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QRS morphology

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https://www.readbyqxmd.com/read/28928045/the-electrocardiographic-triangular-qrs-st-t-waveform-pattern-in-patients-with-st-segment-elevation-myocardial-infarction-incidence-pathophysiology-and-clinical-implications
#1
Alberto Cipriani, Gianpiero D'Amico, Giulia Brunello, Martina Perazzolo Marra, Federico Migliore, Luisa Cacciavillani, Giuseppe Tarantini, Barbara Bauce, Sabino Iliceto, Domenico Corrado, Alessandro Zorzi
BACKGROUND: A specific ECG pattern of presentation of ST-segment elevation acute myocardial infarction (STEMI), characterized by "triangular QRS-ST-T waveform" (TW), has been associated with poor in-hospital prognosis but longitudinal data on its incidence and clinical impact are lacking. We prospectively evaluated the incidence and prognostic meaning of the TW pattern in a cohort of consecutive STEMI patients. METHODS: All STEMI patients who presented within 12h of symptoms onset and showed no complete bundle branch block or paced ventricular rhythm were included...
August 16, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28904685/-poorly-tolerated-broad-qrs-complex-tachycardia-in-a-newborn
#2
Désiré Alain Affangla, Mohamed Leye, Angèle Wabo Simo, Franck D'Almeida, Thérèse Yandé Sarr, Adamson Phiri, Adama Kane
Poorly tolerated broad QRS complex tachycardia in a newborn poses problems with its diagnosis and emergency management. We report the case of a 35-day-old newborn with broad QRS complex tachycardia admitted because of cardiocirculatory distress. Doppler echocardiography showed morphologically normal heart. The patient received a loading dose of amiodarone but it didn't attenuate tachycardia. Normal sinus rhythm was restored after cardioversion through Lifeline semi-automatic external defibrillator. Maintenance therapy was based on oral amiodarone...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28901670/specificity-of-wide-qrs-complex-tachycardia-criteria-and-algorithms-in-patients-with-ventricular-preexcitation
#3
Marek Jastrzębski, Paweł Moskal, Piotr Kukla, Kamil Fijorek, Roksana Kisiel, Danuta Czarnecka
BACKGROUND: Despite substantial progress in the field of differentiation between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with wide QRS complexes, differentiation between VT and preexcited SVT remains largely unresolved due to significant overlap in QRS morphology. Our aim was to assess the specificities of various single ECG criteria and sets of criteria (Brugada algorithm, aVR algorithm, Steurer algorithm, and the VT score) for diagnosis of VT in a sizable cohort of patients with preexcitation...
September 12, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28899954/differentiating-the-qrs-morphology-of-posterior-fascicular-ventricular-tachycardia-from-right-bundle-branch-block-and-left-anterior-hemiblock-aberrancy
#4
Yoav Michowitz, Oholi Tovia-Brodie, Ishai Heusler, Avi Sabbag, Michael Rahkovich, Hezzy Shmueli, Aharon Glick, Bernard Belhassen
BACKGROUND: Left posterior fascicular ventricular tachycardia (LPF-VT) is frequently misdiagnosed as supraventricular tachycardia with aberrant right bundle branch block (RBBB) and left anterior hemiblock (LAHB). The purpose of the present study was to define the morphological ECG characteristics of LPF-VT and attempt to differentiate it from RBBB and LAHB aberrancy. METHODS AND RESULTS: A systematic Medline search was used to identify or locate ECG tracings from patients with LPF-VTs...
September 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28894131/ecg-features-and-methods-for-automatic-classification-of-ventricular-premature-and-ischemic-heartbeats-a-comprehensive-experimental-study
#5
Lucie Maršánová, Marina Ronzhina, Radovan Smíšek, Martin Vítek, Andrea Němcová, Lukas Smital, Marie Nováková
Accurate detection of cardiac pathological events is an important part of electrocardiogram (ECG) evaluation and subsequent correct treatment of the patient. The paper introduces the results of a complex study, where various aspects of automatic classification of various heartbeat types have been addressed. Particularly, non-ischemic, ischemic (of two different grades) and subsequent ventricular premature beats were classified in this combination for the first time. ECGs recorded in rabbit isolated hearts under non-ischemic and ischemic conditions were used for analysis...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28884873/impact-of-premature-activation-of-the-right-ventricle-with-programmed-stimulation-in-brugada-syndrome
#6
Koji Nakagawa, Satoshi Nagase, Hiroshi Morita, Tadashi Wada, Masamichi Tanaka, Masato Murakami, Atsuyuki Watanabe, Nobuhiro Nishii, Kazufumi Nakamura, Kengo F Kusano, Hiroshi Ito, Tohru Ohe
BACKGROUND: In Brugada syndrome (BrS), it has been reported that delayed activation in the RV is related to the development of type-1 ECG which is more critical than type-2. On the other hand, the coexistence of complete right bundle-branch block (CRBBB), which also causes delayed activation in the RV, sometimes makes typical BrS ECG misleading. We hypothesized that premature stimulation of the RV can unmask the influence of delayed activation in the RV and convert the morphology of ECG in BrS patients...
