The electrocardiographic “triangular QRS-ST-T waveform” pattern in patients with ST-segment elevation myocardial infarction: Incidence, pathophysiology and clinical implications

Cipriani, Alberto; D’Amico, Gianpiero; Brunello, G; Marra, Martina Perazzolo; Migliore, Federico; Cacciavillani, Luisa; Tarantini, Giuseppe; Bauce, Barbara; Iliceto, Sabino; Corrado, Domenico; Zorzi, Alessandro

doi:10.1016/j.jelectrocard.2017.08.023

Cited by 48 publications

(52 citation statements)

References 27 publications

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“…The TW pattern is defined as the presence of a giant R wave (>1 mV), followed by a steep down-sloping ST segment, which conceals the T wave, and continues to the isoelectric line, thus forming a triangular shape, looking like a shark fin [ 2 ]. Wang et al found that TW is an extreme form of the lambda wave pattern based on the geometry evaluation [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…The TW pattern identifies a subset of patients at high risk of both ventricular fibrillation (VF) and cardiogenic shock, as well as associated high in-hospital mortality. The incidence of this TW pattern is approximately 1.4% of the population, based on a cohort study of 367 consecutive STEMI patients [ 2 ]. A previous study found that TW pattern was significantly more prevalent among the selected population of STEMI complicated by VF compared with the control population of uncomplicated STEMI (48% vs. 4.1% respectively) [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…A previous study found that TW pattern was significantly more prevalent among the selected population of STEMI complicated by VF compared with the control population of uncomplicated STEMI (48% vs. 4.1% respectively) [ 3 ]. Therefore, a prompt and aggressive strategy is needed for patients presenting with this ECG pattern [ 2 ]. However, this pattern is rarely present in non-ischemic cardiac diseases.…”

Section: Introductionmentioning

confidence: 99%

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Triangular QRS-ST-T Waveform Electrocardiographic Pattern in Acute Myopericarditis: A Case Report from a Limited-Resources Hospital

Hasibuan¹,

Intan²,

Wilujeng³

et al. 2020

Am J Case Rep

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Triangular QRS-ST-T Waveform Electrocardiographic Pattern in Acute Myopericarditis: A Case Report from a Limited-Resources Hospital

Hasibuan¹,

Intan²,

Wilujeng³

et al. 2020

Am J Case Rep

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“…Additionally, the tangent value of the above angle is negative. Cipriani et al [9] suggested that the triangular QRS-ST-T pattern predicted cardiogenic shock associated with high in-hospital mortality. We found that the triangular waveform is an extreme form of the lambda waveform, which also lies in the included angle range (Fig.…”

Section: Discussionmentioning

confidence: 99%

Lambda-like ST-segment elevation in acute myocardial infarction triggered by coronary spasm may be a new risk predictor for lethal ventricular arrhythmia

Wang¹,

Zhao

Zhang³

et al. 2018

Medicine

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Rationale:The lambda-like ST-elevation electrocardiography (ECG) pattern is extremely rare in patients with type 2 myocardial infarction (T2MI) triggered by coronary spasm. When this ECG pattern appears, sudden cardiac death (SCD) caused by lethal ventricular arrhythmia may occur because clinicians do not pay sufficient attention to this phenomenon.Patient concerns:We describe a 41-year-old man who presented with steep down-sloping ST-segment elevation, paroxysmal ventricular tachycardia, severe sinus bradycardia, and intermittent complete atrioventricular block on ECG during the sudden recurrence of clinical symptoms.Diagnosis:T2MI complicated with lethal arrhythmia and caused by coronary spasm.Interventions:The patient received an implantable cardioverter defibrillator (ICD) for SCD caused by lethal ventricular arrhythmia and received long-term calcium-blocker and nitroglycerin therapy.Outcomes:At a 3-month follow-up, no recurrence was noted.Lessons:The lambda-like ST-elevation pattern is identified with other ST-elevation patterns by geometry and may be a new risk predictor for lethal ventricular arrhythmia on ECG. When this pattern is identified, clinicians should adopt aggressive therapeutic strategies, including ICD implantation and etiological treatment.

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“…The normal ECG waveform contains many standard signals P, R, Q, and T waves [31], [32]. The amplitudes of these signals are shown in Table 1 [33].…”

Section: Introductionmentioning

confidence: 99%

ECG Waveform Classification Based on P-QRS-T Wave Recognition

Al-Ani

2018

UHD J SCI TECH

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A B S T R A C TElectrocardiogram (ECG) is a periodic signal reflects the activity of the heart. ECG waveform is an important issue to define the heart function, so it is helpful to recognize the type of heart diseases. ECG graph generates a lot of information that is converted into an electrical signal with standard values of amplitude and duration. The main problem raised in this measurement is the mixing between normal and abnormal, in addition, sometimes, there are overlapping between the P-QRS-T waveform. This research aims to offer an efficient approach to measure all parts of P-QRS-T waveform in order to give a correct decision of heart functionality. The implemented approach including many steps as follows: Preprocessing, baseline process, feature extraction, and diagnosis. The obtained result indicated an adequate recognition rate to verify the heart functionality. The proposed approach depends mainly on the classifier process that based mainly on the extracted ECG waveform features that achieved from exact baseline detection.

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The electrocardiographic “triangular QRS-ST-T waveform” pattern in patients with ST-segment elevation myocardial infarction: Incidence, pathophysiology and clinical implications

Cited by 48 publications

References 27 publications

Triangular QRS-ST-T Waveform Electrocardiographic Pattern in Acute Myopericarditis: A Case Report from a Limited-Resources Hospital

Triangular QRS-ST-T Waveform Electrocardiographic Pattern in Acute Myopericarditis: A Case Report from a Limited-Resources Hospital

Lambda-like ST-segment elevation in acute myocardial infarction triggered by coronary spasm may be a new risk predictor for lethal ventricular arrhythmia

ECG Waveform Classification Based on P-QRS-T Wave Recognition

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