Annals of Noninvasive Electrocardiology最新文献

{"title":"Trends and In-Hospital Outcomes of Ventricular Tachycardia in Ischemic Versus Non-Ischemic Dilated Cardiomyopathy-An Insight From the Nationwide Readmissions Database (2016-2020).","authors":"Medhat Chowdhury, Sanchit Duhan, Rasheed Bahar, Mohamad Hasan Jawadi, Bijeta Keisham, Harini Lakshman, Marc Zughaib, Yasar Sattar, Christopher Bradley, Marcel Zughaib","doi":"10.1111/anec.70232","DOIUrl":"10.1111/anec.70232","url":null,"abstract":"<p><strong>Background: </strong>Ventricular tachycardia (VT) is a major cause of morbidity and mortality in patients with structural heart disease, yet real-world comparisons between ischemic cardiomyopathy (ICM) and non-ischemic dilated cardiomyopathy (NIDCM) remain limited.</p><p><strong>Methods: </strong>The national readmission database (2016-2020) was used to identify hospitalizations for VT. Cohorts were stratified based on underlying cardiomyopathy. A Propensity Score Matching (PSM) model matched ICM to NIDCM patients. Pearson's x2 test was applied to PSM-matched cohorts to compare outcomes.</p><p><strong>Results: </strong>We identified 622,092 VT hospitalizations, of which 575,312 (92.4%) had ICM and 46,780 (7.5%) had NIDCM. Outcomes were compared using multivariable logistic regression and propensity score matching (25,919 matched pairs). Despite being younger, NIDCM patients had higher in-hospital mortality (10.4% vs. 9.6%, p < 0.001; aOR 1.08), stroke (1.7% vs. 1.2%, aOR1.42), acute heart failure (65% vs. 59%, aOR 1.36), acute kidney injury (46.1% vs. 41.7%, aOR1.35), endotracheal intubation (13.1% vs. 14.5%, aOR 1.06), ICD implantation (3.9% vs. 3.5%, aOR1.23), and VT ablation (1.0% vs. 0.5%, aOR1.76). Readmission rates were significantly higher in NIDCM at 30 days (10.4% vs. 8.7%, p = 0.019), 90 days (22.7% vs. 20.0%, p = 0.483), and 180 days (30.7% vs. 27.3%, p = 0.001). In contrast, ICM patients had higher rates of sudden cardiac arrest (10.6% vs. 5.9%, aOR0.55), major adverse cardiovascular events (78.9% vs. 52.2%, aOR0.24), cardiogenic shock (18.4% vs. 12.1%, aOR0.59), ECMO (0.9% vs. 0.4%, aOR0.48), and LVAD use (0.5% vs. 0.3%, aOR0.58). Mortality declined over time in ICM (8.5% in 2016 to 8.2% in 2020, p-trend = 0.006), but not in NIDCM.</p><p><strong>Conclusion: </strong>These findings highlight distinct clinical profiles and emphasize the need for targeted management strategies for VT based on the cardiomyopathy subtype.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":"e70232"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863555","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":"Reversible High-Degree Atrioventricular Block Associated With Magnesium Toxicity in Severe Pre-Eclampsia.","authors":"Alex F Lwiza, Edward Thomas, Nasra Batchu, Lilian G Mmbaga, Simon C Peter, Abid M Sadiq","doi":"10.1111/anec.70233","DOIUrl":"10.1111/anec.70233","url":null,"abstract":"<p><p>We report a 35-year-old woman at 31 weeks and 5 days' gestation with severe pre-eclampsia and acute kidney injury who developed symptomatic hypermagnesemia (4.49 mmol/L) and 2:1 second-degree atrioventricular block after receiving a standard Pritchard magnesium sulfate regimen. Magnesium sulfate was discontinued, intravenous calcium gluconate was administered, and emergency cesarean delivery was performed. The atrioventricular block resolved completely, and the mother recovered well. This case highlights a rare but reversible manifestation of magnesium toxicity and the importance of early recognition in patients with deteriorating renal function.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":"e70233"},"PeriodicalIF":0.