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Aws Alherbish, Cynthia M Westerhout, Yuling Fu, Harvey D White, Christopher B Granger, Galen Wagner, Paul W Armstrong
BACKGROUND: Lead aVR ST-segment deviation has been associated with increased mortality in ST-elevation myocardial infarction patients treated with fibrinolysis. However, its prognostic value in a contemporaneous population undergoing primary percutaneous coronary intervention is unknown. METHODS AND RESULTS: A core laboratory examined the 12-lead baseline electrocardiogram in 5,683 patients presenting within 6 hours of symptom onset in the APEX-AMI trial, and readers were blinded to study treatment and clinical outcomes...
August 2013: American Heart Journal
Cheuk-Kit Wong, Wanzhen Gao, Ralph A H Stewart, Jocelyne Benatar, John K French, Philip E G Aylward, Harvey D White
AIM: This study evaluated the prognostic implications of aVR ST elevation during ST elevation acute myocardial infarction (AMI). METHODS AND RESULTS: The Hirulog and Early Reperfusion/Occlusion-2 study randomized 17 073 patients with acute ST elevation AMI within 6 h of symptom onset to receive either bivalirudin or heparin, in addition to streptokinase and aspirin. The treatments had no effect on the primary endpoint of 30-day mortality. Electrocardiographic recordings were performed at randomization and at 60 min after commencing streptokinase...
August 2010: European Heart Journal
Cheuk-Kit Wong, Wanzhen Gao, Ralph A H Stewart, John K French, Philip E G Aylward, Harvey D White
AIMS: ST-elevation in lead aVR is known to be associated with a worse prognosis in patients with acute ST elevation myocardial infarction (MI) but the significance of ST depression in lead aVR has been unclear. Infarction of the inferior apex of the left ventricle may not be appreciated on the standard 12-lead electrocardiogram (ECG) except by observing ST depression in lead aVR which is reciprocal to lead V(7). We therefore determined the prognostic value of the full spectrum of aVR ST changes in patients presenting with acute ST elevation MI...
February 2012: European Heart Journal
Diego Goldwasser, Annamalai Senthilkumar, Antonio Bayés de Luna, Roberto Elosua, Francesc Carreras, Guillem Pons-Llado, Raymond J Kim
AIMS: It is necessary to clarify if the presence of a prominent R wave in V1, in post-myocardial infarction (MI) patients, is due to the involvement of the posterior wall (currently inferobasal segment) or the lateral wall (as has been demonstrated recently by electrocardiographic contrast-enhanced cardiac magnetic resonance [ECG-CE-CMR] correlations studies). METHODS: In 155 patients with inferolateral zone MI, as detected by CE-CMR, the following ECG parameters were evaluated and correlated with MI location according to CE-CMR: R/S ratio in V1 ≥ 1 (classic criteria for posterior MI), R/S ratio in V1 ≥ 0...
November 2015: Annals of Noninvasive Electrocardiology
Stephen Norda, Kirian van der Weg, Rein Vos, Anton P M Gorgels
PURPOSE: Recent research has established that a tall R-wave in V1 indicates lateral wall involvement in non-anterior wall myocardial infarction (MI). The objective of this study was to assess the value of the admission electrocardiogram (ECG) to predict R-waves and consequently lateral wall damage in the late phase of non-anterior MI. METHODS: ECGs of 69 patients were analyzed. ST-segment changes in representative leads for lateral wall infarction such as V1, V2, V6 and I were correlated with the extent of QRS-wave changes in V1 and V6...
July 2015: Journal of Electrocardiology
Hasan Kadı, Ayşe Kevser Demir, Köksal Ceyhan, İbrahim Halil Damar, Kayıhan Karaman, Çağrı Zorlu
OBJECTIVES: Diastolic dysfunction occurs as a result of interstitial fibrosis in hypertensive patients. Fragmented QRS (fQRS) on ECG signifies myocardial fibrosis in various clinical situations. We investigated whether fQRS on ECG is related to diastolic dysfunction in patients with hypertension. STUDY DESIGN: The study population included 72 hypertensive patients with normal coronary angiogram. Fragmented QRS was defined as the presence of an additional R wave (R'), notching of the R or S wave or fragmentation in two contiguous leads corresponding to a major coronary artery...
