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1. Model-based Estimation of AV-nodal Refractory Period and Conduction Delay Trends from ECG

Author

Karlsson, Mattias, Platonov, Pyotr G, Ulimoen, Sara R., Sandberg, Frida, and Wallman, Mikael

Subjects
Statistics - Applications, Quantitative Biology - Tissues and Organs
Abstract

Atrial fibrillation (AF) is the most common arrhythmia, associated with significant burdens to patients and the healthcare system. The atrioventricular (AV) node plays a vital role in regulating heart rate during AF, but is often insufficient in regards to maintaining a healthy heart rate. Thus, the AV node properties are modified using rate-control drugs. Hence, quantifying individual differences in diurnal and short-term variability of AV-nodal function could aid in personalized treatment selection. This study presents a novel methodology for estimating the refractory period (RP) and conduction delay (CD) trends and their uncertainty in the two pathways of the AV node during 24 hours using non-invasive data. This was achieved using a network model together with a problem-specific genetic algorithm and an approximate Bayesian computation algorithm. Diurnal and short-term variability in the estimated RP and CD was quantified by the difference between the daytime and nighttime estimates and by the Kolmogorov-Smirnov distance between adjacent 10-minute segments in the 24-hour trends. Holter ECGs from 51 patients with permanent AF during baseline were analyzed, and the predictive power of variations in RP and CD on the resulting heart rate reduction after treatment with four rate control drugs was investigated. Diurnal variability yielded no correlation to treatment outcome, and no prediction of drug outcome was possible using the machine learning tools. However, a correlation between the short-term variability for the RP and CD in the fast pathway and resulting heart rate reduction during treatment with metoprolol ($\rho=0.48, p<0.005$ in RP, $\rho=0.35, p<0.05$ in CD) were found. The proposed methodology enables non-invasive estimation of the AV node properties during 24 hours, which may have the potential to assist in treatment selection., Comment: 12 pages, 6 figures, 2 tables, 1 pseudocode

Published
2023

2. ECG-based estimation of respiratory modulation of AV nodal conduction during atrial fibrillation

Author

Plappert, Felix, Engström, Gunnar, Platonov, Pyotr G., Wallman, Mikael, and Sandberg, Frida

Subjects
Physics - Medical Physics, Electrical Engineering and Systems Science - Signal Processing, Quantitative Biology - Tissues and Organs
Abstract

Information about autonomic nervous system (ANS) activity may be valuable for personalized atrial fibrillation (AF) treatment but is not easily accessible from the ECG. In this study, we propose a new approach for ECG-based assessment of respiratory modulation in AV nodal refractory period and conduction delay. A 1-dimensional convolutional neural network (1D-CNN) was trained to estimate respiratory modulation of AV nodal conduction properties from 1-minute segments of RR series, respiration signals, and atrial fibrillatory rates (AFR) using synthetic data that replicates clinical ECG-derived data. The synthetic data were generated using a network model of the AV node and 4 million unique model parameter sets. The 1D-CNN was then used to analyze respiratory modulation in clinical deep breathing test data of 28 patients in AF, where a ECG-derived respiration signal was extracted using a novel approach based on periodic component analysis. We demonstrated using synthetic data that the 1D-CNN can predict the respiratory modulation from RR series alone ($\rho$ = 0.805) and that the addition of either respiration signal ($\rho$ = 0.830), AFR ($\rho$ = 0.837), or both ($\rho$ = 0.855) improves the prediction. Results from analysis of clinical ECG data of 20 patients with sufficient signal quality suggest that respiratory modulation decreased in response to deep breathing for five patients, increased for five patients, and remained similar for ten patients, indicating a large inter-patient variability., Comment: 20 pages, 7 figures, 5 tables

Published
2023
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8. ISE/ISHNE Expert Consensus Statement on ECG Diagnosis of Left Ventricular Hypertrophy: The Change of the Paradigm. The joint paper of the International Society of Electrocardiology and the International Society for Holter Monitoring and Noninvasive Electrocardiology

Author

Bacharova, Ljuba, Chevalier, Philippe, Gorenek, Bulent, Jons, Christian, Li, Yi-Gang, Locati, Emanuela T., Maanja, Maren, Pérez-Riera, Andrés Ricardo, Platonov, Pyotr G., Ribeiro, Antonio Luiz P., Schocken, Douglas, Soliman, Elsayed Z., Svehlikova, Jana, Tereshchenko, Larisa G., Ugander, Martin, Varma, Niraj, Zaklyazminskaya, Elena, and Ikeda, Takanori

Published
2023
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9. Risk of Adverse Outcomes Associated With Cardiac Sarcoidosis Diagnostic Schemes

Author

Myadam, Rahul, Crawford, Thomas C., Bogun, Frank M., Gu, Xiaokui, Ellenbogen, Kenneth A., Jasti, Shilpa, Chicos, Alexandru B., Roukoz, Henri, Zimetbaum, Peter J., Kalbfleisch, Steven J., Murgatroyd, Francis D., Steckman, David A., Rosenfeld, Lynda E., Garlitski, Ann C., Soejima, Kyoko, Bhan, Adarsh K., Vedantham, Vasanth, Dickfeld, Timm-Michael L., De Lurgio, David B., Platonov, Pyotr G., Zipse, Matthew M., Nishiuchi, Suguru, Ortman, Matthew L., Narasimhan, Calambur, Patton, Kristen K., Rosenthal, David G., Mukerji, Siddharth S., Hoogendoorn, Jarieke C., Zeppenfeld, Katja, Sauer, William H., and Kron, Jordana

Published
2023
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10. Prognostic value of early sustained ventricular arrhythmias in ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: A substudy of VALIDATE-SWEDEHEART trial

Author

Demidova, Marina M., Rylance, Rebecca, Koul, Sasha, Dworeck, Christian, James, Stefan, Aasa, Mikael, Hamid, Mehmet, Swahn, Eva, Hambraeus, Kristina, Danielewicz, Mikael, Linder, Rikard, Fröbert, Ole, Grimfjärd, Per, Stewart, Jason, Henareh, Loghman, Andersson, Jonas, Wagner, Henrik, Erlinge, David, and Platonov, Pyotr G.

Published
2023
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13. Rapid Exclusion of COVID Infection With the Artificial Intelligence Electrocardiogram

Author

Attia, Zachi I., Kapa, Suraj, Dugan, Jennifer, Pereira, Naveen, Noseworthy, Peter A., Jimenez, Francisco Lopez, Cruz, Jessica, Carter, Rickey E., DeSimone, Daniel C., Signorino, John, Halamka, John, Chennaiah Gari, Nikhita R., Madathala, Raja Sekhar, Platonov, Pyotr G., Gul, Fahad, Janssens, Stefan P., Narayan, Sanjiv, Upadhyay, Gaurav A., Alenghat, Francis J., Lahiri, Marc K., Dujardin, Karl, Hermel, Melody, Dominic, Paari, Turk-Adawi, Karam, Asaad, Nidal, Svensson, Anneli, Fernandez-Aviles, Francisco, Esakof, Darryl D., Bartunek, Jozef, Noheria, Amit, Sridhar, Arun R., Lanza, Gaetano A., Cohoon, Kevin, Padmanabhan, Deepak, Pardo Gutierrez, Jose Alberto, Sinagra, Gianfranco, Merlo, Marco, Zagari, Domenico, Rodriguez Escenaro, Brenda D., Pahlajani, Dev B., Loncar, Goran, Vukomanovic, Vladan, Jensen, Henrik K., Farkouh, Michael E., Luescher, Thomas F., Su Ping, Carolyn Lam, Peters, Nicholas S., and Friedman, Paul A.