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863542","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":"Electrocardiographic Predictors of Early Recurrence of Atrial Fibrillation After Electrical Cardioversion","authors":"Keisuke Yonezu,&nbsp;Tetsuji Shinohara,&nbsp;Hirochika Yamasaki,&nbsp;Kei Hirota,&nbsp;Hidekazu Kondo,&nbsp;Akira Fukui,&nbsp;Hidefumi Akioka,&nbsp;Yasushi Teshima,&nbsp;Naohiko Takahashi","doi":"10.1111/anec.70225","DOIUrl":"10.1111/anec.70225","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although electrical cardioversion (ECV) effectively restores sinus rhythm in patients with persistent atrial fibrillation (AF), early recurrence after successful ECV remains common in clinical practice. We investigated whether simple 12-lead electrocardiographic markers and a composite ECG score could predict early AF recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 195 patients with persistent AF who underwent successful ECV. Electrocardiograms recorded immediately after ECV were evaluated for notched P-wave, fragmented QRS (fQRS), and early repolarization pattern (ERP). The ECG composite score was defined as the sum of these markers (0–3). Early AF recurrence was defined as electrocardiographically documented recurrence within 10 days after ECV. Multivariable logistic regression analysis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Early AF recurrence occurred in 100 patients (51.3%). AF duration was longer in patients with recurrence (12 [3–57] vs. 5 [2–15] months, <i>p</i> &lt; 0.001). Notched P-wave (76.0% vs. 24.2%, <i>p</i> &lt; 0.001), fQRS (74.0% vs. 57.9%, <i>p</i> = 0.017), and ERP (41.0% vs. 24.2%, <i>p</i> = 0.015) were more frequent in patients with recurrence. In multivariable analysis, notched P-wave (OR 11.80), fQRS (OR 2.34), and ERP (OR 3.54) independently predicted recurrence (all <i>p</i> &lt; 0.05). The ECG composite score was also independently associated with recurrence (OR 4.91 per 1-point increase, <i>p</i> &lt; 0.001), with a stepwise increase in recurrence across score categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Simple 12-lead ECG markers and a composite ECG score may help predict early AF recurrence and guide rhythm-control strategies after ECV in patients with persistent AF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838499","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":"The Value of Left Atrial Strain and Strain Rate for Prediction of Early Postoperative Atrial Fibrillation Following Isolated Off-Pump Coronary Artery Bypass Grafting in Low-Risk Patients","authors":"Leila Bigdelu,&nbsp;Ali Azari,&nbsp;Ossama Maadarani,&nbsp;Somaye Bakefayat,&nbsp;Negar Ebrahimi,&nbsp;Maryam Emadzadeh","doi":"10.1111/anec.70230","DOIUrl":"10.1111/anec.70230","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Following coronary artery bypass grafting (CABG) surgery, postoperative atrial fibrillation (POAF) is a prevalent arrhythmia. Prior research has demonstrated a paucity of reliable approaches to predict early POAF after CABG, particularly in low-risk subjects. The present investigation proposed to assess how effectively left atrial (LA) strain and LA strain rate predict early POAF after isolated off-pump CABG (OPCAB) in low-risk individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and twenty-three low-risk subjects with sinus rhythm who underwent isolated OPCAB were assessed in this prospective research. The velocity vector imaging (VVI) method was utilized to measure LA strain and LA strain rate. Subsequently, the patients were monitored post-surgery for 1 week to assess whether early POAF had occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In contrast to those who did not experience early POAF, individuals with early POAF showed significantly lower LA strain (21.25 vs. 37.59, <i>p</i> &lt; 0.001), lower LA strain rate (1.37 vs. 2.73, <i>p</i> &lt; 0.001), and higher left atrial volume index (LAVI) (<i>p</i> &lt; 0.001). A 1-unit increase in LA strain was associated with a 33% decrease in the odds of early POAF (OR = 0.67, 95% CI: 0.50–0.89; <i>p</i> = 0.006).