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Electrocardiographic marker of ventricular action potential triangulation (the simulation study).

J Electrocardiol

December 2024

Physiology Unit, Department of Pre-Clinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, Mount Hope Hospital, Building 35, Uriah Butler Highway, Trinidad and Tobago.

Background: The aim of this simulation was to examine the utility of a novel ECG-based index of cardiac action potential (AP) triangulation, the Tstart-to-Tpeak (TsTp) interval-to-JTstart (JTs) interval ratio, for assessment of changes in AP profile imposed through variations in the duration of the plateau phase and the phase 3 repolarization.

Methods: ECGs were simulated using a realistic rabbit model based on experimental data. The AP plateau was measured at APD30, and the phase 3 was assessed as APD90-to-APD30 difference (AP durations at 90 % and 30 % repolarization, respectively).

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Background: Wide QRS complex tachycardia (WCT) differentiation into ventricular tachycardia (VT) and supraventricular wide complex tachycardia (SWCT) remains challenging despite numerous 12-lead electrocardiogram (ECG) criteria and algorithms. Automated solutions leveraging computerized ECG interpretation (CEI) measurements and engineered features offer practical ways to improve diagnostic accuracy. We propose automated algorithms based on (i) WCT QRS polarity direction (WCT Polarity Code [WCT-PC]) and (ii) QRS polarity shifts between WCT and baseline ECGs (QRS Polarity Shift [QRS-PS]).

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Heparin is an anticoagulant used invariably in all cardiac surgery. Heparin dosing and its reversal were determined by monitoring activated clotting time (ACT). Intermittent heparin dosing after initial bolus dose is widely practiced to maintain ACT level 200-300 seconds in Off-pump coronary artery bypass surgery (OPCAB).

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Background: Numerous studies have demonstrated the significance of trimethylamine-N-oxide (TMAO) in the progression of atrial fibrillation (AF). However, the association between TMAO and AF recurrence (RAF) post-catheter ablation is not yet fully understood. This study aims to elucidate the predictive capability of pre-procedural TMAO levels in determining RAF following catheter ablation (CA).

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Background: Interventricular dyssynchrony derived from the classic non-physiological stimulation (n-PS) of the right ventricle (RV) is a known cause of left ventricular dysfunction (LVDys).

Methods: This was a prospective descriptive single-center study. We analyzed patients who develop LVDys with n-PS, and the results after upgrading to conduction system pacing (CSP).

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