Circulation and Electrocardiogram - Cardiovascular Update

New Studies: AI Captures Electrocardiogram Patterns That Could Signal a Future Sudden Cardiac Arrest

DAIC

MARCH 1, 2024

In a study published in Communications Medicine , David Ouyang, MD, assistant professor of Cardiology and Medicine at Cedars-Sinai, along with Chugh and fellow investigators trained a deep learning algorithm to study patterns in electrocardiograms, also known as ECGs, which are recordings of the heart’s electrical activity.

Cardiac Arrest

Cardiac Arrest Electrocardiogram Defibrillator Electrophysiology

The Electrocardiogram at 100 Years: History and Future

Circulation

FEBRUARY 4, 2024

Circulation, Volume 149, Issue 6 , Page 411-413, February 6, 2024.

Electrocardiogram

Electrocardiogram Circulation

Abstract 4142589: GLP-1 receptor agonists slow the progression of subclinical cardiovascular risk as detected from 12-lead electrocardiograms

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4142589-A4142589, November 12, 2024. However, it is unclear whether early subclinical therapeutic changes can be detected from routine 12-lead electrocardiograms (ECGs).Methods:We

Electrocardiogram

Electrocardiogram BMI Myocardial Infarction Obesity

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Bridging Innovation & Patient Care: The Growing Role of AI

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Abstract 4136784: Diagnostic significance and prognosis prediction of electrocardiogram plane QRS-T angle in patients with non-ST segment elevation acute coronary syndrome

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4136784-A4136784, November 12, 2024. Objective:For patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS), the diagnostic efficacy of traditional ECG is not sensitive and specific.

Electrocardiogram

Electrocardiogram Chest Pain Circulation Hospital

6 Cardiology Board Review Questions That Will Help You Pass the Boards

BoardVitals - Cardiovascular

JUNE 14, 2017

Question banks are a favorite exam preparation resource for Cardiologists that want to practice in the format of the exam.

Congenital Heart Disease

Congenital Heart Disease Coronary Angiogram Coronary Artery Disease Cardiovascular Disease

Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

MIBHS

OCTOBER 31, 2024

Electrocardiogram (ECG/EKG) An ECG records the electrical activity of the heart and can help detect abnormalities in the heart’s rhythm that might contribute to enlargement. Regular physical activity can strengthen the heart and improve circulation. Avoid smoking and limit alcohol intake.

Blood Pressure

Blood Pressure Blood Clot Heart Valves Heart Rhythm

Comparing Phenotypes for Acute and Long-Term Response to Atrial Fibrillation Ablation Using Machine Learning

Circulation: Arrhythmia and Electrophysiology

FEBRUARY 10, 2025

Circulation: Arrhythmia and Electrophysiology, Ahead of Print. BACKGROUND:It is difficult to identify patients with atrial fibrillation (AF) most likely to respond to ablation. We compared 6 machine learning models to predict acute and long-term end points after ablation and used Shapley explainability analysis to contrast phenotypes.

Atrial Fibrillation

Atrial Fibrillation Ablation Physiology Arrhythmia

Abstract 4146680: Detecting Atrial and Ventricular Ectopy from the Apple Watch with an novel Deep Learning algorithm

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4146680-A4146680, November 12, 2024. Introduction:Personal electrocardiogram (ECG) devices have significant potential for monitoring abnormal heart rhythms outside clinical environments.

Atrial Fibrillation

Atrial Fibrillation Electrocardiogram Heart Rhythm Circulation

Bizarre (Hyperacute??) T-waves

Dr. Smith's ECG Blog

JANUARY 30, 2018

Electromechanical association: a subtle electrocardiogram artifact. Incredibly , this case was just published in Circulation on January 22, 2018 (thanks to Brooks Walsh for finding this!) link] Circulation. link] Circulation. Journal of Electrocardiology. 2012;45(1):15-17. doi:10.1016/j.jelectrocard.2010.12.162.

Article

Article Nursing RN Circulation

Abstract 4145609: The Cardiac Conundrum of Cannabis: A Case of Junctional Bradycardia Triggered by Cannabis Use

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4145609-A4145609, November 12, 2024. Electrocardiogram (ECG) and telemetry revealed junctional bradycardia with heart rate in 30s and sinus pauses (5-7 seconds). Introduction:Cannabis has been increasingly used as a recreational drug. He was euvolemic on physical exam.

