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Lacalzada-Almeida J, Izquierdo-Gómez MM, Laynez-Cerdeña I, García-Niebla J, Bruña V, Bayés de Luna A, Martínez-Sellés M. Electrocardiogram and left atrial abnormality: Design of an observational study to clarify diagnostic criteria. Ann Noninvasive Electrocardiol 2020; 25:e12770. [PMID: 32468671 PMCID: PMC7679830 DOI: 10.1111/anec.12770] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/09/2020] [Accepted: 05/09/2020] [Indexed: 01/06/2023] Open
Abstract
Background The criteria applied for diagnosis of left atrial (LA) abnormality using electrocardiogram (ECG) have high specificity but low sensitivity. In fact, some authors have suggested classifying P‐wave anomalies associated with LA abnormality and interatrial block as “atrial abnormalities.” The most widely known ECG criteria for LA abnormality include P‐wave duration, morphology and voltage of P wave in inferior leads, presence of P‐wave terminal force in V1 (PtfV1), and P‐wave axis and area. PtfV1 has also been reported to vary according to misplacement of the V1 and V2 electrodes. Methods The objective of this observational cohort study is to determine the degree of correlation between ECG criteria for LA abnormality and left atrium volume and functionality, as determined by speckle tracking echocardiography. The study also aims to investigate the correlation between these echocardiographic parameters and PtfV1 value by placing the V1 and V2 electrodes in the second, third, and fourth intercostal spaces. Results and Conclusions Our results could help to clarify whether the decrease in left atrial deformity, which is currently considered a surrogate target of fibrosis, correlates better with ECG criteria for LA abnormality than atrial volumes.
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Affiliation(s)
| | | | | | | | - Vanesa Bruña
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, CIBERCV, Madrid, Spain
| | | | - Manuel Martínez-Sellés
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, CIBERCV, Madrid, Spain.,Universidad Europea, Universidad Complutense Madrid, Madrid, Spain
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2
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Lacalzada-Almeida J, Izquierdo-Gómez MM, Sauchelli G, Marí-López B, García-Niebla J, Laynez-Cerdeña I, Martín-Cabeza M. Cardiac Tamponade as an Initial Manifestation of Infective Endocarditis With Rupture of the Aortic Wall. Circ Cardiovasc Imaging 2020; 13:e009860. [PMID: 31910668 DOI: 10.1161/circimaging.119.009860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Juan Lacalzada-Almeida
- Department of Cardiology (J.L.-A., M.M.I.-G., B.M.-L., I.L.-C., M.M.-C.), Hospital Universitario de Canarias, Tenerife, Spain
| | - María Manuela Izquierdo-Gómez
- Department of Cardiology (J.L.-A., M.M.I.-G., B.M.-L., I.L.-C., M.M.-C.), Hospital Universitario de Canarias, Tenerife, Spain
| | - Guadalupe Sauchelli
- Department of Cardiac Surgery (G.S.), Hospital Universitario de Canarias, Tenerife, Spain
| | - Belén Marí-López
- Department of Cardiology (J.L.-A., M.M.I.-G., B.M.-L., I.L.-C., M.M.-C.), Hospital Universitario de Canarias, Tenerife, Spain
| | - Javier García-Niebla
- Valle del Golfo Health Center, Servicio Canario de Salud, El Hierro, Spain (J.G.-N.)
| | - Ignacio Laynez-Cerdeña
- Department of Cardiology (J.L.-A., M.M.I.-G., B.M.-L., I.L.-C., M.M.-C.), Hospital Universitario de Canarias, Tenerife, Spain
| | - Marta Martín-Cabeza
- Department of Cardiology (J.L.-A., M.M.I.-G., B.M.-L., I.L.-C., M.M.-C.), Hospital Universitario de Canarias, Tenerife, Spain
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3
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Lacalzada-Almeida J, Izquierdo-Gómez MM, Marí-López B, García-Niebla J. An unusual case of cardioembolic stroke in a young female. Eur Heart J Case Rep 2019; 3:1-2. [PMID: 31911976 PMCID: PMC6939792 DOI: 10.1093/ehjcr/ytz213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/20/2019] [Accepted: 11/03/2019] [Indexed: 11/24/2022]
Affiliation(s)
| | | | - Belén Marí-López
- Department of Cardiology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, C/Marcos Luis Barrera, 1. 38911 - Frontera, El Hierro, Spain
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4
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García-Niebla J, Crinion D, Gutierrez G, Chacko S, Lacalzada-Almeida J, Baranchuk A. Smartphone electrocardiograms reveal painful left bundle branch block syndrome and illustrate associated electrophysiological phenomena. Europace 2019; 21:1808. [DOI: 10.1093/europace/euz200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, El Hierro, Spain
| | - Derek Crinion
- Arrhythmia Service, Kingston General Hospital, Queen's University, Kingston, ON K7L 2V7, Canada
| | - Gilmar Gutierrez
- Arrhythmia Service, Kingston General Hospital, Queen's University, Kingston, ON K7L 2V7, Canada
| | - Sanoj Chacko
- Arrhythmia Service, Kingston General Hospital, Queen's University, Kingston, ON K7L 2V7, Canada
| | | | - Adrian Baranchuk
- Arrhythmia Service, Kingston General Hospital, Queen's University, Kingston, ON K7L 2V7, Canada
