Mapping of Ventricular Repolarization Potentials in Patients With Arrhythmogenic Right Ventricular Dysplasia

Ambroggi, L. De; Aimè, Ezio; Ceriotti, Carlo; Rovida, M; Negroni, Silvia

doi:10.1161/01.cir.96.12.4314

Cited by 65 publications

(55 citation statements)

References 23 publications

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“…The PcA of the T-wave led to promising results, in terms of quantification of ventricular repolarization inhomogeneity that may create an arrhythmogenic ventricular substrate [9][10][11][12]. PcA can be used to estimate the dipolar and the not dipolar components of the P-wave, and thus its use could led to interesting results in terms of analysis of atrial path from surface EcG.…”

Section: Discussionmentioning

confidence: 99%

“…Promising results have been obtained by measuring the QT interval (QT dispersion) and by performing the principal component analysis of the T-wave [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…Principal component analysis (PcA) of the T-wave has been extensively used to quantify both the complexity and the not dipolar components of the T-wave [9][10][11][12]: particularly, if the EcG would be completely explained by a single electrical dipole, the three largest principal components (Pcs), and their corresponding orthogonal eigenvectors, would span the real three dimensional space (dipolar components), while the remaining Pcs (not dipolar components) would be zero [12]. For the T-wave it has been demonstrated that the not dipolar components, quantified by the PcA, are not zero, and reflect local repolarization heterogeneity [12].…”

Section: Introductionmentioning

confidence: 99%

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Quantification of not-dipolar components of atrial depolarization by principal component analysis of the P-wave

Censi

Bartolini

Ricci

et al. 2012

Annali Dell'Istituto Superiore Di Sanità

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Abstract.Background. Principal component analysis (PcA) of the T-wave has been demonstrated to quantify the dipolar and not-dipolar components of the ventricular activation, the latter reflecting repolarization heterogeneity. Accordingly, the PcA of the P-wave could help in analyzing the heterogeneous propagation of sinus impulses in the atria, which seems to predispose to fibrillation. aim. The aim of this study is to perform the PcA of the P-wave in patients prone to atrial fibrillation (AF). Methods. PcA is performed on P-waves extracted by averaging technique from EcG recordings acquired using a 32-lead mapping system (2048 Hz, 24 bit, 0-400 Hz bandwidth). We extracted PcA parameters related to the dipolar and not dipolar components of the P-wave using the first 3 eigenvalues and the cumulative percent of variance explained by the first 3 Pcs (explained variance EV). Results and conclusions. We found that the EV associated to the low risk patients is higher than that associated to the high risk patients, and that, correspondingly, the first eigenvalue is significantly lower while the second one is significantly higher in the high risk patients respect to the low risk group. Factor loadings showed that on average all leads contribute to the first principal component.

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Section: Discussionmentioning

confidence: 99%

“…Promising results have been obtained by measuring the QT interval (QT dispersion) and by performing the principal component analysis of the T-wave [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Quantification of not-dipolar components of atrial depolarization by principal component analysis of the P-wave

Censi

Bartolini

Ricci

et al. 2012

Annali Dell'Istituto Superiore Di Sanità

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“…16 Individual QRST isointegral maps, mean QRST integral maps and QRST integral departure maps were obtained as described previously. 17 Briefly, after baseline adjustment, individual QRST isointegral maps were obtained by calculating the algebraic sum at each lead point of all instantaneous potentials from the QRS-onset to the T wave-end, and these were multiplied by the sampling interval. The values were plotted on a diagram representing the thoracic surface, and the QRST isointegral contour lines were separated by 10 mV/ms.…”

Section: Body-surface Qrst Isointegral Mappingmentioning

confidence: 99%

Characteristic Features of QRST Integral Mapping in Patients With High Risk Brugada Syndrome

