Jeongduk Seo MD, Yae Min Park MD, PhD, Yong Hoon Shin MD, Albert Youngwoo Jang MD, PhD, Woong Chol Kang MD, PhD, Wook-Jin Chung MD, PhD, Young-Hoon Kim MD, PhD, In Suck Choi MD, PhD
Atrial fibrosis in the right atrium (RA) presenting as a low-voltage zone might be the mechanism of atrial fibrillation (AF) and intra-atrial conduction delay. The impact of scar homogenization in RA on intra-atrial conduction delay is unknown. We describe a patient with paroxysmal AF and significant intra-atrial conduction delay with repetitive atrial flutter, triggered from the lateral free wall in the RA between the significant low-voltage zone and slow conduction area after pulmonary vein isolation. Linear ablation along the trabeculated lateral free wall in the RA to homogenize the scar was successfully performed, and the intra-atrial conduction delay improved ultimately.
{"title":"Improved intra-atrial conduction delay after successful ablation for atrial fibrillation by scar homogenization in right atrium","authors":"Jeongduk Seo MD, Yae Min Park MD, PhD, Yong Hoon Shin MD, Albert Youngwoo Jang MD, PhD, Woong Chol Kang MD, PhD, Wook-Jin Chung MD, PhD, Young-Hoon Kim MD, PhD, In Suck Choi MD, PhD","doi":"10.1111/anec.13091","DOIUrl":"10.1111/anec.13091","url":null,"abstract":"<p>Atrial fibrosis in the right atrium (RA) presenting as a low-voltage zone might be the mechanism of atrial fibrillation (AF) and intra-atrial conduction delay. The impact of scar homogenization in RA on intra-atrial conduction delay is unknown. We describe a patient with paroxysmal AF and significant intra-atrial conduction delay with repetitive atrial flutter, triggered from the lateral free wall in the RA between the significant low-voltage zone and slow conduction area after pulmonary vein isolation. Linear ablation along the trabeculated lateral free wall in the RA to homogenize the scar was successfully performed, and the intra-atrial conduction delay improved ultimately.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41109692","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}
We aimed to investigate the association between ventricular repolarization instability and sustained ventricular tachycardia and ventricular fibrillation (VT/VF) occurring within 48 h (acute-phase VT/VF) after the onset of acute coronary syndrome (ACS) and the prognostic role of repolarization instability and heart rate variability (HRV) after discharge from the hospital.
Methods
We studied 572 ACS patients with a left ventricular ejection fraction >35%. The ventricular repolarization instability was assessed by the beat-to-beat T-wave amplitude variability (TAV) using high-resolution 24-h Holter ECGs recorded at a median of 11 days from the date of admission. We calculated the HRV parameters including the deceleration capacity (DC) and non-Gaussian index calculated on a 25 s timescale (λ25s). The DC and λ25s were dichotomized based on previous studies' thresholds.
Results
Acute-phase VT/VF developed in 43 (7.5%) patients. In-hospital mortality was significantly higher among VT/VF patients (4.7% vs. 0.9%, p = .03). An adjusted logistic model showed that the maximum TAV (odds ratio 1.02, 95% confidence interval [CI] 1.00–1.29, p = .04) was associated with acute-phase VT/VF. During a median follow-up period of 2.1 years, 19 (3.3%) patients had cardiac deaths or resuscitated cardiac arrest. Acute-phase VT/VF (p = .12) and TAV (p = .72) were not significant predictors of survival. An age and sex-adjusted Cox model showed that the DC (p < .01), λ25s (p < .01), and emergency coronary intervention (p < .01) were independent predictors.
Conclusion
T-wave amplitude variability was associated with acute-phase VT/VF, but the TAV was not predictive of survival post-discharge. The DC, λ25s, and emergency coronary intervention were independent predictors of survival.
