Abstract:
:Early recognition of ST-segment elevation myocardial infarction equivalent electrocardiogram patterns is of paramount importance. Successful identification of these ischemic patterns helps ensure proper triage of patients needing urgent restoration of coronary perfusion. The so-called de Winter sign has become increasingly recognized as a ST-segment elevation myocardial infarction equivalent pattern due to proximal left anterior descending artery occlusion. Yet, despite the de Winter pattern's well-defined electrocardiographic-angiographic relationship, the electrophysiologic explanation for its characteristic electrocardiographic manifestations remains unclear. Herein, we report a case in which an ischemic lateral lead variant of the de Winter pattern emerged from a patient inflicted by an abrupt thrombotic occlusion of the ostial left anterior descending artery, which developed in series with a high-grade stenosis of the distal left main coronary artery. We examine the patient's presenting electrocardiographic findings and clinical course to (i) establish causal inferences that align with the distribution of myocardial ischemia supported by coronary angiography and (ii) provide an accompanying analysis of the relevant scientific literature.
journal_name
J Electrocardioljournal_title
Journal of electrocardiologyauthors
Kashou AH,LoCoco S,Asirvatham SJ,May AM,Noseworthy PAdoi
10.1016/j.jelectrocard.2020.06.002subject
Has Abstractpub_date
2020-01-01 00:00:00pages
77-80eissn
0022-0736issn
1532-8430pii
S0022-0736(20)30291-0journal_volume
61pub_type
杂志文章abstract::Isolated occlusion of the septal perforating branch of the left anterior descending coronary artery is extremely rare. As a result, little is known about its electrocardiographic manifestations compared with those of an anteroseptal myocardial infarction. We present the case of an isolated septal myocardial infarction...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2011.07.013
更新日期:2012-05-01 00:00:00
abstract::The de Winter electrocardiogram (ECG) pattern may signify proximal left anterior descending artery (LAD) occlusion and was suggested to be managed as ST-segment elevation myocardial infarction (STEMI) equivalent for urgent angiography and reperfusion therapy. However, cardiac catheter laboratory is not readily or time...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2019.06.010
更新日期:2019-01-01 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
abstract:BACKGROUND:While J-waves were observed in healthy populations, variations in their reported incidence may be partly explicable by the ECG filter setting. METHODS:We obtained resting 12-lead ECG recordings in 665 consecutive patients and enrolled 112 (56 men, 56 women, mean age 59.3±16.1years) who manifested J-waves on...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2013.10.001
更新日期:2014-01-01 00:00:00
abstract::This study described the linear relationship of the myocardial infarct size, measured postmortem, to the integral of the sequential vector spatial magnitudes analyzed at 400 samples per second during the initial period of abnormal depolarization (IAD) in 25 patients with myocardial infarction (MI) and ten controls. Th...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(82)81002-9
更新日期:1982-10-01 00:00:00
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
pub_type: 杂志文章
doi:10.1016/s0022-0736(75)80040-9
更新日期:1975-01-01 00:00:00
abstract::15-Year-old man's cardiac event monitor showed an episode of wide complex tachycardia which transitioned into narrow complex tachycardia. The tachycardia cycle length was shorter during wide complex tachycardia compared with narrow complex tachycardia. He underwent electrophysiology study in which an orthodromic atrio...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2020.02.002
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:To determine the effect of exercise and heart rate on the early repolarization (ER) pattern; focusing on the new criteria for identification of ER. METHODS:The ECG measurements on the terminal QRS notch or slur found in early repolarization were quantitated before, during and after exercise; specifically: (i...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2019.03.005
更新日期:2019-01-01 00:00:00
abstract::QT and RR intervals' fluctuations are implicated in the development of malignant arrhythmias. Recent research has quantified repolarization lability using stochastic and linear methods. However, QT-RR intervals are nonlinearly coupled. To this end, QT and RR intervals were extracted from twenty four patients with acut...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2004.04.008
更新日期:2004-07-01 00:00:00
abstract::Under healthy conditions, the normal cardiac (sinus) interbeat interval fluctuates in a complex manner. Quantitative analysis using techniques adapted from statistical physics reveals the presence of long-range power-law correlations extending over thousands of heartbeats. This scale-invariant (fractal) behavior sugge...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(95)80017-4
更新日期:1995-01-01 00:00:00
abstract::Serial ECG's were reviewed in 93 consecutive patients who were proven to be susceptible to malignant hyperthermia by caffeine contracture and ATP depletion tests on skeletal muscle biopsies, but who were without a history of pyrexic crises. There were 46 males and 47 females with a mean age of 33 years. Abnormal ECG's...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(82)80007-1
更新日期:1982-04-01 00:00:00
abstract::Precordial electrocardiographic leads V1, V2, V5, V6, and limb leads I and II were recorded simultaneously utilizing radio transparent electrodes and wire leads during coronary angiography in 35 patients with obstructive coronary disease and in 17 subjects with normal coronary angiograms. The pattern of electrocardiog...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(76)80047-7
更新日期:1976-01-01 00:00:00
abstract::Sintered Ag-AgCl needle electrodes were used to record unipolar directly coupled (DC) electrograms transmurally from right and left ventricular myocardium. Direct coupling yields unfiltered low-frequency signal content, preserving repolarization waveform morphology. These electrograms were analyzed using completely au...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(88)90102-1
更新日期:1988-08-01 00:00:00
abstract::Left ventricular systolic function, determined mainly by final infarct size, has a major influence on prognosis after acute myocardial infarction (MI). It was found that infarct size and left ventricular ejection fraction can be predicted using the Selvester QRS-score in patients not receiving reperfusion therapy. We ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1054/jelc.200.20345
更新日期:2000-01-01 00:00:00
abstract::A His bundle electrogram was obtained in a 70 year old male with syncopal episodes. A split bundle of His deflection was recorded. After the intravenous administration of phentolamine, a marked shortening of the H-H' interval was observed. This signifies an improvement in conduction at the bundle of His level. ...
