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QRS morphology

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https://www.readbyqxmd.com/read/28188971/wide-qrs-tachycardia-with-left-bundle-branch-block-morphology-what-is-the-mechanism
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
January 27, 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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27968801/simple-reconstruction-of-spatial-qrs-t-angle-using-morphology-analysis-of-philips-12-lead-algorithm
#11
Tommy Kwak, Sungchoul Pyun
No abstract text is available yet for this article.
November 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27965319/high-prevalence-of-early-repolarization-in-the-paediatric-relatives-of-sudden-arrhythmic-death-syndrome-victims-and-in-normal-controls
#12
Anna McCorquodale, Rachel Poulton, Jennifer Hendry, Gabrielle Norrish, Ella Field, Sarah Mead-Regan, Martin Lowe, Juan Pablo Kaski
AIMS: Elevation of the ECG J-point in the inferior and lateral leads (early repolarization) has been described in survivors of ventricular fibrillation (VF) arrest and occurs in adult first-degree relatives of sudden cardiac death (SCD) probands at a frequency significantly greater than in controls, raising the possibility that this could represent an independent risk factor in the aetiology of SCD. However, data on early repolarization in the paediatric population are lacking. This study aimed to assess the prevalence of early repolarization in paediatric first-degree relatives of sudden arrhythmic death syndrome (SADS) victims...
December 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27933514/changes-in-cardiac-repolarisation-during-spontaneous-nocturnal-hypoglycaemia-in-subjects-with-type-1-diabetes-a-preliminary-report
#13
Minna L Koivikko, Tuomas Kenttä, Pasi I Salmela, Heikki V Huikuri, Juha S Perkiömäki
AIMS: Experimental studies have revealed that hypoglycaemia can result in morphological changes in electrocardiographic repolarisation in subjects with type 1 diabetes. However, the influence of spontaneous nocturnal hypoglycaemia on repolarisation morphology in a 'real life' situation is not clear. METHODS: Adults with type 1 diabetes (n = 11) underwent continuous glucose monitoring with a subcutaneous sensor and digital 12-lead ECG recording for three nights...
December 8, 2016: Acta Diabetologica
https://www.readbyqxmd.com/read/27928828/wide-qrs-complex-arrhythmia-with-alternating-qrs-morphology-what-is-the-mechanism
#14
Esteban González-Torrecilla, Ángel Arenal Maíz, Pablo Ávila Alonso, Francisco Fernández-Avilés
A 75-year-old man was admitted due to an electrical storm with appropriate recurrent implantable cardioverter defibrillator (ICD) discharges. The patient had had an extensive anterolateral myocardial infarction with associated severe left ventricular dysfunction 10 years earlier (left ventricular ejection fraction, 25%), and an ICD was placed 9 years before admission for primary prevention of sudden cardiac death. A first invasive study induced up to five ventricular tachycardias and an extensive endocardial substrate ablation was performed...
January 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27909497/persistent-atrial-fibrillation-and-atrial-flutter-complicated-by-tachycardiomyopathy-because-of-intermittent-conduction-through-accessory-pathway
#15
L Valeri, A Coppolino, G Rossetti, A Vado, G Amoroso, G Bricco, A Battisti, L Correndo, S Dogliani, A Magliarditi, D Pancaldo, M De Benedictis, A Bassignana, B Doronzo
The term tachycardiomyopathy refers to a specific form of tachycardia-related cardiomyopathy caused by supraventricular or ventricular tachyarrhytmias that are both associated with ventricular rates higher than 120 bpm. The arrhythmias which are most frequently associated with these forms of heart disease are atrial fibrillation and atrial flutter, particularly found in the elderly population. The most frequent clinical manifestation is heart failure. In this case we are reporting a clinical case of a patient that came to our attention because of an episode of heart failure associated with atrial fibrillation and atrial flutter...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909478/cardiac-resynchronization-therapy-in-non-ischemic-cardiomyopathy
#16
REVIEW
Miriam Shanks Md PhD, Victoria Delgado Md PhD, Jeroen J Bax Md PhD
Cardiac resynchronization therapy (CRT) is an established therapy for heart failure patients who remain symptomatic despite optimal medical therapy, have reduced left ventricular ejection fraction (<35%) and wide QRS duration (>120 ms), preferably with left bundle branch block morphology. The response to CRT depends on the cardiac substrate: presence of correctable left ventricular mechanical dyssynchrony, presence of myocardial fibrosis (scar) and position of the left ventricular pacing lead. Patients with non-ischemic cardiomyopathy have shown higher response rates to CRT compared with patients with ischemic cardiomyopathy...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27893890/alternating-qrs-complex-morphologic-characteristics-in-a-man-presenting-with-scrotal-edema
#17
Jin Ge, Christopher Groh, Nora Goldschlager
No abstract text is available yet for this article.
January 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27893401/heartbeat-classification-using-abstract-features-from-the-abductive-interpretation-of-the-ecg
#18
Tomas Teijeiro, Paulo Felix, Jesus Presedo, Daniel Castro
: This paper aims to prove that automatic beat classification on ECG signals can be effectively solved with a pure knowledge-based approach, using an appropriate set of abstract features obtained from the interpretation of the physiological processes underlying the signal. METHODS: A set of qualitative morphological and rhythm features are obtained for each heartbeat as a result of the abductive interpretation of the ECG. Then, a QRS clustering algorithm is applied in order to reduce the effect of possible errors in the interpretation...
November 21, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/27844192/-right-bundle-branch-block-during-right-ventricular-pacing
#19
Harilaos Bogossian, Fuad Hasan, Gerrit Frommeyer, Bernd Lemke, Markus Zarse
INTRODUCTION: We describe the case of a 78-year-old patient who presented for ablation of a wide complex tachycardia with right bundle branch block (RBBB) morphology. A pacemaker spike at the QRS onset indicated supraventricular tachycardia with AV synchronous ventricular pacemaker activation. METHODS: Correct positioning of the ventricular lead in the right ventricular apex was confirmed by fluoroscopy and echocardiography, excluding malpositioning of the right ventricular lead...
November 14, 2016: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/27810292/special-electrophysiological-characteristics-of-pediatric-idiopathic-ventricular-tachycardia
#20
Shuenn-Nan Chiu, Wei-Lun Wu, Chun-Wei Lu, Kun-Lang Wu, Wei-Chieh Tseng, Ming-Tai Lin, Chien-Chih Chang, Jou-Kou Wang, Mei-Hwan Wu
BACKGROUND: Idiopathic ventricular tachycardia (VT) is an important pediatric arrhythmia but relevant studies in Asian cohort are rare. We determined the electrophysiological characteristics and outcomes of this rhythm disturbance. METHODS: From an institutional database, patients aged <18years without structural heart disease who have sustained monomorphic VT (longer than 30s) during 1995-2016 were enrolled. RESULTS: We enrolled 57 idiopathic VT patients (male:female=31:26)...
January 15, 2017: International Journal of Cardiology
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