Annals of Noninvasive Electrocardiology最新文献

{"title":"Active Helicobacter pylori Infection and Atrial Fibrillation in Patients Hospitalized With Acute Myocardial Infarction","authors":"Mohammed Hashem,&nbsp;Martin O. Sundqvist,&nbsp;Jonatan Wärme,&nbsp;Magnus Bäck,&nbsp;Robin Hofmann","doi":"10.1111/anec.70245","DOIUrl":"10.1111/anec.70245","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Chronic <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection may promote systemic inflammation and has been proposed as a contributor to atrial fibrillation (AF), but clinical evidence is inconsistent. The aim of the study was to explore whether active <i>H. pylori</i> infection was associated with AF in patients hospitalized with acute myocardial infarction (AMI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional analysis included adults from a two-center observational AMI cohort. Active <i>H. pylori</i> infection was assessed during hospitalization using a urea breath test (UBT). AF was defined as AF documented before admission or identified during the index hospitalization. Associations were estimated using logistic regression adjusted for age, sex, center, and smoking. Exploratory multivariable interaction analyses were also performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 310 enrolled patients, 300 had conclusive <i>H. pylori</i> screening results; 60 (20.0%) were positive. AF was recorded in 4 of 60 <i>H. pylori</i>-positive patients (6.7%) and 30 of 240 <i>H. pylori</i>-negative patients (12.5%). <i>H. pylori</i> positivity was not significantly associated with recorded AF (unadjusted OR, 0.55; 95% CI, 0.17–1.41; <i>p</i> = 0.228; adjusted OR, 0.54; 95% CI, 0.16–1.46; <i>p</i> = 0.235). These estimates refer to pooled AF; only four AF cases occurred among patients testing positive.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>No statistically significant association was detected between <i>H. pylori</i> breath-test positivity and pooled documented AF among patients hospitalized with AMI, but a clinically meaningful association cannot be excluded. Larger prospective studies with longitudinal follow-up are needed to clarify whether active <i>H. pylori</i> infection is associated with incident AF after AMI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 6","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190966","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":"Understanding the Mortality Trends in Patients With Ventricular Arrhythmias and Cardiomyopathy: A 25-Year Retrospective Analysis From 1999–2024","authors":"Nosheen Pervaiz,&nbsp;Hamza Naveed,&nbsp;Muhammad Junaid Razzak,&nbsp;Shaheer Bin Shafiq,&nbsp;Muhammad Hasan,&nbsp;Sawera Gul,&nbsp;Maham Abbasi,&nbsp;Kamil Ahmad Kamil,&nbsp;Syed Ahmed Farhan","doi":"10.1111/anec.70234","DOIUrl":"10.1111/anec.70234","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ventricular Arrhythmias (VA) associated with Cardiomyopathy (CM) continues to be the major cause of death. However, a national longitudinal study examining mortality trends from these conditions is still lacking. This study assessed mortality trends due to these conditions among U.S. adults aged ≥ 25 years from 1999 to 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An observational analysis of U.S. mortalities due to VA in patients with CM (ICD-10 I47.2, I49.0 and I25.5, I42 respectively), was conducted using CDC WONDER. Adjusted Mortality Rates (AAMR) per 100,000 calculated and trends were assessed by calculating Average and Annual Percent Change (AAPC, APC), using joinpoint regression stratified by year, sex, race, and region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1999 to 2024, 81,204 VA with CM-related deaths occurred with the overall AAMR declined from 2.54 in 1999 to 1.01 in 2024 (AAPC: −3.55%; <i>p</i> &lt; 0.000001). AAMRs decreased from 1999 to 2007 (APC: −7.93), remained stable till 2022 (APC: −0.66), and dropped by 2024 (APC: −6.87). Men exhibited greater AAMRs (2.42) than women (0.68). Racially, the AAMRs were most pronounced in Non-Hispanic (NH) Blacks (1.97), followed by NH Whites (1.42), whereas Hispanics and NH Others experienced similar AAMRs of 0.97. Geographically, Delaware and the Western regions experienced the highest rates of mortality (2.2 and 1.53, respectively). Urban areas had higher AAMRs than rural settings (1.45 vs. 1.4)</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although VA-CM mortality has declined over the past two decades, differences by race, sex, and geography remain, underscoring the need for targeted