Published
2021
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14. Right precordial-directed electrocardiographical markers identify arrhythmogenic right ventricular cardiomyopathy in the absence of conventional depolarization or repolarization abnormalities.

Author

Cortez, Daniel, Svensson, Anneli, Carlson, Jonas, Graw, Sharon, Sharma, Nandita, Brun, Francesca, Spezzacatene, Anita, Mestroni, Luisa, and Platonov, Pyotr

Subjects
Arrhythmogenic right ventricular cardiomyopathy, Cascade screening, ECG, Vectorcardiography, Adult, Arrhythmogenic Right Ventricular Dysplasia, Cohort Studies, Cross-Sectional Studies, Electrocardiography, Female, Humans, Internationality, Male, Middle Aged, Retrospective Studies, Young Adult
Abstract

BACKGROUND: Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) carries a risk of sudden death. We aimed to assess whether vectorcardiographic (VCG) parameters directed toward the right heart and a measured angle of the S-wave would help differentiate ARVD/C with otherwise normal electrocardiograms from controls. METHODS: Task Force 2010 definite ARVD/C criteria were met for all patients. Those who did not fulfill Task Force depolarization or repolarization criteria (-ECG) were compared with age and gender-matched control subjects. Electrocardiogram measures of a 3-dimentional spatial QRS-T angle, a right-precordial-directed orthogonal QRS-T (RPD) angle, a root mean square of the right sided depolarizing forces (RtRMS-QRS), QRS duration (QRSd) and the corrected QT interval (QTc), and a measured angle including the upslope and downslope of the S-wave (S-wave angle) were assessed. RESULTS: Definite ARVD/C was present in 155 patients by 2010 Task Force criteria (41.7 ± 17.6 years, 65.2% male). -ECG ARVD/C patients (66 patients) were compared to 66 control patients (41.7 ± 17.6 years, 65.2% male). All parameters tested except the QRSd and QTc significantly differentiated -ECG ARVD/C from control patients (p

Published
2017

15. Atrial time and voltage dispersion are both needed to predict new-onset atrial fibrillation in ischemic stroke patients.

Author

Cortez, Daniel, Baturova, Maria, Lindgren, Arne, Carlson, Jonas, Shubik, Yuri, Olsson, Bertil, and Platonov, Pyotr

Subjects
Atrial fibrillation, Ischemic stroke, P-wave duration, P-wave vector magnitude, Action Potentials, Aged, Aged, 80 and over, Algorithms, Atrial Fibrillation, Brain Ischemia, Chi-Square Distribution, Electrocardiography, Female, Heart Rate, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Patient Admission, Predictive Value of Tests, Prognosis, Proportional Hazards Models, Registries, Retrospective Studies, Risk Factors, Signal Processing, Computer-Assisted, Stroke, Sweden, Time Factors
Abstract

BACKGROUND: Atrial fibrillation (AF) is a known risk factor for ischemic stroke. Electrocardiographic predictors of AF in population studies such as the Framingham Heart Study, as well as in hypertensive patients have demonstrated a predictive value of the P-wave duration for development of AF. QRS vector magnitude has had a predictive value in ventricular arrhythmia development. We aimed to assess the value of the three-dimensional P-wave vector magnitude and its relationship to P-wave duration for prediction of new-onset AF after ischemic stroke. METHODS: First-ever ischemic stroke patients without AF at inclusion in the Lund Stroke Register were included. Measurements of P wave duration (Pd), QRS duration, corrected QT interval, and PQ interval were performed automatically using the University of Glasgow 12-lead ECG analysis algorithm. The P-wave vector magnitude (Pvm) was calculated automatically as the square root of the sum of the squared P-wave magnitudes in leads V6, II and one half of the P-wave amplitude in V2 ([Formula: see text]), based on the P-wave magnitude (Pvm) as defined by the visually transformed Kors Quasi-orthogonal method. RESULTS: The median age was 73 (IQR 63-80) years at stroke onset (135 males, 92 females). Multivariate predictors of new-onset atrial fibrillation included age > 65 years, hypertension, and Pd/Pvm. A cut-off value of 870 ms/mV gave sensitivity, specificity, positive and negative predictive values of 51, 79, 30 and 87%, respectively. The Pd/Pvm was the only ECG predictor of AF with a significant multivariate hazard ratio of 2.02 (95% CI 1.18 to 3.46, p = 0.010). CONCLUSION: P-wave dispersion as measured by the Pd/Pvm was the only ECG parameter measured which independently predicted subsequent AF identification in a cohort of stroke patients. Further prospective studies in larger cohorts are needed to validate its clinical usefulness.

Published
2017

16. 2021 ISHNE/HRS/EHRA/APHRS Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia Pacific Heart Rhythm Society

Author

Varma, Niraj, Cygankiewicz, Iwona, Turakhia, Mintu P., Heidbuchel, Hein, Hu, Yufeng, Chen, Lin Yee, Couderc, Jean-Philippe, Cronin, Edmond M., Estep, Jerry D., Grieten, Lars, Lane, Deirdre A., Mehra, Reena, Page, Alex, Passman, Rod, Piccini, Jonathan P., Piotrowicz, Ewa, Piotrowicz, Ryszard, Platonov, Pyotr G., Ribeiro, Antonio Luiz, Rich, Robert E., Russo, Andrea M., Slotwiner, David, Steinberg, Jonathan S., and Svennberg, Emma

Published
2021
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17. Enhancing rare variant interpretation in inherited arrhythmias through quantitative analysis of consortium disease cohorts and population controls

