Abstract:
BACKGROUND:In a minority of the patients presenting with ST-segment elevation (STE) myocardial infarction (MI), electrocardiogram (ECG) may show a balanced STE in both anterior and inferior lead groups and may cause diagnostic confusion about involved myocardial territory. In this study, we sought ECG clues which may facilitate discriminating (1) MI location and then (2) culprit artery in patients with difficult-to-discern ECGs. MATERIAL AND METHODS:Consecutive patients with the diagnosis of STEMI were scanned and patients with ECGs displaying both anterior and inferior STE were enrolled. ECGs with obvious ST elevation in either lead group and reciprocal ST-segment depression were excluded. Predictive power of several ECG variables has been analyzed and an algorithm has been constructed. RESULTS:A total of 959 STEMI cases were scanned, the final study population was consisted of 114 patients. Our algorithm for locating MI territory had a sensitivity, specificity, positive and negative predictive value of 72.1%, 92.5%, 91.7% and 74.2% for inferior versus anterior location, respectively (P < 0.001, φ = 0.652). As anterior MI was strictly reserved for left anterior descending (LAD) artery occlusion, these diagnostic values were also valid for discriminating circumflex artery [Cx]/right coronary artery [RCA] versus LAD as the culprit artery. In patients classified as having inferior MI, an STE in lead III greater than STE in lead II favored RCA over Cx as the culprit artery with a sensitivity, specificity, positive and negative predictive value of 97%, 46.6%, 80% and 87.5%, respectively (P < 0.001; φ = 0.544). CONCLUSION:Our algorithm can be used in difficult-to-discern ECGs for defining involved myocardial territory and culprit artery.
journal_name
J Electrocardioljournal_title
Journal of electrocardiologyauthors
Bozbeyoğlu E,Aslanger E,Yıldırımtürk Ö,Şimşek B,Karabay CY,Türer A,Kozan Ö,Değertekin Mdoi
10.1016/j.jelectrocard.2018.09.006subject
Has Abstractpub_date
2018-01-01 00:00:00pages
1055-1060issue
6eissn
0022-0736issn
1532-8430pii
S0022-0736(18)30550-8journal_volume
51pub_type
杂志文章abstract::Clinically based studies have indicated that patients who have suffered myocardial infarction (MI) exhibit lower heart rate variability (HRV). Such associations have not been reported at the population level. To investigate whether MI is related to lower HRV in the general population, the authors examined a stratified...
journal_title:Journal of electrocardiology
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doi:10.1016/s0022-0736(96)80082-3
更新日期:1996-07-01 00:00:00
abstract::A prolonged QT interval is an important prognostic indicator for cardiac arrhythmias and sudden death. The conventional QT interval measurement, however, includes in its measure the cardiac depolarization (QRS) as well as the cardiac repolarization (JT) intervals. To evaluate the relative contribution of the depolariz...
journal_title:Journal of electrocardiology
pub_type: 临床试验,杂志文章
doi:10.1016/0022-0736(90)90150-z
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abstract:BACKGROUND:We studied whether social media applications can serve as effective educational tools for teaching electrocardiogram (ECG) interpretation to medical residents. METHODS:39 emergency, family, and internal medicine residents participated in the 33-week "ECG of the Week" curriculum via Facebook and Twitter. ECG...
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doi:10.1016/j.jelectrocard.2017.04.010
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abstract::A patient who had chronic coarse atrial fibrillation developed severe hyperkalemia accompanied by total loss of fibrillatory waves while an irregularly irregular ventricular rhythm persisted. Correction of hyperkalemia resulted in prompt return of coarse atrial fibrillation. This sequence of events renders strong supp...
journal_title:Journal of electrocardiology
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doi:10.1016/s0022-0736(75)80040-9
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abstract::A device has been developed which can be used in conjunction with a direct-writing electrocardiograph to record the high frequency electrocardiogram (ECG) including notches and slurs in the waveform. The device operates on the principle of temporarily storing the QRS complex and then reproducing it at a rate 10 times ...
journal_title:Journal of electrocardiology
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doi:10.1016/s0022-0736(75)80054-9
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abstract::There is increasing evidence that regular intense endurance exercise can promote structural and electrical remodeling of the right ventricle (RV). These physiological changes can be profound and are frequently accompanied by ECG changes in the right precordial leads, thereby mimicking features observed in arrhythmogen...
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abstract:BACKGROUND:Elevated levels of N-terminal pro brain natriuretic peptide (NT-proBNP) are associated with adverse cardiovascular outcome after ST elevation myocardial infarction (STEMI). We hypothesized that decreasing acuteness-score (based on the electrocardiographic score by Anderson-Wilkins acuteness score of myocardi...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2016.11.002
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abstract::The contributions of reduced conduction velocity (CV) and prolonged action potential duration (APD) to QT interval prolongation and T wave and T vector loop morphology in left ventricular hypertrophy (LVH) were studied using an analytical computer model. Three types of anatomic LVH were simulated: concentric and eccen...
journal_title:Journal of electrocardiology
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abstract::The goal of the 2007 PhysioNet/Computers in Cardiology Challenge was to try to establish how well it is possible to characterize the location and extent of old myocardial infarcts using electrocardiographic evidence supplemented by anatomical imaging information. A brief overview of the challenge and how different cha...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2008.07.022
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abstract:BACKGROUND:Sudden arousal has been associated with sudden cardiac death in individuals with ischemic heart disease, cardiac arrhythmias, and the congenital long QT syndrome. This study aimed to determine the effects of arousal on ventricular repolarization in normal individuals by examining the dynamic QT interval-hear...
