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Biomedical subjects

Paulo Ginefra

Publications and source records attributed to Paulo Ginefra.

5 recordsLinked to original sources
PubMed2006

Spectral turbulence analysis of the signal-averaged electrocardiogram of the atrial activation as predictor of recurrence of idiopathic and persistent atrial fibrillation.

The frequency domain analysis of the P-wave signal-averaged ECG (P-SAECG) is able to identify patients at risk for lone atrial fibrillation (AF) after cardioversion to sinus rhythm. The terminal portion of the P-wave of right precordial leads on 12-lead ECG is associated with electrical abnormalities in the atria. The aim of this study was to assess the spectral turbulence analysis (STA) of the P-SAECG as a predictor of recurrence of idiopathic AF. STA was performed in 41 patients with 2 or more symptomatic episodes of idiopathic and persistent AF after successful electrical cardioversion and drug-free state (Group A), and in 25 control individuals during sinus rhythm (Group B), matched by age, gender, and P-wave duration. The orientation of the terminal portion (positive or negative) of the Z-lead was assessed as representing right precordial leads potentials. After 6 months follow-up, Group A was divided into two groups according to recurrence: G-A1--at least one recurrence (21 patients), and G-A2--no recurrence (20 patients). Fragmented electrical activity (FEA) was observed in 19 patients of G-A1 and in 2 of G-A2 (odds ratio = 85.5; p<<0.001). STA showed 90.5% sensitivity and 90.0% specificity for early recurrence of AF. After 12 months, no patients of G-A2 and 15 of G-A1 developed >3 episodes of persistent AF, being FEA observed in 13 (odds ratio = 14.6, p = 0.002). No episodes of AF were observed in Group B. Average time for recurrence of FEA positive patients (4.3 +/- 0.7 months) was significantly shorter than of G-A2 (7.4+/-0.7 months), and log-rank analysis revealed significant difference of event-free rate over time (p = 0.004). In a logistic regression model FEA, use of amiodarone and a positive terminal portion of the Z-lead of the P-SAECG were independent predictors of recurrence of idiopathic and persistent AF.

Amiodarone↗
PubMed2003

Noninvasive cardiac assessment in children of women with systemic lupus erythematosus.

OBJECTIVE: Noninvasive cardiac assessment of newborns and infants of women with systemic lupus erythematosus. The children had no congenital total atrioventricular block and were compared with the children of healthy women. METHODS: We prospectively assessed 13 newborns and infants aged 1 to 60 days, children of women with systemic lupus erythematosus and without congenital total atrioventricular block. These children were compared with 30 children of women who had no lupus or anti-Ro/SSA antibodies, and no risk factors for congenital heart disease either. Their age groups matched. The following examinations were performed: cardiological physical examination, electrocardiography, echocardiography, and signal-averaged electrocardiography. RESULTS: The statistical analysis showed no significant difference in ventricular function or in the cardiac conduction system between the groups. CONCLUSION: In regard to the conduction system and ventricular function in the absence of total atrioventricular block, no statistically significant difference was observed between the children of women with systemic lupus erythematosus and children of healthy women.

Antibodies, Antinuclear↗
PubMed2003

Detection of incipient left ventricular hypertrophy in mild to moderate arterial hypertension with normal electrocardiogram and echocardiogram: a new use for signal-averaged electrocardiography.

OBJECTIVE: To assess signal-averaged electrocardiogram (SAECG) for diagnosing incipient left ventricular hypertrophy (LVH). METHODS: A study with 115 individuals was carried out. The individuals were divided as follows: GI - 38 healthy individuals; GII - 47 individuals with mild to moderate hypertension and normal findings on echocardiogram and ECG; and GIII - 30 individuals with hypertension and documented LVH. The magnitude vector of the SAECG was analyzed with the high-pass cutoff frequency of 40 Hz through the bidirectional four-pole Butterworth high-pass digital filter. The mean quadratic root of the total QRS voltage (RMST) and the two-dimensional integral of the QRS area of the spectro-temporal map were analyzed between 0 and 30 Hz for the frequency domain (Int FD), and between 40 and 250 Hz for the time domain (Int TD). The electrocardiographic criterion for LVH was based on the Cornell Product. Left ventricular mass was calculated with the Devereux formula. RESULTS: All parameters analyzed increased from GI to GIII, except for Int FD (GII vs GIII) and RMST log (GII vs GIII). Int TD showed greater accuracy for detecting LVH with an appropriate cutoff > 8 (sensitivity of 55%, specificity of 81%). Positive values (> 8) were found in 56.5% of the G II patients and in 18.4% of the GI patients (p< 0.0005). CONCLUSION: SAECG can be used in the early diagnosis of LVH in hypertensive patients with normal ECG and echocardiogram.

Adult↗
PubMed2002

Analysis of the prevalence of ventricular late potentials in the late phase of myocardial infarction based on the site of infarction.

OBJECTIVE: The initial site of myocardial infarction (MI) may influence the prevalence of ventricular late potentials (VLP), high-frequency signals, due to the time course of ventricular activation. The prevalence of VLP in a period of more than 2 years after acute MI was assessed focusing on the initially injured wall. METHODS: The prevalence of VLP in a late phase after MI (median of 924 days) in anterior/antero-septal and inferior/infero-dorsal wall lesion was analyzed using signal-averaged electrocardiogram in time domain. The diagnostic performance of the filters employed for analysis on was tested at high-pass cut-off frequencies of 25 Hz, 40 Hz and 80 Hz. RESULTS: The duration of the ventricular activation and its terminal portion were larger in inferior than anterior infarction, at high-pass cut-off frequencies of 40 Hz and 80 Hz. In patients with ventricular tachycardia, these differences were more remarked. The prevalence of ventricular late potentials was three times greater in inferior than anterior infarction. CONCLUSION: Late after myocardial infarction, the prevalence and the duration of ventricular late potentials are greater in lesions of inferior/infero-dorsal than anterior/antero-septal wall confirming their temporal process, reflecting their high-frequency content.

Action Potentials↗