Annals of Noninvasive Electrocardiology最新文献

{"title":"Left ventricular noncompaction cardiomyopathy and short QT syndrome due to primary carnitine deficiency","authors":"Oliver P. Hanington MRCP,&nbsp;Catherine Armstrong MRCPCH,&nbsp;Germaine Pierre MRCPCH,&nbsp;Graham Stuart FRCP,&nbsp;Jules C. Hancox DSc, FRSB, FBPhS","doi":"10.1111/anec.13077","DOIUrl":"10.1111/anec.13077","url":null,"abstract":"<p>We report the case of a 13-year-old female patient presenting with presyncope and palpitations. Her electrocardiogram revealed an abbreviation of the rate-corrected QT interval with imaging showing significant left ventricular dysfunction. Carnitine levels were measured as part of her diagnostic workup, discovering a rare, reversible cause of short QT syndrome (SQTS) and associated cardiomyopathy—primary carnitine deficiency (PCD) caused by a homozygous mutation in the <i>SLC22A5</i> gene, leading to an in-frame deletion mutation (NP_003051.1:p.Phe23del) affecting the organic cation transporter 2 (OCTN2) protein. Following the treatment with oral carnitine supplementation, her QT interval returned to within the normal range with significant improvement in left ventricular function.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10128685","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":"Outcomes of primary leadless pacemaker implantation: A systematic review","authors":"Tayyiba Ahmed Noor MBBS,&nbsp;Muhammad Omer Rehman Rana MBBS,&nbsp;Sapna Kumari MBBS,&nbsp;Bakht Umer MBBS,&nbsp;Jahanzeb Malik MBBS,&nbsp;Amna Ashraf MBBS,&nbsp;Maria Faraz MBBS,&nbsp;Tabligh Hussain MBBS,&nbsp;Muhammad Awais MBBS,&nbsp;Amin Mehmoodi MD,&nbsp;Azmat Hayat MBBS","doi":"10.1111/anec.13084","DOIUrl":"10.1111/anec.13084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>During the last decade, leadless pacemakers (LPMs) have turned into a prevalent alternative to traditional transvenous (TV) pacemakers; however, there is no consolidated data on LPM implantation in emergencies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Digital databases were searched for this review and four relevant studies, including 1276 patients were included in this review with procedure duration, fluoroscopic time, major complications, and mortality as primary outcomes and pacing threshold, impedance, sensing of LPM, and hospital stay as secondary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Gonzales et al. and Marschall et al. showed the duration of the procedure to be 180 ± 45 versus 324.6 ± 92 and 39.9 ± 8.7 versus 54.9 ± 9.8, respectively. Zhang et al. demonstrated the duration of the procedure and fluoroscopy time to be 36 ± 13.4 and 11.1 ± 3.1, respectively. Similarly, Schiavone et al. exhibited intermediate times of implantation at 60 (45–80) versus 50 (40–65) and fluoroscopic times at 6.5 (5–9.7) versus 5.1 (3.1–9). Hospital stay was more with a temp-perm pacemaker as compared to LPM and pacing parameters were not significantly different in all the studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For underlying arrhythmias, whenever appropriate, our review shows that LPMs may be a better option than temporary pacemakers, even as an urgent treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039726","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":"Computational in silico genetic variant prediction tools in cardiovascular disease","authors":"Lydia D. Hellwig PhD, ScM, CGC,&nbsp;Joaquin Villar PhD, FACMG,&nbsp;Clesson Turner MD","doi":"10.1111/anec.13079","DOIUrl":"10.1111/anec.13079","url":null,"abstract":"&lt;p&gt;Clinical genetic testing for hereditary cardiovascular diseases is recommended by many cardiovascular groups (Musunuru et al., &lt;span&gt;2020&lt;/span&gt;; Wilde et al., &lt;span&gt;2022&lt;/span&gt;). Genetic test results can be important for patient medical management and for the care for family members (Cirino et al., &lt;span&gt;2017&lt;/span&gt;). Appropriate classification of genetic variants is a critical component of this process and ultimately impacts patient and family outcomes (Care et al., &lt;span&gt;2017&lt;/span&gt;; Phillips et al., &lt;span&gt;2005&lt;/span&gt;). The American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG/AMP) created recommendations for the classification of pathogenicity of variants in genes associated with monogenic disease (Richards et al., &lt;span&gt;2015&lt;/span&gt;). These recommendations include defining the criteria for evidence used in classification as well as providing a framework for weighing and combining different types of evidence for the classification. Despite this standardized approach to interpretation, analysis and appropriate classification of variants remain challenging across disease contexts in clinical genetics (McInnes et al., &lt;span&gt;2021&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;In this issue of &lt;i&gt;Annals of Noninvasive Electrocardiology&lt;/i&gt;, Younis et al. (&lt;span&gt;2023&lt;/span&gt;) report that computational genetic variant prediction tools could identify the majority of pathogenic variants in congenital long QT syndrome (LQTS) 1–3. The authors also found that the computational scores did not predict clinical outcomes.