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QRS morphology

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https://www.readbyqxmd.com/read/28545282/-electrocardiogram-characteristics-of-patients-with-ventricular-arrhythmia-originating-from-the-distal-great-cardiac-vein
#1
R L Zheng, D P Zhou, J X Lin, Y C Li, J Li, J Li, R P Yin, J F Lin
Objective: To explore the electrocardiographic characteristics of patients with idiopathic ventricular arrhythmias (VAs) originating from different portions of distal great cardiac veins (DGCV). Methods: The study included 49 patients underwent successful RFCA of premature ventricular complex(PVCs)/ventricular tachycardia(VT) from different portions of the DGCV in our department from July 2009 to March 2016. The surface 12-lead electrocardiogram (ECG) and intraventricular ablation mapping features were analyzed...
April 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28543265/stricter-criteria-for-left-bundle-branch-block-diagnosis-do-not-improve-response-to-crt
#2
Emanuele Bertaglia, Federico Migliore, Anna Baritussio, Antonio De Simone, Albino Reggiani, Domenico Pecora, Antonio D'Onofrio, Antonio Rapacciuolo, Gianluca Savarese, Attilio Pierantozzi, Biondino Marenna, Franco Ruffa, Monica Campari, Maurizio Malacrida, Giuseppe Stabile
BACKGROUND: Cardiac resynchronization therapy (CRT) has proved to be effective in patients with heart failure and left bundle branch block (LBBB). Recently, new ECG criteria have been proposed for the diagnosis of LBBB. These criteria are stricter than the current American Heart Association (AHA) criteria. We assessed the rate of echocardiographic response to CRT in patients with traditional LBBB versus patients who met the new criteria (strict LBBB). METHODS: Consecutive patients undergoing CRT were enrolled in the CRT MORE registry...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28543106/the-concept-of-triple-wavefront-fusion-during-biventricular-pacing-using-the-egm-to-produce-the-best-acute-hemodynamic-improvement-in-crt
#3
Iris A H Ter Horst, Margot D Bogaard, Anton E Tuinenburg, Thomas P Mast, Teun P de Boer, Pieter A Doevendans, Mathias Meine
BACKGROUND: Previous reports suggest that Biventricular pacing (BiVp) fused with intrinsic conduction (BiVp-fusion, triple wavefront fusion) is associated with improved resynchronization compared to pure-BiVp in cardiac resynchronization therapy (CRT). This study aimed to assess the association between acute hemodynamic benefit of CRT and signs of BiVp-fusion by using a novel EGM-based method. METHODS: In 17 patients undergoing CRT implantation, 28 combinations of atrioventricular (AV) and interventricular (VV) delays were applied while invasively measuring acute hemodynamic response based on maximum rate of LV pressure rise (LV dP/dtmax ) to assess optimal BiVp settings...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28538417/clinical-and-electrocardiographic-characteristics-of-infarctional-ventricular-ectopic-beats-an-observational-study
#4
Yuechun Li, Shi Zhe-Wei, Zheng Cheng, Chen Guang-Yi, Zhou De-Pu, Li Xiao-Wei, Guan Xueqiang, Lin Jiafeng, Chen Peng
The purpose of this study was to explore the clinical and electrocardiographic characteristics of infarctional ventricular ectopic beats (IVEBs).Thirty-eight acute myocardial infarction (AMI) patients with IVEB and 109 AMI patients without IVEB were analyzed. The morphological changes of QRS complex, ST segment, and T wave were compared to IVEB with sinus rhythm from the same period and fully evolved phase.An IVEB QRS complex often revealed the right bundle branch block morphology, in addition to Q wave AMI; no-Q wave AMI also had IVEB...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28506214/origins-location-of-the-outflow-tract-ventricular-arrhythmias-exhibiting-qrs-pattern-or-qs-pattern-with-a-notch-on-the-descending-limb-in-lead-v1
#5
Cong Lin, Cheng Zheng, De-Pu Zhou, Xiao-Wei Li, Shu-Jie Wu, Jia-Feng Lin
BACKGROUND: Ventricular outflow tract(VOT) ventricular arrhythmias(VAs) presenting qrS pattern or QS pattern with a notch on the descending limb in lead V1 were consistently thought of arising from the commissure between left and right coronary cusp (L-RCC) by previous studies. However, we found they could originate from other anatomic structures in VOT. This study aimed to investigate the exact origin of this kind VAs. METHODS: Forty-nine patients of VOT premature ventricular contrations/ventricular tachycardia(PVCs/VT) with lead V1 presenting qrS pattern or QS pattern with a notch on the descending limb undergoing successful radiofrequency catheter ablation(RFCA) in our center were analyzed...
