QT dispersion in nonsustained ventricular tachycardia and coronary artery disease

Bogun, Frank; Chan, KL; Harvey, Mark; Goyal, Rajiva; Castellani, Mark; Niebauer, Mark; Daoud, Emile G.; Man, K. Ching; Strickberger, S. Adam; Morady, Fred

doi:10.1016/s0002-9149(97)89389-7

Cited by 78 publications

(40 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Bogun, et al have reported that in patients with coronary artery disease who have nonsustained VT, inducibility of monomorphic VT is associated with an increase in QT dispersion. 22) Thus, QT (RT) dispersion may be helpful in predicting which patients with nonsustained VT are likely to have inducible VT by programmed stimulation.…”

Section: Discussionmentioning

confidence: 99%

Development of a Signal-Averaged Vector-Projected 187-Channel High-Resolution Electrocardiogram for the Evaluation of the Spatial Location of High-Frequency Potentials and Abnormal Ventricular Repolarization

et al. 2007

View full text Add to dashboard Cite

SUMMARYNoninvasive risk stratification is important for screening for lethal arrhythmia. We developed a 187-channel signal-averaged vector-projected high-resolution electrocardiograph (187-ch SAVP-ECG) for detecting abnormalities in the spatial location of ventricular high-frequency late potentials (HFLPs) and ventricular repolarization.The subjects consisted of 30 normal controls (CONTROL) and 13 patients with HFLPs (6 with myocardial infarction [MI], 6 with cardiomyopathy, and 1 with Brugada syndrome). The modified X, Y, Z-lead ECG and the synthesized signals from vector-projected 187-channel ECGs were amplified and passed through a digital filter. We calculated the integration of the HFLPs area between QRS end and 30 ms before QRS end . The integrated HFLPs map was superimposed on the corrected recovery time (RTc) and Tpeak-end dispersion maps composed by 187-ch SAVP-ECG. All patients received an examination by 64-channel magnetocardiography (64-ch MCG) on the same day.The spatial distribution of HFLPs by the 187-ch SAVP-ECG map was in agreement with the location of increased RT dispersion in MI. The spatial distribution of HFLPs in DCM demonstrated a wide variety of patterns. Interestingly, the spatial distribution of HFLPs in cases with ARVC was located at around a right ventricular outflow region. The spatial distribution of HFLPs by 187-ch SAVP-ECG was in agreement with those determined by 64-ch MCG.The 187-ch SAVP-ECG might be useful for evaluating the spatial distribution of nonuniform conduction and ventricular repolarization heterogeneity. (Int Heart J 2007; 48: 701-713)

show abstract

Section: Discussionmentioning

confidence: 99%

Development of a Signal-Averaged Vector-Projected 187-Channel High-Resolution Electrocardiogram for the Evaluation of the Spatial Location of High-Frequency Potentials and Abnormal Ventricular Repolarization

et al. 2007

View full text Add to dashboard Cite

show abstract

“…QTD reflects spatial ventricular repolarization inhomogeneity and has been proposed as a risk marker for VT in patients with coronary artery disease. [6][7][8] However, it has had limited success in patients with DCM. Grimm, et al 11) have stated that QTD increased in patients with DCM and VT, but they found its usefulness for arrhythmia-risk prediction limited by the large overlap in QTD for patients with and without VT. Fei, et al 12) have also stated that QTD was not significantly different between patients with and without VT in the setting of DCM.…”

Section: Discussionmentioning

confidence: 99%

“…1,2) Noninvasive markers, such as microvolt T-wave alternans (TWA) and QT interval dispersion (QTD), which reflect temporal and spatial repolarization abnormalities, respectively, have been proposed as useful indices to identify patients at risk of ventricular arrhythmias based on coronary artery disease. [3][4][5][6][7][8] However, little information is available regarding the clinical significance of TWA and QTD in the setting of DCM. [9][10][11][12] Moreover, these markers have not been prospectively compared to each other for patients with DCM.…”

mentioning

confidence: 99%

Comparison of T-Wave Alternans and QT interval Dispersion to Predict Ventricular Tachyarrhythmia in Patients with Dilated Cardiomyopathy and without Antiarrhythmic Drugs.

et al. 2001

View full text Add to dashboard Cite

SUMMARYMicrovolt T-wave alternans (TWA) and QT interval dispersion (QTD), which reflect temporal and spatial repolarization abnormalities, respectively, have been proposed as useful indices to identify patients at risk for ventricular tachyarrhythmias (VTs). The purpose of this study was to clarify which repolarization abnormality marker is more useful in predicting arrhythmic events in patients with dilated cardiomyopathy (DCM).Forty-two consecutive nonischemic DCM patients underwent the assessment of TWA and QTD. Patients undergoing antiarrhythmic pharmacotherapy, except β-blockers and those with irregular basic rhythms, were excluded from entry. Eight patients were also excluded because of indeterminate test results. Therefore, 34 DCM patients were prospectively assessed. The end point of the study was the documentation of VT defined as ≥ 5 consecutive ectopic beats during the follow-up period.TWA and QTD (≥65 msec) were positive in 24 (80%) and 11 (37%) of 30 patients with available follow-up data, respectively. There was no relationship between TWA and QTD. During a follow-up of 13±11 months, VTs occurred in 13 patients (43%). In Cox regression analysis, TWA was a significant risk stratifier (p=0.02), whereas QTD was not. The sensitivity, specificity, and positive and negative predictive values of TWA in predicting VTs were 100%, 35%, 54%, and 100%, respectively.TWA could be a useful noninvasive index to identify patients at risk for VTs in the setting of DCM. This study may suggest that temporal repolarization abnormality is associated more with arrhythmogenesis than with spatial repolarization abnormality in DCM patients. (Jpn Heart J 2001; 42: 451-457)

