bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variable Expression of Long QT Syndrome Among Gene Carriers from Families with Five Different HERG Mutations
Authors: Benhorin Jesaia , Moss Arthur J. , Bak Matthew , Zareba Wojciech , Kaufman Elizabeth S. , Kerem Batsheva , Towbin Jeffrey A. , Priori Silvia , Kass Robert S. , Attali Bernard , Brown Arthur M. , Ficker Eckhard 
Published: October 2006

Objectives: This study assessed the phenotypic variability of LQTS in carriers with the same and with different mutations in the LQT2 gene.Background: Mutations of ion‐channel genes are known to cause the long QT syndrome (LQTS), a disorder associated with distinctive genotypic‐specific electrocardiographic patterns and variable clinical expression.Methods: Clinical and electrocardiographic characteristics were assessed in five large LQTS families, each with a different mutation of the HERG gene (LQT2; n = 469, 69% genotyped, 102 carriers). One mutation was located on the N‐terminus and the other four on the C‐terminus of the HERG channel protein.Results: The QTc duration and the frequency of cardiac events (syncope and LQTS‐related cardiac arrest/deatht were similar among carriers with the five HERG mutations. QTc was as variable in carriers of the same mutation as it was among carriers with different HERG mutations (P = 0.19). Qualitative assessment of the electrocardiograms revealed extensive intra‐and interfamilial variability in T‐vvave morphology. Among carriers with multiple electrocardiograms extending over 2 to 7 years, variation in QTc over time was minimal. A strong association was found between QTc and the occurrence of cardiac events in carriers of all five mutations.Conclusions: The clinical expression of LQTS was equally variable in carriers from families with the same or different HERG mutations. These findings highlight the complexity of the clinical phenotype in this Mendelian dominant disorder and suggest that one or more modifier genes contribute to the variable expression of this syndrome. A.N.E. 2002;7(1):40–46
Patients with Persistent Atrial Fibrillation Taking Oral Verapamil Exhibit a Lower Atrial Frequency on the ECG
Authors: Bollmann Andreas , Sonne Kai , Esperer Hans‐Dieter , Toepffer Ines , Klein Helmut U. 
Published: October 2006

Background: While there is agreement that verapamil attenuates the AF‐ induced refractory period shortening when given before AF induction, controversy exists regarding its effects when given after the onset of persistent AF. This study aimed to compare atrial fibrillatory frequency obtained from the surface ECG in patients with persistent atrial fibrillation (AF) with oral verapamil treatment to those without this treatment.Methods and Results: Surface ECG recordings were performed in 57 patients (34 male, 23 female, mean age 59 ± 11 years) with persistent AF (> 7 days). The frequency content of the fibrillatory baseline was quantified using digital signal processing (filtering, QRST complex averaging and subtraction. Fourier transformation). In 27 patients with verapamil treatment (120 or 240 mg/day for at least 7 days) mean fibrillatory frequency measured 6.4 ± 0.2 Hz, compared to 7.0 ± 0.4 Hz (P = 0.012) in 30 patients without verapamil. In a subset of 20 randomly selected patients (10 with, 10 without verapamil treatment) a 24‐hour Holter ECG recording was performed and fibrillatory frequency determined at 4 PM, 10 PM, 4 AM, and 10 AM. While there was a significant frequency reduction in the verapamil treated patients at night (P = 0.011), it remained constant over time in the other patients.Conclusion: In patients with persistent AF, fibrillatory frequency assessed by spectral analysis of the surface ECG is lower in patients taking verapamil. A.N.E. 2002;7(2):92–97
Observer Variability and Optimal Criteria of Transient Ischemia During ST Monitoring with Continuous 12‐lead ECG
Authors: Jernberg Tomas , Cronblad Jörgen , Lindahl Bertil , Wallentin Lars 
Published: October 2006

