Annals of Noninvasive Electrocardiology最新文献

{"title":"Correlation Analysis of 24-h Minimum Heart Rate Levels and Deceleration Capacity of Heart Rate in Patients With Type 2 Diabetes Mellitus Complicated With Essential Hypertension","authors":"Pingping Wu,&nbsp;Zhengrong Xu,&nbsp;Xiuyu Zheng,&nbsp;Linying Gong,&nbsp;Hongkun Qiao,&nbsp;Guoyan Xu,&nbsp;Qunfang Xie","doi":"10.1111/anec.70189","DOIUrl":"10.1111/anec.70189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the association between 24-h minimum heart rate (MHR) and deceleration capacity (DC) in patients with type 2 diabetes mellitus (T2DM) and essential hypertension (EH) and to explore DC differences across sex-stratified MHR categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-center cross-sectional study, 123 patients with T2DM and EH were stratified by sex-specific 24-h MHR thresholds (reduced/normal/elevated) based on previous studies. DC and heart rate variability (HRV) indices were derived from 24-h Holter recordings. Bivariate correlation analysis was performed to examine the relationship between MHR and DC. Subsequently, multiple linear regression analysis was conducted with DC as the dependent variable to identify independent predictors of DC. Demographics, HRV indices, echocardiographic parameters, and laboratory findings were included as independent variables. Subgroup analyses stratified by sex and MHR categories were also performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MHR showed a significant negative correlation with DC (<i>r</i> = −0.484, <i>p</i> &lt; 0.001). Stepwise multiple linear regression identified age (<i>β</i> = −0.264, <i>p</i> &lt; 0.001), MHR (<i>β</i> = −0.320, <i>p</i> = 0.001), and SDNN_INDX (<i>β</i> = 0.316, <i>p</i> = 0.001) as independent DC predictors. Sex-MHR subgroup analysis revealed: In Group B (normal MHR), age predicted reduced DC in both sexes (males: <i>β</i> = −0.375, <i>p</i> = 0.041; females: <i>β</i> = −0.612, <i>p</i> = 0.009). In Group C (elevated MHR), SDNN_INDX correlated with higher DC in both sexes (males: <i>β</i> = 0.363, <i>p</i> = 0.027; females: <i>β</i> = 0.808, <i>p</i> &lt; 0.001). MHR negatively impacted DC only in males with elevated MHR (<i>β</i> = −0.386, <i>p</i> = 0.019).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Age predicts reduced DC within normal MHR ranges, while preserved SDNN_INDX correlates with higher DC in elevated MHR subgroups. This sex- and MHR-stratified approach enables personalized risk stratification in T2DM and EH patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conduction System Pacing-Induced Ventricular Arrhythmia: Case Report","authors":"Serhat Kesriklioglu,&nbsp;Ahmet Taha Sahin,&nbsp;Mertcan Gezer,&nbsp;Mustafa Celik,&nbsp;Ahmet Lutfu Sertdemir,&nbsp;Enes Elvin Gul","doi":"10.1111/anec.70190","DOIUrl":"10.1111/anec.70190","url":null,"abstract":"<p>Left bundle branch–optimized cardiac resynchronization therapy (LOT-CRT), combining left bundle branch area pacing (LBBAP) with a left ventricular lead, offers physiological activation and improved synchrony compared with conventional biventricular pacing. We report a 78-year-old woman with pacing-induced cardiomyopathy who underwent LOT-CRT, resulting in QRS narrowing but notable QT prolongation and T-wave inversions. On the first post-implant day, she developed ventricular fibrillation triggered by premature ventricular complexes, without reversible metabolic or ischemic cause. This case highlights the potential for early post-procedural ventricular arrhythmias in structurally compromised ventricles, underscoring the importance of vigilant monitoring and individualized risk assessment following LOT-CRT.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stabilizing Extreme Few-Shot ECG Classification via Self-Supervised Contrastive Pretraining","authors":"LiuPing Zeng,&nbsp;JingMei Pan,&nbsp;YangJie Lu,&nbsp;Xian Pan","doi":"10.1111/anec.70188","DOIUrl":"10.1111/anec.70188","url":null,"abstract":"<p>In clinical electrocardiogram (ECG) analysis, high-quality annotations are expensive and difficult to scale, leaving many tasks in an extreme few-shot learning regime. We formulate a single-label Top-5 rhythm classification task on PTB-XL and strictly limit supervised training to <i>N</i> = 70 labeled samples (14 per class) to characterize failure modes of scratch training and assess the stabilizing effect of self-supervised learning (SSL). We first perform SimCLR-style contrastive pretraining with the NT-Xent loss on 16,304 unlabeled ECG recordings, followed by supervised fine-tuning. To isolate the independent