journal_title:Journal of electrocardiology
pub_type: 临床试验,杂志文章
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abstract:INTRODUCTION:Not only repolarization, but also depolarization ECG indexes reflect the progression of ischemic injury. The aim was to assess the QRS duration and morphology dynamics during the prolonged coronary occlusion and their association with the myocardial area at risk (MaR) and final infarct size (IS). METHODS:...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2016.03.014
更新日期:2016-05-01 00:00:00
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journal_title:Journal of electrocardiology
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doi:10.1054/jelc.2002.33766
更新日期:2002-07-01 00:00:00
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journal_title:Journal of electrocardiology
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更新日期:2020-01-01 00:00:00
abstract::We found significant variation within each computer and cardiologist method for measurement of the ECG waveform intervals. Comparison between methods revealed that the HP system had a smaller variability than the MAC or the cardiologist, and that the MAC had a smaller variability than the cardiologist. No variability ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(07)80110-5
更新日期:1989-01-01 00:00:00
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journal_title:Journal of electrocardiology
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doi:10.1016/j.jelectrocard.2015.04.001
更新日期:2015-07-01 00:00:00
abstract::The JTp interval gained interest as a marker differentiating effects of drugs on cardiac ion channels. For JTp interval, both the beginning - identification of J point and identification of T wave end remains the subject of substantial variability. We aimed to analyze diagnostic and prognostic performance of JTp inter...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2017.07.019
更新日期:2017-01-01 00:00:00
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(78)80147-2
更新日期:1978-10-01 00:00:00
abstract::The authors investigated the usefulness of the Karhunen-Loeve technique applied to body surface maps to study regional cardiac excitation. Eigenvectors were derived from the body surface potential maps of 120 healthy adults using the Karhunen-Loeve expansion theory. Then, in the maps of various types of ventricular hy...
journal_title:Journal of electrocardiology
pub_type: 临床试验,杂志文章
doi:10.1016/0022-0736(90)90148-u
更新日期:1990-01-01 00:00:00
abstract::We present a case of a woman with an asymptomatic intermittent 2:1 atrioventricular block. The baseline ECG showed a wide QRS with right bundle branch block pattern. Measurement of the HV interval during electrophysiological study was normal. During electrophysiological stimulation, a unique pattern of paradoxical con...
journal_title:Journal of electrocardiology
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journal_title:Journal of electrocardiology
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doi:10.1016/j.jelectrocard.2015.06.009
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journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(05)80054-8
更新日期:1995-10-01 00:00:00
abstract:INTRODUCTION:The mechanisms of torsade de pointes tachycardia (TdP) are incompletely understood. We aimed to investigate the mechanisms underlying TdP tachycardia in patients with spontaneous high-degree atrioventricular block (AVB). METHODS AND RESULTS:This retrospective study reviewed old TdP recordings after ventri...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
abstract::The electrocardiographic transient display of left ventricular hypertrophy (LVH), during rapid heart rates, in the setting of sinus/supraventricular tachycardias and atrial fibrillation, is illustrated via 3 case reports. This common occurrence is expressed by an increase in the S-waves in leads V2-V5, during tachycar...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
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abstract::An interpolated premature ventricular contraction (PVC) may produce either complete block of the next sinus impulse or depression of A-V nodal conduction with a prolonged A-H interval. When a PVC results in partial depression of a A-V nodal conduction, the effect on subsequent premature atrial stimuli is unknown. The ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
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更新日期:1977-01-01 00:00:00
abstract:OBJECTIVE:We have previously used a 12-lead, signal-processed ECG to calculate blood potassium levels. We now assess the feasibility of doing so with a smartphone-enabled single lead, to permit remote monitoring. PATIENTS AND METHODS:Twenty-one hemodialysis patients held a smartphone equipped with inexpensive FDA-appr...
journal_title:Journal of electrocardiology
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abstract::In recent years, it has become increasingly clear that for an important subset of patients with coronary artery disease, many or all of their ischemic episodes are not accompanied by anginal pain. For these patients, it is desirable to detect these ischemic episodes as periods of ST-segment depression on Holter tapes....
journal_title:Journal of electrocardiology
pub_type: 杂志文章
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abstract:BACKGROUND:No direct comparison of current electrocardiogram (ECG) interpretation programs exists. OBJECTIVE:Assess the accuracy of ECG interpretation programs in detecting abnormal rhythms and flagging for priority review records with alterations secondary to acute coronary syndrome (ACS). METHODS:More than 2,000 di...
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abstract::Syncope is a risk factor for sudden cardiac death (SCD) in many conditions associated with structural heart disease as well as inherited heart disease. The ECG in patients with syncope should be examined carefully for signs of structural heart disease, such as myocardial infarction or cardiomyopathy; signs of conducti...
journal_title:Journal of electrocardiology
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更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to evaluate the nature and onset of changes in the QRS complex in the offspring of patients with diabetes mellitus (DM) and metabolic syndrome (MetS). METHODS AND METHODS:A total of 529 subjects, divided into 5 groups, were included in the study: (i) group DM (n = 92), patients with...
journal_title:Journal of electrocardiology
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doi:10.1016/j.jelectrocard.2012.02.004
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