{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:49:59Z","timestamp":1747187399917,"version":"3.40.5"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T00:00:00Z","timestamp":1634601600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>On surface electrocardiographic (ECGs), it is difficult to differentiate I<jats:sub>to<\/jats:sub>\u2010mediated J waves, a repolarization phenomenon seen in J wave syndromes (JWS) from terminal QRS deflections that mimic J waves (pseudo J waves) in intraventricular conduction delay (IVCD), an abnormality in depolarization. We hypothesize that the difference between the \u201cmaximum QRS duration\u201d inclusive of J point or terminal QRS deflections and the minimum QRS duration identified across a 12\u2010lead ECG is significantly larger in I<jats:sub>to<\/jats:sub>\u2010mediated J waves, and can serve as a marker to make this distinction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was performed on adults with ECGs consisting of one of the four following manifestations: J waves associated with hypothermia and early repolarization, and pseudo J waves associated with right bundle branch block (RBBB) and non\u2010specific intraventricular conduction delay (NS\u2010IVCD). All ECGs were assessed individually and the maximum and minimum discrete QRS deflections on 12\u2010lead tracings, defined as \u201cQRS<jats:sub>max<\/jats:sub>\u201d and QRS<jats:sub>min<\/jats:sub>, were identified. The difference between \u201cQRS<jats:sub>max<\/jats:sub>\u201d and QRS<jats:sub>min<\/jats:sub>, designated as \u2206QRS, was calculated and compared across the studied populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 60 patients consisting of 15 patients in each arm were included in the study. \u0394QRS was significantly larger in the hypothermia and early repolarization groups, compared to RBBB and NS\u2010IVCD (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a0.0001), with the following mean \u2206QRS: hypothermia 54.3\u00a0\u00b1\u00a013.7\u00a0ms, early repolarization pattern 47.3\u00a0\u00b1\u00a015.3\u00a0ms, RBBB 19.3\u00a0\u00b1\u00a06.5\u00a0ms, and NS\u2010IVCD 16.0\u00a0\u00b1\u00a06.6\u00a0ms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>\u2206QRS may serve as a reliable ECG parameter for distinguishing I<jats:sub>to<\/jats:sub>\u2010mediated J waves from pseudo J waves produced by delayed intraventricular conduction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14359","type":"journal-article","created":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T09:47:17Z","timestamp":1631180837000},"page":"1832-1841","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Delta QRS distinguishes I<sub>to<\/sub>\u2010mediated J waves from pseudo J waves produced by conduction delay on body surface electrocardiographic"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3433-0134","authenticated-orcid":false,"given":"Yinn Shaung","family":"Ooi","sequence":"first","affiliation":[{"name":"Lankenau Medical Center  Wynnewood Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mostafa","family":"Amer","sequence":"additional","affiliation":[{"name":"Lankenau Medical Center  Wynnewood Pennsylvania 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Kimmel Medical College at Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,10,19]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(36)90417-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajplegacy.1953.175.3.389"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.2.372"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2014.09.003"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.11.038"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2016.46.5.601"},{"key":"e_1_2_8_8_1","first-page":"p626","article-title":"My approach to early repolarization syndrome","author":"Yan G\u2010X","year":"2015","journal-title":"Braunwald's Heart Disease: A Textbook of Cardiovascular 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