This study aims to scrutinize the association between various Insulin Resistance (IR) indices and heart failure (HF) risk in adult diabetics within the United States.
Methods
The National Health and Nutrition Examination Survey (NHANES) (2005–2018) dataset was used in this study. Weighted logistic regression analysis and restricted cubic spline were employed to ascertain the correlation between IR indices and the incidence of HF in diabetic patients. The predictive capability of the IR indices was evaluated using the Receiver Operating Characteristic curve.
Results
This study included a total of 2574 diabetic patients, out of which 209 (8.1%) were diagnosed with HF. After the adjustment of potential confounders, TyG-BMI (OR: 1.005, 95% CI: 1.002–1.009), TG/HDL-C (OR: 1.138, 95% CI: 1.024–1.265), and METS-IR index (OR: 1.035, 95% CI: 1.015–1.057) were significantly associated with HF risk. RCS curves revealed nonlinear dose–response relationship between TyG, TyG-BMI, TG/HDL-C, and the occurrence of HF in diabetic patients. Subgroup analyses showed that four IR indices were positively associated with the risk of HF in the elderly diabetic population. Unfortunately, all IR indices failed to improve the predictive performance of the underlying risk model for HF in diabetic patients.
Conclusion
Four IR markers may be important predictors of HF risk in diabetics.
{"title":"Association Between Different Insulin Resistance Indices and Heart Failure in US Adults With Diabetes Mellitus","authors":"Lirong Chen, Lin Qian, Yongming Liu","doi":"10.1111/anec.70035","DOIUrl":"10.1111/anec.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to scrutinize the association between various Insulin Resistance (IR) indices and heart failure (HF) risk in adult diabetics within the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The National Health and Nutrition Examination Survey (NHANES) (2005–2018) dataset was used in this study. Weighted logistic regression analysis and restricted cubic spline were employed to ascertain the correlation between IR indices and the incidence of HF in diabetic patients. The predictive capability of the IR indices was evaluated using the Receiver Operating Characteristic curve.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included a total of 2574 diabetic patients, out of which 209 (8.1%) were diagnosed with HF. After the adjustment of potential confounders, TyG-BMI (OR: 1.005, 95% CI: 1.002–1.009), TG/HDL-C (OR: 1.138, 95% CI: 1.024–1.265), and METS-IR index (OR: 1.035, 95% CI: 1.015–1.057) were significantly associated with HF risk. RCS curves revealed nonlinear dose–response relationship between TyG, TyG-BMI, TG/HDL-C, and the occurrence of HF in diabetic patients. Subgroup analyses showed that four IR indices were positively associated with the risk of HF in the elderly diabetic population. Unfortunately, all IR indices failed to improve the predictive performance of the underlying risk model for HF in diabetic patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Four IR markers may be important predictors of HF risk in diabetics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 6","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The de Winter electrocardiogram (ECG) pattern is a rare presentation of ST-segment elevation myocardial infarction (STEMI) equivalent. The clinical profile of de Winter syndrome remains to be clarified.
Methods
Medical records of 1865 consecutive patients with acute myocardial infarction admitted from November 2018 to July 2023 were screened. Twelve patients (0.6%) with de Winter syndrome were included. STEMI patients whose culprit vessel was the left anterior descending artery (LAD) but without de Winter ECG pattern were selected as controls after 1:2 matching for age and sex.
Results
The de Winter syndrome patients were all male, aged 49.0 (46.3–52.5) years. The culprit lesion was the proximal LAD in seven patients (58.3%), the middle LAD in three (25%), the left main coronary artery in one (8.3%), and the ramus intermedius artery in the other. All of their culprit lesions had TIMI Thrombus Grade < 4, Cohen-Rentrop Score ≤ 2, and residual stenosis ≥ 80% after pretreatment with thrombus aspiration or balloon predilatation. Intracoronary imaging data were available in four patients, showing severe atherosclerotic stenosis. Compared with STEMI, de Winter syndrome had a higher prevalence of prior recurrent angina (75.0% vs. 37.5%, p = 0.034), better coronary collateralization (Cohen-Rentrop Score: 1 vs. 0, p = 0.001), lower thrombus burden (TIMI grade: 1 vs. 2, p = 0.005) but more severe atherosclerotic stenosis in the culprit lesions (90% vs. 60%, p < 0.001).
Conclusions
The culprit lesions of de Winter syndrome have a low thrombus burden, severe atherosclerotic stenosis, and poor collateral circulation protection.