Bradycardia

Bradycardia Coronary Artery Disease Kidney Disease Outpatient

Abstract 4139536: Incidence of Severe QT Prolongation and the Assoicated Risk of Ventricular Arrhythmias and Sudden Cardiac Death in Patients Taking Antipsychotics or Antidepressants

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4139536-A4139536, November 12, 2024. Background:Limited data exist on the incidence of severe QT prolongation (SQTP) in patients using antipsychotics or antidepressants and the associated risk of ventricular arrhythmias (VA) and sudden cardiac death (SCD).Aims:This ms and +6.7 ± 36.1

Sudden Cardiac Death

Sudden Cardiac Death Arrhythmia Risk Factors Electrocardiogram

Hypertropic Cardiomyopathy: A Board Review Question Explained By Video

BoardVitals - Cardiovascular

MAY 1, 2017

Explanation: Shown electrocardiogram suggests left ventricular hypertrophy. Shown electrocardiogram suggests left ventricular hypertrophy. Circulation. Start aspirin and Plavix Correct answer: (B) (B) Echocardiogram is indicated. Hypertrophic cardiomyopathy is one of them. Characteristic murmur should not be missed.

Cardiomyopathy

Cardiomyopathy Sudden Cardiac Death Bicuspid/Mitral Electrocardiogram

Abstract 4141052: Rare Combo: An Unusual Case of a 54-year-old Filipino with Coronary Artery Fistula from Left Anterior Descending Artery to Main Pulmonary Artery and Acute Cerebellar Infarct: A Cardio – Cerebral Infarction Syndrome - Case Report

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4141052-A4141052, November 12, 2024. Laboratory tests showed markedly elevated troponin I levels (>50 ng/ml) and atrial fibrillation, along with inferior wall ST elevation on the electrocardiogram. The incidence of this dual infarction is currently unknown due to its rarity.

Pulmonary

Pulmonary Open-Heart Surgery Atrial Fibrillation Myocardial Infarction

Abstract 4140682: Clinical Case: Flipping the Script: Tackling CAD in Dextrocardia During Cardiac Catheterization

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4140682-A4140682, November 12, 2024. Electrocardiogram (ECG) showed a prominent S wave in the left-sided leads and a prominent R wave in the right-sided chest leads, suggesting dextrocardia. Patients usually have a normal life expectancy unless other structural heart diseases are present.

Coronary Artery Disease

Coronary Artery Disease Angioplasty Anatomy Angina

Abstract 4135360: Eosinophilic Myocarditis: An Atypical Presentation with a Labile Course: A Case Report

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4135360-A4135360, November 12, 2024. Electrocardiogram (EKG) was unremarkable. Case presentation:A 64-year-old man presented with one day of chest pain. Initial evaluation showed elevated cardiac enzymes (CE) and normal eosinophil count.

Myocardial Infarction

Myocardial Infarction Coronary Angiogram Echocardiogram Chest Pain

Abstract 4115652: Effect of the sodium-glucose co-transporter 2 inhibitor, Dapagliflozin, on ventricular repolarization electrocardiographic parameters: DAPA-ECG study

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4115652-A4115652, November 12, 2024.

Sudden Cardiac Death

Sudden Cardiac Death Arrhythmia Laboratory Electrocardiogram

Abstract 4134796: Safety of over 1000 consecutive, selected low risk patients with accelerated discharge from a chest pain unit with early generation cardiac troponin use, no cardiac functional or anatomic testing and no clinical risk scores

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4134796-A4134796, November 12, 2024. LR was based on normal examination, stable hemodynamics, normal electrocardiograms (ECG), and negative cardiac troponin I, without pre-discharge functional or anatomic cardiac testing or risk scores.

Chest Pain

Chest Pain ACE Inhibitor Cardiac Function Coronary Artery Disease

Abstract 4120434: A Rare Case Of Localized Ventricular Tachycardia Due To Mitral Annular Disjunction And a Subvalvular Aneurysm

Circulation

NOVEMBER 11, 2024

Circulation, Volume 150, Issue Suppl_1 , Page A4120434-A4120434, November 12, 2024. Electrocardiogram (ECG) showed sustained monomorphic VT at a rate of 160 bpm. Since its identification in 1981 its diagnosis has increased due to the advancements in cardiac imaging. cm SMA on the basal inferior and inferolateral walls.

