Annals of Noninvasive Electrocardiology最新文献

{"title":"Prognostic significance of the Holter-derived T-wave variability in patients with ventricular tachyarrhythmias complicating acute coronary syndrome—TWIST study","authors":"Taro Makino MD,&nbsp;Tomohide Ichikawa MD,&nbsp;Mari Amino MD,&nbsp;Mari Nakamura MD,&nbsp;Masayuki Koshikawa MD,&nbsp;Yuji Motoike MD,&nbsp;Yoshihiro Nomura MD,&nbsp;Masahide Harada MD,&nbsp;Yoshihiro Sobue MD,&nbsp;Eiichi Watanabe MD,&nbsp;Ken Kiyono PhD,&nbsp;Koichiro Yoshioka MD,&nbsp;Yuji Ikari MD,&nbsp;Yukio Ozaki MD,&nbsp;Hideo Izawa MD","doi":"10.1111/anec.13069","DOIUrl":"10.1111/anec.13069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to investigate the association between ventricular repolarization instability and sustained ventricular tachycardia and ventricular fibrillation (VT/VF) occurring within 48 h (acute-phase VT/VF) after the onset of acute coronary syndrome (ACS) and the prognostic role of repolarization instability and heart rate variability (HRV) after discharge from the hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied 572 ACS patients with a left ventricular ejection fraction &gt;35%. The ventricular repolarization instability was assessed by the beat-to-beat T-wave amplitude variability (TAV) using high-resolution 24-h Holter ECGs recorded at a median of 11 days from the date of admission. We calculated the HRV parameters including the deceleration capacity (DC) and non-Gaussian index calculated on a 25 s timescale (λ25s). The DC and λ25s were dichotomized based on previous studies' thresholds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Acute-phase VT/VF developed in 43 (7.5%) patients. In-hospital mortality was significantly higher among VT/VF patients (4.7% vs. 0.9%, <i>p</i> = .03). An adjusted logistic model showed that the maximum TAV (odds ratio 1.02, 95% confidence interval [CI] 1.00–1.29, <i>p</i> = .04) was associated with acute-phase VT/VF. During a median follow-up period of 2.1 years, 19 (3.3%) patients had cardiac deaths or resuscitated cardiac arrest. Acute-phase VT/VF (<i>p</i> = .12) and TAV (<i>p</i> = .72) were not significant predictors of survival. An age and sex-adjusted Cox model showed that the DC (<i>p</i> &lt; .01), λ25s (<i>p</i> &lt; .01), and emergency coronary intervention (<i>p</i> &lt; .01) were independent predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>T-wave amplitude variability was associated with acute-phase VT/VF, but the TAV was not predictive of survival post-discharge. The DC, λ25s, and emergency coronary intervention were independent predictors of survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41100446","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":"Increasing averaging beats improves the test accuracy on Holter-based late potentials in patients with myocardial infarction","authors":"Kenichi Hashimoto MD, PhD, ISHNE-F,&nbsp;Naomi Harada MA,&nbsp;Motohiro Kimata MD,&nbsp;Yusuke Kawamura MD,&nbsp;Naoya Fujita MD,&nbsp;Akinori Sekizawa MD,&nbsp;Yosuke Ono MD, PhD,&nbsp;Yasuhiro Obuchi MD, PhD,&nbsp;Tadateru Takayama MD, PhD,&nbsp;Yuji Kasamaki MD, PhD,&nbsp;Yuji Tanaka MD, PhD","doi":"10.1111/anec.13089","DOIUrl":"10.1111/anec.13089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevalence of Holter-based late potentials (H-LPs) in cases of fatal cardiac events has increased. Although the noise level of H-LP is higher than that of conventional real-time late potential (LP) recording, a procedure to reduce the noise severity in H-LP by increasing the averaging beats has not been investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 104 patients with post-myocardial infarction (MI) and 86 control participants. Among the patients, 30 reported sustained ventricular tachycardia (VT), and the remaining 74 had unrecorded VT. H-LPs were measured twice in all groups to evaluate the efficacy of increasing the averaging beats for H-LPs. Thereafter, the average of LP was calculated at 250 (default setting), 300, 400, 500, 600, 700, and 800 beats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across all three groups (MI-VT group, MI