Pub Date : 2024-11-13DOI: 10.1016/j.jelectrocard.2024.153822
S. Serge Barold MD , David C. Barold MD
{"title":"Centennial of Einthoven's Nobel prize lecture on electrocardiography","authors":"S. Serge Barold MD , David C. Barold MD","doi":"10.1016/j.jelectrocard.2024.153822","DOIUrl":"10.1016/j.jelectrocard.2024.153822","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"88 ","pages":"Article 153822"},"PeriodicalIF":1.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-12DOI: 10.1016/j.jelectrocard.2024.153825
Daniel Bulanda , Janusz A. Starzyk , Adrian Horzyk
The electrocardiogram (ECG) stands out as one of the most frequently used medical tests, playing a crucial role in the accurate diagnosis and treatment of patients. While ECG devices generate a huge amount of data, only a fraction of it holds valuable medical information. To deal with this problem, many compression algorithms and filters have been developed over the years. However, the rapid development of new machine-learning techniques introduces new challenges. To address this class of problems, we have introduced a FlexPoints algorithm. This innovative algorithm searches for characteristic points on the ECG signal and ignores all other points that lack pertinent medical information. The conducted experiments have demonstrated that our proposed algorithm can significantly reduce the number of data points representing ECG signals without losing valuable medical insights. These sparse but essential characteristic points, referred to as flex points, serve as well-fitted input for modern machine learning models. Such models exhibit enhanced performance when using flex points as input, as opposed to raw data or data compressed by other popular algorithms.
{"title":"FlexPoints: Efficient electrocardiogram signal compression for machine learning","authors":"Daniel Bulanda , Janusz A. Starzyk , Adrian Horzyk","doi":"10.1016/j.jelectrocard.2024.153825","DOIUrl":"10.1016/j.jelectrocard.2024.153825","url":null,"abstract":"<div><div>The electrocardiogram (ECG) stands out as one of the most frequently used medical tests, playing a crucial role in the accurate diagnosis and treatment of patients. While ECG devices generate a huge amount of data, only a fraction of it holds valuable medical information. To deal with this problem, many compression algorithms and filters have been developed over the years. However, the rapid development of new machine-learning techniques introduces new challenges. To address this class of problems, we have introduced a FlexPoints algorithm. This innovative algorithm searches for characteristic points on the ECG signal and ignores all other points that lack pertinent medical information. The conducted experiments have demonstrated that our proposed algorithm can significantly reduce the number of data points representing ECG signals without losing valuable medical insights. These sparse but essential characteristic points, referred to as flex points, serve as well-fitted input for modern machine learning models. Such models exhibit enhanced performance when using flex points as input, as opposed to raw data or data compressed by other popular algorithms.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"88 ","pages":"Article 153825"},"PeriodicalIF":1.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jelectrocard.2024.153780
S. Serge Barold , Patrick Hermans , Andreas Kucher , Rik Willems
Nonparoxysmal junctional tachycardia with Wenckebach exit block is known to be associated with digitalis toxicity. This report documents the occurrence of this arrhythmia in the absence of digitalis therapy in a patient with structural heart disease.
{"title":"Nonparoxysmal junctional tachycardia associated with 3:2 Wenckebach exit block in the absence of digitalis therapy","authors":"S. Serge Barold , Patrick Hermans , Andreas Kucher , Rik Willems","doi":"10.1016/j.jelectrocard.2024.153780","DOIUrl":"10.1016/j.jelectrocard.2024.153780","url":null,"abstract":"<div><div>Nonparoxysmal junctional tachycardia with Wenckebach exit block is known to be associated with digitalis toxicity. This report documents the occurrence of this arrhythmia in the absence of digitalis therapy in a patient with structural heart disease.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153780"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jelectrocard.2024.153819
Leonid Makarov MD, PhD, Anush Akopyan MD, Vera Komoliatova MD, PhD
A 12-channel ECG and the ECG patterb from Holter monitoring of a 6-year-girl are presented.