{"title":"Prognostic significance of the Holter-derived T-wave variability in patients with ventricular tachyarrhythmias complicating acute coronary syndrome—TWIST study","authors":"Taro Makino MD, Tomohide Ichikawa MD, Mari Amino MD, Mari Nakamura MD, Masayuki Koshikawa MD, Yuji Motoike MD, Yoshihiro Nomura MD, Masahide Harada MD, Yoshihiro Sobue MD, Eiichi Watanabe MD, Ken Kiyono PhD, Koichiro Yoshioka MD, Yuji Ikari MD, Yukio Ozaki MD, Hideo Izawa MD","doi":"10.1111/anec.13069","DOIUrl":"10.1111/anec.13069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to investigate the association between ventricular repolarization instability and sustained ventricular tachycardia and ventricular fibrillation (VT/VF) occurring within 48 h (acute-phase VT/VF) after the onset of acute coronary syndrome (ACS) and the prognostic role of repolarization instability and heart rate variability (HRV) after discharge from the hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied 572 ACS patients with a left ventricular ejection fraction >35%. The ventricular repolarization instability was assessed by the beat-to-beat T-wave amplitude variability (TAV) using high-resolution 24-h Holter ECGs recorded at a median of 11 days from the date of admission. We calculated the HRV parameters including the deceleration capacity (DC) and non-Gaussian index calculated on a 25 s timescale (λ25s). The DC and λ25s were dichotomized based on previous studies' thresholds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Acute-phase VT/VF developed in 43 (7.5%) patients. In-hospital mortality was significantly higher among VT/VF patients (4.7% vs. 0.9%, <i>p</i> = .03). An adjusted logistic model showed that the maximum TAV (odds ratio 1.02, 95% confidence interval [CI] 1.00–1.29, <i>p</i> = .04) was associated with acute-phase VT/VF. During a median follow-up period of 2.1 years, 19 (3.3%) patients had cardiac deaths or resuscitated cardiac arrest. Acute-phase VT/VF (<i>p</i> = .12) and TAV (<i>p</i> = .72) were not significant predictors of survival. An age and sex-adjusted Cox model showed that the DC (<i>p</i> < .01), λ25s (<i>p</i> < .01), and emergency coronary intervention (<i>p</i> < .01) were independent predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>T-wave amplitude variability was associated with acute-phase VT/VF, but the TAV was not predictive of survival post-discharge. The DC, λ25s, and emergency coronary intervention were independent predictors of survival.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41100446","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 prevalence of Holter-based late potentials (H-LPs) in cases of fatal cardiac events has increased. Although the noise level of H-LP is higher than that of conventional real-time late potential (LP) recording, a procedure to reduce the noise severity in H-LP by increasing the averaging beats has not been investigated.
Methods
We enrolled 104 patients with post-myocardial infarction (MI) and 86 control participants. Among the patients, 30 reported sustained ventricular tachycardia (VT), and the remaining 74 had unrecorded VT. H-LPs were measured twice in all groups to evaluate the efficacy of increasing the averaging beats for H-LPs. Thereafter, the average of LP was calculated at 250 (default setting), 300, 400, 500, 600, 700, and 800 beats.
Results
Across all three groups (MI-VT group, MI non-VT group, and control group), the noise levels significantly decreased in consonance with the increase in averaging beats. In the MI-VT group, the H-LP positive rate considerably increased with the increase in the averaging beats from 250 to 800 both at night and daytime. In the MI-VT group, the LP parameters significantly deteriorated, which led to a positive judgment corresponding to the increment of the averaged night and day beats. The H-LP positive rates were unchanged in the MI non-VT and control groups, while the LP parameters remained consistent, despite the increased averaging beats in the MI non-VT and control groups.
Conclusion
Increasing the calculated averaging beats in H-LPs can improve the sensitivity of predicting fatal cardiac events in patients with MI.
{"title":"Increasing averaging beats improves the test accuracy on Holter-based late potentials in patients with myocardial infarction","authors":"Kenichi Hashimoto MD, PhD, ISHNE-F, Naomi Harada MA, Motohiro Kimata MD, Yusuke Kawamura MD, Naoya Fujita MD, Akinori Sekizawa MD, Yosuke Ono MD, PhD, Yasuhiro Obuchi MD, PhD, Tadateru Takayama MD, PhD, Yuji Kasamaki MD, PhD, Yuji Tanaka MD, PhD","doi":"10.1111/anec.13089","DOIUrl":"10.1111/anec.13089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevalence of Holter-based late potentials (H-LPs) in cases of fatal cardiac events has increased. Although the noise level of H-LP is higher than that of conventional real-time late potential (LP) recording, a procedure to reduce the noise severity in H-LP by increasing the averaging beats has not been investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 104 patients with post-myocardial infarction (MI) and 86 control participants. Among the patients, 30 reported sustained ventricular tachycardia (VT), and the remaining 74 had unrecorded VT. H-LPs were measured twice in all groups to evaluate the efficacy of increasing the averaging beats for H-LPs. Thereafter, the average of LP was calculated at 250 (default setting), 300, 400, 500, 600, 700, and 800 beats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across all three groups (MI-VT group, MI non-VT group, and control group), the noise levels significantly decreased in consonance with the increase in averaging beats. In the MI-VT group, the H-LP positive rate considerably increased with the increase in the averaging beats from 250 to 800 both at night and daytime. In the MI-VT group, the LP parameters significantly deteriorated, which led to a positive judgment corresponding to the increment of the averaged night and day beats. The H-LP positive rates were unchanged in the MI non-VT and control groups, while the LP parameters remained consistent, despite the increased averaging beats in the MI non-VT and control groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Increasing the calculated averaging beats in H-LPs can improve the sensitivity of predicting fatal cardiac events in patients with MI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41105595","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}
Khawaja Afzal Ammar MD, MS, Richard J. Rodeheffer MD
Background
Silent or unrecognized myocardial infarction (UMI) diagnosed by surveillance electrocardiography (ECG) carries similarly poor prognosis as recognized MI (RMI) for poorly understood reasons.