healthcare strategies</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 6","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163748","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":"Reply to the Letter Regarding Atrial Tachycardia Utilizing Bachmann's Bundle as an Epicardial Bypass: A Case Suggestive of a Dual-Loop Mechanism","authors":"Ryutaro Sakurai,&nbsp;Yosuke Nakatani,&nbsp;Kensuke Fujiwara,&nbsp;Takashi Miyamoto","doi":"10.1111/anec.70241","DOIUrl":"10.1111/anec.70241","url":null,"abstract":"&lt;p&gt;We thank the authors for their thoughtful comments. As they point out, direct epicardial mapping would provide the most definitive means of identifying a specific epicardial structure, and the lack of direct mapping of Bachmann's bundle (BB) is an important limitation of our case. However, our interpretation that BB served as an epicardial bypass was based not solely on the presence of breakthrough activation on the anterior wall, but on the combination of multiple electrophysiological findings and their anatomical distribution.&lt;/p&gt;&lt;p&gt;During the initial roof-dependent AT, endocardial activation was interrupted by an extensive low-voltage area (LVA) on the anterior wall, followed by widespread breakthrough activation anterior to the LVA, where fragmented potentials were recorded. Previous high-resolution mapping studies have demonstrated that multiple breakthrough activation is characteristic of a pseudo-focal activation pattern rather than a true focal origin (Takigawa et al. &lt;span&gt;2021&lt;/span&gt;; Nakatani et al. &lt;span&gt;2021&lt;/span&gt;). We agree that neither widespread breakthrough activation nor fragmented potentials alone can identify a specific epicardial structure. However, BB courses broadly along the anterosuperior left atrium and has extensive myocardial connections to the anterior left atrial wall, whereas the septopulmonary bundle is predominantly distributed over the posterior left atrium (Nakatani et al. &lt;span&gt;2021&lt;/span&gt;; Nayak et al. &lt;span&gt;2020&lt;/span&gt;). Therefore, the anatomical distribution of the widespread anterior breakthrough across the anterior LVA observed in this case was considered more compatible with BB involvement than with the septopulmonary bundle.&lt;/p&gt;&lt;p&gt;Further mechanistic evidence was obtained during the localized-reentrant AT, which demonstrated counterclockwise reentrant activation on the anterior wall. The first linear ablation connecting the lateral portion of the LVA to the left pulmonary vein isolation line did not affect the AT. Subsequently, fragmented potentials were identified in the lateral portion of the LVA, and ablation targeting these potentials terminated the AT within 6 s. Thus, in addition to the circuit geometry inferred from the endocardial activation map, the functional response to ablation supported the presence of a reentrant circuit involving an epicardial bypass.&lt;/p&gt;&lt;p&gt;The proposed dual-loop mechanism was also not based solely on the geometry of the activation map. During the initial roof-dependent AT, a counterclockwise localized-reentry-like activation pattern, similar to that observed during the subsequent localized-reentrant AT, was already present on the anterior wall. Furthermore, during roof ablation, the initial AT transitioned to the localized-reentrant AT without prolongation of the tachycardia cycle length. These observations raised the possibility that a roof-dependent loop and an anterior localized-reentrant loop coexisted during the initial AT, with the anterior loop persisting after","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 6","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103335","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":"Atrial Tachycardia Utilizing Bachmann's Bundle as an Epicardial Bypass: A Case Suggestive of a Dual-Loop Mechanism","authors":"Javeria Anees","doi":"10.1111/anec.70240","DOIUrl":"10.1111/anec.70240","url":null,"abstract":"&lt;p&gt;I read with considerable interest the recent case report by Sakurai et al., published in the &lt;i&gt;Annals of Noninvasive Electrocardiology&lt;/i&gt;, describing a novel presentation of post-ablation atrial tachycardia (AT) in which Bachmann's bundle was proposed to function as an epicardial bypass within both roof-dependent and localized-reentrant circuits—a mechanistic constellation reported as previously undescribed in the literature (Sakurai et al. &lt;span&gt;2026&lt;/span&gt;). This case reflects a broader unresolved challenge: Christian-Miller et al. recently demonstrated