Electrocardiographic Findings Research Articles

Evaluation of Arrhythmia Risk in Children with Type 1 Diabetes Mellitus.

Children with type 1 diabetes mellitus are susceptible to arrhythmias and sudden cardiac death. In this study, we aimed to explore the arrhythmia risk among children with type 1 diabetes mellitus by assessing electrocardiographic parameters. A total of 165 children diagnosed with type 1 diabetes mellitus, aged 10-18 years, and 154 healthy children matched for age and gender without any chronic diseases, were included in the study. The electrocardiographical ventricular depolarization-repolarization parameters of both groups and the correlation of these parameters with length of time since diagnosis of type 1 diabetes mellitus, metabolic control, and the presence of additional complications were evaluated. The groups were similar in terms of age, gender, weight, height, and BMI (p>0.05). The median length of time since diagnosis of diabetes was 5 years. QT (maximum), QTc (minimum and maximum), QT and QTc dispersion, Tp-e (minimum and maximum), Tp-e dispersion, Tp-e/ QTc-max values were significantly higher in the diabetic group compared with controls although QTc intervals are within normal ranges. No statistically significant correlation was observed between electrocardiographic findings and length of time since diagnosis of type 1 diabetes mellitus, HbA1c levels, or complications. As children with type 1 diabetes mellitus are at high risk of impaired ventricular depolarization and repolarization, they should undergo cardiac assessment and regular electrocardiographic monitoring.

Association of Electrocardiographic Abnormalities With In-hospital Mortality in Adult Patients With COVID-19 Infection

OBJECTIVES: The study aimed to determine the association of electrocardiographic (ECG) abnormalities and in-hospital mortality of patients with coronavirus disease 2019 (COVID-19) infection admitted in a tertiary care hospital in the Philippines. METHODS: We conducted a retrospective study of confirmed COVID-19–infected patients. Demographic and clinical characteristics and clinical outcomes were extracted from the medical records. Electrocardiographic analysis was derived from the 12-lead electrocardiogram recorded upon admission. The frequencies and distributions of various clinical characteristics were described, and the ECG abnormalities associated with in-hospital mortality were investigated. RESULTS: A total of 163 patients were included in the study; most were female (52.7%) with a median age of 55 years. Sinus rhythm with any ECG abnormality (65%), nonspecific ST and T-wave changes (35%), and sinus tachycardia (22%) were the frequently reported ECG findings. The presence of any ECG abnormality was detected in 78.5% of patients, and it was significantly associated with in-hospital mortality (P = 0.038). The analysis revealed a statistically significant association between in-hospital mortality and having atrial fibrillation or flutter (P = 0.002), supraventricular tachycardia (P = 0.011), ventricular tachycardia (P = 0.011), third-degree atrioventricular block (P = 0.011), T-wave inversion (P = 0.005), and right ventricular hypertrophy (P = 0.011). CONCLUSION: The presence of any ECG abnormality in patients with COVID-19 infection was associated with in-hospital mortality. Electrocardiographic abnormalities that were associated with mortality were atrial fibrillation or flutter, supraventricular tachycardia, ventricular tachycardia, third-degree atrioventricular block, T-wave inversion, and right ventricular hypertrophy. KEYWORDS: COVID-19, electrocardiography, mortality, Philippines

The Prognosis of Idiopathic Premature Ventricular Beats in Children with Structurally Normal Hearts.