&lt;/p&gt;&lt;p&gt;While it is encouraging that the variant prediction tools correlated with pathogenicity in this study, it is also important to note that determination of variant pathogenicity includes multiple types of evidence, including variant prediction evidence. Importantly, computational in silico predictors alone should not be used to classify the pathogenicity of a variant, but can be used as one piece of evidence in the classification of a genetic variant. The ACMG/AMP recommendations specify that using computational predictors are “supporting” level of evidence for or against pathogenicity using criteria PP3 and BP4 (Care et al., &lt;span&gt;2017&lt;/span&gt;). Supporting-level evidence must be combined with other more substantial lines of evidence to classify the variant. Furthermore, a recent manuscript by Pejaver et al. (&lt;span&gt;2022&lt;/span&gt;) provided evidence for redefining how computational tools can be used to provide evidence for or against pathogenicity of variants using the Bayesian adaptation of the ACMG/AMP framework. This work showed that the tools can provide stronger than supporting evidence and the computational tools varied in their ability to reach these levels of evidence. These authors also pointed out that it is important to select a single tool to use for PP3/BP4 missense evidence to avoid biases in results selection.&lt;/p&gt;&lt;p&gt;In addition, although the terms continue to be used interchangeably in the literature, recently, ","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161971","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 diagnostic utility of the basal and post-exercise QRS-T angle in patients with stable coronary artery disease","authors":"Tufan Günay MD,&nbsp;Alper Karakus MD","doi":"10.1111/anec.13082","DOIUrl":"10.1111/anec.13082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To evaluate the diagnostic utility of basal and post-exercise QRS-T angle in patients with stable coronary artery disease (CAD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional and observational study analyzed 190 patients with stable angina. The QRS-T angle is measured on the 12-lead electrocardiograms at baseline and just after stopping the treadmill stress test in patients undergoing conventional coronary angiography (CAG). The pre- and post-exercise QRS-T angle and ΔQRS-T angle were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 190 patients, 66 (34.7%) were assigned to group 1 (patients with coronary lesion) and 124 (65.3%) to group 2 (patients without coronary lesion) after CAG. There was no statistically significant difference in QRS-T angle between groups at baseline (pre-exercise) (30.7 ± 17 vs. 27.8 ± 12.8, <i>p</i> = .233). The QRS-T angle value was significantly higher in group 1 than in group 2 (68.8 ± 40.3 vs. 22.7 ± 21.5, <i>p</i> = .01) after exercise (post-exercise). The ΔQRS-T angle was also significantly higher in group 1 than in group 2 (38.1 ± 37.6 vs. −5.1 ± 22.9, <i>p</i> = .01). Receiver operating characteristic curve revealed that the cut-off value of QRS-T angle (post-exercise) for the coronary obstruction was &gt;51.5° with 81% of sensitivity and 66% of specificity (AUC: 0.832, <i>p</i> = .001, CI: 0.769–0.894). Duke treadmill score for coronary stenosis was &gt;1.5 with 77% of sensitivity and 69% of specificity (AUC: 0.814, <i>p</i> = .001, CI: 0.749–0.878).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It could be proposed that post-exercise QRS-T angle and Δ QRS-T angle are significantly associated with coronary obstruction in patients with stable angina and appear to be more sensitive than the Duke treadmill score and traditional electrocardiographic parameters.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/f5/ANEC-28-e13082.PMC10475882.