Author

Walsh, Roddy, Lahrouchi, Najim, Tadros, Rafik, Kyndt, Florence, Glinge, Charlotte, Postema, Pieter G., Amin, Ahmad S., Nannenberg, Eline A., Ware, James S., Whiffin, Nicola, Mazzarotto, Francesco, Škorić-Milosavljević, Doris, Krijger, Christian, Arbelo, Elena, Babuty, Dominique, Barajas-Martinez, Hector, Beckmann, Britt M., Bézieau, Stéphane, Bos, J. Martijn, Breckpot, Jeroen, Campuzano, Oscar, Castelletti, Silvia, Celen, Candan, Clauss, Sebastian, Corveleyn, Anniek, Crotti, Lia, Dagradi, Federica, de Asmundis, Carlo, Denjoy, Isabelle, Dittmann, Sven, Ellinor, Patrick T., Ortuño, Cristina Gil, Giustetto, Carla, Gourraud, Jean-Baptiste, Hazeki, Daisuke, Horie, Minoru, Ishikawa, Taisuke, Itoh, Hideki, Kaneko, Yoshiaki, Kanters, Jørgen K., Kimoto, Hiroki, Kotta, Maria-Christina, Krapels, Ingrid P.C., Kurabayashi, Masahiko, Lazarte, Julieta, Leenhardt, Antoine, Loeys, Bart L., Lundin, Catarina, Makiyama, Takeru, Mansourati, Jacques, Martins, Raphaël P., Mazzanti, Andrea, Mörner, Stellan, Napolitano, Carlo, Ohkubo, Kimie, Papadakis, Michael, Rudic, Boris, Molina, Maria Sabater, Sacher, Frédéric, Sahin, Hatice, Sarquella-Brugada, Georgia, Sebastiano, Regina, Sharma, Sanjay, Sheppard, Mary N., Shimamoto, Keiko, Shoemaker, M.Benjamin, Stallmeyer, Birgit, Steinfurt, Johannes, Tanaka, Yuji, Tester, David J., Usuda, Keisuke, van der Zwaag, Paul A., Van Dooren, Sonia, Van Laer, Lut, Winbo, Annika, Winkel, Bo G., Yamagata, Kenichiro, Zumhagen, Sven, Volders, Paul G.A., Lubitz, Steven A., Antzelevitch, Charles, Platonov, Pyotr G., Odening, Katja E., Roden, Dan M., Roberts, Jason D., Skinner, Jonathan R., Tfelt-Hansen, Jacob, van den Berg, Maarten P., Olesen, Morten S., Lambiase, Pier D., Borggrefe, Martin, Hayashi, Kenshi, Rydberg, Annika, Nakajima, Tadashi, Yoshinaga, Masao, Saenen, Johan B., Kääb, Stefan, Brugada, Pedro, Robyns, Tomas, Giachino, Daniela F., Ackerman, Michael J., Brugada, Ramon, Brugada, Josep, Gimeno, Juan R., Hasdemir, Can, Guicheney, Pascale, Priori, Silvia G., Schulze-Bahr, Eric, Makita, Naomasa, Schwartz, Peter J., Shimizu, Wataru, Aiba, Takeshi, Schott, Jean-Jacques, Redon, Richard, Ohno, Seiko, Probst, Vincent, Arnaout, Alain Al, Amelot, Mathieu, Anselme, Frédéric, Billon, Olivier, Defaye, Pascal, Dupuis, Jean-Marc, Jesel, Laurence, Laurent, Gabriel, Maury, Philippe, Pasquie, Jean-Luc, Wiart, Francois, Behr, Elijah R., Barc, Julien, and Bezzina, Connie R.

Published
2021
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18. Age-Stratified Clinical Outcome in Patients with Known Heart Failure Who Receive Pacemaker, Resynchronization Therapy, or Defibrillator Implants.

Author

Rorsman, Cecilia, Farouq, Maiwand, Marinko, Sofia, Platonov, Pyotr G., and Borgquist, Rasmus

Subjects
CARDIAC pacing, CARDIAC pacemakers, MYOCARDIAL ischemia, CORONARY disease, HEART failure patients, HEART failure
Abstract

Introduction: Patients with heart failure (HF) and bradycardia may be eligible for different types of cardiac implantable electronic devices (CIED), depending on the presence of atrioventricular conduction disease, age, and comorbidities. We aimed to assess the prognosis for these patients, after CIED implantation, stratified for the type of CIED device. Methods: All patients with preexisting HF diagnosis who received a CIED with a right ventricular lead during the period 2005–2018 in Sweden were identified via the pacemaker registry. Data were crossmatched with the population registry and national disease registries. The outcome was 5-year risk of HF hospitalization and mortality. Results: A total of 37,745 patients were included in the study. Comparing demographics for implantable cardioverter defibrillator versus pacemaker implants, median age was 66 years versus 83 years, 20% versus 41% were female, 64% versus 50% had ischemic heart disease, and 35% versus 67% had atrial fibrillation (all p < 0.001). Five-year mortality was highest in single-chamber pacemaker recipients (61% compared to average 40%, p < 0.001), but the proportion of cardiovascular mortality was highest for cardiac resynchronization therapy (CRT) recipients (68% vs. 63% p < 0.001). Adjusted mortality was higher for pacemaker patients in all age decile groups (ranging from <60 to >90 years old, all p < 0.001), HF hospitalization occurred in 28% (dual-chamber pacemaker) to 39% (CRT-P) of patients, and cause of death was HF in 15% (dual-chamber pacemaker) to 25% (CRT-D), all p < 0.001. Conclusion: In this large real-world cohort of CIED-treated patients with prior HF, demography and mortality data indicate that clinicians chose devices according to the overall status of the patient. HF-related events occurred in all groups but were more common in CRT-treated patients. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Natural Course of Electrocardiographic Features in Arrhythmogenic Right Ventricular Cardiomyopathy and Their Relation to Ventricular Arrhythmic Events

Author

Svensson, Anneli, Jensen, Henrik Kjaerulf, Boonstra, Machteld J., Tétreault-Langlois, Marianne, Dahlberg, Pia, Bundgaard, Henning, Christensen, Alex Hørby, Rylance, Rebecca T., Svendsen, Jesper H., Cadrin-Tourigny, Julia, Te Riele, Anneline S.J.M., Platonov, Pyotr G., Svensson, Anneli, Jensen, Henrik Kjaerulf, Boonstra, Machteld J., Tétreault-Langlois, Marianne, Dahlberg, Pia, Bundgaard, Henning, Christensen, Alex Hørby, Rylance, Rebecca T., Svendsen, Jesper H., Cadrin-Tourigny, Julia, Te Riele, Anneline S.J.M., and Platonov, Pyotr G.

Abstract

Background Electrocardiographic abnormalities are common in arrhythmogenic right ventricular cardiomyopathy and are included in the 2010 Task Force Criteria. Their time course, however, remains uncertain. In this retrospective observational study, we aimed to assess the long‐term evolution of electrocardiographic characteristics and their relation to ventricular arrhythmias. Methods and Results Three hundred fifty‐three patients with arrhythmogenic right ventricular cardiomyopathy as per the 2010 Task Force Criteria with 6871 automatically processed 12‐lead digital ECGs were included. The relationship between the electrocardiographic parameters and the risk of ventricular arrhythmias was assessed at 10 years from the first ECG. Electrocardiographic parameters were compared between the first contact ECG, the ECG at diagnosis, and the most recent ECG. Median time between the first and the latest ECG was 6 [interquartile range, 1–14] years. Reductions of QRS voltage, R‐ and T‐wave amplitudes between the first, diagnostic, and the latest ECGs were observed across precordial and extremity leads. Mean QRS duration increased from 96 to 102 ms (P<0.001), terminal activation duration (V1) from 47 to 52 ms (P<0.001), and QTc from 419 to 432 ms (P<0.001). T‐wave inversions in leads V3 to V6 and aVF at first ECG were associated with ventricular arrhythmias (adjusted hazard ratio [HRadj][V3], 2.03 [95% CI, 1.23–3.34] and HRadj[aVF], 1.87 [95% CI, 1.13–3.08]). Conclusions Depolarization and repolarization parameters evolved over time in patients with arrhythmogenic right ventricular cardiomyopathy, supporting the progressive nature of arrhythmogenic right ventricular cardiomyopathy. Electrocardiographic abnormalities may be detected before diagnosis and might, although not fulfilling the 2010 Task Force Criteria, be markers of early disease. T‐wave inversion in leads V3 or aVF before diagnosis was associated with ventricular arrhythmias during follow‐, BACKGROUND: Electrocardiographic abnormalities are common in arrhythmogenic right ventricular cardiomyopathy and are included in the 2010 Task Force Criteria. Their time course, however, remains uncertain. In this retrospective observational study, we aimed to assess the long-term evolution of electrocardiographic characteristics and their relation to ventricular arrhythmias. METHODS AND RESULTS: Three hundred fifty-three patients with arrhythmogenic right ventricular cardiomyopathy as per the 2010 Task Force Criteria with 6871 automatically processed 12-lead digital ECGs were included. The relationship between the electrocardiographic parameters and the risk of ventricular arrhythmias was assessed at 10 years from the first ECG. Electrocardiographic parameters were compared between the first contact ECG, the ECG at diagnosis, and the most recent ECG. Median time between the first and the latest ECG was 6 [interquartile range, 1-14] years. Reductions of QRS voltage, R- and T-wave amplitudes between the first, diagnostic, and the latest ECGs were observed across precordial and extremity leads. Mean QRS duration increased from 96 to 102 ms (P<0.001), terminal activation duration (V1) from 47 to 52 ms (P<0.001), and QTc from 419 to 432 ms (P<0.001). T-wave inversions in leads V3 to V6 and aVF at first ECG were associated with ventricular arrhythmias (adjusted hazard ratio [HRadj][V3], 2.03 [95% CI, 1.23-3.34] and HRadj[aVF], 1.87 [95% CI, 1.13-3.08]). CONCLUSIONS: Depolarization and repolarization parameters evolved over time in patients with arrhythmogenic right ventricular cardiomyopathy, supporting the progressive nature of arrhythmogenic right ventricular cardiomyopathy. Electrocardiographic abnormalities may be detected before diagnosis and might, although not fulfilling the 2010 Task Force Criteria, be markers of early disease. T-wave inversion in leads V3 or aVF before diagnosis was associated with ventricular arrhythmias during follow-up.