that Bachmann's bundle-related atrial tachycardias remain poorly characterized at a field level precisely because their epicardial location renders them inaccessible to standard endocardial mapping protocols (Christian-Miller et al. &lt;span&gt;2026&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;While we commend the scientific novelty of this report, we wish to draw attention to a fundamental methodological limitation that materially undermines the validity of its central conclusion. The identification of Bachmann's bundle as the responsible epicardial bypass rests exclusively on indirect endocardial evidence: widespread centrifugal breakthrough activation across the anterior wall and fragmented electrograms at the breakthrough site. No direct epicardial mapping was undertaken, and orthodromic capture of the breakthrough site during entrainment pacing could not be established, as the authors themselves acknowledge. Critically, neither finding is specific to Bachmann's bundle. Centrifugal breakthrough patterns may arise equally from the septopulmonary bundle or residual myocardial fiber tracts overlying fibrotic substrate, while fragmented potentials are well-recognized signatures of heterogeneous conduction within scarred myocardium, independent of any specific epicardial structure (Nakatani et al. &lt;span&gt;2021&lt;/span&gt;; Nayak et al. &lt;span&gt;2020&lt;/span&gt;). Furthermore, the dual-loop mechanistic characterization—the manuscript's central novel claim—rests on circuit geometry inferred entirely from endocardial activation sequences, without entrainment confirmation of both loop components independently. The structural identity of the bypass was therefore inferred on the basis of anatomical probability alone, rather than established by electrophysiological confirmation or imaging correlation. This distinction carries direct clinical consequence: the precise structure mediating epicardial bypass conduction directly governs ablation strategy, target site selection, and anticipated recurrence risk. Notably, the very source cited in support of this inference explicitly cautions that such characterization requires direct epicardial access—an inconsistency the manuscript does not resolve (Nakatani et al. &lt;span&gt;2021&lt;/span&gt;). We propose that future cases implicating a specific epicardial bypass structure should satisfy at least two of the following: direct epicardial mapping with activation confirmation, entrainment with orthodromic capture at the","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 6","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079616","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 “Spiked Helmet Sign” on Electrocardiogram Following Left Ventricular Assist Device Implantation: A Case Report","authors":"Qin Qian,&nbsp;Ling Yin","doi":"10.1111/anec.70237","DOIUrl":"https://doi.org/10.1111/anec.70237","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The ECG “Spiked Helmet Sign,” with diffuse concave ST-segment elevation and a J-point spike, typically suggests acute pericarditis. However, after LVAD implantation, it may herald a localized pericardial hematoma and impending tamponade.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 68-year-old male with end-stage ischemic cardiomyopathy underwent LVAD placement. Hours postoperatively, ECG showed this sign with QTc prolongation (578 ms). Bedside echocardiography revealed a 6-mm localized pericardial/mediastinal hematoma. Troponin I peaked on day 1 and fell. Conservative management was successful.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Recognition of this ECG sign after LVAD surgery should prompt immediate echocardiography to detect pericardial complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 6","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70237","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048208","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 of Epicardial Adipose Tissue Thickness With Heart Rate Variability and Electrocardiographic Markers of Electrical Heterogeneity in Obesity","authors":"Ayhan Coşgun,&nbsp;Hüseyin Ören","doi":"10.1111/anec.70238","DOIUrl":"10.1111/anec.70238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Obesity is associated with atrial and ventricular arrhythmias, but the links among excess adiposity, autonomic dysfunction, and electrical heterogeneity remain incompletely defined. We examined whether epicardial adipose tissue (EAT) thickness was associated with heart rate variability (HRV) indices and electrocardiographic markers of electrical heterogeneity in adults with obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study conducted between January 2023 and June 2025, 129 adults with obesity (BMI ≥ 30 kg/m²) and 156 normal-weight controls (BMI &lt; 25 kg/m²) with broadly similar group-level age and sex distributions were evaluated. EAT thickness was measured by transthoracic echocardiography. Autonomic modulation was assessed by 24-h HRV. Electrocardiograms were analyzed for P-wave dispersion (PWD), Tpeak-to-Tend (Tp-e) interval, Tp-e dispersion, and Tp-e/QT ratio. The prespecified primary endpoints were PWD and Tp-e interval.