{"title":"Coronary Angiographic Features of de Winter Syndrome: More Than Just Occlusion of the Left Anterior Descending Artery","authors":"Wenyi Tang, Junwei Xu, Fangyuan Cheng, Tianmin Liu, Zijian Lin, Bairong Chen, Jian Chen, Liyun Luo","doi":"10.1111/anec.70029","DOIUrl":"10.1111/anec.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The de Winter electrocardiogram (ECG) pattern is a rare presentation of ST-segment elevation myocardial infarction (STEMI) equivalent. The clinical profile of de Winter syndrome remains to be clarified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Medical records of 1865 consecutive patients with acute myocardial infarction admitted from November 2018 to July 2023 were screened. Twelve patients (0.6%) with de Winter syndrome were included. STEMI patients whose culprit vessel was the left anterior descending artery (LAD) but without de Winter ECG pattern were selected as controls after 1:2 matching for age and sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The de Winter syndrome patients were all male, aged 49.0 (46.3–52.5) years. The culprit lesion was the proximal LAD in seven patients (58.3%), the middle LAD in three (25%), the left main coronary artery in one (8.3%), and the ramus intermedius artery in the other. All of their culprit lesions had TIMI Thrombus Grade < 4, Cohen-Rentrop Score ≤ 2, and residual stenosis ≥ 80% after pretreatment with thrombus aspiration or balloon predilatation. Intracoronary imaging data were available in four patients, showing severe atherosclerotic stenosis. Compared with STEMI, de Winter syndrome had a higher prevalence of prior recurrent angina (75.0% vs. 37.5%, <i>p</i> = 0.034), better coronary collateralization (Cohen-Rentrop Score: 1 vs. 0, <i>p</i> = 0.001), lower thrombus burden (TIMI grade: 1 vs. 2, <i>p</i> = 0.005) but more severe atherosclerotic stenosis in the culprit lesions (90% vs. 60%, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The culprit lesions of de Winter syndrome have a low thrombus burden, severe atherosclerotic stenosis, and poor collateral circulation protection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 6","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shuang Zhang, Mingxian Chen, Lin Hu, Hanze Tang, Liyi Liao, Xuping Li
Background
Dextrocardia with atrial fibrillation (AF) complicates radiofrequency ablation treatment.
Methods
A case of successful AF ablation in dextrocardia, guided by intracardiac echocardiography (ICE) and the Carto 3 high-density mapping system, is reported.
Results
ICE-guided transseptal puncture and three-dimensional mapping facilitated successful pulmonary vein isolation (PVI). The patient had a good recovery with no recurrence.
Conclusion
ICE and Carto 3 system's high-density mapping aid in ablation for abnormal cardiac anatomy, reducing surgical complications.
{"title":"Intracardiac Echocardiography and Ablation of Atrial Fibrillation in Dextrocardia","authors":"Shuang Zhang, Mingxian Chen, Lin Hu, Hanze Tang, Liyi Liao, Xuping Li","doi":"10.1111/anec.70030","DOIUrl":"10.1111/anec.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dextrocardia with atrial fibrillation (AF) complicates radiofrequency ablation treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A case of successful AF ablation in dextrocardia, guided by intracardiac echocardiography (ICE) and the Carto 3 high-density mapping system, is reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ICE-guided transseptal puncture and three-dimensional mapping facilitated successful pulmonary vein isolation (PVI). The patient had a good recovery with no recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ICE and Carto 3 system's high-density mapping aid in ablation for abnormal cardiac anatomy, reducing surgical complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 6","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: This study aimed to define and explain a novel form of pacemaker-mediated arrhythmia which is initiated and sustained by atrial capture loss coinciding with ventriculoatrial (VA) conduction within the postventricular atrial refractory period (PVARP). Unlike repetitive nonreentrant VA synchrony (RNRVAS), in the pseudo-RNRVAS, the atrium is not stimulated due to pacing below the threshold level, rather than because of refractory atrial myocardium.
Objective: The objective was to elucidate the mechanisms of this pseudo-RNRVAS, identify predisposing factors, and propose preventive strategies.
Methods: Twenty-one patients with dual-chamber cardiac implantable electronic devices (CIEDs) exhibiting stable VA conduction within the PVARP were included. Pseudo-RNRVAS were induced by altering atrial amplitude and lower rate interval while keeping other CIED parameters constant.