Background: ST monitoring with continuous 12‐lead ECG is a well‐established method in patients with unstable coronary artery disease (CAD). However, the method lacks documentation on optimal criteria for episodes of transient ischemia and on observer variability.Methods: Observer variability was evaluated in 24‐hour recordings from 100 patients with unstable CAD with monitoring in the coronary care unit. Influence on ST changes by variations in body position were evaluated by monitoring 50 patients in different body positions. Different criteria of transient ischemia and their predictive importance were evaluated in 630 patients with unstable CAD who underwent 12 hours of monitoring and thereafter were followed for 1 to 13 months. Two sets of criteria were tested: (1) ST deviation ≧ 0.1 mV for at least 1 minute, and (2) ST depression ≧ 0.05 mV or elevation ≧ 0.1 mV for at least 1 minute.Results: When the first set of criteria were used, the interobserver agreement was good (kappa = 0.72) and 8 (16%) had significant ST changes in at least one body position. Out of 100 patients with symptoms suggestive of unstable CAD and such ischemia, 24 (24%) had a cardiac event during follow‐up. When the second set of criteria were used, the interobserver agreement was poor (kappa = 0.32) and 21(42%) had significant ST changes in at least one body position. Patients fulfilling the second but not the first set of criteria did not have a higher risk of cardiac event than those without transient ischemia (5.3 vs 4.3%).Conclusions: During 12‐lead ECG monitoring, transient ischemic episodes should be defined as ST deviations ≧ 0.1 mV for at least 1 minute, based on a low observer variability, minor problems with postural ST changes and an important predictive value. A.N.E. 2002;7(3):181–190
The Value of P Dispersion on Predicting Atrial Fibrillation After Coronary Artery Bypass Surgery: Effect of Magnesium on P Dispersion
Authors: Dagdelen Sinan , Toraman Fevzi , Karabulut Hasan , Alhan Cem 
Published: October 2006

Background: AF is a frequent arrhythmia complicating CABG, and it is well known that dispersion and prolongation of P wave increases the risk of AF. The aim of this study was to investigate the effect of magnesium (Mg) treatment on P‐wave duration and dispersion in patients undergoing CABG.Method: The study included 148 consecutive patients (33 women, 115 men; mean age 62.1 ± 7.0 years) undergoing CABG who were randomly allocated to two groups. Group A consisted of 93 patients to whom 1.5 g daily MgSO4 infusion was applied the day before surgery, just after operation, and 4 days following surgery, and group B consisted of 55 control patients. From the preoperative and postoperative fourth day, 12‐lead ECG recordings, duration of the P waves, and P‐wave dispersions were calculated.Results: There were no differences between the two groups with regard to age, sex, and blood Mg level. Comparison of the baseline and day 4 ECG measurements showed no difference as far as heart rates, duration of PQ, and QRS intervals were concerned. AF developed in 2 (2%) cases in group A and in 20 (36%) cases in group B (P < 0.001). There was no difference between the two groups when average basal P max, P min, P dispersion, and day 4 P min values were compared. In group A, fourth day P max (94.3 ± 11.8 vs 101.0 ± 13.2 ms; P = 0.0025) and P dispersion (38.2 ± 9.2 vs 44.9 ± 10.9 ms; P = 0.0002) were significantly lower as compared to group B. Comparing the patients who developed AF, and who did not, no difference was detected with regard to baseline P max, P min, P dispersion, and day 4 P min. Day 4 P max (95.1 ± 11.8 vs 106.4 ± 14.0 ms, P = 0.0015) and P dispersion (38.9 ± 8.8 vs 50.7 ± 13.0 ms, P = 0.001) of patients who developed AF were significantly higher. Baseline Mg levels were similar in patients who developed AF, and who did not, but the day 4 Mg level was significantly lower in AF group (2.0 ± 0.23 vs 2.15 ± 0.26 mg/dL, P < 0.001).Conclusion: Perioperative Mg treatment reduces P dispersion and the risk of developing AF in patients undergoing CABG. A.N.E. 2002;7(3):211–218
Directct Epicardial Mapping Can Differentiate Hibernating from Scarred Myocardium: A Validation Study with 18F‐FDG‐PET
Authors: Vahlhaus Christian , Schäfers Michael , Bruns Hans‐Jürgen , Janssen Frauke , Stypmann Jorg , Hammel Dieter , Scheld Hans H. , Schober Otmar , Breithardt Günter , Wichter Thomas 
Published: October 2006