Published
2024

27. Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe

Author

Carrick, Richard T., De Marco, Corrado, Gasperetti, Alessio, Bosman, Laurens P., Gourraud, Jean-Baptiste, Trancuccio, Alessandro, Mazzanti, Andrea, Murray, Brittney, Pendleton, Catherine, Tichnell, Crystal, Tandri, Harikrishna, Zeppenfeld, Katja, Wilde, Arthur A. M., Davies, Brianna, Seifer, Colette, Roberts, Jason D., Healey, Jeff S., MacIntyre, Ciorsti, Alqarawi, Wael, Tadros, Rafik, Cutler, Michael J., Targetti, Mattia, Calo, Leonardo, Vitali, Francesco, Bertini, Matteo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Cappelletto, Chiara, De Luca, Antonio, Stolfo, Davide, Duru, Firat, Jensen, Henrik K., Svensson, Anneli, Dahlberg, Pia, Hasselberg, Nina E., Di Marco, Andrea, Jorda, Paloma, Arbelo, Elena, Moreno Weidmann, Zoraida, Borowiec, Karolina, Deliniere, Antoine, Biernacka, Elzbieta K., van Tintelen, J. Peter, Platonov, Pyotr G., Olivotto, Iacopo, Saguner, Ardan M., Haugaa, Kristina H., Cox, Moniek, Tondo, Claudio, Merlo, Marco, Krahn, Andrew D., te Riele, Anneline S. J. M., Wu, Katherine C., Calkins, Hugh, James, Cynthia A., Cadrin-Tourigny, Julia, Carrick, Richard T., De Marco, Corrado, Gasperetti, Alessio, Bosman, Laurens P., Gourraud, Jean-Baptiste, Trancuccio, Alessandro, Mazzanti, Andrea, Murray, Brittney, Pendleton, Catherine, Tichnell, Crystal, Tandri, Harikrishna, Zeppenfeld, Katja, Wilde, Arthur A. M., Davies, Brianna, Seifer, Colette, Roberts, Jason D., Healey, Jeff S., MacIntyre, Ciorsti, Alqarawi, Wael, Tadros, Rafik, Cutler, Michael J., Targetti, Mattia, Calo, Leonardo, Vitali, Francesco, Bertini, Matteo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Cappelletto, Chiara, De Luca, Antonio, Stolfo, Davide, Duru, Firat, Jensen, Henrik K., Svensson, Anneli, Dahlberg, Pia, Hasselberg, Nina E., Di Marco, Andrea, Jorda, Paloma, Arbelo, Elena, Moreno Weidmann, Zoraida, Borowiec, Karolina, Deliniere, Antoine, Biernacka, Elzbieta K., van Tintelen, J. Peter, Platonov, Pyotr G., Olivotto, Iacopo, Saguner, Ardan M., Haugaa, Kristina H., Cox, Moniek, Tondo, Claudio, Merlo, Marco, Krahn, Andrew D., te Riele, Anneline S. J. M., Wu, Katherine C., Calkins, Hugh, James, Cynthia A., and Cadrin-Tourigny, Julia

Abstract

Background and Aims Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death (SCD) in arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to identify cross-continental differences in utilization of primary prevention ICDs and survival free from sustained ventricular arrhythmia (VA) in ARVC.Methods This was a retrospective analysis of ARVC patients without prior VA enrolled in clinical registries from 11 countries throughout Europe and North America. Patients were classified according to whether they received treatment in North America or Europe and were further stratified by baseline predicted VA risk into low- (<10%/5 years), intermediate- (10%-25%/5 years), and high-risk (>25%/5 years) groups. Differences in ICD implantation and survival free from sustained VA events (including appropriate ICD therapy) were assessed.Results One thousand ninety-eight patients were followed for a median of 5.1 years; 554 (50.5%) received a primary prevention ICD, and 286 (26.0%) experienced a first VA event. After adjusting for baseline risk factors, North Americans were more than three times as likely to receive ICDs {hazard ratio (HR) 3.1 [95% confidence interval (CI) 2.5, 3.8]} but had only mildly increased risk for incident sustained VA [HR 1.4 (95% CI 1.1, 1.8)]. North Americans without ICDs were at higher risk for incident sustained VA [HR 2.1 (95% CI 1.3, 3.4)] than Europeans.Conclusions North American ARVC patients were substantially more likely than Europeans to receive primary prevention ICDs across all arrhythmic risk strata. A lower rate of ICD implantation in Europe was not associated with a higher rate of VA events in those without ICDs., Funding Agencies|Leonie-Wild Foundation; Leyla Erkan Family Fund for ARVD Research; Hugh Calkins, Marvin H. Weiner, and Jacqueline J. Bernstein Cardiac Arrhythmia Center; Dr Francis P. Chiaramonte Private Foundation; Dr Satish, Rupal, and Robin Shah ARVD Fund at Johns Hopkins; Bogle Foundation; Campanella Family; Patrick J. Harrison Family; Peter French Memorial Foundation; ALF foundation; Wilmerding Endowments; NIH [T32HL007227]; NIH Loan Repayment Program [L30HL165535]; Philippa and Marvin Carsley Cardiology Research Chair; Montreal Heart Institute Foundation; Norwegian Research Council [309762, 288438, 298736]; ZonMW Off Road personal research grant; Dutch Heart Association; Netherlands Cardiovascular Research Initiative - Dutch Heart Foundation [2018-30 PREDICT2]; Dutch Heart Foundation; Netherlands Heart Institute [06901]; Georg and Bertha Schwyzer-Winiker Foundation; Baugarten Foundation; Swiss National Science Foundation; Swiss Heart Foundation; USZ Foundation; Daniel Bravo Foundation; Spanish Society of Cardiology; Sociedad Espanola de Cardiologia; Swedish Heart Lung Foundation