September 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28877886/pulmonary-right-ventricular-resynchronization-in-congenital-heart-disease-acute-improvement-in-right-ventricular-mechanics-and-contraction-efficiency
#7
Jan Janoušek, Jan Kovanda, Miroslav Ložek, Viktor Tomek, Pavel Vojtovič, Roman Gebauer, Peter Kubuš, Miroslav Krejčíř, Joost Lumens, Tammo Delhaas, Frits Prinzen
BACKGROUND: Electromechanical discoordination may contribute to long-term pulmonary right ventricular (RV) dysfunction in patients after surgery for congenital heart disease. We sought to evaluate changes in RV function after temporary RV cardiac resynchronization therapy. METHODS AND RESULTS: Twenty-five patients aged median 12.0 years after repair of tetralogy of Fallot and similar lesions were studied echocardiographically (n=23) and by cardiac catheterization (n=5) after primary repair (n=4) or after surgical RV revalvulation for significant pulmonary regurgitation (n=21)...
September 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28875096/narrow-complex-ventricular-tachycardia
#8
Murtaza Sundhu, Mehmet Yildiz, Sajjad Gul, Mubbasher Syed, Idrees Azher, Robert Mosteller
Myocardial infarctions are frequently complicated by tachyarrhythmias, which commonly have wide QRS complexes (QRS duration > 120 milliseconds). Many published criteria exist to help differentiate between ventricular and supraventricular mechanisms. We present a case of a 61-year-old male with a history of hypertension, hyperlipidemia and coronary artery disease with prior stenting of the right coronary artery (RCA). He had been noncompliant with his antiplatelet medication and presented with cardiac arrest secondary to in-stent thrombosis...
July 4, 2017: Curēus
https://www.readbyqxmd.com/read/28863167/the-development-and-validation-of-an-easy-to-use-automatic-qt-interval-algorithm
#9
Ben J M Hermans, Arja S Vink, Frank C Bennis, Luc H Filippini, Veronique M F Meijborg, Arthur A M Wilde, Laurent Pison, Pieter G Postema, Tammo Delhaas
BACKGROUND: To evaluate QT-interval dynamics in patients and in drug safety analysis, beat-to-beat QT-interval measurements are increasingly used. However, interobserver differences, aberrant T-wave morphologies and changes in heart axis might hamper accurate QT-interval measurements. OBJECTIVE: To develop and validate a QT-interval algorithm robust to heart axis orientation and T-wave morphology that can be applied on a beat-to-beat basis. METHODS: Additionally to standard ECG leads, the root mean square (ECGRMS), standard deviation and vectorcardiogram were used...
2017: PloS One
https://www.readbyqxmd.com/read/28846152/ablation-of-the-vanishing-pvc-facilitated-by-quantitative-morphology-matching-software
#10
Jeffrey P Moak, Kohei Sumihara, Jonathan Swink, Sridhar Hanumanthaiah, Charles I Berul
BACKGROUND: Ablation of cardiac arrhythmias in children and teenagers often necessitates the use of anesthesia, which can suppress ventricular arrhythmias (VA), making it difficult to map the site of origin using activation-time (AT). Pace-mapping a technique employed to assist with VA origin localization, depends on subjective comparison of paced and targeted QRS morphology. We assessed the utility of a quantitative approach to paced QRS to VA morphology matching using PaSo software (Carto 3, Biosense-Webster), to localize the VA site of origin...
