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Terminal T-wave inversion predicts reperfusion tachyarrhythmias in STEMI

Sedova, Ksenia A ; Demidova, Marina M LU ; Azarov, Jan E ; Hejda, Jan ; Carlson, Jonas LU orcid ; Bernikova, Olesya G ; Arteyeva, Natalia ; Erlinge, David LU orcid and Platonov, Pyotr G LU (2022) In Journal of Electrocardiology 71. p.28-31
Abstract

INTRODUCTION: A reliable electrocardiographic predictor of ventricular fibrillation (VF) in patients with ST elevation myocardial infarction (STEMI) is lacking so far. Previous experimental/simulation study suggested a terminal T-wave inversion (TTWI) in ischemia-related ECG leads corresponding to anterior infarct localization as an independent predictor of reperfusion VF (rVF). This T-wave characteristic has never been tested as a rVF predictor in clinical settings. The aim of this study was to test if terminal T-wave inversion (TTWI) at admission ECG (before reperfusion) can serve as a predictor of ventricular fibrillation during reperfusion (rVF) in patients with anterior STEMI undergoing primary PCI.

METHODS AND RESULTS: Study... (More)

INTRODUCTION: A reliable electrocardiographic predictor of ventricular fibrillation (VF) in patients with ST elevation myocardial infarction (STEMI) is lacking so far. Previous experimental/simulation study suggested a terminal T-wave inversion (TTWI) in ischemia-related ECG leads corresponding to anterior infarct localization as an independent predictor of reperfusion VF (rVF). This T-wave characteristic has never been tested as a rVF predictor in clinical settings. The aim of this study was to test if terminal T-wave inversion (TTWI) at admission ECG (before reperfusion) can serve as a predictor of ventricular fibrillation during reperfusion (rVF) in patients with anterior STEMI undergoing primary PCI.

METHODS AND RESULTS: Study population included consecutive patients with anterior infarct localization admitted for primary PCI (n = 181, age 65 [57; 76] years, 66% male). Of those, 14 patients had rVF (rVF group, age 59 [47; 76] years, 64% male) and patients without rVF comprised the No-rVF group (n = 167, age 65 [57; 76] years, 66% male). Association of TTWI with rVF was analyzed using logistic regression analysis adjusted for relevant clinical and electrocardiographic covariates. The prevalence of TTWI in rVF group was 62% comparing to 23% in the No-rVF group, p = 0.005. TTWI was associated with increased risk of rVF (OR 5.51; 95% CI 1.70-17.89; p = 0.004) and remained a significant predictor after adjustment for age, gender, history of MI prior to index admission, VF before reperfusion, Tpeak-Tend, maximal ST elevation, and QRS duration (OR 23.49; 95% CI 3.14-175.91; p = 0.002).

CONCLUSIONS: The terminal T-wave inversion in anterior leads before PCI independently predicted rVF in patients with anterior MI thus confirming the previous experimental/simulation findings.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Electrocardiology
volume
71
pages
28 - 31
publisher
Elsevier
external identifiers
  • scopus:85122509679
  • pmid:35026678
ISSN
1532-8430
DOI
10.1016/j.jelectrocard.2021.12.008
language
English
LU publication?
yes
additional info
Copyright © 2022 Elsevier Inc. All rights reserved.
id
fd544ca1-f697-411b-9d9e-5fdb8bbd5f0a
date added to LUP
2022-01-14 10:11:07
date last changed
2024-04-06 16:31:59
@article{fd544ca1-f697-411b-9d9e-5fdb8bbd5f0a,
  abstract     = {{<p>INTRODUCTION: A reliable electrocardiographic predictor of ventricular fibrillation (VF) in patients with ST elevation myocardial infarction (STEMI) is lacking so far. Previous experimental/simulation study suggested a terminal T-wave inversion (TTWI) in ischemia-related ECG leads corresponding to anterior infarct localization as an independent predictor of reperfusion VF (rVF). This T-wave characteristic has never been tested as a rVF predictor in clinical settings. The aim of this study was to test if terminal T-wave inversion (TTWI) at admission ECG (before reperfusion) can serve as a predictor of ventricular fibrillation during reperfusion (rVF) in patients with anterior STEMI undergoing primary PCI.</p><p>METHODS AND RESULTS: Study population included consecutive patients with anterior infarct localization admitted for primary PCI (n = 181, age 65 [57; 76] years, 66% male). Of those, 14 patients had rVF (rVF group, age 59 [47; 76] years, 64% male) and patients without rVF comprised the No-rVF group (n = 167, age 65 [57; 76] years, 66% male). Association of TTWI with rVF was analyzed using logistic regression analysis adjusted for relevant clinical and electrocardiographic covariates. The prevalence of TTWI in rVF group was 62% comparing to 23% in the No-rVF group, p = 0.005. TTWI was associated with increased risk of rVF (OR 5.51; 95% CI 1.70-17.89; p = 0.004) and remained a significant predictor after adjustment for age, gender, history of MI prior to index admission, VF before reperfusion, Tpeak-Tend, maximal ST elevation, and QRS duration (OR 23.49; 95% CI 3.14-175.91; p = 0.002).</p><p>CONCLUSIONS: The terminal T-wave inversion in anterior leads before PCI independently predicted rVF in patients with anterior MI thus confirming the previous experimental/simulation findings.</p>}},
  author       = {{Sedova, Ksenia A and Demidova, Marina M and Azarov, Jan E and Hejda, Jan and Carlson, Jonas and Bernikova, Olesya G and Arteyeva, Natalia and Erlinge, David and Platonov, Pyotr G}},
  issn         = {{1532-8430}},
  language     = {{eng}},
  pages        = {{28--31}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Electrocardiology}},
  title        = {{Terminal T-wave inversion predicts reperfusion tachyarrhythmias in STEMI}},
  url          = {{http://dx.doi.org/10.1016/j.jelectrocard.2021.12.008}},
  doi          = {{10.1016/j.jelectrocard.2021.12.008}},
  volume       = {{71}},
  year         = {{2022}},
}