Publications by authors named "Pyotr Platonov"
ECG in Brugada syndrome (BrS) is characterized by a ST-segment elevation in the right precordial leads. Overlap between ST-segment changes in BrS and ischemia may lead to diagnostic challenges. We report a case of a male patient presented with recurrent chest pain episodes and ST elevation in the right precordial leads consistent with Brugada ECG pattern type 1 and was clinically diagnosed with BrS at the age of 30 years.
View Article and Find Full Text PDFBackground: Studies have shown that the risk of new-onset heart failure (HF) is higher postimplantation for patients receiving right ventricular pacing.
Objective: This study aimed to investigate incidence, risk factors, and implications for long-term prognosis of new-onset HF in patients after pacemaker implantation.
Methods: Patients without pre-existing HF who received a pacemaker in Sweden during the period of 2005 to 2020 were identified via the nationwide Pacemaker Registry.
Objectives: To examine cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injury (SCI) compared with the general population, and explore if the neurological level of injury (NLI) is related to cardiovascular autonomic function.
Design: Population-based cross-sectional study with matched controls.
Setting: Outpatient SCI unit in Southern Sweden.
Article Synopsis
- Electrocardiographic abnormalities are common in patients with arrhythmogenic right ventricular cardiomyopathy and were analyzed over the long term in a study involving 353 patients and almost 7,000 ECGs.
- The study found that over time, there were notable changes in QRS voltage, R- and T-wave amplitudes, as well as increases in QRS duration, terminal activation duration, and QTc interval, indicating a progressive worsening of the condition.
- T-wave inversions observed before diagnosis were linked to a higher risk of future ventricular arrhythmias, suggesting these ECG abnormalities could serve as early indicators of the disease even if they don't meet the full diagnostic criteria.
Article Synopsis
- The study investigates how the autonomic nervous system (ANS) affects the progression of atrial fibrillation (AF) and proposes a new ECG-based method to assess this activity, focusing on respiratory modulation of AV nodal conduction.
- A 1-dimensional convolutional neural network (1D-CNN) was trained on synthetic ECG data to estimate respiratory effects on AV node properties, showing strong correlations in its predictions.
- Initial results from clinical tests indicate that this method is promising for monitoring autonomic modulation in AF patients, but more research is needed to confirm its reliability and clinical relevance.
Background: The T-peak-to-T-end ( T) interval has shown potential in predicting ventricular arrhythmic risk. It is an appealing index to be measured during ischemia since it is less influenced by ST-segment changes than the early part of the T wave. A time-warping-based index, derived from a spatially transformed PCA lead, [Formula: see text], quantifying changes in the T morphology, has previously demonstrated utility in tracking repolarization changes induced by a 5-minute ischemia model in humans.
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- Patients undergoing catheter ablation for atrial fibrillation (AF) are typically treated with oral anticoagulants to prevent thromboembolic events, but some develop left atrial appendage thrombus (LAAT), which is monitored using transesophageal ultrasound (TEE).
- A retrospective review of 553 patients from Lund University Hospital showed only 0.54% had LAAT, with 3.25% showing spontaneous echo contrast (SEC); both conditions were linked to higher CHADS-VASc scores and specific AF presentations.
- The study concluded that LAAT and SEC are rare in patients with AF undergoing ablation, especially among those with lower risk profiles, highlighting that no patients with low CHADS-VASc scores
Article Synopsis
- Patients with heart failure (HF) and bradycardia may receive different types of cardiac implantable electronic devices (CIED) based on various factors like age and comorbidities, and the study aimed to evaluate their 5-year outcomes post-implantation.
- The study included 37,745 HF patients in Sweden who received CIEDs from 2005 to 2018 and found significant differences in demographics and outcomes between those receiving implantable cardioverter defibrillators and pacemakers.
- Results indicated higher mortality rates among single-chamber pacemaker recipients (61%) compared to the average (40%), while cardiovascular mortality was highest in cardiac resynchronization therapy recipients, highlighting how device selection correlates with patient
The management of tachycardias depends on their underlying pathophysiology. The key to uncovering this pathophysiology is in finding the temporal relationship between atrial and ventricular activation. The P-waves resulting from atrial activation can however be hard to detect on a traditional EKG in the setting of a tachycardia.
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- * The LOOP study involved 6,004 AF-naïve individuals aged 70-90 with stroke risk factors, comparing outcomes of those monitored with an implantable loop recorder to usual care, finding that a higher ABC-stroke score significantly indicated increased stroke risk.
- * However, results showed that the ABC-stroke score did not effectively identify which individuals would benefit from AF screening or preventive treatment, suggesting the need for further investigation into its clinical utility.
Article Synopsis
- *This study introduces a new method to measure the refractory period and conduction delay in the AV node over 24 hours, using non-invasive data and advanced computational techniques.
- *Results showed that while diurnal changes in heart rate control weren’t linked to treatment outcomes, short-term variability in the AV node's function could indicate how well a specific drug like metoprolol might work.
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.