March 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Lauren R Klein, Gautam R Shroff, William Beeman, Stephen W Smith
BACKGROUND: ST elevation (STE) on the electrocardiogram (ECG) may be due to acute myocardial infarction (AMI) or other nonischemic pathologies such as left ventricular aneurysm (LVA). The objective of this study was to validate 2 previously derived ECG rules to distinguish AMI from LVA. The first rule states that if the sum of T-wave amplitudes in leads V1 to V4 divided by the sum of QRS amplitudes in leads V1 to V4 is greater than 0.22, then acute ST-segment elevation MI is predicted...
June 2015: American Journal of Emergency Medicine
Alessandro Zorzi, Anna Baritussio, Mohamed ElMaghawry, Mariachiara Siciliano, Federico Migliore, Martina Perazzolo Marra, Sabino Iliceto, Domenico Corrado
BACKGROUND: Takotsubo cardiomyopathy (TTC) typically affects postmenopausal women and clinically presents with chest pain, ST-segment elevation, elevated cardiac enzymes and apical left ventricular (LV) wall motion abnormalities that mimic 'apical-anterior' acute myocardial infarction (AMI). This study assessed whether at-admission clinical evaluation helps in differential diagnosis between the two conditions. METHODS: The study compared at-admission clinical, electrocardiographic (ECG) and echocardiographic findings of 31 women (median age 67 years, interquartile range (IQR) 62-76) with typical TTC and 30 women (median age 73 years, IQR 61-81) with apical-anterior AMI due to acute occlusion of the mid/distal left anterior descending coronary artery...
August 2016: European Heart Journal. Acute Cardiovascular Care
Nobuyuki Sato, Rie Sasaki, Marina Imahashi, Eisuke Ito, Kumiko Saito, Haruyo Kubota, Ahmed Karim Talib, Naka Sakamoto, Kazumi Akasaka, Yasuaki Saijo, Yuichiro Kawamura, Satoshi Fujii, Naoyuki Hasebe
BACKGROUND: Intravenous administration of magnesium (Mg(2+)) is effective for polymorphic ventricular tachycardia via homogenization of transmural ventricular repolarization. Mg(2+) likely plays some role in the heterogeneity of repolarization in J wave syndromes. OBJECTIVE: To investigate the relationship between the repolarization parameters and serum Mg(2+), potassium (K(+)), and calcium (Ca(2+)) levels in J wave syndromes. METHODS: Thirteen J-wave syndrome patients (Brugada and early repolarization [ER] syndromes), with documented episodes of ventricular fibrillation (VF), and 13 ER pattern (ERP) or Brugada type ECG patients were enrolled (25 males, mean age 48 ± 15 years)...
January 2015: Magnesium Research: Official Organ of the International Society for the Development of Research on Magnesium
Salah S Al-Zaiti, James A Fallavollita, John M Canty, Mary G Carey
BACKGROUND: Simple and reliable ECG marker(s) for sudden cardiac arrest (SCA) could be very useful in assessing high-risk populations. Since ischemic repolarization abnormalities in the left ventricular (LV) apex are strongly correlated with discordant T waves in lead aVR, we sought to evaluate the clinical and prognostic significance of this feature in ischemic cardiomyopathy. METHODS: The PAREPET trial enrolled patients with ischemic cardiomyopathy eligible for a primary prevention implantable cardiac defibrillator (ICD)...
September 2015: Journal of Electrocardiology
Alexei Shvilkin, Ethan R Ellis, Ernest V Gervino, Anthony D Litvak, Alfred E Buxton, Mark E Josephson
BACKGROUND: Painful left bundle branch block (LBBB) is a rarely diagnosed chest pain syndrome caused by intermittent LBBB in the absence of myocardial ischemia. Its prevalence, mechanism, detailed electrocardiographic (ECG) features, and effective treatments are not well described. OBJECTIVES: The purpose of this study was to characterize clinical and ECG features of patients with painful LBBB syndrome with respect to the LBBB ECG morphology (in particular QRS axis and the precordial S/T wave ratio), clarify diagnostic criteria and possible mechanisms, and provide directions for further evaluation and treatment...