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Preoperative left atrial strain measurements may serve as an effective predictor of early POAF in low-risk patients after isolated OPCAB. Rather than treating all patients undergoing CABG, identifying the group at greater risk for early POAF may enable targeted prophylactic therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811454","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":"Electrocardiogram Characteristics and Outcomes in an Adult Congenital Heart Disease Population","authors":"Seyedeh Somayyeh Mousavi,&nbsp;Cheryl L. Raskind-Hood,&nbsp;Alexandra Haffner,&nbsp;Chad Robichaux,&nbsp;Lindsey C. Ivey,&nbsp;Reza Sameni,&nbsp;Wendy M. Book","doi":"10.1111/anec.70224","DOIUrl":"10.1111/anec.70224","url":null,"abstract":"<p>The electrocardiogram (ECG) is a low-cost, readily available test that may detect dysrhythmia, chamber enlargement, and ischemia in an acquired heart disease population. Use of resting ECG to predict adverse events in an adult congenital heart disease (ACHD) population is unknown. ECG characteristics, outcomes, and vital status of 8130 adults born between 1945 and 2001 with at least two available ECGs during a 10-year surveillance period (2010–2019) were evaluated at baseline and at the end of surveillance. Outcomes included cardiac hospitalizations, cardiac surgery or intervention, or death during surveillance. Broad CHD anatomic groups were analyzed as follows: “<i>left</i>-sided,” “<i>right</i>-sided,” “<i>single</i>-<i>ventricle</i>,” and “<i>neither</i>” to account for differences in loading conditions. Of the cohort, 7.2% died, and 33.0% remained alive without adverse events. ECG parameters associated with mortality include wider QRS duration (QRSd), longer corrected QT (QTc), greater QRS-T angle, left bundle branch block, and rhythm change. Those who died had longer mean baseline QRSd (107.3 ms vs. 101.83 ms, <i>p</i> &lt; 0.0001) and QTc (434.94 ms vs. 425.20 ms, <i>p</i> = 0.0004). Change in QRSd (∆QRSd) was greater in the deceased group than alive (5.18 ms vs. 2.01 ms, <i>p</i> &lt; 0.0001), and in alive with an adverse event compared to those alive without an event (2.78 ms vs. 0.42 ms, <i>p</i> &lt; 0.0001). Mean QRS-T angle remained concordant in those without an adverse event but deviated in the adverse event group (5.65° vs. 22.91°) (<i>p</i> &lt; 0.0001). ECG characteristics and changes over time are associated with adverse cardiac events and mortality in a CHD population. Further study is needed to develop an ECG-based risk model to identify at-risk CHD patients.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70224","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757435","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":"Electrocardiogram Abnormality Classification From Summary Statistics With Patient-Level Validation and Process-Focused Evaluation","authors":"Sungjoon Hong,&nbsp;Christina Hartnett,&nbsp;Michael Ruane,&nbsp;Jason Tagliarino,&nbsp;Michael Nizich,&nbsp;M. Toma","doi":"10.1111/anec.70228","DOIUrl":"10.1111/anec.70228","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Machine learning (ML) applications in clinical medicine are vulnerable to data leakage, particularly temporal leakage from post-diagnostic features and patient-level leakage from improper partitioning, compromising electrocardiogram (ECG) abnormality detection systems. This study addresses these vulnerabilities through patient-level data splitting and systematic evaluation across multiple classification scenarios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ECG data from 4419 observations representing 2180 unique patients were analyzed using Random Under-Sampling Boosting (RUSBoost). Three binary classification scenarios were defined: Scenario 1 (Abnormal vs. Normal, excluding borderline), Scenario 2 (Abnormal + Borderline vs. Normal), and Scenario 3 (Abnormal vs. Normal + Borderline). Patient-level stratified partitioning (60:20:20) prevented information leakage. Models were evaluated using accuracy, sensitivity, specificity, F1-score, learning curves, and precision-recall curves across all partitions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Scenario 1 demonstrated optimal generalization with test accuracy of 70.79%, sensitivity of 60.30%, specificity of 86.50%, and F1-score of 0.712, exhibiting monotonic decline across partitions (73.98%→71.50%→70.79%). Scenario 2 achieved 65.26% test accuracy with greater degradation (6.17 percentage points), reflecting increased difficulty when borderline cases were grouped with abnormal findings. Scenario 3 exhibited problematic non-monotonic patterns (71.84%→67.71%→69.36%) with premature convergence, indicating fundamental generalization challenges despite near-balanced classes (1.07:1 ratio).