本文介绍了一名 6 岁女孩的 12 道心电图和 Holter 监测的心电图模式。
{"title":"The ECG of a 6-year-old girl","authors":"Leonid Makarov MD, PhD, Anush Akopyan MD, Vera Komoliatova MD, PhD","doi":"10.1016/j.jelectrocard.2024.153819","DOIUrl":"10.1016/j.jelectrocard.2024.153819","url":null,"abstract":"<div><div>A 12-channel ECG and the ECG patterb from Holter monitoring of a 6-year-girl are presented.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153819"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jelectrocard.2024.153821
Sandro Pinelli Felicioni MD, PhD , José Nunes de Alencar MD , Marinella Patrizia Centemero MD, PhD , Uelra Rita Lourenço MD, PhD , Mariana Fuziy Nogueira De Marchi MD , Matheus Kiszka Scheffer MD , Ana Carolina Muniz Costa MD , Rinaldo Carvalho Fernandes MD , Vinicius Ruiz Uemoto , Ramon Baronetti
Background
It has been established that concurrent ST-T alterations in limb leads can assist in identifying the location of left anterior descending (LAD) artery occlusion. The de Winter pattern is an atypical electrocardiographic manifestation characterized by ST-segment depression associated with LAD artery occlusion. We hypothesized that this atypical pattern could potentially interfere with the accurate localization of the LAD occlusion site on the electrocardiogram. We aimed to describe the distinctive characteristics of the de Winter pattern and to compare electrocardiographic variables in proximal and distal occlusions of the LAD artery.
Methods
A systematic review was conducted using the PRISMA guidelines. PubMed, Scopus, and Web of Science were searched from their inception to June 2024. Continuous variables were compared using the Kruskal-Wallis test.
Results
Sixty-six cases with LAD related lesions were included. The majority of cases involved young males with a low proportion of prior coronary artery disease. Most patients had sinus rhythm and normal QRS duration. ST-T changes in limb leads were common in the patients studied (91%), but our analysis showed that differentiating between proximal and distal occlusions based on these changes was challenging.
Conclusion
The de Winter pattern is primarily observed in young males with a low proportion of prior coronary artery disease. While ST-T changes in limb leads are frequent, localizing the LAD occlusion site based on these changes can be difficult. Further research is needed to understand the underlying mechanisms, prevalence, and improve diagnostic accuracy for this atypical pattern.
背景：已经证实，肢体导联同时出现的 ST-T 改变有助于确定左前降支（LAD）动脉闭塞的位置。德温特模式是一种非典型心电图表现，其特点是与 LAD 动脉闭塞相关的 ST 段压低。我们假设这种非典型模式可能会干扰心电图对 LAD 闭塞部位的准确定位。我们旨在描述德温特模式的显著特征，并比较 LAD 动脉近端和远端闭塞的心电图变量：采用 PRISMA 指南进行了系统性回顾。对 PubMed、Scopus 和 Web of Science 从开始到 2024 年 6 月进行了检索。采用 Kruskal-Wallis 检验比较连续变量：结果：共纳入66例LAD相关病变病例。大多数病例为年轻男性，既往冠状动脉疾病比例较低。大多数患者为窦性心律，QRS持续时间正常。肢体导联的ST-T改变在所研究的患者中很常见（91%），但我们的分析表明，根据这些改变区分近端和远端闭塞具有挑战性：结论：德温特模式主要见于既往冠状动脉疾病比例较低的年轻男性。虽然肢体导联的 ST-T 变化很常见，但根据这些变化定位 LAD 闭塞部位却很困难。要了解这种非典型模式的潜在机制、发病率并提高诊断准确性，还需要进一步的研究。
{"title":"The de Winter electrocardiographic pattern: A systematic review of case reports","authors":"Sandro Pinelli Felicioni MD, PhD , José Nunes de Alencar MD , Marinella Patrizia Centemero MD, PhD , Uelra Rita Lourenço MD, PhD , Mariana Fuziy Nogueira De Marchi MD , Matheus Kiszka Scheffer MD , Ana Carolina Muniz Costa MD , Rinaldo Carvalho Fernandes MD , Vinicius Ruiz Uemoto , Ramon Baronetti","doi":"10.1016/j.jelectrocard.2024.153821","DOIUrl":"10.1016/j.jelectrocard.2024.153821","url":null,"abstract":"<div><h3>Background</h3><div>It has been established that concurrent ST-T alterations in limb leads can assist in identifying the location of left anterior descending (LAD) artery occlusion. The de Winter pattern is an atypical electrocardiographic manifestation characterized by ST-segment depression associated with LAD artery occlusion. We hypothesized that this atypical pattern could potentially interfere with the accurate localization of the LAD occlusion site on the electrocardiogram. We aimed to describe the distinctive characteristics of the de Winter pattern and to compare electrocardiographic variables in proximal and distal occlusions of the LAD artery.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using the PRISMA guidelines. PubMed, Scopus, and Web of Science were searched from their inception to June 2024. Continuous variables were compared using the Kruskal-Wallis test.</div></div><div><h3>Results</h3><div>Sixty-six cases with LAD related lesions were included. The majority of cases involved young males with a low proportion of prior coronary artery disease. Most patients had sinus rhythm and normal QRS duration. ST-T changes in limb leads were common in the patients studied (91%), but our analysis showed that differentiating between proximal and distal occlusions based on these changes was challenging.</div></div><div><h3>Conclusion</h3><div>The de Winter pattern is primarily observed in young males with a low proportion of prior coronary artery disease. While ST-T changes in limb leads are frequent, localizing the LAD occlusion site based on these changes can be difficult. Further research is needed to understand the underlying mechanisms, prevalence, and improve diagnostic accuracy for this atypical pattern.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153821"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jelectrocard.2024.153824
Juliana Senftinger MD , Nils A. Sörensen MD , Stefan Blankenberg MD, DMSc , Peter Clemmensen MD, DMSc
Background
There is still conflicting evidence regarding the prognostic implications of right bundle branch block (RBBB) in the general population but also in patients with heart diseases like acute coronary syndromes (ACS). In accordance with current guidelines, RBBB in ACS patients is considered as STEMI equivalent. However, recent studies indicate that further differentiation is necessary in this group, as we will outline below.
