{"title":"[Artificial intelligence-enhanced electrocardiography : Will it revolutionize diagnosis and management of our patients?]","authors":"Wilhelm Haverkamp, Nils Strodthoff","doi":"10.1007/s00399-024-00997-0","DOIUrl":"10.1007/s00399-024-00997-0","url":null,"abstract":"<p><p>The use of artificial intelligence (AI) in healthcare has made significant progress in the last 10 years. Many experts believe that utilization of AI technologies, especially deep learning, will bring about drastic changes in how physicians understand, diagnose, and treat diseases. One aspect of this development is AI-enhanced electrocardiography (ECG) analysis. It involves not only optimizing the traditional ECG analysis by the physician and improving the accuracy of automatic interpretation by the ECG device but also introducing entirely new diagnostic options enabled by AI. Examples include assessing left ventricular function, predicting atrial fibrillation, and diagnosing both cardiac and noncardiac conditions. Through AI, the ECG becomes a comprehensive tool for screening, diagnosis, and patient management, potentially revolutionizing clinical practices. This paper provides an overview of the current state of this development, discusses existing limitations, and explores the challenges that may arise for healthcare professionals in this context.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"104-110"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mitteilungen aus der Arbeitsgruppe Elektrophysiologie und Rhythmologie (AGEP).","authors":"","doi":"10.1007/s00399-024-01017-x","DOIUrl":"https://doi.org/10.1007/s00399-024-01017-x","url":null,"abstract":"","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":"35 2","pages":"172-173"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Konstantinos Iliodromitis, Bernd Lemke, Sebastian Robl, Harilaos Bogossian
{"title":"Interrogating a biventricular pacemaker: the importance of 12-lead electrocardiogram.","authors":"Konstantinos Iliodromitis, Bernd Lemke, Sebastian Robl, Harilaos Bogossian","doi":"10.1007/s00399-024-01021-1","DOIUrl":"10.1007/s00399-024-01021-1","url":null,"abstract":"","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"152-154"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Digital competence in rhythmology : Training and education].","authors":"Mahdi Emrani, Matthias Daniel Zink","doi":"10.1007/s00399-024-00990-7","DOIUrl":"10.1007/s00399-024-00990-7","url":null,"abstract":"<p><strong>Background: </strong>The digital transformation in medicine, particularly in technology-orientated areas such as rhythmology, is leading to a rapid change in diagnostic and therapeutic options. Digital skills are helpful and need to keep up with this pace of change.</p><p><strong>Research question: </strong>Which digital technologies and resources with rhythmological relevance play a role today and in the future?</p><p><strong>Methods: </strong>Review of the various digital technologies for rhythm detection and monitoring, as well as current digital resources for training and education.</p><p><strong>Results: </strong>Rhythm detection and monitoring can be optimized with smart devices and telemedicine, while digital platforms such as social media and virtual reality offer new perspectives in the training of rhythmology specialists.</p><p><strong>Conclusion: </strong>Acquiring digital skills will be the basis for future work in rhythmology.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"124-131"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonas Wörmann, David Duncker, Till Althoff, Christian Heeger, Roland Tilz, Heidi Estner, Andreas Rillig, Philipp Sommer, Leon Iden, Victoria Johnson, K R Julian Chun, Henning Jansen, Tilman Maurer, Sonia Busch, Daniel Steven
{"title":"[Lead placement in cardiac implantable electronic devices].","authors":"Jonas Wörmann, David Duncker, Till Althoff, Christian Heeger, Roland Tilz, Heidi Estner, Andreas Rillig, Philipp Sommer, Leon Iden, Victoria Johnson, K R Julian Chun, Henning Jansen, Tilman Maurer, Sonia Busch, Daniel Steven","doi":"10.1007/s00399-024-01019-9","DOIUrl":"10.1007/s00399-024-01019-9","url":null,"abstract":"<p><p>The implantation of electrodes for cardiac implantable electronic devices (CIED) requires profound technical understanding and precise execution. The positioning of electrodes in the right ventricle and atrium has significant implications for patient safety and the effectiveness of CIED therapy. Particular focus is given to the distinction between apical and septal stimulation in ventricular positioning. Based on current data, this article provides a practice-oriented guide that leads implanters through the individual steps of electrode positioning. The implantation of electrodes for physiological stimulation (cardiac resynchronization therapy, CRT, and conduction system pacing, CSP) is not addressed in this article.