August 28, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28838551/general-approach-to-a-wide-qrs-complex
#11
REVIEW
Roberto De Ponti, Giuseppe Bagliani, Luigi Padeletti, Andrea Natale
Wide QRS complex is present when the normal activation pattern is modified by various mechanisms and clinical conditions. Correct interpretation is crucial for appropriate decision making. When approaching an electrocardiogram (ECG) with wide complex tachycardia, one must differentiate between ventricular tachycardia and supraventricular tachycardia conducted with aberrancy. ECG criteria are used and algorithms developed to aid in differential diagnosis. They are based on finding ECG signs of ventriculoatrial dissociation and QRS morphologies inconsistent with classic bundle branch block...
September 2017: Cardiac Electrophysiology Clinics
https://www.readbyqxmd.com/read/28836312/premature-ventricular-contraction-induced-concealed-retrograde-penetration-electrocardiographic-manifestations-on-anterograde-ventricular-preexcitation
#12
Damián Longo, Adrian Baranchuk
In patients with manifest anterograde ventricular preexcitation, the electrocardiographic manifestation of the anomalous conduction through the simultaneous conduction over the atrioventricular (AV) node and the accessory pathway ("delta wave"); depends on several factors, the most representative being the conduction velocity over one or another connection. Occasionally, ventricular ectopic beats may present with retrograde penetration over one or both conduction pathways (AV node and/or accessory pathway), impacting on the morphology of the next immediate anterogradely conducted QRS...
August 24, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28821499/primary-ventricular-tachycardia-in-paediatric-population-in-a-tertiary-centre
#13
Shuenn-Nan Chiu, Wei-Lun Wu, Chun-Wei Lu, Wei-Chieh Tseng, Kun-Lang Wu, Jou-Kou Wang, Mei-Hwan Wu
OBJECTIVE: To delineate the outcome of ventricular tachycardia (VT) in the paediatric population. METHODS: Patients who developed sustained VT between the ages of 0 and 18 years in a referral centre from 1991 to 2015 were enrolled. RESULTS: A total of 116 patients (67 male/49 female) had documented VT, and 53 (46%) had associated heart disease, namely cardiomyopathy in 20 (17%), structural heart disease in 19 (16%) and channelopathy in 14 (12%), and some of them presented with two types of associated heart disease...
August 18, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28819094/atrioventricular-conduction-delay-predicts-impaired-exercise-capacity-in-patients-with-heart-failure-with-reduced-ejection-fraction
#14
Jakub Stępniewski, Grzegorz Kopeć, Wojciech Magoń, Piotr Podolec
BACKGROUND Atrioventricular conduction delay (AVCD) impairs left ventricular (LV) filling and consequently leads to a reduction of cardiac output. We hypothesized that in patients with severely depressed LV function and coexisting intraventricular conduction disturbances (IVCD), AVCD can affect exercise performance. Therefore, we evaluated the association of AVCD and exercise capacity in patients with heart failure (HFREF) and coexisting IVCD. MATERIAL AND METHODS We included patients with stable, chronic HFREF, LVEF <35%, sinus rhythm, and QRS ≥120 ms...
August 18, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28813535/modeling-hypothermia-induced-effects-for-the-heterogeneous-ventricular-tissue-from-cellular-level-to-the-impact-on-the-ecg
#15
Roland Kienast, Michael Handler, Markus Stöger, Daniel Baumgarten, Friedrich Hanser, Christian Baumgartner
Hypothermia has a profound impact on the electrophysiological mechanisms of the heart. Experimental investigations provide a better understanding of electrophysiological alterations associated with cooling. However, there is a lack of computer models suitable for simulating the effects of hypothermia in cardio-electrophysiology. In this work, we propose a model that describes the cooling-induced electrophysiological alterations in ventricular tissue in a temperature range from 27°C to 37°C. To model the electrophysiological conditions in a 3D left ventricular tissue block it was essential to consider the following anatomical and physiological parameters in the model: the different cell types (endocardial, M, epicardial), the heterogeneous conductivities in longitudinal, transversal and transmural direction depending on the prevailing temperature, the distinct fiber orientations and the transmural repolarization sequences...
2017: PloS One
https://www.readbyqxmd.com/read/28794085/idiopathic-ventricular-arrhythmias-originating-from-the-parietal-band-electrocardiographic-and-electrophysiological-characteristics-and-outcome-of-catheter-ablation
#16
Takumi Yamada, Naoki Yoshida, Taihei Itoh, Silvio H Litovsky, Harish Doppalapudi, H Thomas McElderry, G Neal Kay
BACKGROUNDS: The parietal band is one of the muscle bands in the right ventricle. This study investigated the electrocardiographic and electrophysiological characteristics and ablation outcome of idiopathic ventricular arrhythmias (VAs) originating from the parietal band. METHODS AND RESULTS: We studied 14 patients with idiopathic VA origins in the parietal band among 294 consecutive patients with VA origins in the right ventricle. The QRS morphologies of the parietal band VAs were characterized by a left bundle branch block and left inferior (n=12) or superior (n=2) axis pattern with the presence of a notch in the middle of the QRS in all cases, precordial transition at ≤lead V3 in 7 patients, and a slow QRS onset in 4 patients...
