The J wave may be observed in apparently healthy subjects and also in association with sudden cardiac death. We studied its prevalence in the additional 6 right precordial or posterior leads.
Thee hundred and ninety-three patients who visited the Tokyo Medical University Hospital underwent the 18-lead ECG. The J wave was measured in each lead of the 12- and 18-lead ECGs and diagnosed if it was 0.1mV or larger. J wave was predicted theoretically for the additional 6 leads by a new ECG recorder and compared with those of the actual records. The patients with bundle branch block or ventricular pacing were excluded.
The J wave was present in 150 patients (38.2%) in the 12-lead ECGs. Of these, 102 patients (26.0%) showed J waves in the posterior leads and 9 (2.3%) in the right precordial leads. In 30 (12.3%), J waves were observed in the posterior leads but not in the standard 12-leads. Among the 18 leads, the J wave was located most often in the back.
J waves theoretically derived for the right anterior or posterior leads were highly correlated with those of the actual recordings of the 6 leads (r= 0.872-0.965, p<0.001).
J waves are relatively common and might be present in the additional 6 leads. The presence of J waves can easily be predicted by a new ECG recorder. The pathogenesis and significance of such J waves are to be further determined.

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BACKGROUND Atrial fibrillation (AF) is often observed in patients with Brugada Syndrome, but there are few reports on the efficacy of pulmonary vein isolation (PVI) in these patients. METHODS PVI was performed in 18 consecutive patients (16 men and 2 women) with Brugada-type electrocardiogram (ECG) for paroxysmal AF. Mean age was 57±10 years. Of these 18 patients, 3 were symptomatic and 15 were asymptomatic, 3 showed spontaneous coved-type ECG, 13 showed drug-induced coved-type ECG and 2 showed saddle back-type ECG. Of the 4 patients with implantable cardioverter-defibrillator, 3 experienced inappropriate shocks because of AF with rapid ventricular response. We compared the electrophysiological properties and clinical course after PVI of these 18 patients with 30 patients with lone AF. RESULTS No significant differences in age, number of sessions, and PVI strategy were observed in either group. No significant differences in intra-atrial conduction time and effective refractory period of each pulmonary vein were observed in either group. AF-free survival rate post PVI was comparably good in both groups (89% vs. 87%, p=ns). CONCLUSION PVI for paroxysmal AF in patients with Brugada-type ECG is as effective as in patients with lone AF.

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Background. Speech recognition (SR) technology has been successfully used in many specialties, particularly in radiology. However, there have been only a few studies validating its feasibility and favorable system configuration in cardiovascular medicine. Ambulatory electrocardiography (AECG) is one of the most frequently ordered examinations in clinical practice, and its results are ordinarily returned in the form of analysis report by cardiologists. To determine more favorable SR system for AECG reporting generation in terms of time, we evaluated two SR systems using different types of dictating microphones.
Methods. The SR software used was a commercially available SR system called AmiVoice Ex7. One hundred forty AECG reports generated via a conventional USB handmike and 153 reports using a Bluetooth wireless headset with an enhanced reference lexicon associated with cardiovascular medicine were assessed. Report turnaround time includes additional time for correction of recognition errors.
Results. Turnaround time by the headset system was statistically shorter than that by the handmike system (median : 615.5 sec vs. 516.0 sec, p=0.001). Furthermore, this tendency still largely existed regardless of the number of findings associated with significant arrhythmia and myocardial ischemia. Conclusion. Considering the hands-busy setting of AECG analysis, the hands-free SR system specialized for cardiovascular medicine might be more time-efficient and comfortable than exsisting handmike systems in generating electronic AECG reports.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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