Results: Pseudo-RNRVAS developed after atrial capture loss in 20 out of 21 patients. Notably, 11 patients experienced pseudo-RNRVAS at heart rates ≤ 70 bpm, and 7 patients at AV delay ≤ 150 ms. The condition initiated immediately following the first ventricular pace beat after atrial capture loss in 18 patients. In six cases, pseudo-RNRVAS terminated intermittently and then restarted; in 14 cases, it did not resolve.
Conclusion: Pseudo-RNRVAS can occur even at low heart rates and without specific predisposing factors seen in RNRVAS. Conditions that increase atrial pacing probability and threshold raise the likelihood of pseudo-RNRVAS. Early postimplantation may pose a heightened risk, correlating with pacemaker syndrome and susceptibility to heart failure.
{"title":"Introducing a Novel Pacemaker-Mediated Arrhythmia: The Pseudo-RNRVAS Arising From Atrial Capture Challenges.","authors":"Asli Inci Atar, Ilyas Atar","doi":"10.1111/anec.70033","DOIUrl":"10.1111/anec.70033","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to define and explain a novel form of pacemaker-mediated arrhythmia which is initiated and sustained by atrial capture loss coinciding with ventriculoatrial (VA) conduction within the postventricular atrial refractory period (PVARP). Unlike repetitive nonreentrant VA synchrony (RNRVAS), in the pseudo-RNRVAS, the atrium is not stimulated due to pacing below the threshold level, rather than because of refractory atrial myocardium.</p><p><strong>Objective: </strong>The objective was to elucidate the mechanisms of this pseudo-RNRVAS, identify predisposing factors, and propose preventive strategies.</p><p><strong>Methods: </strong>Twenty-one patients with dual-chamber cardiac implantable electronic devices (CIEDs) exhibiting stable VA conduction within the PVARP were included. Pseudo-RNRVAS were induced by altering atrial amplitude and lower rate interval while keeping other CIED parameters constant.</p><p><strong>Results: </strong>Pseudo-RNRVAS developed after atrial capture loss in 20 out of 21 patients. Notably, 11 patients experienced pseudo-RNRVAS at heart rates ≤ 70 bpm, and 7 patients at AV delay ≤ 150 ms. The condition initiated immediately following the first ventricular pace beat after atrial capture loss in 18 patients. In six cases, pseudo-RNRVAS terminated intermittently and then restarted; in 14 cases, it did not resolve.</p><p><strong>Conclusion: </strong>Pseudo-RNRVAS can occur even at low heart rates and without specific predisposing factors seen in RNRVAS. Conditions that increase atrial pacing probability and threshold raise the likelihood of pseudo-RNRVAS. Early postimplantation may pose a heightened risk, correlating with pacemaker syndrome and susceptibility to heart failure.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 6","pages":"e70033"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liang Xiong, Jinzhu Hu, Dandan Wang, Juan Hua, Qi Chen
Ventricular premature contractions (VPC) originating from right ventricular outflow tract is the most common type of ventricular arrhythmias in clinic settings, which can be effectively cured by catheter ablation. Interruption of the inferior vena cava (IVC) is a rare vascular anomaly resulting from aberrant development during embryogenesis. Herein, we reported a very rare case of VPC originating from right ventricular outflow tract (RVOT) with interruption of IVC, which was successfully ablated by transfemoral vein approach.
{"title":"Catheter Ablation of Ventricular Premature Contractions Originating From RVOT With Interruption of the Inferior Vena Cava-A Case Report.","authors":"Liang Xiong, Jinzhu Hu, Dandan Wang, Juan Hua, Qi Chen","doi":"10.1111/anec.70034","DOIUrl":"10.1111/anec.70034","url":null,"abstract":"<p><p>Ventricular premature contractions (VPC) originating from right ventricular outflow tract is the most common type of ventricular arrhythmias in clinic settings, which can be effectively cured by catheter ablation. Interruption of the inferior vena cava (IVC) is a rare vascular anomaly resulting from aberrant development during embryogenesis. Herein, we reported a very rare case of VPC originating from right ventricular outflow tract (RVOT) with interruption of IVC, which was successfully ablated by transfemoral vein approach.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 6","pages":"e70034"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients with ST-segment elevation myocardial infarction (STEMI) may have higher hospitalization costs and poorer prognosis than non-ST-segment elevation myocardial infarction (NSTEMI).
