scholarly journals Diagnostic Value of the TpTe Interval in Children with Ventricular Arrhythmias

2021 ◽  
Vol 18 (22) ◽  
pp. 12194
Author(s):  
Joanna Jaromin ◽  
Grażyna Markiewicz-Łoskot ◽  
Lesław Szydłowski ◽  
Agnieszka Kulawik
Keyword(s):  
Ventricular Arrhythmia ◽  
Ventricular Arrhythmias ◽  
Clinical Symptoms ◽  
Diagnostic Value ◽  
Control Group ◽  
Healthy Children ◽  
T Wave ◽  
Electrical Instability ◽  
Qt Intervals ◽  
Wave Morphology

Background: The changes in the period of ventricular repolarization, i.e., QT interval, QTp (Q-Tpeak) and TpTe interval (Tpeak–Tend), make it possible to assess the electrical instability of the heart muscle, which may lead to the development of life-threatening ventricular arrhythmia. The aim of the study was to determine and evaluate the use of differences in T-wave morphology and durations of repolarization period parameters (QT, TpTe) in resting ECGs for children with ventricular arrhythmias. Methods: The retrospective analysis was made of the disease histories of 80 examined children with resting ECGs, which were admitted to the Children’s Cardiology Department. The study group consisted of 46 children aged 4 to 18 with ventricular arrhythmias and the control group consisted of 34 healthy children between 4 and 18 years of age, with no arrhythmias. Results: The duration of the TpTe interval was significantly (p < 0.001) longer in the group of children with ventricular arrhythmia with abnormal T-wave (bactrian/bifid, humid/biphasic) compared to the TpTe interval in children with ventricular arrhythmia with the normal repolarization period. The duration of the TpTe (p < 0.001), QTcB (p < 0.001) and QTcF (p < 0.001) intervals were significantly longer in the group of children with ventricular arrhythmias and with abnormal T-wave compared to the values of the TpTe, QTcB, and QTcF intervals of the control group with normal morphology of the repolarization period. Only the duration of the TpTe interval was significantly (p = 0.020) longer in the group of children with ventricular arrhythmia without clinical symptoms. Conclusions: Children with benign ventricular arrhythmias recorded on a standard ECG with prolonged TpTe and QT intervals and abnormal T-wave morphology require systematic and frequent cardiac check up with long term ECG recordings due to the possibility of future more severe ventricular arrhythmias. Further follow-up studies in even larger groups of patients are necessary to confirm the values of these repolarization parameters in clinical practice.

Abstract 14311: Qt Interval Correlation Between Telemetry and 12-lead Electrocardiogram

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mohamed Farhan Nasser ◽  
Ahmad Jabri ◽  
Saima Karim ◽  
Elizabeth Kaufman
Keyword(s):  
Qt Interval ◽  
Ventricular Arrhythmias ◽  
Qt Prolongation ◽  
T Wave ◽  
Qt Intervals ◽  
Increased Risk ◽  
Tangent Method ◽  
Wave Morphology ◽  
Monitoring Service ◽  
Inpatient Units

Introduction: QT prolongation is associated with increased risk of ventricular arrhythmias.As many patients with COVID19 may be started on QT prolonging drugs, measuring and monitoring QT is imperative to prevent fatal ventricular arrhythmias. However, we need to limit exposure of staff to patients with confirmed COVID19 and judiciously use personal protective equipment. Thus, it is important to find alternatives to doing frequent 12-lead ECGs. Hypothesis: We hypothesize that the QT interval measured from telemetry is similar to the QT interval on 12-lead ECG. Methods: Telemetry recordings and 12-lead ECGs were obtained from 15 patients at the same time and identical heart rates. Patients were from two different inpatient units with the same telemetry monitoring service. QT intervals were measured manually using calipers with the tangent method, excluding U waves. Telemetry recordings included lead I and II or a precordial lead. QT from telemetry was compared to the corresponding leads and to the longest QT on the 12-lead ECG. In cases of atrial fibrillation (AF), the QT from all the complexes was averaged. Results: Of 15 patients, 2 were in AF and 2 had RBBB. One patient had abnormal T-wave morphology and QT prolongation (abnormal repolarization). In all patients, QT intervals from the same leads as telemetry matched the QT measured from 12-lead. In 14 of 15 patients, telemetry QT matched the longest QT on the 12-lead ECG. However, in the patient with abnormal repolarization, maximum QT on 12-lead ECG was substantially longer than telemetry QT (Figure 1). Conclusion: When using the same lead, QT intervals were identical on telemetry and 12-lead ECG. However, in the patient with abnormal repolarization, the longest QT on 12-lead ECG was not represented on telemetry. In patients with abnormal repolarization on 12-lead ECG, we recommend serial 12-lead ECGs while on QT-prolonging drugs. Telemetry may suffice as a surrogate for 12-lead ECG to follow QT intervals in most patients.

