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Early repolarization

Xiaodong Huang, Tae Yun Kim, Gideon Koren, Bum-Rak Choi, Zhilin Qu
The occurrence of early afterdepolarizations (EADs) and increased dispersion of repolarization are two known factors for arrhythmogenesis in long QT syndrome. However, increased dispersion of repolarization tends to suppress EADs due to the source-sink effect, and thus how the two competing factors cause initiation of arrhythmias remains incompletely understood. Here we used optical mapping and computer simulation to investigate the mechanisms underlying spontaneous initiation of arrhythmias in type 2 long QT (LQT2) syndrome...
October 7, 2016: American Journal of Physiology. Heart and Circulatory Physiology
John P Martin-Beaulieu, Karen M Myrick, Thomas Martin, Rachel W Pata, Richard S Feinn
Electrocardiographic changes can be present in marathon runners. These findings may be misinterpreted as malignant by healthcare providers. For example, incomplete right bundle branch block, early ventricular repolarization, and left ventricular hypertrophy by voltage criteria alone are quite common in athletes, yet considered benign.
October 2016: Clinical Case Reports
Cecilia U D Stenfors, Linda M Hanson, Töres Theorell, Walter S Osika
Objective: Executive cognitive functioning is essential in private and working life and is sensitive to stress and aging. Cardiovascular (CV) health factors are related to cognitive decline and dementia, but there is relatively few studies of the role of CV autonomic regulation, a key component in stress responses and risk factor for cardiovascular disease (CVD), and executive processes. An emerging pattern of results from previous studies suggest that different executive processes may be differentially associated with CV autonomic regulation...
2016: Frontiers in Psychology
Waldemar Elikowski, Małgorzata Małek-Elikowska, Bartosz Kudliński, Paweł Skrzywanek, Sławomir Smól, Stanisław Rzymski
In typical takotsubo cardiomyopathy (TC) apical transient left ventricular dysfunction with concomitant ECG changes mimicking acute anterior myocardial infarction can be observed. Reverse TC (RTC) characterized by contractile disturbances in all basal and often simultaneous mid-ventricular segments is definitely less frequent. ECG pattern of RTC is less known. The authors present ECG findings in 5 cases of RTC in course of intracranial hemorrhage (ICH); 3 patients were diagnosed with subarachnoid hemorrhage (SAH) and the other two with intracerebral hemorrhage or subdural posttraumatic hematoma...
September 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Yang Yang, Ben-Quan Wu, Yan-Hong Wang, Yun-Feng Shi, Jin-Mei Luo, Jun-Hui Ba, Hui Liu, Tian-Tuo Zhang
Macrophages play an important role in inflammatory responses; however, miRNA-mediated repolarization of macrophages is essential for fulfilling this function. To clarify a series of changes at the RNA level in alveolar macrophages under normal and inflammatory conditions, bronchial alveolar lavage liquid (BALF) was collected from healthy volunteers or patients with pneumonia. This approach, which differs from that used in previously, provides more accurate information about the states of macrophages in different lung microenvironments...
October 18, 2016: Immunopharmacology and Immunotoxicology
Shohreh Honarbakhsh, Neil Srinivasan, Claire Kirkby, Eileen Firman, Liam Tobin, Malcolm Finlay, Ross J Hunter, Cliona Murphy, Martin D Lowe, Richard J Schilling, Pier D Lambiase
AIMS: Early repolarization (ER) has been linked to poorer outcomes in idiopathic ventricular fibrillation (IVF). The role of family screening in IVF is not clear. Our aim was to review predictors for poorer outcomes and evaluate the role of family screening in IVF. METHODS AND RESULTS: This was a retrospective multicentre cohort study including all patients diagnosed with IVF. Data were collected on baseline characteristics, ECG findings, and recurrence of ventricular arrhythmia (VA) during follow-up...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Gerrit Frommeyer, Catharina Clauss, Christian Ellermann, Harilaos Bogossian, Dirk G Dechering, Simon Kochhäuser, Florian Reinke, Christian Pott, Lars Eckardt
AIMS: The antiarrhythmic drug vernakalant exerts antiarrhythmic effects in atrial fibrillation. Recent experimental data suggest interactions with the late sodium current and antiarrhythmic effects in ventricular arrhythmias. We aimed at investigating whether treatment with vernakalant reduces polymorphic ventricular tachycardia (VT) in an experimental model of Long-QT-syndrome (LQTS). METHODS AND RESULTS: Twenty-nine isolated rabbit hearts were assigned to two groups and treated with erythromycin (300 µM, n = 15) or veratridine (0...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Enrique Velázquez-Rodríguez, Horacio Rodríguez-Piña, Alex Pacheco-Bouthillier, Marcelo Paz Jiménez-Cruz
BACKGROUND: Typical diagnostic, coved-type 1, Brugada ECG patterns fluctuate spontaneously over time with a high proportion of non-diagnostic ECG patterns. Insulin modulates ion transport mechanisms and causes hyperpolarization of the resting potential. We report our experience with unmasking J-ST changes in response to a dextrose-insulin test. METHODS: Nine patients, mean age 40.5±19.4years (range: 15-65years), presented initially with a non-diagnostic ECG pattern, which was suggestive of Brugada syndrome (group I)...