Methods
A single-center retrospective study was conducted on 758 STEMI patients and 386 NSTEMI patients from January 1, 2020 to May 30, 2023 aimed to investigate the differences in cost and mortality.
Results
STEMI patients had higher maximal troponin I (15,222.5 (27.18, 40,000.00) vs. 2731.5 (10.73, 27,857.25), p < 0.001) and lower left ventricular ejection fraction (LVEF) (56% (53%, 59%) vs. 57% (55%, 59%), p < 0.001) compared to NSTEMI patients. The clinical symptoms were mainly persistent or interrupted chest pain/distress in either STEMI or NSTEMI patients. STEMI patients had a significantly higher risk of combined hypotension than NSTEMI patients (8.97% vs. 3.89%, p = 0.002), and IABP was much more frequently used in the STEMI group with a statistical difference (2.90% vs. 0.52%, p = 0.015). STEMI patients have statistically higher hospitalization costs (RMB, ¥) (31,667 (25,337.79, 39,790) vs. 30,506.91 (21,405.96, 40,233.75), p = 0.006) and longer hospitalization days (10 (8, 11) vs. 9 (8, 11), p = 0.001) compared to NSTEMI patients. Although in-hospital mortality was higher in STEMI patients, the difference was not statistically significant (3.56% vs. 2.07%, p = 0.167). Multivariable logistic regression was performed and found that systolic blood pressure and NT-proBNP were risk factors for patient death (OR ≥ 1).
Conclusion
STEMI patients are more likely comorbid cardiogenic shock, heart failure complications with higher hospitalization costs and longer hospitalization days. And relatively more use of acute mechanical circulatory support devices such as IABP.
Trial Registration
ChiCTR2300077885
背景：与非ST段抬高型心肌梗死（NSTEMI）相比，ST段抬高型心肌梗死（STEMI）患者的住院费用可能更高，预后更差：2020年1月1日至2023年5月30日期间，对758名STEMI患者和386名NSTEMI患者进行了单中心回顾性研究，旨在调查成本和死亡率的差异：STEMI 患者的最大肌钙蛋白 I 较高（15222.5（27.18，40000.00）vs 2731.5（10.73，27857.25），P 结论：STEMI 患者更容易合并其他并发症：STEMI 患者更容易合并心源性休克、心衰并发症，住院费用更高，住院天数更长。使用急性机械循环支持装置（如 IABP）的人数相对较多：ChiCTR2300077885。
{"title":"Reassess Hospital Costs and Mortality Between Myocardial Infarction With and Without ST-Segment Elevation in a Modern Context","authors":"Honglan Ma, Sen Wu, Jinlong Cao, Tianzhi Cai","doi":"10.1111/anec.70027","DOIUrl":"10.1111/anec.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with ST-segment elevation myocardial infarction (STEMI) may have higher hospitalization costs and poorer prognosis than non-ST-segment elevation myocardial infarction (NSTEMI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-center retrospective study was conducted on 758 STEMI patients and 386 NSTEMI patients from January 1, 2020 to May 30, 2023 aimed to investigate the differences in cost and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>STEMI patients had higher maximal troponin I (15,222.5 (27.18, 40,000.00) vs. 2731.5 (10.73, 27,857.25), <i>p</i> < 0.001) and lower left ventricular ejection fraction (LVEF) (56% (53%, 59%) vs. 57% (55%, 59%), <i>p</i> < 0.001) compared to NSTEMI patients. The clinical symptoms were mainly persistent or interrupted chest pain/distress in either STEMI or NSTEMI patients. STEMI patients had a significantly higher risk of combined hypotension than NSTEMI patients (8.97% vs. 3.89%, <i>p =</i> 0.002), and IABP was much more frequently used in the STEMI group with a statistical difference (2.90% vs. 0.52%, <i>p =</i> 0.015). STEMI patients have statistically higher hospitalization costs (RMB, ¥) (31,667 (25,337.79, 39,790) vs. 30,506.91 (21,405.96, 40,233.75), <i>p = 0.006</i>) and longer hospitalization days (10 (8, 11) vs. 9 (8, 11), <i>p = 0.001</i>) compared to NSTEMI patients. Although in-hospital mortality was higher in STEMI patients, the difference was not statistically significant (3.56% vs. 2.07%, <i>p = 0.167</i>). Multivariable logistic regression was performed and found that systolic blood pressure and NT-proBNP were risk factors for patient death (OR ≥ 1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>STEMI patients are more likely comorbid cardiogenic shock, heart failure complications with higher hospitalization costs and longer hospitalization days. And relatively more use of acute mechanical circulatory support devices such as IABP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ChiCTR2300077885</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 6","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11512201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Forward prediction of atrial fibrillation (AF) termination is a challenging technical problem of increasing significance due to rising AF presentations to emergency departments worldwide. The ability to non-invasively predict which AF episodes will terminate has important implications in terms of clinical decision-making surrounding treatment and admission, with subsequent impacts on hospital capacity and the economic cost of AF hospitalizations.
