Background: Prolongation of the peak and the end of T wave (Tp-e) has been reported to be associated with ventricular arrhythmias. Tp-e/QT ratio and Tp-e/QTc ratio are used as an index of ventricular arrhythmogenesis. An increased incidence of ventricular arrhythmias has been reported in patients with obstructive sleep apnea (OSA). The aim of this study was to assess ventricular repolarization in patients with OSA by using Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.Methods: We have studied 72 patients who underwent overnight polysomnography (PSG) between the years 2010-2011 at our institution. Patients with moderate and severe OSA (23 patients; mean age: 45 ± 10), according to the apnea-hypopnea index, constituted the study group. Patients with normal PSG (23 patients; mean age: 42 ± 11) were used as the control group. In all patients, Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio, as well as some other electrocardiogram intervals were measured. Independent samples t-tests were used for comparison of continuous and categorical variables and correlations were calculated by Spearman rank correlation.Results: Although QT and QTc intervals were not different between the groups, mean Tp-e interval (81.6 ± 11.1 msn; 63.9 ± 7.3 msn; respectively; P < 0.001), Tp-e/QT ratio (0.21 ± 0.03; 0.17 ± 0.02; respectively; P < 0.001), and Tp-e/QTc ratio (0.20 ± 0.03; 0.16 ± 0.02; respectively; P < 0.001) were prolonged in the study group compared to the control group. Correlation analysis showed a significant positive correlation between the presence of moderate and severe OSA and Tp-e interval (r = 0.72; P < 0.001), Tpe/QT ratio (r = 0.70; P < 0.001), and Tp-e/QTc ratio (r = 0.70; P < 0.001).
Conclusions:Address for reprints: Alptug Tokatli, M.D., GATA Haydarpasa Egitim Hastanesi, Kardiyoloji servisi, Uskudar-34668; Istanbul, Turkey. Fax: 90 0 212 296 75 12;
BackgroundType 2 diabetes mellitus (T2DM) is associated with increased risk of malignant ventricular arrhythmias. Cardiac electrical inhomogeneity may be the leading cause of the increased arrhythmic risk in patients with T2DM. The peak and the end of the T wave (Tp-e) interval and associated Tp-e/QT ratio are promising measures of ventricular repolarization indicating transmural dispersion of repolarization. The aim of this study was to assess ventricular repolarization in patients with T2DM by using Tp-e interval, Tp-e/QT ratio and Tp-e/corrected QT interval (QTc) ratio.MethodsForty-three patients with T2DM and 43 healthy control subjects, matched by gender and age, were studied. All participants underwent electrocardiography (ECG) recording. PR, RR and QT intervals represents the ECG intervals. These are not abbreviations. In all literature these ECG intervals are written like in this text. Tp-e intervals were measured from 12-lead ECG. Rate QTc was calculated by using the Bazett's formula. Tp-e/QT ratio and Tp-e/QTc ratio were also calculated.ResultsMean Tp-e interval was significantly prolonged in patients with T2DM compared to controls (79.4±10.3, 66.4±8.1 ms, respectively; P<0.001). We also found significantly higher values of Tp-e/QT ratio and Tp-e/QTc ratio in patients with diabetes than controls (0.21±0.03, 0.17±0.02 and 0.19±0.02, 0.16±0.02, respectively; P<0.001). There was no difference in terms of the other ECG parameters between the groups.ConclusionTp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio were prolonged in patients with T2DM. We concluded that T2DM leads to augmentation of transmural dispersion of repolarization suggesting increased risk for ventricular arrhythmogenesis.
The results show that chronic cigarette smoking is associated with a prolonged Tp-e interval, increased Tp-e/QT ratio and Tp-e/QTc ratio. These observations may indicate that there may be a relationship between smoking and altered ventricular repolarization. Abnormal ventricular repolarization values on an ECG may explain the increased cardiovascular event risk in long-term heavy cigarette smokers.
The LV diameters and volumes of patients with classic bileaflet MVP were found to be increased even in the absence of significant MR. These results need to be supported by large-scale clinical studies.
Cutaneous analgesia before TRA for coronary interventions is associated with a substantial reduction in the RAS and the procedure-related level of patient discomfort.
Anteroseptal accessory pathways are relatively rare. Because of the close proximity of the atrioventricular (AV) node, ablation of these accessory pathways has the potential to result in AV block. The anteroseptal region is adjacent to the noncoronary cusp, allowing anteroseptal accessory pathways to be ablated from the noncoronary cusp. A 34 year-old male patient with recurrent episodes of palpitation for approximately ten years was admitted to our department. Twelve lead-ECG was consistent with anteroseptal accessory pathway. Intracardiac recordings were also consistent with anteroseptal accessory pathway. In this case, we found an excellent AV relation while mapping the noncoronary cusp. Radiofrequency (RF) ablation was applied to this region. Pre-excitation was immediately disappeared during RF application. After RF ablation, there was no pre-excitation detectable by ECG. In this report, we present a case of anteroseptal accessory pathway that was successfully ablated from the noncoronary cusp.
IntroductionCarotid artery stenting (CAS) is a promising alternative to surgery in high-risk patients. However, the impact of stent cell design on outcomes in CAS is a matter of continued debate.AimTo compare the periprocedural and clinical outcomes of different stent designs for CAS with distal protection devices.Material and methodsAll CAS procedures with both closed- and hybrid-cell stents performed at our institution between February 2010 and December 2015 were analyzed retrospectively. Adverse events were defined as death, major stroke, minor stroke, transient ischemic attack and myocardial infarction. Periprocedural and 30-day adverse events and internal carotid artery (ICA) vasospasm rates were compared between the closed-cell and hybrid-cell stent groups.ResultsThe study included 234 patients comprising 146 patients with a closed-cell stent (Xact stent, Abbott Vascular) (mean age: 68.5 ±8.6; 67.1% male) and 88 patients with a hybrid-cell stent (Cristallo Ideale, Medtronic) (mean age: 67.2 ±12.8; 68.2% male). There was no significant difference between the groups with respect to periprocedural or 30-day adverse event rates. While there was no difference in terms of tortuosity index between the groups, there was a higher procedural ICA vasospasm rate in the closed-cell stent group (35 patients, 23%) compared with the hybrid-cell stent group (10 patients, 11%) (p = 0.017).ConclusionsThe results of this study showed no significant difference in the clinical adverse event rates after CAS between the closed-cell stent group and the hybrid-cell stent group. However, procedural ICA vasospasm was more common in the closed-cell stent group.
Aorto femoral bypass is usually the recommended therapy for diffuse disease involving the aorta and iliac arteries. In this case report, a case involving a chronic endovascular abdominal aortic stent graft occlusion in which percutaneous angioplasty was performed via a transbrachial and transfemoral approach is presented. This case emphasized that occlusion of an endovascular abdominal aortic stent graft can also be treated, primarily, with an endovascular technique.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.