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10150845","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":"Genetic variant annotation scores in congenital long QT syndrome","authors":"Arwa Younis MD,&nbsp;Christopher Bodurian BA,&nbsp;Dan E. Arking PhD,&nbsp;Nicola Luigi Bragazzi MD, PhD, MPH,&nbsp;Chadi Tabaja MD,&nbsp;Wojciech Zareba MD, PhD,&nbsp;Scott McNitt MS,&nbsp;Mehmet K. Aktas MD, MBA,&nbsp;Bronislava Polonsky MS,&nbsp;Coeli M. Lopes PhD,&nbsp;Nona Sotoodehnia MD,&nbsp;Peter J. Kudenchuk MD,&nbsp;Ilan Goldenberg MD","doi":"10.1111/anec.13080","DOIUrl":"10.1111/anec.13080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Congenital Long QT Syndrome (LQTS) is a hereditary arrhythmic disorder. We aimed to assess the performance of current genetic variant annotation scores among LQTS patients and their predictive impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated 2025 patients with unique mutations for LQT1–LQT3. A patient-specific score was calculated for each of four established genetic variant annotation algorithms: CADD, SIFT, REVEL, and PolyPhen-2. The scores were tested for the identification of LQTS and their predictive performance for cardiac events (CE) and life-threatening events (LTE) and then compared with the predictive performance of LQTS categorization based on mutation location/function. Score performance was tested using Harrell's C-index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 917 subjects were classified as LQT1, 838 as LQT2, and 270 as LQT3. The identification of a pathogenic variant occurred in 99% with CADD, 92% with SIFT, 100% with REVEL, and 86% with PolyPhen-2. However, none of the genetic scores correlated with the risk of CE (Harrell's C-index: CADD = 0.50, SIFT = 0.51, REVEL = 0.50, and PolyPhen-2 = 0.52) or LTE (Harrell's C-index: CADD = 0.50, SIFT = 0.53, REVEL = 0.54, and PolyPhen-2 = 0.52). In contrast, high-risk mutation categorization based on location/function was a powerful independent predictor of CE (HR = 1.88; <i>p</i> &lt; .001) and LTE (HR = 1.89, <i>p</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In congenital LQTS patients, well-established algorithms (CADD, SIFT, REVEL, and PolyPhen-2) were able to identify the majority of the causal variants as pathogenic. However, the scores did not predict clinical outcomes. These results indicate that mutation location/functional assays are essential for accurate interpretation of the risk associated with LQTS mutations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/ad/ANEC-28-e13080.PMC10475886.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10157178","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 silent myocardial infarction on electrocardiogram and coronary artery calcium: The Multi-Ethnic Study of Atherosclerosis","authors":"Richard Kazibwe MD, MSc,&nbsp;Matthew J. Singleton MD, MBE, MHS, MSc,&nbsp;Charles A. German MD, MSc,&nbsp;Elsayed Z. Soliman MD, MSc, MS,&nbsp;Gregory L. Burke MD, MS,&nbsp;Joseph Yeboah MD, MSc","doi":"10.1111/anec.13081","DOIUrl":"10.1111/anec.13081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Silent myocardial infarction (SMI) on electrocardiogram (ECG) is associated with atherosclerotic cardiovascular disease, but the relationship between SMI on ECG and coronary artery calcium (CAC) remains poorly understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Characterize the relationship between SMI on ECG and CAC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eligible participants from the Multi-Ethnic Study of Atherosclerosis study had ECG and CAC scoring at study enrollment (2000–2002). SMI was defined as ECG evidence of myocardial infarction in the absence of a history of clinical cardiovascular disease. CAC was modeled both continuously and categorically. The cross-sectional relationships between SMI on ECG and CAC were assessed using logistic regression and linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 6705 eligible participants, 178 (2.7%) had baseline SMI. Compared to participants without SMI, those with SMI had higher CAC (median [IQR]: 61.2 [0–261.7] vs. 0 [0–81.5]; <i>p</i> &lt; .0001). Participants with SMI were more likely to have non-zero CAC (74% vs. 49%) and were more likely to have CAC ≥ 100 (40% vs. 23%). In a multivariable-adjusted logistic model, SMI was associated with higher odds of non-zero CAC (odds ratio 2.17, 95% CI 1.48–3.20, <i>p</i> &lt; .0001) and 51% higher odds of CAC ≥ 100 (odds ratio 1.51, 95% CI 1.06–2.16, <i>p</i> = .02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An incidental finding of SMI on ECG may serve to identify patients who have a higher odds of significant CAC and may benefit from additional risk stratification to further refine their cardiovascular risk. Further exploration of the utility of CAC assessment in this patient population is needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13081","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10513044","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":"Predicting stroke and mortality in mitral stenosis with atrial flutter: A machine learning approach","authors":"Amer Rauf MBBS,&nbsp;Asif Ullah MBBS,&nbsp;Usha Rathi MBBS,&nbsp;Zainab Ashfaq MBBS,&nbsp;Hidayat Ullah MBBS,&nbsp;Amna Ashraf MBBS,&nbsp;Jateesh Kumar MBBS,&nbsp;Maria Faraz MS,&nbsp;Waheed Akhtar MBBS,&nbsp;Amin Mehmoodi MD,&nbsp;Jahanzeb Malik MBBS","doi":"10.1111/anec.13078","DOIUrl":"10.1111/anec.13078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Our study hypothesized that an intelligent gradient boosting machine (GBM) model can predict cerebrovascular events and all-cause mortality in mitral stenosis (MS) with atrial flutter (AFL) by recognizing comorbidities, electrocardiographic and echocardiographic parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The machine learning model was used as a statistical analyzer in recognizing the key risk factors and high-risk features with either outcome of cerebrovascular events or mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2184 patients with their chart data and imaging studies were included and the GBM analysis demonstrated mitral valve area (MVA), right ventricular systolic pressure, pulmonary artery pressure (PAP), left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) class, and surgery as the most significant predictors of transient ischemic attack (TIA/stroke). MVA, PAP, LVEF, creatinine, hemoglobin, and diastolic blood pressure were predictors for all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The GBM model assimilates clinical data from all diagnostic modalities and significantly improves risk prediction performance and identification of key variables for the outcome of MS with AFL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/53/ANEC-28-e13078.PMC10475890.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161925","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":"Deep learning-mediated prediction of concealed accessory pathway based on sinus rhythmic electrocardiograms","authors":"Lei Wang PhD,&nbsp;Fang Yang MD,&nbsp;Xiao-Jing Bao MD,&nbsp;Xiao-Ping Bo MD,&nbsp;Shipeng Dang MD, PhD,&nbsp;Ru-Xing Wang MD, PhD,&nbsp;Feng Pan PhD","doi":"10.1111/anec.13072","DOIUrl":"10.1111/anec.13072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Concealed accessory pathway (AP) may cause atrial ventricular reentrant tachycardia impacting the health of patients. However, it is asymptomatic and undetectable during sinus rhythm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To detect concealed AP with electrocardiography (ECG) images, we collected normal sinus rhythmic ECG images of concealed AP patients and healthy subjects. All ECG images were randomly allocated to the training and testing datasets, and were used to train and test six popular convolutional neural networks from ImageNet pre-training and random initialization, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We screened 152 ECG recordings in concealed AP group and 600 ECG recordings in control group. There were no statistically significant differences in ECG characteristics between control group and concealed AP group in terms of PR interval and QRS interval. However, the QT interval and QTc were slightly higher in control group than in concealed AP group. In the testing set, ResNet26, SE-ResNet50, MobileNetV3_large_100, and DenseNet169 achieved a sensitivity rate more than 87.0% with a specificity rate above 98.0%. And models trained from random initialization showed similar performance and convergence with models trained from ImageNet pre-training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study suggests that deep learning could be an effective way to predict concealed AP with normal sinus rhythmic ECG images. And our results might encourage people to rethink the possibility of training from random initialization on ECG image tasks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10158553","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":"Design and characteristics of the prophylactic intra-operative ventricular arrhythmia ablation in high-risk LVAD candidates (PIVATAL) trial","authors":"David T. Huang MD,&nbsp;Igor Gosev MD, PhD,&nbsp;Katherine L. Wood MD,&nbsp;Hima Vidula MD,&nbsp;William Stevenson MD,&nbsp;Frank Marchlinski MD,&nbsp;Gregory Supple MD,&nbsp;Sandip K. Zalawadiya MD,&nbsp;J. Peter Weiss MD,&nbsp;Roderick Tung MD,&nbsp;Wendy S. Tzou MD,&nbsp;Joshua D. Moss MD,&nbsp;Krishna Kancharla MD,&nbsp;Sunit-Preet Chaudhry