Journal of Electrocardiology

Society Content from the Journal of Electrocardiology:

September/October 2019:

This edition's highlighted articles are:

  • Distinctive ECG patterns in healthy black adults
    by Brooks Walsh, Peter W. Macfarlane, Jordan M. Prutkin, Stephen W. Smith.
    • Highlights: The authors set out to review those ECG patterns found more often in healthy black adults of African ancestry than in those of other backgrounds (e.g. white European ancestry). Their review, which focussed on non-athletes, highlights that a robust association of “black race” with certain ECG patterns can be found across a wide variety of black populations, from African American military veterans to Bantu villagers. 

  • Electrocardiogram interpretation in NCAA athletes: Comparison of the 'Seattle' and 'International' criteria. 
    by Nicola Hyde, Jordan M. Prutkin, Jonathan A. Drezner.
    • Highlights: The authors note that accurate electrocardiogram (ECG) interpretation in competitive athletes requires the distinction of physiological adaptations from findings suggestive of a pathological condition. The purpose of this study was to compare the performance of the Seattle Criteria to the International Criteria in a large dataset of NCAA athletes screened with an ECG.

 July/August 2019:

This edition's highlighted articles are:

  • The effect of exercise on the ECG criteria for early repolarization pattern
    by Hirmand Nouraei, and Simon W. Rabkin.
    • Highlights: The authors set out to determine the effect of exercise and heart rate on the early repolarization (ER) pattern; focusing on the new criteria for identification of ER.  After testing of 21 subjects, the concluded that each of the newly defined characteristics of the ER are modified and eventually disappear with exercise. The return of ER was dynamic with QRS notching of varying extent being evident first. The changes correlated with variations in heart rate, during both exercise and recovery, suggesting, in part, a role in the underlying mechanism of ER.

  • Electrocardiographic findings of acute total occlusion associated with a sub-occlusion involving the left anterior descending and the right coronary artery. 
    by Zhong-Qun Zhan, Yang-Hua Li, Yang Li, Jian-Ping Li, and Kjell C. Nikus. 
    • Highlights: The authors note that ECG characteristics of simultaneous acute occlusion/sub-occlusion of two coronary arteries involving the left anterior descending (LAD) and right (RCA) coronary artery have been rarely described in the literature.  They present two patient cases, where one of the arteries was totally occluded and the other one had a sub-occlusion with severely limited flow to demonstrate the ECG characteristics of this severe presentation of acute coronary syndrome.  They show that the two ECG patterns suggested simultaneous occlusions of the RCA and LAD.

May/June 2019:

This edition's highlighted articles are:

  • Correction of the QRS duration for heart rate
    by Jay W. Mason, David G. Strauss, Martino Vaglio, and Fabio Badilini.
    • Highlights: The authors recently observed that the QRS duration shortens during spontaneous increases in heart rate. So they analyzed ECG and pharmacokinetic data of 21 subjects who received quinidine in a recent study. These subjects experienced the expected post-quinidine increase in heart rate, allowing the authors to determine if quinidine's well-known QRS prolongation might be attenuated due to the concomitant rate increase.

  • Prognostic significance of electrocardiographic right ventricular hypertrophy in the general population. 
    by Jamie Kowal, Muhammad Imtiaz Ahmad, Yabing Li, and Elsayed Z. Soliman. 
    • Highlights: The authors note that echocardiographically detected right ventricular hypertrophy (RVH) is associated with cardiovascular disease and mortality. However, the prognostic significance of electrocardiographic criteria as predictors of poor outcomes in the general population is unclear.  They report a wide variation in the prevalence of ECG-RVH when different criteria are applied in the general population. However, the presence of ECG-RVH by most criteria regardless of prevalence was associated with poor prognosis suggesting that appropriate choice of criteria may enhance the utilization of these ECG markers in risk stratification.

March/April 2019:

This edition's highlighted articles are:

  • Common source of miscalculation and misclassification of P-wave negativity and P-wave terminal force in lead V1.
    by Maria Uggen Rasmussen, Andreas Fabricius-Bjerre, Preman Kumarathurai, Bjørn Strøier Larsen, and Ahmad Sajadieh.
    • Highlights: The authors describe that misplacement, especially high placement, of precordial electrodes is common and that high placement results in a more than three-fold increase of P-wave terminal force. They also explain that deep terminal negativity is also increased by high placement of the V1 electrode. and theh high placement of the V1 electrode could be a common source of miscalculation.

January/February 2019:

This edition's highlighted articles are:

  • Poor reliability of P-wave terminal force V1 in ischemic stroke. 
    by Jithin K. Sajeev, Anoop N. Koshy, Helen Dewey, Jonathan M. Kalman, ManiniBhatia, Louise Roberts, Jennifer Cooke, Tanya Fronst, Rachel Denver, and Andrew W. Teh. 
    • Highlights: Several ECG markers are postulated to represent underlying atrial remodelling and have been associated with ischemic stroke. P-wave terminal force in lead V1 (PTFV1) is one such marker. The auhors examined the factors that contribute to the reliability of PTFV1 and its association with ischemic stroke. The utility of PTFV1 as a clinical marker for ischemic stroke is limited by the reduction in reliability associated with inter-observer and inter P-wave measurements.