Aim: This study investigated the value of epicardial mapping immediately before CABG in the differentiation of hibernating from scarred myocardium in correlation to the noninvasive gold standard 18F‐FDG PET.Methods and Results: In 35 patients with CAD, myocardial perfusion (99mTc‐Tetrofosmin‐SPECT), viability (18F‐FDG‐PET), and function (LVangiography) were assessed before CABG. 102 bipolar epicardial electrograms per patient (n = 3570 electrograms) were recorded simultaneously with a ventricular jacket array. Based on the scintigraphic and LV angiographic data at the site of each electrode with good myocardial contact (n = 1963), segments (n = 492, 14.1 ± 5.6 per patient; mean ± SD) were classified into three groups: hibernating (n = 139), scarred (n = 104), and control (n = 249). Regional mean bipolar voltage values were calculated for Receiver Operating Characteristic (ROC) analysis. Mean bipolar voltage was significantly lower in scarred when compared to hibernating myocardium. ROC curve analysis (area under the curve of O.92 ± 0.47, mean ± SE) for mean bipolar voltage to discriminate between hibernating and scarred myocardium revealed a sensitivity of 94% with a specificity of 83% at a cut‐off value of 8.75 mV.Conclusion: Hibernating myocardium can be differentiated correctly from scarred myocardium by direct epicardial mapping. In the future, hibernating myocardium may be detectable by body surface mapping techniques using inverse solutions. A.N.E. 2002;7(4):349–356
The Immediate and Short‐Term Effect of Successful Percutaneous Coronary Intervention on Repolarization in Acute Myocardial Infarction Patients
Authors: Giedrimiene Dalia , Giri Satyendra , White C. Michael , Giedrirnas Evaldas , Kluger Jeffrey 
Published: October 2006

Objectives: The primary objective was to assess the immediate and short‐term impact of successful percutaneous coronary intervention (PCI) on QT dispersion (QT disp) and corrected QT dispersion (QTc disp). Secondarily, the impact of PCI on QT and QTc disp within different infarct‐related arteries and the impact of successful PCI in these different arteries were evaluated.Methods: Patients (n = 140, age 61.6 ± 12.9, 69% male) undergoing direct primary PCI for acute Ml were evaluated. Twelve‐lead ECGs were obtained before baseline), immediately after (0 h), 24hours after, and 3 days after PCI. The QT and QTc interval in each of the 12‐leads were measured and the shortest interval was subtracted from the longest to derive the QT disp and QTc disp, respectively.Results: Angiography showed blockages in the left anterior descending, right coronary artery, and circumflex in 37.1, 48.9, and 15.0% of patients, respectively. Overall, 97 patients achieved successful reflow. QT and QTc disp were significantly improved in the group with successful reflow at each follow‐up time after PCI versus baseline and corresponding values in the unsuccessful reflow group. QT disp was improved among patients with successful reflow irrespective of which infarct artery was responsible for the acute myocardial infarction.Conclusions: Successful reflow with PCI is associated with a rapid reduction in QT disp and QTc disp that is maintained for at least 3 days after the event. Conversely, unsuccessful reflow was not associated with significant reductions in QT or QTc disp. A.N.E. 2002;7(4):357–362
P Wave Dispersion and P Wave Duration on SAECG in Predicting Atrial Fibrillation in Patients with Acute Myocardial Infarction
Authors: Rosiak Marcin , Bolinska Halina , Ruta Jan 
Published: October 2006