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with controls, individuals with obesity had greater EAT thickness (7.2 ± 1.1 vs. 4.2 ± 2.1 mm), higher PWD (30.9 ± 5.8 vs. 17.5 ± 2.4 ms), and longer Tp-e interval (96.2 ± 8.8 vs. 83.5 ± 7.4 ms; all <i>p</i> &lt; 0.001). Between-group differences were 13.6 ms for PWD (95% CI 12.5–14.7) and 12.7 ms for Tp-e (95% CI 10.8–14.6). Obesity was also associated with lower SDNN and RMSSD, higher LF/HF ratio, and higher Tp-e dispersion, whereas Tp-e/QT showed only a nominal exploratory difference. In multivariable linear regression, EAT thickness remained independently associated with PWD (standardized β = 0.38, <i>p</i> &lt; 0.001) and Tp-e interval (standardized β = 0.35, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Greater EAT thickness in obesity was associated with an unfavorable HRV profile and increased atrial and ventricular electrical heterogeneity. These findings are associative and should not be interpreted as clinical rhythm-risk stratification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029735","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":"Investigating the Short-Term Changes of the Electrocardiogram Indicators During Hospitalization in Patients With COVID-19 Following the Use of Tocilizumab","authors":"Mahdi Zahedi,&nbsp;Golnaz Houshmand,&nbsp;Tabassom Hosseini","doi":"10.1111/anec.70221","DOIUrl":"10.1111/anec.70221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate short-term changes in electrocardiographic (ECG) parameters after tocilizumab administration in COVID-19 patients, considering the drug's role in treating severe cases and the involvement of IL-6 in cardiovascular effects and ECG alterations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective study, we assessed cardiovascular and electrocardiographic parameters in PCR-confirmed COVID-19 patients who received tocilizumab. ECG variables were evaluated at two time points: 24 h before and 24 h after drug administration. All ECGs were verified by a supervisor, and demographic information was extracted from patient records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>33 patients were included, of whom 36.4% were men. The patients' ages ranged from 37 to 79 years. The corrected QT interval (QTc) measured 24 h before (QTc1) and 24 h after (QTc2) tocilizumab administration showed no significant difference (QTc1: 390.3 ± 31.67 ms; QTc2: 392.73 ± 36.68 ms). No significant ECG changes were observed in the ST segment, ventricular fibrillation (VF), ventricular tachycardia (VT), or atrial fibrillation (AF). Four patients experienced cardiorespiratory arrest within 24 h after receiving tocilizumab.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tocilizumab administration in critically ill COVID-19 patients was not associated with significant short-term ECG changes or specific cardiovascular complications. Although previous studies in inflammatory diseases such as rheumatoid arthritis have reported QTc shortening following tocilizumab treatment, likely through suppression of IL-6-mediated systemic inflammation, no significant QTc reduction was observed in our cohort during the 24-h follow-up period. A few cases of cardiorespiratory arrest occurred; a causal relationship with tocilizumab could not be established due to the severity of illness and limited clinical data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011875","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":"Maskerading Bundle Branch Block Versus Standard Bifascicular Block: A Prognostic Analysis Results Through Electrophysiological Study","authors":"Afonso Luiz Tavares de Albuquerque,&nbsp;Caroline de Paula Coutinho Vaz de Lira,&nbsp;José Nilo de Carvalho Neto,&nbsp;Rodrigo Rufino Pereira Silva,&nbsp;Iremar Salviano de Macedo Neto,&nbsp;Dário Celestino Sobral Filho","doi":"10.1111/anec.70235","DOIUrl":"https://doi.org/10.1111/anec.70235","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Maskerading