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At least 37 records · Page 2Linked to original sources
PubMed2006

Risk stratification in patients with Brugada syndrome: analysis of daily fluctuations in 12-lead electrocardiogram (ECG) and signal-averaged electrocardiogram (SAECG).

INTRODUCTION: Risk stratification between symptomatic and asymptomatic patients with Brugada syndrome is not yet established. We compared daily fluctuations in 12-lead electrocardiogram (ECG) and signal-averaged ECG (SAECG) characteristics between symptomatic and asymptomatic patients with Brugada syndrome to identify new markers for distinguishing between high- and low-risk patients. METHODS AND RESULTS: Thirty-five patients with Brugada syndrome underwent ECG and SAECG simultaneously at least 4 times every 3 months. We evaluated daily fluctuations (differences between maximum and minimum values) in ECG and SAECG characteristics and compared them between symptomatic (N = 11), and asymptomatic (N = 24) patients. On ECG, the daily fluctuations in r-J interval (interval from QRS onset to J point) in leads V1, V2, and V6 were significantly larger in symptomatic than in asymptomatic patients (V1; 20 +/- 6 vs 10 +/- 8 msec, P < 0.01, V2; 22 +/- 8 vs 11 +/- 4 msec, P < 0.01, and V6; 24 +/- 7 vs 14 +/- 7 msec, P < 0.01). On SAECG, daily fluctuations in filtered QRS (f-QRS) duration and LAS40 were significantly larger in symptomatic than in asymptomatic patients (f-QRS; 15 +/- 7 vs 9 +/- 4 msec, P < 0.05, and LAS40; 21 +/- 7 vs 10 +/- 6 msec, P < 0.05). CONCLUSIONS: Instability of depolarization appears to be related to the risk of fatal ventricular arrhythmias in patients with Brugada syndrome. Daily fluctuations in ECG and SAECG characteristics could be useful for distinguishing between high- and low-risk patients with Brugada syndrome.

Brugada Syndrome↗
PubMed2002

[Typical electrocardiogram in atypical context. Or, when history and electrocardiogram are conclusive for a complex diagnosis].

A case of sudden death in an old female carrier of Duchenne muscular dystrophy is reported. Typical electrocardiographic features were registered without other signs or symptoms of heart involvement. In particular, cardiomyopathy was excluded by echocardiographic evaluation. We believe that in case of a typical electrocardiogram of Duchenne muscular dystrophy, a careful family medical history should be undertaken to exclude a carrier condition.

Aged↗
PubMed2006

Comparison of the amplitude of the P-wave from intracardiac electrocardiogram obtained by means of a central venous catheter filled with saline solution to that obtained via esophageal electrocardiogram.

Recognition of the P wave is important for the correct characterization of atrial and ventricular arrhythmias. When the P wave is difficult to identify on standard electrocardiography (SECG), either esophageal electrocardiography (EECG) or intracardiac electrocardiography (IC-ECG), central venous catheter may be used. The feasibility of these methods has already been demonstrated, but there is no published study comparing them. This study compared the amplitude of the P wave obtained by IC-ECG with those of the P waves obtained by EECG and SECG. SECG, EECG, and IC-ECG were performed on each patient. IC-ECG and EECG made it possible to register P waves larger than registered by SECG (p <0.00001). The difference between the largest P waves obtained with IC-ECG (5.93 +/- 3.56 mm) and EECG (4.67 +/- 2.16 mm) was not statistically significant (p = 0.1953). In conclusion, IC-ECG is easy to perform and magnifies the P wave at least as effectively as EECG.

Arrhythmias, Cardiac↗
PubMed1996

Serial electrocardiograms for chest pain patients with initial nondiagnostic electrocardiograms: implications for thrombolytic therapy.

OBJECTIVES: To determine the proportion of acute myocardial infarction (AMI) patients without ST-segment elevation who subsequently develop ST-segment elevation during their hospital courses; and to compare demographics and presenting features of AMI patient subgroups: those with initial ST-segment elevation, those with in-hospital ST-segment elevation, and those with no ST-segment elevation. METHODS: A retrospective cohort analysis of admitted chest pain patients who had a hospital discharge diagnosis of AMI was performed. Each chart was examined for initial ECG interpretation, serial ECG analysis, patient age, gender, cardiac risk factors, in-hospital survival, time between sequential ECGs, and number of ECGs performed within the first 48 hours of hospital admission. RESULTS: Of the 114 charts reviewed, 20 patients had ECGs meeting thrombolytic criteria on arrival. Of the 94 AMI patients who had nondiagnostic ECGs on arrival, 19 (20%) subsequently developed ECG changes meeting thrombolytic criteria. Seven patients developed these changes within eight hours of the initial ECG, four from eight to 12 hours after, two from 12 to 24 hours after, and six more than 24 hours after. Most patients who had documented AMIs did not develop ECG criteria for thrombolytic therapy during their hospitalizations. Male gender and smoking history were more commonly associated with late ST-segment elevation for those presenting with nondiagnostic ECGs. All the patients who had late diagnostic ECG changes survived to hospital discharge. Serial ECGs were performed more frequently in the group who had initially diagnostic ECGs and least frequently in the group who did not develop ST-segment elevation during their hospitalizations. CONCLUSIONS: Most patients with AMI do not meet ECG criteria for the administration of thrombolytic therapy. A significant minority (20%) of the admitted chest pain patients with subsequently confirmed AMIs developed ECG criteria for thrombolytics during their hospitalizations. Further attention to such patients who have delayed ST-segment elevation is warranted. A standardized in-hospital serial ECG protocol should be considered to identify admitted patients who develop criteria for thrombolytic or other coronary revascularization therapy.

Adult↗