contribution of SSL initialization, downstream augmentation is disabled (NoAug) in the core evaluation. Performance and stability are assessed using Macro-F1, best validation epoch, and a collapse rate defined as Best Epoch ≤ 1. Under <i>N</i> = 70, scratch training exhibits systematic early collapse (Macro-F1 = 0.115 ± 0.072; collapse rate = 66.7%), which is not alleviated by strong downstream augmentation alone (0.108 ± 0.042; 66.7%). In contrast, SSL fine-tuning without downstream augmentation improves Macro-F1 to 0.192 ± 0.003 and reduces the collapse rate to 0%, with markedly reduced inter-seed variance. A balanced <i>N</i> = 300 reference achieves Macro-F1 = 0.297 ± 0.018. These results indicate that, in extreme few-shot ECG classification, the primary bottleneck is training reproducibility rather than peak accuracy, and SSL contrastive pretraining provides a robust initialization that substantially mitigates collapse and improves usability.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Outcomes of ICE Versus TEE/Fluoroscopy Guidance Transseptal Puncture in LA Procedures: A Systematic Review and Meta-Analysis","authors":"Asim Mohammed Eldai Abdalla,&nbsp;Kolluru Pavani Durga,&nbsp;Animisha Chukka,&nbsp;Mounika Kotte,&nbsp;Muhammad Awais,&nbsp;Abida Perveen,&nbsp;Jahanzeb Malik","doi":"10.1111/anec.70186","DOIUrl":"10.1111/anec.70186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the comparative efficacy, safety, and radiation exposure outcomes of intracardiac echocardiography (ICE)-guided versus TEE/fluoroscopy-guided trans-septal puncture (TSP) in left atrial procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of randomized and observational studies comparing ICE-guided with TEE- or fluoroscopy-only–guided TSP. Eight studies encompassing over 9000 patients undergoing atrial fibrillation (AF) ablation or left atrial appendage occlusion (LAAO) were included. Primary endpoints were fluoroscopy time, radiation dose, first-pass success, puncture time, total procedure time, and major safety outcomes. Random-effects models were used to pool mean differences or hazard ratios with 95% confidence intervals (CIs). Risk of bias was assessed using validated tools, and funnel plots with sensitivity analyses evaluated robustness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ICE guidance significantly reduced fluoroscopy time (MD –2.07 min, 95% CI –2.37 to −1.77; <i>p</i> &lt; 0.001) and radiation dose (MD –2.30, 95% CI –3.27 to −1.27; <i>p</i> &lt; 0.001). First-pass success and total procedure time were comparable between groups. Safety endpoints, including tamponade, pericardial effusion, and composite major adverse events, showed no significant increase with ICE. Funnel plots and leave-one-out analyses confirmed the stability of results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ICE-guided TSP reduces radiation exposure without compromising efficacy or safety, supporting its adoption as a valuable imaging modality in left atrial interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147637827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Outcomes of Supraclavicular Access in Temporary Pacemaker Implantation”","authors":"Ezgi Çamlı Babayiğit,&nbsp;Erdi Babayiğit,&nbsp;Bülent Görenek","doi":"10.1111/anec.70179","DOIUrl":"10.1111/anec.70179","url":null,"abstract":"&lt;p&gt;We read with great interest the article by Ben Yezza et al. entitled Outcomes of Supraclavicular Access in Temporary Pacemaker Implantation (Yezza et al. &lt;span&gt;2026&lt;/span&gt;). The authors should be commended for addressing an important yet relatively underexplored venous access route in urgent pacing scenarios.&lt;/p&gt;&lt;p&gt;The study highlights the feasibility and high procedural success of the supraclavicular approach, with a reportedly low complication profile. Given the ongoing search for safer and faster vascular access in critically ill patients requiring temporary pacing, these findings are clinically relevant and timely. The straight anatomical course to the brachiocephalic vein and the potential for improved lead stability are particularly noteworthy advantages emphasized by the authors.&lt;/p&gt;&lt;p&gt;However, several methodological points merit clarifications. First, the study design defines the infraclavicular group as patients who underwent femoral venous access. In this context, the reported higher pneumothorax rate in the infraclavicular group appears unexpected, given that pneumothorax is exceedingly rare with femoral cannulation. Clarification of the exact access routes included in each group and the attribution of access-related complications would help readers interpret these findings more accurately.