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García-Niebla J, Lacalzada-Almeida J, Díaz-Muñoz J, Barragán-Acea A, Baranchuk A, Martínez-Sellés M. Interatrial block and takotsubo syndrome. Europace 2019; 21:1755-1755. [DOI: 10.1093/europace/euz241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Affiliation(s)
| | - Juan Lacalzada-Almeida
- Cardiac Imaging Laboratory, Department of Cardiology, University Hospital of Canary Islands, Ofra s/n, La Cuesta, 38320, La Laguna, Tenerife, Spain
| | - Jorge Díaz-Muñoz
- Valle del Golfo Health Center, Servicio Canario de Salud, El Hierro, Spain
| | | | - Adrián Baranchuk
- Heart Rhythm Service, Kingston General Hospital, Queen’s University, Kingston, ON, Canada
| | - Manuel Martínez-Sellés
- Department of Cardiology, Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV and Universidad Europea, Universidad Complutense, Madrid, Spain
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6
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Antiperovitch P, Bayés de Luna A, Nunes de Alencar J, García-Niebla J, Escobar-Robledo LA, Restrepo DW, Aristizabal D, Massó van Roessel A, Bayés-Genís A, Baranchuk A. Old teaching tools should not be forgotten: The value of the Lewis ladder diagram in understanding bigeminal rhythms. Ann Noninvasive Electrocardiol 2019; 24:e12685. [PMID: 31490594 DOI: 10.1111/anec.12685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 07/07/2019] [Accepted: 07/08/2019] [Indexed: 11/29/2022] Open
Abstract
As medical education evolves, some traditional teaching methods often get forgotten. For generations, the Lewis ladder diagram (LLD) has helped students understand the mechanisms of cardiac arrhythmias and conduction disorders. Similarly, clinicians have used LLDs to communicate their proposed mechanisms to their colleagues and trainees. In this article, we revisit this technique of constructing the LLD and demonstrate this process by describing the mechanisms of various bigeminal rhythms.
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Affiliation(s)
- Pavel Antiperovitch
- Division of Cardiology, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
| | - Antoni Bayés de Luna
- Cardiovascular Research Foundation, Cardiovascular ICCC- Program, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | | | | | - Luis Alberto Escobar-Robledo
- Cardiovascular Research Foundation, Cardiovascular ICCC- Program, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Danilo Weir Restrepo
- Cardiovascular Research Foundation, Cardiovascular ICCC- Program, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - David Aristizabal
- Cardiovascular Research Foundation, Cardiovascular ICCC- Program, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Albert Massó van Roessel
- Cardiovascular Research Foundation, Cardiovascular ICCC- Program, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Antoni Bayés-Genís
- Heart Institute, Hospital Universitari Germans Trias I Pujol, Badalona, Spain.,Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Adrián Baranchuk
- Division of Cardiology, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
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7
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García-Niebla J, Díaz-Muñoz J, Hernández Betancor I, Lacalzada-Almeida J. Baseline artefacts: a factor to take into account when ST segment elevation is observed. Emergencias 2019; 30:441-442. [PMID: 30638355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Javier García-Niebla
- Centro de salud Valle del Golfo, Área de Salud de El Hierro, Islas Canarias, España
| | - Jorge Díaz-Muñoz
- Centro de salud Valle del Golfo, Área de Salud de El Hierro, Islas Canarias, España
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Báez-Ferrer N, Izquierdo-Gómez MM, Beyello-Belkasem C, Jorge-Pérez P, García-González MJ, Ferrer-Hita JJ, De la Rosa-Hernández A, García-Niebla J, Lacalzada-Almeida J. Long-Term Radiotherapy-Induced Cardiac Complications: A Case Report. Am J Case Rep 2019; 20:1182-1188. [PMID: 31401643 PMCID: PMC6753667 DOI: 10.12659/ajcr.917224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Patient: Male, 48 Final Diagnosis: Late cardiac complications postradiotherapy Symptoms: Chest pain • dyspnea • syncope Medication: — Clinical Procedure: Diagnostic and therapeutic techniques in cardiology Specialty: Cardiology
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Affiliation(s)
- Néstor Báez-Ferrer
- Department of Cardiology, University Hospital of the Canary Islands, Tenerife, Spain
| | | | | | - Pablo Jorge-Pérez
- Department of Cardiology, University Hospital of the Canary Islands, Tenerife, Spain
| | | | - Julio J Ferrer-Hita
- Department of Cardiology, University Hospital of the Canary Islands, Tenerife, Spain
| | | | - Javier García-Niebla
- Department of Cardiology, University Hospital of the Canary Islands, Tenerife, Spain
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9
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de Luna AB, Platonov PG, García-Niebla J, Baranchuk A. Atypical advanced interatrial block or junctional rhythm? J Electrocardiol 2019; 54:85-86. [PMID: 30953789 DOI: 10.1016/j.jelectrocard.2019.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 03/25/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Antoni Bayés de Luna
- Cardiovascular Research Foundation, Cardiovascular ICCC-Program, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.