Article Synopsis
- The study examines the relationship between P-wave characteristics in ECG readings and the prediction of atrial fibrillation (AF) in a population-based sample of older adults.
- Researchers analyzed data from the Malmö Preventative Project, tracking 983 AF-free individuals for five years while measuring various P-wave features such as duration, axis, and dispersion.
- Results showed that abnormal P-wave axis and a high MVP score were significant predictors of new-onset AF, highlighting the relevance of specific P-wave metrics and the importance of recognizing advanced interatrial block as a risk factor for AF.
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.
Article Synopsis
- The diagnosis of left ventricular hypertrophy (LVH) through ECG primarily relies on measuring the QRS voltage, but this method often lacks sensitivity.
- A new approach emphasizes the understanding of electrical properties of the heart muscle and factors influencing QRS voltage beyond just size, including both spatial and non-spatial determinants.
- This perspective reveals a wide variety of QRS patterns in LVH patients, indicating that a normal QRS complex can still exist despite underlying complications, and highlights the importance of interpreting these changes for assessing cardiovascular risk.
Markers of Atrial Myopathy in the General Population: Prevalence, Predictors, and Inter-Relations.
JACC Clin Electrophysiol
November 2023
Article Synopsis
- * A study involving 6,013 individuals showed that 42% had at least one marker of atrial myopathy, with few having more than one; P-wave duration and left atrial volume index were the most correlated measures.
- * Factors like smoking, high blood pressure, diabetes, and coronary artery disease were linked to increased premature atrial complexes, while physical activity contributed to higher left atrial volume.
Article Synopsis
- The diagnosis of Left Ventricular Hypertrophy (LVH) using ECG mainly relies on measuring the increased amplitude of the QRS complex in specific leads.
- The traditional understanding suggests that a larger left ventricular mass produces a stronger electrical field, leading to heightened QRS forces and amplitudes.
- However, studies show that only a small percentage of LVH patients actually exhibit this increased QRS amplitude, indicating that the current voltage criteria have low sensitivity, prompting a discussion on potential reasons and the introduction of a new diagnostic approach.
Article Synopsis
- * It involved 32 patients and found that 22% relapsed to atrial fibrillation within six weeks, with the pre-cardioversion AFR being similar between those who maintained sinus rhythm and those who did not.
- * The conclusion was that AFR did not predict sinus rhythm maintenance in these patients, contradicting previous research suggesting a link.
Article Synopsis
- The study aimed to assess the effects of age on mortality rates in patients with nonischemic cardiomyopathy treated with either CRT-D or CRT-P devices.
- The research included over 4,000 patients in Sweden from 2005 to 2020 and found that CRT-D treatment was linked with significantly lower overall mortality compared to CRT-P, especially in younger patients under 60.
- The findings highlight that while CRT-D improves 5-year survival rates, the age-related benefits vary, with younger patients experiencing the most noticeable reduction in mortality.
Article Synopsis
- - The study aimed to investigate how physical activity and sedentary time relate to autonomic function, specifically measured through the deep breathing test (DBT), among a group of 4325 individuals aged 50-64.
- - Results showed that higher sedentary time was linked to lower measures of heart rate variability (HRV) and respiratory sinus arrhythmia (RSA), indicating poorer autonomic function, particularly after analyzing by age and sex factors.
- - However, after accounting for heart rate adjustments, these associations lost significance, suggesting that the impact of physical activity on cardiovagal function is closely linked to heart rate levels.
Article Synopsis
- - Prolonged endurance exercise is linked to an increased risk of atrial fibrillation (AF) in men, and the study aims to explore the relationship between LA mechanical dispersion (LA MD), AF, and endurance exercise in veteran athletes.
- - The research involved 293 male participants, including veteran skiers with and without paroxysmal AF (pAF), and measured key variables using echocardiographic exams.
- - Results showed that while LA MD was associated with pAF, it did not provide additional helpful information in identifying pAF beyond existing markers, indicating its potential as a marker of pathological atrial remodeling but limited in predictive value.
Risk of Adverse Outcomes Associated With Cardiac Sarcoidosis Diagnostic Schemes.
JACC Clin Electrophysiol
August 2023
Article Synopsis
- A study evaluated the association of various cardiac sarcoidosis (CS) diagnostic criteria from different years (1993, 2006, 2014, and 2017) with negative health outcomes in patients.
- Research involved analyzing data from a global cardiac sarcoidosis registry and identified adverse events like mortality and surgeries in 587 patients.
- Results showed patients meeting the 1993 and 2006 criteria had significantly higher chances of experiencing adverse outcomes compared to those who didn't, while the 2014 and 2017 criteria did not show a significant correlation with these events.
Article Synopsis
- The study aimed to investigate how different triggers for myocardial infarction (MI) vary between sexes, considering the influence of both internal and external factors.
- Researchers conducted a survey with 451 patients, identifying 27 potential triggers in three categories: activities, emotions, and food/alcohol consumption.
- Results showed that women reported higher levels of emotional triggers like stress and sadness compared to men, emphasizing the need to account for these sex differences in developing preventive strategies for MI.