Unusual Forms of Severe Ventricular Tachyarrhythmias: Their Relationships with the QT Interval and the Vago-Sympathetic Balance

1980 ◽  
pp. 199-215 ◽  
Author(s):  
Ph. Coumel ◽  
J. F. Leclercq ◽  
M. Rosengarten ◽  
P. Attuel ◽  
D. Milosevic
Keyword(s):  
Qt Interval ◽  
Ventricular Tachyarrhythmias

Temporary Disturbances of the QT Interval Precede the Onset of Ventricular Tachyarrhythmias in Patients with Structural Heart Diseases

2002 ◽  
Vol 25 (10) ◽  
pp. 1413-1418 ◽  
Author(s):  
BJORN HENRIK DIEM ◽  
CHRISTOPH STELLBRINK ◽  
MATHIAS MICHEL ◽  
PATRICK SCHAUERTE ◽  
PETER HANRATH
Keyword(s):  
Qt Interval ◽  
Heart Diseases ◽  
Ventricular Tachyarrhythmias ◽  
Structural Heart Diseases

scholarly journals Myocardial electrical instability score: clinical and prognostic significance

2019 ◽  
pp. 55-61 ◽  
Author(s):  
A. V. Frolov ◽  
T. G. Vaykhanskaya ◽  
O. P. Melnikova ◽  
A. P. Vorobev ◽  
A. G. Mrochek
Keyword(s):  
Risk Stratification ◽  
Qt Interval ◽  
Prognostic Significance ◽  
Ventricular Tachyarrhythmias ◽  
T Wave ◽  
Fragmented Qrs ◽  
Electrical Instability ◽  
Life Threatening ◽  
Rate Deceleration ◽  
The Individual

Aim. To develop and test a risk-stratification model for patients with coronary artery disease (CAD) and non-ischemic pathologies based on a computer analysis of electrical instability ECG markers.Material and methods. In the period from 2011 to 2018, the study included 1014 patients with CAD and non-ischemic pathologies. Depending on ventricular arrhythmia status, the analyzed cohort was divided into 3 groups: 1) 644 patients without lifethreatening ventricular tachyarrhythmias (-VTA), mean age 51,7±16,1 years; 2) 280 patients with clinically significant ventricular arrhythmias (+csVA): ventricular extrasystoles (VES) >1500/24 h, coupled VES >50/24 h or unstable ventricular tachycardia (uVT), mean age 46,7±14,0 years; 3) 90 patients with life-threatening ventricular tachyarrhythmias (+VTA): persistent VT (pVT), successful cardiopulmonary resuscitation (CPR), appropriate discharges by implanted cardioverter defibrillator (CVD), sudden cardiac death (SCD), mean age 46,8±12,7 years.Using the Intekard 7.3 software, ECG markers of myocardial electrical instability were analyzed: T wave alternation, QT interval and dispersion, fragmented QRS, spatial QRS-T angle, turbulence onset and slope, and heart rate deceleration/acceleration.Results. Statistically significant differences were found between the values of T wave alternation, QT interval, fragmented QRS and QRS-T angle in groups 1 and 3 (-VTA) and (+VTA), p<0,005.Personalized model was formed for predicting the risk of life-threatening VTA (primary endpoints: pVT, appropriate CVD discharges, CPR, SCD) in patients with CAD and non-ischemic pathologies (cardiomyopathy, channelopathy) in 5 years follow-up. Integral score of myocardial electrical instability is proposed as new quantitative parameter for risk stratification (sensitivity 75%, specificity 78%, accuracy 77%).Conclusion. The myocardial electrical instability score provides the individual assessment of the dynamic SCD risk. The Intekard 7.3 software is a simple, economic and accessible ECG tool for arrhythmia monitoring.

T wave peak-to-end interval and QT dispersion in acquired long QT syndrome: a new index for arrhythmogenicity

2003 ◽  
Vol 105 (6) ◽  
pp. 671-676 ◽  
Author(s):  
Masato YAMAGUCHI ◽  
Masami SHIMIZU ◽  
Hidekazu INO ◽  
Hidenobu TERAI ◽  
Katsuharu UCHIYAMA ◽  
...  
Keyword(s):  
Qt Interval ◽  
Qt Dispersion ◽  
Ventricular Tachyarrhythmias ◽  
Long Qt ◽  
T Wave ◽  
Qt Intervals ◽  
Group A ◽  
Qt Syndrome ◽  
Group B ◽  
Transmural Dispersion

QT dispersion (QTD) on 12-lead ECGs has been proposed as a marker of malignant ventricular tachyarrhythmias, and increased QTD has been reported in long QT syndrome (LQTS). On the other hand, it has been demonstrated that transmural dispersion is associated with ventricular tachyarrhythmias in an experimental model. However, the precise type of QTD or transmural dispersion that contributes most to ventricular tachyarrhythmias in patients with LQTS remains unclear. We evaluated 27 patients with acquired LQTS. These patients were divided into two groups: group A (n=12), patients with polymorphic ventricular tachycardia [torsades de pointes (TdP)], and group B (n=15), patients without TdP. The QT intervals were corrected using Bazett's formula. QTD was measured as the difference between the maximum and the minimum QT intervals, and T wave peak-to-end interval divided by the QT interval (Tpe) in the V5 lead was measured as a new index. Both the corrected QTD (QTDc) and Tpe were significantly larger in group A than in group B. Logistic regression analysis revealed that a reliable predictor for TdP in the QT variables in these patients was not QTDc but Tpe. Cumulative frequency distributions revealed that a Tpe of 0.28 is a good cut-off point for TdP. Tpe did not correlate with the corrected maximum QT interval, whereas the QTDc did correlate with this parameter. In conclusion, Tpe may be the best predictor for TdP in patients with acquired LQTS.

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