| | - Pyotr G Platonov
- Department of Cardiology, Clinical Sciences, Lund University, Sweden
| | - Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, El Hierro, Spain
| | - Adrian Baranchuk
- Heart Rhythm Service, Kingston Hospital, Kingston, Ontario, Canada
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10
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Pérez-Riera AR, Barbosa-Barros R, Daminello-Raimundo R, de Abreu LC, García-Niebla J, de Deus Morais MJ, Nikus K, Marcus FI. Epsilon wave: A review of historical aspects. Indian Pacing Electrophysiol J 2019; 19:63-67. [PMID: 30796961 PMCID: PMC6450822 DOI: 10.1016/j.ipej.2019.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 02/18/2019] [Indexed: 11/28/2022] Open
Abstract
The epsilon wave of the electrocardiogram (ECG) together with fragmented QRS (fQRS), the terminal conduction delay, incomplete right bundle branch block (IRBBB) and complete/advanced RBBB (CRBBB) of peripheral origin are part of a spectrum of ventricular depolarization abnormalities of arrhythmogenic cardiomyopathy(AC). Although the epsilon wave is considered a major diagnostic criterion for AC since 2010 (AC Task Force Criteria), its diagnostic value is limited because it is a sign of the later stage of the disease. It would be more appropriate to say that the epsilon wave is a “hallmark” of AC, but is of low diagnostic sensitivity. Although the epsilon wave has high specificity for AC, it can be present in other pathological conditions. In this update we will cover the nomenclature, association with disease states and electrocardiographic aspects of the epsilon wave.
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Affiliation(s)
- Andrés Ricardo Pérez-Riera
- Laboratório de Pesquisa e Escrita Científica da Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil.
| | - Raimundo Barbosa-Barros
- Coronary Center of the Messejana Hospital Dr. Carlos Alberto Studart Gomes, Fortaleza, Ceará, Brazil
| | - Rodrigo Daminello-Raimundo
- Laboratório de Pesquisa e Escrita Científica da Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Luiz Carlos de Abreu
- Laboratório de Pesquisa e Escrita Científica da Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, Spain
| | - Mauro José de Deus Morais
- Laboratório de Pesquisa e Escrita Científica da Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; Centro de Ciências da Saúde e Desporto, Universidade Federal do Acre, Rio Branco, Acre, Brazil
| | - Kjell Nikus
- Heart Center, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Finland
| | - Frank I Marcus
- Sarver Heart Center, The University of Arizona Health Sciences Hospital, Tucson, AZ, USA
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11
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Miranda-Bacallado J, Izquierdo-Gómez MM, García-Niebla J, Jiménez JJ, Iribarren JL, Laynez-Cerdeña I, Lacalzada-Almeida J. Role of echocardiography in a patient with suspected acute pulmonary embolism: a case report. J Med Case Rep 2019; 13:37. [PMID: 30777120 PMCID: PMC6379930 DOI: 10.1186/s13256-019-1994-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 01/23/2019] [Indexed: 11/25/2022] Open
Abstract
Background Approximately half of pulmonary embolism cases are diagnosed in an emergency context. The classic symptoms of pulmonary embolism are absent in intensive care unit patients who are under sedation and on mechanical ventilation. In this scenario, after the development of sudden, severe hypotension, pulmonary embolism must be considered and included in a differential diagnosis according to the cause of admission. Echocardiography may be of further help in a differential diagnosis of the cause of shock. Case presentation We present a case of a 44-year-old Caucasian man who was admitted to the intensive care unit with a diagnosis of community-acquired pneumonia and respiratory failure and who required invasive mechanical ventilation. During admission, the patient developed sudden, severe hypotension that was refractory to treatment. An adequate diagnosis with transthoracic echocardiography was unachievable because of a poor echocardiographic window. However, the combined use of electrocardiography and transesophageal echocardiography established pulmonary embolism as a high-probability diagnosis based on findings of right ventricular pressure overload and right ventricular dysfunction. The unfavorable hemodynamic situation of the patient prevented his transfer to carry out other complementary tests that could confirm the diagnosis of pulmonary embolism. Fibrinolytic and anticoagulant therapies were administered immediately, and a favorable clinical outcome was achieved. Conclusion This case highlights the fundamental role that echocardiography played in a patient in the intensive care unit who presented with shock secondary to pulmonary embolism with an unfavorable hemodynamic situation and in whom an unnecessary transfer to perform other complementary diagnostic tests was avoided. The combined use of electrocardiography and echocardiography provided a complete differential diagnosis, identifying the cause of shock and allowing the initiation of specific treatment without further delay. Knowledge of the echocardiographic results that are characteristic of pulmonary embolism can aid in the diagnosis. Electronic supplementary material The online version of this article (10.1186/s13256-019-1994-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julio Miranda-Bacallado
- Cardiac Imaging Laboratory, Department of Cardiology, Hospital Universitario de Canarias, Ofra s/n, La Cuesta, 38320, La Laguna, Tenerife, Spain
| | - María Manuela Izquierdo-Gómez
- Cardiac Imaging Laboratory, Department of Cardiology, Hospital Universitario de Canarias, Ofra s/n, La Cuesta, 38320, La Laguna, Tenerife, Spain
| | - Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, El Hierro, Spain
| | - Juan José Jiménez
- Department of Critical Care, Hospital Universitario de Canarias, Tenerife, Spain
| | - José Luis Iribarren
- Department of Critical Care, Hospital Universitario de Canarias, Tenerife, Spain
| | - Ignacio Laynez-Cerdeña
- Cardiac Imaging Laboratory, Department of Cardiology, Hospital Universitario de Canarias, Ofra s/n, La Cuesta, 38320, La Laguna, Tenerife, Spain
| | - Juan Lacalzada-Almeida
- Cardiac Imaging Laboratory, Department of Cardiology, Hospital Universitario de Canarias, Ofra s/n, La Cuesta, 38320, La Laguna, Tenerife, Spain.
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12
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Lacalzada-Almeida J, Izquierdo-Gómez MM, García-Niebla J, Elosua R, Jiménez-Sosa A, Baranchuk A, Bayes de Luna A. Advanced interatrial block is a surrogate for left atrial strain reduction which predicts atrial fibrillation and stroke. Ann Noninvasive Electrocardiol 2019; 24:e12632. [PMID: 30719798 DOI: 10.1111/anec.12632] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 12/28/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The association between advanced interatrial block (aIAB) and atrial fibrillation (AF) is known as "Bayes' Syndrome." There is little information on the prognostic role that new speckle tracking echocardiographic (STE) imaging techniques could play in it. We have examined the relationship between left atrial (LA) STE and the prediction of new-onset AF and/or stroke in IAB patients. METHODS This is an observational prospective and unicentric cohort study with 98 outpatients: 55 (56.2%) controls with normal ECG without IAB, 21 (21.4%) with partial IAB (pIAB) and 22 (22.4%) with aIAB. The end point was new-onset AF, ischemic stroke and the composite of both. RESULTS During a mean follow-up of 1.9 (1.7-2.3) years, 20 patients presented the end point (18 new-onset AF and two strokes): 8 (14.5%) in the control group, 3 (14.3%) in pIAB and 9 (40.9%) in aIAB, p = 0.03. In multivariable comprehensive Cox regression analyses, a decrease in absolute value of strain rate during the booster pump function phase (SRa) was the only variable independently related to the appearance in the evolution of the end point, in the first model (age, P-wave duration and SRa): HR 19.9 (95% CI, 3.12-127.5), p = 0.002 and in the second (age, presence of aIAB and SRa): HR 24.2 (95% CI, 3.15-185.4), p = 0.002. CONCLUSIONS In patients with IAB, a decrease in absolute value of LA SRa with STE predicts new-onset AF and ischemic stroke. Future studies should confirm our results and assess the prognostic usefulness of LA STE in patients with IAB.
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Affiliation(s)
| | | | - Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, El Hierro, Spain
| | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain.,Facultad de Medicina, CIBER Cardiovascular Diseases (CIBERCV), Universidad de Vic-Central de Cataluña, Vic, Spain
| | - Alejandro Jiménez-Sosa
- Research Unit, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | - Adrian Baranchuk
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Antonio Bayes de Luna
- Fundación Investigación Cardiovascular, Institut Català Ciències Cardiovasculars, Barcelona, Catalonia, Spain
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13
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Affiliation(s)
| | | | | | - Adrian Baranchuk
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Antonio Bayés de Luna
- Fundación Investigación Cardiovascular, Institut Català Ciències Cardiovasculars, Barcelona, Catalonia, Spain
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14
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Báez-Ferrer N, Izquierdo-Gómez MM, Marí-López B, Montoto-López J, Duque-Gómez A, García-Niebla J, Miranda-Bacallado J, de la Rosa Hernández A, Laynez-Cerdeña I, Lacalzada-Almeida J. Clinical manifestations, diagnosis, and treatment of ischemic mitral regurgitation: a review. J Thorac Dis 2018; 10:6969-6986. [PMID: 30746243 DOI: 10.21037/jtd.2018.10.64] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Ischemic mitral regurgitation (IMR) is a frequent complication after acute myocardial infarction (AMI) associated with a worse prognosis. The pathophysiological mechanisms of IMR are not fully understood, but it is known to be a complex process in which ventricular remodelling is the main causal factor. The various imaging techniques in cardiology and echocardiography fundamentally have contributed significantly to clarify the mechanisms that cause and progressively aggravate IMR. At present, different therapeutic options, the most important of which are cardio-surgical, address this problem. Nowadays the improvement in cardiac surgery and transcatheter therapies, have shown a therapeutic advance in IMR management. IMR is a predictor of poor prognosis in patients with heart failure and depressed left ventricular (LV) systolic function. However, it remains controversial whether mitral regurgitation (MR) in these patients is a consequence of dilation and dysfunction of the LV, or whether it contributes to worsening the prognosis of the ventricular dysfunction. Given that echocardiography has a fundamental reference role in the identification, graduation of severity and evaluation of the therapeutics used in the treatment of MR, we are going to focus on it over the rest of the imaging techniques. In contrast to primary MR the benefits of mitral surgery in patients with secondary MR are uncertain. Therefore, we will comment fundamentally on the role of mitral surgery in patients with IMR, with an update of the different surgical interventions available, without forgetting to mention the other therapeutic options currently available.