Methods
This study included 5430 consecutive patients who presented to the nuclear laboratory and underwent 2-day stress and rest Tc-99m sestamibi and ECG studies between March 1991 and June 1999. UMI was diagnosed if ECG showed Q-wave MI in the absence of a history of RMI. We measured infarct size (% defect size as compared with the entire left ventricular sestamibi uptake), ejection fraction (EF, %), and summed difference score (SDS, sestamibi uptake by myocardium in stress minus sestamibi uptake in rest images as a marker of ischemia). Survival was determined by follow-up survey (median 6 years).
Results
We identified 346 UMIs, 628 RMIs, and 4456 subjects without MI (No MI). As compared with RMI, UMI patients had lesser abnormalities on nuclear scans (p < .0001 for all), including smaller infarct size (5.7% vs. 12.2%), higher EF (58% vs. 53%), and lesser ischemia (SDS; 3.9% vs. 2.7%). UMI prognosis was as poor as that of RMI (annual mortality rate 4.7% vs. 4.8% with No MI rate of 2.9%; p < .001 for all comparisons), and this persisted after multivariate analysis. Infarct size quantification successfully risk-stratified ECG-UMI patients, but UMI patients continued to predict mortality even if the infarct size was 0%.
Conclusions
Although UMI patients have lesser abnormalities on nuclear scans, ECG-based UMI continues to independently predict mortality, indicating the continuing relevance of ECG in clinical practice.
背景:监测心电图(ECG)诊断的无症状或无法识别的心肌梗死(UMI)与已识别的心肌梗死(RMI)有着相似的不良预后，原因尚不清楚。方法在1991年3月至1999年6月期间，5430例连续到核实验室就诊的患者进行了为期2天的应激休息Tc-99m sestamibi和心电图检查。在没有RMI病史的情况下，如果心电图显示q波MI，则诊断为UMI。我们测量了梗死面积(缺损面积与整个左心室安定比摄取的百分比)、射血分数(EF， %)和总差异评分(SDS，应激状态下心肌安定比摄取减去静止状态下安定比摄取作为缺血标志)。生存率通过随访调查确定(中位6年)。结果我们确定了346名UMIs, 628名RMIs和4456名无MI (No MI)的受试者。与RMI相比，UMI患者在核扫描上的异常较少(p <)。0001)，包括较小的梗死面积(5.7%对12.2%)，较高的EF(58%对53%)和较小的缺血(SDS;3.9% vs. 2.7%)。UMI预后与RMI一样差(年死亡率4.7% vs. 4.8%，无MI率2.9%;p <001)，在多变量分析后，这种情况仍然存在。梗死面积量化成功地对ECG-UMI患者进行了风险分层，但即使梗死面积为0%，UMI患者仍能预测死亡率。尽管UMI患者在核扫描上的异常较小，但基于ECG的UMI仍然可以独立预测死亡率，这表明ECG在临床实践中仍然具有相关性。
{"title":"Reassessing the clinical significance of electrocardiographically unrecognized myocardial infarctions: Radionuclide infarct size and its impact on long-term prognosis","authors":"Khawaja Afzal Ammar MD, MS, Richard J. Rodeheffer MD","doi":"10.1111/anec.13088","DOIUrl":"10.1111/anec.13088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Silent or unrecognized myocardial infarction (UMI) diagnosed by surveillance electrocardiography (ECG) carries similarly poor prognosis as recognized MI (RMI) for poorly understood reasons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 5430 consecutive patients who presented to the nuclear laboratory and underwent 2-day stress and rest Tc-<sup>99m</sup> sestamibi and ECG studies between March 1991 and June 1999. UMI was diagnosed if ECG showed <i>Q</i>-wave MI in the absence of a history of RMI. We measured infarct size (% defect size as compared with the entire left ventricular sestamibi uptake), ejection fraction (EF, %), and summed difference score (SDS, sestamibi uptake by myocardium in stress minus sestamibi uptake in rest images as a marker of ischemia). Survival was determined by follow-up survey (median 6 years).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 346 UMIs, 628 RMIs, and 4456 subjects without MI (No MI). As compared with RMI, UMI patients had lesser abnormalities on nuclear scans (<i>p</i> < .0001 for all), including smaller infarct size (5.7% vs. 12.2%), higher EF (58% vs. 53%), and lesser ischemia (SDS; 3.9% vs. 2.7%). UMI prognosis was as poor as that of RMI (annual mortality rate 4.7% vs. 4.8% with No MI rate of 2.9%; <i>p</i> < .001 for all comparisons), and this persisted after multivariate analysis. Infarct size quantification successfully risk-stratified ECG-UMI patients, but UMI patients continued to predict mortality even if the infarct size was 0%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although UMI patients have lesser abnormalities on nuclear scans, ECG-based UMI continues to independently predict mortality, indicating the continuing relevance of ECG in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232071","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}
Risk stratification for sudden cardiac death in post-myocardial infarction (post-MI) patients remains a challenging task. Several electrocardiographic noninvasive risk factors (NIRFs) have been associated with adverse outcomes and were used to refine risk assessment. This study aimed to evaluate the performance of NIRFs extracted from 45-min short resting Holter ECG recordings (SHR), in predicting ventricular tachycardia inducibility with programmed ventricular stimulation (PVS) in post-MI patients with preserved left ventricular ejection fraction (LVEF).
