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Premature ventricular contraction‐induced concealed retrograde penetration: Electrocardiographic manifestations on anterograde ventricular preexcitation
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Damián Longo RCT Adrian Baranchuk MD FACC FRCPC FCCS 《Annals of noninvasive electrocardiology》2018,23(2)
In patients with manifest anterograde ventricular preexcitation, the electrocardiographic manifestation of the anomalous conduction through the simultaneous conduction over the atrioventricular (AV) node and the accessory pathway (“delta wave”); depends on several factors, the most representative being the conduction velocity over one or another connection. Occasionally, ventricular ectopic beats may present with retrograde penetration over one or both conduction pathways (AV node and/or accessory pathway), impacting on the morphology of the next immediate anterogradely conducted QRS. We present a case of a young patient with WPW syndrome and ectopic ventricular beats with different manifestations on the postectopic QRS due to concealed penetration of different conduction pathways. 相似文献
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Total cosine R‐to‐T for predicting ventricular arrhythmic and mortality outcomes: A systematic review and meta‐analysis
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Gary Tse MPH PhD FESC FACC FRCP Mengqi Gong BS Cheuk Wai Wong Cynthia Chan Stamatis Georgopoulos MD Yat Sun Chan MBBS FRCP FACC Bryan P. Yan MBBS FRCP FACC Guangping Li MD PhD Paula Whittaker MBChB MPH MMed MRCGP Ana Ciobanu MD PhD Sadeq Ali‐Hasan‐Al‐Saegh MD Sunny H. Wong DPhil MRCP William K. K. Wu PhD FRCPath George Bazoukis MD Konstantinos Lampropoulos MD PhD FESC Wing Tak Wong PhD Lap Ah Tse MB PhD Adrian M. Baranchuk MD FACC FRCPC FCCS Konstantinos P. Letsas MD FESC Tong Liu MD PhD International Health Informatics Study Network 《Annals of noninvasive electrocardiology》2018,23(2)
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Umut Kocabas MD Can Hasdemir MD Esra Kaya MD Cuneyt Turkoglu MD Adrian Baranchuk MD FAAC FRCPC FCCS 《Annals of noninvasive electrocardiology》2017,22(6)
Brugada syndrome is a form of inherited arrhythmia syndrome characterized by a distinct ST‐segment elevation in the right precordial leads. Brugada phenocopies are clinical entities that present with an electrocardiographic pattern identical to Brugada syndrome and may obey to various clinical conditions. We present a case of a suicidal attempt using a high dose of propafenone causing a Brugada‐type electrocardiographic pattern. Is this a Brugada syndrome case, a Brugada phenocopy or something else? 相似文献
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Use of fragmented QRS in prognosticating clinical deterioration and mortality in pulmonary embolism: A meta‐analysis
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Amro Qaddoura BHSc Geneviève C. Digby MD Conrad Kabali PhD Piotr Kukla MD Gary Tse MBBS Benedict Glover MD Adrian M. Baranchuk MD FACC FRCPC FCCS 《Annals of noninvasive electrocardiology》2018,23(5)
Background
Fragmented QRS (fQRS) on electrocardiography is potentially valuable in prognosticating acute pulmonary embolism (PE). ECG is one of the first tests performed in the emergency department, quickly interpretable, noninvasive, inexpensive, and available in remote areas. We aimed to review fQRS's role in PE prognostication.Methods
We searched MEDLINE, EMBASE, Google Scholar, Web of Science, abstracts, conference proceedings, and reference lists until October 2017. Eligible studies used fQRS to prognosticate patients for the main outcomes of death and clinical deterioration or escalation of therapy. Two authors independently selected studies, with disagreement resolved by consensus. Ad hoc piloted forms were used to extract data and assess risk of bias. We used a random‐effects model to pool relevant data in meta‐analysis with odds ratios (OR) and 95% confidence intervals (CI), while all other data were synthesized qualitatively. Statistical heterogeneity was assessed using the I2 index.Results
We included five studies (1,165 patients). There was complete agreement in study selection. fQRS significantly predicted in‐hospital mortality (OR [95% CI], 2.92 [1.73–4.91]; p < .001), cardiogenic shock (OR [95% CI], 4.71 [1.61–13.70]; p = .005), and total mortality at 2‐year follow‐up (OR [95% CI], 4.42 [2.57–7.60]; p < .001). Adjusted analyses were generally consistent with these results.Conclusion
Although few studies have explored the current study's question, they showed that fQRS is potentially valuable in PE prognostication. fQRS should be considered as an entry, along with other clinical and ECG findings, in a PE risk score.8.
Anticoagulation in patients at high risk of stroke without documented atrial fibrillation. Time for a paradigm shift?
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Antoni Bayés de Luna MD PhD Adrian Baranchuk MD FACC FRCPC FCCS Manuel Martínez‐Sellés MD FESC Pyotr G. Platonov MD PhD 《Annals of noninvasive electrocardiology》2017,22(1)
Atrial fibrillation (AF) is currently considered a risk factor for stroke. Depending on the severity of clinical factors (risk scores) a recommendation for full anticoagulation is made. Although AF is most certainly a risk factor for ischemic stroke, it is not necessarily the direct cause of it. The causality of association between AF and ischemic stroke is questioned by the reported lack of temporal relation between stroke events and AF paroxysms (or atrial high‐rate episodes detected by devices). In different studies, only 2% of patients had subclinical AF > 6 minutes in duration at the time of stroke or systemic embolism. Is it time to consider AF only one more factor of endothelial disarray rather than the main contributor to stroke? In this “opinion paper” we propose to consider not only clinical variables predicting AF/stroke but also electrocardiographic markers of atrial fibrosis, as we postulate this as a strong indicator of risk of AF/stroke. We ask if it is time to change the paradigm and to consider, in some special situations, to protect patients (preventing stroke) who have no evidence of AF. 相似文献
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