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Affiliation(s)
- Néstor Báez-Ferrer
- Department of Cardiology, Hospital Universitario de Canarias, Tenerife, Spain
| | | | - Belén Marí-López
- Department of Cardiology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Javier Montoto-López
- Department of Cardiovascular Surgery, Hospital Universitario de Canarias, Tenerife, Spain
| | - Amelia Duque-Gómez
- Department of Cardiology, Hospital Universitario de Canarias, Tenerife, Spain
| | - Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, El Hierro, Spain
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15
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García-Niebla J, Pérez-Riera AR, Barbosa-Barros R, Díaz-Muñoz J, Daminello-Raimundo R, de Abreu LC, Nikus K. Acute inferior myocardial infarction with right ventricular involvement and several clinical-electrocardiographic markers of poor prognosis. Ann Noninvasive Electrocardiol 2018; 24:e12592. [PMID: 30106201 DOI: 10.1111/anec.12592] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 07/13/2018] [Indexed: 12/01/2022] Open
Abstract
Right ventricular involvement in inferior myocardial infarction is a marker of poor prognosis. We present a case of a 62-year-old man with very recent onset of acute chest pain and cardiac shock with the triad of elevated jugular venous pressure, distension of the jugular veins on inspiration, and clear lung fields. In addition, the admission electrocardiogram showed a slurring J wave or lambda-like wave and conspicuous ST segment depression in several leads, predominantly in the lateral precordial (V4-V6), all clinical-electrocardiographic features of ominous prognosis.
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Affiliation(s)
- Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, Spain
| | - Andrés Ricardo Pérez-Riera
- Design of Studies and Scientific Writing Laboratory in the ABC School of Medicine, Santo André, São Paulo, Brazil
| | - Raimundo Barbosa-Barros
- Coronary Center of the Messejana Hospital Dr. Carlos Alberto Studart Gomes, Fortaleza, Ceará, Brazil
| | - Jorge Díaz-Muñoz
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, Spain
| | - Rodrigo Daminello-Raimundo
- Design of Studies and Scientific Writing Laboratory in the ABC School of Medicine, Santo André, São Paulo, Brazil
| | - Luiz Carlos de Abreu
- Design of Studies and Scientific Writing Laboratory in the ABC School of Medicine, Santo André, São Paulo, Brazil
| | - Kjell Nikus
- Heart Center, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
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Affiliation(s)
- Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, Spain
| | - Antonio Bayés de Luna
- Institut Catala d'Ciencies Cardiovasculars, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | - Adrian Baranchuk
- Division of Cardiology, Queen's University, Kingston, Ontario, Canada
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Longo D, López C, García-Niebla J. Ventricular tachycardia or artifact? J Thorac Dis 2018; 10:2046-2047. [DOI: 10.21037/jtd.2018.02.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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18
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Lacalzada-Almeida J, De la Rosa-Hernández A, Izquierdo-Gómez MM, García-Niebla J, Hernández-Betancor I, Bonilla-Arjona JA, Barragán-Acea A, Laynez-Cerdeña I. Compression of the right coronary artery by an aortic pseudoaneurysm after infective endocarditis: an unusual case of myocardial ischemia. Clin Interv Aging 2017; 13:9-11. [PMID: 29317805 PMCID: PMC5743124 DOI: 10.2147/cia.s144840] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A 61-year-old male with a prosthetic St Jude aortic valve size 24 presented with heart failure symptoms and minimal-effort angina. Eleven months earlier, the patient had undergone cardiac surgery because of an aortic root dilatation and bicuspid aortic valve with severe regurgitation secondary to infectious endocarditis by Coxiela burnetii and coronary artery disease in the left circumflex coronary artery. Then, a prosthesis valve and a saphenous bypass graft to the left circumflex coronary artery were placed. The patient was admitted to the Cardiology Department of Hospital Universitario de Canarias, Tenerife, Spain and a transthoracic echocardiography was performed that showed severe paraprosthetic aortic regurgitation and an aortic pseudoaneurysm. The 64-slice multidetector computed tomography confirmed the pseudoaneurysm, originating from the right sinus of Valsalva, with a compression of the native right coronary artery and a normal saphenous bypass graft. On the basis of these findings, we performed surgical treatment with a favorable postoperative evolution. In our case, results from complementary cardiac imaging techniques were crucial for patient management. The multidetector computed tomography allowed for a confident diagnosis of an unusual mechanism of coronary ischemia.
