Objective To describe the clinical characteristics of idiopathic ventricular fibrillation （IVF） with fragmented QRS complex （f-QRS） and J wave in resting electrocardiogram. Methods We reviewed data from 21 case su...Objective To describe the clinical characteristics of idiopathic ventricular fibrillation （IVF） with fragmented QRS complex （f-QRS） and J wave in resting electrocardiogram. Methods We reviewed data from 21 case subjects in our hospital who were resuscitated after cardiac arrest due to IVF and assessed the prevalence of f-QRS and J wave in resting electrocardiogram （ECG）. All the case subjects were classified among three groups based on the electrocardiographic morphology： group I, both f-QRS and J wave were observed （n = 6）, group II, only J wave was observed （n = 9）, group III, neither f-QRS nor J wave was observed （n = 6）. Population characteristics, history of syncope or sudden cardiac arrest, incidence of ventricular fibrillation （VF）, and circumstance of VF were evaluated among the three groups. Results The incidence of index events （syncope, survived cardiac arrest and VF episodes recorded in implantable cardioverter defibrillator （ICD） or pacemakers） was 13.4 ~ 5.6 per-year in group I, 10.8 ~ 3.9 per-year in group II, and 9.8 -4- 4.2 per-year in group HI. There were significant differences in incidences among the three groups, the most frequent index events were observed in group I. The hazard ratio for incidence was 3.2 （95%CI, 1.1-7.9; P = 0.01）. The history and circumstance of the index events were different among the groups. In group I, all the index events occurred during sleep in early morning. In group II, four subjects suffered VF during strenuous physical activities or agitation state, two during sleep in early morning, three in usual activity. In group III, one subject suffered VF during sleep in early morning, one in agitation state, four in usual activity. Conclusions This study suggests that the IVF patients with the combined appearance of f-QRS and J wave in the resting ECG suffer an increased risk of VF, this subgroup of IVF patients has a unique clinical feature.展开更多
The electrocardiogram （ECG） has broad applications in clinical diagnosis and prognosis of cardiovascular disease. Many researchers have contributed to its progressive development. To commemorate those pioneers, and ...The electrocardiogram （ECG） has broad applications in clinical diagnosis and prognosis of cardiovascular disease. Many researchers have contributed to its progressive development. To commemorate those pioneers, and to better study and promote the use of ECG, we reviewed and present here a systematic introduction about the history, hotspots, and trends of ECG. In the historical part, information including the invention, improvement, and extensive applications of ECG, such as in long QT syndrome （LQTS）, angina, and myocardial infarction （MI）, are chronologi- cally presented. New technologies and applications from the 1990s are also introduced. In the second part, we use the bibliometric analysis me- thod to analyze the hotspots in the field of ECG-related research. By using total citations and year-specific total citations as our main criteria, four key hotspots in ECG-related research were identified from 11 articles, including atrial fibrillation, LQTS, angina and MI, and heart rate variability. Recent studies in those four areas are also reported. In the final part, we discuss the future trends concerning ECG-related research. The authors believe that improvement of the ECG instrumentation, big data mining for ECG, and the accuracy of diagnosis and application will be areas of continuous concern.展开更多
