Annals of Noninvasive Electrocardiology最新文献

{"title":"Commentary on \"Electrocardiographic Predictors of Major Adverse Cardiovascular Events in Women With Suspected Ischemia and No Obstructive Coronary Artery Disease: Results of the Women's Ischemia Syndrome Evaluation\".","authors":"Fatih Enes Durmaz, Bülent Görenek","doi":"10.1111/anec.70194","DOIUrl":"https://doi.org/10.1111/anec.70194","url":null,"abstract":"","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":"e70194"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760406","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}

{"title":"Reconsidering the Role of Resting Heart Rate as a Sole Electrocardiographic Predictor of MACE in Women With INOCA.","authors":"Ahmet Yılmaz","doi":"10.1111/anec.70193","DOIUrl":"https://doi.org/10.1111/anec.70193","url":null,"abstract":"","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":"e70193"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760449","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}

{"title":"Extraction of Acoustic Features via Empirical Wavelet Transform to Determine Stenosis Degree of the Left Anterior Descending Artery Based on the Diastolic Heart Sounds of 75 Participants.","authors":"Haixia Li, Yafang Zhang, Guofeng Ren, Yun Tian, Yan Chai, Xiaoyan Wang","doi":"10.1111/anec.70195","DOIUrl":"https://doi.org/10.1111/anec.70195","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to develop a method for extracting acoustic features to assess left anterior descending artery (LAD) stenosis severity.</p><p><strong>Methods: </strong>Heart sound data were collected from 75 participants (10 diastoles per participant) using a high-signal-to-noise ratio micro-electro-mechanical systems stethoscope. The diastolic signals were preprocessed, and empirical wavelet transform was applied to decompose their power spectra into three modes (0-150, 150-500, and > 500 Hz). The spectral energies (e(1), e(2), e(3)) of these modes were analyzed, and support vector machine (SVM) and extreme gradient boosting (XGBoost) machine learning algorithms were used to classify LAD stenosis into mild (< 50%), moderate (50%-75%), and severe (> 75%).</p><p><strong>Results: </strong>Spectral energies e(2) and e(3) significantly increased with stenosis severity, and XGBoost outperformed SVM, achieving a test accuracy of 0.8133 and areas under the curve of 0.9358, 0.9644, and 0.9580 for mild, moderate, and severe stenosis, respectively.</p><p><strong>Conclusion: </strong>Empirical wavelet transform-extracted spectral energies of e(2) and e(3), combined with XGBoost, effectively determine LAD stenosis degree, offering a non-invasive screening tool.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":"e70195"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809913","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}

{"title":"Letter to the Editor: Regarding Electrocardiographic Predictors of Major Adverse Cardiovascular Events in Women With INOCA.","authors":"Oguz Kaan Kaya","doi":"10.1111/anec.70191","DOIUrl":"https://doi.org/10.1111/anec.70191","url":null,"abstract":"","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":"e70191"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760431","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}

{"title":"Letter to the Editor Regarding The Effects of Supraphysiological Estrogen Levels Observed During In Vitro Fertilization Treatment on Cardiac Electrophysiology.","authors":"Yongchao Huang","doi":"10.1111/anec.70192","DOIUrl":"https://doi.org/10.1111/anec.70192","url":null,"abstract":"","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":"e70192"},"PeriodicalIF":1.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760420","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}

{"title":"Conduction System Pacing-Induced Ventricular Arrhythmia: Case Report","authors":"Serhat Kesriklioglu,&nbsp;Ahmet Taha Sahin,&nbsp;Mertcan Gezer,&nbsp;Mustafa Celik,&nbsp;Ahmet Lutfu Sertdemir,&nbsp;Enes Elvin Gul","doi":"10.1111/anec.70190","DOIUrl":"10.1111/anec.70190","url":null,"abstract":"<p>Left bundle branch–optimized cardiac resynchronization therapy (LOT-CRT), combining left bundle branch area pacing (LBBAP) with a left ventricular lead, offers physiological activation and improved synchrony compared with conventional biventricular pacing. We report a 78-year-old woman with pacing-induced cardiomyopathy who underwent LOT-CRT, resulting in QRS narrowing but notable QT prolongation and T-wave inversions. On the first post-implant day, she developed ventricular fibrillation triggered by premature ventricular complexes, without reversible metabolic or ischemic cause. This case highlights the potential for early post-procedural ventricular arrhythmias in structurally compromised ventricles, underscoring the importance of vigilant monitoring and individualized risk assessment following LOT-CRT.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669593","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}