The objective of this study is to evaluate the prognosis of idiopathic premature ventricular beats (PVBs) in children. We retrospectively evaluated 73 children (<18 years old) with idiopathic PVBs and structurally normal hearts. All patients were evaluated by 24-hour Holter electrocardiography (ECG) and echocardiography at the first admission and followed with a mean of 27 ± 7.6 months after diagnosis. Baseline Holter ECG and echocardiographic findings were compared to the last visit. The mean age of the patients was 11.1 ± 4.8 years, and half were symptomatic at initial examination. Baseline Holter showed complex beats in 35 cases, non-sustained ventricular tachycardia in 7 cases, and frequent PVBs in 19 cases. Complete recovery (CR) of PVBs was observed in 37 cases (50.7%) at a median of 15 (minimum: 5, maximum: 33) months after diagnosis. There were no significant differences in CR rates between patient groups with left bundle branch block (LBBB) vs. right bundle branch block (RBBB) morphology of PVBs, simple vs. complex PVBs, and daytime vs. nighttime dominance of PVBs (P > .05 for all parameters). The CR rate of PVBs was different among patients with infrequent, moderate, and frequent PVBs (62.8%, 36.4%, and 31.6%, respectively). Premature ventricular beats disappeared more often during follow-up in patients with infrequent PVBs (P = .045). However, the absolute decrease and disappearance rates of PVBs were similar across all groups (72.1%, 81.8%, and 89.5%, respectively; P = .319). The resolution rates of PVBs were not statistically different between the patient group who received pharmacological treatment and the group who followed up without treatment (P = .070). No myocardial dysfunction was observed in any patient during follow-up. No cases experienced major cardiac events. Idiopathic PVBs usually regress in childhood regardless of frequency and complexity or receiving antiarrhythmic medication. The risk of ventricular dysfunction is low during childhood; however, they require careful evaluation and follow-up.

Early Diagnosis of Subclinical Atherosclerosis in Asymptomatic Type 2 Diabetic Normotensive Menopausal Women: A Global Pulse Wave Velocity Study

AbstractArterial stiffness serves as a cardiovascular disease marker, aiding in the early identification of high-risk patients. We aimed to evaluate the prevalence of arterial stiffness, measured by global pulse wave velocity (gPWV), among diabetic normotensive menopausal women (DPMW) and its correlation with levels of glycosylated hemoglobin (HbA1c). We recruited 641 consecutive DPMW diagnosed with type 2 diabetes over 5 years. The control group (CG) consisted of 300 normotensive, normoglycemic menopausal women. Normal gPWV was defined as a velocity ≤7.1 m/s. We enrolled 641 DPMW with a mean age of 57 ± 12 years. The CG comprised 300 normotensive, normoglycemic postmenopausal women with a mean age of 56 ± 4 years. Among DPMW, 29 (4.5%) exhibited increased gPWV compared with 4 (1.3%) in the CG (p &lt; 0.01). Of the 225 (35.1%) DPMW with HbA1c &gt; 7.5%, 23 (10.2%) had increased gPWV. In contrast, among the 416 (64.9%) DPMW with HbA1c &lt; 7.5%, only 6 (1.4%) had increased gPWV (p &lt; 0.0001). Electrocardiographic (ECG) abnormalities were detected in 208 (32.4%) DPMW, with 11 (5.3%) of them exhibiting increased gPWV (p = 0.6). There was a higher prevalence of increased gPWV in asymptomatic normotensive DPMW, with a significant association between increased gPWV and elevated HbA1c levels. However, there was no correlation between increased gPWV and abnormal ECG findings, despite ECG being the sole test recommended by current guidelines for all diabetic patients. Early detection of elevated HbA1c levels and increased gPWV may identify asymptomatic DPMW at higher cardiovascular risk, highlighting the inadequacy of a simple ECG in assessing cardiovascular risk in this population.

Navigating the Diagnostic and Management Challenges of Suspected Cardiac Amyloidosis in Resource-Limited Settings: Ethiopia Experience.

This report discusses the diagnostic and therapeutic complexities encountered in resource-limited environments when assessing patients suspected of cardiac amyloidosis (CA). The study describes a case involving a patient who initially presented with heart failure symptoms and eventually received a CA diagnosis after 13 months and four primary physician visits, primarily based on discrepancies observed between electrocardiographic and echocardiographic findings, alongside elevated cardiac troponin levels. The case underscores the limited awareness of CA among primary healthcare providers in Ethiopia, contributing to a higher likelihood of misdiagnosis and inappropriate treatment approaches. Additionally, the report discusses the specific challenges associated with diagnosing and managing CA patients. It advocates for essential resources such as heightened clinical suspicion, proficiency in recognizing the characteristic electrocardiogram (ECG) and echocardiographic indicators of CA, and prompt referral to cardiologists.