Methods and results
A literature search was conducted in PubMed and Google Scholar.
In previous studies, RBBB in the general population were mostly considered benign changes of the electrical conduction system. However, recent studies indicate that both complete and incomplete RBBB are associated with increased cardiovascular morbidity and mortality. In addition, among unselected patients with suspected ACS presenting to the emergency department, the prevalence of RBBB was 3 % and it was associated with elevated mortality. The subsequent angiographic identification of a culprit coronary artery stenosis leading to stent implantation was similar at approximately 2 % regardless of the initial ECG presentation with narrow QRS complexes, left bundle branch block (LBBB), or RBBB.
Finally, in a group of high-risk patients for ST-elevation myocardial infarction (STEMI), the prevalence of RBBB was 12 %. While RBBB was associated with poor outcome compared to non-BBB and LBBB patients, diagnostic accuracy of STEMI criteria was not affected by the presence of RBBB. However, RBBB patients without distinct STEMI signs in ECG often showed acute STEMI on angiography indicating a potential benefit from immediate transfer to the cardiac catheterization laboratory.
Conclusion
In the general population, patients with RBBB and risk factors may need further evaluation. Regarding ACS patients, recent studies support current guidelines that recommend acute invasive evaluation for high-risk ACS patients with RBBB, regardless of ST-T deviations. However, in an unselected group of ACS patients, differential diagnoses should also be investigated through additional diagnostic procedures.
{"title":"Right bundle branch block in suspected acute coronary syndromes: Diagnostic challenges, treatment and prognosis","authors":"Juliana Senftinger MD , Nils A. Sörensen MD , Stefan Blankenberg MD, DMSc , Peter Clemmensen MD, DMSc","doi":"10.1016/j.jelectrocard.2024.153824","DOIUrl":"10.1016/j.jelectrocard.2024.153824","url":null,"abstract":"<div><h3>Background</h3><div>There is still conflicting evidence regarding the prognostic implications of right bundle branch block (RBBB) in the general population but also in patients with heart diseases like acute coronary syndromes (ACS). In accordance with current guidelines, RBBB in ACS patients is considered as STEMI equivalent. However, recent studies indicate that further differentiation is necessary in this group, as we will outline below.</div></div><div><h3>Methods and results</h3><div>A literature search was conducted in PubMed and Google Scholar.</div><div>In previous studies, RBBB in the general population were mostly considered benign changes of the electrical conduction system. However, recent studies indicate that both complete and incomplete RBBB are associated with increased cardiovascular morbidity and mortality. In addition, among unselected patients with suspected ACS presenting to the emergency department, the prevalence of RBBB was 3 % and it was associated with elevated mortality. The subsequent angiographic identification of a culprit coronary artery stenosis leading to stent implantation was similar at approximately 2 % regardless of the initial ECG presentation with narrow QRS complexes, left bundle branch block (LBBB), or RBBB.</div><div>Finally, in a group of high-risk patients for ST-elevation myocardial infarction (STEMI), the prevalence of RBBB was 12 %. While RBBB was associated with poor outcome compared to non-BBB and LBBB patients, diagnostic accuracy of STEMI criteria was not affected by the presence of RBBB. However, RBBB patients without distinct STEMI signs in ECG often showed acute STEMI on angiography indicating a potential benefit from immediate transfer to the cardiac catheterization laboratory.</div></div><div><h3>Conclusion</h3><div>In the general population, patients with RBBB and risk factors may need further evaluation. Regarding ACS patients, recent studies support current guidelines that recommend acute invasive evaluation for high-risk ACS patients with RBBB, regardless of ST-T deviations. However, in an unselected group of ACS patients, differential diagnoses should also be investigated through additional diagnostic procedures.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153824"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jelectrocard.2024.153816
Naoya Kataoka MD, Teruhiko Imamura MD
{"title":"Detailed association between adolescent obesity and ventricular repolarization","authors":"Naoya Kataoka MD, Teruhiko Imamura MD","doi":"10.1016/j.jelectrocard.2024.153816","DOIUrl":"10.1016/j.jelectrocard.2024.153816","url":null,"abstract":"","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153816"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jelectrocard.2024.153820
Miro Enroth , Harri Sievanen , Tuikku Tuula-Maria Agnes Asikainen , Jari Viik
Background
Exercise electrocardiography (ECG) is a common diagnostic and prognostic method for the detection of coronary artery disease (CAD). However, its accuracy in asymptomatic women has not been comprehensively investigated and the diagnostic criteria may require refinements. This study evaluated the performance of ECG-derived ST/HR-index, ST/HR hysteresis and ST-segment depression parameters among asymptomatic middle-aged women.