January 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Hitoshi Hachiya, Kenzo Hirao, Hiroaki Nakamura, Hiroshi Taniguchi, Shinsuke Miyazaki, Yuki Komatsu, Shigeki Kusa, Takamitsu Takagi, Jin Iwasawa, Noboru Ichihara, Akio Kuroi, Tatsuya Hayashi, Yasuaki Tanaka, Yoshito Iesaka
BACKGROUND: The aim of this study was to identify the ECG features that might differentiate between anterior interventricular vein (AIV) and distal great cardiac vein (d-GCV) outflow tract-ventricular arrhythmias (OT-VAs). METHODS AND RESULTS: Radiofrequency catheter ablation was performed in 13 of 375 patients (3.5%) for AIV or d-GCV OT-VAs. We grouped the 13 patients by the origin, d-GCV (n=9) or AIV (n=4), and compared their ECGs and electrophysiological data...
2015: Circulation Journal: Official Journal of the Japanese Circulation Society
Yong-Soo Baek, Sang-Don Park, Man-Jong Lee, Sung-Woo Kwon, Sung-Hee Shin, Sung-Il Woo, Jun Kwan, Dae-Hyeok Kim
BACKGROUND: J waves are associated with increased vagal activity in patients with idiopathic ventricular fibrillation in several studies to date. However, the relationship between J waves and autonomic nervous activity in patients without structural heart disease remains under investigation. We investigated whether the presence of a J wave on the surface electrocardiogram (ECG) was related to increased vagal activity in patients without structural heart disease. METHODS: This retrospective study included 684 patients without structural heart disease who had undergone Holter ECG and surface ECG monitoring...
September 2015: Annals of Noninvasive Electrocardiology
Zulkif Tanriverdi, Huseyin Dursun, Dayimi Kaya
BACKGROUND: Fragmented QRS (fQRS) has been shown to be related to increased cardiovascular mortality and morbidity. However, limited data are available for evaluating the relationship between the number of leads with fQRS and in-hospital all-cause mortality in patients with acute ST segment elevation myocardial infarction (STEMI). The aim of our study is to investigate the prognostic importance of the number of leads with fQRS in acute STEMI patients treated by primary percutaneous coronary intervention (PCI)...
July 2016: Annals of Noninvasive Electrocardiology
Erkan Ayhan, Turgay Isık, Huseyin Uyarel, Mehmet Ergelen, Gokhan Cicek, Bahman Ghannadian, Mehmet Eren
BACKGROUND: T-wave positivity in aVR lead patients with heart failure and anterior wall old ST-segment elevation myocardial infarction (STEMI) are shown to have a higher frequency of cardiovascular mortality, although the effects on patients with STEMI treated with primary percutaneous coronary intervention (PCI) has not been investigated. In this study, we sought to determine the prognostic value of T wave in lead aVR on admission electrocardiography (ECG) for in-hospital mortality in patients with anterior wall STEMI treated with primary PCI...
January 2013: Annals of Noninvasive Electrocardiology
Alon Grossman, Alex Prokupetz, Nira Koren-Morag, Ehud Grossman, Ari Shamiss
The use of electrocardiography in sports or military screening is considered an effective tool for diagnosing potentially fatal conditions. The present study was designed to compare the yield of electrocardiographic criteria for left ventricular hypertrophy (LVH) criteria for the diagnosis of LVH and hypertrophic obstructive cardiomyopathy in subjects aged <20 years and >30 years. The association between the electrocardiographic (ECG) criteria for LVH (ECG-LVH) and echocardiographic findings was compared in 4 groups of air force academy candidates: (1) young candidates undergoing echocardiography because of ECG-LVH findings (n = 666); (2) young candidates without ECG-LVH findings undergoing routine echocardiography (n = 4,043); (3) older designated aviators undergoing echocardiography because of ECG-LVH findings (n = 196); and (4) older designated aviators undergoing routine echocardiography without ECG-LVH findings (n = 1,098)...
August 1, 2012: American Journal of Cardiology
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