Inferolateral Fibrosis in a Nonhypertrophic Left Ventricle

A 62-year-old recreational cyclist presented with transient loss of consciousness and common electrocardiographic findings. Despite absence of left ventricular hypertrophy, multidisciplinary evaluation and a positive family history led to the diagnosis of non-classical Fabry disease. This case emphasizes the added value of multidisciplinary analysis of nonspecific findings to diagnose a rare disease.

Predictors of Myocardial Fibrosis Detected by CMR in Patients With Idiopathic PVCs.

Premature ventricular contractions (PVCs) are a frequent electrocardiographic finding in routine medical practice, and 16% of the patients with idiopathic PVCs may have underlying heart disease. We analyzed the correlation between the morphology of the PVCs and the myocardial scarring identified by cardiac magnetic resonance (CMR), together with the impact of late gadolinium enhancement (LGE) on the need for ablation. Ninety-four patients (median age 56 years) with frequent PVCs (> 500 PVCs on 24 h) and a structurally normal heart were referred for comprehensive CMR. The patients were followed for 12 months. Patients were referred for ablation if they were symptomatic in the context of frequent PVCs. The prevalence of LGE identified by CMR was higher among males (OR 5.506 (2.092-14.49) p < 0.05), with an age ≥ 50 years (OR 1.047 (1.015-1.08), p < 0.05) and a higher PVC burden (OR 1.922 (1.723-1.976), p < 0.05). Additionally, patients with PVCs with a LBBB inferior axis had four times higher risk of exhibiting LGE (OR 4.09 (1.584-10.565), p < 0.05). In multivariate analysis, age (OR 1.059 (1.019-1.099), p < 0.05) and a LBBB inferior axis (OR 4.605 (1.472-14.404), p < 0.05) were independently associated with the presence of LGE. Patients with PVCs and apparently, structurally normal heart present myocardial scarring identified by CMR in 71.23% of cases. PVCs with LBBB inferior axis pattern, age ≥ 50 years and male sex are associated with the presence of LGE on CMR. In multivariate analysis, age and LBBB inferior axis were independently correlated with the presence of LGE.

QRS complex fragmentation status before and after cardiac resynchronization therapy predicts hospitalizations for heart failure

Abstract Introduction Cardiac resynchronization therapy (CRT) reduces mortality and hospitalization for heart failure (HF) in selected patients with HF with reduced ejection fraction (HFrEF). However, there is a significant percentage of non-responders who are readmitted for HF after implantation. Several biomarkers and electrocardiographic findings have been suggested as prognostic markers in this group of patients. Fragmentation of the QRS complex (QRSf) has been associated with worse prognosis in several cardiac diseases, but evidence in patients undergoing CRT remains to be limited. Purpose To evaluate if the changes in QRSf status before and after CRT implantation have a prognostic role in patients undergoing CRT in terms of hospitalization for HF. Methods Consecutive patients undergoing CRT were prospectively included from October 2009 to December 2022. Demographic clinical, electrocardiographic and echocardiographic variables were recorded. Prospective follow-up variables were collected from electronic clinical records and telephone interview. QRSf complex was defined by the presence of different RSR′ patterns including an additional R-waves (R′) and notches of the R-wave and S-wave in two contiguous leads corresponding to a main coronary artery territory in a 12-lead surface electrocardiogram performed before and after CRT. Results A total of 244 patients (mean age 72 ± 10 years, 80% male) were included. The etiology of the LV systolic dysfunction was ischemic in 50.0%. Mean LVEF before implantation was 25 ± 9% and mean paced QRS width was 141 ± 23 ms. CRT-D was implanted in 176 patients (72.2%). At baseline, 150 patients had a QRSf. After CRT implantation, 69 (28.4%) patients experimented a change in QRSf status: 29 patients (11.9%) without prior QRSf developed QRSf, whereas 40 patients (16.5%) resolved QRSf after CRT. Median follow-up time was 36.0 months (interquartile range 18.2-75.7). At follow-up, 90 patients died and 91 presented at least one hospitalization for HF. Multivariate Cox regression survival analysis showed that development of QRSf after CRT implantation (HR 8.87; 95% CI 1.85-42.50) and the presence of QRSf before implantation with or without paced QRSf after CRT (HR 8.21; 95% CI 1.75-38.50 and HR 16.70; 95% CI 3.88-71.80 respectively) were independently associated with hospitalizations for HF. Univariate and multivariate Cox regression analyses for HF hospitalization are presented in Table 1. Figure 1 presents Kaplan-Meier curves for QRSf status and hospitalizations for HF. Conclusions According to our results, QRSf status before and after CRT have a significant prognostic role in terms of hospitalization for HF after CRT, especially in those who develop QRSf after CRT and those with baseline QRSf regardless QRSf status after CRT. The worse prognosis was observed in those with QRSf before and after CRT. Therefore, these patients should be followed more strictly because they are at higher risk of decompensation.Table 1.Cox Regression Analyses

