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Journal of Electrocardiology

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https://www.readbyqxmd.com/read/28515002/electrocardiographic-qrs-t-angle-and-the-risk-of-incident-silent-myocardial-infarction-in-the-atherosclerosis-risk-in-communities-study
#1
Zhu-Ming Zhang, Pentti M Rautaharju, Ronald J Prineas, Larisa Tereshchenko, Elsayed Z Soliman
BACKGROUND: Silent myocardial infarction (SMI) accounts for about half of the total number of MIs, and is associated with poor prognosis as is clinically documented MI (CMI). The electrocardiographic (ECG) spatial QRS/T angle has been a strong predictor of cardiovascular outcomes. Whether spatial QRS/T angle also is predictive of SMI, and the easy-to-obtain frontal QRS/T angle will show similar association are currently unknown. METHODS: We examined the association between the spatial and frontal QRS/T angles, separately, with incident SMI among 9498 participants (mean age 54years, 57% women, and 20% African-American), who were free of cardiovascular disease at baseline (visit 1, 1987-1989) from the Atherosclerosis Risk in Communities (ARIC) study...
May 4, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28501267/gender-equity-imbalance-in-electrocardiology-a-call-to-action
#2
EDITORIAL
E Clarke Whalen, G Xu, I Cygankiewicz, L Bacharova, W Zareba, J S Steinberg, L G Tereshchenko, A Baranchuk
Despite the increasing number of women entering the medical profession, senior positions and academic productivity in many fields of medicine remain to be men dominated. We explored gender equity in electrocardiology as perceived by recent academic productivity and also active participation (presidencies and board constituents) in both the International Society of Electrocardiology (ISE) and the International Society for Holter and Noninvasive Electrocardiology (ISHNE). Academic productivity was measured by authorship (first and senior) in the Journal of Electrocardiology (JECG) and the Annals of Noninvasive Electrocardiology (ANE) in 2015...
May 4, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28506600/cardiac-hemangioma-caused-ventricular-arrhythmia-a-rare-case-and-literature-review
#3
Yanqiu Wang, Shuang Liu, Jun Yang, Tianxiang Gu, Limin Zhang
Cardiac hemangioma is a rare primary cardiac tumor. We reported the case of patient with left ventricular hemangioma who was referred to our hospital complaining of palpitation for one week. 24 h Holter revealed high episode of ventricular arrhythmia. Echocardiography showed a mass at left ventricle, which was also confirmed by MRI. The mass was successfully resected and postoperative pathology confirmed cardiac capillary hemangioma. The patient recovered well with no cardiac arrhythmia after surgery over 12 months of follow-up...
May 3, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28515003/reverse-atrial-electrical-remodeling-induced-by-cardiac-resynchronization-therapy
#4
Bryce Alexander, Fariha Sadiq, Kousha Azimi, Benedict Glover, Pavel Antiperovitch, Wilma M Hopman, Zardasht Jaff, Adrian Baranchuk
PURPOSE: Cardiac resynchronization therapy (CRT) has been shown to improve left atrial function; however the effect on reverse electrical remodeling has been poorly evaluated. We hypothesized that CRT might induce reverse atrial electrical remodeling manifesting in the surface ECG as a shortening in P-wave duration. METHODS: Patients with CRT and more than 92% biventricular pacing at minimum follow-up of 1 year were included in the analysis. Those with prior history of atrial fibrillation (AF) were excluded...
April 28, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28511782/prevalence-of-early-repolarization-pattern-in-patients-with-lone-atrial-fibrillation
#5
Patrick W McNair, Dan M Benenson, James E Ip, George Thomas, Jim W Cheung, Christopher F Liu, Bruce B Lerman, Steven M Markowitz
BACKGROUND: The objective of this study was to test the association of early repolarization pattern (ER) with lone atrial fibrillation (AF). METHODS: Electrocardiograms (ECGs) were analyzed in blinded fashion in a case-control study of 182 patients with lone AF and 182 controls without AF. RESULTS: Patients with lone AF and controls had similar frequencies of ER pattern (15% vs. 19%, p=0.40). In patients <50years of age, there was also no difference in the percentage of patients with ER in the AF and control groups (17% vs...
April 28, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28499628/a-real-world-wearable-cardioverter-defibrillator-experience-very-high-appropriate-shock-rate-in-ischemic-cardiomyopathy-patients-at-a-european-single-center
#6
Thomas Beiert, Robert Malotki, Natalie Kraemer, Florian Stöckigt, Markus Linhart, Georg Nickenig, Jan W Schrickel, René P Andrié
BACKGROUND: The wearable cardioverter defibrillator (WCD) has emerged as a valuable tool to protect patients with increased risk of sudden cardiac death (SCD). We sought to characterize WCD patients and to analyze predictors of ventricular arrhythmia (VA) occurrence and WCD shock delivery. METHODS AND RESULTS: One hundred fourteen patients with WCD use were included in the study. Indications were mainly ischemic cardiomyopathy (ICM; 31.6%), non-ICM (45.6%) and explantation of implantable cardioverter defibrillator due to device infection (11...