Background: Atrial fibrillation (AF) is a frequent complication of acute myocardial infarction (AMI), with reported incidence of 7% to 18%. The incidence of congestive heart failure, in‐hospital mortality, and long‐term mortality is higher in AMI patients with AF than in AMI patients without AF. P wave duration on signal‐averaged ECG (PWD) and P wave dispersion on standard ECG (Pd) are noninvasive markers of intra‐atrial conduction disturbances, which are believed to be the main electrophysiological cause of AF.Methods: In the present study we investigated prospectively whether P wave duration on SAECG and P wave dispersion on standard ECG can predict development of AF in a group of patients with AMI. One hundred and thirty patients (100 men and 30 women, aged 56.9 ± 12) with AMI were investigated. PWD, Pd, their clinical and hemodynamic characteristics were collected.Results: During the observation up to 14 days, 22 patients (16.9%) developed AF. Univariate analysis variables associated with development of AF: age > 65 years, Killip class III‐IV, PWD > 125 ms, and Pd > 25 ms. Stepwise logistic regression analysis showed that age > 65 years, PWD > 125 ms, and Pd > 25 ms were independently associated with AF.Conclusions: PWD and Pd both measured in a very early period of AMI are useful in predicting AF. A.N.E. 2002;7(4):363–368
Predictive Value of Admission Electrocardiogram For Multivessel Disease in Acute Anterior and Anterior‐Inferior Myocardial Infarction
Authors: Kürüm Turhan , Öztekin Erkan , Özçelik Fatih , Eker Hüseyin , Türe Mevlüt , Özbay Gültç 
Published: October 2006

Background: Our aim was to investigate the correlation between admission ECG and coronary angiography findings in terms of predicting the culprit vessel responsible for the infarct or multivessel disease in acute anterior or anterior‐inferior myocardial infarction (AMI).Methods: We investigated 101 patients with a diagnosis of anterior AMI with or without ST‐segment elevation or ST‐segment depression in at least two leads in Dll, III, aVF. The patients were classified as those with vessel involvement in the left anterior descending (LAD) coronary artery and patients with multivessel disease. Vessel involvement in LAD + circumflex artery (Cx) or LAD + right coronary artery (RCA) or LAD + Cx + RCA were considered as multivessel disease. Thus, (a) anterior AMI patients with reciprocal changes in inferior leads, (b) anterior AMI patients with inferior elevations, (c) all anterior AMI patients according to the ST‐segment changes in the inferior region were analyzed according to the presence of LAD or multivesssel involvement.Results: Presence of ST‐segment depression in aVL and V6 was significantly correlated with the presence of multivessel disease in anterior AMI patients with reciprocal changes in the inferior leads (P = 0.005 and P = 0.003, respectively). No statistically significant difference between the leads were detected in terms of ST‐segment elevation in predicting vessel involvement in the two groups of anterior AMI patients with inferior elevations. When all the patients with anterior AMI were analyzed, the presence of ST‐segment depression in leads aVL, V4, V5 and V6 were significantly associated with the presence of multivessel disease (P = 0.035, P = 0.010, P = 0.011, P = 0.001, respectively).Conclusions: The presence of ST‐segment depression in anterolateral leads in the admission ECG of anterior AMI patients with reciprocal changes in inferior leads was associated with multivessel disease.
Heart Rate Variability by Triangular Index in Infants Exposed Prenatally to Cocaine
Authors: Ken Mehta Sudhir , Super Dennis M. , Salvator Ann , Fradley Linda Goetz , Connuck David , Kaufman Elizabeth S. 
Published: October 2006