Electrocardiographic findings in newborns with inadequate intrauterine growth during pregnancy

Abstract Background Infants born small for gestational age (SGA) or following fetal growth restriction (FGR) have an increased risk of neonatal mortality as well as cardiovascular disease later in life. Prenatal electrocardiograms (ECGs) in fetuses with FGR exhibit QT prolongation. However, neonatal alterations in the conduction system in infants born SGA or with FGR has not previously been assessed in a large cohort of infants. Purpose To investigate potential variations in electrocardiographic parameters between infants born SGA or diagnosed with FGR, in comparison to infants born appropriate for gestational age (AGA). Methods This study was based on data from a population-based cohort study of infants (n&amp;gt;25,000) with prenatal inclusion and postnatal cardiac examination including eight-lead ECG between 2016-2018. We conducted a multiple linear regression analysis to compare ECG parameters among infants with FGR (birthweight &amp;lt;3rd percentile, n=544) and SGA (birthweight ≥3rd and &amp;lt;10th percentile, n=1,384) to infants born AGA (birthweight ≥10th percentile and &amp;lt;90th percentile, n=14,076). Parameters of interest included: heart rate (HR), uncorrected and corrected (Bazzet and Fridericia) QT intervals, QRS duration, PR interval, QRS axis, maximum amplitudes of the R- and S-waves in V1 and V6. All analyses were adjusted for infant sex, gestational age at birth, and weight, length, and age at ECG examination. Results Infants born SGA or with FGR had higher HR and consequently shorter uncorrected QT intervals compared with infants born AGA (Table 1). Infants with FGR had significantly shorter corrected (Fridericias) QT intervals. Infants born SGA had smaller amplitudes of both the R- and S-wave in V6, and significantly larger amplitude of the S-wave in V1, compared with infants born AGA (Table 1). Conclusion ECGs from infants born SGA and infants with FGR differed from infants born AGA, including higher HRs and shorter uncorrected QT-intervals even after adjustments for infant size and age at the examination. Furthermore, we saw infants born SGA had reduced amplitudes of the S and R wave in the lateral lead (V6), and an increased amplitude of the S-wave in V1, compared with infants born AGA. Follow-up examinations of these infants could determine whether these alterations persist beyond the neonatal period, and to fully understand their implications of the cardiac function later in life.

