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Journal of Electrocardiology

Ani Nigolian, Nicolas Dayal, Haïg Nigolian, Carine Stettler, Haran Burri
BACKGROUND: Handheld ECG event recorders are useful for rhythm monitoring but only record a single lead, which may limit interpretation. We sought to investigate if a multi-lead ECG may be reconstituted using this device, and aimed to evaluate diagnostic accuracy. METHODS: A commercially-available handheld bipolar ECG event recorder was used to reconstruct a 9-lead ECG (leads I, II and III, V1-6). Tracings were analyzed independently by a cardiologist and a fellow...
November 21, 2017: Journal of Electrocardiology
Hiroki Kitajima, Yuji Nishikawa, Keitaro Senoo, Masahiro Esato
We describe a patient with perimitral atrial flutter (PMF) following the atrial fibrillation ablation and the linear ablation at the mitral isthmus (MI). From both the activation and the voltage maps using ultra-high resolution mapping, we detected the epicardial connection through the coronary sinus (CS) within the entire reentrant circuit. Point ablation within the CS, not additional linear MI ablation from the endocardium terminates PMF, with a bidirectional block across the low voltage area at the MI.
November 21, 2017: Journal of Electrocardiology
Mert İlker Hayıroğlu, Tufan Çınar, Muhammed Keskin
No abstract text is available yet for this article.
November 21, 2017: Journal of Electrocardiology
Jovil A Kannampuzha, Prasanna Sengodan, Sravani Avula, Bartholomew White, Stephen J Ganocy, Peter J Leo, Elizabeth S Kaufman
BACKGROUND: Patients with long QT syndrome (LQTS) are predisposed to polymorphic ventricular tachycardia (VT) during adrenergic stimulation. Microvolt T-wave alternans (MTWA) is linked to vulnerability to VT in structural heart disease. The prevalence of non-sustained MTWA (NS-MTWA) in LQTS is unknown. METHODS: 31 LQT1, 42 LQT2, and 80 controls underwent MTWA testing during exercise. MTWA tests were classified per standardized criteria, and re-analyzed according to the modified criteria to account for NS-MTWA...
November 21, 2017: Journal of Electrocardiology
Suvi Sirkku Tuohinen, Jani Rankinen, Tanja Skyttä, Heini Huhtala, Vesa Virtanen, Pirkko-Liisa Kellokumpu-Lehtinen, Pekka Raatikainen, Kjell Nikus
BACKGROUND: ST segment depression (STD) and T wave inversion (TWI) are typical electrocardiographic (ECG) findings in non-ST elevation myocardial infarction (NSTEMI). In ST elevation myocardial infarction, ST changes represent transmural ischemia. The pathophysiological mechanisms of the ECG changes in NSTEMI are unclear. PURPOSE: We studied the associations between ECG and the echocardiographic findings in NSTEMI patients. METHODS: Twenty patients with acute NSTEMI were recruited during their hospital stay...
November 21, 2017: Journal of Electrocardiology
C Reitan, U Chaudhry, B Atwater, J Jacobsson, J P Couderc, X Xia, J Carlson, P G Platonov, R Borgquist
BACKGROUND: Cardiac Resynchronization Therapy (CRT) is widely used for treating selected heart failure patients, but patients with myocardial scar respond worse to treatment. The Selvester QRS scoring system estimates myocardial scar burden using 12-lead ECG. This study's objective was to investigate the scores correlation to mortality in a CRT population. METHODS AND RESULTS: Data on consecutive CRT patients was collected. 401 patients with LBBB and available ECG data were included in the study...
November 15, 2017: Journal of Electrocardiology
Yama Fakhri, Maria Sejersten, Mikkel Malby Schoos, Henrik Steen Hansen, Jean-Luc Dubois-Rande, Trygve S Hall, Alf-Inge Larsen, Svend Eggert Jensen, Henrik Engblom, Hakon Arheden, Jens Kastrup, Dan Atar, Peter Clemmensen
BACKGROUND: Terminal "QRS distortion" on the electrocardiogram (ECG) (based on Sclarovsky-Birnbaum's Grades of Ischemia Score) is a sign of severe ischemia, associated with adverse cardiovascular outcome in ST-segment elevation myocardial infarction (STEMI). In addition, ECG indices of the acuteness of ischemia (based on Anderson-Wilkins Acuteness Score) indicate myocardial salvage potential. We assessed whether severe ischemia with or without acute ischemia is predictive of infarct size (IS), myocardial salvage index (MSI) and left ventricular ejection fraction (LVEF) in anterior versus inferior infarct locations...
