Browsing by Subject "Electrocardiogram"

Now showing 1 - 9 of 9
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    2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias
    (Oxford University Press, 2019-08) Cronin, Edmond M.; Bogun, Frank M.; Maury, Philippe; Peichl, Petr; Chen, Minglong; Namboodiri, Narayanan; Aguinaga, Luis; Leite, Luiz Roberto; Al-Khatib, Sana M.; Anter, Elad; Berruezo, Antonio; Callans, David J.; Chung, Mina K.; Cuculich, Phillip; d’Avila, Andre; Deal, Barbara J.; Bella, Paolo Della; Deneke, Thomas; Dickfeld, Timm-Michael; Hadid, Claudio; Haqqani, Haris M.; Kay, G. Neal; Latchamsetty, Rakesh; Marchlinski, Francis; Miller, John M.; Nogami, Akihiko; Patel, Akash R.; Pathak, Rajeev Kumar; Sáenz Morales, Luis C.; Santangeli, Pasquale; Sapp, John L, Jr.; Sarkozy, Andrea; Soejima, Kyoko; Stevenson, William G.; Tedrow, Usha B.; Tzou, Wendy S.; Varma, Niraj; Zeppenfeld, Katja; Medicine, School of Medicine
    Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta-analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow-up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias.
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    A Rare Case of Transient Inferior ST Segment Elevation
    (Wolters Kluwer, 2013) Basir, Babar; Safadi, Bilal; Kovacs, Richard J.; Tahir, Bilal; Medicine, School of Medicine
    The investigators review the electrocardiographic manifestations of hiatal hernia and describe the case of an 86-year-old male who presented with a large distended hiatal hernia causing electrocardiographic findings of new onset ST segment elevation of the inferior leads without reciprocal changes. After decompression, the patient's electrocardiogram demonstrated resolution of the ST segment elevation.
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    Athlete ECG T-wave abnormality interpretation patterns by non-experts
    (Elsevier, 2022-05) Torabi, Asad J.; Nahhas, Omar D.; Dunn, Reginald E.; Martinez, Matthew W.; Tucker, Andrew M.; Lincoln, Andrew E.; Kovacs, Richard J.; Emery, Michael S.; Medicine, School of Medicine
    Background The presence of T-wave abnormalities (TWA) on an athlete's electrocardiogram (ECG) presents as a diagnostic challenge for physicians. Types of TWA patterns classified as abnormal by inexperienced readers have not been systematically analyzed. Methods ECGs from the 2011–2015 National Football League Scouting Combine (initially interpreted by general cardiologists) were retrospectively reviewed by expert sports cardiologists with strict application of the 2017 International Criteria. Patterns of TWA that were altered from the original interpretation were analyzed. Results The study included 1643 athletes (mean age 22 years). There was a 67 % reduction in the number of athletes with any TWA (p < 0.001) with 111 ECGs changed to normal. Inferior TWA was the most common interpreted initial ECG abnormality altered followed by anterior and lateral. Discussion This analysis revealed an initial high rate of TWA by non-expert readers. Tailored education programs to physicians who interpret athlete ECGs should highlight these specific T-wave patterns. We see this as an opportunity to make more clinicians aware of ECG interpretation guidelines as sports trained cardiologists are mostly self-taught.
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    Athlete ECG T-wave abnormality interpretation patterns by non-experts
    (Elsevier, 2022-06-16) Torabi, Asad J.; Nahhas, Omar D.; Dunn, Reginald E.; Martinez, Matthew W.; Tucker, Andrew M.; Lincoln, Andrew E.; Kovacs, Richard J.; Emery, Michael S.; Graduate Medical Education, School of Medicine
    Background: The presence of T-wave abnormalities (TWA) on an athlete's electrocardiogram (ECG) presents as a diagnostic challenge for physicians. Types of TWA patterns classified as abnormal by inexperienced readers have not been systematically analyzed. Methods: ECGs from the 2011-2015 National Football League Scouting Combine (initially interpreted by general cardiologists) were retrospectively reviewed by expert sports cardiologists with strict application of the 2017 International Criteria. Patterns of TWA that were altered from the original interpretation were analyzed. Results: The study included 1643 athletes (mean age 22 years). There was a 67 % reduction in the number of athletes with any TWA (p < 0.001) with 111 ECGs changed to normal. Inferior TWA was the most common interpreted initial ECG abnormality altered followed by anterior and lateral. Discussion: This analysis revealed an initial high rate of TWA by non-expert readers. Tailored education programs to physicians who interpret athlete ECGs should highlight these specific T-wave patterns. We see this as an opportunity to make more clinicians aware of ECG interpretation guidelines as sports trained cardiologists are mostly self-taught.