Predicting atrial fibrillation from ECG characteristics

Abstract Background/Introduction Atrial fibrillation (AF) is the most common cardiac arrythmia, and demographic shifts in age continues to increase the prevalence of atrial fibrillation on a global scale. With manifestations of short and intermittent duration, identifying and diagnosing AF often proves to be a challenge. As a consequence, patients who develop AF are at risk of experiencing stroke and other cardiac diseases such as heart failure (HF) before appropriate treatment is initialized. Despite the potential benefits of early AF detection, risk profiling based on electrocardiographic (ECG) findings is currently lacking. Several smaller studies have identified ECG characteristics associated with increased risk of AF, but these characteristics have not been individually evaluated in large-scale nationwide cohorts, and no evidence exists on the additive effect of these ECG characteristics. Purpose We aimed to evaluate the risk of new-onset AF, HF, and stroke according to five ECG characteristics previously linked to AF, in order to identify potential predictors of AF. Methods We used national registers and the Danish Nationwide ECG Cohort to include patients with ECG measurements taken between 2010 and 2022. Patients were grouped according to how many of the following ECG characteristics were present in their baseline ECG: Elevated heart rate (&amp;gt;80), prolonged PR-interval (≥196 ms for women and ≥204 ms for men), biphasic P-waves (positive and negative amplitude within same p-wave), abnormal P terminal force (≥ 6000 mV×ms), and prolonged P-wave duration(≥120 ms). Patients were followed for 2 years to evaluate the risk of atrial fibrillation, heart failure (HF), and stroke, according to baseline ECG characteristics. Results We included 1,505,474 patients of whom 594,702 had exactly one ECG characteristic, 197,367 had two characteristics, 44,983 had three characteristics, 6,390 had four characteristics, and 451 had all five characteristics on their baseline ECG. The risk of developing AF or HF increased with the number of ECG characteristics present on the baseline ECG. Patients with two ECG characteristics had a 2-fold increased risk of AF or HF compared to patients with no ECG characteristics (HR: 2.11 95%CI: 2.05-2.16). Patients with two or more ECG characteristics present on their baseline ECG exceeded a 5% 2-year absolute risk of developing either AF or HF. Among patients with only one ECG characteristic on their baseline ECG, elevated heart rate and prolonged PR interval were the factors most associated with an increased risk of AF compared to patients with none of the ECG characteristics on their baseline ECG. Conclusions The absolute and relative risk of atrial fibrillation, heart failure, and stroke increased with the number of ECG characteristics present on the baseline ECG. We suggest that the ECG characteristics evaluated in this study could be used in screening scenarios for atrial fibrillation to identify high risk patients.Absolute and relative 2-year risksRisk acc. to specific ECG characteristic

Modified Early-Warning Score combined with early-warning symptoms and electrocardiographic findings in predicting in-hospital cardiac arrest in critically ill patients: a retrospective cohort study

Modified Early-Warning Score combined with early-warning symptoms and electrocardiographic findings in predicting in-hospital cardiac arrest in critically ill patients: a retrospective cohort study

USE OF PAIN SCALE IN CHILDREN WITH CHEST PAIN: AN OBSERVATION IN TERMS OF CARDIAC ORIGIN

OBJECTIVE: Chest pain in children and adolescents is usually due to non-cardiac causes. The basic assumption in distinguishing the etiology is the cardiologic evaluation. The relationship between the severity of pain and its cardiologic etiology has not been investigated before. This study aimed to evaluate the pain scale, demographic-laboratory data, electrocardiographic and echocardiographic findings in order to better define pain in children who were admitted to the pediatric cardiology outpatient clinic with chest pain, based on the hypothesis that there is a correlation between chest pain with cardiac origin and pain severity. MATERIAL AND METHODS: This study was carried out with 131 patients in the pediatric cardiology outpatient clinic of the tertiary pediatric hospital. The Wong-Baker Faces Pain Scale was used to inquire about chest pain. RESULTS: 80 girls and 51 boys were included in the study. The mean age of the cases was 13.4±2.9 years. Echocardiographic findings: 87.8% were normal, 12.2% had pathological findings. The most common cardiac pathology was mitral valve regurgitation (4.6%). According to the Wong-Baker Faces pain scale, patients mostly showed 4 points (29%) and 6 points (47.3%) mimics. CONCLUSIONS: Echocardiography has limited diagnostic power in children with chest pain. This study failed to detect any significant relationship between pain scale and cardiac pathology. The evaluation with the Wong-Baker Faces Pain Scale was assessed to be insufficient.

Electrocardiographic Findings in Patients with Severe COVID-19: Characterisation and Clinical Correlations

In a prospective study of 200 COVID-19 patients, categorised into mild symptoms (category A; n=39), mild symptoms with cardiopulmonary comorbidities (category B; n=68) and severe symptoms with haemodynamic compromise (category C), category C showed higher incidences of left axis deviations, left atrial enlargement, prolonged QRS, elevated left ventricular amplitude, poor R wave progression and T inversion in V1–V6. A novel marker, rS complex – R/S ratio &gt;1 in lead III, was noted. Univariate analysis revealed left atrial enlargement, left axis deviation, left ventricular amplitude and poor R wave progression as mortality predictors. Multivariate analysis identified age and left atrial enlargement as independent predictors. These findings suggest possible elevated left ventricular end-diastolic pressure, which will help in categorising disease severity and predicting outcomes.