Bicuspid/Mitral

Bicuspid/Mitral Aneurysm Sudden Cardiac Death Tachycardia

Safety and Effectiveness of the High-Sensitivity Cardiac Troponin HEART Pathway in Patients With Possible Acute Coronary Syndrome

Circulation: Cardiovascular Quality & Outcomes

FEBRUARY 8, 2024

Circulation: Cardiovascular Quality and Outcomes, Ahead of Print. BACKGROUND:The HEART Pathway (History, Electrocardiogram, Age, Risk factors, Troponin) can be used with high-sensitivity cardiac troponin to risk stratify emergency department patients with possible acute coronary syndrome.

Myocardial Infarction

Myocardial Infarction Chest Pain Electrocardiogram Risk Factors

A woman in her 50s with chest pain and dyspnea

Dr. Smith's ECG Blog

MARCH 17, 2023

Electromechanical association: a subtle electrocardiogram artifact. This case was published in Circulation on January 22, 2018 (thanks to Brooks Walsh for finding this!) link] Circulation. Originally published January 22, 2018 Here is a case from Circulation year 2000 that was misdiagnosed as due to pancreatitis.

Chest Pain

Chest Pain Coronary Angiogram Circulation Electrocardiogram

A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!

Dr. Smith's ECG Blog

JUNE 2, 2023

Usefulness of the Electrocardiogram in Establishing the Diagnosis and Prognosis of Arrhythmogenic Right Ventricular Cardiomyopathy Other References, from the above article: 1 FI Marcus Epsilon waves aid in the prognosis and risk stratification of patients with ARVC/D J Cardiovasc Electrophysiol, 26 (2015), pp. J Electrocardiol, 42 (2009), pp.

Tachycardia

Tachycardia Cardiomyopathy Electrocardiogram Article

Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Dr. Smith's ECG Blog

JANUARY 1, 2024

An initial electrocardiogram (ECG) is provided below. Cannon waves are associated with reduced RV compliance or elevated RV end-diastolic pressure ( Ali et al — Ann Noninvasic Electrocard 22:e12423, 2017 — and — Chen and Pel-Ying Pai — Circulation 119:e381, 2009 ). What do you think? What is the rhythm? The rate is 132 bpm.

Tachycardia

Tachycardia Blog Heart Failure Ischemia

Is OMI an ECG Diagnosis?

Dr. Smith's ECG Blog

APRIL 18, 2024

Circulation 2014 2. International evaluation of an artificial-intelligence- powered electrocardiogram model detecting acute coronary occlusion myocardial infarction. It is not yet available, but this is your way to get on the list. link] References 1. Amsterdam et al. Alencar et al. Int J Cardiol 2024 3. Lupu et al. McLaren and Smith.

STEMI

STEMI Chest Pain Myocardial Infarction Blog

Rise of COVID's JN.1 Sub variant Cases in India in 2023

Wellnest

DECEMBER 31, 2023

1 poses an increased risk to public health compared to other circulating variants. Electrocardiograms (EKG or ECG): This diagnostic method effectively detects irregular heartbeats or arrhythmias by analyzing the electrical signals in the heart. According to doctors, there is no evidence, as per the WHO, that JN.1 Risk posed by JN.1

COVID-19

COVID-19 Heart Attack Heart attacks Exercise

How does Acute Total Left Main Coronary occlusion present on the ECG?

Dr. Smith's ECG Blog

AUGUST 9, 2019

Below are 6 anecdotal cases of true complete left main occlusion with no collateral circulation: 3 have STE in aVR 1 has no ST shift in aVR 2 have STD in aVR The ECG can have a variety of presentations in LM Occlusion. You'll see that there is collateral circulation from the RCA. Below is the angiogram. References 7.

Myocardial Infarction

Myocardial Infarction Ischemia STEMI Cardiogenic Shock

Precordial ST depression. What is the diagnosis?

Dr. Smith's ECG Blog

JANUARY 1, 2013

Circulation 2007;115(10):1306-24. In Wung’s study, 81% of patients with greater than or equal to 1mm STE in posterior leads also had other significant STE on the 12-lead ECG, and 96% had some ST deviation. Kligfield P, Gettes LS, Bailey JJ, et al. Taha B, Reddy S, Agarwal J, Khaw K. J Electrocardiol 1998;31 Suppl:178-9. Wung SF, Drew BJ.