Methods and Results
MEDLINE, EMCare, CINAHL, CENTRAL, and SCOPUS were searched on 29 July 2023 for articles where an attempt to predict AF termination was made using standard surface ECG recordings. The final review included 35 articles. Signal processing techniques fit into three broad categories including machine learning (n = 14), entropy analysis (n = 12), and time–frequency/frequency analysis (n = 9). Retrospectively processed ECG data was used in all studies with no prospective validation studies. Most studies (n = 33) utilized the same ECG database, which included recordings that either terminated within 1 min or continued for over 1 h. There was no significant difference in accuracy between groups (H(2) = 0.058, p-value = 0.971). Only one study assessed recordings earlier than several minutes preceding termination, achieving 92% accuracy using the central 10 s of paroxysmal episodes lasting up to 174.
Conclusions
No studies attempted to forward predict AF termination in real-time, representing an opportunity for novel prospective validation studies. Multiple signal processing techniques have proven accurate in predicting AF termination utilizing ECG recordings sourced from a database retrospectively.
{"title":"Predicting Spontaneous Termination of Atrial Fibrillation Based on Analysis of Standard Electrocardiograms: A Systematic Review","authors":"Brandon Wadforth, Jing Soong Goh, Kathryn Tiver, Sobhan Salari Shahrbabaki, Ivaylo Tonchev, Dhani Dharmaprani, Anand N. Ganesan","doi":"10.1111/anec.70025","DOIUrl":"10.1111/anec.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Forward prediction of atrial fibrillation (AF) termination is a challenging technical problem of increasing significance due to rising AF presentations to emergency departments worldwide. The ability to non-invasively predict which AF episodes will terminate has important implications in terms of clinical decision-making surrounding treatment and admission, with subsequent impacts on hospital capacity and the economic cost of AF hospitalizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>MEDLINE, EMCare, CINAHL, CENTRAL, and SCOPUS were searched on 29 July 2023 for articles where an attempt to predict AF termination was made using standard surface ECG recordings. The final review included 35 articles. Signal processing techniques fit into three broad categories including machine learning (<i>n</i> = 14), entropy analysis (<i>n</i> = 12), and time–frequency/frequency analysis (<i>n</i> = 9). Retrospectively processed ECG data was used in all studies with no prospective validation studies. Most studies (<i>n</i> = 33) utilized the same ECG database, which included recordings that either terminated within 1 min or continued for over 1 h. There was no significant difference in accuracy between groups (H(2) = 0.058, <i>p</i>-value = 0.971). Only one study assessed recordings earlier than several minutes preceding termination, achieving 92% accuracy using the central 10 s of paroxysmal episodes lasting up to 174.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>No studies attempted to forward predict AF termination in real-time, representing an opportunity for novel prospective validation studies. Multiple signal processing techniques have proven accurate in predicting AF termination utilizing ECG recordings sourced from a database retrospectively.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 6","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xuqing Ying, Xinyue Yu, Weixun Cai, Xiaomin Chen, Lihua Wang, Qingcheng Wang, Jie Pang
Objectives
Two patients were received ICDs (Biotronic Iforia7 VR-TDX). Holter analysis revealed pacing spikes, which occurred regularly at 100 ms intervals following QRS complexes, with consecutive 1024 test pulses at hourly intervals during a specific time, and the VP was 0%.
Methods
By analyzing the dynamic electrocardiogram and consulting relevant literature, it was found that this is a feature of the ICD that measures thoracic impedance.
Results
This phenomenon is a special function for the purpose of transthoracic impedance measurement, which can monitor the heart failure.
Conclusions
This phenomenon should not be regarded as an interference signal or an abnormal sign of pacemaker malfunction.
