Journal of electrocardiology
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Atrioventricular block is usually transient during the course of infectious myocarditis. We report the case of a patient presenting with complete infra-hisian atrioventricular block occurring in the setting of infectious myocarditis and in whom a pacemaker should be finally implanted. ⋯ Complete atrioventricular block persisted during the two years of follow-up despite otherwise complete regression of the myocarditis. We then discuss the main features of conduction disturbances complicating infectious myocarditis, including a list as complete as possible of all the causal agents possibly involved.
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There is currently a challenge to produce an electrocardiogram (ECG) recording of waveforms that are "standard" and also achieve the "noise immunity" required for continuous monitoring. The potential solutions that have been considered are to label each torso-recorded ECG as "nonstandard, torso-recorded," designate torso placement as "standard," or to reconstruct the "equivalent distally recorded ECG." The purpose of the present study was to validate an alternative "Lund system" of proximal limb electrode sites as a clinically feasible solution to this challenge. ⋯ Indeed, the Lund system replicated distal waveforms at a clinically acceptable level. Studies of larger patient cohorts including patients with various cardiac pathologies and studies of the noise immunity attained should be performed, and the acceptability by health care professionals should be determined.
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Electrocardiographic low QRS voltage (LQRSV) has many causes, which can be differentiated into those due to the heart's generated potentials (cardiac) and those due to influences of the passive body volume conductor (extracardiac). Peripheral edema of any conceivable etiology induces reversible LQRSV, reduces the amplitude of the P waves and T waves, decreases the duration of P waves, QRS complexes, and QT intervals, and alters in turn the measurements of the signal-averaged electrocardiogram and T wave alternans, all with enormous clinical implications.
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The similarity between and the number of limb lead cables play an important role in the frequency of incorrect connection of limb electrodes. Hence, a modified electrocardiogram (ECG) acquisition procedure is proposed in this brief communication, whereby the left-leg (LL) and right-leg (RL) electrode cables are combined into 1 cable, referred to as combined LL/RL cable. ⋯ The combined LL/RL cable is unique enough (being thicker) not to be mistaken with the upper limb electrode cables. The proposed modification will not in any way influence the ECG waveforms or amplitudes, and it can be expected to substantially reduce incorrect limb electrode placements.