Published
2024
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28. Natural Course of Electrocardiographic Features in Arrhythmogenic Right Ventricular Cardiomyopathy and Their Relation to Ventricular Arrhythmic Events

Author

Onderzoek Precision medicine, Team Medisch, Circulatory Health, Svensson, Anneli, Jensen, Henrik Kjaerulf, Boonstra, Machteld J., Tétreault-Langlois, Marianne, Dahlberg, Pia, Bundgaard, Henning, Christensen, Alex Hørby, Rylance, Rebecca T., Svendsen, Jesper H., Cadrin-Tourigny, Julia, Te Riele, Anneline S.J.M., Platonov, Pyotr G., Onderzoek Precision medicine, Team Medisch, Circulatory Health, Svensson, Anneli, Jensen, Henrik Kjaerulf, Boonstra, Machteld J., Tétreault-Langlois, Marianne, Dahlberg, Pia, Bundgaard, Henning, Christensen, Alex Hørby, Rylance, Rebecca T., Svendsen, Jesper H., Cadrin-Tourigny, Julia, Te Riele, Anneline S.J.M., and Platonov, Pyotr G.

Published
2024

29. Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe

Author

Arts Assistenten Cardiologie, Genetica Groep Van Tintelen, Cancer, Child Health, Circulatory Health, Team Onderzoek, Carrick, Richard T, De Marco, Corrado, Gasperetti, Alessio, Bosman, Laurens P, Gourraud, Jean-Baptiste, Trancuccio, Alessandro, Mazzanti, Andrea, Murray, Brittney, Pendleton, Catherine, Tichnell, Crystal, Tandri, Harikrishna, Zeppenfeld, Katja, Wilde, Arthur A M, Davies, Brianna, Seifer, Colette, Roberts, Jason D, Healey, Jeff S, MacIntyre, Ciorsti, Alqarawi, Wael, Tadros, Rafik, Cutler, Michael J, Targetti, Mattia, Calò, Leonardo, Vitali, Francesco, Bertini, Matteo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Cappelletto, Chiara, De Luca, Antonio, Stolfo, Davide, Duru, Firat, Jensen, Henrik K, Svensson, Anneli, Dahlberg, Pia, Hasselberg, Nina E, Di Marco, Andrea, Jordà, Paloma, Arbelo, Elena, Moreno Weidmann, Zoraida, Borowiec, Karolina, Delinière, Antoine, Biernacka, Elżbieta K, van Tintelen, J Peter, Platonov, Pyotr G, Olivotto, Iacopo, Saguner, Ardan M, Haugaa, Kristina H, Cox, Moniek, Tondo, Claudio, Merlo, Marco, Krahn, Andrew D, Te Riele, Anneline S J M, Wu, Katherine C, Calkins, Hugh, James, Cynthia A, Cadrin-Tourigny, Julia, Arts Assistenten Cardiologie, Genetica Groep Van Tintelen, Cancer, Child Health, Circulatory Health, Team Onderzoek, Carrick, Richard T, De Marco, Corrado, Gasperetti, Alessio, Bosman, Laurens P, Gourraud, Jean-Baptiste, Trancuccio, Alessandro, Mazzanti, Andrea, Murray, Brittney, Pendleton, Catherine, Tichnell, Crystal, Tandri, Harikrishna, Zeppenfeld, Katja, Wilde, Arthur A M, Davies, Brianna, Seifer, Colette, Roberts, Jason D, Healey, Jeff S, MacIntyre, Ciorsti, Alqarawi, Wael, Tadros, Rafik, Cutler, Michael J, Targetti, Mattia, Calò, Leonardo, Vitali, Francesco, Bertini, Matteo, Compagnucci, Paolo, Casella, Michela, Dello Russo, Antonio, Cappelletto, Chiara, De Luca, Antonio, Stolfo, Davide, Duru, Firat, Jensen, Henrik K, Svensson, Anneli, Dahlberg, Pia, Hasselberg, Nina E, Di Marco, Andrea, Jordà, Paloma, Arbelo, Elena, Moreno Weidmann, Zoraida, Borowiec, Karolina, Delinière, Antoine, Biernacka, Elżbieta K, van Tintelen, J Peter, Platonov, Pyotr G, Olivotto, Iacopo, Saguner, Ardan M, Haugaa, Kristina H, Cox, Moniek, Tondo, Claudio, Merlo, Marco, Krahn, Andrew D, Te Riele, Anneline S J M, Wu, Katherine C, Calkins, Hugh, James, Cynthia A, and Cadrin-Tourigny, Julia

Published
2024

30. ECG-based estimation of respiration-induced autonomic modulation of AV nodal conduction during atrial fibrillation

Author

Plappert, Felix, Engström, Gunnar, Platonov, Pyotr, Wallman, Mikael, Sandberg, Frida, Plappert, Felix, Engström, Gunnar, Platonov, Pyotr, Wallman, Mikael, and Sandberg, Frida

Abstract

Introduction: Information about autonomic nervous system (ANS) activity may offer insights about atrial fibrillation (AF) progression and support personalized AF treatment but is not easily accessible from the ECG. In this study, we propose a new approach for ECG-based assessment of respiratory modulation in atrioventricular (AV) nodal refractory period and conduction delay. Methods: A 1-dimensional convolutional neural network (1D-CNN) was trained to estimate respiratory modulation of AV nodal conduction properties from 1-minute segments of RR series, respiration signals, and atrial fibrillatory rates (AFR) using synthetic data that replicates clinical ECG-derived data. The synthetic data were generated using a network model of the AV node and 4 million unique model parameter sets. The 1D-CNN was then used to analyze respiratory modulation in clinical deep breathing test data of 28 patients in AF, where an ECG-derived respiration signal was extracted using a novel approach based on periodic component analysis. Results: We demonstrated using synthetic data that the 1D-CNN can estimate the respiratory modulation from RR series alone with a Pearson sample correlation of r = 0.805 and that the addition of either respiration signal (r = 0.830), AFR (r = 0.837), or both (r = 0.855) improves the estimation. Discussion: Initial results from analysis of ECG data suggest that our proposed estimate of respiration-induced autonomic modulation, aresp, is reproducible and sufficiently sensitive to monitor changes and detect individual differences. However, further studies are needed to verify the reproducibility, sensitivity, and clinical significance of aresp.

