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Georgeta D Vaidean, Marta Manczuk, Jared W Magnani
OBJECTIVE: Obesity and hypertension often coexist and represent risk factors for atrial fibrillation. This study hypothesized that their single and joint effects on atrial remodeling would be reflected in the PR interval and P-wave durations on electrocardiogram (ECG). METHODS: This cross-sectional analysis of a community-based study included 11,308 men and women age 45-64. Atrial indices were obtained from digital standard 12-lead resting ECG. Analyses were adjusted for traditional cardiovascular risk factors...
October 18, 2016: Obesity
Kaylin T Nguyen, Rachel A Gladstone, Jonathan W Dukes, Babak Nazer, Eric Vittinghoff, Nitish Badhwar, Vasanth Vedantham, Edward P Gerstenfeld, Byron K Lee, Randall J Lee, Zian H Tseng, Jeffrey E Olgin, Melvin M Scheinman, Gregory M Marcus
INTRODUCTION: Atrial refractoriness may be an important determinant of atrial fibrillation (AF) risk, but its measurement is not clinically accessible. Because the QT interval predicts incident AF and the atrium and ventricle share repolarizing ion currents, we investigated the association between an individual's QT interval and atrial effective refractory period (AERP). METHODS: In paroxysmal AF patients presenting for catheter ablation, the QT interval was measured from the surface 12-lead ECG...
October 18, 2016: Pacing and Clinical Electrophysiology: PACE
Ana Abreu, Helena Santa Clara
Cardiac resynchronization therapy (CRT) is an established treatment for patients with moderate-to-severe chronic heart failure (CHF) and intraventricular conduction delay, which is identified by a QRS interval of 120msec or more on a 12-lead electrocardiogram (ECG). CRT improved functional capacity, reduced hospitalizations for worsening CHF and increased survival. However, about 30-40% of patients who underwent CRT were non-responders with no clinical or echocardiographic improvement. Imaging parameters for prediction of CRT response have been reviewed...
October 14, 2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Torsten Konrad, Sebastian Sonnenschein, Frank Patrick Schmidt, Hanke Mollnau, Karsten Bock, Blanca Quesada Ocete, Thomas Münzel, Cathrin Theis, Thomas Rostock
AIMS: Different cardiac arrhythmias have been suggested to be associated with Danon disease, e.g. Wolff-Parkinson-White syndrome. However, a systematic electrophysiological investigation of patients with Danon disease is lacking thus far. METHODS AND RESULTS: Seven patients with Danon disease (4 males, 35.8 ± 10.8 years; 3 females, 51.3 ± 19.9 years) from 3 different families were studied. In all patients, the presence of Danon disease was confirmed by western blot of biopsy material or genetic testing...
October 14, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Nathalie Behar, Bertrand Petit, Vincent Probst, Frederic Sacher, Gaelle Kervio, Jacques Mansourati, Paul Bru, Alfredo Hernandez, Philippe Mabo
AIM: Modulation of ST-segment elevation (STE) and tachyarrhythmic events by the autonomic nervous system (ANS) has been reported in patients with Brugada syndrome (BS). This study examined and compared the autonomic characteristics and STE in symptomatic vs. asymptomatic patients with BS. METHODS AND RESULT: We studied 40 symptomatic and 78 asymptomatic patients (mean age = 46.1 ± 13.7 years; 88 men) who underwent 24 h, 12-lead electrocardiograms, and exercise and a head-up tilt tests...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Rajendra Pradeepa, Jayagopi Surendar, Karunakaran Indulekha, Sundarapandi Chella, Ranjit Mohan Anjana, Viswanathan Mohan
OBJECTIVE: The aim of this study was to assess the prevalence of metabolic syndrome (MS) and its association with coronary artery disease (CAD) among an elderly urban population in south India. METHODS: Individuals aged ≥60 years (n=222) were recruited from Phase 3 of the Chennai Urban Rural Epidemiology Study. Anthropometric and blood pressure measurements, oral glucose tolerance test, lipids and fasting insulin were carried out. Prevalence of MS was estimated using the World Health Organization (WHO), Modified National Cholesterol Education Program's Adult Treatment Panel III (ATP-III) and International Diabetes Federation (IDF) criteria...
May 2016: Journal of the Association of Physicians of India
Maura Sammon, Alveena Dawood, Scott Beaudoin, Richard A Harrigan
BACKGROUND: One of the principal tasks of an emergency physician is identifying potentially life-threatening conditions in the undifferentiated patient; cardiac dysrhythmia is an example of such a condition. A systematic approach to a patient with atypical dysrhythmia enables proper identification of such-life threatening conditions. CASE REPORT: We describe a 31-year-old man presenting to the emergency department with an undifferentiated dysrhythmia after naloxone reversal of an opiate overdose...