&lt;/p&gt;&lt;p&gt;Second, the authors state that both supraclavicular and femoral procedures were performed by the same cardiology team and that operator experience was accounted for in the statistical analysis to minimize variability. However, the presentation of operator experience within the baseline characteristics table raises questions regarding how this variable was modeled and adjusted for in the comparative analysis. Providing additional details on whether operator experience was treated as a covariate, stratification factor, or matching variable would strengthen confidence in the internal validity of the results.&lt;/p&gt;&lt;p&gt;An additional anatomical consideration that warrants discussion is the presence of persistent superior vena cava, particularly persistent left superior vena cava (PLSVC) (Hassine et al. &lt;span&gt;2015&lt;/span&gt;). The manuscript notes that procedures were performed via right-sided access, which may have mitigated some of the technical challenges associated with venous anomalies. However, in clinical practice—especially when left supraclavicular access is used—PLSVC can substantially alter lead trajectory via the coronary sinus and increase procedural complexity. Explicit discussion of how the findings might translate to left-sided supraclavicular approaches would further enhance the generalizability and practical relevance of the study.&lt;/p&gt;&lt;p&gt;Despite these limitations, the authors provide valuable data supporting supraclavicular venous access as a viable alternative for temporary pacing. We congratulate the authors on their contribution and look forward to further comparative studies that will help better define the role of this approach in ","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-ROSC ST-Segment Elevation: A Diagnostic Pitfall in Cardiac Arrest Survivors","authors":"Oğuz Kaan Kaya","doi":"10.1111/anec.70187","DOIUrl":"10.1111/anec.70187","url":null,"abstract":"<p>ST-segment elevation detected immediately after return of spontaneous circulation (ROSC) in survivors of cardiac arrest frequently raises concern for acute coronary occlusion and often leads to urgent coronary angiography. However, accumulating evidence suggests that transient ST-segment elevation in this setting does not always represent an acute culprit coronary lesion.</p><p>Several mechanisms may contribute to ST-segment elevation following ROSC. Global myocardial ischemia during cardiac arrest and subsequent reperfusion injury can produce transient repolarization abnormalities. In addition, severe metabolic disturbances, catecholamine surge, and myocardial stunning may alter myocardial electrical activity and mimic electrocardiographic patterns typically associated with acute coronary occlusion (Lemkes et al. <span>2019</span>; Spaulding et al. <span>1997</span>). These mechanisms may result in transient ST-segment elevation despite the absence of obstructive coronary artery disease.</p><p>Importantly, studies evaluating coronary angiography after cardiac arrest have demonstrated that a substantial proportion of patients without ST-segment elevation do not have an acute culprit lesion, highlighting the complexity of electrocardiographic interpretation in the post-resuscitation phase (Lemkes et al. <span>2019</span>). Conversely, transient ST-segment elevation immediately after ROSC may occasionally reflect global ischemia or reperfusion-related electrical instability rather than true ST-elevation myocardial infarction.</p><p>While early coronary angiography remains essential in many patients with suspected acute coronary syndrome, reliance solely on ST-segment elevation immediately after ROSC may occasionally lead to diagnostic uncertainty. Careful integration of clinical findings, hemodynamic status, echocardiographic assessment, and serial electrocardiograms may help distinguish transient post-resuscitation ECG changes from true coronary occlusion (Ibanez et al. <span>2018</span>).</p><p>Greater awareness of this diagnostic challenge may improve interpretation of electrocardiographic findings after cardiac arrest and help guide more individualized decision-making regarding coronary angiography in cardiac arrest survivors.</p><p>The author declares no conflicts of interest.