April 28, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28495230/electrocardiogram-voltage-discordance-interpretation-of-low-qrs-voltage-only-in-the-precordial-leads
#7
Diana H Kim, Ralph J Verdino
OBJECTIVES: To define clinical correlates of low voltage isolated to precordial leads on the surface electrocardiogram (ECG). INTRODUCTION: Low voltage (V) on the ECG is defined as QRS V<5mm in all limb leads and <10mm in all precordial leads. The diagnostic use of ECGs with low voltage isolated to the precordial leads with normal limb lead voltages is unclear. METHODS: Twelve-lead ECGs with QRS V>5mm in one or more limb leads and <10mm in all precordial leads were collected...
April 28, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28479089/factors-affecting-ventriculophasic-response-an-investigation-in-patients-with-permanent-pacemaker
#8
Mohammad Ali Akbarzadeh, Morteza Safi, Soudeh Bayatbayatani, Isa Khaheshi, Mohammadreza Naderian
BACKGROUND: Ventriculophasic response (VR) refers to the shortening of the atrial cycle length (P-P-interval) that occurs during the heart block when a QRS complex is interposed between two P-waves. The aim of this study was to determine the factors affecting this phenomenon. METHODS: Thirty patients with high grade heart block treated with dual chamber pacemaker were studied. The pacer function of the patients' device was temporarily programmed to the ventricular-inhibited mode at 30 pulses per minute...
April 28, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28506602/ventricular-tachycardia-score-a-novel-method-for-wide-qrs-complex-tachycardia-differentiation-explained
#9
Marek Jastrzębski, Piotr Kukla, Danuta Czarnecka
Philosophy, merits and limitations of a novel method for wide QRS complex tachycardia differentiation, based on a scoring system and called the ventricular tachycardia (VT) score, were explained. The following criteria were assigned one point: initial dominant R wave in V1; initial r>40 ms in V1 or V2; notched S in V1; initial R wave in aVR; lead II RWPT≥50 ms; and absence of an RS in leads V1-V6. Atrioventricular dissociation (including fusion/capture beats and partial dissociation) was assigned two points...
April 25, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28476433/intelligent-use-of-advanced-capabilities-of-diagnostic-ecg-algorithms-in-a-monitoring-environment
#10
Reza Firoozabadi, Richard E Gregg, Saeed Babaeizadeh
A large number of ST-elevation notifications are generated by cardiac monitoring systems, but only a fraction of them is related to the critical condition known as ST-segment elevation myocardial infarction (STEMI) in which the blockage of coronary artery causes ST-segment elevation. Confounders such as acute pericarditis and benign early repolarization create electrocardiographic patterns mimicking STEMI but usually do not benefit from a real-time notification. A STEMI screening algorithm able to recognize those confounders utilizing capabilities of diagnostic ECG algorithms in variation analysis of ST segments helps to avoid triggering a non-actionable ST-elevation notification...
April 25, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28511781/correlation-of-right-atrial-enlargement-on-ecg-to-right-atrial-volume-by-echocardiography-in-patients-with-pulmonary-hypertension
#11
John D Allison, Francisco Yuri Macedo, Ihab Rafic Hamzeh, Yochai Birnbaum
Previous attempts to validate ECG criteria for right atrial (RA) enlargement (RAE) have been limited by sample sizes and lack of accepted standards for measuring RA size. New guidelines have recommended that RA volume (RAV) be used to determine RA size. Since these guidelines were released, no studies have been published that correlate RAE by ECG to RAV using the new standards. We aimed to validate previously proposed ECG criteria for RAE, commonly called P pulmonale, and to establish whether a correlation exists between P wave amplitudes and RAV as determined by echocardiogram in patients from the pulmonary hypertension (PHT) clinic...
April 22, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28479090/electrocardiogram-training-for-residents-a-curriculum-based-on-facebook-and-twitter
#12
Stanley S Liu, Sammy Zakaria, Dhananjay Vaidya, Mukta C Srivastava
BACKGROUND: We studied whether social media applications can serve as effective educational tools for teaching electrocardiogram (ECG) interpretation to medical residents. METHODS: 39 emergency, family, and internal medicine residents participated in the 33-week "ECG of the Week" curriculum via Facebook and Twitter. ECG skill was assessed before and after the study with a 10-ECG quiz. Outcomes of interest included predictors of participant response rates and post-study quiz performance...
