- Designing a Low-Cost, Single-Supply ECG System for Suppression of Movement Artifact from Contaminated Magnetocardiogram. [Journal Article]
- STSLAS Technol 2018 Feb 01; :2472630318759063
- Measurement of the late potentials and His-bundle activity is crucial for many clinical studies using the noncontact and noninvasive magnetocardiography (MCG) technique; these weak signals are extrac...
Measurement of the late potentials and His-bundle activity is crucial for many clinical studies using the noncontact and noninvasive magnetocardiography (MCG) technique; these weak signals are extracted by averaging many cardiac cycles aligned using the R-peak of the cardiac cycle identified using an electrocardiography (ECG) lead. ECG is measured simultaneously with MCG using a conventional dual-supply ECG amplifier, which requires either two separate batteries or a single battery with a switching voltage inverter circuit for its proper operation. The ECG circuitry based on two separate batteries requires a relatively large voltage supply (-18 to +18 V). The single-supply (low voltage: 0-9 V) ECG circuitry may be implemented using a switching voltage inverter; however, this mode of operation introduces switching noise in the system. The objective of the present work is to overcome these problems by carefully designing a low-voltage, single-supply ECG system, which can be used simultaneously with the MCG setup without introducing a significant level of additional noise in the MCG measurement system.
- [ECG pearls: Pseudoinfarct Q waves and low voltage]. [Journal Article]
- OHOrv Hetil 2018; 159(8):327-329
- Therapy refracter heart failure is presented. The admission ECG shows low voltage and pseudoinfarct Q waves highly diagnostic for the etiology of heart failure. Orv Hetil. 2018; 159(8): 327-329.
Therapy refracter heart failure is presented. The admission ECG shows low voltage and pseudoinfarct Q waves highly diagnostic for the etiology of heart failure. Orv Hetil. 2018; 159(8): 327-329.
- STABLE-SR (Electrophysiological Substrate Ablation in the Left Atrium During Sinus Rhythm) for the Treatment of Nonparoxysmal Atrial Fibrillation: A Prospective, Multicenter Randomized Clinical Trial. [Randomized Controlled Trial]
- CACirc Arrhythm Electrophysiol 2017; 10(11)
- CONCLUSIONS: STABLE-SR is a simplified, personalized, and effective ablation strategy in nonparoxysmal AF patients. More importantly, over 50% nonparoxysmal AF patients do not need further ablation beyond CPVI and therefore can avoid excessive ablation.
- Selective autonomic stimulation of the AV node fat pad to control rapid post-operative atrial arrhythmias. [Journal Article]
- PlosPLoS One 2017; 12(9):e0183804
- Junctional ectopic tachycardia (JET) and atrial fibrillation (AF) occur in patients recovering from open-heart surgery (OHS). Pharmacologic treatment is used for the control of post-operative atrial ...
Junctional ectopic tachycardia (JET) and atrial fibrillation (AF) occur in patients recovering from open-heart surgery (OHS). Pharmacologic treatment is used for the control of post-operative atrial arrhythmias (POAA), but is associated with side effects. There is a need for a reversible, modulated solution to rate control. We propose a non-pharmacologic technique that can modulate AV nodal conduction in a selective fashion. Ten mongrel dogs underwent OHS. Stimulation of the anterior right (AR) and inferior right (IR) fat pad (FP) was done using a 7-pole electrode. The IR was more effective in slowing the ventricular rate (VR) to AF (52 +/- 20 vs. 15 +/- 10%, p = 0.003) and JET (12 +/- 7 vs. 0 +/- 0%, p = 0.02). Selective site stimulation within a FP region could augment the effect of stimulation during AF (57 +/- 20% (maximum effect) vs. 0 +/- 0% (minimum effect), p<0.001). FP stimulation at increasing stimulation voltage (SV) demonstrated a voltage-dependent effect (8 +/- 14% (low V) vs. 63 +/- 17 (high V) %, p<0.001). In summary, AV node fat pad stimulation had a selective effect on the AV node by decreasing AV nodal conduction, with little effect on atrial activity.
- Resolving Bipolar Electrogram Voltages During Atrial Fibrillation Using Omnipolar Mapping. [Journal Article]
- CACirc Arrhythm Electrophysiol 2017; 10(9)
- CONCLUSIONS: Omnipolar EGMs can extract maximal voltages from AF signals which are not influenced by directional factors, collision or fractionation, compared with contemporary bipolar techniques.
- Diagnostic accuracy of electrocardiographic P wave related parameters in the assessment of left atrial size in dogs with degenerative mitral valve disease. [Journal Article]
- JVJ Vet Med Sci 2017 Oct 07; 79(10):1682-1689
- The purpose of this research was to compare the accuracy of newly described P wave-related parameters (P wave area, Macruz index and mean electrical axis) with classical P wave-related parameters (vo...