October 7, 2016: Journal of Emergency Medicine
Lan Chi Vo, Christopher Snyder, Courtney McCracken, Christopher J McDougle, James T McCracken, Michael G Aman, Elaine Tierney, L Eugene Arnold, Daniel Levi, Michael Kelleman, Deirdre Carroll, John Morrissey, Benedetto Vitiello, Lawrence Scahill
OBJECTIVES: Risperidone is approved for the treatment of serious behavioral problems in children with autism spectrum disorder (ASD). This study examined the effects of risperidone on cardiac conduction in children with ASD. METHODS: Data were collected from an 8-week, five-site trial conducted by the Research Units on Pediatric Psychopharmacology Autism Network. Children (age 5-17 years) were randomly assigned to risperidone (n = 49) or placebo (n = 52) under double-blind conditions...
October 11, 2016: Journal of Child and Adolescent Psychopharmacology
Yasunori Kanzaki, Yasuya Inden, Monami Ando, Yosuke Kamikubo, Tadahiro Ito, Yoshiaki Mizutani, Hiroyuki Kato, Aya Fujii, Satoshi Yanagisawa, Makoto Hirai, Toyoaki Murohara
BACKGROUNDS: Although several prognostic factors of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) have been investigated, the accurate prediction of AF recurrence remains difficult. We propose an ECG index, the P-wave force (PWF), which is the product of the amplitude of the negative terminal phase of the P-wave in the V1 electrode and the filtered P-wave duration (FPD), obtained by a signal-averaged P-wave analysis. This study was conducted to evaluate the impact of the PWF on the recurrence of AF after PVI...
October 10, 2016: Pacing and Clinical Electrophysiology: PACE
Anna Cichocka-Radwan, Małgorzata Lelonek
BACKGROUND: In the elderly the most common cause of hospitalization and the leading cause of death is heart failure. AIM: The purpose was to determine prognostic factors in chronic heart failure (CHF) in octogenarians and nonagenarians. METHODS: The analysis included 197 consecutive patients older than 80 years old (mean age 83.63+3.01 years; 46.19% of men) hospitalized in 2010-2013 in the Department of Cardiology due to CHF. Sixty two parameters were investigated such as: age, gender, NYHA functional class, body mass index, blood pressure, other comorbidities, the parameters of the 12-lead resting ECG and the echocardiography, the results of basic laboratory tests and selected biomarkers, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitive troponin T (hs-TnT), high-sensitive C-reactive protein (hs-CRP)...
October 7, 2016: Kardiologia Polska
Carmen Pizarro, Neele Herweg-Steffens, Martin Buchenroth, Wolfgang Schulte, Christian Schaefer, Christoph Hammerstingl, Nikos Werner, Georg Nickenig, Dirk Skowasch
BACKGROUND: In acute exacerbation of COPD, increased plasma levels of cardiac troponin are frequent and associated with increased mortality. Thus, we aimed at prospectively determining the diagnostic value of coronary angiography in patients with exacerbated COPD and concomitantly elevated cardiac troponin. PATIENTS AND METHODS: A total of 88 patients (mean age 72.9±9.2 years, 56.8% male) hospitalized for acute exacerbation of COPD with elevated plasma troponin were included...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Uğur Aksu, Kamuran Kalkan, Oktay Gülcü, Selim Topcu, Serdar Sevimli, Enbiya Aksakal, Emrah Ipek, Mahmut Açıkel, Ibrahim Halil Tanboğa
BACKGROUND: The atrioventricular (AV) dissociation, which is frequently used in differential diagnosis of wide QRS complex tachycardia (WQCT), is the most specific finding of ventricular tachycardia (VT) with lower sensitivity. Herein, we aimed to show the importance of Lewis lead ECG records to detect 'visible p waves' during WQCT. METHOD: A total of 21 consecutive patients who underwent electrophysiologic study (EPS) were included in the study. During EPS, by using a quadripolar diagnostic catheter directed to the right ventricular apex, a fixed stimulus was given and the ventriculoatrial (VA) Wenkebach point was found, and a VT was simulated by a RV apical stimulus at 300ms...
September 26, 2016: International Journal of Cardiology
Tee Joo Yeo, Sanjay Sharma
This article summarizes the role of the 12-lead electrocardiogram (ECG) for the clinical care of athletes, with particular reference to the influence of age, gender, ethnicity, and type of sport on the appearance of the ECG, and its role in differentiating physiologic exercise-related changes from pathologic conditions implicated in sudden cardiac death (SCD). The article also explores the potential role of the ECG in detecting athletes at risk of SCD. In addition, the article reviews the evolution of ECG interpretation criteria and emphasizes the limitations of the ECG as well as the potential for future research...
November 2016: Cardiology Clinics
Andrew W Cairns, Raymond R Bond, Dewar D Finlay, Cathal Breen, Daniel Guldenring, Robert Gaffney, Anthony G Gallagher, Aaron J Peace, Pat Henn
INTRODUCTION: The 12-lead Electrocardiogram (ECG) presents a plethora of information and demands extensive knowledge and a high cognitive workload to interpret. Whilst the ECG is an important clinical tool, it is frequently incorrectly interpreted. Even expert clinicians are known to impulsively provide a diagnosis based on their first impression and often miss co-abnormalities. Given it is widely reported that there is a lack of competency in ECG interpretation, it is imperative to optimise the interpretation process...