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Aggregate metrics alone inadequately support clinical deployment decisions. Medical AI evaluation must examine learning dynamics, generalization stability, and precision-recall calibration across partitions. Process-focused standards assessing monotonic decline, convergence characteristics, and calibration stability are essential for reliable ECG abnormality detection deployment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70228","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705136","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":"Dynamic Risk Assessment for the Development of Persistent Atrial Fibrillation Using Statistical and Machine Learning Approaches","authors":"Alexei Nakonechnyi,&nbsp;Shaul Geliaks,&nbsp;Ilan Goldenberg,&nbsp;Dillon J. Dzikowicz,&nbsp;Emre Aktas,&nbsp;Susan Schleede,&nbsp;Scott McNitt,&nbsp;Agam Purohit,&nbsp;Burr W. Hall,&nbsp;Spencer Z. Rosero,&nbsp;David Z. Huang,&nbsp;Amole O. Ojo,&nbsp;Wojciech Zareba,&nbsp;Michael Christof,&nbsp;Mehmet K. Aktas","doi":"10.1111/anec.70229","DOIUrl":"10.1111/anec.70229","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cardiac implantable electronic devices (CIEDs) frequently detect brief, often subclinical atrial fibrillation (AF), but their value for predicting progression to persistent AF remains uncertain. Statistical and machine learning (ML) approaches may enable dynamic risk stratification using this longitudinal device data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To develop a risk stratification model using clinical and CIED-derived AF burden measured over a rolling 6-month window to predict progression to persistent AF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed continuous CIED data from 1985 patients without prior persistent AF implanted between 2016 and 2024 at a tertiary medical center. AF burden and clinical variables were summarized using overlapping 6-month rolling windows to estimate 1-year risk of persistent AF. Associations were evaluated using Kaplan–Meier and Cox proportional hazards models. A gradient-boosted decision tree model (XGBoost) was used to predict progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During a mean follow-up of 1192 days, 874 patients (44%) developed paroxysmal AF, of whom 257 (29%) progressed to persistent AF after a mean of 813 days. Patients with no AF or &lt; 1 h/day of AF in the prior 6 months had &gt; 97% 1-year freedom from persistent AF, whereas those with &gt; 8 h/day had a 63% progression rate. Higher AF burden was strongly associated with progression (maximum HR 8.66, <i>p</i> &lt; 0.001). The ML model demonstrated high predictive performance (sensitivity 99.4%, specificity 95.7%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CIED-detected AF burden is strongly associated with progression to persistent AF. ML-based analysis of 6-month device data enables accurate, point-in-time risk stratification to support earlier and more targeted clinical management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700673","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":"Electrocardiographic Repolarization Changes Following Orchiectomy: Insights Into QT Interval Prolongation and Clinical Implications","authors":"Javeria Anees","doi":"10.1111/anec.70226","DOIUrl":"10.1111/anec.70226","url":null,"abstract":"&lt;p&gt;I read with considerable interest the article by Sakaguchi et al., recently published in the &lt;i&gt;Annals of Noninvasive Electrocardiology&lt;/i&gt;, examining electrocardiographic repolarization changes following orchiectomy, with particular emphasis on QT and corrected QT (QTc) interval prolongation. This study addresses a clinically important and insufficiently characterized area of cardio-oncology, and the authors are to be commended for their systematic approach to a topic with meaningful arrhythmic implications.