Aslanger’s sign,also known as the arterial pulse tapping artifact or electromechanical association artifact,is an electrocardiographic artifact caused by arterial pulsation at the site where the limb leads of the sta...Aslanger’s sign,also known as the arterial pulse tapping artifact or electromechanical association artifact,is an electrocardiographic artifact caused by arterial pulsation at the site where the limb leads of the standard 12-lead electrocardiogram near the radial or posterior tibial arteries are positioned,particularly in hyperdynamic states.[1–8]It occurs in every cardiac cycle with a constant coupling interval between the QRS complex and artifact.This synchronization with the underlying heart rhythm makes it less likely to be recognized as an artifact compared to unsynchronized artifacts,such as those caused by limb movement and inadequate contact between the electrode and skin.[1,2,7,8]Almost all reported cases of Aslanger’s sign exhibit an unusual waveform morphology in all 12 leads except one of the standard 12-lead electrocardiogram.This sign is often confused with an electrocardiographic finding commonly observed during acute coronary events.展开更多
Holter usually monitors electrocardiogram(ECG)signals for more than 24 hours to capture short-lived cardiac abnormalities.In view of the large amount of Holter data and the fact that the normal part accounts for the m...Holter usually monitors electrocardiogram(ECG)signals for more than 24 hours to capture short-lived cardiac abnormalities.In view of the large amount of Holter data and the fact that the normal part accounts for the majority,it is reasonable to design an algorithm that can automatically eliminate normal data segments as much as possible without missing any abnormal data segments,and then take the left segments to the doctors or the computer programs for further diagnosis.In this paper,we propose a preliminary abnormal segment screening method for Holter data.Based on long short-term memory(LSTM)networks,the prediction model is established and trained with the normal data of a monitored object.Then,on the basis of kernel density estimation,we learn the distribution law of prediction errors after applying the trained LSTM model to the regular data.Based on these,the preliminary abnormal ECG segment screening analysis is carried out without R wave detection.Experiments on the MIT-BIH arrhythmia database show that,under the condition of ensuring that no abnormal point is missed,53.89% of normal segments can be effectively obviated.This work can greatly reduce the workload of subsequent further processing.展开更多
BACKGROUND:Post-infarct left ventricular free wall rupture(LVFWR)is not always an immediately catastrophic complication.The rupture can be subacute,allowing time for diagnosis and intervention.Accordingly,early recogn...BACKGROUND:Post-infarct left ventricular free wall rupture(LVFWR)is not always an immediately catastrophic complication.The rupture can be subacute,allowing time for diagnosis and intervention.Accordingly,early recognition of the entity may be lifesaving.METHODS:We present an electrocardiogram(ECG)change pattern in two cases,which was erroneously attributed to ischemia.Two women in their 80s were admitted to our institute after experiencing the sudden onset of chest pain.They were managed as anterior ST-segment elevation myocardial infarction without reperfusion treatment.Unfortunately,they experienced a recurrence of severe chest pain with cardiogenic shock during hospitalisation.The ECG recorded at that time showed a ST-segment re-elevation in infract-related leads.RESULTS:The two cases were regrettably received a misjudgement of reinfarction at first,and one of the patients even was administrated with tirofi ban.Afterwards the diagnosis of subacute LVFWR was made through antemortem echocardiography.CONCLUSION:New ST-segment elevation(STE)in infarct-associated leads,coupled with recurrence of chest pain and new-onset hypotension,may constitute the premonitory signs of a subacute LVFWR.展开更多