STEMI

STEMI Ischemia Chest Pain Myocardial Infarction

Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused

Dr. Smith's ECG Blog

OCTOBER 26, 2011

Circulation 1999;99(15):1972-7. Circulation 2000;101(2):125-30. Clinical value of 12-lead electrocardiogram after successful reperfusion therapy for acute myocardial infarction. Circulation 1998;97(23):2303-6. Gibson CM, Cannon CP, Murphy SA, et al. Shah A, Wagner GS, O'Connor CM, et al. Lancet 1997;350(9078):615-9.

STEMI

STEMI Chest Pain Myocardial Infarction Angioplasty

Are these Hyperacute T-waves?

Dr. Smith's ECG Blog

DECEMBER 5, 2022

Electromechanical association: a subtle electrocardiogram artifact. Incredibly , this case was just published in Circulation on January 22, 2018 (thanks to Brooks Walsh for finding this!) link] Circulation. link] Circulation. Journal of Electrocardiology. 2012;45(1):15-17. doi:10.1016/j.jelectrocard.2010.12.162.

Article

Article Chest Pain Circulation Electrocardiogram

Why we need continuous 12-lead ST segment monitoring in Wellens' syndrome

Dr. Smith's ECG Blog

NOVEMBER 15, 2013

Circulation 1991;84:1454-1455. Early continuous ST segment monitoring in unstable angina: prognostic value additional to the clinical characteristics and the admission electrocardiogram. It shows that on a 7 day angiogram, only 58% of re-occlusions were symptomatic: Ohman EM, Califf RM, Topol EJ et al. Eur Heart J 2000;21:1464–1472.

Chest Pain

Chest Pain Thrombosis Myocardial Infarction STEMI

Initial Reperfusion T-waves, Followed by Pseudonormalization. Diagnosis?

Dr. Smith's ECG Blog

MARCH 11, 2016

Circulation 1993; 88:896-904. Circulation 1995; 91:1659-1668. Circulation 1999; 74:1379-1389. Circulation 1990; 82:1147-1158. Prognostic significance of the initial electrocardiogram in patients with acute myocardial infarction. Methods: Oliva et al. (94) Lee KL, Woodlief LH, Topol EJ, et al. Methods: Lee et al.

Myocardial Infarction

Myocardial Infarction Pericarditis Angina STEMI

50-year old with chest pain, “no ischemic changes”

Dr. Smith's ECG Blog

DECEMBER 29, 2023

This again confirms there is a critical lesion in the first diagonal, which is either transiently open or is still occluded but being perfused through collateral circulation. International evaluation of an artificial intelligence-powered electrocardiogram model detecting acute coronary occlusion myocardial infarction.

Chest Pain

Chest Pain STEMI Myocardial Infarction Electrocardiogram

A man in his 70s with weakness and syncope

Dr. Smith's ECG Blog

JULY 22, 2023

Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Circulation, 117, 1890–1893. [3]: Heart Rhythm, 13(7): 1515-1520. [2]: 2]: Junttila MJ, Gonzalez M, Lizotte E, Benito B, Vernooy K, Sarkozy A, Huikuri HV, Brugada P, Brugada J, Brugada R. Brugada electrocardiographic pattern induced by fever.

Chest Pain

Chest Pain Heart Rhythm Sudden Cardiac Death Dysrhythmia

Hyperthermia and ST Elevation

Dr. Smith's ECG Blog

JANUARY 30, 2019

Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Circulation, 117, 1890–1893. [3]: Heart Rhythm, 13(7): 1515-1520. [2]: 2]: Junttila MJ, Gonzalez M, Lizotte E, Benito B, Vernooy K, Sarkozy A, Huikuri HV, Brugada P, Brugada J, Brugada R. Brugada electrocardiographic pattern induced by fever.

Heart Rhythm

Heart Rhythm Sudden Cardiac Death Arrhythmia STEMI

Right precordial ST depression in a patient with chest pain

Dr. Smith's ECG Blog

AUGUST 3, 2017

Circulation. Common pitfalls in the interpretation of electrocardiograms from patients with acute coronary syndromes with narrow QRS: a consensus report. O'Gara et al. Am J Cardiol 2001;87(8):970-4 5. Birnbaum Y, Baves de Luna A, Fiol M. J Electrocardiol. 2012 Sep;45(5):463-75. Boden WE, Kleiger RE, Gibson RS.

Chest Pain

Chest Pain Myocardial Infarction STEMI Ischemia

QT Correction Formulas Compared to The Rule of Thumb ("Half the RR")

Dr. Smith's ECG Blog

NOVEMBER 24, 2017

Essential Reading : Full text link: AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram, Part IV: The ST Segment, T and U Waves, and the QT Interval (full text link). Answer : you must treat the patient's underlying condition causing sinus tachycardia, and repeat the ECG at the lower heart rate.