&lt;/p&gt;&lt;p&gt;In this retrospective analysis of 44 male patients who underwent unilateral or bilateral orchiectomy, the authors report significant prolongation of both QT and QTc intervals following surgery, most pronounced in the bilateral orchiectomy subgroup (QTc: 418 ± 36 ms to 441 ± 37 ms, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). QTc was derived exclusively using Bazett's formula, a methodological choice that, I respectfully contend, warrants critical scrutiny, as it carries material consequences for the validity of the study's principal outcome.&lt;/p&gt;&lt;p&gt;It is well established that Bazett's formula systematically overcorrects QTc at elevated heart rates and undercorrects at lower rates, introducing rate-dependent artifact that can distort the apparent magnitude of repolarization change (Bazett &lt;span&gt;1920&lt;/span&gt;). The group-level heart rate stability reported here (72 ± 16 vs. 72 ± 15 beats/min, &lt;i&gt;p&lt;/i&gt; = 0.97) may mask substantial inter-individual variability inherent in a cohort with a standard deviation of ±15–16 beats/min, a range across which Bazett's formula is well-documented to produce rate-dependent bias (Fridericia &lt;span&gt;2003&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;At the individual level, patients who experienced even a modest heart rate increase at the time of post-operative ECG acquisition, attributable to disease progression, comorbidities, or autonomic remodeling following androgen deprivation, Bazett's formula would yield a spuriously elevated QTc, potentially misattributing a rate-mediated shortening of the RR interval as pathological QT prolongation. Without individual pre- and post-operative heart rate data recorded at the time of ECG acquisition, it is not possible to quantify what proportion of the observed ΔQTc reflects genuine repolarization prolongation versus formula-induced artifact. Concurrent application of Fridericia's cube-root correction or the Framingham linear formula, both shown to outperform Bazett's method across a broad physiological range, would have provided essential corroborative evidence (Luo et al. &lt;span&gt;2004&lt;/span&gt;; Sagie et al. &lt;span&gt;1992&lt;/span&gt;; Rautaharju et al. &lt;span&gt;2009&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;I therefore urge the authors to reanalyze their dataset using at least one validated alternative correction formula. Concordance of QTc prolongation across two independent methods would substantially reinforce the robustness of the findings and strengthen the clinical applicability of the recommendations advanced, particularly given the arrhythmic risk the ","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700749","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":"Association Between Socioeconomic Status and Atrial Fibrillation: A Two-Sample Mendelian Randomization Study","authors":"Shangcai Xie,&nbsp;Xia Zhao,&nbsp;Menghui Mao","doi":"10.1111/anec.70227","DOIUrl":"10.1111/anec.70227","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lower socioeconomic status (SES), reflected by greater socioeconomic deprivation, lower household income, and lower educational attainment (EA), has been associated with atrial fibrillation (AF). This study aimed to examine the causal influence of SES on AF risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single-nucleotide polymorphisms (SNPs) associated with Townsend deprivation index (TDI) or household income from the UK Biobank (<i>N</i> = 462,464 and <i>N</i> = 397,751, respectively) and EA from the Social Science Genetic Association Consortium (<i>N</i> = 3,037,499) were selected as instrumental variables. AF-associated SNPs were extracted from FinnGen data freeze 8 (<i>N</i> = 208,594) and a meta-analysis (<i>N</i> = 1,030,836) by Nielsen et al. Two-sample Mendelian randomization (MR) was used to estimate causal relationships, with validity assessed via sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TDI showed no association with AF risk in either FinnGen (odds ratio (OR) = 0.972, 95% confidence interval (CI): 0.607–1.556, <i>p</i> = 9.00E-01) or Nielsen et al. (OR = 0.805, 95% CI: 0.470–1.381, <i>p</i> = 4.30E-01). Similarly, genetically proxied household income was not associated with AF risk (OR = 1.233, 95% CI: 0.808–1.881, <i>p</i> = 3.30E-01; OR = 0.941, 95% CI: 0.755–1.173, <i>p</i> = 5.90E-01). However, higher genetically proxied EA was associated with lower AF risk in FinnGen (OR = 0.745, 95% CI: 0.653–0.849, <i>p</i> = 1.00E-05) and Nielsen et al. (OR = 0.849, 95% CI: 0.784–0.920, <i>p</i> = 5.90E-05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our MR study found that higher genetically proxied EA was associated with lower AF risk, whereas no evidence of association was found for genetically proxied TDI or household income.