No Association Between T-peak to T-end Interval on the Resting ECG and Long-Term Incidence of Ventricular Arrhythmias Triggering ICD Interventions
Background and ObjectivesPotential of using the T-peak to T-end (TpTe) interval as an electrocardiographic parameter reflecting the transmural dispersion of ventricular repolarization (TDR) to identify patients (pts.) with higher risk of malignant ventricular arrhythmias (MVA) for better selection o...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-08-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphys.2020.01115/full |
| _version_ | 1819203500343558144 |
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| author | Peter Michalek Sasha Benjamin Hatahet Martin Svetlosak Peter Margitfalvi Iveta Waczulikova Sebastian Trnovec Allan Böhm Allan Böhm Ondrej Benacka Ondrej Benacka Robert Hatala Robert Hatala |
| author_facet | Peter Michalek Sasha Benjamin Hatahet Martin Svetlosak Peter Margitfalvi Iveta Waczulikova Sebastian Trnovec Allan Böhm Allan Böhm Ondrej Benacka Ondrej Benacka Robert Hatala Robert Hatala |
| author_sort | Peter Michalek |
| collection | DOAJ |
| description | Background and ObjectivesPotential of using the T-peak to T-end (TpTe) interval as an electrocardiographic parameter reflecting the transmural dispersion of ventricular repolarization (TDR) to identify patients (pts.) with higher risk of malignant ventricular arrhythmias (MVA) for better selection of candidates for implantable cardioverter-defibrillator (ICD) in primary prevention (PP) of sudden cardiac death (SCD) remains controversial. The primary objective of this study was to investigate the relationship between the TpTe interval in patient’s preimplantation resting 12-lead electrocardiogram (ECG) and the incidence of MVA resulting in appropriate ICD intervention (AI). The secondary objective was to assess its relationship to overall mortality.MethodsA total of 243 consecutive pts. with severe left ventricular (LV) systolic dysfunction after myocardial infarction (MI) with a single-chamber ICD for PP of SCD from one implantation center were included. Excluded were all pts. with any other disease that could interfere with the indication of ICD implantation. Primarily investigated intervals were measured manually in accordance with accepted methodology. Data on ICD interventions were acquired from device interrogation during regular outpatient visits. Survival data were collected from the databases of health insurance and regulatory authorities.ResultsWe did not find a significant relationship between the duration of the TpTe interval and the incidence of MVA (71.5 ms in pts. with MVA vs. 70 ms in pts. without MVA; p = 0.408). Similar results were obtained for the corrected TpTe interval (TpTec) and the ratio of TpTe to QT interval (76.3 ms vs. 76.5 ms; p = 0.539 and 0.178 vs. 0.181; p = 0.547, respectively). There was also no significant difference between the duration of TpTe, TpTec and TpTe/QT ratio in pts. groups by overall mortality (71.5 ms in the deceased group vs. 70 ms in the survivors group; HR 1.01; 95% CI, 0.99–1.02; p = 0.715, 76.3 ms vs. 76.5 ms; HR 1.01; 95% CI, 0.99–1.02; p = 0.208 and 0.178 vs. 0.186; p = 0.116, respectively).ConclusionThis study suggests no significant association of overall or MVA-free survival with ECG parameters reflecting TDR (TpTe, TpTec) in patients with systolic dysfunction after MI and ICD implanted for primary prevention. |
| first_indexed | 2024-12-23T04:20:54Z |
| format | Article |
| id | doaj.art-e163248c816144b58292072a5012b6f6 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-23T04:20:54Z |
| publishDate | 2020-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Physiology |
| spelling | doaj.art-e163248c816144b58292072a5012b6f62022-12-21T18:00:16ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2020-08-011110.3389/fphys.2020.01115566377No Association Between T-peak to T-end Interval on the Resting ECG and Long-Term Incidence of Ventricular Arrhythmias Triggering ICD InterventionsPeter Michalek0Sasha Benjamin Hatahet1Martin Svetlosak2Peter Margitfalvi3Iveta Waczulikova4Sebastian Trnovec5Allan Böhm6Allan Böhm7Ondrej Benacka8Ondrej Benacka9Robert Hatala10Robert Hatala11Faculty of Medicine, Comenius University in Bratislava, Bratislava, SlovakiaFaculty of Medicine, Slovak Medical University in Bratislava, Bratislava, SlovakiaDepartment of Arrhythmias and Cardiac Pacing, The National Institute of Cardiovascular Diseases, Bratislava, SlovakiaDepartment of Arrhythmias and Cardiac Pacing, The National Institute of Cardiovascular Diseases, Bratislava, SlovakiaFaculty of Mathematics, Physics and Informatics, Comenius University in Bratislava, Bratislava, SlovakiaFaculty of Medicine, Comenius University in Bratislava, Bratislava, SlovakiaFaculty of Medicine, Slovak Medical University in