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"155-164"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Successful catheter ablation of atrial tachycardia initiated with orthodromic capture of superior vena cava potentials.","authors":"Kohei Ukita, Yasuyuki Egami, Yasuharu Matsunaga-Lee, Masamichi Yano, Masami Nishino","doi":"10.1007/s00399-024-01023-z","DOIUrl":"10.1007/s00399-024-01023-z","url":null,"abstract":"<p><p>A case of successful catheter ablation of paroxysmal atrial fibrillation and atrial tachycardia is reported. After pulmonary vein isolation, atrial tachycardia was induced by the use of isoproterenol and burst pacing from the catheter in the right atrium. An attempt was made to create a three-dimensional (3D) map of the atrial tachycardia, but the atrial tachycardia was terminated in the middle of the mapping. The 3D map was insufficient but indicated that the superior vena cava was involved in the circuit. When the intracardiac electrograms were reviewed, it was found that the atrial tachycardia was initiated with orthodromic capture of superior vena cava potentials and it was considered that the atrial tachycardia involved the superior vena cava-right atrium junction. Accordingly, superior vena cava isolation was performed. After that, atrial fibrillation and atrial tachycardias were not induced by the use of isoproterenol and burst pacing. In this case, an intracardiac electrogram at the time of induction of the tachycardia was helpful for understanding the circuit of the tachycardia.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"148-151"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthijs J M Cluitmans, Gernot Plank, Jordi Heijman
{"title":"Digital twins for cardiac electrophysiology: state of the art and future challenges.","authors":"Matthijs J M Cluitmans, Gernot Plank, Jordi Heijman","doi":"10.1007/s00399-024-01014-0","DOIUrl":"10.1007/s00399-024-01014-0","url":null,"abstract":"<p><p>Cardiac arrhythmias remain a major cause of death and disability. Current antiarrhythmic therapies are effective to only a limited extent, likely in large part due to their mechanism-independent approach. Precision cardiology aims to deliver targeted therapy for an individual patient to maximize efficacy and minimize adverse effects. In-silico digital twins have emerged as a promising strategy to realize the vision of precision cardiology. While there is no uniform definition of a digital twin, it typically employs digital tools, including simulations of mechanistic computer models, based on patient-specific clinical data to understand arrhythmia mechanisms and/or make clinically relevant predictions. Digital twins have become part of routine clinical practice in the setting of interventional cardiology, where commercially available services use digital twins to non-invasively determine the severity of stenosis (computed tomography-based fractional flow reserve). Although routine clinical application has not been achieved for cardiac arrhythmia management, significant progress towards digital twins for cardiac electrophysiology has been made in recent years. At the same time, significant technical and clinical challenges remain. This article provides a short overview of the history of digital twins for cardiac electrophysiology, including recent applications for the prediction of sudden cardiac death risk and the tailoring of rhythm control in atrial fibrillation. The authors highlight the current challenges for routine clinical application and discuss how overcoming these challenges may allow digital twins to enable a significant precision medicine-based advancement in cardiac arrhythmia management.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"118-123"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11161534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Digital precision medicine in rhythmology : Risk prediction of recurrences, sudden cardiac death, and outcome].","authors":"Ann-Kathrin Rahm, Patrick Lugenbiel","doi":"10.1007/s00399-024-01015-z","DOIUrl":"10.1007/s00399-024-01015-z","url":null,"abstract":"<p><p>Digital precision medicine is gaining increasing importance in rhythmology, especially in the treatment of cardiac arrhythmias. This trend is driven by the advancing digitization in healthcare and the availability of large amounts of data from various sources such as electrocardiograms (ECGs), implants like pacemakers and implantable cardioverter-defibrillators (ICDs), as well as wearables like smartwatches and fitness trackers. Through the analysis of this data, physicians can develop more precise and individualized diagnoses and treatment strategies for patients with cardiac arrhythmias. For example, subtle changes in ECGs can be identified, indicating potentially dangerous arrhythmias. Genetic analyses and resulting large datasets also play an increasingly significant role, especially in hereditary ion channel disorders such as long QT syndrome (LQTS) and Brugada syndrome (BrS), as well as in lone atrial fibrillation (AF). Precision medicine enables the development of individualized treatment approaches tailored to the specific needs and risk factors of each patient. This can help improve screening strategies, reduce adverse events, and ultimately enhance the quality of life for patients. Technological advancements such as big data, artificial intelligence, machine learning, and predictive analytics play a crucial role in predicting the risk of arrhythmias and sudden cardiac death. These concepts enable more precise and personalized predictions and support physicians in the treatment and monitoring of their patients.</p>","PeriodicalId":52403,"journal":{"name":"Herzschrittmachertherapie und Elektrophysiologie","volume":" ","pages":"97-103"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}