Methods
108 women (mean age 56 ± 4 years) performed exercise ECG test on treadmill until exhaustion three times within a nine-month period. False-positive rates of maximum ST/HR-index, ST/HR hysteresis, and ST-segment depression values measured from 12 leads at peak exercise and after one-minute recovery were evaluated with recommended diagnostic partition values. Repeatability was assessed with intraclass correlation (ICC) and Bland-Altman plot analysis.
Results
False-positive rate was lower for all variables when a two‑lead configuration was used instead of a single‑lead configuration. Using a two‑lead configuration, ST/HR hysteresis (0–1.9 %) and ST-segment depression after one-minute recovery (0–2.8 %) had lower false-positive rates compared to ST/HR index (3.7–20.4 %) and ST-segment depression at peak exercise (9.3–27.8 %). ICC values indicated moderate repeatability for ST/HR hysteresis while ST/HR index, ST-segment at peak exercise, and ST-segment after one-minute recovery had moderate-to-good repeatability. Bland-Altman analysis indicated poor repeatability for all evaluated ECG variables.
Conclusion
In asymptomatic middle-aged women, practitioners should prefer the use of ST/HR hysteresis and ST-segment after one-minute recovery over the conventional ST-segment depression at peak exercise or ST/HR index, and evaluate the ECG data from a two‑lead configuration instead of single‑lead.
背景：运动心电图（ECG）是检测冠状动脉疾病（CAD）的常用诊断和预后方法。然而，该方法在无症状女性中的准确性尚未得到全面研究，诊断标准可能需要改进。本研究评估了无症状中年女性心电图ST/HR指数、ST/HR滞后和ST段压低参数的性能。方法：108名女性（平均年龄56±4岁）在9个月内三次在跑步机上进行运动心电图测试，直至力竭。用推荐的诊断分区值评估了运动高峰时和一分钟恢复后从 12 个导联测量的最大 ST/HR 指数、ST/HR 滞后和 ST 段压低值的假阳性率。通过类内相关性（ICC）和Bland-Altman图分析评估了重复性：结果：使用双导联配置而非单导联配置时，所有变量的假阳性率均较低。使用双导联配置时，ST/HR 滞后（0-1.9%）和一分钟恢复后的 ST 段压低（0-2.8%）的假阳性率低于 ST/HR 指数（3.7-20.4%）和运动高峰时的 ST 段压低（9.3-27.8%）。ICC值表明ST/HR滞后的重复性为中等，而ST/HR指数、运动高峰时的ST段和一分钟恢复后的ST段的重复性为中等至良好。Bland-Altman分析表明，所有评估的心电图变量的重复性都较差：结论：对于无症状的中年女性，医生应优先使用 ST/HR 滞后和一分钟恢复后的 ST 段，而不是传统的运动高峰期 ST 段压低或 ST/HR 指数，并从双导联配置而不是单导联评估心电图数据。
{"title":"Use of ST/HR hysteresis decreases false positive rate in exercise electrocardiography test of middle-aged asymptomatic women","authors":"Miro Enroth , Harri Sievanen , Tuikku Tuula-Maria Agnes Asikainen , Jari Viik","doi":"10.1016/j.jelectrocard.2024.153820","DOIUrl":"10.1016/j.jelectrocard.2024.153820","url":null,"abstract":"<div><h3>Background</h3><div>Exercise electrocardiography (ECG) is a common diagnostic and prognostic method for the detection of coronary artery disease (CAD). However, its accuracy in asymptomatic women has not been comprehensively investigated and the diagnostic criteria may require refinements. This study evaluated the performance of ECG-derived ST/HR-index, ST/HR hysteresis and ST-segment depression parameters among asymptomatic middle-aged women.</div></div><div><h3>Methods</h3><div>108 women (mean age 56 ± 4 years) performed exercise ECG test on treadmill until exhaustion three times within a nine-month period. False-positive rates of maximum ST/HR-index, ST/HR hysteresis, and ST-segment depression values measured from 12 leads at peak exercise and after one-minute recovery were evaluated with recommended diagnostic partition values. Repeatability was assessed with intraclass correlation (ICC) and Bland-Altman plot analysis.