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Affiliation(s)
| | | | | | - Javier García-Niebla
- Health services from the Health Area of El Hierro, Valle del Golfo Health Center, El Hierro
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Longo D, Poliserpi C, Toscano Quilon F, Díaz Uberti P, López C, García-Niebla J, Ramella I. Diagnostical mistakes in ablation procedures associated with a high placement of the leads V1–V3. J Electrocardiol 2017; 50:433-436. [DOI: 10.1016/j.jelectrocard.2017.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Indexed: 10/20/2022]
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21
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Hernandez-Betancor I, Izquierdo-Gómez MM, García-Niebla J, Laynez-Cerdeña I, García-González MJ, Irribarren-Sarriá JL, Jimenez-Rivera JJ, Lacalzada-Almeida J. Bayes Syndrome and Imaging Techniques. Curr Cardiol Rev 2017; 13:263-273. [PMID: 28707575 PMCID: PMC5730959 DOI: 10.2174/1573403x13666170713122600] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 06/23/2017] [Accepted: 07/03/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Interatrial block (IAB) is due to disruption in the Bachmann region (BR). According to whether interatrial electrical conduction is delayed or completely blocked through the BR, it can be classified as IAB of first, second or third degree. On the surface electrocardiogram, a P wave ≥ 120 ms (partial IAB) is observed or associated to the prolongation of the P wave with a biphasic (positive / negative) morphology in the inferior leads (advanced IAB). Bayes syndrome is defined as an advanced IAB associated with atrial arrhythmia, more specifically atrial fibrillation. Objective and Conclusion: The purpose of this review is to describe the latest evidence about an entity considered an anatomical and electrical substrate with its own name, which may be a predictor of supraventricular arrhythmia and cardioembolic cerebrovascular accidents, as well as the role of new imaging techniques, such as echocardiographic strain and cardiac magnetic resonance imaging, in characterizing atrial alterations associated with this syndrome and generally in the study of anatomy and atrial function.
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Affiliation(s)
- Iván Hernandez-Betancor
- Departamento de Cardiología, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, España
| | | | - Javier García-Niebla
- Centro de Salud Valle del Golfo, Servicios Sanitarios del Área de Salud de El Hierro, Frontera-El Hierro, Santa Cruz de Tenerife, Tenerife, España
| | - Ignacio Laynez-Cerdeña
- Departamento de Cardiología, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, España
| | | | - Barragan-Acea
- Departamento de Cardiología, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, España
- Centro de Salud Valle del Golfo, Servicios Sanitarios del Área de Salud de El Hierro, Frontera-El Hierro, Santa Cruz de Tenerife, Tenerife, España
- Departamento de Unidad de Cuidados Intensivos, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, España
| | - A.
- Departamento de Cardiología, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, España
| | - Jose Luis Irribarren-Sarriá
- Departamento de Unidad de Cuidados Intensivos, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, España
| | - Juan José Jimenez-Rivera
- Departamento de Unidad de Cuidados Intensivos, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, España
| | - Juan Lacalzada-Almeida
- Departamento de Cardiología, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, España
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García-Niebla J, Fiol M, Carrillo-López A, Bayés de Luna A. Electrocardiographic Diagnosis of Right Ventricular Infarction by Proximal Occlusion of a Very Dominant Right Coronary Artery. Am J Med 2016; 129:e41-2. [PMID: 27215998 DOI: 10.1016/j.amjmed.2015.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 09/14/2015] [Accepted: 09/14/2015] [Indexed: 10/21/2022]
Affiliation(s)
- Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, Spain
| | - Miguel Fiol
- Hospital Universitario Son Espases, Unidad Coronaria, Palma de Mallorca, Spain
| | | | - Antonio Bayés de Luna
- Institut Catalá d'Ciències Cardiovasculars, Hospital Santa Creu i Sant Pau, Barcelona, Spain
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García-Niebla J, Baranchuk A, Bayés de Luna A. Epsilon Wave in the 12-Lead Electrocardiogram: Is Its Frequency Underestimated? Rev Esp Cardiol (Engl Ed) 2016; 69:438. [PMID: 26705958 DOI: 10.1016/j.rec.2015.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 09/10/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Javier García-Niebla
- Centro de Salud Valle del Golfo, Servicios Sanitarios del Área de Salud de El Hierro, Frontera-El Hierro, Sta. Cruz de Tenerife, Spain.