Published
2024

31. The ABC-Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention:Results From the Randomized LOOP Study

Author

Xing, Lucas Yixi, Diederichsen, Søren Zöga, Højberg, Søren, Krieger, Derk W., Graff, Claus, Frikke-Schmidt, Ruth, Platonov, Pyotr G., Olesen, Morten S., Brandes, Axel, Køber, Lars, Haugan, Ketil Jørgen, Svendsen, Jesper Hastrup, Xing, Lucas Yixi, Diederichsen, Søren Zöga, Højberg, Søren, Krieger, Derk W., Graff, Claus, Frikke-Schmidt, Ruth, Platonov, Pyotr G., Olesen, Morten S., Brandes, Axel, Køber, Lars, Haugan, Ketil Jørgen, and Svendsen, Jesper Hastrup

Abstract

Background The ABC‐stroke score is a risk scheme for prediction of stroke or systemic embolism (SE) in atrial fibrillation (AF). This study sought to examine whether the score could be useful in predicting stroke in AF‐naïve individuals and risk stratifying for AF screening. Methods and Results The LOOP (Atrial Fibrillation Detected by Continuous ECG Monitoring Using Implantable Loop Recorder to Prevent Stroke in High‐Risk Individuals) study randomized 6004 AF‐naïve individuals aged 70 to 90 years with stroke risk factors to either screening with an implantable loop recorder and anticoagulation upon detection of new‐onset AF episodes ≥6 minutes, or usual care. A total of 5781 participants had available ABC‐stroke score at baseline and were included in this secondary analysis: 4170 (72.1%) with an estimated stroke/SE risk ≤1%/year versus 1611 (27.9%) with an estimated stroke/SE risk >1%/year. Having an annual ABC‐stroke risk >1% was associated with stroke/SE, stroke/SE/cardiovascular death, and all‐cause death (hazard ratio, 1.82 [95% CI, 1.44–2.21], 2.17 [95% CI, 1.80–2.62], and 2.19 [95% CI, 1.87–2.56], respectively). For screening with implantable loop recorder versus usual care, no significant reduction in these study outcomes was obtained in any ABC‐stroke risk groups (P>0.0500 for all), with no signal toward interaction (Pinteraction>0.2500 for all). Similar findings were yielded when assessing the ABC‐stroke score as a continuous variable. Conclusions In an elderly, AF‐naïve population with additional stroke risk factors, a higher ABC‐stroke score could identify individuals with increased stroke risk. However, this risk score may not be useful in pinpointing those more likely to benefit from AF screening and subsequent preventive treatment. These findings should be considered as hypothesis generating and warrant further study., BACKGROUND: The ABC-stroke score is a risk scheme for prediction of stroke or systemic embolism (SE) in atrial fibrillation (AF). This study sought to examine whether the score could be useful in predicting stroke in AF-naïve individuals and risk stratifying for AF screening. METHODS AND RESULTS: The LOOP (Atrial Fibrillation Detected by Continuous ECG Monitoring Using Implantable Loop Recorder to Prevent Stroke in High-Risk Individuals) study randomized 6004 AF-naïve individuals aged 70 to 90 years with stroke risk factors to either screening with an implantable loop recorder and anticoagulation upon detection of new-onset AF episodes ≥6 minutes, or usual care. A total of 5781 participants had available ABC-stroke score at baseline and were included in this secondary analysis: 4170 (72.1%) with an estimated stroke/SE risk ≤1%/year versus 1611 (27.9%) with an estimated stroke/SE risk >1%/year. Having an annual ABC-stroke risk >1% was associated with stroke/SE, stroke/SE/cardiovascular death, and all-cause death (hazard ratio, 1.82 [95% CI, 1.44-2.21], 2.17 [95% CI, 1.80-2.62], and 2.19 [95% CI, 1.87-2.56], respectively). For screening with implantable loop recorder versus usual care, no significant reduction in these study outcomes was obtained in any ABC-stroke risk groups (P>0.0500 for all), with no signal toward interaction (Pinteraction>0.2500 for all). Similar findings were yielded when assessing the ABC-stroke score as a continuous variable. CONCLUSIONS: In an elderly, AF-naïve population with additional stroke risk factors, a higher ABC-stroke score could identify individuals with increased stroke risk. However, this risk score may not be useful in pinpointing those more likely to benefit from AF screening and subsequent preventive treatment. These findings should be considered as hypothesis generating and warrant further study. REGISTRATION: URL: https://www.clinicaltrials.gov; unique identifier: NCT02036450.

Published
2024

32. Prediction of mortality benefit based on periodic repolarisation dynamics in patients undergoing prophylactic implantation of a defibrillator: a prospective, controlled, multicentre cohort study

Author

Merkely, Béla, Perge, Peter, Sallo, Zoltan, Szeplaki, Gabor, Zabel, Markus, Lüthje, Lars, Schlögl, Simon, Haarmann, Helge, Bergau, Leonard, Seegers, Joachim, Hasenfuß, Gerd, Munoz-Exposito, Pascal, Tichelbäcker, Tobias, Kirova, Aleksandra, Friede, Tim, Harden, Markus, Malik, Marek, Hnatkova, Katerina, Vos, Marc, Willich, Stefan N., Reinhold, Thomas, Willems, Rik, Vandenberk, Bert, Klinika, Magdalena, Toplice, Krapinske, Flevari, Panayota, Katsimardos, Andreas, Katsaras, Dimitrios, Hatala, Robert, Svetlosak, Martin, Lubinski, Andrzej, Kuczejko, Tomasz, Hansen, Jim, Sticherling, Christian, Conen, David, Milosrdnice, Sestre, Pavlović, Nikola, Manola, Šime, Vinter, Ozren, Benko, Ivica, Tuinenburg, Anton, Bauer, Axel, Meyer-Zürn, Christine, Eick, Christian, Hastrup, Jesper, Brugada, Josep, Arbelo, Elena, Kaliska, Gabriela, Martinek, Jozef, Dommasch, Michael, Steger, Alexander, Kääb, Stefan, Sinner, Moritz F., Rizas, Konstantinos D., Hamm, Wolfgang, Vdovin, Nikolay, Klemm, Mathias, von Stülpnagel, Lukas, Cygankiewicz, Iwona, Ptaszynski, Pawel, Kaczmarek, Krzysztof, Poddebska, Izabela, Iovev, Svetoslav, Novotný, Tomáš, Kozak, Milan, Huikuri, Heikki, Kenttä, Tuomas, Pelli, Ari, Kasprzak, Jaroslaw D., Qavoq, Dariusz, Brusich, Sandro, Avdovic, Ervin, Klasan, Marina, Galuszka, Jan, Taborsky, Milos, Velchev, Vasil, Dissmann, Rüdiger, Guzik, Przemysław, Bimmel, Dieter, Lieberz, Christiane, Stefanow, Stefan, Rüb, Norman, Wolpert, Christian, Maier, Lars S., Behrens, Steffen, Jurisic, Zrinka, Braunschweig, Frieder, Blaschke, Florian, Pieske, Burkert, Bakotic, Zoran, Anic, Ante, Schwinger, Robert H.G., Platonov, Pyotr, Rizas, Konstantinos D, Lubinski, Andrezej, Flevari, Panagiota, Merkely, Bela, and Schmidt, Georg

Published
2019
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33. P Wave Parameters and Indices: A Critical Appraisal of Clinical Utility, Challenges, and Future Research—A Consensus Document Endorsed by the International Society of Electrocardiology and the International Society for Holter and Noninvasive Electrocardiology

Author

Chen, Lin Yee, Ribeiro, Antonio Luiz Pinho, Platonov, Pyotr G., Cygankiewicz, Iwona, Soliman, Elsayed Z., Gorenek, Bulent, Ikeda, Takanori, Vassilikos, Vassilios P., Steinberg, Jonathan S., Varma, Niraj, Bayés-de-Luna, Antoni, and Baranchuk, Adrian