scholarly journals Evaluation of Galectin-3 Plasma Concentration in Adolescents with Ventricular Arrhythmia

2021 ◽  
Vol 18 (5) ◽  
pp. 2410
Author(s):  
Radosław Pietrzak ◽  
Tomasz M. Książczyk ◽  
Elżbieta Górska ◽  
Łukasz A. Małek ◽  
Bożena Werner
Keyword(s):  
Plasma Concentration ◽  
Ventricular Arrhythmia ◽  
Linear Regression Analysis ◽  
Holter Monitoring ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Healthy Children ◽  
Ventricular Ejection Fraction ◽  
Galectin 3

Galectin-3 (G3) is a biomarker known as an inflammatory state exponent. The aim of this paper was to analyze the G3 in adolescents with ventricular arrhythmia (VES) in order to evaluate its impact on myocardial tissue preservation. The study group (SG) consisted of 25 VES adolescents. The control group (CG) was 21 healthy children. G3 was assessed in the SG and CG. In the SG electrocardiography, Holter monitoring, echocardiography and CMR were performed. The G3 in SG was 13.45 ± 11.4 ng/mL and in CG 7.2 ± 2.0 ng/mL, p < 0.001. Moderate positive correlation between the G3 and z-score of the left ventricular diameter (r = 0.47, p = 0.041) and moderate negative correlation between the G3 and the left ventricular ejection fraction in cardiac magnetic resonance (CMR EF) (−0.49, p = 0.032) were found. According to the multiple linear regression analysis, CMR EF and VES were independent predictors for G3 elevation. Conclusion: Galectin-3 plasma concentration is elevated and correlates with the chosen left ventricular dysfunction parameters in adolescents suffering from ventricular arrhythmia. Further investigation is necessary to establish if elevated G3 is a useful biomarker for screening young individuals with ventricular arrhythmia who are at risk of structural cardiovascular pathology.

Empagliflozin significantly attenuates QTc prolongation in rats due to sotalol

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V.O Baris ◽  
B Dincsoy ◽  
E Gedikli ◽  
A Erdem
Keyword(s):  
Qt Prolongation ◽  
Control Group ◽  
Diabetic Patients ◽  
Protective Effects ◽  
Qtc Prolongation ◽  
Positive Effects ◽  
T Wave ◽  
Qt Intervals ◽  
Electrocardiogram Ecg

Abstract Introduction Sotalol (SOT) is a Class 3 antiarrhythmic drug and commonly used for various arrhythmia treatments. However; it can prolong QT interval and lead to malignant arrhythmias. Empagliflozin is a selective SGLT-2 inhibitor used in the treatment of Type 2 diabetes and has been shown to have positive effects on cardiovascular outcomes. Since the effect of empagliflozin (EMPA) on potassium channel activation is not yet known, there is no recommendation for the concomitant use of these drugs. Purpose In this study, we aimed to evaluate possible protective effects of empagliflozin in sotalol induced QT prolongation. Materials and methods Twenty-four male Wistar Alba rats were randomized into four groups. The first (control) group (n: 6) received only serum physiologic (1ml) via orogastric gavage (OG). The second (EMPA) group (n: 6) received EMPA (10 mg/kg) via OG. The third (SOT) group (n: 6) received SOT (80 mg/kg) via OG. The fourth (EMPA+SOT) group (n: 6) received EMPA (10 mg/kg) and SOT (80 mg/kg) via OG. Under anesthesia; PR, QT intervals and heart rate (HR) were measured and QTc value was also calculated at second hour on lead II using electrocardiogram (ECG). Results In the SOT group; QT intervals, T wave durations and QTc values were found to be statistically longer than the control group, whereas HR was found to be lower than the control group (p&lt;0.01). In the EMPA+SOT group; QT intervals, T wave durations and QTc values were significantly lower and HR was significantly higher compared to the SOT group (p&lt;0.001, p&lt;0.01, p&lt;0.001, p&lt;0.001 respectively) (Table) Conclusion In the present study, we detected that EMPA significantly ameliorates SOT induced QT prolongation. In addition to this, we have also shown that EMPA can be used safely with SOT in clinical practice. With more clinical trials, the routine use of EMPA may be suggested to prevent QTc prolongation in diabetic patients receiving SOT. Finally; our study indicates that EMPA can effect on potassium channels. Funding Acknowledgement Type of funding source: None

