Journal of electrocardiology
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The YEARS algorithm was successfully developed to reduce the number of computed tomography pulmonary angiography (CTPA) investigations in the diagnostic management of patients with suspected pulmonary embolism (PE), although half of patients still needed to be referred for CTPA. We hypothesized that ECG derived ventricular gradient optimized for right ventricular pressure overload (VG-RVPO), an easy to use tool for detecting PE-induced pulmonary hypertension (PH), may further improve the efficiency of the YEARS algorithm. ⋯ This post-hoc analysis of the YEARS study failed to demonstrate incremental diagnostic value of VG-RVPO for acute PE, either as stand-alone diagnostic test or combined with the YEARS algorithm. Nevertheless, the role of VG-RVPO recorded on admission could potentially be valuable in the risk stratification of PE during hospitalization, although this remains to be studied.
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Case Reports
Wide complex tachycardia cycle length shorter than the narrow complex tachycardia. What is the mechanism?
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 atrioventricular reentrant tachycardia (wide and narrow complex tachycardia) utilizing left posterolateral bypass tract was induced. We propose the mechanism for shorter tachycardia cycle length during wide complex tachycardia compared with narrow complex tachycardia.
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Screening and early diagnosis of mitral regurgitation (MR) are crucial for preventing irreversible progression of MR. In this study, we developed and validated an artificial intelligence (AI) algorithm for detecting MR using electrocardiography (ECG). ⋯ The proposed AI algorithm demonstrated promising results for MR detecting using 12-lead and single-lead ECGs.
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To investigate the characteristics of early recurrence (ER) of atrial tachyarrhythmia (ATA) defined as atrial fibrillation (AF), atrial tachycardia (AT), or atrial flutter (AFL) during a 90-day blanking period after pulmonary vein isolation by cryoablation (PVI-C) in patients with symptomatic drug refractory AF. Specifically, to determine if ER of ATA during the blanking period can predict late recurrence (LR) during a 12-month follow-up period. ⋯ In our study, ER of ATA was a common phenomenon during the 90-day blanking period after PVI-C for AF, and it mostly occurred in the first month following the index ablation across all patients. ER is not equal to the LR of ATA; however, patients with an ER event had a higher risk of a LR during the 12-month follow-up period.
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Sleep disordered breathing [SDB] is a well-known problem in patients with cardiovascular diseases. Around 50% of pts. with SDB present positional sleep disordered breathing [PSDB]. ⋯ Sleep disordered breathing SDB is a frequent problem of pts. with cardiovascular diseases. It may influence the prognosis. Moderate or severe SDB is recorded in 44% of pts. with arrhythmias, almost 50% of them have positional SDB. Percent of time of sleeping in supine position has an important independent impact on the presence of SDB. 3. Big studies should be conducted to verify if avoidance of sleeping in supine position may improve clinical outcome. What is new?