April 22, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28476432/fainting-episode-in-a-pacemaker-dependent-patient-with-two-implanted-devices-too-much-of-a-good-thing
#13
Filippo Maria Cauti, Pietro Rossi, Luigi Iaia, Stefano Bianchi
A 73 year old man with CRT-D system and pacemaker dependence was admitted to the emergency department due to a syncopal episode. The device interrogation was performed. An RV ventricular sensing test was executed in VVI mode at 50 b/m. During testing the patient developed transient loss of consciousness with full recovery after stopping the sensing test. Applying asynchronous pacing mode, a pacing spike occurred at a faster rate of 65 b/m without evoking any ventricular capture. Looking at the chest X-ray, we found an abandoned right sided, single chamber VVI pacemaker in a submuscular pocket...
April 22, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28506601/a-flatline-lead-i-in-a-neonate-with-suspected-congenital-heart-disease
#14
Kristy Riniker, Luis Rigales, Irwin Hoffman
In a neonate with bradycardia and hypoxia, and clinical concern for critical congenital heart disease (CCHD), highly unusual ECG findings were present. These included a flatline Lead 1, and identical Leads 2, 3, and AVF. These abnormalities were due to bilateral arm to leg lead exchanges and not to heart disease. Complete cardiac workup including echocardiogram was normal.
April 21, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28460689/a-new-4-variable-formula-to-differentiate-normal-variant-st-segment-elevation-in-v2-v4-early-repolarization-from-subtle-left-anterior-descending-coronary-occlusion-adding-qrs-amplitude-of-v2-improves-the-model
#15
Brian E Driver, Ayesha Khalil, Timothy Henry, Faraz Kazmi, Amina Adil, Stephen W Smith
INTRODUCTION: Precordial normal variant ST elevation (NV-STE), previously often called "early repolarization," may be difficult to differentiate from subtle ischemic STE due to left anterior descending (LAD) occlusion. We previously derived and validated a logistic regression formula that was far superior to STE alone for differentiating the two entities on the ECG. The tool uses R-wave amplitude in lead V4 (RAV4), ST elevation at 60 ms after the J-point in lead V3 (STE60V3) and the computerized Bazett-corrected QT interval (QTc-B)...
April 19, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28502464/small-signs-important-diagnoses
#16
LETTER
Javier García-Niebla, Carlos López, Damian Longo
No abstract text is available yet for this article.
April 18, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28465023/the-impact-of-fever-on-corrected-qt-interval
#17
Doran Drew, Adrian Baranchuk, Wilma Hopman, Robert J Brison
AIMS: We were interested in the impact of fever on the QT interval as information on this subject is limited. METHODS: We performed a retrospective, single centre study over a two year period, ending December 31st, 2013. Participants were identified using an electronic chart review of emergency department records linked to an ECG data base. Study subjects were drawn from patients presenting with fever to an academic emergency department in Canada. Our study identified febrile (T>38...
April 18, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28442147/troubleshooter-in-electrical-storm-mechanical-unloading-leads-to-heart-rhythm-stabilization
#18
Johannes Mierke, Tobias Loehn, Christian Pfluecke, Karim Ibrahim
The electrical storm is a life-threatening situation which causes a complex antiarrhythmic treatment. We firstly report a rhythmological stabilization through mechanical unloading of the left ventricle in a health patient who developed electrical storm after endo- and epicardiac re-ablation and who previously underwent 27 unsuccessful defibrillations. No evidence for a specific etiology of the rhythm disturbances was found. After implantation of a percutaneous left ventricular assist device (pLVAD) a single additional defibrillation was needed to terminate ventricular fibrillation...
April 18, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28431690/elevated-hemi-diaphragms-as-a-cause-of-st-segment-elevation-a-case-report-and-review-of-literature
#19
Manmohan Singh, Aditya Sood, Mobeen Ur Rehman, Mahmoud Othman, Luis Afonso
While ST-segment elevation (STE) on ECG is widely recognized as representing myocardial infarction or injury such as coronary occlusion or pericarditis, STE may occasionally ensue from non-cardiac etiologies. Indeed, gastrointestinal disorders causing STE are not well documented in the literature. We present a case wherein extreme abdominal distension and hemi-diaphragm elevation resulted in extrinsic cardiac and epicardial coronary compression manifesting as STE. Subsequent relief of the abdominal distension resulted in resolution of STE representing a noncoronary cause of STE...
April 6, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28366419/an-evaluation-of-planarity-of-the-spatial-qrs-loop-by-three-dimensional-vectorcardiography-its-emergence-and-loss
#20
Dipanjan Ray, Sandipan Hazra, Damodar Prasad Goswami, Peter W Macfarlane, Arnab Sengupta
AIMS: To objectively characterize and mathematically justify the observation that vectorcardiographic QRS loops in normal individuals are more planar than those from patients with ST elevation myocardial infarction (STEMI). METHODS: Vectorcardiograms (VCGs) were constructed from three simultaneously recorded quasi-orthogonal leads, I, aVF and V2 (sampled at 1000 samples/s). The planarity of these QRS loops was determined by fitting a surface to each loop. Goodness of fit was expressed in numerical terms...
March 22, 2017: Journal of Electrocardiology
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