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668333","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":"Methodological Considerations on Pre-Sport Cardiac Evaluation in Children: Detection of Risks Other Than Sudden Cardiac Death","authors":"Abdullah Aman,&nbsp;Ahmed Raza,&nbsp;Shahzadi Gulfishan","doi":"10.1111/anec.70222","DOIUrl":"https://doi.org/10.1111/anec.70222","url":null,"abstract":"&lt;p&gt;We read with interest the recent article by Öncül and Gülyüz (&lt;span&gt;n.d.&lt;/span&gt;) evaluating cardiovascular screening in pediatric athletes using electrocardiography and echocardiography. The authors are to be commended for addressing this important topic and for highlighting the role of pre-participation cardiovascular screening in identifying potentially significant cardiac abnormalities among young athletes. Their work adds valuable evidence to this evolving field. However, several methodological limitations merit consideration, as they may affect the interpretation and generalizability of the findings.&lt;/p&gt;&lt;p&gt;&lt;i&gt;First&lt;/i&gt;, the single-center, hospital-based retrospective design introduces selection bias and limits generalizability. Because participants were referred to a tertiary pediatric cardiology center for sports clearance rather than randomly selected from the community, the reported prevalence of cardiac abnormalities (9.3%) and major cardiac conditions (2.3%) may overestimate that in the general pediatric athletic population. Malhotra et al. (&lt;span&gt;2018&lt;/span&gt;) demonstrated that outcomes of cardiac screening depend strongly on the characteristics of the screened population and the screening environment.&lt;/p&gt;&lt;p&gt;&lt;i&gt;Second&lt;/i&gt;, there is an absence of a control group without ECG/ECHO abnormalities in the study. Without comparison with children who underwent routine evaluation but had normal findings, it is difficult to determine whether detected abnormalities are clinically meaningful or represent common benign pediatric variations. This may lead to overinterpretation of minor structural or electrical findings as disease. Maron et al. (&lt;span&gt;2014&lt;/span&gt;) emphasized that screening tests in healthy young populations must be interpreted against false-positive rates and predictive values.&lt;/p&gt;&lt;p&gt;&lt;i&gt;Third&lt;/i&gt;, there is no long-term follow-up in order to determine clinical significance of detected abnormalities. The study identifies structural abnormalities such as mitral valve regurgitation, MVP, bicuspid aortic valve, LV hypertrophy, and arrhythmias, but it does not demonstrate whether these findings progressed, caused symptoms, affected sports participation, or resulted in cardiovascular events. Therefore, the conclusion that early detection improves future morbidity remains hypothetical. Corrado et al. (&lt;span&gt;2006&lt;/span&gt;) demonstrated that screening findings require outcome validation rather than only detection.&lt;/p&gt;&lt;p&gt;&lt;i&gt;Fourth&lt;/i&gt;, there is an absence of standardized diagnostic criteria or blinded interpretation of ECG/ECHO findings. The article reports ECG and echocardiographic abnormalities but does not clarify whether interpretation was performed by multiple blinded cardiologists or whether interobserver agreement was assessed. Pediatric echocardiographic interpretation, especially for MVP, valve regurgitation, and LV hypertrophy, may vary between observers. This introduces measurement bias. Fritsch et al. (&lt;span&gt;2017&lt;/span&gt;) emphasized t","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148652429","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}