Published
2022
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35. T-Wave Peak-to-End Changes Quantified by Time-Warping Predicts Ventricular Fibrillation in a Porcine Myocardial Infarction Model

Author

Gomez, Neurys, Ramirez, Julia, Martin-Yebra, Alba, Demidova, Marina M., Platonov, Pyotr, Martinez, Juan Pablo, and Laguna, Pablo

Abstract

Background: The $\mathrm{T}_{pe}$-interval time-warping-based morphology variation index, derived from a spatially transformed PCA lead, $d^{\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$, has previously demonstrated utility in tracking repolarization changes induced by a 5-minute ischemia model in humans. The value of $d^{\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ as a predictor of ventricular fibrillation (VF) episodes is assessed in a 40-minutes porcine infarction model. Preocclusion and occlusion ECG recordings from 10 pigs who suffered a late VF episode and 16 who did not were analyzed. The $d^{\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ series was measured by comparing $\mathrm{T}_{pe}$ morphologies at different stages of the occlusion relative to a baseline. During baseline, $d^{\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ remained stationary with an intra-recording median [IQR] value of 1.60 [1.33] ms. During occlusion, $d^{\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ followed a well-marked gradual increasing trend, reaching a median of 14.58 [17.72] ms. $d^{\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ averages were significantly higher in the VF group than in the Non-VF group at five time intervals taken every 5 minutes after occlusion onset with median values of 12.5, 18.8, 26.8, 24.0, and 31.0, vs 6.3, 7.6, 8.0, 7.8, and 7.8, and also at three consecutive 5-minute intervals prior to VF 18.6, 25.0 and 28.8 vs 8.5, 7.2 and 6.0 ms, respectively. The $\mathrm{T}_{pe}^{\text{PCA}}$ interval was also significantly higher in the VF group at all analyzed time periods, but with a lower significance level. Pigs with maximum $d^{\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ &GreaterEqual; 20.0 ms and $\mathrm{T}_{pe}^{\text{PCA}}$ &GreaterEqual; 85.4 ms in the early 5-10 minutes interval after occlusion, had significantly higher risk for VF occurring with 90.0%/75.0% and 80.0%/69.0% sensitivity/ specificity, respectively. In conclusion, $d^{\text{PCA}}_{w,{\scriptscriptstyle \mathrm{T}_{pe}}}$ is a stronger VF predictor than $\mathrm{T}_{pe}^{\text{PCA}}$ during ischemia in a porcine model.

Published
2024
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36. The ABC‐Stroke Risk Score and Effects of Atrial Fibrillation Screening on Stroke Prevention: Results From the Randomized LOOP Study

Author

Xing, Lucas Yixi, primary, Diederichsen, Søren Zöga, additional, Højberg, Søren, additional, Krieger, Derk W., additional, Graff, Claus, additional, Frikke‐Schmidt, Ruth, additional, Platonov, Pyotr G., additional, Olesen, Morten S., additional, Brandes, Axel, additional, Køber, Lars, additional, Haugan, Ketil Jørgen, additional, and Svendsen, Jesper Hastrup, additional

Published
2024
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37. Implantable cardioverter defibrillator use in arrhythmogenic right ventricular cardiomyopathy in North America and Europe

Author

Carrick, Richard T, primary, De Marco, Corrado, additional, Gasperetti, Alessio, additional, Bosman, Laurens P, additional, Gourraud, Jean-Baptiste, additional, Trancuccio, Alessandro, additional, Mazzanti, Andrea, additional, Murray, Brittney, additional, Pendleton, Catherine, additional, Tichnell, Crystal, additional, Tandri, Harikrishna, additional, Zeppenfeld, Katja, additional, Wilde, Arthur A M, additional, Davies, Brianna, additional, Seifer, Colette, additional, Roberts, Jason D, additional, Healey, Jeff S, additional, MacIntyre, Ciorsti, additional, Alqarawi, Wael, additional, Tadros, Rafik, additional, Cutler, Michael J, additional, Targetti, Mattia, additional, Calò, Leonardo, additional, Vitali, Francesco, additional, Bertini, Matteo, additional, Compagnucci, Paolo, additional, Casella, Michela, additional, Dello Russo, Antonio, additional, Cappelletto, Chiara, additional, De Luca, Antonio, additional, Stolfo, Davide, additional, Duru, Firat, additional, Jensen, Henrik K, additional, Svensson, Anneli, additional, Dahlberg, Pia, additional, Hasselberg, Nina E, additional, Di Marco, Andrea, additional, Jordà, Paloma, additional, Arbelo, Elena, additional, Moreno Weidmann, Zoraida, additional, Borowiec, Karolina, additional, Delinière, Antoine, additional, Biernacka, Elżbieta K, additional, van Tintelen, J Peter, additional, Platonov, Pyotr G, additional, Olivotto, Iacopo, additional, Saguner, Ardan M, additional, Haugaa, Kristina H, additional, Cox, Moniek, additional, Tondo, Claudio, additional, Merlo, Marco, additional, Krahn, Andrew D, additional, te Riele, Anneline S J M, additional, Wu, Katherine C, additional, Calkins, Hugh, additional, James, Cynthia A, additional, and Cadrin-Tourigny, Julia, additional

Published
2024
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38. Reply

Author

Myadam, Rahul, primary, Crawford, Thomas C., additional, Bogun, Frank M., additional, Gu, Xiaokui, additional, Ellenbogen, Kenneth A., additional, Jasti, Shilpa, additional, Chicos, Alexandru B., additional, Roukoz, Henri, additional, Zimetbaum, Peter J., additional, Kalbfleisch, Steven J., additional, Murgatroyd, Francis D., additional, Steckman, David A., additional, Rosenfeld, Lynda E., additional, Garlitski, Ann C., additional, Soejima, Kyoko, additional, Bhan, Adarsh K., additional, Vedantham, Vasanth, additional, Dickfeld, Timm-Michael L., additional, De Lurgio, David B., additional, Platonov, Pyotr G., additional, Zipse, Matthew M., additional, Nishiuchi, Suguru, additional, Ortman, Matthew L., additional, Narasimhan, Calambur, additional, Patton, Kristen K., additional, Rosenthal, David G., additional, Mukerji, Siddharth S., additional, Hoogendoorn, Jarieke C., additional, Zeppenfeld, Katja, additional, Sauer, William H., additional, and Kron, Jordana, additional

Published
2023
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42. The ability of the electrocardiogram in left bundle branch block to detect myocardial scar determined by cardiovascular magnetic resonance

Author

Wieslander, Björn, Xia, Xiaojuan, Jablonowski, Robert, Axelsson, Jimmy, Klem, Igor, Nijveldt, Robin, Maynard, Charles, Schelbert, Erik B., Sörensson, Peder, Sigfridsson, Andreas, Chaudhry, Uzma, Platonov, Pyotr G., Borgquist, Rasmus, Engblom, Henrik, Couderc, Jean-Philippe, Strauss, David G., Atwater, Brett D., and Ugander, Martin

Published
2018
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45. ISE/ISHNE expert consensus statement on the ECG diagnosis of left ventricular hypertrophy: The change of the paradigm