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    Electronic Heart (ECG) Monitoring at Birth and Newborn Resuscitation
    (MDPI, 2024-06-04) Mende, Sarah; Ahmed, Syed; DeShea, Lise; Szyld, Edgardo; Shah, Birju A.; Pediatrics, School of Medicine
    Background: Approximately 10% of newborns require assistance at delivery, and heart rate (HR) is the primary vital sign providers use to guide resuscitation methods. In 2016, the American Heart Association (AHA) suggested electrocardiogram in the delivery room (DR-ECG) to measure heart rate during resuscitation. This study aimed to compare the frequency of resuscitation methods used before and after implementation of the AHA recommendations. Methods: This longitudinal retrospective cohort study compared a pre-implementation (2015) cohort with two post-implementation cohorts (2017, 2021) at our Level IV neonatal intensive care unit. Results: An initial increase in chest compressions at birth associated with the introduction of DR-ECG monitoring was mitigated by focused educational interventions on effective ventilation. Implementation was accompanied by no changes in neonatal mortality. Conclusions: Investigation of neonatal outcomes during the ongoing incorporation of DR-ECG may help our understanding of human and system factors, identify ways to optimize resuscitation team performance, and assess the impact of targeted training initiatives on clinical outcomes.
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    Familial Hypertrophic Cardiomyopathy With Fasciculoventricular Accessory Pathway
    (Elsevier, 2022) Kalra, Vikas; Akrawinthawong, Krittapoom; Kalra, Maitri; Jain, Rahul; Medicine, School of Medicine
    Hypertrophic cardiomyopathy (HCM) is a common but an underdiagnosed condition. Fasciculoventricular bypass tract (FVBT) is rare. Concomitant presence of both conditions is well described in Danon disease. We report a case of familial HCM with FVBT linked to a heterozygous pathogenic variant, c.655G>C (p.Val219Leu), in the cardiac myosin binding protein C3 (MYBPC3) gene.
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    Interassociation Consensus Statement on Cardiovascular Care of College Student-Athletes
    (American College of Cardiology Foundation, 2016-04) Hainline, Brian; Drezner, Jonathan; Baggish, Aaron; Harmon, Kimberly G.; Emery, Michael S.; Myerburg, Robert J.; Sanchez, Eduardo; Molossi, Silvana; Parsons, John T.; Thompson, Paul D.; Kinesiology, School of Physical Education and Tourism Management
    Cardiovascular evaluation and care of college student-athletes is gaining increasing attention from both the public and medical communities. Emerging strategies include screening of the general athlete population, recommendations of permissible levels of participation by athletes with identified cardiovascular conditions, and preparation for responding to unanticipated cardiac events in athletic venues. The primary focus has been sudden cardiac death and the utility of screening with or without advanced cardiac screening. The National Collegiate Athletic Association convened a multidisciplinary task force to address cardiovascular concerns in collegiate student-athletes and to develop consensus for an interassociation statement. This document summarizes the task force deliberations and follow-up discussions, and includes available evidence on cardiovascular risk, pre-participation evaluation, and the recognition of and response to cardiac arrest. Future recommendations for cardiac research initiatives, education, and collaboration are also provided.
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    Isolated Right Ventricular Myocardial Infarction Presenting With Anterior ST-Segment Elevation
    (Elsevier, 2022-05-04) Mallory, Ryan; Kreutz, Rolf P.; Medicine, School of Medicine
    Isolated right ventricular myocardial infarctions (MIs) are rare, especially those presenting with anterior ST-segment elevation, which is normally seen in anterior MI. This occurs if the right coronary artery is nondominant. Differentiating between them is important for clinical management. Our case demonstrates a right ventricular MI presenting as an anterior ST-segment elevation myocardial infarction.
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    Neonatal Deletion of Hand1 and Hand2 within Murine Cardiac Conduction System Reveals a Novel Role for HAND2 in Rhythm Homeostasis
    (MDPI, 2022-07-04) George, Rajani M.; Guo, Shuai; Firulli, Beth A.; Rubart, Michael; Firulli, Anthony B.; Pediatrics, School of Medicine
    The cardiac conduction system, a network of specialized cells, is required for the functioning of the heart. The basic helix loop helix factors Hand1 and Hand2 are required for cardiac morphogenesis and have been implicated in cardiac conduction system development and maintenance. Here we use embryonic and post-natal specific Cre lines to interrogate the role of Hand1 and Hand2 in the function of the murine cardiac conduction system. Results demonstrate that loss of HAND1 in the post-natal conduction system does not result in any change in electrocardiogram parameters or within the ventricular conduction system as determined by optical voltage mapping. Deletion of Hand2 within the post-natal conduction system results in sex-dependent reduction in PR interval duration in these mice, suggesting a novel role for HAND2 in regulating the atrioventricular conduction. Surprisingly, results show that loss of both HAND factors within the post-natal conduction system does not cause any consistent changes in cardiac conduction system function. Deletion of Hand2 in the embryonic left ventricle results in inconsistent prolongation of PR interval and susceptibility to atrial arrhythmias. Thus, these results suggest a novel role for HAND2 in homeostasis of the murine cardiac conduction system and that HAND1 loss potentially rescues the shortened HAND2 PR phenotype.