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Qiu S, Liu T, Zhan Z, Li X, Liu X, Xin X, Lu J, Wu L, Wang L, Cui K, Xiu J. Revisiting the diagnostic and prognostic significance of high-frequency QRS analysis in cardiovascular diseases: a comprehensive review. Postgrad Med J 2024:qgae064. [PMID: 38796714 DOI: 10.1093/postmj/qgae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/07/2024] [Accepted: 04/19/2024] [Indexed: 05/28/2024]
Abstract
Cardiovascular diseases (CVDs) present a significant global public health threat, contributing to a substantial number of cases involving morbidity and mortality. Therefore, the early and accurate detection of CVDs plays an indispensable role in enhancing patient outcomes. Decades of extensive research on electrocardiography at high frequencies have yielded a wealth of knowledge regarding alterations in the QRS complex during myocardial ischemia, as well as the methodologies to assess and quantify these changes. In recent years, the analysis of high-frequency QRS (HF-QRS) components has emerged as a promising non-invasive approach for diagnosing various cardiovascular conditions. Alterations in HF-QRS amplitude and morphology have demonstrated remarkable sensitivity as diagnostic indicators for myocardial ischemia, often surpassing measures of ST-T segment changes. This comprehensive review aims to provide an intricate overview of the current advancements, challenges, and prospects associated with HF-QRS analysis in the field of CVDs.
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Affiliation(s)
- Shifeng Qiu
- Department of Cardiology, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Shock and Microcirculation, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- State Key Laboratory of Organ Failure Research, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
| | - Tinghui Liu
- Department of Cardiology, Southern Medical University, Nanfang Hospital Zengcheng Campus, Guangzhou 511340, China
| | - Zijin Zhan
- Department of Cardiology, Southern Medical University, Nanfang Hospital Zengcheng Campus, Guangzhou 511340, China
| | - Xue Li
- Department of Gastroenterology, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
| | - Xuewei Liu
- Guangdong Provincial Key Laboratory of Shock and Microcirculation, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Southern Medical University or The First School of Clinical Medicine, Southern Medical University, Dongguan 523018, China
| | - Xiaoyu Xin
- Department of Cardiology, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Shock and Microcirculation, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- State Key Laboratory of Organ Failure Research, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
| | - Junyan Lu
- Department of Cardiology, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Shock and Microcirculation, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- State Key Laboratory of Organ Failure Research, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
| | - Lipei Wu
- Department of Cardiology, Southern Medical University, Nanfang Hospital Zengcheng Campus, Guangzhou 511340, China
| | - Li Wang
- Department of General Internal Medicine Unit One, Southern Medical University, Nanfang Hospital Zengcheng Campus, Guangzhou 511340, China
| | - Kai Cui
- Department of Cardiology, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Shock and Microcirculation, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- State Key Laboratory of Organ Failure Research, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
| | - Jiancheng Xiu
- Department of Cardiology, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- Guangdong Provincial Key Laboratory of Shock and Microcirculation, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
- State Key Laboratory of Organ Failure Research, Southern Medical University, Nanfang Hospital, Guangzhou 510515, China
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Leinveber P, Halamek J, Curila K, Prinzen F, Lipoldova J, Matejkova M, Smisek R, Plesinger F, Nagy A, Novak M, Viscor I, Vondra V, Jurak P. Ultra-high-frequency ECG volumetric and negative derivative epicardial ventricular electrical activation pattern. Sci Rep 2024; 14:5681. [PMID: 38454102 PMCID: PMC10920693 DOI: 10.1038/s41598-024-55789-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 02/27/2024] [Indexed: 03/09/2024] Open
Abstract
From precordial ECG leads, the conventional determination of the negative derivative of the QRS complex (ND-ECG) assesses epicardial activation. Recently we showed that ultra-high-frequency electrocardiography (UHF-ECG) determines the activation of a larger volume of the ventricular wall. We aimed to combine these two methods to investigate the potential of volumetric and epicardial ventricular activation assessment and thereby determine the transmural activation sequence. We retrospectively analyzed 390 ECG records divided into three groups-healthy subjects with normal ECG, left bundle branch block (LBBB), and right bundle branch block (RBBB) patients. Then we created UHF-ECG and ND-ECG-derived depolarization maps and computed interventricular electrical dyssynchrony. Characteristic spatio-temporal differences were found between the volumetric UHF-ECG activation patterns and epicardial ND-ECG in the Normal, LBBB, and RBBB groups, despite the overall high correlations between both methods. Interventricular electrical dyssynchrony values assessed by the ND-ECG were consistently larger than values computed by the UHF-ECG method. Noninvasively obtained UHF-ECG and ND-ECG analyses describe different ventricular dyssynchrony and the general course of ventricular depolarization. Combining both methods based on standard 12-lead ECG electrode positions allows for a more detailed analysis of volumetric and epicardial ventricular electrical activation, including the assessment of the depolarization wave direction propagation in ventricles.