</p><p>The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on the Predictive Value of P-Wave Dispersion and QTc Dispersion in Preeclampsia","authors":"Selda Murat,&nbsp;Ugur Keser,&nbsp;Bulent Gorenek","doi":"10.1111/anec.70185","DOIUrl":"10.1111/anec.70185","url":null,"abstract":"&lt;p&gt;We read with great interest the recent article by Zhi et al. investigating the predictive value of P-wave dispersion (PWD) and QTc dispersion (QTc-d) in pregnant women with preeclampsia (Zhi et al. &lt;span&gt;2026&lt;/span&gt;). The authors report that both parameters were independently associated with preeclampsia and propose diagnostic cut-off values. Given that hypertensive disorders of pregnancy are increasingly recognized as markers of future cardiovascular risk, this study addresses a clinically relevant question. Nevertheless, several methodological aspects warrant further consideration.&lt;/p&gt;&lt;p&gt;First, the interpretation of “predictive value” should be approached cautiously given the cross-sectional design of the study. Electrocardiographic parameters and preeclampsia were assessed simultaneously, precluding any temporal relationship between ECG changes and disease development. It remains unclear whether these alterations precede preeclampsia or reflect secondary hemodynamic changes. Establishing true predictive value would require prospective studies with pre-diagnostic ECG assessment. This distinction between diagnostic association and true prediction is essential for clinical interpretation.&lt;/p&gt;&lt;p&gt;Second, the relatively small sample size (&lt;i&gt;n&lt;/i&gt; = 185), with only 56 patients in the preeclampsia group, raises concerns about the robustness of the proposed diagnostic thresholds. Cut-off values derived from limited datasets are prone to overfitting and may lack reproducibility in external populations. The use of internal validation methods, such as bootstrapping or cross-validation, could have strengthened the reliability of the reported ROC-based thresholds (Collins et al. &lt;span&gt;2015&lt;/span&gt;; Steyerberg et al. &lt;span&gt;2013&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;Third, the multivariable model included only ECG parameters without adjustment for key clinical confounders. Factors such as gestational age, parity, body mass index (BMI), and disease severity may influence ECG morphology and arrhythmogenic indices. Notably, BMI differed between groups, and obesity is known to affect ECG parameters, including P-wave characteristics (Dykiert et al. &lt;span&gt;2024&lt;/span&gt;; Parikh et al. &lt;span&gt;2018&lt;/span&gt;). Lack of adjustment may introduce residual confounding and affect the interpretation of the reported associations.&lt;/p&gt;&lt;p&gt;Fourth, the manual measurement of ECG parameters introduces the possibility of measurement bias. Although excellent interobserver agreement was reported, intraobserver variability was not described, and the method used to resolve discrepancies between observers was not specified. In addition, QT correction was performed using Bazett's formula, which is known to overcorrect QT intervals at higher heart rates. Considering the physiologically elevated heart rate during pregnancy, alternative correction methods such as Fridericia's formula may have provided more reliable QTc estimates in this population (Andršová et al. &lt;span&gt;2021&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;Finally, while PWD demonstra","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589566","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":"Mixed Reality-Assisted Thoracic Endovascular Aortic Repair: A Retrospective Study on Efficacy and Safety","authors":"Jian-Jun Gu,&nbsp;Teng-Yue Zhao,&nbsp;Xiao-Chao Tian,&nbsp;Ying-Chao Ma","doi":"10.1111/anec.70184","DOIUrl":"10.1111/anec.70184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the efficacy and safety of Mixed Reality (MR)-Assisted Thoracic Endovascular Aortic Repair (TEVAR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 46 patients with aortic dissection who underwent TEVAR. In the Control Group, Computed Tomography Angiography (CTA) was performed on the thoracic and abdominal aorta, after which surgery was performed based on traditional 2D imaging data. In the observation group, the Star Map HoloLens Image System was used for data processing and 3D modeling, and preoperative analysis and intraoperative path guidance were conducted with the MR Microsoft HoloLens Headset. The communication time, satisfaction, and anxiety after communication, as well as the operation duration, intraoperative blood loss, postoperative complications, and rehabilitation of these two groups were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study aimed to evaluate the perioperative outcomes of MR-guided stent placement. A total of 46 