August 19, 2016: Journal of Electrocardiology
Yun-Jiu Cheng, Xiao-Xiong Lin, Cheng-Cheng Ji, Xu-Miao Chen, Li-Juan Liu, Kai Tang, Su-Hua Wu
BACKGROUND: An early repolarization pattern (ERP) has been hypothesized to be arrhythmogenic in experimental studies, but the prognostic significance of the ERP in the general population is controversial. We performed a meta-analysis to examine the link between ERP and the risk of sudden cardiac arrest (SCA), cardiac death, and death from any cause. METHODS AND RESULTS: We performed a literature search using MEDLINE (January 1, 1966 to July 31, 2015) and EMBASE (January 1, 1980 to July 31, 2015) with no restrictions...
2016: Journal of the American Heart Association
John J Wang, Olle Pahlm, Galen S Wagner, James W Warren, B Milan Horáček, John L Sapp
BACKGROUND: Existing criteria recommended by ACC/ESC for identifying patients with ST elevation myocardial infarction (STEMI) from the 12-lead ECG perform with high specificity (SP) but low sensitivity (SE). In our previous studies, we found that the SE of acute ischemia detection can be markedly improved without any loss of SP by calculating, from the 12-lead ECG, ST deviation in 3 "optimal" vessel-specific leads (VSLs). To further validate the method, we evaluated the SP performance using a dataset with non-ischemic ST-segment changes...
August 18, 2016: Journal of Electrocardiology
Samy A Abdelghani, Todd M Rosenthal, Daniel P Morin
BACKGROUND: Heart disease is a major cause of death in industrialized nations, with approximately 50% of these deaths attributable to sudden cardiac arrest. If patients at high risk for sudden cardiac arrest can be identified, their odds of surviving fatal arrhythmias can be significantly improved through prophylactic implantable cardioverter defibrillator placement. This review summarizes the current knowledge pertaining to surface electrocardiogram (ECG) predictors of sudden cardiac arrest...
2016: Ochsner Journal
Daniel H Lee, Brooks Walsh, Stephen W Smith
BACKGROUND: Early repolarization (ER) and acute left anterior descending artery occlusion (LADO) may be difficult to distinguish. Terminal QRS distortion (TQRSD), defined by the absence of both an S wave and J wave in either of leads V2 or V3, is often present in anterior ST-segment elevation myocardial infarction. We hypothesized that this finding would always be absent in ER. METHODS: This was a retrospective analysis of electrocardiograms (ECGs) of consecutive patients who presented to the emergency department with ischemic symptoms and had a cardiologist interpretation of "benign ER" on the initial emergency department ECG...
August 27, 2016: American Journal of Emergency Medicine
Raya Safa, Ronald Thomas, Peter P Karpawich
BACKGROUND: The early ECG repolarization QRS pattern (ERp), with J-point elevation of 0.1 mV in two contiguous inferior and/or lateral leads, can be associated with ventricular arrhythmias among adults. The significance of an ERp in the young is unknown. OBJECTIVE: The purpose of this study was to assess the prevalence of ERp among young patients (pts), describe and correlate the characteristics with clinical presentations and any arrhythmias. METHODS: This was a 1 y retrospective review of ECGs obtained from patients referred specifically for documented arrhythmias, possible arrhythmia-related symptoms or sports clearance...