Electrocardiogram(ECG)is a low-cost,simple,fast,and non-invasive test.It can reflect the heart’s electrical activity and provide valuable diagnostic clues about the health of the entire body.Therefore,ECG has been wi...Electrocardiogram(ECG)is a low-cost,simple,fast,and non-invasive test.It can reflect the heart’s electrical activity and provide valuable diagnostic clues about the health of the entire body.Therefore,ECG has been widely used in various biomedical applications such as arrhythmia detection,disease-specific detection,mortality prediction,and biometric recognition.In recent years,ECG-related studies have been carried out using a variety of publicly available datasets,with many differences in the datasets used,data preprocessing methods,targeted challenges,and modeling and analysis techniques.Here we systematically summarize and analyze the ECGbased automatic analysis methods and applications.Specifically,we first reviewed 22 commonly used ECG public datasets and provided an overview of data preprocessing processes.Then we described some of the most widely used applications of ECG signals and analyzed the advanced methods involved in these applications.Finally,we elucidated some of the challenges in ECG analysis and provided suggestions for further research.展开更多
目的探讨左心衰竭合并肺动脉高压(PH-LHF)发生不同类型心律失常的危险因素。方法回顾性分析2022年1月至2023年12月在江苏省中医院心内科收治的789例左心衰竭患者的临床资料。根据肺动脉收缩压(PASP)将其分为non PH-LHF组(PASP<33 mm ...目的探讨左心衰竭合并肺动脉高压(PH-LHF)发生不同类型心律失常的危险因素。方法回顾性分析2022年1月至2023年12月在江苏省中医院心内科收治的789例左心衰竭患者的临床资料。根据肺动脉收缩压(PASP)将其分为non PH-LHF组(PASP<33 mm Hg,n=374)和PH-LHF组(PASP≥33 mm Hg,n=415),比较两组不同类型心律失常的发生率。根据有无心律失常,将患者分为心律失常组(n=334)和对照组(n=81),并采用单因素及多因素Logistic回归分析PH-LHF发生室上性快速型心律失常(SVT)、复杂室性心律失常(CVA)及缓慢型心律失常的危险因素。结果PH-LHF组发生SVT、CVA及缓慢型心律失常的比例分别为69.4%、19.0%、20.5%。多因素logistic回归分析结果显示年龄(OR=1.034)、RAD(OR=1.064)是PH-LHF合并上述任意心律失常的危险因素(P<0.05);年龄(OR=1.024)、高血压(OR=1.827)、LAD(OR=1.048)、RAD(OR=1.031)、RVD(OR=1.061)是其发生SVT的危险因素(P<0.05);冠心病(OR=2.679)、LVDd(OR=1.080)是其发生CVA的危险因素(P<0.05);RAD(OR=1.094)、E/e′(OR=1.069)是其发生缓慢型心律失常的危险因素(P<0.001)。结论PH-LHF容易发生SVT、CVA和缓慢型心律失常,其中高龄、高血压、冠心病、心房心室结构异常是常见的危险因素,临床应根据患者具体情况采取合理的心律失常管理策略。展开更多
目的 分析两种心电图(ECG)检查对冠心病(CHD)患者心肌缺血、心律失常的诊断价值。方法 回顾性选择在本院治疗的CHD患者92例,以冠状动脉(冠脉)造影检查为金标准,比较24 h动态心电图(AECG)与常规ECG对CHD患者心肌缺血的诊断效能、心律失...目的 分析两种心电图(ECG)检查对冠心病(CHD)患者心肌缺血、心律失常的诊断价值。方法 回顾性选择在本院治疗的CHD患者92例,以冠状动脉(冠脉)造影检查为金标准,比较24 h动态心电图(AECG)与常规ECG对CHD患者心肌缺血的诊断效能、心律失常检出情况及ST段异常检出情况。结果 以冠脉造影检查结果为金标准,92例患者共检出心肌缺血者78例。24 h AECG对CHD患者心肌缺血诊断的敏感度、准确度、阴性预测值分别为96.15%、94.57%、80.00%,显著高于常规ECG的75.64%、75.00%、34.48%,差异显著(P<0.05);两种检查方式对CHD患者心肌缺血诊断的特异度、阳性预测值及各类心律失常类型的检出率的差异不显著(P>0.05)。24 h AECG对CHD患者ST段抬高、ST段压低的检出率及心律失常总检出率均显著高于常规ECG,差异显著(P<0.05)。结论 24 h AECG对CHD患者心肌缺血及心律失常的检出率更高,值得推广和应用。展开更多
文摘Objective To describe the clinical characteristics of idiopathic ventricular fibrillation （IVF） with fragmented QRS complex （f-QRS） and J wave in resting electrocardiogram. Methods We reviewed data from 21 case subjects in our hospital who were resuscitated after cardiac arrest due to IVF and assessed the prevalence of f-QRS and J wave in resting electrocardiogram （ECG）. All the case subjects were classified among three groups based on the electrocardiographic morphology： group I, both f-QRS and J wave were observed （n = 6）, group II, only J wave was observed （n = 9）, group III, neither f-QRS nor J wave was observed （n = 6）. Population characteristics, history of syncope or sudden cardiac arrest, incidence of ventricular fibrillation （VF）, and circumstance of VF were evaluated among the three groups. Results The incidence of index events （syncope, survived cardiac arrest and VF episodes recorded in implantable cardioverter defibrillator （ICD） or pacemakers） was 13.4 ~ 5.6 per-year in group I, 10.8 ~ 3.9 per-year in group II, and 9.8 -4- 4.2 per-year in group HI. There were significant differences in incidences among the three groups, the most frequent index events were observed in group I. The hazard ratio for incidence was 3.2 （95%CI, 1.1-7.9; P = 0.01）. The history and circumstance of the index events were different among the groups. In group I, all the index events occurred during sleep in early morning. In group II, four subjects suffered VF during strenuous physical activities or agitation state, two during sleep in early morning, three in usual activity. In group III, one subject suffered VF during sleep in early morning, one in agitation state, four in usual activity. Conclusions This study suggests that the IVF patients with the combined appearance of f-QRS and J wave in the resting ECG suffer an increased risk of VF, this subgroup of IVF patients has a unique clinical feature.