{"title":"Biotronik Implantable Cardioverter Defibrillator for Measurement of Intrathoracic Impedance: A Report of Two Cases","authors":"Xuqing Ying, Xinyue Yu, Weixun Cai, Xiaomin Chen, Lihua Wang, Qingcheng Wang, Jie Pang","doi":"10.1111/anec.70015","DOIUrl":"10.1111/anec.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Two patients were received ICDs (Biotronic Iforia7 VR-TDX). Holter analysis revealed pacing spikes, which occurred regularly at 100 ms intervals following QRS complexes, with consecutive 1024 test pulses at hourly intervals during a specific time, and the VP was 0%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>By analyzing the dynamic electrocardiogram and consulting relevant literature, it was found that this is a feature of the ICD that measures thoracic impedance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This phenomenon is a special function for the purpose of transthoracic impedance measurement, which can monitor the heart failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This phenomenon should not be regarded as an interference signal or an abnormal sign of pacemaker malfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 6","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas Lachlan, Hejie He, Kengo Kusano, Takeshi Aiba, Donatella Brisinda, Riccardo Fenici, Faizel Osman
Sudden cardiac death (SCD) is responsible for 15%–20% of deaths globally/year, predominantly due to ventricular arrhythmias (VA) caused by vulnerable cardiac substrate. Identifying those at risk has proved difficult with several limitations of current methods. We evaluated the evidence for magnetocardiography (MCG) in predicting SCD events. We searched Embase/Medline databases for English language papers evaluating MCG in patients at risk of VA. A total of 119 papers were screened with 27 papers included for analysis (23 case–controlled, four cohort studies); study sizes varied (n = 12 to 158). Etiology was ischemic cardiomyopathy (ICM) in 22, dilated cardiomyopathy in 2, arrhythmogenic cardiomyopathy in 1 and mixed in 2. In patients with ICM there were consistent discriminatory features seen using time-based and signal-complexity measures that persisted when evaluating the independence of these parameters. Current flow analysis demonstrated promising discriminatory results in other etiologies. The features studied support the role of MCG in identifying substrate for VA, particularly in ICM.
全球每年有 15%-20% 的人死于心脏性猝死 (SCD)，主要原因是脆弱的心脏基质导致室性心律失常 (VA)。由于目前的方法存在一些局限性，因此很难识别高危人群。我们评估了磁心动图 (MCG) 预测 SCD 事件的证据。我们在 Embase/Medline 数据库中检索了对有 VA 风险的患者进行 MCG 评估的英文论文。共筛选出 119 篇论文，并纳入 27 篇论文进行分析（23 篇病例对照研究，4 篇队列研究）；研究规模各不相同（n = 12 到 158）。在 ICM 患者中，使用基于时间和信号复杂性的测量方法可以发现一致的鉴别特征，在评估这些参数的独立性时，这些特征依然存在。当前的血流分析表明，对其他病因也有很好的鉴别效果。所研究的特征支持 MCG 在识别 VA 底物方面的作用，尤其是在 ICM 中。
{"title":"Magnetocardiography in the Evaluation of Sudden Cardiac Death Risk: A Systematic Review","authors":"Thomas Lachlan, Hejie He, Kengo Kusano, Takeshi Aiba, Donatella Brisinda, Riccardo Fenici, Faizel Osman","doi":"10.1111/anec.70028","DOIUrl":"10.1111/anec.70028","url":null,"abstract":"<p>Sudden cardiac death (SCD) is responsible for 15%–20% of deaths globally/year, predominantly due to ventricular arrhythmias (VA) caused by vulnerable cardiac substrate. Identifying those at risk has proved difficult with several limitations of current methods. We evaluated the evidence for magnetocardiography (MCG) in predicting SCD events. We searched Embase/Medline databases for English language papers evaluating MCG in patients at risk of VA. A total of 119 papers were screened with 27 papers included for analysis (23 case–controlled, four cohort studies); study sizes varied (<i>n</i> = 12 to 158). Etiology was ischemic cardiomyopathy (ICM) in 22, dilated cardiomyopathy in 2, arrhythmogenic cardiomyopathy in 1 and mixed in 2. In patients with ICM there were consistent discriminatory features seen using time-based and signal-complexity measures that persisted when evaluating the independence of these parameters. Current flow analysis demonstrated promising discriminatory results in other etiologies. The features studied support the role of MCG in identifying substrate for VA, particularly in ICM.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 6","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zihan Jiang, Shengsheng Zhuang, Min Tang, Zhuang Tian, Shuyang Zhang
Objectives
The calculation of left ventricular mass varies in different studies, and reference values of the voltage-to-mass ratio for diagnosing cardiac amyloidosis (CA) are lacking. This study aimed to determine the value of the voltage-to-mass ratio in diagnosing CA and provide an optimal cut-off value for different calculation methods.