non-VT group, and control group), the noise levels significantly decreased in consonance with the increase in averaging beats. In the MI-VT group, the H-LP positive rate considerably increased with the increase in the averaging beats from 250 to 800 both at night and daytime. In the MI-VT group, the LP parameters significantly deteriorated, which led to a positive judgment corresponding to the increment of the averaged night and day beats. The H-LP positive rates were unchanged in the MI non-VT and control groups, while the LP parameters remained consistent, despite the increased averaging beats in the MI non-VT and control groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Increasing the calculated averaging beats in H-LPs can improve the sensitivity of predicting fatal cardiac events in patients with MI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41105595","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":"Reassessing the clinical significance of electrocardiographically unrecognized myocardial infarctions: Radionuclide infarct size and its impact on long-term prognosis","authors":"Khawaja Afzal Ammar MD, MS,&nbsp;Richard J. Rodeheffer MD","doi":"10.1111/anec.13088","DOIUrl":"10.1111/anec.13088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Silent or unrecognized myocardial infarction (UMI) diagnosed by surveillance electrocardiography (ECG) carries similarly poor prognosis as recognized MI (RMI) for poorly understood reasons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 5430 consecutive patients who presented to the nuclear laboratory and underwent 2-day stress and rest Tc-^99m sestamibi and ECG studies between March 1991 and June 1999. UMI was diagnosed if ECG showed <i>Q</i>-wave MI in the absence of a history of RMI. We measured infarct size (% defect size as compared with the entire left ventricular sestamibi uptake), ejection fraction (EF, %), and summed difference score (SDS, sestamibi uptake by myocardium in stress minus sestamibi uptake in rest images as a marker of ischemia). Survival was determined by follow-up survey (median 6 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 346 UMIs, 628 RMIs, and 4456 subjects without MI (No MI). As compared with RMI, UMI patients had lesser abnormalities on nuclear scans (<i>p</i> &lt; .0001 for all), including smaller infarct size (5.7% vs. 12.2%), higher EF (58% vs. 53%), and lesser ischemia (SDS; 3.9% vs. 2.7%). UMI prognosis was as poor as that of RMI (annual mortality rate 4.7% vs. 4.8% with No MI rate of 2.9%; <i>p</i> &lt; .001 for all comparisons), and this persisted after multivariate analysis. Infarct size quantification successfully risk-stratified ECG-UMI patients, but UMI patients continued to predict mortality even if the infarct size was 0%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although UMI patients have lesser abnormalities on nuclear scans, ECG-based UMI continues to independently predict mortality, indicating the continuing relevance of ECG in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232071","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":"Risk assessment of post-myocardial infarction patients with preserved ejection fraction using 45-min short resting Holter electrocardiographic recordings","authors":"Konstantinos Triantafyllou MD,&nbsp;Nikolaos Fragakis MD, PhD,&nbsp;Konstantinos A. Gatzoulis MD, PhD,&nbsp;Antonios Antoniadis MD, PhD,&nbsp;Georgios Giannopoulos MD, PhD,&nbsp;Petros Arsenos MD, PhD,&nbsp;Dimitrios Tsiachris MD, PhD,&nbsp;Christos-Konstantinos Antoniou MD, PhD,&nbsp;Konstantinos Trachanas MD, PhD,&nbsp;Konstantinos Tsimos MD, PhD,&nbsp;Vassilios Vassilikos MD, PhD","doi":"10.1111/anec.13087","DOIUrl":"10.1111/anec.13087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Risk stratification for sudden cardiac death in post-myocardial infarction (post-MI) patients remains a challenging task. Several electrocardiographic noninvasive risk factors (NIRFs) have been associated with adverse outcomes and were used to refine risk assessment. This study aimed to evaluate the performance of NIRFs extracted from 45-min