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Affiliation(s)
- Pavel Leinveber
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic.
| | - Josef Halamek
- Institute of Scientific Instruments, The Czech Academy of Sciences, Brno, Czech Republic
| | - Karol Curila
- Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Frits Prinzen
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
| | - Jolana Lipoldova
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
- First Department of Internal Medicine and Cardioangiology, St. Anne's University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Magdalena Matejkova
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Radovan Smisek
- Institute of Scientific Instruments, The Czech Academy of Sciences, Brno, Czech Republic
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czech Republic
| | - Filip Plesinger
- Institute of Scientific Instruments, The Czech Academy of Sciences, Brno, Czech Republic
| | - Andrej Nagy
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
- First Department of Internal Medicine and Cardioangiology, St. Anne's University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Miroslav Novak
- International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
- First Department of Internal Medicine and Cardioangiology, St. Anne's University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ivo Viscor
- Institute of Scientific Instruments, The Czech Academy of Sciences, Brno, Czech Republic
| | - Vlastimil Vondra
- Institute of Scientific Instruments, The Czech Academy of Sciences, Brno, Czech Republic
| | - Pavel Jurak
- Institute of Scientific Instruments, The Czech Academy of Sciences, Brno, Czech Republic
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Jurak P, Bear LR, Nguyên UC, Viscor I, Andrla P, Plesinger F, Halamek J, Vondra V, Abell E, Cluitmans MJM, Dubois R, Curila K, Leinveber P, Prinzen FW. 3-Dimensional ventricular electrical activation pattern assessed from a novel high-frequency electrocardiographic imaging technique: principles and clinical importance. Sci Rep 2021; 11:11469. [PMID: 34075135 PMCID: PMC8169848 DOI: 10.1038/s41598-021-90963-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/19/2021] [Indexed: 11/29/2022] Open
Abstract
The study introduces and validates a novel high-frequency (100–400 Hz bandwidth, 2 kHz sampling frequency) electrocardiographic imaging (HFECGI) technique that measures intramural ventricular electrical activation. Ex-vivo experiments and clinical measurements were employed. Ex-vivo, two pig hearts were suspended in a human-torso shaped tank using surface tank electrodes, epicardial electrode sock, and plunge electrodes. We compared conventional epicardial electrocardiographic imaging (ECGI) with intramural activation by HFECGI and verified with sock and plunge electrodes. Clinical importance of HFECGI measurements was performed on 14 patients with variable conduction abnormalities. From 3 × 4 needle and 108 sock electrodes, 256 torso or 184 body surface electrodes records, transmural activation times, sock epicardial activation times, ECGI-derived activation times, and high-frequency activation times were computed. The ex-vivo transmural measurements showed that HFECGI measures intramural electrical activation, and ECGI-HFECGI activation times differences indicate endo-to-epi or epi-to-endo conduction direction. HFECGI-derived volumetric dyssynchrony was significantly lower than epicardial ECGI dyssynchrony. HFECGI dyssynchrony was able to distinguish between intraventricular conduction disturbance and bundle branch block patients.
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Affiliation(s)
- Pavel Jurak
- Institute of Scientific Instruments, The Czech Academy of Sciences, Kralovopolska 147, Brno, 635 00, Czech Republic.
| | - Laura R Bear
- IHU Liryc, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Univ. Bordeaux, CRCTB, U1045, Bordeaux, France.,INSERM, CRCTB, U1045, Bordeaux, France
| | - Uyên Châu Nguyên
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ivo Viscor
- Institute of Scientific Instruments, The Czech Academy of Sciences, Kralovopolska 147, Brno, 635 00, Czech Republic
| | - Petr Andrla
- Institute of Scientific Instruments, The Czech Academy of Sciences, Kralovopolska 147, Brno, 635 00, Czech Republic
| | - Filip Plesinger
- Institute of Scientific Instruments, The Czech Academy of Sciences, Kralovopolska 147, Brno, 635 00, Czech Republic
| | - Josef Halamek
- Institute of Scientific Instruments, The Czech Academy of Sciences, Kralovopolska 147, Brno, 635 00, Czech Republic
| | - Vlastimil Vondra
- Institute of Scientific Instruments, The Czech Academy of Sciences, Kralovopolska 147, Brno, 635 00, Czech Republic
| | - Emma Abell
- IHU Liryc, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Univ. Bordeaux, CRCTB, U1045, Bordeaux, France.,INSERM, CRCTB, U1045, Bordeaux, France