May 15, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28484841/-bundle-branch-reentry-vt-diagnosis-mapping-and-ablation
#6
REVIEW
Christopher Reithmann
Macroreentry in the His-Purkinje system can result in sustained ventricular tachycardia (VT) termed bundle branch reentry VT. Bundle branch reentry is usually associated with His-Purkinje disease and depressed left ventricular function. In the case of typical bundle branch reentry, the right bundle is activated in the anterograde direction and ventricular depolarization begins at the distal end of the right bundle on the ventricular septum generating a typical left bundle branch block QRS morphology. However, atypical surface ECGs can also be found in patients with severe left ventricular dysfunction and involvement of the right ventricle complicating the diagnosis of bundle branch reentry VT...
May 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28444176/-j-waves-induced-after-short-coupling-intervals-a-manifestations-of-latent-depolarization-abnormality
#7
Yoshifusa Aizawa, Masafumi Nakayama, Masahito Sato, Masaaki Okabe, Yoshiyasu Aizawa, Seiji Takatsuki, Keiichi Fukuda
Aims: To confirm the presence of tachycardia-induced slur or notch in the terminal portion of the QRS complexes in a general patient population. Methods and results: A tachycardia-induced J wave was defined as a slur or notch in the terminal portion of the QRS complexes newly induced at short RR intervals during atrial premature contractions (APCs) or atrial electrical stimulation in the electrophysiological study (EPS). Twenty-three out of 2000 patients with general diseases were involved...
April 24, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28431055/electrocardiographic-differentiation-of-idiopathic-right-ventricular-outflow-tract-ectopy-from-early-arrhythmogenic-right-ventricular-cardiomyopathy
#8
Jan Novak, Alessandro Zorzi, Silvia Castelletti, Antonis Pantasis, Ilaria Rigato, Domenico Corrado, William Mckenna, Pier D Lambiase
Aims: The differentiation between idiopathic right ventricular outflow tract (RVOT) arrhythmias and early arrhythmogenic right ventricular cardiomyopathy (ARVC) can be challenging. We aimed to assess whether QRS morphological features and coupling interval of ventricular ectopic beats (VEBs) can improve differentiation between the two conditions. Methods and Results: Twenty desmosomal-gene mutation carriers (13 females, mean age 43 years) with no or mild ARVC phenotypic expression and 33 age- and sex-matched subjects with idiopathic RVOT arrhythmias were studied...
April 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28427578/implantable-cardioverter-defibrillators-with-versus-without-resynchronization-therapy-in-patients-with-a-qrs-duration%C3%A2-180-ms
#9
Varun Sundaram, Jayakumar Sahadevan, Albert L Waldo, George J Stukenborg, Yogesh N V Reddy, Samuel J Asirvatham, Judith A Mackall, Anselma Intini, Brigid Wilson, Daniel I Simon, Kenneth C Bilchick
BACKGROUND: More than 20% of Medicare beneficiaries receiving cardiac resynchronization therapy defibrillators (CRT-D) have a very wide (≥180 ms) QRS complex duration (QRSD). Outcomes of CRT-D in these patients are not well-established because they have been underrepresented in clinical trials. OBJECTIVES: This study examined outcomes in patients with CRT-D in a very wide QRSD with left bundle branch block (LBBB) versus those without LBBB. METHODS: Medicare patients from the Implantable Cardioverter Defibrillator Registry (January 1, 2005, through April 30, 2006) with a CRT-D and confirmed Class I or IIa indications for CRT-D were matched to implantable cardioverter-defibrillator (ICD) patients without CRT despite having Class I or IIa indications for CRT...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28422337/in-vivo-validation-of-a-novel-algorithm-for-automatic-premature-ventricular-contractions-recognition
#10
Jedrzej Kosiuk, Guilherme Portugal, Sebastian Hilbert, Silke John, Mario Oliveira, Gerhard Hindricks, Andreas Bollmann
INTRODUCTION: Template-matching algorithms are routinely used in the catheter ablation of patients with premature ventricular contractions (PVCs). However, systematic analysis of the accuracy and spatial resolution of such systems is lacking. Therefore, the aim of this evaluation was to perform a systematic in-vivo validation of performance of a novel automated template-matching algorithm. METHODS AND RESULTS: In a porcine model, paced beats simulating PVCs from different origins were investigated...