short resting Holter ECG recordings (SHR), in predicting ventricular tachycardia inducibility with programmed ventricular stimulation (PVS) in post-MI patients with preserved left ventricular ejection fraction (LVEF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied 99 post-MI ischemia-free patients (mean age: 60.5 ± 9.5 years, 86.9% men) with LVEF ≥40%, at least 40 days after revascularization. All the patients underwent PVS and a high-resolution SHR. The following parameters were evaluated: mean heart rate, ventricular arrhythmias (premature ventricular complexes, couplets, tachycardias), QTc duration, heart rate variability (HRV), deceleration capacity, heart rate turbulence, late potentials, and T-wave alternans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PVS was positive in 24 patients (24.2%). HRV, assessed by the standard deviation of normal-to-normal R–R intervals (SDNN), was significantly decreased in the positive PVS group (42 ms vs. 51 ms, <i>p</i> = .039). SDNN values &lt;50 ms were also associated with PVS inducibility (OR 3.081, <i>p</i> = .032 in univariate analysis, and 4.588, <i>p</i> = .013 in multivariate analysis). No significant differences were identified for the other NIRFs. The presence of diabetes, history of ST-elevation MI (STEMI) and LVEF &lt;50% were also important predictors of positive PVS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HRV assessed from SHR, combined with other noninvasive clinical and echocardiographic variables (diabetes, STEMI history, LVEF), can provide an initial, practical, and rapid screening tool for arrhythmic risk assessment in post-MI patients with preserved LVEF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223305","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 right bundle branch block or intraventricular conduction delay with recurrence of atrial fibrillation after catheter ablation","authors":"Sung Ho Lee MD, PhD,&nbsp;Ji-Hoon Choi MD,&nbsp;Seung-Jung Park MD, PhD,&nbsp;Kyoung-Min Park MD, PhD,&nbsp;June Soo Kim MD, PhD,&nbsp;Young Keun On MD, PhD","doi":"10.1111/anec.13083","DOIUrl":"10.1111/anec.13083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between bundle branch block (BBB) and recurrence of atrial fibrillation (AF) after catheter ablation is unclear. The aim of this study was to determine whether AF combined with BBB is associated with AF recurrence after catheter ablation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 477 consecutive AF patients who underwent catheter ablation were included. The AF patients were divided into three groups according to BBB: AF without BBB (<i>n</i> = 427), AF with right bundle branch block (AF with RBBB) (<i>n</i> = 16), and AF with intraventricular conduction delay (AF with IVCD) (<i>n</i> = 34).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 477 AF patients (mean age 57 years, 81% men, median CHA₂DS₂-VASc score of 1), 16 (3.4%) patients had RBBB, and 34 (7.1%) patients had IVCD. During a mean follow-up of 15.2 ± 6.7 months, 119 patients (24.9%) had recurrence of AF. Of these, 111 (26%) patients were in the AF without BBB group, with 2 (12.5%) and 6 (17.6%) patients in the RBBB and IVCD groups, respectively. The Kaplan–Meier estimate of the rate of recurrent AF was not significantly different among the three groups (<i>p</i> = .39). Multivariable analysis showed that persistent AF (HR 1.7, 95% CI 1.15–2.50, <i>p</i> = .007), chronic kidney disease (HR 2.94, 95% CI 1.20–7.17, <i>p</i> = .01), and left atrial diameter (HR 1.04, 95% CI 1.009–1.082, <i>p</i> = .01) were significantly associated with AF recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AF with BBB was not significantly associated with the recurrence of AF after catheter ablation in middle-aged patients with low-risk cardiovascular profile.