scholarly journals Prolongation of Electrocardiographic T Wave Parameters Recorded during the Head-Up Tilt Table Test as Independent Markers of Syncope Severity in Children

2020 ◽  
Vol 17 (18) ◽  
pp. 6441
Author(s):  
Grażyna Markiewicz-Łoskot ◽  
Ewelina Kolarczyk ◽  
Bogusław Mazurek ◽  
Marianna Łoskot ◽  
Lesław Szydłowski
Keyword(s):  
Vasovagal Syncope ◽  
The Other ◽  
Control Group ◽  
Tilt Table Test ◽  
Tilt Table ◽  
T Wave ◽  
Good Discriminator ◽  
Wave Morphology ◽  
Head Up Tilt ◽  
T Waves

The head-up tilt table test (HUTT) with the upright phase is used to help determine an imbalance of the sympathetic nervous system that is related to abnormal electrocardiographic repolarization in children with vasovagal syncope (VVS) and also in patients with the long QT syndrome (LQTS). The study attempted to evaluate T wave morphology and QT and TpTe (Tpeak–Tend) intervals recorded in ECG during the HUTT for a more accurate diagnosis of children with VVS. The group investigated 70 children with a negative HUTT result: 40 patients with VVS and 30 healthy volunteers without syncope. The RR interval as well as TpTe, and QTc intervals were measured in lead V5 of electrocardiogram (ECG) on admission to the hospital and during three phases of the HUTT. In syncopal children, which included 23 children with bifid or flat T waves and 17 patients with normal T waves in the upright phase, the QTc and TpTe were longer (p < 0.001) compared to the other test phases and longer (p < 0.001) than in the control group, respectively, with the risk of arrhythmias. Only in the control group, the TpTe was shorter (p < 0.001) in the upright phase than in the other tilt phases. The TpTe in the upright phase (>70 ms) was a good discriminator, and was better than the QTc (>427 ms). Prolongation of electrocardiographic TpTe and QT intervals, in addition to the (abnormal T wave morphology recorded during the HUTT, are helpful for identifying VVS children more predisposed to ventricular arrhythmias with a latent risk of LQTS. Further studies are required to assess the value of these repolarization parameters in clinical practice.

scholarly journals 203 Changes in T wave morphology prior to Onset of Ventricular Arrhythmias in ICDs

2010 ◽  
Vol 2 (1) ◽  
pp. 64-65
Author(s):  
Philippe Maury ◽  
Frank Raczka ◽  
Jean-Luc Pasquié ◽  
Lionel Beck ◽  
Jerome Taieb ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
T Wave ◽  
Wave Morphology

scholarly journals 183 Changes in T wave morphology prior to onset of ventricular arrhythmias in ICDs

2011 ◽  
Vol 3 (1) ◽  
pp. 59-60
Author(s):  
Philippe Maury ◽  
Frank Raczka ◽  
Jean Luc Pasquié ◽  
Lionel Beck ◽  
Jerome Taieb ◽  
...  
Keyword(s):  
Ventricular Arrhythmias ◽  
T Wave ◽  
Wave Morphology

Differentiation of acute pyelonephritis from other febrile states in children using urinary neutrophil gelatinase-associated lipocalin (uNGAL)

2016 ◽  
Vol 54 (1) ◽  
Author(s):  
Jadranka Arambašić ◽  
Sanja Mandić ◽  
Željko Debeljak ◽  
Dario Mandić ◽  
Vesna Horvat ◽  
...  
Keyword(s):  
Acute Pyelonephritis ◽  
Clinical Symptoms ◽  
Characteristic Curve ◽  
Severe Disease ◽  
White Blood Cells ◽  
Diagnostic Value ◽  
University Hospital ◽  
Control Group ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

