A Novel ECG‐Index for Prediction of Ventricular Arrhythmias in Patients after Myocardial Infarction. Issue 4 (10th March 2014)

• Record Type: Journal Article
• Authors: Hetland, Mathias; Haugaa, Kristina H.; Sarvari, Sebastian I.; Erikssen, Gunnar; Kongsgaard, Erik; Edvardsen, Thor
• Is Part Of: Annals of noninvasive electrocardiology. Volume 19:Issue 4(2014:Jul.)
• Page Start: 330
• Page End: 337
• Publication Date: 2014-03-10
• Subjects: Electrocardiography -- Periodicals; Arrhythmia -- Periodicals; 616.1207547
• DOI: 10.1111/anec.12152
• Languages: English
• ISSNs: 1082-720X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="anec12152-sec-0010" sec-type="section"> <title>Background</title> <p>Risk prediction of ventricular arrhythmias after myocardial infarction (MI) is still insufficient. Prolonged QTc is a known risk marker of mortality and ventricular arrhythmias. QTc has not achieved clinical importance in predicting arrhythmic events in patients after MI. Recent studies have displayed that the terminal part of the QT‐interval, T<sub>peak</sub> to T<sub>end</sub> (TpTe), may be a more promising predictor of adverse outcome. Herein, we assessed whether TpTe may serve as a predictor of ventricular arrhythmias in patients with previous MI fulfilling current implantable cardioverter‐defibrillator (ICD) indications.</p> </sec> <sec id="anec12152-sec-0020" sec-type="section"> <title>Methods</title> <p>Seventy‐six patients with previous MI eligible for ICD therapy were prospectively enrolled. ECG measurements at baseline were recorded using a 12‐lead ECG with 50 mm/s paper speed. TpTe was measured from peak of the T wave to end of T wave. Events during follow up were defined as ventricular arrhythmias requiring appropriate ICD therapy, including antitachycardia pacing and shock.</p> </sec> <sec id="anec12152-sec-0030" sec-type="section"> <title>Results</title> <p>During 23 ± 19 months, arrhythmic events occurred in 36 (47%) patients. TpTe was longer in ICD patients with recorded ventricular arrhythmias compared with those without (116 ± 26 ms vs. 102 ± 20 ms; P = 0.01), whereas ejection fraction (EF) at baseline did not differ (35 ± 9% vs. 35 ± 11%; P = 0.87). TpTe was an independent predictor of ventricular arrhythmias when adjusted for age, EF and QRS duration (HR 1.16; 95% CI 1.03–1.31; P = 0.02).</p> </sec> <sec id="anec12152-sec-0040" sec-type="section"> <title>Conclusions</title> <p>TpTe predicted malignant arrhythmias in patients after MI independently of EF. TpTe may contribute in the risk stratification of patients to identify post‐MI patients disposed to malignant arrhythmias and their need of ICD therapy.</p> </sec> </abstract>