Journal of electrocardiology
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Randomized Controlled Trial Multicenter Study
Correlation of anteroseptal ST elevation with myocardial infarction territories through cardiovascular magnetic resonance imaging.
Anteroseptal ST elevation myocardial infarction (STEMI) is traditionally defined on the electrocardiogram (ECG) by ST elevation (STE) in leads V1-V3, with or without involvement of lead V4. It is commonly taught that such infarcts affect the basal anteroseptal myocardial segment. While there are suggestions in the literature that Q waves limited to V1-V4 represent predominantly apical infarction, none have evaluated anteroseptal ST elevation territories. We compared the distribution of the myocardium at risk (MaR) in STEMI patients presenting with STE limited to V1-V4 and those with more extensive STE (V1-V6). ⋯ Patients with acute STEMI and STE in leads V1-V4, exhibit MaR in predominantly apical territories and rarely in the basal anteroseptum. We found no evidence to support existence of isolated basal anteroseptal or septal STEMI. "Anteroapical" infarction is a more precise description than "anteroseptal" infarction for acute STEMI patients exhibiting STE in V1-V4.
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Multicenter Study Observational Study
Racial susceptibility for QT prolongation in acute drug overdoses.
QT prolongation independently predicts adverse cardiovascular events in suspected poisoning. We aimed to evaluate the association between race and drug-induced QT prolongation for patients with acute overdose. ⋯ We found significant racial susceptibility to drug-induced QT prolongation in this large urban study of acute overdoses.
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Multicenter Study Comparative Study
Quality of anticoagulation with warfarin in patients with nonvalvular atrial fibrillation in the community setting.
The benefit of oral anticoagulation therapy with warfarin for stroke prevention in atrial fibrillation (AF) is directly dependent on the quality of anticoagulation (QoA), which in the US is provided predominantly in the community setting. With the emergence of new oral anticoagulation agents, the current QoA needs to be assessed. ⋯ The QoA with warfarin, as assessed by TTR, in the current community setting remains suboptimal, and there has been little to no improvement in current clinical practices. TTR should be considered when assessing the recent comparative studies evaluating novel pharmacologic agents to warfarin for the treatment of AF. SUBJECT AREAS: Arrhythmias, preventive cardiology, anticoagulation, thromboembolism, cardiovascular disease risk factors.
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Multicenter Study Comparative Study
A comparison of commonly used QT correction formulae: the effect of heart rate on the QTc of normal ECGs.
The corrected QT interval (QTc) is widely used in pharmaceutical studies and clinical practice. Bazett's QT correction formula is still the most popular, despite Simonson's warning in 1961 that it could not be recommended. Other QTc formulae, e.g. ⋯ Numerous references recommend 420 to 440 ms as the threshold for reporting prolonged QTc when using Bazett's formula. Based on this database, 30% of apparently normal ECGs would be reported as having abnormal QT intervals for the 440 ms threshold, or 10% if 460 ms is chosen, compared to <2% for the other formulae. It was also noted that QT has a linear trend with HR but not with RR.