Professor Emeritus in Kyushu University, Kyushu University Hospital, Japan.
Haradoi Hospital, Japan.
Intern Med. 2023 Nov 15;62(22):3267-3275. doi: 10.2169/internalmedicine.2298-23. Epub 2023 Aug 23.
Vaccination against COVID-19 has raised concerns about myocarditis in young men, as out-of-hospital cardiac arrest (OHCA) or sudden death after vaccination has been reported sporadically. Common features of these cases are occurrence in young men, within a few weeks after vaccination, in patients with no structural heart diseases. Cases of unexplained nocturnal death showed fibrotic or hypertrophied myocardium, and one case of OHCA presented ventricular fibrillation (VF) triggered by a prominent J wave on an automated external defibrillator and histopathologic findings compatible with myocarditis. Both myocarditis and J waves are prevalent in young men, and these cases imply that myocarditis augments J waves, which trigger VFs, and primary electrical disorders are a leading cause of death. To prevent such issues, artificial intelligence (AI)-assisted interpretation of historical electrocardiogram findings may help predict future J wave formation leading to VF, as digital electrocardiogram (ECG) findings are well suited for AI interpretation.
接种 COVID-19 疫苗后，年轻人心肌炎的担忧增加了，因为有报道称接种疫苗后会零星出现院外心脏骤停（OHCA）或猝死。这些病例的共同特征是发生在年轻人中，在接种疫苗后几周内，患者无结构性心脏病。不明原因的夜间死亡病例显示纤维性或肥厚性心肌炎，一例 OHCA 呈现心室颤动（VF），自动体外除颤器上的突出 J 波触发，组织病理学检查结果符合心肌炎。心肌炎和 J 波在年轻人中很常见，这些病例表明心肌炎增强了 J 波，从而引发 VF，原发性电紊乱是导致死亡的主要原因。为了预防此类问题，人工智能（AI）辅助解读历史心电图结果可能有助于预测未来导致 VF 的 J 波形成，因为数字心电图（ECG）结果非常适合 AI 解读。