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::Percutaneous radiofrequency catheter ablation (RFCA) has a very high success rate for certain arrhythmias, such as Wolff-Parkinson-White syndrome and idiopathic ventricular tachycardias in the right ventricular outflow tract. These arrhythmias are typically characterized by a single site of arrhythmogenic tissue that ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(94)80073-1
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:"Cardiac memory" (CM) refers to a change in repolarization induced by an altered pathway of activation, manifested after resumption of spontaneous ventricular activation (SVA). AIMS:To investigate for the first time in humans the effects of left ventricular (LV) pacing on CM development through vectorcard...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2015.05.007
更新日期:2015-07-01 00:00:00
abstract::Electrocardiographic manifestation mimicking the hyperacute phase of myocardial infarction and the electrical alternans of the elevated ST-segment in association with subarachnoid hemorrhage were reported in two patients with no evidence of heart disease. In both cases the ST-segment changes were transient and there w...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(89)90082-4
更新日期:1989-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to investigate the effect of cardiac resynchronization therapy (CRT) on P wave maximum duration (PWM) and P wave dispersion (PWD) in patients with advanced heart failure. METHODS:Forty-six patients (33 men; mean age, 60 +/- 11 years) with CRT were enrolled in the present study. P...
journal_title:Journal of electrocardiology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jelectrocard.2009.02.005
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:QRS-duration predicts mortality in patients with heart failure and, to a lesser extent, the general population. However, in patients with diabetes, its prognostic significance is unknown. To better understand how QRS-duration relates to mortality among those with diabetes, we explored survival as a function ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2019.11.053
更新日期:2020-01-01 00:00:00
abstract:UNLABELLED:Cardiac function management devices, including implantable pacemakers and implantable defibrillators, include at least 1 cardiac lead having an electrode for making contact with a portion of the heart. It has been previously shown that the braided multifilament wire electrodes have a high failure rate both f...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2009.07.019
更新日期:2009-11-01 00:00:00
abstract::The authors present an original method for the discrimination of patients prone to ventricular tachycardia. The wavelet transform, which is a new time-scale technique suitable for transient signal detection, was applied to bipolar unfiltered X, Y, Z signal-averaged electrocardiograms in 20 postinfarction patients with...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/0022-0736(93)90052-f
更新日期:1993-10-01 00:00:00
abstract::The long-term goal of electrocardiography is to relate electric potentials on the body surface with activities in the heart. Many previously reported studies have focused on direct links between heart and body surface potentials. The goals of this study were first to validate computational methods of determining volum...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1054/jelc.2000.20309
更新日期:2000-01-01 00:00:00
abstract::An inexpensive system was developed for automated on-line analysis of ST segment heights, Q, R, and S heights and areas under these peaks, using an LSI-11 microcomputer. System accuracy was evaluated using a computer graphics technique which enabled magnification and labelling of the computed peaks on 60 maps from 17 ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(82)80032-0
更新日期:1982-01-01 00:00:00
abstract::The paper electrocardiogram (ECG) has been widely used for cardiac assessment for well over a century. ECGs can be obtained quickly and cheaply. For this reason, an ever-growing amount of paper ECG records continue to accumulate, some of which are stored into a paper-only format. Converting paper ECGs into digital for...
journal_title:Journal of electrocardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jelectrocard.2016.09.007
更新日期:2017-01-01 00:00:00
abstract::A common basis of orthogonal waveform functions was derived from 128 lead body surface potential maps of 405 subjects. Twelve such orthogonal functions or frames were adequate for reconstruction of original ECGs from the beginning of QRS to the end of T. A larger number of frames (18) was required when basis functions...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(85)80016-9
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND:Temporary-permanent pacemakers [TPPM] are externally placed permanent generators attached to active fixation transvenous leads. TPPM can be used as an alternative to standard temporary pacing leads when placement of a permanent pacemaker is contraindicated. We sought to determine the incidence and risk facto...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2016.05.004
更新日期:2016-07-01 00:00:00
abstract::This contribution discusses the dominant T wave, a concept providing an overall view on the repolarization currents of the ventricular myocardium. The dominant T wave is a weighted mean of the T waves on the body surface. It can be estimated from the matrix of sampled observed potentials. The timing of its peak reveal...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2004.08.056
更新日期:2004-01-01 00:00:00
abstract::In order to examine the clinical usefulness of the vulnerability map, body surface mapping was performed in ten normal subjects and 32 patients with CAD using dipyridamole infusion to induce ventricular arrhythmias. A vulnerability map and the vulnerability index (VI) proposed by Urie et al. were constructed from QRS ...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/s0022-0736(87)80100-0
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND:Most patients presenting with suspected acute coronary syndrome (ACS) are admitted to telemetry units. While telemetry is an appropriate level of care, acute complications requiring a higher level of care in the intensive care unit (ICU) occur. PURPOSE:Among patients admitted to telemetry for suspected ACS,...
journal_title:Journal of electrocardiology
pub_type: 杂志文章
doi:10.1016/j.jelectrocard.2016.08.010
更新日期:2016-01-01 00:00:00