AbstractAcute pyelonephritis is a severe disease which is sometimes difficult to recognize based on clinical symptoms and routinely available diagnostic tests, especially in young children. The aim of this study was to assess the diagnostic value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a biomarker of acute pyelonephritis.In this case-control study we analyzed 134 children (median age 2.5 years) who were admitted to the Pediatric Clinic of University Hospital Centre Osijek, Croatia. Eighty of them had acute pyelonephritis, while 54 children had febrile state of different etiology including cystitis and they represented the control group. uNGAL, white blood cells, C-reactive protein, urinanalysis, urine culture, kidney ultrasound and a dimercaptosuccinic acid scintigraphic scan were done for each child. uNGAL was measured using chemiluminiscent microparticle immunoassay on ARHITECT i1000SR (Abbott Diagnostics, IL, USA).uNGAL values were significantly higher in children with acute pyelonephritis compared to the control groups (113.6 ng/mL vs. 10.2 ng/mL, p<0.001). A receiver operating characteristic curve comparison was done for tested parameters and encouraging results were obtained for uNGAL (AUC=0.952). A cut-off value of 29.4 ng/mL had 92.5% sensitivity and 90.7% specificity. We showed that uNGAL can also serve in differentiating acute pyelonephritis from cystitis (cut-off 38.5 ng/mL), and for differentiation of cystitis from febrile states with etiology other than urinary tract infection (UTI) (cut-off 20.4 ng/mL).uNGAL can be a useful diagnostic biomarker in acute pyelonephritis in children, but also in differentiating cystitis from febrile states other than UTI.

scholarly journals Exocrine pancreatic dysfunction in children with obesity: characteristics of clinical picture and diagnostics

2020 ◽  
pp. 36-41
Author(s):  
I. S. Lembryk ◽  
O. V. Tymoshchuk
Keyword(s):  
Abdominal Pain ◽  
Clinical Symptoms ◽  
High Density Lipoproteins ◽  
Exocrine Function ◽  
Control Group ◽  
Type I ◽  
Healthy Children ◽  
Obese Children ◽  
Pancreatic Lesion ◽  
Functional Changes

Introduction. During the last twenty-five years the occurrence of obesity in children and teenagers has increased significantly. Materials and methods. 110 adolescents of 12–17 years old, with alimentary-constitutional obesity and involvement of pancreas and without its injury, as compared to the 30 healthy children of control group, were examined. The research provided determination of the sizes and elasticity of pancreas. The detection of the total cholesterol, high density lipoproteins and leptin level was carried out. Intensity of clinical symptoms (spastic pain in epigastrium and left subcostal arc; abdominal pain without localization, vomit without relief, general weakness) have been made accordingly to sum of points (from 0 to 3 points). If sum of points makes from 0 to 2 – intensive character of abdominal pain is low, from 3 to 5 points – it is high, from 5 to 10 points – it is very high. Normal level of amylase in a blood serum (Karavey’s method) is 12–32 g/(hour l), аnd diastase in urine – 20–160 g/(hour l). We made a screening test for elastase-I level by ELISA test. Normal activity of this enzyme in feces is 200 мkg/g. We have used sonographic method for detection of pancreatic diseases in obese children due to echo-structure of parotid gland. The analysis and statistical data processing were made by computer program "Statistica 7.0" and MS Excel XP. Research data. Physical inspection of our patients confirms prevalence of І degree over II degree obesity (52.7 % and 47.3 %, respectively; Р < 0.05). We have confirmed valid risk factor of pancreatic lesion in obese children – presence of diabetes mellitus type I in close relatives (80 % and 65 %, χ2 = 2,05; Р < 0.05). The changes of exocrine function of the pancreas in children with the stage II obesity were established. Echographic signs of the pancreas lesion in teenagers with obesity indicate the presence of functional changes: edema of head or entire edema, partial increase of parenchymal echogenicity, insufficient enlargement of the duct of Wirsung.

scholarly journals Short‐Term Variability of the QT Interval Can be Used for the Prediction of Imminent Ventricular Arrhythmias in Patients With Primary Prophylactic Implantable Cardioverter Defibrillators