The purpose of this research was to compare the accuracy of newly described P wave-related parameters (P wave area, Macruz index and mean electrical axis) with classical P wave-related parameters (voltage and duration of P wave) for the assessment of left atrial (LA) size in dogs with degenerative mitral valve disease. One hundred forty-six dogs (37 healthy control dogs and 109 dogs with degenerative mitral valve disease) were prospectively studied. Two-dimensional echocardiography examinations and a 6-lead ECG were performed prospectively in all dogs. Echocardiography parameters, including determination of the ratios LA diameter/aortic root diameter and LA area/aortic root area, were compared to P wave-related parameters: P wave area, Macruz index, mean electrical axis voltage and duration of P wave. The results showed that P wave-related parameters (classical and newly described) had low sensitivity (range=52.3 to 77%; median=60%) and low to moderate specificity (range=47.2 to 82.5%; median 56.3%) for the prediction of left atrial enlargement. The areas under the curve of P wave-related parameters were moderate to low due to poor sensitivity. In conclusion, newly P wave-related parameters do not increase the diagnostic capacity of ECG as a predictor of left atrial enlargement in dogs with degenerative mitral valve disease.
- Unipolar Endocardial Voltage Mapping in the Right Ventricle: Optimal Cutoff Values Correcting for Computed Tomography-Derived Epicardial Fat Thickness and Their Clinical Value for Substrate Delineation. [Journal Article]
- CACirc Arrhythm Electrophysiol 2017; 10(8)
- CONCLUSIONS: For identification of epicardial right ventricular scar, an endocardial UV cutoff value of 3.9 mV is more accurate than previously reported cutoff values. Although the majority of epicardial abnormal electrograms are associated with transmural scar with low endocardial BV, the additional use of endocardial UV at normal BV sites improves the diagnostic accuracy resulting in identification of all epicardial abnormal electrograms at sites with <1.0 mm fat.
- A rash with a heavy heart. [Journal Article]
- EREcho Res Pract 2017 Jul 07
- Cardiac amyloidosis (CA) is relatively rare and frequently misdiagnosed. Other disorders presenting with increased left ventricular (LV) mass can mimic its diagnosis. This case illustrates unique fin...
Cardiac amyloidosis (CA) is relatively rare and frequently misdiagnosed. Other disorders presenting with increased left ventricular (LV) mass can mimic its diagnosis. This case illustrates unique findings of primary light chain (AL) amyloidosis in a patient with remarkable signs of CA. Here, we report a 49-year-old man with prior diagnosis of hypertrophy cardiomyopathy (HCM) based on an echocardiogram performed 1 year earlier that presented with 8 weeks of periorbital rash. He had numbness in the past 3 years. More recently, he presented with shortness of breath. Physical examination was remarkable for periorbital purpura, macroglossia, and orthostatic hypotension. Cardiac auscultation showed S3 and S4. Electrocardiography (ECG) showed diffuse low-voltage QRS complexes. Echocardiography revealed severe diastolic impairment; granular "sparkling" pattern of the myocardium with thickened walls, interatrial septum, and valves; and pericardial effusion. Diastolic dysfunction and thick walls with low ECG voltage are compelling diagnostic findings. Laboratory work up showed increased free light chain-differential (FLC-diff), N-terminal fragment of brain natriuretic peptide (NT-BNP), and cardiac Troponin T (cTnT). Bone marrow biopsy confirmed AL amyloidosis. A diagnosis of AL amyloidosis with cardiac involvement mimicking HCM was made. The patient died during hospitalization due to sudden cardiac death. This cases illustrates the importance of the combination of clinical, serological, electro- and echocardiographic findings to establish the diagnosis of CA.
- Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities. [Journal Article]
- CClinics (Sao Paulo) 2017; 72(6):343-350
- CONCLUSIONS: All five evaluated criteria are inadequate for detecting left ventricular hypertrophy, but the Perugia, Cornell and Romhilt-Estes criteria are useful for excluding its presence. The Perugia and Cornell criteria were more effective at excluding left ventricular hypertrophy in athletes involved in a sport modality with low-static and high-dynamic component predominance.
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- Association between electrocardiographic and echocardiographic right ventricular hypertrophy in a military cohort in Taiwan: The CHIEF study: ECG criteria for RVH. [Journal Article]
- IHIndian Heart J 2017 May - Jun; 69(3):331-333
- We compared electrocardiographic and echocardiographic right ventricular hypertrophy (RVH) in 264 military members in Taiwan. The correlations of the Myers et al. and Sokolow-Lyon criteria with RV wa...
We compared electrocardiographic and echocardiographic right ventricular hypertrophy (RVH) in 264 military members in Taiwan. The correlations of the Myers et al. and Sokolow-Lyon criteria with RV wall thickness were low (r<0.1). Our data supported the American guidance that RVH voltage criteria violations should not receive further echocardiographic investigation.