ECG Evaluation of Ventricular Properties: The Importance of Cardiac Cycle Length

Introduction:The aim of the study was to assess the time course effect of IKr blockade on ECG biomarkers of ventricular repolarization and to evaluate the accuracy of a fully automatic approach for QT duration evaluation.Methods: Twelve-lead digital ECG Holter was recorded in 38 healthy subjects (27 males, mean age = 27.4 ± 8.0 years) on baseline conditions (day 0) and after administration of 160 mg (day 1) and 320 mg (day 2) of d-l sotalol. For each 24-hour period and each subject, ECGs were extracted every 10 minutes during the 4-hour period following drug dosage. Ventricular repolarization was characterized using three biomarker categories: conventional ECG time intervals, principal component analysis (PCA) analysis on the T wave, and fully automatic biomarkers computed from a mathematical model of the T wave.Results: QT interval was significantly prolonged starting 1 hour 20 minutes after drug dosing with 160 mg and 1 hour 10 minutes after drug dosing with 320 mg. PCA ventricular repolarization parameters sotalol-induced changes were delayed (>3 hours). After sotalol dosing, the early phase of the T wave changed earlier than the late phase prolongation. Globally, the modeled surrogate QT paralleled manual QT changes.The duration of manual QT and automatic surrogate QT were strongly correlated (R 2 = 0.92, P < 0.001). The Bland and Altman plot revealed a nonstationary systematic bias (bias = 26.5 ms ± 1.96 * SD = 16 ms).Conclusions: Changes in different ECG biomarkers of ventricular repolarization display different kinetics after administration of a potent potassium channel blocker. These differences need to be taken into account when designing ventricular repolarization ECG studies.

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“…39 This effect was also observed in this study after pooling baseline and placebo data (Fig. 4 upper panel).…”

Section: Effect Of Sotalol On T-wave Amplitudesupporting

confidence: 53%

The Time Course of New T‐Wave ECG Descriptors Following Single‐ and Double‐Dose Administration of Sotalol in Healthy Subjects

Extramiana

Dubois

Vaglio³

et al. 2010

Noninvasive Electrocardiol

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“…First, a heart rate-related effect, the amplitude of T-wave apex relative to baseline has been shown to be rate dependent in normal subject. 39 This effect was also observed in this study after pooling baseline and placebo data (Fig. 4 upper panel).…”

Section: Effect Of Sotalol On T-wave Amplitudesupporting

confidence: 79%

206 The time course of new T-wave ECG descriptors following single and double dose administration of Sotalol in healthy subjects

Extramiana

Dubois

Roussel

et al. 2010

Archives of Cardiovascular Diseases Supplements

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The aim of the study was to assess the time course effect of IKr blockade on ECG biomarkers of ventricular repolarization and to evaluate the accuracy of a fully automatic approach for QT duration evaluation. Methods: Twelve-lead digital ECG Holter was recorded in 38 healthy subjects (27 males, mean age = 27.4 ± 8.0 years) on baseline conditions (day 0) and after administration of 160 mg (day 1) and 320 mg (day 2) of d-l sotalol. For each 24-hour period and each subject, ECGs were extracted every 10 minutes during the 4-hour period following drug dosage. Ventricular repolarization was characterized using three biomarker categories: conventional ECG time intervals, principal component analysis (PCA) analysis on the T wave, and fully automatic biomarkers computed from a mathematical model of the T wave. Results: QT interval was significantly prolonged starting 1 hour 20 minutes after drug dosing with 160 mg and 1 hour 10 minutes after drug dosing with 320 mg. PCA ventricular repolarization parameters sotalol-induced changes were delayed (>3 hours). After sotalol dosing, the early phase of the T wave changed earlier than the late phase prolongation. Globally, the modeled surrogate QT paralleled manual QT changes. The duration of manual QT and automatic surrogate QT were strongly correlated (R 2 = 0.92, P < 0.001). The Bland and Altman plot revealed a nonstationary systematic bias (bias = 26.5 ms ± 1.96 * SD = 16 ms). Conclusions: Changes in different ECG biomarkers of ventricular repolarization display different kinetics after administration of a potent potassium channel blocker. These differences need to be taken into account when designing ventricular repolarization ECG studies.

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“…The exercise test further indicated the changes in QTc interval that can occur with increased heart rate. 115 Three patients without LQTS mutations detected, had reductions to their QTc interval from above to significantly below 500 msec with increased heart rate, illustrating the reverse frequency-dependent effect of druginduced QTc prolongation. 116 One male was found to carry a heterozygous mutation in the KCNQ1 gene, known as LQTS1.…”

Section: Discussion Of Resultsmentioning

confidence: 97%

Mortality prior to, during and after opioid maintenance treatment (OMT): A national prospective cross-registry study

Clausen

Anchersen

Waal

2008

Drug and Alcohol Dependence

244

159

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ECG Evaluation of Ventricular Properties: The Importance of Cardiac Cycle Length

Cited by 7 publications

References 41 publications

The Time Course of New T‐Wave ECG Descriptors Following Single‐ and Double‐Dose Administration of Sotalol in Healthy Subjects

The Time Course of New T‐Wave ECG Descriptors Following Single‐ and Double‐Dose Administration of Sotalol in Healthy Subjects

206 The time course of new T-wave ECG descriptors following single and double dose administration of Sotalol in healthy subjects

Mortality prior to, during and after opioid maintenance treatment (OMT): A national prospective cross-registry study

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