Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
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Ann Noninvasive Electrocardiol · Jul 2003
Comparative StudyPredictive value of P-wave signal-averaged electrocardiogram for atrial fibrillation in acute myocardial infarction.
Atrial fibrillation (AF) is a common complication of acute myocardial infarction (AMI) with a reported incidence of 7-18%. Recently, P-wave signal-averaged electrocardiogram (P-SAECG) has been used to assess the risk of paroxysmal AF attacks in some diseases. The aim of this study was to determine prospectively whether patients with AMI at risk for paroxysmal AF would be identified by P-SAECG and other clinical variables. ⋯ An abnormal P-SAECG may be a predictor of paroxysmal AF in patients with AMI. Advanced age and systolic heart failure were detected as two important clinical risk factors for the development of AF.
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Ann Noninvasive Electrocardiol · Jul 2003
Comparative StudyNovel compound heterozygous mutations in the KCNQ1 gene associated with autosomal recessive long QT syndrome (Jervell and Lange-Nielsen syndrome).
The Jervell and Lange-Nielsen syndrome (JLNS) is the autosomal recessive form of long QT syndrome (LQTS)--a familial cardiac disorder that causes syncope, seizures, and sudden death from ventricular arrhythmias, specifically torsade de pointes. JLNS is associated with sensorineural deafness and has been shown to occur with homozygous mutations in KCNQ1 or KCNE1 in JLNS families in which QTc prolongation is inherited as a dominant trait. This study investigated the molecular pathology of a family with clinical evidence of JLNS. ⋯ Novel compound heterozygous nonsense mutations in C-terminus of KCNQ1 can cause JLNS.
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Ann Noninvasive Electrocardiol · Jul 2003
Comparative StudyDiagnostic value of aVL derivation for right ventricular involvement in patients with acute inferior myocardial infarction.
Right ventricular (RV) involvement is associated with increased morbidity and mortality in patients with acute inferior myocardial infarction (MI). Although electrocardiography is probably the most useful, simple, and objective tool for the diagnosis of acute MI, there are no well-defined criteria in the standard 12-lead electrocardiogram to properly identify RV involvement in patients with acute inferior MI. Our objective was to evaluate the value of ST-segment depression in lead aVL in diagnosing RV involvement in patients with acute inferior MI. ⋯ More than 1 mm ST-segment depression in lead aVL was found to have high sensitivity (87%), specificity (91%), high positive and negative predictive value (90%, 88%, respectively), and high diagnostic accuracy (89%) in diagnosing RV involvement in patients with acute inferior MI. Therefore, by using a simple 12-lead electrocardiographic sign, ST-segment depression >1 mm in lead aVL, obtained on admission, it is possible to identify RV involvement in patients with acute inferior MI.
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Ann Noninvasive Electrocardiol · Jul 2003
Case ReportsGiant J wave on 12-lead electrocardiogram in hypothermia.
Findings on standard 12-lead electrocardiogram in patients with hypothermia include sinus bradycardia, prolonged QT and PR interval, wide QRS complex, supraventricular and ventricular arrhythmia, and the most striking electrocardiographic abnormality, the J wave. Although characteristic of hypothermia, J wave also occurs in other conditions. The electro-physiologic basis of J wave in hypothermia has been recently elucidated. We present a case of giant J wave due to accidental hypothermia and in addition discuss the features, mechanism, and significance of J wave in hypothermia.