2020 ◽  
Vol 9 (23) ◽  
Author(s):  
Agnieszka Smoczyńska ◽  
Vera Loen ◽  
David J. Sprenkeler ◽  
Anton E. Tuinenburg ◽  
Henk J. Ritsema van Eck ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Ventricular Arrhythmia ◽  
Qt Interval ◽  
Ventricular Arrhythmias ◽  
Sustained Ventricular Tachycardia ◽  
Control Group ◽  
Implantable Cardioverter Defibrillators ◽  
Short Term ◽  
Cardioverter Defibrillators ◽  
Holter Recordings

Background Short‐term variability of the QT interval (STV QT ) has been proposed as a novel electrophysiological marker for the prediction of imminent ventricular arrhythmias in animal models. Our aim is to study whether STV QT can predict imminent ventricular arrhythmias in patients. Methods and Results In 2331 patients with primary prophylactic implantable cardioverter defibrillators, 24‐hour ECG Holter recordings were obtained as part of the EU‐CERT‐ICD (European Comparative Effectiveness Research to Assess the Use of Primary Prophylactic Implantable Cardioverter Defibrillators) study. ECG Holter recordings showing ventricular arrhythmias of >4 consecutive complexes were selected for the arrhythmic groups (n=170), whereas a control group was randomly selected from the remaining Holter recordings (n=37). STV QT was determined from 31 beats with fiducial segment averaging and calculated as , where D n represents the QT interval. STV QT was determined before the ventricular arrhythmia or 8:00  am in the control group and between 1:30 and 4:30  am as baseline. STV QT at baseline was 0.84±0.47 ms and increased to 1.18±0.74 ms ( P <0.05) before the ventricular arrhythmia, whereas the STV QT in the control group remained unchanged. The arrhythmic patients were divided into three groups based on the severity of the arrhythmia: (1) nonsustained ventricular arrhythmia (n=32), (2) nonsustained ventricular tachycardia (n=134), (3) sustained ventricular tachycardia (n=4). STV QT increased before nonsustained ventricular arrhythmia, nonsustained ventricular tachycardia, and sustained ventricular tachycardia from 0.80±0.43 ms to 1.18±0.78 ms ( P <0.05), from 0.90±0.49 ms to 1.14±0.70 ms ( P <0.05), and from 1.05±0.22 ms to 2.33±1.25 ms ( P <0.05). This rise in STV QT was significantly higher in sustained ventricular tachycardia compared with nonsustained ventricular arrhythmia (+1.28±1.05 ms versus +0.24±0.57 ms [ P <0.05]) and compared with nonsustained ventricular arrhythmia (+0.34±0.87 ms [ P <0.05]). Conclusions STV QT increases before imminent ventricular arrhythmias in patients, and the extent of the increase is associated with the severity of the ventricular arrhythmia.

scholarly journals Effects of parenteral administration of enrofloxacin on electrocardiographic parameters in hospitalized dogs

2012 ◽  
Vol 81 (4) ◽  
pp. 409-414 ◽  
Author(s):  
Carlos Fernando Agudelo Ramírez ◽  
Peter Scheer ◽  
Jaroslava Tomenendálová
Keyword(s):  
Qt Interval ◽  
Ventricular Arrhythmias ◽  
Parenteral Administration ◽  
Control Group ◽  
Once Daily ◽  
Corrected Qt Interval ◽  
Qt Intervals ◽  
Amoxicillin Clavulanate ◽  
Electrocardiographic Parameters ◽  
Experimental Group

The effect of enrofloxacin on the QT interval of the electrocardiogram was studied in 30 hospitalized dogs. The experimental group (n = 15) received enrofloxacin parenterally (subcutaneously) at a dose of 5 mg/kg twice daily and amoxicillin-clavulanate intravenously at a dose of 22 mg/kg three times daily. The control group (n = 15) received only amoxicillin-clavulanate. Electrocardiography was carried out for 5 min once daily for 6 days. The QT interval was corrected by four different formulae. No differences were found between the two groups or within each group for the duration of the study. On the last day of the study the average QT interval for the control and experimental groups was 213.2 ms and 202.9 ms, respectively. Enrofloxacin did not cause prolongation of the QT or corrected QT intervals. We can conclude that the parenteral administration of enrofloxacin in non-cardiac dogs does not adversely affect the electrocardiographic indicators (no prolongation of the QT or corrected QT interval) and does not induce ventricular arrhythmias. Parenteral use of enrofloxacin is thus safe and effective in non-cardiac dogs.

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