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QRS morphology

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https://www.readbyqxmd.com/read/28320746/race-and-sex-differences-in-qrs-interval-and-associated-outcome-among-patients-with-left-ventricular-systolic-dysfunction
#1
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
#2
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
#3
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
#4
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
#5
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...
March 15, 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
#6
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
#7
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 consequence 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...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28217309/qrs-duration-versus-morphology-and-survival-after-cardiac-resynchronization-therapy
#8
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
https://www.readbyqxmd.com/read/28217233/bidirectional-ventricular-tachycardia-in-cardiac-sarcoidosis
#9
Mina M Benjamin, Kevin Hayes, Michael E Field, Melvin M Scheinman, Kurt S Hoffmayer
A 73-year-old man with history of pulmonary sarcoidosis was found to have runs of non-sustained bidirectional ventricular tachycardia (BVT) with two different QRS morphologies on a Holter monitor. Cardiac magnetic resonance delayed gadolinium imaging revealed a region of patchy mid-myocardial enhancement within the left ventricular basal inferolateral myocardium. An 18-fluorodeoxyglucose positron emission tomography (FDG-PET) showed increased uptake in the same area, consistent with active sarcoid, with no septal involvement...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28215467/cardiovascular-screening-in-low-income-settings-using-a-novel-4-lead-smartphone-based-electrocardiograph-d-heart%C3%A2
#10
Niccolo' Maurizi, Alessandro Faragli, Jacopo Imberti, Nicolò Briante, Mattia Targetti, Katia Baldini, Amadou Sall, Abibou Cisse, Francesca Gigli Berzolari, Paola Borrelli, Fulvio Avvantaggiato, Stefano Perlini, Niccolo' Marchionni, Franco Cecchi, Gianbattista Parigi, Iacopo Olivotto
BACKGROUND: MHealth technologies are revolutionizing cardiovascular medicine. However, a low-cost, user-friendly smartphone-based electrocardiograph is still lacking. D-Heart® is a portable device that enables the acquisition of the ECG on multiple leads which streams via Bluetooth to any smartphone. Because of the potential impact of this technology in low-income settings, we determined the accuracy of D-Heart® tracings in the stratification of ECG morphological abnormalities, compared with 12-lead ECGs...
February 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28188971/wide-qrs-tachycardia-with-left-bundle-branch-block-morphology-what-is-the-mechanism
#11
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Krishna Chaitanya, Sreevilasam Pushpangadhan Abhilash, Anees Thajudeen, Ajitkumar Valaparambil
A 55-year-old woman was referred for radiofrequency catheter ablation of narrow QRS tachycardia that was terminated with intravenous adenosine. Twelve-lead ECG was normal during sinus rhythm. The electrophysiological study showed an AH interval of 114 ms and HV interval of 42 ms during sinus rhythm. This article is protected by copyright. All rights reserved.
February 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28185354/eligibility-of-pacemaker-patients-for-subcutaneous-implantable-cardioverter-defibrillators
#12
James E Ip, Michael S Wu, Peter J Kennel, George Thomas, Christopher F Liu, Jim W Cheung, Steven M Markowitz, Bruce B Lerman
INTRODUCTION: The subcutaneous implantable cardioverter defibrillator (ICD) has emerged as a viable therapeutic option for patients who are deemed high risk for sudden cardiac death. Previous studies have shown that 7-15% of patients are not candidates for the S-ICD based on their intrinsic QRS/T-wave morphology. Presently, it is not known if the S-ICD can be considered as supplementary therapy in patients who are ventricularly paced. We sought to determine the proportion of ventricularly paced patients who would qualify for an S-ICD...
February 10, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28176418/impact-of-qrs-complex-duration-and-morphology-on-left-ventricular-reverse-remodelling-and-left-ventricular-function-improvement-after-cardiac-resynchronization-therapy
#13
Pieter van der Bijl, Mand Khidir, Melissa Leung, Bart Mertens, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
AIMS: To evaluate the impact of the interaction of QRS duration and morphology on left ventricular (LV) reverse remodelling and LV functional improvement in heart failure (HF) patients treated with cardiac resynchronization therapy (CRT). METHODS AND RESULTS: From an ongoing registry of HF patients treated with CRT according to contemporary guidelines, demographic, clinical, electrocardiographic (ECG) and echocardiographic characteristics were analysed. Patients were divided according to QRS duration and morphology: <150 ms vs...
February 8, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28169058/accuracy-of-computer-calculated-and-manual-qrs-duration-assessments-clinical-implications-to-select-candidates-for-cardiac-resynchronization-therapy
#14
Jan De Pooter, Milad El Haddad, Roland Stroobandt, Marc De Buyzere, Frank Timmermans
BACKGROUND: QRS duration (QRSD) plays a key role in the field of cardiac resynchronization therapy (CRT). Computer-calculated QRSD assessments are widely used, however inter-manufacturer differences have not been investigated in CRT candidates. METHODS: QRSD was assessed in 377 digitally stored ECGs: 139 narrow QRS, 140 LBBB and 98 ventricular paced ECGs. Manual QRSD was measured as global QRSD, using digital calipers, by two independent observers. Computer-calculated QRSD was assessed by Marquette 12SL (GE Healthcare, Waukesha, WI, USA) and SEMA3 (Schiller, Baar, Switzerland)...