MD,&nbsp;Parin J. Patel MD,&nbsp;Arfaat M. Khan MD,&nbsp;Claudio Schuger MD,&nbsp;Guy Rozen MD,&nbsp;Michael S. Kiernan MD,&nbsp;Gregory S. Couper MD,&nbsp;Marzia Leacche MD,&nbsp;Ezequiel J. Molina MD,&nbsp;Anand D. Shah MD,&nbsp;Michael Lloyd MD,&nbsp;Jakub Sroubek MD, PhD,&nbsp;Edward Soltesz MD,&nbsp;Kalyanam Shivkumar MD, PhD,&nbsp;Casey White MD,&nbsp;Sinan Tankut MD,&nbsp;Brent A. Johnson PhD,&nbsp;Scott McNitt MS,&nbsp;Valentina Kutyifa MD, PhD,&nbsp;Wojciech Zareba MD, PhD,&nbsp;Ilan Goldenberg MD","doi":"10.1111/anec.13073","DOIUrl":"10.1111/anec.13073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The use of a Left Ventricular Assist Device (LVAD) in patients with advanced heart failure refractory to optimal medical management has progressed steadily over the past two decades. Data have demonstrated reduced LVAD efficacy, worse clinical outcome, and higher mortality for patients who experience significant ventricular tachyarrhythmia (VTA). We hypothesize that a novel prophylactic intra-operative VTA ablation protocol at the time of LVAD implantation may reduce the recurrent VTA and adverse events postimplant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We designed a prospective, multicenter, open-label, randomized-controlled clinical trial enrolling 100 patients who are LVAD candidates with a history of VTA in the previous 5 years. Enrolled patients will be randomized in a 1:1 fashion to intra-operative VTA ablation (<i>n</i> = 50) versus conventional medical management (<i>n</i> = 50) with LVAD implant. Arrhythmia outcomes data will be captured by an implantable cardioverter defibrillator (ICD) to monitor VTA events, with a uniform ICD programming protocol. Patients will be followed prospectively over a mean of 18 months (with a minimum of 9 months) after LVAD implantation to evaluate recurrent VTA, adverse events, and procedural outcomes. Secondary endpoints include right heart function/hemodynamics, healthcare utilization, and quality of life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The primary aim of this first-ever randomized trial is to assess the efficacy of intra-operative ablation during LVAD surgery in reducing VTA recurrence and improving clinical outcomes for patients with a history of VTA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/ac/ANEC-28-e13073.PMC10475893.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161420","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":"A method for noninvasive beat-by-beat visualization of His bundle signals","authors":"S. Sengottuvel ME,&nbsp;S. Shenbaga Devi PhD,&nbsp;M. Sasikala PhD,&nbsp;S. Satheesh DM,&nbsp;R. J. Selvaraj MD","doi":"10.1111/anec.13076","DOIUrl":"10.1111/anec.13076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Invasive recording of His bundle signals (HBS) in electrophysiological study (EPS) is important in determining HV interval, the time taken to activate the ventricles from the His bundle. Noninvasive surface measurements of HBS are attempted by averaging typically 100–200 cardiac cycles of ECG time series in body surface potential mapping (BSPM) and in magnetocardiography (MCG) which records weak cardiac magnetic fields by highly sensitive detectors. However, noninvasive beat-by-beat extraction of HBS is challenged by ramp-like atrial signals and noise in PR segment of the cardiac cycle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>By making use of a signal-averaged trace showing prominent HBS as a guide trace, we developed a method combining interval-dependent wavelet thresholding (IDWT) and signal space projection (SSP) technique to eliminate artifacts from single beats. The method was applied on MCG recorded on 21 subjects with known HV intervals based on EPS and noninvasive signal-averaging, including five subjects with BSPM recorded subsequently. The method was also applied on stress-MCG of a subject featuring autonomic dynamics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HBS could be extracted from 19 out of 21 subjects by signal-averaging whose timing differed from EPS between −8 and 11 ms as tested by 2 observers. HBS in single beats were seen as aligned patterns in inter-beat contours and were appreciable in stress-MCG and conspicuous than BSPM. The performance of the method was evaluated on simulated and measured MCG to be adequate if the signal-to-noise ratio was at least 20 dB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results suggest the use of this method for noninvasive assessments on HBS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10512538","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}