic error. Cardiologist over-read improves accuracy and may reduce preventable harm.</div></div><div><h3>Condensed abstract</h3><div>Computerized ECG interpretation misclassified AF in 30 % of cases, 11 % overcalls and 19 % missed diagnoses. Cardiologist over-reading demonstrated superior accuracy (87 % sensitivity, 99 % specificity), minimizing both false positives and negatives. In 41 % of erroneous computer interpretations, providers failed to recognize the error, leading to delayed anticoagulation, inappropriate therapy, two thromboembolic events, and one bleeding-related hospitalization. Ventricular pacing, undetermined rhythms, and tachycardia were key predictors of misclassification. These findings highlight the limitations of automated ECG analysis and support structured cardiologist over-read to safeguard against diagnostic errors and improve patient outcomes in AF detection.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154147"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421903","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":"Triphasic QRS morphology: What is the mechanism?","authors":"Hans C. Helseth BA ,&nbsp;William H. Frick MD","doi":"10.1016/j.jelectrocard.2025.154128","DOIUrl":"10.1016/j.jelectrocard.2025.154128","url":null,"abstract":"<div><div>We present an electrocardiogram with triphasic QRS morphology variation and discuss the mechanism and clinical implications for this finding.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154128"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086353","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":"Novel presentation of CACNA1C variant as neonatal complete atrioventricular block, heart failure and non-compaction cardiomyopathy with oligogenic influences","authors":"Sydney R. Rooney MD ,&nbsp;Brock Karolcik MD ,&nbsp;Shawn West MD ,&nbsp;Christopher Follansbee MD ,&nbsp;Mousumi Moulik MD ,&nbsp;Gaurav Arora MD","doi":"10.1016/j.jelectrocard.2025.154139","DOIUrl":"10.1016/j.jelectrocard.2025.154139","url":null,"abstract":"<div><div>Pathogenic CACNA1C variants are associated with long QT syndrome, cardiac conduction disorders (CCD), short QT or Brugada syndromes, sudden cardiac death, and rarely hypertrophic cardiomyopathy. Neonatal complete AV block (CAVB) has not been previously reported in patients with CACNA1C-mutations. We present a neonate with CAVB, severe heart failure, and non-compaction cardiomyopathy, found to have a de novo, likely pathogenic, heterozygous CACNA1C variant and heterozygous variants of uncertain significance (VUS) in TNNI3K, GATA6, and PDHK1 genes. This case expands the CACNA1C-associated phenotype to include neonatal CAVB and suggests a potential oligogenic contribution to severe neonatal cardiac disease.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154139"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244534","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":"U wave manifesting in alternating beats: The bigeminal U wave. Can the U wave and the P wave be related?","authors":"Francesco Luzza MD,&nbsp;Francesco Catanzariti MD,&nbsp;Michela Navarra MD,&nbsp;Pietro Pugliatti MD","doi":"10.1016/j.jelectrocard.2025.154110","DOIUrl":"10.1016/j.jelectrocard.2025.154110","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154110"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080776","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 reflects anatomical-electrophysiological-related ischemia—not a signature of remote ischemic preconditioning","authors":"Zhong-Qun Zhan","doi":"10.1016/j.jelectrocard.2025.154111","DOIUrl":"10.1016/j.jelectrocard.2025.154111","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154111"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060861","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":"Short-term repeatability of artificial intelligence estimated electrocardiographic age","authors":"Katherine M. Conners ,&nbsp;Varun Divi ,&nbsp;Elsayed Z. Soliman ,&nbsp;Annie Green Howard ,&nbsp;Eric A. Whitsel ,&nbsp;Didong Li ,&nbsp;Michelle L. Meyer ,&nbsp;Shaaf Ahmad ,&nbsp;Christy L. Avery ,&nbsp;Faisal F. Syed","doi":"10.1016/j.jelectrocard.2025.154153","DOIUrl":"10.1016/j.jelectrocard.2025.154153","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"93 ","pages":"Article 154153"},"PeriodicalIF":1.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512967","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}