Prolongation of Electrocardiographic T Wave Parameters Recorded during the Head-Up Tilt Table Test as Independent Markers of Syncope Severity in Children

Markiewicz-Łoskot, Grażyna; Kolarczyk, Ewelina; Mazurek, Bogusław; Łoskot, Marianna; Szydłowski, Lesław

doi:10.3390/ijerph17186441

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…In a study by Markiewicz-Łoskot and colleagues, they found that patients who experienced vasovagal syncope had longer T wave parameters [12]. Our explanation for this phenomenon is possible muscarinic receptor stimulation of some potassium channels which are responsible for the duration of action potential.…”

Section: Discussionmentioning

confidence: 72%

Long QT syndrome diagnosis may be affected by positive tilt table test; a cross-sectional study

Nikoo

Hassani

Kamrava

et al. 2023

Preprint

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Background Tilt Table Test (TTT) is usually used for assessment of syncope with undefined etiology. Positive test occurs in those with parasympathetic overstimulation. This overactivation of parasympathetic system may affect QTc measurement; not only through rate modulation, but also from through potassium ionic channels as muscarinic activated inward rectifying K + current.Methods and Materials: in this cross-sectional study, 478 patients with syncopal attacks of unknown origin underwent evaluation with TTT as well as 24-hour Holter electrocardiogram monitoring. Schwartz score (for diagnosis of Long QT syndrome) was calculated for all of them. Those with secondary causes of long QT excluded from survey. Then the association of positive TTT and Schwartz score was assessed.Results 478 patients entered the study 208 (43.4%) of whom were male and 270 (56.4%) were female. The mean age of the patients was 42.43 ± 17.979 years old. TTT was positive in 289 (60.46%) patients and was negative in 189 (39.54%) patients. the mean Schwartz score was significantly higher in patients with positive TTT (2.77 ± 0.08 vs. 1.99 ± 0.12) (P < 0.001).Conclusion Diagnosis of long QT syndrome as a cause of syncope should not be made hesitantly by the use of Schwartz score as this scoring system might need to be modified based on the results of tilt table test.

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Section: Discussionmentioning

confidence: 72%

Long QT syndrome diagnosis may be affected by positive tilt table test; a cross-sectional study

Nikoo

Hassani

Kamrava

et al. 2023

Preprint

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“…In a very recent study by Loskot et al, 29 QT intervals were similar between NMS and control groups both at baseline and in the recovery phase, but T peak to T end interval, which is a newly suggested indicator of repolarization disparity, has been significantly higher in syncopal group compared to control group.…”

Section: Discussionmentioning

confidence: 84%

Repolarization disparity as a predictor of response to Head up Tilt‐table Test in pediatric syncope

Khalilian

Ghasemi

Khazaei

et al. 2021

Pacing Clinical Electrophis

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Background Head up Tilt‐table Test (HUTT) is a practical examination of the most common type of pediatrics syncope. The electrocardiographic (ECG) changes during this test, show the autonomic defects that cause neuraly‐mediated syncope in response to tilting process. Methods All pediatric syncope patients referred to our center in a 1‐year period, were included in the study. HUTT was performed and patients were classified into two groups of Negative and Positive HUTT results, and the latter group was subclassified as three subgroups of “vasodepressor”, “cardioinhibitory” and “mixed type” responses to HUTT. QT and corrected QT (QTc) dispersion was measured by the baseline standard 12‐lead ECG obtained before HUTT. Results Eighty‐six patients with a mean age of 12.19 ± 5.34 were included. Patients with positive HUTT were significantly younger and male gender was more prevalent in this group. Mean QT dispersion was significantly higher in patients with positive HUTT result and also in patients with mixed response to HUTT compared to isolated vasodepressor response. Duration of QTc interval did not change between different study groups. Reciever‐Operating‐Characteristic (ROC) analysis showed that QT dispersion higher than 32 ms is a significant predictor of positive HUTT result (with 92% sensitivity and 98% specificity) and values higher than 40 ms can predict the mixed type of response to HUTT (with 84% sensitivity and 63% specificity). Conclusions Baseline myocardial repolarization disparity significantly correlates with susceptibility to symptomatic vasovagal syncope. This pathology seems to play its role mainly via excessive vagotonic response to sympathetic activation during HUTT process (known as cardioinhibitory response).

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“…As a more sensitive indicator for judging arrhythmia, it can eliminate the influence of heart rate and individual QT interval variability on Tp-Te (54). Markiewicz-Łoskot et al (47) found that the Tp-Te interval in lead V5 was consistently prolonged during HUTT in 40 children with VVS compared to healthy children [in supine position: 89 ms vs. 80 ms, P < 0.01; syncope occurred: 100 ms vs. 60 ms, P < 0.01; after syncope: 90 ms vs. 80 ms, P < 0.01]. According to ROC, Tp-Te interval > 70 ms (AUC = 1) was recommended for predicted VVS with good sensitivity and specificity (both 100%).…”

Section: T Wave Amplitude and Morphologymentioning

confidence: 99%

Research progress on the predictive value of electrocardiographic indicators in the diagnosis and prognosis of children with vasovagal syncope

Zhao

Wang²,

Wang³

et al. 2022

Front. Cardiovasc. Med.

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Neurally mediated syncope (NMS) is a common type of syncope in children in clinical practice, among which vasovagal syncope (VVS) is the most frequent. In recent years, more and more studies have been carried out to assess the diagnosis and prognosis of VVS. The electrocardiographic indicators such as heart rate variability (HRV), QT dispersion (QTd), P-wave dispersion (Pd), ventricular late potentials (VLP), deceleration ability of heart rate (DC), etc., are easy to obtain and inexpensive. With the help of electrocardiographic indicators, the diagnostic procedure and individualized treatment strategies of pediatric VVS can be optimized. This article reviews the value of electrocardiographic indicators in the diagnosis and prognosis of children with VVS.

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Prolongation of Electrocardiographic T Wave Parameters Recorded during the Head-Up Tilt Table Test as Independent Markers of Syncope Severity in Children

Cited by 7 publications

References 27 publications

Long QT syndrome diagnosis may be affected by positive tilt table test; a cross-sectional study

Long QT syndrome diagnosis may be affected by positive tilt table test; a cross-sectional study

Repolarization disparity as a predictor of response to Head up Tilt‐table Test in pediatric syncope

Research progress on the predictive value of electrocardiographic indicators in the diagnosis and prognosis of children with vasovagal syncope

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