bundle branch block (MBBB) is a rare variant of standard bifascicular bundle branch block (SBBB), associated with poor prognosis and a higher need for pacemaker implantation. Most available data are limited to case reports and reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective cross-sectional study, we evaluated 27 patients with MBBB (Group I) and 18 with SBBB (Group II), all undergoing echocardiography, 24-h Holter monitoring, and invasive electrophysiological study (EPS) after recruitment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Group I patients had worse functional status (NYHA III–IV), larger ventricular diameters, and lower ejection fraction. The HV interval was significantly longer in Group I (66.3 ± 18.3 vs. 52.9 ± 8.1 ms; <i>p</i> = 0.006). Pacemaker implantation was required in 48% of Group I patients versus none in Group II (<i>p</i> = 0.001). Persistent atrial fibrillation was also more frequent in Group I (39.5% vs. 16.6%; <i>p</i> = 0.018).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MBBB is associated with more severe myocardial and conduction system impairment compared to SBBB, supporting its role as a marker of worse prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943180","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":"Prognostic Value of Spatial Trajectory of J-Point Amplitude Across Left Precordial Leads in a Community-Based Population","authors":"Chenhui Tai,&nbsp;Zhe Wang","doi":"10.1111/anec.70236","DOIUrl":"10.1111/anec.70236","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Early repolarization has historically been regarded as benign in many settings, although specific J-point features have been linked to adverse outcomes. Whether spatial variation in J-point amplitude across adjacent precordial leads carries prognostic information remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included participants aged 40–90 years without self-reported myocardial infarction or heart failure from the Third National Health and Nutrition Examination Survey (NHANES-III). Latent class trajectory analysis was used to identify spatial trajectories of J-point amplitude across leads V4–V6. The primary outcomes were all-cause mortality and cardiac death. Cox proportional hazards regression and competing risk models were used to evaluate associations between J-point trajectory patterns and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 5696 eligible participants, the mean age was 57.6 ± 12.9 years, 3092 were women, and 3986 were non-Hispanic White. LCTA identified two spatial trajectories: Class 1 included 5295 participants and showed a low, mildly decreasing amplitude pattern, whereas Class 2 included 401 participants and showed higher V4 amplitude with a steeper decline toward V5–V6. During a median follow-up of 303 months, all-cause deaths occurred in 2935 and 257 participants, with 790 and 87 cardiac deaths, respectively. In fully adjusted models, Class 2 was associated with higher risks of all-cause mortality (HR, 1.20; 95% CI, 1.03–1.39) and cardiac death (HR, 1.31; 95% CI, 1.01–1.71).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A steep V4-to-V6 decline in J-point amplitude was associated with increased long-term all-cause and cardiac mortality. This spatial ECG phenotype may capture prognostic information beyond conventional early repolarization criteria and warrants external validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910827","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":"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,&nbsp;Sanchit Duhan,&nbsp;Rasheed Bahar,&nbsp;Mohamad Hasan Jawadi,&nbsp;Bijeta Keisham,&nbsp;Harini Lakshman,&nbsp;Marc Zughaib,&nbsp;Yasar Sattar,&nbsp;Christopher Bradley,&nbsp;Marcel Zughaib","doi":"10.1111/anec.70232","DOIUrl":"10.1111/anec.70232","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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%, <i>p</i> &lt; 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%, <i>p</i> = 0.019), 90 days (22.7% vs. 20.0%, <i>p</i> = 0.483), and 180 days (30.7% vs. 27.3%, <i>p</i> = 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, <i>p</i>-trend = 0.006), but not in NIDCM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings highlight distinct clinical profiles and emphasize the need for targeted management strategies for VT based on the cardiomyopathy subtype.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 5","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-08-31","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}