Prolonged Tpeak-Tend interval is associated with ventricular fibrillation during reperfusion in ST-elevation myocardial infarction
(2019) In International Journal of Cardiology 280. p.80-83- Abstract
Aim: Ventricular fibrillation (VF) during reperfusion in ST-elevation myocardial infarction (STEMI) is associated with increased in-hospital mortality. Dispersion of ventricular repolarization contributes to ventricular vulnerability during ischemia. Tpeak-Tend interval was proposed as a ventricular repolarization dispersion marker, however its value for prediction of reperfusion VF remains uncertain. We aimed to assess whether Tpeak-Tend before PCI in STEMI is associated with reperfusion VF. Methods: STEMI patients admitted for primary PCI were retrospectively assessed for VF during reperfusion. Pre-PCI ECGs recorded in 40 patients with reperfusion VF (rVF group; age 65 ± 13 years, 80% male)... (More)
Aim: Ventricular fibrillation (VF) during reperfusion in ST-elevation myocardial infarction (STEMI) is associated with increased in-hospital mortality. Dispersion of ventricular repolarization contributes to ventricular vulnerability during ischemia. Tpeak-Tend interval was proposed as a ventricular repolarization dispersion marker, however its value for prediction of reperfusion VF remains uncertain. We aimed to assess whether Tpeak-Tend before PCI in STEMI is associated with reperfusion VF. Methods: STEMI patients admitted for primary PCI were retrospectively assessed for VF during reperfusion. Pre-PCI ECGs recorded in 40 patients with reperfusion VF (rVF group; age 65 ± 13 years, 80% male) were compared with 374 consecutive patients without reperfusion arrhythmias (No-rVF group; age 67 ± 12 years; 68% male). Digital ECGs were automatically processed and Tpeak-Tend interval computed on a per-lead basis. The global Tpeak-Tend was calculated between the earliest Tpeak and the latest Tend in any lead, and tested for association with reperfusion VF using logistic regression analysis. Results: The leftward shift of Tpeak toward QRS complex in ischemic leads resulted in Tpeak-Tend prolongation. Global Tpeak-Tend in rVF group was higher than in No-rVF group (142 ± 24 vs 130 ± 27 ms; p = 0.007). Global Tpeak-Tend ≥ 131 ms predicted reperfusion VF (OR = 3.41; 95% CI 1.66–7.04; p = 0.001) and remained a significant predictor of reperfusion VF in multivariable analysis. Conclusion: Tpeak-Tend interval before PCI in STEMI was an independent predictor of reperfusion VF. Our findings warrants further research aimed at prospective validation of Tpeak-Tend as a marker of periprocedural arrhythmic risk.
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- author
- Demidova, M. M. LU ; Carlson, J. LU ; Erlinge, D. LU ; Azarov, J. E. and Platonov, P. G. LU
- organization
- publishing date
- 2019-01-04
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Myocardial ischemia, ST-elevation myocardial infarction, TT, Ventricular fibrillation
- in
- International Journal of Cardiology
- volume
- 280
- pages
- 80 - 83
- publisher
- Elsevier
- external identifiers
-
- scopus:85060076230
- pmid:30661844
- ISSN
- 0167-5273
- DOI
- 10.1016/j.ijcard.2019.01.008
- language
- English
- LU publication?
- yes
- id
- 3f9f46c9-7091-4202-bc87-d0d6e8eb24c2
- date added to LUP
- 2019-01-29 14:33:57
- date last changed
- 2024-09-17 12:40:59
@article{3f9f46c9-7091-4202-bc87-d0d6e8eb24c2, abstract = {{<p>Aim: Ventricular fibrillation (VF) during reperfusion in ST-elevation myocardial infarction (STEMI) is associated with increased in-hospital mortality. Dispersion of ventricular repolarization contributes to ventricular vulnerability during ischemia. T<sub>peak</sub>-T<sub>end</sub> interval was proposed as a ventricular repolarization dispersion marker, however its value for prediction of reperfusion VF remains uncertain. We aimed to assess whether T<sub>peak</sub>-T<sub>end</sub> before PCI in STEMI is associated with reperfusion VF. Methods: STEMI patients admitted for primary PCI were retrospectively assessed for VF during reperfusion. Pre-PCI ECGs recorded in 40 patients with reperfusion VF (rVF group; age 65 ± 13 years, 80% male) were compared with 374 consecutive patients without reperfusion arrhythmias (No-rVF group; age 67 ± 12 years; 68% male). Digital ECGs were automatically processed and T<sub>peak</sub>-T<sub>end</sub> interval computed on a per-lead basis. The global T<sub>peak</sub>-T<sub>end</sub> was calculated between the earliest T<sub>peak</sub> and the latest T<sub>end</sub> in any lead, and tested for association with reperfusion VF using logistic regression analysis. Results: The leftward shift of T<sub>peak</sub> toward QRS complex in ischemic leads resulted in T<sub>peak</sub>-T<sub>end</sub> prolongation. Global T<sub>peak</sub>-T<sub>end</sub> in rVF group was higher than in No-rVF group (142 ± 24 vs 130 ± 27 ms; p = 0.007). Global T<sub>peak</sub>-T<sub>end</sub> ≥ 131 ms predicted reperfusion VF (OR = 3.41; 95% CI 1.66–7.04; p = 0.001) and remained a significant predictor of reperfusion VF in multivariable analysis. Conclusion: T<sub>peak</sub>-T<sub>end</sub> interval before PCI in STEMI was an independent predictor of reperfusion VF. Our findings warrants further research aimed at prospective validation of T<sub>peak</sub>-T<sub>end</sub> as a marker of periprocedural arrhythmic risk.</p>}}, author = {{Demidova, M. M. and Carlson, J. and Erlinge, D. and Azarov, J. E. and Platonov, P. G.}}, issn = {{0167-5273}}, keywords = {{Myocardial ischemia; ST-elevation myocardial infarction; TT; Ventricular fibrillation}}, language = {{eng}}, month = {{01}}, pages = {{80--83}}, publisher = {{Elsevier}}, series = {{International Journal of Cardiology}}, title = {{Prolonged T<sub>peak</sub>-T<sub>end</sub> interval is associated with ventricular fibrillation during reperfusion in ST-elevation myocardial infarction}}, url = {{http://dx.doi.org/10.1016/j.ijcard.2019.01.008}}, doi = {{10.1016/j.ijcard.2019.01.008}}, volume = {{280}}, year = {{2019}}, }