November 13, 2017: Journal of Electrocardiology
Alexander Wutzler, Carlo De Asmundis, Hisao Matsuda, Marwin Bannehr, Lena Loehr, Katharina Voelk, Johannes Jungmann, Martin Huemer, Philipp Attanasio, Abdul Parwani, Leif-Hendrik Boldt, Pedro Brugada, Wilhelm Haverkamp
BACKGROUND: Propofol is commonly used for procedural sedation in interventional electrophysiology. However, ventricular arrhythmias under Propofol have been reported. Our aim was to investigate ventricular repolarization and incidence of ventricular arrhythmias under Propofol infusion in adults with cardiac arrhythmias. METHODS: QRS, QTcB (Bazett), QTcFri (Fridericia), JTc, measurement of T peak to Tend time (Tp-e) at baseline and under Propofol infusion was performed in 235 patients...
November 11, 2017: Journal of Electrocardiology
Javier C Barcos, Iván A Tello Santacruz, César Cáceres Monié, María L Fernández Recalde, Juan D Humphreys
A Brugada phenocopy has been defined as a clinical situation that presents with an abnormal electrocardiogram identical to any of the electrocardiographic patterns found in Brugada syndrome in the absence of the characteristic congenital genetic abnormalities. The first confirmed case of type 1 Brugada phenocopy associated with severe left pneumothorax is presented. A provocative test with ajmaline, which proved to be negative, was performed to confirm the diagnosis. The presence of ST-segment elevation in the context of pneumothorax is most infrequent...
October 28, 2017: Journal of Electrocardiology
Ryan E Alanzalon, Jonathan R Burris, Jeffrey M Vinocur
Two patients without cardiac history demonstrated type 1 Brugada pattern during hospitalization for diabetic ketoacidosis (DKA). Both patients had normalization of their ECGs after treatment of marked electrolyte abnormalities and metabolic acidosis. In this report, we describe two cases of Brugada phenocopy associated with DKA in children.
October 28, 2017: Journal of Electrocardiology
Alejandro Alcaine, David Soto-Iglesias, Juan Acosta, Viatcheslav Korshunov, Diego Penela, Mikel Martínez, Markus Linhart, David Andreu, Juan Fernández-Armenta, Pablo Laguna, Juan Pablo Martínez, Oscar Camara, Antonio Berruezo
PURPOSE: Activation mapping is used to guide ablation of idiopathic outflow tract ventricular arrhythmias (OTVAs). Isochronal activation maps help to predict the site of origin (SOO): left vs right outflow tract (OT). We evaluate an algorithm for automatic activation mapping based on the onset of the bipolar electrogram (EGM) signal for predicting the SOO and the effective ablation site in OTVAs. METHODS: Eighteen patients undergoing ablation due to idiopathic OTVAs were studied (12 with left ventricle OT origin)...
October 27, 2017: Journal of Electrocardiology
Jonathan Araujo Queiroz, Alfredo Junior, Fausto Lucena, Allan Kardec Barros
BACKGROUND: The electrocardiogram (ECG) is one of the most non-invasive techniques to give support to the atrial fibrillation (AF) diagnosis. Several authors use the temporal difference between two consecutive R waves, a method known as RR interval, to perform the AF diagnosis. However, RR interval-based analysis does not detect distortions on the other ECG waves. PURPOSE: Thus, the present work proposes a diagnostic decision support systems for AF based on higher order spectrum analysis of the voltage variation on the ECG...
October 27, 2017: Journal of Electrocardiology
Michele M Pelter, Yuan Xu, Richard Fidler, Ran Xiao, David W Mortara, Hu Xiao
BACKGROUND: Patients hospitalized for suspected acute coronary syndrome (ACS) are at risk for transient myocardial ischemia. During the "rule-out" phase, continuous ECG ST-segment monitoring can identify transient myocardial ischemia, even when asymptomatic. However, current ST-segment monitoring software is vastly underutilized due to false positive alarms, with resultant alarm fatigue. Current ST algorithms may contribute to alarm fatigue because; (1) they are not designed with a delay (minutes), rather alarm to brief spikes (i...
October 24, 2017: Journal of Electrocardiology
Luigi Sciarra, Paolo Golia, Zefferino Palamà, Antonio Scarà, Ermenegildo De Ruvo, Alessio Borrelli, Anna Maria Martino, Monia Minati, Alessandro Fagagnini, Claudia Tota, Lucia De Luca, Domenico Grieco, Pietro Delise, Leonardo Calò
BACKGROUND: Left bundle branch block (LBBB) and left axis deviation (LAD) patients may have poor response to resynchronization therapy (CRT). We sought to assess if LBBB and LAD patients show a specific pattern of mechanical asynchrony. METHODS: CRT candidates with non-ischemic cardiomyopathy and LBBB were categorized as having normal QRS axis (within -30° and +90°) or LAD (within -30° and -90°). Patients underwent tissue Doppler imaging (TDI) to measure time interval between onset of QRS complex and peak systolic velocity in ejection period (Q-peak) at basal segments of septal, inferior, lateral and anterior walls, as expression of local timing of mechanical activation...