{"title":"Stabilizing Extreme Few-Shot ECG Classification via Self-Supervised Contrastive Pretraining","authors":"LiuPing Zeng,&nbsp;JingMei Pan,&nbsp;YangJie Lu,&nbsp;Xian Pan","doi":"10.1111/anec.70188","DOIUrl":"10.1111/anec.70188","url":null,"abstract":"<p>In clinical electrocardiogram (ECG) analysis, high-quality annotations are expensive and difficult to scale, leaving many tasks in an extreme few-shot learning regime. We formulate a single-label Top-5 rhythm classification task on PTB-XL and strictly limit supervised training to <i>N</i> = 70 labeled samples (14 per class) to characterize failure modes of scratch training and assess the stabilizing effect of self-supervised learning (SSL). We first perform SimCLR-style contrastive pretraining with the NT-Xent loss on 16,304 unlabeled ECG recordings, followed by supervised fine-tuning. To isolate the independent contribution of SSL initialization, downstream augmentation is disabled (NoAug) in the core evaluation. Performance and stability are assessed using Macro-F1, best validation epoch, and a collapse rate defined as Best Epoch ≤ 1. Under <i>N</i> = 70, scratch training exhibits systematic early collapse (Macro-F1 = 0.115 ± 0.072; collapse rate = 66.7%), which is not alleviated by strong downstream augmentation alone (0.108 ± 0.042; 66.7%). In contrast, SSL fine-tuning without downstream augmentation improves Macro-F1 to 0.192 ± 0.003 and reduces the collapse rate to 0%, with markedly reduced inter-seed variance. A balanced <i>N</i> = 300 reference achieves Macro-F1 = 0.297 ± 0.018. These results indicate that, in extreme few-shot ECG classification, the primary bottleneck is training reproducibility rather than peak accuracy, and SSL contrastive pretraining provides a robust initialization that substantially mitigates collapse and improves usability.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669613","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}

{"title":"Comparative Outcomes of ICE Versus TEE/Fluoroscopy Guidance Transseptal Puncture in LA Procedures: A Systematic Review and Meta-Analysis","authors":"Asim Mohammed Eldai Abdalla,&nbsp;Kolluru Pavani Durga,&nbsp;Animisha Chukka,&nbsp;Mounika Kotte,&nbsp;Muhammad Awais,&nbsp;Abida Perveen,&nbsp;Jahanzeb Malik","doi":"10.1111/anec.70186","DOIUrl":"10.1111/anec.70186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the comparative efficacy, safety, and radiation exposure outcomes of intracardiac echocardiography (ICE)-guided versus TEE/fluoroscopy-guided trans-septal puncture (TSP) in left atrial procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of randomized and observational studies comparing ICE-guided with TEE- or fluoroscopy-only–guided TSP. Eight studies encompassing over 9000 patients undergoing atrial fibrillation (AF) ablation or left atrial appendage occlusion (LAAO) were included. Primary endpoints were fluoroscopy time, radiation dose, first-pass success, puncture time, total procedure time, and major safety outcomes. Random-effects models were used to pool mean differences or hazard ratios with 95% confidence intervals (CIs). Risk of bias was assessed using validated tools, and funnel plots with sensitivity analyses evaluated robustness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ICE guidance significantly reduced fluoroscopy time (MD –2.07 min, 95% CI –2.37 to −1.77; <i>p</i> &lt; 0.001) and radiation dose (MD –2.30, 95% CI –3.27 to −1.27; <i>p</i> &lt; 0.001). First-pass success and total procedure time were comparable between groups. Safety endpoints, including tamponade, pericardial effusion, and composite major adverse events, showed no significant increase with ICE. Funnel plots and leave-one-out analyses confirmed the stability of results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ICE-guided TSP reduces radiation exposure without compromising efficacy or safety, supporting its adoption as a valuable imaging modality in left atrial interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637827","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}

