Journal of electrocardiology
-
Arrhythmias are frequent causes of morbidity and mortality in patients with single ventricle physiology after Fontan operation. The aim of this study was to evaluate which type of Fontan procedure--lateral tunnel (LT) or extracardiac conduit (EC)--provides superior outcomes related to the problem of early postoperative and 1-year follow-up arrhythmias. ⋯ Extracardiac conduit as compared with LT does not provide superior outcomes related to the problem of early and 1-year onset arrhythmias. Other factors than the risk of early postoperative and early follow-up arrhythmias should be considered in surgical preference of modification strategy.
-
Time from symptom onset to reperfusion is essential in patients with ST-segment elevation acute myocardial infarction. Prior studies have indicated that prehospital 12-lead electrocardiogram (ECG) transmission can reduce time to reperfusion. ⋯ Transmission of prehospital ECG is technically feasible and reduces time to pPCI in ST-segment elevation acute myocardial infarction patients.
-
Patients presenting to the emergency department with chest pain are triaged to early reperfusion therapies based on their initial 12-lead electrocardiogram (ECG). The standard 12-lead ECG lacks sensitivity to detect acute myocardial infarction (AMI). Electrocardiographic diagnosis of non-ST-elevation myocardial infarction (non-STEMI) is especially difficult and is delayed until cardiac biomarkers turn positive, indicating onset of myocardial necrosis. ⋯ Patients diagnosed with non-STEMI have distinct distribution of K-L coefficients compared with non-ACS cardiac patients. Coefficients from the first 50 samples of the ST-T wave (ST segment) better predict diagnostic category than do coefficients derived from the entire ST-T wave. Karhunen-Loève coefficient feature analysis may provide early diagnostic information to distinguish patients with non-STEMI vs non-ACS cardiac patients.
-
Recent reports have highlighted the importance of a family history of sudden death as a risk for ventricular fibrillation (VF) in patients experiencing acute myocardial infarction (AMI), pointing to the possibility of a genetic predisposition. This report briefly reviews 2 recent studies designed to examine the hypothesis that there is a genetic predisposition to the development of arrhythmias associated with AMI. Ventricular tachycardia and VF (VT/VF) complicating AMI as well as arrhythmias associated with Brugada syndrome, a genetic disorder linked to SCN5A mutations, have both been linked to phase 2 reentry. ⋯ Expression of this polymorphism has previously been shown to cause a loss of function in HERG current consistent with the long-QT phenotype. These observations suggest a genetic predisposition to the development of long-QT intervals and torsade de pointes in the days after an AMI. These preliminary studies provide support for the hypothesis that there is a genetic predisposition to the type and severity of arrhythmias that develop during and after an AMI, and that additional studies are warranted.