November/December 2018:

This edition's highlighted articles are:

  • The S-wave angle identifies arrhythmogenic right ventricular cardiomyopathy in patients with electrocardiographically concealed disease phenotype.
    by DanielCortez, Anneli Svensson, JonasCarlson, SharonGraw, Nandita Sharma,  Francesca Brun, Anita Spezzacatene, Luisa Mestroni, and Pyotr Platonov.
    • Highlights: The S-wave angle identifies arrhythmogenic right ventricular cardiomyopathy in the absence of conventional or signal-averaged depolarization or repolarization abnormalities.  The right precordial S-wave angle is a novel characteristic of depolarization that can be measured by protractor or automatically. Increased S-wave angle may identify patients with definite 2010 Taskforce criteria ARVC diagnosis in absence of conventional ECG criteria.

  • Association between typical electrocardiographic abnormalities and NT-proBNP elevation in a large cohort of patients with Chagas disease from endemic area. 
    by Bruno Oliveira de Figueiredo Brito, Marcelo Martins Pinto-Filho, Clareci Silva Cardoso, Claudia Di Lorenzo Oliveira, Ariela MotaFerreirac, Lea Campos de Oliveir, PauloGomes, Maria do Carmo Pereira Nunes, Ester Cerdeira Sabino and Antonio Luiz Pinho Ribeiro. 
    • Highlights:  This summary describes electrocardiograms of a large cohort of patients with Chagas disease and reports that a) Typical ECG alterations of Chagas disease have greater odds of NT-proBNP elevation and b) Men had more major ECG abnormalities than women. The authors conclude that the ECG is a simple and accurate method to predict Chagas disease severity. 

September/October 2018:

This edition's highlighted articles are:

  • New Insights on Verapamil-Sensitive Idiopathic Left Fascicular Tachycardia.
    by Yoav Michowitz and Bernard Belhassen
    • Highlights: Ths review articles aims to summarize up to date aspects of Verapamil-sensitive left fascicular monomorphic ventricular tachycardia (LF-VT), which was first described ~4  decades ago. The article focuses on facets of the condition such as ECG recognition, new considerations of the reentrant circuit, ablation targets in inducible and non-inducible patients, and the approach to LF-VT with multiform morphology.

  • The ability of the electrocardiogram in left bundle branch block to detect myocardial scar determined by cardiovascular magnetic resonance. 
    by Björn Wieslander, Xiaojuan Xia, Robert Jablonowski, Jimmy Axelsson, Igor Klem, Robin Nijveldt, Charles Maynard, Erik B. Schelbert, Peder Sörensson, Andreas Sigfridsson, Uzma Chaudhry, Pyotr G. Platonov, Rasmus Borgquist, Henrik Engblom, Jean-Philippe Couderc, David G. Strauss, Brett D. Atwater, and Martin Ugander. 
    • Highlights:  This large scale study underscores the persistent challenge of detecting myocardial scar in LBBB patients from the ECG. The international team of experts developed a multivariable logistic model for ECG scar detection in LBBB by comparing 44 selected semi-automatically measured ECG variables to CMR in 325 LBBB patients.  Performance of the logistic model in this training set was moderate, with 54% sensitivity and 84% specificity; performance of the 2009 Selvester QRS score was also poor.  Despite extensive comparison of ECG versus CMR, they were unable to identify ECG variables that correlated well with scar extent or location.

July/August 2018:

This edition's highlighted articles are:

  • New ECG markers for predicting long-term mortality and morbidity in patients receiving cardiac resynchronization therapy.
    by  Kisiel, Fijorek, Moskal, Kukla, Sondej, Czarnecka, and Jastrzębski
    • Highlights: The team investigated the prognostic value of four recently proposed ECG markers in patients with cardiac resynchronization therapy (CRT): 1. pathological preimplantation QRS axis, 2. increase in QRS amplitude in V3 during biventricular pacing, 3. negative QRS in V1/V2 during left ventricular (LV)-only pacing, and 4. longer QRS duration during LV-only pacing on 552 subjects.  Long LV-paced QRS and pathological axis predicted unfavorable prognosis in Kaplan-Meier analysis. In multivariable Cox model (functional class, LV ejection fraction, LV end-diastolic dimension, permanent atrial fibrillation, age, gender, heart failure etiology, creatinine level, diabetes mellitus), LV-paced QRS duration remained a significant determinant of both endpoints. The other studied ECG markers lacked independent prognostic value.

