Publications by authors named "Jose Nunes de Alencar Neto"

Background: Accurate estimation of accessory pathway (AP) localization in patients with ventricular pre-excitation or Wolff-Parkinson-White (WPW) syndrome remains a diagnostic challenge. Existing algorithms have contributed significantly to this area, but alternative algorithms can offer additional perspectives and approaches to AP localization.

Objective: This study introduces and evaluates the diagnostic accuracy of the EPM algorithm in AP localization, comparing it with established algorithms Arruda and EASY.

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Article Synopsis
  • - The study aimed to assess how effectively ST-segment elevation on a 12-lead ECG identifies acute coronary occlusions (ACO), questioning traditional STEMI vs. NSTEMI diagnostic classifications.
  • - After analyzing three studies with nearly 24,000 patients, it was found that ST-segment elevation has a low sensitivity (43.6%) for detecting ACO, suggesting many cases may not show this elevation, but it has high specificity (96.5%).
  • - An alternative diagnostic approach, the OMI-NOMI strategy, demonstrated improved sensitivity (78.1%) while keeping a similar high specificity, indicating a need for broader research to validate these findings in different contexts.
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Electrocardiograms (ECGs) are a cornerstone in cardiac care. Traditional statistical metrics like sensitivity and specificity are commonly used for diagnostic evaluations but are limited when applied in clinical settings due to their inability to incorporate pre-test likelihoods or individual patient context. Traditional diagnostic metrics do not provide a complete picture in clinical scenarios.

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Cognitive biases can cause diverse medical errors and lead to malpractice with potential harm to patients. Some cognitive biases are due to social behavior, professional specialization, and personal experience, leading to commission or omission in medical conduct. We would like to propose a previously undescribed cognitive bias called "Schrödinger's cat bias.

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Atypical bypass tracts or variants of ventricular pre-excitation are rare anatomic structures often with rate-dependent slowing in conduction, called decremental conduction. During sinus rhythm, electrocardiographic recognition of those structures may be difficult because unlike in the Wolff-Parkinson-White syndrome where usually overt ventricular pre-excitation is present, the electrocardiogram (ECG) often shows a subtle pre-excitation pattern because of less contribution to ventricular activation over the slow and decrementally conducting bypass. Following the structure described by Ivan Mahaim and Benatt corresponding to a fasciculoventricular pathway, several other new variants of ventricular pre-excitation were reported.

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Since it was first reported in 1912, acute coronary syndrome (ACS) has become the leading cause of death in the Western world. Several improvements that have been made over the years in the pharmacological treatment of ACS have reduced the relative risk of death due to myocardial infarction from 35-45% previously to approximately 3.5% at present.

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Background: Electrocardiogram is the initial test in the investigation of heart disease. Electrocardiographic changes in hypertrophic cardiomyopathy have no set pattern, and correlates poorly with echocardiographic findings. Cardiac magnetic resonance imaging has been gaining momentum for better assessment of hypertrophy, as well as the detection of myocardial fibrosis.

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Arrhythmogenic right ventricular dysplasia or cardiomyopathy (ARVD/C) is a pathologic condition where the right ventricle is partially or totally replaced by fatty and fibrous tissue. The electrocardiogram (ECG) has a central role for diagnosis since it comprises two major and two minor criteria in the diagnostic criteria published by the Task 1 Force, although it is not 100% necessary to make a final diagnosis, because around 10% of patients with ARVD/C present with a normal ECG. In this article, we review the 12-lead electrocardiographic findings of patients with ARVD/C.

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