Diretriz da Sociedade Brasileira de Cardiologia sobre a Análise e Emissão de Laudos Eletrocardiográficos – 2022

Samesima, Nelson; God, Epotamenides Good; Kruse, Jose Claudio Lupi; Leal, Marta Lizandra do Rêgo; Pinho, Claudio; França, Francisco Faustino de A. C.; Pimenta, João; Cardoso, Acácio Fernandes; Paixão, Adail; Fonseca, Alfredo José da; Pérez‐Riera, Andrés Ricardo; Ribeiro, Antônio Luiz Pinho; Madaloso, Bruna Affonso; Filho, Bráulio Luna; Oliveira, Carlos Alberto Rodrigues de; Grupi, César José; Moreira, Dalmo Antônio Ribeiro; Kaiser, Elisabeth; Paixão, Gabriela M. M.; Feitosa-Filho, Gilson Soares; Pereira, Horacio Gomes; Grindler, José; Aziz, José Luiz; Molina, Marcos Sleiman; Facin, Mirella; Tobias, Nancy Maria Martins de Oliveira; Oliveira, Patrícia Alves de; Sanches, Paulo César R.; Teixeira, Ricardo Alkmim; Atanes, Severiano Melo; Pastore, Carlos Alberto

doi:10.36660/abc.20220623

Arquivos Brasileiros De Cardiologia

2022

DOI: 10.36660/abc.20220623

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Diretriz da Sociedade Brasileira de Cardiologia sobre a Análise e Emissão de Laudos Eletrocardiográficos – 2022

Nelson Samesima¹,

Epotamenides Good God²,

Jose Claudio Lupi Kruse³

et al.

Abstract: DiretrizesSamesima et al. Diretriz da Sociedade Brasileira de Cardiologia sobre a Análise e Emissão de Laudos Eletrocardiográficos -2022 Nota: Estas diretrizes se prestam a informar e não a substituir o julgamento clínico do médico que, em última análise, deve determinar o tratamento apropriado para seus pacientes.

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Cited by 4 publications

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References 173 publications

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“…Recently, important data on ECG interpretation were extensively reviewed in the IV Guidelines of the Sociedade Brasileira de Cardiologia on Analysis and Issuance of Electrocardiographic Reports published in 2022. 1 But what is the role of the electrocardiogram, especially applied to pediatrics, in the 21 st century? What is normal for the child?…”

mentioning

confidence: 99%

O Eletrocardiograma na População Pediátrica no Século XXI. Como Continuar Evoluindo após 135 Anos de História da Descoberta do Método

Andalaft

2022

Arquivos Brasileiros De Cardiologia

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mentioning

confidence: 99%

O Eletrocardiograma na População Pediátrica no Século XXI. Como Continuar Evoluindo após 135 Anos de História da Descoberta do Método

Andalaft

2022

Arquivos Brasileiros De Cardiologia

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This Could Mean a True Tetrafascicular Intraventricular Block

2023

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To the Editor We read with interest the case report by Dr Scheffer and colleagues. 1 However, we find it necessary to make some comments about the report, including the interpretation of the electrocardiogram (ECG) findings.The P-wave duration is extremely long at 220 milliseconds (ms), with a biphasic pattern in leads III and aVF, while the final part of the P wave is isodiphasic in lead II. These changes are compatible with type I atypical advanced interatrial block, which predisposes to atrial fibrillation. 2 We found that the changes in the precordial leads fulfill all the criteria for left septal fascicular block according to the 2022 Brazilian Guidelines: qR complex from V 1 to V 4 , increasing R-wave amplitude (maximum ≥15 mm) from V 1 to V 2 , decreasing QRS complex amplitude from V 4 to V 6 , and partly negative T waves in the right precordial leads. These criteria are valid in the absence of right ventricular hypertrophy, septal hypertrophy, and old lateral myocardial infarction. 3 In addition, there is an increased R wave peak time (80 ms) in lead V 2 . 4 The coexistence of first-degree atrioventricular block, left anterior fascicular block (LAFB), left septal fascicular block, and right bundle-branch block means that the patient has incomplete left posterior fascicular block. We consider this ECG case to be tetrafascicular intraventricular block, which has never been published before, to our knowledge. Compared with patients with typical bifascicular block, patients with tri-and tetrafascicular block have more extensive fibrosis and degeneration of the left bundle pathways.Dr Scheffer and colleagues 1 consider the left axis deviation with absence of S waves in leads I and aVL to be a pattern of left bundle-branch block in the extremity leads. However, the ECG findings of this patient fulfill the criteria for LAFB: SIII greater than SII, frontal plane QRS complex axis of −75°, qR in lead aVR and aVL, and R wave peak time of 45 ms or greater. Because this is not typical bifascicular block with LAFB and right bundlebranch block, there are no S waves in leads I and aVL.Regarding the authors' definition of the ECG diagnosis of masquerading bundle-branch block, 1 we want to add that the ECG tracing of this patient shows an RS pattern in leads V 5 and V 6 . When discussing diseases associated with masquerading bundle-branch blocks, it is important to mention the progressive cardiac conduction defect (Lenègre disease). Finally, we want to point out that the terms posterior or posterolateral myocardial infarction should be replaced by the term lateral myocardial infarction. 5

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Electrovectorcardiographic study of left ventricular aneurysm in ischemic heart disease

Varoni,

Samesima,

Facin

et al. 2023

Front. Cardiovasc. Med.

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The aim was to characterize the electrovectorcardiographic pattern of ventricular aneurysms in ischemic cardiopathy by analyzing the cardiac ventricular repolarization. The medical records of 2,670 individuals were analyzed in this cross-sectional study. A test phase included 33 patients who underwent transthoracic echocardiogram with ultrasonic enhancing agent, electrocardiogram, and vectorcardiogram (aneurysm group - n = 22, and akinesia group - n = 11). In the validation phase, cardiac magnetic resonance imaging established the left ventricle segmental contractility in 16 patients who underwent electrocardiographic and vectorcardiographic tests (aneurysm group, n = 8, and akinesia group, n = 8). The variables studied were the presence of the T-wave plus-minus pattern and the T-wave loop anterior-posterior pattern in V2–V4. The diagnostic indices used were sensitivity, specificity, and predictive values, with their respective 95% confidence intervals. During the test and validation phases, the analysis of the presence of the T-wave plus-minus pattern identified the aneurysm group with a sensitivity of 91% vs. 87% and specificity of 91% vs. 87% (p < 0.0001 vs. p = 0.01), respectively. Meanwhile, the T-wave loop anterior-posterior pattern evidenced sensitivity of 95% vs. 77% and specificity of 91% vs. 87% (p < 0.0001 vs. p = 0.04), respectively. The electrovectorcardiographic parameters showed high accuracy for recognizing left ventricular aneurysms in ischemic heart disease.

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Diretriz da Sociedade Brasileira de Cardiologia sobre a Análise e Emissão de Laudos Eletrocardiográficos – 2022

Cited by 4 publications

References 173 publications

O Eletrocardiograma na População Pediátrica no Século XXI. Como Continuar Evoluindo após 135 Anos de História da Descoberta do Método

O Eletrocardiograma na População Pediátrica no Século XXI. Como Continuar Evoluindo após 135 Anos de História da Descoberta do Método

This Could Mean a True Tetrafascicular Intraventricular Block

Electrovectorcardiographic study of left ventricular aneurysm in ischemic heart disease

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