Methods
We studied 99 post-MI ischemia-free patients (mean age: 60.5 ± 9.5 years, 86.9% men) with LVEF ≥40%, at least 40 days after revascularization. All the patients underwent PVS and a high-resolution SHR. The following parameters were evaluated: mean heart rate, ventricular arrhythmias (premature ventricular complexes, couplets, tachycardias), QTc duration, heart rate variability (HRV), deceleration capacity, heart rate turbulence, late potentials, and T-wave alternans.
Results
PVS was positive in 24 patients (24.2%). HRV, assessed by the standard deviation of normal-to-normal R–R intervals (SDNN), was significantly decreased in the positive PVS group (42 ms vs. 51 ms, p = .039). SDNN values <50 ms were also associated with PVS inducibility (OR 3.081, p = .032 in univariate analysis, and 4.588, p = .013 in multivariate analysis). No significant differences were identified for the other NIRFs. The presence of diabetes, history of ST-elevation MI (STEMI) and LVEF <50% were also important predictors of positive PVS.
Conclusions
HRV assessed from SHR, combined with other noninvasive clinical and echocardiographic variables (diabetes, STEMI history, LVEF), can provide an initial, practical, and rapid screening tool for arrhythmic risk assessment in post-MI patients with preserved LVEF.
背景:心肌梗死后(post-MI)患者心源性猝死的风险分层仍然是一个具有挑战性的任务。一些心电图无创危险因素(nirf)与不良结果相关，并被用于完善风险评估。本研究旨在评估从45分钟短静息动态心电图记录(SHR)中提取的nirf在保留左室射血分数(LVEF)的心肌梗死后患者的程序性心室刺激(PVS)预测室性心动过速诱发性中的作用。方法我们研究了99例心肌梗死后无缺血患者(平均年龄:60.5±9.5岁，86.9%为男性)，LVEF≥40%，血运重建术后至少40天。所有患者均行PVS和高分辨率SHR。评估以下参数:平均心率、室性心律失常(室性早搏、室性心律联、心动过速)、QTc持续时间、心率变异性(HRV)、减速能力、心率湍流、晚期电位和t波交替。结果PVS阳性24例(24.2%)。通过正常到正常R-R区间(SDNN)的标准偏差评估，PVS阳性组的HRV显著降低(42 ms vs 51 ms, p = 0.039)。SDNN值<50 ms也与PVS诱导性相关(OR 3.081, p =。单变量分析为0.32,p = 4.588, p =。多变量分析(013)。其他nirf没有发现显著差异。糖尿病的存在、st段抬高性心肌梗死(STEMI)史和LVEF <50%也是PVS阳性的重要预测因素。结论SHR评估HRV，结合其他无创临床和超声心动图变量(糖尿病、STEMI病史、LVEF)，可为心肌梗死后保留LVEF患者心律失常风险评估提供初步、实用和快速的筛查工具。
{"title":"Risk assessment of post-myocardial infarction patients with preserved ejection fraction using 45-min short resting Holter electrocardiographic recordings","authors":"Konstantinos Triantafyllou MD, Nikolaos Fragakis MD, PhD, Konstantinos A. Gatzoulis MD, PhD, Antonios Antoniadis MD, PhD, Georgios Giannopoulos MD, PhD, Petros Arsenos MD, PhD, Dimitrios Tsiachris MD, PhD, Christos-Konstantinos Antoniou MD, PhD, Konstantinos Trachanas MD, PhD, Konstantinos Tsimos MD, PhD, Vassilios Vassilikos MD, PhD","doi":"10.1111/anec.13087","DOIUrl":"10.1111/anec.13087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Risk stratification for sudden cardiac death in post-myocardial infarction (post-MI) patients remains a challenging task. Several electrocardiographic noninvasive risk factors (NIRFs) have been associated with adverse outcomes and were used to refine risk assessment. This study aimed to evaluate the performance of NIRFs extracted from 45-min short resting Holter ECG recordings (SHR), in predicting ventricular tachycardia inducibility with programmed ventricular stimulation (PVS) in post-MI patients with preserved left ventricular ejection fraction (LVEF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We studied 99 post-MI ischemia-free patients (mean age: 60.5 ± 9.5 years, 86.9% men) with LVEF ≥40%, at least 40 days after revascularization. All the patients underwent PVS and a high-resolution SHR. The following parameters were evaluated: mean heart rate, ventricular arrhythmias (premature ventricular complexes, couplets, tachycardias), QTc duration, heart rate variability (HRV), deceleration capacity, heart rate turbulence, late potentials, and T-wave alternans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PVS was positive in 24 patients (24.2%). HRV, assessed by the standard deviation of normal-to-normal R–R intervals (SDNN), was significantly decreased in the positive PVS group (42 ms vs. 51 ms, <i>p</i> = .039). SDNN values <50 ms were also associated with PVS inducibility (OR 3.081, <i>p</i> = .032 in univariate analysis, and 4.588, <i>p</i> = .013 in multivariate analysis). No significant differences were identified for the other NIRFs. The presence of diabetes, history of ST-elevation MI (STEMI) and LVEF <50% were also important predictors of positive PVS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HRV assessed from SHR, combined with other noninvasive clinical and echocardiographic variables (diabetes, STEMI history, LVEF), can provide an initial, practical, and rapid screening tool for arrhythmic risk assessment in post-MI patients with preserved LVEF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223305","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}
Sung Ho Lee MD, PhD, Ji-Hoon Choi MD, Seung-Jung Park MD, PhD, Kyoung-Min Park MD, PhD, June Soo Kim MD, PhD, Young Keun On MD, PhD
Background
The association between bundle branch block (BBB) and recurrence of atrial fibrillation (AF) after catheter ablation is unclear. The aim of this study was to determine whether AF combined with BBB is associated with AF recurrence after catheter ablation.