  • Outcome of all-comers with STEMI based on the grade of ischemia in the presenting ECG. 
    by  Koivula,  Eskola, Viikilä, Lilleberg, Huhtala,  Birnbaum, and Nikus. 
    • Highlights: The aim of the study was to establish the prognostic significance of grade 2 ischemia (G2I), G3I and the STEMI patients excluded from ischemia grading (No grade of ischemia, NG) in a real-life patient population. We assessed in-hospital, 30-day and 1-year mortality as well as other endpoints.  The NG patients had more comorbidities and longer treatment delays than the two other groups. Short-term and 1-year mortality were highest in patients with NG and lowest in patients with G2I. Maximum troponin level was highest in G3I, followed by NG and G2I. In logistic regression multivariable analysis, NG was independently associated with 1-year mortality.

       

May/June 2018:

This edition's highlighted articles are:

  • New formula for defining “normal” and “prolonged” QT in patients with bundle branch block.
    by Yankelson, Hochstadt,  Sadeh,  Pick,  Finkelstein,  Rosso, and Sami Viskin.
    • Highlights:  The object of the study was to predict the QT interval in the presence of normal QRS for patients with left bundle branch block (LBBB). We measured the QT interval in patients with new onset LBBB who had a recent electrocardiogram with narrow QRS for comparison. 48 patients who developed in-hospital LBBB were studied. Patients who had similar heart rate before and after LBBB were included. We used linear regression, the Bogossian method, and our new fixed QRS replacement method to evaluate the most reliable correction method.

March/April 2018:

This edition's highlighted articles are:

  • Noninvasive clues for diagnosing ventricular tachycardia mechanism
    by Andres Enriquez, MD, Michael Riley, MD, and Francis Marchlinski, MD.
    • Highlights:  The electrophysiologic mechanism of ventricular tachycardia (VT) are enhanced automaticity, triggered activity and reentry. Understanding the VT mechanism is relevant for the prognosis, pharmacological therapy and ablation strategy. We review clues from the history, 12-lead ECG, monitoring and response to pharmacologic agents, to predict the VT mechanism.

  • Smartphone ECG for evaluation of ST-segment elevation myocardial infarction (STEMI): Design of the ST LEUIS International Multicenter Study 
    by Alejandro Barbagelata, MD, Charles F. Bethea, MD, Harry W. Severance, MD, Robert J. Mentz, MD, David Albert, MD, Gregory W. Barsness, MD, Viet T. Le, PA-C, Jeffrey L. Anderson, MD, T. Jared Bunch, MD, Frank Yanowitz, MD, Benjamin Chisum, BS, Brianna S. Ronnow, MS, Joseph B. Muhlestein, MD.
    • Highlights:  In STEMI patients, a 12-lead ECG is vital for rapid diagnosis and immediate access to treatment.  New technology allows for 12-lead ECG readings through a smartphone app and attachment. ST LEUIS was designed to determine if the smartphone ECG is comparable to a standard 12-lead ECG.

       

January/February 2018:

This edition's highlighted articles are:

  • Interatrial block, frailty, and prognosis in elderly patients with myocardial infarction. 
    by Eva Bernal, MD, Antoni Bayés-Genís, MD, PhD, Albert Ariza-Solé, MD, PhD, Francesc Formiga, MD, PhD, Maria T. Vidán, MD, PhD, Luis Alberto Escobar-Robledo, MS, Jaime Aboal, MD, Lídia Alcoberro, MD, Carme Guerrero, MD, Iván Ariza-Segovia, MD, Ana Hernández de Benito, MD, Pau Vilardell, MD, José Carlos Sánchez-Salado, MD, Victoria Lorente, MD, Antoni Bayés de Luna, MD, PhD, and Manuel Martinez-Sellés, MD, PhD
    • Highlights: Almost one of each three elderly patients with myocardial infarction in sinus rythm do not have a normal P wave on ECG.  Advanced interatrial block was associated with a trend toward more fraity, but not with the rest of geriatric syndromes. Elderly patients with MI and advanced IAB had a slightly higher mortality and new onset atrial fibrillation at one year.

  • Electrocardiographic recognition of right ventricular hypertrophy 
    by Kjell Nikus, MD, PhD, Andrés Ricardo Pérez-Riera, MD, PhDlink, Kaari Konttila, MS, and Raimundo Barbosa-Barros, MD.
    • Highlights: The ECG is a relatively insensitive tool for the detection of right ventricular hypertrophy, but some criteria have high specificity. ECG criteria are not sensitive/specific enough for screening for mild right ventricular hypertrophy in adults without clinical cardiovascular disease. The greatest accuracy of the ECG is in congenital heart disease

November/December 2017:

This edition's highlighted article is

The ICE article for this edition is:

September/October 2017:

This edition's highlighted article (available freely as open access!) is:

The ICE article for this edition is:

 

July, 2017:

  • IRIS-2017-Ukraine: the International Research Interdisciplinary School 2017, Zhovkva, Ukraine, May 8 -12, 2017
  • Welcome to ISE from Andrian Baranchuk, ISE President