ScienceOpenSep 29, 2025

🫀📄 #WorldHeartDay: 'Electrocardiographic Strain and Relationship with Left Ventricular Remodelling and Clinical Outcomes in Patients with Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation' - a research article in the Karger: Cardiovascular System Collection on #ScienceOpen 🔗 https://www.scienceopen.com/document?vid=96c293ec-03c9-46ed-bf91-ce2b451d58b7

#AorticStenosis #TAVI #Electrocardiography #Cardiology

Electrocardiographic Strain and Relationship with Left Ventricular Remodelling and Clinical Outcomes in Patients with Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation

<p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" dir="auto" id="d7341480e220"> <b> <i>Introduction:</i> </b> Left ventricular (LV) remodelling and fibrosis are known to occur in patients with aortic stenosis (AS) and are linked to post-intervention outcomes. These myocardial changes may be detected upon the routine 12-lead electrocardiogram (ECG) by the presence of a LV strain pattern (LVS-ECG). Although LVS-ECG has been related to excessive cardiovascular morbidity and mortality in multiple patient populations, there is currently a dearth of data upon its impact in patients undergoing transcatheter aortic valve implantation (TAVI). The aim of the current study was to investigate the prevalence, predictors, and prognostic value of LVS-ECG. <b> <i>Methods:</i> </b> Between 2012 and 2019, 640 consecutive patients underwent TAVI at Haukeland University Hospital, Bergen. Of these, 600 patients with severe AS were included in the TAVI-NOR study. Patients with known bundle branch block ( <i>n</i> = 85) or permanent pacing ( <i>n</i> = 25) were excluded, leaving 490 patients (mean age 81 ± 6 years, 52% females) eligible for the analyses. LVS-ECG was defined as down-sloping, convex ST-segment depression with asymmetric T-wave inversion in V5 or V6. <b> <i>Results:</i> </b> LVS-ECG was present in 25.7% patients. Higher levels of NT-proBNP (OR 1.96; 95% CI: 1.08–3.55, <i>p</i> = 0.028), left ventricular ejection fraction (LVEF) <50% (OR 3.14; 95% CI: 1.61–6.13, <i>p</i> = 0.001), increase in LV mass index per SD (32 g/m <sup>2</sup>) (OR 1.37; 95 CI: 1.06–1.76, <i>p</i> = 0.014), and the presence of LV hypertrophy on ECG (OR 3.23; 95% CI: 1.97–5.32, <i>p</i> < 0.001) were independent predictors of LVS-ECG in the multivariable-adjusted analysis. Although all-cause mortality was significantly higher in patients with LVS-ECG compared to those without (54.8% vs. 44.2%, <i>p</i> = 0.041), the presence of LVS-ECG did not predict all-cause mortality during a mean follow-up of 64 ± 24 months (HR 1.05; 95% CI: 0.79–1.39, <i>p</i> = 0.742). Patients with LVEF <50% and concomitant LVS-ECG had a worse prognosis than those with LVEF >50% and no LVS-ECG ( <i>p</i> < 0.001). <b> <i>Conclusions:</i> </b> LVS-ECG may represent a simple marker of structural and functional LV remodelling that signals a propensity to excess mortality during long-term follow-up after TAVI, as it is strongly associated with other prognosticators such as reduced LVEF and increased levels of NT-proBNP. </p>

ScienceOpen
emergenciespirineusFeb 24, 2025

Llibre d'ECG del Dr Brugada en català!

De moment ja n'he comprat dos exemplars, un per mi i un altre per donar a algú que se'l mereixi😉

#electrocardiografia #electrocardiography #ECG #EmergencyMedicine

https://www.documentauniversitaria.com/producte/electrocardiografia-al-teu-abast-2/

Electrocardiografia al teu abast | Documenta Universitaria

hackaday unofficialMay 4, 2021

ECG Project With All the Messy Safety Details

We’ve seen a number of heart rate monitoring projects on Hackaday, but [Peter's] electrocardiography (ECG) Instructable really caught out attention.

If you've followed Hackaday for any period of time, you're probably already somewhat familiar with the hardware needed to record the ECG. First, you need a high input impedance instrumentation amplifier to pick up the millivolt signal from electrical leads carefully placed on the willing subject's body. To accomplish this, he used an AD8232 single-lead ECG module (we've actually seen this part used to make a soundcard-based ECG). This chip has a built-in instrumentation amplifier as well as an optional secondary amplifier for additional gain and low-pass filtering. The ECG signal is riddled with noise from mains that can be partially attenuated with a simple low-pass filter. Then, [Peter] uses an Arduino Nano to sample the output of the AD8232, implement a digital notch filter for added mains noise reduction, and display the output on a 2.8″ TFT display.

Other than the circuit itself, two things about his project really caught our attention. [Peter] walks the reader through all the different safety considerations for a commercial ECG device and applies these principles to his simple DIY setup to ensure his own safety. As [Peter] put it, professional medical electronics should follow IEC 60601. It's a pretty bulky document, but the main tenets quoted from [Peter's] write-up are:

  • limiting how much current can pass through the patient
  • how much current can I pass through the patient?
  • what electrical isolation is required?
  • what happens if a "component" fails?
  • how much electromagnetic interference can I produce?
  • what about a defibrillator?

    • [Peter] mentions that his circuit itself does not fully conform to the standard (though he makes some honest attempts), but lays out a crude plan for doing so. These include using high-valued input resistors for the connections to the electrodes and also adding a few protection diodes to the electrode inputs so that the device can withstand a defibrillator. And of course, two simple strategies you always want to follow are using battery power and placing the device in a properly shielded enclosure.

    [Peter] also does a great job breaking down the electrophysiology of the heart and relates it to terms maybe a bit more familiar to non-medical professionals. Understanding the human heart might be a little less intimidating if we relate the heart to a simple voltage source like a battery or maybe even a function generator. You can imagine the ions in our cells as charger carriers that generate electrical potential energy and nerve fibers as electrical wires along which electrical pulses travel through the body.

    Honestly, [Peter] has a wealth of information and tools presented in his project that are sure to help you in your next build. You might also find his ECG simulator code really handy and his low-memory display driver code helpful as well. Cool project, [Peter]!

    Measuring ECG is something that is near and dear to my heart (sorry, couldn't resist). Two of my own projects that were featured on Hackaday before I became a writer here include a biomedical sensor suite in Arduino shield form factor, and a simple ECG built around an AD623 instrumentation amplifier.

    #arduinohacks #medicalhacks #arduino #biomedicalengineering #digitalfilter #electrocardiography #electrophysiology #iec

    ECG Project With All The Messy Safety Details

    We’ve seen a number of heart rate monitoring projects on Hackaday, but [Peter’s] electrocardiography (ECG) Instructable really caught out attention. If you’ve followed Hackaday for any …

    Hackaday