Methods
A total of 477 consecutive AF patients who underwent catheter ablation were included. The AF patients were divided into three groups according to BBB: AF without BBB (n = 427), AF with right bundle branch block (AF with RBBB) (n = 16), and AF with intraventricular conduction delay (AF with IVCD) (n = 34).
Results
Of the 477 AF patients (mean age 57 years, 81% men, median CHA2DS2-VASc score of 1), 16 (3.4%) patients had RBBB, and 34 (7.1%) patients had IVCD. During a mean follow-up of 15.2 ± 6.7 months, 119 patients (24.9%) had recurrence of AF. Of these, 111 (26%) patients were in the AF without BBB group, with 2 (12.5%) and 6 (17.6%) patients in the RBBB and IVCD groups, respectively. The Kaplan–Meier estimate of the rate of recurrent AF was not significantly different among the three groups (p = .39). Multivariable analysis showed that persistent AF (HR 1.7, 95% CI 1.15–2.50, p = .007), chronic kidney disease (HR 2.94, 95% CI 1.20–7.17, p = .01), and left atrial diameter (HR 1.04, 95% CI 1.009–1.082, p = .01) were significantly associated with AF recurrence.
Conclusion
AF with BBB was not significantly associated with the recurrence of AF after catheter ablation in middle-aged patients with low-risk cardiovascular profile.
背景:束支阻滞(BBB)与导管消融后房颤(AF)复发的关系尚不清楚。本研究的目的是确定房颤合并血脑屏障是否与导管消融后房颤复发有关。方法连续477例房颤患者行导管消融治疗。根据血脑屏障情况将房颤患者分为3组:无血脑屏障房颤(n = 427)、右束支阻滞房颤(n = 16)、室内传导延迟房颤(n = 34)。结果477例房颤患者(平均年龄57岁，81%为男性，CHA2DS2-VASc中位评分为1)，16例(3.4%)患者有RBBB, 34例(7.1%)患者有IVCD。在平均15.2±6.7个月的随访中，有119例(24.9%)患者发生房颤复发，其中无血凝血组111例(26%)，RBBB组2例(12.5%)，IVCD组6例(17.6%)。Kaplan-Meier估计的房颤复发率在三组间无显著差异(p = 0.39)。多变量分析显示，持续性房颤(HR 1.7, 95% CI 1.15-2.50, p = 0.007)、慢性肾脏疾病(HR 2.94, 95% CI 1.20-7.17, p = 0.01)和左房内径(HR 1.04, 95% CI 1.009-1.082, p = 0.01)与房颤复发显著相关。结论中年低危心血管患者房颤伴血脑梗死与房颤消融后复发无显著相关性。
{"title":"Association of right bundle branch block or intraventricular conduction delay with recurrence of atrial fibrillation after catheter ablation","authors":"Sung Ho Lee MD, PhD, Ji-Hoon Choi MD, Seung-Jung Park MD, PhD, Kyoung-Min Park MD, PhD, June Soo Kim MD, PhD, Young Keun On MD, PhD","doi":"10.1111/anec.13083","DOIUrl":"10.1111/anec.13083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between bundle branch block (BBB) and recurrence of atrial fibrillation (AF) after catheter ablation is unclear. The aim of this study was to determine whether AF combined with BBB is associated with AF recurrence after catheter ablation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 477 consecutive AF patients who underwent catheter ablation were included. The AF patients were divided into three groups according to BBB: AF without BBB (<i>n</i> = 427), AF with right bundle branch block (AF with RBBB) (<i>n</i> = 16), and AF with intraventricular conduction delay (AF with IVCD) (<i>n</i> = 34).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 477 AF patients (mean age 57 years, 81% men, median CHA<sub>2</sub>DS<sub>2</sub>-VASc score of 1), 16 (3.4%) patients had RBBB, and 34 (7.1%) patients had IVCD. During a mean follow-up of 15.2 ± 6.7 months, 119 patients (24.9%) had recurrence of AF. Of these, 111 (26%) patients were in the AF without BBB group, with 2 (12.5%) and 6 (17.6%) patients in the RBBB and IVCD groups, respectively. The Kaplan–Meier estimate of the rate of recurrent AF was not significantly different among the three groups (<i>p</i> = .39). Multivariable analysis showed that persistent AF (HR 1.7, 95% CI 1.15–2.50, <i>p</i> = .007), chronic kidney disease (HR 2.94, 95% CI 1.20–7.17, <i>p</i> = .01), and left atrial diameter (HR 1.04, 95% CI 1.009–1.082, <i>p</i> = .01) were significantly associated with AF recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AF with BBB was not significantly associated with the recurrence of AF after catheter ablation in middle-aged patients with low-risk cardiovascular profile.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193399","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}