Background: In adults, heart rate variability triangular index (HRVi) is a highly reproducible measure of heart rate variability (HRV), which makes it more suitable for use in longitudinal studies. Although normative data have been published for newborns, studies in infants with pathological conditions are lacking.Methods: From 1997 to 2000, within the first 4 days of life, we prospectively evaluated HRVi in cocaine‐exposed asymptomatic newborns (N = 97) by Holter monitoring. Their data were compared with infants from two control groups (one with no in utero drug exposure, N = 102; the other with exposure to alcohol, nicotine, or marijuana but no cocaine, N = 111).Results: In assessing concordance between and within operators for HRVi, the intraclass correlations were 0.983 (95% Cl: 0.958, 0.994) and 0.997 (95% Cl: 0.984, 0.999), respectively. Infants with in utero cocaine exposure had significantly (P < 0.0001) lower HRVi than those exposed to other drugs and to no drugs in utero. If abnormal HRVi is defined as < fifth percentile for the no drug exposed group (HRVi < 8), 10% of the cocaine‐exposed newborns, in contrast to 2% in each of the control groups (P = 0.003) had abnormal values.Conclusion: HRVi is a reliable measure to study heart rate variability in newborns. Asymptomatic infants with in utero cocaine exposure have lower HRVi. Our study supports the clinical use of an abnormal HRVi as a value < 8 for newborn infants. A.N.E. 2002;7(4):374–378
Cardiac Effects of Chronic Oral Beta‐Blockade:
Authors: Extramiana Fabrice , Maison‐Blanche Pierre , Tavernier René , Jordaens Luc , Leenhardt Antoine , Coumel Philippe 
Published: October 2006

Background: Although well established on the sinus node, the effects of beta‐blockade on ventricular repolarization are still conflicting. The aim of the study was to investigate the effects of a chronic beta‐blockade on sinus node and repolarization parameters and their relationship.Methods: Sixteen healthy volunteers (10 males, mean age: 40 ± 6.7 years) were randomized to placebo or atenolol (100 mg). After 7 days, subjects were crossed over. Heart rate (HR) and HRV indices were calculated from long‐term ECG recordings separately during the day and at night, together with ventricular repolarization parameters (QT interval duration and QT rate‐dependence).Results: Mean R‐R intervals were significantly and consistently increased after atenolol (Day: 916 ± 103 ms vs. 712 ± 89 ms, and Night: 1149 ± 93 vs. 996 ± 125 ms). HRV changes under atenolol were also consistent, with a significant decrease in sympathovagal ratio. In contrast, atenolol only lowered diurnal QT rate‐dependence (0.123 ± 0.032 vs. 0.190 ± 0.065 on placebo, P < 0.001), but not the nocturnal pattern. After multivariate analysis QT rate‐dependence changes induced by atenolol were correlated with pretreatment QT/RR relation (r = 0.65, P < 0.01) but not with any HR or HRV parameters.Conclusions: In healthy subjects, repolarization changes following chronic beta‐blockade cannot be predicted by HR or HRV changes, but are dependent on pretreatment rate‐dependence. A.N.E. 2002;7(4):379–388
Late QRS Activity in Signal‐Averaged Magnetocardiography, Body Surface Potential Mapping, and Orthogonal ECG in Postinfarction Ventricular Tachycardia Patients
Authors: Korhonen Petri , Tierala Ilkka , Simelius Kim , Väänänen Heikki , Mäkijärvi Markku , Nenonen Jukka , Katila Toivo , Toivonen Lauri 
Published: October 2006