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193399","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":"Mayo Clinic VT calculator: A practical tool for accurate wide complex tachycardia differentiation","authors":"Anthony H. Kashou MD,&nbsp;Sarah LoCoco MD,&nbsp;Matthew R. Gardner MBA, MDes,&nbsp;Jocelyn Webb BS,&nbsp;Jacob C. Jentzer MD,&nbsp;Peter A. Noseworthy MD,&nbsp;Christopher V. DeSimone MD, PhD,&nbsp;Abhishek J. Deshmukh MBBS,&nbsp;Samuel J. Asirvatham MD,&nbsp;Adam M. May MD","doi":"10.1111/anec.13085","DOIUrl":"10.1111/anec.13085","url":null,"abstract":"<p>The discrimination of ventricular tachycardia (VT) versus supraventricular wide complex tachycardia (SWCT) via 12-lead electrocardiogram (ECG) is crucial for achieving appropriate, high-quality, and cost-effective care in patients presenting with wide QRS complex tachycardia (WCT). Decades of rigorous research have brought forth an expanding arsenal of applicable manual algorithm methods for differentiating WCTs. However, these algorithms are limited by their heavy reliance on the ECG interpreter for their proper execution. Herein, we introduce the Mayo Clinic ventricular tachycardia calculator (MC-VTcalc) as a novel generalizable, accurate, and easy-to-use means to estimate VT probability independent of ECG interpreter competency. The MC-VTcalc, through the use of web-based and mobile device platforms, only requires the entry of computerized measurements (i.e., QRS duration, QRS axis, and T-wave axis) that are routinely displayed on standard 12-lead ECG recordings.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161214","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 large population-based study on the prevalence of electrocardiographic abnormalities: A result of Mashhad stroke and heart atherosclerotic disorder cohort study","authors":"Sara Saffar Soflaei MD, PhD,&nbsp;Mahmoud Ebrahimi MD,&nbsp;Hamid Reza Rahimi MD, PhD,&nbsp;AmirAli Moodi Ghalibaf MD,&nbsp;Maryam Jafari MD,&nbsp;Hedieh Alimi MD,&nbsp;Nasrin Talkhi MSc,&nbsp;Bahram Shahri MD,&nbsp;Alireza Heidari-Bakavoli MD,&nbsp;Fatemeh Malakouti,&nbsp;Mahla Velayati,&nbsp;Reza Assaran-Darban PhD,&nbsp;Malihehsadat Abedsaeidi MSc,&nbsp;Farnoosh Azarian MSc,&nbsp;MohammadReza Latifi MSc,&nbsp;Mohammad Reza Mohammad Taghizadeh Sarabi MSc,&nbsp;Gordon A. Ferns MD, PhD,&nbsp;Habibollah Esmaily PhD,&nbsp;Mohsen Moohebati MD,&nbsp;Majid Ghayour-Mobarhan MD, PhD","doi":"10.1111/anec.13086","DOIUrl":"10.1111/anec.13086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Twelve-lead electrocardiogram (ECG) is a common and inexpensive tool for the diagnostic workup of patients with suspected cardiovascular disease, both in clinical and epidemiological settings. The present study was designed to evaluate ECG abnormalities in Mashhad population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ECGs were taken as part of MASHAD cohort study (phase1) and were coded according to the Minnesota coding criteria. Data were analyzed using SPSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total 9035 ECGs were available for final analysis including 3615 (40.0%) male and 5420 (60.0%) female. Among ECG abnormalities precordial Q wave, major T-wave abnormalities, inferior Q wave, sinus bradycardia, and left axis deviation were the most prevalent abnormalities. The frequency of precordial and inferior Q wave, inferior QS pattern, major and minor ST abnormalities, major and minor T abnormalities, Wolff-Parkinson-White and Brugada pattern, sinus bradycardia, sinus tachycardia, left axis deviation, ST elevation, and tall T wave were significantly different between two genders. Moreover, the frequency of Q wave in precordial and aVL leads, QS pattern in precordial and inferior leads, major and minor T-wave abnormalities, Wolff-Parkinson-White, atrial fibrillation, sinus bradycardia, left axis deviation, and ST elevation were significantly different in different age groups. A comparison of the heart rate, P-wave duration, and QRS duration between men and women indicated that there was a significant difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our finding indicated that the prevalence ECG abnormalities are different between men and women and also it varied in different age groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10518924","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":"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}