T-wave Right Slope Provides a New Angle in the Prediction of Drug-Induced Ventricular Arrhythmias

Heijman, Jordi; Crijns, Harry J.G.M.

doi:10.1007/s10557-015-6620-7

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…T slope showed a strong correlation with death when equal to or greater than 70°. [13] Although a review of the literature reveals a few reports on repolarization abnormalities measured by T slope, such as the work of Strebel et al [14] in myocardial infarction and Heijman et al [15] in drug-induced ventricular arrhythmias, the signifi cance of it remains to be determined in future studies.…”

Section: Discussionmentioning

confidence: 99%

Mortality-related electrocardiogram indices in methanol toxicity

Nikoo¹

2022

World J Emerg Med

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Section: Discussionmentioning

confidence: 99%

Mortality-related electrocardiogram indices in methanol toxicity

Nikoo¹

2022

World J Emerg Med

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“…Although literature review shows a few researches about repolarization abnormalities measured by T slope such as the work of Strebel et al [27] in myocardial infarction and Heijman et al [28] in druginduced ventricular arrhythmias, the signi cance of it remained to be determined in future surveys.…”

Section: Discussionmentioning

confidence: 99%

Useful Electrocardiographic and Laboratory Findings in Shiraz Outbreak of 356 Methanol Poisoned Patients

Nikoo

Estedal

Pakfetrat

et al. 2020

Preprint

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Background: Binge alcohol eating especially in underdeveloped countries may be complicated by methanol toxicity, especially when blinded drunken cases come to emergency department. Unfortunately, in early months of 2020, Fars, one of the largest provinces in southern Iran, reported one of the largest methanol poisoning outbreaks with high case-fatality rate. Here we like to share our experience and introduce some simple measures which may announce more urgent dialysis to save the lives of these patients.Method: In this study, 356 cases with methanol toxicity referred to the Tertiary Hospitals (Faghihi and Namazi) affiliated to Shiraz University of Medical Sciences during March and April, 2020. To collect the required data, clinical findings on blindness and impaired level of consciousness, laboratory data such as arterial blood gas, electrolytes, and creatinine, and the most common findings from ECGs were collected. Results: Among the participants, 321 (90.2%) patients were male, and 162 persons (45.5%) were aged below 30 years old. Reviewing the laboratory data of the included patients revealed that PH, HCO3, and O2 saturation decreased. While PCO2, Cr, K, BS increased (P<0.05). In the multiple analysis, when the intervening factors of age and gender were adjusted and all ECG items were included in the model, T slope>=70, Brugada pattern, low voltage QRS, severe metabolic acidosis (PH<7.2) and lack of hyperventilation when severely acidotic showed independent relationship with mortality with the odds ratios of 3.42, 5.65, 6.70, 4.55 and 5.74 respectively.Conclusion: Apart from usual modalities like acidosis, electrolyte imbalance, QTc prolongation and prominent U wave, we found Brugada like ECG, notch in QRS and steeply terminal T wave more than 70 degrees to be ominous signs and need urgent attention.

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“…Personalized risk stratification for diLQTS is aided by the Pro‐QTc score and Tisdale score diagnostic tools (Haugaa et al, 2013; Schwartz & Woosley, 2016; Tisdale et al, 2013). TWM has also been shown to enhance discrimination of abnormal repolarization in aLQTS (Couderc et al, 2011; Graff et al, 2009; Graff et al, 2010; Heijman & Crijns, 2015; Johannessen et al, 2014; Sugrue et al, 2015; Sugrue, Noseworthy, et al, 2017; Vicente et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

The diagnostic role of T wave morphology biomarkers in congenital and acquired long QT syndrome: A systematic review

Tardo

Peck

Subbiah

et al. 2022

Noninvasive Electrocardiol

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Introduction QTc prolongation is key in diagnosing long QT syndrome (LQTS), however 25%–50% with congenital LQTS (cLQTS) demonstrate a normal resting QTc. T wave morphology (TWM) can distinguish cLQTS subtypes but its role in acquired LQTS (aLQTS) is unclear. Methods Electronic databases were searched using the terms “LQTS,” “long QT syndrome,” “QTc prolongation,” “prolonged QT,” and “T wave,” “T wave morphology,” “T wave pattern,” “T wave biomarkers.” Whole text articles assessing TWM, independent of QTc, were included. Results Seventeen studies met criteria. TWM measurements included T‐wave amplitude, duration, magnitude, Tpeak‐Tend, QTpeak, left and right slope, center of gravity (COG), sigmoidal and polynomial classifiers, repolarizing integral, morphology combination score (MCS) and principal component analysis (PCA); and vectorcardiographic biomarkers. cLQTS were distinguished from controls by sigmoidal and polynomial classifiers, MCS, QTpeak, Tpeak‐Tend, left slope; and COG x axis. MCS detected aLQTS more significantly than QTc. Flatness, asymmetry and notching, J‐Tpeak; and Tpeak‐Tend correlated with QTc in aLQTS. Multichannel block in aLQTS was identified by early repolarization (ERD30%) and late repolarization (LRD30%), with ERD reflecting hERG‐specific blockade. Cardiac events were predicted in cLQTS by T wave flatness, notching, and inversion in leads II and V5, left slope in lead V6; and COG last 25% in lead I. T wave right slope in lead I and T‐roundness achieved this in aLQTS. Conclusion Numerous TWM biomarkers which supplement QTc assessment were identified. Their diagnostic capabilities include differentiation of genotypes, identification of concealed LQTS, differentiating aLQTS from cLQTS; and determining multichannel versus hERG channel blockade.

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T-wave Right Slope Provides a New Angle in the Prediction of Drug-Induced Ventricular Arrhythmias

Cited by 4 publications

References 14 publications

Mortality-related electrocardiogram indices in methanol toxicity

Mortality-related electrocardiogram indices in methanol toxicity

Useful Electrocardiographic and Laboratory Findings in Shiraz Outbreak of 356 Methanol Poisoned Patients

The diagnostic role of T wave morphology biomarkers in congenital and acquired long QT syndrome: A systematic review

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