April 19, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28419605/radiofrequency-catheter-ablation-of-atrial-fibrillation-electrical-modification-suggesting-transmurality-is-faster-achieved-with-remote-magnetic-catheter-in-comparison-with-contact-force-use
#11
Sok-Sithikun Bun, Anis Ayari, Decebal Gabriel Latcu, Abdelkarim Errahmouni, Nadir Saoudi
BACKGROUND: Remote magnetic navigation (RMN) and contact force (CF) sensing catheters are available technologies for radiofrequency (RF) catheter ablation of atrial fibrillation (AF). Our purpose was to compare time to electrogram (EGM) modification suggesting transmural lesions between RMN and CF-guided AF ablation. METHODS AND RESULTS: A total of 1,008 RF applications were analyzed in 21 patients undergoing RMN (n = 11) or CF-guided ablation (n = 10) for paroxysmal AF...
April 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28340026/high-rate-of-subcutaneous-implantable-cardioverter-defibrillator-sensing-screening-failure-in-patients-with-brugada-syndrome-a-comparison-with-other-inherited-primary-arrhythmia-syndromes
#12
Giulio Conte, Mihoko Kawabata, Carlo de Asmundis, Erika Taravelli, Francesco Petracca, Diego Ruggiero, Maria Luce Caputo, François Regoli, Gian-Battista Chierchia, Alessandra Chiodini, Alessandro Del Bufalo, Tiziano Moccetti, Masahiko Goya, Kenzo Hirao, Alessandro Vicentini, Gaetano M De Ferrari, Pedro Brugada, Angelo Auricchio
Aims: Subcutaneous implantable cardioverter-defibrillator (S-ICD) can avoid important complications associated with transvenous leads in patients with inherited primary arrhythmia syndromes, who do not need pacing therapy. Few data are available on the percentage of patients with inherited arrhythmia syndromes eligible for S-ICD implantation. Aim of this study was to analyse the eligibility for S-ICD in a series of patients with Brugada syndrome (BrS), and to compare it with patients with other channelopathies...
March 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28320746/race-and-sex-differences-in-qrs-interval-and-associated-outcome-among-patients-with-left-ventricular-systolic-dysfunction
#13
Tiffany C Randolph, Samuel Broderick, Linda K Shaw, Karen Chiswell, Robert J Mentz, Valentina Kutyifa, Eric J Velazquez, Francis R Gilliam, Kevin L Thomas
BACKGROUND: Prolonged QRS duration is associated with increased mortality among heart failure patients, but race or sex differences in QRS duration and associated effect on outcomes are unknown. METHODS AND RESULTS: We investigated QRS duration and morphology among 2463 black and white patients with heart failure and left ventricular ejection fraction ≤35% who underwent coronary angiography and 12-lead electrocardiography at Duke University Hospital from 1995 through 2011...
March 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28318665/the-relation-between-local-repolarization-and-t-wave-morphology-in-heart-failure-patients
#14
Francesco Maffessanti, Joris Wanten, Mark Potse, Francois Regoli, Maria Luce Caputo, Giulio Conte, Daniel Sürder, Annekatrin Illner, Rolf Krause, Tiziano Moccetti, Angelo Auricchio, Frits W Prinzen
BACKGROUND: Both duration and morphology of the T-wave are regarded important parameters describing repolarization of the ventricles. Conventionally, T-wave concordance is explained by an inverse relation between the time of depolarization (TD) and repolarization (TR). Little is known about T-wave morphology and TD-TR relations in patients with heart failure. METHODS: Electro-anatomic maps were obtained in the left (LV) and right ventricle (RV) and in the coronary sinus (CS) in patients with heart failure with narrow (nQRS, n=8) and wide QRS complex with (LBBB, n=15) and without left bundle branch block (non-LBBB, n=7)...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28299892/the-relationship-between-j-waves-and-contact-of-lung-cancer-with-the-heart
#15
Hideki Hayashi, Qi Wu, Minoru Horie
BACKGROUND: J waves result mainly from an increased density of transient outward current (Ito ). Mechanical stretch to the heart activates multiple signal transduction pathways, in which Ito may be involved. The purpose of this study was to test the hypothesis that mechanical contact of lung cancer with the heart may manifest J waves. METHODS: We reviewed 12-lead electrocardiograms to examine whether J waves were associated with contact of lung cancer with the heart...