Bradycardia

Bradycardia Article Atrial Fibrillation Chest Pain

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

Dr. Smith's ECG Blog

APRIL 8, 2015

Abnormal Electrocardiogram (ECG): Defined (San Fran syncope rule) as any new changes when compared to the last ECG or presence of non-sinus rhythm. Results : Electrocardiograms (99%), telemetry (95%), cardiac enzymes (95%), and head computed tomography (CT) (63%) were the most frequently obtained tests.

Arrhythmia

Arrhythmia Outcomes Risk Factors Chest Pain

New Studies: AI Captures Electrocardiogram Patterns That Could Signal a Future Sudden Cardiac Arrest

The Electrocardiogram at 100 Years: History and Future

Abstract 4142589: GLP-1 receptor agonists slow the progression of subclinical cardiovascular risk as detected from 12-lead electrocardiograms

Webinars

Abstract 4136784: Diagnostic significance and prognosis prediction of electrocardiogram plane QRS-T angle in patients with non-ST segment elevation acute coronary syndrome

6 Cardiology Board Review Questions That Will Help You Pass the Boards

Understanding an Enlarged Heart (Cardiomegaly): Causes, Symptoms, and Treatment

Comparing Phenotypes for Acute and Long-Term Response to Atrial Fibrillation Ablation Using Machine Learning

Abstract 4146680: Detecting Atrial and Ventricular Ectopy from the Apple Watch with an novel Deep Learning algorithm

Bizarre (Hyperacute??) T-waves

Abstract 4145609: The Cardiac Conundrum of Cannabis: A Case of Junctional Bradycardia Triggered by Cannabis Use

Abstract 4139536: Incidence of Severe QT Prolongation and the Assoicated Risk of Ventricular Arrhythmias and Sudden Cardiac Death in Patients Taking Antipsychotics or Antidepressants

Hypertropic Cardiomyopathy: A Board Review Question Explained By Video

Abstract 4141052: Rare Combo: An Unusual Case of a 54-year-old Filipino with Coronary Artery Fistula from Left Anterior Descending Artery to Main Pulmonary Artery and Acute Cerebellar Infarct: A Cardio – Cerebral Infarction Syndrome - Case Report

Abstract 4140682: Clinical Case: Flipping the Script: Tackling CAD in Dextrocardia During Cardiac Catheterization

Abstract 4135360: Eosinophilic Myocarditis: An Atypical Presentation with a Labile Course: A Case Report

Abstract 4115652: Effect of the sodium-glucose co-transporter 2 inhibitor, Dapagliflozin, on ventricular repolarization electrocardiographic parameters: DAPA-ECG study

Abstract 4134796: Safety of over 1000 consecutive, selected low risk patients with accelerated discharge from a chest pain unit with early generation cardiac troponin use, no cardiac functional or anatomic testing and no clinical risk scores

Abstract 4120434: A Rare Case Of Localized Ventricular Tachycardia Due To Mitral Annular Disjunction And a Subvalvular Aneurysm

Safety and Effectiveness of the High-Sensitivity Cardiac Troponin HEART Pathway in Patients With Possible Acute Coronary Syndrome

A woman in her 50s with chest pain and dyspnea

A young lady with wide complex tachycardia. My first time actually making this diagnosis de novo in real life in the ED!

Physical Examination as a Helpful Aid in Decision-Making in Challenging ECGs

Is OMI an ECG Diagnosis?

Rise of COVID's JN.1 Sub variant Cases in India in 2023

How does Acute Total Left Main Coronary occlusion present on the ECG?

Precordial ST depression. What is the diagnosis?

Four anterior STEMIs: acute and reperfused vs. won't reperfuse, subacute and reperfused vs. not reperfused

Are these Hyperacute T-waves?

Why we need continuous 12-lead ST segment monitoring in Wellens' syndrome

Initial Reperfusion T-waves, Followed by Pseudonormalization. Diagnosis?

50-year old with chest pain, “no ischemic changes”

A man in his 70s with weakness and syncope

Hyperthermia and ST Elevation

Right precordial ST depression in a patient with chest pain

QT Correction Formulas Compared to The Rule of Thumb ("Half the RR")

Emergency Department Syncope Workup: After H and P, ECG is the Only Test Required for Every Patient.

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