Relationship Between Exercise Electrocardiography Findings and Cardiovascular Events and the Extent of Coronary Artery Disease: What is New?

Relationship Between Exercise Electrocardiography Findings and Cardiovascular Events and the Extent of Coronary Artery Disease: What is New?

Magnitude of cardiac abnormality and its associated factors among hyperthyroidism patients on follow-up at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

BackgroundThyroid hormones have an effect on every organ system, in particular, the heart responds to minimal changes in serum thyroid hormone level. Thyroid hormone causes a lot of changes in the cardiovascular system, such as increased heart rate, contractility, systolic hypertension, changes in peripheral vascular resistance, atrial fibrillation (AF), and hypercoagulability from the direct effect of thyroid hormone on cardiac myocyte and /or due to increased metabolic state. However, the magnitude of such heart abnormalities and its associated factors were not well studied in Ethiopia.ObjectiveTo determine the magnitude of cardiac abnormality and its associated factors among hyperthyroidism patients on follow-up at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia, 2022.MethodsAn institution-based cross-sectional study was carried out among 318 hyperthyroid patients who were on follow-up at the endocrine clinic of TASH, Addis Ababa, Ethiopia from June to October 2022. The data were collected using a pretested structured interviewer administered questionnaire. The data were entered into the computer using EpiData version 3.1 and analyzed using SPSS version 25 software. Bivariable and multivariable logistic regression models were fitted to determine the association between the independent and dependent variables. Adjusted odds ratio with its 95% confidence interval and p-value < 0.05 were used to declare the presence and strength of statistically significant associations.ResultIn this study a total of 318 hyperthyroid patients were participated, most (90.9%) of them were females. The overall prevalence of heart failure among hyperthyroid patients was 17.0% (95% CI = 13.0, 21.6). More than half (52.7%) and one third (33.2%) of the participants showed abnormal electrocardiographic and echocardiographic findings respectively. Marital status (not married) [AOR = 2.37, 95% CI (1.03, 5.44)], pattern of hyperthyroidism [AOR = 13.09, 95% CI (4.70, 36.41)], being Asthmatic [AOR = 7.63, 95% CI (1.55, 37.52)], type of medication [AOR = 3.49, 95% CI (1.11, 11.02)] and duration of treatment [AOR = 4.95, 95% CI (2.05,11.99)] were significantly associated with cardiac abnormality.ConclusionA significant portion of hyperthyroid patients overburdened by cardiac abnormalities. Being unmarried, overt hyperthyroid, Asthmatic, long stay on treatment and type of treatment were significantly associated with cardiac abnormality. Hence, attention should be given for cardiac abnormalities while treating hyperthyroid patients.

Association Between Electrocardiographic Abnormalities and In-Hospital Adverse Outcome in COVID-19 Patients

Background: SARS-CoV-2 is increasingly recognized for its cardiovascular complications. To address the knowledge gap in our region, this study investigated the relationship between electrocardiographic (ECG) features and in-hospital mortality among COVID-19 patients. Methods: A prospective cohort study was conducted involving 140 RT-PCR-confirmed COVID-19 patients at Dhaka Medical College Hospital from August 2021 to July 2022. Patients were divided into two groups based on ECG findings: normal (Group A) and abnormal (Group B). Clinical data and ECG parameters were analyzed using SPSS 24.0. Results: Patients with abnormal ECGs were older, more likely male, and presented with higher rates of dyspnea and palpitations. They were also at increased risk of severe COVID-19 and had longer hospital stays. In-hospital mortality was significantly higher in Group B (21.4% vs.4.3%). ST-T changes and atrial fibrillation were associated with increased mortality. Independent predictors of in-hospital mortality included ECG abnormalities and admission SpO₂ &lt; 90%. Conclusion: ECG abnormalities are significantly associated with adverse outcomes in COVID-19 patients. Further large-scale studies are warranted to strengthen these findings.