patients were equally divided into the MR group and control group (<i>n</i> = 23 each), with data analyzed via non-parametric tests. Compared with the control group, the MR group exhibited significantly shorter operation duration (70.91 ± 8.533 vs. 77.48 ± 8.474 min, <i>Z</i> = −2.785, <i>p</i> = 0.005), fewer fluoroscopy times (3.74 ± 1.214 vs. 5.61 ± 1.530, <i>Z</i> = −3.813, <i>p</i> &lt; 0.001), and less stent adjustments (1.65 ± 1.152 vs. 2.91 ± 1.411, <i>Z</i> = −2.765, <i>p</i> = 0.006), suggesting MR guidance may optimize perioperative efficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Multimodal MR has an important auxiliary role in patient education, surgical planning, and accurate positioning of the surgical approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580159","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":"Alternative Lead ECG Placements","authors":"José Luis Morales-Arteaga,&nbsp;Amin Meghdadi,&nbsp;Derek Wu,&nbsp;Abdullah Bhuiyan,&nbsp;Nicole Langleben,&nbsp;Cengiz Burak,&nbsp;Emily Wilson,&nbsp;Ashley Pellerito,&nbsp;David Aristizábal,&nbsp;Keanu Razzaghi,&nbsp;Juan Maria Farina,&nbsp;Shyla Gupta,&nbsp;Adrian Baranchuk","doi":"10.1111/anec.70176","DOIUrl":"10.1111/anec.70176","url":null,"abstract":"<p>Electrocardiography (ECG) is a critical diagnostic tool for identifying cardiac conditions. While standard lead positions are widely used to ensure diagnostic accuracy, alternative lead placements have been developed to address specific clinical scenarios. These alternative configurations can overcome physical or technical challenges, enhance rhythm assessment, improve signal quality, and provide greater specificity for certain conditions, ultimately enabling more personalized diagnostic strategies. This paper examines the clinical significance of alternative ECG lead positions, highlighting their advantages, limitations, and potential applications in various clinical settings.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147525674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrocardiographic Predictors of Major Adverse Cardiovascular Events in Women With Suspected Ischemia and no Obstructive Coronary Artery Disease: Results of the Women's Ischemia Syndrome Evaluation","authors":"Jennifer R. Dungan,&nbsp;Yasmeen K. Taha,&nbsp;Qinglin Pei,&nbsp;Michael T. Weaver,&nbsp;Michael J. Tavormina,&nbsp;Steven E. Reis,&nbsp;Eileen M. Handberg,&nbsp;C. Noel Bairey Merz,&nbsp;Carl J. Pepine","doi":"10.1111/anec.70168","DOIUrl":"10.1111/anec.70168","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>An estimated four million individuals have suspected Ischemia and No Obstructive Coronary Arteries (INOCA), often due to coronary microvascular dysfunction, a subtype of ischemic heart disease that disproportionately affects women. Previously hypothesized as a benign condition, patients with INOCA demonstrate an elevated risk profile for major adverse cardiovascular events (MACE), yet biomarkers to inform this risk have not been identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To examine ECG indices as predictors of MACE among women with INOCA, we conducted a secondary analysis of the Women's Ischemia Syndrome Evaluation (WISE) original cohort in 481 women with suspected INOCA and complete data. Cox multivariable regression analysis was conducted in baseline ECG indices (intervals, rate, rhythm, and abnormalities) and their association with time-to-incident MACE (angina hospitalization, myocardial infarction, stroke, heart failure, revascularization with stent or angioplasty, or all-cause death). Cox proportional hazards modeling was performed as time from study enrollment to event censored on days to last contact, using stepwise backward selection and bootstrapping for model determination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 165 (34.3%) experienced at least one MACE, including 26 (5.41%) all cause deaths, over an average follow-up time of 5.25 years. Significant predictors in the final model were resting heart rate (RHR), race, CHF, depression, and use of nitrates within 24 h of ECG measurement. Higher RHR was associated with increased hazards of incident composite MACE (adjusted hazard ratio 1.018, <i>p</i> = 0.0348).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Identifying unique biomarkers for MACE among women with INOCA is a clinical and research priority to inform screening and prevention strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"31 3","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147525741","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}