| | - Adrián Baranchuk
- Heart Rhythm Service, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada
| | - Antonio Bayés de Luna
- Institut Catala de Ciencies Cardiovasculars, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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Fiol Sala M, Bayés de Luna A, Carrillo López A, García-Niebla J. The "De Winter Pattern" Can Progress to ST-segment Elevation Acute Coronary Syndrome. ACTA ACUST UNITED AC 2015; 68:1042-3. [PMID: 26410027 DOI: 10.1016/j.rec.2015.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 07/10/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Miquel Fiol Sala
- Instituto de Investigación Sanitaria de Palma (IdISPa), Palma de Mallorca, Islas Baleares, Spain
| | - Antonio Bayés de Luna
- Institut Català de Ciencies Cardiovasculars, Hospital Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Centro de Salud Valle del Golfo, Frontera, Sta. Cruz de Tenerife, Spain.
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García-Niebla J, Díaz-Muñoz J, Fiol M, Bayés de Luna A. It Is Important to Distinguish Between Ischemia-induced ST Elevation and That Caused by Early Repolarization. Am J Med 2015; 128:e33-4. [PMID: 26319665 DOI: 10.1016/j.amjmed.2015.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 01/20/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, Spain
| | - Jorge Díaz-Muñoz
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, Spain
| | - Miguel Fiol
- Hospital Universitario Son Espases, Unidad Coronaria, Palma de Mallorca, Spain
| | - Antonio Bayés de Luna
- Institut Catala d'Ciencies Cardiovasculars, Hospital Santa Creu i Sant Pau, Barcelona, Spain
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26
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García-Niebla J, Baranchuk A, Bayés de Luna A. Measuring the base of the triangle is a useful tool to differentiate between electrocardiographic patterns of healthy athletes and Brugada syndrome. Am J Cardiol 2015; 115:1001. [PMID: 25665764 DOI: 10.1016/j.amjcard.2015.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 01/09/2015] [Indexed: 10/24/2022]
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27
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Díaz-Muñoz J, García-Niebla J. Patrón de Brugada desenmascarado por flecainida oral en una paciente con historia de taquiarritmia supraventricular. Semergen 2015; 41:54-6. [DOI: 10.1016/j.semerg.2014.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 12/30/2013] [Accepted: 01/06/2014] [Indexed: 10/25/2022]
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28
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Baranchuk A, Enriquez A, García-Niebla J, Bayés-Genís A, Villuendas R, Bayés de Luna A. Differential diagnosis of rSr' pattern in leads V1 -V2. Comprehensive review and proposed algorithm. Ann Noninvasive Electrocardiol 2014; 20:7-17. [PMID: 25546557 DOI: 10.1111/anec.12241] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
One of the more frequent dilemmas in ECG interpretation is the differential diagnosis of an rSr' pattern in leads V1 -V2 . We often face this finding in asymptomatic and otherwise healthy individuals and the causes may vary from benign nonpathological variants to severe or life-threatening heart diseases, such as Brugada syndrome or arrhythmogenic right ventricular dysplasia. In other cases, a normal variant of rSr' pattern can be misinterpreted as pathological after the occurrence of certain clinical events such as cardiac arrest or syncope of unknown cause. In this review we analyze in detail all the possible conditions, both benign and pathological that may explain the presence of this electrocardiographic pattern. We also propose a simple electrocardiographic algorithm for differential diagnosis.
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Affiliation(s)
- Adrian Baranchuk
- Division of Cardiology, Queen's University, Kingston, Ontario, Canada
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29
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Affiliation(s)
- Javier García-Niebla
- Servicios Sanitarios del Área de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, Spain.
| | - Adrián Baranchuk
- Division of Cardiology, Electrophysiology and Pacing, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada
| | - Antonio Bayés de Luna
- Institut Catala d'Ciencies Cardiovasculars, Hospital Santa Creu i Sant Pau, Barcelona, Spain
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30
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Noris M, Carrillo A, Campuzano O, Santaella A, Brugada R, García-Niebla J, Fiol M. Syncope and polymorphic ventricular tachycardia in the setting of a febrile illness. J Electrocardiol 2013; 46:666-9. [PMID: 23522323 DOI: 10.1016/j.jelectrocard.2013.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Indexed: 10/27/2022]
Abstract
An asymptomatic woman with no clinical history consulted for pneumonia-induced fever; she then presented episodes of syncope due to polymorphic ventricular tachycardia and ECG alterations compatible with Brugada syndrome. Genetic studies showed no alterations in the SCN5A gene but other polymorphisms were observed. Further genetic studies are required to elucidate the pathophysiological mechanisms of fever and the function of sodium channels.