Anthony H. Kashou MD, Sarah LoCoco MD, Matthew R. Gardner MBA, MDes, Jocelyn Webb BS, Jacob C. Jentzer MD, Peter A. Noseworthy MD, Christopher V. DeSimone MD, PhD, Abhishek J. Deshmukh MBBS, Samuel J. Asirvatham MD, Adam M. May MD
The discrimination of ventricular tachycardia (VT) versus supraventricular wide complex tachycardia (SWCT) via 12-lead electrocardiogram (ECG) is crucial for achieving appropriate, high-quality, and cost-effective care in patients presenting with wide QRS complex tachycardia (WCT). Decades of rigorous research have brought forth an expanding arsenal of applicable manual algorithm methods for differentiating WCTs. However, these algorithms are limited by their heavy reliance on the ECG interpreter for their proper execution. Herein, we introduce the Mayo Clinic ventricular tachycardia calculator (MC-VTcalc) as a novel generalizable, accurate, and easy-to-use means to estimate VT probability independent of ECG interpreter competency. The MC-VTcalc, through the use of web-based and mobile device platforms, only requires the entry of computerized measurements (i.e., QRS duration, QRS axis, and T-wave axis) that are routinely displayed on standard 12-lead ECG recordings.
{"title":"Mayo Clinic VT calculator: A practical tool for accurate wide complex tachycardia differentiation","authors":"Anthony H. Kashou MD, Sarah LoCoco MD, Matthew R. Gardner MBA, MDes, Jocelyn Webb BS, Jacob C. Jentzer MD, Peter A. Noseworthy MD, Christopher V. DeSimone MD, PhD, Abhishek J. Deshmukh MBBS, Samuel J. Asirvatham MD, Adam M. May MD","doi":"10.1111/anec.13085","DOIUrl":"10.1111/anec.13085","url":null,"abstract":"<p>The discrimination of ventricular tachycardia (VT) versus supraventricular wide complex tachycardia (SWCT) via 12-lead electrocardiogram (ECG) is crucial for achieving appropriate, high-quality, and cost-effective care in patients presenting with wide QRS complex tachycardia (WCT). Decades of rigorous research have brought forth an expanding arsenal of applicable manual algorithm methods for differentiating WCTs. However, these algorithms are limited by their heavy reliance on the ECG interpreter for their proper execution. Herein, we introduce the Mayo Clinic ventricular tachycardia calculator (MC-VTcalc) as a novel generalizable, accurate, and easy-to-use means to estimate VT probability independent of ECG interpreter competency. The MC-VTcalc, through the use of web-based and mobile device platforms, only requires the entry of computerized measurements (i.e., QRS duration, QRS axis, and T-wave axis) that are routinely displayed on standard 12-lead ECG recordings.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13085","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10161214","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}
Sara Saffar Soflaei MD, PhD, Mahmoud Ebrahimi MD, Hamid Reza Rahimi MD, PhD, AmirAli Moodi Ghalibaf MD, Maryam Jafari MD, Hedieh Alimi MD, Nasrin Talkhi MSc, Bahram Shahri MD, Alireza Heidari-Bakavoli MD, Fatemeh Malakouti, Mahla Velayati, Reza Assaran-Darban PhD, Malihehsadat Abedsaeidi MSc, Farnoosh Azarian MSc, MohammadReza Latifi MSc, Mohammad Reza Mohammad Taghizadeh Sarabi MSc, Gordon A. Ferns MD, PhD, Habibollah Esmaily PhD, Mohsen Moohebati MD, Majid Ghayour-Mobarhan MD, PhD
Background
Twelve-lead electrocardiogram (ECG) is a common and inexpensive tool for the diagnostic workup of patients with suspected cardiovascular disease, both in clinical and epidemiological settings. The present study was designed to evaluate ECG abnormalities in Mashhad population.
Methods
ECGs were taken as part of MASHAD cohort study (phase1) and were coded according to the Minnesota coding criteria. Data were analyzed using SPSS.