{"title":"Comment on “Outcomes of Supraclavicular Access in Temporary Pacemaker Implantation”","authors":"Ezgi Çamlı Babayiğit,&nbsp;Erdi Babayiğit,&nbsp;Bülent Görenek","doi":"10.1111/anec.70179","DOIUrl":"10.1111/anec.70179","url":null,"abstract":"&lt;p&gt;We read with great interest the article by Ben Yezza et al. entitled Outcomes of Supraclavicular Access in Temporary Pacemaker Implantation (Yezza et al. &lt;span&gt;2026&lt;/span&gt;). The authors should be commended for addressing an important yet relatively underexplored venous access route in urgent pacing scenarios.&lt;/p&gt;&lt;p&gt;The study highlights the feasibility and high procedural success of the supraclavicular approach, with a reportedly low complication profile. Given the ongoing search for safer and faster vascular access in critically ill patients requiring temporary pacing, these findings are clinically relevant and timely. The straight anatomical course to the brachiocephalic vein and the potential for improved lead stability are particularly noteworthy advantages emphasized by the authors.&lt;/p&gt;&lt;p&gt;However, several methodological points merit clarifications. First, the study design defines the infraclavicular group as patients who underwent femoral venous access. In this context, the reported higher pneumothorax rate in the infraclavicular group appears unexpected, given that pneumothorax is exceedingly rare with femoral cannulation. Clarification of the exact access routes included in each group and the attribution of access-related complications would help readers interpret these findings more accurately.&lt;/p&gt;&lt;p&gt;Second, the authors state that both supraclavicular and femoral procedures were performed by the same cardiology team and that operator experience was accounted for in the statistical analysis to minimize variability. However, the presentation of operator experience within the baseline characteristics table raises questions regarding how this variable was modeled and adjusted for in the comparative analysis. Providing additional details on whether operator experience was treated as a covariate, stratification factor, or matching variable would strengthen confidence in the internal validity of the results.&lt;/p&gt;&lt;p&gt;An additional anatomical consideration that warrants discussion is the presence of persistent superior vena cava, particularly persistent left superior vena cava (PLSVC) (Hassine et al. &lt;span&gt;2015&lt;/span&gt;). The manuscript notes that procedures were performed via right-sided access, which may have mitigated some of the technical challenges associated with venous anomalies. However, in clinical practice—especially when left supraclavicular access is used—PLSVC can substantially alter lead trajectory via the coronary sinus and increase procedural complexity. Explicit discussion of how the findings might translate to left-sided supraclavicular approaches would further enhance the generalizability and practical relevance of the study.&lt;/p&gt;&lt;p&gt;Despite these limitations, the authors provide valuable data supporting supraclavicular venous access as a viable alternative for temporary pacing. We congratulate the authors on their contribution and look forward to further comparative studies that will help better define the role of this approach in ","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589538","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}

{"title":"Post-ROSC ST-Segment Elevation: A Diagnostic Pitfall in Cardiac Arrest Survivors","authors":"Oğuz Kaan Kaya","doi":"10.1111/anec.70187","DOIUrl":"10.1111/anec.70187","url":null,"abstract":"<p>ST-segment elevation detected immediately after return of spontaneous circulation (ROSC) in survivors of cardiac arrest frequently raises concern for acute coronary occlusion and often leads to urgent coronary angiography. However, accumulating evidence suggests that transient ST-segment elevation in this setting does not always represent an acute culprit coronary lesion.</p><p>Several mechanisms may contribute to ST-segment elevation following ROSC. Global myocardial ischemia during cardiac arrest and subsequent reperfusion injury can produce transient repolarization abnormalities. In addition, severe metabolic disturbances, catecholamine surge, and myocardial stunning may alter myocardial electrical activity and mimic electrocardiographic patterns typically associated with acute coronary occlusion (Lemkes et al. <span>2019</span>; Spaulding et al. <span>1997</span>). These mechanisms may result in transient ST-segment elevation despite the absence of obstructive coronary artery disease.</p><p>Importantly, studies evaluating coronary angiography after cardiac arrest have demonstrated that a substantial proportion of patients without ST-segment elevation do not have an acute culprit lesion, highlighting the complexity of electrocardiographic interpretation in the post-resuscitation phase (Lemkes et al. <span>2019</span>). Conversely, transient ST-segment elevation immediately after ROSC may occasionally reflect global ischemia or reperfusion-related electrical instability rather than true ST-elevation myocardial infarction.</p><p>While early coronary angiography remains essential in many patients with suspected acute coronary syndrome, reliance solely on ST-segment elevation immediately after ROSC may occasionally lead to diagnostic uncertainty. Careful integration of clinical findings, hemodynamic status, echocardiographic assessment, and serial electrocardiograms may help distinguish transient post-resuscitation ECG changes from true coronary occlusion (Ibanez et al. <span>2018</span>).</p><p>Greater awareness of this diagnostic challenge may improve interpretation of electrocardiographic findings after cardiac arrest and help guide more individualized decision-making regarding coronary angiography in cardiac arrest survivors.</p><p>The author declares no conflicts of interest.</p><p>The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589563","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}