Controversial and similar aspects of the Brugada and J wave patterns: The vectorcardiogram point of view

Pastore, Carlos Alberto; Samesima, Nelson; Filho, Horácio Gomes Pereira; Madaloso, Bruna Affonso

doi:10.1016/j.jelectrocard.2016.03.018

Cited by 8 publications

(7 citation statements)

References 22 publications

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“…In the ER pattern 9,25 (Figure 10) we see a clockwise rotation (terminal portion of the QRS) of the same segments, resembling a "fishhook". In all the ER cases the ECD position was in the left quadrant, with a shorter duration.…”

Section: Introductionmentioning

confidence: 97%

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Applicability of the Electro-Vectorcardiogram in Current Clinical Practice

Pastore

Samesima

Filho

et al. 2019

Arquivos Brasileiros De Cardiologia

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The electrocardiogram (ECG) has been reinvigorated by the identification of electrical alterations that were not definitely clarified before. In this context, and mainly regarding the definition of arrhythmogenic substrates, the association of the ECG with the vectorcardiogram (VCG) has gathered much more information about the cardiac electrical phenomena, thus allowing us to differentiate potentially fatal cases from benign ones. Obtaining a VCG concomitantly with the performance of an ECG has led to a significant gain in the definition of extremely sophisticated pathologies, which function suffer some type of structural or dynamic alterations, involving either the reduction or enhancement of ionic channels and currents. The classic aspects of the ECG/VCG association in the differential diagnosis of myocardial infarctions, conduction disorders, atrial and ventricular hypertrophies, and the correlations between these electrical disorders are still valid and assertive. The association of these pathologies is further clarified when they are seen through the ECG/VCG dyad. The three-dimensional spatial orientation of both the atrial and the ventricular activity provides a far more complete observation tool than the ECG linear form. The modern analysis of the ECG and its respective VCG, simultaneously obtained by the recent technique called electro-vectorcardiogram (ECG/VCG), brought a significant gain for the differential diagnosis of some pathologies. Therefore, we illustrate how this type of analysis can elucidate some of the most important diagnoses found in our daily clinical practice as cardiologists.

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Section: Introductionmentioning

confidence: 97%

“…The Brugada syndrome has shown to be very dynamic regarding its arrhythmogenic substrate, and the ECG/VCG follow-up can be very useful to define this process. 29,30 (Figure 12).…”

Section: Introductionmentioning

confidence: 99%

Applicability of the Electro-Vectorcardiogram in Current Clinical Practice

Pastore

Samesima

Filho

et al. 2019

Arquivos Brasileiros De Cardiologia

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“…Compared with ECG, it is more informative and accurate and can be used to diagnose culprit vessels, providing a reference for physicians for the use of diagnosis. [4] Taking patients with acute inferior MI as research objects, this research is aimed at the diagnostic value of VCG combined with CDE for acute inferior MI culprit vessel.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of VCG combined with CDE for acute inferior MI culprit vessel

Zhao

Jiang

2019

DCC

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Objective: To explore the diagnostic value of vectorcardiography (VCG) combined with color Doppler echocardiography (CDE) for acute inferior myocardial infarction (MI) culprit vessel.Methods: A total of 82 patients who had been clinically diagnosed as acute inferior MI and had received coronary arteriography (CAG) were selected as research objects. They received bedside VCG and CDE examinations after admission. Their culprit vessels were analyzed and compared with CAG results to evaluate the diagnostic efficiency.Results: The detection rate of acute inferior MI culprit vessel by VCG combined with CDE was 76.83%, including 18 left circumflex (LCX) branches and 45 right coronary arteries (RCA). The lower left constituent ratio of LCX was 61.11%, which was significantly higher than 20.00% in RCA (p < .05); the lower right constituent ratio of RCA was 71.11%, which was much higher than 11.11% in LCX (p < .05); the sensitivity and the accuracy of RCA culprit vessel judged with frontal plane ST-vector pointing to the lower right quadrant were 71.11% and 53.33% respectively; the diagnostic efficiency of LCX culprit vessel judged with frontal plane ST-vector pointing to the lower left quadrant was 61.11% and 50.00% respectively. The maximum amplitude of the frontal plane in LCX culprit vessel was significantly lower than that in RCA culprit vessel; and the frontal plane vector angle in LCX was significantly greater than that in RCA culprit vessel (p < 0.05).Conclusions: VCG combined with CDE can effectively diagnose acute inferior MI. It has a good diagnostic efficiency by judging culprit vessels according to the frontal plane ST-vector direction.

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“…Algumas medidas eletrocardiográficas foram propostas com esse objetivo, entre eles: Zorzi et al 31 analisaram atletas com elevação do segmento ST em "domo " (repolarização precoce) em V 1 a V 3 e indivíduos com o diagnóstico de Brugada, e compararam a elevação do ponto J/80ms nos dois grupos 7,[31][32][33][34] .…”

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“…Assim, atualmente o vetorcardiograma continua sendo utilizado, pois revela anormalidades elétricas, pouco ou não detectáveis na análise eletrocardiográfica 23,[31][32][33]40 , além de ser um auxílio didático no ensino da eletrocardiografia 41 .…”

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Contribuição do vetorcardiograma no diagnóstico diferencial do padrão eletrocardiográfico de Brugada

Madaloso¹

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Agradeço a Deus pela sustentação inabalável nessa trajetória.A meus pais, Eduardo e Marcia, por todo ensinamento, pela base que permitiu a chegada desse momento. A meu irmão Breno pelo estímulo, mesmo que inconsciente, no ensino da eletrovetorcardiografia.As minhas avós, Eunice e Angelina, pilar e presença incansável em toda minha jornada, meu muito obrigada pelo apoio, oração e confiança na minha capacidade.Aos meus tios, Marli e Renato, e Giovana por sempre terém fé em mim.A meu marido, João Carlos, pela infinita paciência e amor em cada passo.A todos os mestres que fizeram parte da minha trajetória, em especial: Dr. José Eduardo Martinelli, sua presença foi fundamental na minha vida profissional. Dr. Alfredo José Mansur, pela disposição em ensinar e ampliar minha visão de mundo; sou eternamente grata.Prof. Dr. Carlos Alberto Pastore, meu incentivador e orientador, meu imenso obrigada por ter me aberto tantas portas, ter confiado em minha capacidade profissional e por me permitir a realização pessoal de participar de sua equipe no serviço de eletrocardiografia do Incor.Dr. Nelson Samesima, sem sua ajuda eu não teria chegado até aqui. Você foi um pilar fundamental na conclusão desse projeto.A meus colegas de trabalho e principalmente amigos: Dra. Nancy Tobias, por todo carinho e orientação, sou sua fã; Dr. Horácio G. Pereira Filho, meu parceiro na pós-graduação, seu entusiasmo diminui o peso das dificuldades, estamos quase lá; Dra. Mirella, por toda a disposição e colaboração em ajudar.

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Controversial and similar aspects of the Brugada and J wave patterns: The vectorcardiogram point of view

Cited by 8 publications

References 22 publications

Applicability of the Electro-Vectorcardiogram in Current Clinical Practice

Applicability of the Electro-Vectorcardiogram in Current Clinical Practice

Diagnostic value of VCG combined with CDE for acute inferior MI culprit vessel

Contribuição do vetorcardiograma no diagnóstico diferencial do padrão eletrocardiográfico de Brugada

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