Electrocardiographic Changes, Mortality, and Late Period Findings in Methyl Alcohol Poisoning

Background: Methyl alcohol poisoning (MAP) is a common commercial compound that can lead to significant morbidity and mortality when exposed to high levels. This study aims to describe MAP-related electrocardiography (ECG) changes and post-acute late complications. Materials and Methods: The study was conducted through a retrospective data review between 2017 and 2023. Patient data were recorded, including demographic information, medication use, and laboratory results. Twelve-lead ECG recordings were evaluated and the results were recorded. The cases included in the study were grouped according to QTc distance, ECG findings, late-term complications, treatment status, and mortality. Results: The mean age of all cases included in the study (n = 227) was 43.23 ± 11.11 years, 8 (3.5%) cases were female, and the age distribution was between 19 and 68 years (p = 0.792). The age distribution of QTc groups was not significant (p = 0.792). The mean QTc distance was 442.7 ± 60.1 ms in all cases (n = 227) and 514.08 ± 5.45 ms in cases with mortality (n = 49) (p &lt; 0.001). The mean time to application of the patients to the hospital (n = 227) was 19.1 ± 4.61 h, and blood sugar was 130.7 ± 32.09 mg/dL (p &lt; 0.001). In addition, the mean pH of the cases (n = 227) was 7.14 ± 0.2, bicarbonate was 17.17 ± 4.86 mmol/L, the base deficit was −6.21 ± 3.18 mmol/L, the anion gap was 19.36 ± 7.31 mmol/L, and lactate was 4.82 ± 2.45 mmol/L (p &lt; 0.001). Mortality occurred in 49 (21.6%) of the patients, and all of them were in-hospital deaths. In all cases where mortality occurred, pH was below 6.93 ± 0.22 and severe acidosis was directly related to death. MAP, sinus tachycardia in 31 (13.7%) cases, bradycardia in 8 (3.5%), atrial fibrillation in 5 (2.2%), accelerated idioventricular rhythm in 3 (1.3%), and 11 (4.8%), left bundle branch block, and right bundle branch block were detected in 22 (9.7%). All of these ECG findings were newly developed conditions with no previous history. In the 6-month follow-up after discharge, 4 (1.8%) of the cases developed neurological deficit, 15 (6.6%) had acute coronary syndrome and severe heart failure, 23 (10.1%) had permanent blindness, 6 (2.7%) had renal failure, and 6 (2.7%) had pancreatitis. Conclusion: Methyl alcohol poisoning can cause various ECG changes; sinus tachycardia, nonspecific changes, and QTc prolongation are the most common findings. These changes are more pronounced in cases of severe acidosis. Patients should be warned of late signs of MAP.

Clinical Findings, Laboratory Results, Electrocardiography and Echocardiography Findings in Dairy Buffaloes with Theileriosis.

Tropical theileriosis is a tick-borne haemoprotozoan disease, and cardiac function assessment in buffaloes with theileriosis was poorly documented. The Present study was carried out from April 2022 to December 2022. Theileriosis was confirmed by microscopic examination of stained blood smears and lymphnode smearsfurther confirmed by PCR assay. Electrocardiography was performed byusing the base apex lead system, and echocardiography was performed byusing the right parasternal view. The incidence of theileriosis was 16.25% by examination of stained blood smears, and 30.42% by PCR examination in 240 buffaloes. Repeatedly noted clinical signs were the absence of rumination, anorexia, loss of milk yield, depressed demeanour, emaciation, hyperthermia, lymphadenopathy, tick infestation, tachycardia, cardiac arrhythmia, and increased intensity of heartbeat. Haematological findings disclosed decreased haemoglobin, packed cell volume, total erythrocyte count, and neutrophils; increased eosinophils and monocytes. Serum biochemical findings revealed decreased albumin, albumin/globulin ratio, glucose, calcium, phosphorous, sodium, potassium, and chloride; increased globulin, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, cholesterol, lactate dehydrogenase, gamma-glutamyl transferase, and creatine kinase myocardial band isoenzymes. Electrocardiography explorations were sinus tachycardia, broad T wave, and sinus arrhythmia. Echocardiography examination showed ventricular wall thickening, cardiac chamber dilatation, valvular defects/valvular regurgitation, and pericarditis/cardiac tamponade. The present research proposes the changes in the electrocardiography and echocardiography findings in buffaloes with theileriosis, which are essential in clinics to identify the secondary complications during theileriosis and formulate therapeutics.