Methods
We reviewed the electrocardiograms and echocardiograms of 213 consecutive biopsy-proven CA patients, 236 hypertrophic cardiomyopathy (HCM) patients, 100 hypertensive heart disease patients, and 181 healthy controls. Left ventricular mass was calculated using linear and cross-sectional area (CSA) methods. The voltage-to-mass ratios were compared between the CA group and other groups. The voltage-to-mass ratio obtained was used to build multivariate logistic regression models that predicted the log odds of developing CA.
Results
The CA group had a significantly lower voltage-to-mass ratio than the HCM, hypertensive heart disease, and healthy control groups. The voltage-to-mass ratio was an independent factor significantly associated with the CA diagnosis after adjusting for baseline characteristics. Linear and CSA methods yielded areas under the ROC curve of 0.86 and 0.90, respectively. Using the CSA method, the optimal cut-off was 16.42 mV/mm2/m2, with 89.0% sensitivity and 80.8% specificity.
Conclusion
The voltage-to-mass ratio could differentiate patients with CA, HCM, and hypertensive heart disease from healthy controls, potentially providing an accurate and non-invasive alternative to current expensive and invasive diagnostic techniques.
目的：不同研究对左心室质量的计算方法不尽相同，缺乏诊断心脏淀粉样变性（CA）的电压-质量比参考值。本研究旨在确定电压-质量比在诊断 CA 中的价值，并为不同的计算方法提供一个最佳临界值：我们对 213 名连续活检证实的 CA 患者、236 名肥厚型心肌病（HCM）患者、100 名高血压心脏病患者和 181 名健康对照者的心电图和超声心动图进行了复查。采用线性和横截面积（CSA）方法计算左心室质量。比较了 CA 组和其他组的电压-质量比。获得的电压-质量比被用于建立多变量逻辑回归模型，预测罹患 CA 的对数几率：结果：CA 组的电压质量比明显低于 HCM 组、高血压心脏病组和健康对照组。在调整基线特征后，电压质量比是与 CA 诊断显著相关的独立因素。线性法和 CSA 法的 ROC 曲线下面积分别为 0.86 和 0.90。使用 CSA 方法，最佳临界值为 16.42 mV/mm2/m2，敏感性为 89.0%，特异性为 80.8%：电压-质量比可将 CA、HCM 和高血压性心脏病患者与健康对照者区分开来，有望为目前昂贵的有创诊断技术提供一种准确、无创的替代方法。
{"title":"Diagnostic Value of the Voltage-to-Mass Ratio in Biopsy-Proven Cardiac Amyloidosis","authors":"Zihan Jiang, Shengsheng Zhuang, Min Tang, Zhuang Tian, Shuyang Zhang","doi":"10.1111/anec.70026","DOIUrl":"10.1111/anec.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The calculation of left ventricular mass varies in different studies, and reference values of the voltage-to-mass ratio for diagnosing cardiac amyloidosis (CA) are lacking. This study aimed to determine the value of the voltage-to-mass ratio in diagnosing CA and provide an optimal cut-off value for different calculation methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed the electrocardiograms and echocardiograms of 213 consecutive biopsy-proven CA patients, 236 hypertrophic cardiomyopathy (HCM) patients, 100 hypertensive heart disease patients, and 181 healthy controls. Left ventricular mass was calculated using linear and cross-sectional area (CSA) methods. The voltage-to-mass ratios were compared between the CA group and other groups. The voltage-to-mass ratio obtained was used to build multivariate logistic regression models that predicted the log odds of developing CA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The CA group had a significantly lower voltage-to-mass ratio than the HCM, hypertensive heart disease, and healthy control groups. The voltage-to-mass ratio was an independent factor significantly associated with the CA diagnosis after adjusting for baseline characteristics. Linear and CSA methods yielded areas under the ROC curve of 0.86 and 0.90, respectively. Using the CSA method, the optimal cut-off was 16.42 mV/mm<sup>2</sup>/m<sup>2</sup>, with 89.0% sensitivity and 80.8% specificity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The voltage-to-mass ratio could differentiate patients with CA, HCM, and hypertensive heart disease from healthy controls, potentially providing an accurate and non-invasive alternative to current expensive and invasive diagnostic techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"29 6","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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