基金This research was supported in part by National Natural Science Foundation of China，supported by Research Funds of China Space Medical Engineering，supported by State Key Laboratory of Space Medicine Fundamentals and Applications, China Astronaut Research and Training Centre
文摘The electrocardiogram （ECG） has broad applications in clinical diagnosis and prognosis of cardiovascular disease. Many researchers have contributed to its progressive development. To commemorate those pioneers, and to better study and promote the use of ECG, we reviewed and present here a systematic introduction about the history, hotspots, and trends of ECG. In the historical part, information including the invention, improvement, and extensive applications of ECG, such as in long QT syndrome （LQTS）, angina, and myocardial infarction （MI）, are chronologi- cally presented. New technologies and applications from the 1990s are also introduced. In the second part, we use the bibliometric analysis me- thod to analyze the hotspots in the field of ECG-related research. By using total citations and year-specific total citations as our main criteria, four key hotspots in ECG-related research were identified from 11 articles, including atrial fibrillation, LQTS, angina and MI, and heart rate variability. Recent studies in those four areas are also reported. In the final part, we discuss the future trends concerning ECG-related research. The authors believe that improvement of the ECG instrumentation, big data mining for ECG, and the accuracy of diagnosis and application will be areas of continuous concern.
文摘Aslanger’s sign,also known as the arterial pulse tapping artifact or electromechanical association artifact,is an electrocardiographic artifact caused by arterial pulsation at the site where the limb leads of the standard 12-lead electrocardiogram near the radial or posterior tibial arteries are positioned,particularly in hyperdynamic states.[1–8]It occurs in every cardiac cycle with a constant coupling interval between the QRS complex and artifact.This synchronization with the underlying heart rhythm makes it less likely to be recognized as an artifact compared to unsynchronized artifacts,such as those caused by limb movement and inadequate contact between the electrode and skin.[1,2,7,8]Almost all reported cases of Aslanger’s sign exhibit an unusual waveform morphology in all 12 leads except one of the standard 12-lead electrocardiogram.This sign is often confused with an electrocardiographic finding commonly observed during acute coronary events.
文摘Holter usually monitors electrocardiogram(ECG)signals for more than 24 hours to capture short-lived cardiac abnormalities.In view of the large amount of Holter data and the fact that the normal part accounts for the majority,it is reasonable to design an algorithm that can automatically eliminate normal data segments as much as possible without missing any abnormal data segments,and then take the left segments to the doctors or the computer programs for further diagnosis.In this paper,we propose a preliminary abnormal segment screening method for Holter data.Based on long short-term memory(LSTM)networks,the prediction model is established and trained with the normal data of a monitored object.Then,on the basis of kernel density estimation,we learn the distribution law of prediction errors after applying the trained LSTM model to the regular data.Based on these,the preliminary abnormal ECG segment screening analysis is carried out without R wave detection.Experiments on the MIT-BIH arrhythmia database show that,under the condition of ensuring that no abnormal point is missed,53.89% of normal segments can be effectively obviated.This work can greatly reduce the workload of subsequent further processing.
基金supported by National Natural Science Foundation of China General Program(81970298)the National Key R&D Project(2016YFC1301300,2016YFC1301303)
文摘BACKGROUND:Post-infarct left ventricular free wall rupture(LVFWR)is not always an immediately catastrophic complication.The rupture can be subacute,allowing time for diagnosis and intervention.Accordingly,early recognition of the entity may be lifesaving.METHODS:We present an electrocardiogram(ECG)change pattern in two cases,which was erroneously attributed to ischemia.Two women in their 80s were admitted to our institute after experiencing the sudden onset of chest pain.They were managed as anterior ST-segment elevation myocardial infarction without reperfusion treatment.Unfortunately,they experienced a recurrence of severe chest pain with cardiogenic shock during hospitalisation.The ECG recorded at that time showed a ST-segment re-elevation in infract-related leads.RESULTS:The two cases were regrettably received a misjudgement of reinfarction at first,and one of the patients even was administrated with tirofi ban.Afterwards the diagnosis of subacute LVFWR was made through antemortem echocardiography.CONCLUSION:New ST-segment elevation(STE)in infarct-associated leads,coupled with recurrence of chest pain and new-onset hypotension,may constitute the premonitory signs of a subacute LVFWR.