September 21, 2016: Congenital Heart Disease
Martin Reindl, Sebastian Johannes Reinstadler, Hans-Josef Feistritzer, Agnes Mayr, Gert Klug, Peter Marschang, Bernhard Metzler
Acute myocardial infarction (AMI) is one of the major causes of mortality and morbidity worldwide. In Central Europe, causes of AMI other than atherosclerosis are unusual. Coronary artery vasculitis is one potential non-atherosclerotic process causing AMI. Herein, the authors depict a very rare case of AMI as a clinical manifestation of polyarteritis nodosa (PAN), a necrotizing systemic vasculitis. A 49-year-old male patient presented to our clinic with abdominal pain and markedly elevated concentrations of C‑reactive protein, creatinine and high-sensitivity cardiac troponin T...
September 13, 2016: Wiener Klinische Wochenschrift
Caterina Rizzo, Francesco Monitillo, Massimo Iacoviello
The 12-lead electrocardiogram (ECG) is still the most used tool in cardiology clinical practice. Considering its easy accessibility, low cost and the information that it provides, it remains the starting point for diagnosis and prognosis. More specifically, its ability to detect prognostic markers for sudden cardiac death due to arrhythmias by identifying specific patterns that express electrical disturbances of the heart muscle, which may predispose to malignant arrhythmias, is universally recognized. Alterations in the ventricular repolarization process, identifiable on a 12-lead ECG, play a role in the genesis of ventricular arrhythmias in different cardiac diseases...
August 26, 2016: World Journal of Cardiology
Xu-Miao Chen, Cheng-Cheng Ji, Yun-Jiu Cheng, Li-Juan Liu, Wei-Qi Zhu, Ying Huang, Wei-Ying Chen, Su-Hua Wu
BACKGROUND: Just as high-risk populations for cardiac arrest exist in patients with Brugada syndrome or long QT syndrome, high-risk and low-risk populations for cardiac arrest also exist in patients with early repolarization pattern (ERP). HYPOTHESIS: Electrocardiographic (ECG) characteristics can aid the risk stratification of patients with ERP. METHODS: Electrocardiographic parameters such as magnitude of J-point elevation and J/R ratio were measured...
September 6, 2016: Clinical Cardiology
Wesley T O'Neal, Yi Grace Wang, Hau-Tieng Wu, Zhu-Ming Zhang, Yabing Li, Larisa G Tereshchenko, E Harvey Estes, Ingrid Daubechies, Elsayed Z Soliman
The association between the J wave, a key component of the early repolarization pattern, and adverse cardiovascular outcomes remains unclear. Inconsistencies have stemmed from the different methods used to measure the J wave. We examined the association between the J wave, detected by an automated method, and adverse cardiovascular outcomes in 14,592 (mean age = 54 ± 5.8 years; 56% women; 26% black) participants from the Atherosclerosis Risk In Communities (ARIC) study. The J wave was detected at baseline (1987 to 1989) and during follow-up study visits (1990 to 1992, 1993 to 1995, and 1996 to 1998) using a fully automated method...
September 15, 2016: American Journal of Cardiology
Mehmet Eyuboglu, Mehmet Akif Ekinci
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Glenn Lines, Bernardo de Oliveira, Ola Skavhaug, Mary Maleckar
There is pressing clinical need to identify developing heart attack (infarction) in patients as early as possible. However, current state-of-the-art tools in clinical practice, underpinned by evaluation of elevation of the ST-segment of the 12-lead electrocardiogram, do not identify all patients suffering from lack of blood flow to the heart muscle (cardiac ischemia), worsening the risk for further adverse events and patient outcome overall. In this study, we aimed to explore and compare the portions of cardiac repolarization in the ECG that best capture the electrophysiological changes associated with ischemia...
August 25, 2016: IEEE Transactions on Bio-medical Engineering
Giulio Conte, Carlo de Asmundis, Juan Sieira, Giuseppe Ciconte, Giacomo Di Giovanni, Gian-Battista Chierchia, Ruben Casado-Arroyo, Giannis Baltogiannis, Erwin Ströker, Ghazala Irfan, Gudrun Pappaert, Angelo Auricchio, Pedro Brugada
BACKGROUND: The phenotypic heterogeneity of Brugada syndrome (BrS) can lead some patients to show an additional inferolateral early repolarization pattern (ERP), or fragmented QRS (f-QRS). The aim of the study was to investigate the prevalence and clinical impact of f-QRS, ERP or combined f-QRS/ERP in high-risk patients with BrS. METHODS AND RESULTS: Patients with spontaneous or drug-induced BrS and an indication to receive an implantable cardioverter-defibrillator (ICD) were considered eligible for this study...
September 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
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