Results
Total 9035 ECGs were available for final analysis including 3615 (40.0%) male and 5420 (60.0%) female. Among ECG abnormalities precordial Q wave, major T-wave abnormalities, inferior Q wave, sinus bradycardia, and left axis deviation were the most prevalent abnormalities. The frequency of precordial and inferior Q wave, inferior QS pattern, major and minor ST abnormalities, major and minor T abnormalities, Wolff-Parkinson-White and Brugada pattern, sinus bradycardia, sinus tachycardia, left axis deviation, ST elevation, and tall T wave were significantly different between two genders. Moreover, the frequency of Q wave in precordial and aVL leads, QS pattern in precordial and inferior leads, major and minor T-wave abnormalities, Wolff-Parkinson-White, atrial fibrillation, sinus bradycardia, left axis deviation, and ST elevation were significantly different in different age groups. A comparison of the heart rate, P-wave duration, and QRS duration between men and women indicated that there was a significant difference.
Conclusions
Our finding indicated that the prevalence ECG abnormalities are different between men and women and also it varied in different age groups.
{"title":"A large population-based study on the prevalence of electrocardiographic abnormalities: A result of Mashhad stroke and heart atherosclerotic disorder cohort study","authors":"Sara Saffar Soflaei MD, PhD, Mahmoud Ebrahimi MD, Hamid Reza Rahimi MD, PhD, AmirAli Moodi Ghalibaf MD, Maryam Jafari MD, Hedieh Alimi MD, Nasrin Talkhi MSc, Bahram Shahri MD, Alireza Heidari-Bakavoli MD, Fatemeh Malakouti, Mahla Velayati, Reza Assaran-Darban PhD, Malihehsadat Abedsaeidi MSc, Farnoosh Azarian MSc, MohammadReza Latifi MSc, Mohammad Reza Mohammad Taghizadeh Sarabi MSc, Gordon A. Ferns MD, PhD, Habibollah Esmaily PhD, Mohsen Moohebati MD, Majid Ghayour-Mobarhan MD, PhD","doi":"10.1111/anec.13086","DOIUrl":"10.1111/anec.13086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Twelve-lead electrocardiogram (ECG) is a common and inexpensive tool for the diagnostic workup of patients with suspected cardiovascular disease, both in clinical and epidemiological settings. The present study was designed to evaluate ECG abnormalities in Mashhad population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ECGs were taken as part of MASHAD cohort study (phase1) and were coded according to the Minnesota coding criteria. Data were analyzed using SPSS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Total 9035 ECGs were available for final analysis including 3615 (40.0%) male and 5420 (60.0%) female. Among ECG abnormalities precordial Q wave, major T-wave abnormalities, inferior Q wave, sinus bradycardia, and left axis deviation were the most prevalent abnormalities. The frequency of precordial and inferior Q wave, inferior QS pattern, major and minor ST abnormalities, major and minor T abnormalities, Wolff-Parkinson-White and Brugada pattern, sinus bradycardia, sinus tachycardia, left axis deviation, ST elevation, and tall T wave were significantly different between two genders. Moreover, the frequency of Q wave in precordial and aVL leads, QS pattern in precordial and inferior leads, major and minor T-wave abnormalities, Wolff-Parkinson-White, atrial fibrillation, sinus bradycardia, left axis deviation, and ST elevation were significantly different in different age groups. A comparison of the heart rate, P-wave duration, and QRS duration between men and women indicated that there was a significant difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our finding indicated that the prevalence ECG abnormalities are different between men and women and also it varied in different age groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10518924","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}
Oliver P. Hanington MRCP, Catherine Armstrong MRCPCH, Germaine Pierre MRCPCH, Graham Stuart FRCP, Jules C. Hancox DSc, FRSB, FBPhS
We report the case of a 13-year-old female patient presenting with presyncope and palpitations. Her electrocardiogram revealed an abbreviation of the rate-corrected QT interval with imaging showing significant left ventricular dysfunction. Carnitine levels were measured as part of her diagnostic workup, discovering a rare, reversible cause of short QT syndrome (SQTS) and associated cardiomyopathy—primary carnitine deficiency (PCD) caused by a homozygous mutation in the SLC22A5 gene, leading to an in-frame deletion mutation (NP_003051.1:p.Phe23del) affecting the organic cation transporter 2 (OCTN2) protein. Following the treatment with oral carnitine supplementation, her QT interval returned to within the normal range with significant improvement in left ventricular function.
