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Progressive increase of the Tpeak-Tend interval is associated with ischaemia-induced ventricular fibrillation in a porcine myocardial infarction model

Azarov, Jan E.; Demidova, Marina M. LU ; Koul, Sasha LU ; Van Der Pals, Jesper LU ; Erlinge, David LU and Platonov, Pyotr G. LU (2018) In Europace 20(5). p.880-886
Abstract

Aims:Repolarization indices of ECG have been widely assessed as predictors of ventricular arrhythmias. However, little is known of the dynamic changes of these parameters during continuous monitoring in acute ischaemic episodes. The objective of the study was to evaluate repolarization-related predictors of ventricular fibrillation (VF) during progression of experimental myocardial infarction. Methods and results: Myocardial infarction was induced in 27 pigs by 40-min balloon inflation in the left anterior descending coronary artery, and 12-lead ECG was continuously recorded. Rate-corrected durations of the total Tpeak-Tend intervals measured from the earliest T-wave peak to the latest T-wave end in any lead were... (More)

Aims:Repolarization indices of ECG have been widely assessed as predictors of ventricular arrhythmias. However, little is known of the dynamic changes of these parameters during continuous monitoring in acute ischaemic episodes. The objective of the study was to evaluate repolarization-related predictors of ventricular fibrillation (VF) during progression of experimental myocardial infarction. Methods and results: Myocardial infarction was induced in 27 pigs by 40-min balloon inflation in the left anterior descending coronary artery, and 12-lead ECG was continuously recorded. Rate-corrected durations of the total Tpeak-Tend intervals measured from the earliest T-wave peak to the latest T-wave end in any lead were determined at baseline and at minute 1, 2, 5, and then every 5th minute of occlusion. There were 7 early (1-3 min) and 10 delayed (15-30 min) VFs in 16 pigs. Baseline Tpeak-Tend did not differ between animals with and without VF. Tpeak-Tend interval rapidly increased immediately after balloon inflation and was greater in VF-susceptible animals at 2-15 min compared with the animals that never developed VF (P < 0.05). Tpeak-Tend was tested as a predictor of delayed VFs. Median Tpeak-Tend at 10th min of occlusion was higher in delayed VF group (n = 10) than in animals without VF (n = 11): 138 [IQR 121-148] ms vs. 111 [IQR 106-127] ms, P = 0.02. Tpeak-Tend ≥123 ms (10th min) predicted delayed VF episodes with HR = 4.5 95% CI 1.1-17.8, P = 0.031.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Myocardial infarction, Myocardial ischaemia, Pig, Prediction, T-T interval, Ventricular fibrillation
in
Europace
volume
20
issue
5
pages
7 pages
publisher
Oxford University Press
external identifiers
  • scopus:85046994470
ISSN
1099-5129
DOI
10.1093/europace/eux104
language
English
LU publication?
yes
id
f3ddfcb6-c4d2-4b81-b3fa-05587c40b5a8
date added to LUP
2018-05-30 13:42:05
date last changed
2019-09-17 04:33:20
@article{f3ddfcb6-c4d2-4b81-b3fa-05587c40b5a8,
  abstract     = {<p>Aims:Repolarization indices of ECG have been widely assessed as predictors of ventricular arrhythmias. However, little is known of the dynamic changes of these parameters during continuous monitoring in acute ischaemic episodes. The objective of the study was to evaluate repolarization-related predictors of ventricular fibrillation (VF) during progression of experimental myocardial infarction. Methods and results: Myocardial infarction was induced in 27 pigs by 40-min balloon inflation in the left anterior descending coronary artery, and 12-lead ECG was continuously recorded. Rate-corrected durations of the total T<sub>peak</sub>-T<sub>end</sub> intervals measured from the earliest T-wave peak to the latest T-wave end in any lead were determined at baseline and at minute 1, 2, 5, and then every 5th minute of occlusion. There were 7 early (1-3 min) and 10 delayed (15-30 min) VFs in 16 pigs. Baseline T<sub>peak</sub>-T<sub>end</sub> did not differ between animals with and without VF. T<sub>peak</sub>-T<sub>end</sub> interval rapidly increased immediately after balloon inflation and was greater in VF-susceptible animals at 2-15 min compared with the animals that never developed VF (P &lt; 0.05). T<sub>peak</sub>-T<sub>end</sub> was tested as a predictor of delayed VFs. Median T<sub>peak</sub>-T<sub>end</sub> at 10th min of occlusion was higher in delayed VF group (n = 10) than in animals without VF (n = 11): 138 [IQR 121-148] ms vs. 111 [IQR 106-127] ms, P = 0.02. T<sub>peak</sub>-T<sub>end</sub> ≥123 ms (10th min) predicted delayed VF episodes with HR = 4.5 95% CI 1.1-17.8, P = 0.031.</p>},
  author       = {Azarov, Jan E. and Demidova, Marina M. and Koul, Sasha and Van Der Pals, Jesper and Erlinge, David and Platonov, Pyotr G.},
  issn         = {1099-5129},
  keyword      = {Myocardial infarction,Myocardial ischaemia,Pig,Prediction,T-T interval,Ventricular fibrillation},
  language     = {eng},
  month        = {05},
  number       = {5},
  pages        = {880--886},
  publisher    = {Oxford University Press},
  series       = {Europace},
  title        = {Progressive increase of the T<sub>peak</sub>-T<sub>end</sub> interval is associated with ischaemia-induced ventricular fibrillation in a porcine myocardial infarction model},
  url          = {http://dx.doi.org/10.1093/europace/eux104},
  volume       = {20},
  year         = {2018},
}