January 31, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28159452/should-women-have-different-ecg-criteria-for-crt-than-men
#15
REVIEW
Noel S Lee, Felice Lin, Ulrika Birgersdotter-Green
One of the key aspects of heart failure management is whether patients should be considered for device therapy. Clinical trials, which have employed QRS duration and morphology as measures of left ventricular dyssynchrony, have demonstrated the morbidity and mortality benefit of cardiac resynchronization therapy. Women, however, are underrepresented in these trials, the basis of which current guidelines and standards of care are derived. Despite low enrollment of women, several studies highlight the statistically significant improvement in risk reduction that women gain from cardiac resynchronization therapy compared to men...
January 31, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28139199/wide-qrs-in-a-2-month-infant-associated-with-recurrent-ventricular-tachycardia-a-case-of-brugada-like-syndrome
#16
W Jomaa, W Selmi, S Hamdi, M A Azaiez, A El Hraiech, K Ben Hamda, F Maatouk
We report the case of a 2-month old infant who experienced recurrent sustained ventricular tachycardia (VT) in a structurally normal heart. Resting electrocardiogram (ECG) showed wide QRS with a complete right bundle branch bloc (RBBB) morphology. There was no family history of syncope or sudden death, but the ECGs of the father and the brother showed incomplete RBBB with negative T waves on V1 lead. This case seems to fit well with the newly defined entity of Brugada-like syndrome with a highly suspected genetic underlying disposition...
February 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28045413/vitamin-d-levels-predict-the-response-to-cardiac-resynchronization-therapy-in-patients-with-systolic-heart-failure
#17
Hamza Sunman, Adem Özkan, Hikmet Yorgun, Uğur Canpolat, Naresh Maharjan, Serkan Asil, Ergün Barış Kaya, Tülin Bayrak, Lale Tokgözoğlu, Asuman Özkara, Kudret Aytemir, Ali Oto
OBJECTIVE: The aim of this study was to examine the relationship between vitamin D levels in patients with heart failure (HF) and response to cardiac resynchronization therapy (CRT). METHODS: We studied 57 patients (mean age: 60.47±13.09 years) with New York Heart Association Class II or III heart failure, QRS duration ?120 milliseconds, and ejection fraction <35% (mean: 27.1±4.4%) who underwent CRT. All patients were taking optimal medical treatment for HF...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28031213/relationship-between-distance-and-change-in-surface-ecg-morphology-during-pacemapping-as-a-guide-to-ablation-of-ventricular-arrhythmias-implications-for-the-spatial-resolution-of-pacemapping
#18
Anthony Li, Joseph Samuel Davis, Jeremiah Wierwille, Keith Herold, Dennis Morgan, Elijah Behr, Stephen Shorofsky, Magdi Saba
BACKGROUND: Pacemapping is used to localize the exit site of ventricular arrhythmia. Although the relationship between distance and change in QRS morphology is its basis, this relationship has not been systematically quantified. METHODS AND RESULTS: Patients (n=68) undergoing ventricular arrhythmia ablation between March 2012 and July 2013 were recruited. Pacemapping was targeted to areas of voltage >0.5 mV. Linear mixed-effects models were constructed of distance against morphology difference measured by the root mean square error sum across all 12 ECG leads (E12)...
January 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28028497/providing-an-efficient-algorithm-for-finding-r-peaks-in-ecg-signals-and-detecting-ventricular-abnormalities-with-morphological-features
#19
Mohammad Pooyan, Fateme Akhoondi
Ventricular arrhythmias are one of the most important causes of annual deaths in the world, which may lead to sudden cardiac deaths. Accurate and early diagnosis of ventricular arrhythmias in heart diseases is essential for preventing mortality in cardiac patients. Ventricular activity on the electrocardiogram (ECG) signal is in the interval from the beginning of QRS complex to T wave end. Variations in the ECG signal and its features may indicate heart condition of patients. The first step to extract features of ECG in time domain is finding R peaks...
October 2016: Journal of Medical Signals and Sensors
https://www.readbyqxmd.com/read/28011826/human-ventricular-activation-sequence-and-the-simulation-of-the-electrocardiographic-qrs-complex-and-its-variability-in-healthy-and-intraventricular-block-conditions
#20
Louie Cardone-Noott, Alfonso Bueno-Orovio, Ana Mincholé, Nejib Zemzemi, Blanca Rodriguez
AIMS: To investigate how variability in activation sequence and passive conduction properties translates into clinical variability in QRS biomarkers, and gain novel physiological knowledge on the information contained in the human QRS complex. METHODS AND RESULTS: Multiscale bidomain simulations using a detailed heart-torso human anatomical model are performed to investigate the impact of activation sequence characteristics on clinical QRS biomarkers. Activation sequences are built and validated against experimentally-derived ex vivo and in vivo human activation data...
December 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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