October 21, 2017: Journal of Electrocardiology
S Serge Barold, Andreas Kucher
Biotronik devices used for cardiac resynchronization therapy (CRT) combined with defibrillation function (CRT-D) are capable of left ventricular (LV) sensing. Under certain circumstances, LV sensing may cause loss of CRT. The third generation of the Biotronik i-family CRT-Ds enables the recording of event-triggered tracings of the electrogram particularly those involving "CRT pacing interrupt" episodes. We report three cases of a sudden "CRT pacing interrupt" initiated by an atrial premature complex. This was caused by realignment of the LV timing cycles induced by the APCs whereupon LV pacing was inhibited and a self-perpetuating desynchronization process was initiated...
October 21, 2017: Journal of Electrocardiology
Alejandro Barbagelata, Charles F Bethea, Harry W Severance, Robert J Mentz, David Albert, Gregory W Barsness, Viet T Le, Jeffrey L Anderson, T Jared Bunch, Frank Yanowitz, Benjamin Chisum, Brianna S Ronnow, Joseph B Muhlestein
In patients experiencing an ST-elevation myocardial infarction (STEMI), rapid diagnosis and immediate access to reperfusion therapy leads to optimal clinical outcomes. The rate-limiting step in STEMI diagnosis is the availability and performance of a 12-lead ECG. Recent technology has provided access to a reliable means of obtaining an ECG reading through a smartphone application (app) that works with an attachment providing all 12-leads of a standard ECG system. The ST LEUIS study was designed to validate the smartphone ECG app and its ability to accurately assess the presence or absence of STEMI in patients presenting with chest pain compared with the gold standard 12-lead ECG...
October 19, 2017: Journal of Electrocardiology
Riccardo Scagliola
Electrocardiogram (ECG) is one of the first procedures performed in the initial assessment of patients with suspected pulmonary embolism (PE), although one of its main advantages is in suspecting alternative clinical conditions, including acute coronary syndrome (ACS). ST-elevation remains an uncommon ECG pattern in PE. Cardiac ultrasound can help to the differential diagnosis from ACS and to a fast detection of acute right ventricle (RV) overload. In the presence of hemodynamic instability, with ECG signs of RV strain and concomitant ST-elevation, massive PE should be suspected as shown in the present case report...
October 19, 2017: Journal of Electrocardiology
Mert İlker Hayıroğlu, Ahmet Okan Uzun, Muhammed Keskin, Edibe Betül Börklü, Ceyhan Türkkan, Ahmet İlker Tekkeşin, Ömer Kozan
BACKGROUND: Acute transmural ischemia due to left anterior descending artery (LAD) occlusion changes precordial R and Q wave durations owing to depressed intramyocardial activation. We investigated the prognostic value of sum of precordial Q wave duration/sum of precordial R wave duration ratio (Q/R) in patients with first acute anterior myocardial infarction (AAMI) treated with primary percutaneous coronary intervention (PPCI). METHODS: In this prospective analysis, we evaluated the no-reflow predictive value of Q/R on 403 patients with first AAMI...
October 18, 2017: Journal of Electrocardiology
Timothy F Simpson, Nora Goldschlager
A 58-year-old male underwent ambulatory ECG monitoring with continuous patch monitoring (Zio XT Patch) for the complaint of episodic dyspnea. In the period of monitoring the patient suffered sudden cardiac death (SCD) with continuous ECG recording showing pronounced ST segment elevations followed by bradycardia and death. This report highlights the growing potential of continuous ST segment monitoring, and features the infrequent entity of ischemic electromechanical dissociation with bradyarrhythmia as a cause of SCD...
October 18, 2017: Journal of Electrocardiology
Ronald J Prineas, Zhu-Ming Zhang, Cladd E Stevens, Elsayed Z Soliman
BACKGROUND: The prevalence and determinants of QRS transition zones are not well established. METHODS: We examined the distributions of Normal, clockwise (CW) and counterclockwise (CCW)) QRS transition zones and their relations to disease, body size and demographics in 4624 black and white men and women free of cardiovascular disease and major ECG abnormalities enrolled in the NHANES-III survey. RESULTS: CW transition zones were least observed (6...
October 18, 2017: Journal of Electrocardiology
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