Terminal T-wave inversion predicts reperfusion tachyarrhythmias in STEMI
(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.
(Less)
- author
- Sedova, Ksenia A ; Demidova, Marina M LU ; Azarov, Jan E ; Hejda, Jan ; Carlson, Jonas LU ; Bernikova, Olesya G ; Arteyeva, Natalia ; Erlinge, David LU and Platonov, Pyotr G LU
- organization
- publishing date
- 2022
- 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}}, }