Fragmented QRS in patients with preeclampsia.

This study aims to investigate the prevalence, clinical correlates, and prognostic implications of fragmented QRS complexes (fQRS) in pregnant women with preeclampsia (PE), shedding light on the potential role of electrocardiographic markers in identifying cardiac involvement in hypertensive disorders of pregnancy. Patients with PE and age-matched low-risk control patients were recruited at a tertiary hospital between January 2015 and January 2023. A comprehensive assessment, including heart rate, PR duration, QRS duration, corrected QT duration, and fragmented QRS, was conducted by 12-lead electrocardiography. Baseline clinical characteristics, laboratory parameters, and electrocardiographic findings were compared between the study groups. 128 preeclampsia patients and 122 age- and comorbidity-matched controls were included in the study. The prevalence of fQRS was significantly higher in preeclamptic women compared to normotensive controls (14.1% vs. 3.3%, p = 0.04). ALT levels of pregnant women with preeclampsia and without preeclampsia groups were 43,77 (35.25-48.22) and 23,18 (13.75-33.00) (p: 0.038), respectively. In univariate regression analyses, Na and fragmented QRS were found to be associated with preeclampsia. (p: 0.016 and 0.009, respectively). After multivariable adjustment for variables, Na and fragmented QRS remained strongly associated with preeclampsia (OR: 4.787 (1.556-14.720), p: 0.06; 0.941 (0.893-0.992), p: 0.023, respectively). This study provides compelling evidence of an association between preeclampsia and fragmented QRS complexes, implicating electrolyte imbalances and hemodynamic stress as potential contributors to myocardial electrical instability in hypertensive disorders of pregnancy. Further research is warranted to validate these findings and improve risk stratification and clinical outcomes in affected women. Number: 2023/4705 Retrospectively Registered.

Maternal hypertensive disorders of pregnancy and electrocardiographic findings among newborns: The Copenhagen Baby Heart Study.

Maternal preeclampsia is associated with both congenital heart defects and changes in left ventricular structure and function in the offspring. Whether preeclampsia and gestational hypertension also affect the offspring's cardiac conduction system is unknown. This study assesses whether infants exposed to maternal hypertensive disorders of pregnancy (HDPs) exhibit changes in their electrocardiogram (ECG) compared with infants unexposed to HDPs. This population-based cohort study included newborns from the Copenhagen Baby Heart Study who had an ECG performed within 30 days of birth and had available obstetric information. ECG parameters of newborns exposed to maternal HDPs were compared with those of unexposed newborns using linear regression. Our study cohort included 11,826 newborns, including 441 exposed to maternal preeclampsia and 320 exposed to gestational hypertension. Infants exposed to preeclampsia had prolonged QRS durations (adjusted mean difference 0.6 ms, 95% confidence interval [CI] 0.04, 1.16) and lower maximum amplitudes of the R-wave in V1 (adjusted mean difference, linear scale 0.95, 95% CI 0.90, 1.00), compared with unexposed infants. Exposure to maternal preeclampsia was not associated with changes in other ECG parameters. Exposure to gestational hypertension was associated with increased QT interval durations (QTc Bazett, adjusted mean difference 2.48 ms, 95% CI -0.23, 5.20; QTc Fridericia, adjusted mean difference 2.32 ms, 95% CI -0.19, 4.83). Our findings suggest that the newborn cardiac conduction system is affected by exposure to maternal preeclampsia. This could reflect the previously described thickening of the left ventricular myocardium in infants exposed to preeclampsia.