Background: Delayed electrical activity necessary for re‐entrant ventricular tachycardia (VT) is detectable noninvasively with high resolution techniques. We compared high resolution signalaveraged analysis of magnetocardiography (MCG), body surface potential mapping (BSPM), and orthogonal three‐lead ECG (SA‐ECG) in the identification of patients prone to VT after myocardial infarction (Ml).Methods: Patients with remote myocardial infarction and cardiac dysfunction were studied, 22 with (VT group) and 22 without VT (control group). MCG with seven channels and BSPM with 63 and SA‐ECG with three orthogonal leads were registered. After signal‐averaging and highpass filtering, three time domain analysis (TDA) parameters describing late electrical activity were computed: QRS duration (QRSd), root mean square amplitude (RMS) of the last 40 ms of QRS, and the duration of the low‐amplitude QRS end (LAS).Results: All parameters by each method were significantly different between the patients’groups. For example, LAS parameter in MCG was 59 (SD 22) ms in the VT group vs. 37 (SD 13) ms in controls (P < 0.001), 77 (SD 22) ms vs. 56 (SD 19) ms in BSPM (P = 0.002), and 60 (SD 24) ms vs. 39 (SD 22) ms in SA‐ECG (P = 0.005). The combination of LAS parameter in MCG and SA‐ECG resulted in improved performance in comparison to any single parameter with 95% sensitivity and 68% specificity.Conclusions: All three high resolution methods identified VT propensity among post‐Mi patients with cardiac dysfunction and between‐method differences were small. Information in MCG and SA‐ECG may be complementary and their combination could be of value in postinfarction arrhythmia risk assessment. A.N.E. 2002;7(4):389–398
Implementation of MADIT and MUSTT in Clinical Practice: Results of an International Survey
Authors: Nisam Seah , Henry Sophie , Wilber David J. 
Published: October 2006

Background: The long‐awaited dramatically positive outcome of the Multicenter Automatic Defi‐brillator Implantation Trial (MADIT II), just published by Moss et al.,14 has generated cardiologists’interest on the implementation into clinical practice of that trial. Important lessons may be learned by examining the clinical implementation of two preceding randomized, prospective, prophylactic ICD trials: the original MADIT trial, published late 1996, and the Multicenter Unsustained Tachycardia Trial (MUSTT), published late 1999. Both demonstrated that implantable cardioverter defi‐brillators reduce all‐cause mortality by over 50% in high risk patients without previous sustained arrhythmias.Methods: In early 2000, we surveyed 133 active electrophysiology centers (47 American, 81 European, 5 Canadian) to determine the extent to which these practices have been implemented in clinical practice during 1999, and the responses were compared to a similar survey for the year 1998.Results: ICDs implanted for MADIT or MUSTT criteria accounted for 18% of new ICD implants in 1999, 65% greater than in 1998, increasing from 6% to 11% in Europe, and from 15% to 24% in America. During 1999, 53% of patients receiving ICDs for these indications were inpatients identified during hospitalization, 27% were outpatients referred specifically for MADIT/MUSTT indications, and 20% were identified by routine screening. Per the survey, in 1999 68% of responders were “somewhat 10–20%)” and 14% were “considerably (>20%)” more likely to implant ICDs for all indications.Conclusions: Extrapolating the results of this survey to all initial ICD implants for 1999, we estimate that 8500 implants for MADIT/MUSTT criteria took place in 1999, with the overall number of such implants substantially increased over the previous year, irrespective of geographic location, and influenced significantly by the publication of MUSTT. However, screening and implant practices between centers continue to vary over a broad spectrum. It will be interesting to observe whether similar patterns will follow with MADIT II. A.N.E. 2002;7(4):399–405
Assessment of the Cardiff nephrectomy cut-up protocol with total blocking of the renal sinus: effect on tumour staging and practical issues
Authors: Soilleux E J , Roberts I S D 
Published: October 2006

Aim:To evaluate the effects on detection of vascular invasion and workload of a new standard dissection protocol for examining nephrectomy specimens for renal cell carcinoma.Methods:Using 192 consecutive renal cell carcinoma nephrectomy specimens, the incidence of vascular invasion and number of tissue blocks per tumour were compared before and after introduction of the new protocol.Results:The Cardiff protocol increased the percentage of tumours staged as T3b (renal sinus or hilar vein invasion) from 37.7% to 55.7% cases (p<0.001), with an increase from 9.1% to 21.7% of those staged as T3b due to renal sinus vein invasion alone (p<0.01). A small, but significant, permanent increase in workload was observed from an average of 11.7 to 13.4 blocks per case (p<0.001).Conclusions:This protocol is suitable for use in routine practice to evaluate pathological prognostic determinants important for clinical management, while causing only a small increase in workload.