基金Supported by the NSFC-Zhejiang Joint Fund for the Integration of Industrialization and Informatization(U1909208)the Science and Technology Major Project of Changsha(kh2202004)the Changsha Municipal Natural Science Foundation(kq2202106).
文摘Electrocardiogram(ECG)is a low-cost,simple,fast,and non-invasive test.It can reflect the heart’s electrical activity and provide valuable diagnostic clues about the health of the entire body.Therefore,ECG has been widely used in various biomedical applications such as arrhythmia detection,disease-specific detection,mortality prediction,and biometric recognition.In recent years,ECG-related studies have been carried out using a variety of publicly available datasets,with many differences in the datasets used,data preprocessing methods,targeted challenges,and modeling and analysis techniques.Here we systematically summarize and analyze the ECGbased automatic analysis methods and applications.Specifically,we first reviewed 22 commonly used ECG public datasets and provided an overview of data preprocessing processes.Then we described some of the most widely used applications of ECG signals and analyzed the advanced methods involved in these applications.Finally,we elucidated some of the challenges in ECG analysis and provided suggestions for further research.
文摘目的探讨左心衰竭合并肺动脉高压(PH-LHF)发生不同类型心律失常的危险因素。方法回顾性分析2022年1月至2023年12月在江苏省中医院心内科收治的789例左心衰竭患者的临床资料。根据肺动脉收缩压(PASP)将其分为non PH-LHF组(PASP<33 mm Hg,n=374)和PH-LHF组(PASP≥33 mm Hg,n=415),比较两组不同类型心律失常的发生率。根据有无心律失常,将患者分为心律失常组(n=334)和对照组(n=81),并采用单因素及多因素Logistic回归分析PH-LHF发生室上性快速型心律失常(SVT)、复杂室性心律失常(CVA)及缓慢型心律失常的危险因素。结果PH-LHF组发生SVT、CVA及缓慢型心律失常的比例分别为69.4%、19.0%、20.5%。多因素logistic回归分析结果显示年龄(OR=1.034)、RAD(OR=1.064)是PH-LHF合并上述任意心律失常的危险因素(P<0.05);年龄(OR=1.024)、高血压(OR=1.827)、LAD(OR=1.048)、RAD(OR=1.031)、RVD(OR=1.061)是其发生SVT的危险因素(P<0.05);冠心病(OR=2.679)、LVDd(OR=1.080)是其发生CVA的危险因素(P<0.05);RAD(OR=1.094)、E/e′(OR=1.069)是其发生缓慢型心律失常的危险因素(P<0.001)。结论PH-LHF容易发生SVT、CVA和缓慢型心律失常,其中高龄、高血压、冠心病、心房心室结构异常是常见的危险因素,临床应根据患者具体情况采取合理的心律失常管理策略。
文摘目的 分析两种心电图(ECG)检查对冠心病(CHD)患者心肌缺血、心律失常的诊断价值。方法 回顾性选择在本院治疗的CHD患者92例,以冠状动脉(冠脉)造影检查为金标准,比较24 h动态心电图(AECG)与常规ECG对CHD患者心肌缺血的诊断效能、心律失常检出情况及ST段异常检出情况。结果 以冠脉造影检查结果为金标准,92例患者共检出心肌缺血者78例。24 h AECG对CHD患者心肌缺血诊断的敏感度、准确度、阴性预测值分别为96.15%、94.57%、80.00%,显著高于常规ECG的75.64%、75.00%、34.48%,差异显著(P<0.05);两种检查方式对CHD患者心肌缺血诊断的特异度、阳性预测值及各类心律失常类型的检出率的差异不显著(P>0.05)。24 h AECG对CHD患者ST段抬高、ST段压低的检出率及心律失常总检出率均显著高于常规ECG,差异显著(P<0.05)。结论 24 h AECG对CHD患者心肌缺血及心律失常的检出率更高,值得推广和应用。