show abstract

“…Several investigators [8][9][10][11][12][13][14] have reported on QT dispersion in patients with MI or coronary artery disease, including analysis of ventricular arrhythmias. Some have suggested that QT dispersion is greater in patients with ventricular arrhythmias than in those without or that increased QT dispersion may be associated with subsequent mortality and/or sudden cardiac death.…”

Section: Discussionmentioning

confidence: 99%

“…Some have suggested that QT dispersion is greater in patients with ventricular arrhythmias than in those without or that increased QT dispersion may be associated with subsequent mortality and/or sudden cardiac death. [10][11][12][13][14] However, the clinical usefulness of QT dispersion for risk prediction remains limited because of the wide overlap in QT dispersion between patients with and without arrhythmic events.…”

Section: Discussionmentioning

confidence: 99%

Unsuitability of Corrected QT Dispersion as a Marker for Ventricular Arrhythmias and Cardiac Sudden Death After Acute Myocardial Infarction

et al. 1999

View full text Add to dashboard Cite

ecently, much attention has been focused on variations of ventricular repolarization because of their relation to cardiac arrhythmia. In some clinical disorders, 1-5 QT dispersion measured on a standard 12-lead electrocardiogram (ECG) has been reported to be significantly greater in patients with ventricular arrhythmias than in those without. However, it is disputed whether increased QT dispersion can be a predictive value in patients after acute myocardial infartion (MI). The purpose of the present study was to assess whether corrected QT (QTc) dispersion can play a role as marker of ventricular arrhythmias and sudden cardiac death after acute MI. Methods Study PatientsOne hundred consecutive patients with acute MI who were admitted to Saisei-kai Kurihashi Hospital and who were examined by coronary angiography and 24-h ambulatory ECG during the recovery stage were selected for this study. In selecting patients, the following criteria were used: (1) a clinical diagnosis of acute MI characterized by typical chest pain, serum enzyme elevation and the presJapanese Circulation Journal Vol.63, June 1999 ence of ST elevation on ECG on admission, with subsequent abnormal Q waves (duration >40 ms) or persistent ST-T changes; (2) absence of prior MI; (3) no other complicating organic heart disease such as cardiomyopathy or valvular heart disease; and (4) no conduction disturbance or atrial fibrillation on ECG. The patient group consisted of 76 men and 24 women with a mean age of 60±11 years (range, 22-81). Localization of the MI using the 12-lead ECG indicated anterior MI (including anterior, anteroseptal, anterolateral, and lateral locations) in 60 patients and inferior MI (including inferior, inferoposterior, posterior, and inferolateral locations) in 40 patients. Sixtyeight patients received reperfusion therapy (including intracoronary thrombolysis in 53 patients, intravenous thrombolysis in 12 patients, and coronary angioplasty in 3 patients). Infarct-related vessels were indicated as left anterior descending artery (LAD) in 59 patients, left circumflex artery (LCX) in 13 patients, and right coronary artery (RCA) in 28 patients. Standard 12-Lead ECG and 24-h Ambulatory ECGAll standard 12-lead ECGs were recorded at a paper speed of 25 mm/s during the recovery phase (15±9 days) after the onset of MI. Measurements of QT and RR intervals were performed manually with the use of a digitizing tablet by one observer who did not know the patient's clinical data. The RR intervals were measured at surface ECG lead V1 for 3 consecutive cycles and the average value used. The QT intervals were measured at each lead of the 12-lead surface ECG for 1 cycle from the beginning of QRS complexes to the intersections between the tangential lines over the terminal limbs of the T waves and the Jpn Circ J 1999; 63: 467 -470 (Received October 26, 1998; revised manuscript received March 4, 1999; accepted March 18, 1999 The present study investigated whether corrected QT (QTc) dispersion could play a role as a marker of ventricular arrhythmias...

show abstract

QT dispersion in nonsustained ventricular tachycardia and coronary artery disease

Cited by 78 publications

References 10 publications

Development of a Signal-Averaged Vector-Projected 187-Channel High-Resolution Electrocardiogram for the Evaluation of the Spatial Location of High-Frequency Potentials and Abnormal Ventricular Repolarization

Development of a Signal-Averaged Vector-Projected 187-Channel High-Resolution Electrocardiogram for the Evaluation of the Spatial Location of High-Frequency Potentials and Abnormal Ventricular Repolarization

Comparison of T-Wave Alternans and QT interval Dispersion to Predict Ventricular Tachyarrhythmia in Patients with Dilated Cardiomyopathy and without Antiarrhythmic Drugs.

Unsuitability of Corrected QT Dispersion as a Marker for Ventricular Arrhythmias and Cardiac Sudden Death After Acute Myocardial Infarction

Contact Info

Product

Resources

About