March 16, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28292752/fascicular-ventricular-tachycardia-originating-from-papillary-muscles-purkinje-network-involvement-in-the-reentrant-circuit
#16
Yuki Komatsu, Akihiko Nogami, Kenji Kurosaki, Itsuro Morishima, Keita Masuda, Tomoya Ozawa, Takashi Kaneshiro, Yuichi Hanaki, Yasutoshi Shinoda, Ahmed Karim Talib, Shinya Kowase, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: Verapamil-sensitive fascicular ventricular tachycardia (FVT) has been demonstrated to be a reentrant mechanism using the Purkinje network as a part of its reentrant circuit. Although the papillary muscles (PMs) are implicated in arrhythmogenic structure, reentrant FVT originating from the PMs has not been well defined. METHODS AND RESULTS: We studied 13 patients in whom FVT was successfully eliminated by ablation at the posterior PMs (n=8; PPM-FVT) and anterior PMs (n=5; APM-FVT)...
March 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28292197/sudden-death-risk-stratification-in-non-ischemic-dilated-cardiomyopathy-using-old-and-new-tools-a-clinical-challenge
#17
REVIEW
Antonis S Manolis
Risk stratification for sudden cardiac death in non-ischemic dilated cardiomyopathy (NIDCM) remains a clinical challenge. Areas covered: Currently, left ventricular ejection fraction (LVEF), severity of heart failure symptoms according to NYHA classification, and morphology and duration of the QRS complex guide device management in these patients with implantation of a cardioverter defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) devices. Recently, the results of a randomized trial stirred some controversy regarding the utility of ICD in NIDCM patients, however, a subsequent meta-analysis confirmed prior findings of the survival-prolonging benefit of device therapy...
April 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28258544/effect-of-loss-of-heart-rate-variability-on-t-wave-heterogeneity-and-qt-variability-in-heart-failure-patients-implications-in-ventricular-arrhythmogenesis
#18
Sachin Nayyar, Muhammad A Hasan, Kurt C Roberts-Thomson, Thomas Sullivan, Mathias Baumert
Heart rate variability (HRV) modulates dynamics of ventricular repolarization. A diminishing value of HRV is associated with increased vulnerability to life-threatening ventricular arrhythmias, however the causal relationship is not well-defined. We evaluated if fixed-rate atrial pacing that abolishes the effect of physiological HRV, will alter ventricular repolarization wavefronts and is relevant to ventricular arrhythmogenesis. The study was performed in 16 subjects: 8 heart failure patients with spontaneous ventricular tachycardia [HFVT], and 8 subjects with structurally normal hearts (H Norm)...
March 3, 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/28256252/full-development-of-consequences-of-congenital-pulmonic-stenosis-in-eighty-four-years
#19
William C Roberts, Paul A Grayburn, Joseph M Guileyardo, Robert C Stoler
Described herein is an 84-year-old woman, the oldest reported, with severe pulmonic stenosis who underwent a highly successful pulmonic valvotomy at age 77 and highly unsuccessfully attempted percutaneous pulmonic valve implantation at age 84. During the 84 years she developed nearly all clinical and morphologic consequences of pulmonic stenosis, including heavy calcification of the pulmonic valve, heavy calcification of the tricuspid valve annulus, severe right ventricular wall thickening without ventricular cavity dilation, aneurysm of the pulmonary truck, multiple focal ventricular wall scars without narrowing of the epicardial coronary arteries, wall thickening and luminal narrowing of the intramural coronary arteries, and extremely low 12-lead QRS electrocardiographic voltage...
April 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28217309/qrs-duration-versus-morphology-and-survival-after-cardiac-resynchronization-therapy
#20
Mand J H Khidir, Victoria Delgado, Nina Ajmone Marsan, Martin J Schalij, Jeroen J Bax
AIMS: The prognostic implications of QRS duration and morphology in heart failure patients treated with cardiac resynchronization therapy (CRT) remains debated. The present evaluation investigated the association between QRS duration (<150 vs. ≥150 ms) and QRS morphology (left bundle brand block [LBBB] vs. non-LBBB) and long-term prognosis of a large cohort of unselected heart failure patients treated with CRT according to contemporary guidelines. METHODS AND RESULTS: Of 973 heart failure patients treated with CRT (mean age 66...
February 2017: ESC Heart Failure
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