| | - Matthijs J M Cluitmans
- Department of Cardiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Rémi Dubois
- IHU Liryc, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Univ. Bordeaux, CRCTB, U1045, Bordeaux, France.,INSERM, CRCTB, U1045, Bordeaux, France
| | - Karol Curila
- Cardiocenter, Department of Cardiology, 3rd Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Pavel Leinveber
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic
| | - Frits W Prinzen
- Department of Physiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
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Curila K, Prochazkova R, Jurak P, Jastrzebski M, Halamek J, Moskal P, Stros P, Vesela J, Waldauf P, Viscor I, Plesinger F, Sussenbek O, Herman D, Osmancik P, Smisek R, Leinveber P, Czarnecka D, Widimsky P. Both selective and nonselective His bundle, but not myocardial, pacing preserve ventricular electrical synchrony assessed by ultra-high-frequency ECG. Heart Rhythm 2020; 17:607-614. [DOI: 10.1016/j.hrthm.2019.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Indexed: 10/25/2022]
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Jurak P, Curila K, Leinveber P, Prinzen FW, Viscor I, Plesinger F, Smisek R, Prochazkova R, Osmancik P, Halamek J, Matejkova M, Lipoldova J, Novak M, Panovsky R, Andrla P, Vondra V, Stros P, Vesela J, Herman D. Novel ultra‐high‐frequency electrocardiogram tool for the description of the ventricular depolarization pattern before and during cardiac resynchronization. J Cardiovasc Electrophysiol 2019; 31:300-307. [DOI: 10.1111/jce.14299] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 11/18/2019] [Accepted: 11/23/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Pavel Jurak
- Institute of Scientific InstrumentsThe Czech Academy of SciencesBrno Czech Republic
| | - Karol Curila
- Department of Cardiology, Cardiocenter, Third Faculty of MedicineCharles University, University Hospital Kralovske VinohradyPrague Czech Republic
| | - Pavel Leinveber
- International Clinical Research CenterSt Anneʼs University HospitalBrno Czech Republic
- First Department of Internal Medicine‐CardioangiologyFaculty of Medicine of Masaryk University, St Anneʼs University HospitalBrno Czech Republic
| | - Frits W. Prinzen
- Department of Physiology, Cardiovascular Research Institute MaastrichtMaastricht UniversityMaastricht The Netherlands
| | - Ivo Viscor
- Institute of Scientific InstrumentsThe Czech Academy of SciencesBrno Czech Republic
| | - Filip Plesinger
- Institute of Scientific InstrumentsThe Czech Academy of SciencesBrno Czech Republic
| | - Radovan Smisek
- Institute of Scientific InstrumentsThe Czech Academy of SciencesBrno Czech Republic
- Department of Biomedical Engineering, The Faculty of Electrical Engineering and CommunicationBrno University of TechnologyBrno Czech Republic
| | - Radka Prochazkova
- Department of Cardiology, Cardiocenter, Third Faculty of MedicineCharles University, University Hospital Kralovske VinohradyPrague Czech Republic
| | - Pavel Osmancik
- Department of Cardiology, Cardiocenter, Third Faculty of MedicineCharles University, University Hospital Kralovske VinohradyPrague Czech Republic
| | - Josef Halamek
- Institute of Scientific InstrumentsThe Czech Academy of SciencesBrno Czech Republic
| | - Magdalena Matejkova
- International Clinical Research CenterSt Anneʼs University HospitalBrno Czech Republic
| | - Jolana Lipoldova
- International Clinical Research CenterSt Anneʼs University HospitalBrno Czech Republic
- First Department of Internal Medicine‐CardioangiologyFaculty of Medicine of Masaryk University, St Anneʼs University HospitalBrno Czech Republic
| | - Miroslav Novak
- International Clinical Research CenterSt Anneʼs University HospitalBrno Czech Republic
- First Department of Internal Medicine‐CardioangiologyFaculty of Medicine of Masaryk University, St Anneʼs University HospitalBrno Czech Republic
| | - Roman Panovsky
- International Clinical Research CenterSt Anneʼs University HospitalBrno Czech Republic
- First Department of Internal Medicine‐CardioangiologyFaculty of Medicine of Masaryk University, St Anneʼs University HospitalBrno Czech Republic
| | - Petr Andrla
- Institute of Scientific InstrumentsThe Czech Academy of SciencesBrno Czech Republic
| | - Vlastimil Vondra
- Institute of Scientific InstrumentsThe Czech Academy of SciencesBrno Czech Republic
| | - Petr Stros
- Department of Cardiology, Cardiocenter, Third Faculty of MedicineCharles University, University Hospital Kralovske VinohradyPrague Czech Republic
| | - Jana Vesela
- Department of Cardiology, Cardiocenter, Third Faculty of MedicineCharles University, University Hospital Kralovske VinohradyPrague Czech Republic
| | - Dalibor Herman
- Department of Cardiology, Cardiocenter, Third Faculty of MedicineCharles University, University Hospital Kralovske VinohradyPrague Czech Republic
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