September 26, 2016: Journal of Biomedical Informatics
Anishkumar Nair, Chakanalil Govindan Sajeev, Kader Muneer
CLINICAL INTRODUCTION: A 50-year-old hypertensive smoker presented with a typical angina of 2 days duration. An urgent ECG revealed extensive anterior wall myocardial infarction. In view of the delayed presentation, the patient was conservatively managed with heparin. In-hospital echocardiogram showed akinesia of entire left anterior descending artery (LAD) territory with severe left ventricular (LV) dysfunction. He was discharged with a plan for early coronary intervention. However, he presented a fortnight later with acute pulmonary oedema...
September 29, 2016: Heart: Official Journal of the British Cardiac Society
Jani Pirinen, Jukka Putaala, Karoliina Aarnio, Aapo L Aro, Juha Sinisalo, Markku Kaste, Elena Haapaniemi, Turgut Tatlisumak, Mika Lehto
INTRODUCTION: Ischemic stroke (IS) in a young patient is a disaster and recurrent cardiovascular events could add further impairment. Identifying patients with high risk of such events is therefore important. The prognostic relevance of ECG for this population is unknown. MATERIALS AND METHODS: A total of 690 IS patients aged 15-49 years were included. A 12-lead ECG was obtained 1-14 d after the onset of stroke. We adjusted for demographic factors, comorbidities, and stroke characteristics, Cox regression models were used to identify independent ECG parameters associated with long-term risks of (1) any cardiovascular event, (2) cardiac events, and (3) recurrent stroke...
September 29, 2016: Annals of Medicine
Henri K Terho, Jani T Tikkanen, Tuomas V Kenttä, M Juhani Junttila, Aapo L Aro, Olli Anttonen, Tuomas Kerola, Harri A Rissanen, Paul Knekt, Antti Reunanen, Heikki V Huikuri
INTRODUCTION: The long-term prognostic value of a standard 12-lead electrocardiogram (ECG) for predicting cardiac events in apparently healthy middle-aged subjects is not well defined. MATERIALS AND METHODS: A total of 9511 middle-aged subjects (mean age 43 ± 8.2 years, 52% males) without a known cardiac disease and with a follow-up 40 years were included in the study. Fatal and non-fatal cardiac events were collected from the national registries. The predictive value of ECG was separately analyzed for 10 and 30 years...
September 29, 2016: Annals of Medicine
Daniel Cortez, Nandita Sharma, Pei-Ni Jone
BACKGROUND: Kawasaki disease (KD) is the leading cause of acquired heart disease in children. Signal average electrocardiogram changes in patients during the acute phase of KD with coronary artery anomalies (CAA) include depolarization changes. We set out to determine if 12-lead-derived atrioventricular depolarization differences can identify CAA in patients with KD. METHODS: A blinded, retrospective case-control study of patients with KD was performed. Deep Q waves, corrected QT-intervals (QTc), spatial QRS-T angles, T-wave vector magnitudes (RMS-T), and a novel parameter for assessment of atrioventricular depolarization difference (the spatial PR angle) and a two dimensional PR angle were assessed...
September 28, 2016: Annals of Noninvasive Electrocardiology
Kishan S Parikh, Melissa A Greiner, Takeki Suzuki, Adam D DeVore, Chad Blackshear, Joseph F Maher, Lesley H Curtis, Adrian F Hernandez, Emily C O'Brien, Robert J Mentz
Importance: Increased resting heart rate is associated with worse outcomes in studies of mostly white populations, but its significance is not well established in African Americans persons whose cardiac comorbidities and structural abnormalities differ. Objective: To study the prognostic utility of heart rate in a community-based African American cohort in the Jackson Heart Study. Design, Setting, and Participants: A total of 5261 participants in the Jackson Heart Study, a prospective, community-based study in Jackson, Mississippi, were evaluated...
September 28, 2016: JAMA Cardiology
Srinivasa Prasad, Narayanan Namboodiri, Anees Thajudheen, Gurbhej Singh, Mukund A Prabhu, S P Abhilash, Krishnakumar Mohanan Nair, Aamir Rashid, V K Ajit Kumar, Jaganmohan A Tharakan
BACKGROUND: Many subjects in community have non-type 1 Brugada pattern ECG with atypical symptoms, relevance of which is not clear. Provocative tests to unmask type 1 Brugada pattern in these patients would help in diagnosing Brugada Syndrome. However sensitivity and specificity of provocating drugs are variable. METHODS: We studied 29 patients referred to our institute with clinical presentation suggestive but not diagnostic of Brugada or with non-Type 1 Brugada pattern ECG...
March 2016: Indian Pacing and Electrophysiology Journal
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