August 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28746519/single-derivation-fragmented-qrs-can-predict-poor-prognosis-in-successfully-revascularized-acute-stemi-patients
#17
Zulkif Tanriverdi, Huseyin Dursun, Tugce Colluoglu, Dayimi Kaya
Background: QRS fragmentation (fQRS) is classically defined as the presence of slurred QRS morphology in at least two contiguous leads, and its prognostic importance has been shown in ST elevation myocardial infarction (STEMI). However, no study has investigated the significance of single lead fQRS (sl-fQRS) in surface electrocardiography (ECG). Objectives: To evaluate whether sl-fQRS is as valuable as classical fQRS in patients with acute STEMI who had successful revascularization with primary percutaneous coronary intervention (pPCI)...
July 20, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28705874/automated-quantification-of-low-amplitude-abnormal-qrs-peaks-from-high-resolution-ecg-recordings-predicts-arrhythmic-events-in-patients-with-cardiomyopathy
#18
Moloy Das, Adrian M Suszko, Sachin Nayyar, Karthik Viswanathan, Danna A Spears, George Tomlinson, Arnold Pinter, Eugene Crystal, Rupin Dalvi, Sridhar Krishnan, Vijay S Chauhan
BACKGROUND: Cardiomyopathy patients are at risk of sudden death, typically from scar-related abnormalities of electrical activation that promote ventricular tachyarrhythmias. Abnormal intra-QRS peaks may provide a measure of altered activation. We hypothesized that quantification of such QRS peaks (QRSp) in high-resolution ECGs would predict arrhythmic events in implantable cardioverter-defibrillator (ICD)-eligible cardiomyopathy patients. METHODS AND RESULTS: Ninety-nine patients with ischemic or non-ischemic dilated cardiomyopathy undergoing prophylactic ICD implantation were prospectively enrolled (age 62±11 years, left ventricular ejection fraction 27±7%)...
July 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28695377/ventricular-dyssynchrony-assessment-using-ultra-high-frequency-ecg-technique
#19
Pavel Jurak, Josef Halamek, Jaroslav Meluzin, Filip Plesinger, Tereza Postranecka, Jolana Lipoldova, Miroslav Novak, Vlastimil Vondra, Ivo Viscor, Ladislav Soukup, Petr Klimes, Petr Vesely, Josef Sumbera, Karel Zeman, Roshini S Asirvatham, Jason Tri, Samuel J Asirvatham, Pavel Leinveber
PURPOSE: The aim of this proof-of-concept study is to introduce new high-dynamic ECG technique with potential to detect temporal-spatial distribution of ventricular electrical depolarization and to assess the level of ventricular dyssynchrony. METHODS: 5-kHz 12-lead ECG data was collected. The amplitude envelopes of the QRS were computed in an ultra-high frequency band of 500-1000 Hz and were averaged (UHFQRS). UHFQRS V lead maps were compiled, and numerical descriptor identifying ventricular dyssynchrony (UHFDYS) was detected...
September 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28652528/electrophysiological-characteristics-and-radiofrequency-catheter-ablation-treatment-of-idiopathic-ventricular-arrhythmias-successfully-ablated-from-the-ostium-of-the-coronary-sinus
#20
Yoshiaki Yui, Yukio Sekiguchi, Akihiko Nogami, Hiro Yamasaki, Takeshi Machino, Kenji Kuroki, Miyako Igarashi, Kazutaka Aonuma
BACKGROUND: Idiopathic ventricular arrhythmias (VAs) rarely arise from the epicardium at the crux of the heart. However, the electrophysiological characteristics of VAs successfully ablated from the ostium of the coronary sinus (CSO) have not yet been documented.Methods and Results:Electrocardiographic and electrophysiological data were analyzed in patients with idiopathic VAs successfully ablated from the CSO.Among 309 patients with idiopathic VAs treated with radiofrequency catheter ablation (RFCA), 6 (1...
June 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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