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QRS morphology

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https://www.readbyqxmd.com/read/28431055/electrocardiographic-differentiation-of-idiopathic-right-ventricular-outflow-tract-ectopy-from-early-arrhythmogenic-right-ventricular-cardiomyopathy
#1
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
#2
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
#3
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
#4
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: 1008 RF applications were analyzed in 21 patients undergoing RMN (n = 11) or CF-guided ablation (n = 10) for paroxysmal AF. All procedures were performed in sinus rhythm during general anaesthesia...
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Krishna Chaitanya, Sreevilasam Pushpangadhan Abhilash, Anees Thajudeen, Ajitkumar Valaparambil
No abstract text is available yet for this article.
February 11, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28185354/eligibility-of-pacemaker-patients-for-subcutaneous-implantable-cardioverter-defibrillators
#17
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
#18
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
#19
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
#20
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
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