Kanahara

Kai

Toyomasu

et al. 2007

Circ J

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rugada syndrome (BS) is associated with a high risk of sudden cardiac death secondary to life-threatening arrhythmias; that is, ventricular tachycardia and fibrillation (VT/VF) in young and otherwise healthy adults. 1-4 ECG abnormalities constitute the hallmark of BS and include a coved or saddleback-type ST-segment elevation in the right precordial leads (V1-3) accompanied by T wave alterations, with or without some degree of right bundle branch block in the absence of identifiable structural cardiac abnormalities. However, there are a substantial number of patients who show Brugada-type ECGs but do not develop fatal arrhythmias. Therefore, it is important in the clinical practice to discriminate patients with the Brugada-type resting ECG who are at a high risk for lifethreatening ventricular arrhythmias from those at low risk. However, at present there is not a non-invasive method of risk stratification.Among the approaches to detect patients at risk of lifethreatening ventricular arrhythmias, QRST integral mapping is of particular interest. The spatial distributions of the QRST integrals reflect an anatomic and electrophysiological substrate for fatal ventricular arrhythmias. 5-10 It has Circulation Journal Vol. 71, January 2007 been shown that QRST integral mapping is capable of assessing the vulnerability to ventricular arrhythmias in various heart diseases. [11][12][13][14] Accordingly, we investigated whether patients with Brugada-type resting ECGs and life-threatening arrhythmias can be non-invasively characterized using QRST integral mapping. If so, QRST integral mapping could be a new non-invasive screening method to discriminate between high and low risk patients with regard to life-threatening arrhythmias. In the present study, QRST isointegral maps and QRST integral departure maps were created in patients with Brugada-type resting ECGs with at least 1 of the following: aborted sudden death, a history of spontaneous sustained VT/VF or programmed electrical stimulation (PES)-inducible sustained VT/VF. These findings were compared with those of Brugada-type ECG patients who had not experienced such cardiac events. Methods Study GroupsThis retrospective study included 24 consecutive patients with Brugada-type resting ECGs, all of whom underwent body-surface QRST isointegral mapping at Kurume University Hospital from January 1997 to August 2005. The enrolled patients had no evidence of structural abnormalities of the heart based upon cardiac echocardiograms, coronary angiograms, and right and left ventriculograms. None of the patients enrolled in this study was taking antiarrhythmic drugs. The present study was approved by the Ethical Committee for Clinical Research of Kurume University, and all subjects gave written informed consent.The Brugada-type ECGs were recognized as having type- Characteristic Features of QRST Integral Mapping in Patients With High Risk Brugada SyndromeMasaaki Kanahara, MSc; Hisashi Kai, MD*; Koji Toyomasu, MD**; Teruhisa Yoshida, MD*; Tatsuro Hiraki, MD*; Kimitaka Sagawa, MD...

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“…Whilst the diagnostic [1][2][3] and prognostic [4,5] value of PCA of the T wave has been demonstrated, the effect of physiological factors on the QRS and T wave complexity is unknown. The T wave shape or polarity can be influenced by age, sex, heart rate, body position, autonomic activity, respiration, temperature, electrolyte concentration, food and mental activity [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Effect of heart rate and body position on the complexity of the QRS and T wave in healthy subjects

Batchvarov

Bortolan

Christov

2008

2008 Computers in Cardiology

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We analysed the effect of heart rate and body position on the complexity of the QRS and T wave quantified by the ratio of 2 nd /1 st eigenvalue from principal component analysis (PCA) (QRS-PCA, T-PCA) . In both positions, the intrasubject variability of QRS-PCA and T-PCA was significantly smaller than the inter-subject variability. IntroductionPrincipal component analysis (PCA) quantifies the complexity of the ECG waves by defining a set of independent forms (components) with decreasing relative value, which can fully describe their shape. Visibly more complex QRS or T waves with irregularities, notches, etc., which are frequently observed in diseased hearts are described by a greater number of independent components, with increasing relative value of the smaller components.Whilst the diagnostic [1-3] and prognostic [4,5] value of PCA of the T wave has been demonstrated, the effect of physiological factors on the QRS and T wave complexity is unknown. The T wave shape or polarity can be influenced by age, sex, heart rate, body position, autonomic activity, respiration, temperature, electrolyte concentration, food and mental activity [6][7][8][9][10]. It is possible that these factors can also affect T wave complexity. We investigated the effect of heart rate and body position on QRS and T wave complexity using an ECG database recorded in healthy subjects. MethodsA digital ECG database was previously recoded for another project in 15 subjects (8 men, 7 women, age 28.6±7.5 years, range 21.5 -49.1 years) with negative medical history, normal physical examination and normal resting 12-lead ECG, who were not taking any medications during the project.Data were acquired after 5 minutes of rest in the supine position. In each subject, a continuous digital 12-lead ECG was recorded for 25 minutes (5 minutes supine → 10 minutes standing → 10 minutes supine) with Mason-Likar electrode positions [11] using a PC-based 12-lead ECG recorder (CardioSoft™, GE Medical Systems, Milwaukee, USA, 500 Hz, 4.88 µV resolution). In each individual, the same protocol was repeated after approximately 1 week at the same time of the day (within±1 hour). The local Ethics Committee approved the study protocol and each subject provided a written consent. Data analysisAll ECG recordings were visually assessed on screen using the CardioSoft™ software programme in order to exclude segments with noise or premature beats. The first 2 minutes and the last 30 seconds of recording in each position were excluded from the study, and 2.5 minutes supine → 7.5 minutes standing → 7.5 minutes supine were analysed. The ECG were preprocessed suppressing power-line interference, electromyogram noise and baseline drift according to our previously published material on Q-onset and T-end delineation [12].QRS detection was performed following the work of Christov [13], then one complex lead was synthesised from the initials 8 leads [14]. The QRS and the T wave boundaries as well as the RR interval were delineated and

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Mapping of Ventricular Repolarization Potentials in Patients With Arrhythmogenic Right Ventricular Dysplasia

Cited by 65 publications

References 23 publications

Quantification of not-dipolar components of atrial depolarization by principal component analysis of the P-wave

Quantification of not-dipolar components of atrial depolarization by principal component analysis of the P-wave

Characteristic Features of QRST Integral Mapping in Patients With High Risk Brugada Syndrome

Effect of heart rate and body position on the complexity of the QRS and T wave in healthy subjects

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