{"title":"Left ventricular noncompaction cardiomyopathy and short QT syndrome due to primary carnitine deficiency","authors":"Oliver P. Hanington MRCP, Catherine Armstrong MRCPCH, Germaine Pierre MRCPCH, Graham Stuart FRCP, Jules C. Hancox DSc, FRSB, FBPhS","doi":"10.1111/anec.13077","DOIUrl":"10.1111/anec.13077","url":null,"abstract":"<p>We report the case of a 13-year-old female patient presenting with presyncope and palpitations. Her electrocardiogram revealed an abbreviation of the rate-corrected QT interval with imaging showing significant left ventricular dysfunction. Carnitine levels were measured as part of her diagnostic workup, discovering a rare, reversible cause of short QT syndrome (SQTS) and associated cardiomyopathy—primary carnitine deficiency (PCD) caused by a homozygous mutation in the <i>SLC22A5</i> gene, leading to an in-frame deletion mutation (NP_003051.1:p.Phe23del) affecting the organic cation transporter 2 (OCTN2) protein. Following the treatment with oral carnitine supplementation, her QT interval returned to within the normal range with significant improvement in left ventricular function.</p>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10128685","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}
Tayyiba Ahmed Noor MBBS, Muhammad Omer Rehman Rana MBBS, Sapna Kumari MBBS, Bakht Umer MBBS, Jahanzeb Malik MBBS, Amna Ashraf MBBS, Maria Faraz MBBS, Tabligh Hussain MBBS, Muhammad Awais MBBS, Amin Mehmoodi MD, Azmat Hayat MBBS
Background
During the last decade, leadless pacemakers (LPMs) have turned into a prevalent alternative to traditional transvenous (TV) pacemakers; however, there is no consolidated data on LPM implantation in emergencies.
Methods
Digital databases were searched for this review and four relevant studies, including 1276 patients were included in this review with procedure duration, fluoroscopic time, major complications, and mortality as primary outcomes and pacing threshold, impedance, sensing of LPM, and hospital stay as secondary outcomes.
Results
Gonzales et al. and Marschall et al. showed the duration of the procedure to be 180 ± 45 versus 324.6 ± 92 and 39.9 ± 8.7 versus 54.9 ± 9.8, respectively. Zhang et al. demonstrated the duration of the procedure and fluoroscopy time to be 36 ± 13.4 and 11.1 ± 3.1, respectively. Similarly, Schiavone et al. exhibited intermediate times of implantation at 60 (45–80) versus 50 (40–65) and fluoroscopic times at 6.5 (5–9.7) versus 5.1 (3.1–9). Hospital stay was more with a temp-perm pacemaker as compared to LPM and pacing parameters were not significantly different in all the studies.
Conclusion
For underlying arrhythmias, whenever appropriate, our review shows that LPMs may be a better option than temporary pacemakers, even as an urgent treatment.
在过去的十年中，无导线起搏器(lpm)已经成为传统经静脉(TV)起搏器的普遍替代方案;然而，没有关于紧急情况下LPM植入的综合数据。方法检索数字数据库，纳入本综述和4项相关研究，共纳入1276例患者，以手术时间、透视时间、主要并发症和死亡率为主要结局，以起搏阈值、阻抗、LPM感知和住院时间为次要结局。Gonzales et al.和Marschall et al.分别显示手术持续时间为180±45对324.6±92和39.9±8.7对54.9±9.8。Zhang等人证实手术时间和透视时间分别为36±13.4和11.1±3.1。同样，Schiavone等人的植入中间次数为60(45-80)和50(40-65)，透视次数为6.5(5-9.7)和5.1(3.1-9)。与LPM相比，使用恒温起搏器的住院时间更长，起搏参数在所有研究中均无显著差异。结论:对于潜在的心律失常，无论何时，我们的综述显示lpm可能是比临时起搏器更好的选择，即使是作为紧急治疗。
{"title":"Outcomes of primary leadless pacemaker implantation: A systematic review","authors":"Tayyiba Ahmed Noor MBBS, Muhammad Omer Rehman Rana MBBS, Sapna Kumari MBBS, Bakht Umer MBBS, Jahanzeb Malik MBBS, Amna Ashraf MBBS, Maria Faraz MBBS, Tabligh Hussain MBBS, Muhammad Awais MBBS, Amin Mehmoodi MD, Azmat Hayat MBBS","doi":"10.1111/anec.13084","DOIUrl":"10.1111/anec.13084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>During the last decade, leadless pacemakers (LPMs) have turned into a prevalent alternative to traditional transvenous (TV) pacemakers; however, there is no consolidated data on LPM implantation in emergencies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Digital databases were searched for this review and four relevant studies, including 1276 patients were included in this review with procedure duration, fluoroscopic time, major complications, and mortality as primary outcomes and pacing threshold, impedance, sensing of LPM, and hospital stay as secondary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Gonzales et al. and Marschall et al. showed the duration of the procedure to be 180 ± 45 versus 324.6 ± 92 and 39.9 ± 8.7 versus 54.9 ± 9.8, respectively. Zhang et al. demonstrated the duration of the procedure and fluoroscopy time to be 36 ± 13.4 and 11.1 ± 3.1, respectively. Similarly, Schiavone et al. exhibited intermediate times of implantation at 60 (45–80) versus 50 (40–65) and fluoroscopic times at 6.5 (5–9.7) versus 5.1 (3.1–9). Hospital stay was more with a temp-perm pacemaker as compared to LPM and pacing parameters were not significantly different in all the studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For underlying arrhythmias, whenever appropriate, our review shows that LPMs may be a better option than temporary pacemakers, even as an urgent treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8074,"journal":{"name":"Annals of Noninvasive Electrocardiology","volume":"28 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/anec.13084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039726","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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