</div></div><div><h3>Results</h3><div>False-positive rate was lower for all variables when a two‑lead configuration was used instead of a single‑lead configuration. Using a two‑lead configuration, ST/HR hysteresis (0–1.9 %) and ST-segment depression after one-minute recovery (0–2.8 %) had lower false-positive rates compared to ST/HR index (3.7–20.4 %) and ST-segment depression at peak exercise (9.3–27.8 %). ICC values indicated moderate repeatability for ST/HR hysteresis while ST/HR index, ST-segment at peak exercise, and ST-segment after one-minute recovery had moderate-to-good repeatability. Bland-Altman analysis indicated poor repeatability for all evaluated ECG variables.</div></div><div><h3>Conclusion</h3><div>In asymptomatic middle-aged women, practitioners should prefer the use of ST/HR hysteresis and ST-segment after one-minute recovery over the conventional ST-segment depression at peak exercise or ST/HR index, and evaluate the ECG data from a two‑lead configuration instead of single‑lead.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153820"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jelectrocard.2024.153823
Marco Biasin MD , Sara Lomi MD , Laura Pagani MD, Gabriele Facci MD, Davide Betta MD, Giovanni Morani MD
Chest pain is a common and complex condition in emergency departments, often complicating the diagnostic process due to its wide range of potential causes. This case report presents a 72-year-old man with chest pain and ST-segment elevation on ECG, initially suggestive of acute coronary syndrom. AI-assisted ECG analysis reinforced this suspicion; however, angiography revealed patent coronary arteries. When his symptoms persisted, further investigation uncovered a pneumothorax. Additional evaluation identified a digitization error affecting the AI interpretation. This case underscores the importance of a comprehensive clinical approach for chest pain and highlights the need for quality data input and alternative imaging, such as thoracic ultrasound, for accurate and timely differential diagnoses.
胸痛是急诊科常见且复杂的病症，由于其潜在病因广泛，往往使诊断过程复杂化。本病例报告的患者是一名 72 岁的男性，胸痛和心电图 ST 段抬高最初提示急性冠状动脉综合征。人工智能辅助心电图分析加强了这一怀疑；然而，血管造影显示冠状动脉通畅。当他的症状持续存在时，进一步检查发现了气胸。额外的评估发现了一个影响人工智能解读的数字化错误。本病例强调了胸痛综合临床方法的重要性，并突出了高质量数据输入和替代成像（如胸部超声）对准确及时的鉴别诊断的必要性。
{"title":"Chest pain and AI interpretation: The essential role of clinical judgment and quality data","authors":"Marco Biasin MD , Sara Lomi MD , Laura Pagani MD, Gabriele Facci MD, Davide Betta MD, Giovanni Morani MD","doi":"10.1016/j.jelectrocard.2024.153823","DOIUrl":"10.1016/j.jelectrocard.2024.153823","url":null,"abstract":"<div><div>Chest pain is a common and complex condition in emergency departments, often complicating the diagnostic process due to its wide range of potential causes. This case report presents a 72-year-old man with chest pain and ST-segment elevation on ECG, initially suggestive of acute coronary syndrom. AI-assisted ECG analysis reinforced this suspicion; however, angiography revealed patent coronary arteries. When his symptoms persisted, further investigation uncovered a pneumothorax. Additional evaluation identified a digitization error affecting the AI interpretation. This case underscores the importance of a comprehensive clinical approach for chest pain and highlights the need for quality data input and alternative imaging, such as thoracic ultrasound, for accurate and timely differential diagnoses.</div></div>","PeriodicalId":15606,"journal":{"name":"Journal of electrocardiology","volume":"87 ","pages":"Article 153823"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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