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Affiliation(s)
- Marta Noris
- Hospital Universitario Son Espases. Unidad Coronaria. Palma de Mallorca, España
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31
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Fiol M, Carrillo A, Rodriguez A, Herrero J, García-Niebla J. Left ventricular ballooning syndrome due to vasospasm of the middle portion of the left anterior descending coronary artery. Cardiol J 2012; 19:314-6. [PMID: 22641552 DOI: 10.5603/cj.2012.0055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
We report a case that shows vasospasm to be one of the mechanisms responsible for left ventricular ballooning syndrome. Our case suggests that identical ventriculographic findings in patients with tako-tsubo syndrome and those with coronary vasospasm of a long left anterior descending artery coronary artery may be due to a common etiology.
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Affiliation(s)
- Miguel Fiol
- Hospital Son Espases, Palma de Mallorca, Spain.
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32
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García-Niebla J, Rodríguez-Morales M, Valle-Racero JI, de Luna AB. Negative P wave in V1 is the key to identifying high placement of V1-V2 electrodes in nonpathological subjects. Am J Med 2012; 125:e9-10; author reply e13. [PMID: 22938933 DOI: 10.1016/j.amjmed.2011.12.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 12/03/2011] [Accepted: 12/05/2011] [Indexed: 10/27/2022]
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García-Niebla J, Serra-Autonell G, Bayés de Luna A. Brugada syndrome electrocardiographic pattern as a result of improper application of a high pass filter. Am J Cardiol 2012; 110:318-20. [PMID: 22732021 DOI: 10.1016/j.amjcard.2012.04.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2012] [Revised: 04/26/2012] [Accepted: 04/27/2012] [Indexed: 12/20/2022]
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34
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Carrillo A, Fiol M, García-Niebla J, de Luna AB. Electrocardiographic Differential Diagnosis Between Takotsubo Syndrome and Distal Occlusion of LAD Is Not Easy. J Am Coll Cardiol 2010; 56:1610-1; author reply 1611. [DOI: 10.1016/j.jacc.2010.07.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Accepted: 07/06/2010] [Indexed: 10/18/2022]
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García-Niebla J, Serra-Autonel G, de Luna AB. Certain things to bear in mind when recording electrocardiograms in subjects with early repolarization. Am J Cardiol 2010; 105:1202-3. [PMID: 20381678 DOI: 10.1016/j.amjcard.2009.12.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Revised: 12/20/2009] [Accepted: 12/20/2009] [Indexed: 11/17/2022]
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García-Niebla J, Luna ABD, Baranchuk A. High degree atrio-ventricular block: what is the mechanism? Cardiol J 2010; 17:198-199. [PMID: 20544624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Affiliation(s)
- Javier García-Niebla
- Servicios Sanitarios del Area de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, Spain.
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García-Niebla J, Llontop-García P, Valle-Racero JI, Serra-Autonell G, Batchvarov VN, de Luna AB. Technical mistakes during the acquisition of the electrocardiogram. Ann Noninvasive Electrocardiol 2009; 14:389-403. [PMID: 19804517 PMCID: PMC6932211 DOI: 10.1111/j.1542-474x.2009.00328.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In addition to knowledge of normal and pathological patterns, the correct interpretation of electrocardiographic (ECG) recordings requires the use of acquisition procedures according to approved standards. Most manuals on standard electrocardiography devote little attention to inadequate ECG recordings. In this article, we present the most frequent ECG patterns resulting from errors in limb and precordial lead placement, artifacts in 12-lead ECG as well as inadequate filter application; we also review alternative systems to the standard ECG, which may help minimize errors.
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Affiliation(s)
- Javier García-Niebla
- Servicios Sanitarios del Area de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, Spain.
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Abstract
Some technical aspects in the ECG recording, although basic, are not well enough known. In this short communication we present two examples in which the low-pass filter attenuates or eliminates electrocardiographic signals which are important from the clinical point of view.
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Affiliation(s)
- Javier García-Niebla
- Servicios Sanitarios del Area de Salud de El Hierro, Valle del Golfo Health Center, Islas Canarias, España.
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Sclarovsky S, García-Niebla J. Current role of electrocardiography in acute ischemic syndromes: is it an outdated technique? Rev Esp Cardiol 2009; 62:456-459. [PMID: 19401136 DOI: 10.1016/s1885-5857(09)71678-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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41
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Sclarovsky S, García-Niebla J. Papel actual del ECG en los síndromes isquémicos agudos: ¿una herramienta anticuada? Rev Esp Cardiol (Engl Ed) 2009. [DOI: 10.1016/s0300-8932(09)70908-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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42
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García-Niebla J. Morphologies suggestive of V1 and V2 lead misplacement. Rev Esp Cardiol 2008; 61:1109-1110. [PMID: 18817693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Abstract
Accidental interchange between precordial and limb leads, although unusual, can be possible given that some of them share the same color. We present the case where interchange of V(2) and left arm cables produced significant electrocardiographic abnormalities, which created many doubts and discussion within the clinical team.
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