Bratislava, Bratislava, SlovakiaDepartment of Acute Cardiology, The National Institute of Cardiovascular Diseases, Bratislava, SlovakiaFaculty of Medicine, Comenius University in Bratislava, Bratislava, SlovakiaDepartment of Arrhythmias and Cardiac Pacing, The National Institute of Cardiovascular Diseases, Bratislava, SlovakiaFaculty of Medicine, Slovak Medical University in Bratislava, Bratislava, SlovakiaDepartment of Arrhythmias and Cardiac Pacing, The National Institute of Cardiovascular Diseases, Bratislava, SlovakiaBackground and ObjectivesPotential of using the T-peak to T-end (TpTe) interval as an electrocardiographic parameter reflecting the transmural dispersion of ventricular repolarization (TDR) to identify patients (pts.) with higher risk of malignant ventricular arrhythmias (MVA) for better selection of candidates for implantable cardioverter-defibrillator (ICD) in primary prevention (PP) of sudden cardiac death (SCD) remains controversial. The primary objective of this study was to investigate the relationship between the TpTe interval in patient’s preimplantation resting 12-lead electrocardiogram (ECG) and the incidence of MVA resulting in appropriate ICD intervention (AI). The secondary objective was to assess its relationship to overall mortality.MethodsA total of 243 consecutive pts. with severe left ventricular (LV) systolic dysfunction after myocardial infarction (MI) with a single-chamber ICD for PP of SCD from one implantation center were included. Excluded were all pts. with any other disease that could interfere with the indication of ICD implantation. Primarily investigated intervals were measured manually in accordance with accepted methodology. Data on ICD interventions were acquired from device interrogation during regular outpatient visits. Survival data were collected from the databases of health insurance and regulatory authorities.ResultsWe did not find a significant relationship between the duration of the TpTe interval and the incidence of MVA (71.5 ms in pts. with MVA vs. 70 ms in pts. without MVA; p = 0.408). Similar results were obtained for the corrected TpTe interval (TpTec) and the ratio of TpTe to QT interval (76.3 ms vs. 76.5 ms; p = 0.539 and 0.178 vs. 0.181; p = 0.547, respectively). There was also no significant difference between the duration of TpTe, TpTec and TpTe/QT ratio in pts. groups by overall mortality (71.5 ms in the deceased group vs. 70 ms in the survivors group; HR 1.01; 95% CI, 0.99–1.02; p = 0.715, 76.3 ms vs. 76.5 ms; HR 1.01; 95% CI, 0.99–1.02; p = 0.208 and 0.178 vs. 0.186; p = 0.116, respectively).ConclusionThis study suggests no significant association of overall or MVA-free survival with ECG parameters reflecting TDR (TpTe, TpTec) in patients with systolic dysfunction after MI and ICD implanted for primary prevention.https://www.frontiersin.org/article/10.3389/fphys.2020.01115/fullelectrocardiographyprimary prevention of sudden cardiac deathtransmural dispersion of ventricular repolarizationT-peak to T-endventricular tachyarrhythmia |
| spellingShingle | Peter Michalek Sasha Benjamin Hatahet Martin Svetlosak Peter Margitfalvi Iveta Waczulikova Sebastian Trnovec Allan Böhm Allan Böhm Ondrej Benacka Ondrej Benacka Robert Hatala Robert Hatala No Association Between T-peak to T-end Interval on the Resting ECG and Long-Term Incidence of Ventricular Arrhythmias Triggering ICD Interventions Frontiers in Physiology electrocardiography primary prevention of sudden cardiac death transmural dispersion of ventricular repolarization T-peak to T-end ventricular tachyarrhythmia |
| title | No Association Between T-peak to T-end Interval on the Resting ECG and Long-Term Incidence of Ventricular Arrhythmias Triggering ICD Interventions |
| title_full | No Association Between T-peak to T-end Interval on the Resting ECG and Long-Term Incidence of Ventricular Arrhythmias Triggering ICD Interventions |
| title_fullStr | No Association Between T-peak to T-end Interval on the Resting ECG and Long-Term Incidence of Ventricular Arrhythmias Triggering ICD Interventions |
| title_full_unstemmed | No Association Between T-peak to T-end Interval on the Resting ECG and Long-Term Incidence of Ventricular Arrhythmias Triggering ICD Interventions |
| title_short | No Association Between T-peak to T-end Interval on the Resting ECG and Long-Term Incidence of Ventricular Arrhythmias Triggering ICD Interventions |
| title_sort | no association between t peak to t end interval on the resting ecg and long term incidence of ventricular arrhythmias triggering icd interventions |
| topic | electrocardiography primary prevention of sudden cardiac death transmural dispersion of ventricular repolarization T-peak to T-end ventricular tachyarrhythmia |
| url | https://www.frontiersin.org/article/10.3389/fphys.2020.01115/full |
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