Author

Bacharova, Ljuba, primary, Chevalier, Philippe, additional, Gorenek, Bulent, additional, Jons, Christian, additional, Li, Yi‐Gang, additional, Locati, Emanuela T., additional, Maanja, Maren, additional, Pérez‐Riera, Andrés Ricardo, additional, Platonov, Pyotr G., additional, Ribeiro, Antonio Luiz Pinho, additional, Schocken, Douglas, additional, Soliman, Elsayed Z., additional, Svehlikova, Jana, additional, Tereshchenko, Larisa G., additional, Ugander, Martin, additional, Varma, Niraj, additional, Elena, Zaklyazminskaya, additional, and Ikeda, Takanori, additional

Published
2023
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48. Sudden Cardiac Death Prediction in Arrhythmogenic Right Ventricular Cardiomyopathy: A Multinational Collaboration

Author

Cadrin-Tourigny, Julia, Bosman, Laurens P., Wang, Weijia, Tadros, Rafik, Bhonsale, Aditya, Bourfiss, Mimount, Lie, Øyvind H., Saguner, Ardan M., Svensson, Anneli, Andorin, Antoine, Tichnell, Crystal, Murray, Brittney, Zeppenfeld, Katja, van den Berg, Maarten P., Asselbergs, Folkert W., Wilde, Arthur A.M., Krahn, Andrew D., Talajic, Mario, Rivard, Lena, Chelko, Stephen, Zimmerman, Stefan L., Kamel, Ihab R., Crosson, Jane E., Judge, Daniel P., Yap, Sing-Chien, Van der Heijden, Jeroen F., Tandri, Harikrishna, Jongbloed, Jan D.H., van Tintelen, J. Peter, Platonov, Pyotr G., Duru, Firat, Haugaa, Kristina H., Khairy, Paul, Hauer, Richard N.W., Calkins, Hugh, te Riele, Anneline S.J.M., and James, Cynthia A.

Published
2021
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49. Prevalence and prognostic value of electrocardiographic abnormalities in hypokalemia: A multicenter cohort study.

Author

Kildegaard, Helene, Brabrand, Mikkel, Forberg, Jakob Lundager, Platonov, Pyotr, Lassen, Annmarie Touborg, and Ekelund, Ulf

Subjects
PROPENSITY score matching, PROGNOSIS, HYPOKALEMIA, VENTRICULAR arrhythmia, ARRHYTHMIA, COHORT analysis
Abstract

Background: Hypokalemia is common in hospitalized patients and associated with ECG abnormalities. The prevalence and prognostic value of ECG abnormalities in hypokalemic patients are, however, not well established. Methods: The study was a multicentered cohort study, including all ault patients with an ECG and potassium level <4.4 mmol/L recorded at arrival to four emergency departments in Denmark and Sweden. Using computerized measurements from ECGs, we investigated the relationship between potassium levels and heart rate, QRS duration, corrected QT (QTc) interval, ST‐segment depressions, T‐wave flattening, and T‐wave inversion using cubic splines. Within strata of potassium levels, we further estimated the hazard ratio (HR) for 7‐day mortality, admission to the intensive care unit (ICU), and diagnosis of ventricular arrhythmia or cardiac arrest, comparing patients with and without specific ECG abnormalities matched 1:2 on propensity scores. Results: Among 79,599 included patients, decreasing potassium levels were associated with a concentration‐dependent increase in all investigated ECG variables. ECG abnormalities were present in 40% of hypokalemic patients ([K+] <3.5 mmol/L), with T‐wave flattening, ST‐segment depression, and QTc prolongation occurring in 27%, 16%, and 14%. In patients with mild hypokalemia ([K+] 3.0–3.4 mmol/L), a heart rate >100 bpm, ST‐depressions, and T‐wave inversion were associated with increased HRs for 7‐day mortality and ICU admission, whereas only a heart rate >100 bpm predicted both mortality and ICU admission among patients with [K+] <3.0 mmol/L. HR estimates were, however, similar to those in eukalemic patients. The low number of events with ventricular arrhythmia limited evaluation for this outcome. Conclusions: ECG abnormalities were common in hypokalemic patients, but they are poor prognostic markers for short‐term adverse events under the current standard of care. [ABSTRACT FROM AUTHOR]

Published
2024
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50. Transethnic Genome-Wide Association Study Provides Insights in the Genetic Architecture and Heritability of Long QT Syndrome

Author

Lahrouchi, Najim, Tadros, Rafik, Crotti, Lia, Mizusawa, Yuka, Postema, Pieter G., Beekman, Leander, Walsh, Roddy, Hasegawa, Kanae, Barc, Julien, Ernsting, Marko, Turkowski, Kari L., Mazzanti, Andrea, Beckmann, Britt M., Shimamoto, Keiko, Diamant, Ulla-Britt, Wijeyeratne, Yanushi D., Kucho, Yu, Robyns, Tomas, Ishikawa, Taisuke, Arbelo, Elena, Christiansen, Michael, Winbo, Annika, Jabbari, Reza, Lubitz, Steven A., Steinfurt, Johannes, Rudic, Boris, Loeys, Bart, Shoemaker, M. Ben, Weeke, Peter E., Pfeiffer, Ryan, Davies, Brianna, Andorin, Antoine, Hofman, Nynke, Dagradi, Federica, Pedrazzini, Matteo, Tester, David J., Bos, J. Martijn, Sarquella-Brugada, Georgia, Campuzano, Óscar, Platonov, Pyotr G., Stallmeyer, Birgit, Zumhagen, Sven, Nannenberg, Eline A., Veldink, Jan H., van den Berg, Leonard H., Al-Chalabi, Ammar, Shaw, Christopher E., Shaw, Pamela J., Morrison, Karen E., Andersen, Peter M., Müller-Nurasyid, Martina, Cusi, Daniele, Barlassina, Cristina, Galan, Pilar, Lathrop, Mark, Munter, Markus, Werge, Thomas, Ribasés, Marta, Aung, Tin, Khor, Chiea C., Ozaki, Mineo, Lichtner, Peter, Meitinger, Thomas, van Tintelen, J. Peter, Hoedemaekers, Yvonne, Denjoy, Isabelle, Leenhardt, Antoine, Napolitano, Carlo, Shimizu, Wataru, Schott, Jean-Jacques, Gourraud, Jean-Baptiste, Makiyama, Takeru, Ohno, Seiko, Itoh, Hideki, Krahn, Andrew D., Antzelevitch, Charles, Roden, Dan M., Saenen, Johan, Borggrefe, Martin, Odening, Katja E., Ellinor, Patrick T., Tfelt-Hansen, Jacob, Skinner, Jonathan R., van den Berg, Maarten P., Olesen, Morten Salling, Brugada, Josep, Brugada, Ramón, Makita, Naomasa, Breckpot, Jeroen, Yoshinaga, Masao, Behr, Elijah R., Rydberg, Annika, Aiba, Takeshi, Kääb, Stefan, Priori, Silvia G., Guicheney, Pascale, Tan, Hanno L., Newton-Cheh, Christopher, Ackerman, Michael J., Schwartz, Peter J., Schulze-Bahr, Eric, Probst, Vincent, Horie, Minoru, Wilde, Arthur A., Tanck, Michael W.T., and Bezzina, Connie R.

Published
2020
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